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    Program Descriptions S-Z

    Small Business Innovation Research (SBIR)

      The SBIR Program promotes technological innovation within the American small business community by giving small businesses an increased role in Federal biomedical research. The NIDDK SBIR program works to attract private capital to commercialize the results of federally funded research into basic mechanisms of organ and tissue function and diseases of interest to NIDDK. For more information, visit the NIH SBIR/STTR web page.

      SBIR topics of interest to NIDDK are also listed in the Omnibus Solicitation.

      For further information, or to order a solicitation book, contact the following directors:

      Chris Mullins, Ph.D., KUH Urology SBIR Program Director,
      Betsy Wilder, Ph.D., KUH Basic Kidney SBIR Program Director,
      Marva Moxey-Mims, M.D., KUH Applied Kidney SBIR Program Director,
      Terry Rogers Bishop, Ph.D., KUH Hematology SBIR Program Director,
      Judith Podskalny, Ph.D., DDN, SBIR Program Director,
      Sandy Garfield, Ph.D., DEM, SBIR Program Director.

    Small Business Technology Transfer (STTR)

    Steroid Metabolism

      This program includes the biochemistry, molecular biology, intermediary metabolism, function and structure of steroids and similar molecules derived from cholesterol, including sex steroids and other hormones (glucocorticoids, mineralocorticoids), retinoids, cardiac glycosides, prostaglandins and eicosanoids, and bile acids.

      Structural and functional studies of the heme proteins, like mitochondrial cytochromes and cytochrome P450 are included in this program. It can also include enzyme structure and biology in activated nitrogen and oxygen species metabolism (nitric oxide, superoxide, hydrogen peroxide, and antioxidant enzymes).

      For further information, contact Ronald Margolis, Ph.D., Senior Advisor, Molecular Endocrinology and Associate Director for Grants Administration.

    Training and Career Development

      The Training and Careers Programs offer research training and career development awards in the clinical and basic sciences for predoctoral and postdoctoral training and career development in the broad areas of research supported by NIDDK.

      Of particular program interest are training and development of underrepresented minority investigators for retention in academic research and the training of future independent researchers in all of the areas of interest to the NIDDK. For specific information regarding the NIDDK training and career development programs, please see our training page.

      For further information, contact Judith Podskalny, Ph.D., Training Program Director (DDN), James Hyde, Ph.D., Training Program Director (DEM), or Terry Rogers Bishop, Ph.D., Training and Careers Program Director (KUH).

    Type 1 Diabetes Clinical Trials

    Type 2 Diabetes Clinical Trials

    Type 2 Diabetes in the Pediatric Population

      This program encompasses research on the pathopysiology, prevention, and treatment of type 2 diabetes in children.

      Specific areas of support include studies:

      • To describe the epidemiology (incidence, prevalence, risk factors) of type 2 diabetes and its complications in children;
      • To develop diagnostic criteria to distinguish type 1 and type 2 diabetes in children;
      • To define the metabolic abnormalities (and the natural history of such abnormalities) in children with type 2 diabetes;
      • To develop practical, effective strategies for the prevention and/or treatment of type 2 diabetes in children;
      • To understand the basis for race/ethnic disparities in the incidence of type 2 diabetes in the pediatric population.

      For further information, contact Barbara Linder, M.D., Ph.D., Senior Advisor for Childhood Diabetes Research.

    Urologic Diseases Epidemiology

      The Urologic Diseases Epidemiology Program funds descriptive and analytic epidemiology, including development and analysis of surveillance databases, cross-sectional surveys, prospective observational studies, and case-control studies (for evaluating rare diseases).

      Key areas of interest include preventing disease, developing early markers of injury, defining risk factors for morbidity and mortality, and increasing evaluation of urologic disease measurements and outcomes in ongoing observational studies.

      The program is dedicated to increasing the availability of epidemiologic data through both development of new databases and full utilization of existing Federal, State, and private sources of data. The program is working with the National Center for Health Statistics to develop and analyze the urology component measured in the third National Health and Nutrition Examination Survey.

