Identification Of The Mechanisms Of Hepatic Fibrogenesis Aid In The Detection And Prediction Of Clinical Outcomes In Paediatric Cholestatic Liver Disease.
Funder
National Health and Medical Research Council
Funding Amount
$624,429.00
Summary
Biliary Atresia (BA) and Cystic Fibrosis Liver Disease (CFLD) are important causes of childhood cirrhosis. Diagnosis is difficult, treatments problematic, and outcomes suboptimal. In BA, bile duct obstruction in infants rapidly progresses to liver failure. It is the most common indication for liver transplantation in children. CFLD causes significant morbidity/mortality in about 20% of CF children. This proposal investigates the mechanisms of liver fibrosis (scarring) and the role of fibrosis in ....Biliary Atresia (BA) and Cystic Fibrosis Liver Disease (CFLD) are important causes of childhood cirrhosis. Diagnosis is difficult, treatments problematic, and outcomes suboptimal. In BA, bile duct obstruction in infants rapidly progresses to liver failure. It is the most common indication for liver transplantation in children. CFLD causes significant morbidity/mortality in about 20% of CF children. This proposal investigates the mechanisms of liver fibrosis (scarring) and the role of fibrosis in both diagnosis and predicting clinical outcome.Read moreRead less
Investigation Of The Role Of The Renin-Angiotensin System In Hepatic Fibrosis.
Funder
National Health and Medical Research Council
Funding Amount
$246,990.00
Summary
Hepatic fibrosis is a common response to chronic liver injury, during which the normal liver architecture is distorted by scar tissue. Hepatic fibrosis can lead to cirrhosis and liver transplantation may be required for patients with liver failure and hepatocellular carcinoma. The chronic liver injury may result from a number of causes including alcohol, persistent viral infections and metabolic disorders. The mechanisms causing fibrosis in liver are similar to those causing fibrosis in other or ....Hepatic fibrosis is a common response to chronic liver injury, during which the normal liver architecture is distorted by scar tissue. Hepatic fibrosis can lead to cirrhosis and liver transplantation may be required for patients with liver failure and hepatocellular carcinoma. The chronic liver injury may result from a number of causes including alcohol, persistent viral infections and metabolic disorders. The mechanisms causing fibrosis in liver are similar to those causing fibrosis in other organs such as kidney and heart. In those organs, the renin-angiotensin system has been shown to contribute to the progression of fibrosis. This system has not been investigated in hepatic fibrosis. We have recently shown in patients with chronic hepatitis C (HCV), that those patients who are genetically pre-disposed to produce higher levels of angiotensin have more liver fibrosis. This application will investigate the role of the renin-angiotensin system in hepatic fibrosis and whether using currently available drugs to inhibit this system can decrease the rate of progression of fibrosis in liver. Liver failure due to chronic HCV infection is currently the leading indication for liver transplantation in Australia. For those patients who fail to respond to anti-viral therapy, there are currently no approved therapeutic options designed to delay or reverse the progression of fibrosis. Based on current known numbers of HCV patients it has been estimated that by the year 2020, over 2000 HCV patients will require a liver transplant each year in Queensland alone. Currently the number of donor livers available allows about 50 transplants per year. Thus there is a desperate need for therapeutic treatments that will delay or reverse the progression of hepatic fibrosis. A successful conclusion to this study will provide a clinically useful treatment strategy that can delay the progression of hepatic fibrosis and thus prevent the need for liver transplantation in many patients.Read moreRead less
Mechanisms Of Hepatic Fibrogenesis In Chronic Liver Disease
Funder
National Health and Medical Research Council
Funding Amount
$697,209.00
Summary
Despite advances made in understanding the mechanisms of liver injury, chronic liver disease continues to be one of the most rapidly growing causes of death in subjects aged <65 years. This is the result of uncontrolled wound healing and regeneration leading ultimately to cirrhosis and liver cancer. This research will identify and characterise pathways that control the wound healing response to liver injury, involving the processes of inflammation, scarring and restitution of normal liver mas ....Despite advances made in understanding the mechanisms of liver injury, chronic liver disease continues to be one of the most rapidly growing causes of death in subjects aged <65 years. This is the result of uncontrolled wound healing and regeneration leading ultimately to cirrhosis and liver cancer. This research will identify and characterise pathways that control the wound healing response to liver injury, involving the processes of inflammation, scarring and restitution of normal liver mass.Read moreRead less
Hepatic Fibrogenesis In Paediatric Cholestatic Liver Disease.
