Stål and Wahlin group

Our group has a focus on metabolic and inflammatory liver diseases, and liver cancer. We perform clinical and translational studies on hereditary hemochromatosis, porphyric liver disease, non-alcoholic fatty liver disease, autoimmune hepatitis, primary biliary cholangitis and hepatocellular carcinoma. As hospital clinicians with collaborations with basic scientists, we are uniquely positioned to study liver disease from many different perspectives.

About our research

By using data from well characterized clinical patient cohorts, we can combine outcome data with findings from tissue analyses. We perform systematic biobanking of liver tissue, DNA and plasma, and have unique possibilities to study long-term prognosis and pathogenetic mechanisms of liver diseases. We also perform investigator-initiated prospective clinical trials on porphyria, non-alcoholic fatty liver disease and hemostasis in cirrhosis.

We have a large network of partners in both basic and clinical research departments, and we have access to advanced techniques for translational studies. Our prospective studies aim to find diagnostic and prognostic biomarkers of liver disease and liver cancer development, and to evaluate new treatments. Ultimately, we aspire to improve care for patients with liver disease.

Keywords

Autoimmune hepatitis, Primary Biliary Cholangitis, Porphyric liver diseases, NAFLD; hereditary hemochromatosis, hepatocellular carcinoma (HCC)

Group leader

Per Stål

Affiliated to research
H7 Department of Medicine, Huddinge

Co-group leader

Staffan Wahlin

MD, PhD, Associate professor, Co-group leader

Staffan Wahlin is senior clinical consultant in the Hepatology Division, Department of Upper GI Diseases and since 2015 associate professor of Gastroenterology and Hepatology. His main research interests are porphyria, autoimmune liver disease and transplant hepatology.

Group members

Catarina Lindqvist

RD, PhD

Catarina received her RD degree from Uppsala University in 2008 and is a Specialist Dietitian in Hepatology working at the Medical Unit Clinical Nutrition at Karolinska University Hospital. She defended her thesis “Assessment and prognostic importance of nutritional status and body composition in liver transplantation” in 2020. Current projects include research of the importance of nutrition for disease progression in chronic liver disease, both in patients with NAFLD, PSC and in patients with liver cirrhosis.  

Mattias Lissing

MD, PhD student

Mattias received his MD degree from Karolinska Institutet 1997 and is a specialist in internal medicine, gastroenterology and hepatology since 2008. He is working as a hepatologist at Karolinska University Hospital. His main research focus during the PhD studies is on hepatological aspects of acute hepatic porphyria such as comorbidity, risk of primary liver cancer and liver transplantation for acute hepatic porphyria.

Magnus Holmer

MD, PhD student

Magnus received his MD degree from Karolinska Institutet in 2005 and is a specialist in internal medicine and gastroenterology and hepatology since 2015. He is currently working as the Head of the Hepatology Unit at Karolinska University Hospital. His main research focus during his PhD studies is the study of non-alcoholic liver disease (NAFLD) with aspects on epidemiology, prognosis and treatment.   

Robin Zenlander

MD, PhD student

Robin received his MD degree from the Sahlgrenska Academy in 2012. He is currently working as a resident physician in the Clinical Chemistry department at the Karolinska University Laboratory. His PhD Project will focus on new biomarkers and genetic polymorphisms in liver diseases, mainly NAFLD, hepatic iron overload and hepatocellular carcinoma.

Sanna Norén

Affiliated to research

M.D. with interest in hemostasis in liver disease. Will register for a Ph.D. project (the HELICS study) in 2022.

Rupesh Rajani

MD, PhD

Rupesh received his MD 1999 and PhD 2011 from Linköping University. He is a  a senior consultant at the Hepatology Unit. His main research interests are in vascular liver diseases, especially portal vein thrombosis and Budd-Chiari syndrome.

Stefan Gilg

MD, PhD, postdoc

Stefan is a senior consultant HPB surgeon at the Department of HPB surgery, Karolinska Huddinge and defended his thesis about post-hepatectomy liver failure in 2018. Since June 2019 he is a post doc in the research group under supervision of Per Stål. The main focus of his research is to continue with projects about liver regeneration and failure and the improvement of diagnosis, treatment and outcome of patients with HCC.

Åsa Lindé

Research nurse

Åsa has a long experience as a research nurse especially in nephrology, and is working in the MILES group since 2020, with a focus on clinical studies in NAFLD and cirrhosis.   

Gösta Eggertsen

Affiliated to teaching/tutoring

Senior Professor in Clinical Chemistry with interest in bile acid metabolism and plasma biomarkers.

