Early signs of parecholytic cholangitis suggest treatment with omega-3 polyunsaturated fatty acids could help people with the condition live longer
Surgeons have discovered the first evidence to show that polyunsaturated fatty acids, essential to human survival, could have positive effects on liver disease, a discovery that could lead to the first successful treatments of the condition.
This untreatable disease attacks the liver, disrupting its function and causing the patient to bleed if they swallow or have a cut. Tests show that people with the disease can live up to 10 times longer than those who do not have the condition.
The disease is thought to be a genetic mutation linked to a molecule called isomerase, which is a protein that breaks down complex fatty acids. Scientists believe that before people develop the disease, the majority of people have a mother or father who has the defect, but in people who do not, the “accidental” mutation seems to have happened.
After research carried out on patients with a genetic variant of this disease, British Liver Trust researchers at UCL, St George’s, University of London, King’s College London and Imperial College London, used precise imaging techniques to map how isomerase proteins were moving around the liver. This showed that isomerase was transiting fatty acids from the esophagus and gut to the liver very quickly.
“We noticed that half of the fat globules, or fibres, in the liver moved into the small intestine in just under two minutes, so we put it down to isomerase genes acting as a temporary bridge from the stomach to the liver,” says Majid Shere, a consultant hepatologist at UCL. “We hypothesised that if people with the condition did not have isomerase, their cells would not efficiently get rid of their fats.”
Using high-resolution X-ray imaging equipment, the researchers found that the amount of cholesterol moving between the colon and liver actually went down in people with the disease, which they say suggested that isomerase acted as a sort of crash barrier.
“This was amazing because we had no real idea what this gene did, so we had to understand what it was telling us,” says Shere. “Isomerase protects the liver from chronic, excessive inflammation, so if we can understand its mechanism and find a treatment that is non-invasive, then this could change the lives of people with the disease.”
However, to use this discovery as a treatment, researchers need to understand how the molecule works.
“If the liver is in danger, people with this condition need to go to hospital in a hurry, or be in an accident,” says Shere. “Doing an operation to give these fatty acids to people could also have the added benefit of reducing inflammation.”