The National Institute on Alcohol Abuse and Alcoholism has awarded LSU Health New Orleans a $401,500 grant, over two years, to study the role of gut bacteria in the development of heart and metabolic diseases in those with HIV who use alcohol, as well as to devise strategies to address these risks. David Welsh, MD, Associate Professor of Medicine at LSU Health New Orleans School of Medicine, and Patricia Molina, MD, PhD, Professor and Head of Physiology at LSU Health New Orleans School of Medicine and School of Graduate Studies, will lead the research.
“This project will develop prebiotic and probiotic therapies that are personalized for each patient in order to reduce comorbid illness, particularly illness related to harmful alcohol use, in people living with HIV,” notes Dr. David Welsh, the study’s principal investigator.
Communities of bacteria, or microbiota, that live in the gastrointestinal tract are increasingly recognized as a focal point in the regulation of metabolic disorders and related conditions, such as cardiovascular disease. Both alcohol use and HIV infection disturb the gut microbiota, and increase their ability to breach the gut barrier and leak into tissues, triggering immune activation and inflammation.
Although early clinical trials of probiotics in people living with HIV yielded mixed results, it could be because individual differences in their gut bacteria were not taken into account. The LSU Health researchers believe that by developing a Precision Medicine strategy based upon individual gut microbiota characteristics, using specific combinations of prebiotics and probiotics, gut bacteria may be kept in balance, and the risk of heart disease, diabetes, and other metabolic disorders linked to harmful alcohol use may be reduced in this vulnerable population.
“Therapeutic interventions targeting the microbiota offer great potential to attenuate the metabolic health issues prevalent in alcohol-using people living with HIV,” says Welsh. “The data generated by this project will provide guidance for the design of clinical trials to be conducted in the second component of the grant.”
According to the Centers for Disease Control and Prevention, at the end of 2014, the estimated number of new HIV infections in the United States was 37,600, and an estimated 1.1 million persons aged 13 and older were living with HIV infection in the United States, including an estimated 166,000 (15%) persons whose infections had not been diagnosed.