Primary sclerosing cholangitis (PSC) is a chronic liver disease involving inflammation and damage to the bile ducts, which can eventually lead to liver failure or cancer. We found that imidazole propionate (ImP), a molecule produced by gut bacteria, may contribute to disease progression. People with PSC had higher ImP levels in their blood, and higher levels were linked to poorer survival. Laboratory and animal studies showed that ImP can trigger inflammatory and fibrotic processes in the liver. These findings suggest that the gut microbiome may directly influence PSC progression and that reducing ImP production or blocking its effects could provide new treatment opportunities.

To the article in Nature Metabolism