kristoff@NET.BIO.NET (Dave Kristofferson) (10/13/89)
Vol. 18, No. 33, September 22, 1989 - Page 14 FULL TEXT OF RFAs FOR ONLINE ACCESS RFA: 89-HL-18-B THE ROLE OF HEMOSTATIC FACTORS AND ENDOTHELIAL CELL REACTIVITY IN VASO OCCLUSION SICKLE CELL DISEASE P.T. 34; K.W. 1003002, 1002004, 1002034, 0785070 NATIONAL HEART, LUNG, AND BLOOD INSTITUTE* Application Receipt Date: March 15, 1990 PURPOSE The Division of Blood Diseases and Resources (DBDR) of the National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), invites research grant applications for a single competition for the support of basic and clinical research to clarify the role of cellular, humoral, and vascular factors of blood coagulation in the pathophysiology of sickle cell disease and to define new therapeutic strategies that might help to limit or reverse the process of vaso occlusion. DISCIPLINES AND EXPERTISE Among the disciplines and expertise that may be appropriate for this research program are hematology, cell biology, biochemistry, physiology, thrombosis and hemostasis. ADMINISTRATIVE BACKGROUND The Sickle Cell Disease Branch (SCDB) of the DBDR has the responsibility for the design and administration of a national program to develop and support clinical and basic research activities to reduce the morbidity and mortality from sickle cell disease. SCIENTIFIC BACKGROUND Sickle cell anemia, an inherited disorder that occurs as a result of the expression of a mutant beta globin gene, was the first disease to be described on the molecular level. This disease is characterized by a chronic hemolytic anemia and recurrent vaso occlusive episodes that cause severe pain and widespread organ damage. The prevalence of sickle cell disease in blacks in the United States is approximately 1 in 400 black newborns and is a worldwide problem occurring in the Mediterranean countries, India, Middle East, Caribbean, and South America. Our knowledge of sickle cell disease at the molecular, cellular and clinical levels has advanced significantly over the past decade. The DNA mutation in sickle cell anemia has been defined and the ultrastructure of the sickle hemoglobin has been resolved in great detail. Recent studies on the clinical course of sickle cell disease have provided new insight into the morbidity and mortality of this disease process. Data from these investigations have also yielded important information necessary for effective management of symptoms, as well as for the prevention of early complications associated with this disease. Activation of the coagulation and fibrinolytic systems appears to play a role in the complex physiologic interactions of sickle cell disease. Though these observations have been most frequently noted during episodes of painful vaso occlusion, some abnormalities have also been detected in sickle cell subjects during the steady state. Perhaps, for this reason, it has been difficult to correlate such findings with the actual severity of sickle cell disease, and it has been hard to define the specific role(s) played by disordered hemostasis in clinical manifestations that, together, are referred to as sickle cell crises. Because no coherent formulation has emerged on the role of hemostasis in sickle cell vaso occlusion, it is essential that basic scientists, particularly those knowledgeable in the fields of hemostasis and thrombosis, be encouraged to propose research to illuminate and relate these complex processes to sickle cell disease in general and to sickle cell crisis in particular. Such studies should examine and characterize the involvement of various humoral amplification systems (e.g. coagulation, fibrinolysis, complement, and kinin), as well as their interaction with a number of cellular components (e.g. platelets, endothelial cells, and erythrocytes). It is hoped that these studies will define the role of humoral and cellular factors in sickle cell disease and will open new avenues for treating or preventing episodes of vaso occlusion. There is general agreement that microvascular occlusion is responsible for painful crises and damage to various end organs, which together represent the major clinical manifestations of sickle cell disease. Histologic studies have shown that blood vessels adjacent to infarcted areas are occluded by both fibrin and by sickled erythrocytes. Since this finding does not define whether the activation of clotting factors took place before or after blood vessel occlusion by sickled erythrocytes, the pathophysiology of microvascular occlusion remains poorly defined. Early investigators thought that impaired blood flow and subsequent vaso occlusion resulted primarily from the abnormal shape and reduced deformability of the sickle RBC's. Experimental evidence that has since been accumulated from a wide variety of in vitro and in vivo studies (see examples below) clearly indicates that this theory is far too simplistic, and that vaso occlusion is a very complicated process involving cellular, vascular, and humoral factors. A brief synopsis of the work in this area that has been carried out to date is presented below. PLATELETS Early autopsy reports showing the deposition of fibrin and platelets in the liver of patients with sickle cell disease led to studies which searched for a role for platelets or the coagulation system in the development of painful crises. In the case of platelets, results were at least suggestive. During the steady state, sickle cell patients exhibit mild to moderate thrombocytosis. Platelet counts fall transiently at the onset of a vaso occlusive event. Over the ensuing 7 to 10 days, platelet counts rebound, leading to markedly elevated counts in the post crisis period. During the vaso occlusive crisis, platelet production and turnover have both been shown to be increased. In addition, circulating platelet aggregates and megathrombocytes give further evidence of platelet consumption. It is important to remember, however, that certain of these abnormalities, notably thrombocytosis, megathrombocytes, and platelet aggregates may accompany the postsplenectomy state. Therefore, at least some of these findings may be related to the asplenia of adult patients with sickle cell disease. Unlike the rather consistent findings indicated above, measurements of platelet release products or in vitro studies of platelet aggregation, performed both during vaso occlusive crisis and the steady state, have produced widely discrepant results. Increased, decreased and even normal aggregation in response to such agents as ADP, epinephrine and collagen have been reported. Studies of beta thromboglobulin and platelet factor 4 release have yielded evidence of increased platelet turnover in sickle cell crises, while others have not confirmed this finding. To date, most of these data are based on studies of relatively small groups of patients with varying types of sickle hemoglobinopathies (sickle cell anemia (SS), sickle cell hemoglobin C (SC), S beta thalassemia, sickle cell trait (AS)). In addition, control subjects used in