Causal Therapy Research Articles

From ECG to Ablation: A Modern Review of Wolff-Parkinson-White Syndrome

Wolff-Parkinson-White (WPW) syndrome is a clinical manifestation of pre-excitation syndrome, characterized by the congenital presence of an additional conduction pathway in the form of a muscle fibre - Kent's bundle between the atria and ventricles, resulting in paroxysmal supraventricular tachycardia and increasing the risk of sudden cardiac death when atrial fibrillation occurs. The aim of this study is to show a structured knowledge of the pathophysiology and epidemiology, clinical manifestations, diagnosis, risk assessment and management of Wolff-Parkinson-White syndrome based on a review of the literature, Pubmed and Google Scholar databases. Based on current data, the prevalence of electrographic features of pre-excitation is estimated at 0.15-0.25% in the general population. The presence of an additional conduction pathway between the ventricles, predominantly conducting impulses like healthy His and Purkinje fibres, results in a characteristic ECG pattern, allowing the diagnosis of pre-excitation syndrome. Each excitation from sinoatrial node is conducted not only by the physiological pathway, but also by an accessory pathway, the clinical consequences of which will be the occurrence of supraventricular tachycardias such as an orthodromic and antidromic atrioventricular reentrant tachycardia (AVRT), atrial fibrillation or even the ventricular fibrillation, which can be the first symptom of the syndrome. The diagnosis is aided by electrophysiology studies (EPS) to confirm the presence of an accessory pathway, with usually simultaneous invasive treatment - percutaneous ablation, which is also a causal therapy with an efficacy of approximately 92%. Pharmacological treatment of patients with WPW is based on group IA and IC antiarrhythmic drugs, but these act only for symptoms, they are ineffective in eliminating the underlying cause of disease.

Peri-Implantitis Causal Therapy with and Without Doxycycline: Retrospective Cohort Clinical Study

Background: Topical application within peri-implant pockets ensures high drug concentrations at the infection site while minimizing systemic exposure. However, the comparative effectiveness of non-surgical causal therapy alone versus its combination with doxycycline remains unclear. This retrospective observational clinical study aimed to evaluate the impact of adjunctive doxycycline on peri-implant parameters, considering smoking, systemic conditions, and implant–prosthetic rehabilitation (single implant, implant-supported bridge, or full-arch). Methods: Patients were retrospectively assigned to a control group (CG), receiving non-surgical causal therapy alone, or a test group (TG), which is also treated with topical doxycycline. Peri-implant parameters, including Peri-implant Probing Depht (PPD), Bleeding on Probing (BoP), Plaque Index (PI), and suppuration, were assessed at baseline (T0) and follow-up (T1). Multivariate logistic regression and stratified subgroup analyses were conducted to adjust for confounders such as smoking, systemic conditions, and implant–prosthetic rehabilitation types. Results: Two hundred nine patients were included in the study, of whom 97 were in the CG and 112 were in the TG. At T1, the TG exhibited a statistically significant reduction in PPD, BoP, PI, and suppuration compared to the CG (p < 0.05). Conclusions: The adjunctive use of topical doxycycline significantly enhances clinical outcomes in non-surgical peri-implantitis treatment. Further longitudinal studies are needed to confirm these findings and assess long-term stability.

Imaging and Fluid Biomarkers of Alzheimer Disease: Complementation Rather Than Competition.

With the introduction of the new causal amyloid targeting therapies, the role of biomarker-assisted diagnosis of Alzheimer disease (AD) has received a further boost. In addition to the well-established gold standard, amyloid PET imaging, cerebrospinal fluid diagnostics are currently being suggested for therapy inclusion and patient selection. In addition, new types of blood-based biomarkers are being introduced, holding diagnostic potential together with potentially easy and broad accessibility in the future. In addition to the introduction of new biomarkers and new therapeutic approaches, the guidelines for biomarker-based classification of AD are also in flux, sometimes clustering biomarker classes and neglecting their individual characteristics, leading to divergent or controversial discussions. It is difficult to keep pace with these rapid developments, and the respective roles of the various AD biomarkers have not yet been clearly defined. Thus, in this paper, we attempt to discuss the strengths and weaknesses of the various imaging and fluid biomarkers of AD and classify what we consider to be their complementary, nonredundant value for various diagnostic questions. We propose an integrated biomarker algorithm for the purpose of reliable AD patient selection for amyloid targeting therapies.

