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

基本信息

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
项目类别：
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

项目摘要

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：Adit Ginde，医学博士、公共卫生硕士，是科罗拉多大学丹佛分校 (UCD) 急诊医学助理教授。他之前接受过公共卫生硕士和研究奖学金培训，他的早期研究生涯主要集中在维生素 D 和急性呼吸道感染 (ARI) 的观察性研究。他寻求从机构 KL2 奖过渡到 Beeson 职业发展奖，重点关注维生素 D 在与年龄相关的免疫功能下降中的作用，特别是老年人对感染和疫苗的反应。导师/环境：主要导师 Robert Schwartz 医学博士是老年医学部门负责人兼 UCD 老龄化中心主任。免疫学联合导师迈伦·莱文 (Myron Levin) 医学博士是都柏林大学医学和儿科教授，其研究重点是表征和改善对流感和带状疱疹疫苗的反应。两人都是资金雄厚的 NIH 临床研究员，并指导了许多初级教师在衰老和免疫学研究领域取得了成功的独立职业生涯。培训：拟议的 Beeson 职业发展计划以奖学金和早期职业发展奖项的先前经验为基础，重点关注需要额外培训的三个主要主题领域：1）转化和介入研究设计； 2）老龄化/疗养院研究； 3) 临床免疫学。金德博士建议加强专题指导、重点课程/研讨会和指导研究。研究：感染在老年人中很常见，导致医疗保健利用率和发病率增加。疫苗可以提高宿主对病原体的防御能力，并减少常见感染的发生率、严重程度和持续时间。然而，对传染性病原体的免疫反应和疫苗的有效性随着年龄的增长而下降。补充维生素 D 改善老年人对病原体和疫苗反应的能力此前尚未在临床试验中进行过研究。在对老年（年龄 > 60 岁）长期护理居民进行每月口服高剂量维生素 D3 补充剂与标准剂量维生素 D3 补充剂的临床试验的背景下，我们提出以下具体目标：1) 衡量每月高剂量口服高剂量维生素 D3 补充剂（相当于 3,000-4,000 IU/天）与标准剂量维生素 D3 补充剂（400-1,000 IU/天）相比IU/天）用于预防 200 名老年人（年龄 60 岁）长期护理居民的 ARI； 2)通过维生素D3补充剂量和接种前血清25-羟基维生素D水平确定对非活性季节性流感疫苗的特异性体液免疫反应的差异； 3) 通过维生素 D3 补充剂量和疫苗接种前 25-羟基维生素 D 水平确定对带状疱疹减毒活疫苗的特异性细胞介导免疫反应的差异。摘要：本次创新研究计划；来自老年病学、传染病、免疫学和疫苗专家的强有力指导；拟议的职业发展经验将帮助金德博士成为改善免疫衰老和减轻老年人感染负担的干预措施的主要研究者。

项目成果

期刊论文数量（6）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Has the time for advanced pre-hospital care of severe sepsis finally arrived?

严重脓毒症院前高级救治的时代终于到来了吗？

DOI：
发表时间：
2012-12-15
期刊：
影响因子：
24.7
作者：
Ginde, Adit A;Moss, Marc
通讯作者：
Moss, Marc

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：
发表时间：
2017-05
期刊：
影响因子：
6.3
作者：
Ginde, Adit A;Blatchford, Patrick
通讯作者：
Blatchford, Patrick

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

2001-2009 年美国急诊科重症监护入院人数增加。

DOI：
发表时间：
2013-05
期刊：
影响因子：
8.8
作者：
Herring, Andrew A;Ginde, Adit A;Fahimi, Jahan;Alter, Harrison J;Maselli, Judith H;Espinola, Janice A;Sullivan, Ashley F;Camargo Jr, Carlos A
通讯作者：
Camargo Jr, Carlos A

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。