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MICROCIRCULATION AND TARGET ORGAN DAMAGE IN RHEUMATIC AND SKIN DISEASES

RELEASE DATE:  November 25, 2002
 
RFA: AR-03-005

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
 (http://www.niams.nih.gov)
National Eye Institute (NEI)
 (http://www.nei.nih.gov/)
Office of Research on Women's Health (ORWH)
 (http://www4.od.nih.gov/orwh/)

LETTER OF INTENT RECEIPT DATE: February 10, 2003

APPLICATION RECEIPT DATE: March 20, 2003
 
THIS RFA CONTAINS THE FOLLOWING INFORMATION

o Purpose of this RFA
o Research Objectives
o Mechanisms of Support
o Funds Available
o Eligible Institutions
o Individuals Eligible to Become Principal Investigators
o Where to Send Inquiries
o Letter of Intent
o Submitting an Application
o Peer Review Process
o Review Criteria
o Receipt and Review Schedule
o Award Criteria
o Required Federal Citations

PURPOSE OF THIS RFA

The National Institute of Arthritis and Musculoskeletal and Skin 
Diseases (NIAMS), the National Eye Institute (NEI) and the Office of 
Research on Women's Health (ORWH) invite applications to address the 
mechanisms of end organ damage and alterations in the microcirculation 
in rheumatic and autoimmune skin diseases.  This initiative has three 
primary purposes.  The first purpose is to promote research targeted 
towards identification and evaluation of cellular, molecular and 
genetic pathways involved in target organ damage and altered 
microcirculation in rheumatic and skin diseases.  The second purpose of 
this request for applications is to stimulate and encourage: a) 
innovative and multidisciplinary basic, translational and clinical 
studies and b) discovery research projects using new technologies (e.g. 
microarrays, high throughput sequencing, multi-color flow cytometry, 
differential display, proteomics, etc).  Finally, the purpose of this 
initiative is to encourage applications as collaborations or as 
research teams combining interdisciplinary approaches between 
autoimmune disease researchers and experts in other related scientific 
fields, such as nephrology and neurology, and vascular biology.  The 
applications in response to this RFA may be for individual research 
projects (R01) or for exploratory/developmental grants (R21).  This RFA 
solicits basic, translational, and clinical research projects but not 
epidemiological or clinical treatment projects.

RESEARCH OBJECTIVES

Background

Although immune dysregulation plays a major role in the induction of 
autoimmunity, recent evidence suggests that structural and functional 
properties of target/end organs, such as eyes, kidneys, synovium, skin, 
thyroid gland, and islet cells, may contribute significantly to the 
development of tissue damage and clinical disease.  In animal models, a 
variable threshold to renal and cardiac damage has been clearly 
demonstrated. This finding is consistent with clinical observations 
showing that individuals with the same serologic abnormality do not 
necessarily have the same tissue abnormality.  Some of the deleterious 
effects of autoreactivity are likely due to interactions between 
autoantibodies and specific cellular elements in the target organ 
beyond the activation of the complement cascade.  For example, 
autoantibodies may bind to cell surface receptors and trigger cell 
activation, modify cell function, or induce apoptosis.  Further, the 
type of interaction may influence clinical expression.  In lupus 
nephritis, immunoglobulins produce distinguishable deposit patterns in 
specific glomerular locations and this is associated with different 
disease profiles.  The differences appear to be based on the 
differential reactivity of the autoantibodies with specific glomerular 
antigens, suggesting that antigen display in the target organ 
influences tissue damage. 

Recent advances indicate that other end organ processes may be related 
to the induction and maintenance of damage in the context of rheumatic 
and autoimmune skin diseases. These include expression of proteins 
related to organ development, either spontaneously or induced by the 
cytokine milieu created by the inflammatory response, events related to 
single cell death during organ development and repair, and newly 
identified binding properties of autoantibodies present in sera from 
patients with autoimmune diseases that trigger apoptosis, cell 
activation or block binding of the natural ligand. 

Vulnerability of the target organ to immune-mediated damage also 
appears to be genetically determined.  In fact, the genetic mapping of 
susceptibility genes in diabetes and lupus suggests an important role 
for the target organ in the induction of tissue injury, with 
contributions made by the cellular components and their interactions 
with the extracellular matrix, independent of other known factors such 
as HLA. For example, in murine models of systemic lupus, nephritis is 
differentially induced in different strains of mice, in spite of 
similar autoantibody profiles and in the presence of similar T-cell 
reactivity.  Recent data from genetic analysis of backcrosses of 
autoimmune- disease-prone mice in a model of autoimmune myocarditis 
also suggest that genetic factors unrelated to immune-related 
susceptibility loci are important in the development and severity of 
symptoms.

