Professor Guruprasad Aithal

Professor Guruprasad Aithal

Queens Medical Centre Campus, Derby Road, Nottingham, NG7 2UH

+44 115 746 5124 View full bio
GI & Liver Disorders Theme Lead
Professor of Hepatology, Head of Nottingham Digestive Diseases Centre

Biography

Professor Guruprasad P. Aithal is the Professor of Hepatology and the Head of the Division for the Nottingham Digestive Diseases Centre and Deputy Director of Nottingham Molecular Pathology Node.

Professor Aithal is the GI & Liver Disorder Theme Lead at the NIHR Nottingham Biomedical Research Centre, and was the Director of NIHR Nottingham Digestive Diseases BRU between 2008 & 2016.

He won the NHS Innovation Award (2013), Shire Award for Gastrointestinal Excellence (2015) and was BMJ Gastroenterology team finalist (2015).

Professor Aithal’s research interests include drug-induced liver injury, metabolic liver disease, hepatopancreaticobiliary imaging and epidemiology of liver and biliary disorders.

His landmark study on warfarin pharmacogenetics (Lancet 1999) catalysed the field, leading the US Food and Drug administration (FDA) to recommend (2007 & 2010) genetic testing during warfarin dosing and its wider application in practice. He also led an international expert panel to establish phenotypic standardisation in drug-induced liver injury (DILI) (Clin Pharmacol Ther. 2011). He co-chaired international DILI consortia (iDILIC) to conduct a seminal genome-wide association studies identifying key associations with key polymorphisms in HLA and other genes with DILI (Nat Genet. 2009, Gastroenterology 2017).

Professor Aithal contributed critically to the evaluation of the Enhanced Liver Fibrosis panel (Hepatology. 2008, Hepatology. 2013), the only non-invasive marker recommended for clinical use by National Institute for Health and Care Excellence, UK in 2016. He also evaluated piogltazone (Gastroenterology. 2008) which has been recommended by NICE, European Association for the Study of the Liver (EASL), European Association for the Study of Diabetes (EASD) and European Association for the Study of Obesity (EASO) for the treatment of non-alcoholic steatohepatitis (NASH) in 2016. He was also involved in liraglutide (Lancet 2016) in phase II trial to demonstrate efficacy in NASH.

Professor Aithal has led the development of fast, and inexpensive magnetic resonance imaging (MRI) method to estimate the degree of inflammation and fibrosis within the whole liver (NMR Biomed. 2015). Recently, he used this method to estimate portal pressure (J Hepatol 2016), showing that it correlates with hepatic venous pressure gradient measurements - the current gold standard but invasive and expensive test, only available in selected centres.

Expertise Summary

Pharmacogenetics

Non-alcoholic fatty liver disease (mechanisms, biomarkers of liver injury and effective lifestyle and pharmacological interventions)

epidemiology of liver and biliary disease (cause and consequences)

Hepatobiliary imaging (assessment of degree of liver injury and endoscopic imaging techniques).

Drug-induced liver injury ((DILI) causality assessment, outcome, genetic and environmental factors that effect drug metabolism and hepatoxicity)

Teaching Summary

Having worked in University hospitals in the United Kingdom and abroad, Guru has gained experience in a variety of teaching environments and modalities. He has been a Member of the Specialty… read more

Research Summary

Current Research:

Drug-induced liver injury (DILI): Genetic and environmental factors associated with drug-induced liver injury, non-invasive markers to detect and monitor hepatotoxicity.

Non-alcoholic fatty liver disease (NAFLD): Interaction of dietary and genetic factors in the pathogenesis, non-invasive detection and stratification of NAFLD, effective interventions

Non-invasive evaluation of chronic liver disease: Application of Quantitative Magnetic Resonance Imaging methods to detect and estimate degree of liver injury in chronic liver diseases.

Hepato-pancreatico-biliary imaging: Optimising endoscopic evaluation of hepato-pancreatico-biliary neoplacia; tools and techniques