      NIDDK has established a national data system program, Urologic Diseases in America (UDA). UDA collects, analyzes, and distributes information about diseases of the bladder and other structures of the lower urinary tract. Data includes incidence, morbidity and mortality, outcomes, and economic health impact of these diseases as well as data on practice patterns in urology. The 2004 UDA Interim Compendium covers urinary stones, urinary incontinence, urinary tract infections, benign prostatic hyperplasia, and sexually transmitted diseases. Still to come are chapters on perinatal hydronephrosis; male reproductive disorders; diseases of the urethra; kidney, bladder, and testicular cancer; and the pelvic pain syndromes interstitial cystitis and prostatitis.

      For further information, contact Paul Eggers, Ph.D., Urologic Diseases Epidemiology Program Director.

    Urology

    The Urology Program supports basic and clinical research on the normal and abnormal development, structure, and function of the genitourinary tract and studies on the genitourinary effects of diabetes mellitus, spinal cord injury, and multiple sclerosis.

    The program's is especially interested in research on the etiology, diagnosis, pathophysiology, therapy, and prevention of major adult urological diseases and disorders such as

    • BPH
    • Erectile impotence and other sexual dysfunctions
    • Abnormal bladder function, such as urinary incontinence pyelonephritis
    • Chronic inflammatory disorders of the genitourinary tract, such as interstitial cystitis, prostatitis, epididymitis, and orchitis.

    The program is also interested in research on

    • Shock-wave and laser lithotripsy
    • Urolithiasis inhibitors
    • Bladder substitution procedures and devices
    • Prostate growth inhibitor and reduction therapies.

    For further information, contact Leroy M. Nyberg, Jr., Ph.D., M.D., Basic Urology Program Director; Christopher Mullins, Ph.D., Basic Cell Biology of the Bladder and Prostate Program Director.

    Urology Genetics and Genomics

    The primary emphasis of the Urology Genetics and Genomics Program is on studies that use genomics and genetics approaches to elucidate the normal and pathologic function of the urinary and urogenital tracts. Relevant studies include

    • Urology genetics studies, such the elucidation of the inheritability or molecular genetic basis of single-gene or genetically complex familial diseases in humans
    • Identification and characterization of quantitative trait loci or of modifier loci affecting single-gene traits in humans or animal models
    • Mutagenesis and mutant screens in model organisms
    • Genotype-phenotype correlations in humans and animal models

    In addition, the program includes genomics- and proteomics-based urology studies, such as

    • Development of novel tools for tissue-specific gene expression or site-directed mutagenesis in animal models
    • Microarray-based genotyping or expression studies
    • High-throughput characterization of tissue-specific gene or protein expression patterns
    • High-throughput characterization of tissue-specific protein-protein interactions

    For more information, please contact Rebekah Rasooly, Ph.D., director, Genetics and Genomics Program.

    Virahep-C

    Recent large randomized controlled trials of therapies for chronic hepatitis C have reported sustained eradication of hepatitis C virus (HCV) and remission in disease in over half of treated patients. In two separate studies, enrolling more than 1000 patients each, the combination of peginterferon and ribavirin was found to be superior to standard interferon and ribavirin and to achieve sustained virological response rates of 54% and 56%. These excellent response rates provide justification for treating patients with hepatitis C who have histological and/or clinical evidence of progressive disease.

    Unfortunately, therapies that are proven to be safe and effective in well designed, multicenter randomized trials may not prove to be as safe or as effective when applied in clinical practice. Perhaps the major reason for this discrepancy is that the average patient enrolled in a clinical trial that satisfies all inclusion and exclusion criteria may not be representative of the average patient with hepatitis C in practice. Several groups of patients with hepatitis C are underrepresented in the registration trials of new therapies for this disease, some intentionally and some by chance. Such understudied groups include children, the elderly, minority individuals, patients with comorbidities of human immunodeficiency virus infection, neuropsychiatric or renal disease, persons in institutions or who are incarcerated, patients with advanced hepatitis C, and patients who have had a solid organ transplant.

