Profiles
Dr Ashwin Dhanda
Honorary Associate Professor in Hepatology
Peninsula Medical School (Faculty of Health)
Biography
Biography
I am a Consultant Hepatologist and Clinician Scientist with an interest in translational research relating to inflammatory liver diseases, particularly alcohol-related liver disease. I am part of a national MRC funded consortium aiming to minimise death from alcoholic hepatitis and am leading a workstream to validate a novel bioassay to measure response to glucocorticoid (steroid) therapy. I am seeking biomarkers of survival from alcohol-related liver disease including measures of immune function and circulating microbiome. I am also Chief Investigator of a pilot randomised controlled trial of Functional Imagery Training to treat alcohol dependence in patients with alcohol-related liver disease.
On a national level I lead the British Association for the Study of the Liver (BASL) Special Interest Group for alcohol-related liver disease (https://www.basl.org.uk/index.cfm/content/page/cid/35). This multidisciplinary group brings together active clinicians and researchers to develop national studies and trials in alcohol-related liver disease.
I am an active clinician as a Consultant Hepatologist and manage patients with acute and chronic liver disease at the South West Liver Unit at Derriford Hospital, University Hospitals Plymouth NHS Trust (https://www.plymouthhospitals.nhs.uk/dhanda-a).
Qualifications
BSc (Hons), University of Edinburgh 2000
MBChB, University of Edinburgh 2003
MRCP, Royal College of Physicians of London 2006
PGCert Health Education, St George's University of London 2007
PhD, University of Bristol 2014
FRCP, Royal College of Physicians of London 2021
Roles on external bodies
Lead of British Association for the Study of the Liver Special Interest Group on alcohol-related liver disease
Topic Expert for NICE Clinical Guidelines Update Committee for Alcohol Use DisordersCommittee member of the British Society of Gastroenterology Liver Clinical Research Group
Publications
Publications
Key publications
Key publications are highlighted
Journals
Articles
(2023) 'Assessment of immune function and prediction of survival and infection in patients with severe alcoholic hepatitis: An exploratory study' JGH Open , DOI
(2023) 'Deaths from alcohol-related liver disease in the UK: an escalating tragedy' The Lancet 401, (10375) 418-420 , DOI
(2023) 'Editorial: the burden of alcohol‐related liver disease emergency admissions in England may be twice as high as previously thought—authorsʼ reply' Alimentary Pharmacology & Therapeutics 57, (4) 437-438 , DOI
(2023) 'Can We Get Consensus on the Best Surgical Approach to Symptomatic Gallstones and Common Bile Duct Stones? Results from a Prospective Multi-centre UK Wide Study (P-ALICE)' HPB 25, S514-S514 , DOI
(2023) 'Laparoscopic Common Bile Duct Exploration: Results From a Prospective Multi-centre Prospective UK-wide Study (P-ALiCE)' HPB 25, S264-S265 , DOI
(2023) 'Outcomes of Laparoscopic Common Bile Duct Exploration: Results from a Multi-centre UK-wide Study (R-ALiCE)' HPB 25, S211-S211 , DOI
(2023) 'Trans-cystic versus Trans-choledochal Approach for Treating Common Bile Duct Stones: Which Approach Is Better? Results from R-ALICE Study' HPB 25, S300-S300 , DOI
(2023) 'Variations in the Trans-choledochal Laparoscopic Bile Duct Exploration: Is this Time for Consensus Guidelines? Results from a Retrospective Multi-centre Study (R-ALICE)' HPB 25, S513-S513 , DOI
(2022) 'The Liverpool alcohol‐related liver disease algorithm identifies twice as many emergency admissions compared to standard methods when applied to Hospital Episode Statistics for England' Alimentary Pharmacology & Therapeutics , DOI Open access
(2022) 'Alcohol misuse in patients with alcohol‐related liver disease: How can we do better? A narrative review of the literature' Alcoholism: Clinical and Experimental Research 46, (8) 1364-1370 , DOI Open access
(2022) 'The effect of increasing intestinal short‐chain fatty acid concentration on gut permeability and liver injury in the context of liver disease: A systematic review' Journal of Gastroenterology and Hepatology , DOI Open access
(2022) 'Mental Imagery to Reduce Alcohol- related harm in patients with alcohol dependence and alcohol-related liver damaGE: the MIRAGE pilot trial protocol' BMJ Open Gastroenterology 12, (5) , DOI Open access
(2022) 'A UK survey on variation in the practice of management of choledocholithiasis and laparoscopic common bile duct exploration (ALiCE Survey)' Surgical Endoscopy 36, (8) 5882-5896 , DOI Open access
(2022) 'Patients with moderate to severe COVID-19 have an impaired cytokine response with an exhausted and senescent immune phenotype' Immunobiology 227, (2) , DOI Open access
