Researchers

Kerri Boutelle, PhD performs research focusing on the causes, characterization, prevention and treatment of childhood, adolescent and adult obesity and eating disorders. Overarching research objectives include investigating the role of familial factors in the etiology, prevention, and treatment of obesity and eating disorders in youth, utilizing principles of basic behavioral science to inform and improve treatments for obesity and eating disorders; and determining intervention and prevention strategies aimed at changing the trajectory of weight and eating disorders in children and adolescents. In ongoing studies, Dr. Boutelle hopes to identify innovative and cost-effective treatment strategies for obese children (parent-only treatments), to develop new treatments based on basic behavioral research for children who binge eat (self-regulation treatments), and to disseminate current behavioral treatment through innovative methods (guided self-help, computer-based guidance for primary care physicians). Dr. Boutelle’s clinical interests lie in the treatment of childhood and adolescent obesity and eating disorders, and the concomitant depression, anxiety, oppositional, personality, behavioral and family changes that occur with eating-related difficulties. Her clinical work is grounded in empirically based cognitive-behavioral, interpersonal and family-based treatments, and she provides and supervises individual, group and family therapy.

 

Rebecca Cherry, MD, MPH, is the Interim Director of the Motility Center at RCHSD, providing consultation and diagnostic procedures for children with GI dysmotility as well as persistent abdominal pain. She is also the Interim Director for Nutrition Support, overseeing clinical management of patients with intestinal failure and other complex nutritional needs. She has recent and ongoing research activities in both these fields. In the area of motility and abdominal pain, she is studying outcomes of physical therapy for intractable chronic constipation. She also has obtained compassionate use access to cisapride, a prokinetic medication. She is actively collaborating with the UCSD Center for Mindfulness to develop mind-body programs for patients with chronic abdominal pain. She has an upcoming project to study the genetics of carbohydrate digestion in patients with abdominal pain. In the area of nutrition, Dr. Cherry was the local investigator for the Second International Study of PICU Nutrition in 2012. She is involved in the experimental use of fish-oil based lipid emulsions for patients with parenteral-nutrition related cholestatic liver disease, and will soon be investigating the use of teduglutide, a GLP-2 analogue, to increase intestinal adaptation in patients with short bowel syndrome. She is also studying the use of oral viscous budesonide for symptomatic and histologic improvement in patients with eosinophilic esophagitis.

 

Lillian Choi, MD has special interests in pediatric gastroenterology that include functional abdominal pain. She was an active co-investigator of a pilot open-labeled trial investigating the effectiveness of SAM-e for the treatment of Functional Abdominal Pain (FAP) in children. Dr. Choi is also the Director of Endoscopy. Her goals are to maximize quality and patient safety. This includes regularly updating the endoscopy suite in regards to the latest endoscopic technologies and procedural equipment, and to expand the repertoire of endoscopic procedures available to patients which will allow for more efficient, more therapeutic, and most importantly, more reliable and safer care for patients. She has instituted regular and iterative quality improvement evaluations regarding the procedural service to ensure excellent patient care and comfort.

 

Ranjan Dohil, MB, BcH ‘s research interest has included eosinophilic esophagitis in childhood and gastrointestinal manifestations of cystinosis. He has been awarded grants from the Hearst and the Cystinosis Research Foundation which have allowed him to study different aspects of these diseases. Data accrued from studies of the pharmacokinetics and pharmacodynamics of cysteamine bitartrate in children with cystinosis were used to develop a new formulation of cysteamine which patients could tolerate better (fewer GI symptoms) and required twice-daily rather than every 6 hour ingestion. On April 2013 the new delayed and extended-release formulation of cysteamine (RP103 or ProcystbiTM), developed at UCSD along with Raptor Pharmaceuticals, was FDA approved and will now be commercially available for the treatment of cystinosis. The new drug has already been shown in the long-term studies to improve the quality of life for many of these patients. An article about the development of Procysbi was recently published in the New York Times. Following the development of RP103 a number of multicenter studies have been started using this drug in the treatment of NAFLD and Huntington’s disease.

