Research

Rana Chakraborty is Professor of Pediatrics and Division Chief in Pediatric Infectious Diseases at University of Miami Miller School of Medicine and Jackson Health System.

In humans, the hemochorial placenta is a unique temporary organ that forms during pregnancy to support fetal development, gaseous exchange, delivery of nutrition, removal of waste products and provides immune protection, while maintaining tolerance to the HLA-haploidentical fetus. In addition, the placenta provides a protective barrier to prevent the transmission of pathogens (i.e., viruses, bacteria, parasites) from mom to fetus. Although the cells of the placenta protect against most infections, pathogens like HIV, toxoplasma, Zika and CMV can cross the placenta resulting in detrimental outcomes to the developing fetus. The mechanisms these pathogens use to penetrate and replicate in the placenta are poorly understood. Previous data from our lab has demonstrated that fetal macrophages (Hofbauer cells) play an important role in the infection process. Therefore, the Chakraborty laboratory focuses on individual host cell-viral interactions within immune cell populations in the maternal decidua and villous (fetal) placenta. Studying these mechanisms could lead to the development of treatment, prevention, or diagnostic strategies to improve outcomes during pregnancy. Dr. Chakraborty’s current research investigates the role of maternal infection and associated inflammation on fetal and infant immunity. Dr. Chakraborty’s research portfolio also includes clinical research and serving as the Principal Investigator for PHACS studies, Surveillance Monitoring for ART Toxicities Study (SMARTT) and the Adolescent Master Protocol (AMP/AMP UP).

Dr. Ivan Gonzalez is a Pediatric Infectious Diseases expert with the University of Miami Miller School of Medicine Division of Pediatric Infectious Diseases and the Director of UM’s Zika Response Team. Dr. Gonzalez served as the principal investigator on the proposed grant titled Pediatric Zik-Action: Evaluation of Zika End Organ Damage: A Team Science Approach. His efforts were recognized nationally, and he was invited as a speaker for the American Society of Tropical Medicine and Hygiene (ASTMH) Annual Meeting that occurred in November 2016. Dr. Gonzalez was joined by the President of the ASTMH and CDC laboratory directors to discuss strategies in handling Zika virus infections in the U.S. In addition, Dr. Gonzalez was invited by the CDC to participate in the Forum on the Diagnosis, Evaluation, and Management of Zika Virus Infection Among Infants. He was also selected by the CDC for a feature in the series entitled “CDC Response to Zika, Features from the Frontline”.

As part of his clinical responsibilities, the role of pediatric infectious diseases transplant liaison increases the capture of potential needs to enhance patient care. Currently there is a need for multicenter studies for the best evidence-based practices that will impact patient outcomes. Thus far, the division has had success investigating our standard of care leading to changes in our clinical protocols resulting in a decrease in morbidity and mortality. These studies shed light on current practices and may lead to multicenter studies through our national association. Dr. Gonzalez also holds a pilot grant titled: Prognostic Capability of CMV and EBV IGRA in Pediatric Solid Organ Transplant Recipients. This pilot will begin to address predictive biomarkers to determine morbidity and mortality associated with the two viruses often detected in solid organ transplant recipients. The grant will also create a sample biorepository to facilitate future projects for potential biomarkers for infection and/or rejection in the pediatric population. In addition, the division is investigating how patients with normal and abnormal immunity respond to vaccines such a pneumococcal and influenza vaccine to develop more effective immunization strategies. These studies are conducted in conjunction with solid organ transplantation services.

During the last 30 years at the University of Miami Miller School of Medicine, Dr. Charles Mitchell has consistently been involved in research related to the global pandemic of HIV among mothers and their infants, both domestically and internationally. During that time, he has been the Principal Investigator for three Fogarty International Center Training Initiatives, including an AIDS International Training and Research Program, an International Maternal and Child Health Training and Research Program, and Medical Informatics. Thirty-five international investigators from countries where Pediatric HIV is endemic were trained in HIV research as a result of these programs. He has been a co-investigator with Dr. Charles Wood of the University of Nebraska on a long-term study of the Epidemiology of Human Herpesvirus Type 8 in Zambia. He is currently the IMPAACT (International Maternal Pediatric Adolescent AIDS Clinical Trials) Clinical Research Site Leader at the University of Miami Miller School of Medicine. As a result of his involvement in IMPAACT, he was one of the originators and co-chairs of IMPAACT Protocol P1041 (a large phase III randomized, placebo-controlled study to determine the efficacy of primary INH prophylaxis in preventing TB disease and latent TB infection in HIV perinatally exposed South African infants). He was awarded an NIAID RO1 grant to study Microbial Translocation and Alterations in the Bowel Microbiota and Microbiome (“the MITABS study”) in newly diagnosed HIV perinatally infected infants as well as perinatally exposed, uninfected infants in Santo Domingo, the Dominican Republic (DR). During 2017, he received the Batchelor Foundation award for Excellence in Child Health Research and is currently the Principal Investigator on a study funded by this award Evaluating the Utility of a MTB CFP10 Blood Assay for both diagnosing and monitoring the response to TB therapy in Dominican children with TB.

Dr. Scott was previously the Director, Division of Pediatric Infectious Diseases for more than 25 years and is now an Emeritus Professor at the University of Miami Miller School of Medicine. Throughout her career, she has dedicated herself to the advancement and education of pediatric HIV and pediatric infectious diseases. Dr. Scott is a distinguished physician scientist with many accomplishments. Her expansive academic reputation may be attested to by her track record in providing scientific leadership at the regional and national level. She was one of the first Directors of the NIH funded Pediatric AIDS Clinical Trials Group and was actively involved in the study that led to the first “home run” in the AIDS epidemic. It was this study that documented that the administration of prenatal AZT to pregnant HIV infected women could reduce maternal-infant transmission by almost 70%. This initial breakthrough led to subsequent perinatal intervention studies in which she was also involved. These studies led the decrease of perinatal HIV transmission. Dr. Scott has also chaired the NICHD Pediatric HIV/AIDS group (PHACS) Network, the Perinatal Transmission Committee of the Pediatric Clinical Trials Group, and has served as a working member of innumerable task forces, committees and advisory groups concerned with the HIV agenda including the Red Book Committee on Pediatric Infectious Diseases of the American Academy of Pediatrics. 

The Division of Infectious Diseases participates in the International Maternal Pediatric Adolescent AIDS Clinical Trials (IMPAACT Network) which offers clinical trials to HIV seropositive pregnant women and infected infants and children. The division has a distinguished history in clinical trials. Investigators participated in the design and implementation of clinical trials for both Zidovudine and Didanosine in children with HIV infection. Results of these trials were critical for the licensure of both drugs for use in children. The team was also instrumental in initiating trials of Zidovudine in pregnant women. We participated in a large, double blind, placebo controlled, multicenter trial to test the effect of Zidovudine use by HIV seropositive pregnant women. Results showed a significant reduction of perinatal HIV transmission from 25% to 8%. The study enrolled 50 women and their infants in this trial, the largest number at any single site. The findings of this trial represent a breakthrough in the prevention of pediatric HIV infection. The division participates in the Pediatric HIV/AIDS Cohort Study (PHACS Study) which is a longitudinal cohort study investigating the long-term effects of HIV infection and ARV (antiretroviral) medications in children and young adults who were born with or exposed to HIV. The study follows newborns, children, adolescents, and young adults.

For additional information regarding our research efforts and clinical trials please contact us at 305-243-4447