Amelioration of female menopausal syndrome by intravenous administration of autologous menstrual blood-derived stem cells.

Amelioration of female menopausal syndrome by intravenous administration of autologous menstrual blood-derived stem cells.

Ocular alterations in pseudoxanthoma elasticum : The eye as a window to diagnosing a systemic disease

Pseudoxanthoma elasticum (PXE) is an autosomal-recessive multisystem disease characterized by elastic fiber calcification in the skin, the cardiovascular system, and eyes. PXE is caused by biallelic mutations in the ABCC6gene on chromosome16, resulting in low inorganic pyrophosphate plasma levels. Typical ocular manifestations result from calcification of Bruch's membrane and include peau d'orange, angioid streaks, and comet-tail lesions. Advances in multimodal imaging have significantly improved the detection of these features. Ocular complications in PXE include the development of secondary neovascularization, which can be treated with anti-vascular endothelial growth factor (VEGF) injections. In cases of suspected PXE, genetic testing and genetic counseling should be performed for diagnostic confirmation. Early referral to aspecialized center is essential. Interdisciplinary care and management of complications, particularly in collaboration with angiologists, are crucial for treating this multisystem disorder. Although no approved causal therapy for PXE currently exists to date, accurate and early diagnosis using phenotypic characteristics is critical. Early identification of other affected family members and timely treatment of secondary complications allow for better disease management and offer patients the opportunity to participate in ongoing clinical trials. Promising therapeutic options are currently emerging and may significantly improve management and prognosis in the future.

Experts Teaching Wound Management-A Survey of Current Practices in Germany.

This study aimed to gain insights into wound care education for medical students in Germany. An exploratory study with an online survey was conducted among wound experts of different professions, requesting details about educational programmes concerning teaching content, methodology, integration into current curricula and teaching faculty. The analysis included 118 datasets gathered from 17 doctors, 93 nurses and eight other health professionals. In 48.9% of cases, wound management was taught by different health care professionals, with doctors and nurses building a teaching team most frequently (68.2%). In about half of the cases, the medical students were learning together with trainees from other health professions. The teaching team was interdisciplinary in 40.4% of the courses. The large range of medical disciplines in which wound care was taught shows how variably this topic can be used in medical teaching. Nevertheless, the results from this survey also show that the topic is still clearly underrepresented in medical training, even though there is a high level of interest among medical students and a clear relevance for everyday practice as a physician. The medical teachers in this survey suggest more practical sessions on causal therapy, wound pain, quality of life and local wound care in the regular medical curriculum.

Penanganan Kasus Cystitis Hemoragik pada Kucing Mix Persian di Klinik Hewan Awal Care

Hemorrhagic Cystitis is an inflammation accompanied by bleeding that occurs in the urinary bladder characterized by thickening of the urinary bladder wall and has clinical symptoms of hematuria or urine with blood, dysuria, abdominal distension and pain when palpated in the abdominal area. Patients with symptoms of weakness, loss of appetite and vomiting. An examination was carried out by a doctor and a pain response was found in the abdomen, after further observation by palpation, an enlarged VU was felt and hematuria was present. The results of the Ultrasonography examination found a thickening of the urinary bladder wall, then a microscopic examination of native urine found red blood cells. Hematology results showed an increase in parameters in leukocytes, and granulocytes and a decrease in platelets indicating acute infection and also bleeding or acute inflammation. A blood chemistry examination showed an increase in BUN and Creatinine levels caused by post-renal Azotemia. The results of the signaling and anamnesis were associated with the results of the supporting examination of the chika cat diagnosed with Hemorrhagic Cystitis and cystotomy treatment was performed. Treatment and handling are done after cystotomy surgery with treatment in the form of antibiotics as causative therapy, musculorelaxants and anti-fibrinolytics as symptomatic therapy, and multivitamins as supportive therapy. Handling is done by giving special diet feed, catheterization, and laser therapy on post-operative wounds.