The vasculature is often a direct target of autoimmune damage.  End 
organ damage may be secondary to primary damage to the vasculature in 
some cases, or vascular damage and compromised circulation may further 
contribute to target organ damage.  Indeed, the microcirculation has 
been shown to be involved in the pathogenesis and target organ damage 
in several rheumatic diseases.  Scleroderma is fraught with 
microvascular alterations resulting in general changes in 
vasoreactivity as seen in Raynaud's syndrome, as well as decreased 
angiogenesis.  On the other hand, increased angiogenesis is seen in 
rheumatoid arthritis and skin manifestations of lupus.  Increased 
levels of angiogenic growth factors may be a biomarker for ankylosing 
spondylitis.  The immune complex deposition and thrombotic events 
leading to stroke and myocardial infarction in systemic lupus 
erythematosus (SLE, lupus) occur in the microcirculation.  Where the 
microcirculation lies in the cause and effect of rheumatic diseases is 
unclear, but its involvement warrants study.

In recent years, knowledge of angiogenesis and the microcirculation has 
dramatically increased, as has the ability to manipulate genetic 
material and cell behavior.  Several aspects of angiogenesis have 
undergone substantial growth and development and, in a parallel 
fashion, several new technologies and methodologies have been applied 
to the study of the cells that make up the microcirculation, 
endothelial cells, pericytes and smooth muscle cells.  Insights into 
mechanisms associated with embryonic development, cancer, and vascular 
remodeling during injury or inflammation could have a strong impact on 
rheumatic and skin diseases.  For example, integrins, growth factors, 
chemokines and/or inflammatory cytokines as well as receptors for any 
of them, are all current targets for therapeutic blockers of 
inflammation.  Angiostatins, found to be effective in starving tumors 
of their blood supply, are now in clinical trials for cancer patients.  
In addition, gene therapies are being developed for constitutive or 
inducible production of a particular protein for systemic or tissue 
specific application.  Previous results have shown that angiogenesis 
inhibitors may delay or prevent onset of experimental arthritis in mice 
and rats.  Preliminary work is underway to identify angiogenesis 
inhibitors for use in humans with rheumatoid arthritis (RA).  
Therefore, the application of current concepts in vascular biology to 
the study of rheumatic and autoimmune skin diseases may provide new 
insights into disease progression and expand the therapeutic options.

Scope

The focus of the studies is to be on the immune and nonimmune 
mechanisms of induction and development of injury, and dissection of 
the genetics, of microcirculation and end organ involvement in the 
context of rheumatic and autoimmune skin diseases.  Relevant rheumatic 
diseases covered under this RFA include but are not limited to lupus, 
rheumatoid arthritis, scleroderma, dermatomyositis, vasculitis, 
juvenile rheumatic diseases and Sjogren's syndrome, as well as ocular 
manifestations of rheumatic diseases (e.g. uveitis, retinopathy).  
Relevant skin diseases include but are not limited to psoriasis, atopic 
dermatitis, autoimmune bullous diseases, alopecia areata, vitiligo and 
vasculitis.  Knowledge gained by research in this area will make it 
possible to construct a more comprehensive picture of disease 
pathogenesis.  Definition of discrete pathogenic processes involving 
the target organs may provide the scientific rationale for new forms of 
interventions. 

Appropriate research areas may include, but are not limited to, the 
following:

o   Development and evaluation of new experimental systems, including 
the generation of transgenic and other genetically engineered 
animal models, to study cellular, molecular, and genetic aspects 
of target organ involvement.  

o   Development of new in vitro models to analyze the effects of 
inflammatory, immune, and other mechanisms of injury on target 
organ/cell function and structure.

o   Identification and characterization of cellular and molecular 
pathways involved in target/end organ damage.

o   Mechanistic studies on the initiation and perpetuation of local 
immune and inflammatory responses that occur in organs involved 
in autoimmune diseases.

o   Mechanistic studies of sex differences in susceptibility and 
severity of altered microcirculation and end organ damage in 
autoimmune diseases.

