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205 results on '"Dhanda, Ashwin"'

5. IL-1 Signal Inhibition in Alcohol-Related Hepatitis: A Randomized, Double-Blind, Placebo-Controlled Trial of Canakinumab

Author

Vergis, Nikhil, Patel, Vishal, Bogdanowicz, Karolina, Czyzewska-Khan, Justyna, Keshinro, Rosemary, Fiorentino, Francesca, Day, Emily, Middleton, Paul, Atkinson, Stephen, Tranah, Thomas, Cross, Mary, Babalis, Daphne, Foster, Neil, Lord, Emma, Quaglia, Alberto, Lloyd, Josephine, Goldin, Robert, Rosenberg, William, Parker, Richard, Richardson, Paul, Masson, Steven, Whitehouse, Gavin, Sieberhagan, Cyril, Patch, David, Naoumov, Nikolai, Dhanda, Ashwin, Forrest, Ewan, and Thursz, Mark

Published
2024
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7. Trajectory of Serum Bilirubin Predicts Spontaneous Recovery in a Real-World Cohort of Patients With Alcoholic Hepatitis

Author

Parker, Richard, Cabezas, Joaquin, Altamirano, Jose, Arab, Juan Pablo, Ventura-Cots, Meritxell, Sinha, Ashish, Dhanda, Ashwin, Arrese, Marco, McCune, C. Anne, Rowe, Ian A., Schnabl, Bernd, Mathurin, Phillipe, Shawcross, Debbie, Abraldes, Juan G., Lucey, Michael R., Garcia-Tsao, Guadalupe, Verna, Elizabeth, Brown, Robert S., Jr., Bosques-Padilla, Francisco, Vargas, Victor, Louvet, Alexandre, Holt, Andrew P., and Bataller, Ramon

Published
2022
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8. SAT-467 Prioritisation of research to tackle stigma in alcohol-related liver disease: results from the ARMS-Hub partnership

Author

Dhanda, Ashwin, primary, Allgar, Victoria, additional, Bhala, Neeraj, additional, Callaghan, Lynne, additional, Castro, Joana, additional, Chokshi, Shilpa, additional, Clements, Amanda, additional, Forrest, Ewan H., additional, Manning, Lesley, additional, Parker, Richard, additional, Shawcross, Debbie L., additional, and Towey, Jennifer, additional

Published
2024
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11. Top ten research priorities for alcohol use disorder and alcohol-related liver disease: results of a multistakeholder research priority setting partnership

Author

Subhani, Mohsan, primary, Dhanda, Ashwin, additional, Olaru, Adina, additional, Dunford, Louise, additional, Ahmad, Nahid, additional, Wragg, Andrew, additional, Frost, Kate, additional, Greenwood, Justin, additional, King, Melinda, additional, Jones, Katy A, additional, Rosenberg, William, additional, Sinclair, Julia, additional, Rennick-Egglestone, Stefan, additional, Morling, Joanne R, additional, Patel, Krishna, additional, and Ryder, Stephen D, additional

Published
2024
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13. Mechanisms of glucocorticoid resistance in inflammatory diseases of the gut and liver

Author

Dhanda, Ashwin Deep

Subjects
615.794
Abstract

Glucocorticoids (GCs) are widely used to treat inflammatory diseases of the gut and liver. However, they are ineffective in up to a third of patients. In ulcerative colitis (UC) such GC resistant individuals require a colectomy, while patients with severe alcoholic hepatitis (AH) develop fatal progressive liver failure. Early stratification of these high-risk patients is critical to improve our understanding of the mechanisms of GC resistance and also for the development of better therapies. The work presented in this thesis aimed to extend the application of a candidate biomarker of GC resistant disease from UC to AH. Based on this, differential lymphocyte responses to GCs were then interrogated, and the effect of interleukin-2 on GC responsiveness assessed. An evaluation of the role of different T helper (Th) cell subsets in driving the GC resistant phenotype was then conducted, followed by an investigation of the role of monocytes in shaping these T cell responses to GCs. These studies have confirmed that the in vitro effect of GCs on lymphocyte proliferation corresponds with clinical outcome in AH as well as UC, highlighting the role of T cell responses. Blockade of IL-2 improved GC sensitivity in vitro and investigation of intracellular signalling pathways demonstrated that there was impaired GC regulation of the pro-inflammatory transcription factor NFKB in GC resistant cells. NFKB can induce Th17 cell differentiation and IL-17 expression was found to be refractory to GC suppression in CD4+ T cells. Toll-like receptors (TLRs) were then shown to influence monocyte-mediated CD4+ T cell differentiation in both man (in vitro) and mouse (in vivo). Monocyte subsets were critical in determining this T cell fate, and innate immune responses are therefore a key potential driver of the GC resistant phenotype. This work has led to the development of a protocol for a Phase II clinical trial of IL-2 blockade in GC resistant AH and also further mechanistic studies to evaluate the role of monocytes in GC resistant diseases.

