AUTOIMMUNITY CENTERS OF EXCELLENCE

RELEASE DATE:  May 13, 2002 

(see addendum NOT-AI-02-053)

RFA: AI-02-006 - (Reissued as RFA-AI-08-010)

PARTICIPATING INSTITUTES AND CENTERS (ICs):  
National Institute of Allergy and Infectious Diseases  
 (http://www.niaid.nih.gov)
National Institute of Diabetes and Digestive and Kidney Diseases 
 (http://www.niddk.nih.gov/)
Office of Research on Women's Health, NIH 
 (http://www4.od.nih.gov/orwh)

LETTER OF INTENT RECEIPT DATE: September 17, 2002
APPLICATION RECEIPT DATE: October 16, 2002

APPLICATIONS IN RESPONSE TO THIS REQUEST FOR APPLICATIONS (RFA) MUST BE 
PREPARED USING A MULTI-PROJECT GRANT APPLICATION FORMAT; SPECIFIC INSTRUCTIONS 
FOR COMPLETING THE APPLICATION ARE IN THE NIAID BROCHURE ENTITLED 
"INSTRUCTIONS FOR APPLICATIONS FOR MULTI-PROJECT AWARDS" at 
http://www.niaid.nih.gov/ncn/grants/multibron.htm

THIS RFA CONTAINS THE FOLLOWING INFORMATION

o Purpose of this RFA
o Research Objectives
o Mechanism(s) of Support 
o Funds Available
o Eligible Institutions
o Individuals Eligible to become Principal Investigators
o Special Requirements 
o Cooperative Agreement Terms and Conditions of Award
o Where to send Inquiries
o Letter of Intent
o Submitting an Application
o Special Instructions for Completion of Applications in Response to This RFA
o Peer Review Process
o Review Criteria
o Receipt and Review Schedule
o Award Criteria
o Required Federal Citations

PURPOSE OF THIS RFA 

The National Institute of Allergy and Infectious Diseases (NIAID), National 
Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), and the 
Office of Research on Women's Health (ORWH) invite applications for 
Autoimmunity Centers of Excellence (ACEs).  The purpose of this cooperative 
research program is to support integrated basic, pre-clinical and clinical 
research centers to: conduct single site and multi-site cooperative clinical 
trials and studies of mechanisms of action of tolerance induction and new 
immune modulation interventions in multiple autoimmune diseases; accelerate 
early translation of basic findings into clinical application; facilitate the 
utilization of clinical materials for basic research studies; enhance the 
exchange of information between basic scientists and clinicians and among 
various specialists involved in treating autoimmune diseases; and establish a 
collaborative approach to clinical and basic research among multiple 
institutions in various geographic areas. Each Center will include: 1) a 
clinical component, incorporating multiple clinical specialists to conduct 
trials and clinical studies of new immunotherapies for autoimmune diseases in 
cooperation with other Center clinical components; and 2) two or more 
multidisciplinary, interactive basic and/or pre-clinical research components, 
focused on elucidation of the basic mechanisms of autoimmunity, self tolerance 
and/or immune modulation. The basic and clinical components of all Centers 
will work cooperatively to select, design, and perform the clinical 
trials/studies and the adjunct basic mechanistic studies. All applicants must 
comply with the Cooperative Agreement Terms and Conditions of Award presented 
below.

RESEARCH OBJECTIVES

Background

Autoimmune diseases result from direction of an immune response towards the 
body's own tissues.  The most common of these diseases include systemic lupus 
erythematosus, multiple sclerosis, type 1 diabetes mellitus, and rheumatoid 
arthritis.  However, the immune response toward self can affect any organ or 
organ system, resulting in a wide variety of autoimmune diseases, including 
autoimmune myositis, thyroid disease, oophoritis and orchitis, hepatitis, 
hemolytic anemia, pemphigus, inflammatory bowel disease, and alopecia.  Many 
of these autoimmune diseases by themselves are considered orphan diseases, but 
in toto autoimmune diseases disproportionately afflict millions of women in 
this country. The costs of these diseases are enormous, including 
hospitalizations, outpatient visits, lost productivity, and decreased quality  
of life for patients and their families.

The underlying immune mechanisms of these multiple diseases may be 
overlapping. Self-reactive T cells play an important role in the immune 
responses leading to many of these clinically divergent diseases. The 
presence, number, activity, and specificity of these self-reactive cells are 
regulated by complex processes involving multiple molecules and mechanisms. 
These include: the binding and presentation of antigen by the molecules of the 
major histocompatibility complex (MHC); the number and affinity of specific T 
cell receptors for these complexes; the presence of co- stimulatory molecules, 
including the B.7 and CD40 families; the activity of regulatory T cells, both 
T helper and T cytotoxic cells; the presence and pattern of extracellular 
mediators including cytokines, lymphokines, and chemokines; and the 
intracellular pathways leading to apoptosis or cell death. Strategies to 
interrupt the immune response at any of these sites could prevent or down 
regulate the self-reactive response leading to autoimmune disease. In fact, 
agents which block co-stimulatory signals (anti-CD40L, CTLA4-Ig) or cytokines 
(anti-TNF-alpha, TNFR:Fc, IL-1Ra), interrupt or alter binding of antigen to 
MHC (antigen peptides, MHC peptides, peptide oligomers), or modulate the 
appearance and activity of regulatory cells (various cytokines and anti-
cytokines) are now being evaluated for treatment of multiple autoimmune 
diseases.  Equally, T cell independent mechanisms may be important mediators 
of B cell tolerance.  Thus, approaches that target various molecules in these 
unique pathways, including complement, B cell receptor, PD-1, CD22, Fc?Rs, 
CD19, and B lymphocyte stimulator (BlyS), are under evaluation.  Other 
approaches are likely to be discovered in the next few years. Clinical 
evaluation of new immune interventions in various diseases has often been 
performed without basic mechanistic studies to define the actions of the 
experimental agents. Closer interactions between clinicians and basic 
scientists should accelerate clinical testing of new approaches to tolerance 
induction and immune modulation and enhance understanding of their underlying 
mechanisms of action.