o   Studies on the changes in target organ structure and function due 
to the presence of local immune, inflammatory, and other forms of 
tissue injury related to autoimmune disease.

o   Studies of the effects of immune and nonimmune mechanisms of 
tissue damage and their effects on target organ cell structure 
and function.

o   Studies on the effects of autoreactive or other relevant immune 
or inflammatory responses on target/end organ repair processes.

o   Studies of mechanisms underlying phenotypic changes in cellular 
components of target organs during different phases of disease.

o   Identification of biochemical, structural, or other markers that 
may correlate with early, preclinical target organ involvement 
and that may predict disease progression or severity.

o   Studies to identify mediators and mechanisms that may protect 
target organs from the inflammatory, immune, and other forms of 
tissue injury involved in rheumatic and skin diseases.

o   Immediate and long term effects on the microvascular function of 
antibody therapy for rheumatic and skin diseases. 

o   Molecular approaches to affect vascular dysfunction in rheumatic 
diseases, such as use of angiostatins or angiogenic factors.

o   Targeting molecules involved in maintaining vascular structure 
and function for local or systemic therapy using gene therapy and 
other pharmacologic interventions (constitutive or inducible) in 
rheumatic and skin diseases.

o   Translational research aimed at correlating clinical findings 
with markers of end organ damage.

o   New methodologies to facilitate studies of gene expression and 
characterization of the phenotype of involved tissues.

o   Application of new genetic, molecular, biochemical, imaging or 
bioinformatics methodologies to the study of end organ damage and 
its manifestations. 

This list is intended to be illustrative and not exclusive or 
restrictive. 

MECHANISM OF SUPPORT
 
This RFA will use the NIH Research Project Grant (R01) and the 
Exploratory/Developmental Research Project (R21).  As an applicant you 
will be solely responsible for planning, directing, and executing the 
proposed project.  This RFA is a one-time solicitation.  Future 
unsolicited, competing-continuation applications, based on this project 
will compete with all investigator-initiated applications and will be 
reviewed according to the customary peer review procedures.  The 
anticipated award date is September 30, 2003. 

This RFA uses just-in-time concepts.  It also uses either the modular 
or the non-modular budgeting formats
(see http://grants.nih.gov/grants/funding/modular/modular.htm). 
Specifically, if you are submitting an application with direct costs in 
each year of $250,000 or less, use the modular format. Otherwise follow 
the instructions for non-modular research grant applications.

R01 Applications:  An R01 applicant may request a project period of up 
to 4 years and a budget for direct costs not to exceed $500,000 per 
year. 

R21 Applications.  The R21 application may request a project period up 
to two years with a budget not to exceed $100,000 per year in direct 
costs, not including indirect costs for collaborating institutions, if 
any.  

The R21 projects solicited under this RFA are exploratory/developmental 
grants.  In the context of this RFA, exploratory/ developmental grants 
are to be used to either a) gather preliminary data to develop a 
research basis for a subsequent application through other mechanisms, 
i.e., R01, P01, or b) to explore the feasibility of an innovative or 
conceptually creative research question or approach that may not be 
justifiable through existing research to compete as a standard research 
project grant (e.g., R01).  Because innovative projects may require a 
preliminary test of feasibility, the R21 mechanism could provide short-
term support for such preliminary work.  Exploratory/developmental 
studies are not intended for large-scale undertakings, nor are they 
intended to support or supplement ongoing research.

Investigators with expertise in the physiology, pathology, and genetics 
of organs and tissues involved in rheumatic, skin, and autoimmune 
diseases who wish to establish research programs in the context of 
autoimmune diseases are encouraged to apply.  Also encouraged are 
investigators with expertise in immune mechanisms of disease and 
autoimmunity who wish to expand their research to mechanisms of target 
organ damage.

FUNDS AVAILABLE 
 
The estimated total funds (direct and facilities and administrative 
(F&A) costs) available for the first year of support for all awards 
made under this RFA will be $3,250,000.  Because the nature and scope 
of the proposed research will vary from application to application, it 
is anticipated that the size and duration of each award will also vary.  
Although the FY 2003 financial plans of the NIAMS provide support for 
this program, awards pursuant to the RFA are contingent upon the 
availability of funds and the receipt of a sufficient number of 
meritorious applications.  At this time, it is not known if this RFA 
will be reissued. 

