Optimizing interventions to mitigate schistosomiasis-related morbidity among pregnant women and children

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Project Summary This renewal application for a K24 seeks to continue to provide time for the candidate, Jennifer Friedman, MD, PhD, to provide mentorship to junior faculty in patient oriented research (POR) with a focus on optimizing interventions for parasitic diseases among pregnant women and children. The second goal is to provide time for Dr. Friedman to further her own career development through a) pursuit of advanced education in Structural Equation Modeling and characterization of the human microbiome and b) leading policy changes to include pregnant women and young children in treatment programs for schistosomiasis. Dr. Friedman proposes to continue to mentor junior faculty and fellows conducting POR at the Center for International Health Research (CIHR). The Center is an outstanding model for interdisciplinary team science, where most faculty are physician-scientists and other scientists carry out translational research as an integral part of these teams. In the first phase of this K24, Dr. Friedman closely mentored five junior faculty at CIHR. Of these, four were recipients of Career Development Awards with Dr. Friedman as primary or co-mentor and the other was a target young investigator on a large training grant (Centers for Biomedical Research Excellence (COBRE)) in infectious diseases. In addition, one mentee (Levine) received his first independent grants (R03 and R01) in 2017 with grant writing mentorship provided by Dr. Friedman. The overarching scientific goal of this proposal is to advance studies elucidating mechanisms through which schistosomiasis contributes to environmental enteropathy, culminating in microbial translocation, systemic immune activation, and adverse pregnancy and nutritional outcomes. Dr. Friedman has two current R01s that provide outstanding opportunities for junior faculty to conduct POR in global health. The first is a longitudinal birth cohort (PIs Friedman, Gundogan) that has already enrolled N=400 pregnant women and is now following the newborns until age two. The second is a multi-site RCT (PIs Friedman, Bustinduy) examining optimal dose and dosing frequency of praziquantel for children under the age of four. Both grants provide both opportunities to conduct field work at sites with longstanding collaborations and will offer a wealth of well characterized data and samples to address the aims proposed in this K24 as well as other aims conceived of by mentees. They will also be able to engage in other NIH grants at CIHR with co-mentoring by Dr. Friedman and other faculty (see letters of support). Brown University affiliated hospitals provide a rich source of potential mentees from a range of Divisions housing junior faculty interested in conducting POR in infectious diseases. In addition, although there are numerous other training grants at Brown affiliates, there are two T32 awards, two COBRE awards, and one R25, which could specifically provide a pipeline for young investigators and co-funding in research areas of interest to Dr. Friedman.