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Centenary Institute - Medical Research
Centenary Institute - Medical Research

Reducing cirrhosis threat for high-risk drinkers

Research led by the Centenary Institute has shown that a healthy weight and coffee consumption may help lower the risk of high-risk drinkers developing alcohol-induced cirrhosis (scarring of the liver), which causes approximately 300,000 deaths globally each year.

Also found by the researchers in this multi-national GenomALC Consortium–involving QIMR Berghofer Medical Research Institute and the Southern California Institute for Research and Education (SCIRE)–is that susceptibility to cirrhosis among high-risk drinkers is affected by a family history of alcohol-induced liver disease.

“Only a minority of high-risk drinkers, approximately 10-15 percent, actually end up developing alcohol-induced cirrhosis. But the survival time for those individuals who do develop this devastating disease can be as low as 1-2 years,” said Clinical Associate Professor Devanshi Seth, Head of the Centenary Institute Alcoholic Liver Disease Research Program and senior author of the published study.

“The best way to reduce harm from alcohol (including cirrhosis) is by reducing or cutting out alcohol. High-risk drinking is chronic alcohol use above the recommended guidelines that may result in cirrhosis. Unfortunately, individuals may not be aware of the dangers that heavy drinking entails. The aim of our study was to identify risks associated with cirrhosis in heavy drinkers and to gain insights into additional measures that could help in preventing or reducing cirrhosis in patients whose drinking places them at risk,” she said.

Lead author of the study, which was published in the prestigious science journal ‘American Journal of Gastroenterology’, was Dr John Whitfield from QIMR Berghofer Medical Research Institute.

Dr Whitfield says their study found evidence that an increased risk of developing alcohol-induced cirrhosis could be inherited, especially from fathers.

“Our study showed that risk of cirrhosis was significantly increased in individuals if the father was a chronic alcohol user and had died from liver disease. We also found that high-risk drinkers who consumed coffee were less likely to develop cirrhosis, while tea drinking only marginally lowered the risk,” Dr Whitfield said.

Dr Timothy Morgan, co-senior author of the study and researcher at the SCIRE notes that they’ve also been able to show that obesity and diabetes are both independently linked with an increased risk of alcohol-induced cirrhosis. “High-risk drinkers who have diabetes in middle age are particularly likely to progress to cirrhosis,” he said.

Clinical Associate Professor Seth believes that their findings may have major public health consequences. “Measures such as maintaining a healthy bodyweight, intensive treatment of diabetes or pre-diabetic states, and encouragement of coffee consumption may be useful lifestyle interventions to reduce the risk of alcohol-induced cirrhosis for high-risk drinkers.” she said.

The research was funded by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) a part of the National Institutes of Health (NIH), USA.

Read the full media release here.

Publication: Obesity, Diabetes, Coffee, Tea, and Cannabis Use Alter Risk for Alcohol-Related Cirrhosis in 2 Large Cohorts of High-Risk Drinkers.

Gene discovery linked to alcohol-induced liver disease

The findings of an international study led by the Centenary Institute suggests that the possibility of high-risk drinkers developing alcohol-induced cirrhosis is in part related to genetic factors.

“Only a small proportion of high-risk drinkers, about 15 percent, actually develop cirrhosis but those who do are at high risk of death and require substantial health-care support,” said senior author of the published study Clinical Associate Professor Devanshi Seth, Head of the Centenary Institute Alcoholic Liver Disease Research Program and also affiliated with Drug Health Services, Royal Prince Alfred Hospital, Sydney Local Health District.

“We wanted to see if certain high-risk drinkers had a genetic predisposition for alcohol-induced cirrhosis. High-risk drinking is chronic alcohol use above recommended guidelines,” said Clinical Associate Professor Seth.

Reported in the science journal ‘Hepatology’ the study was undertaken by a multi-national GenomALC Consortium involving the Southern California Institute for Research and Education (SCIRE) and other research collaborators.

Identified by the study researchers is a new gene associated with alcohol-induced cirrhosis. The novel FAF2 gene is associated with a reduced cirrhosis risk for heavy drinkers. Also confirmed by the study were four additional genes, three previously found to be associated with an increased risk and one with reduced risk of cirrhosis in heavy drinkers.

“Interestingly, a commonality of these genes, including the novel FAF2, is that they appear to affect the lipid (fat) metabolism pathway,” said Clinical Associate Professor Seth.

“The findings are important as due to heavy drinking, it is the build-up of lipid droplets in the liver, that can cause inflammation, and which may then lead to serious liver complications such as cirrhosis in some drinkers,” she said.

The researchers believe that the identified genes are influencing the body’s ability to regulate lipid droplets in the liver and are therefore influencing cirrhosis risk levels.

“This new understanding opens the door to the future development of exciting new drug treatments that can potentially target these specific genes and lipid processes, and reduce the chances of at-risk individuals contracting this devastating disease,” said Dr Timothy Morgan, co-senior author of the study and researcher at the SCIRE.

Clinical Associate Professor Seth says, “Abstaining or reducing alcohol use remains the most effective treatment, however fully understanding the genetic mechanics of alcohol-induced cirrhosis is also key to improving patient diagnosis and treatment decisions.”

“Identifying these genes at an individual level, in combination with assessing lifestyle options, means that we will now be able to predict an individual’s risk profile and then better personalise an appropriate treatment response,” she said.

The research was funded by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) a part of the National Institutes of Health (NIH), USA.

Read the full media release here.

Publication: Genome-wide association study and meta-analysis on alcohol-related liver cirrhosis identifies novel genetic risk factors.