An Israeli Arab doctor who heads the Liver Unit at Jerusalem’s Hadassah University Hospital, has discovered the gene responsible for liver disease.

Dr. Rifat Safedi, an Israeli Arab doctor who heads the Liver Unit at Hadassah University Hospital, has discovered that Neuroligin 4 (NLGN4) is the gene responsible for liver disease. Usually, if someone is healthy, NLGN4 can help repair tissues within the body, but if the health of the person is adversely affected by alcohol consumption, over-eating, etc. the gene works to enhance liver disease within the body.

“Everyone has the gene,” says Safedi, “whether it’s over-expressed or not. Our approach is how to target the over-expression and to reduce this expression to control the fibrosis.”

“We located a gene whose over-expression in the NK cells of the immune system exposes the body to cirrhosis,” Safedi said. “When cirrhosis of the liver develops, the NK cells in the immune system, in their healthy form, kill the scar-tissue cells. We found that the over-expression of this gene put a mechanism into operation that kept these cells from their anti-scarring work.” Safedi’s research team has also found a connection between Neuroligin 4 and insulin reception by various cells. When there is insulin resistance, the expression of Neuroligin 4 usually increases.

The next step for Safedi is to discover a drug to treat the advanced phases of liver disease based on their research on NKGN4 which will be able to assist people who have liver disease in the later phases. Such a drug could have the potential to save the lives of millions of people who die of cirrhosis each year worldwide. “Our drug will target pathways to reduce the fibrosis tissue,” Safedi stated.

Safedi claims that alcohol consumption is one of the main causes of liver disease. “We call it liver disease when we don’t find the cause and most cases of this ‘cryptogenic liver disease’ are found in alcoholics,” he said. For many patients, once liver disease is found to be in their body, often merely eliminating alcohol consumption can cure the illness. Yet for others, deeper treatment is necessary. Safedi discovered the role that this gene plays in liver disease while researching liver disease in the more advanced phases.

Safedi believes that alcoholism is underestimated. “In my clinic [in Nazareth] I saw a large number of alcoholic liver disease,” he says. Yet Safedi claims that even social drinkers are not immune from liver damage. “Patients in our community, for various reasons, are under-reporting their consumption. It’s only when you repeat the questions in different ways and see a patient over time and win his trust does the true story come out.”

By Rachel Avraham