The recipient of this year’s Distinguished Achievement Award credits three icons of hepatology for launching him into his career in liver disease.
Scott L. Friedman, MD, FAASLD, was a second year medical school student at the Mount Sinai School of Medicine (now Icahn School of Medicine at Mount Sinai) when he attended lectures by Hans Popper, MD, PhD, and Fenton Schaffner, MD, then spent time in the liver unit of Dame Sheila Sherlock later that year.
“From the very beginning, the liver just struck me as an incredibly mysterious and interesting organ,” said Dr. Friedman. “I sought out Fenton to ask if he would be my med school advisor after that lecture, and he in turn helped me spend three months as a visiting student after my second year of medical school in 1977 at the iconic Royal Free Hospital liver unit led by Prof. Sherlock After that I was fully hooked.”
Dr. Friedman will be honored with the Distinguished Achievement Award in a Monday presentation at 9:30 am in the auditorium and balcony of the convention center. The Distinguished Achievement Award is given to an individual in honor of his or her sustained scientific contributions to the field of liver disease and the scientific foundations of hepatology. The award honors a sustained contribution rather than a single discovery or major achievement.
Dr. Friedman’s pioneering research in hepatic fibrosis, supported by NIH since 1986, combined with his mentoring of over 80 trainees, has contributed to the emergence of fibrosis as an exciting new therapeutic area in hepatology.
Dr. Friedman’s early days at Mount Sinai came full circle with his appointment in 2001 as Chief of the Division of Liver Diseases and in 2012 as Dean for Therapeutic Discovery at the Icahn School of Medicine at Mount Sinai, appointments he continues to hold today.
“I think the key point is that these early career exposures and influences can be very formative. It’s one of the reasons why many years later, as the division chief in the same role that Fenton had when he advised me, I emphasize to my faculty how important it is to imprint young trainees, particularly medical students, with their own joy of the liver both as clinicians and as scientists,” he said.
In addition to his notable career achievements, he has been actively involved with AASLD since the second year of his GI fellowship at the University of California-San Francisco. He has served the association in a variety of roles, from Associate Editor of HEPATOLOGY, on a number of different committees and then ultimately on the Governing Board and as AASLD President in 2009.
“AASLD has been the touchstone of my career professionally from the very beginning,” he said. “I’ve been blessed with a lifelong association with AASLD and have benefitted much more from the association than I could have possibly given.”
He noted that the changes in the field since his early days as a fellow and new AASLD member have been “stunning.”
“We had no liver specific therapies, no transplants, and a very incomplete understanding of liver physiology and pathophysiology,” he said. “And in particular we had a very limited understanding of liver fibrosis, which became my field of interest.”
Dr. Friedman has performed pioneering research into the underlying causes of scarring, or fibrosis associated with chronic liver disease, and was among the first to isolate and characterize the hepatic stellate cell, the key cell type responsible for scar production in liver. His work has spawned an entire field that is now realizing its translational and therapeutic potential, with new anti-fibrotic therapies for liver disease reaching clinical trials.
“We now have curative therapies for hepatitis C, which at the time wasn’t even discovered, we have highly effective suppressive therapies for hepatitis B, and of course we now have liver transplants that have saved thousands of lives,” he said. “We have witnessed major insights into developmental and inflammatory liver diseases, and we have an emerging new world of antifibrotic therapies and treatments for fatty liver disease. In the 34 years since I started in the field, it has just been an astonishing ride in terms of the revolutionary changes in our ability to help and sometimes cure patients.”
Looking forward, Dr. Friedman expects continued advances in his own work in developing antifibrotic therapies, as well as in therapies for fatty liver disease, and the development of stem cell technologies that could potentially lead to liver cell and genetic enzyme replacement or populate liver assist device technologies.
“The new technologies for liver gene editing could have a major impact on liver diseases caused by mutations. The integration of big data approaches to the diagnosis and treatment of liver diseases is becoming a reality,” he said. “In contrast, we are still very early in our understanding of the molecular basis of liver cancer, but are already making inroads in understanding molecular defects in the disease, and witnessing progress in using immunotherapies that are increasingly successful in other cancers.”
With the exciting research and advances still on the horizon, he makes it his goal to continue to encourage medical students and fellows to follow the exciting path to the study of liver diseases. His advice to new researchers and clinicians?
“Seek and embrace change. Understanding and correlating basic and translational science with clinical care are going to be major opportunities in hepatology. Learn to work well in teams and to exploit the complementary strengths of other specialties,” he said. “And always ask questions. Always ask why. Always seek new technologies or new solutions and try to understand why things are happening to our patients and how we can mitigate them.”