The liver and the intestine are two important organs in the digestive system. Although diseases affecting these tissues are often studied in the same hospital department, i.e. hepatogastroenterology, they are most often treated separately. And yet there exists a liver disease referred to as primary sclerosing cholangitis or PSC, which is very often associated with an inflammatory intestinal disease named ulcerative colitis (UC). A team at the Cleveland Clinic in the US sought to determine whether, when these two diseases are combined, they can influence each other.
In an initial study, the authors demonstrated that the fact of having UC had very little influence upon the evolution of PSC, even though the colitis did seem to slow down liver complications. In contrast, PSC+UC patients had six times greater risk of developing colon cancer than patients with PSC alone.
In a second study, those same authors demonstrated that in PSC+UC patients, colitis was often dormant. Several reports in the literature had indicated that liver transplantation in these patients "woke up" the UC. In this study, however, transplantation seemed to maintain the dormancy of the UC. This difference was probably due to anti-rejection treatments prescribed after transplantation, i.e., the immunosuppressants, often used in treatment of UC. Nonetheless, in these patients, the liver disease would seem to have a protective effect upon the intestine.
Based on these studies, we can retain the fact that the liver and intestine are two intimately linked organs and seem to "communicate". It will be interesting to elucidate this communication so as to identify the protective mechanisms of each organ with respect to the other.
Par Laurent Dubuquoy
Références :
U. Navaneethan, P. G. K. Venkatesh, B. A. Lashner, B. Shen, R. P. Kiran. The impact of ulcerative colitis on the long-term outcome of patients with primary sclerosing cholangitis. Aliment Pharmacol Ther 2012. 35(9):1045–1053.
U. Navaneethan, M. Choudhary, P. G. K. Venkatesh, B. A. Lashner, F. H. Remzi, B. Shen, R. P. Kiran. The effects of liver transplantation on the clinical course of colitis in ulcerative colitis patients with primary sclerosing cholangitis. Aliment Pharmacol Ther 2012. 35(9):1054-1063.
