Current research at the Institute of Hepatology builds on experience in developing and applying clinical hepatic magnetic resonance spectroscopy techniques in an imaging setting, for example in measuring hepatic lipid levels in chronic hepatitis C, as well as using NMR spectroscopy to develop clinical biomarkers.
1. Biomarkers of Liver Disease: My current research into liver damage is based on the assumption that the diseased liver will cause specific changes in the chemical composition of blood or urine. This is important as some stages of liver damage, for example during the development of fatty liver disease or the early indications of liver cancer, can be difficult to detect using routine clinical tests. I am particularly interested in using NMR spectroscopy techniques to provide a non-selective snapshot assessment of a range of metabolic processes. Such metabolic changes may provide earlier markers of disease than are currently available clinically.
2. A Urinary Fingerprint for Liver Cancer: A number of studies have shown an identifying urinary metabolic profile in liver cancer. Patient groups from Nigeria, Egypt and Bangladesh have been studied and the urine composition of patients with hepatocellular carcinoma (HCC) differed across a range of metabolites, consistent with the diverse effects of liver cancer on metabolic pathways and the interrelationship with the gut microbiome. A panel of metabolic markers might form the basis of a cost-effective HCC dipstick screening test and urinary NMR studies are being expanded to determine if this is possible.
3. The Role of Intestinal Microbiota: Information about the gut-liver-brain axis can be determined from the analysis of certain urinary metabolites which are related to gut microbial metabolism. Such an indirect urinary measurement of gut function is being used to assess the effects of new treatments.
4. Treatment of Cirrhosis: As the burden of liver disease continues to increase, both in the UK and world-wide, treatment options are being sought for patients with cirrhosis. Urinary metabolic profiling analyses are being incorporated into treatment studies to provide an additional measure of outcome.
Contact Dr Jane Cox: email@example.com
Professor Simon D Taylor-Robinson, Imperial College London, UK; Dr Jasmohan Bajaj, Virginia Commonwealth University, USA; Dr Mamun Al-Mahtab, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh; Professor Rajiv Jalan, UCL Institute for Liver and Digestive Health, London, UK
Urinary metabolic profiling by 1H NMR spectroscopy in patients with cirrhosis currently discriminates overt but not minimal hepatic encephalopathy. McPhail MJW, Montagnese S, Villanova M, El Hadi M, Amodio P, Crossey MME, Williams R, COX IJ, Taylor-Robinson SD. Metabolic Brain Disease 2017; 32: 331-341. DOI: 10.1007/s11011-016-9904-0.
Urinary proton NMR spectroscopy of a Bangladeshi cohort with hepatocellular carcinoma corroborates a urinary fingerprint for liver cancer. COX IJ, Aliev AE, Crossey MME, Dawood M, Al-Mahtab M, Akbar SMR, Rahman S, Williams R, Taylor-Robinson SD. World J Gastroenterol 2016; 22: 4191-4200. DOI: 10.3748/wjg.v22.i16.4191.
1H-NMR metabolic profiling of plasma reveals additional phenotypes in knockout mouse models. Probert F, Rice P, Scudamore CL, Wells S, Williams R, Hough TA, COX IJ. J. Proteome Res. 2015; 14: 2036-45. Epub 2015 Apr 7. DOI: 10.1021/pr501039k.
The role of intestinal microbiota in murine models of acetaminophen-induced hepatotoxicity. Possamai LA, McPhail MJW, Wu B, Concas D, Harrison M, Williams R, Cox RD, COX IJ, Anstee QM, Thursz MR. Liver Int. 2015; 35: 764-73.
Serum metabolic profiling in inflammatory bowel disease. Williams HRT, Willsmore JD, COX IJ, Walker DG, Taylor-Robinson SD, Orchard TR. Digest Disease Sci 2012; 57: 2157-65.
Urinary metabolic biomarkers of hepatocellular carcinoma in an Egyptian population. Shariff MIF, Gomaa AI, COX IJ, Patel M, Williams HRT, Crossey MME, Thillainayagam AVT, Thomas HC, Waked I, Khan SA, Taylor-Robinson SD. J Proteome Res 2011; 10:1828-36.