Vitamin D and Immunosenescence in Older Long-Term Care Residents

老年长期护理居民的维生素 D 和免疫衰老

• 批准号: 8521040
• 负责人: Adit A. Ginde
• 金额: $ 20.66万
• 依托单位: UNIVERSITY OF COLORADO DENVER
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-15 至 2015-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8521040
• 关键词: 25-hydroxyvitamin D; Accident and Emergency department; Acute respiratory infection; Age; Aging; Antibodies; Antigen Presentation; Area; Attenuated; Award; B-Lymphocytes; Biological Assay; Biology; Cholecalciferol; Clinical; Clinical Immunology; Clinical Investigator; Clinical Trials; Colorado; Data; Dendritic Cells; Development Plans; Dose; Elderly; Emergency Medicine; Environment; Faculty; Fellowship; Funding; Geriatrics; Head; Health Care Costs; Hemagglutination; Herpes zoster disease; Herpesvirus Type 3; Homing; Hospitalization; Host Defense; Immune response; Immunity; Immunology; Incidence; Infection; Infectious Disease Immunology; Influenza; Influenza vaccination; Interferons; Intervention; K-Series Research Career Programs; Lead; Learning; Life; Life Expectancy; Long-Term Care; Lymphoid; Measures; Mediating; Mediator of activation protein; Medicine; Memory; Mentors; Mentorship; Morbidity - disease rate; Myron; Natural Immunity; Nursing Homes; Observational Study; Oral; Organ; Pediatrics; Predisposition; Prevention; Public Health; Research; Research Design; Research Personnel; Risk; Role; Sample Size; Serum; Severities; Site; Supplementation; T cell response; T-Lymphocyte; Time; Training; United States National Institutes of Health; Universities; Vaccination; Vaccines; Visit; Vitamin D; Vitamin D Deficiency; age related; antimicrobial peptide; career; career development; cell mediated immune response; cohort; enzyme linked immunospot assay; experience; health care service utilization; immune function; immunogenicity; immunosenescence; improved; influenza virus vaccine; innovation; pathogen; pilot trial; prevent; professor; prospective; receptor; respiratory; response; seasonal influenza; senescence; trafficking; vaccine effectiveness

DESCRIPTION (provided by applicant): Candidate: Adit Ginde, MD, MPH is an Assistant Professor of Emergency Medicine at University of Colorado Denver (UCD). He has prior MPH and research fellowship training, and his early research career has focused on observational studies in vitamin D and acute respiratory infection (ARI). He seeks to transition from his institutional KL2 Award to this Beeson Career Development Award to focus on the role of vitamin D in the age related decline in immune function and specifically, response to infection and vaccine in older adults. Mentors/Environment: The primary mentor, Robert Schwartz, MD, is the Division Head of Geriatric Medicine and Director of the UCD Center on Aging. The co-mentor for immunology, Myron Levin, MD, is Professor of Medicine and Pediatrics at UCD, whose research has focused on characterizing and improving response to influenza and herpes zoster vaccines. Both are well-funded NIH clinical investigator and have mentored numerous junior faculty to successful independent careers in aging and immunology research. Training: The proposed Beeson career development plan builds on prior experience from fellowship and early career development awards to focus on three primary topical areas that require additional training: 1) Translational and Interventional Study Design; 2) Aging/Nursing Home Research; and 3) Clinical Immunology. Dr. Ginde proposes intensive topical mentorship, focused coursework/seminars, and mentored research. Research: Infections are common in older adults resulting in increased healthcare utilization and morbidity. Vaccines improve host defense against pathogens and reduce the incidence, severity, and duration of common infections. However, the immune response to infectious pathogens and effectiveness of vaccines decline with advancing age. The ability of vitamin D supplementation to improve response to pathogens and vaccines in older adults has not been previously investigated in a clinical trial. In the context of a clinical trial of monthly oral high-dose vitamin D3 supplementation vs. standard dose vitamin D3 supplementation in older (age > 60 years) long-term care residents, we propose the following specific aims: 1) Measure the efficacy of high dose monthly oral high-dose vitamin D3 supplementation (equivalent to 3,000-4,000 IU/day) compared to standard dose vitamin D3 supplementation (400-1,000 IU/day) in prevention of ARIs in 200 older (age ?? 60 years) long-term care residents; 2) Determine the difference in specific humoral immune response to the inactive seasonal influenza vaccine by vitamin D3 supplementation dose and pre-vaccination serum 25- hydroxyvitamin D levels; 3) Determine the difference in specific cell-mediated immune response to the live, attenuated zoster vaccine by vitamin D3 supplementation dose and pre-vaccination 25-hydroxyvitamin D levels. Summary: This innovative research plan; strong mentorship from geriatrics, infectious disease, immunology, and vaccine experts; and proposed career development experience will help Dr. Ginde become a leading investigator of interventions to improve immunosenescence and reduce the burden of infection in older adults.

