Estrogen receptors α and β have been found on cholangiocytes of cystic tissue from polycystic liver disease patients, while these receptors are absent in normal biliary structures of either polycystic liver disease patients or healthy controls.[6] Addition of estradiol increases the proliferation of liver cyst-derived cholangiocytes in vitro.[6] If estrogen receptor degraders such as fulvestrant are added, proliferation is significantly slowed.[6] A possible role of progesterone in PLD remains to be elucidated. This evidence concerns the gene ESR1 and Hepatic cysts.