Overview
The Division of Allergy, Immunology, and Transplantation (DAIT) focuses on the ways the immune system functions in maintaining health and the ways it malfunctions in producing disease. The human immune system is composed of networks of specialized cells, molecules, and organs that act together to defend the body against foreign invaders such as viruses, bacteria, and fungi that can cause disease. However, aberrant immune responses play a critical role in immune mediated diseases and in the rejection of transplanted organs, tissues, and cells. There is increasing recognition of the important role the immune system plays in numerous diseases, including:
- Traditional congenital diseases, such as severe combined immune deficiency, as well as in acquired immunodeficiency diseases, other than AIDS;
- Asthma and allergic diseases, such as hay fever and contact dermatitis;
- Autoimmune diseases, such as insulin-dependent diabetes mellitus and systemic lupus erythematosus;
- Acute and chronic inflammatory disorders.
Collectively, these diseases affect tens of millions of Americans, resulting in considerable morbidity (sickness), mortality (death), pain and suffering, and medical costs. Furthermore, these diseases cross many clinical specialties; thus, knowledge of the immune system and its role in disease is increasingly important in the daily practice of medicine.
DAIT supports basic and clinical research to increase our understanding of the causes and mechanisms that lead to the development of immunologic diseases and to expand knowledge that can be applied to developing improved techniques of diagnosis, treatment, and prevention. The Division supports a broad array of investigator-initiated studies and specific research programs, including:
- Cooperative research centers in asthma, allergic, and immunologic diseases, and human immunology in the context of biodefense;
- Multidisciplinary projects in autoimmunity, transplantation immunology, new methods of immune intervention, host defense, and the basic biology of the immune system; and
- Cooperative multicenter clinical trials in asthma and kidney transplantation.
Through outreach, demonstration, and education projects, DAIT supports testing the effectiveness of interventions to promote health and prevent disease in specific populations. DAIT's approach integrates basic science with relevant clinical specialties.
Basic Immunology
Investigations look at the properties, interactions, and functions of the cells of the innate and adaptive immune systems (that is, the immune system you are born with and the immunities you acquire) and the products made by those cells. This information serves as a basis for clinical strategies and biotechnical applications. Clinical immunology studies are concerned with clinical disorders of the immune system and look at a broad spectrum of diseases, including autoimmune diseases affecting the joints, the nervous system, and the endocrine system.
Allergic Disease
Because allergic diseases, including asthma, are currently among the major causes of illness and disability in the United States, the cause, pathogenesis, course of disease, diagnosis, treatment, and prevention of allergic diseases are an important focus of DAIT. Among the research initiatives in this area are the genetics of asthma, cytokines and adhesion molecules in hypersensitivity and inflammation, and asthma as a T-cell-mediated disease.
Autoimmunity
DAIT supports several clinical research programs on autoimmune diseases. The Autoimmunity Centers of Excellence facilitate close interactions between clinicians and basic researchers to promote collaborative research on autoimmune diseases, including pilot clinical trials of immunomodulatory therapies. Numerous ongoing clinical trials include anti-CD20 antibody for treatment of lupus, anti-tumor necrosis factor for treamtent of lupus nephritis, and a preclinical study of DNase treament. The Autoimmune Disease Prevention Centers conduct research on the development of new prevention strategies for autoimmune diseases and evaluation of these approaches in pilot and clinical studies.
Transplant Immunology
NIAID supports research in genetics and transplantation, which is intended to clarify the organization and the mechanisms of expression of the genes on which immune function depends, to characterize the proteins that genes produce, to determine the manner in which these gene products affect the body’s responses to foreign antigens, and to make it easier for transplanted organs and tissue to be accepted by the body.
Biodefense
DAIT also supports biodefense-related contracts and grants which focus on the immunology of infectious diseases caused by Category A, B, and C pathogens (these are disease-producing bacteria, viruses, and parasites). Specific programs include:
- The identification of antibody and T cell epitopes (parts of proteins that antibodies and T cells will recognize) within such pathogens;
- Investigation of the manner in which immune response gene polymorphisms are associated with the outcomes of vaccination or infection;
- The discovery of new adjuvant (chemical compounds that enhance immune response) candidates for vaccine development;
- The discovery of improved technologies to advance the study of immunology in humans to create better vaccines and therapeutics.
Medical Countermeasures Against Radiological and Nuclear Threats
DAIT is coordinating and administering the recent NIH effort to develop new medical countermeasures against radiological and nuclear threats. Specific programs include a network of research centers whose mission is to identify and translate new discoveries of drugs and biological approaches into treatments to reverse or prevent radiological injury to a variety of tissues and organs.
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