Hepatology and Gastroenterology
Since 2009 Hepatology and Gastroenterology have been combined into a single section.
Headed by Professor Mark Thursz, the Section includes academic clinicians and non-clinical scientists, as well as postgraduate students and research fellows.
The Section run a successful MSc course in the Molecular Biology and Pathology of Viruses, a BSc in Hepatology and Gastroenterology and also coordinate the teaching in hepatology and gastroenterology within the MB BS course.
Hepatology has a longstanding research record in viral hepatitis, which is both nationally and internationally recognized. This encompasses studies in molecular virology, biology and immunology, as well as clinical studies involving trials of antiviral therapy and non-invasive methods of assessing liver fibrosis.
The Section has recently opened the Robert Hesketh Hepatology Clinical Research Facility to facilitate the development of studies of the pathogenesis and treatment of chronic liver disease and primary liver cancer.
The Section has established programmes on viral, alcohol and non-alcohol related steato-hepatitis, and on primary liver cancer (hepatocellular cancer and cholangiocarcinoma).
Viral Liver Disease.
The Section has one of the largest cohorts of patients with chronic hepatitis B and C in the UK. The studies are focused on determining the genetic and environmental factors that determine the rate of progression of these diseases by candidate gene association and genome wide association studies. Such studies have identified genetic polymorphisms of innate immunity (alpha and Lambda interferon systems), adaptive immunity (MHC antigen presentation), the coagulation system (pro-coagulant factors such as the Leiden Factor V mutation) and of lipid metabolism, in influencing persistance of these viruses and the severity of the induced inflammation and fibrosis. These studies have led directly to two MRC EXperimental Medicine grants looking at the role of anticoagulants in slowing the rate of hepatic fibrosis in recurrent HCV infection after liver transplantation and one looking at the role of stains in modifying progression of chronic hepatitis C infection.
In addition the Section are studying novel nucleoside and nucleotide inhibitors of HBV infection and both protease and polymerase inhibitors in phase 2 and 3 protocols. Patients are invited to enter these studies which have substantially improved the overall repsonse rates of patients attending the Liver Centre.
Alcohol Induced and Non-alcohol Induced (type 2 diabetes and obesity related Steatohepatitis.
In collaboration with the MRC Mammalian Genetics at Harwell, the Section are using large scale ENU mutagenesis to identify genetic factors influencing susceptibility to alcohol and non-alcohol related steatohepatitis. Several genetic models of non alcohol related disease have been identified and similarities to human steatohepatitis shown by metabonomic and proteomic approaches.
We have also identified two genetically determined models of alcoholism and have gone on to show that the same genes are involved in some patients with alcoholism. These are currently being investigated to determine the mechanisms involved in addiction.
Primary liver cancer (hepatocellular cancer and cholangiocarcinoma).
Together with collaborators from West Africa and Egypt, there is an active hepatocellular carcinoma research programme looking at diagnostics and therapeutics in a resource-poor setting and also in the UK.The Section was the first to highlight the fact that mortality from cholangiocarciona was increasing ,both in the UK and worldwide. There is an active genetic, proteomic and metabonomic research grouping, which has strong links to the School of Public Health and The School of International Development at Imperial College London. There is a very strong imaging centre at Imperial College London and diagnostic and therapeutic approaches using laser-guidance and focused ultrasound are being developed, together with the Engineering Department at South Kensington Campus.
Members of the Section are involved with a spin-out company, Riotech Pharmaceuticals Ltd (Imperial based), which is developing novel approaches to the treatment of flaviviral diseases.
The members of the Section serve on several editorial boards and edit the Journal of Viral Hepatitis and the textbook Viral Hepatitis.
Gastroenterology supports one of the largest inflammatory bowel disease (IBD) clinics in London and through this conducts trials of biological therapies to aid in disease management. The investigators have an interest in the extra-intestinal manifestations of IBD. In addition there is a research programme on small bowel transporter systems.