AIDS and Oral Manifestations of Immunosuppression Program
Infectious Diseases and Immunity Branch
Division of Basic and Translational Sciences
Objective: The primary goal of this initiative is to encourage the formation of multidisciplinary scientific teams to study the oral manifestations and complications associated with HIV/AIDS-related immunosuppression. The applicants are expected to develop 3-5 highly integrated projects that address the existing gaps in our knowledge of the pathogenesis of the oral complications of HIV disease. The projects will be expected to be synergistic and to utilize cutting-edge approaches such as genomics, proteomics, molecular imaging and other emerging technologies to achieve their goals. In addition it is expected that these projects will provide multidisciplinary career development opportunities for investigators new to the field of oral AIDS.
Background: HIV infection continues to be a major public health problem throughout the world. The oral manifestations of HIV infection occur in 30 to 80 percent of the affected patient population. These patients are vulnerable to several oral complications, including oral tumors, oral candidiasis, oral viral infections, HIV related salivary gland disorders, mucositis and oral ulcerations. Some of these conditions are aggressive, difficult to treat, and can dramatically affect the quality of life of the patients.
Despite outstanding advances in oral AIDS research, many unresolved issues still exist in our understanding of how HIV infection affects the oral cavity. Research leading to advances in AIDS has come from studies involved in viral transmission, host defenses, oral mucosal immunology and vaccines, salivary gland disorders, complications associated with opportunistic infections of the oral cavity, AIDS-related oral malignancies, and biomarkers and diagnostics. NIDCR has been successful in supporting individual investigators in all of these major areas of AIDS/HIV research. However, the opportunities for advancement in this research area are unprecedented today, as a result of, for example, the completion of the human genome, new information on microbial interactions, advances in immunology, genomics and proteomic approaches to science, and bioinformatics. The complexity of research, though, demands knowledge and expertise in many areas, and, by working as teams, researchers are now making progress much more rapidly than that achieved by the individual investigator. Multidisciplinary research projects with a common theme that addresses the pathogenesis of the oral manifestations associated with AIDS will greatly enhance an understanding of these disorders. Integrating expertise from diversified scientific fields such as virology, immunology, pathology, molecular biology, bioimaging, high throughput technology, nanotechnology, systems biology, mathematical modeling and bioinformatics will facilitate the performance of cutting edge studies to advance the field. The information gained from such multidisciplinary research could provide the basis for the accelerated development of novel diagnostic, preventive and therapeutic strategies for HIV-related oral disorders.
Current Portfolio Overview: The AIDS extramural portfolio in the NIDCR is comprised of 87 projects, with an emphasis in HIV pathogenesis and transmission, oral immunology, vaccines, AIDS-related opportunistic infections, AIDS-related oral cancers, biomarkers, diagnostics and therapeutics. Most of the oral AIDS/HIV research is currently supported through individual investigator funding mechanisms. The NIDCR does support two multi-project grants, both of which have been very successful as measured by publications and training opportunities.
Recommendations From Workshops: Multidisciplinary, multi-project research grants to support the study of oral complications associated with HIV were recommended by the participants of the NIDCR Grantees Meeting that was held in Bethesda, MD on April 26-28, 2004.
Collaborative Activities: None
Funding Mechanisms: This initiative will use the Program Project (P01) mechanism.