This theme conducts innovative, interdisciplinary research aimed at improving the understanding, diagnosis, and treatment of liver diseases starting with children and young people and extending into adulthood. Our work spans four core areas:

Paediatric Liver Disease Pathophysiology and Immune Regulation
We investigate the biological mechanisms underlying liver disease in paediatrics, with a focus on immune dysregulation, chronic inflammation, and metabolic dysfunction.
Key research activities include:

• Characterising systemic inflammation in children with chronic liver disease
• Profiling T cell subsets and immune regulation in paediatric portal hypertension
• Investigating immunometabolic pathways in paediatric liver disease
• Identifying somatic mutations in paediatric metabolic liver disorders

Rare and Complex Liver Conditions
We study the clinical course, genetic underpinnings, and therapeutic options for rare and syndromic liver diseases to improve diagnostic accuracy and patient outcomes.
Current projects include:

• Investigating Fontan-associated liver disease
• Studying primary sclerosing cholangitis (PSC) during pregnancy
• Defining the natural history of autoimmune sclerosing cholangitis (ASC)
• Mapping the mutational landscape in PSC
• Leading the ASSERT trial of odevixibat in Alagille syndrome

Diagnostic Innovation and Disease Modelling
We utilise advanced genomic techniques and patient-derived organoid systems to uncover disease mechanisms and enable earlier, more accurate diagnoses.
Current initiatives include:

• Whole genome and transcriptome sequencing in undiagnosed paediatric liver disease
• Development of patient-derived and iPSC-derived cholangiocyte organoids for disease modelling

Child Development, Outcomes, and Nutritional Interventions
Recognising the holistic impact of liver disease, we examine developmental, educational, and nutritional outcomes in affected children and adolescents.
Ongoing studies include:

• Assessing brain maturation in children with liver disease
• Evaluating educational outcomes for paediatric liver disease patients in England
• Trialling medium-chain triglyceride supplementation in infants with biliary atresia
• Exploring polyphenol-rich dietary interventions in autoimmune liver disease