Full Text AA-97-002 BIOMEDICAL RESEARCH ON ALCOHOL AND AIDS NIH GUIDE, Volume 25, Number 41, November 29, 1996 RFA: AA-97-002 P.T. 44 Keywords: Alcohol/Alcoholism AIDS National Institute on Alcohol Abuse and Alcoholism Letter of Intent Receipt Date: March 21, 1997 Application Receipt Date: April 24, 1997 PURPOSE The National Institute on Alcohol Abuse and Alcoholism (NIAAA) is seeking applications to support human immunodeficiency virus (HIV)-related biomedical alcohol research. Investigations into the biologic determinants of HIV disease have begun to yield interventions that can transform HIV disease from a fatal condition to a chronic, manageable disease syndrome. As understanding of the pandemic progresses, and as HIV/AIDS research becomes more focused, it is becoming increasing apparent that cofactors such as alcohol consumption may play an important role in sexual transmission, susceptibility to infection, and progression of HIV disease. Alcohol has been suggested as a cofactor in HIV disease (Crum, et al.; Alcoholism Clin Exp Res 20:364-371, 1996) and recent evidence demonstrated additive effects of alcohol abuse and HIV infection on brain function (Fein, et al.; Biological Psychiatry 37:183-195, 1995). However, there is no conclusive evidence that acute or chronic alcohol consumption increases susceptibility to HIV infection or accelerates AIDS progression. Strain variations of HIV, individual differences in susceptibility, and long incubation time following seroconversion are some of the difficulties in studying disease progression. Whether alcohol consumption increases susceptibility to opportunistic infections in HIV+ patients and whether alcohol-induced immunosuppression is associated with stimulation, expansion, and perpetuation of disease are important questions to be answered. The purpose of this Request for Applications (RFA) is to solicit applications to study two of the most important questions in alcohol-AIDS research: 1. Does alcohol consumption modulate host susceptibility to HIV infection? 2. Does alcohol consumption accelerate progression of AIDS or predispose to new complications of HIV infection? HEALTHY PEOPLE 2000 The Public Health Service (PHS) is committed to achieving the health promotion and disease prevention objectives of "Healthy People 2000," a PHS-led national activity for setting priority areas. This RFA, Biomedical Research on Alcohol and AIDS, is related to the priority area of AIDS prevention. Potential applicants may obtain a copy of "Healthy People 2000" (Full Report: Stock No. 017-001-00474-0 or Summary Report: Stock No.017-001-00473-1) through the Superintendent of Documents, Government Printing Office, Washington, DC 20402-9325 (telephone 202-512-1800). ELIGIBILITY Applications may be submitted by domestic and foreign, for-profit and non-profit, public and private organizations, such as universities, colleges, hospitals, laboratories, units of State and local governments, and eligible agencies of the Federal government. Racial/ethnic minority individuals, women, and persons with disabilities are encouraged to apply as Principal Investigators. Foreign institutions are not eligible for First Independent Research Support and Transition (FIRST) (R29) awards. Research project grant applications (R01) from foreign institutions are limited to three years. MECHANISM OF SUPPORT Research support may be obtained through applications for a regular research project grant (R01) or FIRST (R29) award. Applications are also encouraged for exploratory/developmental grants (R21), which are limited to two years for up to $70,000 per year for direct costs. Applicants may also submit applications for Investigator-Initiated Interactive Research Project Grants (IRPGs). Interactive Research Project Grants require the coordinated submission of related research project grant (R01) and, to a limited extent FIRST Award (R29) applications from investigators who wish to collaborate on research, but do not require extensive shared physical resources. These applications must share a common theme and describe the objectives and scientific importance of the interchange of, for example, ideas, data, and materials among the collaborating investigators. A minimum of two independent investigators with related research objectives may submit concurrent, collaborative, cross-referenced individual R01 and R29 applications. Applicants may be from one or several institutions. Further information on the IRPG mechanism is available in program announcement PA-96-001, NIH Guide for Grants and Contracts, Vol. 24, No. 35, October 6, 1995. Potential applicants for FIRST Awards and Exploratory/Developmental Grants may obtain copies of the specific announcements for these programs from the NIAAA Home Page at HTTP://WWW.NIAAA.NIH.GOV or from the Office of Scientific Affairs, NIAAA, Willco Building, Suite 409, 6000 Executive Boulevard