Clinical and Research Interests: I am a liver physician-scientist. My clinical interests include the management of patients with alcoholic and non-alcoholic fatty liver disease and critically-ill cirrhotic patients. I have worked the last ten years in a multidisciplinary team to treat patients with alcoholic liver disease. My main research interests include liver fibrosis and the mechanisms and determinants of mortality of alcoholic liver disease. I have mostly performed translational studies including human samples and experimental models of liver disease. Also, I recently started a line of research on global public health aspects of alcoholic liver disease. I am currently the overall PI of a NIH-funded consortium (InTeam) for translational research of alcoholic hepatitis. The main goals of the InTeam consortium are the identification of molecular subtypes and the identification of novel targets for therapy.
Ongoing Research Studies:
- Metabolic and transcription factor reprogramming in alcoholic hepatitis. By combining RNAseq and metabolic studies from human samples, we have found profound changes in glucose metabolism and also decreased activity of transcription factors that regulate hepatocyte metabolic function.
- Mechanisms of fibrosis and portal hypertension in alcoholic hepatitis. We identified lipocalin-2 and the endothelin system as potential regulators of fibrosis and portal hypertension in human samples. We are currently performing functional studies in animal models and in cultured cells.
- Clinical studies in patients with alcoholic liver disease. We are developing a new fibrosis scoring system in patents with alcoholic hepatitis. Moreover, we are investigating the predictors of alcohol relapse in these patients and the impact of alcohol intake on long-term outcome. We are currently analyzing the prevalence and impact of trauma and PTSD in this patient population.
- Global public health studies in the field of alcoholic liver disease. We are currently performing a global study (25 centers from 5 continents) showing the lack of early detection of alcoholic liver disease worldwide. Also we are studying the impact of inequality in the prevalence and mortality of alcoholic liver disease as well as the role of colder weather and sun light hours in the prevalence of alcoholic cirrhosis. Finally, we are analyzing the impact of regulatory measures at the county and state levels on the prevalence of alcoholism and alcoholic cirrhosis in the US.