Reshetnyak VI, Reshetnyak AA, Maev IV. Peribiliary and colonic crypt glands in primary sclerosing cholangitis and inflammatory bowel disease pathogenesis: New research perspectives. World J Hepatol 2026; 18(8): 123377 [DOI: 10.4254/wjh.123377]
Corresponding Author of This Article
Vasiliy Ivanovich Reshetnyak, MD, PhD, Full Professor, Department of Propaedeutics of Internal Diseases and Gastroenterology, Russian University of Medicine, No. 20 Delegatskaya Street, Moscow 127473, Russia. vasiliy.reshetnyak@yandex.ru
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Gastroenterology & Hepatology
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review-article
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Reshetnyak VI, Reshetnyak AA, Maev IV. Peribiliary and colonic crypt glands in primary sclerosing cholangitis and inflammatory bowel disease pathogenesis: New research perspectives. World J Hepatol 2026; 18(8): 123377 [DOI: 10.4254/wjh.123377]
World J Hepatol. Aug 27, 2026; 18(8): 123377 Published online Aug 27, 2026. doi: 10.4254/wjh.123377
Peribiliary and colonic crypt glands in primary sclerosing cholangitis and inflammatory bowel disease pathogenesis: New research perspectives
Vasiliy Ivanovich Reshetnyak, Alexandra Andreevna Reshetnyak, Igor Veniaminovich Maev
Vasiliy Ivanovich Reshetnyak, Igor Veniaminovich Maev, Department of Propaedeutics of Internal Diseases and Gastroenterology, Russian University of Medicine, Moscow 127473, Russia
Alexandra Andreevna Reshetnyak, Public Health and Health Professions, University of Florida, Gainesville, FL 32611, United States
Author contributions: Reshetnyak VI, Reshetnyak AA, and Maev IV contributed equally to this work. Reshetnyak VI, Reshetnyak AA, and Maev IV conceptualized and designed the study, created the artwork, conducted the literature review and analysis, interpreted the data, drafted the original manuscript, prepared the draft, made critical revisions, and approved the submitted final version.
AI contribution statement: The authors claim that no AI tools were used in the creation of this manuscript, and assume full responsibility for the originality of all materials contained in this work.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Vasiliy Ivanovich Reshetnyak, MD, PhD, Full Professor, Department of Propaedeutics of Internal Diseases and Gastroenterology, Russian University of Medicine, No. 20 Delegatskaya Street, Moscow 127473, Russia. vasiliy.reshetnyak@yandex.ru
Received: May 18, 2026 Revised: June 8, 2026 Accepted: July 17, 2026 Published online: August 27, 2026 Processing time: 94 Days and 11.8 Hours
Core Tip
Core Tip: This review presents a novel hypothesis explaining the pathogenesis of primary sclerosing cholangitis (PSC), focusing on the key role of peribiliary glands (PBGs) and colonic crypt glands as a common morphofunctional structure linking pathology of bile ducts and colon. The hypothesis proposes that simultaneous structural and functional impairment of these mucin-producing glands may trigger PSC development. The unifying mechanism, which links PSC and inflammatory bowel disease (IBD) through dysfunction PBGs and colonic crypt glands, probably closely related to mutations in the FUT2 gene affecting fucosylation of protective mucins in bile ducts and colonic mucosa. This hypothesis explains key clinical features of PSC: (1) Selective involvement of extrahepatic and large intrahepatic bile ducts; (2) Formation of characteristic concentric strictures; (3) Strong association between PSC in IBD; (4) Sparing of small intralobular and interlobular bile ducts; and (5) Increased risk of cholangiocellular carcinoma and colorectal cancer. The proposed mechanism provides a comprehensive framework for understanding PSC pathogenesis and identifies potential therapeutic targets.