描述（由申请人提供）：候选人：MD的Adit Ginde，MPH是科罗拉多大学丹佛分校（UCD）的急诊医学助理教授。他先前接受过MPH和研究奖学金培训，他的早期研究职业集中于维生素D和急性呼吸道感染（ARI）的观察性研究。他试图从他的机构KL2奖中过渡到Beeson职业发展奖，以重点关注维生素D在年龄相关的免疫功能下降中的作用，特别是对老年人的感染和疫苗的反应。导师/环境：主要导师，医学博士罗伯特·施瓦茨（Robert Schwartz）是老年医学的部门负责人，也是UCD老化中心主任。免疫学的同事Myron Levin，医学博士是UCD的医学和儿科教授，其研究重点是表征和改善对流感和疱疹带状疱疹疫苗的反应。两者都是资金良好的NIH临床研究者，并为成功的独立职业提供了众多初级教师，从事衰老和免疫学研究。培训：拟议的Beeson职业发展计划基于研究金和早期职业发展奖的先前经验，专注于需要额外培训的三个主要主题领域：1）翻译和介入的研究设计； 2）老化/疗养院研究； 3）临床免疫学。 Ginde博士提出了密集的主题指导，专注的课程/研讨会和指导研究。研究：感染在老年人中很常见，导致医疗保健利用和发病率增加。疫苗可以改善宿主对病原体的防御，并减少常见感染的发病率，严重程度和持续时间。但是，随着年龄的增长，对传染病的免疫反应和疫苗的有效性下降。先前尚未在一项临床试验中研究了补充维生素D补充对老年人病原体和疫苗反应的能力。 In the context of a clinical trial of monthly oral high-dose vitamin D3 supplementation vs. standard dose vitamin D3 supplementation in older (age > 60 years) long-term care residents, we propose the following specific aims: 1) Measure the efficacy of high dose monthly oral high-dose vitamin D3 supplementation (equivalent to 3,000-4,000 IU/day) compared to standard dose vitamin D3 supplementation （400-1,000 IU/天）预防200年龄（年龄60岁）的长期护理居民的ARIS； 2）确定维生素D3补充剂量和疫苗接种前血清25-羟基维生素D水平的特定体液免疫反应对不活跃的季节性流感疫苗的特异性免疫反应差异； 3）确定特异性细胞介导的免疫反应对维生素D3补充剂量和疫苗接种前25-羟基维生素D水平对活细胞的潜水疫苗的差异。摘要：这个创新的研究计划；老年医学，传染病，免疫学和疫苗专家的强烈指导；拟议的职业发展经验将有助于Ginde博士成为改善免疫衰老并减轻老年人感染负担的干预措施的主要研究者。

项目成果

Electronic communication capabilities of residential care facilities at times of transition.

过渡时期住宅护理设施的电子通信能力。

• DOI: 10.1111/jgs.12905
• 发表时间: 2014
• 期刊: Journal of the American Geriatrics Society
• 影响因子: 6.3
• 作者: Burke,RobertE;Jones,ChristineD;Levy,Cari;Ginde,AditA
• 通讯作者: Ginde,AditA

Reply to: Analysis Leads to Unreliable Results in Study of Vitamin D and Acute Respiratory Infection.

回复：维生素 D 与急性呼吸道感染研究的分析导致结果不可靠。

• DOI: 10.1111/jgs.14851
• 发表时间: 2017
• 期刊: Journal of the American Geriatrics Society
• 影响因子: 6.3
• 作者: Ginde,AditA;Blatchford,Patrick
• 通讯作者: Blatchford,Patrick

Has the Time for Advanced Pre-Hospital Care of Severe Sepsis Finally Arrived?

• DOI: 10.1164/rccm.201210-1895ed
• 发表时间: 2012-12-15
• 期刊: AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE
• 影响因子: 24.7
• 作者: Ginde, Adit A.;Moss, Marc
• 通讯作者: Moss, Marc

The role of vitamin D in prevention and treatment of infection.

• DOI: 10.2174/18715281113129990046
• 发表时间: 2013-08
• 期刊: Inflammation & allergy drug targets
• 作者: Gunville CF;Mourani PM;Ginde AA
• 通讯作者: Ginde AA

Increasing critical care admissions from U.S. emergency departments, 2001-2009.

• DOI: 10.1097/ccm.0b013e31827c086f
• 发表时间: 2013-05
• 期刊: Critical care medicine
• 影响因子: 8.8
• 作者: Herring AA;Ginde AA;Fahimi J;Alter HJ;Maselli JH;Espinola JA;Sullivan AF;Camargo CA Jr
• 通讯作者: Camargo CA Jr