IN VITRO INACTIVATION OF VIRUSES IN BLOOD COMPONENTS Release Date: January 18, 2000 RFA: HL-00-010 National Heart, Lung, and Blood Institute Letter of Intent Receipt Date: March 1, 2000 Application Receipt Date: April 12, 2000 THIS RFA USES "MODULAR GRANT" AND "JUST-IN-TIME" CONCEPTS. IT INCLUDES DETAILED MODIFICATIONS TO STANDARD APPLICATION INSTRUCTIONS THAT MUST BE USED WHEN PREPARING APPLICATIONS IN RESPONSE TO THIS RFA. PURPOSE The objective of this program is to encourage basic and applied research on the development and evaluation of procedures to remove or destroy the infectivity of transfusion-transmitted viruses and other pathogens in blood components, while maintaining the therapeutic effectiveness of these preparations. HEALTHY PEOPLE 2000 The Public Health Service (PHS) is committed to achieving the health promotion and disease prevention objectives of Healthy People 2000, a PHS-led national activity for setting priority areas. This Request for Applications (RFA), AIn Vitro Inactivation of Viruses in Blood Components,@ is related to the priority areas of HIV Infection, Immunization and Infectious Diseases. Potential applicants may obtain a copy of "Healthy People 2000" (Full Report: Stock No. 017-001-00474-0) or Summary Report: Stock No. 017-001-00473-1 through the Superintendent of Documents, Government Printing Office, Washington, D.C. 20402-9325 (telephone 202-512-1800 or at ). http://odphp.osophs.dhhs.gov/pubs/hp2000/ ELIGIBILITY REQUIREMENTS Applications may be submitted by domestic and foreign for-profit and non-profit organizations, public and private, such as universities, colleges, hospitals, laboratories, units of State or local governments, and eligible agencies of the Federal government. Racial/ethnic minority individuals, women, and persons with disabilities are encouraged to apply as Principal Investigators. All current policies and requirements that govern the research grant programs of the National Institutes of Health (NIH) will apply to grants awarded under this RFA. MECHANISM OF SUPPORT This RFA will use the National Institutes of Health (NIH) research project grant (R01) award mechanism. Responsibility for the planning, direction, and execution of the proposed project will be solely that of the applicant. The total project period for an application submitted in response of this RFA may not exceed 5 years. This RFA is one- time solicitation. Future unsolicited competing continuation applications will compete with all investigator-initiated applications and be reviewed according to the customary peer review procedures. The anticipated award date is September 30, 2000. FUNDS AVAILABLE The NHLBI intends to commit approximately $1.5 million in FY 2000 to fund four (4) to six (6) new grants in response to this RFA. An applicant may request a project period up to five (5) years and a budget for direct costs for up to ten (10) modules of $25,000 each per year, including Facilities and Administrative Costs on consortium arrangements. Because the nature and scope of the research proposed may vary, it is anticipated that the size of each award will also vary. Although the financial plans of the NHLBI provide support for this program, awards pursuant to this RFA are contingent upon the availability of funds and the receipt of a sufficient number of applications of outstanding scientific and technical merit. At this time, it is not known if competing renewal applications will be accepted and/or if this RFA will be reissued. RESEARCH OBJECTIVES BACKGROUND Annually, an estimated 3.8 million Americans are transfused with 28.2 million blood components derived from 12.8 million units of blood donated by apparently healthy volunteers. A rigorous scrutiny of blood donors and the screening of donated blood for various serological markers of asymptomatic infection have significantly reduced the morbidity and mortality due to transfusion-associated infectious agents. The enzyme immunoassays used for routine screening may detect viral antigens or antibodies, but not the infectious agents themselves. Thus, there could be an asymptomatic window- period of infectivity responsible for a residual risk of post-transfusion infections. Recent progress in inactivating viruses in plasma derivatives has been substantial. Safe and efficient inactivation procedures have been developed and are now widely available. One of these methods, developed with NHLBI support, involves treatment of material with organic solvent and detergent. This approach, which destroys viruses with phospholipid envelopes, has been applied successfully to coagulation factor concentrates, immune globulins, lymphokines, and other growth factors. Plasma derivatives treated with solvent/detergent mixtures are now prepared in many countries around the world. Derivatives that are manufactured using this method have shown no evidence of transmission of hepatitis B virus (HBV), hepatitis C virus (HCV), or human immunodeficiency virus (HIV). An important scientific and technical challenge is to achieve similar safety in cellular blood products such as platelet concentrates and packed red cells. Attempts to develop inactivation procedures to destroy the infectivity of viruses in blood