Funder
National Health and Medical Research Council
Funding Amount
$254,250.00
Summary
Liver disease in children causes a significant impact on lifespan and quality of life. The commonest causes of liver disease in children are cholestatic, or diseases related to obstruction of bile flow out of the liver. In ways we are only beginning to understand, obstruction of bile flow stimulates liver scar formation which, if untreated, leads to replacement of normal liver tissue and ultimately to failure of the liver. In infants, the most common and serious cholestatic liver disease is bili ....Liver disease in children causes a significant impact on lifespan and quality of life. The commonest causes of liver disease in children are cholestatic, or diseases related to obstruction of bile flow out of the liver. In ways we are only beginning to understand, obstruction of bile flow stimulates liver scar formation which, if untreated, leads to replacement of normal liver tissue and ultimately to failure of the liver. In infants, the most common and serious cholestatic liver disease is biliary atresia. It develops at, or shortly after birth with progressive destruction of the bile ducts, responsible for transporting bile out of the liver. Without early diagnosis and surgery these infants develop progressive liver scarring leading to liver failure and death or liver transplantation within 1-2 years. It is the commonest reason for liver transplantation in children (55-60%) in the Western world. Even with successful surgery, most, if not all patients will come to liver transplantation over the subsequent 25 years because of ongoing, but slower, scar formation. In older children, diseases like cystic fibrosis cause bile duct blockages leading to progressive liver scarring that is slower and unpredictable, contributing to ill health in up to 20% of patients and death from end stage liver disease or liver transplantation in 5%. Using liver tissue from children with these two disorders we have been able to identify the key cells that control the liver scar process, the Hepatic Stellate Cell. We now need to investigate the role of bile constituents on the scar-forming process in these two diseases. We will utilise a well characterised animal model to investigate the influence of bile constituents on cells isolated from this model and apply these findings back to patient samples to determine their role in paediatric cholestatic liver disease. This will help us to better understand the disease process and importantly, develop more effective and earlier treatment.Read moreRead less
MERTK Receptor Tyrosine Kinase: A Novel Therapeutic Target For Liver Fibrosis
Funder
National Health and Medical Research Council
Funding Amount
$870,972.00
Summary
Hepatic fibrosis is the principal cause of liver-related morbidity and mortality, for which there are no effective therapies. Thus, there is an urgent and unmet need to identify new targets to treat liver fibrosis. We have demonstrated for the first time, that liver fibrosis correlates with elevated hepatic expression of MERTK, a receptor tyrosine kinase. This project will explore whether MERTK function can be exploited to target and reverse liver fibrosis
The sphincter of Oddi is a valve-like structure, which regulates the flow of bile and pancreatic juice into the gut. The sphincter of Oddi is under complex control involving nerves and hormones. We know that abnormal sphincter of Oddi function (sphincter of Oddi dysfunction) is associated with a number of human diseases including acute pancreatitis. We are able to recognise abnormal sphincter activity, but we do not know what causes it. One possible reason may be that the nerves going to the sph ....The sphincter of Oddi is a valve-like structure, which regulates the flow of bile and pancreatic juice into the gut. The sphincter of Oddi is under complex control involving nerves and hormones. We know that abnormal sphincter of Oddi function (sphincter of Oddi dysfunction) is associated with a number of human diseases including acute pancreatitis. We are able to recognise abnormal sphincter activity, but we do not know what causes it. One possible reason may be that the nerves going to the sphincter along the bile duct (which carries bile from the liver and gallbladder) may be damaged due to the passage of gallstones or during surgery on the bile ducts or gallbladder. We know that the main bile duct is able to sense pressure changes within and communicate this information (via nerves) to the sphincter which inturn alters its activity to relieve the pressure. Where these nerves are located and the chemical messages they use, are unknown. The aim of this project is to gain some of this information. This knowledge may allow us to design different surgical procedures or develop drugs to prevent or manage the abnormal sphincter of Oddi.Read moreRead less