Jorge Rakela, M.D.

My research program is focused on the treatment of acute and chronic liver diseases of viral etiology. We evaluate of the safety and efficacy of new agents (direct acting antivirals, DAAs) in the treatment of chronic hepatitis C.

We also evaluate new agents for the treatment of chronic hepatitis B. These new treatment modalities although more efficacious are accompanied by a higher rate of adverse events, and the possibility of the emergence of resistant viral strains. We are setting up a focused team to treat patients with new treatment modalities, to manage untoward effects from these treatments and monitor the emergence of resistant viral strains.

We are active participants in Mayo Clinic's liver transplantat program. About 40 percent of the candidates are infected with HCV. The recurrence of HCV after transplantation is almost universal, which has mstimulated us to seek effective preventive measures and treatment of HCV re-infection. The new antiviral agents, DAAs, will be evaluated in the setting of recurrent HCV infection after transplantation.

We are positioned to evaluate the safety and efficacy of these new treatment modalities in the immunosuppressed host. We collaborate with the gene therapy team at the University of Navarra, Pamplona, Spain. We have special interest in the potential clinical application of cardiotropin-1 (CT-1). CT-1 is an effective hepatocyte protector agent that would also stimulate hepatic regeneration.

There are Phase 1 studies being conducted in Europe and we are planning a multicenter trial in patients with acute liver failure designed to asses the safety and efficacy of CT-1 in acute liver failure. We are collaborating with the University of Texas, Southwestern, Dallas; and the NIH-sponsored clinical research network, Acute Liver Failure Study Group (ALFSG).Our aim is to evaluate CT-1 in a multicenter trial among participants of the ALFSG.

Lastly, we have obtained research support for a collaborative project with TGen in Phoenix, Ariz., to investigate the diagnostic and prognostic value of micro-RNA patterns among patients with varying degrees of fibrosis. Our aim is to evaluate patterns of microRNA as a substitute to liver biopsy in determining the degree of liver fibrosis present in a patient with chronic liver disease.