ELIGIBLE INSTITUTIONS
 
You may submit an application if your institution has any of the 
following characteristics:

o   For-profit or non-profit organization
o   Public or private institutions such as universities, colleges, 
    hospitals, and 
o   Laboratories
o   National laboratories
o   Units of state and local governments
o   Eligible agencies of the Federal government
o   Domestic or foreign
 
INDIVIDUALS ELIGIBLE TO BECOME PRINCIPAL INVESTIGATORS   

Any individuals with the skills, knowledge, and resources necessary to 
carry out the proposed research are invited to work with their 
institutions to develop an application for support.  Individuals from 
underrepresented racial and ethnic groups as well as individuals with 
disabilities are always encouraged to apply for NIH programs.   

WHERE TO SEND INQUIRIES

We encourage inquiries concerning this RFA and welcome the opportunity 
to answer questions from potential applicants.  Inquiries may fall into 
three areas:  scientific/research, peer review, and financial or grants 
management issues:
o Direct your questions about scientific/research issues to:

J. Elizabeth Gretz, Ph.D.
Director, Immunology and Inflammation Program
Rheumatic Diseases Branch, NIAMS, NIH 
One Democracy Plaza
6701 Democracy Boulevard, Suite 800, MSC 4872
Bethesda, MD  20872-4872
Telephone: (301) 594-5032
FAX: (301) 480-4543
Email: [email protected]

Alan Moshell, M.D.
Director, Skin Diseases Program, NIAMS, NIH
One Democracy Plaza
6701 Democracy Boulevard, Suite 800, MSC 4872
Bethesda, MD  20872-4872
Telephone: (301) 594-5017
FAX: (301) 480-4543
Email: [email protected]

Richard S. Fisher, Ph.D. 
Director, Corneal Diseases Program   
Division of Extramural Research
6120 Executive Blvd, MSC 7164 Bethesda, MD 20892-7164
National Eye Institute, NIH
Executive Plaza South, Suite 350
Bethesda, MD 20892-7164    
(For FEDEX use:  Rockville, MD  20852)
FAX: 301-402-0528 
Telephone: 301-451-2020
Email:  [email protected]

Lisa Begg, Dr.P.H., R.N.
Director of Research Programs
Office of Research on Women's Health
Office of the NIH Director, NIH
Building 1, Room 201
9000 Rockville Pike
Bethesda, MD 20892-0161
Telephone: 301/402-1770
FAX: 301/402-1798
Email: [email protected]

o Direct your questions about peer review issues to:

Tracy Shahan, Ph.D.
National Institute of Arthritis and Musculoskeletal and Skin Diseases
One Democracy Plaza
6701 Democracy Boulevard, Suite 800, MSC 4872
Bethesda, MD  20872-4872
Telephone: (301) 594- 4952
FAX: (301) 402- 2406
Email: [email protected]

o Direct your questions about financial or grants management matters 
to: 

Mr. Michael G. Morse
Deputy Grants Management Officer 
National Institute of Arthritis and Musculoskeletal and Skin Diseases
One Democracy Plaza
6701 Democracy Boulevard, Suite 800, MSC 4872
Bethesda, MD  20872-4872
Telephone: (301) 594-3535
FAX: (301) 480- 5450
Email: [email protected]

William W. Darby
Grants Management Officer
Division of Extramural Research 
National Eye Institute Executive Plaza South, Suite 350 
6120 Executive Blvd, MSC 7164 Bethesda, MD 20892-7164 
Telephone: (301) 496-5884 
FAX: (301- 496-9997 
Email: [email protected]

LETTER OF INTENT
 
Prospective applicants are asked to submit a letter of intent that 
includes the following information:

o  Descriptive title of the proposed research
o  Name, address, and telephone number of the Principal Investigator
o  Names of other key personnel
o  Participating institutions
o  Number and title of this RFA 

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 NIAMS staff to estimate the potential review 
workload and plan the review.
 
The letter of intent is to be sent by the date listed at the beginning 
of this document.  It is preferred that the letter of intent be sent 
electronically.  If necessary, the letter of intent can be sent by 
regular mail. The letter of intent should be sent to:

J. Elizabeth Gretz, Ph.D.
Director, Immunology and Inflammation Program
Rheumatic Diseases Branch, NIAMS, NIH 
One Democracy Plaza
6701 Democracy Boulevard, Suite 800, MSC 4872
Bethesda, MD  20872-4872
Telephone: (301) 594-5032
FAX: (301) 480-4543
Email: [email protected]

SUBMITTING AN APPLICATION

Applications must be prepared using the PHS 398 research grant 
application instructions and forms (rev. 5/2001).  The PHS 398 is 
available at http://grants.nih.gov/grants/funding/phs398/phs398.html in 
an interactive format.  For further assistance contact GrantsInfo, 
Telephone (301) 710-0267,
Email:  [email protected].

