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GROW: Adapting and Enhancing Group-based Prenatal Care to Support Healthy Gestational Weight Gain for HIV-affected Women

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FIC - John E. Fogarty International Center for Advanced Study in the Health Sciences

ABSTRACT: Suboptimal gestational weight gain (GWG) is a modifiable risk factor for adverse pregnancy outcomes, postpartum weight retention and obesity, and subsequently, the long-term development of non-communicable diseases (NCD) among women and children. In South Africa, 45% of women exceed the Institute of Medicine’s (IOM) recommended weight gain in pregnancy, and 38% gain too little weight, putting them at risk for poor perinatal and postpartum NCD outcomes. Women in low- and middle-income countries (LMICs) with a high burden of HIV and NCDs, such as South Africa, are at particularly high risk of suboptimal weight gain due to poor diet quality, limited physical activity, high levels of psychosocial stressors, and, for women with HIV (WHIV), possible antiretroviral-associated weight gain. By supporting healthy GWG, there is strong potential to reduce postpartum NCD risk and improve perinatal outcomes for women with and without HIV. However, few GWG interventions are available for delivery in LMICs, and none have been adapted to address excessive and inadequate GWG or enhanced to meet the unique needs of women with and without HIV. To address this gap, our team previously developed an innovative, theoretically driven group prenatal care (GPNC) intervention and adapted it to reduce GWG and NCD (GPNC-NCD) risk in resource-constrained settings. GPNC-NCD is an evidence-based intervention, based on social cognitive theory, that builds health literacy, self-efficacy, social support, and satisfaction with care, leading to improved perinatal, GWG, NCD, and perinatal outcomes. The goal of this proposal is to adapt the GPNC-NCD intervention for use in South Africa to support healthy GWG (not too much or too little), enhance it to address the needs of WHIV and without HIV, and evaluate the feasibility, acceptability, and preliminary efficacy of the intervention to improve GWG, NCD, perinatal, and HIV care and prevention outcomes in a pilot randomized trial. Our specific aims are: 1) to adapt the GPNC-NCD intervention for use in South Africa to support healthy GWG and enhance it to address HIV status as a driver of GWG, and 2) to determine the feasibility, acceptability, and preliminary efficacy of the adapted and enhanced GPNC intervention. In a pilot trial, 80 women will be individually randomized by HIV status at ≤14 weeks gestation to GPNC (n=20 WHIV, n=20 HIV-) versus usual care (n=20 WHIV, n=20 HIV-). We hypothesize that adapted GPNC will be feasible, acceptable and show preliminary efficacy to improve GWG, NCD (blood pressure, breastfeeding, diet, physical activity), HIV care/prevention (ART adherence, viral suppression, or PreP uptake), and perinatal (birthweight, large-for-gestational age, cesarean delivery) outcomes. This proposal addresses the goals of PAR-23-191 by leveraging the evidence-based GPNC intervention to support healthy GWG, addresses HIV-NCD disparities, and builds capacity for HIV/NCD research in LMICs. If successful, our adapted GPNC intervention has strong potential to serve as a model for how to integrate NCD and HIV care and prevention support into routine prenatal care in LMICs to improve perinatal, HIV, and NCD outcomes.

Up to $92K
2028-03-31
health research

Free to search & build · $99 one-time to unlock the application pack · No subscription

Harnessing Androgen-Driven Immune Modulation to Enhance Immunotherapy for Endocrine Cancers

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NCI - National Cancer Institute

PROJECT SUMMARY Immunotherapy has transformed cancer treatment, yet patients with endocrine tumors, including adrenal and ovarian cancers, rarely benefit due to poor immune infiltration and activation in steroid-rich environments. Androgens, traditionally viewed as cancer-promoting, may enhance anti-tumor immunity. High androgen receptor expression correlates with improved outcomes in adrenal, ovarian, and select breast cancers; however, the mechanisms underlying these effects remain poorly understood. Using a mouse model of adrenal cancer, my work revealed a sex bias in tumor incidence, with males exhibiting lower tumor burden, which was associated with androgen-driven immune activation. Androgen-secreting adrenal tumors in the clinic show better prognosis and greater immune infiltration, while androgen deprivation in our mouse model reduces intratumoral myeloid and lymphoid cells. Androgen supplementation increases circulating inflammatory monocytes, suggesting a tumor-protective role via immune activation. Similar androgen-driven immune responses occur in the ovary, paralleling clinical data linking androgens to reduced ovarian cancer risk. These findings support a translational potential for androgen-mediated immunity across endocrine malignancies. In the K99 phase, I will investigate how androgens enhance myeloid and lymphoid immune responses to improve ICB efficacy in ACC. Aim 1 will assess how androgens modulate myeloid cell function and recruit the adaptive immune response to promote anti-tumor immunity. I will use a syngeneic ACC mouse model with immune cell depletion and ICB, real-time ultrasound tumor tracking, and Xenium transcriptomics to dissect androgen-driven immune mechanisms. Findings will be validated in androgen-secreting ACC patient tumors. In the R00 phase, I will extend this work to ovarian cancer, a leading cause of gynecologic cancer mortality. Aim 2 will examine how androgen signaling enhances immune infiltration in the ovary and whether this can improve ICB efficacy in ovarian cancer. I will use AR-deficient myeloid mouse models, syngeneic ovarian tumor injections, and Xenium transcriptomics to define androgen-mediated immune effects. This will establish a potential rationale for androgen-based immunotherapeutics in ovarian cancer. My career development plan includes training in tumor immunology, Xenium transcriptomics, and ovarian cancer biology, supported by mentorship from leaders in the field. The research environment at Huntsman Cancer Institute offers state-of-the-art resources and collaborative opportunities to achieve these goals. The K99/R00 award will enable me to establish my independent research lab, where I aim to advance our understanding of how hormones impact the tumor immune environment and ultimately use this to improve therapeutic strategies.

