Richard L. Guerrant

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Primary Appointment

Thomas Harrison Hunter Professor of International Medicine, Medicine- Infectious Diseases and International Health

Education

  • BS, Davidson College, Davidson, NC
  • MD, Department of Medicine, University of Virginia

Research Disciplines

Infectious Diseases/Biodefense

Research Interests

Recognition, diagnosis, pathogenesis, impact, treatment and prevention of enteric infections; global health and tropical infectious diseases

Research Description


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 host and microbial genetics, ApoE4 (protection), enteric cytokines and neutrophils and the neutrophil marker lactoferrin in pathogenesis and diagnosis as well as of zinc and glutamine derivatives in the repair of disrupted intestinal barrier function.
Guerrant's research with Cirle Warren, MD, and Laurie Archbald-Pannone, MD, on the leading cause of hospital-acquired diarrhea, Clostridium difficile, has revealed a key role for PLA2, PAF and COX-2 in the secretory and inflammatory effects of C. difficile toxin A, and of adenosine A2a-agonitt, A2b antagonists, PPAR-?, ApoE-peptides, zinc and alanyl-glutamine in preventing inflammation or secretion in animal models of enteric infections. Current work involves animal model, tissue culture, 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 21st year, shows new and emerging pathogens to be leading causes of persistent diarrhea: enteroaggregative E. coli, Cryptosporidium and perhaps Giardia. 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 repair therapy (ORRT) 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 with Glynis Kolling, Martin Wu and Michael Timko to examine normal and probiotic flora and to engineer Arg-Gln derivatives into edible plants or probiotic bacteria.

Personal Statement

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.
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Training

  • Global Biothreats Training Program
  • Global Infectious Disease Research Training Grant at UVa
  • Interdisciplinary Training Program in Immunology

Selected Publications

Boone JH, Archbald-Pannone LR, Wickham KN, Carman RJ, Guerrant RL, Franck CT, Lyerly DM, Ribotype 027 Clostridium difficile infections with measurable stool toxin have increased lactoferrin and are associated with a higher mortality., 2014; European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology. () . PMID: 24449345 | PMCID: PMC4013447

Azevedo OG, Bolick DT, Roche JK, Pinkerton RF, Lima AA, Vitek MP, Warren CA, Oriá RB, Guerrant RL, Apolipoprotein E Plays a Key Role against Cryptosporidial Infection in Transgenic Undernourished Mice., 2014; PloS one. 9(2) e89562. PMID: 24586873

Richard SA, Black RE, Gilman RH, Guerrant RL, Kang G, Lanata CF, Mølbak K, Rasmussen ZA, Sack RB, Valentiner-Branth P, Checkley W, Catch-Up Growth Occurs after Diarrhea in Early Childhood., 2014; The Journal of nutrition. () . PMID: 24699805

Lima AA, Anstead GM, Zhang Q, Figueiredo IL, Soares AM, Mota RM, Lima NL, Guerrant RL, Oriá RB, Effects of glutamine alone or in combination with zinc and vitamin A on growth, intestinal barrier function, stress and satiety-related hormones in Brazilian shantytown children., 2014; Clinics (São Paulo, Brazil). 69(4) 225-33. PMID: 24714829

Mathers AJ, Guerrant RL, Dissecting the evolutionary stealth of our flora against antibiotics., 2014; Transactions of the Royal Society of Tropical Medicine and Hygiene. 108(3) 121-2. PMID: 24535149

Bartelt LA, Guerrant RL, Antibiotics help control rotavirus infections and enhance anti-rotaviral immunity: Are you serious?, 2014; The Journal of infectious diseases. () . PMID: 24625806

Lima AA, Kvalsund MP, Souza PP, Figueiredo ÃL, Soares AM, Mota RM, Lima NL, Pinkerton RC, Patrick PP, Guerrant RL, Oriá RB, Zinc, vitamin A, and glutamine supplementation in Brazilian shantytown children at risk for diarrhea results in sex-specific improvements in verbal learning., 2013; Clinics (São Paulo, Brazil). 68(3) 351-8. PMID: 23644855 | PMCID: PMC3611743

