School of Medicine lends support to World Liver Day

Liver Specialists at Dundee, working with colleagues in the UK, US, Canada and Spain, have published a commentary on Resmetirom, the first licenced therapeutic for Metabolic dysfunction-associated steatohepatitis (MASH) liver disease in Nature Medicine. 

The commentary focuses on this novel drug and the public health strategies for treating patients with MASH, previously known as Non-alcoholic fatty liver disease (NAFLD) or Non-alcoholic steatohepatitis (NASH). It also sheds light on the challenges faced by health care systems, agencies and governmental bodies in tackling the disease. These include the need to ensure wide availability of the drug, combining treatment with non-pharmacological interventions, such as nutrition and exercise, and raising awareness of the treatment beyond gastroenterologists and hepatologists. It also highlights the need for an evolution in diagnosis of liver disease and destigmatisation.  

World Liver Day began as a national effort in India but has evolved into a global campaign to destigmatise and raise awareness about liver health, and the prevalence of liver diseases around the world. 

Thousands of people are diagnosed with liver disease every year, with more than 1.5 billion individuals living with chronic liver conditions. Two million lives are lost to liver conditions annually. 

The commentary published in Nature Medicine follows other significant work undertaken by the University’s School of Medicine and NHS Tayside to tackle liver diseases. 

In 2020, NHS Tayside announced that it was the first region in the world to eradicate Hepatitis C through a unique, geographically targeted ‘micro-elimination’ programme led by Professor John Dillon, Consultant Hepatologist and Gastroenterologist, at the School of Medicine. 

The programme focused on a series of initiatives to tackle the spread of Hepatitis C among injecting drug users through a programme which started with a single Dundee needle exchange project, before expanding to multiple research projects and a redesign of services. 

It is estimated that 50 million people in the world have chronic Hepatitis C with the vast majority remaining undiagnosed, so this programme is of huge significance in demonstrating pathways to improve identification and ultimately treatment of the condition. 

Other important initiatives led by Prof Dillon include his work on Intelligent Liver Function Testing (ILFT), an evolution of existing Liver Function Testing (LFT). 

Prof Dillon and Dr Ellie Dow, Consultant in Biochemical Medicine, worked with colleagues from the University of Dundee and NHS Tayside to implement an intelligent prediction algorithm which standardises the application and investigation of LFT results. By adding other data, including referral recommendations and management plans, iLFT provides highly cost-effective automated pathways for investigating abnormal liver function tests. 

Dr Paul Brennan, Clinical Lecturer in Hepatology at the School of Medicine, and senior author of the commentary in Nature Medicine, said early prevention can save countless lives, so raising awareness of the risks and preventative steps is crucial. 

Dr Brennan said, “The liver is a remarkable organ, which is vital for a healthy life. It performs more than 500 complex and vital functions, including filtering toxins, aiding in digestion, and supporting metabolism. 

“Its importance can be overlooked, so we need to raise awareness of the need for people to take steps to manage their health. These include always drinking alcohol in moderation if at all, adopting a healthy diet and taking regular exercise. 

“Liver diseases can go unnoticed and therefore the work being undertaken at the School of Medicine, in collaboration with global partners, is vital in supporting early and critical diagnosis. However, it is our hope that educating the global population about the need for a healthy lifestyle will play a major part in reducing liver diseases and deaths overall.” 

Find out more about how you can help support liver health at worldliverday.org and the British Liver Trust.