June 7, 2019

Dr. Sylvia LaCourse awarded two R21 awards to investigate novel TB diagnostic methods in HIV-infected pregnant women and children

Tuberculosis (TB) contributes to substantial morbidity and mortality among HIV-infected peripartum women and their children.  We are pleased to announce that Dr. Sylvia LaCourse (Acting Assistant Professor, Medicine and Co-Director, HIV and Co-Infections Scientific Priority Area) received two National Institutes of Health-funded R21 awards to investigate novel TB diagnostic methods in HIV-infected children and TB-specific immune responses in pregnant women.

Dr. LaCourse has multiple ongoing research projects primarily in Kenya that focuses on improving TB screening and prevention in HIV-infected peripartum women and their children.  She is involved in several local and international research organizations:

• Tuberculosis Research & Training Center (TRTC)
• Kenya Research and Training Center (KRTC)
• TB ECHO (Extension for Community Healthcare Outcomes)
• IMPAACT (International Maternal Pediatric Adolescent AIDS Clinical Trials Network)
• International Union Against TB and Lung Disease Maternal Child Health Working Group

Despite advances in rapid TB diagnostics, sample collection remains a challenge.  TB is mainly present in the lungs; however, young children, especially those with HIV, are more likely to develop extrapulmonary TB elsewhere in the body or disseminated throughout the body, which is missed by respiratory sampling.

In one study entitled, “NanoDisk-MS measured Mtb antigen peptides for TB diagnosis and treatment monitoring in HIV-infected children,” Dr. LaCourse is evaluating the performance of a blood-based diagnostic tool, developed by Dr. Tony Hu at the Arizona State University BioDesign Institute, to detect minute traces of TB (Mtb specific antigen peptides) using nanotechnology.  This approach has features may make it exceptionally well suited for children including small blood volume requirement (<1ml) and improved performance in extrapulmonary and disseminated TB.  The study will use cryopreserved samples from the completed Global WACh study, Pediatric Urgent Start of HAART (PUSH) trial (PI: Grace John-Stewart).  Co-investigators include Dr. Dalton Wamalwa and Dr. Lisa Maleche-Obimbo, Professors of Pediatrics at the University of Nairobi, and Dr. Lurdes Inoue (Professor, UW Biostatistics).

In the second study, “Dynamics of tuberculosis immune response in peripartum HIV-infected and HIV-uninfected women,” Dr. LaCourse and Dr. Javeed Shah (Co-PI and Assistant Professor, Medicine) are investigating the effect of pregnancy and HIV on TB responses.  This study will utilize a combination of samples from Dr. LaCourse’s ongoing maternal-infant cohorts in Kenya, and Partners in PrEP and Partners HIV/HSV Prevention studies to understand how pregnancy influences women’s TB immune responses.  The diversity of samples collected during pre-pregnancy and pregnancy stages will help in characterizing the effects.  Co-investigators include Drs. Jairam Lingappa (Professor, Global Health and Medicine; Associate Director, International Clinical Research Center), Barbra Richardson (Research Professor, Biostatistics and Global Health), and Grace John-Stewart (Professor and Global WACh Director).

With TB now surpassing HIV as one of the leading infectious killers globally, TB has become a high priority for international action and research.  Dr. LaCourse and colleagues’ research findings will contribute to the growing development of innovative and accurate TB diagnostics and a better understanding of the immune changes in pregnancy that may impact the risk of developing TB.  We look forward to the results in 2021.