Creating Connections for Liver Disease Research 

Liver disease has long been a focus of basic and clinical investigation in the division. Building on this foundation, Dr. Mullen, who joined the division as academic chief in 2022, plans to expand the research program by welcoming diverse approaches that connect to liver disease. “As we look to recruit new research faculty, we are open to research related to liver disease in any biological models and look forward to the synergy of connecting investigators from diverse scientific backgrounds,” said Dr. Mullen.  

Along with Dr. Mullen’s lab which focuses on hepatic cell biology and liver fibrosis, the division has a core group of basic science investigators including Pranoti Mandrekar, PhD, professor of medicine, associate vice chair for faculty development in the Department of Medicine, and long-time faculty in the division, and Meng-Ju Wu, PhD, a junior faculty member who will join them in October. Dr. Mandrekar’s research centers on investigating the mechanisms of alcohol-mediated organ damage, liver disease, and the progression to cancer. Specifically, her work is dedicated to understanding signaling mechanisms in immune cells, cellular stress, immune and metabolic interactions, and end-organ injury. Dr.  Wu's research focuses on understanding how metabolic and epigenetic alterations in cholangiocarcinoma drive immune evasion within the tumor microenvironment, with the goal of developing novel therapeutic strategies to restore anti-tumor immunity. 

Dr. Mullen also anticipates extensive areas of opportunity in the clinical research domain. Clinicians in the division care for patients with a range of conditions including alcohol-related liver injury, metabolic dysfunction-associated steatotic liver disease (previously known as non-alcoholic fatty liver disease), and cholangiocarcinoma. Over time, the goal will be to engage basic science investigators in more interactive projects with clinical investigators. “There is a lot of opportunity for synergistic work,” said Dr. Mullen. “For example, bench scientists have tools that allow them to interrogate diseases that they model in mice or cell culture, but they may not have access to human tissue or the specific challenges that come with managing an individual disease.” Dr. Mandrekar and Deepika Devuni, MD, associate professor of medicine, are currently conducting one such project, bringing together their basic science and clinical expertise around liver injury resulting from alcohol use disorder, through an NIH-sponsored project. 

Building Support Systems for Clinical Research 

Establishing reliable systems to support the growth of clinical research and help generate new funding is critically important. The division has built infrastructure by establishing a core staff who will support clinical trials and help faculty develop projects. “We don’t want faculty who are trying to develop a project on their own or who are approached by industry to feel under-supported and overwhelmed,” said Dr. Mullen. Anne Foley, a senior clinical research coordinator who has extensive regulatory knowledge is now the lead coordinator for the division. She and the other division-based clinical research coordinators as well as the Department of Medicine Clinical Research Core have been helpful in their efforts to provide support and stability. “If we build most of the infrastructure now, we hope to be able to increase funding support from grants and industry collaborations within a couple of years,” said Dr. Mullen.  

Cross-Institutional Collaboration in AI for Clinical Diagnosis and Inflammatory Bowel Disease 

The division’s clinical investigators are currently making transformative strides using artificial intelligence technology to enhance diagnostics for patients with cholangiocarcinoma. Neil Marya, MD, assistant professor of medicine and a director of the Program in Digital Medicine, along with co-investigator Navine Nasser-Ghodsi, MD, assistant professor of medicine, and colleagues in the Department of Surgery, are utilizing AI to analyze and interpret cholangioscopy videos to improve diagnostic accuracy. “Adding an AI component will lead to a transformation in how we can make diagnoses,” said Dr. Mullen. Investigators are also starting to think about how they can apply AI technology to other areas such as liver ultrasound and abdominal ultrasound as a newer way of looking at inflammation in the intestines for inflammatory bowel disease. “These are areas where we are looking to expand and take advantage of the evolving technology as well as our faculty’s expertise,” said Dr. Mullen.  

Collaborative efforts are also underway in inflammatory bowel disease research between Abbas Rupawala, MD, assistant professor of medicine and director of the IBD Clinic, Leo Boneschansker, MD, PhD, assistant professor of medicine, and Ana Maldonado-Contreras, PhD, the Marcellette G. Williams Scholar and assistant professor of microbiology. As part of one of their current studies, the team is starting to collect tissue samples from patients with IBD. Their goal is to start banking samples and eventually create a repository that will help facilitate additional collaborative opportunities in the future. “Dr. Boneschansker has a protocol to collect tissue, other specimens, and clinical data to allow them to work towards their goal,” said Dr. Mullen. “While he is a clinical IBD specialist, he also has a background in immunology and is enthusiastic about establishing collaborations with labs across UMass Chan.”  

Interactive Research for Tomorrow’s Physicians  

Fellowship is a time for rigorous clinical training. Still, various research opportunities are available within the division, Department of Medicine, and across campus in which trainees can engage. Fellows can pursue multiple avenues beyond their clinical training. Whether they are interested in conducting research in immunology, metabolism, or digital medicine, if they want to earn a master’s of science in clinical investigation, or want to pursue an interest in gender equity and medical ethics by working with Lauren Feld, MD, assistant professor of medicine, they can explore any of those opportunities on campus. “When I came to UMass Chan, I was really excited about the breadth of research and educational opportunities that already existed. My goal is to ensure that our fellows are aware of the possibilities,” said Dr. Mullen. To that end, Krunal Patel, MD, assistant professor of medicine, and Anita Krishnarao, MD, MPH, assistant professor of medicine, director and assistant director of the Gastroenterology and Hepatology Fellowship, respectively, have developed an option for second and third-year fellows that allows them to pursue different research and educational pathways. Structured courses and programming enable the fellows to take advantage of resources at UMass Chan that are relevant to their goals, whether these are in a gastroenterology lab, immunology lab, population health sciences, or with another group on campus.  

Seizing Opportunities “Right Across the Lawn” 

Dr. Mullen sees UMass Chan/UMass Memorial Medical Center as a unique environment that naturally lends itself to collaboration and innovation, and he is excited about the opportunities that division faculty and trainees have on campus. “There are fantastic labs and field-leading experts all around campus,” he said. “I think that sometimes our clinicians and fellows don't realize how much research is going on right across the lawn from the hospital. We want to be sure everyone takes advantage of those opportunities if that is something that they want to do.”