most of these studies were not well matched, and the concentrations of aggregating agents employed varied from study to study. THE COAGULATION CASCADE Assembly of the procoagulant moieties in the coagulation cascade require a phospholipid surface, and leads to cleavage of prothrombin to thrombin, the active serine protease. While the membrane of the normal erythrocyte does not provide an appropriate catalytic surface, studies suggest that the membrane from sickled erythrocytes may do so. Sickling and unsickling of sickle RBC's destabilizes the lipid bilayer, thereby altering the lipids exposed on the outer face of the red cell membrane. Thus, while deoxygenation of normal RBC's does not influence its membrane phospholipid composition, deoxygenation and sickling of sickled erythrocytes leads to the exposure of phosphatidyl ethanolamine and phosphatidylserine on the outer surface of the sickled cell. Ordinarily these aminophospholipids are buried deep in the inner membrane leaflet. Their appearance is particularly prominent in the regions of the membrane where long, slender spicules are formed. Fragmentation of these spicules and shedding from the cell surface results in the formation of vesicles which have the same lipid composition as the native erythrocyte. These vesicles are able to dramatically enhance the rate of thrombin generation by providing the proper catalytic surface for assembly of the prothrombinase complex. These spectrin free spicules, which have phosphatidylserine on their surface, have been identified in the plasma of patients with sickle cell disease and perhaps are one of the stimuli responsible for the hypercoagulable state seen in this disorder. It is perhaps a consequence of the exposure of these aminophospholipids that increased plasma levels of fibrinopeptide A, a small peptide produced by the thrombin cleavage of the alpha chain of fibrinogen, have been found in the plasma of sickle cell patients during vaso occlusive crisis. The role of tissue factor, the initiator of the extrinsic pathway of coagulation, in sickle cell disease related coagulation remains largely untouched. It has been known for more than a century that many tissues contain a potent procoagulant activity. Early studies of this so called tissue thromboplastin demonstrated that the biological activity was composed of both lipid and protein components. This molecule has now been isolated and cloned. It is constitutively expressed by some extravascular cells and inducible in certain cells of the vasculature including monocytes and endothelial cells. An integral membrane component, tissue factor is fundamental to hemostasis, serving to initiate coagulation on cell surfaces by binding Factor VII. It has also been shown that phosphotidylserine directly alters tissue factor function, increasing the catalytic efficiency of the tissue factor factor VII complex. In 1979, sickled cells were reported to adhere to confluent monolayers of endothelial cells to a far greater degree than did normal RBC's. However, because of the static conditions employed in cell monolayer tissue culture studies, it was essential that these adherence studies also be performed under conditions of dynamic flow. To accomplish this, perfusion devices were designed to allow the study of sickle cell RBC adherence to vascular endothelial cells under conditions simulating the wall shear rates present in the microcirculation. Using this model system, the increased adherence of sickle cells was confirmed. The adherence was particularly prominent in those areas where injury to the endothelial cell produced turbulence and stagnation of blood flow. Recent single cell adherence studies, utilizing micropipette technology, have shown that not only are sickle cells more adherent to endothelial cells, but also that the degree of adherence can be markedly influenced by a variety of plasma factors. Several of these factors seem to be present in higher concentrations in plasma obtained from patients with sickle cell disease. It has been suggested that these plasma factors may be the same adhesive glycoproteins which play a central role in the adhesion of platelets to damaged endothelium. However, a similar role for erythrocyte interaction with such adhesive glycoproteins remains to be defined. The clinical relevance of sickle cell endothelial cell adherence is suggested by a variety of studies comparing samples from sickle cell patients both in and out of vaso occlusive crisis. Using a "clinical severity index" score, it was noted that red cells, which were obtained from individuals with the most severe disease, were far more adherent to endothelial cells than red cells from patients with low severity scores. Again, it was noted that plasma factors could influence the degree of adherence of sickle RBC's. When suspended in buffer, the number of adherent sickle RBC's was found to be the same if cells were obtained from a patient during a vaso occlusive crisis or in the steady state. If, however, the same sickle RBC's were suspended in their own plasma, the degree of adherence was far greater in cells taken from the subject during a vaso occlusive event. Thus, most investigators have found sickle cells to be more adherent to endothelial cells than normal cells. This property of enhanced adherence is promoted by both turbulence of blood flow and by endothelial cell injury. The increased adherence appears to be related not only to cellular differences between normal and sickle RBC's, but also to a variety of proteins (but not limited to) fibrinogen, laminin, fibronectin, thrombospondin, and von Willebrand factor (vWF). BLOOD RHEOLOGY The pathogenesis of the abnormal blood rheology that is noted in patients with sickle cell disease is incompletely understood. It is clear, however, that disturbances of blood flow, in general, are influenced by whole blood viscosity. In sickle cell patients, the abnormalities of cellular deformability, coupled with increased plasma levels of a variety of large protein molecules, such as fibrinogen and fibrinogen-fibrin complexes, cause increased whole blood viscosity and impaired blood flow. The resulting vicious cycle causes further vascular occlusion as impairment of blood flow which, in turn, promotes more and more cell sickling. These abnormalities of blood flow can also be linked to sickle cell endothelial cell adherence. Blood of high viscosity, particularly under conditions of shear, can effect damage to the endothelium, thereby leading to the deposition of both platelets and fibrin. (In this regard, it is of note that periods of vaso occlusion are marked by an increase in the turnover of both platelets and fibrinogen.) As suggested previously, endothelial damage and the resulting changes in blood flow (both turburlence and stasis) can lead to further increases in erythrocyte endothelial cell adherence. CONTACT ACTIVATION FACTORS As early as 1967, abnormalities of factor XI and XII levels were found in patients with SS disease. Because significant reductions of Factor