Multidisciplinary Collaborative Research in NIDDK Program Area Diseases

有资格证书的NIDDK临床工作人员拥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。NIDDK临床医生需要在糖尿病、内分泌学、新陈代谢、胃肠病学、肝病、肾脏病和血液学领域的专业知识提供咨询互动，才能为整个NIH临床研究中心的患者提供专门的医疗服务。除了患者支持服务，这些咨询互动导致合作的临床调查，以促进对疾病自然历史的研究，新的诊断和治疗方法，以及促进对疾病发病机制和病理生理学的理解。 临床服务包括： 1.过去一年设立的血糖管理服务，包括全面管理胰岛素缺乏或胰岛素抵抗的糖尿病患者。 2.内分泌、消化内科、肝脏内科、肾脏内科、囊性纤维化及血液内科的会诊服务。 3.胃肠内窥镜检查，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、持续静脉-静脉血液滤过、专门研究肾功能测试 最近完成的和正在进行的从咨询活动中产生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、肝肾并发症； 移植物抗宿主病的胃肠道并发症(NHLBI、NCI、NIAID)； 3.慢性肉芽肿性疾病(NIAID)、Hermansky-Pudlak综合征(NHGRI)和膀胱癌(NHGRI)的肝脏并发症； 4.镰状细胞性贫血(NHLBI)肾、肝并发症的自然病史及处理； 5.艾滋病毒病的肾脏并发症和艾滋病毒药物治疗(NIAID)； 6.周期性发热和系统性自身炎症性疾病(NIAMS)的肾脏表现和并发症； 7.遗传性膀胱癌(NHGRI)、慢性肉芽肿(NIAID)、von Hippel-Lindau病(NCI)的肾移植； 8.重组酶治疗法布里病(NINDS)的肾脏表现及疗效； 9.非清髓性干细胞移植(NHLBI)患者的膜性肾病； 10.显微镜下多血管炎、韦格纳肉芽肿(NIAID)、Wiskott-Aldrich综合征(NHGRI)患者的肾血管炎；

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 created within the past year which 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 Examples of recently completed and ongoing collaborative clinical research projects emerging from consultation activities 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 complications in periodic fever and systemic autoinflammatory diseases (NIAMS); 7. Kidney transplantation in hereditary cystinosis (NHGRI), chronic granulomatous disease (NIAID), von Hippel-Lindau disease (NCI); 8. Kidney manifestations and effects of recombinant enzyme treatment of Fabry disease (NINDS); 9. Membranous nephropathy in patients with non-myeloablative stem cell transplants (NHLBI); 10. Renal vasculitis in patients with microscopic polyangiitis, Wegener granulomatosis (NIAID), Wiskott-Aldrich syndrome (NHGRI);