(2021) 'Recurrent Chronic HEV in Severe Combined Immunodeficiency' Journal of Clinical Immunology 41, (5) 1103-1105 , DOI Open access
(2021) 'Trajectory of Serum Bilirubin Predicts Spontaneous Recovery in a Real-World Cohort of Patients With Alcoholic Hepatitis' Clinical Gastroenterology and Hepatology , DOI Open access
(2020) 'Glucocorticoid treatment in patients with newly diagnosed immune thrombocytopenia switches CD14
++
CD16
+
intermediate monocytes from a pro‐inflammatory to an anti‐inflammatory phenotype' British Journal of Haematology 192, (2) 375-384 , DOI Open access
(2020) 'Editorial: can quantitative fibrosis assessment be used to enhance prediction of outcomes in patients with alcohol-related liver disease?' Alimentary Pharmacology and Therapeutics 53, (1) 183-184 Publisher Site , DOI Open access
(2020) 'Effect of zinc treatment on clinical outcomes in patients with liver cirrhosis: A systematic review and meta-analysis' World Journal of Hepatology 12, (7) 389-398 , DOI Open access
(2020) 'Oxidative stress in alcohol-related liver disease' World Journal of Hepatology 12, (7) 332-349 , DOI Open access
(2020) 'Effect of zinc treatment on clinical outcomes in patients with liver cirrhosis: A systematic review and meta-analysis' World Journal of Hepatology 12, (7) 390-399 , DOI Open access
(2020) 'Trace element deficiency is highly prevalent and associated with infection and mortality in patients with alcoholic hepatitis' Alimentary Pharmacology & Therapeutics , DOI Open access
(2019) 'Intermediate Monocytes in Acute Alcoholic Hepatitis Are Functionally Activated and Induce IL-17 Expression in CD4+ T Cells' The Journal of Immunology 203, (12) 3190-3198 , DOI
(2019) 'Ex Vivo T Cell Cytokine Expression Predicts Survival in Patients with Severe Alcoholic Hepatitis' Gut and Liver , DOI Open access
(2019) 'Baseline neutrophil‐to‐lymphocyte ratio predicts response to corticosteroids and is associated with infection and renal dysfunction in alcoholic hepatitis' Alimentary Pharmacology & Therapeutics 50, (4) 442-453 , DOI
(2019) 'Systematic review with meta‐analysis: high mortality in patients with non‐severe alcoholic hepatitis' Alimentary Pharmacology and Therapeutics , DOI Open access
(2017) 'Application of prognostic scores in the STOPAH trial: Discriminant function is no longer the optimal scoring system in alcoholic hepatitis' Journal of Hepatology 68, (3) 511-518 , DOI Open access
(2017) 'Infection does not increase long-term mortality in patients with acute severe alcoholic hepatitis treated with corticosteroids' World Journal of Gastroenterology 23, (11) 2052-2052 , DOI Open access
(2016) 'Development and validation of a novel bioassay to determine glucocorticoid sensitivity' Biomarker Research 4, 26-26 , DOI Open access
(2015) 'CD14++CD16+ Monocytes Are Enriched by Glucocorticoid Treatment and Are Functionally Attenuated in Driving Effector T Cell Responses' The Journal of Immunology 194, (11) 5150-5160 , DOI
(2015) 'PTH-122 Multidisciplinary team approach is accurate in diagnosing benign liver lesions: Abstract PTH-122 Table 1' Gut 64, (Suppl 1) A461.2-A462 , DOI
(2015) 'PWE-089 Abstinence from alcohol is the most important factor in predicting long term survival after hospitalisation with severe alcoholic hepatitis' Gut 64, (Suppl 1) A251.1-A251 , DOI
(2015) 'Glucocorticoid-resistant Th17 cells are selectively attenuated by cyclosporine A' Proceedings of the National Academy of Sciences 112, (13) 4080-4085 , DOI
(2015) 'Immune dysfunction in acute alcoholic hepatitis' World Journal of Gastroenterology 21, (42) 11904-11904 , DOI
(2014) 'Development and validation of a tool to select patients for admission to medical short stay units' Clinical Medicine 14, (4) 371-375 , DOI
(2014) 'Long‐term outcome in patients with severe alcoholic hepatitis can be reliably determined using an in vitro measure of steroid sensitivity' Hepatology 61, (3) 1099-1099 , DOI
(2014) 'PWE-064 Management Of Large Colonic Polyps In The Severn Deanery Hospitals: An Audit Of Current Practice' Gut 63, (Suppl 1) A151.2-A152 , DOI
(2014) 'P161 CD14CD16 MONOCYTES FROM PATIENTS WITH SEVERE ALCOHOLIC HEPATITIS DRIVE MEMORY T CELL PROLIFERATION AND POLARISE THEM TO A STEROID RESISTANT TH17 PHENOTYPE' Journal of Hepatology 60, (1) S119-S119 , DOI
(2013) 'UK wide survey on the prevention of post-ERCP pancreatitis' Frontline Gastroenterology 5, (2) 103-110 , DOI
(2013) 'OC-004 In Vitro Steroid Sensitivity Accurately Predicts 6 Month Mortality in Patients with Severe Alcoholic Hepatitis' Gut 62, (Suppl 1) A2.1-A2 , DOI
