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SOX9 regulated matrix proteins are increased in patients serum and correlate with severity of liver fibrosis (2018)
Journal Article
Athwal, V. S., Pritchett, J., Martin, K., Llewellyn, J., Scott, J., Harvey, E., …Hanley, K. P. (2018). SOX9 regulated matrix proteins are increased in patients serum and correlate with severity of liver fibrosis. Scientific Reports, 8(1), Article 17905. https://doi.org/10.1038/s41598-018-36037-4

Extracellular matrix (ECM) deposition and resultant scar play a major role in the pathogenesis and progression of liver fibrosis. Identifying core regulators of ECM deposition may lead to urgently needed diagnostic and therapetic strategies for the d... Read More about SOX9 regulated matrix proteins are increased in patients serum and correlate with severity of liver fibrosis.

Short-term changes observed in multi-parametric liver MRI following therapy with direct acting antivirals in chronic hepatitis C virus patients (2018)
Journal Article
Bradley, C., Scott, R., Cox, E., Palaniyappan, N., Thompson, B., Ryder, D., …Francis, S. (2019). Short-term changes observed in multi-parametric liver MRI following therapy with direct acting antivirals in chronic hepatitis C virus patients. European Radiology, 29(6), 3100–3107. https://doi.org/10.1007/s00330-018-5788-1

Methods: We applied multiparametric MRI to assess changes in liver composition, perfusion and blood flow in 17 patients before DAA therapy and after treatment completion (within 12 weeks of last DAA tablet swallowed). Results: We observed changes in... Read More about Short-term changes observed in multi-parametric liver MRI following therapy with direct acting antivirals in chronic hepatitis C virus patients.

Time to endoscopy for acute upper gastrointestinal bleeding: results from a prospective multicentre trainee-led audit (2018)
Journal Article
Siau, K., Hodson, J., Ingram, R., Baxter, A., Widlak, M. M., Sharratt, C., …Major, G. (2018). Time to endoscopy for acute upper gastrointestinal bleeding: results from a prospective multicentre trainee-led audit. United European Gastroenterology Journal, https://doi.org/10.1177/2050640618811491

Background: Endoscopy within 24 hours of admission (early endoscopy) is a quality standard in acute upper gastrointestinal bleeding (AUGIB). We aimed to audit time to endoscopy outcomes and identify factors affecting delayed endoscopy (>24h of admiss... Read More about Time to endoscopy for acute upper gastrointestinal bleeding: results from a prospective multicentre trainee-led audit.

MRI assessment of altered dynamic changes in liver haemodynamics following a meal challenge in compensated cirrhosis (2018)
Journal Article
Cox, E. F., Palaniyappan, N., Aithal, G. P., Guha, I. N., & Francis, S. T. (2018). MRI assessment of altered dynamic changes in liver haemodynamics following a meal challenge in compensated cirrhosis. European Radiology Experimental, 2, Article 26. https://doi.org/10.1186/s41747-018-0056-3

Background: To use magnetic resonance imaging (MRI) to dynamically assess postprandial changes in hepatic and collateral blood flow, liver perfusion and oxygenation in healthy participants and patients with liver disease with compensated cirrhosis (C... Read More about MRI assessment of altered dynamic changes in liver haemodynamics following a meal challenge in compensated cirrhosis.

Using MRI to study the alterations in liver blood flow, perfusion and oxygenation in response to physiological stress challenges: meal, hyperoxia and hypercapnia (2018)
Journal Article
Cox, E. F., Palaniyappan, N., Aithal, G. P., Guha, I. N., & Francis, S. T. (in press). Using MRI to study the alterations in liver blood flow, perfusion and oxygenation in response to physiological stress challenges: meal, hyperoxia and hypercapnia. Journal of Magnetic Resonance Imaging, ISSN 1053-1807

Background: Non-invasive assessment of dynamic changes in liver blood flow, perfusion and oxygenation using magnetic resonance imaging (MRI) may allow detection of subtle haemodynamic alterations in cirrhosis. Purpose: To assess the feasibility of... Read More about Using MRI to study the alterations in liver blood flow, perfusion and oxygenation in response to physiological stress challenges: meal, hyperoxia and hypercapnia.

