Goal 1: Promote Human Health

To expand knowledge of the molecular and physiological mechanisms governing the normal function of heart, lung, blood, and sleep systems as essential elements for sustaining human health.

Goal 1: Promote Human Health

ORAL HEALTH AND HEART TREATMENT

Compelling Question:

It is very well established now that oral health, particularly gingavitis, play a significant role in cardiac health.

Why this reality is not considered as integral part of Cardiac care?

Submitted by (@abasit88)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Details on the impact of addressing this CQ or CC :

It is expected that incorporating Oral Bacterial ailments such as Gingivitis for cardiac care will more than pay for itself. It will significantly improve the cardiac event prognoses and CUT THE COST OF CARDIAC CARE.

Feasibility and challenges of addressing this CQ or CC :

It is quite feasible and practically possible to incorporate Gingivitis or other serious bacterial oral health problems as integral part of the work of a Cardiologist.

CHALLENGES: Researching the contribution of Oral bacterial issues such as Gingivitis as compared to smoking, obesity and cholesterol levels.

My hypothesis is that Chronoc Oral Bactrial diseases are significant contributors to cardiac problems.

Name of idea submitter and other team members who worked on this idea : Abdul Basit, Ph. D.

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Goal 1: Promote Human Health

Basic research in glycobiology is urgently needed

There are two areas in which glycobiology has been very successful: technology development and disease correlation. Through efforts exemplified by the CFG, major strides in mass spectroscopy and the creation of novel technologies for probing glycan-protein interactions (e.g. glycan microarrays) have been seen. Likewise, the success of the Programs of Excellence in Glycoscience and those of us focused on disease have also ...more »

Submitted by (@nhlbiforumadministrator)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Critical Challenge (CC)

Details on the impact of addressing this CQ or CC :

If my experience as a standing member of a study section and as a PI who submits greater

than ten R01 applications for every one funded, the reason for this gap in our knowledge is not an inability to

pursue such projects, nor is it a lack of desire within the field. The reason is that these studies never make it

through study section. Why? I believe the explanation is found in the nature of glycosylation: heterogeneity.

The strong bias in modern molecular-based science is that if something is not isolatable in a pure pristine

homogeneity, it cannot be studied. Not only is this short-sighted, it fundamentally betrays the nature of biology.

Feasibility and challenges of addressing this CQ or CC :

Part of the solution for these issues is improving education in glycobiology. The other part of the solution is below:

1. Provide opportunities for R01 and individual PI-focused fundamental glycobiology studies. Promote the dissection of fundamental pathways of regulation and function within in vivo settings so that we might

begin to convert disease correlation into pathways ripe for therapeutic targeting. There is nothing to translate to the clinic without detailed knowledge of these fundamental pathways.

2. Provide opportunities to expand local expertise and infrastructure in glycosciences across the country, rather than focusing on a few centers of strength. My experience tells me that investigators outside of glycobiology are far more likely to engage a local collaborator and/or core facility to help explore a glycan-related topic than to deal with a large center in a far-off university – at which they know no one.

3. There should be a push to promote individual labs with diverse interests and systems to broaden the impact by integrating glycobiology across multiple fields, rather than on concentrating expertise in a small number of large centers.

Name of idea submitter and other team members who worked on this idea : Brian Cobb

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Goal 1: Promote Human Health

The Human Virome and Host Interactions in Heart, Lung, and Blood

What are the unknown elements of the human virome, and what host-virome interactions affect the heart, lung, and blood health and diseases? A major challenge has been the need for in vitro culture systems and animal models for studying the virome, which is a significant limitation that has forced current studies of the virome to be mostly descriptive. NHLBI has supported one research group to identify human virome and ...more »

Submitted by (@nhlbiforumadministrator)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Details on the impact of addressing this CQ or CC :

• The virome contains the most abundant and fastest mutating genetic elements on Earth. The human virome is constituted of viruses that infect host cells, virus-derived elements in our chromosomes, and viruses that infect the broad array of other types of organisms that inhabit us. The virome may influence the host in profound ways independent of classical viral disease. The immune system is continuously stimulated by chronic systemic viruses and this aspect of host-microbiome interactions appears specific to the virome. The virome is considered one of the drivers of idiopathic systemic inflammation that has been linked to many of the most severe public health threats, including cardiovascular diseases. Disruptions in immunity by immunosuppressing events can undoubtedly alter the interactions of the virome with the host. However, little research has been done in all of these aspects other than limited descriptive studies to identify the presence or composition of the human virome. The NHLBI Microbiome Working Group in June 2014 clearly identified under-representation of studies of the human virome. Identification and characterization of unknown viral elements of the human virome and research on the interactions with the host will allow exploration of their impact on heart, lung and blood health and diseases, including impact in the presence of immunosuppression with the host such as in AIDS or HIV infection.