Published
2014

17. Quality standards for the management of alcohol-related liver disease: consensus recommendations from the British Association for the Study of the Liver and British Society of Gastroenterology ARLD special interest group

Author

Parker, Richard, primary, Allison, Michael, additional, Anderson, Seonaid, additional, Aspinall, Richard, additional, Bardell, Sara, additional, Bains, Vikram, additional, Buchanan, Ryan, additional, Corless, Lynsey, additional, Davidson, Ian, additional, Dundas, Pauline, additional, Fernandez, Jeff, additional, Forrest, Ewan, additional, Forster, Erica, additional, Freshwater, Dennis, additional, Gailer, Ruth, additional, Goldin, Robert, additional, Hebditch, Vanessa, additional, Hood, Steve, additional, Jones, Arron, additional, Lavers, Victoria, additional, Lindsay, Deborah, additional, Maurice, James, additional, McDonagh, Joanne, additional, Morgan, Sarah, additional, Nurun, Tania, additional, Oldroyd, Christopher, additional, Oxley, Elizabeth, additional, Pannifex, Sally, additional, Parsons, Graham, additional, Phillips, Thomas, additional, Rainford, Nicole, additional, Rajoriya, Neil, additional, Richardson, Paul, additional, Ryan, J, additional, Sayer, Joanne, additional, Smith, Mandy, additional, Srivastava, Ankur, additional, Stennett, Emma, additional, Towey, Jennifer, additional, Vaziri, Roya, additional, Webzell, Ian, additional, Wellstead, Andrew, additional, Dhanda, Ashwin, additional, and Masson, Steven, additional

Published
2023
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19. Proactive case finding of alcohol‐related liver disease in high‐risk populations: A systematic review.

Author

Archer, Ann J., Phillips, Jennifer, Subhani, Mohsan, Ward, Zoe, Gordon, Fiona H., Hickman, Matthew, Dhanda, Ashwin D., and Abeysekera, Kushala W. M.

Subjects
ALCOHOLISM, ALCOHOL-induced disorders, LIVER diseases, PATIENT participation, GREY literature
Abstract

Background: Alcohol‐related liver disease (ARLD) is often diagnosed at a late stage when mortality is unacceptably high. Earlier identification of ARLD may lead to reduced alcohol intake, participation in hepatocellular carcinoma surveillance and reduction in liver‐related morbidity and mortality. People with alcohol use disorder (AUD) are at highest risk of ARLD. The aim of this systematic review was to understand the yield of proactive screening for ARLD amongst high‐risk groups. Methods: Embase, Medline, Scopus and grey literature were searched for studies describing proactive assessment for alcohol‐related liver disease in people with a history of alcohol excess or diagnosed AUD. Outcomes of interest were fibrosis and cirrhosis detection rates, clinical outcomes, portal hypertension evaluation, attendance at follow‐up and cost‐effectiveness. Results: Fifteen studies were identified for inclusion from 1115 returned by the search. Four key settings for patient engagement were identified as inpatient addiction services, outpatient addiction services, general acute hospital admissions and community outreach. Of these, acute hospital admissions were the highest yield for cirrhosis at 10.8%–29.6% and community outreach the lowest was 1.2%–2.3%. Conclusions: Targeted fibrosis assessment of high‐risk populations for ARLD is feasible to conduct and identifies a proportion of patients at risk of advanced liver disease. The highest yield is amongst inpatients admitted with AUD. Prospective work is needed to establish which are the most effective and acceptable screening methods and the impact on long‐term outcomes. [ABSTRACT FROM AUTHOR]

