Q&A with the Institute’s Inaugural Director of Alcohol Sciences, J.P. Arab, M.D.

Editor’s note: Prior to joining the Institute, Dr. Arab was an associate professor in the Department of Medicine and the Department of Epidemiology and Biostatistics at Schulich School of Medicine, Western University, Ontario. He trained at the Mayo Clinic.

Q: What is your background? How did you get into hepatology, specifically alcohol-related liver disease?

Dr. Arab: I’ve always been passionate about medicine’s potential to alleviate suffering through accurate diagnosis and treatment. Early in my medical career, I became intrigued by hepatology due to its complexity and the critical role the liver plays in overall health. I’ve tried to combine both science and clinical medicine. I became fond of clinical work while increasingly engaging in research. This allowed me to appreciate the beauty of learning the underlying mechanisms of diseases and exploring population health.

Through my university training (at the Pontificia Universidad Católica, Chile), I learned the different aspects of hepatology and liver transplantation and became convinced that these disciplines were what I wanted to pursue for the rest of my career. On my journey toward becoming a clinical researcher, I’ve been fortunate to interact with bright and dedicated academic mentors. These individuals, including some giants in the field of hepatology such as Drs. Marco Arrese, Ramón Bataller, Vijay Shah, and Patrick Kamath, have served as exemplary career models. Thus, I developed a special interest in alcohol-related liver disease (ALD).

The intersection of alcohol use, liver health, and public health fascinated me — particularly how preventable liver damage can be if addressed early, as well as the barriers that exist in helping this population, including stigma. This motivated me to focus my research and clinical work on ALD, aiming to advance early diagnosis and treatment strategies to improve patient outcomes.

Q: What is the significance of your research?

Dr. Arab: I specialize in diagnosing and treating liver diseases, with a focus on alcohol-related liver disease. My work is important because ALD is one of the leading causes of liver failure and liver cancer worldwide, yet it is largely preventable. By improving early diagnosis and developing better treatment strategies, my goal is to prevent irreversible damage and reduce the burden of liver disease on patients and healthcare systems. In addition to clinical work, I conduct research to uncover new biomarkers and treatment pathways that can save the lives of people struggling with alcohol use disorder.

Q: What’s your most significant recent accomplishment so far?

Dr. Arab: One of my most significant recent accomplishments is leading two global initiatives on alcohol-related liver disease: the Global AlcHep Big Data Network and the Alcohol-associated Hepatitis in Latin America (AH-LATIN) initiative. These efforts involve over 200 centers across 50 countries and have advanced our understanding of ALD’s global impact. These networks provide valuable data on how ALD progresses, which, in turn, helps us design better prevention and treatment strategies. The collaborative nature of these initiatives has been transformative in elevating ALD research worldwide. Additionally, data from these consortia helped us identify the optimal therapeutic window to treat patients with severe alcohol-associated hepatitis.

Q: What’s changing in ALD research and among patients?

Dr. Arab: The field of hepatology, especially in ALD, is experiencing shifts in patient demographics. There’s been an increase in ALD among younger populations and women, who traditionally had lower rates of severe liver disease. The COVID-19 pandemic exacerbated alcohol consumption, leading to a rise in alcohol-associated liver disease cases. This has prompted new research on the impact of stress and economic factors on alcohol use and liver disease, highlighting the importance of integrating addiction treatment into liver care. Furthermore, certain ethnic groups, particularly Hispanics/Latinos, are more susceptible to liver damage, so I am studying the genetic and social determinants in this population.

Q: How has your research affected patient care?

Dr. Arab: I hope my work is impacting patient care by promoting early detection of alcohol-associated liver disease and improving treatment pathways. This includes identifying whom to treat, when to treat, and how to treat correctly. Through multidisciplinary approaches that incorporate lifestyle changes, pharmacotherapy, and addiction support, I’ve helped shape more comprehensive management strategies for ALD. The establishment of large-scale collaborations, like the Global AlcHep Network, has also enabled us to gather more robust data, which directly informs clinical guidelines and improves care for patients globally.

Q: What are your goals for the institute regarding alcohol-related liver disease?

Dr. Arab: As the Director of Alcohol Sciences at the Stravitz-Sanyal Institute for Liver Disease and Metabolic Health, my goal is to position it as a global leader in ALD research and treatment. I plan to establish specialized clinics focused on ALD, create biobanks for collaborative research, and develop clinical trials to test new treatments. I aim to foster collaborations not just locally but internationally, to drive groundbreaking research and improve clinical outcomes for patients. Ultimately, I want the institute to be at the forefront of ALD innovation and patient care, incorporating the views of our patients to help us remove stigma and understand their priorities and needs.

Q: Why do you serve on committees of liver organizations?

Dr. Arab: Being involved in various liver organizations allows me to contribute to shaping the future of hepatology on a global scale. Serving on committees such as the American Association for the Study of Liver Diseases (AASLD) Alcohol-associated Liver Disease Special Interest Group, the Latin American Association for the Study of the Liver (ALEH), and the International Liver Transplantation Society enables me to collaborate with other experts, influence guidelines, and foster international research efforts. I currently chair the AASLD ALD Special Interest Group. The AASLD is committed to advancing understanding and care for patients with ALD.

I volunteer because I believe in the power of collaboration to advance our field and improve patient outcomes. These roles also allow me to stay at the cutting edge of hepatology research and practice. On a personal note, the AASLD Foundation supported my training, so this is a way for me to “give back” to those who believed in me and my vision.