    Quite striking in many of the initial large randomized controlled trials of interferon-based therapy of hepatitis C has been the underrepresentation of African Americans. In a combined analysis of studies of standard interferon monotherapy and combination therapy, less than 5% of patients enrolled were black, despite the fact that African Americans have a higher rate of hepatitis C than non-Hispanic white Americans and probably account for more than 20% of cases of chronic hepatitis C in the United States. Also, striking has been a lower response rate to interferon-based therapies among African Americans compared to Caucasians. In several studies, the sustained response rate among African Americans was one-third to one-half of that in whites. In the recent multi-national studies of peginterferon and ribavirin, blacks represented less than 5% of patients enrolled and had response rates that were less than half of the average, even after controlling for genotype. The numbers of African Americans in these studies, however, were not adequate to provide an accurate estimate of response rate.

    For these reasons, the Division of Digestive Diseases and Nutrition of NIDDK is funding a multicenter clinical trial of peginterferon and ribavirin therapy in a cohort of patients that would include an adequate number of African Americans to establish an accurate estimation of the response rate in this group and to initiate basic research studies of the reasons for non-response and antiviral resistance. The "Study of Viral Resistance to Antiviral Therapy of Chronic Hepatitis C (Virahep-C)" is being conducted at eight clinical centers in the United States. The study is supervised by a data coordinating center. In addition, four ancillary studies are supported which focus on analyses of the basis for antiviral resistance. The participants are shown below:

    Clinical Centers:

    Beth Israel Deaconess Medical Center, Dr. Nezam Afdhal
    New York-Presbyterian Medical Center, Drs. Robert Brown and Lorna Dove
    University of Michigan, Drs. Hari Conjeevaram and Robert Fontana
    University of North Carolina, Chapel Hill: Drs. Michael Fried and Scott Smith
    University of Maryland, Dr. Charles Howell
    University of Miami, Drs. Lennox Jeffers and Shvawn Baker
    University of California, San Francisco, Dr. Norah Terrault
    Rush University Medical Center, Chicago, Dr. Thelma Wiley

    Ancillary Studies

    Cedars-Sinai Medical Center, Los Angeles, Dr. Huiying Yang, Host genetics
    Indiana University, Dr. Milton Taylor, Interferon signaling
    St. Louis University, Dr. John Tavis, Virology
    Portland Veterans Administration Medical Center, Dr. Hugo Rosen, Immunology

    Data Coordinating Center:
    University of Pittsburgh, School of Public Health, Dr. Steven Belle

    NIH Staff:

    Dr. Patricia Robuck, Project Officer Dr. David Kleiner, Pathologist
    Dr. Jay Hoofnagle, Scientific Advisor

    A web site describing the trial is available at www.edc.gsph.pitt.edu/virahepc. The study has enrolled 402 adult patients with chronic hepatitis C of genotype 1 who have never been treated with interferon. Of the total, 196 patients are African Americans and 206 are Caucasian Americans and all participants were born in the United States. All patients were started on the combination of peginterferon alfa-2a and ribavirin and are being followed rigorously for symptoms, side effects, compliance, serum biochemical markers of liver disease, and HCV RNA levels. Special blood samples are taken at specified intervals for studies of HCV RNA virology, immune function, interferon signaling and genetic analyses. The study is being conducted under a clinical research and development agreement (CRADA) with Roche Pharmaceuticals to provide the study medications and limited support for virological and other measurements. The initial patients were started on therapy in September 2002 and the full enrollment was achieved by January 2004. All patients are treated for at least 24 weeks, and those who become HCV RNA negative on treatment (a virological response) will continue therapy for a full 48 weeks. Thereafter, patients will be followed off therapy for at least one year. The major endpoint of the study is sustained eradication of HCV RNA. The major focus of this study is to elucidate the cause of a lack of virological response to interferon therapy.

    The elucidation of the nature and determinants of a response to antiviral therapy and a more clear delineation of the efficacy of combination therapy in all groups of patients with hepatitis C are areas of high priority for the National Institutes of Health in the long-term initiative on prevention and control of hepatitis C.


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