Therapeutic Modality of Mesenchymal Stem Cells for Moderate to Severe Knee Osteoarthtritis: A Systematic Review

Background: Osteoarthritis (OA) is a chronic degenerative joint disease that commonly affects weight-bearing joints, such as the knee. A potential treatment is the intra-articular injection of mesenchymal stem cells (MSCs), which may stimulate joint tissue regeneration, cartilage formation, and angiogenesis. This systematic review aimed to evaluate the efficacy and safety of MSC therapy in moderate-to-severe knee OA.Methods: Literature searches were conducted using PubMed, Science Direct, Taylor and Francis, Google Scholar, Springer Link, Wiley, and the Garuda Portal. From the 644 identified articles, only seven randomized controlled trials published within the last 10 years met the inclusion criteria.Results: Five of the seven studies demonstrated significant reductions in pain based on Visual Analog Scale (VAS) scores following MSC injections. Four studies reported significant improvements in WOMAC scores, whereas one study showed no notable change. Adverse effects noted after injections included joint swelling, contusions, postprocedural hematomas, mild effusion, and injection site pain.Conclusions: Intra-articular MSC therapy shows potential for reducing pain and improving joint function in moderate-to-severe knee OA. Improvements in VAS and WOMAC scores suggest clinical benefits that can last up to 12–48 months post-treatment. MSC injections may be considered as a causal therapy in addition to symptomatic treatments, such as analgesics, to enhance patient quality of life.

Health worker’s attitude, accessibility of health services and compliance with antiretroviral therapy in patients with HIV/AIDS: a cross-sectional study

The key to success in HIV treatment is compliance with antiretroviral therapy (ART). This is because continuous AR therapy can suppress HIV to undetectable levels, reduce the risk of drug resistance, improve quality of life and survival, improve overall health, and reduce the risk of HIV transmission. On the other hand, non-compliance with treatment can be a major cause of therapy failure.The aim: to identify factors influencing compliance with ART therapy in patients with HIV/AIDSMaterial and Methods. This study used a cross-sectional method. It involved 289 respondents as samples. The sample size was based on HSIEH formula (1989). Univariate analysis used frequency distribution to describe the percentage. Bivariate Logistic regression analysis (Adjusted OR and 95% confident interval) and multivariate analysis used Multiple logistic regression with Adjusted OR, 95% Confident Interval (CI), and a significant value of <0.05.Results and discussion. Some factors had a significant relationship to the outcome, namely age with a p-value of <0.001 (95% CI 4.15–134.09), Occupation with a p-value of 0.002 (95% CI 2.7–32.7), Knowledge with a p-value <0.001 (95% CI 6.15– 43.8), attitude with a p-value of <0.001 (95% CI 3.37–43.8), accessibility of health services with a p-value of 0.004 (95% CI 1.5–9.4), and health worker’s attitudes with a p-value <0.001 (95% CI 1.88–9.21).Conclusion. Another factor is also important, namely a good patient-provider relationship. Increasing patient trust through non-judgmental and supportive care and using positive motivational strategies can affect treatment compliance. Considering each measure taken is important to achieve optimal clinical outcomes and realize public health with preventive treatment

Periodontal Disease and Age-Related Maculopathy: A Case Report

Age-related macular degeneration (AMD) is a leading cause of significant vision impairment in individuals aged 50 and older, primarily impacting central vision. This study seeks to investigate potential associations between periodontal disease and age-related maculopathy in the analyzed clinical case. A male subject of 66 years old, with age-related degenerative maculopathy and severe periodontal disease, was evaluated and treated. After an initial phase of non-surgical causal periodontal therapy, the periodontal indices were re-evaluated. In addition, the extraction of hopeless teeth replaced by dental implants was performed. A retinal topography was used to assess possible regression of the pathology, and proper anti-VEGF therapy was administered. The results showed a regression of periodontal disease and an improvement of the degenerative maculopathy. These preliminary results, even if encouraging, should be supported by larger prospective trials.

Management of drug-induced liver injury associated with anti-cancer therapy.

Drug-induced liver injury (DILI) is a leading cause of drug withdrawal, a particular cause for concern among patients receiving anti-cancer treatment. This review summarizes the available evidence on the efficacy of hepatoprotective drugs in normalizing liver enzyme abnormalities among patients with DILI due to treatment with anti-cancer therapies. Across relevant publications, the effects of several compounds on anti-cancer therapy-induced DILI were assessed. Treatment with hepatoprotective agents which is usually initiated after DILI has been detected and involves cessation of causative anti-cancer therapy, has demonstrated improvements in liver enzyme elevation. However, prophylactic treatment with two agents in particular, ademetionine and bicyclol have shown hepatoprotective effects that enabled patients to continue with their anti-cancer therapy with a reduced subsequently reduced risk of hepatotoxicity. While these publications show some evidence for the benefits of hepatoprotective agents among patients with DILI due to anti-cancer therapy, more research is needed to fully determine the effects of hepatoprotective drugs in resolving DILI signs and symptoms among patients receiving treatment for cancer.