Collaborations

  1. SweHep national study group (BIGMAP study and PBC in Sweden)
  2. Myriam Aouadi at the Center for Infectious Medicine, and Mikael Rydén at MedH, Endocrinology Unit (The MacinNASH study)
  3. Charlotte Thålin at KI Danderyds hospital and Maria Magnusson at the Coagulation Unit (Hemostasis in liver cirrhosis - HELICS).
  4. Anna Passetto, Dept of Laboratory Medicine, (Characterization of circulating neo-antigens recognized by PD-1+ lymphocytes in hepatocellular carcinoma)
  5. Mikael Björnstedt, Unit of Pathology, and prof. Hugh Salter, Anocca AB, (Micro-RNA pattern in liver tissue as a prognostic marker in HCC)
  6. Daniel Hagey at Dept. of Laboratory medicine (Dynamic profiling of vesicle-borne RNA in HCC).
  7. Jochen Schwenk at SciLifeLab (Protein plasma biomarkers in HCC)
  8. Torkel Brismar at the radiology department (TREND study).
  9. Eliane Sardh at Porphyria Centre Sweden, Centre for Inherited Metabolic Diseases (CMMS) (Cancer and comorbidity in acute hepatic porphyria)
  10. Cumali Efe at Harran University Hospital, Turkey and multinational collaborators (Clinical studies om autoimmune liver diseases)

Projects

1. Biomarkers in hepatocellular carcinoma (HCC) 

The aim of the project is to develop panels of serum proteins, micro-RNAs or vesicle-borne mRNAs as biomarkers for early diagnosis or prognostication of HCC.
Collaborations: Jochen Schwenk (SciLifeLab in Solna), Hugh Salter (Anocca AB), Mikael Björnstedt (Dept of Pathology), Daniel Hagey (Dept of Laboratory Medicine).
Funding: Cancerfonden, CIMED and Region Stockholm

2. Role of liver macrophage populations in the development of non-alcoholic steatohepatitis - NASH (MacinNASH)

The aim of the project is to define a subpopulation of macrophages in NASH with a gene expression profile that initiates fibrosis (scarring of the liver).
Collaborations: Myriam Aouadi (Center for Infectious Medicine).
Funding: European Research Council.

3. Biochemical, clinical, and genetic markers for prognostication in liver cirrhosis (BIGMAP)

The aim of the project is to create a national biobank for future biomarker evaluations for prognostication of liver-related events.
Collaborations: The SweHep research network. The biobank is linked to the Swedish Register for Liver Cirrhosis.
Funding: Swedish Cancer Society.

4. Hemostasis in liver cirrhosis (HELICS)

The aim of the project is to evaluate new methods for hemostasis assessment in patients with liver cirrhosis or HCC.
Collaborations: Maria Magnusson (Coagulation Unit) and Charlotte Gran (Dept of Molecular Medicine and Surgery) KI.
Funding: Region Stockholm.

5. Characterization of circulating neo-antigens recognized by PD-1+ lymphocytes in HCC (CHANNEL)

The aim of the project is to assess if neoantigens in circulating cell free DNA (cfDNA) can be recognized by PD-1+ lymphocytes.
Collaborations: Anna Pasetto (Dept. of Laboratory Medicine).
Funding: Swedish Cancer Society.

6. Hepatopathy, cancer and comorbidity in acute hepatic porphyria

The aim of the project is to characterize risks and mechanisms of long-term complications.
Collaborations: Eliane Sardh, CMMS.
Funding: Region Stockholm, CIMED & Alnylam

7. Clinical research on autoimmune liver diseases

Collaborations: Cumali Efe and multinational network of hepatologists, The SweHep research network.
Funding: Bent Ihre Foundation

Research support

  • The Swedish Cancer Society
  • Region Stockholm
  • Center for Innovative Medicine (CIMED)
  • Bent Ihre Foundation
  • Alnylam

Publications

  1. Treatment of non-alcoholic fatty liver disease with intermittent calorie restriction vs. low-carb high-fat diet – a randomized controlled trial.
    Holmer M, Lindqvist C, Petersson S, Moshtaghi-Svensson J, Tillander V, Brismar TB, Hagström H, Stål P. JHep Reports 2021 Feb 17;3(3):100256. doi: 10.1016/j.jhepr.2021.100256. PMID: 33898960.
     
  2. Morbidity, risk of cancer and mortality in 3,645 HFE mutations carriers.
    Hagström H, Ndegwa N, Ekstedt M, Posserud I, Rorsman F, Nyhlin N, Klintman D, Werner M, Marschall H-U, Jalmeus M, Askling J, Stål P. Liver International 2021 41(3):545-553. PMID: 33450138.
     
