From your experience as a researcher and clinician, why is liver disease such a complex challenge to tackle?
Liver disease is challenging because it’s not a single condition with one clear cause. It’s driven by a combination of factors – metabolism, the immune system, infection, lifestyle, and how all of those interact over time.
What makes it particularly difficult is that it often develops silently. People can feel completely well for years while damage is building up, and by the time they come to medical attention, the disease is often very advanced.
So from both a clinical and research perspective, you have to think broadly. At the Roger Williams Institute of Liver Studies, we’re not just looking at the liver in isolation, we’re looking at how it interacts with the rest of the body, particularly the gut and the immune system. That’s where we’re starting to unlock some of the most important insights.
How common is liver disease in the UK today, and are we seeing particular trends that concern you?
It’s far more common than most people realise. Liver disease is now the third biggest cause of premature death in the UK, and it’s the only major one where death rates are still going up.
What concerns me most is who it’s affecting. We’re seeing it in people much earlier in life than we used to, often in their 40s and 50s, and it’s hitting the most deprived communities hardest.
We’re also seeing a shift in what’s driving it. Alcohol remains a major factor, but there’s been a very rapid rise in liver disease linked to obesity and diabetes. That reflects wider changes in how we live, and it means the problem is only going to grow unless we act.
How is the Roger Williams Institute of Liver Studies uniquely placed to tackle liver disease and improve outcomes for patients?
What makes the Institute distinctive is the way everything is joined up. We have discovery scientists, clinicians and translational researchers all working closely together, and crucially, we’re embedded within King’s College London and King’s College Hospital.
That means we can take ideas from the lab and move them into clinical practice much quicker than you can in other settings.
We’re also able to look at liver disease from multiple angles at once, whether that’s understanding the biology, improving diagnosis, or developing new treatments. And because we’re working at King’s College Hospital within one of the largest liver centres in Europe, we can test and apply those advances directly in patients.
That combination, of depth in science and proximity to clinical care, is allowing us to make real progress.
The theme of this year’s World Liver Day is ‘Solid Habits, Stronger Liver,’ emphasising the importance of a balanced diet, exercise, reducing alcohol intake and getting regular liver checks in keeping the liver healthy. How do these themes align with the research priorities of the RW-ILS?
They align very closely. We now have very strong evidence that everyday factors like diet, physical activity and alcohol intake play a central role in liver health.
A lot of our research is about understanding how those factors actually drive disease at a biological level. For example, how changes in the gut microbiome influence inflammation, or how metabolic stress affects liver function.
Encouragingly, this also means many forms of liver disease are preventable, and in some cases reversible, if we identify them early enough.
At the same time, we know fighting liver disease isn’t as simple as just telling people to change their behaviour. That’s why we’re also focused on developing better diagnostics and treatments, to support patients alongside lifestyle changes.
What were your motivations for pursuing liver disease research and care?
For me, it’s always come back to patients. Liver disease can be treated, but what’s frustrating is how often we meet people whose condition is already advanced.
Early in my career, it was clear there was a gap between what we were starting to understand scientifically and what we could actually offer patients in the clinic. Closing that gap has really driven my work.
Thankfully, we’re starting to diagnose earlier, understand the disease better, and develop more targeted treatments. And being part of the Institute, working with colleagues at King’s and beyond, puts us in a strong position to push that even further.
The goal is simple, really: fewer people developing advanced disease, and better outcomes for those who do.