Paul Angulo: Clinician investigator
Authors: Jacob George, Elisabetta Bugianesi
Journal: Journal of Hepatology (2015)

Clinician investigators are a rare breed, and ones that do it with aplomb, even more hard to find. Early this year, the Hepatology community learnt about the sad and sudden demise of one of its foremost clinician investigators, Paul Angulo. As most of the readership will be aware, Paul was an outstanding investigator with an international reputation on the clinical aspects of fatty liver disease. At the time of his death, Paul was a Professor of Medicine and Section Chief of Hepatology at the University of Kentucky, a position he held for 5 years. His prior work and the pathway to a proliferative publishing career, was fostered at the Mayo Clinic, the institution that first described the clinical entity of non-alcoholic steatohepatitis, 30 years ago. Paul did his undergraduate studies in Medicine at the Universidad Michoacana de San Nicolás de Hildalgo in Mexico, before undertaking gastroenterology training at the Instituto Nacional de la Nutricion Salvador Zubirán in Mexico City. He subsequently moved to the Mayo Clinic, Rochester, MN to undertake a postdoctoral research fellowship under the mentorship of Keith Lindor. From there on, Paul established himself as a highly successful and renowned clinical investigator, with over 110 published papers, 46 chapters and review articles and 22 editorials and correspondences. To this, Paul was successful in obtaining highly competitive NIH R01 grants, and had numerous national and international invited presentations, including to AASLD, DDW, EASL and APASL. In terms of other service to the discipline of Hepatology, Paul contributed on numerous committees including the scientific committees of the NIDDK, the AASLD Annual Meeting Education Committee, the AASLD Clinical Research Committee and as liaison to the Hepatology Associates Committee and to Special Interest Groups (SIG) on Steatosis and Steatohepatitis, and Cholestatic Liver Disorders. Paul was an Associate Editor for Liver International and on the editorial board of a host of journals including Gastroenterology, Hepatology and the Journal of Hepatology. Paul is best known for his contributions in the field of fatty liver disease. These include studies on natural history, the histological course of NAFLD, intervention trials (ursodeoxycholic acid, pentoxyfylline, ecosapentanoic acid, betaine), and on the role of lifestyle intervention in children with NAFLD. In 2007, Paul led the multinational multicentre collaborative study that developed the NAFLD fibrosis score, perhaps the most widely used and accepted non-invasive scoring system for the disease. This group led by Paul, not only developed the original score, but more recently defined that the score predicts the long-term outcomes of people with the disease and is now in common use as an App available on the web. While Paul’s academic achievements speak for themselves, much less is known about Paul as a person. For those of us who knew him well, while an intensely private person, he was always a tremendous and willing collaborator, happy to contribute to scientific discourse and to share data. Paul was one of those rare individuals, who was both enthusiastic and passionate about clinical research, and as well, was able to put his efforts where his passion lay, working ceaselessly to undertake analysis and to get manuscripts to the required quality for submission. To his students, he was a great mentor, leader and teacher, who was willing to give his time to support and guide junior faculty. Above all, it was great to have him as a friend, colleague and collaborator. The Hepatology community has lost at a young age, one who contributed so much to our speciality, and to our patients. Goodbye Paul, you will be missed.