Keusch GT, Rosenberg IH, Denno DM, Duggan C, Guerrant RL, Lavery JV, Tarr PI, Ward HD, Black RE, Nataro JP, Ryan ET, Bhutta ZA, Coovadia H, Lima A, Ramakrishna B, Zaidi AK, Burgess DC, Brewer T, Implications of acquired environmental enteric dysfunction for growth and stunting in infants and children living in low- and middle-income countries., 2013; Food and nutrition bulletin. 34(3) 357-64. PMID: 24167916

Richard SA, Black RE, Gilman RH, Guerrant RL, Kang G, Lanata CF, Mølbak K, Rasmussen ZA, Sack RB, Valentiner-Branth P, Checkley W, Diarrhea in early childhood: short-term association with weight and long-term association with length., 2013; American journal of epidemiology. 178(7) 1129-38. PMID: 23966558 | PMCID: PMC3783094

Medeiros P, Bolick DT, Roche JK, Noronha F, Pinheiro C, Kolling GL, Lima A, Guerrant RL, The micronutrient zinc inhibits EAEC strain 042 adherence, biofilm formation, virulence gene expression, and epithelial cytokine responses benefiting the infected host., 2013; Virulence. 4(7) 624-33. PMID: 23958904

Wazny K, Zipursky A, Black R, Curtis V, Duggan C, Guerrant R, Levine M, Petri WA, Santosham M, Scharf R, Sherman PM, Simpson E, Young M, Bhutta ZA, Setting research priorities to reduce mortality and morbidity of childhood diarrhoeal disease in the next 15 years., 2013; PLoS medicine. 10(5) e1001446. PMID: 23690756 | PMCID: PMC3653794

Bartelt LA, Lima AA, Kosek M, Peñataro Yori P, Lee G, Guerrant RL, "Barriers" to child development and human potential: the case for including the "neglected enteric protozoa" (NEP) and other enteropathy-associated pathogens in the NTDs., 2013; PLoS neglected tropical diseases. 7(4) e2125. PMID: 23593514 | PMCID: PMC3623703

Bartelt LA, Sevilleja JE, Barrett LJ, Warren CA, Guerrant RL, Bessong PO, Dillingham R, Samie A, High anti-Cryptosporidium parvum IgG seroprevalence in HIV-infected adults in Limpopo, South Africa., 2013; The American journal of tropical medicine and hygiene. 89(3) 531-4. PMID: 23836569 | PMCID: PMC3771295

Bartelt LA, Roche J, Kolling G, Bolick D, Noronha F, Naylor C, Hoffman P, Warren C, Singer S, Guerrant R, Persistent G. lamblia impairs growth in a murine malnutrition model., 2013; The Journal of clinical investigation. 123(6) 2672-84. PMID: 23728173 | PMCID: PMC3668820

Leite RD, Lima NL, Leite CA, Farhat CK, Guerrant RL, Lima AA, Improvement of intestinal permeability with alanyl-glutamine in HIV patients: a randomized, double blinded, placebo-controlled clinical trial., 2013; Arquivos de gastroenterologia. 50(1) 56-63. PMID: 23657308

Bolick DT, Roche JK, Hontecillas R, Bassaganya-Riera J, Nataro JP, Guerrant RL, Enteroaggregative Escherichia coli strain in a novel weaned mouse model: exacerbation by malnutrition, biofilm as a virulence factor and treatment by nitazoxanide., 2013; Journal of medical microbiology. 62(0) 896-905. PMID: 23475903 | PMCID: PMC3709553

DeBoer MD, Chen D, Burt DR, Ramirez-Zea M, Guerrant RL, Stein AD, Martorell R, Luna MA, Early childhood diarrhea and cardiometabolic risk factors in adulthood: the Institute of Nutrition of Central America and Panama Nutritional Supplementation Longitudinal Study., 2013; Annals of epidemiology. 23(6) 314-20. PMID: 23608305

Santos AA, Braga-Neto MB, Oliveira MR, Freire RS, Barros EB, Santiago TM, Rebelo LM, Mermelstein C, Warren CA, Guerrant RL, Brito GA, Glutamine and alanyl-glutamine increase RhoA expression and reduce Clostridium difficile toxin-a-induced intestinal epithelial cell damage., 2013; BioMed research international. 2013() 152052. PMID: 23484083 | PMCID: PMC3591182

Sanders ME, Guarner F, Guerrant R, Holt PR, Quigley EM, Sartor RB, Sherman PM, Mayer EA, An update on the use and investigation of probiotics in health and disease., 2013; Gut. 62(5) 787-96. PMID: 23474420