Multi‐Omic Insight Into the Molecular Networks in the Pathogenesis of Coronary Artery Disease

BackgroundGenome‐wide association studies have revealed numerous loci associated with coronary artery disease (CAD). However, some potential causal/risk genes remain unidentified, and causal therapies are lacking.Methods and ResultsWe integrated multi‐omics data from gene methylation, expression, and protein levels using summary data‐based Mendelian randomization and colocalization analysis. Candidate genes were prioritized based on protein‐level associations, colocalization probability, and links to methylation and expression. Single‐cell RNA sequencing data were used to assess differential expression in the coronary arteries of patients with CAD. TAGLN2 (Transgelin 2), APOB (Apolipoprotein B), and GIP (Glucose‐dependent insulinotropic polypeptide) were identified as the genes most strongly associated with CAD, with TAGLN2 exhibiting the most significant association. Higher methylation levels of TAGLN2 at specific Cytosine‐phosphate‐Guanine sites were negatively correlated with its gene expression and associated with a lower risk of CAD, whereas higher circulating TAGLN2 protein levels were positively associated with CAD risk (odds ratio,1.66 [95% CI, 1.32–2.08). These results suggest distinct regulatory mechanisms for TAGLN2. In contrast, APOB and GIP showed positive associations with CAD risk, whereas DHX58 (DExH‐box helicase 58) and SWAP70 (Switch‐associated protein 70) were associated with decreased risk.ConclusionsOur findings provide multi‐omics evidence suggesting that TAGLN2, APOB, GIP, DHX58, and SWAP70 genes are associated with CAD risk. This work provides novel insights into the molecular mechanisms of CAD and highlights the potential of integrating multi‐omics data to uncover potential causal relationships that cannot be fully captured by traditional genome‐wide association studies.

Cross-sector Management of Medical Treatment and Integrated Forms of Therapy for Post-COVID-19 Patients with Fatigue and Sensorimotor Instability

For the medical treatment of post-COVID-19 syndrome, only a few cross-sector medical treatment networks, such as the Post-COVIDLMU CONCEPT [1], are currently being implemented. However, no causal therapy can be reliably recommended based on evidence-based criteria. A cross-sector, doctor-led treatment management will be inaugurated for post-COVID-19, initially focusing on the syndrome of fatigue/immunometabolic depression (as a target for precision medicine) and sensorimotor instability as a cognitive parameter. The corresponding parameters will be recorded and analyzed in real time and at the same time become an important environmentally stable training object. The use of internet and mobile-based interventions represents an essential component here.Changes in the leading syndromes of fatigue and sensorimotor instability through stress-controlled standardized training therapy, intensified cognitive behavioral therapy and the process design of interdisciplinary therapy management in compliance with the guidelines of the Federal Joint Committee (G-BA) for cross-professional and cross-sector care for post-COVID-19 patients were the overarching goals of an intervention study at the post-COVID-19-Center Lausitz over a 3-year period (Q1-2021-Q2-2024). The results of a stress-controlled intervention study were integrated into the derivation, design and evaluation of a cross-sector management process. The outcome and management of the training therapy were assessed based on the post-COVID-19 key symptoms and motor fatigue parameters. A secondary psychosomatic syndrome that emerged during treatment was examined using cognitive fatigue parameters.With the stress-controlled sensorimotor intervention integrated into the designed management process as well as intensified cognitive behavioral therapy, improvements in post-COVID-19 key symptoms as well as in the parameters of motor and cognitive fatigability were achieved. The timing of the start of the process stages of the overall management had an influence on the outcome of the treatment path. Intensification of cognitive behavioral therapy also had positive effects, resulting in an increasing level of activity and self control in patients.