Published
2024
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22. The Liverpool alcohol-related liver disease algorithm identifies twice as many emergency admissions compared to standard methods when applied to Hospital Episode Statistics for England

Author

Dhanda, Ashwin, Bodger, Keith, Hood, Steve, Henn, Clive, Allison, Michael, Amasiatu, Chioma, Burton, Robyn, Cramp, Matthew, Forrest, Ewan, Khetani, Meetal, MacGilchrist, Alastair, Masson, Steven, Parker, Richard, Sheron, Nick, Simpson, Ken, Vergis, Nikhil, White, Martin, BASL ARLD SIG National Service Evaluation Group, Dhanda, Ashwin [0000-0002-0523-0193], Bodger, Keith [0000-0002-1825-3239], Forrest, Ewan [0000-0002-7293-2574], Masson, Steven [0000-0003-1041-9844], Parker, Richard [0000-0003-4888-8670], and Apollo - University of Cambridge Repository

Subjects
Hospitalization, England, Liver Diseases, Humans, COVID-19, Pandemics, Hospitals, Algorithms
Abstract

BACKGROUND: Emergency admissions in England for alcohol-related liver disease (ArLD) have increased steadily for decades. Statistics based on administrative data typically focus on the ArLD-specific code as the primary diagnosis and are therefore at risk of excluding ArLD admissions defined by other coding combinations. AIM: To deploy the Liverpool ArLD Algorithm (LAA), which accounts for alternative coding patterns (e.g., ArLD secondary diagnosis with alcohol/liver-related primary diagnosis), to national and local datasets in the context of studying trends in ArLD admissions before and during the COVID-19 pandemic. METHODS: We applied the standard approach and LAA to Hospital Episode Statistics for England (2013-21). The algorithm was also deployed at 28 hospitals to discharge coding for emergency admissions during a common 7-day period in 2019 and 2020, in which eligible patient records were reviewed manually to verify the diagnosis and extract data. RESULTS: Nationally, LAA identified approximately 100% more monthly emergency admissions from 2013 to 2021 than the standard method. The annual number of ArLD-specific admissions increased by 30.4%. Of 39,667 admissions in 2020/21, only 19,949 were identified with standard approach, an estimated admission cost of £70 million in under-recorded cases. Within 28 local hospital datasets, 233 admissions were identified using the standard approach and a further 250 locally verified cases using the LAA (107% uplift). There was an 18% absolute increase in ArLD admissions in the seven-day evaluation period in 2020 versus 2019. There were no differences in disease severity or mortality, or in the proportion of admissions with decompensation of cirrhosis or alcoholic hepatitis. CONCLUSIONS: The LAA can be applied successfully to local and national datasets. It consistently identifies approximately 100% more cases than the standard coding approach. The algorithm has revealed the true extent of ArLD admissions. The pandemic has compounded a long-term rise in ArLD admissions and mortality.

Published
2022
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23. Mental Imagery to Reduce Alcohol-related harm in patients with alcohol use disorder and alcohol-related liver damaGE: the MIRAGE randomised pilot trial results.

Author

Dhanda, Ashwin, Andrade, Jackie, Allende, Hannah, Allgar, Victoria, Bailey, Matthew, Callaghan, Lynne, Cocking, Laura, Goodwin, Elizabeth, Hawton, Annie, Hayward, Christopher, Hudson, Ben, Ingram, Wendy, Jeffery, Alison, King, Angela, Lavers, Victoria, Lomax, Joe, McCune, C. Anne, Musicha, Crispin, Parker, Richard, and Rollinson, Christopher

Published
2024
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24. Strategies are needed to support people with alcohol use disorder and alcohol-related liver disease to take part in randomised clinical trials: results from the MIRAGE pilot trial of functional imagery training

Author

Dhanda, Ashwin, primary, Allgar, Victoria, additional, Andrade, Jackie, additional, Callaghan, Lynne, additional, Hudson, Benjamin, additional, Ingram, Wendy, additional, King, Angela, additional, Lavers, Victoria, additional, Lomax, Joe, additional, McCune, Anne, additional, Musicha, Crispin, additional, Parker, Richard, additional, Rollinson, Christopher, additional, and Creanor, Siobhan, additional

