Goal 3: Advance Translational Research

To facilitate innovation and accelerate research translation, knowledge dissemination, and implementation science that enhances public health.

Goal 3: Advance Translational Research

Translational Research for HIV/AIDS and HLB Health and Diseases

What are the best inroads for the NHLBI to support innovative approaches in the next 5-10 years, especially blood cell therapies based on hematopoietic stem cell and novel gene therapy approaches to control or even cure HIV infection?

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 :

HIV control or possibly even HIV cure could result from developing novel cell therapies, especially hematopoietic stem cell (HSC) transplants, and might also result from early use of antiretroviral therapy in acutely HIV-infected individuals.

• Transplantation of HSC including engineered cells has the potential to eradicate HIV reservoirs for HIV cure: the Berlin patient treated with HSC transplant remains free of HIV and is still the only patient cured of HIV infection as of today;

• Identification of acute HIV infections through routine blood donor screening and early anti-retroviral therapy for identified HIV-infected donors can limit or even prevent the establishment of HIV reservoirs.

Feasibility and challenges of addressing this CQ or CC :

• The Berlin patient has provided the proof of concept that HIV infection can be eradicated, that is, sterilizing cure can be achieved, through HSC transplantation in combination with other therapies;

• Recent studies have shown that early identification of HIV infection and treatment of infected individuals with anti-retroviral therapy as soon as possible can significantly limit the size of the HIV reservoirs even if such early treatment may not be able to completely prevent the establishment of HIV reservoirs; routine blood donor screening for both anti-HIV antibodies and HIV RNA among blood donors offers unique opportunities to identify acute HIV infections.

 

 

For HIV cure, the challenges include:

 

• Generation of HIV-resistant HSCs in adequate quantity for transplantation;

 

• Efficiency of homing and expansion of HIV-resistant HSC transplants;

 

• Efficiency in replacing HIV-infected cells, including CD4+ resting cells as the major HIV reservoirs, with HIV-resistant HSCs following transplantation;

 

• Efficiency in immune reconstitution by HSC transplants;

 

• Safety of HSC transplantation with needed GVHD to eliminate HIV-infected resting T cells while avoiding irreversible damage to the host.

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

Voting

-16 net votes
15 up votes
31 down votes
Active

Goal 3: Advance Translational Research

The effect of continuous LTOT in COPD targeting fixed oxygen flow rates vs. oxygen saturation on patient-reported outcomes

What is the comparative effectiveness of prescribing continuous LTOT in COPD that targets fixed oxygen flow rates vs. oxygen saturation on patient-reported outcomes (symptom frequency, activities of daily living, quality of life, sleep quality, exacerbations)?

Submitted by (@amutso)

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

Name of idea submitter and other team members who worked on this idea : Amelia Mutso, PhD, collaborator with COPD Foundation

Voting

13 net votes
16 up votes
3 down votes
Active

Goal 3: Advance Translational Research

It’s not just about adults…

Given the lack of outcomes data in the pediatric population, there is a need to develop a repository of data, including integrated electronic clinical data (outpatient, inpatient, laboratory, imaging, prescription), on all CVD risk factors (e.g. hypertension, dyslipidemia) in children. One approach is to start with leveraging health care systems that have existent electronic clinical data, infrastructure in place for ...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 :

Fill a huge void of information on CVD risk and outcomes in the pediatric population. Provide essential information for prevention, determining events, tailoring interventions, facilitate targeted screening, and much more. Provide longitudinal information.

Feasibility and challenges of addressing this CQ or CC :

We have the technology of EHRs and many are ripe for this pursuit.

This could provide a wealth of information. Imagine if we did this repository in health care systems where they can track a decent proportion of these kids into their adult years?

