Carl Grunfeld, MD

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

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: 
Research Summary: 
Metabolic Changes and the Host Response to Infection

Contributions of HIV, HCV, and traditional vascular risk factors to peripheral artery disease in women.

AIDS (London, England)

Cedarbaum E, Ma Y, Scherzer R, Price JC, Adimora AA, Bamman M, Cohen M, Fischl MA, Matsushita K, Ofotokun I, Plankey M, Seaberg EC, Yin MT, Grunfeld C, Vartanian S, Sharma A, Tien PC

Association of Statin Use with Kidney Damage and Function Among HIV-infected Men.

Journal of acquired immune deficiency syndromes (1999)

Ascher SB, Scherzer R, Nishtala A, Jotwani V, Grunfeld C, Parikh CR, Ng D, Wang R, Palella FJ, Shlipak MG, Estrella MM

Mortality following myocardial infarction among HIV-infected persons: the Center for AIDS Research Network Of Integrated Clinical Systems (CNICS).

BMC medicine

Feinstein MJ, Nance RM, Delaney JAC, Heckbert SR, Budoff MJ, Drozd DR, Burkholder GA, Willig JH, Mugavero MJ, Mathews WC, Moore RD, Eron JJ, Napravnik S, Hunt PW, Geng E, Hsue P, Peter I, Lober WB, Crothers K, Grunfeld C, Saag MS, Kitahata MM, Lloyd-Jones DM, Crane HM

Tenofovir disoproxil fumarate initiation and changes in urinary biomarker concentrations among HIV-infected men and women.

AIDS (London, England)

Zhang WR, Scherzer R, Estrella MM, Ascher SB, Muiru A, Jotwani V, Grunfeld C, Parikh CR, Gustafson D, Kassaye S, Sharma A, Cohen M, Tien PC, Ng DK, Palella FJ, Witt MD, Ho K, Shlipak MG

Leptinemia is Associated With Peripheral Artery Disease.

The Journal of surgical research

Zahner GJ, Ramirez JL, Spaulding KA, Khetani SA, Gasper WJ, Grunfeld C, Hills NK, Schafer AL, Grenon SM