Mentorship and Patient-Oriented Research in Tuberculosis, HIV and Global Health

描述(由申请人提供)：尼尔·甘地，医学博士，埃默里罗林斯公共卫生学院的内科科学家，80%的精力致力于以患者为中心的研究(POR)。他通过K24职业中期调查员奖寻求资金，以扩大他在耐药结核病(TB)、艾滋病毒和全球卫生方面的POR计划，并指导这些领域的临床调查人员。耐药结核病和艾滋病毒之间的交集是一个新出现的全球公共卫生问题，威胁着十年来在结核病控制方面取得的成果。除了培养一批受过结核病/艾滋病毒和全球卫生POR培训的科学家外，越来越需要在结核病基因组学、免疫学和治疗学方面进行创新研究。在过去的十年里，甘地博士一直致力于结核病/艾滋病毒和全球健康方面的临床、流行病学和转化性研究，包括迄今成功指导了24名学员的良好记录。埃默里大学通过其学位项目(公共卫生硕士、硕士、博士)、博士后奖学金和多学科中心(CTSA、CFAR、全球卫生)，为培训临床研究人员提供了良好的环境。在这种非常有利的培训环境中，甘地博士创建了一个全面的指导计划，重点是设计和负责任地进行假设驱动的研究，以帮助受训者成为独立的调查人员。这一K24奖项将极大地促进PI的近期和长期职业目标，其中包括：1)了解全基因组测序如何进一步阐明耐药结核病流行中获得性耐药和传播的机制；2)增进他的人类免疫学知识，为未来关于艾滋病毒感染者中结核病易感性增加的研究提供信息；3)扩展临床试验技能，以促进耐药结核病和结核病/艾滋病毒试验的设计和实施；以及4)加强他对寻求以患者为导向的结核病、艾滋病毒和全球卫生研究职业生涯的受训者的指导结构和内容。该奖项将利用美国国立卫生研究院资助的对南非耐药结核病和艾滋病毒的多项研究框架，调查两个新的具体研究目标：1)检查在对治疗产生额外耐药性的耐多药结核病受试者中出现的结核分枝杆菌基因组的多态；2)调查全基因组测序在识别大基因群中广泛耐药结核病传播的微群方面的增量收益。K24奖项将使甘地博士能够继续他在结核病、艾滋病毒和全球健康方面非常成功的研究计划，并指导这一重要研究领域的下一代研究人员。

DESCRIPTION (provided by applicant): Neel Gandhi, M.D., is a physician-scientist at Emory's Rollins School of Public Health with 80% effort dedicated to patient-oriented research (POR). He seeks funding through the K24 Midcareer Investigator Award to expand his POR program in drug-resistant tuberculosis (TB), HIV and global health, and to mentor clinical investigators in these areas. The intersection between drug-resistant TB and HIV is an emerging global public health issue which threatens a decade of gains in TB control. There is a growing need for innovative research in TB genomics, immunology, and therapeutics, in addition to developing a pool of scientists trained in TB/HIV and global health POR. Dr. Gandhi has demonstrated a commitment to clinical, epidemiologic and translational research in TB/HIV and global health over the past decade, including a strong record of successfully mentoring 24 trainees, to date. Emory University provides a robust environment for training clinical investigators through its degree programs (MPH, MS, PhD), post-doctoral fellowships and multi-disciplinary centers (CTSA, CFAR, Global Health). Within this highly conducive training environment, Dr. Gandhi has created a comprehensive mentoring program that focuses on the design and responsible conduct of hypothesis-driven research to assist trainees in becoming independent investigators. This K24 award will greatly facilitate the PI's immediate and long-term career goals, which include to: 1) Understand how whole genome sequencing can further elucidate mechanisms of acquired resistance and transmission in drug- resistant TB epidemics; 2) Advance his knowledge of human immunology to inform future studies of increased TB susceptibility among HIV-infected individuals; 3) Expand clinical trials skills to facilitate the design and implementation of drug-resistant TB and TB/HIV trials; and 4) Enhance the structure and content of his mentorship of trainees pursuing careers in patient- oriented TB, HIV and Global Health research. This award will utilize a framework of multiple NIH-funded studies in drug-resistant TB and HIV in South Africa to investigate two novel specific research aims: 1) To examine polymorphisms in the M.tuberculosis genome which arise among MDR TB subjects who develop additional resistance on treatment, and 2) To investigate the incremental yield of whole genome sequencing in identifying micro-clusters of XDR TB transmission in large genotypic clusters. The K24 award will allow Dr. Gandhi to continue his highly-successful research program in TB, HIV and global health, and mentor the next generation of investigators in this vital research field.