components have been uniformly unsuccessful despite considerable research activity in this area. The difficult problem of virus inactivation is exacerbated in cellular products due to the inherent lability of membranes and sensitive proteins in cells. As a result, the destruction of viral activity is often accompanied by loss of cellular function. Consequently, whole blood and cellular components including red cells, platelets, and leukocytes continue to carry a risk of virus transmission. In addition, although the risk of acquiring identified pathogens through transfusion is lower than ever, world-wide travel and changing demographics have in the past and most certainly will continue to spread new pathogens into the U.S. blood donor population in the future. Therefore, the prevention of transfusion-transmitted diseases remains a top priority of transfusion medicine research. Current estimated risks of being infected with a unit of screened blood are 1/1,000,000 for hepatitis A virus (HAV), 1/30,000 - 1/250,000 for HBV, 1/30,000 - 1/150,000 for HCV, 1/200,000 - 1/2,000,000 for HIV, 1/250,000 - 1/2,000,000 for human T-cell lymphotropic viruses (HTLV) types I and II, and 1/10,000 for parvovirus B19. In addition, viruses such as cytomegalovirus (CMV) and Epstein-Barr virus (EBV) also pose potential risks following the transfusion of blood or blood components. Also, new and emerging agents are constantly posing new threats to the blood supply. Recent examples are HHV-8, HGV, and TTV. Their transmissibility via blood and clinical significance are being investigated. Furthermore, the estimated frequency of bacterial contamination of red blood cells is 1/500,000 units, and the risk of platelet-related sepsis is estimated to be 1/12,000. Despite advances in donor selection and blood donor screening, it is unlikely that the risk of transmission of these viruses and bacteria will be completely eliminated without the introduction of efficient virucidal or virus-removal procedures that maintain cellular function. Over the past 5 years, investigators supported under an NHLBI RFA program have explored a number of different approaches to inactivate or remove viruses from blood and blood components including the use of UV-C irradiation, filtration, hydrolyzed diol epoxides, ozone, halogenated oxidizing agents, and photoactive dyes for viral sterilization of fresh frozen plasma, red blood cell concentrates, and platelet concentrates. Removal of leukocytes by filtration was shown to reduce CMV transmission to susceptible patients; however, elimination of HIV-infected cells by this method was incomplete, as filtration could not be expected to remove cell-free virus. The use of UV or ionizing irradiation is attractive because of its simplicity; however, the dose of gamma- irradiation used to inactivate lymphocytes is not sufficiently virucidal, and the virucidal doses are generally cell-destructive. UV irradiation was found to inactivate HIV under conditions generally favorable to platelets. However, important caveats on the use of UV remain; viral sensitivity to UV treatment seems to depend on the size of the viral genome and whether it is single or double stranded. Furthermore, it appears that suboptimal doses for viral inactivation induce virus activation and/or replication. Hydrolyzable compounds such as beta-propriolactone have proved highly virucidal but fail to destroy sufficient virus under conditions tolerated by cellular components. Ozone has been shown to inactivate HIV but virucidal doses often cause hemolysis. The most promising results have been obtained with the treatment of platelet concentrates with photodynamically active dyes. The precise biologic mechanisms of in vitro photochemical inactivation of pathogens are poorly understood. An investigator supported under this RFA developed a photochemical decontamination technique using a synthetic psoralen and long wavelength UV light to form covalent adducts between viral nucleic acids and the psoralens. This method effectively inactivates a number of viruses and also destroys the bacteria often associated with platelets without significant adverse effects in in vitro platelet function. In order to minimize the damage to platelets caused by irradiation, however, the process must be conducted in the absence of oxygen or in the presence of agents that remove damaging reactive intermediate compounds. Also, the potential toxicity of a virucidal process that adds photoreactive dyes or other potentially carcinogenic or teratogenic compounds will require careful assessment. The procedure has been tested in animal models and it is currently being evaluated in clinical trials. While significant progress has been made under the previous RFA program toward the development of inactivation procedures, additional research is urgently needed to better understand the mode of action of these as well as other virucidal reagents and procedures so as to apply and optimize their use in a blood banking environment. Furthermore, studies on the removal of viruses from biological materials in ways that permit the treated products to be used clinically are also needed and constitute the ultimate goal of this RFA. Possible approaches