ADAPT: an algorithm incorporating PRO-C3 accurately identifies patients with NAFLD and advanced fibrosis (2018)
Journal Article
Daniels, S. J., Leeming, D. J., Eslam, M., Hashem, A. M., Nielsen, M. J., Krag, A., …George, J. (2019). ADAPT: an algorithm incorporating PRO-C3 accurately identifies patients with NAFLD and advanced fibrosis. Hepatology, 69(3), 1075-1086. https://doi.org/10.1002/hep.30163

Given the high global prevalence of nonalcoholic fatty liver disease (NAFLD), the need for relevant noninvasive biomarkers and algorithms to accurately stage disease severity is a critical unmet medical need. Identifying those with advanced fibrosis... Read More about ADAPT: an algorithm incorporating PRO-C3 accurately identifies patients with NAFLD and advanced fibrosis.

Multi-organ assessment of compensated cirrhosis patients using quantitative magnetic resonance imaging (2018)
Journal Article
Bradley, C. R., Cox, E. F., Scott, R. A., James, M. W., Kaye, P., Aithal, G. P., …Guha, I. N. (2018). Multi-organ assessment of compensated cirrhosis patients using quantitative magnetic resonance imaging. Journal of Hepatology, 69(5), 1015-1024. https://doi.org/10.1016/j.jhep.2018.05.037

© 2018 European Association for the Study of the Liver Background & Aims: Advancing liver disease results in deleterious changes in a number of critical organs. The ability to measure structure, blood flow and tissue perfusion within multiple organs... Read More about Multi-organ assessment of compensated cirrhosis patients using quantitative magnetic resonance imaging.

The XL probe: a luxury or a necessity? risk stratification in an obese community cohort using transient elastography (2018)
Journal Article
Harris, R., Card, T. R., Delahooke, T., Aithal, G. P., & Guha, I. N. (2018). The XL probe: a luxury or a necessity? risk stratification in an obese community cohort using transient elastography. United European Gastroenterology Journal, 6(9), 1372-1379. https://doi.org/10.1177/2050640618772944

Background: Transient elastography is a non-invasive tool which can stratify patients at risk of chronic liver disease. However, a raised body mass index has been independently associated with a failed or unreliable examination. Objective: The pur... Read More about The XL probe: a luxury or a necessity? risk stratification in an obese community cohort using transient elastography.

Analysis of genotyping for predicting liver injury marker, Procollagen III in persons at risk of non-alcoholic fatty liver disease (2018)
Journal Article
Grove, J. I., Thiagarajan, P., Astbury, S., Harris, R., Delahooke, T., Guha, I. N., & Aithal, G. P. (2018). Analysis of genotyping for predicting liver injury marker, Procollagen III in persons at risk of non-alcoholic fatty liver disease. Liver International, 38(10), 1832-1838. https://doi.org/10.1111/liv.13733

Background & Aims Chronic liver disease presents a major global public health challenge. Stratification of asymptomatic, at-risk patients in primary care using non-invasive methods has the potential to address this by identifying those likely to pr... Read More about Analysis of genotyping for predicting liver injury marker, Procollagen III in persons at risk of non-alcoholic fatty liver disease.

Hepatic elastin content is predictive of adverse outcome in advanced fibrotic liver disease (2018)
Journal Article
Kendall, T., Dolman, G., Duff, C., Paish, E. C., Zaitoun, A., Irving, W. L., …Guha, I. N. (2018). Hepatic elastin content is predictive of adverse outcome in advanced fibrotic liver disease. Histopathology, 73(1), 90-100. https://doi.org/10.1111/his.13499

Aims. Needle biopsy remains essential for diagnosis in assessment of liver disease, although there remains associated risk. Examination is largely limited to subjective evaluation and biopsies are not exploited to provide personalised prognostic info... Read More about Hepatic elastin content is predictive of adverse outcome in advanced fibrotic liver disease.

