Udeme Ekong, MD, MPH

Associate Professor of Pediatrics (Gastroenterology)

Research Departments & Organizations

Pediatrics: Pediatric Gastroenterology & Hepatology

Human and Translational Immunology Program

Research Interests

Gastroenterology; Hepatitis; Immune Tolerance; Liver Diseases; Liver Transplantation; Pediatrics

Research Summary

Dr Ekong is interested in developing ways to predict children who can discontinue their anti-rejection medications (immunosuppression) following liver transplantation and prior to joining the faculty at Yale, she was the center Principal Investigator on a clinical study on Immunosuppression Withdrawal in Pediatric Liver Transplant Recipients, conducted by the Immune Tolerance Network (ITN) and sponsored by the National Institute of Allergy and Infectious Diseases (NIAID).

Specialized Terms: Immune tolerance following pediatric liver transplantation; Immune dysregulation in autoimmune hepatitis; Immune mediated liver disease.

Extensive Research Description

Dr Ekong's research interest includes immune tolerance following liver transplantation and prior to joining the faculty at Yale, was the center Principal Investigator on a clinical study on Immunosuppression Withdrawal in Pediatric Liver Transplant Recipients, conducted by the Immune Tolerance Network (ITN) and sponsored by the National Institute of Allergy and Infectious Diseases (NIAID). She is also interested in the role regulatory T cell dysfunction plays in the immune pathogenesis of de novo autoimmune hepatitis and autoimmune hepatitis.

  1. The role of sodium chloride and the Treg/Th17 axis in Autoimmune Hepatitis

This project is investigating if a salt restriction protocol will improve immune parameters in patients with autoimmune hepatitis.

  1. De NovoAutoimmune Hepatitis in Pediatric Liver Transplantation

This project is investigating the role of the Inflammasome, ER stress and T cell immunity in de novo autoimmune hepatitis.

  1. Studies of Pediatric Liver Transplantation (SPLIT)

The mission of the Studies of Pediatric Liver Transplantation is to improve the outcome, and provide educational and advocacy resources for children who require, or have received, liver transplantation in the United States and Canada.

Clinical Trials

Conditions Study Title
Immune System Efficacy and Safety of Maribavir in Transplant Recipients With Cytomegalovirus (CMV) Infections That Are Refractory or Resistant to Treatment
Immune System, Infectious Diseases Multicenter, Open Label, Phase 3 Trial of ATA129 for Solid Organ Transplant Subjects With Epstein-Barr Virus-Associated Post-Transplant Lymphoproliferative Disease After Failure of Rituximab or Rituximab and Chemotherapy (ALLELE Study)
Diseases of the Digestive System - Liver, Diseases of the Eye, Diseases of the Nervous System Wilson Disease Registry
Hepatitis, HIV/AIDS, Immune System, Infectious Diseases Screening In Anticipation of Future Research
Children's Health, Diseases of the Digestive System - Liver De Novo Autoimmune Hepatitis in Pediatric Liver Transplantation
Hepatitis, Children's Health, Diseases of the Digestive System - Liver, Immune System The Role of Sodium Chloride and the Treg/Th17 Axis in Autoimmune Hepatitis

Activities

  • American Liver Foundation Connecticut Division New Haven, United States (2017 - 2017)

  • World Congress of Pediatric Gastroenterology, Hepatology and Nutrition Montreal, Canada (2016 - 2016)

  • American Liver Foundation Connecticut Division New Haven, United States (2016 - 2016)

  • American Transplant Congress Boston, United States (2016 - 2016)

    The Long-term Outcomes of De Novo Autoimmune Hepatitis in Pediatric Liver Transplant Recipients

  • PSC Partners Conference New Haven, United States (2016 - 2016)

  • Yale-Cambridge Transplantation Symposium New York, United States (2015 - 2015)

  • First Years' Fellows Conference North American Society of Pediatric Gastroenterology, Hepatology and Nutrition Fort Lauderdale, United States (2015 - 2015)

  • North American Society for Pediatric Gastroenterology, Hepatology, Nutrition Atlanta, United States (2014 - 2014)

