The science of liver regeneration
- Leanne Rencken
The liver may already know how to heal itself but Wits scientists are exploring innovative ways to help it along.
Advances in gene editing, nanomedicine and 3D bioprinting are pushing the limits of liver regeneration and reframing what recovery means.
At the Antiviral Gene Therapy Research Unit (AGTRU), researchers are developing genetic treatments that could permanently disable the hepatitis B virus (HBV), one of the world’s most persistent and under-recognised causes of liver disease – and a particular burden on South African healthcare.
‘Scissors’ snip virus
Gene therapy uses DNA and RNA to achieve therapeutic results. At the AGTRU, molecular “scissors”, known as TALENs, snip the HBV DNA inside liver cells, forcing the virus to repair itself imperfectly and become inactive.
“By cutting the DNA, it induces an error-prone repair mechanism that disables the virus permanently,” explains Professor Patrick Arbuthnot, Director of the AGTRU.
Unlike conventional antivirals, which initially suppress infection but enable its return once treatment stops, the TALENs method aims for a lasting cure. “It’s much better if you can get to the source of the problem, rather than treat the result,” says Arbuthnot.
By eliminating the infection entirely, the body can begin to regenerate healthy liver tissue, offering patients the possibility to thrive.
The four R's of drug delivery
While the AGTRU tackles disease at the genetic level, the Wits Advanced Drug Delivery Platform (WADDP) focuses on healing at the cellular and structural level. Its work centres on biomimicry, designing materials that imitate how the body repairs itself.
“Although liver tissue can regenerate, it cannot do so efficiently in the presence of chronic HBV infection that eventually leads to severe damage,” says Professor Yahya Choonara, Director of the WADDP. “Early intervention with more precise delivery technologies for genes is critical either to cure or halt ongoing inflammation and tissue scarring.”
The WADDP team uses 3D bioprinting to create biodegradable scaffolds that are seeded with living cells. Once implanted, these structures help the body’s tissue to regrow and eventually replace them. “We use the body’s surviving liver cells to help regenerate itself,” explains Choonara.
To understand and strengthen the body’s own regenerative responses better, the WADDP team studies the secretome – the microscopic chemical signals that cells send to coordinate repair. “We are trying to amplify the body’s own language of healing,” says Choonara.
For the WADDP, effective treatment is as much about precision as innovation. Choonara describes this principle as the four Rs of drug delivery: delivering the right dose, to the right patient, at the right site in the body, at the right time. It’s a philosophy that guides how new materials are designed and how medicines reach diseased tissue more directly, with fewer side effects.
Regenerating Africa
Both the AGTRU and the WADDP are challenging the traditional approach to chronic illness, shifting the focus from indefinite treatment, often limited by access or adherence, to targeted, once-off repair.
It’s also part of a broader transformation: science made in Mzansi, for Mzansi. As Arbuthnot says, “It’s important that we train students locally — these are skills that can’t only live in the Global North.”
Affordability and accessibility are key to that vision. One example is the AGTRU’s Africa-grown cashew-nut lipid project. Nut shells, usually discarded as agricultural waste, contain a by-product that can be refined into lipids capable of carrying RNA therapies safely into cells. “Working in Africa, we are very aware of issues around access,” says Arbuthnot. “This project is an example of ways in which we can make things more affordable.”
At Wits, thriving means both patients and scientists flourish. Across the AGTRU and the WADDP, teams are building local expertise while contributing to a rapidly evolving international field. “We are on par globally…but our focus is to have an Africa-centric vision,” notes Choonara, whose platform trains dozens of postgraduate students and postdoctoral scholars, many of them first-generation scientists, to carry this work forward.
Both research teams operate in highly competitive fields, advancing South Africa’s growing presence in regenerative science through international collaborations and the patents that protect their work.
As these technologies evolve, they also raise complex questions about safety, equity and the line between healing and enhancement. Yet the work is firmly grounded in realism and responsibility. “We don’t oversell what we do,” says Choonara, while Arbuthnot emphasises a conservative approach. It’s a reminder that even with such extraordinary promise, progress must undergo years of testing, funding, ethics application and regulatory review before it reaches patients.
- Leanne Rencken is a freelance writer.
- This article first appeared in?CURIOS.TY,?a research magazine produced by?Wits Communications?and the?Research Office.
- Read more in the 20thissue, themed #Thrive, which explores what it truly means to flourish — across a lifespan, within communities, and on and with our planet.