Regulation of cholangiocyte proliferation

Intrahepatic bile duct epithelial cells (i.e., cholangiocytes) are the target cells of chronic cholestatic liver diseases (i.e., cholangiopathies), which makes these cells of great interest to clinical hepatologists. This review will focus on “typical” cholangiocyte proliferation, whereas “atypical” (extension of cholangiocyte proliferation into parenchyma), and premalignant “oval” cell proliferation are reviewed elsewhere. The bile duct ligated (BDL) rat model, where most of the known mechanisms of cholangiocyte proliferation have been illustrated, was the first and remains the prototype animal model for “typical” cholangiocyte proliferation. Following a short overview of cholangiocyte functions, we briefly discuss the: (i) in vivo models [i.e., BDL ( Fig. 1 and 4), chronic α‐naphthylisothiocyanate (ANIT) or bile acid feeding ( Fig. 2), acute carbon tetrachloride (CCl 4 ) feeding and partial hepatectomy; and (ii) in vitro experimental tools [e.g., purified cholangiocytes and isolated intrahepatic bile duct units (IBDU)] that are key to the understanding of the mechanisms of “typical” cholangiocyte growth. In the second part of the review, we discuss a number of potential factors or conditions [e.g., gastrointestinal hormones, nerves, estrogens, blood supply, and growth factors] as well as the intracellular mechanisms [e.g., adenosine 3′,5′‐monophosphate (cAMP), and protein kinase C (PKC)] that may regulate “typical” cholangiocyte hyperplasia. 1Measurement of the number of intrahepatic bile ducts by histochemistry for γ‐GT[a specific cholangiocyte marker (1, 3, 27)] in liver sections from normal rats [left] and rats that (immediately following bile duct ligation (BDL)) were infused by osmotic minipumps with 0.2% bovine serum albumin (BSA, control) [middle] or gastrin (2.5 nmol/kg/h) in 0.2% BSA [right] for 1 week. Following BDL [middle], there was a marked increase in the number of ducts as compared to normal rats [left]. Chronic gastrin infusion [right] markedly decreased the number of intrahepatic bile ducts as compared to BSA‐treated BDL rats [middle]. Orig. magn., ×125. Reproduced with permission from reference (17).4In situ immunohistochemistry for CK‐19 [a cholangiocyte‐specific marker (3)] in frozen liver sections n =6) from BDL [a] and BDL+vagotomy [b] rats. Note that vagotomy induced a marked decrease in the number of ducts as compared with BDL control rats. Orig. magn., ×125. Reproduced with permission from reference (11).2In situ immunohistochemistry for cellular nuclear antigen (PCNA) in liver sections from normal rats [left] and normal rats fed 1% TC [middle] or 1% TLC [right] for 1 week. Chronic feeding of TC [middle] and TLC [right] induced a significant increase in the number of PCNA‐positive cholangiocytes as compared with liver sections from normal rats [left]. Reproduced with permission from reference (7).