(2013) 'PWE-064 Uk Wide Survey On the Prevention of Post-Ercp Pancreatitis' Gut 62, (Suppl 1) A156.3-A157 , DOI
(2013) '524 IN VITRO STEROID SENSITIVITY ACCURATELY PREDICTS 6 MONTH MORTALITY IN PATIENTS WITH SEVERE ALCOHOLIC HEPATITIS' Journal of Hepatology 58, S215-S215 , DOI
(2013) 'Is liver biopsy necessary in the management of alcoholic hepatitis?' World Journal of Gastroenterology 19, (44) 7825-7825 , DOI
(2012) 'Can endoscopy be avoided in the assessment of ulcerative colitis in clinical trials?' Inflammatory Bowel Diseases 18, (11) 2056-2062 , DOI
(2012) 'Basiliximab Does Not Increase Efficacy of Corticosteroids in Patients With Steroid-Refractory Ulcerative Colitis' Gastroenterology 143, (2) 356-364.e1 , DOI
(2012) 'Fragility fracture risk in cirrhosis: a comparison of the fracture risk assessment tool, British Society of Gastroenterology and National Institute for Health and Clinical Excellence guidelines' Frontline Gastroenterology 3, (4) 220-227 , DOI
(2012) 'PMO-112 Is primary biliary cirrhosis a steroid sensitive autoimmune disease?' Gut 61, (Suppl 2) A118.1-A118 , DOI
(2012) 'Is primary biliary cirrhosis a steroid-sensitive autoimmune disease?' Hepatology Research 42, (6) 619-620 , DOI
(2012) 'Molecular targets in the treatment of alcoholic hepatitis' World Journal of Gastroenterology 18, (39) 5504-5504 , DOI
(2011) 'NFκB and glucocorticoid receptor activity in steroid resistance' Journal of Receptors and Signal Transduction 32, (1) 29-35 , DOI
(2011) 'P25 Fragility fracture risk in cirrhosis: a comparison of the fracture risk assessment tool (FRAX_), BSG and NICE guidelines' Gut 60, (Suppl 2) A11-A12 , DOI
(2011) 'Can Endoscopy Be Avoided in the Assessment of Ulcerative Colitis in Clinical Trials?' Gastroenterology 140, (5) , DOI
(2011) 'Endoscopy can be avoided in the assessment of ulcerative colitis in clinical trials' Gut 60, (Suppl 1) A140-A141 , DOI
Chapters
(2020) 'Hepatitis viruses (excluding hepatitis C virus)' Oxford Textbook of Medicine Oxford University PressOxford 889-C8.5.21.P45 , DOI
Conference Papers
(2016) 'Sustained viral clearance of HCV with DAA treatment is associated with restoration of effector T cell phenotype' 745A-745A
Presentations and posters
'High oxidative stress in T cells and monocytes correlates with mortality from alcoholic hepatitis' , DOI
'P78 Patients with alcohol related liver disease have high levels of oxidative stress' , DOI
'A NOVEL FUNCTIONAL BIOASSAY PREDICTS 90-DAY SURVIVAL IN PATIENTS WITH SEVERE ALCOHOLIC HEPATITIS' , DOI Open access
'A novel lymphocyte proliferation assay accurately predicts 90-day survival in severe alcoholic hepatitis patients' , DOI
'A UK Survey on Variation in Practice of Management of Choledocholithiasis and Laparoscopic Common Bile Duct Exploration (ALiCE Survey)' , DOI
'Corticosteroid treatment is associated with a resolution of altered CD4+ T cell phenotype in patients with severe alcoholic hepatitis' , DOI
'HPB O07 Complication profile of laparoscopic common bile duct exploration: Results from R-ALiCE Study' , DOI
'Intermediate (CD14++CD16+) monocytes from patients with acute severe alcoholic hepatitis are activated and functionally similar to classical (CD14++CD16−) monocytes' , DOI
'OP05 Antioxidant supplementation alters immune cell phenotype and function in patients with alcohol-related hepatitis' , DOI
'P026 Differential epigenetic regulation in survivors and non-survivors from severe alcoholic hepatitis' , DOI
'P03 Mortality from severe alcoholic hepatitis is associated with increased oxidative stress and epigenetic alterations' , DOI
'P032 Increasing burden of alcohol-related liver disease in the UK associated with the coronavirus pandemic' , DOI
'P380 Inpatients with advanced alcohol-related liver disease are not being considered for transplantation: a regional audit' , DOI
'PTU-025 Obesity is associated with severity and outcome of alcoholic hepatitis' , DOI
'THU-261-Validation of the pre-treatment neutrophil-to-lymphocyte ratio to predict response to corticosteroids in severe alcoholic hepatitis' , DOI
'Variation in the use of corticosteroids for the treatment of acute severe alcoholic hepatitis in the post-STOPAH era: results of a UK national survey' , DOI Open access
'OC-008 Stratification of patients with alcoholic hepatitis by analysis of trajectory of serum bilirubin concentration' , DOI
'Strategies are needed to support people with alcohol use disorder and alcohol-related liver disease to take part in randomised clinical trials: results from the MIRAGE pilot trial of functional imagery training' , DOI
'Il-1beta Signal Inhibition in acute alcoholic hepatitis: a multicentre, randomised, double-blind, placebo-controlled phase 2 trial of canakinumab therapy (ISAIAH)' , DOI