Gastroenterology Research

The division is recognized nationally and internationally for its contributions to diagnostic/therapeutic endoscopy, inflammatory bowel disease and GI outcomes research.

Inflammatory Bowel Disease

Investigators, led by Fabio Cominelli, MD, PhD, formed an integrated team to explore multiple aspects of intestinal inflammation utilizing clinical resources as well as animal models of Crohn's disease and ulcerative colitis.

Some of the topics under investigation include intestinal cytokine regulation, immune-nonimmune cell interactions, extracellular matrix biology, tolerance to indigenous intestinal flora, and state-of-the-art gene expression profiling by DNA microarray technology.

In collaboration with the Division of Pediatric Gastroenterology and Nutrition, these investigators have been previously awarded by the National Institutes of Health a large five-year program project grant to study pediatric inflammatory bowel disease, the only such program in the country during that period.

Basic research is complemented by a variety of clinical and translational studies. Dr. Jeffry Katz is actively participating in clinical trials with new therapies for inflammatory bowel disease, studies of disease natural history, evaluation of new diagnostic approaches and techniques, and assessment and prevention of colon cancer risk.

Health Services and Outcomes Research

The research in the emerging field of Health Services and Outcomes Research encompasses several interrelated areas including the use of large health care and tumor registry databases, decision analysis, and identification of risk factors and outcome prediction in common gastrointestinal conditions. There is active collaboration of divisional faculty with members of the Departments of Population and Quantitative Health Sciences and the Center for Community Health Integration.

Dr. Gregory Cooper's main interests are large database research, alternative screening and surveillance strategies, and interventions to improve delivery of cancer prevention and control services. Dr. Linda Cummings studies interventions to improve screening and surveillance of esophageal adenocarcinoma as well as cancer risk in cystic fibrosis.

Division investigators have been successful in obtaining grant funding from the NIH, the American Cancer Society and the American Society for Gastrointestinal Endoscopy, and have published extensively in the gastroenterology, oncology and health service literature.

Barrett's Esophagus and Esophageal Cancer

Investigators, led by Amitabh Chak, MD, are studying factors that may cause Barrett's esophagus and esophageal cancer to run in families, including analyzing blood for genetic markers for both diseases. They have identified genes that confer susceptibility to Barrett's and are studying the functions of these genes in mice.

The investigative team leads one of only three BETRNet Centers in the country and is further developing novel nonendoscopic methods for detecting and surveying Barrett's esophagus. Researchers in the BETRNet Center are also studying epigenetic and transcriptomic alterations that lead to the development of Barrett's esophagus and its progression to cancers. The goal of BETRNet is to improve the detection, prevention and treatment of esophageal cancer.

Bioengineering and Endoscopic Research

The research interests in bioengineering and endoscopic research span several areas of medical physics and bioengineering related to optical remote sensing and high-resolution imaging within the body. Current research topics include high-resolution sub-surface endoscopic imaging using optical interferometry, spectroscopic characterization of pre-cancerous states in gastrointestinal tissues, and spectrally resolved confocal microscopy. Amitabh Chak, MD, is one of three investigators participating in an NIH research- funded protocol screening patients in a primary care setting for Barret's esophagus with in-office unsedated small-caliber endoscopy.

Hepatology

Drs. Yngve Falck-Ytter, Stanly Cohen and Perica Davitkov are actively participating in several pragmatic randomized controlled clinical trials evaluating the management of nonalcoholic fatty liver disease with monotherapy or combination of two of the new glycemia-lowering and weight lost agents as GLP-1RAs and SGLT2i(s). In addition, a large database study using VINCI software for access to national VA data to evaluate incidence of HCC in advanced liver fibrosis (F3) patients is in progress.

Several current clinical trials for chronic viral hepatitis treatment are in progress. More recently, clinical trials evaluating the management of hepatocellular carcinoma have been adopted. In addition, clinical trials in transplant patients and patients with fulminant liver failure are ongoing.

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