Investigators at the University of California, San Diego propose their continued inclusion as a Clinical Center within the "Nonalcoholic Steatohepatitis Clinical Research Network (NASH CRN)". NASH is the most prevalent liver disease in children and one of the most common causes of chronic liver disease in adults. NASH is associated with cardiovascular disease risk factors such as type 2 diabetes, hypertension, dyslipidemia and obesity. The Network's broad, long-term objectives are to advance understanding of the pathogenesis, natural history, genetics, histopathology and treatment for NASH. The NASH CRN currently is conducting 2 multi-center, double-blind, randomized, placebo-controlled clinical trials which require completion in the renewal period, one In children 8-17 years inclusive and the other in adults 18 years and over. The pediatric study called "TONIC", has 173 subjects enrolled for a 2-year treatment, assessing safety and efficacy of metformin or Vitamin E versus placebo. The adult study called "PIVENS", has 247 subjects enrolled for 2-years of treatment to assess pioglitazone or Vitamin E versus placebo. Additionally, there is a genetics study called "GOALS", which requires many more children and their parents to enroll in order to identify candidate genes associated with NASH, and an ongoing Database study with 1262 current subjects intended to assess the natural history of NASH. The Database also will be invaluable for evaluating life-style factors in NASH and evaluating noninvasive biomarkers and imaging for diagnosis and progression. In this renewal we aim to expand the database with under-represented and important biopsy-proven sub-populations such as children (particularly girls), Hispanics, blacks and those with cirrhosis to better understand the role of age, gender, ethnicity, race, genetics and lifestyle in the development of NASH and Its co-morbidities.
We aim to Identify appropriately matched control populations without NAFLD to permit comparisons to those with NAFLD. We propose the conduct of another randomized placebo-controlled clinical trial to assess other treatment options for children with NASH, and we will complete, analyze and report on the treatment studies from the last grant period now coming to fruition.
(provided by the applicant): This national multi-center Clinical Research Network is studying the genetic and environmental reasons why certain people develop fat accumulation of the liver with oft concomitant hepatic inflammation and scarring. Further knowledge about this common and increasingly prevalent disease is needed for prevention, non-invasive diagnosis, understanding of natural history and evaluation of safe and effective therapy.
|Africa, Jonathan A; Newton, Kimberly P; Schwimmer, Jeffrey B (2016) Lifestyle Interventions Including Nutrition, Exercise, and Supplements for Nonalcoholic Fatty Liver Disease in Children. Dig Dis Sci 61:1375-86|
|Nobili, Valerio; Alisi, Anna; Newton, Kimberly P et al. (2016) Comparison of the Phenotype and Approach to Pediatric vs Adult Patients With Nonalcoholic Fatty Liver Disease. Gastroenterology 150:1798-810|
|Schwimmer, Jeffrey B (2016) Clinical advances in pediatric nonalcoholic fatty liver disease. Hepatology 63:1718-25|
|Klair, Jagpal Singh; Yang, Ju Dong; Abdelmalek, Manal F et al. (2016) A longer duration of estrogen deficiency increases fibrosis risk among postmenopausal women with nonalcoholic fatty liver disease. Hepatology 64:85-91|
|Nelson, J E; Handa, P; Aouizerat, B et al. (2016) Increased parenchymal damage and steatohepatitis in Caucasian non-alcoholic fatty liver disease patients with common IL1B and IL6 polymorphisms. Aliment Pharmacol Ther 44:1253-1264|
|Schwimmer, Jeffrey B; Lavine, Joel E; Wilson, Laura A et al. (2016) In Children With Nonalcoholic Fatty Liver Disease, Cysteamine Bitartrate Delayed Release Improves Liver Enzymes but Does Not Reduce Disease Activity Scores. Gastroenterology 151:1141-1154.e9|
|Kanwar, Pushpjeet; Nelson, James E; Yates, Katherine et al. (2016) Association between metabolic syndrome and liver histology among NAFLD patients without diabetes. BMJ Open Gastroenterol 3:e000114|
|Kohli, Rohit; Sunduram, Shikha; Mouzaki, Marialena et al. (2016) Pediatric Nonalcoholic Fatty Liver Disease: A Report from the Expert Committee onÂ Nonalcoholic Fatty LiverÂ Disease (ECON). J Pediatr 172:9-13|
|Goyal, Nidhi P; Schwimmer, Jeffrey B (2016) The Progression and Natural History of Pediatric Nonalcoholic Fatty Liver Disease. Clin Liver Dis 20:325-38|
|Hourigan, Suchitra K; Abrams, Stephanie; Yates, Katherine et al. (2015) Relation between vitamin D status and nonalcoholic fatty liver disease in children. J Pediatr Gastroenterol Nutr 60:396-404|
Showing the most recent 10 out of 77 publications