Multi-modal non-invasive biomarker screening for high-risk undiagnosed liver disease

非酒精性脂肪性肝病（NAFLD）和非酒精性脂肪性肝炎（NASH）在英国越来越普遍，估计有20%的成年人受到影响。这些疾病与肥胖和2型糖尿病有关，并可能导致严重的肝损伤，包括肝硬化和肝癌。在英国，治疗肝病的费用估计每年约为65亿英镑，因为它出现较晚，给国家卫生服务（NHS）资源带来了巨大压力。NASH和NAFLD患者的预期寿命缩短，患心血管疾病，肝癌和肝功能衰竭的风险更高。此外，这些病症通常是无症状的，这意味着患者通常直到疾病进展到更严重的阶段才被诊断出来。这增加了治疗的复杂性和成本，并降低了干预措施的有效性。除了治疗NASH和NAFLD的直接成本外，这些疾病的更广泛的经济影响也不容忽视。由于疾病导致的生产力降低和缺勤增加可能对英国经济产生重大影响，估计每年在70亿至130亿英镑之间。NASH和NAFLD日益严重的问题的一个有希望的解决方案是使用具有成本效益的非侵入性方法在早期阶段识别风险患者。该申请提出将纵向生物标志物分析、非侵入性肝脏扫描和非侵入性基因检测相结合，可以比现有方法更早地识别高风险肝病病例，特别关注早发性（25-35岁）和快速进展的肝脏疾病。萨默塞特FT与预测健康智能合作开发的算法已被证明可以识别高从NHS记录中已经存在的常见血液检测中发现的风险肝病病例（由NIHR i4 i计划资助- 200965），从而减少了对健康人进行进一步检测的需要。与此同时，佐野遗传学公司开发了一个平台，用于非侵入性基因检测、远程样本采集和纵向患者报告结果。该提案将使这两个中小企业之间的合作，可以在两个独立的NHS环境中快速验证。

Non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) are becoming increasingly prevalent in the UK, with an estimated 20% of the adult population affected. These conditions are associated with obesity and type 2 diabetes, and can lead to serious liver damage, including cirrhosis and liver cancer. The cost of treating liver disease in the UK is estimated to be around £6.5 billion per year because it presents late, putting a significant strain on the National Health Service (NHS) resources.Patients with NASH and NAFLD have a reduced life expectancy and a higher risk of cardiovascular disease, liver cancer, and liver failure. Furthermore, these conditions are often asymptomatic, meaning that patients are often not diagnosed until the disease has progressed to a more serious stage. This increases the complexity and cost of treatment, as well as reducing the effectiveness of interventions.In addition to the direct cost of treating NASH and NAFLD, the wider economic impact of these conditions cannot be ignored. Reduced productivity and increased absenteeism due to illness can have a significant impact on the UK economy as a whole estimated at between £7 and £13 billion per year.A promising solution to the growing problem of NASH and NAFLD is the use of cost-effective non-invasive approaches to identify at-risk patients at an earlier stage. This application proposes combining longitudinal biomarker analysis, non-invasive liver scanning, and non-invasive genetic testing can identify high-risk liver disease cases far earlier than existing approaches, with a particular focus on early-onset (25-35 years old) and fast-progressing liver disease.Algorithms developed by Somerset FT in collaboration with Predictive Health Intelligence have been shown to identify high-risk liver disease cases from common blood tests already present in NHS records (funded by NIHR i4i Programme -- 200965), thus reducing the need for further testing of healthy people. In parallel, Sano Genetics have developed a platform for non-invasive genetic testing, remote sample collection, and longitudinal patient reported outcomes. This proposal will enable a collaboration between these two SMEs that can be rapidly validated in two independent NHS contexts.