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NIH 1998 Almanac/The Organization/NIDDK/      

National Institute of Diabetes and Digestive and Kidney Diseases : Research Programs


Division of Intramural Research

The Division of Intramural Research conducts research and training within the institute’s laboratories and clinical facilities in Bethesda, Md., and at the Phoenix Epidemiology and Clinical Research Branch in Arizona.

The division has 8 branches and 11 laboratories, which cover a wide range of research areas. In addition, there is a section on veterinary sciences and an interinstitute training program with NICHD in clinical endocrinology.

Six branches are engaged primarily in basic and clinical research on diabetes, bone metabolism, endocrinology, hematology, digestive diseases, and genetics. The Phoenix Epidemiology and Clinical Research Branch develops and applies epidemiologic and genetic methods in field studies throughout the world on selected populations at risk of developing specific diseases, especially diabetes and its complications. The eighth branch addresses mathematical modeling of biological problems.

The laboratories are engaged in fundamental research related to the institute’s mission (e.g., molecular biology, chemistry, cell biology, toxicology, pharmacology, physics, biochemistry, neuroscience, and developmental biology). The laboratory animal science section provides research animal support and collaboration to the research programs of the institute.

Division of Diabetes, Endocrinology and Metabolic Diseases

The DEMD supports research and research training related to diabetes mellitus, endocrinology, and metabolic diseases including cystic fibrosis. In addition, DEMD leads the administration of the Trans-NIH Diabetes Program and coordinates federally supported diabetes-related activities. The division also administers the Trans-NIH Cystic Fibrosis Program.

Diabetes Programs Branch Diabetes Research Program. This program supports basic and clinical studies related to the etiology, pathogenesis, prevention, diagnosis, treatment, and cure of diabetes mellitus and its complications. The program also supports investigations related to pancreas and islet transplantation, automated insulin delivery systems, glucose sensors, the epidemiology of diabetes and its complications, and behavioral research related to diabetes.

Diabetes Centers Program. Two types of awards are made: Diabetes/Endocrinology Research Centers, exclusively oriented toward biomedical research goals, and the Diabetes Research and Training Centers (DRTC), which include training and information transfer components in addition to research. The DERCs and DRTCs integrate, coordinate, and foster interdisciplinary cooperation of investigators in diabetes and related endocrine and metabolic disorders. Both programs also provide limited funds for pilot and feasibility studies to encourage young investigators and new initiatives.

Clinical Trials Program. This program supports a multicenter randomized clinical trials on the treatment and prevention of insulin-dependent and noninsulin-dependent diabetes mellitus.

National Diabetes Data Group. The NDDG serves as the major Federal focus for the collection, analysis, and dissemination of data on diabetes and its complications.

WHO Collaborating Center for Diabetes. This center, sponsored by the Division of Diabetes, Endocrinology, and Metabolic Diseases, solicits and provides guidance in developing international research about diabetes through NIH research grants and contracts; promotes interchange of scientific and health information among WHO member countries; and provides expert advice and consultation to WHO and other international committees and agencies.

Endocrinology and Metabolic Diseases Programs Branch

Endocrinology Research Program. Basic and clinical studies on the mechanism of hormone action and hormonal regulation of gene expression is supported. Principal areas include nuclear and orphan hormones and their receptors; signal transduction through cell surface, cytoplasmic and nuclear receptors; regulation of the expression, processing, and secretion of hormones; dysfunctional hormonal regulation which causes or is the result of diseases such as osteoporosis, breast cancer and AIDS.

Also investigated are the effects of peptide hormones on gene expression; endocrine regulation of bone metabolism; basic research on the hypothalamic-pituitary axis; the identification and characterization of novel hypothalamic or pituitary hormones or receptors; and basic and clinical research on the effects of growth factors and related hormon-like substances.

Hormone Distribution Program. This program makes available to the research community human and animal pituitary hormones, antisera against the hormones, and selected other hormonal and biological products. An important research resource for the scientific community, this program gives scientists access to hormones and antisera of known composition and potency, most of which are unavailable commercially.

Metabolic Diseases Research. This consists of the Metabolic Deseases and Gene Therapy Research Program and the Metabolism and Structural Biology Research Program.

The first supports investigator-initiated research on intermediary metabolism and its regulation in health and disease. Particular areas include studies of etiology, pathogenesis, prevention, diagnosis, pathophysiology, and treatment of genetic metabolic diseases; characterization of the genes, gene defects and regulatory alterations characterizing the underlying causes of these diseases; development of enzyme replacement therapy; creation of animal models; and characterization of normal and abnormal metabolic biochemical processing in specialized tissues.

The second funds studies that examine structure-function relationships of peptides, proteins and polynucleotides relevant to normal and disease states. These include investigations on elucidating mechanisms of the fundamental processes of endocytosis, exocytosis, intracellular protein trafficking and membrane transport; evaluations of relationships of cellular membranes; elucidation of three-dimensional structures of proteins/enzymes; and clarification of the biolgical activities of organelle-derived peptides.

