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Stavra A. Xanthakos, MD, MSAssociate Professor Medical Director, Surgical Weight Loss Program for TeensCo-Director, Steatohepatitis CenterDepartment of Pediatrics; Division of Gastroenterology, Hepatology and Nutrition
Dr. Xanthakos’ primary research focus is to identify the biologic determinants of non-alcoholic steatohepatitis (NASH), including potential gene-environment interactions with dietary intake during childhood and adolescence. Dr. Xanthakos characterized the histologic spectrum of non-alcoholic fatty liver disease (NAFLD) in morbidly obese adolescents undergoing bariatric surgery at Cincinnati Children’s Hospital Medical Center in a collaborative study with Dr. Inge. These studies revealed that the histologic spectrum of NASH in morbidly obese adolescents differs considerably from the features of NASH described in adults, with more portal inflammation and fibrosis than is seen in adults. The etiology of the difference in histologic pattern between children and adults is not known. Importantly, nearly 20%of morbidly obese adolescents do not develop NASH, despite similar degrees of morbid obesity and insulin resistance. Long-term research goals include 1) determining the biological factors that regulate hepatic susceptibility to inflammation and fibrosis in response to obesity, 2) analyzing how genetic polymorphisms in key cytokines and adipokines alter the expression of genes that regulate inflammation and fibrogenesis, 3) identifying dietary factors that may predispose genetically-susceptible individuals to develop the NASH and 4) developing and applying mechanistically based therapies for NASH in childhood and adolescence. Dr. Xanthakos also serves as the center PI at CCHMC for the NASH Clinical Research Network CCHMC will be participating in a new clinical trial for pediatric NASH sponsored by the NASH CRN beginning in 2011.
Dr. Xanthakos collaborates with Dr. Inge studying the determinants of inflammation and fibrogenesis in morbidly obese subjects. Additionally, she works with Dr. Kohli identifying serum molecules to serve as biomarkers for the severity of fibrosis in NASH patients. Anticipated Core use: Gene and Protein Expression, Bioinformatics, and Integrative Morphology Cores.
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Liver biopsy samples from pediatric patients with nonalcoholic fatty liver disease (NAFLD). The specimens shown are representative of the various histopathological features found in children with NAFLD. (A) Portal inflammation. (B) Lobular inflammation. (C) Bridging fibrosis. (Original magnification x400.) Figure from Hepatology, 2009;50:1113-1120.
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