By A.J. Hostetler

Arun Sanyal, director of the Stravitz-Sanyal Institute for Liver Disease and Metabolic Health at the Virginia Commonwealth University School of Medicine, is the world’s No. 2 specialist in liver diseases, according to ScholarGPS, which ranks researchers and their publications based on productivity, impact and quality.

ScholarGPS, whose database covers more than 30 million scholars in more than 200 counties, released its latest rankings for 2022 in September. Sanyal, M.D., a physician whose research focuses on fatty liver disease (now called steatotic liver disease) as well as complications of end-stage liver disease, was given a lifetime ranking of No. 2 in three categories: liver disease as well as alcohol-related and nonalcoholic fatty liver disease. His lifetime ranking overall in hepatology is No. 5.

Additionally, Clarivate, a leading global information services provider, announced this month that Sanyal is one of three VCU researchers among the top-cited researchers worldwide. Its 2023 list of the “world’s influential researchers” has included Sanyal since 2017.

Sanyal has published about 1,000 publications in such journals as Cell Metabolism, Nature Medicine, New England Journal of Medicine, Lancet, Gastroenterology, Hepatology, and the Journal of Infectious Diseases, and he has been cited by other researchers more than 104,500 times, according to the ScholarGPS database. He has been continuously funded by the National Institutes of Health since 1995 and is the principal investigator of four active NIH grants.

A faculty member at the School of Medicine since 1989, Sanyal is internationally known for his work in the development of therapeutics for reducing liver disease around the globe. For years, he has led VCU’s program in gastroenterology and hepatology, which in 2022 was ranked 17th in the world by U.S. News & World Report. 

Liver disease is among the top 10 causes of death in most parts of the world, Sanyal noted.

“Liver disease is called a ‘silent killer’ because the liver won’t tell you when things start to go wrong. It will quietly keep trying to work away until one day it just gives up,” he said. “By the time symptoms for liver disease become apparent, a liver transplant is often the only treatment option. Liver transplantation is a lifesaving treatment, but many patients with advanced liver disease will never have access to one in their lifetime due to overwhelming demand.”

Sanyal’s research efforts have shaped the practice of medicine and care of liver diseases worldwide, improving the health of several hundred million individuals.

His contributions focus on two major areas.

First, for those with end-stage liver disease, Sanyal pioneered using shunts to save the lives of those with severe internal hemorrhage due to cirrhosis, or the buildup of fluid in the abdomen that requires repeated hospitalization and leads to kidney failure. He established rifaximin as the gold standard treatment for a devastating disorder, hepatic encephalopathy, in which the brain stops working due to cirrhosis.

Then in the late 1990s, Sanyal turned his attention to a condition then called nonalcoholic fatty liver disease. His landmark studies determined NAFLD’s link to insulin, and thus to heart disease, Type 2 diabetes and chronic kidney disease. His key contributions include understanding how the liver drives heart disease by making excess cholesterol and how liver disease progresses to cirrhosis.

Sanyal’s research continues to inform the development of drugs – all major classes of drugs used to treat NAFLD are directly linked to his work. His published work this summer demonstrated that pegozafermin can improve both liver fibrosis, or scarring of the liver, and liver inflammation in patients. He also studies resmetirom, which shows potential to reduce inflammatory liver fat and fibrosis while lowering cholesterol and other atherogenic lipids.

Sanyal’s leadership of the VCU hepatology program was an inspiration for the transformational $104 million gift by longtime friend and colleague R. Todd Stravitz, M.D., to fast-track Sanyal’s vision for the liver institute. That funding fuels research activity and treatment, as well as provides training for a future global network of liver health researchers and clinicians.

After receiving his medical degree from the All India Institute of Medical Sciences in New Delhi in 1983, Sanyal completed a residency in internal medicine at Texas Tech University Health Sciences Center and then a fellowship in gastroenterology at the Medical College of Virginia (now the VCU School of Medicine) before joining the faculty. He is interim chair of the Division of Gastroenterology, Hepatology and Nutrition at VCU and VCU Health.

Sanyal is the recipient of the Distinguished Mentorship Award from the American Gastroenterological Association, the Distinguished Scientific Achievement Award from the American Liver Foundation and the Distinguished Achievement Award from the American Association for the Study of Liver Diseases.

Sanyal’s lifetime rankings from the ScholarGPS database:

• 2: Fatty liver disease
• 2: Liver disease
• 2: Nonalcoholic fatty liver disease
• 3: Portosystemic shunt
• 4: Nonalcoholic drink
• 5: Hepatology
• 11: Alcoholic liver disease
• 11: Gastroenterology