Since the affected organ systems vary in different diseases, autoimmune 
diseases are usually treated by multiple clinical specialists. Thus, multiple 
sclerosis is treated by neurologists; type 1 diabetes, Graves' disease, and 
Hashimoto's thyroiditis by endocrinologists; systemic lupus erythematosus, 
rheumatoid arthritis, and scleroderma by rheumatologists; idiopathic 
thrombocytopenia purpura by hematologists; and inflammatory bowel disease by 
gastroenterologists. Many of these diseases are treated by multiple 
specialists. Because all these diseases will be increasingly approached with 
immunologic interventions, a cooperative group with the capability to evaluate 
a new agent in any of a number of diseases offers considerable advantages. 
Increased interaction of clinical specialists in planning, performance, and 
evaluation of trials/studies should lead to a more coordinated approach to 
development of new immune-based therapies for all autoimmune diseases.

Research Objectives and Scope

The major goal of this program is to support an integrated basic and clinical 
research program focused on tolerance induction and immune modulation to 
prevent or treat autoimmune disease.  The close interaction between basic 
researchers and clinicians will accelerate the translation of basic advances 
to the clinic and the utilization of patient materials for basic research. 
NIAID is seeking multidisciplinary centers that emphasize new ideas, novel 
approaches, and state of the art technology to increase our understanding of 
the basic mechanisms of autoimmunity and self tolerance and the translation of 
that knowledge to design and evaluate clinical interventions to prevent or 
treat autoimmune diseases. The clinical components of the Autoimmunity Centers 
of Excellence will perform pilot or exploratory clinical trials or clinical 
studies, hereafter designated clinical trials/studies, in patients with 
autoimmune disease(s) to test, evaluate, develop, or determine mechanism of 
action of agents or interventions to prevent or treat autoimmune disease by 
induction of tolerance or immune modulation. While industry has supported some 
translational activities, industry-supported trials have generally not focused 
on questions about the basic mechanisms of action of these agents. 
Collaboration of the Autoimmunity Centers of Excellence with industry in 
performance of clinical trials/studies and adjunct basic mechanistic studies 
is encouraged.

Specific areas of interest include, but are not limited to:

o  clinical trials of tolerogenic and immunomodulatory approaches and agents 
to treat and prevent autoimmune disease, including co-stimulatory blockade, 
such as anti-CD40 ligand antibody and CTLA4-Ig; cytokines and anti-cytokine 
molecules, such as anti-TNF, IL-4, and IL-12; and peptide ligands, such as MHC 
peptides, antigen-specific peptides, or peptide oligomers;

o  clinical trials of novel approaches to modulate B cell tolerance, including 
anti-CD19, anti CD22, anti-BlyS, and anti-apoptotic agents; 

o  immune ablation with or without reconstitution with hematopoietic stem cell 
or bone marrow transplantation for treatment of autoimmune disease; 
determination of course of development of tolerance and/or immunity, the cells 
that are necessary for tolerance induction, and the role of chimerism;

o  relationship of response to therapy and various parameters: stage of 
disease, subsets of disease (i.e., relapsing vs. chronic progressive multiple 
sclerosis), patient characteristics including race, ethnic background, and 
genetic background, route of administration of agents;

o  development of new clinically useful agents to modulate the immune response 
and modification of currently available agents to enhance agonist or 
antagonist activity, to enhance efficacy, and/or eliminate adverse effects;

o  determination of the mechanism of action of agents utilized: the role of 
cytokines, regulatory T cells, accessory cells (including macrophages, NK 
cells, dendritic cells, and B cells), shifts in T cell subset response, T cell 
anergy, T cell deletion, or induction of cell death pathways;

o  mechanisms responsible for tolerance initiation, maintenance, or loss; and

o  basic hypothesis driven research into mechanisms of self tolerance, the 
pathogenesis of human autoimmune disease and/or its modulation.

MECHANISM OF SUPPORT

This RFA will use the NIH Multi-project Cooperative Agreement (U19) mechanism. 
As an applicant you will be solely responsible for planning, directing, and 
executing the proposed project.  This RFA is a one-time solicitation.  The 
anticipated award date is September 2003.

The NIH (U19) is a cooperative agreement award mechanism in which the 
Principal Investigator retains the primary responsibility and dominant role 
for planning, directing, and executing the proposed project, with NIH staff 
being substantially involved as a partner with the Principal Investigator, as 
described under the section "Cooperative Agreement Terms and Conditions of 
Award."  

Essential elements of the multi-project cooperative agreement mechanism also 
include: (1) a minimum of three interrelated individual research projects 
organized around a central theme; (2) collaborative efforts and interaction 
among independent projects and their investigators to achieve a common goal; 
(3) a single Principal Investigator who will be scientifically and 
administratively responsible for the group effort; (4) a single applicant 
institution that will be legally and financially responsible for the use and 
disposition of funds awarded; and (5) support provided, as necessary, for 
"Core" resources or facilities, each of which is expected to be utilized by at 
least two research projects in order to facilitate the research effort.  

The total project period for applications submitted in response to this RFA 
may not exceed five years.  At this time, the NIAID has not determined whether 
or how this solicitation will be continued beyond the present RFA.  

FUNDS AVAILABLE 

The estimate total funds, direct and facilitites and administrative (F & A), 
available from participating IC(s) for the first year of support of this 
program are $6.25 million.  In fiscal year 2003, the sponsoring institutes 
intend plan to award 5 new and/or competitive continuation grants in response 
to this RFA.  First year budget requests may not exceed $800,000 total costs 
for the basic projects and any proposed cores (excludes costs for clinical 
component).  The additional funds of approximately $2.5 million (ACE Clinical 
Research Fund) will be available to successful applicants to support the 
clinical components and new clinical trials.  Although the financial plans of 
the IC(s) provide support for this program, awards pursuant to this RFA are 
contingent upon the availability of funds and the receipt of a sufficient 
number of meritorious applications. 

