I am a Professor of Medicine at the University of California San Francisco (UCSF). I am a pulmonary and critical care medicine specialist with a clinical and translational research focus in HIV-associated pulmonary diseases, and I am committed to training the next generation of researchers in this field. For this K24 renewal, my career goals and research objectives are to: (1) continue to provide comprehensive mentoring and research support to T32/F32 fellows and K Assistant Professors on research and career development and focused mentoring to other junior investigators on specific research projects. A special emphasis will be assisting my K mentees to make the challenging transition to full independence (e.g., R01 award);(2) expand my Distance Mentoring and """"""""Mentoring the Mentor"""""""" experience;(3) join a new UCSF initiative and assist under-represented minority and women faculty obtain their own K24 awards;(4) continue my research focus on HIV-associated opportunistic pneumonias, the lung microbiome, and chronic obstructive pulmonary disease (COPD) and expand my current research to study the lung microbiome that persists after pneumonia and declines in lung function and development COPD. Our central hypothesis is that post-pneumonia changes in the lung microbiome are associated with declines in lung function and the development of COPD in HIV- infected persons.
Aim 1 : To compare the composition of the lung microbiome at baseline and 3-months and 1- year after acute pneumonia treatment using a standardized phylogenetic microarray (PhyloChip).
Aim 2 : To compare the structure of the lung microbiome at baseline and 3-months and 1-year after acute pneumonia treatment using high-throughput DNA sequencing (Illumina MiSeq).
Aim 3 : To correlate the lung microbiome composition and structure with changes in lung function and development of COPD in this cohort. To address these aims, we will conduct a longitudinal study of 25 HIV-infected Pneumocystis pneumonia (PCP) subjects and 25 HIV-infected TB subjects, and we will perform research bronchoscopy at 3-months and 1-year after the completion of pneumonia treatment. We will compare the lung microbiome in these individuals at the time of pneumonia to the lung microbiome after the completion of treatment using PhyloChip and MiSeq and will correlate microbiome composition and structure with lung function and chest computed tomography measurements.

Public Health Relevance

This proposal studies the convergence of four of the greatest causes of morbidity and mortality in the world. Worldwide, HIV/AIDS, pneumonia, TB, and COPD are among the top 10 causes of death. The proposed studies have the potential for advancing our knowledge of the link between HIV-associated pneumonias, including TB, and COPD.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Midcareer Investigator Award in Patient-Oriented Research (K24)
Project #
2K24HL087713-06A1
Application #
8659967
Study Section
Special Emphasis Panel (ZHL1-CSR-X (O1))
Program Officer
Colombini-Hatch, Sandra
Project Start
2006-09-30
Project End
2018-12-31
Budget Start
2014-01-01
Budget End
2014-12-31
Support Year
6
Fiscal Year
2014
Total Cost
$181,443
Indirect Cost
$13,440
Name
University of California San Francisco
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
094878337
City
San Francisco
State
CA
Country
United States
Zip Code
94143
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Auld, Elizabeth; Lin, Jue; Chang, Emily et al. (2016) HIV Infection Is Associated with Shortened Telomere Length in Ugandans with Suspected Tuberculosis. PLoS One 11:e0163153
Drummond, M Bradley; Kunisaki, Ken M; Huang, Laurence (2016) Obstructive Lung Diseases in HIV: A Clinical Review and Identification of Key Future Research Needs. Semin Respir Crit Care Med 37:277-88
Katagira, Winceslaus; Walter, Nicholas D; Den Boon, Saskia et al. (2016) Empiric TB Treatment of Severely Ill Patients With HIV and Presumed Pulmonary TB Improves Survival. J Acquir Immune Defic Syndr 72:297-303
Cribbs, Sushma K; Uppal, Karan; Li, Shuzhao et al. (2016) Correlation of the lung microbiota with metabolic profiles in bronchoalveolar lavage fluid in HIV infection. Microbiome 4:3
Shenoy, Meera K; Iwai, Shoko; Lin, Din L et al. (2016) Immune Response and Mortality Risk Relate to Distinct Lung Microbiomes in HIV-Pneumonia Patients. Am J Respir Crit Care Med :
Walter, Nicholas D; de Jong, Bouke C; Garcia, Benjamin J et al. (2016) Adaptation of Mycobacterium tuberculosis to Impaired Host Immunity in HIV-Infected Patients. J Infect Dis 214:1205-11
Leader, Joseph K; Crothers, Kristina; Huang, Laurence et al. (2016) Risk Factors Associated With Quantitative Evidence of Lung Emphysema and Fibrosis in an HIV-Infected Cohort. J Acquir Immune Defic Syndr 71:420-7
Attia, Engi F; McGinnis, Kathleen A; Feemster, Laura C et al. (2015) Association of COPD With Risk for Pulmonary Infections Requiring Hospitalization in HIV-Infected Veterans. J Acquir Immune Defic Syndr 70:280-8
Koss, Catherine A; Jarlsberg, Leah G; den Boon, Saskia et al. (2015) A Clinical Predictor Score for 30-Day Mortality among HIV-Infected Adults Hospitalized with Pneumonia in Uganda. PLoS One 10:e0126591

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