Paul Middleton

Title: Characterisation of neutrophil and regulatory T-cell/effector T-cell interactions in alcohol-related liver disease

Summary: Cirrhosis is the end-stage of liver disease and has long been associated with an increase susceptibility to infection. Infection represents a major cause of deterioration, hospitalisation and death in patients with cirrhosis. Previous studies have identified significant changes in the immune system of patients with cirrhosis which may explain this increased risk of infection. Immune cells in patients with cirrhosis are found to simultaneously be over-activated whilst having impaired ability to fight infection. Over-activation of immune cells causes collateral damage to the body and may promote further deterioration in liver function. As cirrhosis progresses, the immune system becomes exhausted and its ability to fight infection diminishes, leading to overwhelming infection and death. This study aims to further understand these changes by examining the function and interaction of two main immune cell groups, neutrophils and T-cells, in healthy volunteers compared to patients with cirrhosis secondary to alcohol-related liver disease.  This may help identify novel targets to develop treatments to reverse or prevent immune dysfunction.