Gut bacteria may play an important role in how primary biliary cholangitis (PBC) starts and worsens, according to a recent review in the Journal of Clinical and Translational Hepatology.
Studies show that people with PBC often have fewer “good” gut bacteria and more “bad” bacteria compared to people without the condition. The good bacteria usually help calm inflammation and protect the gut lining, while the bad ones may confuse the immune system into attacking the liver.
An imbalance between good and bad gut bacteria can also make the gut lining weaker, letting harmful substances enter the bloodstream and reach the liver. Additionally, an imbalance in gut bacteria can disrupt bile recycling, causing toxic bile acids to damage the liver further.
Scientists are exploring whether gut bacteria could be used as markers to diagnose PBC and to predict how severe the disease is or how well treatments will work. For example, patients who don’t respond to ursodeoxycholic acid, the main treatment for PBC, often have lower levels of beneficial bacteria like Clostridia. These findings suggest that gut microbiota analysis could help guide personalized treatment strategies.
Read more about PBC therapies
“Therapies targeting microbial composition are becoming a highly promising research direction,” the researchers said. These therapies, which focus on restoring healthy gut balance, include probiotics (helpful bacteria taken as supplements), fecal microbiota transplantation (putting stool containing healthy gut bacteria from a donor into a patient), antibiotics (used to reduce harmful bacteria) and bacteriophage therapy (using viruses that kill only specific bad bacteria).
Clinical trials are needed to check if these therapies are safe and effective for treating PBC, but researchers hope they could one day give patients with this condition more options.
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