XII, prekallikrien, and high molecular weight kininogen are known to occur in patients with disseminated intravascular coagulation (DIC), investigators have recently expanded studies of the role of coagulation in sickle cell disease by focusing on these components of the contact activation system. The results indicated relatively low levels of all three moieties in the steady state which decreased even further during periods of vaso occlusive crisis. These results are compatible with ongoing activation of the intrinsic pathway of blood coagulation. The activation process is further increased during periods of vaso occlusion, with consumption of Factor XII, prekallikrein, and high molecular weight kininogen at rates unable to be compensated for by hepatic production. Because kinins mediate vasodilatation, local edema, and pain, it has been suggested that they may play a role in the symptomatology of sickle cell crisis. As kinins are generated by kininogen proteolysis, the increased turnover of the contact activation factors in sickle cell crisis is consistent with this hypothesis. While high local levels of kinins cause arteriolar vasodilatation, they also cause constriction of small veins. Such mediation of venule constriction can further increase the interrelated events of sickling, including stasis and local tissue hypoxia. In at least one study, however, the degree of decrease in plasma kininogen did not correlate with severity of symptoms or physical findings of sickle cell crisis. In addition to kinin release, contact activation of the intrinsic pathway of coagulation when Factor XII interacts with a thrombogenic surface can lead to activation of other amplification systems including fibrinolysis and complement. The constant challenge to the integrity of the vascular endothelium by its interaction with sickled erythrocytes can lead to loss of endothelial integrity and exposure of subendothelium. The resulting adhesion of platelets and Factor XII to collagen in exposed subendothelium promotes and or sustains the ongoing hypercoagulable state. FIBRINOLYTIC SYSTEM The fibrinolytic system in sickle cell anemia patients during vaso occlusive crisis has been reported to be somewhat depressed. Therefore, lysis of fibrin formed at sites of vaso occlusion may be retarded. However, recently published studies have demonstrated that during vaso occlusive crisis, fragment D dimer, the product of plasmin degradation of Factor XIIIa crosslinked fibrin, is generated. In addition, patients with other complications of sickle cell disease (leg ulcers, cholecystitis, etc.), elevated levels of fragment D dimer were found, thus indicating active lysis of fibrin. These data strongly suggest that Factor XIIa crosslinked fibrin is constantly being formed and lysed during vaso occlusive crisis, thus indicating thrombin generation and fibrinolysis in this setting. Finally, the role of plasminogen activators and inhibitors has yet to be investigated in sickle cell crisis. OBJECTIVES AND SCOPE This special grant program is for the support of research designed to further our understanding of the role of cellular, humoral and vascular factors of blood coagulation in the pathophysiology of sickle cell crisis and to define new therapeutic strategies that might help to limit or reverse the process of vaso occlusion. EXAMPLES OF RESEARCH PROJECTS Examples of topics that would be appropriate for this program are shown below. The list is not to be regarded as complete or exclusive, and other research areas proposed by applicants that meet the objectives of this program will be welcomed by the NHLBI. Representatives areas of research include: A The role of abnormal rheology in vaso occlusive crisis. What role, if any, does stasis in areas of low flow play in vaso occlusive crises? How much do changes in whole blood viscosity and the resulting alteration in wall shear rates contribute to this process? What are the contributions of adhesive plasma proteins such as vWF and cross-linked fibrin to impaired blood flow in the microvasculature? B Erythrocyte endothelial interactions. Is the reported correlation between erythrocyte endothelial interaction and severity of vaso occlusion a consistent observation? What plasma proteins cause the increased adherence of SS erythrocytes to endothelial cells? Are they the same or similar to adhesive glycoproteins which promote platelet adhesion to damaged endothelium? Does the expression of tissue factor play a role in endothelial cell erythrocyte interactions? Do sickled erythrocytes or shed vesicles, similar to platelet microparticles, provide a proper catalytic surface for the enhanced assembly of the prothrombinase complex? C Is platelet activation a component of vaso occlusive crisis? What is the basis for increased platelet production and turnover in sickle cell crisis? Does release of platelet products occur during the steady state or during crisis? Does thrombospondin contribute to the adhesion reactions? Can newer methods (e.g. flow cytometry of platelet activation antigen) be used to define the role of platelet activation in sickle cell disease? A careful study with adequate controls is needed. What are the roles of prostacyclin synthesis and thromboxane A in this process? Is there a role for thromboxane antagonists in this setting? D What is the status of the endothelium in sickle cell patients? Are there specific structural and metabolic alterations of endothelial cells in sickle cell patients? During vaso occlusive crisis, is it possible that cytokines and other factors lead to expression of tissue factor and altered metabolism of endothelial cells? Since vWF is thought to be synthesized by the endothelial cells, the higher concentration and or larger polymers of vWF observed in sickle cell disease tend to support the hypothesis of an altered metabolic state in this condition. What are roles of endothelium derived relaxation or contractile factors in this process? Might injury and or other stimuli induce the expression of tissue factor in endothelial cells thus explaining the hypercoagulable state in sickle cell disease? E What role do contact activation factors play in vaso occlusive crisis? The levels of Factor XII, prekallikrein and high molecular weight kininogen are low in SS disease and are further reduced during crisis. Does this reflect consumption or a decrease in production? F Does vWF play any role in sickle cell disease? What is the etiological basis for elevated levels of vWF in patients with sickle cell disease? Does any change in vWF multimer pattern characterize vaso occlusive crisis? Does this lead to increased adhesion of platelets to the subendothelium? If so, is there any evidence that such a change could promote vaso occlusive events? MECHANISM OF SUPPORT The support mechanism for this FIVE YEAR program will be the traditional, individual research project grant (RO1). Although the financial plans for fiscal year 1990 include $1.0 million in total costs for this announcement, award of grants pursuant