Vishal Patel is a Consultant Hepatologist & Endoscopist at the Liver Unit, King’s College Hospital, having been involved in the inception of the Advanced Chronic Liver Disease (ACLD) service and managing complications related to portal hypertension. He is a Principal Investigator and Group Lead for ACLD Experimental & Therapeutics with his research group based at the Roger Williams Institute of Liver Studies, and is an Adjunct Reader in Hepatology at King’s College London.

His laboratory group focuses on translational research on the oral-gut-liver axis in cirrhosis, evolving from his doctorate research, and infection-related complications that patients with ACLD suffer with, in an era of ever-escalating threats from antimicrobial resistance. His group is focuses on metagenomic and other -omics profiling, with primary interests based around characterising and understanding the pathophysiological role of the microbiome in driving chronic liver failure syndromes and clinical complications, and developing non-antimicrobial-based therapeutic interventions that can more effectively target oral-gut dysbiosis, pathological bacterial translocation and immune dysfunction.

Linked to this is the ‘Rapid Infection Diagnostics in Cirrhosis’ (RIDiC) study evaluating the role of sequencing-based molecular approaches as a means to combat AMR, in industry collaboration with Oxford Nanopore Technologies. His group has active works-streams exploring the role of circulating cell-free DNA (cfDNA) and coagulation dysfunction in chronic liver failure syndromes where epigenetic profiling of cfDNA is being used as a novel approach via the concept of ‘liquid biopsy’ to assess covert organ dysfunction, working with the University of Pittsburgh, USA.

He is Chief Investigator of the NIHR HTA-funded £2.5 million BOPPP trial (ClinicalTrials.gov ID: NCT03776955) evaluating the effectiveness of non-selective beta-blockers to prevent hepatic decompensation in patients with small oesophageal varices and cirrhosis, working closely with Dr Mark McPhail. BOPPP is currently the largest portal hypertension trial globally, and successfully surpassed the recruitment target of 740 patients across 55 UK sites in July 2024.

Vishal is involved in several observational and interventional studies in chronic liver failure syndromes, including acute alcohol-related hepatitis, hepatic encephalopathy, and faecal microbial transplantation in cirrhosis. He has extensive study set up and trial delivery experience and expertise, having also been involved in the interventional trial portfolio during the COVID19 pandemic. He is the Liver Research Delivery Unit Clinical Lead at King's College Hospital, overseeing one of the largest portfolios of non-commercial and commercial trials in Europe. He has assumed the national role of Clinical Research Lead & Sub-Committee Chair for the British Association for Study of the Liver, overseeing the promotion and development of the UK liver research strategy and education (clinical and translational), via the BASL Research Development Group.

“Chronic liver disease is a condition which I am dedicated to treating clinically and still represents so much unmet need. Translational research in this area is pivotal to improving patient outcomes and quality of life in those that are afflicted. My group in collaboration with others are determined to make real progress in this area."

You can find more information about Vishal's publications and work with the following links:

• Publications: https://www.ncbi.nlm.nih.gov/myncbi/vishal.patel.7/bibliography/public/
• ORCID: https://orcid.org/0000-0001-6616-3628
• BOPPP trial: https://www.boppp-trial.org

Currently working on:

The ACLD Experimental & Therapeutics group based at the Roger Williams Institute of Hepatology actively collaborates with clinical, translational and basic science groups as well as industry and biotech. Research work-streams are focused on advanced chronic liver disease (ACLD) to better understand (i) patho-biological pathways and disease mechanisms, and (ii) to develop novel diagnostics and (iii) therapeutic interventions:

1. The oral-gut-liver axis:

• Oral and gut micro-/mycobiome, viromic and functional alterations
• Intestinal barrier dysfunction in cirrhosis:
  • PhD studentship commenced Oct 2024 (Dr Ema Maxan)
• Non-antibiotic based therapeutics – pre-clinical development and in-human trials.

2. Rapid Infection Diagnostics in Cirrhosis (RIDiC):

• Clinical metagenomic approaches including antimicrobial resistance evaluation
  • Dr Merianne Mohamed (post-doctoral scientist)
  • PhD studentship commencing Feb 2025

3. Cell-free DNA, epigenetic profiling and coagulation dysfunction:

• Coagulation, immuno-inflammatory and haemostasis pathway interrogation (collaboration with Prof Ton Lisman and Dr Mark Roest, Netherlands)
• Epigenetic approaches to study organ dysfunction
  • PhD studentship commencing Feb 2025

This research is resourced by a combination of (inter)national grants and funding, involving collaborations with research groups across King’s Health Partners, within London and the UK, and working with international partners based in Denmark, Germany, Spain, Sweden, North America and Australia.

Teaching

• Vishal is a teacher on the course: Microbiome in Health & Disease MSc