Gut microbiome in autoimmune liver disease Flashcards
What is primary Sclerosing Cholangitis (PSC)?
Chronic, progressive liver disease that causes inflammation and scarring in the bile ducts
Is there an association between PSC and IBD?
Yes, 70-80% of patients with PSC also have IBD
What can influence gut microbiome?
- pollution
- smoking
- western diet
- chemicals
- drugs
- stress
- infections
What is the difference between gut microbiome in health and in disease?
- diversity -> no diversity
- protective metabolites -> no protective metabolites
- secondary bile acids -> no secondary bile acids
- intestinal barrier function -> impaired intestinal barrier function
-Tolerance promoting microbiota -> immune activating microbiota
What is the connection between IBD and PSC?
In IBD there is a problem with gut barrier and mucosal lymphocytes activated in the gut traffic to the liver via vascular adhesion protein 1 (VAP-1). VAP-1 is mainly expressed on endothelial cells. In autoimmune liver disease there is over expression of VAP-1 compared to healthy controls (Trivedi 2018)
What are treatments for PSC?
- Vancomycin
- Faecal microbiota transplantation
- Carbalive project
Vancomycin?
Oral vancomycin is supposed to have an immunomodulatory effect by inducing an increase of Tregs and TGF-B without alterations in th1 and th2 cytokine production patterns. Oral vancomycin treatment showed benefits in PSC and IBD (Giorgio 2021)
Faecal microbiota transplantation?
Aims to address dysbiosis by introducing diverse range of beneficial bacteria from a healthy donor to the patients gut. It is explored in treatment of cirrhosis (irreversible scarring of the liver) (Boicean 2023)
Carbalive project
It investigated a use of engineered microporous carbons as potential treatment for liver cirrhosis. It is removing harmful bacterial toxins from the gut reducing inflammation.