 

Ariel Feldstein, MD is Chief of the Division. He is regarded as a leading physician scientist in the field of Pediatric Hepatology. Dr. Feldstein’s research program is focused on dissecting the biochemical pathways of cell death trigger by over-accumulation of fatty acids and other lipids in the liver and other organs, which may play an important role in disease processes such as obesity-associated liver disease (nonalcoholic steatohepatitis or NASH), and type 2 diabetes. A second objective is to better understand the events that link excessive accumulation of lipids in the liver (steatosis) to liver injury, fibrosis and carcinogenesis. His research is currently supported by several grants from the National Institutes of Health (NIH) as well as foundation (American College of Gastroenter-ology) and industry (Nestle) grants. His laboratory has provided key evidence to support the currently most accepted theory of the role of hepatic lipid compartmentation and lipotoxicity in the pathogenesis of steatohepatitis development. Most recently, he provided key evidence for a novel pathogenic role for adipocyte cell death, and in particular the Fas extrinsic pathway of apoptosis in the recruitment of macrophages to adipose tissue, inflammation and subsequent

metabolic disruption resulting in insulin resistance and hepatic lipid accumulation during weight gain. At the translational level, Dr. Feldstein has pioneered the role of examining cytokeratin-18 fragments as biomarkers for liver injury in NASH. This marker is currently considered the most promising non-invasive test for liver injury in patients with NASH. His laboratory routinely utilizes a variety of in vivo and in vitro experimental models in various projects on the basic mechanisms involved in steatosis and NASH development as well as an array of mass spectrometry based approaches (LC/ESI/MS/MS, proteomics) directed toward translational studies to identify mechanism-based disease biomarkers. Dr. Feldstein’s lab offers a unique environment for fellows in the gastroenterology training program combining significant clinical and translational endeavors with substantial basic research opportunities.

M. Abigail Garcia, MD receives funding from the Cystic Fibrosis Foundation to research gastrointestinal manifestations of cystic fibrosis. Dr. Garcia focuses on understanding the patho-physiological basis of cystic fibrosis (CF). Her research aims to understand the consequences of diminished bicarbonate transport in CF and how this affects development of mucoviscidosis. She has shown that bicarbonate is essential for optimal mucus secretion in mouse models, and that bicarbonate deficiency inhibits intestinal mucus release. She is further investigating the mechanisms behind this finding to provide an effective treatment option to CF patients who suffer from distal intestinal obstruction syndrome or chronic constipation.

 

Jeannie Huang, MD, MPH is a member of the Center for Wireless & Population Health Systems, which is a body of investigators whose work focuses on the creative use of networked technologies and ubiquitous computing to improve population health (cwphs.ucsd.edu). Dr. Huang has led and currently collaborates on several highly innovative health intervention projects addressing personal health behaviors and public health issues, including Texting to promote Adolescent Health Liaisons and Communication (TAHLC), a technology (website + SMS)-based intervention for adolescents with chronic disease to increase health-related self-efficacy and healthcare engagement among adolescents with chronic disease as they prepare for their transition to adult care; Fit4Life, a technology-based weight management program among children who have survived acute lymphoblastic leukemia; and SMART: A Social and Mobile Weight Control Program for Young Adults, that utilizes the Facebook platform to deliver a weight management program to obese young adults. Dr. Huang also is PI of a state-of-the-art NIH-funded project with Dr. Bartlett in the School of Engineering using facial recognition technologies to evaluate pain expressions in children with clinical pain. Finally, she is a co-investigator in two NSF-funded projects with Drs. Patrick and Tilak from the Qualcomm Institute of Technology at UCSD evaluating how cloud data processing may be used to provide real-time clinical feedback for real world health sensor data.

Dr. Huang, who is the Director of the UCSD Pediatric Gastroenterology and Hepatology Fellowship, has also been and currently is involved in a number of national medical education efforts, including the award-winning Health and Obesity: Prevention and Education project. She is the Chair of the NASPGHAN Maintenance of Certification Task Force and currently leads a number of national quality improvement projects targeting both clinical and procedural issues.

