Balkan Nephropathy: Environmental/Clinical Epidemiology

描述（由申请人提供） 本申请是对RFA-TW-02-002“新外国研究者全球健康研究倡议计划”的回应。主要研究者于2001年5月在密歇根州立大学（MSU）成功完成了NIH D43项目（ITREOH）（编号2 D43 TW 00641 -06）的培训，获得了流行病学硕士学位和巴尔干半岛的地方性肾病（BEN）研究。PI于2001年5月返回他的国家，目前与保加利亚索菲亚国家卫生、医学生态和营养中心（NCHMEN）有约。在NCHMEN，他担任流行病学实验室负责人，负责发展流行病学领域。目前，他继续对BEN进行研究并广泛发表。他在密歇根州立大学接受NIH 2 D43 TW 00641 -06的培训，并继续与密歇根州立大学合作，这将极大地促进他在NCHMEN和大索菲亚制定流行病学计划（培训和研究）的任务，以及他的BEN研究。 我们建议在保加利亚Vratza区开展巴尔干半岛的地方性肾病研究。BEN是一种疾病，仅影响巴尔干半岛的国家农村地区的人，包括保加利亚Vratza区。在该地区，这种疾病仍然是一个谜，风险因素仍然是假定的。有必要确定该疾病的病因，以便可能地防止其发展。BEN无症状地运行，因此，它在其最后阶段被诊断出来。诊断标准尚未明确。有必要在疾病的早期阶段确定临床发展，这将有助于及时发现和治疗。这项工作将为巴尔干半岛的地方性肾病的早期发现和诊断标准提供重要信息。通过本项目，我们希望提高我们对BEN的诊断标准和早期标志物的认识。因此，我们将有助于发现这种疾病，这种疾病在妇女中占主导地位-三分之二的病例是妇女。在环境层面，我们将确定该地区环境中存在的一些天然毒物是否有助于BEN的发展，以及这些毒物是否与该疾病的任何早期标志物有关。拟议的赠款将加强首席研究员与他的前美国科学导师之间的合作。

DESCRIPTION (provided by applicant) This application responds to RFA-TW-02-002 "Global Health Research Initiative Program For New Foreign Investigators". The Principal Investigator successfully completed his training under an NIH D43 Program (ITREOH), Number 2 D43 TW00641-06, in May 2001, at Michigan State University (MSU) for a Master's Degree in Epidemiology and research on Balkan Endemic Nephropathy (BEN). The PI returned to his country in May 2001 and presently has an appointment with the National Center of Hygiene, Medical Ecology and Nutrition (NCHMEN), Sofia, Bulgaria. In the NCHMEN, he occupies the position of the Head of Epidemiology Laboratory, and he is entrusted with the task of developing the field of Epidemiology. Currently he continues his research on BEN and publishes extensively. His training at MSU, under NIH 2 D43 TW00641-06, and continuing collaboration with MSU will greatly facilitate his task in developing an epidemiology program (training and research) at the NCHMEN and the greater Sofia, and his BEN research. We propose to conduct research on Balkan Endemic Nephropathy in Vratza district, Bulgaria. BEN is a disease, which affects people only in rural areas in Balkan countries, including Vratza district, Bulgaria. In the region, the disease is still a mystery and risk factors remain putative. There is a need to identify the etiology of the disease in order to possibly prevent its development. BEN runs asymptomatically, and, as a result, it is diagnosed at its latest stages. Diagnostic criteria are not well established. There is a need to identify the clinical development in the early stages of the disease, which will help for timely detection and possibly treatment. The proposed work would provide critical information for early detection and a scientific base for the diagnostic criteria of Balkan Endemic Nephropathy. Through this project, we expect to improve our knowledge about diagnostic criteria and early markers of BEN. Thus, we will contribute to the detection of the disease, which is predominant in women - 2/3 of cases are women. At the environmental level, we will identify whether some natural toxicants present in the environment in the region contribute to the development of BEN, and whether these are associated with any early markers of the disease. The proposed grant would strengthen collaboration between the Principal Investigator and his former U.S. scientific mentors.