Published
2023
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27. Glucocorticoid-resistant Th17 cells are selectively attenuated by cyclosporine A

Author

Schewitz-Bowers, Lauren P., Lait, Philippa J. P., Copland, David A., Chen, Ping, Wu, Wenting, Dhanda, Ashwin D., Vistica, Barbara P., Williams, Emily L., Liu, Baoying, Jawad, Shayma, Li, Zhiyu, Tucker, William, Hirani, Sima, Wakabayashi, Yoshiyuki, Zhu, Jun, Sen, Nida, Conway-Campbell, Becky L., Gery, Igal, Dick, Andrew D., Wei, Lai, Nussenblatt, Robert B., and Lee, Richard W. J.

Published
2015

29. Deaths from alcohol-related liver disease in the UK: an escalating tragedy

Author

Allison, Michael E D, primary, Verne, Julia, additional, Bernal, William, additional, Clayton, Michelle, additional, Cox, Sam, additional, Dhanda, Ashwin, additional, Dillon, John F, additional, Ferguson, James, additional, Foster, Graham, additional, Gilmore, Ian, additional, Hebditch, Vanessa, additional, Jones, Rebecca, additional, Masson, Steven, additional, Oates, Beverley, additional, Richardson, Paul, additional, Sinclair, Julia, additional, Wendon, Julia, additional, and Wood, David, additional

Published
2022
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35. Il-1beta Signal Inhibition in acute alcoholic hepatitis: a multicentre, randomised, double-blind, placebo-controlled phase 2 trial of canakinumab therapy (ISAIAH)

Author

Vergis, Nikhil, primary, Patel, Vishal C., additional, Bogdanowicz, Karolina, additional, Czyzewska-Khan, Justyna, additional, Keshinro, Rosemary, additional, Fiorentino, Francesca, additional, Day, Emily, additional, Middleton, Paul, additional, Atkinson, Stephen, additional, Cross, Mary, additional, Babalis, Daphne, additional, Foster, Neil, additional, Quaglia, Alberto, additional, Lloyd, Josephine, additional, Goldin, Robert D., additional, Rosenberg, William, additional, Parker, Richard, additional, Richardson, Paul, additional, Masson, Steven, additional, Whitehouse, Gavin, additional, Sieberhagen, Cyril, additional, Patch, David, additional, Dhanda, Ashwin, additional, Lord, Emma, additional, Forrest, Ewan, additional, Naoumov, Nikolai, additional, and Thursz, Mark, additional

Published
2022
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36. Methods to engage ‘hard-to-reach’ people with chronic disease in contributing to research: A scoping review

Author

Dhanda, Ashwin and Boeira, Paula

Subjects
Hepatology, Mental and Social Health, Other Mental and Social Health, Medicine and Health Sciences, Medical Specialties, Substance Abuse and Addiction
Abstract

Objective: The objective of this scoping review is to explore what is known about methods of engagement of under-represented groups in research, especially people with chronic disease. Introduction: Researchers continue to encounter a number of difficulties to access and engage members of socially disadvantaged groups and ethnic minorities in clinical research. Understanding these challenges is essential for developing innovative ways to increase engagement for under-represented groups with chronic disease. Inclusion criteria: This scoping review will explore what is known about engaging under-represented adults with chronic disease in research. Studies published in English describing strategies used to engage hard-to-reach populations in research will be eligible for inclusion. Methods: Searches in databases of peer-reviewed literature such as Google Scholar, Web of Science and Scopus plus grey literature including UK charity websites, reports and surveys.

