Why do some heavy drinkers get liver cirrhosis and some don’t?
“We still don’t understand why only a proportion of moderate to heavy drinkers get liver cirrhosis,” said Professor Chris Day, liver expert at Newcastle University and within Newcastle Hospitals NHS Foundation Trust.
“Nothing so far has been able to explain the unpredictability of why some people get cirrhosis and others who drink equal amounts don’t,” he said.
In 2008, there were 6000 deaths from alcoholic liver disease in the UK and in 2007 188,000 hospital admissions. While the disease has been predominantly seen among men over 50 years of age, it is becoming more frequent worldwide among younger adults and young women.
It is the leading cause of alcohol-related death and contributes to 50% of the total burden of liver disease and to 15% of liver transplants.
The Newcastle research team will soon be collecting samples from 300 North East patients being treated at the Newcastle Hospitals Trust and Plummer Court Drug and Alcohol Addiction Unit and analysing their findings alongside international colleagues in Australia, USA, UK, Germany, Switzerland and France. Half the recruits will have cirrhosis and the other half, the control group, will have been heavy drinkers for 10 years but be free of liver disease. The £1.7 million international study has received funding from the US government.
“Apart from alcohol consumption, several contributory factors, including diet, lifestyle, mental health, viral infection and gender, influence the risk of developing cirrhosis. There is also evidence that genes influence the development and progression of this disease,” Professor Day said.
“We hope that by analysing the genes in a large international group comprising thousands of drinkers we can detect the genetic risks that predispose some drinkers to get alcoholic liver cirrhosis.”
Like other multi-factorial diseases, alcoholic liver cirrhosis is controlled by a number of genes, each of which makes a small overall contribution. Previous genetic searches have been inconclusive because the studies performed to date have generally been too small to yield definitive results.
“The lack of specific markers for diagnosis and effective treatment compound the burden of the disease. That is why this research is so important,” says Professor Day. “The results will help us identify and treat the people most at risk from drinking.”