COVID-19 has reduced resources for other studies
Prof. Rudolf E. Stauber, MD, PhD, of the Division of Gastroenterology and Hepatology, Department of Internal Medicine of the Medical University of Graz, Austria, feels very honoured to be this year’s finalist as this means that his work gets international attention beyond the publication in the Journal of Hepatology.
Over the years, he has been managing severely ill patients with liver failure and he has observed that the sickest of patients demonstrate very low cholesterol levels. In collaboration with colleagues from the Division of Pharmacology of the Otto Loewi Research Center, Prof. Stauber and his team investigated in detail the disturbed lipid metabolism and found markedly reduced levels of high-density lipoprotein (HDL) and apolipoprotein A-I (apoA-I, the protein moiety of the HDL). This is clinically important since the HDL has immunomodulatory properties and can protect patients from an exaggerated inflammatory response to bacterial infections.
In their study of 508 patients with chronic liver failure, they demonstrate that reduced levels of the HDL and apoA-I are closely related to the severity of liver failure, its complications and the fatal outcome. These two markers can be easily measured in clinical laboratories and have the same prognostic value as currently used scores calculated from several laboratory values by complex formulas, such as the MELD score. The HDL could serve as a single prognostic marker for the advanced liver failure and for selecting patients for a liver transplantation. However, before this can be applied, the prognostic value of the HDL needs to be validated in large prospective trials. The research team are currently planning such a validation within the multinational European PREDICT Study. In Prof. Stauber’s own words, these findings may open a new therapeutic option, i.e. the infusion of recombinant HDL in patients with chronic liver failure in order to improve their prognosis.
Research alongside the clinical work is very important to Prof. Stauber as it improves the understanding of disease mechanisms and keeps him up-to-date on diagnostic measures and therapeutic interventions in order to benefit his patients. The conditions for research in his country are overall satisfactory. His interest in research began in 1988 when he started an experimental study in portal hypertension during his research fellowship at the University of Pittsburgh, Pennsylvania, USA.
Clinical research in Austria is well-supported by the pharmaceutical industry and efficient research management at medical universities. However, the Austrian Science Fund has a rather low rate of acceptance for clinical research proposals. At present, COVID-19 has a negative impact on clinical research since the capacity for some studies has been reduced due to lack of resources.
Although devoted to his work, Prof. Stauber tries to enjoy as much of free time as possible; he likes to spend it hiking, running, working out in the gym, and in summer, he likes to sail.