2023 Department of Pediatrics Academic Annual Report

of infants worldwide. The UAB team led the First Breath trials, the first GN-wide trial. This trial led to World Health Organization (WHO) and national and international guidelines for practice and training programs being implemented in more than 100 countries. The A-PLUS multicenter trial of prophylactic intrapartum azithromycin (N= 29,000) in the GN led by Dr. Carlo and Alan Tita, M.D., Ph.D., resulted in a New England Journal of Medicine publication that will impact care as maternal sepsis/death and maternal infections were reduced. In addition, UAB received a grant from the Bill and Melinda Gates Foundation to lead the studies on the effects of intrapartum azithromycin maternal and infant antimicrobial resistance patterns, microbiome and resistome. Dr. Carlo was invited to submit an NICHD grant application for an intrapartum administration of a pharmacologic intervention to improve feto-maternal blood perfusion to reduce birth asphyxia. The proposed trial will enroll 34,000 women, and UAB will lead two sites (Zambia and Cameroon), a mechanism that is being approved for the first time for the GN. This opportunity places UAB in a unique role in the GN, as it will have two full clinical sites. OPIOID-EXPOSED NEWBORN RESEARCH Dr. Ambalavanan is the principal investigator on multiple NIH grants on opioid-exposed newborns, including an R01 grant on “Vital Signs in Opioid-exposed Neonates,” a UG1 multicenter grant on Neonatal Opioid Withdrawal Pharmacological Treatments and a RL1/PL1 grant on Outcomes of Babies with Opioid Exposure (OBOE) project. Myriam Peralta-Carcelen, M.D., received a large NIH U01 award, HEALthy Brain and Child Development (HBCD) Study at UAB and the University of Alabama. Dr. Peralta serves in the steering committee for the HBCD consortium from the NIDA/NIH. She is also the MPI in the RL1/PL1 grant on Outcomes of Babies with Opioid Exposure (OBOE) project. She is a co-investigator in the recently funded 1 UG3 HL 162973-01 ENRICH study from the National Heart, Lung and Blood Institute that will evaluate the clinical efficacy and implementation outcomes of the behavioral intervention designed to promote maternal and child cardiovascular health. NEONATAL INFECTIOUS DISEASES Nitin Arora, M.D., MPH, received funding through a P30 from the National Institute of Allergy and Infectious Diseases (NIAID) and UAB Center for AIDS Research (CFAR) to evaluate the effect of cART therapy on placental morphology and pregnancy outcomes, and a Kaul Pediatric Research Institute grant to evaluate the interaction between human cytomegalovirus (HCMV) and FcRn to understand viral transcytosis across the maternal-fetal interface. He also has received funding through the NIH Congenital and Perinatal Infections Consortium (CPIC) to investigate the impact of HCMV on placental morphology and neonatal outcomes in primary and non primary infected pregnancies. He has grant funding through the UAB Sparkman Center to characterize the burden of congenital cytomegalovirus in Uganda. Dr. Arora is the principal investigator on all the studies mentioned above. He is also a co-investigator on the recently funded Pregnancy Clinical Cohort of the National Institute of Health (NIH) REsearching COVID to Enhance Recovery (RECOVER) Initiative. Dr. Carlo has a second grant from the Bill and Melinda Gates Foundation for antimicrobial resistance, microbiome, metagenomics and resistome analysis of samples from eight international sites in the A-PLUS trial. The laboratory work is being conducted at UAB and Boston University. NEONATAL CHORIOAMNIONITIS RESEARCH Viral Jain, M.D., leads a multicenter study that has recently shown that acute histologic chorioamnionitis (chorio) increases the risk for brain injury and delayed maturation, both directly and indirectly, by inducing premature birth. In addition, transcriptomic analysis of chorio-exposed infants has demonstrated “Airway inflammation in COPD and Asthma” as well as IL17 A to be the top pathways on ingenuity pathway analysis. The TH17 cytokines were also found to be elevated in the tracheal aspirate of chorio-exposed infants. We also established a mice model of chorio and showed that worse lung development and poor lung function start while in utero and last well into adulthood at six to eight weeks of life. These preliminary results suggest that this lung inflammation is mediated by TH17 cells. NEONATAL NUTRITION RESEARCH Ariel A. Salas, M.D., received a CARES award from the UAB Center for Outcomes and Effectiveness Research and Education. Through his K23 grant from the NICHD, he continues to optimize quantitative and qualitative outcomes of growth and neurodevelopment in preterm infants. NEONATAL LUNG BIOLOGY RESEARCH Vivek Lal, M.D., has continued to innovate in research. In addition to progress in his K08, he founded UAB start-ups ResBiotic and Alveolus Bio for development of consumer products and therapeutics, respectively, for chronic lung diseases. He also served in an NIH study section. Kent Willis, M.D., received a Research Continuity and Retention Supplement to his NIH K08 Career Development Award to add to his internal and NIH Loan Repayment Program funding. His laboratory has expanded to include a postdoctoral researcher, graduate student and two technicians. His laboratory published three articles this year. Tamás Jilling, M.D., in collaboration with the UAB Department of Anesthesiology, conducts research funded by the CounterACT Network of the NIH. The CounterACT network operates under the oversight of the Office of Biodefense Research and Surety (OBRS), and its main goal is to bolster medical readiness to care for victims of mass casualties by chemical threat agents. Dr. Jilling is principal investigator of the R21 grant awarded by the CounterACT Program to perform preclinical studies in multiple animal models to test the therapeutic efficacy of esomeprazole as a countermeasure against pregnancy-specific toxicity of bromine gas inhalation. Dr Jilling is a co-investigator (PI: Alishlash, Ammar) on another CounterACT R21 project titled “Sickle Cell Trait Mice Are More Susceptible to Chlorine and Haptoglobin Improves the Outcomes” and on an R01 project (PI: Matalon) titled “Mitochondrial DNA Injury Is a Key Contributor to the Development of Chemical Lung Injury.” A pending MPI R21 project titled “Mechanisms of Extracellular Vesicle Mediated Endothelial Dysfunction in Pre-Eclampsia” (Contact PI: Berkowitz PI: Jilling) received an 18th percentile score and is awaiting funding consideration. Dr Jilling is a co-PI of an internally funded project by the Department of Anesthesiology (Reinvent, PI: Tubinis).

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