  3. Liver Transplantation for Acute Intermittent Porphyria.
    Lissing M, Nowak G, Adam R, Karam V, Boyd A, Gouya L, Meersseman W, Melum  Ołdakowska-Jedynak U, Reiter FP, Colmenero J, Sanchez R, Herden U, Langendonk J, Ventura P, Isoniemi H, Boillot O, Braun F, Perrodin S, Mowlem E, Wahlin S; European Liver and Intestine Transplant Association. Liver Transpl. 2021 Apr;27(4):491-501. PMID: 33259654
     
  4. Extrahepatic autoimmune diseases in primary biliary cholangitis: Prevalence and significance for clinical presentation and disease outcome.
    Efe C, Torgutalp M, Henriksson I, Alalkim F, Lytvyak E, Trivedi H, Eren F, Fischer J, Chayanupatkul M, Coppo C, Purnak T, Muratori L, Werner M, Muratori P, Rorsman F, Onnerhag K, Nilsson E, Heurgué-Berlot A, Demir N, Semela D, Kıyıcı M, Schiano TD, Montano-Loza AJ, Berg T, Ozaslan E, Yoshida EM, Bonder A, Marschall HU, Beretta-Piccoli BT, Wahlin S. J Gastroenterol Hepatol. 2021 Apr;36(4):936-942. PMID: 32790935.
     
  5. Outcome of COVID-19 in Patients With Autoimmune Hepatitis: An International Multicenter Study.
    Efe C, Dhanasekaran R, Lammert C, Ebik B, Higuera-de la Tijera F, Aloman C, Rıza Calışkan A, Peralta M, Gerussi A, Massoumi H, Catana AM, Torgutalp M, Purnak T, Rigamonti C, Gomez Aldana AJ, Khakoo N, Kacmaz H, Nazal L, Frager S, Demir N, Irak K, Ellik ZM, Balaban Y, Atay K, Eren F, Cristoferi L, Batıbay E, Urzua Á, Snijders R, Kıyıcı M, Akyıldız M, Ekin N, Carr RM, Harputluoğlu M, Hatemi I, Mendizabal M, Silva M, Idilman R, Silveira M, Drenth JPH, Assis DN, Björnsson E, Boyer JL, Invernizzi P, Levy C, Schiano TD, Ridruejo E, Wahlin S. Hepatology. 2021 Jun;73(6):2099-2109. doi: 10.1002/hep.31797. Erratum in: Hepatology. 2021 Dec 8; PMID: 33713486
     
  6. Energy expenditure early after liver transplantation: Better measured than predicted.Lindqvist C, Nordstedt P, Nowak G, Slinde F, Majeed A, Bottai M, Wahlin S. Nutrition. 2020 Nov-Dec;79-80:110817. PMID: 32653820.
     
  7. Comparison of lipiodol infusion and drug-eluting beads transarterial chemoembolization of hepatocellular carcinoma in a real-life setting.
    Karalli A, Teiler J, Haji M, Seth E, Brismar TB, Wahlin S, Axelsson R, Stål P. Scand J Gastroenterol. 2019 Jul;54(7):905-912. PMID: 31287338
     
  8. Characteristics and outcome of hepatocellular carcinoma in patients with NAFLD without cirrhosis.
    Bengtsson B, Stål P, Wahlin S, Björkström NK, Hagström H. Liver Int. 2019 Jun;39(6):1098-1108. PMID: 30829446
     
  9. Validation of Risk Scoring Systems in Ursodeoxycholic Acid-Treated Patients With Primary Biliary Cholangitis
    Efe C, Taşçilar K, Henriksson I, Lytvyak E, Alalkim F, Trivedi H, Eren F, Eliasson J, Beretta-Piccoli BT, Fischer J, Calişkan AR, Chayanupatkul M, Coppo C, Ytting H, Purnak T, Muratori L, Werner M, Muratori P, Rorsman F, Önnerhag K, Günşar F, Nilsson E, Heurgué-Berlot A, Güzelbulut F, Demir N, Gönen C, Semela D, Aladağ M, Kiyici M, Schiano TD, Montano-Loza AJ, Berg T, Ozaslan E, Yoshida EM, Bonder A, Marschall HU, Wahlin S. . Am J Gastroenterol. 2019 Jul;114(7):1101-1108. PMID: 31241547.
     
  10. Quality of life as a prognostic factor for survival in hepatocellular carcinoma.
    Sternby Eilard M, Hagström H, Mortensen KE, Wilsgaard T, Vagnildhaug OM, Dajani O, Stål P, Rizell M. Liver Int. 2018;38:885-894. PMID: 28941130

 

20-07-2022
Per Stål