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Estrogens in polycystic liver disease: A target for future therapies?
Author(s) -
Aapkes Sophie E.,
Bernts Lucas H. P.,
Barten Thijs R. M.,
Berg Marjan,
Gansevoort Ron T.,
Drenth Joost P. H.
Publication year - 2021
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/liv.14986
Subject(s) - estrogen , menopause , medicine , polycystic liver disease , disease , liver disease , hormone , selective estrogen receptor modulator , hormone replacement therapy (female to male) , polycystic ovarian disease , endocrinology , physiology , estrogen receptor , bioinformatics , polycystic ovary , diabetes mellitus , testosterone (patch) , biology , breast cancer , insulin resistance , cancer , transplantation , liver transplantation
Abstract Background and Aims Patients suffering from polycystic liver disease (PLD) can develop large liver volumes, leading to physical and psychological complaints, reducing quality of life. There is an unmet need for new therapies in these patients. Estrogen seems to be a promising target for new therapies. In this review, we summarize the available experimental and epidemiological evidence to unravel the role of estrogens and other female hormones in PLD, to answer clinical questions and identify new targets for therapy. Methods We identified all experimental and epidemiologial studies concerning estrogens or other female hormones and PLD, to answer pre‐defined clinial questions. Results Female sex is the most important risk factor for the presence and severity of disease; estrogen supplementation enhances liver growth and after menopause, liver growth decreases. Experimental studies show the presence of the estrogen receptors alfa and beta on cystic cholangiocytes, and increased in vitro growth after administration of estrogen. Conclusions Based on the available evidence, female PLD patients should be discouraged from taking estrogen‐containing contraceptives or hormone replacement therapy. Since liver growth rates decline after menopause, treatment decisions should be based on measured liver growth in postmenopausal women. Finally, blockage of estrogen receptors or estrogen production is a promising target for new therapies.