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Interference with the lower gut–liver axis induces remission of primary sclerosing cholangitis in a patient with ulcerative colitis

The gut–liver axis describes the complex interactions between gut microbiota, the small and large bowel, the immune system and the liver. Current evidence associates abnormalities within the gut–liver axis with liver disease such as primary sclerosing cholangitis (PSC). PSC is believed to be an immu...

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Autores principales: Ong, John, Mebarek, Leila, Bath, Michael, Swift, Carla, Javaid, Babur, Patel, Jenish, Al-Naeeb, Yasseen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6267462/
https://www.ncbi.nlm.nih.gov/pubmed/30555709
http://dx.doi.org/10.1136/bmjgast-2018-000239
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author Ong, John
Mebarek, Leila
Bath, Michael
Swift, Carla
Javaid, Babur
Patel, Jenish
Al-Naeeb, Yasseen
author_facet Ong, John
Mebarek, Leila
Bath, Michael
Swift, Carla
Javaid, Babur
Patel, Jenish
Al-Naeeb, Yasseen
author_sort Ong, John
collection PubMed
description The gut–liver axis describes the complex interactions between gut microbiota, the small and large bowel, the immune system and the liver. Current evidence associates abnormalities within the gut–liver axis with liver disease such as primary sclerosing cholangitis (PSC). PSC is believed to be an immune-mediated disease though the exact mechanism of its pathogenesis remains unknown. Here, we report a case of a 66 -year-old woman with treatment-resistant ulcerative colitis and PSC which continued to be active following subtotal colectomy. Interestingly, her PSC achieved full remission after proctectomy for treatment-resistant proctitis in the rectal stump. This case report supports existing hypotheses that PSC is an immune-mediated disease triggered by antigens within the gut. More notably, it suggests the yet unidentified pathogens may be localised to the lower gastrointestinal tract including the rectum.
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spelling pubmed-62674622018-12-16 Interference with the lower gut–liver axis induces remission of primary sclerosing cholangitis in a patient with ulcerative colitis Ong, John Mebarek, Leila Bath, Michael Swift, Carla Javaid, Babur Patel, Jenish Al-Naeeb, Yasseen BMJ Open Gastroenterol Case Report The gut–liver axis describes the complex interactions between gut microbiota, the small and large bowel, the immune system and the liver. Current evidence associates abnormalities within the gut–liver axis with liver disease such as primary sclerosing cholangitis (PSC). PSC is believed to be an immune-mediated disease though the exact mechanism of its pathogenesis remains unknown. Here, we report a case of a 66 -year-old woman with treatment-resistant ulcerative colitis and PSC which continued to be active following subtotal colectomy. Interestingly, her PSC achieved full remission after proctectomy for treatment-resistant proctitis in the rectal stump. This case report supports existing hypotheses that PSC is an immune-mediated disease triggered by antigens within the gut. More notably, it suggests the yet unidentified pathogens may be localised to the lower gastrointestinal tract including the rectum. BMJ Publishing Group 2018-11-14 /pmc/articles/PMC6267462/ /pubmed/30555709 http://dx.doi.org/10.1136/bmjgast-2018-000239 Text en © Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0
spellingShingle Case Report
Ong, John
Mebarek, Leila
Bath, Michael
Swift, Carla
Javaid, Babur
Patel, Jenish
Al-Naeeb, Yasseen
Interference with the lower gut–liver axis induces remission of primary sclerosing cholangitis in a patient with ulcerative colitis
title Interference with the lower gut–liver axis induces remission of primary sclerosing cholangitis in a patient with ulcerative colitis
title_full Interference with the lower gut–liver axis induces remission of primary sclerosing cholangitis in a patient with ulcerative colitis
title_fullStr Interference with the lower gut–liver axis induces remission of primary sclerosing cholangitis in a patient with ulcerative colitis
title_full_unstemmed Interference with the lower gut–liver axis induces remission of primary sclerosing cholangitis in a patient with ulcerative colitis
title_short Interference with the lower gut–liver axis induces remission of primary sclerosing cholangitis in a patient with ulcerative colitis
title_sort interference with the lower gut–liver axis induces remission of primary sclerosing cholangitis in a patient with ulcerative colitis
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6267462/
https://www.ncbi.nlm.nih.gov/pubmed/30555709
http://dx.doi.org/10.1136/bmjgast-2018-000239
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