Cystic Fibrosis Research Program. This program supports initiated research projects and center grants encompassing fundamental and clinical studies of the etiology, molecular pathogenesis, pathophysiology, diagnosis and treatment of CF and its complications.

Division of Digestive Diseases and Nutrition

This division supports research related to liver and biliary diseases, pancreatic diseases, gastrointestinal diseases, including neuroendocrinology, motility, immunology, and digestion in the GI tract, nutrient metabolism, obesity, eating disorders, and energy regulation. The division provides leadership in coordinating activities related to digestive diseases and nutrition throughout the NIH and with various other Federal agencies.

Digestive Diseases Branch

Liver and Biliary Program. This program supports basic and clinical research into the normal function and the diseases of the liver and biliary tract. Areas of study include hepatic regeneration, gene therapy, liver cell injury, fibrosis, and apoptosis; liver transplantation; metabolism of bile acids and bilirubin; physiology of bile formation; factors controlling cholesterol levels in bile; gallbladder and bile duct function; cholesterol and pigment gallstones; inborn errors in bile acid metabolism; chronic hepatitis that evolves from autoimmune, viral, or alcoholic disease; and other liver diseases.

Pancreas Program. This program encourages research into the structure, function, and diseases (excluding cancer and cystic fibrosis) of the exocrine pancreas. Research efforts focus on hormonal and neural regulation of electrolyte, fluid, and enzyme secretion; receptors for secretagogues; stimulus-secretion coupling mechanisms; gut-islet-acinar interrelations; organization and expression of pancreatic genes; protein synthesis and export; tissue injury, repair, and regeneration; physiology and pathology of trophic responses; neural innervation; transcapillary solute and fluid exchange; pancreatic transplantation, storage, and preservation; imaging of the pancreas; pancreatic insufficiency; and acute and chronic pancreatitis and relevant experimental models.

Gastrointestinal Neuroendocrinology Program. This program supports both basic and clinical studies on normal and abnormal function of the enteric nervous system and the central nervous system elements that control the enteric nervous system. Research focuses on gastrointestinal hormones and peptides and studies on disease conditions associated with excessive or deficient secretions of neuropeptides.

Gastrointestinal Transport and Absorption Program. This program supports research on the process of food digestion in the gastrointestinal tract (GIT). Areas of research focus on the regulation of gene expression in the GIT; structure and function of the gut mucosa; cytoskeletal structure and contractility in brush border; growth and differentiation of gastrointestinal cells in normal and disease states; intestinal transplantation, storage, and preservation; and gastrointestinal tissue injury, repair, and regeneration.

Also supported are studies on gastrointestinal diseases such as maldigestion and malabsorption syndromes.

Gastrointestinal Motility Program. This program supports research on structure and function of gastrointestinal muscles, the biochemistry of contractile processes and mechanochemical energy conversion relations between metabolism and contractility in smooth muscle, extrinsic control of digestive tract motility, and fluid mechanics of gastrointestinal flow. Areas of interest include actions of drugs on gastrointestinal motility, intestinal obstruction, and diseases such as irritable bowel syndrome, colonic diverticular disease, swallowing disorders, and gastroesophageal reflux.

Gastrointestinal, Mucosal and Immunology Program. Research focuses on intestinal immunity and inflammation. Areas include: ontogeny and differentiation of gut-associated lymphoid tissue; migratory pathways of intestinal lymphoid cells; humoral antibody responses; cell-mediated cytotoxic reactions; genetic control of the immune response at mucosal surfaces; immune response to enteric antigens in both intestinal/extraintestinal sites; granulomatous inflammation; lymphokines and cellular immune regulation; leukotrienes/prostaglandin effects on intestinal immune responses; T-cell mediated intestinal injury; intestinal mast cells and their role in inflammation; approaches to optimal mucosal immunoprophylaxis, including viral, bacterial, and parasitic diseases; and diseases such as gluten sensitive enteropathy, inflammatory bowel disease, and gastritis.

Acquired Immunodeficiency Syndrome Program. This program encourages research into the characterization of intestinal injury, mechanism of maldigestion, and intestinal mucosal functions, as well as hepatic and biliary dysfunction in AIDS. In addition, studies are supported on mechanisms of nutrient dysfunction, nutritional management in the wasting syndrome and other aspects of malnutrition related to AIDS.

Digestive Diseases Centers Program. This program currently administers research core center grant awards. These awards provide a mechanism for integrating, coordinating, and fostering interdisciplinary cooperation between groups of established investigators who conduct programs of high-quality research that relate to a common theme in digestive disease research.

