As part of The Ohio State University Wexner Medical Center — nationally ranked by U.S. News & World Report in 10 specialties, including gastroenterology and gastrointestinal surgery — the Gastroenterology, Hepatology and Nutrition Division has a robust and rapidly growing research program. The division has a wide range of projects aimed to improve care and outcomes for patients with liver disease, inflammatory bowel disease, gastrointestinal cancer, pancreatic disorders and other common and serious conditions of the digestive tract. Additionally, its NIH-funded basic science program is rapidly growing and gaining a national reputation for scientific excellence.
“Our overall research portfolio has grown exponentially in the past eight years, and is an emerging well-respected, academic research program,” says Darwin Conwell, MD, the division’s director. “We’ve been very successful in building our research infrastructure in three major areas: clinical trials, health services research and National Institutes of Health (NIH)-funded basic and translational research.”
Inflammatory bowel disease clinical trials provide novel therapeutic options for IBD clinic referrals
Anita Afzali, MD, MPH, medical director of the Ohio State Wexner Medical Center IBD Program, has brought cutting-edge clinical trials to central Ohio. Currently, over 15 clinical trials are available for patients with intractable symptoms or difficult-to-manage IBD. The IBD Center is committed to participating in as many existing IBD trials as possible and providing the best treatment opportunities for patients. Its goals are to contribute to the research that will one day find a cure for IBD, and in the meantime, to help patients live more fulfilling, symptom-free lives.
Conwell notes that referring physicians can now keep patients in central Ohio for their IBD care, avoiding long travel. “They have access to personalized IBD care at the Ohio State Wexner Medical Center and have the opportunity to obtain novel, innovative drug therapy,” says Conwell. “The development of the IBD Center is a game-changer for the citizens of Ohio and attracts drug companies wishing to perform clinical trials on new promising FDA-approved pharmacologic agents.”
Health services research using big data catapults GHN Division into national spotlight in its early years
In 2014, Somashekar Krishna, MD, MPH, director of Clinical Research in Ohio State’s Division of Gastroenterology, Hepatology and Nutrition, partnered with Catalyst Medical Consulting, LLC, to lead a weekend-long Big Database Analysis Research Workshop investigating research questions about GI Disorders in the Nationwide Inpatient Sample, which contains millions of patient data points.
The workshop generated over 20 abstracts, three oral presentations and multiple awards for Ohio State at the 2014 American College of Gastroenterology Scientific Session. Since this inaugural event, numerous local, regional and national awards and recognitions have been given yearly to medical students, residents, fellows and GHN faculty from Ohio State using large databases to perform health services research. GHN faculty publications have also grown exponentially into top peer-reviewed publications and the GHN Clinical Research Group, under Krishna’s leadership has successfully supported many internal medicine resident applicants into gastroenterology fellowship programs. And several GHN faculty and fellows in the research group have received national recognition and published studies in hepatology (Mumtaz, Conteh, Sobotka), colon cancer (Stanich), IBD (Afzali), obesity (Hussan), pancreatitis (Lara, Ramsey), motility (Bala) and endoscopy (Krishna).
In addition, the Ohio State GHN Division was one of the highest-enrolling academic medical centers in the North American Alliance for the Study of Digestive Manifestations of COVID-19. A total of 1,992 patients across 36 centers met eligibility criteria and were included to assess the prevalence, spectrum, severity and significance of digestive illness in hospitalized patients with COVID-19. Currently, 10 publications have resulted from this multicenter collaboration. (Papachristou, Lara, Uchechi Okafor – lead CRC.)
NIH-funded translational studies in pancreatitis and pancreas cancer aimed to unravel mechanistic underpinnings of disease
Pancreatitis is one of the leading causes of gastrointestinal-related hospitalizations in the United States, and its incidence is rising. Improving care and outcomes for this painful, potentially deadly condition is one of the top priorities of the National Institutes of Health (NIH). George Papachristou, MD, PhD, and Phil Hart, MD, recently were awarded a National institute of Diabetes and Digestive and Kidney Diseases (NIDDK) grant to study the relationship between diabetes and acute pancreatitis. A few of the many ongoing NIH-funded projects tackling care, treatment and management for acute, recurrent or chronic pancreatitis include:
- Diabetes RElated to Acute pancreatitis and its Mechanisms (DREAM) study: The Type 1 Diabetes in Acute Pancreatitis Consortium (T1DAPC) is a group of 10 clinical centers and one data coordinating center that was formed in 2020 by the National Institute of Diabetes and Digestive and Kidney Diseases. Its purpose is to study type 1 diabetes and other forms of diabetes that occur during or after one or more episodes of acute pancreatitis. In order to accomplish this, T1DAPC’s main study will follow participants with a recent acute pancreatitis diagnosis to find out how many develop diabetes.
- Stent vs. Indomethacin for Preventing Post-ERCP Pancreatitis (SVI trial): One serious possible complication of ECRP is pancreatitis. A temporary pancreatic stent combined with rectal indomethacin can help prevent pancreatitis after ECRP. This study aims to determine whether rectal indomethacin alone could be just as effective, preventing the need for stent placement. The study will also provide the collection of biospecimens from study participants, to help fuel and inform future translational research on post-ERCP pancreatitis and acute pancreatitis.
- RCP pancreatitis and acute pancreatitis.
NIH-funded basic science laboratories in GHN division foster rich learning and mentoring environment and collaboration with physician scientists
Zobeida Cruz-Monserrate, PhD, director of Basic Research and the GHN Molecular and Cell Biology Laboratory, has received R01 and R21 funding from the National Cancer Institute for her research studying pancreatic cancer. She has developed a robust laboratory environment that fosters academic excellence. She has won numerous teaching and mentoring awards for her education and teaching of graduate students and postdoctoral research fellows.
“The long-term goal of my research is to develop strategies for the detection, prevention and treatment of PDAC and pancreatitis by uncovering mechanisms related to the initiation of these diseases,” Cruz-Monserrate says. “We have shown that the molecule integrin alpha6beta4, the enzyme Cathepsin E (CTSE) and pH-sensitive imaging probes are all early biomarkers of PDAC development.”
Tom Mace, PhD, is another basic scientist in the Division of GHN and a member of the Translational Therapeutics Program at The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC - James) who has been recognized for his scientific investigations and collaboration with physician scientists. He has received recognition by national organizations such as the American Pancreatic Association for scientific investigations in pancreas cancer immunology.
“I am investigating how cell surface proteins (e.g., CD200) expressed by the tumor and stromal cells promote the expansion and function of immunosuppressive cell types like myeloid-derived suppressor cells (MDSC), as well as how these immunosuppressive immune populations affect cancer-induced cachexia, a debilitating syndrome in patients with pancreatic cancer,” Mace says.
Leading research for the benefit of Ohioans
The research program’s impressive growth over the past eight years, Conwell says, can be credited to the team’s commitment and desire to deliver the best health care possible.
“Each team member, from basic scientist to nurse to endoscopist or hepatologist or advanced practice provider, is committed to constantly improving digestive health care delivery for every patient that walks into an Ohio State University clinic. They are the people of this great state we call O-H-I-O.
“For me, the words that best summarize what I think our academic medical center really stands for come from Dr. Steven Gabbe, former Ohio State Wexner Medical Center CEO:
We are The Ohio State University.
We are the people's University.
The citizens of Ohio depend on us.
And we do not turn anyone away.”