Up to $127K
2028-04-30
health research

Free to search & build · $99 one-time to unlock the application pack · No subscription

Harnessing Hydrophobic Interactions for Photocaging and Photoproximity Labeling

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NIGMS - National Institute of General Medical Sciences

Project Summary. In recent years, the catalytic proximity labeling (CPL) approaches have emerged as viable tools for in situ biological study that can capture and identify the collection of proteins from a particular cellular location or interaction. The proximity labeling largely relies on combined H-bonding, ionic interaction, and hydrophobic force between ligands and biomolecules. It is noteworthy that many biological interactions are dominated by hydrophobic interactions. For example, such interactions are heavily involved in lipid-protein and recent emerged hydrophobic tag (HyT) based protein degrader. However, the exploration of hydrophobic interactions in CPL is a largely untapped area while offering unique opportunities to gain (new) insights of lipid- proteomic networks and understand the unknown mechanism of action in HyT degraders. The goal of this application is to develop photocatalytic proximity labeling (PPL) platforms to map protein interactions in lipid and HyT-based protein degraders, and to develop new ‘hydrophobic interactions photocaging’ strategy for spatiotemporal modulation of lipid signaling and HyT-based protein degradation in living cells. In Aim 1, I will develop an unprecedented near-infrared (NIR) -responsive photocaging methods to modulate HyT-based protein degradation and lipid signaling. The conceptually innovative ‘photocaging hydrophobic interaction’ method provides a new platform to probe the role of hydrophobic interactions in biological systems. In Aim 2, I will develop NIR-activated proximity labeling platforms to comprehensively map lipid–protein interactions. This light-responsive platform will address the limitations of conventional diazirine-based photoaffinity labeling method and has potential to uncover new drug targets and lipid-binding proteins. In Aim 3, I will further profile HyT degrader interactomes using NIR-triggered proximity labeling. Hydrophobic tag (HyT)-based degraders offer a promising alternative to PROTACs due to their lower molecular weight and improved pharmacokinetics. However, the mechanistic basis of HyT-induced protein degradation remains poorly understood. These studies will provide mechanistic insight into HyT-mediated degradation and inform rational design of next-generation degraders. The proposed studies will be conducted at UC San Diego, an internationally recognized research university distinguished by its collaborative culture, interdisciplinary strengths, and state-of-the-art core facilities. Throughout the K99/R00 phase, I will benefit from the mentorship of my advisory committee, including Dr. Benjamin Cravatt, a pioneer in chemical biology and proteomics, Dr. Eric Bennett, an expert in protein quality control and proteomics, and Dr. Fleur Ferguson, a leader in targeted protein degradation. Their collective guidance in scientific training and career development, together with the structured training afforded by the K99/R00, will provide the critical foundation for me to launch an independent research program at the interface of chemical biology, proteomics, and photochemistry.

Up to $125K
2028-07-31
health research

Free to search & build · $99 one-time to unlock the application pack · No subscription

Harnessing Metabolic Machinery of Gut Bacteria for Metabolic Dysfunction-Associated Steatohepatitis

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NIDDK - National Institute of Diabetes and Digestive and Kidney Diseases

