About
Dr. Abrams is the Chief of Gastroenterology/Hepatology at Prisma Health Upstate. He received his medical degree from Albert Einstein College of Medicine, Bronx, New York, and completed his medical residency and Gastroenterology/Hepatology fellowship training at Yale. He was an NIH-funded clinical research investigator during his fellowship specializing in hepatology. Due the epidemic of obesity, currently the most common cause for elevated liver tests is nonalcoholic fatty liver disease (NAFLD). Dr. Abrams’ research over the past 12 years has examined NAFLD in the bariatric population undergoing gastric bypass surgery with respect to the spectrum of histopathology, the relationship of hepatopathology in morbidly obese subjects with and without metabolic syndrome, and the utility of ""NAFLD Fibrosis Score"" in morbidly obese individuals with NAFLD. He has previously collaborated with basic science colleagues examining mitochondrial respiration and proteomic modification in animals fed high fat diets and hepatic steatosis. Dr. Abrams’ and Dr. Susan Duckett have had discussions regarding future collaborations to investigate the efficacy of palmitoleic acid in a piglet model of NAFLD as well as to establish a novel animal model of NAFLD with Dr. Renee Cottle in Clemson’s bioengineering department. For more information, see his Curriculum Vitae.
How their research is transforming health care
Dr. Abrams’ initial studies investigated pulmonary dysfunction in subjects with cirrhosis-specifically Hepatopulmonary Syndrome (HPS). He and his colleagues developed a clinical algorithm to screen for HPS for early identification and listing criteria for liver transplantation eligibility. Their studies have expanded the histopathologic spectrum of NAFLD in the adult bariatric population, and resolution of NAFDL post-surgery and its relationship to the metabolic syndrome. In addition to the standard histological findings diagnostic for NASH (steatosis, inflammation and ballooning hepatocytes) they identified a subset of individuals with isolated portal fibrosis without evidence of NASH (now commonly identified in the obese pediatric population). They applied new upper limits of ALT activity for men (30 IU/ml) and women (19 IU/ml) to the bariatric population demonstrating 65% of obese subjects undergoing GBY would be considered to have an elevated ALT compared to 28% using the laboratory ULN. However, the prevalence of NASH remained similar (23-26%). A subset of their bariatric database underwent repeat liver biopsy approximately 18 months post GBY revealing statistical significant improvements in steatosis and ballooning hepatocytes whereas inflammatory cells and fibrosis did not significantly change. Most recently, Dr. Abrams’ and his colleagues have identified 105 subjects in their database of 445 GBY subjects that did not meet criteria for the metabolic syndrome defined by the International Diabetes Foundation. A substantial prevalence of NAFLD persisted composed of 56% with Fatty Liver only and 18% demonstrated NASH.
Health research keywords
Nonalcoholic Fatty Liver Disease, Cirrhosis, Pulmonary Dysfunction in Cirrhosis
