Chronic liver diseases: molecular mechanisms and clinical consequences

Problem

Cirrhosis is a common disease with high morbidity and mortality rates. The only definitive treatment is a liver transplant. The disease evolves from a compensated phase, in which the patient shows no symptoms and presents a good prognosis, to patients who present complications and a worse outcome. Multiorgan failure with a high mortality rate may also occur in certain patients.

It is therefore very important to research the pathophysiological mechanisms that explain the disease’s progression in order to find therapeutic targets and stop its course.

Approach

The group researches the pathophysiologic mechanisms that explain the disease’s progression. It starts with the intestinal microbiome and analyses the hepatic transcriptome and systemic and hepatic inflammation. It studies different biomarkers to determine the prognosis of patients with cirrhosis and its complications, such as renal failure. It trials new treatments, such as albumin, for patients with complications of cirrhosis and conducts therapeutic studies to try to prevent the progression of the disease.

Impact

Patients with cirrhosis present an abnormal intestinal microbiome and hepatic transcriptome, with increased expression of proinflammatory genes and increased systemic inflammation.

In one of the projects, the patients receive anti-inflammatory treatment (statins) and treatment for the microbiome (rifaximin) and the number of complications these patients present is expected to decline, along with the incidence of acute versus chronic liver failure. Furthermore, using liver elastography, the group identifies patients at early stages of the disease in order to provide them with early treatment.