Liver
Research Unit:
The Liver Research Unit was established in 1978 by Professor T.
W.Warnes to carry out research in liver disease and to provide specialist
biochemical services not normally available within the routine Biochemistryservice.
The Unit has developed expertise in a number of fields:
Assessment of partial hepatic functions using
dynamictests
These include the galactose elimination capacity and bromosulphophthalein
elimination test. These are used to accurately assess residual liver
function and are of particular value in assessing prognosis, assessing
function prior to liver transplantation and determining response
to treatment during clinical trials of new drugs.
Non-invasive assessment of hepatic fibrosis
The Unit has pioneered the use of serum assays to assess the activity
of hepatic fibrogenesis (deposition of new scar tissue) within the
liver. This can be used in place of liver biopsy which has a significant
morbidity and mortality. The assay which has proved to be of most
valuein research and routine use is for Type III Procollagen
Peptide (P3NP)and this has now been established as a routine referral
service both within the North West region and for centres throughout
the UK. A poster describing the use of this assayin psoriatic patients
receiving methotrexate was awarded the “Best in Trust Award” for
1998 at the Trust Research Exhibition. this work has led tochanges
in the UK Guidelines for the use of Methotrexate in psoriasis.
Serum isoenzyme markers of hepatocellular carcinoma
(HCC)
The Unit has developed the use of HCC specific isoenzyme markers
of alkaline phosphatase and gamma glutamyl transpeptidase in the
early detection of primary liver cancer. These isoenzymes are used
in conjunction with the more generally available techniques of hepatic
ultrasound and alphafoetoprotein (AFP) determination. We have established
that these assayscan improve the sensitivity of detection in high
risk groups, particularly in subgroups of patients where AFP is
of less value.
Oxidant stress in liver disease
Oxidant stress occurs when oxidative processes leading to the generation
of highly reactive free radicals exceed the anti-oxidant capacity
of the body. This process, leading to organ damage has been recognised
for some time in other disease processes but until recently, has
not been widely investigated in liver disease especially in a clinical
setting.
We have established a range of assays designed to measure the activity
of both pro and anti-oxidant processes to allow us to develop an
accurate picture of the degree and pattern of oxidant stress in
different liver conditions. The effect of the administration of
anti-oxidant supplements in a clinical trial of interferon in hepatitis
C is also generating interesting data.
Clinical trials
The Research Unit supports the Clinical Liver Unit in the conduct
of clinical trials in liver disease. Currently these include trials
of the following:
1 The nucleoside analogue lamivudine in chronic hepatitis B (International).
2 The nucleoside analogue adefovir dipivoxil in chronic hepatitis
B (International).
3 Interferon and ribavirin in mild hepatitis C (UK multi centre
trial)
4 Interferon and antioxidants in chronic hepatitis C (Local study)
5 Maxamine (histamine) and interferon in chronic hepatitis C (International).
6 Colchicine and ursodeoxycholic acid in primary biliary cirrhosis
(Local study).
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