Principal Investigator: Aziz Aadam, MD Gastroparesis is a debilitating condition that can cause persistent nausea, vomiting, and abdominal pain due to delayed stomach (gastric) emptying. The inability to eat or drink can lead to malnutrition and reduced quality of life. Current treatments are limited in both effectiveness and durability. A minimally invasive endoscopic procedure called G-POEM has recently shown promise in improving spasms of the sphincter muscle that prevent proper gastric emptying. G-POEM involves cutting this smooth band of muscle—that connects the stomach to the small intestine—to prevent further spasms and to allow the stomach to empty. Dr. Cai hopes to identify which gastroparesis patients would most likely benefit from this treatment using two novel methods: EndoFLIP, a probe that measures sphincter flexibility and antroduodenal manometry (ADM), a catheter that measures pressures throughout the upper gastrointestinal tract. Her team will look for specific EndoFLIP and ADM metrics that can be used to more effectively select patients for and predict improvement after...
Principal Investigator: Xiaoying Liu, PhD The term cholestasis describes any condition that impairs normal bile flow from the liver into the bile ducts and then into the intestine. This disease state can cause chronic liver damage, cirrhosis, end-stage liver disease (requiring a liver transplant), and death. Cholestatic liver diseases include primary sclerosing cholangitis (PSC) and primary biliary cholangitis (PBC). Cholestasis also occurs frequently after liver transplantation, which can result in the need for repeat liver transplantation or death. Unfortunately, the molecular drivers of cholestasis are still poorly understood with few effective medical therapies. The liver unfolded protein response (UPR) is a molecular pathway that protects cells from injury. UPR has been demonstrated to be important in many liver diseases, although its role in cholestasis remains unknown. Dr. Liu intends to investigate the activation of the liver UPR pathways in liver transplant patients with cholestasis. Identifying new UPR protein and gene targets will ultimate aid in developing novel drug therapies and improving liver transplant...
Principal Investigator: Jonah J. Stulberg, MD, PhD, MPH | Salva Balbale, PhD The national opioid crisis continues to adversely affect millions of lives, including a growing number of individuals with inflammatory bowel disease (IBD), including Crohn’s disease and ulcerative colitis. Studies have suggested that long-term opioid use among IBD patients can result in serious detrimental effects on GI function. Opioid use disorders in this population have also been linked to longer hospital stays, increasing health care costs, and deaths. Yet a comprehensive understanding of the opioid usage and pain management needs of these patients remains elusive. Additionally, no published studies have explored the decision-making process that IBD providers use when prescribing opioids. Dr. Stulberg’s study will lay the groundwork for developing best practices to optimize the use of opioids for IBD patients. The researchers will conduct interviews with IBD providers, in addition to focus groups with IBD patients to ensure all voices are heard and incorporated in future opioid safety efforts to enhance the care and pain management for patients with inflammatory bowel disease. (Dr. Stulberg led a previous DHF-funded study in 2017 that tracked and greatly reduced opioid prescriptions and risk of misuse in GI surgery...
Principal Investigator: Beatriz Sosa-Pineda, PhD Pancreatic cancer has one of the worst survival rates in the world, and patients have very limited therapeutic options to fight the disease. It is predicted that close to 47,000 Americans will succumb to pancreatic ductal adenocarcinoma (PDAC) in 2020. Meeting the dire need for new therapies and diagnostic methods requires a better understanding of the fundamental biology of PDAC. Learning more about the molecular mechanisms that govern tumor formation, progression, and spread (metastasis) is critical to improving outcomes. In this study, Dr. Sosa-Pineda intends to build on her lab’s previous findings to firmly establish the role of a new gene regulator, the transcription factor ONECUT2, in the development of pancreatic cancer. This project will use molecular approaches to abolish the expression of ONECUT2 and test its effect on pancreatic tumor function. The Sosa-Pineda team will employ additional approaches to identify specific pathways and functions regulated by ONECUT2 in pancreatic...
Principal Investigator: Sri Komanduri, MD | Co- Principal Investigator: Domenico Farina, MD Esophageal cancer is a deadly and increasingly common disease in the United States. Up to 15 percent of patients with gastro-esophageal reflux disease (GERD) will develop Barrett’s esophagus (BE), a pre-cancerous state that can develop into esophageal cancer. While BE is highly treatable, the progression to esophageal cancer still commonly occurs due to missed detection and diagnosis of Barrett’s esophagus, which often returns despite treatment. A new technology, Wide-Area Trans-Epithelial Sampling (WATS-3D), may offer improved detection of abnormal cells (dysplasia) in Barrett’s. WATS-3D uses brush sampling to examine larger areas of the esophagus than is achieved in conventional biopsies. Preliminary studies show improved detection of cancerous changes in Barrett’s esophagus surveillance. Dr. Komanduri’s team hopes to determine if the addition of WATS-3D increases the rate of detection of recurrent Barrett’s following treatment. If so, this could be a game changer for patients, allowing for earlier re-treatment of Barrett’s and, ultimately, for the prevention of esophageal...
