There are approximately four million Americans with Hepatitis C. Over 25% of adult Americans have abnormal liver enzymes with non-alcoholic fatty liver disease associated with obesity. Alcoholic steatohepatitis has a higher mortality rate than many cancers, including breast and prostate cancers. Colon cancer is a leading cause of death in America. Many of our major diseases are significantly impacted by genetics/epigenetics, environmental factors, and dietary nutrients; all areas of active investigation by our research team.
The Division has a highly interactive basic/clinical/translational research program with > $5 million in federal research support this year. Our research laboratories are located in the Clinical and Translational Research Building. We have over 20,000 square feet of contiguous, open-concept laboratory space and state-of-the-art equipment. We also interact closely with industry and have an outstanding group of clinical trials coordinators, and an active clinical trials research program. Our objectives are to enhance our understanding concerning these complex diseases with an ultimate goal of developing new therapeutic interventions.
An example is our NIH-funded novel therapies for alcoholic hepatitis research.
Dr. Thomas Abell is a world leader in device development/testing related to modulation of GI motility. Dr. Gerald Dryden has received three Coulter Awards over the past two years and filed four patents for new endoscopic devices ranging from novel snares to foreign body retrievers. GI faculty interact closely with our Bioengineering Department, with some faculty having joint appointments or shared graduate students.
Drs. Ashutosh Barve, Shirish Barve, Gerald Dryden, and Kristine Krueger are our experts in gastrointestinal cancer. We have animal models for many types of cancer. Dr. Ashutosh Barve conducts trials and directs a Hepatocellular Carcinoma clinic at both the Robley Rex Veterans Affairs Medical Center and the KentuckyOne Health Network.
Dr. Dryden conducts research on the effects of green tea polyphenols in the treatment of IBD and the effects of stem cells in fistulizing Crohn's disease, and he has extensive ongoing clinical trials in IBD.
We are home to a rodent endoscopy center, one of only a few such facilities in the country, which represents a breakthrough in the conduct of animal (rodent) experiments (see endoscopic photo on the right).
Drs. Craig McClain, Luis Marsano, Daniell Hill, Matthew Cave, Ashutosh Barve, Robert Tatum, Shirish Barve, Swati Joshi-Barve, Irina Kirpich, Leila Gobejishvili, Wenke Feng, and Walter Watson are our liver disease experts focusing on alcoholic liver disease, NASH, viral liver diseases, toxicant-mediated liver disease.
Dr. McClain was the first to describe dysregulated cytokine metabolism in alcoholic liver disease. Our liver research program has made major advances in the understanding of the gut: liver axis in liver disease. We have described the importance of macro- and micro-nutrients (e.g., fat, zinc) in maintaining gut barrier function and protecting against liver injury (see zinc figure below). Importantly, basic research translates into clinical therapies. For example, we have an NIH-sponsored clinical trial on zinc therapy for alcoholic hepatitis (Dr. Cave is PI) and an NIH-sponsored clinical trial on Novel Therapies for Alcoholic Hepatitis (Dr. McClain is PI).
We are leaders in the area of environmental hepatotoxicity.
We have a large biobank coordinated by Drs. McClain and Cave. It was initiated 35 years ago by the late Dr. Carlo Tamburro when it was noted that several workers exposed to vinyl chloride had hepatic hemangiosarcoma, a rare and rapidly fatal liver cancer. Our database contains the largest cluster of hemangiosarcoma patients in the world, and includes medical information, demographic data, and blood/liver biopsy specimens. This information has led to recognition of other disease conditions.
Indeed Dr. Cave has recently described Toxicant-Associated Steatohepatitis (TASH), a newly recognized liver disease (see photo below). He is actively collaborating with the Environmental Protection Agency to elucidate the role of environmental chemicals in liver diseases. We interact with several local industries to help ensure environmental safety.
Our nutrition experts are Drs. Stephen McClave, Craig McClain, Luis Marsano, Matthew Cave, Kristine Krueger, Wenke Feng, Irina Kirpich, and Walter Watson. We have Nutrition programs at three different hospitals. Dr. McClave (Past President, American Society for Parenteral and Enteral Nutrition) is director at the University of Louisville. Dr. McClain (Past President of the American College of Nutrition), is director at the Veterans Affairs Medical Center. Dr. Marsano is director at Jewish Hospital. Drs. McClain and McClave are boarded in Nutrition. These investigators are leaders in nutrition research in liver disease, pancreatic disease, obesity, and complementary and alternative medicine.
Drs. Kristine Krueger, Stephen McClave and Dr. Dipendra Parajuli lead our pancreatic program. Dr. McClave is an internationally recognized expert evaluating early enteral feeding in acute pancreatitis and the role of gut barrier dysfunction and pancreatitis.
We have a Swallowing and Motility Center housed at Frazier Rehabilitation Institute and supported by KentuckyOne Health. We study patients with a wide spectrum of patients with GI motility problems. Dr. Abell directs a NIH U01 consortium grant on gastroparesis research. He is a world-recognized leader in intestinal stimulation and gastric pacemaker placement. Dr. Abell also evaluates modulation of intestinal motility as novel therapy for obesity.
We have an established clinical trials program in both luminal GI diseases and liver diseases. We have multiple studies on-going, ranging from viral liver disease (e.g., hepatitis C) to inflammatory bowel disease. We have well trained study coordinators and regulatory personnel.