to this RFA is contingent upon availability of funds for this purpose. The specific number will depend on the merit and scope of the applications received and the availability of funds. Since a variety of approaches would represent valid responses to this announcement, it is anticipated that there will be a range of costs among individual grants awarded. While multidisciplinary approaches are encouraged, it is not the intent of this announcement to solicit proposals for large studies encompassing a variety of individual sub projects, i.e., program projects. If collaborative arrangements through subcontracts with other institutions are planned, consult the Chief, Blood Grants Management Section, NHLBI Grants Operations Branch (301-496-7255) regarding procedures. Consortium arrangements are allowed but must clearly be conducive to the goals of the RFA. Applications for grants proposing clinical studies should include members of minority groups and women in the study populations. Otherwise, a clear rationale for their exclusion must be provided in the application. Awards in response to this announcement will be made to foreign institutions only for research of very unusual merit, need, and promise, and in accordance with PHS policy governing such awards. Upon initiation of the program, DBDR will sponsor periodic meetings to encourage exchange of information among investigators who participate in this program and other investigators with related interests. In the preparation of the budget for the grant application, applicants should request travel funds for a two-day meeting each year, most likely to be held in Bethesda, Maryland. Applicants should also include a statement in the budget section of their applications indicating their willingness to participate in such meetings. THIS IS INTENDED TO BE A FIVE YEAR PROGRAM. However, applicants are requested to furnish their own estimates of the time required to achieve the objectives of the proposed research project; up to FIVE years of support may be requested. It is anticipated that support will begin on July 1, 1990. The current policies and requirements that govern the research grant program of the NIH will apply to grants awarded under this RFA. Administrative adjustments in project duration and amount may be required at the time of award. During the final year of support, renewal applications may be submitted for further competitive review through the regular grant program of the NIH. REVIEW PROCEDURES AND CRITERIA Review Method: Applications submitted in response to this RFA will be reviewed by the NHLBI to determine if they satisfy the criteria of the RFA. If an application is judged unresponsive at this stage, the applicant will be contacted and given an opportunity to withdraw the application or to have it considered for the regular research grant program of the NIH. Every effort will be made to include unresponsive applications in the same review cycle, but this may not be possible. All responsive applications will be reviewed for scientific and technical merit by an initial review group, which will be convened by the Division of Extramural Affairs of the NHBLI, solely to review these applications. If an application submitted in response to this RFA is substantially similar to a research grant application already submitted to the NIH for review, the applicant will be asked to withdraw one of them. Simultaneous submission of identical applications will not be allowed. Review Criteria: The factors to be considered in the evaluation of scientific merit of each application will be similar to those used in the review of traditional research project grant applications, including the novelty, originality, and feasibility of the approach; the training, experience, and research competence of the investigator(s); the adequacy of the experimental design; the suitability of the facilities; and the appropriateness of the requested budget to the work proposed. METHOD OF APPLYING Letter of Intent: The Institute requests that prospective applicants submit a one-page letter of intent that includes a descriptive title and identification of any other participating institutions. Such letters are requested only for the purpose of providing an indication of the number and scope of applications to be received, therefore their receipt is usually not acknowledged. A letter of intent is not binding and will not enter into the review of any application subsequently submitted; nor is it a necessary requirement for application. This letter of intent should be sent by January l5, 1990, to: Dr. Charles L. Turbyfill Review Branch Division of Extramural Affairs National Heart, Lung, and Blood Institute National Institutes of Health Westwood Building, Room 553 Bethesda, Maryland 20892 Format for Applications: Applications should be submitted on the traditional research project grant application form, PHS 398 (revised l0/88). This form is available in an applicant institution's office of sponsored research or business office or may be obtained from the following: Office of Grants Inquiries Division of Research Grants NIH, Bethesda, Maryland 20892 Telephone: (30l) 496-7441 Use the conventional format for research project grant applications and ensure that the points identified in the Section on "Review Procedures and Criteria" are fulfilled. To identify the application as a response to this RFA, check "YES" on Item 2 of page 1 of the application and enter the title and RFA Number: "HEMOSTASIS AND ENDOTHELIAL REACTIVITY IN SICKLE CELL DISEASE," RFA 89-HL-18-B. THE RFA LABEL (AVAILABLE IN THE l0/88 REVISION OF APPLICATION FORM 398) MUST BE AFFIXED TO THE BOTTOM OF THE FACE PAGE OF THE ORIGINAL COPY OF THE APPLICATION. FAILURE TO USE THIS LABEL COULD RESULT IN DELAYED PROCESSING OF YOUR APPLICATION. APPLICATION PROCEDURE Send or deliver the completed application and four (4) signed, exact photocopies of it to: Division of Research Grants National Institutes of Health Westwood Building, Room 240 Bethesda, Maryland 20892** Send an additional two (2) copies of the application to Dr. Charles L. Turbyfill at the address listed under Letter of Intent. IT IS IMPORTANT TO SEND THESE 2 COPIES AT THE SAME TIME AS THE ORIGINAL AND 4 COPIES ARE SENT TO THE DIVISION OF RESEARCH GRANTS, OTHERWISE THE NHLBI CANNOT GUARANTEE THAT THE APPLICATION WILL BE REVIEWED IN COMPETITION FOR THIS RFA. Applications must be received by March 15, 1990. An application not received by this date will be considered ineligible. TIMETABLE Letter of Intent January l5, 1990 Application Receipt Date March 15, 1990 Review by the National Heart, Lung, and Blood Advisory Council September 6-7, 1990 Anticipated Award Date September 30, 1990 INQUIRIES Inquiries regarding this announcement, including clarification of the scope, organization, requirement, and features of the announcement, as well as assistance on the specific details of the application procedure, may be directed to: Dr. Charles A. Wells National Heart, Lung, and Blood Institute National Institutes