Discovering Biomarkers for Autoimmune Liver Disease Stratification

  • Research type

    Research Study

  • Full title

    Identification of new Biomarkers and Inflammatory Pathways in Autoimmune Liver Disease.

  • IRAS ID

    254179

  • Contact name

    Douglas Thorburn

  • Contact email

    douglas.thorburn@nhs.net

  • Sponsor organisation

    Royal Free London NHS Foundation Trust

  • Duration of Study in the UK

    5 years, 0 months, 4 days

  • Research summary

    Liver and digestive system diseases comprise a broad spectrum of disorders, part of which are still under diagnosed, unknown or for which treatment is only partially beneficial. Along these lines, many diseases are still labelled as idiopathic (uncertain cause) or cryogenic (uncertain origin), highlighting a lack of knowledge on the cause or parthenogenesis. Autoimmune liver diseases represent a particular subgroup of disorders:autoimmune hepatitis, primary sclerosing cholangitis, primary biliary cirrhosis,overlap syndromes and other sub-types. The overall cause of the liver disease is an immune system mediated or by the result of the interaction between identified or unidentified factors and the immune system. The consequences are chronic liver inflammation which may lead to cirrhosis. Interactions between the liver, gut and biliary system represents a fundamental link in the pathophysiological process of these diseases. In primary sclerosing cholangitis, for example, the prevalence of inflammatory bowel diseases are extremely high, suggestive of an important role of gut inflammation in the underlying pathogenesis. Moreover, neoplastic (abnormal of excessive growth often cancer) transformation is a recognised risk of chronic liver disease. Especially, hepatocellular carcinoma and cholangiocarcinoma develop on the background of liver cirrhosis. However, cholangiocarcinoma may also complicate primary sclerosing cholangitis even in the absence of overt cirrhosis making the follow­up and management of these patients particularly challenging.

    In addition, relapse of autoimmune liver diseases after liver
    transplant may be present in 40­50% of cases in primary sclerosing
    cholangitis.

    There is an urgent need to improve the outcome of these patients by achieving a better understanding of the underlying pathological processes responsible for these diseases, how they progress, if there is a way to predict their complications, including neoplastic
    transformation and relapse after liver transplantation.

  • REC name

    London - Riverside Research Ethics Committee

  • REC reference

    19/LO/1616

  • Date of REC Opinion

    17 Oct 2019

  • REC opinion

    Further Information Favourable Opinion