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Manipulation of the Gut-Liver Axis Using Microbiome Restoration Therapy in Primary Sclerosing Cholangitis

Bajaj, Jasmohan S. MD1; Hays, R. Ann MD2

American Journal of Gastroenterology: July 2019 - Volume 114 - Issue 7 - p 1027–1029
doi: 10.14309/ajg.0000000000000191

Alteration of the normal gut-liver axis is important in primary sclerosing cholangitis (PSC). Lack of effective medical therapy for PSC makes microbiome restoration an alluring therapeutic target. Allegretti et al. performed an open-label safety trial of fecal microbiota transplant (FMT) in noncirrhotic PSC patients with inflammatory bowel disease in remission on minimal therapy. FMT was safe in this population, and after FMT, there was a stable, early increase in microbial diversity and donor engraftment with mixed effects on alkaline phosphatase but no significant change in fecal bile acid profile. Further trials are needed to find whether FMT has a role to play in PSC therapy.

1Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University and McGuire VA Medical Center, Richmond, Virginia, USA;

2Division of Gastroenterology and Hepatology, University of Virginia Health System, Charlottesville, Virginia, USA.

Correspondence: Jasmohan S. Bajaj. E-mail:

Received January 04, 2019

Accepted February 11, 2019

© The American College of Gastroenterology 2019. All Rights Reserved.
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