Richard L. Guerrant

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Richard L. Guerrant (born July 21, 1943) is an American physician, medical school professor, and medical researcher, specializing in infectious diseases and tropical medicine.

Contents

Biography

Guerrant received his bachelor's degree from Davidson College and his M.D. from the University of Virginia School of Medicine. [1] He completed his residency in internal medicine and infectious diseases at Harvard Medical Service at Boston City Hospital, where Maxwell Finland was his supervising attending physician and mentor. [2]

After his cholera field research in Bangladesh, he returned to the University of Virginia School of Medicine. There he became a professor and the founding director of the Center for Global Health. [2] He is the author or co-author of over 700 articles [3] and the co-editor of several books.

In field studies, particularly in Brazil, he and his colleagues investigated the developmental problems of children who suffered from persistent diarrheal diseases in the critical first years of their lives. These investigations showed that such diseases stunted growth and harmed cognitive skills. The pathological cognitive effects, involving losses up to 10 IQ points, were linguistically not phonetic, but semantic, similar to the cognitive deficits in Alzheimer's patients. Guerrant and his team also found that APOE-ε4, the main risk allele in Alzheimer's disease, protects children against such cognitive losses due to diarrhea. This protection is a possible explanation for the spread of the allele APOE-ε4. [4] [5] [6] [7] [8] This unexpected effect of the allele APOE-ε4 is analogous to the role of sickle cell anemia as a side effect of protection against malaria and the allele associated with cystic fibrosis as protection against cholera and other diarrheal diseases. He is continuing the research with a grant from the Bill and Melinda Gates Foundation. [2]

The Infectious Diseases Society of America honored Guerrant with the Joseph E. Lectureship in 1993 [9] and the Walter E. Stamm Mentor Award in 2009. [10] In 1997 he was the president of the American Society of Tropical Medicine and Hygiene (ASTMH), [11] was named Henderson Innovator of the Year at the University of Virginia, [2] and received the Emilio Ribas Medal from the Sociedade Brasileira de Infectologia (Brazilian Society of Infectious Diseases). [12] In 2002 he gave the Wesley Spink Memorial Lecture at the University of Minnesota's Department of Medicine. [13] In 2003 Guerrant was elected a member of the National Academy of Medicine. [14] He received in 2008 the Walter Reed Medal from the ASTMH [15] and in 2014 the Maxwell Finland Award from the National Foundation for Infectious Diseases. [2]

Richard L. Guerrant and his wife Nancy B. Guerrant established the Richard and Nancy Guerrant Center for Global Health Scholar Award at the University of Virginia. [16] The couple have two sons and a daughter.

Selected publications

Articles

Books

Related Research Articles

<span class="mw-page-title-main">Malaria</span> Mosquito-borne infectious disease

Malaria is a mosquito-borne infectious disease that affects vertebrates and Anopheles mosquitoes. Human malaria causes symptoms that typically include fever, fatigue, vomiting, and headaches. In severe cases, it can cause jaundice, seizures, coma, or death. Symptoms usually begin 10 to 15 days after being bitten by an infected Anopheles mosquito. If not properly treated, people may have recurrences of the disease months later. In those who have recently survived an infection, reinfection usually causes milder symptoms. This partial resistance disappears over months to years if the person has no continuing exposure to malaria. The mosquito vector is itself harmed by Plasmodium infections, causing reduced lifespan.

<span class="mw-page-title-main">Diarrhea</span> Loose or liquid bowel movements

Diarrhea, also spelled diarrhoea or diarrhœa, is the condition of having at least three loose, liquid, or watery bowel movements in a day. It often lasts for a few days and can result in dehydration due to fluid loss. Signs of dehydration often begin with loss of the normal stretchiness of the skin and irritable behaviour. This can progress to decreased urination, loss of skin color, a fast heart rate, and a decrease in responsiveness as it becomes more severe. Loose but non-watery stools in babies who are exclusively breastfed, however, are normal.

<span class="mw-page-title-main">Chylomicron</span> One of the five major groups of lipoprotein

Chylomicrons, also known as ultra low-density lipoproteins (ULDL), are lipoprotein particles that consist of triglycerides (85–92%), phospholipids (6–12%), cholesterol (1–3%), and proteins (1–2%). They transport dietary lipids, such as fats and cholesterol, from the intestines to other locations in the body, within the water-based solution of the bloodstream. ULDLs are one of the five major groups lipoproteins are divided into based on their density. A protein specific to chylomicrons is ApoB48.