include viral adherence to affinity columns; use of monoclonal antibodies for in vitro neutralization; absorption- filtration procedures; centrifugal removal of viruses; and use of filters for leukodepletion. Other innovative strategies for in vitro inactivation or removal of blood-borne agents that maintain the functional integrity of blood components also need to be pursued. For example, in view of the enhanced antigen neutralizing capability imparted by catalytic function, it is possible that the development of catalytic antibodies to specific pathogen epitopes may lead to catalytic cleavage of the agent=s targeted polypeptides, resulting in the elimination of infectivity. A similar approach may be to use ribozymes, which exhibit catalytic activity. Synthesis of a ribozyme with flanking segments that contain nucleotide sequences complementary to portions of a viral mRNA target could bind and degrade the intracellular viral mRNA with consequent virus inhibition. Strategies to deliver such large therapeutic molecules intracellularly are also within the scope of this RFA. In summary, transfusion practices continue to carry a small but unacceptable risk of infection from transfusion-transmitted viruses. The solution to this problem is the development of inactivation or virus removal procedures that do not destroy the functional integrity of blood or blood components. Some procedures are currently available such as the use of photochemicals that inactivate nucleic acids and destroy virus infectivity with minimal effects on nucleic acid-free red cells and platelets. Technological advances are needed that would permit the use of photochemicals as well as other inactivation procedures in an efficient cost-effective fashion that is compatible with the operation of a large-scale blood center. This program encourages basic and applied research on the development and evaluation of procedures to remove or destroy the infectivity of transfusion-transmitted viruses in blood components while maintaining the therapeutic effectiveness of these preparations. Applicants must delineate a research plan that focuses on completing a Phase I clinical trial (safety and pharmacokinetics) during the final year of this RFA program. PROPOSED RESEARCH The objective of this program is to encourage basic and applied research on the development and evaluation of procedures to remove or destroy the infectivity of transfusion-transmitted viruses and other pathogens in blood components, while maintaining the therapeutic effectiveness of these preparations. Possible approaches include viral adherence to affinity columns; use of monoclonal antibodies for in vitro neutralization; absorption-filtration procedures; centrifugal removal of viruses; and use of filters for leukodepletion. Other innovative strategies for in vitro inactivation or removal of blood-borne agents that maintain the functional integrity of blood components also need to be pursued. For example, in view of the enhanced antigen neutralizing capability imparted by catalytic function, it is possible that the development of catalytic antibodies to specific pathogen epitopes may lead to catalytic cleavage of the agent=s targeted polypeptides, resulting in the elimination of infectivity. A similar approach may be to use ribozymes, which exhibit catalytic activity. Synthesis of a ribozyme with flanking segments that contain nucleotide sequences complementary to portions of a viral mRNA target could bind and degrade the intracellular viral mRNA with consequent virus inhibition. Strategies to deliver such large therapeutic molecules intracellularly are also within the scope of this RFA. SPECIAL REQUIREMENTS Upon initiation of the program, the NHLBI will sponsor annual meetings to encourage the exchange of information among investigators who participate in this program. Travel funds for a one day meeting each year, most likely to be held in Bethesda, Maryland, should be included in the modules. Applicants should also include a statement in the application indicating their willingness to participate in such meetings. INCLUSION OF WOMEN AND MINORITIES IN RESEARCH INVOLVING HUMAN SUBJECTS It is the policy of the NIH that women and members of minority groups and their subpopulations must be included in all NIH supported biomedical and behavioral research projects involving human subjects, unless a clear and compelling rationale and justification is provided that inclusion is inappropriate with respect to the health of the subjects or the purpose of research. This policy results from the NIH Revitalization Act of 1993 (Section 492B of Public Law 103-43). All investigators proposing research involving human subjects should read the "NIH Guidelines for Inclusion of Women and Minorities as Subjects in Clinical Research", which have been published in the Federal Register of March 28, 1994 (FR 59 14508- 14513), and in the NIH GUIDE FOR GRANTS AND CONTRACTS, Volume 23, Number 11, March 18, 1994, available on the Web at: https://grants.nih.gov/grants/guide/notice-files/not94-100.html INCLUSION OF CHILDREN AS PARTICIPANTS IN RESEARCH INVOLVING HUMAN SUBJECTS It is the policy of the NIH that children (i.e., individuals under the age of 