Noroviruses (NoVs) are the most common cause of foodborne illnesses and acute non-bacterial gastroenteritis worldwide. The lack of a cell culture and animal model has hindered progress in understanding host susceptibility and host-viral interactions. Recently, NoVs have been identified as an important enteric pathogen of travelers'diarrhea. The principal investigator has a unique opportunity to study host genetic determinants and immune responses to NoV gastroenteritis in a large (n = 600) prospective cohort of US travelers to Mexico, India, or Peru. Our longterm goals are to: 1) to define important genetic determinants of susceptibility and mechanisms of host immunity to NoV infection to further vaccine development against NoVs, and 2) to identify vulnerable populations who may most benefit from vaccination. In order to achieve these goals, we propose the following specific aims: 1) to evaluate whether secretor status is an important determinant of risk of NoV infection, clinical severity of infection, and level of fecal viral shedding;2) to study the role of preexisting antibodies to NoVs in protection against NoV infection;3) to evaluate the cellular immune response elicited in subjects with NoV diarrhea. The 1st specific aim will be accomplished by secretor phenotyping with saliva specimens and genotyping from serum samples. NoV detection will be performed with quantitative real-time PCR and serum antibody conversion. The 2nd aim will be achieved by evaluating for preexisting anti-NoV antibodies and assessing for potential neutralization capacity of detected antibodies, with in vitro inhibition of VLP binding to histo-blood group antigen carbohydrates assays. The 3rd aim will be accomplished by measuring cytokines from fecal specimens and from NoV virus-like particle stimulation of peripheral blood mononuclear cells. The correlation between the intestinal immune response and the systemic immune response to NoV infection will be studied. This project will also provide essential training and skills for the development of the PI into a successful independent clinical investigator of enteric diseases.

Public Health Relevance

NoVs are important enteric pathogens of foodborne diseases and infects approximately 23 million people annually in the US. Susceptible populations include restaurant patrons, children, elderly, institutionalized patients, the military, and travelers. With a low infectious dose, ease of transmission, environmental stability, and resistance to cleansing agents, NoVs are considered as a Category B candidate agent of bioterrorism.

Agency
National Institute of Health (NIH)
Institute
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
1K23DK084513-01
Application #
7571922
Study Section
Microbiology and Infectious Diseases B Subcommittee (MID)
Program Officer
Podskalny, Judith M,
Project Start
2009-07-01
Project End
2013-06-30
Budget Start
2009-07-01
Budget End
2010-06-30
Support Year
1
Fiscal Year
2009
Total Cost
$177,121
Indirect Cost
Name
Baylor College of Medicine
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
051113330
City
Houston
State
TX
Country
United States
Zip Code
77030
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Crews, Jonathan D; Koo, Hoonmo L; Jiang, Zhi-Dong et al. (2014) A hospital-based study of the clinical characteristics of Clostridium difficile infection in children. Pediatr Infect Dis J 33:924-8
Koo, Hoonmo L; Neill, Frederick H; Estes, Mary K et al. (2013) Noroviruses: The Most Common Pediatric Viral Enteric Pathogen at a Large University Hospital After Introduction of Rotavirus Vaccination. J Pediatric Infect Dis Soc 2:57-60
Shah, D N; Bhatt, N S; Welch, J K et al. (2013) Defining acute renal dysfunction as a criterion for the severity of Clostridium difficile infection in patients with community-onset vs hospital-onset infection. J Hosp Infect 83:294-9
Khalaf, Natalia; Crews, Jonathan D; DuPont, Herbert L et al. (2012) Clostridium difficile: an emerging pathogen in children. Discov Med 14:105-13
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Siddiq, Danish M; Koo, Hoonmo L; Adachi, Javier A et al. (2011) Norovirus gastroenteritis successfully treated with nitazoxanide. J Infect 63:394-7
Ajami, N; Koo, H; Darkoh, C et al. (2010) Characterization of norovirus-associated traveler's diarrhea. Clin Infect Dis 51:123-30
Koo, Hoonmo L; Ajami, Nadim; Atmar, Robert L et al. (2010) Noroviruses: The leading cause of gastroenteritis worldwide. Discov Med 10:61-70
Koo, Hoonmo L; Ajami, Nadim J; Jiang, Zhi-Dong et al. (2010) Noroviruses as a cause of diarrhea in travelers to Guatemala, India, and Mexico. J Clin Microbiol 48:1673-6

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