of Health Federal Building, Room 508 Bethesda, Maryland 20892 Telephone: (301) 496-6931 Consultation as early as possible in the planning stage is strongly encouraged. The programs of the Division of Blood Diseases and Resources are described in the Catalog of Federal Domestic Assistance, No. 13.839, Blood Diseases and Resources. Awards will be made under authority of the Public Health Service Act, Section 301 (42 USC 241) and administered under PHS grant policies and Federal Regulations 42 CFR Part 52 and 45 CFR Part 74. This program is not subject to the intergovernmental review requirements of Executive Order 12372 or to Health Systems Agency review. ------------------------------------------------------------------------ NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES (NIAID) AIDS INSTITUTIONAL TRAINING GRANTS (T32) NIH-NIAID-89-AI-20 P.T. 44; K.W. 0715008, 0720005, 0765033, 1002008, 1002045, 0755025, 0710030 NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES Letter of Intent Receipt Date: November 17, 1989 Application Receipt Date: January 10, 1990 This Request for Applications (RFA) is for the development of institutional training grants to fund long-term training in AIDS research. I. BACKGROUND Studies of pathogenic mechanisms, and development of vaccines and therapeutics require close collaboration between clinicians and epidemiologists working with HIV-infected patients and basic research scientists in biochemistry, chemistry, immunology, molecular biology, pharmacology, virology, and biostatistics. The collaboration between clinicians and basic research scientists requires individuals appropriately trained in multiple disciplines who have developed an understanding of the requirements and limitations of each discipline. Recognizing this need, the NIAID Divison of AIDS is establishing a multi-disciplinary postdoctoral training program in AIDS research. II. OBJECTIVES AND SCOPE AIDS Institutional Training Grants will be awarded by the Basic Research and Development Program (BRDP), Division of AIDS, NIAID, and administered by the Pathogenesis Branch of BRDP. These grants will fund programs for long-term training in AIDS research. Grants will be made to successfully competing institutions for a period of up to five years. The Division of AIDS anticipates that $875,000 will be available to support the AIDS Institutional Training Grant Program in FY90. The review criteria are those for National Research Service Award (NRSA) T32 Research Training Grants with some modifications. The initial expedited review of these applications will be performed by the relevant subcommittee of the AIDS Research Review Committee. Secondary review will be conducted by the NIAID Advisory Allergy and Infectious Diseases Council in May 1990. The BRDP encourages applications focusing on the biological mechanisms by which immunodeficiency viruses cause disease and on mechanisms of prevention and treatment. Strongly encouraged are novel studies addressing the pathogenesis of HIV infection, potential avenues for enhanced and/or selective immune protection, and potential strategies for effective drug development. Some of the research areas which may be addressed are: mechanisms of T4 cell depletion, mechanisms of functional alteration of T4 and T8 cells, factors regulating latency or suppression of viral production, possible pathogenic roles of defective viruses, mechanisms of variant virus production and the significance of genetic variation in the escape from protective host defenses, importance of viral integration in T4 cells and macrophages, mechanism of cell-cell virus transfer, mechanisms of virus mediated or initiated autoimmune self-destruction, cellular factors necessary for latency or lytic infection, development of humoral and cellular immunity, stimulation of lymphocyte subsets with viral antigens or peptides, and biochemistry and pharmacology of novel therapeutic agents. A. Eligibility AIDS Institutional Training Grants are available on a competitive basis to domestic institutions under the terms of the National Research Service Act of 1974. Trainees must be United States citizens or nationals, or must have been officially admitted to the United States as permanent residents. B. Minority Recruitment The policy of NIAID and National Institutes of Health (NIH) is to promote broad and systematic efforts to recruit individuals from minority groups currently underrepresented in biomedical research. Applicants must provide a description of special plans or efforts to recruit minorities to the Institutional AIDS Training Program. Applications without such specific plans will be judged not responsive and returned without review. The following list of potential elements of a minority recruitment plan is intended as a guide. Applicants should provide detailed descriptions and explore other options. o Advertisements actively recruiting minorities to the program. o Posters and flyers actively recruiting minorities. o Visits by the program director to minority institutions. o Cooperative programs with minority institutions. o Procedures to identify minority applicants. o Mailings to minority groups from various lists. o Invitations to prospective minority applicants using institutional funds. C. Program Content An applicant institution should propose a program in accordance with the following guidelines: o Training is limited to postdoctoral fellows (Ph.D. or M.D.) for a maximum of three years per trainee. o Training programs are encouraged in which the training faculty include both basic research scientists and clinicians working with AIDS patients. o Research projects jointly sponsored by two or more laboratories with different disciplines are strongly encouraged. o If research includes patient care activities, this activity may not require more than 20 percent of the trainee's time. o Training should be interpreted as the acquisition of new skills outside the area of the trainee's doctoral experience. o Training grant funds are to be used exclusively for trainee stipends, medical insurance, and travel to scientific meetings. It is the intention that trainees be located in research laboratories with adequate active research support. Therefore, no support for faculty salary, tuition, administration, equipment, supplies or indirect costs should be requested. o The budget should include a request for travel funds for both an annual meeting of AIDS postdoctoral fellows sponsored by the Division of AIDS in Bethesda and an AIDS-related scientific meeting. o To provide funding for the maximum number of applications possible, it is the intention that AIDS Institutional Training Grants be limited to $175,000/year per application. This level of support should be sufficient for four or five fellows. III. MECHANISM OF SUPPORT A. Awards will be made as institutional training grants (T32). Responsibility for the planning, direction, and execution of the proposed training will be that of the applicant. B. NIAID has set aside $875,000 in total costs for