<span class="mw-page-title-main">Gastroenteritis</span> Inflammation of the stomach and small intestine

Gastroenteritis, also known as infectious diarrhea, is an inflammation of the gastrointestinal tract including the stomach and intestine. Symptoms may include diarrhea, vomiting, and abdominal pain. Fever, lack of energy, and dehydration may also occur. This typically lasts less than two weeks. Although it is not related to influenza, in the U.S. and U.K., it is sometimes called the "stomach flu".

<span class="mw-page-title-main">Global health</span> Health of populations in a global context

Global health is the health of populations in a worldwide context; it has been defined as "the area of study, research, and practice that places a priority on improving health and achieving equity in health for all people worldwide". Problems that transcend national borders or have a global political and economic impact are often emphasized. Thus, global health is about worldwide health improvement, reduction of disparities, and protection against global threats that disregard national borders, including the most common causes of human death and years of life lost from a global perspective.

<span class="mw-page-title-main">Apolipoprotein E</span> Cholesterol-transporting protein most notably implicated in Alzheimers disease

Apolipoprotein E (Apo-E) is a protein involved in the metabolism of fats in the body of mammals. A subtype is implicated in Alzheimer's disease and cardiovascular diseases. It is encoded in humans by the gene APOE.

Diseases of poverty, also known as poverty-related diseases, are diseases that are more prevalent in low-income populations. They include infectious diseases, as well as diseases related to malnutrition and poor health behaviour. Poverty is one of the major social determinants of health. The World Health Report (2002) states that diseases of poverty account for 45% of the disease burden in the countries with high poverty rate which are preventable or treatable with existing interventions. Diseases of poverty are often co-morbid and ubiquitous with malnutrition. Poverty increases the chances of having these diseases as the deprivation of shelter, safe drinking water, nutritious food, sanitation, and access to health services contributes towards poor health behaviour. At the same time, these diseases act as a barrier for economic growth to affected people and families caring for them which in turn results into increased poverty in the community. These diseases produced in part by poverty are in contrast to diseases of affluence, which are diseases thought to be a result of increasing wealth in a society.

The common disease-common variant hypothesis predicts that common disease-causing alleles, or variants, will be found in all human populations which manifest a given disease. Common variants are known to exist in coding and regulatory sequences of genes. According to the CD-CV hypothesis, some of those variants lead to susceptibility to complex polygenic diseases. Each variant at each gene influencing a complex disease will have a small additive or multiplicative effect on the disease phenotype. These diseases, or traits, are evolutionarily neutral in part because so many genes influence the traits. The hypothesis has held in the case of putative causal variants in apolipoprotein E, including APOE ε4, associated with Alzheimer's disease. IL23R has been found to be associated with Crohn's disease; the at-risk allele has a frequency of 93% in the general population.

<span class="mw-page-title-main">APOA5</span> Protein-coding gene in the species Homo sapiens

Apolipoprotein A-V is a protein that in humans is encoded by the APOA5 gene on chromosome 11. It is significantly expressed in liver. The protein encoded by this gene is an apolipoprotein and an important determinant of plasma triglyceride levels, a major risk factor for coronary artery disease. It is a component of several lipoprotein fractions including VLDL, HDL, chylomicrons. It is believed that apoA-V affects lipoprotein metabolism by interacting with LDL-R gene family receptors. Considering its association with lipoprotein levels, APOA5 is implicated in metabolic syndrome. The APOA5 gene also contains one of 27 SNPs associated with increased risk of coronary artery disease.

<span class="mw-page-title-main">TOMM40</span> Protein-coding gene in the species Homo sapiens

Mitochondrial import receptor subunit TOM40 homolog is a protein which in humans is encoded by the TOMM40 gene.

<span class="mw-page-title-main">Alzheimer's disease</span> Progressive neurodegenerative disease

Alzheimer's disease (AD) is a neurodegenerative disease that usually starts slowly and progressively worsens, and is the cause of 60–70% of cases of dementia. The most common early symptom is difficulty in remembering recent events. As the disease advances, symptoms can include problems with language, disorientation, mood swings, loss of motivation, self-neglect, and behavioral issues. As a person's condition declines, they often withdraw from family and society. Gradually, bodily functions are lost, ultimately leading to death. Although the speed of progression can vary, the average life expectancy following diagnosis is three to twelve years.

