Birmingham study explores potential target to treat liver disease

The research focused on a protein involved in liver inflammation and fibrosis.

Liver 3D model in the foreground, with a doctor speaking to a patient holding their painful stomach in the background

A clinical trial led by Birmingham researchers investigated targeting a molecule causing liver inflammation and fibrosis to treat patients with Primary sclerosing cholangitis (PSC) – a debilitating liver disease for which there is currently no treatment.

The findings, published in Hepatology Communications, highlight how the therapeutic agent timolumab was able to safely block the molecule of interest, a vascular adhesion protein called VAP-1, without causing significant adverse effects. However, it did not produce significant change in the levels of alkaline phosphatase (ALP), an enzyme associated with liver disease, which meant the trial was stopped due to lack of treatment efficacy.

Our findings may well help guide other studies using monotherapy or combined therapy with VAP-1, both in the liver and in other sites of inflammation and fibrosis.

Dr Chris Weston, University of Birmingham

Nevertheless, researchers remain hopeful about the potential of VAP-1 as a target in inflammatory diseases – also thanks to the breadth of previous evidence gained in previous studies led by Professor David Adams at the University of Birmingham – and believe these findings may help guide future research focusing on this protein.

Dr Chris Weston, Associate Professor at the University of Birmingham’s Institute of Immunology and Immunotherapy, member of the NIHR Birmingham Biomedical Research Centre’s Inflammatory Liver Disease theme, and co-author of the study said: “We believe that VAP-1 remains a viable target in inflammatory and fibrotic disease given the wealth of evidence in other preclinical models, and the use of small molecule inhibitors of VAP-1 that have been developed may provide an alternative means to target VAP-1. Our findings may well help guide other studies using monotherapy or combined therapy with VAP-1, both in the liver and in other sites of inflammation and fibrosis.”

Lead Clinical Investigator for the trial Professor Gideon Hirschfield, Chair in Autoimmune Liver Disease Research at the Toronto Centre for Liver Disease and Honorary Professor at the University of Birmingham, added: “Primary sclerosing cholangitis can be a very debilitating chronic disease, which most often affects people of working age. It is key that we continue to investigate this condition, its causes and potential avenues for treatment, to find effective ways to improve the lives of patients in the UK and across the globe.”

Primary sclerosing cholangitis (PSC) is a progressive inflammatory liver disease where the body’s immune attacks its own liver. It affects people of all ages, frequently in association with inflammatory bowel disease (IBD).

The BUTEO trial was sponsored by the University of Birmingham and run by the Birmingham Cancer Research UK Clinical Trials unit, with patients recruited from six hospitals in the UK. The project was funded by the NIHR Efficacy and Mechanism Evaluation Scheme in partnership with Biotie Therapies (now a part of Acorda Therapeutics).

Notes for editors

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The University of Birmingham is ranked amongst the world’s top 100 institutions. Its work brings people from across the world to Birmingham, including researchers, teachers and more than 8,000 international students from over 150 countries.

The University of Birmingham is a founding member of Birmingham Health Partners (BHP), a strategic alliance which transcends organisational boundaries to rapidly translate healthcare research findings into new diagnostics, drugs and devices for patients. Birmingham Health Partners is a strategic alliance between seven organisations who collaborate to bring healthcare innovations through to clinical application:

  • University of Birmingham
  • University Hospitals Birmingham NHS Foundation Trust
  • Birmingham Women’s and Children’s Hospitals NHS Foundation Trust
  • Aston University
  • The Royal Orthopaedic Hospital NHS Foundation Trust
  • Sandwell and West Birmingham Hospitals NHS Trust
  • West Midlands Academic Health Science Network
  • Birmingham and Solihull Mental Health NHS Foundation Trust

About the National Institute for Health and Care Research

The mission of the National Institute for Health and Care Research (NIHR) is to improve the health and wealth of the nation through research. We do this by:

  • Funding high quality, timely research that benefits the NHS, public health and social care;
  • Investing in world-class expertise, facilities and a skilled delivery workforce to translate discoveries into improved treatments and services;
  • Partnering with patients, service users, carers and communities, improving the relevance, quality and impact of our research;
  • Attracting, training and supporting the best researchers to tackle complex health and social care challenges;
  • Collaborating with other public funders, charities and industry to help shape a cohesive and globally competitive research system;
  • Funding applied global health research and training to meet the needs of the poorest people in low and middle income countries.

NIHR is funded by the Department of Health and Social Care. Its work in low and middle income countries is principally funded through UK Aid from the UK government.

The NIHR Birmingham Biomedical Research Centre translates new scientific discoveries into treatments and diagnostics to improve people’s health. We focus on inflammation and the diagnosis, prevention and treatment of its associated long-term diseases. We are part of the NIHR and hosted by University Hospitals Birmingham NHS Foundation Trust in partnership with the University of Birmingham.