Nutritional Sciences Branch

Nutrient Metabolism Program. This program supports basic and clinical studies related to the requirement, bioavailability, and metabolism of nutrients and other dietary components. Specific areas of research interest include understanding of physiological function and mechanism of action/interaction of nutrients within the body; effects of environment, heredity, stress, drug use, toxicants, and physical activity on problems of nutrient imbalance and nutrient requirements in health and disease; and specific metabolic considerations relating to alternative forms of nutrient delivery and use such as total parenteral nutrition.

The program also supports research to improve methods of assessing nutritional status in health and disease.

Obesity, Eating Disorders, and Energy Regulation Program. This program funds research on the biomedical and behavioral aspects of obesity, anorexia nervosa, bulimia, and other eating disorders.

The goals are to establish a clear understanding of the etiology, prevention, and treatment of these multifaceted conditions. Areas of research interest focus on factors that affect food choices, food intake, eating behavior, appetite, and satiety; effects of taste, smell, and gastric and humoral (including neurotransmitters) responses associated with dietary intake and subsequent behavior; physiological and metabolic consequences of weight loss or gain; effect of mild exercise on appetite and weight control; and individual variability in energy utilization and thermogenesis.

The program encourages investigations on dietary determinants of growth and control of adipocyte size and number; responsiveness of the adipocyte to metabolic and pharmacologic stimuli; prevention of obesity and other eating disorders; improved methods of assessing body composition; examination of health risk factors associated with specific degrees of obesity or body composition; and determining the effect of exercise on body composition.

Clinical Nutrition Research Units. The CNRU is an integrated array of research, educational, and service activities focused on human nutrition in health and disease. It serves as the focal point for an interdisciplinary approach to clinical nutrition research and for the stimulation of research in improved nutritional support of acutely and chronically ill persons, assessment of nutritional status, effects of disease states on nutrient needs, and effects of changes in nutritional status on disease.

Obesity/Nutrition Research Centers. The ONRCs encourage collaboration among researchers and a multidisciplinary approach to the treatment and prevention of obesity. They will help to capitalize on emerging research opportunities in obesity and to enhance the translation of research findings to the public.

U.S.-Japan Malnutrition Panel. In 1965 President Lyndon B. Johnson and Japanese Prime Minister Eisaku Sato issued a joint communique recognizing their mutual concern for the health and well-being of all peoples of Asia. This led to the formation of the U.S.-Japan Cooperative Medical Science Program, which operates within a bilateral government framework. The malnutrition panel was established in 1966 to foster and support investigator-initiated research to help alleviate the serious problem of malnutrition.

Current topics of importance to the U.S. and Japan focus on consequences of changing dietary patterns on health, development of disease, and disease prevention. Specific research includes the nutritional significance of varying the amount of polyunsaturated fatty acids in the diet, nutritional aspects of bone disease, endogenous mediators of nutritional metabolism, and improved methodologies applicable to nutritional assessment.

Epidemiological Clinical Trials Branch

Clinical Trials Program. This program includes all prospective studies in digestive diseases and nutrition. Using 10 or more patients, studies compare two forms of treatment, one of which could be placebo or "standard" care.

Epidemiology and Data Systems Program. P.L. 99-158 authorized the establishment of this program for collection, storage, analysis, retrieval, and dissemination of data derived from patient populations with digestive diseases and, where possible, data involving general populations to detect individuals with a risk of developing digestive diseases.

Division of Kidney, Urologic and Hematologic Diseases

The division supports research on diseases of the kidney, genitourinary tract, and blood and blood-forming organs, and on the fundamental biology relevant to these organ systems. It funds training and professional development of investigators in disciplines critical for research in these areas.

Kidney Research

Basic Renal Biology Program.

This program supports research on normal development, structure and function of the kidney. Areas of emphasis include glomerular function and cell biology, transport physiology and structure-function analysis of transport proteins, and integrated regulation of solute and water excretion. The program supports investigation of adverse effects of nephrotoxic drugs and environmental toxins and mechanisms of hypoxic renal cell injury. A major area of strength are studies examining intracellular signal transduction for renal hormones and growth factors. In addition to study on mammalian systems, investigation is supported on transport function and development using simple systems such as C. elegans and zebrafish.

Chronic Renal Diseases Program. This program supports basic and clinical studies on the etiology, prevention, diagnosis and treatment of chronic renal diseases. Disease categories receiving particular emphasis include analgesic nephropathy, polycystic kidney disease, diabetic nephropathy, glomerulonephritis and other immune disorders of the kidney, hypertensive nephrosclerosis and HIV nephropathy. A major interest in this program are renal diseases that affect children and the effects of chronic renal insufficiency on growth and development of children.

End-Stage Renal Disease Program. This program supports investigation on the pathogenesis of the uremic state, on end-stage renal disease treatment by peritoneal and hemodialysis, and on nutrition in renal disease. Investigation on renal transplantation is supported with particular emphasis on nonimmunological renal injury and on methods of increasing organ availability, particularly in minority populations.

