Exploring Periodontitis In Cirrhosis (EPIC)
Research type
Research Study
Full title
A single arm feasibility study to explore the relationship between periodontitis and infection in patients with liver cirrhosis
IRAS ID
270236
Contact name
Louise China
Contact email
Sponsor organisation
Royal Free Hospital
Duration of Study in the UK
1 years, 0 months, 15 days
Research summary
There is a clear need for intervention to prevent patients with advanced liver disease (liver cirrhosis) from acquiring infection which is the most common reason for deterioration and death.
Periodontitis (a chronic inflammatory gum disease) is a poorly investigated area in liver cirrhosis that potentially contains a key step in the pathway of infection, organ failure and death. There is a very plausible underlying mechanism - inflamed gums could provide an open route for bacteria to enter the circulation and constant stimulation of the immune system could lead to a defective response to future bacterial challenges.
However the prevalence of periodontitis in patients with advanced liver disease in the UK is unknown. We also do not know if it would be acceptable to patients for them to undergo an oral screening examination to see if they have periodontitis.
This feasibility study aims to evaluate acceptability of oral assessment in patients with advanced liver disease compared to healthy volunteers and accurately define periodontitis prevalence using established, standardised dental assessment in patients with advanced liver cirrhosis. Subsequent evaluation of rates of infection, hospital admission and death in liver disease patients with and without periodontitis will be evaluated in order to design a larger study assessing these outcomes. Exploration of the theoretical, pathophysiological mechanistic steps (altered gut bacteria and excess systemic inflammation) could provide the first steps to establishing a link between the two pathologies.
This could potentially lead to the identification of a simple, safe, inexpensive and non-pharmacological intervention in this high risk patient group.
REC name
London - Riverside Research Ethics Committee
REC reference
19/LO/1897
Date of REC Opinion
28 Feb 2020
REC opinion
Further Information Favourable Opinion