21) must be included in all human subjects research, conducted or supported by the NIH, unless there are scientific and ethical reasons not to include them. This policy applies to all initial (type 1) applications submitted for receipt dates after October 1, 1998. All investigators proposing research involving human subjects should read the NIH Policy and Guidelines on the Inclusion of Children as Participants in Research Involving Human Subjects that was published in the NIH Guide for Grants and Contracts, March 6, 1998, and is available at the following URL address: https://grants.nih.gov/grants/guide/notice-files/not98-024.html LETTER OF INTENT Prospective applicants are asked to submit a letter of intent that includes a descriptive title of the proposed research, the name, address, and telephone number of the Principal Investigator, the identities of other key personnel and participating institutions, and the number and title of the RFA in response to which the application may be submitted. Although the letter of intent is not required, is not binding, and does not enter into the review of a subsequent application, the information that it contains allows the NHLBI staff to estimate the potential review workload and to avoid conflict of interest in the review. The letter of intent is to be mailed, or faxed by the letter of intent receipt date listed in the heading of this RFA to: Dr. C. James Scheirer Division of Extramural Affairs, NHLBI 6701 Rockledge Drive, Room 7220, MSC 7924 Bethesda, Maryland 20892-7924 Tel: (301) 435-0266 FAX: (301) 480-3541 E-Mail Address: js110j@nih.gov APPLICATION PROCEDURES Specific application instructions have been modified to reflect "MODULAR GRANT" and "JUST-IN-TIME" streamlining efforts being examined by the NIH. Complete and detailed instructions and information on Modular Grant applications can be found at https://grants.nih.gov/grants/funding/modular/modular.htm The modular grant concept establishes specific modules in which direct costs may be requested as well as a maximum level for requested budgets. Only limited budgetary information is required under this approach. The just-in-time concept allows applicants to submit certain information only when there is a possibility for an award. It is anticipated that these changes will reduce the administrative burden for the applicants, reviewers and Institute staff. The research grant application form PHS 398 (rev. 4/98) is to be used in applying for these grants, with the modifications noted below. The research grant application form PHS 398 (rev. 4/98) is to be used in applying for these grants. These forms are available at most institutional offices of sponsored research and from the Division of Extramural Outreach and Information Resources, National Institutes of Health, 6701 Rockledge Drive, MSC 7910, Bethesda, MD 20892-7910, telephone 301/710-0267, email: GrantsInfo@nih.gov . The RFA label available in the PHS 398 (rev. 4/98) application form must be affixed to the bottom of the face page of the application. Type the RFA number on the label. Failure to use this label could result in delayed processing of the application such that it may not reach the review committee in time for review. In addition, the RFA title and number must be typed on line 2 of the face of the face page of the application for and the YES box must be marked. The sample RFA label available at: https://grants.nih.gov/grants/funding/phs398/label-bk.pdf has been modified to allow for this change. Please note this is in pdf format. Submit a signed, typewritten original of the application, including the Checklist, and three signed, photocopies, in one package to: CENTER FOR SCIENTIFIC REVIEW NATIONAL INSTITUTES OF HEALTH 6701 ROCKLEDGE DRIVE, ROOM 1040, MSC 7710 BETHESDA, MD 20892-7710 BETHESDA, MD 20817 (for express/courier service) At the time of submission, two additional copies of the application must be sent to: Dr. C. James Scheirer Division of Extramural Affairs National Heart, Lung, and Blood Institute 6701 Rockledge Drive, Room 7220, MSC 7924 Bethesda, MD 20892-7924 Telephone: (301) 435-0266 FAX: (301) 480-3541 Email: js110j@nih.gov Applications must be received by the application receipt date listed in the heading of this RFA. If an application is received after that date, it will be returned to the applicant without review. The Center for Scientific Review (CSR) will not accept any application in response to this RFA that is essentially the same as one currently pending initial review, unless the applicant withdraws the pending application. The CSR will not accept any application that is essentially the same as one already reviewed. This does not preclude the submission of substantial revisions of applications already reviewed, but such applications must include an introduction addressing the previous critique. BUDGET INSTRUCTIONS Modular Grant applications will request direct costs in $25,000 modules, up to a total direct cost request of $250,000 per year. The total direct costs must be requested in accordance with the program guidelines and the modifications made to the standard PHS 398 application instructions described below: PHS 398 o FACE PAGE: Items 7a and 7b should be