Philipson CW, Bassaganya-Riera J, Viladomiu M, Pedragosa M, Guerrant RL, Roche JK, Hontecillas R, The role of peroxisome proliferator-activated receptor γ in immune responses to enteroaggregative Escherichia coli infection., 2013; PloS one. 8(2) e57812. PMID: 23469071 | PMCID: PMC3585146

Lima IF, Boisen N, Quetz Jda, Havt A, de Carvalho EB, Soares AM, Lima NL, Mota RM, Nataro JP, Guerrant RL, Lima AÃ, Prevalence of enteroaggregative Escherichia coli and its virulence-related genes in a case-control study among children from north-eastern Brazil., 2013; Journal of medical microbiology. 62(0) 683-93. PMID: 23429698 | PMCID: PMC3709657

Khan OA, Guerrant R, Sanders J, Carpenter C, Spottswood M, Jones DS, O'Callahan C, Brewer TF, Markuns JF, Gillam S, O'Neill J, Nathanson N, Wright S, Global health education in U.S. medical schools., 2013; BMC medical education. 13() 3. PMID: 23331630 | PMCID: PMC3637494

Rodrigues RS, Oliveira RA, Li Y, Zaja-Milatovic S, Costa LB, Braga Neto MB, Kolling GL, Lima AA, Guerrant RL, Warren CA, Intestinal epithelial restitution after TcdB challenge and recovery from Clostridium difficile infection in mice with alanyl-glutamine treatment., 2013; The Journal of infectious diseases. 207(10) 1505-15. PMID: 23359592 | PMCID: PMC3627196

Su YH, Tsegaye M, Varhue W, Liao KT, Abebe LS, Smith JA, Guerrant RL, Swami NS, Quantitative dielectrophoretic tracking for characterization and separation of persistent subpopulations of Cryptosporidium parvum., 2013; The Analyst. 139(1) 66-73. PMID: 24225592

Warren CA, Calabrese GM, Li Y, Pawlowski SW, Figler RA, Rieger J, Ernst PB, Linden J, Guerrant RL, Effects of adenosine AâA receptor activation and alanyl-glutamine in Clostridium difficile toxin-induced ileitis in rabbits and cecitis in mice., 2012; BMC infectious diseases. 12() 13. PMID: 22264229 | PMCID: PMC3323464

Mitter SS, Oriá RB, Kvalsund MP, Pamplona P, Joventino ES, Mota RM, Gonçalves DC, Patrick PD, Guerrant RL, Lima AA, Apolipoprotein E4 influences growth and cognitive responses to micronutrient supplementation in shantytown children from northeast Brazil., 2012; Clinics (São Paulo, Brazil). 67(1) 11-8. PMID: 22249475 | PMCID: PMC3248595

Preidis GA, Saulnier DM, Blutt SE, Mistretta TA, Riehle KP, Major AM, Venable SF, Barrish JP, Finegold MJ, Petrosino JF, Guerrant RL, Conner ME, Versalovic J, Host response to probiotics determined by nutritional status of rotavirus-infected neonatal mice., 2012; Journal of pediatric gastroenterology and nutrition. 55(3) 299-307. PMID: 22343914

Kosek M, Haque R, Lima A, Babji S, Shrestha S, Qureshi S, Amidou S, Mduma E, Lee G, Yori PP, Guerrant RL, Bhutta Z, Mason C, Kang G, Kabir M, Amour C, Bessong P, Turab A, Seidman J, Olortegui MP, Quetz J, Lang D, Gratz J, Miller M, Gottlieb M, Fecal markers of intestinal inflammation and permeability associated with the subsequent acquisition of linear growth deficits in infants., 2012; The American journal of tropical medicine and hygiene. 88(2) 390-6. PMID: 23185075 | PMCID: PMC3583335

DeBoer MD, Lima AA, Oría RB, Scharf RJ, Moore SR, Luna MA, Guerrant RL, Early childhood growth failure and the developmental origins of adult disease: do enteric infections and malnutrition increase risk for the metabolic syndrome?, 2012; Nutrition reviews. 70(11) 642-53. PMID: 23110643 | PMCID: PMC3493112

