BRONX, N.Y., Nov. 18, 2021 /PRNewswire/ -- The Bronx is
home to more than 27,000 people living with HIV, the majority of
whom are Black or Hispanic men. People living with HIV have an
increased risk for depression and substance use, which in turn can
make adhering to daily antiviral treatments difficult, negatively
impacting both quality of life and overall health.
Now, the National Institutes of Health (NIH) has awarded
researchers at Albert Einstein
College of Medicine and Montefiore Health System two
five-year grants totaling $7.6
million to study the structural and chemical changes in the
brains of people living with HIV, depression, and cannabis use
disorder.
"Given the health disparities associated with both a mental
health diagnosis and HIV-positive status, we're hopeful our
findings will serve as an important step in advancing health equity
in the Bronx and around the
country," said Vilma Gabbay, M.D.,
M.S., co-director of the Psychiatry Research Institute at
Montefiore Einstein and co-principal investigator on both
grants.
Cannabis Use and Depression in People with HIV
The
first research project, funded by a five-year, $4 million grant, will enroll 280 people ages
18-34 who are living with HIV. Some of the participants will have
depression and regularly use cannabis. Investigators will use
neuroimaging, including functional MRI, to examine brain circuitry
related to reward and pain to better understand their links to
depression and substance use disorder in this population. Principal
investigators on the grant are Dr. Gabbay, Anjali Sharma, M.D., M.S., associate professor
of medicine at Einstein and an internist and infectious diseases
specialist at Montefiore; and Joanna
Starrels, M.D., M.S., associate professor of medicine at
Einstein and an internist and addiction medicine specialist at
Montefiore.
"Our collaborative project involves experts in depression, HIV,
addiction medicine, and neuroimaging, who will investigate the role
of neural mechanisms to learn about the connection between cannabis
use and depression in people living with HIV," said Dr. Gabbay, who
is also associate professor of psychiatry and behavioral sciences
and in the Dominick P. Purpura Department of Neuroscience at
Einstein. "We hope to identify specific biomarkers of
depression and develop better treatments."
Understanding Depression in People Living with HIV
The second project, funded by a five-year, $3.6 million grant, will examine how the immune
system, brain circuits, and neurochemicals interact in people
living with HIV. Investigators, led by Dr. Gabbay and Dr. Sharma,
who co-chair the HIV and Mental Health Scientific Working Group for
the Einstein-Rockefeller-CUNY Center for AIDS Research, hope to
untangle this complex system to understand why these individuals
are more vulnerable to depression.
The Einstein-Montefiore researchers believe that when the
central nervous system (CNS) becomes inflamed by HIV, it results in
two adverse effects: chemicals called free radicals injure nerves
of the CNS and levels of gamma-aminobutyric acid (GABA)—a
neurotransmitter known to have a calming effect—are
reduced. These neurochemical changes are believed to cause
depression.
"If we can confirm that this chain of events leads to
depression," said Dr. Gabbay, "we may be able to devise treatment
strategies that can ward off depression in people infected by
HIV—perhaps by inhibiting the inflammatory proteins that accompany
HIV infection."
Researchers will enroll 300 people living with and without HIV.
At the start of the study, participants will be tested for levels
of depression or anxiety, past psychiatric trauma, HIV treatment,
and levels of CD4+ T cells (a type of T cell affected by HIV
infection). The tests will be repeated after six and 12 months.
The first grant, titled "The Neural Underpinnings of Depression
and Cannabis Use in Young PLWH," was awarded by the National
Institute on Drug Abuse, part of the National Institutes of Health
(1R01DA054885-01). The second grant, initially titled "The
Neuroimmunology of Depression in Women Living With HIV," was
awarded by the National Institute of Mental Health, part of the
National Institutes of Health (1R01MH128878-01).
About Montefiore Health System
Montefiore Health
System is one of New York's
premier academic health systems and is a recognized leader in
providing exceptional quality and personalized, accountable
care to approximately three million people in communities
across the Bronx, Westchester and the Hudson Valley. It is
comprised of 10 hospitals, including the Children's Hospital
at Montefiore, Burke Rehabilitation Hospitaland more than 200
outpatient ambulatory care sites. The advanced clinical and
translational research at its medical school, Albert Einstein College of Medicine, directly
informs patient care and improves outcomes. From the
Montefiore-Einstein Centers of Excellence in cancer, cardiology and
vascular care, pediatrics, and transplantation, to its
preeminent school-based health program, Montefiore is a fully
integrated healthcare delivery system providing coordinated,
comprehensive care to patients and their families. For
more information, please visit www.montefiore.org.
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About Albert Einstein College
of Medicine
Albert Einstein College of
Medicine is one of the nation's premier centers for research,
medical education and clinical investigation. During the 2020-21
academic year, Einstein is
home to 721 M.D. students, 178 Ph.D.
students, 109 students in the combined M.D./Ph.D. program, and
265 postdoctoral research fellows. The College of Medicine has
more than 1,900 full-time faculty members located on the main
campus and at its clinical affiliates. In 2020, Einstein
received more than $197 million in
awards from the National Institutes of Health (NIH). This includes
the funding of major research centers at Einstein in
aging, intellectual development disorders, diabetes, cancer,
clinical and translational research, liver disease, and AIDS. Other
areas where the College of Medicine is concentrating its efforts
include developmental brain research, neuroscience, cardiac
disease, and initiatives to reduce and eliminate ethnic
and racial health disparities. Its partnership
with Montefiore, the University Hospital and academic medical
center for Einstein, advances clinical and translational
research to accelerate the pace at which new discoveries
become the treatments and therapies that benefit patients. Einstein
runs one of the largest residency and fellowship training programs
in the medical and dental professions in the United States through Montefiore and an
affiliation network involving hospitals and medical centers in the
Bronx, Brooklyn and on Long
Island. For more information, please
visit www.montefiore.org. Follow us
on Twitter and Instagram and LinkedIn, or view us
on Facebook and YouTube.
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SOURCE Montefiore Health System