Multidisciplinary Collaborative Research in NIDDK Program Area Diseases

获得认证的NIDDK临床工作人员具有必要的相关专业知识，以支持参与校内研究计划中所有研究所和中心进行的临床研究的人类受试者的患者护理需求。 需要NIDDK临床医生提供的在糖尿病、内分泌学、代谢、胃肠病学、肝病学、肾病学和血液学领域具有专业知识的咨询互动，以便在NIH的临床研究中心向患者提供专业医疗服务。 除了患者支持服务，这些咨询互动导致合作临床研究，以推进疾病的自然史，新的诊断和治疗方法的研究，以及推进对疾病发病机制和病理生理学的理解。 临床服务包括： 1. 血糖管理服务为胰岛素不足或胰岛素抵抗的糖尿病患者提供全面的血糖管理服务。 2. 内分泌科、消化科、肝病科、肾病科、囊性纤维化和血液科的咨询服务。 3. 胃肠道内窥镜检查，包括活组织检查和治疗程序 4. 肝活检和肝纤维扫描 5. 肾活检、血液透析、连续性静脉-静脉血液滤过、专门研究肾功能检查 6. 生物储存库：收集、条形码化、索引、储存和检索人类样本 7. 为临床研究方案的制定、监测和分析提供生物统计学支持 咨询服务和临床核心服务中出现的已完成和正在进行的合作临床研究项目的例子包括： 1. 转移性黑色素瘤免疫治疗、干细胞移植、化疗和新型生物抗肿瘤药物（NCI、NHLBI）的内分泌、胃肠道、肝脏和肾脏并发症; 2. 移植物抗宿主病的胃肠道并发症（NHLBI、NCI、NIAID）; 3. 慢性肉芽肿病（NIAID）、Hermansky-Pudlak综合征（NHGRI）和胱氨酸病（NHGRI）的肝脏并发症; 4. 镰状细胞性贫血（NHLBI）肾脏和肝脏并发症的自然史和处理; 5. HIV疾病和HIV药物治疗的肾脏并发症（NIAID）; 6. 法布里病的肾脏表现和重组酶治疗的效果; 7. 非清髓性干细胞移植（NHLBI）患者的膜性肾病; 8. Wiskott-Aldrich综合征肾血管炎（NHGRI）; 9. 干细胞移植中的内皮损伤和血栓性微血管病（NHLBI、NCI、NIAID）

Credentialed NIDDK clinical staff members have relevant expertise necessary to support patient care needs of human subjects involved in clinical research conducted by all institutes and centers in the intramural research program. Consultative interactions provided by NIDDK clinicians with expertise in the fields of diabetes, endocrinology, metabolism, gastroenterology, hepatology, nephrology and hematology are required for delivery of specialized medical services to patients throughout the Clinical Research Center at NIH. Beyond patient support services, these consultative interactions lead to collaborative clinical investigations to advance the study of natural history of disease, new approaches to diagnosis and treatment, as well as advancing the understanding of disease pathogenesis and pathophysiology. Clinical services include: 1. Blood Glucose Management Service involves comprehensive management of patients with insulin deficient or insulin resistant diabetes mellitus. 2. Consultation services in endocrinology, gastroenterology, hepatology, nephrology, cystic fibrosis and hematology. 3. Gastrointestinal endoscopy, including biopsies and therapeutic procedures 4. Liver biopsies and liver fibroscanning 5. Renal biopsies, hemodialysis, continuous veno-venous hemofiltration, specialized research renal function tests 6. Biorepository: collection, barcoding, indexing, storing, and retrieving human samples 7. Biostatistical support for developing, monitoring, analyzing clinical research protocols Examples of completed and ongoing collaborative clinical research projects emerging from consultation services and clinical core services include: 1. Endocrine, gastrointestinal, liver and kidney complications of immunotherapy of metastatic melanoma, stem cell transplantation, chemotherapy and novel biologic anti-tumor agents (NCI, NHLBI); 2. Gastrointestinal complications of graft versus host disease (NHLBI, NCI, NIAID); 3. Liver complications of chronic granulomatous disease (NIAID), Hermansky-Pudlak syndrome (NHGRI) and cystinosis(NHGRI); 4. Natural history and management of kidney and liver complications of sickle cell anemia (NHLBI); 5. Renal complications of HIV disease and HIV drug therapies (NIAID); 6. Kidney manifestations and effects of recombinant enzyme treatment of Fabry disease (NINDS); 7. Membranous nephropathy in patients with non-myeloablative stem cell transplants (NHLBI); 8. Renal vasculitis in Wiskott-Aldrich syndrome (NHGRI); 9. Endothelial injury and thrombotic microangiopathy in stem cell transplants (NHLBI, NCI, NIAID)