The Division of Allergy, Immunology, and Transplantation (DAIT) focuses on the ways the immune system functions in maintaining health and the ways it malfunctions in producing disease. The immune system is composed of networks of specialized cells and organs that act together to defend the body against disease-causing organisms such as viruses, bacteria, parasites, and fungi. However, abnormal immune responses also can cause disease as well as the rejection of transplanted organs, tissues, and cells. The immune system plays an important role in numerous disorders, including the following:
- Traditional congenital diseases, such as severe combined immune deficiency, and acquired immunodeficiency diseases other than AIDS
- Asthma, food allergy, atopic dermatitis (eczema), and other allergic diseases such as rhinitis (which affects the nose) and rhinosinusitis (which affects the sinuses)
- Autoimmune diseases, such as insulin-dependent diabetes mellitus and systemic lupus erythematosus
- Acute and chronic inflammatory disorders such as inflammatory bowel disease
Collectively, these diseases affect millions of Americans, resulting in considerable morbidity (sickness), mortality (death), pain and suffering, and medical costs. Furthermore, these diseases cross many clinical specialties; thus, knowledge of the immune system and its role in disease is increasingly important in the daily practice of medicine.
DAIT supports basic and clinical research to increase our understanding of the causes and mechanisms that lead to the development of immunologic diseases and to expand knowledge that can be applied to improving techniques of diagnosis, treatment, and prevention. The division supports a broad array of investigator-initiated studies and specific research programs, including the following:
- Cooperative research centers in asthma, allergic, and immunologic diseases, and human immunology in the context of biodefense
- Multidisciplinary projects in autoimmunity, transplantation immunology, new methods of immune intervention, host defense, and the basic biology of the immune system
- Cooperative multicenter clinical trials in asthma, food allergy, atopic dermatitis, and solid organ transplantation
Through outreach, demonstration, and education projects, DAIT supports testing the effectiveness of interventions to promote health and prevent disease in specific populations. DAIT's approach integrates basic science with relevant clinical specialties.
DAIT-funded researchers study in people and animal models the properties, interactions, and functions of the cells of the innate and adaptive immune systems (i.e., the immune system you are born with and the immunities you acquire) and the products made by those cells. This information serves as a basis for developing new clinical strategies and biotechnical applications relevant to infectious disease and to immune-mediated conditions such as allergy, asthma, autoimmune disease, and transplant rejection.
Asthma, food allergy, atopic dermatitis, rhinitis, and rhinosinusitis are diseases with very high prevalence in the United States and around the world. The development, history, genetics, diagnosis, management, and prevention of these conditions are important scientific research areas for DAIT. The division supports a wide portfolio of investigator-initiated scientific projects in basic research and clinical trials, as well as initiatives such as the Inner City Asthma Consortium, the Consortium for Food Allergy Research, the Atopic Dermatitis Research Network, the Asthma and Allergic Diseases Cooperative Research Centers, and the Allergen Epitope Research and Validation Centers that address major aspects of these conditions. During fiscal year 2014, DAIT-funded research involved 4,500 clinical trial and 25,000 observational study participants with these conditions.
DAIT supports several clinical research programs on autoimmune diseases. For example, the Autoimmunity Centers of Excellence facilitate close interactions between clinicians and basic researchers to promote collaborative research on autoimmune diseases, including clinical trials of immunomodulatory therapies. Another program, the Autoimmune Disease Prevention Centers, conducts research on the development of new prevention strategies for autoimmune diseases and evaluates these approaches in pilot and clinical studies.
The goal of NIAID transplantation research is to improve the long-term success of organ, tissue, and cell transplantation by understanding the role the immune system plays in transplant success or failure. NIAID-supported investigators are working to selectively control or eliminate unwanted immune responses while maintaining the immune system's ability to fight infection and cancer. The aim is to modify the immune response in a way that will improve long-term transplant survival and reduce the need for broadly immunosuppressive medications, which can cause significant side effects.
DAIT supports biodefense-related contracts and grants that focus on the immunology of infectious diseases caused by Category A, B, and C pathogens (disease-producing bacteria, viruses, and parasites). Specific programs include the following:
- Identifying antibody and T cell epitopes (parts of proteins that antibodies and T cells will recognize) within such pathogens
- Investigating how genetic differences in the immune system influence the outcomes of vaccination or infection
- Discovering new adjuvant (chemical compounds that enhance immune response) candidates for vaccine development
- Improving technologies to advance the study of human immunology to create better vaccines and therapeutics
Medical Countermeasures Against Radiological and Nuclear Threats
DAIT is coordinating and administering the National Institutes of Health effort to develop new medical countermeasures against radiological and nuclear threats. This includes research and development of the following:
- Drugs to treat radiation injury to tissues and organs such as the bone marrow, intestines, skin, lungs, kidneys, and brain
- Biological markers to determine if a person has been exposed to radiation
- Drugs to remove internalized radiation from the body
Specific programs include a network of research centers to identify and translate new discoveries of drugs and biological approaches into treatments to reverse or prevent radiological injuries, as well as a portfolio of grants, contracts, and inter-agency agreements to develop drugs to treat radiation exposure and study the effects experienced by survivors of radiation exposure.