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Primary sclerosing cholangitis may drive colon cancer through antigen-driven inflammation

Primary sclerosing cholangitis dramatically increases the risk of colon cancer in patients with inflammatory bowel disease. Our study associates a newly discovered antigen-driven adaptive immune signature with the development of colorectal cancer in patients with primary sclerosing cholangitis and might help explain the high incidence of colon cancer in those patients.

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Fig. 1: A unique inflammatory signature in PSC is associated with the development of colorectal cancer.


  1. Broomé, U., Löfberg, R., Veress, B. & Eriksson, L. S. Primary sclerosing cholangitis and ulcerative colitis: Evidence for increased neoplastic potential. Hepatology 22, 1404–1408 (1995). This paper established a dysregulated adaptive immune response associated with increased IgG and an I2 transcriptional signature as a risk factor for colorectal cancer in patients with PSC.

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  2. Loftus, E. V. et al. PSC-IBD: a unique form of inflammatory bowel disease associated with primary sclerosing cholangitis. Gut 54, 91–96 (2005). This paper reports the differences in presentation of the colonic inflammation in PSC versus IBD.

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This is a summary of: Shaw, D. G. et al. Antigen-driven colonic inflammation is associated with development of dysplasia in primary sclerosing cholangitis. Nat. Med. (2023).

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Primary sclerosing cholangitis may drive colon cancer through antigen-driven inflammation. Nat Med 29, 1332–1333 (2023).

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