Guerrant RL, Bartelt LA, Scharf RJ, Thinking deeper about important mass treatment trials., 2012; Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 54(11) 1674-5. PMID: 22431805 | PMCID: PMC3404721

Roche JK, Rojo AL, Costa LB, Smeltz R, Manque P, Woehlbier U, Bartelt L, Galen J, Buck G, Guerrant RL, Intranasal vaccination in mice with an attenuated Salmonella enterica Serovar 908htr A expressing Cp15 of Cryptosporidium: impact of malnutrition with preservation of cytokine secretion., 2012; Vaccine. 31(6) 912-8. PMID: 23246541 | PMCID: PMC3563240

Guerrant RL, DeBoer MD, Moore SR, Scharf RJ, Lima AA, The impoverished gut--a triple burden of diarrhoea, stunting and chronic disease., 2012; Nature reviews. Gastroenterology & hepatology. 10(4) 220-9. PMID: 23229327 | PMCID: PMC3617052

Li Y, Figler RA, Kolling G, Bracken TC, Rieger J, Stevenson RW, Linden J, Guerrant RL, Warren CA, Adenosine A2A receptor activation reduces recurrence and mortality from Clostridium difficile infection in mice following vancomycin treatment., 2012; BMC infectious diseases. 12() 342. PMID: 23217055 | PMCID: PMC3523970

Lima IF, Quetz Jda, Guerrant RL, Nataro JP, Houpt ER, Lima AA, Havt A, Enteroaggregative Escherichia coli quantification in children stool samples using quantitative PCR., 2012; APMIS : acta pathologica, microbiologica, et immunologica Scandinavica. 121(7) 643-51. PMID: 23216208 | PMCID: PMC3604144

Costa LB, Noronha FJ, Roche JK, Sevilleja JE, Warren CA, Oriá R, Lima A, Guerrant RL, Novel in vitro and in vivo models and potential new therapeutics to break the vicious cycle of Cryptosporidium infection and malnutrition., 2012; The Journal of infectious diseases. 205(9) 1464-71. PMID: 22454464 | PMCID: PMC3324401

Fischer Walker CL, Lamberti L, Adair L, Guerrant RL, Lescano AG, Martorell R, Pinkerton RC, Black RE, Does childhood diarrhea influence cognition beyond the diarrhea-stunting pathway?, 2012; PloS one. 7(10) e47908. PMID: 23118906 | PMCID: PMC3485308

Warren CA, van Opstal EJ, Riggins MS, Li Y, Moore JH, Kolling GL, Guerrant RL, Hoffman PS, Vancomycin treatment's association with delayed intestinal tissue injury, clostridial overgrowth, and recurrence of Clostridium difficile infection in mice., 2012; Antimicrobial agents and chemotherapy. 57(2) 689-96. PMID: 23147742 | PMCID: PMC3553708

Viladomiu M, Hontecillas R, Pedragosa M, Carbo A, Hoops S, Michalak P, Michalak K, Guerrant RL, Roche JK, Warren CA, Bassaganya-Riera J, Modeling the role of peroxisome proliferator-activated receptor γ and microRNA-146 in mucosal immune responses to Clostridium difficile., 2012; PloS one. 7(10) e47525. PMID: 23071818 | PMCID: PMC3469550

Warren CA, Li Y, Calabrese GM, Freire RS, Zaja-Milatovic S, van Opstal E, Figler RA, Linden J, Guerrant RL, Contribution of adenosine A(2B) receptors in Clostridium difficile intoxication and infection., 2012; Infection and immunity. 80(12) 4463-73. PMID: 23045479 | PMCID: PMC3497433

Braga-Neto MB, Oliveira BM, Rodrigues RS, Noronha FJ, Leitao RF, Brito GA, Lima AA, Guerrant RL, Warren CA, Protective effects of alanyl-glutamine supplementation against nelfinavir-induced epithelial impairment in IEC-6 cells and in mouse intestinal mucosa., 2012; Cancer biology & therapy. 13(14) 1482-90. PMID: 22986234 | PMCID: PMC3542240

Kolling G, Wu M, Guerrant RL, Enteric pathogens through life stages., 2012; Frontiers in cellular and infection microbiology. 2() 114. PMID: 22937528 | PMCID: PMC3427492

