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The medical student researchers and their faculty team in Boston

University of Hawaiʻi John A. Burns School of Medicine researchers had already sparked national news when they presented research posters last November in Boston at the national conference of the American Association for the Study of Liver Diseases, the leading organization of scientists and health-care professionals committed to preventing and curing liver disease.

The findings by the JABSOM students and supervising faculty led to the issuance of several national health warnings and triggered an overdue discussion over whether strict regulations are warranted for health supplements.

A sudden outbreak

As of October 2013, there were 56 cases of acute liver failure or acute hepatitis linked to a product called OxyElite Pro. Forty-three of the cases were in Hawaiʻi.

UH medical students Resham Ramkissoon and Christina Wu are both working on projects evaluating treatment regimens for Hepatitis C, chronic infections that kill more Americans annually than HIV. Wu’s project focus is on autoimmune hepatitis caused by dietary supplements. During the students’ research, they took note of the alarming increase in acute liver failure and acute hepatitis. They reported their findings to the Hawaiʻi State Department of Health, which helped orchestrate the recall of the dietary supplement implicated in the illnesses.

“As soon as we suspected a possible link between OxyElite Pro products and cases of liver failure and non-viral hepatitis in Hawaiʻi, we warned the public and immediately launched an investigation with state officials and the Centers for Disease Control and Prevention,” said Daniel Fabricant, director of Food and Drug Administration’s Division of Dietary Supplement Programs. “Our mandate to protect the public was fulfilled by ensuring the swift removal of the product from the marketplace.”

The FDA used new enforcement tools provided by the FDA Food Safety Modernization Act to respond quickly in the face of a potential danger to public health.

“The students have done a great job in this learning experience from study concept, design and data analysis and finally conclusion,” said Naoky Tsai, a JABSOM clinical professor.

More awards followed

There is even more success to report. Ramkissoon received first place for his presentation at the most recent American College of Physicians/American Society of Internal Medicine Hawaiʻi Chapter annual convention. Christine Lee won first place in the clinical vignette category. “We will be presenting Resham’s expanded study on chronic Hepatitis C at the European Liver Congress in April 2015 in Vienna, Austria,” said Tsai. “This is a distinguished honor.”

Meanwhile, earlier in 2014, second-year medical students Tanner Kim and Jaqueline Kagihara presented a poster at the Digestive Disease Week, a national gastrointestinal meeting in Chicago. They are now diligently writing up papers to be sent for publication.

Said Tsai, “This has been a very productive year. And this would not be possible without the medical students, Dr. Marina Roytman—our clinical professor who directly supervises all the medical students who come through the liver center—and full support from The Queen’s Medical Center ʻohana.”

A John A. Burns School of Medicine story

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