<span class="mw-page-title-main">Iquitos Satellite Laboratory</span>

The Iquitos Satellite Laboratory (IQTLAB) was established in 2002 in the city of Iquitos, Peru by doctor Margaret Kosek, biologist Maribel Paredes Olortegui, and nurse Pablo Peñataro Yori, with the collaboration of the Dr. Robert Gilman working group in Lima, Peru and the US Naval Medical Research Unit No. 6 (NAMRU-6).

Alzheimer's Disease Neuroimaging Initiative (ADNI) is a multisite study that aims to improve clinical trials for the prevention and treatment of Alzheimer's disease (AD). This cooperative study combines expertise and funding from the private and public sector to study subjects with AD, as well as those who may develop AD and controls with no signs of cognitive impairment. Researchers at 63 sites in the US and Canada track the progression of AD in the human brain with neuroimaging, biochemical, and genetic biological markers. This knowledge helps to find better clinical trials for the prevention and treatment of AD. ADNI has made a global impact, firstly by developing a set of standardized protocols to allow the comparison of results from multiple centers, and secondly by its data-sharing policy which makes available all at the data without embargo to qualified researchers worldwide. To date, over 1000 scientific publications have used ADNI data. A number of other initiatives related to AD and other diseases have been designed and implemented using ADNI as a model. ADNI has been running since 2004 and is currently funded until 2021.

The Lothian birth-cohort studies are two ongoing cohort studies which primarily involve research into how childhood intelligence relates to intelligence and health in old age. The Lothian Birth Cohort studies of 1921 and 1936 have, respectively, followed up Lothian-based participants in the Scottish Mental Surveys of 1932 and 1947 in old age. Scottish Mental Survey data has provided a measure of the intelligence of Lothian Birth Cohort participants at age 11, which has enabled the investigation of how childhood intelligence relates to cognition, mental health and physical health in old age.

<span class="mw-page-title-main">Environmental enteropathy</span> Disorder of chronic intestinal inflammation

Environmental enteropathy is an acquired small intestinal disorder characterized by gut inflammation, reduced absorptive surface area in small intestine, and disruption of intestinal barrier function. EE is most common amongst children living in low-resource settings. Acute symptoms are typically minimal or absent. EE can lead to malnutrition, anemia, stunted growth, impaired brain development, and impaired response to oral vaccinations.

Robert Steffen is an Emeritus Professor at the Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Switzerland and an adjunct professor at the University of Texas School of Public in Houston. He is an editor of the Journal of Travel Medicine.

Herbert "Bert" Lancashire DuPont is an American physician, medical school professor, and medical researcher, specializing in infectious diseases.

Alzheimer's disease (AD) in the Hispanic/Latino population is becoming a topic of interest in AD research as Hispanics and Latinos are disproportionately affected by Alzheimer's Disease and underrepresented in clinical research. AD is a neurodegenerative disease, characterized by the presence of amyloid-beta plaques and neurofibrillary tangles, that causes memory loss and cognitive decline in its patients. However, pathology and symptoms have been shown to manifest differently in Hispanic/Latinos, as different neuroinflammatory markers are expressed and cognitive decline is more pronounced. Additionally, there is a large genetic component of AD, with mutations in the amyloid precursor protein (APP), Apolipoprotein E APOE), presenilin 1 (PSEN1), bridging Integrator 1 (BIN1), SORL1, and Clusterin (CLU) genes increasing one's risk to develop the condition. However, research has shown these high-risk genes have a different effect on Hispanics and Latinos then they do in other racial and ethnic groups. Additionally, this population experiences higher rates of comorbidities, that increase their risk of developing AD. Hispanics and Latinos also face socioeconomic and cultural factors, such as low income and a language barrier, that affect their ability to engage in clinical trials and receive proper care.

Alzheimer's disease (AD) in African Americans is becoming a rising topic of interest in AD care, support, and scientific research, as African Americans are disproportionately affected by AD. Recent research on AD has shown that there are clear disparities in the disease among racial groups, with higher prevalence and incidence in African Americans than the overall average. Pathologies for Alzheimer’s also seem to manifest differently in African Americans, including with neuroinflammation markers, cognitive decline, and biomarkers. Although there are genetic risk factors for Alzheimer’s, these account for few cases in all racial groups.

