Researcher

Title

• Professor, Department of Pediatrics, University of Montreal, 1999.
• Director, Hepatic Transplantation Program, CHU Sainte-Justine, University of Montreal, 1995.

• Postdoctorate, Department of Cell Biology, New York University, 1982-1985.
• Postdoctoral training, Liver Diseases Unit, Hôpital de Bicêtre, Université de Paris, 1972-1982.
• Residence in Pediatrics, Children’s Hospital, Buenos Aires, 1975-1978.
• MD, University of Buenos Aires, 1974.

The liver is constantly exposed to multiple antigens and products from the microbiota. The liver shows different strategies for the development of immune tolerance, and at the same time can mount immune responses during infections. In cases of autoimmune hepatitis, the tolerance is broken, in contrast, in cases of chronic viral hepatitis the persistence of a tolerance can be responsible of liver injury. In our laboratory and clinical practice, we study the liver immune tolerance using animal models of autoimmune hepatitis and viral induced liver inflammation, as well as samples from our patients. Currently, we develop new strategies for the treatment of autoimmune hepatitis, having as main objective the reconstitution of a tolerance after the complete control of the liver inflammation. In the long term our objective is to identify therapies targeting specific pathogenic mechanisms, allowing to obtain a immune homeostasis and an efficient immune response in transplanted patients for autoimmune hepatitis or chronic liver infections for hepatitis B or C.

Genetic cholestasis are chronic liver diseases representing a clinical challenge for: 1) diagnosis; 2) specific treatments, as well as nutritional support; 3) prognosis. The number of genetic causes of cholestasis is rapidly increasing, leading as to classify these diseases according to cell biology mechanisms. Itching secondary to cholestasis can be refractory to standard treatments (UDCA and Rifampicin). New molecules inhibiting the absorption of bile acids in the intestine are currently studied.

• Liver & Immunity
• Autoimmune hepatitis – Pathogenesis
• Neonatal cholestasis – Diagnosis – Treatment
• Acute liver failure – Treatment
• Nutrition and liver diseases

Career Summary

Hospital Appointments

• 2009-2014 : Chief, Division of Gastroenterology, Hepatology & Nutrition, CHU Sainte-Justine, University of Montreal.
• 2001-2006 : Chief, Department of Pediatrics, Hôpital Sainte-Justine.
• 1992-  : Attending Staff Physician, Gastroenterology-Nutrition Unit, Hôpital Ste-Justine, University of Montreal, Canada.
• 1985-1992 : Associate Physician, Pediatric Liver Diseases Unit, Hôpital de Bicêtre, France.

Academic appointments

• 2001-2006 : Director, Department of Pediatrics, University of Montreal.1992-1999            Associate Professor, Gastroenterology-Nutrition Unit, Hôpital Sainte-Justine, University of Montreal, Canada.
• 1999-  : Professor of pediatrics, CHU Sainte-Justine, University of Montréal, Canada.
• 1999-2000 : President of the Research Subcommittee of the Ethical Research Committee, Hôpital Sainte-Justine, University of Montréal.
• 1997-2001 : President of Institutional Committee on Animal Care. Hôpital Sainte-Justine, University of Montreal

Awards and Distinctions

• 2018: «Sass-Kortsak Award ». Fondation canadienne du foie (CLF) en partenariat avec l'Association canadienne pour l'étude du foie (CASL). Canada.
• 2010: « Miembro Honorario » Congreso International del Colegio Colombiano de Gastroenterología, Hepatología y Nutrición Pediátrica. Colombia. Bogotá.
• 2000 : « Prix d’excellence en enseignement » Études médicales postdoctorales. Département de pédiatrie. Université de Montréal. Montréal. Canada.
• 1998 : « Miembro Honorario Nàcionàl»  Sociedad Argentina de Pediatria. Buenos Aires, Argentina.
• 1998 : « Hinda Copelman » Memorial Lecture. Canadian Association of Gastroenterology.  Canada.
• 1987 : « Prix de la Recherche Clinique » Fondation pour la Recherche Médicale. Paris, France.
• 1982 : « Diploma de Honor ». Fundacion de Investigacion Médica. Candida Medrano de Merlo. Madrid, Spain.

