Improved diagnosis of liver disease

24 September 2019
Background
Chronic liver disease is a major cause of morbidity and mortality worldwide, with increasing prevalence. In
terms of total years of life lost, it is now the thirteenth most burdensome disease overall and the fifth leading
cause of death in the young adult age group of 25 – 50 years. In Europe, liver disease causes 2% of all deaths.
The main culprits are alcohol abuse, and, rapidly increasing, nonalcoholic fatty liver disease (NAFLD) that
is associated with diabetes and obesity. All of these lead to hepatocyte cell death and chronic liver inflammation, often triggering liver fibrosis and progressive loss of functional liver architecture. In the cirrhosis stage of the disease, the risk of liver cancer increases up to 40-fold. Furthermore, progressive cirrhosis leads to complications that eventually require liver transplantation.

Preventive approaches to date are difficult to comply with. Without improved diagnostics, the  osteffectiveness of interventions using existing and emerging pharmacological and surgical treatments will
remain suboptimal.

Goals
The main diagnostic challenges that drive the hepatology biomarker project, are:
- biomarker-based detection of nonalcoholicsteatohepatitis (NASH) and the activity of the pathogenic processes in NASH in patients with steatosis, to guide treatment decisions and monitor the outcome of treatment.
- increase the proportion of hepatocellular carcinomas that are detected at an early stage, to enable curative
treatment in a higher proportion of patients. 
- avoiding transplantation of livers that will lead to catastrophic Primary Non-Function (failure of the donor liver to function after transplantation).

This VIB-GCP collaboration guarantees the further translation of established glycomics-based candidate
biomarkers for the three diagnostic challenges listed above. These can go straight into validation studies and alpha site usage along current clinical practice to start yielding benefit for the patients in our university hospitals. On top of that, the core analytical technologies proposed are all ready to go to clinical validation or exploration after these years of prior technology development.

The team will also develop new biomarkers with clinical proof of concept. These biomarkers will be clinically validated and provide a solid foundation for rapid further development and implementation in clinical practice.

Partners
The VIB Center for Medical Biotechnology, directed by Nico Callewaert, coordinates the project and serves as
the home base for the team that develops and performs the wet lab analytics as well as the data warehousing
and data analysis.

This VIB center has joined forces with expert hepatologists from the three leading university hospital hepatology and transplantation centers in Flanders: UZ Gent (Hans Van Vlierberghe, Xavier Verhelst), UZA (Sven Francque), UZ Leuven (David Cassiman). Finally, three VIB core facilities are involved: the Proteomics Core, the Metabolomics Core and the Nucleomics Core partners.

As involved researcher, this project allows me to close the gap between research and healthcare, something
I consider to be very important in pursuing research beneficial to patients,” says Leander Meuris, (VIB-UGent Center for Medical Biotechnology).

Societal impact
This project will draw attention to chronic liver diseases as a prevalent and ‘invisible’ scourge of 21st century
healthcare with a huge impact on patient lives, healthcare systems, and clinical developments. As part
of this project, multiple stakeholders will be involved in empowering patients to make the case for prioritization of research into chronic liver failure and potential new diagnostics and treatment options.

Go back to the overview: 'the Grand Challenges Program'​

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