Jonathan Fallowfield's research interests span basic science and translational/clinical studies in hepatology. Key topics include mechanisms of liver fibrogenesis and fibrosis regression; portal hypertension and hepatorenal syndrome; biomarkers (particularly imaging); and discovery/development of novel therapies for liver fibrosis, NASH and portal hypertension. Engagement with industry is a high priority theme.
I am an NHS Research Scotland (NRS) Senior Clinical Fellow at the University of Edinburgh and Honorary Consultant Hepatologist at the Royal Infirmary of Edinburgh. During medical training in Southampton, I undertook an intercalated BSc focused on mechanisms of liver inflammation and a PhD investigating the reversibility of liver fibrosis as an MRC Clinical Research Training Fellow. I relocated to Edinburgh in 2008 as an Academy of Medical Sciences/Health Foundation Clinician Scientist, determined to tackle the major unmet clinical need in hepatology for robust non-invasive biomarkers and effective treatments for patients with chronic liver disease.
My group has a successful track-record in translating scientific advances from bench-to-bedside and collaborating with Industry. Having demonstrated preclinical proof-of-concept for human-2 relaxin as an antifibrotic and vasoactive treatment in cirrhosis (Fallowfield et al, Hepatology 2014), we then led a Novartis-sponsored Phase II randomized trial of serelaxin in human cirrhosis (Snowdon et al, PLoS Medicine 2017). Furthermore, in 2014 I was awarded a GSK-DPAc to discover a novel small-molecule agonist of the relaxin receptor. We have recently secured further funding from Novartis to undertake an Investigator Initiated Trial ('Serelaxin To Lower Portal Pressure (STOPP)' study). Previous studies establishing macrophages as key players in the regression of liver fibrosis in rodents (Fallowfield et al, J Immunol 2007; Ramachandran et al, PNAS 2012) have paved the way for an ongoing Phase I/II autologous macrophage cell therapy trial in Edinburgh led by collaborator Professor Stuart Forbes. Current research into biomarkers includes a CSO Catalytic grant to identify a sensitive/early analyte that can detect kidney dysfunction in cirrhosis patients ('Prognostic Biomarkers for Acute Kidney Injury in Liver Cirrhosis') and an Innovate UK Biomedical Catalyst Early Stage Award evaluating multiparameter MRI for the non-invasive assessment of liver disease ('HepaT1ca - Quantifying liver health in surgical candidates for liver malignancies'). There are additional opportunities in Edinburgh to explore novel liver/kidney imaging technologies (eg MRI, molecular) with local collaborators. Finally, we also have active preclinical drug development collaborations with Pharma companies to determine the efficacy and mechanism of several pipeline liver disease therapeutics.
NRS/ Scottish Senior Clinical Fellowship 2014-
My clinical activity includes outpatient general hepatology clinics and therapeutic upper GI endoscopy. I also take an active role in teaching of preclinical and clinical trainees.