Sherry Huang, MD is involved in studies of kindreds with early colon cancer risk, with particular interest in patients with hamartomatous polyposis syndromes. She is involved in research evaluating the genetics of early colon cancer in children and its pathogenesis. Her projects involve the role the oncogene PTEN plays in relation to DNA mismatch repair. She also has projects looking at activation of Wnt Signaling in hamartomatous polyposis. Dr. Huang also studies the AKT pathway in hamartomaotus polyps with special focus on mTOR signaling.

Dr. Huang’s clinical focus is on the early detection of colon cancer and at-risk kindreds. Working with geneticists from UCSD Moores Cancer Center, Dr. Huang evaluates and counsels kindreds at risk for colon cancer. Dr. Huang recently became the Director for the UCSD Pediatrics Residency Program.

Martin Kagnoff, MD (Emeritus) is Director of the Warren Medical Research Center for Celiac Disease and the Laboratory of Mucosal Immunology at UCSD. He has served as Editor for two biomedical research journals and is currently the Chairman of the Immunology, Microbiology, and Inflammatory Bowel Disease section of the American Gastroenterological Association. Dr. Kagnoff is an active physician scientist who works closely with the medical personnel who care for adults and children through the UCSD Celiac Disease Clinics. He led the current NIH consensus panel on the care of patients with celiac disease.

 

Kimberly Newton, MD serves as the Director of the Celiac Disease Clinic at Rady Children’s Hospital, San Diego. This clinic is one of fewer than 5 clinics in the western United States dedicated to the diagnosis and treatment of celiac disease in children. Once diagnosed, children are followed closely to ensure adaptation and adherence to the gluten-free diet, and to monitor growth and other nutritional parameters over time. The clinic currently cares for over 220 children with celiac disease. Dr. Newton has recently participated in a national working group, which is currently developing Best Practices expert consensus statement pertaining to management of celiac disease in children. She has also been actively engaged in numerous outreach and educational activities including the formation of a new pediatric celiac disease support group, Kickstart. In addition to celiac disease, Dr. Newton’s clinical focus has broadened to include

hepatology, and she is currently the Interim Medical Director of the Pediatric Liver Transplant Program at RCHSD, and is also co-investigator in several clinical research studies investigating pediatric nonalcoholic fatty liver disease.

Jeffrey Schwimmer, MD is Director of the Weight and Wellness Center, a multi-disciplinary program for the evaluation and treatment child and adolescent obesity at RCHSD. Dr. Schwimmer’s research emphasis is on the complications of obesity, both metabolic and behavioral. Dr. Schwimmer also Director of the Fatty Liver Clinic at RCHSD, the first clinic in the U.S. dedicated to the care of children with fatty liver disease. Fatty liver is now the most common cause of chronic liver disease in children. Dr. Schwimmer’s research includes the development and validation of non-invasive imaging for diagnosis, clinical trials for the treatment of steatohepatitis in children, and the role of the intestinal microbial environment in susceptibility to fatty liver.

 

Warren Shapiro, MD continues to be interested in functional GI disorders. He implemented a GI Biofeedback Clinic at Kaiser, which has had significant success in helping the difficult cases. He inaugurated a similar clinic at RCHSD.

 

Mamata Sivagnanam, MD research focuses on congenital tufting enteropathy. This is a severe and life-threatening problem presenting with intractable diarrhea in infancy. Using modern genetic technology, Dr. Sivagnanam isolated epithelial cell adhesion molecule (EpCAM) as a gene associated responsible for this condition. She focuses on the effect it has on intestinal epithelial physiology. She hopes to gain a better understanding of the role of adhesion molecules in intestinal epithelial development in health and disease.

 

Sharon Taylor, MD is Director of Nutrition Support Services. She runs the Intestinal Rehabilitation clinic, managing most of the complex short bowel pediatric population in San Diego. She is responsible for RCHSD Nutrition Manual and Guidelines.

 

Elizabeth L. Yu, MD completed her pediatric GI fellowship at Rady Children’s hospital/UCSD (’12) and joined the GI division. Her research focuses on Histone deacetylase inhibitor (HDACi) mediated hepato-protective effects on nonalcoholic steatohepatitis (NASH) and attenuation of obesity-induced metabolic dysfunction. As current therapy for NASH is lifestyle modification through diet and exercise, the eventual goal is to have a clinical application for HDACis in treatment of NASH.