MSC 7003, Bethesda, Maryland 20892-7003, telephone: 301-443-4375 or FAX 301-443-6077. Further information on these and other grant mechanisms may be obtained from the program staff listed under INQUIRIES. FUNDS AVAILABLE It is estimated that up to $2.0 million will be available to fund approximately twelve grants under this RFA. This level of support is dependent on the receipt of sufficient number of applications of high scientific merit. Although this program is provided for in the financial plan of the NIAAA, the award of grants pursuant to this RFA is also contingent upon the availability of funds for this purpose. The earliest possible award date is September 30, 1997. RESEARCH OBJECTIVES Chronic and acute alcohol consumption has been demonstrated to be immunosuppressive, to decrease host defense against infection, and to increase viral replication. Given the frequency of alcohol consumption (to moderate and excessive extents), alcohol drinking has the potential to influence the severity and course of disease. Sophisticated molecular and cellular biology methodologies are revealing the detailed cellular processes responsible for virus growth and escape from host defense systems, and alcohol/AIDS researchers are beginning to define mechanisms of ethanol-induced immune impairments. However, basic questions such as whether alcohol consumption can modulate susceptibility to HIV infection remain unanswered. Although alcoholics have been reported to be at higher risk for HIV infection because of associated intravenous drug use, recent studies on HIV seropositivity rates in alcoholics without a history of intravenous drug use reported significant rates of HIV infection ranging from 4.5 percent (Schleiffer, et al.; Alcohol Clin Exp Res 20:75-80, 1996) to 11.4 percent (Lee, et al.; Am J Addiction 1:85-88, 1992 ). Behavioral studies in adolescents, gay men, and alcoholics in treatment settings indicate a substantial correlation between alcohol consumption and risky sexual behavior which can result in increased frequency of exposure to HIV. However, regardless of the route of primary HIV infection, once infected, whether alcohol consumption can accelerate the clinical course of the disease is a second critical question that remains unanswered. Although progress in alcohol/AIDS research has been significant, many areas require further investigation. Strategies to study the effects of alcohol consumption on modulating host susceptibility to primary HIV infection may include investigations on: o HIV infectivity on host immune function including studies on immune activation, suppression, and differentiation, and alteration of cytokine production by lymphocytes, monocytes/ macrophages, dendritic cells, and neural cells; o HIV factors including studies on early replication events such as attachment, uncoating and reverse transcription; o Host organ systems that may alter HIV infectivity and/or replication characteristics including studies on mucosal integrity, mucosal immunity, inflammation, microflora, and viral uptake; and o Other host factors that may alter HIV infectivity including studies on nutritional consequences, changes in regional immunity, and interactions with underlying disease, e.g., alcoholic liver disease and alcoholic neurologic disease, and other sexually transmitted diseases. Strategies to elucidate the effects of alcohol consumption on acceleration of progression of HIV disease or on predisposition to new complications of HIV infection may include studies on: o HIV-infected cells including studies on upregulation of HIV gene expression and replication in permissive cells, and in activated versus resting CD4+ cells; cytopathogenic effects; cell-to-cell transmission; and differences in HIV phenotype; o Host immune mechanisms directed against HIV including studies on whether ethanol enhances the acquisition of Th2-like state by T cells from HIV+ patients or enhances the immunodeficient state in animal models of ethanol consumption and AIDS; o Host immunosuppression as a consequence of HIV infection including studies on localized and systemic opportunistic infections; cancer development, progression, and metastasis; and o HIV-specific complications including studies on the neuropathogenesis and pathogenic processes involved in HIV wasting, neuropathy, encephalopathy, and enteropathy; studies that evaluate whether ethanol alters efficacy of AIDS treatment strategies, especially by interfering with drug absorption and altered hepatic drug metabolism; and whether ethanol increases toxicity of AIDS therapeutics. INCLUSION OF WOMEN AND MINORITIES IN RESEARCH INVOLVING HUMAN SUBJECTS It is the policy of the NIH that women and members of minority groups and their subpopulations must be included in all NIH supported biomedical and behavioral research projects involving human subjects, unless a clear and compelling rationale and