Feasibility and challenges of addressing this CQ or CC :

This initiative is feasible because of new technologies that have been developed recently such as the deep sequencing techniques. The initiative is also timely in that research supported by the NIH Human Microbiome Program and other programs has allowed us to better understand microbiome, especially bacteria in and on humans, and we began to realize the magnitude of the virome. This initiative will attract more investigators to not only identify more elements of the virome but more importantly to understand the roles of the human virome in heart, lung and blood health and diseases, and eventually to help develop diagnostic and intervention strategies.

Name of idea submitter and other team members who worked on this idea : NHLBI Staff

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Goal 1: Promote Human Health

New Approaches to study interactions of blood cells with components of the vascular wall

To eventually modulate pathologic communication processes employing new therapeutics, there is a need to better understand the transcellular communication between blood cells and components of the vascular layer in vivo.

Submitted by (@nhlbiforumadministrator)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Critical Challenge (CC)

Details on the impact of addressing this CQ or CC :

A better understanding of this largely unrecognized and underappreciated form of transcellular communication would allow us to use the information to not only detect disease at its very earliest stages, but perhaps also modulate pathologic communication processes employing new therapeutics.

Feasibility and challenges of addressing this CQ or CC :

It is now feasible to address this CQ because of the availability of techniques such as atomic force microscopy, multi-photon intravital microscopy, computational and experimental approaches.

Name of idea submitter and other team members who worked on this idea : NHLBI Staff

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25 up votes
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Goal 1: Promote Human Health

Understanding normal aging

Understanding normal aging

Submitted by (@nhlbiforumadministrator)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Critical Challenge (CC)

Details on the impact of addressing this CQ or CC :

While we are fully supportive of the recent emphasis on patient‐centered outcomes and implementation science, we are also reminded of the critical importance of investigating underlying mechanisms of pulmonary, critical care and sleep disorders. Recent discoveries have created exciting progress in the areas of cystic fibrosis, pulmonary hypertension, pulmonary fibrosis, and biological therapies in asthma. Only through further efforts to elucidate underlying mechanisms are new therapeutic approaches likely to emerge. Promoting further academic‐industry interactions are likely to yield benefits, which will ultimately lead to improvements in the health of our nation.

Name of idea submitter and other team members who worked on this idea : Research Advocacy Committee, American Thoracic Society

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Goal 1: Promote Human Health

Glycans are critical for mammalian biology at a fundamental level

There is a pervasive view of glycobiology as a niche field that does not warrant significant attention. This is borne out of a profound ignorance. It is not an exaggeration to state that carbohydrates are just as important as proteins, nucleic acids, and lipids. Dismissing the impact of glycans is like stating that proteins are not very important to biology, and their importance is seen in the lethality of many mutations ...more »

Submitted by (@nhlbiforumadministrator)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Critical Challenge (CC)

Details on the impact of addressing this CQ or CC :

In my opinion, glycomics is the next big frontier in mammalian biology and will be fueled by dissecting its regulation, mechanistic roles in disease, and the therapeutic potential of its manipulation.

Name of idea submitter and other team members who worked on this idea : Brian Cobb

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Goal 1: Promote Human Health

Transforming Transplantation with RISC

What is necessary to reprogram the immune system to improve transplant outcomes of hearts, lungs, and hematopoietic cells? While NIAID is a major funder of immunology research, we are a major contributor to stem cell research. Our resources could be combined, where NIAID would support this approach for autoimmune diseases, and we would support work in tolerance for transplants. If the NCI also wants to collaborate on ...more »

Submitted by (@nhlbiforumadministrator1)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Critical Challenge (CC)

Details on the impact of addressing this CQ or CC :

This innovative and transformative proposal could improve tolerance to many different types of transplants.

