Publications by authors named "Suz Warner"

Background & Aims: Long-term follow-up studies of paediatric onset autoimmune liver disease (AILD) are invaluable in helping better understand the clinical course of disease. In day-to-day practice clinicians struggle with disease definitions whilst patients and parents lack clear prognostic information.

Methods: The clinical progression of 159 patients with childhood onset AILD between June 1990 and December 2013 was reviewed, capturing data up to adulthood (ending May 2021).

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Article Synopsis
  • The 2022 global outbreak of acute hepatitis in young children pointed to abnormal causes, particularly linked to infections like HHV-6B and adenovirus-41F in severely affected cases requiring liver transplants.
  • The end of COVID lockdowns likely exposed children to infections they hadn’t encountered before, potentially leading to abnormal immune responses and serious complications.
  • A case series highlighted three infants with primary HHV-6B infection who developed acute hepatitis and liver failure, underscoring the lethal potential of these common viruses in young children with immature immune systems.
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The devastating impact of the COVID-19 pandemic on global health and economic stability is immeasurable. The situation is dynamic and fast-evolving, with the world facing new variants of concern which may have immune escape potential. With threatened treatment and preventative strategies at stake, and the prospect of reinfection prolonging the pandemic, it is more crucial than ever to understand the pathogenesis of SARS-CoV-2 infection, which intriguingly disproportionately affects adults and the elderly.

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The liver is an important contributor to the human immune system and it plays a pivotal role in the creation of both immunoreactive and tolerogenic conditions. Liver transplantation provides the best chance of survival for both children and adults with liver failure or cancer. With current demand exceeding the number of transplantable livers from donors following brain death, improved knowledge, technical advances and the desire to prevent avoidable deaths has led to the transplantation of organs from living, ABO incompatible (ABOi), cardiac death donors and machine based organ preservation with acceptable results.

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Article Synopsis
  • There are currently no effective treatments for autoimmune biliary diseases, making it essential to understand their underlying immunopathology.
  • The study reveals that biliary epithelial cells (BEC) respond to gut microbes and inflammatory cytokines, leading to the recruitment of specific T cells (like Th17) that influence immune responses in the liver.
  • Research indicates a feedback loop where Th17 cells not only promote the survival and polarization of CD4 T cells but also enhance the proliferation of BEC, suggesting a collaborative role in liver health and regeneration during inflammation.
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Hepatopulmonary syndrome (HPS) in stable patients with cirrhosis can easily be overlooked. We report on the presenting symptoms, disease progression, and outcomes after liver transplantation (LT) in children with HPS. Twenty patients were diagnosed with HPS between 1996 and 2016.

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The gut-liver axis is increasingly considered to play a vital part in the progression of chronic inflammatory gut and liver diseases. Hence, a detailed understanding of the local and systemic regulatory mechanisms is crucial to develop novel therapeutic approaches. In this review, we discuss in-depth the roles of regulatory T cells (Tregs) and mucosal-associated invariant T cells (MAITs) within the context of inflammatory bowel disease, primary sclerosing cholangitis, and non-alcoholic steatohepatitis.

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