From the Guidelines
There is no evidence to suggest that vaccines cause Primary Sclerosing Cholangitis (PSC). PSC is a chronic liver disease characterized by inflammation and scarring of the bile ducts, both inside and outside the liver, which can lead to liver damage and eventually liver failure. The exact cause of PSC remains unknown, but it is believed to be an autoimmune condition where the body's immune system mistakenly attacks the bile ducts. According to the British Society of Gastroenterology and UK-PSC guidelines for the diagnosis and management of primary sclerosing cholangitis, published in Gut in 2019 1, PSC is a progressive biliary disorder strongly associated with inflammatory bowel disease (IBD).
Some key points to consider about PSC include:
- The disease is often associated with inflammatory bowel disease, particularly ulcerative colitis
- It tends to affect certain populations more frequently, such as those of Northern European descent
- The disease typically progresses slowly over many years
- Management focuses on treating symptoms, managing complications, and monitoring for potential development of cholangiocarcinoma (bile duct cancer), which occurs at higher rates in PSC patients
- The etiology of PSC is complex and likely involves genetic predisposition, environmental factors, and immune dysregulation, as noted in the EASL clinical practice guidelines: management of cholestatic liver diseases, published in the Journal of Hepatology in 2009 1.
However, vaccines have not been established as a trigger or cause of PSC, and the most recent and highest quality evidence, such as the 2019 guidelines published in Gut 1, does not support a link between vaccination and the development of PSC. If you're concerned about PSC, it's essential to consult with a hepatologist or gastroenterologist for proper evaluation and care.
From the Research
Primary Sclerosing Cholangitis (PSC) and Vaccines
- There is no direct evidence to suggest that vaccines cause Primary Sclerosing Cholangitis (PSC) 2, 3, 4, 5, 6.
- PSC is a chronic inflammatory bile duct disease of unknown etiology, frequently associated with inflammatory bowel disease and leading to end-stage liver disease requiring liver transplantation 2.
- The etiopathogenesis of PSC remains poorly understood, and it is thought to be an immune-mediated disease with genetic and environmental factors contributing to its development 3, 4, 6.
- Associations with inflammatory bowel disease (IBD), particularly ulcerative colitis, and with particular autoimmune diseases, as well as genetic associations, further suggest that PSC may be an immune-mediated disease 3, 6.
- Infections or toxins entering the portal circulation through a permeable colon may trigger PSC in genetically susceptible individuals, evoking an abnormal immune response 3.
Vaccine Safety and PSC
- None of the studies reviewed mention vaccines as a potential cause of PSC 2, 3, 4, 5, 6.
- The focus of research on PSC has been on understanding its etiopathogenesis, clinical features, and treatment options, with no evidence to suggest a link between vaccines and the development of PSC 2, 3, 4, 5, 6.