SUPPLEMENTAL INSTRUCTIONS:

RESEARCH PLAN - The research plan (a-d) is limited to 25 pages for R01 
applications and 10 pages for R21 applications. Applications that 
exceed the page limit will be returned without review.  An appendix may 
be included in the application; however, the appendix is not to be used 
to circumvent the page limit of the research plan. 

For the R21 application, preliminary data supporting feasibility of 
approach are not required, however, if included, the section may not 
exceed 1 page. In addition, a paragraph should be included in the 
Significance section of the application that specifies either how the 
project presents a new direction for the work performed in the PI's 
laboratory or the innovative nature of the research question or 
approach, and how it may advance the understanding of the mechanisms of 
target organ damage or altered microcirculation in rheumatic and 
autoimmune skin diseases. 
  
SPECIFIC INSTRUCTIONS FOR MODULAR GRANT APPLICATIONS: Applications 
requesting up to $250,000 per year in direct costs must be submitted in 
a modular grant format.  The modular grant format simplifies the 
preparation of the budget in these applications by limiting the level 
of budgetary detail.  Applicants request direct costs in $25,000 
modules.  Section C of the research grant application instructions for 
the PHS 398 (rev. 5/2001) at 
http://grants.nih.gov/grants/funding/phs398/phs398.html includes step-
by-step guidance for preparing modular grants.  Additional information 
on modular grants is available at 
http://grants.nih.gov/grants/funding/modular/modular.htm.

USING THE RFA LABEL: The RFA label available in the PHS 398 (rev. 
5/2001) application form must be affixed to the bottom of the face page 
of the application.  Type the RFA number on the label.  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. The RFA 
label is also available at: 
http://grants.nih.gov/grants/funding/phs398/label-bk.pdf
 
SENDING AN APPLICATION TO THE NIH: Submit a signed, typewritten 
original of the application, including the Checklist, and three signed, 
photocopies, in one package to:
 
Center For Scientific Review
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 be sent to:

Tracy Shahan, Ph.D.
National Institute of Arthritis and Musculoskeletal and Skin Diseases
One Democracy Plaza
6701 Democracy Boulevard, Suite 800, MSC 4872
Bethesda, MD  20872-4872
Telephone: (301) 594-4952
FAX: (301) 402-2406
Email: [email protected]

  
APPLICATION PROCESSING: Applications must be received by the 
application receipt date listed in the heading of this RFA.  If an 
application is received after that date, it will be returned to the 
applicant without review.
 
The Center for Scientific Review (CSR) 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 CSR 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.

PEER REVIEW PROCESS  
 
Upon receipt, applications will be reviewed for completeness by the CSR 
and responsiveness by the NIAMS.  Incomplete applications will be 
returned to the applicant without further consideration.  And, if the 
application is not responsive to the RFA, NIAMS 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 appropriate NIH 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 NIAMS in accordance with the review 
criteria stated below.  As part of the initial merit review, all 
applications will:

o  Receive a written critique
o  Undergo a process in which only those applications deemed to have 
the highest scientific merit, generally the top half of the 
applications under review, will be discussed and assigned a priority 
score
o  Receive a second level review by an appropriate council or board 

REVIEW CRITERIA

The goals of NIH-supported research are to advance our understanding of 
biological systems, improve the control of disease, and enhance health.  
In the written comments, reviewers will be asked to discuss the 
following aspects of your application in order to judge the likelihood 
that the proposed research will have a substantial impact on the 
pursuit of these goals: 

o   Significance
o   Approach 
o   Innovation
o   Investigator
o   Environment
  
The scientific review group will address and consider each of these 
criteria in assigning your application's overall score, weighting them 
as appropriate for each application.  Your application does not need to 
be strong in all categories to be judged likely to have major 
scientific impact and thus deserve a high priority score.  For example, 
you may propose to carry out important work that by its nature is not 
innovative but is essential to move a field forward.

