Digestive and liver research has been an important focus historically at the University of Pennsylvania. Furthermore, digestive research has always been interdisciplinary and the Division of Gastroenterology represents a marked enhancement of that effort. Dr. William Osler Abbott, Professor of Physiology and Pharmacology, performed early and important experiments in the absorption of electrolytes and nutrients from the small intestine. He teamed with Dr. T. Grier Miller, the first Chief of Gastroenterology (established 1926), to develop the Miller-Abbott tube for intestinal decompression. Other early contributions include the work of Joseph Stokes and John R. Neefe, who demonstrated there were two types of viral hepatitis, and Katherine O'Shea Elsom who examined the effects of vitamin deficiency on the intestine.
Over the next four decades, digestive research grew in parallel with discoveries that catapulted medicine into the modern scientific era. In 1963, the Penn Training Program in Gastrointestinal Sciences was established by Dr. Frank Brooks and funded by the NIH. As the methods of cellular and molecular biology accelerated the pace of scientific discovery, it became necessary for the training and scientific programs in digestive sciences to expand to include these revolutionary methods. As a reflection of this trend, the Penn training program expanded the faculty of preceptors to include scientists in basic science departments. This important trend has been strengthened over the years with more scientists in basic departments becoming involved in digestive and liver research and more scientists in clinical departments using molecular approaches.
Since its formation in 1926, these prominent Chiefs have led the GI Division:
Drs. Miller, Brooks and Cohen have served as President of the American Gastroenterology Association (AGA), the subspecialty's highest organization. Each also was the recipient of the Friedenwald Award, the AGA's distinguished lifetime service achievement award. Dr. Rustgi is President of the AGA for 2013 to 2014. Furthermore, Dr. Brooks is regarded as one of the pioneers in pancreatic physiology and motility, and served as Editor of the journal Digestive Diseases and Sciences. Dr. Cohen is viewed as one of the leading authorities in esophageal motility disorders. He became Chairman of Medicine at Temple from 1986 to 2001, and is now Professor of Medicine at Jefferson Medical College. Dr. Traber ushered in the era of molecular biology to the GI Division upon his arrival in 1992. He was Chairman of Medicine at Penn from 1997 to 2000, and was then President and CEO of Baylor Medical College. Dr. Rustgi has expanded the GI division in all arenas of research, teaching and education, and clinical care, and brought it to national preeminence as elaborated upon in the next section. Dr. Rustgi was Editor-in-Chief of Gastroenterology from 2006 to 2011.
Division of Gastroenterology Today
The Division of Gastroenterology in the Department of Medicine at Penn is a robust academic unit, with 70 full-time faculty whose clinical and scientific expertise covers the spectrum of areas within modern gastroenterology. There are 25 fellows in training. The total staff is over 250.
The clinical focus of the Division is in the following programmatic areas: inflammatory bowel disease (IBD), hepatology and liver transplantation, gastrointestinal oncology, gastrointestinal motility and physiology, advanced interventional endoscopy, and general gastroenterology. Since Dr. Rustgi assumed leadership of the Division in 1998, there has been robust growth in the number of patients awaiting liver transplantations and obtaining liver transplants; improved quality and quantity of endoscopic procedures; and an increasingly complex nature of GI subspecialty consultations in the areas of hepatology, oncology, IBD, and motility/physiology from local, regional and national referral bases.
The Division also participates intensively in the education and training of undergraduate students, medical and graduate students, combined degree students, medical residents, and GI fellows. GI fellows are recruited from outstanding medical residency programs. The GI fellowship is supported through two NIH T32 training grants, one in basic sciences and the other in GI epidemiology. Intensive efforts are pursued on behalf of medical students in their basic science and clinical curricula, with venues for research at all stages. Finally, an innovative research program for undergraduate students was initiated and has matured into an NIH R25 training grant.
The Division's research programs are nationally renowned, and multidisciplinary and multidepartmental in focus. Based upon a rich history of research in GI motility and physiology under Drs. Brooks and Cohen, the molecular medicine era was initiated by Dr. Traber and further expanded upon by Dr. Rustgi, especially in developmental biology, cancer biology, cell cycle regulation, immunobiology and organ specific biology (e.g., liver, IBD). In addition, Dr. Rustgi has brought in the era of translational research and epidemiology research to the GI Division. Among the GI faculty of 65 members, there are 18 physician-scientists and research faculty engaged in NIH-funded research, and many of the clinician-educators have funded research programs.
Sponsored program awards and proposals have grown impressively under Dr. Rustgi since October 1998. Total awards have increased from $4.525 million in FY1999 to $20 million in FY2018. The Division has witnessed the rapid emergence of multidisciplinary research-funded efforts which have nurtured collaborative relationships across the Penn campus and beyond.
NIH/NIDDK Center for Molecular Studies in Digestive and Liver Diseases (P30), Anil K. Rustgi, MD, Director - Comprising nearly 45 members and nearly 20 associate members from various schools, departments, centers and institutes at the University of Pennsylvania, this Center is only one of 17 funded major GI/Liver Centers in the United States.
NIH/NCI Program Project "Mechanisms of Esophageal Carcinogenesis" (PO1), Anil K. Rustgi, MD, PI - This program project encompasses investigators from the GI Division and Abramson Cancer Center. GI cancers has emerged as a major area of emphasis of the Abramson Cancer Center, and of the medical school's strategic initiative in cancer biology. This particular PO1 is only the second one obtained in the area historically through the NCI.
Dr. Rustgi has emphasized partnerships between the GI Division and industry - pharmaceutical and biotechnology. Particular areas of focus include tissue procurement and analysis, databases and translational research.
New clinical research grants have been fostered. Particular areas of growth have occurred in hepatology, GI oncology, IBD, advanced endoscopy, esophagology and neurogastroenterology/GI motility.