Primary sclerosing cholangitis: what is new in the therapeutic landscape

Primary sclerosing cholangitis (PSC) is a rare, chronic cholestatic liver disease affecting the intra- and extra-hepatic bile ducts, leading to progressive inflammation and fibrosis. Its pathogenesis is complex and involves genetic predisposition, environmental triggers, and their interaction throug...

Full description

Saved in:
Bibliographic Details
Published in:Current opinion in immunology Vol. 96; p. 102613
Main Authors: Curto, Armando, Cristoferi, Laura, Carbone, Marco, Galli, Andrea, Invernizzi, Pietro
Format: Journal Article
Language:English
Published: England Elsevier Ltd 01.10.2025
Subjects:
Animals
Cholangitis, Sclerosing - diagnosis
Cholangitis, Sclerosing - etiology
Cholangitis, Sclerosing - immunology
Cholangitis, Sclerosing - therapy
Gastrointestinal Microbiome
Humans
Liver Transplantation
ISSN:0952-7915, 1879-0372, 1879-0372
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Primary sclerosing cholangitis (PSC) is a rare, chronic cholestatic liver disease affecting the intra- and extra-hepatic bile ducts, leading to progressive inflammation and fibrosis. Its pathogenesis is complex and involves genetic predisposition, environmental triggers, and their interaction through the gut–liver axis, mediated by the microbiota. To date, no approved therapies modify the natural history of PSC, and liver transplantation remains the only curative option. This review provides an overview of current investigational therapies for PSC, emphasizing their mechanisms of action and relevance to the underlying disease biology. It also examines key challenges in therapeutic development, including the lack of validated surrogate end points, clinical heterogeneity, and the confounding effects of concomitant inflammatory bowel disease treatments factors that complicate trial design and interpretation. Clarifying these aspects is essential to support the development of effective, targeted therapies for this complex and currently untreatable condition.
Bibliography:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
ObjectType-Review-3
content type line 23
ISSN:0952-7915
1879-0372
1879-0372
DOI:10.1016/j.coi.2025.102613