Joe Varghese

Professor and Head,

Department of Biochemistry,

Christian Medical College,

Bagayam, Vellore, Tamil Nadu, India – 632002

Phone: +91-416-2284267 (office), +91-416-2284458 (lab)

E-mail: joevarghese@cmcvellore.ac.in

EDUCATIONAL QUALIFICATIONS

Degree                               Period                Institution                                            University

RESEARCH INTERESTS

The broad area of my research is in the field of iron metabolism. Iron is a transition metal that plays a critical role in a variety of physiological processes, such as growth and proliferation, oxygen transport, enzyme activity etc. Our understanding of the regulation of systemic and cellular iron homeostasis has increased exponentially over the past couple of decades. At the same time, it is also being recognized that dysregulation of iron homeostasis is involved in the pathogenesis of several diseases as well. In my research, I am currently focused on studying the role of iron in the pathogenesis of diabetes mellitus in general and gestational diabetes mellitus in particular, and chronic non-healing ulcers.

Iron supplementation and gestational diabetes mellitus

All pregnant women in India are routinely prescribed oral iron supplements, as part of the Anemia Mukt Bharat (AMB) program. In women with iron-deficiency anemia, the benefits of iron supplementation during pregnancy for both the mother and child are very clear. Since the prevalence of anemia among pregnant women is unacceptably high (52.2% as per NFHS-5 data), the current strategy of universal iron supplementation to all pregnant women (irrespective of anemia status) makes logistical sense. Nevertheless, in non-anemic pregnant women, the benefits of iron supplementation vis-à-vis associated risks have not been studied adequately. Studies have suggested that iron may impair insulin secretion, thus increasing the risk of gestational diabetes mellitus (GDM). It is therefore important to generate evidence on the safety of the current strategy of iron supplementation in this sub-group (non-anemic pregnant women) of Indian women.

To address this, we are carrying out a randomized, parallel-group, double-blinded clinical trial funded by the ICMR, where the incidence of GDM in non-anemic primigravidae who receive oral iron supplementation of 60 mg of elemental iron per day (as per AMB program) will be compared to that in those who receive 30 mg of elemental iron/day for a period of 12 weeks in the second trimester of pregnancy. In addition, we plan to study kinetics of insulin secretion during the oral glucose tolerance test (OGTT) and levels of circulating unmethylated INS DNA (a sensitive and specific marker of beta-cell damage) in these two groups of women.

Effect of iron on insulin secretion and insulin resistance

A mild-to-moderate increase in body iron stores is known to be associated with diabetes mellitus. A few studies have suggested that an increase in beta-cell iron levels may adversely affect its function and potentially increase the risk of beta cell failure. However, very little is known about the underlying mechanisms involved. Planned and on-going work in the lab is aimed at studying this at the molecular and functional level, both in humans and in animal models. In a related project funded by SERB, we are looking at the relationship between gestational diabetes mellitus and circulating levels of non-transferrin bound iron (NTBI). We hypothesize that elevated levels of NTBI may be related to impaired beta-cell function in pregnant women with GDM.

I the past I have received the Early Career Fellowship from the Wellcome Trust-DBT India Alliance, spanning from 2012 to 2016. The research funded by the India Alliance has significantly contributed to understanding the connections between iron homeostasis and insulin resistance, leading to the publication of multiple research papers (refer to the publication list for details). 

Role of iron in wound healing and the pathogenesis of pressure ulcers

There is an urgent need to develop new and effective therapeutic strategies to promote wound healing in patients with chronic non-healing ulcers. Iron is essential for normal wound healing. However, iron tends to accumulate in chronic wounds, and it is thought to impair the healing process in this setting. The underlying mechanisms involved are, however, not clear.

In collaboration with the Department of Physical Medicine and Rehabilitation at CMC, Vellore, we have initiated translational research work which will look at the pathophysiological role of iron overload that is often seen in pressure ulcers, a common cause of chronic non-healing ulcers. In addition, our work in this area is also focused on evaluating iron chelation as a novel therapeutic modality to accelerate healing in such wounds.

Role of iron in the pathogenesis of metabolic dysfunction-associated steatotic liver disease 

It has been shown that iron may play a role in the pathogenesis of metabolic dysfunction-associated steatotic liver disease or MASLD (earlier called non-alcoholic fatty liver disease or NAFLD). On-going work in this area is looking at the underlying molecular mechanisms. In particular, we are interested in studying whether iron chelation can significantly retard the development and progression of MASLD.

In the past, I have been awarded a grant under the Rapid Grant for Young Investigators (RGYI) scheme of the Department of Biotechnology (DBT), Govt. of India (2008-2011), to study the role of heme oxygenase – 1 (HO-1) in the pathogenesis of iron overload associated with alcoholic liver disease. 

TEACHING AND TRAINING

Undergraduate training

I teach undergraduate medical, AHS and nursing students. For the first year MBBS students, I teach the modules on molecular biology, water and electrolyte balance, heme metabolism, immunology, liver function tests and integration of metabolism. In my teaching, I explore innovative methods to help students understand the importance of a sound foundation in the basic medical sciences for their further development as clinicians. In this connection, I am especially interested in the use of electronic resources (e-learning) as an aid to help students learn the clinical and applied aspects of Biochemistry more effectively. I also have a special interest in teaching undergraduate and post-graduate students the basics of ethical academic/research writing.

Postgraduate training

I am involved in the training of MD (Biochemistry) students. I serve as a resource person for faculty lectures, weekly post-graduate seminars and journal clubs. In addition, I am involved in the supervision of research work undertaken by postgraduate students as part of their dissertation work. 

RESEARCH GRANTS HELD

As Principal Investigator or co-principal investigator:

Ongoing extramural:

Ongoing intramural:

Past extramural:

Past intramural:

As Co-investigator:

Ongoing intramural:

Ongoing extramural:

Past extramural:

PUBLICATIONS

Research papers:

Chapters in books

i. Co-author of Harper’s Illustrated Biochemistry  (32nd edition , 2023) McGraw Hill Lange, USA.

The chapter written is as follows:


ii. Co-author of Harper’s Illustrated Biochemistry (31st edition , 2018) McGraw Hill Lange, USA.

The chapters written are as follows:


iii. Co-author of Harper’s Illustrated Biochemistry (30th edition, 2015) McGraw Hill Lange, USA.

The chapters written are as follows:


iv. Co-author of Harper’s Illustrated Biochemistry (29th edition, 2012) McGraw-Hill Publishers (Lange)

The chapters written are as follows:


FELLOWSHIPS


AWARDS