New PSC Support Research Uncovers Critical Link Between Liver and Small Intestine
PSC Support has funded important research to better understand the connection between the liver and the digestive system in primary sclerosing cholangitis (PSC). The digestive system is extremely complex, and while research has historically focused on the large intestine (bowel) due to its known link with inflammatory bowel disease (IBD), this study specifically focused on the small intestine. Led by Dr Nicholas Ilott, the team investigated how the flow of bile acids from the liver might affect the small intestine’s ability to function.
How does PSC affect the small intestine?
The small intestine has previously been overlooked in PSC research because it does not usually show obvious symptoms. Dr Ilott hypothesised that a reduced flow of bile acids from the liver to the small intestine in PSC may still impact the barrier function of the small intestine, even without visible signs of disease. Bile acids, produced by the liver, help to digest fats and keep the intestinal barrier intact.
What is the link between liver function and gut protection?
Using advanced scientific methods (single cell RNA-sequencing), the team confirmed that cells forming the small intestinal barrier in people with PSC express lower levels of protective genes. These lower levels were more pronounced in patients with particularly high levels of the liver enzyme, alkaline phosphatase (ALP). Using models of PSC, Dr Ilott was able to show that these protective genes are decreased when the liver isn’t functioning as it should and this is probably because of bile acids.
What do these findings mean for future PSC treatments?
This initial work could be a key target for new medicines.
Dr Ilott commented, "Our initial insights that have been aided by funding from PSC Support suggest that we may be able to target the small intestine – perhaps by changing the gut microbiome – to stop PSC from progressing".
The team will now pursue further work to determine if these protective mechanisms are critical in the overall progression of PSC.
Next Steps
PSC Support is proud to fund research that is unlocking fundamental understanding of PSC and its potential drivers. We need your help to continue funding vital projects like this.
Turning Ambition into Action in 2026:
Our Fortnight in Focus
At PSC Support, we want a world without PSC. We work tirelessly behind the scenes to drive research and improve lives. Here is a snapshot of what we've been up to:
Global Research Preparation: We helped develop patient consent documentation for a global PSC research initiative coming to the UK in 2026 so it aligns with UK patient needs.
Representing the Patient Voice: We provided the patient perspective in a panel interview with a major funder regarding a potential new clinical trial for PSC.
Patient-Led Governance: We convened a Patient Panel to review a plans for a new UK study, ensuring the research focuses on the practical needs and safety concerns of people with PSC.
Global Advocacy: We had a late-night meeting to finalise a joint abstract with PSC Partners Seeking a Cure (USA) to present our shared patient survey data at a major European conference.
Regulator Collaboration: We participated in a national workshop with regulators to identify ways to speed up access to new rare disease treatments.
Scientific Leadership: We received excellent editorial feedback on a new textbook chapter about PSC we've been working on with European Reference Network for Rare Liver Diseases experts to improve clinical knowledge of PSC.
Research Governance: We initiated a project to update our research governance protocols and migrate historical research data into our new Grant Management System, ensuring all the research we fund is accurately recorded.
Supporting our Fundraisers: We simplified the process for applying for a Great North Run this year, making it easier for fundraisers and more efficient for PSC Support - win/win!