Professor William Alazawi, MA(Cantab) MB BChir PhD FRCP

Death rates from liver disease are rising across the world.   Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease worldwide affecting a quarter of the population in the West and is closely associated with obesity and type II diabetes.  Our understanding of the development of chronic liver diseases is that persistent injury – whether this is fat, alcohol or another liver disease - occurs alongside exaggerated or inappropriate inflammatory and repair responses and altered metabolism. This leads to scarring or fibrosis and cirrhosis, which, in turn, can lead to liver failure and liver cancer.  

Non-alcoholic steatohepatitis, or NASH, is the inflammatory and progressive form of NAFLD and the Alazawi group’s principal focus is on the key early steps in this process: inflammation and metabolic dysfunction. Our integrated research programme has a firm foundation in basic molecular and disease model discovery science, supported by the Medical Research Council and many other generous funders. We have thriving collaborations with the Bariatric & Metabolic Surgery services at Homerton Hospital and Kings College London and with colleagues across the UK, Europe and USA. 

We have a strong track record in the use of electronic health record data to understand the epidemiology and natural history of NAFLD with recent high impact publications.  To directly impact clinical care, we are developing innovative approaches to delivering liver services in primary and secondary care including the development and evaluation of abnormal liver test and fatty liver pathways.  We are a major site for clinical trials in novel therapies for NASH and fibrosis.

Current Research Projects:

• Multimodal profiling of inflammatory and immune cells, including single-cell methods, to determine stage and treatment response in people living with NASH and type II diabetes
• Targeting innate immune pathways in basic models of lipotoxicity and NASH
• Determining the role of the oral and fecal microbiome in the progression of NASH
• Single cell techniques to predictors sepsis and related outcomes in patients undergoing liver and pancreatic surgery
• Population studies investigating risk factors for NAFLD and its complications
• Evaluating primary and secondary liver care pathways

Socioeconomic Factors Associated with Liver-Related Mortality from 1985-2015 in 36 developed countries Li W, Kemos P, Salciccioli JD, Marshall DC, Shalhoub J, Alazawi W Clin Gastro Hep. 2020 In Press

Stat2 loss disrupts damage signalling and is protective in acute pancreatitis.  Heath H,  Britton G, Kudo H, Renney G, Ward M, Hutchins R, Foster GR, D Goldin R, Alazawi W. J Path 2020 252(1):41-52

Improving prevention strategies for cardiometabolic disease. Sattar N, Gill J, Alazawi W. Nature Medicine 2020 26(3):320-325

Obesity predicts liver function testing and abnormal liver results. Li W,  Homer K, Hull S, Boomla K, Robson J, Alazawi W. Obesity, 2020 28(1):132-138

Recorded diagnosis of NAFLD and the risk of incident acute myocardial infarction and stroke: findings from matched cohort study of 18 million European adults. Alexander M,  Loomis AK, van der Lei J, Duarte-Salles T, Prieto-Alhambra D, Ansell D, Pasqua A, Lapi F, Rijnbeek P, Mosseveld M, Avillach P, Egger P, Dhalwani NN, Kendrick S, Celis-Morales C, Waterworth DM, Alazawi W,  *, Sattar N*. *Joint Senior Authors. BMJ 2019 Oct 367:I5367

ADAM17-mediated reduction in CD14++CD16+ monocytes ex vivo and reduction in intermediate monocytes with immune paresis in acute pancreatitis and acute alcoholic hepatitis. Waller KJ,  James C, de Jong A, Blackmore L, Ma Y, Stagg A, Kelsell D, O'Dwyer M, Hutchins R, Alazawi W. Frontiers in Immunology. 2019 Aug 10: 1902

Risks and clinical predictors of cirrhosis and hepatocellular carcinoma diagnoses in adults with diagnosed NAFLD: real-world study of 18 million patients in four European cohorts. Alexander M,  Loomis AK, van der Lei J, Duarte-Salles T, Prieto-Alhambra D, Ansell D, Pasqua A, Lapi F, Rijnbeek P, Mosseveld M, Waterworth DM, Kendrick S, Sattar N, Alazawi W. BMC Medicine. 2019 May 20;17(1):95

Real world data reveal a diagnostic gap in non-alcoholic fatty liver disease. Alexander M,  Loomis AK, Fairburn-Beech J, van der Lei J, Duarte-Salles T, Prieto-Alhambra D, Ansell D, Pasqua A, Lapi F, Rijnbeek P, Mosseveld M, Avillach P, Egger P, Kendrick S, Waterworth DM, Sattar N, Alazawi W. BMC Medicine 2018 16: 130.

Non-invasive markers of liver fibrosis in fatty liver disease are unreliable in people of South Asian descent. De Silva S,  Li W, Kemos P, Brindley JH, Mecci J, Samsuddin S, Chin-Aleong J, Feakins RM, Foster GR, Syn WK,  Alazawi W. Front Gastro 2017. 9(2):115-121

Periodontitis is associated with significant hepatic fibrosis in patients with non-alcoholic fatty liver disease. Alazawi W, Bernabe E, Tai D, Janicki T, Kemos P, Samsuddin S, Syn WK, Gillam D, Turner W. PLoS One 2017 journal.pone.0185902

Systemic inflammatory response syndrome (SIRS) after major abdominal surgery is predicted by early upregulation of TLR4 and TLR5.  Lahiri R, Derwa Y, Bashir Z, Giles E, Torrance HD, Owen HC, O'Dwyer MJ, O'Brien A, Stagg AJ, Bhattacharya S, Foster GR,  Alazawi W. Annals of Surgery 2015. 263(5):1028-37.

Elevated prostaglandin E2 mediates immune suppression in acute-on-chronic liver failure. O’Brien A, Fullerton J, Newson J, Massey K, Sewell, Hobbs A, Alazawi W, Winstanley A, Nicolaou A, Gilroy D. Nature Medicine, 2014. 20:518-23.

Stat2 loss leads to cytokine-independent, cell-mediated lethality in LPS-induced sepsis. Alazawi W, Heath HE, Waters JA,  Woodfin A, O’Brien A, Scarzello AJ, Lopez-Otalora Y, Jacobs M, Petts G, Goldin RD, Nourshargh S, Gamero AM, Foster GR. Proceedings of the National Academy of Science, USA, 2013 110(21) 8656-8661.