ELIGIBLE INSTITUTIONS
 
You may submit (an) application(s) if your institution the following 
characteristics:

o Domestic (US) for-profit or non-profit organizations 
o Public or private institutions, such as universities, colleges, hospitals, 
and laboratories 
o Units of State and local governments
o Eligible agencies of the Federal government  

INDIVIDUALS ELIGIBLE TO BECOME PRINCIPAL INVESTIGATORS   

Any individual with the skills, knowledge, and resources necessary to carry 
out the proposed research is invited to work with their institution to develop 
an application for support.  Individuals from underrepresented racial and 
ethnic groups as well as individuals with disabilities are always encouraged 
to apply for NIH programs.   

SPECIAL REQUIREMENTS

Each Autoimmunity Center of Excellence must have a clinical research 
component, two or more research projects and participate in cooperative and 
collaborative projects within each Center and among the Centers. For detailed 
information, see "Cooperative Agreement Terms And Conditions Of Award" and 
"SPECIAL INSTRUCTIONS FOR COMPLETION OF APPLICATIONS IN RESPONSE TO THIS RFA" 
below.

Cooperative Agreement Terms And Conditions Of Award

The following terms and conditions will be incorporated into the award 
statement and provided to the Principal Investigator as well as the 
institutional official at the time of award.

These special Terms of Award are in addition to, and not in lieu of, otherwise 
applicable OMB administrative guidelines, HHS Grant Administration Regulations 
at 45 CFR part 74 and 92, and other HHS, PHS, and NIH Grant Administration 
policy statements.

The administrative and funding instrument used for this program is the 
multiproject cooperative agreement (U19), an "assistance" mechanism rather 
than an "acquisition" mechanism, in which substantial NIH scientific and/or 
programmatic involvement with the awardee is anticipated during the 
performance of the activity.  Under the cooperative agreement, the NIH purpose 
is to support and/or stimulate the recipient's activity by involvement in and 
otherwise working jointly with the award recipient in a partner role, but it 
is not to assume direction, prime responsibility, or a dominant role in the 
activity.  Consistent with this concept, the dominant role and prime 
responsibility for the activity resides with the awardees for the project as a 
whole, although specific tasks and activities in carrying out the research 
will be shared among the awardees and the NIAID Research Coordinator.

1.  Monitoring Clinical Studies 

When clinical studies or trials are a component of the research proposed, 
NIAID policy requires that studies be monitored commensurate with the degree 
of potential risk to study subjects and the complexity of the study.  Terms 
and Conditions of Award will be included with awards.  NIAID policy was 
announced in the NIH Guide on February 24, 2000 and is available at: 
http://grants.nih.gov/grants/guide/notice-files/NOT-AI-00-003.html.  The full 
policy including terms and conditions of award is available at: 
http://www.niaid.nih.gov/ncn/pdf/clinterm.pdf

All investigators proposing clinical research should comply with the AMENDMENT 
"NIH Guidelines for Inclusion of Women and Minorities as Subjects in Clinical 
Research - Amended, October, 2001," published in the NIH Guide for Grants and 
Contracts on October 9, 2001 
(http://grants.nih.gov/grants/guide/notice-files/NOT-OD-02-001.html);
a complete copy of the updated Guidelines are available at 
http://grants.nih.gov/grants/funding/women_min/guidelines_amended_10_2001.htm. 
The amended policy incorporates: the use of an NIH definition of clinical 
research; updated racial and ethnic categories in compliance with the new OMB 
standards; clarification of language governing NIH-defined Phase III clinical 
trials consistent with the new PHS Form 398; and updated roles and 
responsibilities of NIH staff and the extramural community.  The policy 
continues to require for all NIH-defined Phase III clinical trials that: a) 
all applications or proposals and/or protocols must provide a description of 
plans to conduct analyses, as appropriate, to address differences by 
sex/gender and/or racial/ethnic groups, including subgroups if applicable; and 
b) investigators must report annual accrual and progress in conducting 
analyses, as appropriate, by sex/gender and/or racial/ethnic group 
differences.

DATA AND SAFETY MONITORING BOARD. The NIAID will appoint an independent Data 
and Safety Monitoring Board to monitor the endpoint and safety data for all 
trials/studies on an ongoing basis, but at least twice a year.  This Board is 
advisory to the Institute staff; feedback is provided to investigators as 
well.  This Board will be funded separately from the Centers.  

2.  Awardee Rights and Responsibilities

Awardees will have primary responsibility for defining the details of the 
project within the guidelines of the RFA AI-02-006 and for performing the 
scientific activity, and agree to accept close coordination, cooperation, and 
participation of the NIAID staff in those  aspects of the scientific and 
technical management of the project described below.  Specifically, awardees 
have primary responsibility as described below.

Designation of the Clinical Research Representative and the Basic Research 
Representative

The Clinical Research Representative is the person responsible for the overall 
management of the clinical research component, including:  coordination of the 
participating Center specialists, whether within a single institution or a 
consortium of institutions; design and submission of proposed protocols for 
clinical trials/studies; and implementation, monitoring, and data submission 
and analysis of clinical trials/studies.  This person must be a physician with 
substantial training and experience in 1) clinical management of one or 
multiple autoimmune diseases, 2) clinical immunology, and 3) the design, 
implementation and evaluation of clinical trials.  

The Basic Research Representative is the person responsible for coordination 
of the Center's basic research scientists, whether within a single institution 
or a consortium of institutions, in: development of proposed clinical 
trials/studies and adjunct basic studies in cooperation with clinicians, 
conduct of the basic studies in conjunction with ongoing clinical 
trials/studies; and collaboration and sharing of basic resources and reagents 
within a Center and with other Centers.  The collaboration of clinicians 
and/or basic scientists from different Centers is highly encouraged based on 
shared interests and complementary talents.  

Designation of the Clinical Research Representative and the Basic Research 
Representative is the responsibility of the Center Principal Investigator, who 
may serve as either representative, but not both.  

