Dr. Angela Peck is a 3rd year fellow in Pediatric Infectious Diseases at the University of Washington. Her long-term goal is an academic career, with a clinical research program that uses novel laboratory assaysto study the epidemiology and pathogenesis of respiratory virus infections among healthy and immuno- compromised patients. She has long-standing interests and research experience in the field of respiratory viruses, and her proposed career development plan incorporates an intense, closely mentored patient- oriented training environment with a plan for a comprehensive didactic curriculum. Dr. Peck will investigate parainfluenza virus (PIV) infections after hematopoietic cell transplant (HCT). PIV infections are not only common, but often severe and fatal in HCT recipients, and frequently cause pulmonary sequelae among long-term survivors. Even upper respiratory infection with PIV is associated with increased mortality after HCT. Preliminary data suggest that PIV infection occurs frequently in the absence of symptomsamong HCT recipients. The overall hypothesis of this proposal is that asymptomatic, or subclinical, PIV shedding in HCT recipients is common, related to host immunologic factors, and may increase PIV transmission to others.
For Aims 1 and 2, a cohort of 500 HCT recipients will be followed with nasal wash sampling and serum collection for 1 year after HCT. By testing the respiratory samples for PIV using RT-PCR, these studies will define frequency and duration of PIV shedding, risk factors for symptomatic progression, and correlation of PIV virus quantitation and disease severity. Serum samples from patients in this cohort will be tested for PIV-specific neutralizing antibody, and a nested case-control analysiswill be performed to determine whether humoral immunity is protective against acquisition and progression of PIV infection in HCT recipients.
Aim 3 is to develop and validate a new self-collection method of nasal secretions for detection of respiratory viruses by RT-PCR. This method will be compared to nasal washes, the current standard of care. By characterizing PIV infections that occur without symptoms after HCT, and studying factors which affect whether patients acquire PIV and progress to serious disease, these studies may ultimately provide targets for PIV prevention and therapy. Development of a self-collection method will allow for frequent sampling in outpatients, and provide a foundation for future studies of PIV pathogenesis and transmission.

National Institute of Health (NIH)
National Heart, Lung, and Blood Institute (NHLBI)
Mentored Patient-Oriented Research Career Development Award (K23)
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Special Emphasis Panel (ZHL1-CSR-R (O1))
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Mondoro, Traci
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Seattle Children's Hospital
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Ogimi, Chikara; Xie, Hu; Leisenring, Wendy M et al. (2018) Initial High Viral Load Is Associated with Prolonged Shedding of Human Rhinovirus in Allogeneic Hematopoietic Cell Transplant Recipients. Biol Blood Marrow Transplant 24:2160-2163
Xue, Katherine S; Stevens-Ayers, Terry; Campbell, Angela P et al. (2017) Parallel evolution of influenza across multiple spatiotemporal scales. Elife 6:
Cheng, Guang-Shing; Campbell, Angela P; Xie, Hu et al. (2016) Correlation and Agreement of Handheld Spirometry with Laboratory Spirometry in Allogeneic Hematopoietic Cell Transplant Recipients. Biol Blood Marrow Transplant 22:925-31
Campbell, Angela P; Guthrie, Katherine A; Englund, Janet A et al. (2015) Clinical outcomes associated with respiratory virus detection before allogeneic hematopoietic stem cell transplant. Clin Infect Dis 61:192-202
Chu, Helen Y; Englund, Janet A; Podczervinski, Sara et al. (2014) Nosocomial transmission of respiratory syncytial virus in an outpatient cancer center. Biol Blood Marrow Transplant 20:844-51
Seo, S; Xie, H; Karron, R A et al. (2014) Parainfluenza virus type 3 Ab in allogeneic hematopoietic cell transplant recipients: factors influencing post-transplant Ab titers and associated outcomes. Bone Marrow Transplant 49:1205-11
Seo, Sachiko; Xie, Hu; Campbell, Angela P et al. (2014) Parainfluenza virus lower respiratory tract disease after hematopoietic cell transplant: viral detection in the lung predicts outcome. Clin Infect Dis 58:1357-68
Seo, Sachiko; Campbell, Angela P; Xie, Hu et al. (2013) Outcome of respiratory syncytial virus lower respiratory tract disease in hematopoietic cell transplant recipients receiving aerosolized ribavirin: significance of stem cell source and oxygen requirement. Biol Blood Marrow Transplant 19:589-96
Waghmare, Alpana; Campbell, Angela P; Xie, Hu et al. (2013) Respiratory syncytial virus lower respiratory disease in hematopoietic cell transplant recipients: viral RNA detection in blood, antiviral treatment, and clinical outcomes. Clin Infect Dis 57:1731-41
Campbell, Angela P; Kuypers, Jane; Englund, Janet A et al. (2013) Self-collection of foam nasal swabs for respiratory virus detection by PCR among immunocompetent subjects and hematopoietic cell transplant recipients. J Clin Microbiol 51:324-7

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