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

Voting

21 net votes
32 up votes
11 down votes
Active

Goal 3: Advance Translational Research

Non-invasive vs Invasive Positive Pressure Ventilation in Managing Acute Respiratory Failure

What is the comparative effectiveness of a Non-invasive vs. Invasive Positive Pressure

 

Ventilation Protocol for managing acute respiratory failure due to acute exacerbations of COPD

Submitted by (@joem00)

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

Voting

1 net vote
1 up votes
0 down votes
Active

Goal 3: Advance Translational Research

Behavioral and Clinical Researcher Interactions

A critical challenge is the need to bring together basic behavioral scientists interested in understanding human behavior at a fundamental level, including how and why people become motivated and capable of undertaking behavioral changes, with clinical researchers interested in developing and testing new strategies for tackling resistant behavioral problems such as obesity and non-adherence.

Submitted by (@nhlbiforumadministrator1)

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

Feasibility and challenges of addressing this CQ or CC :

Obesity and non-adherence are two of the most important yet challenging behavioral problems contributing to cardiovascular morbidity and mortality. One way to address this challenge is to fund a network of “behavior change labs,” each of which bring together teams of basic behavioral scientists who are investigating the bases of behavior and behavior change with clinical researchers interested in designing, optimizing and testing novel ideas for tackling the difficult behavior problems of obesity and non-adherence to cardiac medications.

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

Voting

20 net votes
52 up votes
32 down votes
Active

Goal 3: Advance Translational Research

Increased testing of new ideas

As indicated in two influential papers we have published, there are many potential contributing factors to obesity beyond those commonly discussed and studied and some of these are potentially modifiable. Increased research to understand whether these putative factors are really influential and whether they can be modified to produce benefits with respect to obesity are in order.

Submitted by (@nhlbiforumadministrator)

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

Feasibility and challenges of addressing this CQ or CC :

The two papers we referenced in this Critical Challenge were: 1) Keith SW, Redden DT, Katzmarzyk PT, Boggiano MM, Hanlon EC, Benca RM, Ruden D, Pietrobelli A, Barger JL, Fontaine KR, Wang C, Aronne LJ, Wright SM, Baskin M, Dhurandhar NV, Lijoi MC, Grilo CM, DeLuca M, Westfall AO, Allison DB. Putative contributors to the secular increase in obesity: exploring the roads less traveled. Int J Obes (Lond). 2006;30(11):1585-94. doi: 10.1038/sj.ijo.0803326. PMID: 16801930; and 2) McAllister EJ, Dhurandhar NV, Keith SW, Aronne LJ, Barger J, Baskin M, Benca RM, Biggio J, Boggiano MM, Eisenmann JC, Elobeid M, Fontaine KR, Gluckman P, Hanlon EC, Katzmarzyk P, Pietrobelli A, Redden DT, Ruden DM, Wang C, Waterland RA, Wright SM, Allison DB. Ten putative contributors to the obesity epidemic. Crit Rev Food Sci Nutr. 2009;49(10):868-913. doi: 10.1080/10408390903372599. PMID: 19960394; PMCID: PMC2932668.

Name of idea submitter and other team members who worked on this idea : David B. Allison, Ph.D.; Kevin Fontaine, Ph.D.; Kathryn A. Kaiser, Ph.D.; Andrew W. Brown, Ph.D.; Edward C. Archer, Ph.D.

Voting

0 net votes
1 up votes
1 down votes
Active

Goal 3: Advance Translational Research

Build a National Surveillance of Chronic CV and Lung Diseases

There is a need to build a robust coordinated surveillance system on the incidence and prevalence of chronic diseases. Surveillance data are needed to: •Describe and monitor the burden, trends, and patterns of these diseases •Set parameters and metrics of research priorities •Identify where to target resources for prevention, treatment, and delivery of care •Track and monitor progress toward public health disease ...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 :

The high prevalence of chronic cardiovascular and lung diseases has created burden in increasing healthcare costs and high mortality rates in the US compared to other developed countries. Even so, they remain among the most preventable health problems. A national surveillance system for chronic cardiovascular and lung diseases would enable data-driven decision-making about public health strategies for prevention, management, and cost containment.

