When it comes to the subject of liver research, it’s hard to know where to begin, as new advances are continuously evolving. However, the biggest hurdle comes from the lack of funding from both the Government and private enterprises. Far more money is needed if we are going to resolve the unacceptably high death rate due to liver disease, which is increasing exponentially year on year.

The Gut

NIHR Birmingham Biomedical Liver Research Centre Transforming outcomes for patients with inflammatory liver disease through early diagnosis and developing new therapies.

The Liver Dialysis Machine

A news story dated the 20 th of March 2025, “Royal Free Hospital leads pivotal trial of a novel 'liver dialysis' machine for liver failure patients”. A pivotal trial involving a new liver dialysis machine for patients with liver failure will get underway at the Royal Free Hospital (RFH) in the early autumn. The DIALIVE device will be used to help patients with a severe liver condition called acute-on-chronic liver failure (ACLF). The condition often causes multi-organ failure, and many patients don’t survive. DIALIVE works by removing toxins from patients’ blood and by exchanging ‘dysfunctional’ albumin for healthy albumin. This allows the patient time for their liver to recover and regenerate so it can start functioning on its own. A previous Europe-wide study showed the device is safe and offers benefits. The study indicated that for those treated with DIALIVE, ACLF was resolved approximately twice as frequently and, significantly, more rapidly than those on standard treatments. The full story can be found here: h t t p s : / / w w w . r o y a l f r e e . n h s . u k / n e w s / r o y a l - f r e e - h o s p i t a l - l e a d s - p i v o t a l - t r i a l - n o v e l - l i v e r - d i a l y s i s - m a c h i n e - l i v e r - f a i l u r e - patients#:~:text=A%20pivotal%20trial%20involving%20a,chronic%20liver%20failure%20(ACLF) . News of the Liver Dialysis Machine broke back in June 2023.

And even more Gut Stuff - The “Boost” Trial

This study is being put together by Prof Ashwin Dhanda at Plymouth University. In the gut (intestines), certain bacteria break down dietary fibre into short-chain fatty acids (SCFAs). SCFAs are important for the proper function of cells lining the gut. Without them, the gut becomes leaky, letting parts of bacteria into the bloodstream, leading directly to the liver. This triggers liver inflammation and scar formation. A leaky gut, due to the breakdown of the gut lining, drives liver damage in cirrhosis. Currently, there are no established treatments for liver scarring or leaky gut. Increasing gut SCFAs may be effective in treating cirrhosis by restoring the gut lining. HMB, a naturally occurring substance that is already available as a dietary supplement to increase muscle strength, also increases SCFA levels in the gut. In small test trials, HMB was safe and had only minor side effects in people with cirrhosis. The   study   is   being   carried   out   by   experts   in   liver   disease,   dietetics   and   immunology   from   the University   of   Plymouth,   University   of   Southampton   and   Imperial   College,   London.   The   trial   will be managed by Peninsula Clinical Trials Unit (PenCTU) . (Click on SCIBiTE to hear the podcast.) More information can be found here: https://scitechdaily.com/could-a-gym-supplement-transform-liver-disease-treatment-a-new-clinical- trial/

While over in Australia Similar work is being carried out at the QIMR Berghofer Medical Research Institute, Brisbane  ,   Australia.    Here,   Prof Grant Ramm, Deputy Director of QIMR Berghofer Medical Research Institute and head of the Hepatic Fibrosis Laboratory, said this finding could pave the way for new targeted therapeutics to treat both inherited and acquired liver disease.

YAQRIT   is   a   UCL   spinout   company   dedicated   to   specialising   in   interventions   in   liver   disease,   based   on   20   years   of research     and     development     at     the     University     College     London     (UCL).     Their     website     can be found here: https://yaqrit.com /

Can Carbon beads help restore a healthy gut microbiome and reduce liver disease progression? The study has found that the carbon beads, licensed to UCL-spinout Yaqrit, were effective in restoring gut health and had a positive impact on liver, kidney and brain function in rats and mice. They were also found to be safe for human use. The next step will be to see if the same benefits can be realised in humans, which would pave the way for them to be used to treat diseases linked to poor gut health. Worldwide, it is estimated that around 100 million people living with cirrhosis of the liver, and 10 million have cirrhosis plus an additional complication. Explaining the current clinical challenges, senior author Professor Rajiv Jalan from the UCL Institute for Liver and Digestive Health, said: “The influence of the gut microbiome on health is only just beginning to be fully appreciated. When the balance of the microbiome is upset, ‘bad’ bacteria can proliferate and out-compete the ‘good’ bacteria that help keep the gut healthy. “One of the ways they do this is by excreting endotoxin, toxic metabolites and cytokines that transform the gut environment to make it more favourable to them and hostile to good bacteria. These substances, particularly endotoxin, can trigger gut inflammation and increase the leakiness of the gut wall, resulting in damage to other organs such as the liver, kidneys and brain. “In cirrhosis, a condition characterised by scarring of the liver, it is known that inflammation caused by endotoxins can exacerbate liver damage. Part of the standard treatment for cirrhosis is antibiotics aimed at controlling bad bacteria, but this comes with the risk of antibiotic resistance and is only used in late-stage disease.” To overcome this, scientists at UCL, in collaboration with Yaqrit, developed tiny oral carbon beads that have a special microscopic physical structure designed to adsorb both large and small molecules in the gut. In the study, researchers from UCL tested the effectiveness of the carbon beads, known by the product name CARBALIVE, to restore gut health and assessed the impact on liver, kidney and brain function in rats and mice. They found that when ingested every day for several weeks, the beads were effective in preventing the progression of liver scarring and injury in animals with cirrhosis, and reduced mortality in animals with acute-on-chronic-liver-failure (ACLF). The beads were also tested on 28 cirrhosis patients and proved to be safe with negligible side effects. If the same benefits observed in animal models occur in humans, the beads could be an important new tool to help tackle liver disease. Michal Kowalski, a Vice President and the CARBALIVE product lead at Yaqrit, said: “These novel, engineered carbon beads, which are swallowed and pass through the body unaltered, are smaller than a grain of salt. They work by absorbing the endotoxins and other metabolites produced by ‘bad’ bacteria in the gut, creating a better environment for the good bacteria to flourish and helping to restore microbiome health. This prevents these toxins from leaching into other areas of the body and causing damage, as they do in cirrhosis. “The results in animal models are very positive, with a reduction in gut permeability, liver injury, as well as brain and kidney dysfunction.” The results open the door for further trials to test the efficacy of the carbon beads in humans, one of which is due to start soon. If the beads are proven to be effective at halting or slowing the progression of liver damage, they could be an invaluable tool for treating liver disease and possibly other conditions associated with poor microbiome health. Professor Rajiv Jalan, a Professor of Hepatology at UCL and consultant at the Royal Free Hospital, added: “I have high hopes that the positive impact of these carbon beads in animal models will be seen in humans, which is exciting not just for the treatment of liver disease but potentially any health condition that is caused or exacerbated by a gut microbiome that doesn’t work as it should. This might include conditions such as irritable bowel syndrome, for example, which is on the rise in many countries.

Revolutionary Liver Organoids: A New Era in Research

These are very exciting times for liver research. I can see there’s going to be a big explosion over the next few years as new technologies and medications become available. There will be an ever-increasing demand for those who have lived experience to become involved. Liver Organoids are just one of the areas that show promise. Liver organoids are derived from human iPS cells and have been cultured for more than 24 days. (iPS cells are a type of stem cell that can be generated in the lab from adult somatic cells, such as skin or blood cells, by reprogramming them to an embryonic stem cell-like state.) This video was published earlier this year.