justification is provided that inclusion is inappropriate with respect to the health of the subjects or the purpose of the research. This new policy results from the NIH Revitalization Act of 1993 (Section 492B of Public Law 103-43) and supersedes and strengthens the previous policies (Concerning the Inclusion of Women in Study Populations, and Concerning the Inclusion of Minorities in Study Populations), which have been in effect since 1990. The new policy contains some provisions that are substantially different from the 1990 policies. All investigators proposing research involving human subjects should read the "NIH Guidelines For Inclusion of Women and Minorities as Subjects in Clinical Research," which have been published in the Federal Register of March 20, 1994 (FR 59 14508-14513) and reprinted in the NIH Guide for Grants and Contracts, Volume 23, Number 11, March 18, 1994. Investigators also may obtain copies of the policy from the program staff listed under INQUIRIES. Program staff may also provide additional relevant information concerning the policy. LETTER OF INTENT Prospective applicants are asked to submit, by March 21, 1997, a letter of intent that includes a descriptive title of the proposed research, the name, address, and telephone number of the Principal Investigator, the identities of other key personnel and participating institutions, and the number of title of the RFA in response to which the application may be submitted. Although a letter of intent is not required, is not binding, and does not enter into the review of a subsequent application, the information that it contains allows NIAAA staff to estimate the potential review workload and avoid conflict of interest in the review. The letter of intent is to be sent to: RFA-AA-97-002 Office of Scientific Affairs National Institute on Alcohol Abuse and Alcoholism Willco Building, Suite 409 6000 Executive Boulevard MSC 7003 Bethesda, MD 20892-7003 FAX: (301) 443-6077 APPLICATION PROCEDURES The research grant application form PHS 398 (rev. 5/95) is to be used in applying for these grants. Applications kits are available at most institutional offices of sponsored research and may be obtained from the Grants Information Office, Office of Extramural Outreach and Information Resources, National Institutes of Health, 6701 Rockledge Drive, MSC 7910, Bethesda, MD 20892-7910, telephone 301/710-0267, email: ASKNIH@odrockm1.od.nih.gov. The RFA label available in the PHS 398 (rev. 5/95) application form must be affixed to the bottom of the face page of the application. 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. In addition, the RFA title and number must be typed on line 2 of the face page of the application form and the YES box must be marked. Applications for support mechanisms other than R01 (i.e., an R29) must cite the relevant program announcement on line 2 in addition to listing the current RFA. Applications for FIRST awards (R29) must include at least three sealed letters of reference attached to the face page of the original application. FIRST award (R29) applications submitted without the required number of reference letters will be considered incomplete and will be returned without review. Page limits and limits on size of type are strictly enforced. Non-conforming applications will be returned without being reviewed. Submit a signed, typewritten original of the application, including the checklist and three signed photocopies in one package to: DIVISION OF RESEARCH GRANTS NATIONAL INSTITUTES OF HEALTH 6701 ROCKLEDGE DRIVE, ROOM 1040 - MSC 7710 BETHESDA, MD 20892-7710 BETHESDA, MD 20817 (for express/courier service) At the time of submission, two additional copies of the application must also be sent to: RFA AA-97-002 Office of Scientific Affairs National Institute on Alcohol Abuse and Alcoholism Willco Building, Room 409 6000 Executive Boulevard, MSC 7003 Bethesda, MD 20892-7003 Rockville, MD 20852 (for express/courier service) Failure to forward the above two applications to the NIAAA at the above address may delay consideration of an application such that it may not be received in time for FY 1997 funding consideration. Applications must be received by April 24, 1997. If an application is received after that date, it will be returned to the applicant without review. The Division of Research Grants (DRG) will not accept any application in response to this RFA that is essentially the same as one currently pending initial review, unless the applicant withdraws the pending application. The DRG will not accept any application that is essentially the same as one already reviewed. This does not preclude the submission of substantial revisions of applications already reviewed, but such applications must include an introduction addressing the previous critique and must be prepared in the format of a revised application. REVIEW CONSIDERATIONS Upon