the initial year's funding, and awards in total costs of $175,000/year per application will be made for up to five years. It is anticipated that 5 awards will be made. C. Only domestic institutions are eligible to apply for this funding. D. All policies and requirements that govern the grant program of the U.S. Public Health Service (PHS), and the NIH apply. E. Although this program is provided for in the financial plans of the NIAID, awards pursuant to this RFA are also contingent on the continuing availability of funds for this purpose. F. The Division of AIDS may consider program goals in addition to priority scores in funding decisions. IV. LETTER OF INTENT Prospective applicants are asked to submit by November 17, 1989, a letter of intent that includes a descriptive title and a description (not to exceed one page) of the proposed research. The letter of intent is requested in order to provide an indication of the number and scope of applications to be reviewed and provides a means of early contact between prospective applicants and NIAID staff and making early preparations for review. The letter of intent does not commit the sender to submit an application, nor is it a requirement for submission of an application. The letter of intent should be sent to: Dr. Gregory Milman Chief, Pathogenesis Branch Division of AIDS, NIAID, NIH 6003 Executive Boulevard, Room 242P Rockville, MD 20892 Telephone (301) 496-8378 V. REVIEW METHOD AND PEER REVIEW CRITERIA A. Consequence of Lack of Responsiveness to RFA Applications that are incomplete for review or not responsive to this RFA will be identified by NIH staff upon receipt and returned to the applicants without further consideration. B. Consequences of Late Submission In light of accelerated solicitation to award processing requirements mandated by Section 2302 of the Title II (AIDS amendment of 1988), the receipt date announced in this RFA must be strictly adhered to. No exceptions will be made. All applications received past the receipt date will be returned to the applicant. C. Peer Review of Responsive Applications Applications that are complete and responsive may be subjected to a triage by a peer review group to determine their scientific merit relative to other applications received in response to this RFA. The NIH will withdraw from competition those applications judged to be noncompetitive and notify the applicant and institutional business official. Those applications judged to be competitive will be further reviewed for scientific and technical merit by a AIDS Research Review Committee, NIAID, NIH. The second level of review will be provided by the National Advisory Allergy and Infectious Disease Council. Review Criteria Applicants should address the following criteria which will be employed by the AIDS Research Review Committee in evaluating applications. The criteria are the same as those used for evaluating other NRSA applications but have been expanded to take into account the special emphases in the new program. o Scientific merit of the long-term training program including program objectives and program design. o The proposed or ongoing research programs and the role of the trainees in these programs. o Multi-disciplinary nature of proposed program. o Scientific environment and active resources of the applicant institution including current AIDS research support. o Cohesiveness of program including mechanisms for promoting interdisciplinary exchange of information such as seminar series, journal clubs, laboratory rotations, and research presentations. o The applicant's ability to attract high-caliber trainees. o Description of the steps to be taken for recruitment of individuals from minority groups. o Qualifications of training faculty, the relevance of their current research activities to AIDS research, and their previous research training experience. o Extent of commitment of the institution to the proposed training program. VI. METHOD OF APPLYING A. Receipt Date The deadline for receipt of applications is January 10, 1990. Applications received after this date will be considered as not responsive to this RFA and will be returned without review. B. General 1. The research grant application form PHS-398 (revised 10/88) must be used in applying. The application kit contains special instructions for preparing NRSA institutional fellowship award applications. The PHS 398 forms are available at most institutional business offices or from the Division of Research Grants, National Institutes of Health, Room 449, Westwood Building, Bethesda, MD 20892. o Submit a signed, typewritten original of the application, including the Checklist and four (4) signed, exact, single-sided photocopies, in one package to: DRG AIDS Coordinator Division of Research Grants National Institutes of Health Westwood Building - Room 240 5333 Westbard Avenue Bethesda, MD 20892 o Submit, in addition, 19 exact photocopies of the application and six (6) copies of appendices (appendices are optional) to: Dr. John Meyer, Executive Secretary Basic Science Subcommittee II AIDS Research and Review Committee Program and Project Review Branch Division of Extramural Activities NIAID, NIH Westwood Building, Room 3A-11 Bethesda, MD 20892 Telephone (301) 496-8426 2. TO ASSURE THE IDENTIFICATION OF YOUR APPLICATION WITH THIS RFA: a. The application form should have "NIAID AIDS Institutional Training Grants" (RFA 89-AI-20) typed on line 2 of the face page of the application form. b. The RFA label provided with the instructions must be affixed to the bottom of the face page. Failure to use this label could result in delayed processing of your application so that it may not reach the review committee in time for review. VI. INQUIRIES o Inquiries of Programmatic nature should be addressed to Dr. Gregory Milman. o Inquiries pertaining to review of applications should be addressed to Dr. John Meyer. o Inquiries regarding fiscal matters should be addressed to Ms. Mary Kirker: Ms. Mary Kirker Grants Management Branch Division of Extramural Affairs NIAID, NIH Westwood Building, Room 710 Bethesda, MD 20892 Telephone (301) 496-7075 This program is described in the Catalog of Federal Domestic Assistance, 13.856 - Microbiology and Infectious Diseases Research and 13.855 - Immunology, Allergic and Immunologic Diseases Research. Grants are awarded under the authority of the Public Health Service Act, Section 301 (42 USC 241) and administered under PHS grant policies and Federal Regulations, most specifically at 42 CFR Part 52 and 45 CFR Part 74. This program is not subject to review by a Health Systems Agency. ------------------------------------------------------------------------ RFA 89-HD-09 SPECIALIZED RESEARCH CENTER PROGRAMS IN REPRODUCTION (P50s) OR CENTER CORE GRANTS TO SUPPORT REPRODUCTION RESEARCH (P30s) P.T. 04; K.T. 0413002, 0710110, 0710115, 0710030, 0785105, 0760025 NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN DEVELOPMENT Application Receipt Date: June 11, 1990 The National Institute of Child Health and Human