Candidate: Dr. Ghanem, M.D., is an Assistant Professor of Infectious Diseases and a Ph.D. candidate in the Graduate Training Program in Clinical Investigation at Johns Hopkins University School of Medicine. The goal of this K23 resubmission is to enhance his practical research skills and laboratory-based skills through focused didactics and the combined expertise of mentors and collaborators. These skills will complement the theoretical skills he has acquired thus far in his training, allowing him to become an independent and productive translational researcher. Background: Over 100 million women worldwide use hormonal contraceptives (HC). Their effects on mucosal and systemic immune responses are poorly understood. Observational studies have linked HC use to increased risk of sexually transmitted infection (STI) acquisition, including HIV. Preliminary Data: We have shown that cytokine production in a human-derived cervical and vaginal epithelial cell culture model was influenced by sex hormones in a compartment-specific manner. This finding was extended to a longitudinal study of 967 women where progesterone based HC were found to be independent predictors of lower genital tract inflammation.
Specific Aims : 1) To compare cervicovaginal lavage fluid to endocervical, ectocervical, and vaginal wicks in evaluating lower genital tract mucosal immune responses; 2) To determine whether the use of HC affects cervicovaginal levels of soluble and cellular markers of inflammation in women infected with Neisseria gonorrhoeae, before and after therapy; and 3) To determine whether the use of HC affects systemic humoral and T-cell responses directed against N. gonorrhoeae outer membrane proteins. Significance: The findings from this proposal will help define optimal methods to measure genital immune responses; they will provide data that may guide the introduction of STI screening strategies specifically targeting HC users, and they will help define the potential role of sex hormones as adjuvants for mucosal vaccines in women.

National Institute of Health (NIH)
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Mentored Patient-Oriented Research Career Development Award (K23)
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Pediatrics Subcommittee (CHHD)
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Kaufman, Steven
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Johns Hopkins University
Internal Medicine/Medicine
Schools of Medicine
United States
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Brotman, R M; Melendez, J H; Ghanem, K G (2011) A case control study of anovaginal distance and bacterial vaginosis. Int J STD AIDS 22:231-3
Blank, Leah J; Rompalo, Anne M; Erbelding, Emily J et al. (2011) Treatment of syphilis in HIV-infected subjects: a systematic review of the literature. Sex Transm Infect 87:9-16
Ghanem, Khalil G; Datta, S Deblina; Unger, Elizabeth R et al. (2011) The association of current hormonal contraceptive use with type-specific HPV detection. Sex Transm Infect 87:385-8
Johnson, Hope L; Ghanem, Khalil G; Zenilman, Jonathan M et al. (2011) Sexually transmitted infections and adverse pregnancy outcomes among women attending inner city public sexually transmitted diseases clinics. Sex Transm Dis 38:167-71
Ghanem, Khalil G; Moore, Richard D; Rompalo, Anne M et al. (2009) Lumbar puncture in HIV-infected patients with syphilis and no neurologic symptoms. Clin Infect Dis 48:816-21
Ghanem, Khalil G; Moore, Richard D; Rompalo, Anne M et al. (2008) Neurosyphilis in a clinical cohort of HIV-1-infected patients. AIDS 22:1145-51
Ghanem, Khalil G; Moore, Richard D; Rompalo, Anne M et al. (2008) Antiretroviral therapy is associated with reduced serologic failure rates for syphilis among HIV-infected patients. Clin Infect Dis 47:258-65
Brotman, Rebecca M; Erbelding, Emily J; Jamshidi, Roxanne M et al. (2007) Findings associated with recurrence of bacterial vaginosis among adolescents attending sexually transmitted diseases clinics. J Pediatr Adolesc Gynecol 20:225-31
Johnson, Hope L; Erbelding, Emily J; Zenilman, Jonathan M et al. (2007) Sexually transmitted diseases and risk behaviors among pregnant women attending inner city public sexually transmitted diseases clinics in Baltimore, MD, 1996-2002. Sex Transm Dis 34:991-4