Biomarkers and Their Role in Understanding Osteoarthritis

Osteoarthritis (OA) is a degenerative joint disease characterized by progressive damage and loss of articular cartilage with concomitant structural and functional changes in the joint. It is the most common cause of joint pain globally and the resulting productivity loss to the economy. The clinical symptoms of osteoarthritis are mostly determined by the difficulties of patients related to the development of articular degenerative changes, which secondarily lead to joint stiffness and functional limitation. The diagnosis of this disease is currently based on typical clinical symptoms and radiographic findings (e.g. joint space narrowing, osteophytes, subchondral sclerosis, etc.). These parameters, however, are difficult to detect in the early stages of the disease and are most often recognized in the advanced stages. For these reasons, the diagnosis of osteoarthritis is often delayed until irreversible destruction of joint tissue occurs and conservative treatment is less effective. Despite recent scientific progress in understanding the genetic and molecular principles of joint degeneration, currently there is no reliable causal therapy for OA. This review aims to summarize current knowledge of osteoarthritis and possible future directions for diagnosis and early intervention. One of such directions is the study of the so-called biomarkers. A biomarker is defined as an indicator of biological processes and can include radiographic, histological, physiological, or molecular characteristics. In particular, molecular biomarkers are widely studied in knee OA. Attention of the research community is focused on the study of biomarkers as a method of detection and prediction of the early stages of osteoarthritis before irreversible joint damage occurs. Biomarkers help develop more effective and, above all, personalized treatment, thus improve the overall clinical approach to the patient.

Systemic therapies for pediatric patients with ichthyosis

Hereditary ichthyoses are rare, etiologically and clinically heterogeneous epidermal keratinization disorders that are characterized by excessive dryness with scaling of the skin and in some cases increased palmoplantar keratinization. Additional inflammation is common and there are forms associated with blistering. In terms of differential diagnosis, ichthyoses with associated erythroderma in particular must be distinguished from primary atopic diseases with immunodeficiency. The aim is to provide basic knowledge of the classification and nomenclature of ichthyoses and of current guideline-based and approved therapies. Readers should also be made aware of the difficulties of treating this rare skin disease in children and adolescents with only afew approved therapies. New and innovative treatment options are described and thereafter the reader should be able to confidently identify potential patients for approved and novel therapies. The current guidelines as well as the current literature and expert consensus on systemic therapies for ichthyosis with afocus on pediatric patients are discussed. Precise phenotyping, endotyping and the inclusion of the patient's expectations with regard to therapy currently allow comprehensive treatment to alleviate symptoms with good interdisciplinary cooperation. In the absence of causal therapy options, hereditary ichthyosis usually requires lifelong symptomatic individualized therapy. The basis of therapy is local therapy. Acitretin is currently the only approved systemic therapy. Pathophysiologically driven and therefore personalized and targeted therapies, in the form of topical replacement proteins or lipids, small molecules with avariety of target structures and biologics to address inflammation, are the focus of new therapeutic options. Causal therapeutic approaches, such as gene therapies, are currently under development.

Females with X-Linked Muscle Disorders: an underestimated patient population.

Carriers of genetic diseases including female carriers of X-linked disorders are traditionally believed to be asymptomatic due to the compensatory presence of the unmutated gene on the other allele. However, in recent decades numerous contributions have appeared in the literature showing how females carrying X-linked diseases can also present signs and symptoms linked to the specific gene defect. To explain the clinical manifestations observed in female carriers, several mechanisms leading to a reduced protein expression have been hypothesized, in particular the role of the X-chromosome inactivation (XCI). In this review, the focus will be on the relationship between skewed XCI and the development of muscle or cardiac symptoms in female carriers of the most frequent types of muscle disorders such as Duchenne and Becker muscular dystrophies, Emery-Dreifuss muscular dystrophy and Myotubular Myopathy. In all cases, there is a tendency for females with a more severe phenotype to have a skewed pattern of XCI, while females with an intermediate phenotype have a random pattern. Given the increasing recognition of important clinical presentations in females with X-linked muscle disorders and the recent availability of causal therapies for these diseases, specific guidelines are desirable and recommended that allow women to be properly recognized and have access to appropriate therapies.

