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Liver disease and the windmills of your mind

You may imagine that your brain is the most amazing part of you.  It is entertaining to wonder about how you can wonder about yourself and the mysteries of consciousness and self awareness are worthy of awe but the miracle of your body is really your liver.  I grew up in the computer industry and since I'm not as young as you thought, I remember a time when a single person could actually understand everything going on in a computer.  Today computer systems are so complex that no one can understand it all.  The liver is like that.  Hundreds of interacting chemicals churning through  chains of reactions with a vast number of interlocking functions.  If you examine biochemistry in any detail you have to wonder how it is even possible for you to be alive.

This link below expresses that vision of impossible elegance and beauty to me.  Not my usual story but I invite you to enjoy before you read about the boring stuff to follow.



I've had the opportunity to look closely at some of the research that is going on with liver disease treatments and I really have to admire the teams that are tackling this problem.  The liver cell is rather like a bunch of finely tuned clocks within clocks and if you touch any part of any clock it may stop some other clock from keeping the proper time. The people on the front lines of this research face real challenge, but the good news is that we can now see that there will be successes and cirrhosis may not be the toboggan ride to hell that it is now for too much longer.

Gilead and Intercept are two of the companies who are working hard to develop treatments for liver disease. 

Intercept has been working in the area of PBC, primary biliary cholangitis, which is a disease that attacks the main outlet system of the liver.  One of the key functions of the liver is to make the bile that is responsible for your ability to digest fats.  Their front line product is obetocholic acid which has been granted accelerated approval by the FDA and is now under study for NASH and other liver problems.  Intercept is a leader in the race for some kind of treatment for this category of disease.

Gilead made its bones with Harvoni which cures hepatitis C.  This is an immensely important event because millions of people were doomed to suffer liver disease since hep C was incurable.  Now Gilead is mounting a very important effort to make a similar contribution to NASH and cirrhosis.  Gilead's approach is a bit different from that of most of the industry as they are assuming a multi-drug combination will be the solution. Most companies believe that but are focused on specific single step strategies that likely lead to a cocktail but Gilead's research seeks to build the cocktail from the beginning.

These are just glimpses into the industry and we could look at the 400 or so molecules under study and all are interesting views of how one might attack the problem of liver disease but remember, none of these can be done without clinical trials.  If you have any interest in participating in a trial take a look at our trial tool and see if anything is a match for you.  Here is a link to that system.

Clinical Trial Finder