Carl Grunfeld, MD, PhD

Chief, Metabolism and Endocrine Sections, Department of Veterans Affairs Medical Center, San Francisco
Professor
Department of Medicine
+1 415 750-2005

Our laboratory studies the metabolic disturbances that occur during infection. Our major focuses are changes in lipid metabolism and energy balance. Using intact animals, we determine the physiological consequences of the host response to infection and define the cytokine mediators. We then determine the underlying cellular and molecular basis for these changes using both in vivo animal studies and cultured cells. For example, we have identified regulation in the activity of lipid synthesizing enzymes and related proteins that occurs at the level of transcription or post translation. For transcriptional regulation, the response elements and transactivating factors are then defined. Transgenic mouse models are developed to define the roles of key molecules in the host response. 

Our laboratory has shown that many of the metabolic changes are part of host defense and not detrimental. We have shown that lipoproteins induced during the host response to infection scavenge toxic bacterial fragments such as LPS and LTA. We have defined the molecules involved in their neutralization. 

With regard to energy balance, we determined the mechanisms that induce wasting in AIDS. We also developed specific therapies. We have recently identified a candidate for the molecule that generates fever during the response to infection: Uncoupling Protein 2 (UCP2).

Primary Thematic Area: 
Vascular & Cardiac Biology
Secondary Thematic Area: 
Immunology
Research Summary: 
Metabolic Changes and the Host Response to Infection
Publications: 

CHA2DS2-VASc Score, Warfarin Use, and Risk for Thromboembolic Events Among HIV-Infected Persons With Atrial Fibrillation.

Journal of acquired immune deficiency syndromes (1999)

Chau KH, Scherzer R, Grunfeld C, Hsue PY, Shlipak MG

Association of Tenofovir Use With Risk of Incident Heart Failure in HIV-Infected Patients.

Journal of the American Heart Association

Chen R, Scherzer R, Hsue PY, Jotwani V, Estrella MM, Horberg MA, Grunfeld C, Shlipak MG

Associations Between At-Risk Alcohol Use, Substance Use, and Smoking with Lipohypertrophy and Lipoatrophy Among Patients Living with HIV.

AIDS research and human retroviruses

Noorhasan M, Drozd DR, Grunfeld C, Merrill JO, Burkholder GA, Mugavero MJ, Willig JH, Willig AL, Cropsey KL, Mayer KH, Blashill A, Mimiaga M, McCaul ME, Hutton H, Chander G, Mathews WC, Napravnik S, Eron JJ, Christopoulos K, Fredericksen RJ, Nance RM, Delaney JC, Crane PK, Saag MS, Kitahata MM, Crane HM

Higher CD163 levels are associated with insulin resistance in hepatitis C virus-infected and HIV-infected adults.

AIDS (London, England)

Reid M, Ma Y, Scherzer R, Price JC, French AL, Plankey MW, Grunfeld C, Tien PC

Association of serum albumin and AST with 5-year all-cause mortality in HIV/HCV coinfection and HIV monoinfection.

AIDS (London, England)

Scherzer R, Heymsfield SB, Rimland D, Powderly WG, Tien PC, Bacchetti P, Shlipak MG, Grunfeld C