Investigating mechanisms in non-alcoholic fatty liver disease
Research type
Research Study
Full title
Investigating pathological mechanisms in non-alcoholic fatty liver disease: cross-sectional comparative study between patients and healthy controls
IRAS ID
247449
Contact name
William Alazawi
Contact email
Sponsor organisation
Queen Mary, University of London
Duration of Study in the UK
2 years, 0 months, 5 days
Research summary
Non-alcoholic fatty liver disease (NAFLD) is a major cause of morbidity and mortality worldwide. It affects 20-30% of the general population, 58% of overweight individuals and 70% of diabetics. NAFLD reflects a spectrum of disease from fatty infiltration without inflammation and 12-20% of individuals with NAFLD who develop the aggressive form of disease, non-alcoholic steatohepatitis (NASH). This is characterised by liver cell death, inflammation and fibrosis (scarring) which can lead to cirrhosis, liver failure and liver cancer and increased risk of death from multiple causes.
The mechanisms in the multi-system disease of NASH are not fully understood; however, metabolic disturbance, altered gut bacteria, and overactive inflammation and immune responses contribute to disease progression. Historically co-ordinated tissue assessment has been difficult, but the expansion of weight loss surgery as a metabolic intervention enables biopsying multiple tissues at the time of surgery with minimal additional risk.
We will collect paired tissue, blood, stool, urine and saliva samples and use novel experimental techniques to compare metabolism, inflammation, the immune system and gut bacteria between the different stages of the disease and evaluate the effect weight loss has upon these features. Additionally, we will compare this to people without NAFLD.
Participants would attend for two visits lasting approximately 60 minutes to provide a medical history, samples and undergo a liver scan. Tissue samples will be collected by the study team on the day of planned surgery or liver biopsy. There is an optional liver fine needle aspiration performed at study visits.
The potential benefits of this study will include identifying features which could aid disease staging; reducing the need for invasive liver biopsy but also identify those individuals at risk of disease progression. Furthermore, a greater understanding of the inflammatory responses in NASH could highlight potential therapeutic targets for future drug development.
REC name
London - Brent Research Ethics Committee
REC reference
18/LO/1759
Date of REC Opinion
5 Dec 2018
REC opinion
Further Information Favourable Opinion