Obesity and type 2 diabetes are important risk factors underlying previously undiagnosed cirrhosis in general practice: a cross-sectional study using Transient Elastography (2017)
Journal Article
Harman, D. J., Ryder, S. D., James, M. W., Wilkes, E. A., Card, T. R., Aithal, G. P., & Guha, I. N. (2018). Obesity and type 2 diabetes are important risk factors underlying previously undiagnosed cirrhosis in general practice: a cross-sectional study using Transient Elastography. Alimentary Pharmacology and Therapeutics, 47(4), 504-515. https://doi.org/10.1111/apt.14463

Background: Rising cirrhosis incidence and mortality in the United Kingdom has been attributed predominantly to excess alcohol consumption. However, metabolic risk factors such as type 2 diabetes and obesity may also be important. Aim: To screen at-... Read More about Obesity and type 2 diabetes are important risk factors underlying previously undiagnosed cirrhosis in general practice: a cross-sectional study using Transient Elastography.

SOX9 predicts progression towards cirrhosis in patients while its loss protects against liver fibrosis (2017)
Journal Article
Athwal, V. S., Pritchett, J., Llewellyn, J., Martin, K., Camacho, E., Raza, S. M., …Hanley, K. P. (in press). SOX9 predicts progression towards cirrhosis in patients while its loss protects against liver fibrosis. EMBO Molecular Medicine, 9(12), https://doi.org/10.15252/emmm.201707860

Fibrosis and organ failure is a common endpoint for many chronic liver diseases. Much is known about the upstream inflammatory mechanisms provoking fibrosis and downstream potential for tissue remodeling. However, less is known about the transcriptio... Read More about SOX9 predicts progression towards cirrhosis in patients while its loss protects against liver fibrosis.

Economic evaluation of a community-based diagnostic pathway to stratify adults for non-alcoholic fatty liver disease: a Markov model informed by a feasibility study (2017)
Journal Article
Tanajewski, L., Harris, R., Harman, D. J., Aithal, G. P., Card, T. R., Gkountouras, G., …Elliott, R. (in press). Economic evaluation of a community-based diagnostic pathway to stratify adults for non-alcoholic fatty liver disease: a Markov model informed by a feasibility study. BMJ Open, 7(6), https://doi.org/10.1136/bmjopen-2016-015659

Objectives: To assess the long-term cost-effectiveness of a risk stratification pathway, compared with standard care, for detecting non-alcoholic fatty liver disease (NAFLD) in primary care. Setting: Primary care general practices in England. P... Read More about Economic evaluation of a community-based diagnostic pathway to stratify adults for non-alcoholic fatty liver disease: a Markov model informed by a feasibility study.

Prevalence of clinically significant liver disease within the general population, as defined by non-invasive markers of liver fibrosis: a systematic review (2017)
Journal Article
Harris, R., Harman, D. J., Card, T. R., Aithal, G. P., & Guha, I. N. (2017). Prevalence of clinically significant liver disease within the general population, as defined by non-invasive markers of liver fibrosis: a systematic review. The Lancet Gastroenterology & Hepatology, 2(4), 288-297. https://doi.org/10.1016/S2468-1253%2816%2930205-9

As of 2016, there is no evidence-based pathway to stratify the risk of chronic liver disease in a general population setting. Non-invasive tests of liver fibrosis might provide a mechanism for earlier diagnosis. These tests have been extensively vali... Read More about Prevalence of clinically significant liver disease within the general population, as defined by non-invasive markers of liver fibrosis: a systematic review.

Non-invasive assessment of portal hypertension using quantitative magnetic resonance imaging (2016)
Journal Article
Palaniyappan, N., Cox, E., Bradley, C., Scott, R., Austin, A., O’Neill, R., …Aithal, G. P. (2016). Non-invasive assessment of portal hypertension using quantitative magnetic resonance imaging. Journal of Hepatology, 65(6), 1131-1139. https://doi.org/10.1016/j.jhep.2016.07.021

Background & Aims Hepatic venous pressure gradient (HVPG) measurement is currently the only validated technique to accurately evaluate changes in portal pressure. In this study, we evaluate the use of non-contrast quantitative magnetic resonance i... Read More about Non-invasive assessment of portal hypertension using quantitative magnetic resonance imaging.

