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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)
  • fax0115 970 9012


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.

His landmark study on warfarin pharmacogenetics (Lancet 1999) catalysed the field, leading the US Food and Drug administration (FDA) to recommend (2007 & 2010) genetic testing during warfarin dosing and its wider application in practice. He also led an international expert panel to establish phenotypic standardisation in drug-induced liver injury (DILI) (Clin Pharmacol Ther. 2011). He co-chaired international DILI consortia (iDILIC) to conduct a seminal genome-wide association studies identifying key associations with key polymorphisms in HLA and other genes with DILI (Nat Genet. 2009, Gastroenterology 2017).

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

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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