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Hunter Prof Int Med/Head, Geo and Int Med/Dir Ctr Global Hlt


PO Box 801379
MR-4, 3148
Charlottesville, VA 22908-1379

Research Interests

Building on a background of work defining the unique, prolonged activation of adenylate cyclase by cholera toxin and E. coli LT (1971-1972), the development of the CHO cell assay for cholera toxin and E. coli LT (1974-1976), and the discovery that particulate guanylate cyclase is activated by E. coli ST (1978-1981) and on field work defining the magnitude of diarrheal diseases and their nutritional impact in rural and urban communities in Northeast Brazil (1978-present), Guerrant's laboratory is focused on the recognition, diagnosis, pathogenesis, impact, treatment and prevention of enteric infections. This work includes active studies of the roles of PLA2, PAF, enteric cytokines and neutrophils and the neutrophil marker lactoferrin in pathogenesis and diagnosis as well as of glutamine derivatives in the repair of disrupted intestinal barrier function. Guerrant's research on the leading cause of hospital-acquired diarrhea, Clostridium difficile, shows a key role for PLA2, PAF and COX-2 in the secretory and inflammatory effects of C. difficile toxin A. Guerrant's laboratory also finds PAF to be a key mediator of cholera toxin-induced secretion as well. Current work involves animal, tissue culture, Using chamber, and clinical studies of the roles of these mediators in inflammatory, parasitic (Cryptosporidium) and microbial adhesion or toxin-induced (ex. enteroaggregative E. coli, C. difficile, cholera) diarrheas. Work with colleagues at the Federal University of Ceara in Fortaleza, Brazil, supported by a current NIH International Collaboration for Infectious Diseases Research (ICIDR) award in its 16th year, shows three new and emerging pathogens to be leading causes of persistent diarrhea: enteroaggregative E. coli, Cryptosporidium and toroviruses. In addition, Cryptosporidium and other persistent diarrheas disrupt intestinal barrier function (as determined by lactulose:mannitol permeability) and lead to substantial increased diarrhea burdens for extended periods thereafter in young children. Having recently shown an apparent role for leukocytes (with fecal lactoferrin) in cryptosporidial and enteroaggregative E. coli persistent diarrheas, current work includes studies of the roles of cytokines in intestinal barrier disruption and secretion in bacterial and parasitic diarrheas. Most important, with colleagues in Brazil, Guerrant has shown that early childhood diarrhea and enteric infections have a lasting impact on growth and cognitive development, more than doubling the global diarrhea DALYs (disability-adjusted life years lost). Current work involves in-vitro, animal model and field studies of mechanisms, genetics (including APOE polymorphisms) and micronutrient interventions to ameliorate these effects. Having also recently demonstrated in collaborative studies that glutamine (the major bowel enterocyte energy source) and its new stable derivatives enhance intestinal sodium absorption at least as well if not better than glucose, current studies are addressing the roles of these compounds and micronutrients in speeding the repair of intestinal barrier functions oral rehydration and nutrition therapy (ORNT) and hence improving child development and also absorption of antiretroviral drugs in collaborative studies at Virginia, Haiti, South Africa and in Brazil. This work also involves collaborations to address HIV drug malabsorption and resistance genotyping and, with Michael Timko, to engineer Arg-Gln derivatives into edible plants. Richard L. GUERRANT — Asia Institute, University of Virginia


  • Bachelor of Science (BS), Davidson College
  • Doctor of Medicine (MD), University of Virginia

Research Projects

  • MD-INMD-ID257-APOE and Malnutrition R01
    • Project Sponsored By: U.S. Nih Of Child Health & Human Development
    • 09/22/2006 - 07/31/2012
    • Award Amount: $1,538,490.00
  • MD-INMD Long-term Impact and Intervention for Diarrhea in Brazil
    • Project Sponsored By: U.S. Nih Allergy & Infectious Diseases
    • 07/15/2007 - 4/30/2010
    • Award Amount: $1,643,295.00
  • MD-INMD Tailoring Novel Therapeutics for Emerging Drug-Resistant C. Difficile Colitis
    • Project Sponsored By: U.S. Nih Allergy & Infectious Diseases
    • 08/01/2007 - 07/31/2012
    • Award Amount: $2,839,631.00
  • MD-INMD ID257 Global Infectious Disease Research Training Grant at UVa
    • Project Sponsored By: U.S. John E. Fogarty International Center
    • 08/01/2008 - 03/31/2013
    • Award Amount: $649,260.00
  • MD-INMD-ID257 Gates Malnutrition & Enteric Disease
    • Project Sponsored By: Foundation for the National Institutes of Health
    • 12/01/2008 - 12/01/2013
    • Project Sponsored By: U.S. John E. Fogarty International Center
    • 09/01/2009 - 08/31/2011
    • Award Amount: $108,000.00
  • Long term Impact and Intervention for Diarrhea in Brazil
    • Project Sponsored By: U.S. Nih Allergy & Infectious Diseases
    • 05/01/2010 - 04/30/2015
    • Award Amount: $1,365,911.00
  • MD-INMD-ID257 UMB Obrig sub Shiga toxin
    • Project Sponsored By: University Of Maryland
    • 09/01/2010 - 08/31/2011
    • Award Amount: $111,408.00
  • Modeling Water Use & Health in Rural South Africa: An Innovative Training Tool
    • Project Sponsored By: U.S. John E. Fogarty International Center
    • 09/15/2010 - 08/31/2011
    • Award Amount: $269,500.00
  • Modeling Immunity for Biodefense
    • Project Sponsored By: Virginia Tech
    • 09/30/2010 - 09/29/2015
    • Award Amount - $1,782,180.00


  • Niehaus MD, Moore SR, Patrick PD, Derr LL, Lorntz B, Lima AA, Guerrant RL. Early childhood diarrhea is associated with diminished cognitive function 4 to 7 years later in children in a northeast Brazilian shantytown. Am J Trop Med Hyg. 2002 May;66(5):590-3.
  • Thielman NM, Rust PF, Guerrant RL. Criterion-related validity of a diarrhea questionnaire in HIV-infected patients. Dig Dis Sci. 2002 Jul;47(7):1421-6
  • Lima AA, Carvalho GH, Figueiredo AA, Gifoni AR, Soares AM, Silva EA, Guerrant RL. Effects of an alanyl-glutamine-based oral rehydration and nutrition therapy solution on electrolyte and water absorption in a rat model of secretory diarrhea induced by cholera toxin. Nutrition. 2002 Jun;18(6):458-62.
  • Newman RD, Moore SR, Lima AA, Nataro JP, Guerrant RL, Sears CL. A longitudinal study of Giardia lamblia infection in north-east Brazilian children. Trop Med Int Health. 2001 Aug;6(8):624-34.

Additional Publications