Direct targeting of risk factors significantly increases the detection of liver cirrhosis in primary care: a cross-sectional diagnostic study utilising transient elastography (2015)
Journal Article
Harman, D. J., Ryder, S. D., James, M. W., Jelpke, M., Ottey, D. S., Wilkes, E. A., …Guha, I. N. (2015). Direct targeting of risk factors significantly increases the detection of liver cirrhosis in primary care: a cross-sectional diagnostic study utilising transient elastography. BMJ Open, 5(4), Article e007516. https://doi.org/10.1136/bmjopen-2014-007516

OBJECTIVES: To assess the feasibility of a novel diagnostic algorithm targeting patients with risk factors for chronic liver disease in a community setting. DESIGN: Prospective cross-sectional study. SETTING: Two primary care practices (adult... Read More about Direct targeting of risk factors significantly increases the detection of liver cirrhosis in primary care: a cross-sectional diagnostic study utilising transient elastography.

A study of T1 relaxation time as a measure of liver fibrosis and the influence of confounding histological factors (2015)
Journal Article
Hoad, C. L., Palaniyappan, N., Kaye, P., Chernova, Y., James, M. W., Costigan, C., …Aithal, G. P. (2015). A study of T1 relaxation time as a measure of liver fibrosis and the influence of confounding histological factors. NMR in Biomedicine, 28(6), 706-714. https://doi.org/10.1002/nbm.3299

Liver biopsy is the standard test for the assessment of fibrosis in liver tissue of patients with chronic liver disease. Recent studies have used a non‐invasive measure of T1 relaxation time to estimate the degree of fibrosis in a single slice of the... Read More about A study of T1 relaxation time as a measure of liver fibrosis and the influence of confounding histological factors.

?-Glutamyltransferase, but not markers of hepatic fibrosis, is associated with cardiovascular disease in older people with type 2 diabetes mellitus: the Edinburgh Type 2 Diabetes Study (2015)
Journal Article
Morling, J. R., Fallowfield, J. A., Williamson, R. M., Robertson, C. M., Glancy, S., Guha, I. N., …Price, J. F. (2015). γ-Glutamyltransferase, but not markers of hepatic fibrosis, is associated with cardiovascular disease in older people with type 2 diabetes mellitus: the Edinburgh Type 2 Diabetes Study. Diabetologia, 58(7), 1484-1493. https://doi.org/10.1007/s00125-015-3575-y

© 2015, The Author(s). Aims/hypothesis: We examined the association of prevalent and incident cardiovascular disease (CVD) with chronic liver disease in a cohort of community-based people with type 2 diabetes, in order to clarify the relationship bet... Read More about ?-Glutamyltransferase, but not markers of hepatic fibrosis, is associated with cardiovascular disease in older people with type 2 diabetes mellitus: the Edinburgh Type 2 Diabetes Study.

Multiplex protein analysis to determine fibrosis stage and progression in patients with chronic hepatitis C. (2014)
Journal Article
Patel, K., Remlinger, K. S., Walker, T. G., Leitner, P., Lucas, J. E., Gardner, S. D., …Guha, I. N. (2014). Multiplex protein analysis to determine fibrosis stage and progression in patients with chronic hepatitis C. Clinical Gastroenterology and Hepatology, 12(12), 2113-2120.e3. https://doi.org/10.1016/j.cgh.2014.04.037

Background & Aims: Noninvasive tests cannot differentiate between adjacent stages of fibrosis, which limits assessment of disease progression and regression during therapy. We investigated whether levels of cytokines and extracellular matrix proteins... Read More about Multiplex protein analysis to determine fibrosis stage and progression in patients with chronic hepatitis C..