Meet Chief of Division of Gastroenterology, Hepatology, and Nutrition: Dr. Binita Kamath

Editor’s Note: Children’s Hospital of Philadelphia’s Chief of the Division of Gastroenterology, Hepatology, and Nutrition, Binita Kamath, MBBChir, MRCP, MTR, has been settling into her new role for the past six months. In addition to her divisional leadership position, she is a pediatric gastroenterologist and hepatologist at CHOP, and a Professor of Pediatrics in the Perelman School of Medicine at the University of Pennsylvania. In this Q&A, Dr. Kamath shares her vision for the Division’s future, especially in the realm of research. This article, originally appearing in CHOP News, has been edited for clarity and length.

Dr. Kamath, an international leader and world-renowned expert in Pediatric Hepatology, joined CHOP June 1, after serving as Interim Head of the Division of Gastroenterology, Hepatology and Nutrition at the Hospital for Sick Children in Toronto, Ontario. This is a homecoming of sorts for Dr. Kamath, as she spent several years at CHOP as a resident, fellow, and junior faculty member.

Dr. Kamath’s research covers pediatric liver disease. She takes a translational approach and is focused on both patient-based studies and basic science. One of her key interest areas is Alagille syndrome, an inherited liver disorder that also affects the heart, eyes, bones, kidneys, vasculature, and other organs. She seeks to understand the phenotypic manifestations, genotype-phenotype relationships, and natural history of this condition.

What’s your vision for the future for CHOP’s Division of Gastroenterology, Hepatology, and Nutrition? 

The Division of Gastroenterology, Hepatology, and Nutrition is already a fantastic division, and I am so honored and proud to be given this role. The Division is undoubtedly one of the top-tier groups in North America. My vision is to put this Division on the global stage. Because I have worked in three different countries — with three different healthcare systems — I have a worldwide view of our field with clinical and research collaborations all over the world.

What areas of research would you like to focus on at CHOP? 

I want to be able to support and facilitate all the wonderful research that’s going on in the Division. We have a very diverse Division with people doing all types of research in different super-specialty areas within gastroenterology, hepatology, and nutrition. I’m a liver specialist — a hepatologist — and so my research has focused on cholestatic liver diseases, bile duct disorders of the liver, and inherited disorders of the liver.

One particular condition I’ve spent most of my career working on is Alagille syndrome, and that is incredibly important to this hospital because both of the genes that cause this condition were identified here in Dr. Nancy Spinner’s Lab. I started my career in Alagille syndrome here, I’ve continued my research for 15 years in Canada, and I am thrilled to bring my research back to the mothership. 

Why is it important to have patients — and their voices — involved in research?

Having a patient voice in your research is key. In 2018, I established a global database of Alagille syndrome patients. Before we collected one piece of data, we sent our case report forms — where we would collect the information — to the Alagille Syndrome Alliance, a family advocacy group, to get their opinions and feedback. We made changes based on their recommendations. I want to make sure the patient voice is central to any research we are doing.

What is the role of philanthropic donors in GI research and care at CHOP?

Philanthropy is absolutely crucial. I’ve spent a large part of my career writing grant applications for federal funding and foundations. While I’ve personally had success — and this Division has had success — it is a very difficult stream of funds to access, and it takes an enormous amount of effort. And whilst we will continue to do that, philanthropy is an absolute lifesaver to research in the current arena. It frees up our time and gives us space to be creative. Many granting agencies will require you to write a specific grant, and then you almost have answered the questions by the time you submit the grant. Philanthropic funds allow us to think outside the box.

What do you enjoy most about working with children with GI, hepatology, and nutrition concerns?

I appreciate the diversity of problems we encounter. There is a huge variety in the nature of the diseases we see — and more importantly — there have been, and continue to be, substantial advances in therapies. Care of inflammatory bowel disease patients is ever-evolving, especially for those with very early onset disease. 

Liver transplantation is no longer an experimental therapy; it is standard of care. But we’re looking at more innovative ways to transplant children, to get organs, and to manage immunosuppressive strategies. The future is going to be exploring opportunities like gene therapy.

Can you describe a patient or patient family who had a significant impact on you as a doctor or as an individual?

There is a patient with Alagille syndrome whom I’ve taken care of in Canada. They are an extraordinary family — very dedicated to their child — and he suffered from extreme itching. That’s one of the most serious manifestations of liver disease and Alagille syndrome.

You might think it just sounds like scratching, but when I say itching, the child wakes up and there’s blood in their sheets because they’ve scratched so hard that they’ve broken the skin. When your child itches that much, they don’t sleep. And when they don’t sleep, parents don’t sleep, so everyone experiences severe fatigue. In addition, the scratching disturbs daily activities and school performance.

So just imagine a family where nobody has had a full night’s rest for years. The reason that this particular child and family comes to my mind is that we were able to get involved in the development of a new drug to treat the itching. I was able to go to the FDA to advocate for the approval of this drug, and he’s one of the first patients I enrolled in the clinical trial. It is a trial that ran across North America. His itching got better, and his family came to the clinic and said to me, “We got a new child.” 

He’s now a young teenager. He’s taller than me, and everything got better. His itching got better, he slept better, he grew better, and he’s just a delightful young teenager. I feel privileged to have been involved in getting the drug approved by regulatory agencies and seeing the direct benefit on my patient. That has been very powerful.