Development (NICHD) provides funding for a limited number of research centers in the area of population research. These centers are broadly based investigative endeavors encompassing research of a biomedical nature. They are supported through either Center Core Grants (P30) or Specialized Research Center Grants (P50). These centers are considered a national resource. They form a national network that fosters communication, innovation, and high quality research. Population Research Centers provide a stimulating, multidisciplinary environment that attracts and nurtures both established and promising young investigators. Each Center participating in the Center Network works closely with NICHD staff in carrying out its objectives in a manner consistent with the goals and missions of the NICHD. BACKGROUND The Reproductive Sciences Branch (RSB) of the Center for Population Research (CPR) of the National Institute of Child Health and Human Development (NICHD) supports basic and clinical research on human reproduction which relies on a variety of approaches in the biomedical sciences. Among the grant mechanisms used to provide research support, the RSB uses: 1) Specialized Research Center Grants (P50s), which support integrated groups of research projects and supporting core service facilities. The research activities included in such project grants must comprise, by definition, a multidisciplinary approach to biomedical problems in reproduction. These research programs may have more than one theme, focus, or emphasis when all of them are responsive to one or more specific research areas of reproduction promulgated by the CPR. 2) Center Core Grants (P30s), which support Center Core facilities designed to enhance the existing federally supported research projects within the purview of the RSB, CPR, NICHD. Such center awards require a critical mass of individual awards where coordinated technical support would be cost-effective to the NIH. Although Core Grants provide no funds for the direct support of research projects other than for new program development, by making cost-effective resources and facilities available they enhance the productivity of existing projects either integrated into a specialized research area or organized within a central theme of research. At present, the RSB supports a fixed number of centers with a commitment of five years of support that is competitively renewable for additional five-year periods. Two P50 centers and two P30 centers will seek renewal in FY 1991. In addition, one new center grant (P50 or P30) will be awarded in FY 1991. This RFA, therefore, represents a competition for a total of five grant awards. RESEARCH GOALS AND SCOPE The ultimate goals of biomedical research in the reproductive sciences are to develop new knowledge leading to clinical applications that will enable men and women to control their fertility with methods that are safe, effective, inexpensive, reversible, and acceptable to various population groups, and to overcome problems of infertility and reproductive disorders. The Reproductive Sciences centers designated as "Specialized Population Research Centers" (P50s) and as "Population Research Centers" (P30s) are awarded funds for the support of comprehensive population research programs of high quality that focus on topics deemed to be of high priority and significance because of their critically important relationship to the mission of the CPR. Such topics currently include reproductive neuroendocrinology, reproductive endocrinology, reproductive biology, reproductive genetics, and biomedical studies related to potential fertility regulating methods or human infertility. In order to receive funding, a grant for a specialized population research center (P50) must have three (3) or more related, integrated, and high quality research projects that provide a multidisciplinary, yet thematic, approach to the problems to be investigated. These research projects may be accompanied by an appropriate number and type of core facilities providing cost-effective technical support. A grant for a population research Center Core facility (P30) must be predicated on the existence of a substantial number of eligible, funded research grants which will be active on April 1, 1991. The funded grant group must hold relevant NIH or other federally funded grants. These grants must support active users of the core facilities and services proposed in the center grant application and represent scientific research relevant to the mission of the CPR. Because population research center grants are complex entities, interested applicants should contact the RSB staff for a consultation regarding the center programs. This RFA is specifically designed to stimulate the reproduction research community to organize or to maintain population research centers of outstanding standards which, serving as national research resources, form a network that fosters communication, innovation, and high quality research. Applications are encouraged for, but not limited to, the biomedical topics listed below: 1. Neuroendocrinology of reproduction: Clarification of the regulatory mechanisms of the hypothalamo-pituitary- gonadal axis 2. Regulatory mechanism(s) of gonadal function 3. Regulatory mechanism(s) of gametogenesis 4. Mechanism(s) of follicular selection, atresia and ovulation 5. Mechanism of action of reproductive hormones 6. Structure and function of reproductive hormones 7. Studies on fertilization, preimplantation development of embryos, or blastocyst implantation 8. Mechanisms regulating genital tract functions 9. Immunological mechanisms regulating fertility MECHANISM OF SUPPORT The support mechanisms of these programs are the P50 Specialized Population Research Center Grants and the P30 Population Research Center Core Grants mechanisms. Although this solicitation is included in the plans for FY 1991, support for these center grants is contingent upon the receipt of funds for these purposes. The number of grants to be awarded is also contingent upon a sufficient number of applications receiving a high enough level of merit to be considered for an award. It is expected that up to five (5) awards will be made as a result of this announcement. The applications should be prepared in a manner consistent with the guidelines presented in the publications entitled either P50 SPECIALIZED RESEARCH CENTER GRANT GUIDELINES or P30 CENTER CORE GRANT GUIDELINES which are available from the NICHD offices listed below. The current policies and requirements that govern the research grant programs of NIH will prevail (Code of Federal Regulations, Title 42, Part 52 and Title 45, Part 75). Applications for grants involving clinical studies should include members of minority groups and women in the study populations. Otherwise, a clear rationale for their exclusion must be provided in the application. REVIEW PROCEDURES AND CRITERIA An administrative review of the application will be performed by the Review, Program, and Grants Management staff for