Steering Committee Membership and Meeting Attendance

Each Center Principal Investigator will designate a Clinical Research 
Representative and a Basic Research Representative to serve as voting members 
of the Steering Committee and participate in all Committee activities and 
decisions including, but not limited to, conference calls and special 
subcommittees as may be necessary.  The Steering Committee shall be 
responsible for determining the frequency of meetings and scheduling the time 
and location.  The Steering committee will establish the procedures for the 
function of the Centers network, as outlined in section "Steering Committee."

Data Coordination and Management

Each awardee will be responsible for providing the NIAID with all primary 
study data for management, quality control and analysis, using procedures and 
standards determined by the Steering Committee.  All data will be available to 
all awardees.  Specific analysis to be performed by NIAID will be directed by 
the Steering Committee or its designee.  The awardees will retain custody of 
and have primary rights to all data developed under these awards, subject to 
Government rights of access consistent with HHS and NIH policies.

Publication and Presentation of Study Findings

Early publication of major findings is encouraged.  Publications and oral 
presentations of work performed under this agreement will require appropriate 
acknowledgment of the Autoimmunity Centers of Excellence and NIAID support.  
Analyses to be performed using collective data from multiple centers will be 
determined by the Steering Committee.  Centers wishing to perform analysis of 
local data or of single site studies should inform the Steering Committee 
prior to initiation to avoid duplication.  The Steering Committee will 
establish the procedures and criteria for presentation and publication of data 
developed within the Centers network.

Federally Mandated Regulatory Requirements

Each institution participating in the Clinical component of an Autoimmunity 
Center of Excellence is required to meet DHHS regulations for the protection 
of human subjects and FDA requirements for the conduct of research using 
investigational agents.  At a minimum, these include:

o  methods for assuring that each institution at which Autoimmunity Centers of 
Excellence investigators are conducting clinical studies has registered with 
the Office of Human Research Protections (OHRP; http://www.hhs.gov/ohrp/) 
and has a Federalwide Assurance; that study protocols are reviewed and 
approved by the responsible Institutional Review Board (IRB) prior to patient 
entry; that active protocols are reviewed at least annually by the IRB, and 
that amendments are approved by the IRB.

o  methods for assuring or documenting that each patient, or patient's 
parent/legal guardian, gives fully informed consent to participation in a 
research protocol prior to the initiation of the experimental intervention.

3.  NIAID Staff Responsibilities

NIAID staff assistance will be provided by an NIAID Autoimmunity Research 
Coordinator, who will have substantial scientific/programmatic involvement 
during the conduct of this activity through technical assistance, advice and 
coordination above and beyond normal program stewardship for grants, as 
described below.

Steering Committee Membership and Meeting Attendance

The NIAID Autoimmunity Research Coordinator will serve as a voting member of 
the Steering Committee, will attend all Steering Committee meetings, and will 
participate in other Committee activities, including, but not limited to, 
conference calls, subcommittees, and special committees.

Monitoring Performance

The NIAID Autoimmunity Research Coordinator will provide assistance to the 
Steering Committee in the development of procedures for monitoring the 
performance of the clinical trials/studies.  This includes participation in 
periodic on-site monitoring with respect to compliance with protocol 
specifications, quality control and accuracy of data recording, and accrual.

Clinical Data Coordination and Management

The NIAID will be responsible for ensuring the provision of centralized data 
management and coordination assistance, including analysis support.  Under the 
direction of the Steering Committee, the NIAID will provide technical 
assistance and data management services to the Autoimmunity Centers of 
Excellence with respect to quality control, uniformity of data collection, 
management of the collective data base, and data analysis.

Publication and Presentation of Clinical Trials/Studies Findings

The NIAID Autoimmunity Research Coordinator may contribute, through review, 
comment, analysis, and/or co-authorship, to reporting results of the clinical 
studies and trials/studies to the investigator community and other interested 
scientific and lay organizations.  Co-authorship by the NIAID Autoimmunity 
Research Coordinator will be subject to approval in accordance with the NIH 
policies regarding staff authorship of publications resulting from extramural 
awards.

NIAID Program Director

The NIAID Autoimmunity Research Coordinator, who is an NIAID Program Director, 
will be responsible for normal programmatic stewardship and monitoring of this 
award. These duties include:

The Government, via the NIAID Program Director, will have access to data 
generated under this Cooperative Agreement and may periodically review the 
data and progress reports.  Information obtained from the data may be used by 
NIAID staff for the preparation of internal reports on the activities of the 
clinical trials/studies.  However, awardees will retain custody of and have 
primary rights to all data developed under these awards.

Study Materials:  The NIAID may negotiate with companies interested in 
participating in trials or studies.  The NIAID may facilitate the appropriate 
approvals (when necessary) from the Food and Drug Administration with respect 
to the use of investigational drugs.

4.  Collaborative Responsibilities

Each clinical and basic component of each Center must be willing to work 
cooperatively and collaboratively both within their Center and with other 
Centers. 

Steering Committee

A Steering Committee will be established to serve as the main governing body 
of the cooperative network.  At a minimum, the Steering Committee will be 
composed of the NIAID Autoimmunity Research Coordinator and two 
representatives from each of the Centers: one Clinical Research Representative 
and one Basic Research Representative.  Each Basic and Clinical Research 
Representative will be expected to actively participate in all Steering 
Committee activities.

The Chairperson of the Steering Committee will be selected by the Steering 
Committee from among the non-Federal members during one of the early meetings 
of the Committee to be convened by the NIAID Autoimmunity Research 
Coordinator.  All major scientific decisions will be determined by the 
Steering Committee, with each Clinical Research Representative, Basic Research 
Representative, and the NIAID Autoimmunity Research Coordinator having one 
vote.  The Committee will meet at least three times during the first 12 months 
of the program and at least semi-annually thereafter.