    Meet The Professor Breakfast

  • North American Society for Pediatric Gastroenterology, Hepatology, Nutrition Chicago, United States (2013 - 2013)

  • “The Inflammatory Milieu in De Novo Autoimmune Hepatitis Reduces Regulatory T-cell Function.” Boston, United States (2012 - 2012)

  • , “De Novo Autoimmune Hepatitis Post Liver Transplant associated with Immunoregulatory Dysfunction.” San Francisco, United States (2011 - 2011)

  • “Clinical Outcomes Following Immunosuppression Withdrawal in Pediatric Living Donor Liver Transplant Recipients” Atlanta, United States (2011 - 2011)

  • “Successful Immunosuppression Minimization in Pediatric Liver Transplantation.” Boston, United States (2009 - 2009)

Selected Publications

See list of PubMed publications

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Contact Info

Udeme Ekong, MD, MPH
Mailing Address
Pediatric Gastroenterology & HepatologyPO Box 208064
New Haven, CT 06820-8064

Ekong Lab

TH1 and TH17 polarizing cytokines and their key signature cytokines, IFN-γ and IL-17A, make up the cytokine milieu within livers with de novo autoimmune hepatitis.

A) 40X magnification: a cluster of IL-6 positive cells within the portal tract (DAPI-blue, IL-6-red). B) 40X magnification: very few IL-1β positive cells present within the portal tract (DAPI-blue, IL-1β-red). C-D) 20X magnification: several IL-17A positive cells present within the portal tract (DAPI-blue, IL-17A-red) and co-expressed with FOXP3. Arrowheads point to FOXP3/IL17A co-expressing cells. (DAPI-blue, IL-17A-red, FOXP3 green). 60X magnification: Several CD4 positive cells seen that co-express with FOXP3 (DAPI-blue, CD4-green, FOXP3-red). E-F) 20X magnification: the TH1 polarizing cytokine, IL-12 (DAPI-blue, IL-12-red) as well as its signature cytokine, IFN-γ (DAPI-blue, IFN-γ-red), present within portal inflammatory infiltrates. G) 20X magnification: a few IFN-γ positive cells co-expressed with FOXP3 on same cell. Arrowheads point to FOXP3/IFN-γ co-expressing cells. (DAPI-blue, FOXP-green, IFN-γ-red). (H) 60X magnification: IL-12 co-expressed with CD68 (DAPI-blue, IL-12-red, CD68-green); as well as IL-6 (40X magnification) (DAPI-blue, IL-12-red, IL-6-green). (I) 20X magnification: CD14+ cells co-expressed with CD68+ cells (white arrows) (DAPI-blue, CD14-red, CD68-green). (J) 20X magnification. Representative slides from isotype controls from one patient are shown.

Liver histology of de novo autoimmune hepatitis

Hematoxylin and Eosin stains of liver biopsies with de novo autoimmune hepatitis. Portal tracts containing inflammation, which is predominantly lymphocytic, and foci of interface hepatitis (IH). Bile ducts (BD) show no significant infiltration of the epithelium by inflammatory cells or other injury. Portal vein branches show no significant endothelialitis or other injury. Original magnification of all images = 100X.

Regulatory T cell (Treg) function is impaired in patients with de novo autoimmune hepatitis

A) Regulatory T cells from healthy non-transplanted subjects (HC) (n=5) as well as subjects with de novo autoimmune hepatitis (dAIH) (n=5) are similarly demethylated in the TSDR region. B) Regulatory T cells from subjects with de novo autoimmune hepatitis (n=7) suppress effector cell proliferation less efficiently compared to sorted Tregs from healthy non-transplanted subjects (n=9) and liver transplanted subjects without de novo autoimmune hepatitis (LTC) (n=3) (dAIH vs. LTC 2:1, 4:1, p=0.03, 0.02 respectively) (dAIH vs. HC 2:1, 4:1, 8:1, p=0.005, 0.002, 0.03 respectively). C) Representative histogram for dAIH. Tresponder:Treg ratio 2:1. D) Representative histogram for LTC. Tresponder:Treg ratio 2:1.