Tiny carbon beads could offer hope to those with liver disease

A breakthrough treatment for liver disease could offer hope to the millions worldwide who suffer from the illness and reduce the annual UK toll of 13,000 deaths from obesity and alcohol-related conditions.

The treatment involves swallowing a sachet containing tiny carbon beads that are designed to remove toxins produced by bacteria in the gut of heavy drinkers and the obese and stop them attacking the liver.

The research team, which included BRC supported Professor Rajiv Jalan, are about to announce that they have also won ethical approval and funding to develop what they hope will be the first liver dialysis machine, for those whose livers are no longer able to function. The only dialysis now available is for kidneys.

Professor Jalan, whose work underpins the treatments, said: “This is revolutionary because at the moment we treat these patients with antibiotics and if you treat them for a year or 18 months they introduce many resistant strains.”

Daniel Green, chief executive of Yaqrit, the UCL spinout company developing the treatments, said liver disease had been neglected for years even though it was largely preventable. It was also the only widespread potentially fatal condition where death rates were still increasing: “Look at heart disease, respiratory diseases, diabetes, cancer, and there are new products the whole time but there [has been] virtually nothing for [obesity and alcohol-related] liver disease. “We know what the problems are for antibiotics. This will transform it from a 20th-century to a 21st-century treatment.”

According to Professor Jalan, if the trials are successful patients would take a teaspoon of nanoporous carbon in a sachet before bedtime. The carbon would remove toxins produced by bacteria in the gut that would otherwise enter the body and liver, allowing them to pass harmlessly through the body.

Underlying Professor Jalan’s treatment is the understanding that although the liver is damaged directly by alcohol and fatty food, it is the bacterial toxins getting through the gut wall that exacerbate the damage.

About 40,000 people in the UK have cirrhosis of the liver, according to the British Liver Trust, but about one in five of the population is at risk of developing serious liver problems at some point. Over the past decade there has been a five-fold increase in the development of cirrhosis in those aged 35 to 55.

There were 916 liver transplants in the past year and approximately 600 people are on the liver transplant waiting list.

Professor Jalan said: “If the clinical trials are successful, it could revolutionise the management of patients with liver disease as statins have done for patients with high cholesterol levels and insulin has done for diabetic patients.”

Production of the carbon beads will start soon in Hampshire and 48 patients will take part in the first trial. The research projects received €12.4m (£10.6m) of European Union Horizon 2020 research funding.

Andrew Langford, chief executive of the British Liver Trust, said: “If successful, this treatment could prove vital for anyone who has been diagnosed with cirrhosis as it may help prevent the complications caused by infections. Liver disease often does not have any symptoms and those at risk of developing the disease are often missed. This means that three-quarters of people already have severe problems or cirrhosis at the point of diagnosis when the options for treatment are limited.”