Infectious Disease Lab – Dr. Aronson
The Problems
Leishmaniasis is caused by a parasite that is transmitted by the nocturnal bite of an infected sand fly. Depending on the species of Leishmania parasite, infected people typically get chronic scarring skin lesions that may take months to years to resolve without treatment and in some species may also result in metastatic mucosal involvement which can become disfiguring. There were over 2500 cases of cutaneous leishmaniasis (CL) in recent military operations in South West Asia, making it one of the most common tropical diseases among our deployed military. There is no preventive vaccine or prophylactic medication, and treatment can be complicated depending on species and clinical manifestations.
Additionally there is another type of leishmaniasis, visceral leishmaniasis (VL), caused by different parasite species. This form has no typical skin lesion but invades the reticuloendothelial system including liver, spleen and bone marrow and can cause infection that lasts for life, varying from asymptomatic, to oligosymptomatic, to the symptomatic “kala azar” syndrome that can be fatal if left untreated. We recently identified that 19.5% of healthy soldiers deployed to Iraq returned with asymptomatic VL, a latently infected human reservoir that can potentially reactivate later in life with symptomatic infection. There is no vaccine or prophylactic medication to prevent VL. Gaps in leishmaniasis include prevention measures, better treatment for cutaneous leishmaniasis, and qualified diagnostic tests for asymptomatic VL. The Aronson laboratory positions its projects in the translational space, seeking to improve human health with innovation.
An additional research thrust is Bacille Calmette Guerin, the only licensed tuberculosis (TB) vaccine. TB is the leading global infectious diseases killer and a notable contributor to world antimicrobial resistance challenges. BCG vaccine has not been used in the US as part of our public health strategy (although there is a FDA approved BCG vaccine), and TB is of low incidence in the US. However, our military project/may project into other parts of the world (like high TB burden prior Soviet countries including Ukraine; China, India, areas in the South Pacific and Africa) where multidrug resistant TB —spread by breathing infected air— can pose risk to our fighting force who will be vulnerable to this contagious illness. BCG has been recently identified to have an interesting trained immunity superpower, where it seems to protect against other infections (especially respiratory), infectious mortality, lung cancer, eczema, multiple sclerosis and possibly dementia. These nonspecific effects are important to better understand.
Current research
Clinical Trials
We are testing BCG to prevent primary TB infection, as well as all cause respiratory infection, in 2000 travelers going to high TB burden countries. NCT04453293
Currently we are using data collected from a controlled trial of BCG vs placebo in American indigenous children, to determine whether BCG was protective of other pediatric infections.
Surveillance Projects
We are evaluating our military working dogs who deployed to Iraq using banked serum and whole blood to test for visceral leishmaniasis and Bartonellosis. As part of this project, we are reviewing their medical history, preventive measures, pre and post deployment. We have developed a novel laboratory testing approach for Bartonella, which can be a fatal infection for dogs.
Our lab developed tools to test human blood for asymptomatic visceral leishmaniasis and has conducted surveillance of US military who deployed to Iraq. We are now looking at asymptomatic VL screening among those who deployed to Afghanistan, collecting potential risk factors and health information, matching that to research blood testing results. In addition, we are conducting a VL surveillance project among individuals who deployed to either Afghanistan and/or Iraq and then subsequently became immunosuppressed due to one of 3 conditions, TNF alpha blockers, solid organ transplant or HIV infection.
Bench Research
We use a mouse model for CL or VL and are currently testing novel agents for the treatment of cutaneous leishmaniasis. We are exploring the role of bacterial coinfection in CL. In the process of this experimentation, we are also immunologically exploring conventional and unconventional T cells, Natural Killer cells in the immune response to CL using flow cytometry and immunohistochemistry. Our collaborators will evaluate congruent transcriptomic profiling at the lesion level.
The People
Dr. Aronson has many years of working with trainees, including medical students, residents and infectious diseases fellows on clinical research projects and she welcomes their interest.
Organic to the Aronson laboratory:
Fernanda Fortes de Araujo PhD. Postdoctoral Fellow
Fernanda is in her final USU postdoctoral year, she completed her PhD at Rene Rachou Institute, Fiocruz-Minas, Belo Horizonte, Brazil, and did a prior postdoctoral fellowship with the FDA in the laboratory of Alain Debrabant studying Trypanosoma cruzi.