Project Summary/Abstract Metabolic dysfunction-associated steatohepatitis (MASH) is a growing public health concern in industrialized nations, with an estimated cost of $1.66 trillion in the U.S. by 2039. Despite its prevalence, therapeutic strategies remain limited due to an incomplete understanding of its pathogenesis. Emerging evidence suggests that the gut microbiota plays a critical role in modulating metabolic and inflammatory processes in MASH through the production of microbiota-dependent metabolites (MDMs). Therefore, a promising approach is to augment therapeutic MDMs in the gut by reintroducing their producers. However, current microbiome-based interventions, such as fecal microbiota transplantation (FMT), have been largely ineffective in ameliorating MASH due to critical gaps in identifying potent MDM-producing bacterial strains and elucidating the mechanisms that enable their durable engraftment in the gut. My long-term goal is to develop rationally designed microbiome therapeutics for MASH and other metabolic diseases by leading a multidisciplinary research program. This proposal aims to establish a foundational strategy to combat liver inflammation in MASH by leveraging bacterial strains with high MDM-producing capacity, focusing on Clostridia isolated from the Hadza hunter-gatherers. The Hadza harbor a highly distinct gut microbiome enriched with bacterial strains that efficiently utilize dietary polysaccharides and synthesize health-promoting MDMs, presenting promising therapeutic potential. Aim 1 will identify Hadza-derived Clostridia that produce anti-inflammatory MDMs. Aim 2 will investigate the mechanisms enabling their stable MDM production in the gut, with a focus on their polysaccharide-utilizing machinery that facilitates engraftment. Aim 3 will determine their immune and therapeutic effects in diet-induced MASH models. The successful completion of this study will enhance our understanding of gut bacterial metabolism in MASH and establish a rational framework for developing targeted microbiome therapeutics beyond current FMT approaches. Additionally, this K99/R00 award will provide essential training in both scientific and career development, facilitating my transition to becoming an interdisciplinary independent researcher. My training will be supported by a distinguished mentoring team with expertise in microbiome science (Dr. Justin Sonnenburg, primary mentor), liver biology (Dr. Natalie Torok, co-mentor), metabolomics (Dr. Michael Fischbach, advisor), gut ecology (Dr. Kerwyn Casey Huang, advisor), and immune profiling (Dr. Holden Maecker, advisor). Stanford University, a renowned institution in biomedical research, provides extensive resources, state-of-the-art equipment, and unparalleled opportunities to support my training. In summary, this K99/R00 proposal will equip me with the necessary skills to launch an independent research program in microbiome therapeutics for MASH and other metabolic diseases. The research findings will provide key insights into the role of microbiota in MASH and establish the groundwork for translational strategies aimed at improving metabolic and liver health.

Up to $92K
2028-01-31
health research

Free to search & build · $99 one-time to unlock the application pack · No subscription

Harnessing Technology to Develop a Just-in-Time Adaptive Intervention to Promote Physical Activity in Adolescents with Type 2 Diabetes

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NIDDK - National Institute of Diabetes and Digestive and Kidney Diseases

PROJECT SUMMARY/ABSTRACT The incidence of youth-onset type 2 diabetes (T2D) is on the rise, with a 95% escalation rate since 2001, and a staggering 77% increase during the COVID-19 pandemic. Regular physical activity is a cornerstone of T2D treatment. Yet, physical activity engagement is alarmingly low among youth with T2D, and effective interventions are lacking. Dr. Gutierrez-Colina’s long-term career objective is to improve health outcomes for youth with T2D by developing state-of-the-art mobile health (mHealth) interventions that provide personalized support for T2D self-management. The goal of this K23 proposal is to develop a novel just-in-time adaptive intervention (JITAI) that integrates dissemination and implementation science with real-time assessments of physical activity barriers and facilitators to deliver tailored strategies for promoting physical activity in adolescents with T2D. In Aim 1, a sequential exploratory design will be used to identify time-varying factors (e.g., motivation, fatigue, self- regulation) that influence physical activity engagement in adolescents with T2D. Qualitative interviews with N=18 T2D stakeholders will be conducted to gather in-depth feedback about physical activity barriers and facilitators. Qualitative findings will be integrated into the development of a 2-week ecological momentary assessment protocol designed to examine daily temporal associations between real-world barriers/facilitators and physical activity in the daily lives of N=25 adolescents with T2D. In Aim 2, the intervention components of a physical activity JITAI (e.g., personalized text messages, tailoring variables) will be co-developed with an advisory board of adolescents and caregivers. Intervention development will draw from dissemination and implementation science frameworks, as well as the “Capability, Opportunity, and Motivation (COM-B) Model,” a well-established theory of health behavior change. The JITAI will target activity barriers/facilitators related to Capability, Opportunity, and Motivation and deliver tailored support at the right time, in the right dose, and only when needed. In Aim 3, a sequential factorial experimental design will be used to pilot a 28-day micro-randomized trial of the physical activity JITAI with N=30 adolescents. Study feasibility and acceptability will be evaluated through usability surveys and post-intervention end-user interviews. Findings will generate critical data to inform an R01 application focused on a full-scale micro-randomized trial to optimize the physical activity JITAI. The proposed K23 research and career development plan will be supported by an outstanding mentorship team and a rich research environment at Colorado State University and the University of Colorado/Children's Hospital Colorado. Completion of the K23 training goals in (1) qualitative/mixed methods, (2) JITAI intervention development with an emphasis on dissemination and implementation science, and (3) the design and evaluation of micro- randomized clinical trials will equip Dr. Gutierrez-Colina with essential expertise in digital interventions and the rigorous methods involved in their evaluation. This training will directly support her successful transition to an independent research career focused on advancing personalized digital interventions for youth with T2D.

Up to $184K
2031-03-31
health research

Free to search & build · $99 one-time to unlock the application pack · No subscription

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