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SteatoSITE, a ‘big data’ approach to non-alcoholic fatty liver disease

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Jenny Cameron
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Professor Jonathan Fallowfield is working with clinical and industry partners on a ground-breaking, multi-centre integrated gene-to-patient ‘data commons’ that will enable researchers and clinicians to better understand non-alcoholic fatty liver disease, and play a vital role in the development of new tests and therapies.

Twenty-five percent of the world’s population has non-alcoholic fatty liver disease (NAFLD), an umbrella term for a range of conditions characterised by a build-up of fat in the liver. Causes include obesity, a genetic predisposition, and diabetes, and while many people with a fatty liver will display no symptoms and the condition will not advance, it can progress to non-alcoholic steatohepatitis (NASH), which is more serious. NASH can cause liver scarring and sometimes lead to end-stage liver disease (cirrhosis), for which the only curative treatment is liver transplantation. There are currently no approved medicines for the treatment of NAFLD or NASH, but a better understanding of these conditions could lead to the development of new tests and treatments.


Professor Jonathan Fallowfield is Chair of Translational Liver Research at the University of Edinburgh’s Centre for Inflammation Research, and Honorary Consultant Hepatologist at the Royal Infirmary of Edinburgh. Looking after patients with chronic liver conditions, he was acutely aware of the absence of useful tests and effective treatments for NAFLD, and he wanted to understand why only around 10% of people with NAFLD go on to develop serious liver problems. Knowing that the answer to this could pave the way for new diagnostic tests and treatments, Professor Fallowfield partnered with Precision Medicine Scotland, the national centre for accelerating the advancement and adoption of precision medicine, and a Cambridge-based bioinformatics company (Eagle Genomics) to take his project forward.

The end product is SteatoSITE, a ground-breaking, multi-centre integrated gene-to-patient ‘data commons’ for NAFLD research comprising hepatic RNA-sequencing, quantitative digital pathology and comprehensive electronic health record data across the complete NAFLD disease spectrum. Funded by two Innovate UK grants, and with a team including Senior Clinical Fellow in Pathology and Honorary Consultant Histopathologist Dr Tim Kendall, Professor Fallowfield and SteatoSITE co-investigators have built up a large group of nearly 1,000 NAFLD cases from across Scotland, collecting existing information about the sort of liver damage that can develop in NAFLD livers; which genes are present in the liver as NAFLD worsens; and how this relates to various health outcomes in people with NAFLD.

Moving forward

The SteatoSITE data commons brings together data, storage and computing systems, and will create a valuable resource for a wide range of users from researchers and clinicians to charities and even patients. There are also rich opportunities to collaborate with Pharma and Biotech companies with an interest in NAFLD, so Professor Fallowfield is also drawing on the expertise of Edinburgh Innovations, the University of Edinburgh’s commercialisation service, to provide business development support and identify further funding opportunities.

As more health data is added, SteatoSITE will evolve into a smarter, more comprehensive knowledge system that will be used to make new discoveries and will enable researchers and clinicians to better understand NAFLD and NASH. From this point, SteatoSITE will play a vital role in the development and validation of new tests and therapies, and has the potential to transform the care of people living with NAFLD.

Related links

Read more about Jonathan Fallowfield and his work


Precision Medicine Scotland

Centre for Inflammation Research

Read the Nature Medicine paper on Steatosite from October 2023

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