People living with HIV have an increased risk for depression and substance use disorders, which can interfere with adherence to daily anti-viral treatments. The National Institutes of Health (NIH) has awarded researchers at Einstein and Montefiore two five-year grants totaling $7.6 million to study the structural and chemical changes in the brains of people living with HIV, depression, and cannabis use disorder. The findings may help advance health equity in the Bronx and around the country. Vilma Gabbay, M.D., M.S., director of the Psychiatry Research Institute at Montefiore Einstein, is a co-principal investigator on both grants. Other co-investigators are Anjali Sharma, M.D., M.S., professor of medicine at Einstein and an internist and infectious disease specialist at Montefiore; and Joanna Starrels, M.D., M.S., professor of medicine at Einstein and an internist and addiction medicine specialist at Montefiore.
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Research on Two Deadly Blood Diseases
The National Cancer Institute (NCI) has awarded Ulrich G. Steidl, M.D., Ph.D., a seven-year, $7 million grant to study molecular and cellular mechanisms that lead to myelodysplastic syndromes (MDS) and acute myeloid leukemia (AML). The grant accompanies Dr. Steidl’s receipt of the NCI’s Outstanding Investigator Award, given to cancer-research leaders who’ve made significant contributions to their field. In recent studies, Dr. Steidl and colleagues have shown that MDS and AML both arise from preleukemic stem cells (pre-LSCs), a subpopulation of blood-forming stem cells that have genetic and nongenetic aberrations. They hope to understand the dynamics and regulation of different pre-LSC clones and their interplay, which trigger the onset and progression of MDS and AML. Dr. Steidl is a professor of cell biology and of medicine, deputy director of the NCI-designated Albert Einstein Cancer Center, and the Rose C. Falkenstein Chair in Cancer Research.
Treating Chronic Pain and Opioid Use Disorder
People in chronic pain, with mental health disorders, or who live in poverty are especially susceptible to opioid use disorder (OUD). In addition, those with OUD often have trouble obtaining care for chronic pain. The NIH has awarded Einstein and Montefiore a $5.1 million grant for the first two years of work to create a research center to treat people with both chronic pain and opioid use disorder; funding for three more years is expected. The grant is part of the NIH’s Helping to End Addiction Long-term Initiative. Co-principal investigators are Joanna Starrels, M.D., M.S., professor of medicine at Einstein and an internist and addiction medicine specialist at Montefiore; Julia Arnsten, M.D., M.P.H., chief of the division of general internal medicine at Einstein and Montefiore; and Vilma Gabbay, M.D., M.S., director of the Psychiatry Research Institute at Montefiore-Einstein.
Managing Asthma Symptoms in Children
In some Bronx neighborhoods, the asthma prevalence is as high as 25%, the highest rate among New York boroughs. The NIH has awarded Einstein and the Children’s Hospital at Montefiore (CHAM) a five-year, $4.2 million grant to evaluate the Asthma Management Program to Promote Activity for Students in Schools (Asthma-PASS), aimed at helping high-risk urban schoolchildren manage their asthma symptoms. The project will involve up to 40 public, charter, and parochial schools across the Bronx and enroll 416 students ages 4 to 12. Participating schools will be randomly assigned to either Asthma-PASS or an asthma-management comparison group. Children in Asthma-PASS schools will participate in, among other things, activities such as making posters and learning facts about asthma to reduce stigma about the disease. The principal investigator is Marina Reznik, M.D., M.S., vice chair for clinical and community-based research at CHAM and Einstein and professor of pediatrics at Einstein, who helped develop Asthma-PASS.
