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Breakthrough in PSC research: EBV revealed as a possible trigger!
Kiel University is researching primary sclerosing cholangitis, a rare liver disease, and its connection to EBV.
Breakthrough in PSC research: EBV revealed as a possible trigger!
Primary sclerosing cholangitis (PSC) is a chronic inflammatory disease of the bile ducts that occurs primarily in Northern Europe and the USA. Loud Precision medicine PSC leads to inflammation, scarring and narrowing of the bile ducts, which can lead to liver failure in the long term. A particular challenge with this disease lies in the fact that there is currently no cure. In advanced cases, the only treatment option is a liver transplant.
The disease affects around 10 out of 100,000 people, with the risk being significantly increased in patients with chronic inflammatory bowel diseases such as Crohn's disease or ulcerative colitis. Such comorbidities occur in 60 to 80 percent of PSC patients, further complicating the situation ( Liver help ).
Clinical symptoms and diagnosis
Typical symptoms of PSC are jaundice, severe yellowing of the skin and eyes, itching, greasy stools and a deficiency of fat-soluble vitamins such as A, D, E and K. The diagnosis is often difficult because there are no clear blood values that could confirm the disease. However, increased levels of alkaline phosphatase and gamma-GT are often observed ( DocCheck Flexikon ).
Endoscopic retrograde cholangiography (ERCP) is considered the gold standard for the diagnosis of PSC. Typical features such as multiple short-stretch stenoses in the bile ducts can be identified, which produce a “string-of-pearl-like” picture, while magnetic resonance cholangiopancreatography (MRCP) is becoming increasingly important as a non-invasive alternative.
Connection with Epstein-Barr virus and PFifferian glandular fever
Researchers from the Cluster of Excellence “Precision Medicine in Chronic Inflammation” in Kiel have discovered an increased immune response against the Epstein-Barr virus (EBV) in PSC patients. A large study that analyzed blood samples from over 500 people with PSC and more than 900 healthy controls identified specific T cell receptors that are more common in people with PSC. These receptors bind to EBV proteins, whose reactivation may contribute to the development of PSC ( Precision medicine ).
Interestingly, there is a clear connection between the development of PSC and Pfeiffer's glandular fever, a disease caused by EBV. Over 95 percent of the population is infected with EBV; The initial infection can lead to infectious mononucleosis, but is often asymptomatic. Future research should clarify how exactly EBV reactivation is linked to the development of PSC in order to potentially develop new therapeutic approaches.
Current treatment options and research
There is currently no approved drug therapy for PSC, but ursodeoxycholic acid (UDCA) is used off-label because it can improve liver function tests, although its effect on disease progression remains controversial. In the long term, there is hope that norucholic acid will be approved by 2026 ( Liver help ). Treatment focuses primarily on relieving symptoms such as itching and bile duct infections as well as correcting vitamin deficiencies.
In summary, primary sclerosing cholangitis not only represents a complex and challenging disease, but also has an important need for research to better understand the relationships between the immune system, EBV and the development of PSC.