Alzheimer's disease (AD) is a complex neurodegenerative disease that affects millions of people across the globe. It is also a topic of interest in the East Asian population, especially as the burden of disease increases due to aging and population growth. The pathogenesis of AD between ethnic groups is different. However, prior studies in AD pathology have focused primarily on populations of European ancestry and may not give adequate insight on the genetic, clinical, and biological differences found in East Asians with AD. Gaps in knowledge regarding Alzheimer's disease in the East Asian population introduce serious barriers to screening, early prevention, diagnosis, treatment, and timely intervention.

References

  1. ↑ "Guerrant, Richard L." Research Faculty Directory, University of Virginia School of Medicine. (with Selected Publications)
  2. 1 2 3 4 5 "Richard L. Guerrant, MD, 2014 Maxwell Finland Award for Scientific Achievement Awardee" (PDF). National Foundation for Infectious Diseases.
  3. ↑ "Richard L. Guerrant, MD". Center for Global Health Equity, University of Virginia.
  4. ↑ Oriá, Reinaldo B.; Patrick, Peter D.; Zhang, Hong; Lorntz, Breyette; De Castro Costa, Carlos Maurício; Brito, Gerly A C.; Barrett, Leah J.; Lima, Aldo A M.; Guerrant, Richard L. (2005). "APOE4 Protects the Cognitive Development in Children with Heavy Diarrhea Burdens in Northeast Brazil". Pediatric Research. 57 (2): 310–316. doi: 10.1203/01.PDR.0000148719.82468.CA . PMID   15611352. S2CID   10285777.
  5. ↑ Oriá, Reinaldo B.; Patrick, Peter D.; Blackman, James A.; Lima, Aldo A.M.; Guerrant, Richard L. (2007). "Role of apolipoprotein E4 in protecting children against early childhood diarrhea outcomes and implications for later development". Medical Hypotheses. 68 (5): 1099–1107. doi:10.1016/j.mehy.2006.09.036. PMC   3993898 . PMID   17098371.
  6. ↑ Guerrant, Richard L.; Oriá, Reinaldo B.; Moore, Sean R.; Oriá, Mônica OB; Lima, Aldo AM (2008). "Malnutrition as an enteric infectious disease with long-term effects on child development". Nutrition Reviews. 66 (9): 487–505. doi:10.1111/j.1753-4887.2008.00082.x. PMC   2562291 . PMID   18752473.
  7. ↑ Mitter, SS; Oria, RB; Kvalsund, MP; Pamplona, P.; Joventino, ES; Mota, RMS; Goncalves, DC; Patrick, PD; Guerrant, RL; Lima, AAM (2012). "Apolipoprotein E4 influences growth and cognitive responses to micronutrient supplementation in shantytown children from northeast Brazil". Clinics. 67 (1): 11–18. doi:10.6061/clinics/2012(01)03. PMC   3248595 . PMID   22249475.
  8. ↑ Azevedo, Orleâncio G. R.; Bolick, David T.; Roche, James K.; Pinkerton, Relana F.; Lima, Aldo A. M.; Vitek, Michael P.; Warren, Cirle A.; Oriá, Reinaldo B.; Guerrant, Richard L. (2014). "Apolipoprotein e Plays a Key Role against Cryptosporidial Infection in Transgenic Undernourished Mice". PLOS ONE. 9 (2): e89562. Bibcode:2014PLoSO...989562A. doi: 10.1371/journal.pone.0089562 . PMC   3938486 . PMID   24586873.
  9. ↑ "Past Joseph E. Smadel Lectureship Winners". Infectious Diseases Society of America (IDSA).
  10. ↑ "Past Walter E. Stamm Mentor Award Winners". Infectious Diseases Society of America (IDSA).
  11. ↑ Guerrant, R. L. (1998). "Why America must care about tropical medicine: threats to global health and security from tropical infectious diseases". The American Journal of Tropical Medicine and Hygiene. 59 (1): 3–16. CiteSeerX   10.1.1.198.5345 . doi:10.4269/ajtmh.1998.59.3. PMID   9684618. (presidential address delivered December 9, 1997)
  12. ↑ "Richard L. Guerrant". antimicrobe.org.
  13. ↑ "Annual Wesley Spink Memorial Lecture". Department of Medicine, University of Minnesota. 15 December 2019.
  14. ↑ "Guerrant, Richard L." General Directory, National Academy of Medicine.
  15. ↑ "Walter Reed Medal". American Society of Tropical Medicine and Hygiene.
  16. ↑ "The Richard and Nancy Guerrant Center for Global Health Scholar Award". Center for Global Health Equity, University of Virginia.
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