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:
Improving Care: We attended a major national clinical conference to equip general gastroenterologists and nurses with specialist knowledge, which helps ensure future work is better aligned with what people with PSC need by improving local care and pathways.
Progressing Research: Our 2024 investment into early-stage research to build necessary scientific evidence enabled Dr James Sun to secure major national funding to explore the genetic drivers of the disease. This foundational knowledge is essential for identifying potential new treatments.
Progressing Research: We supported the development of a research manuscript on nutrition in PSC, so that the findings can be effectively shared with the wider medical community. This will help us advocate for the needs of people with PSC to ensure they get the care they need at the right time.
Improving Care: We hosted a clinical consensus meeting to map out an ideal PSC care pathway, which helps ensure future PSC management is better aligned with what people with PSC need. Establishing standard protocols across the NHS is essential for eliminating regional variations in care.
Progressing Research: We contributed to the strategic planning of an international rare liver disease network, which supports progress towards better care for people with PSC. Broadening our influence ensures patient needs are integrated into wider clinical strategies.
Improving Care: We shared firsthand experiences of living with PSC at an international medical school event, which improves clinical understanding of the disease for healthcare professionals. This is important because ensuring future specialists understand the human impact of PSC helps drive patient-centered care and clinical excellence.
Progressing Research: After just over 48 hours on our Big Give Small Charity Week match funding initiative, your donations helped us get to 78% of the way to our £20,000 goal! Thank you! Can we reach 100%?