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Exploring All the Options
CHORI Scientist Garners Highly Competitive ~ $900,000 NIH Contract for 18-Month Study

Parvin Azimi, MD, CHORI scientist in the Center for Immunology and Vaccine Development, has just completed negotiations this month on an National Institutes of Health (NIH) contract to investigate the relationship of Group B Streptococcus (GBS) serum bacterial phospholipids to the occurrence of respiratory distress in newborns of mothers who are asymptomatic carriers of GBS.

“It’s a very involved research project requiring two microbiologists, three nurses, a couple of physicians and a coordinator to carry out,” explains Dr. Azimi.

While competition for NIH contracts is fierce, by collaborating with Alta Bates Summit Medical Center, which serves a highly diverse ethnic, racial and socioeconomic population, Dr. Azimi and her colleagues were uniquely prepared to take on the study.

"The diversity of the population in California that Alta Bates serves is very desirable for this kind of study," Dr. Azimi explains. "Epidemiological studies like this one need to represent all of the ethnic backgrounds of the United States in order to have the most widely applicable results."

In addition to the issue of diversity, however, Dr. Azimi was also the most ideal choice for NIH because she was intimately familiar with the findings on which the current study is based.

"This study is actually an offshoot of research we did in the late 1990's," says Dr. Azimi, who, while studying maternal antibody levels to GBS, discovered a significant increase in the number of infants born with respiratory distress.

"Respiratory distress in newborns is generally high, around 3 to 4 percent," says Dr. Azimi. "In our study population of infants born to mothers who were GBS carriers, the incidence was 8.8 percent."

There was also a 2.62 fold increase in the incidence of respiratory distress in infants whose mothers had been treated with penicillin during labor, the current standard of care for maternal GBS carriers in order to prevent transmission to the newborn, which can cause potentially deadly sepsis.

"Our hypothesis is that GBS carriage may be a risk factor for respiratory distress in newborns and that penicillin-use during labor may exaggerate the problem," says Dr. Azimi.

The reason for this suspicion is that the GBS bacteria have phospholipids in their cell walls, which have been shown to cause pulmonary hypertension. Once those cell walls are broken down, phospholipids are released into the blood stream.

Should Dr. Azimi's hypothesis prove true, alternative treatment options for maternal GBS colonization may need to be explored.

"Perhaps we should be looking at alternative antibiotics, or even a vaccine, for example," suggests Dr. Azimi. "We could consider immunizing all women of child-bearing age against GBS. This would mean they would have high levels of anti-GBS antibodies in their blood regardless of whether they are colonized by GBS, and their babies would be safe from both sepsis and respiratory distress."

NIH contract now in hand, Dr. Azimi hopes to have answers to the question of GBS and respiratory distress within 2 years, paving the way for healthier and happier babies, one study at a time.

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Monday, May 16, 2011 11:33 PM

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