Vishal Patel is a Consultant Hepatologist & Endoscopist at the Liver Unit, King’s College Hospital, focusing on Advanced Chronic Liver Disease (ACLD) and portal hypertension. He is a Principal Investigator and Group Lead for Microbiome in ACLD at the Roger Williams Institute of Hepatology, and Honorary Reader in Hepatology within the School of Immunology & Microbial Sciences at King’s College London.

Research:

The Patel group is focused on two key work-streams in advanced chronic liver disease:

The oral-gut-liver axis in ACLD:

1. Characterising the changes that occur in the oral and gut micro-/mycobiome in ACLD by metagenomic sequencing
2. Utilising novel markers to measure gut-derived bacterial translocation
3. Assess the intestinal barrier in cirrhosis (inflammatory and immune characterisation)
4. Profiling of microbiome generated metabolites e.g. plasma and faecal bile acids and by urinary NMR
5. Rapid Infection Diagnostics in Cirrhosis (RIDiC) – being led by Dr Merianne Mohamed (Postdoctoral Researcher)

Coagulation pathways, organ dysfunction and role of cell-free DNA – being led by Marilena Stamouli (Research Associate):

1. Cell-free DNA component profiling at various stages of ACLD
2. Coagulation pathway interrogation (working with Prof Ton Lisman, Netherlands)
3. Immuno-inflammatory interactions and pathways linking above
4. Utilising epigenetic techniques to interrogate organ dysfunction

The above work is resourced by a combination of grants and funding from GUTS UK, Oxford Nanopore, Association of Physicians of Great Britain and Ireland, The Foundation for Liver Research, and the Intensive Care Society as well as King’s College Hospital Charity, and involves collaborations with research groups in London, UK, Denmark, Germany, Spain, Sweden, North America and Australia.

Projects:

1. In-depth shotgun metagenomic analysis of the oral and gut microbiome identifies striking overlaps in microbial community structure, virulence factors and antimicrobial resistance based on severity and stage of cirrhosis
2. Evaluating the role of circulating cell-free DNA-mediated coagulation dysfunction, systemic inflammation, and organ injury in chronic liver failure syndromes
3. Development and evaluation of point-of-care diagnostics utilising clinical metagenomic sequencing for rapid pathogen and antimicrobial resistance detection in decompensated cirrhosis and acute-on-chronic liver failure
4. Beta-blockers Or Placebo for Primary Prophylaxis of oesophageal varices (BOPPP Trial). A blinded, UK multi-centre, clinical effectiveness and cost-effectiveness randomised controlled trial (NIHR funded £2.5 million) – Chief Investigator, sponsored by King’s College Hospital

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