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Telomere attrition marks disease severity in chronic cholestatic liver diseases

Epigenetic telomere length analysis in patients with sclerosing or biliary cholangitis reveals converging markers of accelerated biological aging.

Alimentary pharmacology & therapeutics · Alsakarneh SG et al. · Paper published 29 Sep 2026

Paper

In a human observational study, researchers evaluated DNA methylation-derived telomere length in 474 patients with primary sclerosing cholangitis, 291 patients with primary biliary cholangitis, and matched controls. The team investigated associations between this marker of cellular turnover, clinical outcomes, the PREsTO risk score, and epigenetic age acceleration measured by AgeAccelGrim. Patients with primary sclerosing cholangitis had significantly shorter age-adjusted telomere lengths than controls. Across the cohorts, shortened telomere length independently correlated with disease severity in primary sclerosing cholangitis. Together with epigenetic age acceleration, these converging biological aging signatures support a model of accelerated biological aging in chronic cholestatic liver diseases.

Why it matters

The findings suggest that cellular turnover and biological aging signatures converge during chronic organ pathology. Understanding these aging metrics could provide insight into progressive biliary injury and fibrosis.

Caveats

The study uses an observational design, which cannot establish whether accelerated biological aging drives disease progression. The results are also limited to cohorts with these two specific chronic cholestatic conditions.

Written from the paper’s abstract, and every claim checked against it before publishing. Read the paper for the full methods and data.

The paper

Accelerated Biological Aging in Cholestatic Liver Disease: Telomere Attrition and Association With Disease Severity

Alsakarneh SG, Juran BD, Fernandez J et al.

Alimentary pharmacology & therapeutics · 29 Sep 2026 · Peer-reviewed

Relevance
Core geroscience
News value
Notable
Evidence
Humans
Status
Peer-reviewed
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