SARCOPTES SCABIEI INFECTION ACCOMPANIED BY HYPOCHROMIC MICROCYTIC ANEMIA IN A DOMESTIC DOG

Scabies is a skin infection caused by ectoparasites of the mite type, Sarcoptes scabiei. These mites infect the host's skin by making tunnels in the epidermis layer which will cause itching. This article aims to describe the occurrence of scabiosis due to Sarcoptes scabiei infection in local dogs. A series of examinations to determine the diagnosis, and the therapy given. A case study was conducted on a local male dog, named Boby, aged 4 months who had itching all over his body that had lasted for one month. Physical examination found alopecia, scales, and crusts on the head, hind legs, front legs, both ears, abdomen, back, and tail. Examination using the skin scraping method found Sarcoptes scabiei mites. Hematological examination showed that the case animal had lymphocytosis, monocytosis, granulocytopenia, hypochromic microcytic anemia, and thrombocytosis. Based on anamnesis, clinical examination results, and supporting examinations, the case animal was diagnosed with scabiosis with a prognosis of fausta. The case dog was given causative therapy in the form of ivermectin at a dose of 0.2 mg/kg BW, subcutaneous injection with two administrations at an interval of 28 days, Symptomatic therapy was given subcutaneous injection of diphenhydramine HCl at a dose of 3 mg/kg BW with two administrations at an interval of 28 days, chlorpheniramine maleate at a dose of 0.5 mg/kg BW orally for 14 days. Supportive therapy B-complex was given 1 tablet once a day for 21 days, fish oil as much as 1 tablet once a day for 20 days, and bathed with shampoo containing sulfur (twice a week). The results of treatment for 28 days showed changes in the condition of the case dog improving, pruritus, crusts, scales, lichenification began to decrease. On the 40th day the case dog showed new hair growth. The awareness of pet owners, especially those who keep dogs, must be increased by always maintaining the cleanliness of their dog's cage, eating utensils, and play equipment.

Early Sacral Neuromodulation: A Promising Opportunity or an Overload for Patients with a Recent Spinal Cord Injury? A Cross-Sectional Study.

Background: A solid rationale exists for early sacral neuromodulation in the form of causal therapy that improves neurogenic lower urinary tract dysfunction after complete spinal cord injury. However, the short and early time frame for minimally invasive therapy poses a series of ethical and medical issues, which has impeded clinical realisation thus far. Objectives: We performed a cross-sectional study on patients with chronic spinal cord injury to learn about patients' attitudes towards early treatment to prepare for large randomised controlled trials. Methods: A cohort of patients (n = 86, mixed genders) with spinal cord injury over two years was analysed. Their lower urinary tract-related quality of life was assessed using the Qualiveen-30 tool. The extent of neurogenic lower urinary tract dysfunction, patients' awareness of it, and their attitude towards early sacral neuromodulation were explored with a specific questionnaire. Results: A total of 61.9% (n = 52) of patients declared that, in retrospect, they would have agreed to early treatment prior to the emergence of their autonomic dysfunction. Of these patients, 51.8% (n = 29) would have also consented to early sacral neuromodulation. Quality of life had no impact on their decision. More than half of the patients (n = 49, 57.0%) stated they had not grasped the momentous nature of neurogenic lower urinary tract dysfunction when being informed about it. This finding was subsequently correlated with a decreased lower urinary tract-related quality of life. Conclusion: Patients with neurogenic lower urinary tract dysfunction are likely to agree to an early therapeutic approach. Clinical implementation requires knowledge and acceptance of the procedure on the part of patients and their caregivers.

Correction of aberrant splicing of ELP1 pre-mRNA by kinetin derivatives - A structure activity relationship study.

Correction of aberrant splicing of ELP1 pre-mRNA by kinetin derivatives - A structure activity relationship study.

PSC and colitis: A complex relationship.

Primary sclerosing cholangitis is one of the most challenging conditions in hepatology, and due to our limited understanding of its pathogenesis, no causal therapies are currently available. While it was long assumed that a minority of people with IBD also develop PSC, which is sometimes labeled an extraintestinal manifestation of IBD, the clinical phenotype, genetic and intestinal microbiota associations strongly argue for PSC-IBD being a distinct form of IBD, existing alongside ulcerative colitis and Crohn's disease. In fact, the liver itself could contribute to intestinal pathology, clinically overt in 60 - 80 % of patients. Recent studies suggested that on a molecular level, almost all people with PSC have underlying colitis. The extent to which the liver and gut influence each other clinically and in terms of disease progression has not yet been conclusively revealed. However, while it seemed intuitive that the two diseases have a negative influence on each other, evidence suggests that sclerosing cholangitis can also be protective for the gut and that colitis can in certain settings ameliorate liver pathology. This underscores the complex pathophysiological relationships, where factors such as genetic predisposition, changes in the intestinal microbiota, altered bile acid metabolism, and immune cell migration are among the suspected contributors. PSC is an emerging disease with a significant impact on health-related quality of life of affected people. With this review, we aim to summarize the current knowledge on the gut-liver axis in PSC-IBD, provide new perspectives on risk stratification and treatment and identify gaps in our current knowledge. Our understanding of this complex relationship will therefore help to design clinical trials and shape the future therapy of PSC-IBD.