Investigating the role of altered lung microbiome in fueling Th17 mediated airway inflammation in COPD among HIV-infected individual

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Abstract Research bronchoscopies have enabled access to distal airway samples by investigators, yielding valuable information about the inflammatory processes in distal airways. Such procedures, however, pose a significant burden on research participants, with a thin line between risk and benefit. In Uganda, we lack national policies on elective research bronchoscopy. Furthermore, community engagement, a critical aspect of ethical research conduct, is not routinely done in most bronchoscopy studies in Uganda. Therefore, there is a pressing need to explore potential participants’ understanding of research bronchoscopy, what would motivate them to participate in research bronchoscopy, and their concerns in order to inform consenting processes for future clinical studies and national policy. Within the research framework of the ongoing HIV-BAL study (R21 study) in the rural Nakaseke district of Uganda, aimed at investigating the association between lung microbiome and immune profile in the distal airways of HIV-infected individuals with COPD in a Ugandan HIV cohort, we propose to (i) explore the needs and concerns of prospective research bronchoscopy participants in rural Ugandan communities; (ii) develop and integrate a community engagement plan promoting community-based participatory research in bronchoscopy studies and (iii) integrate a mentored non-degree bioethics training in research bronchoscopy in Uganda. With the successful execution of our plan, we hope to inform study design, information provision, and consenting processes in bronchoscopy studies in Uganda. Ultimately, we hope to inform national guidelines governing research bronchoscopies in Uganda.