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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...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2018
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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. |
format | Online Article Text |
id | pubmed-6267462 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
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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