Gastroenterology Fellowship – Massachusetts General Hospital, Boston, MA
Clinical Hepatology Fellows
Primary sclerosing cholangitis (PSC) is a rare, chronic cholestatic liver and biliary tract disease, with a highly variable clinical presentation and natural history. The pathogenesis of PSC remains elusive, nevertheless, cumulative evidence suggests its development is immune-mediated and follows an immune priming event in genetically pre-disposed individuals.
The intricate relationships and interactions between host genetics, immune responses, behavioral and environmental triggers underlying the pathogenesis of PSC have not yet been elucidated. My main research interest is to identify those interactions and their role in the development of PSC.
Other research interests of mine include, liver manifestations in syndromes of immune disregulation and understanding the differential metabolic pathways dominating in post prandial state in NAFLD patients versus healthy controls.
Liver disease is fascinating-the liver controls a host of processes in the body ranging from the immune system to metabolism. My interests include delta hepatitis, non-cirrhotic portal hypertension and the association of fatty liver disease with abnormalities in metabolic pathways of the body. The recent advent of novel viral prenylation inhibitors for delta hepatitis is a rapidly developing field; NIDDK has been actively involved in phase 2 studies that show promising results.
Non-cirrhotic portal hypertension is a diverse group of disorders with widely varying causes and outcomes, there has been no treatment identified to modify the natural history of the disease-perhaps given the heterogeneity. My clinical focus is to work on the characterization of the natural history of non-cirrhotic portal hypertension.
I am also interested in the physiologic and metabolic pathways connecting the liver and the cardiovascular system, how changes in one can affect the other.
Fatty liver disease currently affects one third of the United States population and it is projected to become number one cause for liver transplant in 2020. Despite the tremendous advancement in different fields of hepatology, we still have a lot to investigate in the pathogenesis of fatty liver disease and finding treatment for the disease. My primary interest is in evaluating new treatment methods for fatty liver disease, and finding non-invasive methods the could estimate accurately the severity of the disease.
I was drawn to NIH because of their unique approaches to answer basic biological questions through clinical research trials. One of my research interests is to understand the role of liver immune system in pathogenesis of liver diseases, especially liver cancer and autoimmune liver diseases. The unique immune tolerogenicity of liver is evident from the low-level immunosuppression required in a HLA-mismatched, orthotopic liver recipient, contrary to other solid organ transplantations. Additionally, the liver confers the same immunotolerance to the kidney in recipients of dual liver-kidney transplant. This phenomenon shows that the liver can modulate systemic immune response but may be predisposed to chronic infection and malignancy. Researchers have explored different methods to modulate the hepatic immune system, and our lab recently showed that gut microbiota-dependent changes in bile acid composition can modulate immune surveillance of liver tumors in a murine model. My goal is to dissect the molecular mechanism using tissue culture and mouse model, and to correlate these findings in human. This research may lead to novel therapies for primary and metastatic liver cancers.
Bethesda, MD 20892
Bethesda, MD 20892