A look at the work of Brent Neuschwander-Tetri, M.D., professor of Internal Medicine and Fellow with the SLU Research Institute.
Brent Neuschwander-Tetri, M.D., has been at Saint Louis University long enough to see a lot of change come down the pike. “We’ve always had a sustained, persistent effort to have a larger research footprint,” said the professor of internal medicine at SLU’s School of Medicine. “The driving energy behind it has always been the mission of the University to make a difference in the world.”
In his role at SLU, where he’s held a faculty position since 1991, Neuschwander-Tetri has contributed to the SLU mission of improving the greater good by studying steatotic (fatty) liver disease, which killed more than 38,000 Americans between 1999 and 2022 according to a July 2023 study published in Hepatology Communications, and was poorly understood when he started his research on it more than 25 years ago.
“Now we have therapies that are looking very promising in clinical trials, and we've participated in some of those clinical trials, both with industry support, but also with National Institutes of Health (NIH) support,” Neuschwander-Tetri said.
Neuschwander-Tetri noted that he’s been funded by the NIH since 2002 to participate in the Nonalcoholic Steatohepatitis Clinical Research Network (NASH CRN). This has allowed him and his collaborators at eight other trial sites to understand the causes, consequences and treatment options for the disease. This work has resulted in several major publications, most recently contributing genetic data to a Nature Genetics paper that reveals some of the genetic underpinnings of the condition and a New England Journal of Medicine paper that demonstrates the progression of liver disease in this large cohort.
In 2023, Neuschwander-Tetri and his colleagues celebrated the availability of a huge new dataset that contains the genetic-sequence data of thousands of their patients, who consented to being a part of the sprawling study.
“Over the next three years, that'll be one of the major areas that we as a network will be focused on understanding,” he said. “We feel very strongly that this disease has major genetic underpinnings, and it reflects the interface between the genetics of obesity, which is very complicated, the genetics of liver disease, and the overlap between the two.”
Neuschwander-Tetri also co-authored of the American Association for the Study of Liver Diseases guidance that was published in 2023 for medical practitioners who treat patients with steatotic liver disease.
In September 2023, Nature Medicine published a paper that Neuschwander-Tetri co-authored reporting a comparison of different non-invasive, diagnostic biomarkers for steatohepatitis, the progressive form of steatotic liver disease — historically, this severe form of the disease was diagnosed with a liver biopsy, which is very invasive.
In addition to his research, Neuschwander-Tetri set up a clinic at SLU’s Salus Center more than 20 years ago to provide clinical care for patients with steatotic liver disease and to enroll them in the NASH CRN observational study.
“It's a big part of why our site has the highest rate of patient retention, I believe, in the whole [NASH Clinical Research] network,” Neuschwander-Tetri said. “We've really retained our patients very well over the years by combining excellent clinical care with their study participation.”
Neuschwander-Tetri noted that the funding tied to the NASH CRN is drawing to a close, but much work lies ahead.
“We'll wrap up the patient visits in their final year starting [summer 2024] and going through summer 2025,” he said. “And then two more years of basically going through all the data to learn as much as we can and publishing our findings.”
Those papers, which will report crucial findings, will include genetic data, serum proteomic data, and liver RNA transcriptomic data that could lead to better diagnostic tools or treatments for steatotic liver disease. Neuschwander-Tetri said: “It will be a lot of exciting work and a lot of opportunities to generate new knowledge.”
Story by Bob Grant, executive director of communications, research.
This piece was written for the 2023 SLU Research Institute Annual Impact Report. The Impact Report is printed each spring to celebrate the successes of our researchers from the previous year and share the story of SLU's rise as a preeminent Jesuit research university. Read the report for more information.