Bernd Schnabl, MD

PSC Research Fund Pilot Research Award
$50,000 over one year

University of California San Diego

The role of bacterial virulence factors in primary sclerosing cholangitis

Primary sclerosing  cholangitis  (PSC) is a serious liver disease where the bile ducts in the liver become inflamed and scarred. Over time, this can lead to severe liver damage and ultimately, liver failure. Right now, the only cure for this disease is a liver transplant as there are no effective medicines to stop the disease from getting worse.

Scientists believe that PSC happens because of a combination of genetic factors, problems with the immune system, and environmental factors. One important environmental factor might be changes in the gut bacteria of patients with PSC, since the disease occurs mostly in patients with concomitant inflammatory bowel disease (IBD). Our studies have shown that a specific type of bacteria called Escherichia coli (E. coli), which carries a specific harmful component, is found more often in patients with PSC than in healthy individuals. This harmful component seems to make the disease worse and decrease the survival of patients without needing a transplant.

In our research, we want to understand how these harmful E. coli contribute to PSC. We've developed a new mouse model that mimics the human gut environment to study this. We'll look at how E. coli with the harmful component manages to stick in the gut and then move to the liver, where it avoids being destroyed by the liver s immune cells, worsening the liver inflammation and disease.

Our research could help find new ways to treat or prevent PSC. By understanding and eventually blocking the harmful effects of these bacteria, we hope to develop new treatments that could help patients manage their condition better and avoid the need for a liver transplant.