The Steering Committee will have responsibility for facilitating the conduct 
of clinical trials/studies and basic research related to these trials/studies, 
promoting trans-Center collaboration among and between clinical and basic 
components, analyzing and interpreting Center-wide study data, and 
establishing procedures for reporting results of Center trials/studies.  
Proposed protocols for clinical trials/studies to be performed by a single 
Center or groups of Centers will be submitted to the Steering Committee for 
review and evaluation.  Protocols to be implemented will be selected by the 
Steering Committee in accordance with criteria and procedures established by 
the Steering Committee. Timely review and evaluation are expected.  After 
approval, those clinical investigators participating in the trial/study in 
collaboration with investigators from the basic components who will be 
performing adjunct basic mechanistic studies will develop detailed protocols.  
As needed, the Steering Committee may establish subcommittees for special 
purposes.  It is expected that most of the work of the Steering Committee will 
be performed in these subcommittees.  

Clinical trials/studies will proceed into the implementation stage only with 
the concurrence of the Steering Committee and the NIAID Autoimmunity Research 
Coordinator.  The Steering Committee will be responsible for management of the 
ACE Clinical Research Fund. 

5.  Arbitration

Any disagreement that may arise on scientific or programmatic matters (within 
the scope of the award) between award recipients and the NIAID may be brought 
to arbitration.  An arbitration panel will be formed to review any scientific 
or programmatic issue that is significantly restricting progress. This panel 
will be composed of three members -- one selected by the Steering Committee or 
by the individual awardee in the event of an individual disagreement, a second 
member selected by the NIAID, and a third member with expertise in the 
relevant area and selected by the two prior members.  While the decisions of 
the Arbitration Panel are binding, these special arbitration procedures will 
in no way affect the awardee's right to appeal an adverse action in accordance 
with PHS regulations at 42 CFR Part 50, subpart D, and HHS regulations at 45 
CFR Part 16.

WHERE TO SEND INQUIRIES

We encourage inquiries concerning this RFA and welcome the opportunity to 
answer questions from potential applicants.  Inquiries may fall into three 
areas:  scientific/research, peer review, and financial or grants management 
issues:

o Direct your questions about scientific/research issues to:

Elaine Collier, MD  
Division of Allergy, Immunology, and Transplantation
National Institute of Allergy and Infectious Diseases  
6700-B Rockledge Drive, Room 5135, MSC-7460
Bethesda, MD  20892-7640
Telephone: (301) 496-7104
FAX: (301) 402-2571
E-Mail: ECollier@niaid.nih.gov

Beena Akolkar, Ph.D.
Program Director, Immunopathogenesis and Genetics of Type 1 Diabetes
Division of Diabetes, Endocrinology, and Metabolic Diseases
National Institute of Diabetes and Digestive and Kidney Diseases
6707 Democracy Boulevard, Room 681
Bethesda, MD 20892
Phone: 301 594-8812
FAX: 301 480-3503
Email:  ba92i@nih.gov

o Direct your questions about peer review issues; 
  
Priti Mehrotra, Ph.D.  
Division of Extramural Activities  
National Institute of Allergy and Infectious Diseases  
Room 2100, MSC-7616
6700-B Rockledge Drive  
Bethesda, MD  20892-7616
Telephone: (301) 435-9369
FAX: (301) 402-2638
E-Mail: pm158b@nih.gov

o Direct your questions about financial or grants management matters to:

Ann Devine   
Division of Extramural Activities  
National Institute of Allergy and Infectious Diseases  
Room 2118, MSC-7614
6700-B Rockledge Drive  
Bethesda, MD  20892-7614  
Telephone: (301) 402-5601
Fax: (301) 480-3780
E-mail: ad22x@nih.gov 

LETTER OF INTENT

Prospective applicants are asked to submit a letter of intent that includes 
the following information:

o Descriptive title of the proposed research
o Name, address, and telephone number of the Principal Investigator
o Names of other key personnel 
o Participating institutions
o Number and title of this RFA 

Although a letter of intent is not required, is not binding, and does not 
enter into the review of a subsequent application, the information that it 
contains allows IC staff to estimate the potential review workload and plan 
the review.
 
The letter of intent is to be sent by the date listed at the beginning of this 
document.  The letter of intent should be sent to:

Priti Mehrotra, Ph.D.  
Division of Extramural Activities  
National Institute of Allergy and Infectious Diseases  
Room (insert), MSC-7616
6700-B Rockledge Drive  
Bethesda, MD  20892-7616
Telephone: (301) 435-9369
FAX: (301) 402-2638
E-Mail: pm158b@nih.gov

SUBMITTING AN APPLICATION

Applicants for U19 grants must follow special application guidelines in the 
NIAID Brochure entitled INSTRUCTIONS FOR APPLICATIONS FOR MULTI-PROJECT 
AWARDS; this brochure is available via the WWW at: 
http://www.niaid.nih.gov/ncn/grants/multibron.htm

Applications must be prepared using the PHS 398 research grant application 
instructions and forms (rev. 5/2001). The PHS 398 is available at 
http://grants.nih.gov/grants/funding/phs398/phs398.html in an interactive 
format.  For further assistance contact GrantsInfo, Telephone (301) 435-0714, 
Email: GrantsInfo@nih.gov.

USING THE RFA LABEL: The RFA label available in the PHS 398 (rev. 5/2001) 
application form must be affixed to the bottom of the face page of the 
application.  Type the RFA number on the label.  Failure to use this label 
could result in delayed processing of the application such that it may not 
reach the review committee in time for review.  In addition, the RFA title and 
number must be typed on line 2 of the face page of the application form and 
the YES box must be marked. The RFA label is also available at: 
http://grants.nih.gov/grants/funding/phs398/label-bk.pdf.

SENDING AN APPLICATION TO THE NIH: Submit a signed, typewritten original of 
the application, including the Checklist, and three signed, photocopies, in 
one package to:

Center For Scientific Review
National Institutes Of Health
6701 Rockledge Drive, Room 1040, MSC 7710
Bethesda, MD  20892-7710
Bethesda, MD  20817 (for express/courier service)

At the time of submission, two additional exact copies of the grant 
application and all five sets of any appendix material must be sent to:

Priti Mehrotra, Ph.D.
Division of Extramural Affairs
National Institute of Allergy and Infectious Diseases
Room Number 2100, MSC-7616
6700-B Rockledge Drive
Bethesda, MD  20892-7616
BETHESDA, MD  20817 (for express mail or courier service)

Applications that are not received as a single package on the receipt date or 
that do not conform to the instructions contained in PHS 398 (rev. 5/01) 
Application Kit (as modified in, and superseded by, the NIAID BROCHURE 
ENTITLED "INSTRUCTIONS FOR APPLICATIONS FOR MULTI-PROJECT AWARDS"), will be 
judged non-responsive and will be returned to the applicant. 

