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Guru Aithal

Head of Division, Faculty of Medicine & Health Sciences


  • workRoom W/E 1418 E Floor, West Block
    Queen's Medical Centre
    NG7 2UH
  • work0115 823 1149 (PA)
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Professor Guruprasad P. Aithal is the Professor of Hepatology and the Head of the Division for the Nottingham Digestive Diseases Centre and Deputy Director of Nottingham Molecular Pathology Node.

Professor Aithal is the GI & Liver Disorder Theme Lead at the NIHR Nottingham Biomedical Research Centre, and was the Director of NIHR Nottingham Digestive Diseases BRU between 2008 & 2016.

He won the NHS Innovation Award (2013), Shire Award for Gastrointestinal Excellence (2015) and was BMJ Gastroenterology team finalist (2015).

Professor Aithal's research interests include drug-induced liver injury, metabolic liver disease, hepatopancreaticobiliary imaging and epidemiology of liver and biliary disorders.

Professor Aithal's study on pharmacogenetics of warfarin (Lancet 1999) stimulated the evaluation and application of pharmacogenetics in reducing drug related adverse events; FDA updated the warfarin labelling in 2007 and again in 2010 with a dosing table including CYP2C9 and VKORC1 genotype information. Leading national (DILIGEN) and international (iDILIC) consortia, their discoveries have established the role of adaptive immunity in the pathogenesis of human drug-induced liver injury (DILI) (Nat Genet 2009, Gastroenterology 2017 and 2019) and role of genetic tests in its diagnosis. FDA issued 'Clinical Pharmacogenomics: Premarket Evaluation in Early-Phase Clinical Studies and Recommendations for Labelling' in 2013' ( RegulatoryInformation/Guidances/default.htm).

Professor Aithal am the Deputy Co-ordinator & DILI work package lead for the Innovation Medicines Initiative funded TransBioLine programme (2019-24) and the Vice-Chair of the European Cooperation in Science & Technology (COST Action CA17112), 'Prospective European Drug-Induced Liver Injury Network' (2018-22).

He has contributed critically to the evaluation of the Enhanced Liver Fibrosis panel (Hepatology. 2008 and 2013), the first non-invasive marker recommended for clinical use by National Institute for Health and Care Excellence (NICE), UK in 2016. Professor Aithal evaluated piogltazone (Gastroenterology. 2008) which has been recommended by NICE and European Association for the Study of the Liver (EASL) for the treatment of non-alcoholic steatohepatitis in 2016. He was the co-investigator in the phase II trial of liraglutide (Lancet 2016) demonstrating its efficacy in the treatment of NASH.

Professor Aithal has led the development of fast, and inexpensive magnetic resonance imaging (MRI) method to estimate the degree of inflammation and fibrosis within the whole liver (NMR Biomed. 2015). Recently, he used this method to estimate portal pressure (J Hepatol 2016), showing that it correlates with hepatic venous pressure gradient measurements - the current gold standard but invasive and expensive test, only available in selected centres.

He has in total 197 publications including 104 original articles, 55 invited reviews/ editorials/ textbook chapters, 34 letters/ case reports and 4 collaborations. His H index is 53 currently.

Expertise Summary

  • Pharmacogenetics
  • Non-alcoholic fatty liver disease (mechanisms, biomarkers of liver injury and effective lifestyle and pharmacological interventions)
  • epidemiology of liver and biliary disease (cause and consequences)
  • Hepatobiliary imaging (assessment of degree of liver injury and endoscopic imaging techniques).
  • Drug-induced liver injury ((DILI) causality assessment, outcome, genetic and environmental factors that effect drug metabolism and hepatoxicity)

Teaching Summary

Having worked in University hospitals in the United Kingdom and abroad, Guru has gained experience in a variety of teaching environments and modalities. He has been a Member of the Specialty… read more

Research Summary

Current Research

Drug-induced liver injury (DILI): Genetic and environmental factors associated with drug-induced liver injury, non-invasive markers to detect and monitor hepatotoxicity.

Non-alcoholic fatty liver disease (NAFLD): Interaction of dietary and genetic factors in the pathogenesis, non-invasive detection and stratification of NAFLD, effective interventions

Non-invasive evaluation of chronic liver disease: Application of Quantitative Magnetic Resonance Imaging methods to detect and estimate degree of liver injury in chronic liver diseases.

Hepato-pancreatico-biliary imaging: Optimising endoscopic evaluation of hepato-pancreatico-biliary neoplacia; tools and techniques

Recent Publications

Having worked in University hospitals in the United Kingdom and abroad, Guru has gained experience in a variety of teaching environments and modalities. He has been a Member of the Specialty Certificate Examination (SCE) Examining Board in Gastroenterology since inception in 2007.

Past Research

  • Drug-induced liver injury (causality assessment, outcome, genetic and environmental factors that effect drug metabolism and hepatotoxicity).
  • Non-alcoholic fatty liver disease (mechanisms and biomarkers of liver injury and effective interventions).
  • Epidemiology of liver and biliary disease (cause and consequences)
  • Endoscopic hepato-pancreatico-biliary imaging (tools and techniques)

Future Research

Quantitative and dynamic MRI techniques in chronic liver disease: In collaboration with Prof Penny Gowland and Dr Susan Francis (Sir Peter Mansfield MRI Centre), we have validated simple, non-contrast MRI methods to quantify fat, inflammation, iron and fibrosis within the liver. We will use quantitative and dynamic MRI techniques to investigate the pathophysiology of non-alcoholic fatty liver disease and portal hypertension. We will evaluate the relationship between splanchnic perfusion, bowel transit and bacterial translocation. We will use MR spectrospcopic methods to evaluate the effects of dietary and life style interventions in chronic liver diseases

Dietary, life style and genetic factors associated with the non-alcoholic fatty liver disease (NAFLD): Considering its prevalence, any intervention that is proposed in the prevention and therapy of NAFLD, essentially has to be applicable to a substantial proportion of the population. Currently, I am collaborating with Prof Macdonald, Prof Andy Salter and Dr Andrew Bennett to investigate intense dietary interventions in bariatric surgery patients. I have also established collaboration with Institute of Population Health and Science, Trevandrum and Centre for Cellular and Molecular Biology, Hyderabad, India; in a well characterized population based cohort we will investigate the interaction between dietary and environmental factors related to the development of NAFLD.

Identification, development and validation of markers of liver injury: As a co-chair of International DILI Consortium (iDILIC), I have collected a large cohort of deeply phenotyped patients with DILI for pharmacogenetics studies. We will perform large scale case-control association studies using 'whole genome genotyping/ exon sequencing' methods to identify novel genetic factors underlying DILI pathogenesis.

School of Medicine

University of Nottingham
Medical School
Nottingham, NG7 2UH

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