Published
2022
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39. Mental Imagery to Reduce Alcohol-related harm in patients with alcohol dependence and alcohol-related liver damaGE: the MIRAGE pilot trial protocol

Author

Dhanda, Ashwin D, primary, Allende, Hannah, additional, Allgar, Victoria, additional, Andrade, Jackie, additional, Bailey, Matthew Peter, additional, Callaghan, Lynne, additional, Cocking, Laura, additional, Goodwin, Elizabeth, additional, Hawton, Annie, additional, Hayward, Christopher, additional, Hudson, Ben, additional, Jeffery, Alison, additional, King, Angela, additional, Lavers, Victoria, additional, Lomax, Joe, additional, McCune, C Anne, additional, Parker, Richard, additional, Rollinson, Christopher, additional, Wilks, Jonny, additional, and Creanor, E Siobhan, additional

Published
2022
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41. The Liverpool alcohol‐related liver disease algorithm identifies twice as many emergency admissions compared to standard methods when applied to Hospital Episode Statistics for England.

Author

Dhanda, Ashwin, Bodger, Keith, Hood, Steve, Henn, Clive, Allison, Michael, Amasiatu, Chioma, Burton, Robyn, Cramp, Matthew, Forrest, Ewan, Khetani, Meetal, MacGilchrist, Alastair, Masson, Steven, Parker, Richard, Sheron, Nick, Simpson, Ken, Vergis, Nikhil, White, Martin, Saleh, Ahmed, Boyd, Alex, and Brind, Alison

Subjects
*HOSPITAL statistics, *ALCOHOL-induced disorders, *LIVER diseases, *COVID-19 pandemic, *HOSPITAL admission & discharge, *COVID-19
Abstract

Summary: Background: Emergency admissions in England for alcohol‐related liver disease (ArLD) have increased steadily for decades. Statistics based on administrative data typically focus on the ArLD‐specific code as the primary diagnosis and are therefore at risk of excluding ArLD admissions defined by other coding combinations. Aim: To deploy the Liverpool ArLD Algorithm (LAA), which accounts for alternative coding patterns (e.g., ArLD secondary diagnosis with alcohol/liver‐related primary diagnosis), to national and local datasets in the context of studying trends in ArLD admissions before and during the COVID‐19 pandemic. Methods: We applied the standard approach and LAA to Hospital Episode Statistics for England (2013–21). The algorithm was also deployed at 28 hospitals to discharge coding for emergency admissions during a common 7‐day period in 2019 and 2020, in which eligible patient records were reviewed manually to verify the diagnosis and extract data. Results: Nationally, LAA identified approximately 100% more monthly emergency admissions from 2013 to 2021 than the standard method. The annual number of ArLD‐specific admissions increased by 30.4%. Of 39,667 admissions in 2020/21, only 19,949 were identified with standard approach, an estimated admission cost of £70 million in under‐recorded cases. Within 28 local hospital datasets, 233 admissions were identified using the standard approach and a further 250 locally verified cases using the LAA (107% uplift). There was an 18% absolute increase in ArLD admissions in the seven‐day evaluation period in 2020 versus 2019. There were no differences in disease severity or mortality, or in the proportion of admissions with decompensation of cirrhosis or alcoholic hepatitis. Conclusions: The LAA can be applied successfully to local and national datasets. It consistently identifies approximately 100% more cases than the standard coding approach. The algorithm has revealed the true extent of ArLD admissions. The pandemic has compounded a long‐term rise in ArLD admissions and mortality. [ABSTRACT FROM AUTHOR]

Published
2023
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47. FRI-418 - Strategies are needed to support people with alcohol use disorder and alcohol-related liver disease to take part in randomised clinical trials: results from the MIRAGE pilot trial of functional imagery training

Author

Dhanda, Ashwin, Allgar, Victoria, Andrade, Jackie, Callaghan, Lynne, Hudson, Benjamin, Ingram, Wendy, King, Angela, Lavers, Victoria, Lomax, Joe, McCune, Anne, Musicha, Crispin, Parker, Richard, Rollinson, Christopher, and Creanor, Siobhan

Published
2023
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50. P380 Inpatients with advanced alcohol-related liver disease are not being considered for transplantation: a regional audit

Author

Phoolchund, Anju, primary, Babar, Nauman, additional, Backhouse, Laura, additional, Badrulhisham, Fakhirah, additional, Donnelly, Hannah, additional, Keelty, Nigel, additional, Lee, Irene, additional, Marley, Fenella, additional, Nott, James, additional, Saunsbury, Emma, additional, Wright, Kathryn, additional, and Dhanda, Ashwin, additional

Published
2021
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