It is highly recommended that the appropriate NIAID program contact be 
consulted before submitting the letter of intent and during the early stages 
of preparation of the application.  (See program contact under INQUIRIES).

SPECIAL INSTRUCTIONS FOR COMPLETION OF APPLICATIONS IN RESPONSE TO THIS RFA

Applicants for U19 cooperative agreements must follow special application 
guidelines in the NIAID Brochure entitled INSTRUCTIONS FOR APPLICATIONS FOR 
MULTI-PROJECT AWARDS; this brochure is available from NIAID listed under 
INQUIRIES via the WWW at: http://www.niaid.nih.gov/ncn/grants/multibron.htm.

This brochure presents specific instructions for sections of the PHS 398 (rev. 
5/01) application form that should be completed differently than usual.  For 
all other items in the application, follow the usual instructions in the PHS 
398.

For this RFA, the description of each basic project is limited to 25 pages 
each.  The description of the clinical component is also limited to 25 pages.  
Within the 25 page limit for the clinical component, the description of each 
proposed clinical trial is limited to not more than 10 pages each.  

CLINICAL RESEARCH COMPONENT. Each Autoimmunity Center of Excellence 
application must describe a SINGLE clinical research component that 
encompasses significant participation by multiple clinical specialists who 
have access to patient populations in which to conduct clinical trials/studies 
in autoimmune diseases. This component must include a minimum of three 
clinical specialties and demonstrate the ability to perform clinical 
trials/studies in at least three different autoimmune diseases. The clinical 
component may represent a single institution or a consortium of institutions. 
Diseases amenable to clinical intervention and of interest to the NIAID 
include, but are not limited to: systemic lupus erythematosus, multiple 
sclerosis, rheumatoid arthritis, type 1 diabetes mellitus, idiopathic 
thrombocytopenia purpura, inflammatory bowel disease, and scleroderma. 
Specialists that could participate in the clinical component include, but are 
not limited to: endocrinologists, neurologists, rheumatologists, 
gastroenterologists, and hematologists. The multiple specialists in the 
clinical component must be willing and able to work collaboratively and 
cooperatively, both within their Center and with clinical and basic components 
of other Centers to facilitate clinical and adjunct basic studies.  The 
application should include written letters of commitment to this principal.  
Applications proposing clinical components that do not meet the above criteria 
concerning the number of clinical specialties represented and available 
disease populations will be judged non-responsive and returned to the 
applicant without review.

The application for the clinical component should describe the populations of 
patients available for utilization in clinical trials/studies, and demonstrate 
the ability to perform clinical trials/studies, including the ability to 
recruit and retain subjects for at least three different autoimmune diseases.  
The application should include two proposed clinical trial/study protocols for 
immune interventions for autoimmune diseases. These protocols should include 
the rationale for the agent(s) and disease(s) selected, patient population, 
study design, and primary and secondary outcome measures.  These two protocols 
may utilize the same or different agents, but must intervene on different 
autoimmune diseases.  Award of a Center does not imply that the proposed 
protocols will be implemented.  Since the clinical trials/studies that are 
ultimately undertaken by the Centers will be selected by the Steering 
Committee (see TERM AND CONDITIONS OF AWARD), the trials/studies selected for 
implementation may not be identical to any single protocol submitted in 
response to this RFA.  Funding for clinical components will be contingent upon 
participation in approved clinical studies or trials.

In addition to the two proposed clinical trials/studies submitted with the 
application, proposals for adjunct basic studies related to these clinical 
trials/studies should be included in the application.  The submitting Center's 
basic components do not necessarily need to include the expertise to perform 
these studies, however, the studies must be feasible, i.e., the techniques 
must be established.

BASIC RESEARCH COMPONETS. Each Autoimmunity Center of Excellence application 
must include TWO or more basic research components.  The basic components must 
be multi-disciplinary, interactive basic or pre-clinical research projects 
focused on elucidation of the basic mechanisms and pathogenesis of 
autoimmunity, self tolerance, and/or immune modulation.  In addition, the 
basic research components must have the interest and capability to carry out 
adjunct basic studies related to clinical trials/studies in the context of an 
overall Centers' program; work cooperatively with basic and clinical 
components from their and other Centers; work with clinicians in development 
of clinical trials/studies; and attend biannual Centers' meetings.  These 
basic research projects may utilize animal models, but must also incorporate 
basic research in humans.

To promote the development of an interactive integrated network, a minimum 
number of issues need to be addressed in the applications, as outlined below.

a.  Intra- and Inter-Institutional Arrangements

Single institutions or consortia of institutions may submit applications. 
However, the application must identify a single applicant organization that 
will be legally and financially responsible and accountable for the use and 
disposition of funds awarded to the other institutions.  The development of 
Centers, which include multiple institutions and geographic areas, is 
encouraged when such an institutional arrangement provides the most 
appropriate mixture of clinical and basic science components.  Evidence that 
the components can work together effectively must be provided in all 
applications regardless of whether the applicant is a single institution or a 
consortium of institutions.

b.  Cooperative and Collaborative Responsibilities

Each clinical and basic component of each Center must be willing to work 
cooperatively and collaboratively both within their Center and with other 
Centers. The application must indicate commitment/willingness to the 
collaborative organization, steering committee, and participation of NIAID 
staff as described in the Cooperative Agreement Terms And Conditions Of Award. 
The Steering Committee as defined in section entitled "Steering Committee" 
will be the main governing body of the Centers network and will have 
responsibility for establishing procedures for the selection of clinical 
trials/studies and adjunct basic studies to be performed; developing 
procedures for prioritization of use of samples from patients for basic 
studies; implementing clear, inclusive, and effective communication among the 
components of all Centers; establishing procedures for the monitoring of 
performance and progress of the clinical trials/studies, including accrual, 
timely submission and quality of data and samples, and conscientious 
observance of protocol requirements; and instituting procedures for data 
collection, management, quality control, and reporting results of clinical 
trials/studies.

