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Cirrhosis & the Gut–Liver–Brain Axis
Liver disease deaths have soared more than 400% in the past 50 years. At the heart of that rise is cirrhosis – the final stage of chronic liver injury, and one of the hardest to treat.
Once cirrhosis develops, the liver’s function becomes severely impaired. Patients face life-threatening complications like internal bleeding, infections, cognitive decline and ultimately, multi-organ failure.
But a major shift is underway in how scientists understand these complications – and how we might treat them.
Instead of looking at the liver in isolation, we’re now exploring a powerful, interconnected network: the gut–liver–brain–immune axis. This complex system appears to drive much of the inflammation, immune dysfunction and cognitive impairment seen in advanced liver disease.
It’s opening up a whole new world of therapeutic possibilities. And at the forefront, our researchers are:
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Studying the immune, microbial and neurological triggers of organ failure
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Mapping how signals between the gut, liver and brain contribute to decompensation
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Identifying early biomarkers that predict who’s most at risk
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Testing new ways to strengthen resilience in patients with cirrhosis
From experimental medicine studies to international trial platforms, we’re integrating discovery science with real-world clinical data to accelerate the development of smarter, more personalised treatments.
Our ultimate goal? To change the trajectory of cirrhosis – by intervening earlier, preventing decline and giving patients with end-stage liver disease a better chance of survival and a better quality of life.
The gut-liver-brain axis is one of the most futuristic and promising areas of liver research today – and we’re proud to be leading on it.
Theme Leads
Dr Anna Hadjihambi
Principal Investigator
Honorary Lecturer - King's College London
Dr Vishal C Patel
Principal Investigator & Adjunct Reader in Hepatology - King's College London
Consultant Hepatologist & Endoscopist - King's College Hospital NHS Foundation Trust