Presentations

• CHARTIER ME, BEAUNOYER M, PAGANELLI M, LALLIER M, ALVAREZ F, LEMOINE CP. Outcomes After Liver Transplant for Children with Progressive Cholestasis of Northwestern Quebec. American Transplant Congress (ATC) conference (Philadelphia, USA). Juin 2024.
• ALVAREZ F. 450-C: IL-16 and IL-10 as biomarkers of disease activity and response to treatment in patients with autoinmune hepatitis. AASLD Liver Meeting. Boston, USA. November 10-14, 2023.
• COSTAGUTA G, DION S, CHARTIER M-E. PAGANELLI M, ALVAREZ F. Increase of circulating IgA levels after pediatric liver transplantation: A retrospective study. Society of Pediatric Liver Transplantation. 27th Annual Meeting. Montréal, Canada. October 16-17, 2023.
• COSTAGUTA A, COSTAGUTA A, COSTAGUTA G, D’AGOSTINO D, GONDOLESI G, PALLITTO B, RUMBO C, BOTTASSO O, ALVAREZ F. Lack of differences in safety and effectivity among three induction immunosuppression protocols during the first-year post-liver transplantation in pediatric patients. A multicenter study. Society of Pediatric Liver Transplantation. 27th Annual Meeting. Montréal, Canada. October 16-17, 2023.
• COSTAGUTA G, D’AGOSTINO D, GONDOLESI G, PALLITTO B, RUMBO C, BOTTASSO O, ALVAREZ F. Lack of differences in safety and effectivity among three induction immunosuppression protocols during the first-year post-liver transplantation in pediatric patients. A multicenter study. E-Poster en el 55th ESPGHAN, May 17-20, 2023, Viena.

Publications

1. MERZ S, SENEE V, PHILIPPI A, OSWALD F, SHAIGAN M, FUEHRER M, DREWES C, ALLGOEWER C, OELLINGER R, HENI M, BOLAND A, DELEUZE JF, BIRKHOFER F, GUSMAO EG, WAGNER M, HOHWIELER M, BREUNIG M, RAD R, SIEBERT R, MESSERER DAC, COSTA FILHO IG, ALVAREZ F, JULIER C, HELLER S, KLEGER A. A ONECUT1 regulatory, non-coding region in pancreatic development and diabetes. Cell Reports-D-24-03387R3 (sous presse).
2. COSTAGUTA AC; COSTAGUTA GA; RUMBO C; GONDOLESI G; D’AGOSTINO D; PALLITTO MB; BOTTASSO O; ÁLVAREZ F. Lack of differences in outcomes between 3 immunosuppression protocols in the first year after pediatric liver transplantation: A multicenter study. Liver Transpl 2024 Jul 2. Doi: 10.1097/LVT. 0000000000000427. Online ahead of print.
3. ÁLVAREZ F, CIOCCA M. Genetic cholestasis: classification according to the cellular defect. Arch Argent Pediatr. 2024; 122: :e202410380.
4. COSTAGUTA GA, ÁLVAREZ F. B cell depletion for autoimmune liver diseases: A retrospective review of indications and outcomes. JPGN Rep .2024; 5: 326-333. doi: 10.1002/jpr3.12098. eCollection 2024 Aug.
5. COHEN A, ALVAREZ F. Immunosuppression in two cases of indeterminate hepatitis. Can Liver J. 2024 Feb 26;7(1):64-69. doi: 10.3138/canlivj-2023-0019. eCollection 2024. PMID: 38505788.
6. COSTAGUTA G, DION S, CHARTIER M-E, PAGANELLI M, ALVAREZ F. Increase in circulating IgA levels after pediatric liver transplantation. A retrospective cohort study. J Liver Transpl 2024; 13: 100194.
7. LAPIERRE P, ALVAREZ F. Type 2 autoimmune hepatitis: Genetic susceptibility. Front Immunol 2022 Sep 29;13:1025343. doi: 10.3389/fimmu.2022.1025343. PMID: 36248826. eCollection 2022.
8. HERCUN J, WILLEMS P, BILODEAU M, VINCENT C, ALVAREZ F. Long-term follow-up into adulthood of pediatric-onset primary sclerosing cholangitis and autoimmune sclerosing cholangitis. J Pediatri Gastroenterol Nutr Rep 2022;3:3(e220).
9. KORNITZER G, ALVAREZ F. A novel single variant TJP2 mutation in a case of benign recurrent intrahepatic cholestasis. J Pediatri Gastroenterol Nutr Rep 2021;2:3(e087).
10. CUARTEROLO ML, CIOCCA M, LÓPEZ S, ARAUJO M, ÁLVAREZ F. Autoimmune Hepatitis in Children: Prednisone Plus Azathioprine Versus Cyclosporine: A Randomized Trial. J Pediatr Gastroenterol Nutr 2020;71(3):376-380. doi: 10.1097/MPG.0000000000002776.