c. Budgets

All costs requested for the proposed basic studies must be included in the 
application.  Requested budgets should include: 1) travel for three one-day 
Steering Committee meetings during the first 12 months of the program and 
semiannual Steering Committee meetings thereafter for the Clinical and Basic 
Research Representatives of each Center; and 2) travel for the Principal 
Investigator of the Center components to a two-day biannual meeting (usually 
in Washington, DC area), beginning in the second year.  Funding for clinical 
trials (including basic mechanistic studies associated with that trial) will 
be provided out of the ACE Clinical Research Fund.The Steering Committee must 
approve all clinical trials and will administer the ACE clinical research 
fund.  

APPLICATION PROCESSING: Applications must be received by the application 
receipt date listed in the heading of this RFA.  If an application is received 
after that date, it will be returned to the applicant without review.
 
The Center for Scientific Review (CSR) will not accept any application in 
response to this RFA that is essentially the same as one currently pending 
initial review, unless the applicant withdraws the pending application.  The 
CSR will not accept any application that is essentially the same as one 
already reviewed. This does not preclude the submission of substantial 
revisions of applications already reviewed, but such applications must include 
an Introduction addressing the previous critique.

Concurrent submission of an R01 and a Component Project of a Multi-project 
Application:  Current NIH policy permits a component research project of a 
multi-project grant application to be concurrently submitted as a traditional 
individual research project (R01) application.  If, following review, both the 
multi-project application and the R01 application are found to be in the 
fundable range, the investigator must relinquish the R01 and will not have the 
option to withdraw from the multi-project grant.  This is an NIH policy 
intended to preserve the scientific integrity of a multi-project grant, which 
may be seriously compromised if a strong component project(s) is removed from 
the program.  Investigators wishing to participate in a multi-project grant 
must be aware of this policy before making a commitment to the Principal 
Investigator and awarding institution.

PEER REVIEW PROCESS  

Upon receipt, applications will be reviewed for completeness by the CSR and 
responsiveness by the NIAID.

Incomplete and/or non-responsive applications will be returned to the 
applicant without further consideration.

Applications that are complete and responsive to the RFA will be evaluated for 
scientific and technical merit by an appropriate peer review group convened by 
NIAID in accordance with the review criteria stated below.  As part of the 
initial merit review, all applications will:

o Receive a written critique
o Undergo a selection process in which only those applications deemed to have 
the highest scientific merit, generally the top half of applications under 
review, will be discussed and assigned a priority score
o Receive a second level review by the National Advisory Allergy and 
Infectious Diseases Council.

REVIEW CRITERIA

The general review criteria for U19 multi-project cooperative agreement 
applications are presented in the NIAID brochure entitled "INSTRUCTIONS FOR 
APPLICATIONS FOR MULTI-PROJECT AWARDS" at 
http://www.niaid.nih.gov/ncn/grants/multibron.htm

In addition, the following review criteria specific to this RFA will be used 
in evaluation of applications: 

o  the scientific and clinical expertise of the Principal Investigator, 
Project Leaders, and key personnel;

o  a documented commitment to the clinical and basic study of multiple 
autoimmune diseases by the investigators and their institutions;

o  willingness to work cooperatively and collaboratively both within the 
proposed Center and with other Centers and to accept the participation and 
assistance of the NIAID staff in accordance with the guidelines outlined under 
"Terms and Condidtions of Award."

ADDITIONAL REVIEW CRITERIA: In addition to the above criteria, your 
application will also be reviewed with respect to the following:

o PROTECTIONS: The adequacy of the proposed protection for humans, animals, or 
the environment, to the extent they may be adversely affected by the project 
proposed in the application.

o INCLUSION: The adequacy of plans to include subjects from both genders, all 
racial and ethnic groups (and subgroups), and children as appropriate for the 
scientific goals of the research.  Plans for the recruitment and retention of 
subjects will also be evaluated. (See Inclusion Criteria included in the 
section on Federal Citations, below)

o DATA SHARING: The adequacy of the proposed plan to share data. 

o BUDGET: The reasonableness of the proposed budget and the requested period 
of support in relation to the proposed research.

RECEIPT AND REVIEW SCHEDULE

Letter of Intent Receipt Date:  September 17, 2002
Application Receipt Date:  October 16, 2002
Scientific Review Date:  February 12, 2003
Advisory Council Date:  May 29, 2003
Earliest Date of Award:  September 2003

AWARD CRITERIA

Award criteria that will be used to make award decisions include:

o Scientific merit (as determined by peer review)
o Availability of funds
o Programmatic priorities.

REQUIRED FEDERAL CITATIONS 

MONITORING PLAN AND DATA SAFETY AND MONITORING BOARD: Research components 
involving Phase I and II clinical trials must include provisions for 
assessment of patient eligibility and status, rigorous data management, 
quality assurance, and auditing procedures.  In addition, it is NIH policy 
that all clinical trials require data and safety monitoring, with the method 
and degree of monitoring being commensurate with the risks (NIH Policy for 
Data Safety and Monitoring, NIH Guide for Grants and Contracts, June 12, 1998: 
http://grants.nih.gov/grants/guide/notice-files/not98-084.html).  

INCLUSION OF WOMEN AND MINORITIES IN CLINICAL RESEARCH:  It is the policy of 
the NIH that women and members of minority groups and their sub-populations 
must be included in all NIH-supported clinical research projects unless a 
clear and compelling justification is provided indicating that inclusion is 
inappropriate with respect to the health of the subjects or the purpose of the 
research. This policy results from the NIH Revitalization Act of 1993 (Section 
492B of Public Law 103-43).

