Nonalcoholic fatty liver disease (NAFLD) is a common cause of chronic liver disease in the United States. It encompasses both a fatty liver and nonalcoholic steatohepatitis (NASH). The NASH Clinical Research Network (NASH CRN) was established in 2002 to conduct research related to the clinical features, risk factors, pathogenesis, natural history and treatment of NAFLD in children and adults. Encouraged by its success, the NIDDK has issued RFA-DK-08-505 whose objective is to continue the NASH CRN for five more years. The objectives of the NASH CRN during the next five years are: (1) to successfully complete three network wide studies initiated during the initial funding period. These include an observational longitudinal study of NAFLD in adults and children (NAFLD database study, n=1215), a randomized double blind controlled trial of pioglitazone or vitamin E vs. placebo (PIVENS) (n=247) in nondiabetic adults with NASH, and a randomized double blind controlled trial of metformin or vitamin E vs. placebo (TONIC) (n= 173). These studies are fully enrolled. The NAFLD database will be amended to allow further follow up of enrolled subjects, perform liver biopsies on selected subjects and add carefully defined controls as well as additional subjects with NAFLD. The rationale for this is to definitively evaluate the natural history of the disease, develop and validate biomarkers and complete ancillary studies that are still underpowered despite use of the current database, (2) to complete the numerous pilot and ancillary studies that have been initiated, (3) to perform additional therapeutic trials in adults and children with NASH. The specific studies will be based on proposals received from individual centers that are approved by the NASH CRN steering committee and the NIDDK for which funding is available, and (4) to conduct new ancillary studies proposed by individual centers. Two studies are proposed by this center: (a) to validate the metabolomic signature of NASH. Preliminary studies have identified a distinct lipidomic signature of NASH, (b) to perform a randomized controlled trial of laparoscopic adjustable band gastroplasty (LABG) for adults with NASH who have a BMI between 30-45. This trial will test the hypothesis that LABG is a safe and effective treatment of NASH. Together, all of these studies are directly aligned with the NIH liver action plan for NAFLD. Public Health Relevance: (provided by the applicant): NAFLD and NASH are important health problems and their incidence is expected to increase. During the initial funding period, the CRN has made important contributions to the field of NAFLD and NASH, however there remain numerous unanswered questions. During the next funding period, the CRN will continue to investigate risk factors, clinical aspects, natural history and optimal treatment for NASH and associated conditions

Agency
National Institute of Health (NIH)
Institute
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type
Research Project--Cooperative Agreements (U01)
Project #
3U01DK061731-08S1
Application #
8012896
Study Section
Special Emphasis Panel (ZDK1-GRB-7 (M1))
Program Officer
Robuck, Patricia R
Project Start
2010-02-01
Project End
2011-01-31
Budget Start
2010-02-01
Budget End
2011-01-31
Support Year
8
Fiscal Year
2010
Total Cost
$104,771
Indirect Cost
Name
Virginia Commonwealth University
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
105300446
City
Richmond
State
VA
Country
United States
Zip Code
23298
Middleton, Michael S; Van Natta, Mark L; Heba, Elhamy R et al. (2018) Diagnostic accuracy of magnetic resonance imaging hepatic proton density fat fraction in pediatric nonalcoholic fatty liver disease. Hepatology 67:858-872
Africa, Jonathan A; Behling, Cynthia A; Brunt, Elizabeth M et al. (2018) In Children With Nonalcoholic Fatty Liver Disease, Zone 1 Steatosis Is Associated With Advanced Fibrosis. Clin Gastroenterol Hepatol 16:438-446.e1
Ajmera, Veeral; Belt, Patricia; Wilson, Laura A et al. (2018) Among Patients With Nonalcoholic Fatty Liver Disease, Modest Alcohol Use Is Associated With Less Improvement in Histologic Steatosis and Steatohepatitis. Clin Gastroenterol Hepatol 16:1511-1520.e5
Vuppalanchi, Raj; Siddiqui, Mohammad S; Van Natta, Mark L et al. (2018) Performance characteristics of vibration-controlled transient elastography for evaluation of nonalcoholic fatty liver disease. Hepatology 67:134-144
Loomba, Rohit; Sanyal, Arun J; Kowdley, Kris V et al. (2018) Factors Associated With Histologic Response in Adult Patients With Nonalcoholic Steatohepatitis. Gastroenterology :
Brunt, Elizabeth M; Kleiner, David E; Wilson, Laura A et al. (2018) Improvements in Histologic Features and Diagnosis associated with Improvement in Fibrosis in NASH: Results from the NASH Clinical Research Network Treatment Trials. Hepatology :
Chalasani, Naga; Abdelmalek, Manal F; Loomba, Rohit et al. (2018) Relationship Between Three Commonly Used Non-invasive Fibrosis Biomarkers and Improvement in Fibrosis Stage in Patients With NASH. Liver Int :
Harlow, Kathryn E; Africa, Jonathan A; Wells, Alan et al. (2018) Clinically Actionable Hypercholesterolemia and Hypertriglyceridemia in Children with Nonalcoholic Fatty Liver Disease. J Pediatr 198:76-83.e2
Perito, Emily R; Ajmera, Veeral; Bass, Nathan M et al. (2017) Association Between Cytokines and Liver Histology in Children with Nonalcoholic Fatty Liver Disease. Hepatol Commun 1:609-622
Newton, Kimberly P; Feldman, Haruna S; Chambers, Christina D et al. (2017) Low and High Birth Weights Are Risk Factors for Nonalcoholic Fatty Liver Disease in Children. J Pediatr 187:141-146.e1

Showing the most recent 10 out of 75 publications