Studies
Title Start Date Status
Pro-Euro-DILI Registry: Creation of a multicentre and multidisciplinary European registry of prospec 1st February 2016 In Recruitment
A Phase 3, double blind, Randomised, Long-Term, Placebo Controlled, Multicentre study Evaluating the 1st April 2016 In Recruitment
The Impact of Type 2 Diabetes and Exercise on Liver Fat Quality 1st September 2018 Active
Drug Induced Liver Injury Cohort in Nottingham (DILICIN) 1st January 2014 Ended
Magnetic resonance spectroscopy (MRS) Estimation of Glutathione flux in the Liver (MEGL) 1st August 2015 Active
A Phase 2 double blinded, randomised, placebo controlled dose-finding study to evaluate the safety t 1st February 2017
Nottingham Digestive Diseases Biomedical Research Unit Research Tissue Bank 1st January 2015 In Recruitment
Effect of Carnitine supplementation on Liver steatosis, Insulin sensitivity, Plasma glucose homeosta 7th March 2018 In Recruitment
Biomarkers of idiosyncratic drug-induced liver injury in patients taking Diclofenac 1st February 2011 Ended
Randomised evaluation of algorithm for Crohn’s treatment - Study 2 (REACT 2) 1st December 2014 In Recruitment
A two-part randomized, double-blind, placebo-controlled multicenter dose ranging and confirmatory st 11th April 2018 Active
Double blind, randomised controlled trial to investigate the efficacy of ANTOX(vers)1.2 and MGCT (Ma 1st December 2011 Active
A single arm, two-stage, multi-centre, phase II clinical trial investigating the safety and activity 4th September 2015 Active
Pharmacogenetics of drug induced liver injury (DILIGEN) 1st June 2009 Ended
A 48-weeks phase 2, randomised, double blinded placebo controlled, parallel group, multi centre tria 1st February 2011 Ended
A pivotal study to evaluate the efficacy of GFT505 80mg and GFT505 160mg on steatohepatitis in patie 1st February 2013 Ended
Case-control Study Evaluating the Genetic Factors Associated with the Development of Non-alcoholic S 23rd November 2015 In Recruitment
The Evaluation of Portal Hypertension Using Quantitative Magnetic Resonance Imaging (MRQuee study 1st April 2013 In Recruitment
HCV Research UK MRI Study 1st April 2014 In Recruitment
A cross-sectional study to assess the reliability of infrared thermography (IRT) in measuring brown 1st August 2017 Active
Evaluation of the role of AST:ALT ratio, ELF markers and fibroscan in the detection of methotrexate 1st June 2014 In Recruitment
Magnetic Resonance Imaging in the evaluation of hepatic fibrosis:search for MRI biomarker (Mrker) 1st December 2009 Ended
Case control study evaluating the genetic factors associated with the development of non-alcoholic s 1st January 2012 In Recruitment
NASH meal response study: The Study of Genetic Factors Involved in Post-Prandial Fat Processing and 1st July 2016 Active
The influence of ethnicity on non-alcoholic fatty liver disease in people of South Asian origin 1st August 2017 Active
Publications
Title
Case Definition and Phenotype Standardization in Drug-Induced Liver Injury
The Road to a Successful Transjugular Intrahepatic Portosystemic Shunt (Tips) Service: Experience of
TM6SF2 rs58542926 influences hepatic fibrosis progression in patients with non-alcoholic fatty liver
A study of T1 relaxation time as a measure of liver fibrosis and the influence of confounding histol
Effects of short-term energy restriction on liver lipid content and inflammatory status in severely
Effects of sprint interval training on ectopic lipids and tissue-specific insulin sensitivity in men
Randomized, placebo-controlled trial of pioglitazone in nondiabetic subjects with nonalcoholic steat
Incidence and prevalence of cirrhosis in the United Kingdom, 1992-2001: A general population-based s
Mind the Gap
Abnormal liver tests in people aged 75 and above: prevalence and association with mortality
Immune dysfunction and changes in intestinal morphology in patients with obstructive jaundice
Pharmacogenetic testing in idiosyncratic drug-induced liver injury: current role in clinical practic
The quest for an evidence-based approach to surveillance for methotrexate-related hepatotoxicity: pr
Obesity and type 2 diabetes are important risk factors underlying previously undiagnosed cirrhosis i
Multi organ assessment of Compensated Cirrhosis Patients using quantitative Magnetic Resonance Imagi
The antecedents of biliary cancer: a primary care case-control study in the United Kingdom
Preempting and preventing drug-induced liver injury
The communication of a secondary care diagnosis of autoimmune hepatitis to primary care practitioner
Genetic Basis of Drug-Induced Liver Injury: Present and Future
Pharmacogenetic testing in idiosyncratic drug-induced liver injury: current role in clinical practic
Visual morphometry and three non-invasive markers in the evaluation of liver fibrosis in chronic liv
Drug-induced liver injury: recent advances in diagnosis and risk assessment
Dyspnoea in a patient with cirrhosis
Preoperative Drainage in Pancreatic Cancer
Susceptibility to Amoxicillin-Clavulanate-Induced Liver Injury Is Influenced by Multiple HLA Class I
End-stage methotrexate-related liver disease is rare andassociated with features of the metabolic sy
1 and 5 year survival estimates for people with cirrhosis of the liver in England, 1998-2009: A larg
Visual morphometry and three non-invasive markers in the evaluation of liver fibrosis in chronic liv