All investigators proposing clinical research should read the AMENDMENT "NIH 
Guidelines for Inclusion of Women and Minorities as Subjects in Clinical 
Research - Amended, October, 2001," published in the NIH Guide for Grants and 
Contracts on October 9, 2001 
(http://grants.nih.gov/grants/guide/notice-files/NOT-OD-02-001.html); 
a complete copy of the updated Guidelines are available at 
http://grants.nih.gov/grants/funding/women_min/guidelines_amended_10_2001.htm. 
The amended policy incorporates: the use of an NIH definition of clinical 
research; updated racial and ethnic categories in compliance with the new OMB 
standards; clarification of language governing NIH-defined Phase III clinical 
trials consistent with the new PHS Form 398; and updated roles and 
responsibilities of NIH staff and the extramural community.  The policy 
continues to require for all NIH-defined Phase III clinical trials that: a) 
all applications or proposals and/or protocols must provide a description of 
plans to conduct analyses, as appropriate, to address differences by 
sex/gender and/or racial/ethnic groups, including subgroups if applicable; and 
b) investigators must report annual accrual and progress in conducting 
analyses, as appropriate, by sex/gender and/or racial/ethnic group 
differences.

INCLUSION OF CHILDREN AS PARTICIPANTS IN RESEARCH INVOLVING HUMAN SUBJECTS:  
The NIH maintains a policy that children (i.e., individuals under the age of 
21) must be included in all human subjects research, conducted or supported by 
the NIH, unless there are scientific and ethical reasons not to include them. 
This policy applies to all initial (Type 1) applications submitted for receipt 
dates after October 1, 1998.

All investigators proposing research involving human subjects should read the 
"NIH Policy and Guidelines" on the inclusion of children as participants in 
research involving human subjects that is available at 
http://grants.nih.gov/grants/funding/children/children.htm. 

REQUIRED EDUCATION ON THE PROTECTION OF HUMAN SUBJECT PARTICIPANTS: NIH policy 
requires education on the protection of human subject participants for all 
investigators submitting NIH proposals for research involving human subjects.  
You will find this policy announcement in the NIH Guide for Grants and 
Contracts Announcement, dated June 5, 2000, at 
http://grants.nih.gov/grants/guide/notice-files/NOT-OD-00-039.html.

HUMAN EMBRYONIC STEM CELLS (hESC):  Criteria for federal funding of research 
on hESCs can be found at http://grants.nih.gov/grants/stem_cells.htm and at 
http://grants.nih.gov/grants/guide/notice-files/NOT-OD-02-005.html.  Only 
research using hESC lines that are registered in the NIH Human Embryonic Stem 
Cell Registry will be eligible for Federal funding (see http://escr.nih.gov).   
It is the responsibility of the applicant to provide the official NIH 
identifier(s)for the hESC line(s)to be used in the proposed research.  
Applications that do not provide this information will be returned without 
review. 

PUBLIC ACCESS TO RESEARCH DATA THROUGH THE FREEDOM OF INFORMATION ACT: The 
Office of Management and Budget (OMB) Circular A-110 has been revised to 
provide public access to research data through the Freedom of Information Act 
(FOIA) under some circumstances.  Data that are (1) first produced in a 
project that is supported in whole or in part with Federal funds and (2) cited 
publicly and officially by a Federal agency in support of an action that has 
the force and effect of law (i.e., a regulation) may be accessed through FOIA.  
It is important for applicants to understand the basic scope of this 
amendment.  NIH has provided guidance at 
http://grants.nih.gov/grants/policy/a110/a110_guidance_dec1999.htm.

Applicants may wish to place data collected under this PA in a public archive, 
which can provide protections for the data and manage the distribution for an 
indefinite period of time.  If so, the application should include a 
description of the archiving plan in the study design and include information 
about this in the budget justification section of the application. In 
addition, applicants should think about how to structure informed consent 
statements and other human subjects procedures given the potential for wider 
use of data collected under this award.

URLs IN NIH GRANT APPLICATIONS OR APPENDICES: All applications and proposals 
for NIH funding must be self-contained within specified page limitations. 
Unless otherwise specified in an NIH solicitation, Internet addresses (URLs) 
should not be used to provide information necessary to the review because 
reviewers are under no obligation to view the Internet sites.   Furthermore, 
we caution reviewers that their anonymity may be compromised when they 
directly access an Internet site.

HEALTHY PEOPLE 2010: The Public Health Service (PHS) is committed to achieving 
the health promotion and disease prevention objectives of "Healthy People 
2010," a PHS-led national activity for setting priority areas. This RFA is 
related to one or more of the priority areas. Potential applicants may obtain 
a copy of "Healthy People 2010" at http://www.health.gov/healthypeople.

AUTHORITY AND REGULATIONS:  This program is described in the Catalogue of 
Federal Domestic Assistance in the following citations: No. 93.855, 
Immunology, Allergy, and Transplantation Research, No. 93.847, Diabetes, 
Endocrinology, and Metabolism Research, and . Awards are made under 
authorization of Sections 301 and 405 of the Public Health Service Act as 
amended (42 USC 241 and 284) and administered under NIH grants policies and 
Federal Regulations 42 CFR 52 and 45 CFR Parts 74 and 92.  This program is not 
subject to the intergovernmental review requirements of Executive Order 12372 
or Health Systems Agency review.

The NIH Grants Policy Statement is available at 
http://grants.nih.gov/grants/policy/policy.htm.  This document includes 
general information about the grant application and review process; 
information on the terms and conditions that apply to NIH Grants and 
cooperative agreements; and a listing of pertinent offices and officials at 
the NIH.

The PHS strongly encourages all grant recipients to provide a smoke-free 
workplace and discourage the use of all tobacco products.  In addition, Public 
Law 103-227, the Pro-Children Act of 1994, prohibits smoking in certain 
facilities (or in some cases, any portion of a facility) in which regular or 
routine education, library, day care, health care, or early childhood 
development services are provided to children.  This is consistent with the 
PHS mission to protect and advance the physical and mental health of the 
American people.


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