(1) SIGNIFICANCE:  Does your study address an important problem? If the 
aims of your application are achieved, how do they advance scientific 
knowledge?  What will be the effect of these studies on the concepts or 
methods that drive this field?

(2) APPROACH:  Are the conceptual framework, design, methods, and 
analyses adequately developed, well integrated, and appropriate to the 
aims of the project?  Do you acknowledge potential problem areas and 
consider alternative tactics?

(3) INNOVATION:  Does your project employ novel concepts, approaches or 
methods? Are the aims original and innovative?  Does your project 
challenge existing paradigms or develop new methodologies or 
technologies?

(4) INVESTIGATOR: Are you appropriately trained and well suited to 
carry out this work?  Is the work proposed appropriate to your 
experience level as the principal investigator and to that of other 
researchers (if any)?

(5) ENVIRONMENT:  Does the scientific environment in which your work 
will be done contribute to the probability of success?  Do the proposed 
experiments take advantage of unique features of the scientific 
environment or employ useful collaborative arrangements?  Is there 
evidence of institutional support? 

ADDITIONAL REVIEW CRITERIA: In addition to the above criteria, your 
application will also be reviewed with respect to the following: 

o   PROTECTIONS:  The adequacy of the proposed protection for humans, 
animals, or the environment, to the extent they may be adversely 
affected by the project proposed in the application.

o   INCLUSION:  The adequacy of plans to include subjects from both 
genders, all racial and ethnic groups (and subgroups), and 
children as appropriate for the scientific goals of the research.  
Plans for the recruitment and retention of subjects will also be 
evaluated. (See Inclusion Criteria included in the section on 
Federal Citations, below).

o   DATA SHARING: The adequacy of the proposed plan to share data.

o   BUDGET:  The reasonableness of the proposed budget and the 
requested period of support in relation to the proposed research.

OTHER REVIEW CRITERIA:

In addition to the above criteria, in accordance with NIH policy, all 
R21 applications will also be reviewed with respect to the following:

o   In the context of this RFA, the R21 exploratory/developmental 
grants are to be used to either: a) gather preliminary data to 
develop a research basis for a subsequent application through 
other mechanisms, i.e., R01, P01, or b) explore the feasibility 
of an innovative or conceptually creative research question or 
approach that may not be justifiable through existing research to 
compete as a standard research project grant (e.g., R01).  

o   Preliminary data supporting feasibility of approach are not 
required.

RECEIPT AND REVIEW SCHEDULE

Letter of Intent Receipt Date:  February 10, 2003
Application Receipt Date:  March 20, 2003
Peer Review Date:  July 2003
Council Review:  September 2003
Earliest Anticipated Start Date:  September 2003

AWARD CRITERIA

Award criteria that will be used to make award decisions include:

o   Scientific merit (as determined by peer review).
o   Use of interdisciplinary team/approaches.
o   Availability of funds.
o   Programmatic priorities.
 
REQUIRED FEDERAL CITATIONS 

INCLUSION OF WOMEN AND MINORITIES IN CLINICAL RESEARCH: It is the 
policy of the NIH that women and members of minority groups and their 
sub-populations must be included in all NIH-supported clinical research 
projects unless a clear and compelling justification is provided 
indicating that inclusion is inappropriate with respect to the health 
of the subjects or the purpose of the research. This policy results 
from the NIH Revitalization Act of 1993 (Section 492B of Public Law 
103-43).

All investigators proposing clinical research should read the AMENDMENT 
"NIH Guidelines for Inclusion of Women and Minorities as Subjects in 
Clinical Research - Amended, October, 2001," published in the NIH Guide 
for Grants and Contracts on October 9, 2001 
(http://grants.nih.gov/grants/guide/notice-files/NOT-OD-02-001.html); a 
complete copy of the updated Guidelines is available at 
http://grants.nih.gov/grants/funding/women_min/guidelines_amended_10_2001.htm.
The amended policy incorporates: the use of an NIH definition 
of clinical research; updated racial and ethnic categories in 
compliance with the new OMB standards; clarification of language 
governing NIH-defined Phase III clinical trials consistent with the new 
PHS Form 398; and updated roles and responsibilities of NIH staff and 
the extramural community.  The policy continues to require for all NIH-
defined Phase III clinical trials that: a) all applications or 
proposals and/or protocols must provide a description of plans to 
conduct analyses, as appropriate, to address differences by sex/gender 
and/or racial/ethnic groups, including subgroups if applicable; and b) 
investigators must report annual accrual and progress in conducting 
analyses, as appropriate, by sex/gender and/or racial/ethnic group 
differences.