Association of Liver Injury From Specific Drugs, or Groups of Drugs, With Polymorphisms in HLA and O
A randomized, placebo-controlled trial of cenicriviroc for treatment of nonalcoholic steatohepatitis
The rate of decompensation and clinical progression of disease in people with cirrhosis: a cohort st
All-cause mortality in people with cirrhosis compared with the general population: a population-base
Mass Spectrometric Characterization of Circulating Covalent Protein Adducts Derived from a Drug Acyl
The evaluation of portal hypertension using quantitative magnetic resonance imaging (MRI)
Genome-Wide Association Studies in Drug-Induced Liver Injury: Step Change in Understanding the Patho
The effect of prone positioning with surgical bolsters on liver blood flow in healthy volunteers
Clinical and microbiological features of infection in alcoholic hepatitis: an international cohort s
Hip fracture risk in patients with alcoholic cirrhosis: A population-based study using English and D
Efficacy of Recombinant Human Interleukin-10 in Prevention of Post-Endoscopic Retrograde Cholangiopa
Effectiveness of a nurse-led alcohol liaison service in a secondary care medical unit
End-stage methotrexate-related liver disease is rare and associated with features of the metabolic s
Liraglutide safety and efficacy in patients with non-alcoholic steatohepatitis (LEAN): a multicentre
Immune dysfunction in patients with obstructive jaundice before and after endoscopic retrograde chol
Current and Future Magnetic Resonance Technologies for Assessing Liver Disease in Clinical and Exper
The influence of adiposity and acute exercise on circulating hepatokines in normal-weight and overwe
High-resolution endoscopy and endoscopic ultrasound for evaluation of early neoplasia in Barrett’s e
How to tackle rising rates of liver disease in the UK
Prevalence and Natural History of Histologically Proven Chronic Liver Disease in a Longitudinal Coho
Investigating the effects of an Oral Fructose Challenge on Hepatic ATP Reserves in Healthy Volunteer
Liraglutide safety and efficacy in patients with non-alcoholic steatohepatitis (LEAN): a multicentre
Liver-related outcomes in a large cohort of patients with Type 2 diabetes on insulin or sulphonylure
Dynamics of 5-carboxylcytosine during hepatic differentiation: Potential general role for active dem
Pharmacogenomics of drug-induced liver injury (DILI): Molecular biology to clinical applications
Incidence and prevalence of cirrhosis in the United Kingdom, 1992-2001: A general population-based s
Efficacy, Safety, and Predictive Factors for a Positive Yield of EUS-Guided Trucut Biopsy: A Large T
Hepatotoxicity related to antirheumatic drugs
Effect of prone positioning on cardiac output and liver blood flow in the awake healthy volunteer
Lack of Efficacy of an Inhibitor of PDE4 in Phase 1 and 2 Trials of Patients With Nonalcoholic Steat
Pretreatment Lesions on Magnetic Resonance Imaging in Patients With Hepatitis C Virus Infection Diag
Risk of Cardiovascular and Cerebrovascular Events in Primary Biliary Cirrhosis: A Population-Based C
Endoscopic-ultrasound-guided mural trucut biopsy in the investigation of unexplained thickening of e
Monozygotic twins with NASH cirrhosis: cumulative effect of multiple single nucleotide polymorphism
Regional anthropometric measures associated with the severity of liver injury in patients with non-a
An analysis of rebleeding rates for variceal haemorrhage at a regional centre: what is the applicabi
Immune dysfunction in patients with obstructive jaundice before and after endoscopic retrograde chol
Fast-food hyper-alimentation and exercise restriction in healthy subjects
Investigating the effects of an oral fructose challenge on hepatic ATP reserves in healthy volunteer
Development and evaluation of a nurse-led transient elastography service for the staging of hepatic
A low calorie morning meal prevents the decline of hepatic glycogen stores: a pilot in vivo (13)C ma
Prevalence of clinically significant liver disease within the general population, as defined by non-
Diffuse nesidioblastosis causing hyperinsulinemic hypoglycemia: the importance of pancreatic samplin
Safety and factors predicting diagnostic yield of EUS-guided trucut biopsy technique: a large single
Human leukocyte antigen genetic risk factors of drug-induced liver toxicology
Monozygotic twins with NASH cirrhosis: cumulative effect of multiple single nucleotide polymorphisms
Economic evaluation of a community-based diagnostic pathway to stratify adults for non-alcoholic fat
Risk of hepatocellular carcinoma among individuals with different aetiologies of cirrhosis: a popula
Prevalence and Natural History of Histologically Proven Chronic Liver Disease in a Longitudinal Coho
Direct targeting of risk factors significantly increases the detection of liver cirrhosis in primar
Obesity and type 2 diabetes are important risk factors underlying previously undiagnosed cirrhosis i
The detection of oesophageal varices using a novel, disposable, probe-based transnasal endoscope: a
The detection of oesophageal varices using a novel, disposable, probe-based transnasal endoscope: a
Increased liver fat and glycogen stores after consumption of high versus low glycaemic index food: A
Non-invasive assessment of portal hypertension using quantitative magnetic resonance imaging