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:
Building Partnerships: We contributed a comprehensive chapter to a new medical textbook for nurses and allied health professionals, ensuring that the patient perspective is integrated into clinical education.
Building Partnerships: We participated in a planning meeting for the update of national clinical guidelines for PSC.
Building Partnerships: We prepared strategic questions for an upcoming international forum titled “Putting Patients First: From Research to Treatment.”
Organisational Excellence: We updated our web details to make it less likely information from us sent by email ends up in your spam folders.
Progressing Research: We are collaborating with European partners to develop a simplified research registry for pregnancy outcomes, building the evidence base needed to improve medical guidance for women with PSC.
Progressing Research: We completed a formal submission to the Scottish Medicines Consortium to advocate for the value of a potential new treatment for PSC patients.
Progressing Research: We reviewed the participant information for a new academic clinical trial to ensure it is clear and accessible for patients.