Feasibility and challenges of addressing this CQ or CC :

A 2011 Institute of Medicine (IOM) report concluded that a coordinated surveillance system is needed. It proposed a framework for such a system that would integrate existing information through collective efforts of multiple stakeholders. The time is right to gain from and build upon numerous ongoing broad initiatives in biomedical Big Data, including growing health IT adoption mandated by the HITECH Act, ONCHIT efforts to achieve health IT interoperability, the NIH BD2K initiative, and the multiorganizational network participating in FDA Mini-Sentinel, HCS Collaboratory, and PCORnet, among others. The NHLBI is well-positioned to lead, develop and implement the IOM’s recommended framework and system. (IOM report - http://www.iom.edu/Reports/2011/A-Nationwide-Framework-for-Surveillance-of-Cardiovascular-and-Chronic-Lung-Diseases.aspx)

Existing data sources (i.e., population surveys, registries, cohort studies, administrative data, and vital statistics) do not individually provide nationally representative data, cannot be linked, and are not currently readily accessible to all levels of users. One potential way to build such a system is to integrate and expand existing data sources.

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

Voting

5 net votes
13 up votes
8 down votes
Active

Goal 3: Advance Translational Research

The effectiveness of a protocol-based screening in treating common COPD comorbidities

Does a protocol-based screening for commonly occurring comorbid conditions in patients with COPD (eg. CAD, CHF, depression, sleep apnea) improve management and outcomes for patients with COPD?

Submitted by (@dmcgowan)

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

Details on the impact of addressing this CQ or CC :

Many times co- morbidities are not address appropriately in patients with COPD- a protocol- based screening would support better identification and adherence to guidelines and would improve management and outcomes of individuals with COPD>

Voting

13 net votes
15 up votes
2 down votes
Active

Goal 3: Advance Translational Research

Personalized Medicine thru CV bioinformation/tissue repository

There is a need to establish virtual CV biologic tissues and a bioinformational repository for specific CV diseases, including congenital cardiovascular malformations, genetic or other unique cardiomyopathies, such as stress cardiomyopathy and giant cell myocarditis.

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 :

Personalized medicine promises patient-tailored management enhancing patient care and decreasing overall treatment costs by focusing on genetics/omics data obtained from patient biospecimens and electronic medical records (EMR) to guide therapy that generate optimal clinical outcomes. The approach relies on diagnostic and prognostic use of novel biomarkers discovered through combinations of tissue banking, bioinformatics, and electronic medical records. The analytical power of bioinformatic platforms combined with patient clinical data from EMRs can reveal potential biomarkers and clinical phenotypes that allow researchers to develop experimental strategies using selected patient biospecimens stored in tissue banks.

Feasibility and challenges of addressing this CQ or CC :

the repository would utilize high quality biospecimens in concert with reliable EMR collected at diagnosis and through various treatment stages to provide crucial resources help identify a new risk factors and to facilitate development of novel therapies. The data obtained would also require cross-disciplinary collaborations to translate experimental results into clinical practice and diagnostic and prognostic use in personalized medicine. The repository focus would be on the discovery of predictive, diagnostic, and prognostic biomarkers that will allow proper diagnosis of specific CV diseases, increase information about a particular disease, and indicate the direction treatment should take.

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

Voting

-13 net votes
10 up votes
23 down votes
Active

Goal 3: Advance Translational Research

Developing a Research Community for T4 Translation Research

What incentives will encourage current and new NHLBI investigators to pursue late translation (T4) research of proven effective interventions in heart, lung, blood, and sleep diseases? One of NHLBI’s current strategic plan’s goals is to translate discovery and early translation research knowledge to late stage T4 translation for use in populations so that it has significant positive health impacts and provides a return ...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 :

A robust global T4 translation research community that will implement proven-effective interventions across populations resulting in a significant positive health impact

Feasibility and challenges of addressing this CQ or CC :

The NHLBI Global Health and Health Inequities Think Tanks identified T4 translation research as an important area that needs development in the very near future.

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

Voting

-3 net votes
8 up votes
11 down votes
Active