Boosting the power of antibiotics in patients with liver disease

Patel, Dr Janisha (hepatology) photo

Researchers in Southampton are using a protein found in the blood to help boost the power of antibiotics in patients with liver disease.

Fighting infections

Your liver plays a vital role in fighting infections. It holds over half of your body’s macrophages (white blood cells that destroy foreign bacteria in your body) and it cleans blood coming from the bowel which can carry toxins and cause infection.

The liver also produces a protein called albumin which helps transport antibiotics and important immune molecules around the blood to infection sites.

Patients living with long-term liver disease have developed permanent damage to their liver – preventing it from working properly and hampering its ability to produce albumin – making them more prone to infections.


End stage liver disease

600,000 people in England and Wales have some form of liver disease and 60,000 of these have end stage liver disease – also known as cirrhosis. Cirrhosis is the scarring of the liver caused by long-term damage which can eventually lead to liver failure.

Cirrhosis is a frequent killer of working-aged people between 18-65 years and the most common cause is drinking too much alcohol over many years. Other causes include hepatitis B and C viruses, and conditions such as diabetes, high blood pressure and obesity.

The condition can go undetected for a number of years with no symptoms to suggest anything is wrong until the liver is severely damaged.


Boosting the power of antibiotics

This latest Southampton study, led by Dr Janisha Patel, a consultant hepatologist at University Hospital Southampton NHS Foundation Trust, will recruit patients presenting with end stage liver disease at Southampton General Hospital’s emergency department.

“Often people aren’t aware they have a problem until they require emergency care. In fact, over 75% of patients who end up in A&E have not seen by a doctor in relation to this condition before, as they’ve had no previous complaints or symptoms”, explains Dr Patel.

“We know people with cirrhosis are more prone to infection as their liver is not functioning properly and is not producing albumin. So when patients come into hospital, it’s important they’re assessed for infections and treated with antibiotics to prevent further complications.”

“Patients will be given albumin to bring their levels close to the same as a healthy person – which will help restore their immune system and boost the power of antibiotics they’re given.”


Positive results

Currently there is no cure for cirrhosis and one in three patients admitted to the emergency department with the condition do not survive. However, Dr Patel explains how this study shows real potential for patients:

“We believe that giving patients albumin will improve their recovery from the time they’re admitted to hospital and up to six months after.

“Patients who go on to make positive changes to their lifestyle, such as giving up alcohol and better controlling their diabetes, have an 80% chance of survival over two years. This is compared to 20% if they do not make changes.”

Posted on Tuesday 20 February 2018