INCLUSION OF CHILDREN AS PARTICIPANTS IN RESEARCH INVOLVING HUMAN 
SUBJECTS: The NIH maintains a policy that children (i.e., individuals 
under the age of 21) must be included in all human subjects research, 
conducted or supported by the NIH, unless there are scientific and 
ethical reasons not to include them. This policy applies to all initial 
(Type 1) applications submitted for receipt dates after October 1, 
1998.

All investigators proposing research involving human subjects should 
read the "NIH Policy and Guidelines" on the inclusion of children as 
participants in research involving human subjects that is available at 
http://grants.nih.gov/grants/funding/children/children.htm.

REQUIRED EDUCATION ON THE PROTECTION OF HUMAN SUBJECT PARTICIPANTS: NIH 
policy requires education on the protection of human subject 
participants for all investigators submitting NIH proposals for 
research involving human subjects.  You will find this policy 
announcement in the NIH Guide for Grants and Contracts Announcement, 
dated June 5, 2000, at 
http://grants.nih.gov/grants/guide/notice-files/NOT-OD-00-039.html.

HUMAN EMBRYONIC STEM CELLS (hESC):  Criteria for federal funding of 
research on hESCs can be found at 
http://grants.nih.gov/grants/stem_cells.htm and at 
http://grants.nih.gov/grants/guide/notice-files/NOT-OD-02-005.html.  
Only research using hESC lines that are registered in the NIH Human 
Embryonic Stem Cell Registry will be eligible for Federal funding (see 
http://escr.nih.gov).   It is the responsibility of the applicant to 
provide the official NIH identifier(s)for the hESC line(s)to be used in 
the proposed research.  Applications that do not provide this 
information will be returned without review.

PUBLIC ACCESS TO RESEARCH DATA THROUGH THE FREEDOM OF INFORMATION ACT: 
The Office of Management and Budget (OMB) Circular A-110 has been 
revised to provide public access to research data through the Freedom 
of Information Act (FOIA) under some circumstances.  Data that are (1) 
first produced in a project that is supported in whole or in part with 
Federal funds and (2) cited publicly and officially by a Federal agency 
in support of an action that has the force and effect of law (i.e., a 
regulation) may be accessed through FOIA.  It is important for 
applicants to understand the basic scope of this amendment.  NIH has 
provided guidance at 
http://grants.nih.gov/grants/policy/a110/a110_guidance_dec1999.htm.

Applicants may wish to place data collected under this initiative in a 
public archive, which can provide protections for the data and manage 
the distribution for an indefinite period of time.  If so, the 
application should include a description of the archiving plan in the 
study design and include information about this in the budget 
justification section of the application. In addition, applicants 
should think about how to structure informed consent statements and 
other human subjects procedures given the potential for wider use of 
data collected under this award.

URLs IN NIH GRANT APPLICATIONS OR APPENDICES: All applications and 
proposals for NIH funding must be self-contained within specified page 
limitations. Unless otherwise specified in an NIH solicitation, 
Internet addresses (URLs) should not be used to provide information 
necessary to the review because reviewers are under no obligation to 
view the Internet sites.  Furthermore, we caution reviewers that their 
anonymity may be compromised when they directly access an Internet 
site.

HEALTHY PEOPLE 2010: The Public Health Service (PHS) is committed to 
achieving the health promotion and disease prevention objectives of 
"Healthy People 2010," a PHS-led national activity for setting priority 
areas. This RFA is related to one or more of the priority areas. 
Potential applicants may obtain a copy of "Healthy People 2010" at 
http://www.health.gov/healthypeople.

AUTHORITY AND REGULATIONS: This program is described in the Catalog of 
Federal Domestic Assistance No. Nos. 93.846 and is not subject to the 
intergovernmental review requirements of Executive Order 12372 or 
Health Systems Agency review.  Awards are made under authorization of 
Sections 301 and 405 of the Public Health Service Act as amended (42 
USC 241 and 284) and administered under NIH grants policies described 
at http://grants.nih.gov/grants/policy/policy.htm
and under Federal Regulations 42 CFR 52 and 45 CFR Parts 74 and 92. 

The PHS strongly encourages all grant recipients to provide a smoke-
free workplace and discourage the 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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