Chief Gastroenterology, Mass General Brigham

Clinicn Investigator, Full Prf Gastroenterology, Mass General Research Institute

Distinguished Physician Gastroenterology, Massachusetts General Hospital

Professor of Medicine Harvard Medical School

Kevin and Polly Maroni MGH Research Scholar 2013-2018 Mass General Research Institute, Massachusetts General Hospital

Affiliate Faculty Harvard Stem Cell Institute

MD Yale University School of Medicine 1986

autoimmune liver disease; carcinoma hepatocellular; chemoprevention; hepatitis b chronic; hepatitis b virus; hepatitis c; hepatitis c chronic; liver cirrhosis; nonalchoholic fatty liver disease

Our laboratory has two major areas of focus. We are investigating the mechanisms by which HIV accelerates the progression of liver disease for two key conditions frequently found in patients living with HIV, chronic HBV infection, and metabolic dysfunction-associated steatotic liver disease (MASLD/MASH). We are using cell-based, spheroid, organoid, animal and human tissue models to conduct this work. We are specifically exploring the interaction of key metabolic pathways perturbed by HIV that enhance fibrogenesis.  Independently, we are exploring the residual immunosuppressive effects of chronic hepatitis virus infection on innate immune responses.

In light of the fact that established fibrotic or cirrhotic liver disease may not be fully reversible and remain at risk for complications, we are also exploring the utility and mechanism of lipophilic statins as chemopreventive agents in patients at high risk for hepatocellular carcinoma (HCC) and decompensated liver disease, regardless of cause. To this end, we are conducting a randomized clinical trial of atorvastatin to assess its ability to reduce a highly predictive proteomic risk signature. We are also investigating biobanked samples of patients receiving statins and their controls to explore their effects on these signatures. We are evaluating large electronic health record databases to assess the real-world chemopreventive effects of these agents in at-risk populations with cirrhotic liver disease. Separately, we are also using discovery-based approaches to identify novel chemopreventive agents.