Feasibility and challenges of addressing this CQ or CC :

In 2002, Hochedlinger and Jaenisch (Nature 415:1035-1038) created a mouse by nuclear transplantation from a mature B-cell. This was proof of principle that the immune system can be reprogrammed entirely. Since then there has been little work in this area, but Reprogramming Immune System Cells (RISC) is risky but promising.

A second approach involves mechanisms that cancer cells use to evade immune detection. While most cancer research works to restore immune competence for therapy, the basic biology of evading immune detection could be exploited to improve tolerance. These approaches could be tested in an animal model in 5 years.

Name of idea submitter and other team members who worked on this idea : NHLBI Staff

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15 up votes
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Goal 1: Promote Human Health

Hypertension in children and adolescents - diagnosis and long term outcomes in large populations

Can we improve the thresholds for defining hypertension in children and adolescents based on risks for future adverse cardiovascular sequelae? In addition, can we to better understand how early identification of hypertension impacts long term health outcomes?

Submitted by (@elyse.o.kharbanda)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Details on the impact of addressing this CQ or CC :

Current thresholds for diagnosing hypertension in children and adolescents are based on the distribution of BP in general populations but are not linked to clinical outcomes. Most elevated BP in children and adolescents remains unrecognized, and there is little population level data on the benefits of early idnetification and treatment. There is a critical need for longitudinal data on BP with considerations that thresholds for diagnosing hypertension, evaluating for secondary causes and treating in this age group shoudl be linked to risks for long term cardiovasular sequelae. Important to consider is that labeling a child with mildly elevated BP as having hypertension could adversely impact family functioning and childhood health.

Feasibility and challenges of addressing this CQ or CC :

This could be addressed through a population-based, observational cohort study, spanning childhood through young adulthood.

Name of idea submitter and other team members who worked on this idea : Elyse Kharbanda

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16 up votes
4 down votes
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Goal 1: Promote Human Health

Establishing A Mobil Health Apps Monitoring Program

The recent Manhattan Research survey noted the increasing proliferation of health monitoring apps, which are accessible on mobile devices. Some experts believe that there are more than 40,000 of them already available. They mostly deal with wellness and fitness. The quality is very uneven and there is uncertainty among physicians which ones should be recommended to their patients.

Submitted by (@vlady.rozenbaum)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Details on the impact of addressing this CQ or CC :

A recent commentary in JAMA indicated a need for an independent or a government body to review and certify apps. That would be helpful to patients, particularly those suffering from chronic diseases. Very interesting discussion of this topic was published last October in Medical Economics.

Feasibility and challenges of addressing this CQ or CC :

Considering the fact that the number of physicians using apps continually increases, soliciting information on their experiences should not add an undue burden. Physicians will report their experiences and a quarterly assessment of the collected data will provide the expected reassurances to physicians and patients.

Name of idea submitter and other team members who worked on this idea : COPD-ALERT

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40 up votes
13 down votes
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Goal 1: Promote Human Health

Improve understanding of cardiometabolic health in Asian Americans

We are only now beginning to recognize that certain Asian American subpopulations are at high risk for cardiometabolic (CM) disorders thanks to recent ethnicity-specific studies (e.g., MASALA study). For the most part, however, our understanding of CM risk in Asian Americans is based on aggregated data. Further, a perception remains that other, understudied groups (e.g., Chinese Americans) are at low risk because of their ...more »

Submitted by (@mtseng)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Details on the impact of addressing this CQ or CC :

Decisions regarding public health programming, education, and resources are based on an assumed understanding of cardiometabolic health/risk in Asian American populations rather than on existing, high quality, epidemiologic evidence. Addressing this CQ would provide necessary surveillance/monitoring information for appropriate targeting of resources and it would point to important contextual or individual level determinants to be targeted for programming or intervention.

Feasibility and challenges of addressing this CQ or CC :

This CQ is entirely feasible using established epidemiologic methods although new recruitment methodologies might be necessary to reach broad, population-based samples. The primary obstacle is in recognizing this as a significant public health issue.

Name of idea submitter and other team members who worked on this idea : Marilyn Tseng

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