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However, clinical trials and real-world evidence consistently show that weight reduction with GLP-1RAs is accompanied by decrease in lean body mass, raising concern in patients already predisposed to muscle wasting and underscoring the need for integrated management strategies

and by negative regulation of PPAR gamma

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In cholangitis, prolonged and persistent inflammatory stimulation induces inflammatory cells, such as Kupffer cells, to secrete a variety of mediators, thereby establishing a tumor-promoting microenvironment

doi: 10.1038/nri2566 329 SteinKSMcFarlaneICGoldbergNGinzlerEM