The over-arching objectives of the Neuromedical Core (NMC) are to provide comprehensive clinical andlaboratory evaluations, scientific consultation, and mentorship, training, and community education inNeuroAIDS. In the current funding period the NMC facilitated 79 research projects including observationalcohort studies, clinical-pathological investigations, imaging studies, clinical trials and international researchperformed by collaborating investigators at UCSD and many other institutions. The HNRC's collaboratinginvestigators find data generated by the NMC, including neurological diagnostic formulations, antiretroviral(ARV) treatment information, HIV disease staging information, viral loads and a variety of other clinicallaboratory measurements, to be essential for their data analyses and publications.Recognizing that maintaining vitality and scientific relevance necessitates continual adaptation to thechanging needs of the HNRC research enterprise and the scientific agendas of its many principalinvestigators and collaborators, we propose to enhance the NMC in this renewal in two ways. First, we willadd a pharmacology component that will focus on ARV drug penetration into the CMS. Second, we willincorporate functions previously carried out by the Cellular Immunology and Fluids Core. The newly-organizedNMC is made up of three cooperative units, each comprising common resources (equipment,supplies) and staff that interact on a daily basis: a Clinical Unit; a Patient-Derived Sample Unit; and aPharmacology & Biomarker Unit. Examples of scientific questions the Core will facilitate answering are1) What is the contributory role in neuroAIDS of co-pathogens and comorbidities such as hepatitis C virus(HCV) and substance abuse? 2) Does cerebrospinal fluid (CSF) provide a useful window to evaluatevirus-host interactions and molecular pathogenesis in neuroAIDS? 3) What is the role of the CNS in viralevolution, adaptation and the occurrence of ARV drug resistance? 4) How do host genetics influence HIVneuropathogenesis?By assisting investigators in widely diverging disciplines at all levels of project development, fromconceptualization of hypotheses to study implementation, analysis, interpretation and dissemination, theNMC encourages the application of multiple scientific perspectives and stimulates interdisciplinarycollaboration and coordination. We will collaborate closely with the Neuroimaging, Neurobehavioral,Neurovirology and Neurobiology Cores to further stimulate transdisciplinary aims. In addition to supportingthe performance of research research, the NMC also enhances and extends the effectiveness and publichealth impact of new findings related to mental health and HIV/AIDS.
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