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Semin Liver Dis 2017; 37(04): 314-331
DOI: 10.1055/s-0037-1608801
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The Microbiome in Primary Sclerosing Cholangitis: Current Evidence and Potential Concepts

Johannes R. Hov
1   Division of Surgery, Inflammatory Diseases and Transplantation, Department of Transplantation Medicine, Norwegian PSC Research Center and Section of Gastroenterology, Oslo University Hospital Rikshospitalet, Oslo, Norway
2   Institute of Clinical Medicine, University of Oslo, Oslo, Norway
3   Division of Surgery, Inflammatory Diseases and Transplantation, Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway
,
Tom H. Karlsen
1   Division of Surgery, Inflammatory Diseases and Transplantation, Department of Transplantation Medicine, Norwegian PSC Research Center and Section of Gastroenterology, Oslo University Hospital Rikshospitalet, Oslo, Norway
2   Institute of Clinical Medicine, University of Oslo, Oslo, Norway
3   Division of Surgery, Inflammatory Diseases and Transplantation, Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway
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Publication History

Publication Date:
22 December 2017 (online)

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Abstract

The close relationship between primary sclerosing cholangitis (PSC) and inflammatory bowel disease has inspired hypothetical models in which gut bacteria or bacterial products are key players in PSC pathogenesis. Several studies using high-throughput sequencing technology to characterize the gut microbiota in PSC have been published over the past years. They all report reduced diversity and significant shifts in the overall composition of the gut microbiota. However, it remains unclear as to whether the observed changes are primary or secondary to PSC development and further studies are needed to assess the biological implications of the findings. In the present article, we review the published data in perspective of similar studies in other diseases. We discuss aspects of methodology and study design that are relevant to interpretation of the data. Furthermore, we propose that interpretation and further assessments of findings are structured into conceptual compartments, and elaborate three such possible concepts relating to immune function (the “immunobiome”), host metabolism (the “endobiome”), and dietary and xenobiotic factors (the “xenobiome”) in PSC.

Keywords

primary sclerosing cholangitis - microbiota - dysbiosis - liver disease