conformance to NIH policy and NICHD guidelines, as well as for relevance to the program purview of the RSB. Applications that fail to comply with NIH policy and/or NICHD guidelines will be formally returned to the applicant. Applications may be subjected to a triage by a peer review group to determine their potential competitiveness relative to other applications submitted. The Institute will withdraw from competition those applications judged by the triage procedure to be noncompetitive and notify the applicant and institutional business official. Those applications judged to be competitive will be further evaluated by peer review for scientific/technical merit. The Executive Secretary of the Population Research Committee (PRC) may forward the application to selected members of the PRC for their evaluation to determine if a site visit is needed. A site visit is not a prerequisite, however, for consideration of an application by the PRC, NICHD. If a site visit is required, the Executive Secretary will communicate with the applicant for the visit arrangements as described in the guidelines. All competitive applications received in response to this RFA will be reviewed on a nationwide competitive basis. The initial review for scientific merit will be carried out by the PRC. The second-level review will be made by the National Advisory Child Health and Human Development Council. The earliest possible funding date is April 1, 1991. Review procedures and criteria are detailed in the P50 SPECIALIZED RESEARCH CENTER GRANT GUIDELINES and P30 CENTER CORE GRANT GUIDELINES (available from the NICHD offices listed below). METHOD OF APPLYING Interested applicants should contact the RSB staff for an advisory consultation regarding reproductive sciences center grants (P50s and P30s). If an applicant intends to apply, it is strongly recommended, but not mandatory, that potential applicants send a letter of intent to the RSB staff at the address listed below by January 1, 1990. This letter should outline the organizational structure of the proposed center, list the titles of the relevant research projects to be associated with it, and the names of the relevant principal investigators. The letter of intent should be received by the RSB no later than January 1, 1990, but applicants are encouraged to send it as soon as they decide to apply for the grant so that the RSB staff can be of maximum assistance in the application process. The standard grant application forms (PHS-398 rev. 10/88) are used to prepare these applications. The RFA number and the type of center grant request (P50 or P30) should be indicated on the face page of the application in item #2. The RFA label available in the 10/88 version of PHS Form 398 must be affixed to the bottom of the face page. Failure to use this label could result in delayed processing of the application such that it may not reach the review committee in time for review. The PHS-398 form is available from most business offices or grant/contract offices at most institutions and can also be obtained from NIH by calling 301/496-7441. It is especially important that applicants note the supplemental NICHD guidelines, which require certain tabulations in addition to the usual instructions. Applications must be submitted by June 11, 1990. Send or deliver the original, completed, signed application and four (4) complete copies to: Application Receipt Office Division of Research Grants National Institutes of Health Westwood Building, Room 240 Bethesda, Maryland 20892** In addition to those applications mailed to the Division of Research Grants, two (2) copies of the application should be sent under separate cover directly to: Laurance Johnston, Ph.D. Scientific Review Program National Institute of Child Health and Human Development National Institutes of Health 6130 Executive Boulevard, Suite EPN-520 Bethesda, Maryland 20892 Late applications will not be accepted and will be returned to the applicants. For further information contact: Koji Yoshinaga, Ph.D. Reproductive Sciences Branch Center for Population Research National Institute of Child Health and Human Development National Institutes of Health Executive Plaza North, Room 603 Bethesda, Maryland 20892 Telephone: 301/496-6515 This program is described in the Catalog of Federal Domestic Assistance No. 13.864, Population Research. Awards will be made under the authority of the Public Health Service Act 301 (42 USC 241) and 441 (USC 289d) and administered under PHS Grant Policies and Federal Regulations 42 CFR Part 52 and 45 CFR Part 74. This program is not subject to A-95 or Health Systems Agency review. ------------------------------------------------------------------------ SUPPLEMENTAL INSTRUCTIONS - SMALL GRANTS PROGRAM FOR LABORATORY RESEARCH RELATED TO THE CLINICAL EVALUATION OF AIDS THERAPIES P.T. 34; K.W. 0715008, 0785035, 0745000, 0715125, 0755015, 0755010 National Institute of Allergy and Infectious Diseases Applications are to be submitted on the standard PHS research grant application form (PHS-398, Rev. 10/88), following the instructions supplied with those forms EXCEPT for the following (see pages 12-23, Instructions Sheet for PHS-398): Section 1. 1. Face page of application: Item 2: Mark "Yes" and enter: Small Grants Program for Laboratory Research Related to the Clinical Evaluation of AIDS Therapies, NIAID. Item 6: Only one or two years of support is provided. Item 10: Not applicable; mark N/A. 2. Application page 4 and 5: Detailed budget for the first and second year (optional) must be limited to the following categories: personnel, supplies, and small equipment items. The total award request for a 1-2 year period may not exceed a maximum of $45,000 direct costs. 3. Biographic data: Not to exceed one page for principal investigator. List most important positions and relevant publications. 4. Other Support: Applicant should identify other AIDS NIAID, Division of AIDS funding, e.g., Centers for AIDS Research (CFAR), etc. Section 2. 1. Introduction: Not applicable. 2. Research Plan A. Specific Aims: Not to exceed one-half page. B. Background and Significance: Not to exceed one page. C. Progress Report/Preliminary Studies: A progress report is not applicable. If data from preliminary studies are available, the report should not exceed one-half page. Since this award mechanism intends to fund pilot projects, preliminary data are not required. D. Experimental Design and Methods: Not to exceed three pages. H. Consortium/Contractual Arrangements: Not to exceed one-half page. I. Literature Cited: Not to exceed one page. Section 3. Appendix: Optional. Submit the original application and four copies to: Division of Research Grants Westwood Building, Room 240 National Institutes of Health Bethesda, MD 20892** Mail 2 exact copies of the application and 2 sets of appendices (appendices are optional) to: Dr. Sally Mulhern AIDS Review Section Program and Project Review Branch National Institute of Allergy and Infectious Diseases Westwood Building, Room 3A12 Bethesda, MD 20892