Kolling GL, Wu M, Warren CA, Durmaz E, Klaenhammer TR, Timko MP, Guerrant RL, Lactic acid production by Streptococcus thermophilus alters Clostridium difficile infection and in vitro Toxin A production., 2012; Gut microbes. 3(6) 523-9. PMID: 22895082 | PMCID: PMC3495789

Queiroz DM, Silva CI, Goncalves MH, Braga-Neto MB, Fialho AB, Fialho AM, Rocha GA, Rocha AM, Batista SA, Guerrant RL, Lima AA, Braga LL, Higher frequency of cagA EPIYA-C phosphorylation sites in H. pylori strains from first-degree relatives of gastric cancer patients., 2012; BMC gastroenterology. 12() 107. PMID: 22891666 | PMCID: PMC3462145

Richard SA, Black RE, Gilman RH, Guerrant RL, Kang G, Lanata CF, Mølbak K, Rasmussen ZA, Sack RB, Valentiner-Branth P, Checkley W, Wasting is associated with stunting in early childhood., 2012; The Journal of nutrition. 142(7) 1291-6. PMID: 22623393 | PMCID: PMC3374667

Warren CA, van Opstal E, Ballard TE, Kennedy A, Wang X, Riggins M, Olekhnovich I, Warthan M, Kolling GL, Guerrant RL, Macdonald TL, Hoffman PS, Amixicile, a novel inhibitor of pyruvate: ferredoxin oxidoreductase, shows efficacy against Clostridium difficile in a mouse infection model., 2012; Antimicrobial agents and chemotherapy. 56(8) 4103-11. PMID: 22585229 | PMCID: PMC3421617

Guerrant RL, Oria RB, Moore SR, Scharf R, Lima AA, Enteric protozoa and human potential., 2011; Annals of tropical paediatrics. 31(3) 201-3. PMID: 21781413

Costa LB, Johnbull EA, Reeves JT, Sevilleja JE, Freire RS, Hoffman PS, Lima AA, Oria RB, Roche JK, Guerrant RL, Warren CA, CRYPTOSPORIDIUM- MALNUTRITION INTERACTIONS: MUCOSAL DISRUPTION, CYTOKINES AND TLR SIGNALING IN A WEANED MURINE MODEL., 2011; J Parasitol. 0(0) null. PMID:

Costa LB, JohnBull EA, Reeves JT, Sevilleja JE, Freire RS, Hoffman PS, Lima AA, Oriá RB, Roche JK, Guerrant RL, Warren CA, Cryptosporidium-malnutrition interactions: mucosal disruption, cytokines, and TLR signaling in a weaned murine model., 2011; The Journal of parasitology. 97(6) 1113-20. PMID: 21711105 | PMCID: PMC3247658

Ueno PM, Oriá RB, Maier EA, Guedes M, de Azevedo OG, Wu D, Willson T, Hogan SP, Lima AA, Guerrant RL, Polk DB, Denson LA, Moore SR, Alanyl-glutamine promotes intestinal epithelial cell homeostasis in vitro and in a murine model of weanling undernutrition., 2011; American journal of physiology. Gastrointestinal and liver physiology. 301(4) G612-22. PMID: 21799183

Pinkerton RC, Oriá RB, Kent JW, Kohli A, Abreu C, Bushen O, Lima AA, Blangero J, Williams-Blangero S, Guerrant RL, Evidence for genetic susceptibility to developing early childhood diarrhea among shantytown children living in northeastern Brazil., 2011; The American journal of tropical medicine and hygiene. 85(5) 893-6. PMID: 22049044

Moore SR, Lima AA, Guerrant RL, Infection: Preventing 5 million child deaths from diarrhea in the next 5 years., 2011; Nature reviews. Gastroenterology & hepatology. 8(7) 363-4. PMID: 21725348

Dillingham R, Leger P, Beauharnais CA, Miller E, Kashuba A, Jennings S, Dupnik K, Samie A, Eyma E, Guerrant R, Pape J, Fitzgerald D, AIDS diarrhea and antiretroviral drug concentrations: a matched-pair cohort study in Port au Prince, Haiti., ; Am J Trop Med Hyg. 84(6) 878-82. PMID: | PMCID: PMC3110379

Guerrant RL, Oria RB, Moore SR, Lima AA, Enteric protozoa and human potential., ; Ann Trop Paediatr. 31(3) 201-3. PMID: