Liver Disease is the one chronic disorder that's increasing in frequency with a steady rise in deaths each year.

Professor Roger Williams CBE

Dr I. Jane Cox PhD, FRCP Hon

Principal Investigator

Head of the Metabonomics Group

Researching biomarkers of liver damage using metabolic profiling of urine, blood, and intact liver tissue. 

The aim is to provide earlier markers of liver disease before symptoms are obvious clinically, for example the early indications of liver cancer.

Visiting Scientist,
The Francis Crick Institute, London

Contact Dr I. Jane Cox:

Twitter: @IJCox_NMR

Pioneers, innovators and advocates recognised with RCP honorary fellowships RCP London


Dr Cox is particularly interested in using NMR spectroscopy techniques to provide a non-selective snapshot of a range of metabolic processes. These studies can also be used to document liver disease progression, including the impact of the microbiome in patients with cirrhosis. 


  1. Magic angle spinning NMR studies of intact liver tissue (for example, DOI: 10.1016/j.jhep.2009.10.006) to document metabolite differences between liver tissue from hepatocellular carcinoma (HCC) and surrounding liver tissue, obtained at the time of liver resection, and to correlate metabolite changes with clinical and laboratory immunological findings. Collaboration with Drs Shilpa Chokshi & Antonio Riva.
  2. To investigate how dietary changes can modulate gut microbiota and interact with cirrhosis. Our aim is to define gut microbial functional and metabolomic changes to understand disease processes and to increase insight into the impact of dietary intervention in patients with liver disease. For example, DOI: 10.1111/liv.15329.
  3. In collaboration with Dr Neil Youngson and Professor Luca Valenti, we investigated the role of the gut in affected COVID-19 patients, grouped according to mild and moderately severe disease. We propose that the reduced circulating FABP2 in moderate to severe COVID-19 is a marker of infected enterocyte functional change rather than gut damage, which could also contribute to the development of hypolipidemia in patients with more severe disease. doi: 10.1038/s41598-022-23282-x

Institute collaborations:

  1. Dr Vishal Patel. Urinary metabolic profiling to investigate the gut liver axis in patients with chronic liver disease.
  2. Dr Anna Hadjichambi. NMR of lipid and aqueous tissue extracts for the study ‘Partial MCT1 invalidation protects against diet-induced non-alcoholic fatty liver disease and the associated brain dysfunction’. DOI: 10.1016/j.jhep.2022.08.008
  3. Dr Luca Urbani. NMR of supernatants from bioreactor and static cell cultures for the study ‘Three-dimensional conditions in a perfusion bioreactor to support maturation of human amnion epithelial stem cells into functional hepatocyte-like cells’. DOI:

External Collaborations: 

Professor Sasi Conte, Drs James Jarvis & Adrien Le Guennec, King’s College London, UK;
Drs Geoff Kelly & Alain Oregioni, The Francis Crick Institute, London, UK;
Professor Jasmohan Bajaj, Virginia Commonwealth University, USA;
Professor Ramazan Idilman, University of Ankara, Turkey;
Professor Aldo Torre, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico;
Dr Marcela Peña Rodríguez, Laboratory for the Diagnosis of Emerging and Reemerging Diseases (LaDEER), University Center for Health Sciences, University of Guadalajara, Mexico;
Professor Luca Valenti, Fondazione IRCSS Ca’ Granda Ospedale Maggiore Policlinico, Milano, Italy;
Dr Mamun Al-Mahtab, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh;
Professor Rajiv Jalan & Dr Jane McNaugthan, UCL Institute for Liver and Digestive Health, London, UK;
Professor Simon D Taylor-Robinson, Emeritus, Imperial College London, UK.

Key publications:

Is reduced circulating FABP2 a biomarker of enterocyte functional change rather than cell death in patients with severe COVID-19? Assante G, Tourna A, Carpani R, Ferrari F, Prati D, Peyvandi F, Blasi F, Bandera A, Le Guennec A, Chokshi S, Patel VC, COX IJ*, Valenti L*, Youngson NA*. Sci Rep. 2022 Nov 5;12(1):18792. doi: 10.1038/s41598-022-23282-x.

Stool microbiota, compared to salivary microbiota, show more extensive correlations with plasma metabolites in decompensated cirrhosis in a multinational cirrhosis cohort. COX IJ, Peña Rodríguez M, Fagan A, Rojas-Lara MV, Le Guennec A, Rodriguez-Alvarez F, McGeorge S, Escalona-Nandez I, Torre A, Bajaj JS. Liver Int. Liver International. 2022;42:2274–2282.

Pro-arrhythmic effects of elevated branched chain amino acid levels. Portero V, Nicol T, Podliesna S, Marchal GA, Baartscheer A, Casini S, Tadros R, Treur JL, Tanck MWT, COX IJ, Probert F, Hough TA, Falcone S, Beekman L, Müller-Nurasyid M, Kastenmüller G, Gieger C, Peters A, Kääb S, Sinner MF, Blease A, Verkerk AO, Bezzina CR, Potter PK, Remme CA. Cardiovasc Res. 2022;118: 1742–1757. doi: 10.1093/cvr/cvab207.

Metabolomics and microbial composition increase insight into the impact of dietary differences in cirrhosis. COX IJ, Idilman R, Fagan A, Turan D, Ajayi L, Le Guennec A, Taylor-Robinson SD, Karakaya F, Gavis EA, Atkinson RA, Williams R, Sikaroodi M, Nizam S, Gillevet PM, Bajaj JS. Liver International 2020; 40: 416–42. Epub Sep 23 2019. doi: 10.1111/liv.14256.

Fecal microbiota transplant from a rational stool donor improves hepatic encephalopathy: A randomized clinical trial. Bajaj JS, Kassam Z, Fagan A, Gavis EA, Liu E, COX IJ, Kheradman R, Heuman D, Wang J, Gurry T, Williams R, Sikaroodi M, Fuchs M, Alm E, John B, Thacker LR, Riva A, Smith M, Taylor-Robinson SD, Gillevet P. Hepatology 2017; 66: 1727-1738. DOI: 10.1002/hep.29306. Epub 6 Jun 2017. #Top20Article Downloaded Article 2017-18.

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.


PhD (Chemistry, University of East Anglia, Norwich, UK);

BA Natural Sciences (Chemistry, University of Cambridge, Cambridge, UK).


The Foundation runs on donations. Every little helps us continue our work.

Donate now

One In Ten

1 in 10 people will experience problems with their liver at some point in their life. Help us FIGHT liver disease.
Donate now
We are a member of the Association of Medical Research Charities (AMRC). All AMRC members support the AMRC position statement on the use of animals in research.