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Dr Jesús Bañales

Metabolic based prediction of prognosis and early detection of bile duct cancer and recurrent PSC

Awarded to the Biodonostia Health Research Institute

Awardholder: Dr Jesús Bañales, Liver Diseases Group

The total grant awarded is £45,000

Duration of award: September 2019 to 31 December 2021 (extension agreed due to COVID)

Award details: Metabolic-based prediction of prognosis in patients with primary sclerosing cholangitis and early diagnosis of cholangiocarcinoma: new non-invasive strategy.

End of Study Report

31 March 2022

Aim

To investigate non-invasive biomarkers in blood to predict PSC prognosis and early cholangiocarcinoma (CCA) development.

Results

221 blood samples from 183 patients were collected. A cutting-edge technology called ultra-high performance liquid chromatography – mass spectrometry (UHPLC-MS) was used to evaluate the metabolomic profiles of each sample.

What is a metabolomic profile?

In this study, a metabolomic profile is a biological ‘signature’ based on different substances found in the blood. You can think of metabolomic profiles as chemical fingerprints detected in blood.

Cholangiocarcinoma (CCA)

Dr Bañales’ team found marked differences between the metabolomic profiles (the chemical fingerprints) of individuals with PSC and CCA compared to those with PSC alone. They then found that the metabolomic profiles of people with PSC who later went on to develop CCA were also different from patients with PSC that never developed CCA. This suggests that specific metabolomic features are associated with the early development of CCA. The team proposes that checking PSC patients’ metabolomic profiles (in blood tests) for these features could help detect early signs of CCA. This is particularly important because the early diagnosis of CCA in PSC patients is extremely challenging, and we want to be able to detect it as early as possible so that treatments options can have the best chance of success.

Recurrent PSC (rPSC)

Dr Bañales’ team looked at the metabolomic profiles in blood of PSC patients who underwent liver transplantation. PSC developed again in some of these patients (rPSC). They found that the individuals who went on to get rPSC also had specific metabolomic features in their blood that may help to identify the patients with higher risk to develop again PSC that could be seen even before their transplant. Again, this suggests that a blood test could be used to identify those for whom PSC will return after transplant, and importantly, those for whom it will not return.

Can we start doing blood tests now?

No. This research used cutting-edge technology and these discoveries are very new. The findings now need to be validated in a larger group of people (a ‘validation phase’) so that strong evidence can be developed to show that these new blood biomarkers (that is, the metabolomic features identified) do indeed predict the groups of patients who will develop CCA or rPSC (and equally, who will not develop rPSC).

When will the validation phase go ahead?

The team is already on it! They hope to have their results at the end of 2022.

 

Updated with this final report: 31 March 2022

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