HIV activation in secondary pulmonary infection

描述（由申请人提供）：我是一名临床研究者，研究兴趣是肺部感染的病理生物学。我对通过支气管肺泡灌洗获得的临床样本进行分子检测，然后在模型系统中进行机制研究。这种方法是富有成效的，在培训临床研究者方面是有效的。我的研究得到了2个R 01赠款的支持。“肺中的HIV/TB相互作用”研究了静息肺泡巨噬细胞表达一组转录抑制因子的假设，这些转录抑制因子通常抑制肺中的HIV复制。在结核病（TB）期间，炎性细胞被募集到肺，接触巨噬细胞，并抑制HIV-1 LTR。来自炎症细胞的可溶性因子然后激活转录。这两步过程对于在结核病患者中观察到的HIV-1高水平复制是必要和充分的。第二个最近资助的R 01支持的研究，我是一个共同的PI，题为“艾滋病毒相关的细菌性肺炎的纵向研究。“这项研究扩展了实验室研究细菌性肺炎的工作。第二项研究的假设是，接受抗逆转录病毒治疗的艾滋病毒阳性个体将继续发展细菌性肺炎和其他肺部感染，这将导致肺部特征性细胞募集和激活。这一过程将增强HIV-1的复制和突变，加速艾滋病的进程。纵向研究是该基金研究部分的主题。目前，我在临床服务方面投入了45%的精力。K24以患者为导向的研究中期职业研究者奖将使我能够将患者护理责任减少到10%，因此我可以更加专注于培训下一代临床研究者。我将能够增加2倍的医生，我可以充分指导他们进行转化研究。K24奖的第二个目标是获得传染病流行病学的培训，并在哥伦比亚大学的MPH计划录取。这种教学经验将加强我与流行病学家的合作，并使我能够学习分析大型数据集所需的定量技术。K24奖提供的支持将增强我参与转化研究项目的潜力，这些项目旨在开发有效的新策略，以改善继发性肺部感染的HIV感染患者的护理。

DESCRIPTION (provided by applicant): I am a clinical investigator with a research interest in the pathobiology of pulmonary infections. I perform molecular assays on clinical samples obtained by bronchoalveolar lavage and then conduct mechanistic studies in model systems. This approach has been productive and has been effective in training clinical investigators. My research is supported by 2 R01 grants. "HIV/TB Interaction in the Lung" investigates the hypothesis that resting alveolar macrophages express a set of transcriptional repressers that normally inhibit HIV replication in the lung. During tuberculosis (TB), inflammatory cells are recruited to the lung, contact macrophages, and derepress the HIV-1 LTR. Soluble factors from the inflammatory cells then activate transcription. This 2-step process is necessary and sufficient for the high-level replication of HIV-1 observed in persons with TB. A second recently funded R01-supported study, for which I am a co-Pi, is titled "Longitudinal Studies of HIV-Associated Bacterial Pneumonia." This study extends the work of the laboratory to investigate bacterial pneumonia. The hypothesis of this second study is that HIV-positive individuals receiving antiretroviral therapy will continue to develop bacterial pneumonia and other pulmonary infections that will lead to characteristic cellular recruitment and activation in the lung. This process will enhance HIV-1 replication and mutation, accelerating the course of AIDS. The longitudinal study is the subject of the research section of this grant. I currently spend 45% effort in clinical service. The K24 Midcareer Investigator Award in Patient-Oriented Research would enable me to reduce patient care responsibilities to 10% effort, so I can increase my focus on training the next generation of clinical investigators. I will be able to increase by 2-fold the number of physicians who I can adequately mentor in translational research. A second goal of the K24 award is to obtain training in infectious diseases epidemiology and matriculate in the MPH program at Columbia University. This didactic experience will enhance my collaboration with epidemiologists and will allow me to learn the quantitative techniques required to analyze large data sets. The support provide by the K24 award will enhance my potential to participate in translational research programs that develop effective novel strategies for the improved care of HIV-infected patients with secondary pulmonary infections.