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Tackling Depression in Teenagers
An estimated 2.9 million adolescents had at least one major depressive episode in 2020. Now the NIH has awarded Einstein and Montefiore researchers a five-year, $4 million grant to seek biological factors that predict the duration and severity of depression in adolescents, with the goal of improving clinical care. The researchers will collaborate with the Nathan S. Kline Institute for Psychiatric Research to enroll 120 adolescents with depressive symptoms and follow them over two years. After clinical evaluation, teens diagnosed with depression will take computerized tests that measure brain reward circuitry. Blood tests will look for depression-associated biomarkers, and functional MRI will evaluate the teens’ ability to feel pleasure, along with depression severity, functioning, anxiety, and risk of suicide. The research may help identify teens needing more-significant help with their depression and lead to better therapies. The principal investigator is Vilma Gabbay, M.D., M.S., director of the Psychiatry Research Institute at Montefiore-Einstein.
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Emphasizing Health Equity in Diabetes Research
Einstein has received a five-year, $4 million NIH grant to support the New York Regional Center for Diabetes Translation Research (NY-CDTR). One of only seven such centers in the country and the only one in the Northeast, the NY-CDTR promotes collaboration and research on effective strategies to improve diabetes prevention, care, and self-management, with an emphasis on health equity. The funding supports investigators conducting research to help people of color and those with lower socioeconomic status, who bear the greatest burden of diabetes in the United States. They are also at increased risk for diabetes-related complications, such as lower-limb amputations, vision loss, and kidney failure. Jeffrey Gonzalez, Ph.D., is the principal investigator on the grant and the director of the NY-CDTR. He is also a professor of medicine and of epidemiology & population health at Einstein, a psychologist at Montefiore, and a professor of psychology at the Ferkauf Graduate School of Psychology at Yeshiva University.
One Vaccine Against Two Viruses
Infection with more than one Dengue virus strain—or with both Dengue and Zika viruses—can result in severe disease and death. The public health risk is especially serious in areas where both viruses are common. A single vaccine that is effective against both Dengue and Zika viruses is urgently needed. Jonathan Lai, Ph.D., has received a five-year, $3.7 million NIH grant to engineer a broadly effective vaccine that can provide protection against the two viruses. Dr. Lai will use protein-engineering techniques to create vaccine candidates that focus the antibody response on epitopes (viral sites) that are present on the glycoproteins of both Dengue and Zika viruses and are targeted by antibodies that protect against disease. These vaccine candidates will be tested in mice to determine whether they can elicit antibodies that protect against both Dengue and Zika viruses. Dr. Lai is a professor of biochemistry at Einstein.
Reversing Fibrosis Due to Kidney Disease
More than one in seven Americans live with chronic kidney disease (CKD). People who have severe CKD often develop skeletal muscle fibrosis, which can lead to loss of muscle function and, ultimately, to immobility and disability. Matthew Abramowitz, M.D., M.S., has received a five-year, $3.5 million grant from the NIH to see if kidney dialysis can help reverse muscle fibrosis. Due to side effects such as infection and low blood pressure, dialysis for CKD patients is typically delayed until symptoms of kidney failure develop. Dr. Abramowitz will follow patients after they start dialysis and evaluate whether it can prevent physical decline in CKD patients with skeletal muscle fibrosis. To assess the effectiveness of dialysis, he and his colleagues will measure muscle strength and endurance and analyze skeletal muscle using quantitative magnetic resonance imaging, proteomic studies, and other techniques. Dr. Abramowitz is an associate professor of medicine at Einstein and a nephrologist at Montefiore.
Limiting the Spread of COVID-19 After Incarceration
Incarcerated people face an increased risk for COVID-19. After release, they often transition to homeless shelters and group homes, where infections can continue spreading. The NIH has awarded researchers at Einstein and Montefiore a five-year, $3.4 million grant to test a program for reducing SARS-CoV-2 transmission among formerly incarcerated people. The researchers will collaborate with the Fortune Society, a New York City–based nonprofit, to conduct a randomized trial assessing an on-site COVID-19 testing and education program. The study will involve 250 people who’ve been released from prison or jail. All will receive education about the importance of testing for the virus. Half will be referred to off-site testing; the other half will be offered rapid PCR tests every three months at the Fortune Society offices in Harlem and Long Island City. The principal investigator is Matthew Akiyama, M.D., associate professor of medicine at Einstein and an infectious disease specialist at Montefiore.