Pediatric Nephrology Program. This program supports basic and clinical research on the causes, treatments, and prevention of kidney diseases of children. Research efforts focus on inherited and congenital renal diseases kidney disease of diabetes mellitus IgA nephropathy and kidney disease and hypertension, which starts in early childhood.

Renal Epidemiology Program. Investigation into the incidence and prevalence of renal diseases, the factors associated with increased mortality and comorbidity and cost-benefit assessment of prevention and treatment strategies are areas supported through the renal epidemiology program. The U.S. Renal Data System (USRDS), an information resource for the epidemiology of end-stage renal disease, is supported through this program. USRDS investigation of cost factors in dialysis care is cofunded with the Health Care Financing Administration.

Urology Research

Basic Urology Program. This program supports basic research on the normal and abnormal development, structure and function of the genitourinary tract. A major area of interest is investigation of the biology of bladder cells, including studies on transport properties, effects of obstruction on patterns of protein expression and examination of interactions between urinary pathogens and cells of the urinary tract. The program on prostate biology has particular strengths in investigation of prostate cell growth and mechanisms of growth factor signal transduction.

 

The major emphasis of this program is to develop a source of epidemiologic information that may further understanding of natural history, risk factors and health resource utilization for urologic conditions. Plans are to collect and analyze new and existing data on incidence, prevalence, morbidity, mortality and health resource utilization associated with various urologic conditions of high public health importance. The information will be presented in a planned publication tentatively titled "Urologic Diseases in America."

Hematology Research

Basic Hematology Program. This program supports fundamental investigation of the hematopoietic system, including studies of relevance to sickle cell anemia, thalassemia, hemochromatosis, iron deficiency anemia, thrombocytopenia and hemolytic anemia. Areas of particular interest include hematopoietic development--for example, molecular mechanisms for determination of the hematopoietic cell lineages; stem cell biology; hemoglobin biology such as globin gene regulation; and the biology of iron, including iron transport, mechanisms of regulation of gene expression by iron and mechanisms of cellular toxicity of iron.

Office of the Director

Advisory Board

National Task Force on Prevention and Treatment of Obesity. The task force was established in June 1991 to synthesize current scientifically based information on the prevention and treatment of obesity and to develop statements about topics of clinical importance that are based on critical analyses of the literature. It is composed of leading obesity researchers and clinicians who advise the institute on research needs and sponsor workshops on topics related to the prevention and treatment of obesity. Organizationally, it is placed under the auspices of the NIDDK Advisory Council.

Other Activities

National Diabetes Education Program. The NDEP, a federally sponsored initiative, involves public and private partners to improve treatment and outcomes for people with diabetes, to promote early diagnosis, and ultimately to prevent the onset of diabetes.

Information Services

National Diabetes Information Clearinghouse (NDIC).

National Digestive Diseases Information Clearinghouse (NDDIC).

National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC).

The three clearinghouses serve as information resources for patients, the public, and health professionals concerned with diabetes, digestive diseases, and kidney and urologic diseases. Each was authorized by Congress to increase knowledge and understanding about these areas through the effective dissemination of information. The NDIC was authorized by Congress in 1976; the NDDIC in 1980; and the NKUDIC in 1987.

To accomplish this mission, the clearinghouses answer inquiries; develop, review, and distribute publications; and work closely with professional and patient-advocacy organizations and Government agencies to coordinate informational resources about diabetes, digestive diseases, and kidney and urologic diseases.

The clearinghouses also develop and maintain relevant sections of the Combined Health Information Database--a free, online bibliographic database of references to books, journal articles, audiovisuals, directories, bibliographies, manuals, product descriptions, brochures and pamphlets, computer programs, monographs, newsletters, and other educational materials. The health education resources indexed in CHID are often not indexed elsewhere.

CHID and all the clearinghouse publications are available through the NIDDK home page, at http://www.niddk.nih.gov/. Mailing addresses are: NDIC, 1 Information Way, Bethesda, MD 20892-3560; NDDIC, 2 Information Way, Bethesda, MD 20892-3570; NKUDIC, 2 Information Way, Bethesda, MD 20892-3580.

Weight-Control Information Network. WIN is a national information service established in 1994 to provide health professionals and consumers with science-based information on obesity, weight control, and nutrition. The WIN program supplements the work of the Clinical Nutrition Research Units, the Obesity/Nutrition Research Centers, and the National Task Force on Prevention and Treatment of Obesity. WIN publications are available through the NIDDK home page, at http://www.niddk.nih.gov/health/nutrit/win.htm. The mailing address is: Weight-control Information Network, 1 WIN Way, Bethesda, MD 20892-3665; phone: (301) 984-7378 or 1-800-WIN-8098.


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