MATERNAL INFLAMMATION, DIET AND GUT MICROBIOME IN HIV: IMPACT ON INFANT OUTCOMES

早产是儿童发病率和死亡率的主要原因之一。hiv感染 孕妇有更高的PTB发病率，这一人群值得进一步研究，以确定 危险因素一些风险因素，如母体CD 4计数低、病毒载量高、合并感染、合并症 和治疗方案与早产增加有关，但是否以及在多大程度上 炎症是未感染艾滋病毒人群中PTB的一个危险因素， 受感染的妇女仍有待研究。我正在寻求独立之路奖，以获得 额外的培训，以满足我的职业目标：成为一个独立的调查员进行研究， 产妇免疫、微生物和营养因素，影响母婴健康， 传染病，特别是艾滋病毒/艾滋病。在这样做的时候，我将富有成效地弥合不同学科的公共 卫生流行病学、免疫学、微生物学和营养学。本提案的培训计划结合了 各种形式的学习方法，包括教学课程、讲习班、学徒制， 出版物、定向阅读和职业发展研讨会和活动。这些是为我设计的 获得以下方面的特定技能：1）营养流行病学和围产期营养，2）微生物组数据分析。 我从培训计划中学到的能力将应用到提案的研究阶段 (K99尤其是R 00）。研究部分建议研究母亲饮食， 肠道微生物组和炎症及其与艾滋病毒感染孕妇中PTB的关联。 利用最近资助的一项针对400名艾滋病毒感染者和未感染者的NIH队列免疫学研究， 孕妇，我将在本母试验中嵌套我的研究，以收集饮食信息和粪便样本， 解决我的具体目标：1）检查怀孕期间炎症和发病率之间的关联 艾滋病毒感染孕妇的不良分娩结果，以及2）确定a）饮食 摄入量和B）HIV感染孕妇炎症状态肠道微生物组。考虑到这种饮食习惯 和肠道微生物组是两个可以影响炎症的环境可改变因素，我的研究将 确定减少炎症和改善HIV感染人群婴儿结局的机制。的 拟议的培训和研究计划将导致出版物和会议介绍，导致职业生涯 发展成为R 00阶段的独立调查员，并有能力成功地 申请R 01补助金

Preterm birth (PTB) is one of the leading causes of childhood morbidity and mortality. HIV-infected pregnant women have a greater incidence of PTB and this population warrants further studies to determine the risk factors. Some risk factors such as low maternal CD4 count, high viral load, co-infections, co-morbidities and treatment regimen are associated with increased preterm birth, but whether and the extent to which inflammation, a risk factor for PTB in HIV-uninfected populations, affects adverse birth outcomes among HIV- infected women remains to be studied. I am seeking the Pathway to Independence Award in order to gain additional training to meet my career goals: to become an independent investigator conducting research on maternal immune, microbiological and nutritional factors that affect maternal-child health in the context of infectious diseases, especially HIV/AIDS. In doing so, I will productively bridge the different disciplines of public health epidemiology, immunology, microbiology and nutrition. The training plan for this proposal combines various forms of learning methods including didactic courses, workshops, apprenticeships resulting in publications, directed readings and career development seminars and activities. These are designed for me to gain specific skills in: 1) Nutritional Epidemiology and Perinatal Nutrition, and 2) Microbiome data analyses. The competencies I learn from the training plan will then be applied to the research phase of the proposal (K99, and especially R00). The research component proposes to study the relationship between maternal diet, gut microbiome and inflammation and their association with PTB among HIV-infected pregnant women. Leveraging a recently funded NIH cohort immunology study of 400 HIV-infected and uninfected pregnant women, I will nest my study within this parent trial to collect dietary information and stool samples to address my specific aims: 1) Examine association between inflammation during pregnancy and incidence of adverse birth outcomes among HIV-infected pregnant women, and 2) Determine the relationship of a) dietary intake and b) gut microbiome with inflammation status among HIV-infected pregnant women. Given that diet and gut microbiome are two environmentally modifiable factors that can affect inflammation, my study will identify mechanisms to reduce inflammation and improve infant outcomes in HIV-infected populations. The proposed training and research plan will result in publications and conference presentations leading to career development to become an independent investigator during the R00 phase and with the ability to successfully compete for a R01 grant.