Barts Liver Centre

Barts Liver Centre - Addressing the Rising Burden of Liver Disease, ‘A Slient Killer’ in East London; Building an International Academic Liver Unit at Barts Health/QMUL

Professor Graham Foster, Dr Patrick Kennedy and Dr William Alazawi

Awarded £1.3M

The Barts Liver Centre aims to improve liver health in East London and develop strategies and care pathways that will impact on patients around the world.

Tower Hamlets ranks amongst the worst in the country for most indicators of liver mortality and morbidity. The high rate of serious liver disease in the local community presents a significant clinical challenge to regional health care services, but also an opportunity for our clinicians to develop innovative new approaches to transform disease management.

Liver diseases may develop over many years with persistent injury from alcohol, dietary fats or viruses damaging liver cells. Injury causes inflammation and scar tissue (fibrosis) to form in the liver. Eventually, fibrosis leads to cirrhosis, which in turn can lead to liver cancer, liver failure and death. Even patients with cirrhosis can be asymptomatic and so liver disease really is a ‘silent’ killer.

This award will support the recruitment of three new senior post-doctoral basic scientists and three PhD students, who will work on three pioneering projects to reduce the burden of liver disease:

Exercise and Alcohol: an innovative clinical trial to address the issue of alcohol abuse that will examine whether supervised exercise can reduce excessive alcohol consumption. This novel trial builds on the unit’s reputation in accessing ‘difficult to reach’ communities allowing Prof Foster’s group to transition from highly successful studies in hepatitis C to another major cause of liver disease.

Non-alcoholic fatty liver disease: can we identify patients who have the progressive non-alcoholic steatohepatitis (NASH) from those who have non-progressive steatosis without doing a liver biopsy? Developing such advanced diagnostics would provide important information to aid patient lifestyle choices, more appropriate screening for clinical trials and the selection of patients for novel therapies. Linking to East London Genes and Health, this project will examine, for the first time, healthy humans with genetic lesions to determine how inflammatory signals are affected when key components of the ‘liver inflammation pathway’ are disrupted.

Chronic Hepatitis B (CHB) is a leading cause of liver disease and liver cancer, accounting for 780,000 deaths per year worldwide. Whilst current treatment cannot provide a cure, early treatment can avert the complications of chronic infection. This work will undertake a detailed study of the virus using the latest techniques to identify differences in the virus make-up which might contribute to different disease outcomes. A deeper understanding of the virus and the immune response will enable identification of patients at greatest risk of the complications of CHB and those with the greatest need for treatment.