receipt, applications will be reviewed for completeness by the DRG and for responsiveness by the NIAAA. Incomplete applications will be returned to the applicant without further consideration. If the application is not responsive to the RFA, the DRG staff may contact the applicant to determine whether to return the application to the applicant or submit it for review in competition with unsolicited applications at the next review cycle. Applications that are complete and responsive to the RFA will be evaluated for scientific and technical merit by an appropriate peer review group convened by the Institute in accordance with the review criteria stated below. As part of the initial merit review, a streamlined review process may be used by the initial review group in which applications may or may not be discussed based on their scientific merit relative to other applications received in response to the RFA. Applications that are fully discussed will be assigned a priority score. Applications that are not discussed will be withdrawn from further considerations and the Principal Investigator and the official signing for the applicant organization will be notified. The second level of review will be provided by the National Advisory Council on Alcohol Abuse and Alcoholism. Review Criteria Criteria to be used in the scientific and technical merit review of the research grant applications will include the following: 1. The scientific, technical, or medical significance and originality of the proposed research and its relevance to the goals of this RFA. 2. The appropriateness and adequacy of the experimental approach and methodology, including adequacy of quality control methods, proposed to carry out the research. 3. The adequacy of the qualifications (including level of education and training) and relevant research experience of the principal investigator and key research personnel. 4. The availability of adequate facilities, general environment for the conduct of the proposed research, other resources, and collaborative arrangements necessary for the research. 5. The reasonableness of budget estimates and duration for the proposed research. 6. When applicable, adequacy of plans to include both genders and minorities and their subgroups as appropriate for the scientific goals of the research. Plans for the recruitment and retention of these subjects will also be evaluated. When applicable, the initial review group will also examine the provisions for the protection of human and animal subjects and the safety of the research environment. The review criteria for Exploratory/Developmental Grants (R21) and FIRST Awards (R29) are contained in their program announcements. AWARD CRITERIA Applications recommended for approval by the National Advisory Council on Alcohol Abuse and Alcoholism will be considered for funding on the basis of the overall scientific and technical merit of the application as determined by peer review, NIAAA programmatic needs and balance, and the availability of funds. INQUIRIES Inquiries concerning this RFA are encouraged. The opportunity to clarify any issues or questions from potential applicants is welcome. Direct inquiries regarding programmatic issues to: Leslie Isaki, Ph.D. Division of Basic Research National Institute on Alcohol Abuse and Alcoholism 6000 Executive Boulevard MSC 7003 Bethesda, MD 20892-7003 Telephone: (301) 443-4224 FAX: (301) 594-0673 Email: lisaki@willco.niaaa.nih.gov Direct inquiries regarding fiscal matters to: Linda Hilley Office of Planning and Resource Management National Institute on Alcohol Abuse and Alcoholism 6000 Executive Boulevard MSC 7003 Bethesda, MD 20892-7003 Telephone: (301) 443-4703 FAX: (301) 443-3891 Email: lhilley@willco.niaaa.nih.gov AUTHORITY AND REGULATIONS This program is described in the Catalog of Federal Domestic Assistance, No. 93.273. Awards are made under the authorization of the Public Health Service Act, Sections 301 and 464H, and administered under the PHS policies and Federal Regulations at Title 42 CFR Part 52, "Grants for Research Projects;" Title 45 CFR Parts 74 and 92, "Administration of Grants;" and 45 CFR Part 46, "Protections of Human Subjects." This program is not subject to the intergovernmental review requirements of Executive Order 12372 or Health Systems Agency review. The PHS strongly encourages all grant recipients to provide a smoke-free workplace and promote the non-use of all tobacco products. In addition, Public Law 103-227, the Pro-Children Act of 1994, prohibits smoking in certain facilities (or in some cases, any portion of a facility) in which regular or routine education, library, day care, health care, or early childhood development services are provided to children. This is consistent with the PHS mission to protect and advance the physical and mental health of the American people. .
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