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AASLD plenaries highlight clinical applications of liver disease research

Ronald J. Sokol, MD, FAASLD
Ronald J. Sokol, MD, FAASLD

AASLD will feature the most innovative research in its two plenary sessions at DDW®. The Basic Science Plenary Session will be held Sunday morning and the Clinical Science Plenary Session will be held Monday morning. Each will offer something for all AASLD members and DDW attendees.

“In the basic science session, we’ve tried to choose abstracts that open up new doors to possible therapeutics in the future,” said AASLD President Ronald J. Sokol, MD, FAASLD, professor of pediatrics-gastroenterology, hepatology and nutrition at the University of Colorado School of Medicine, Aurora. “As a clinician, you want to be aware of how new science is moving forward and, without knowing the details of every technique, have the opportunity to learn about new discoveries that are important across relevant fields of science.”

The session will feature new information on the effects of Micro RNA-34a on fibrosis in chronic liver disease. The research suggests that Micro RNA-34a is involved in transmitting a message to cells in the liver that are producing the fibrosis in a bile duct ligation model of cholestasis.

“This raises the question as to whether inhibiting or blocking Micro RNA-34a could be an important target for future therapies to prevent 
or reverse liver fibrosis in cholestatic liver diseases,” said Dr. Sokol.

Another abstract that could eventually translate to patient care involves a genetically engineered bacteria given orally to mice with liver failure. The bacteria was designed to consume ammonia and metabolize it in the intestine, thereby preventing its absorption. Researchers not only found much lower blood ammonia levels in the mice, but they unexpectedly found increased urea production.

“This study in mice was very provocative and raised a whole new potential mechanism for treating hyperammonemia associated with hepatic encephalopathy,” Dr. Sokol explained.

Monday’s clinical science plenary includes research into spontaneous bacterial peritonitis, pediatric biliary atresia, risk of non-hepatic cancer after hepatitis C treatment, solid organ transplant with hepatitis C positive donors, hospitalization outcomes in patients with genetic hemochromatosis and alcohol relapse in patients after liver transplantation.

Kimberly A. Brown, MD, FAASLD
Kimberly A. Brown, MD, FAASLD

This liver-focused research is particularly useful at DDW because many attendees are not focused primarily on liver disease, noted AASLD Secretary Kimberly A. Brown, MD, FAASLD, chief of gastroenterology and hepatology at Henry Ford Hospital, Detroit, MI.

The abstract on nonhepatic cancer risk in patients with hepatitis C treated with direct-acting antivirals (DAA) found that DAA treatment not only cures patients with hepatitis C in almost every case, but also reduces risk of liver cancer and overall cancer.

“This is just another piece of information to suggest that if you’re able to cure a patient of hepatitis C, they derive many benefits, not only a reduction in liver cancer but also a reduction in overall cancer as well,” Dr. Brown said.

Another abstract looks at early versus late alcohol relapse in patients receiving liver transplants due to alcoholic liver disease. This single-center study of 900 patients examined whether patients transplanted before a six-month sobriety period were more likely to relapse than patients who finished a six-month sobriety period. The study found the relapse rate in the expedited group was 40 percent compared with 12 percent in the patients who followed the standard wait.

“This is an important abstract because there’s a lot of discussion now about our criteria for transplanting patients with alcoholic liver disease,” Dr. Brown said. “One of the concerns that the community has had is that the six-month rule is not a great measurement. It’s just what we have. But we clearly know it doesn’t do a great job in predicting who will go back to alcohol. But if that’s the case, we also don’t have any other criteria that accurately predict. When you start making up different criteria for different patients, you run the risk of bias.”

Please refer to the DDW Mobile App or the Program section in the Sunday and Monday issues for the times and locations of these and other DDW events.

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