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Primary Sclerosing Cholangitis
Nasir Hussain1, Palak J Trivedi1
1National Institute for Health and Care Research (NIHR) Birmingham, Centre for Liver and Gastrointestinal Research, School of Infection, Inflammation and Immunology, University of Birmingham, Birmingham, UK; Liver Unit, University Hospitals Birmingham, Birmingham, UK.
Clinics in Liver Disease
|July 22, 2026
Summary
Primary sclerosing cholangitis (PSC) is a rare liver disease with rising incidence. This overview covers PSC epidemiology, natural history, and emerging therapies like bile acid treatments and microbiome interventions.
Area of Science:
- Hepatology and Gastroenterology
- Autoimmune Liver Diseases
- Biliary Tract Disorders
Background:
- Sclerosing cholangitis involves multi-level biliary stricturing.
- Primary sclerosing cholangitis (PSC) is the most common form.
- PSC incidence and prevalence are increasing globally.
Purpose of the Study:
- To provide a clinical overview of PSC.
- To discuss epidemiology, natural history, monitoring, and surveillance.
- To explore potential therapeutic avenues.
Main Methods:
- Review of current literature on PSC.
- Analysis of epidemiological data.
- Discussion of clinical management strategies.
Main Results:
- PSC is a leading indication for liver transplantation due to rising prevalence and lack of curative therapies.
- Gut inflammation may significantly impact patient clinical course.
- Emerging therapies include bile acid treatments, antifibrotics, and microbiome-based interventions.
Conclusions:
- PSC management requires comprehensive understanding of its epidemiology and natural history.
- Monitoring and surveillance are crucial for timely intervention.
- Novel therapeutic strategies targeting gut inflammation and fibrosis show promise.
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Assessment:
Assessment: