By A.J. Hostetler

Rows of attentive faces, name tags and lots of coffee marked the first day of “MASH School,” a two-day training program hosted last week by Virginia Commonwealth University’s Stravitz-Sanyal Institute for Liver Disease and Metabolic Health.

The participants – 15 of Brazil’s top hepatologists – had traveled to Richmond to take part in the institute’s inaugural program to train the next generation of liver specialists. Last year, the VCU institute formalized multiple agreements with academic institutions around the globe, including the University of São Paulo, to further its education and research goals.

“VCU’s Stravitz-Sanyal liver institute is on a critical global mission to expand our ability to control, treat, prevent and research liver and metabolic illnesses,” said VCU President Michael Rao, Ph.D. “Liver health is truly an urgent public health issue worldwide, and our ability to advance treatments and cures depends on innovative research that is focused on patient-centered science and clinical care. Our goal is for VCU to be a global magnet for this training and research – we welcome partnerships with institutions like USP as we all work together to overcome this global health challenge.”

In addition to the arrangement with USP, VCU has agreements with centers and universities in India, Singapore, Mexico and Turkey, and with industry partners throughout Europe, Southeast Asia and elsewhere. These partnerships will support the institute’s goal of establishing a global cohort of 100,000 patients for long-term studies on treatment and prevention of liver disease and to better understand liver function in metabolic health.

Arun Sanyal, M.D., director of the VCU Stravitz-Sanyal Institute for Liver Disease and Metabolic Health, was among those welcoming the visiting liver specialists. (VCU Enterprise Marketing and Communications)

“We are uniquely positioned to address the pressing challenges posed by liver-related diseases on a global scale through strategic partnerships with institutions across continents. This is what will pave the way for groundbreaking research, transformative education and impactful collaborations to reduce the burden of liver disease,” said Arun Sanyal, M.D., director of the liver institute and a professor in the VCU School of Medicine.

Approximately 1 in 10 adults in the U.S. has some form of liver disease, with many people unaware until the disorder has advanced. MASH – metabolic dysfunction-associated steatohepatitis – is characterized by fat accumulation, scarring and inflammation of the liver, and it poses significant risks, including cirrhosis, liver cancer or the potential of a liver transplant. Typically, patient treatment has focused on weight loss and lifestyle changes. Only last month did the FDA approve the first drug to treat MASH.

As obesity and diabetes rates surge globally, liver disease stands as the ninth-leading cause of death in the U.S. and the eighth in Brazil.

The VCU-USP agreement allows trainees to immerse themselves at the VCU liver institute to learn and work alongside its world-class liver specialists, gaining comprehensive clinical and research experience in gastroenterology, transplant hepatology and transplant surgery. VCU’s gastroenterology/hepatology program is ranked 17th in the world by U.S. News & World Report, based on academic research performance.

“We believe this collaboration on MASH School will result in groundbreaking discoveries, advanced medical practices and enriched learning experiences for students at both institutions and improve the care of our patients,” said Claudia Oliveira, M.D., the hepatologist and professor from the Brazilian university who helped arrange the agreement with VCU. She added that the collaboration should help build Brazil’s liver research workforce capacity as well as expand skills and knowledge among her country’s physicians to help its health care system confront the rising rate of liver disease.

During the visit, VCU faculty from the School of Medicine engaged with their Brazilian counterparts to discuss various MASH-related topics: its biology, connection to cardiovascular disease, diagnosis, cirrhosis, treatment and the special concerns of liver disease in children and women.

“This was a great opportunity to come and discuss our cases of [MASH]. It’s an epidemic not only here in the U.S. but in the whole of Latin America,” said Mario Pessôa, M.D., an assistant professor at University of São Paulo and president-elect of the Latin American Association for the Study of the Liver. “I hope this course can continue so that other colleagues from around the world have the opportunity to come here.”

The CEO and founder of Avant Santé Research Center SA de CV, Mexico, Sitaramaraju Yarramraju, Ph.D., told the MASH School participants about his efforts to combat the high rate of liver disease in Latin America. He described his company’s plans to expand knowledge about liver disease among primary care physicians, in part by developing “centers of excellence” for metabolic health and liver disease in Colombia and Brazil, and eventually throughout Latin America. They would create opportunities for more powerful research on not just treating but preventing liver disease.

Later this year, VCU’s Sanyal will travel to the National University of Singapore as part of the institute’s emphasis on collaboration to combat liver diseases globally.