Impact of intestinal helminth infection on HPV co-infection and the cervico-vaginal environment.

项目摘要 克拉克博士是贝勒医学院儿科热带医学和传染病的助理教授。 医学(BCM)和一名受过免疫寄生虫学培训的内科科学家。她的职业目标是成为一名 独立的分子流行病学家，并进行高质量的临床研究，以改善 生活在低资源环境中的人们。热带低地妇女癌症死亡的主要原因 乳头状瘤病毒(HPV)。患有大肠蠕虫的LMICs的宫颈癌发病率尤其高。 负担和初步数据显示，肠道蠕虫之间存在显著的种群水平关联 感染和人乳头瘤病毒感染。克拉克博士建议评估肠道蠕虫感染是否促进HPV 通过改变宫颈-阴道环境而引起的混合感染。她将对成年人进行一项横断面研究 秘鲁正在接受宫颈癌筛查的妇女。这项创新的研究旨在确定患病率 HPV感染，评估宫颈阴道细胞因子谱，检查宫颈阴道分布 有肠道蠕虫感染和无肠道蠕虫感染的妇女的微生物区系。这项工作的结果将是新颖的 预防生活在LMICs中的妇女患宫颈癌的迫切需要的干预措施。克拉克博士是独一无二的 技能组合将使她成为临床发现和公共卫生系统实施之间的纽带 预防宫颈癌的新策略。从公共卫生的角度来看，如果肠道蠕虫感染 增加妇女感染HPV的风险，从而增加宫颈癌的风险，驱虫-一种广泛可用的低成本- 成本干预--应降低宫颈癌发病率，从而增加宫颈癌的可行性 筛查计划的实施和降低与宫颈发育不良早期检测和治疗相关的成本 治疗方案。为了实现这些目标，克拉克博士发展了一个全面的职业生涯 将彻底的指导和培训活动结合到她的临床研究中的发展计划 程序。她将定期与她的导师团队，病毒权威伊丽莎白·焦立中博士举行会议 媒介恶性肿瘤和HPV筛查，以及寄生虫学和全球卫生领域的领导者彼得·霍特兹博士， 并将从她的科学顾问委员会获得额外的专家级指导。有指导的研究 将辅以正式的培训活动，包括研究生水平的课程、指导学习、广告 参加科学会议。她的职业发展计划得到了一位世界级的科学家的支持 BCM的环境，为初级教师的发展提供了充足的机会，并提供了所有 实现她的职业目标所需的资源。拟议的有指导的职业发展活动将 提供克拉克博士成功所需的有重点的指导和职业发展活动 独立资助的分子流行病学家，从事高质量、高影响力的国际研究。

Project Summary Dr. Clark is an Assistant Professor of Pediatric Tropical Medicine and Infectious Diseases at Baylor College of Medicine (BCM) and a physician-scientist trained in immunoparasitology. Her career goal is to become an independent molecular epidemiologist and perform high-quality clinical research that improves the health of people living in low resource settings. The leading cause of cancer death for women in tropical low- and middle-income countries (LMICs) is cervical cancer, which is caused by persistent infection with the human papilloma virus (HPV). Cervical cancer rates are particularly high in LMICs with large intestinal helminth burdens, and preliminary data show a significant population level association between intestinal helminth infection and HPV infection. Dr. Clark proposes to evaluate whether intestinal helminth infection facilitates HPV co-infection by altering the cervico-vaginal environment. She will conduct a cross-sectional study of adult women undergoing cervical cancer screening in Peru. This innovative study aims to determine the prevalence of HPV infection, evaluate cervico-vaginal cytokine profiles, and examine the distribution of cervico-vaginal microbiota in women with and without intestinal helminth infection. Results of this work will suggest novel interventions that are urgently needed to prevent cervical cancer in women living in LMICs. Dr. Clark’s unique skill set will allow her to serve as a link between clinical discovery and public health system implementation of new strategies for cervical cancer prevention. From a public health perspective, if intestinal helminth infection increases a woman’s risk for HPV infection and therefore cervical cancer, deworming—a widely available, low- cost intervention—should reduce the cervical cancer rates, thereby increasing the feasibility of cervical cancer screening program implementation and reducing costs associated with early cervical dysplasia detection and treatment programs. To accomplish these goals, Dr. Clark has developed a comprehensive career development plan that combines thorough mentoring and training activities integrated into her clinical research program. She will have regular meetings with her mentorship team, Dr. Elizabeth Chiao, an authority in virus mediated malignancies and HPV screening, and Dr. Peter Hotez, a leader in parasitology and global health, and will receive additional expert-level mentorship from her scientific advisory committee. Mentored research will be supplemented with formal training activities including graduate-level coursework, directed studies, ad participation in scientific meetings. Her career development plan is supported by a world-class scientific environment at BCM, which offers ample opportunities for junior faculty development and provides all the resources needed to achieve her career goals. The proposed mentored career development activities will provide the focused mentorship and career development activities that Dr. Clark requires to succeed as an independently funded molecular epidemiologist conducting high quality, high impact international research.