A new study published in Liver International suggests that removing plasma cells may decrease liver inflammation in primary biliary cholangitis (PBC), raising new possibilities for future treatments.
The main treatment for PBC, ursodeoxycholic acid (UDCA), helps many patients, but up to 40% respond poorly. These patients remain at higher risk for serious liver complications, so researchers continue to explore new treatment strategies.
Read more about therapies used in treating PBC
In the current study, investigators analyzed liver tissue from 55 people with PBC. They found that the number of plasma cells in the liver was closely linked to higher disease severity, autoantibody levels and poorer overall response to UDCA treatment. By contrast, other immune system cells called B cells did not show the same associations.
To further investigate, the team turned to a mouse model of PBC. When treated with bortezomib (BTZ), a drug that removes plasma cells, the mice showed clear improvements. The BTZ-treated mice demonstrated reduced liver inflammation, lower antibody levels and less liver scarring.
In additional experiments, transferring plasma cells into other mice confirmed that these cells worsened inflammation and liver damage. Removing other types of immune cells, such as B cells, did not improve disease features. This highlights the unique role of plasma cells in driving liver damage.
“The data indicate a pathogenic role for plasma cells in PBC,” the study’s authors wrote. “The depletion of plasma cells alleviated cholangitis in PBC mice, indicating a promising new therapeutic strategy for PBC.”
For people living with PBC, the findings suggest that plasma cells may be a significant reason why some individuals do not respond to standard therapies. Drugs that specifically target these cells could one day expand the treatment landscape for PBC. However, experts stress that the results are still preclinical. More studies are needed to confirm whether plasma cell-directed therapies are safe and effective in people.
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