Fig. 3

Role of the role of pathobionts in intestinal barrier dysfunction and liver inflammation via he Th17 immune response in patients with PSC. Klebsiella pneumoniae, Proteus mirabilis, and Enterococcus gallinarum are prevalent in patients with PSC. Of these pathobionts, Klebsiella pneumoniae damages the colonic epithelium and translocates to the mesenteric lymph nodes, where it induces Th17 with other pathobionts, contributing to the exacerbation of hepatobiliary inflammation. Other pathobionts such as Enterococcus faecalis and Escherichia coli, along with their metabolites may contribute to the pathogenesis of PSC by directly entering the portal circulation