Fellowship Program Director: Avindra Nath, MD
Overview
This is a clinical fellowship in neuroimmunology and neurovirology within the Clinical Neurosciences Program of the National Institutes of Neurological Disorders and Stroke (NINDS). The focus of neuroimmunological and neuroinfectious disease research at NINDS is on understanding disease mechanisms and developing new treatments. Particular focus is placed on diseases such as multiple sclerosis (MS) and diseases that may be examples of viral-induced immunopathologic processes such as HIV-associated neurocognitive disorders, HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP), neurodegenerative conditions associated with endogenous retroviruses, progressive multifocal encephalopathy (PML), and human herpesvirus-6. Research ranges from studies of basic molecular immunology and virology development of new imaging techniques to clinically applied research, preclinical therapeutic development, early phase clinical trials using small molecules, biologics and gene therapy. Investigators make a concerted effort to extend findings made at the basic level into the clinic. For example, approaches to modifying pathologic immune (including antiviral) responses in vitro are extended into studies in experimental animal models, and then into early phase clinical trials in patients at the NIH Clinical Center.
Program Structure
The program consists of several labs ("Sections" and "Units") and a shared clinical team. The clinical team evaluates patients either under natural-history protocols or in investigator-initiated therapeutic trials. Patients and their biologic samples are also evaluated in the individual labs:
- The Section of Infections of the Nervous System studies the role of endogenous retroviruses in neurodegenerative diseases, neuropathogenesis of HIV infection, and emerging infections.
- The Translational Neuroradiology Unit works on new imaging methods and their application to evaluation of new treatments and monitoring of disease course in MS.
- The Viral Immunology Section focuses on mechanisms of viral-induced pathology both in MS and HAM/TSP.
- The Experimental Immunotherapeutics Unit studies the pathogenesis of PML and developing novel treatment strategies.
- The NeuroImmunopathogenesis Unit performs an integrated bench to bedside research to better understand the role of immunodeficiencies in the nervous system.
- The International Neuroinfectious Diseases Program studies the neurologic manifestations and sequelae on emerging and re-emerging infectious diseases, often in an international setting.
Fellows will receive comprehensive clinical training in the evaluation and treatment of patients with neuroimmunological and neuroinfectious diseases. In addition, fellows will choose to work with a mentor in one of the labs. Collaborative projects are highly encouraged. Some fellows come to gain experience in basic science research, whereas others come with a greater interest in clinical research projects. An effort is made to integrate all of the research efforts, which is accomplished primarily through a weekly seminar and journal club. In addition, each lab has its own weekly research meeting.
Fellows will be able to engage in research opportunities focused on:
- Clinical/translational research to evaluate patients on natural history protocols to thoroughly characterize diseases and syndromes, gain unique insight into disease pathophysiology, develop biomarkers and identify therapeutic targets, and develop and manage interventional protocols with with novel therapeutics.
- Laboratory research to use cutting-edge technologies such as pathogen and auto-antibody discovery, spatial transcriptomics, use of brain organoids, high throughput screening, genetics, development of targeted therapeutics using RNAi technology, cell-based therapies, flow cytometry and novel brain imaging techniques.
- Bioinformatics to utilize NIH computing capacity and wide array of computational programs.
Additional educational opportunities include lectures and conferences such as:
- Weekly fellow lectures focusing on a wide array of topics led b experts from NIH and external institutions.
- Weekly and monthly case conferences to discuss complex neuroimmunological, neuroinfectious, neurodegenerative, and neurodevelopmental cases in collaboration with academic institutions.
- Workshops in neuroinfectious diseases and neuroimmunology which bring together clinical, translational, and basic science researchers to discuss advances in understanding the nervous system in the context of infection and immune responses.
- Attendance at an academic/professional conference to present research findings.
Application Information
Apply to this program via the NIH Graduate Medical Education Application System. For more information, please see the NINDS intramural program website.
Fellows interested in conducting clinical research should have completed an approved neurology residency in the United States and be board-eligible. Applicants who hold a valid ECFMG certificate may also apply and will be evaluated accordingly.