completed, indicating Direct Costs (in $25,000 increments up to a maximum of $250,000) and Total Costs [Modular Total Direct plus Facilities and Administrative (F&A) costs] for the initial budget period Items 8a and 8b should be completed indicating the Direct and Total Costs for the entire proposed period of support. o DETAILED BUDGET FOR THE INITIAL BUDGET PERIOD - Do not complete Form Page 4 of the PHS 398. It is not required and will not be accepted with the application. o BUDGET FOR THE ENTIRE PROPOSED PERIOD OF SUPPORT - Do not complete the categorical budget table on Form Page 5 of the PHS 398. It is not required and will not be accepted with the application. o NARRATIVE BUDGET JUSTIFICATION - Prepare a Modular Grant Budget Narrative page. (See https://grants.nih.gov/grants/funding/modular/modular.htm for sample pages.) At the top of the page, enter the total direct costs requested for each year. This is not a Form page. o Under Personnel, List key project personnel, including their names, percent of effort, and roles on the project. No individual salary information should be provided. However, the applicant should use the NIH appropriation language salary cap and the NIH policy for graduate student compensation in developing the budget request. For Consortium/Contractual costs, provide an estimate of total costs (direct plus facilities and administrative) for each year, each rounded to the nearest $1,000. List the individuals/organizations with whom consortium or contractual arrangements have been made, the percent effort of key personnel, and the role on the project. Indicate whether the collaborating institution is foreign or domestic. The total cost for a consortium/contractual arrangement is included in the overall requested modular direct cost amount. Include the Letter of Intent to establish a consortium. Provide an additional narrative budget justification for any variation in the number of modules requested. o BIOGRAPHICAL SKETCH - The Biographical Sketch provides information used by reviewers in the assessment of each individual's qualifications for a specific role in the proposed project, as well as to evaluate the overall qualifications of the research team. A biographical sketch is required for all key personnel, following the instructions below. No more than three pages may be used for each person. A sample biographical sketch may be viewed at: https://grants.nih.gov/grants/funding/modular/modular.htm - Complete the educational block at the top of the form page; - List position(s) and any honors; - Provide information, including overall goals and responsibilities, on research projects ongoing or completed during the last three years. - List selected peer-reviewed publications, with full citations. o CHECKLIST - This page should be completed and submitted with the application. If the F&A rate agreement has been established, indicate the type of agreement and the date. All appropriate exclusions must be applied in the calculation of the F&A costs for the initial budget period and all future budget years. o The applicant should provide the name and phone number of the individual to contact concerning fiscal and administrative issues if additional information is necessary following the initial review. REVIEW CONSIDERATIONS Upon receipt, applications will be reviewed for completeness by the CSR and responsiveness by the NHLBI. Incomplete and/or non-responsive applications will be returned to the applicant without further consideration. Applications that are complete and responsive to the RFA will be evaluated for scientific and technical merit by an appropriate peer review group convened by the NHLBI in accordance with the review criteria stated below. As part of the initial merit review, a process will be used by the initial review group in which applications receive a written critique and undergo a process in which only those applications deemed to have the highest scientific merit, generally the top half of the applications under review, will be discussed, assigned a priority score, and receive a second level review by the NHLBI National Advisory Council. Review Criteria The goals of NIH-supported research are to advance our understanding of biological systems, improve the control of disease, and enhance health. In the written comments reviewers will be asked to discuss the following aspects of the application in order to judge the likelihood that the proposed research will have a substantial impact on the pursuit of these goals. Each of these criteria will be addressed and considered in assigning the overall score, weighting them as appropriate for each application. Note that the application does not need to be strong in all categories to be judged likely to have major scientific impact and thus deserve a high priority score. For example, an investigator may propose to carry out important work that by its nature is not innovative but is essential to move a field forward. (1) Significance: Does this study address an important problem? If the aims of the application are achieved, how will scientific knowledge be advanced? What will be the effect of these studies on the concepts or methods that drive this field? (2) Approach: Are the conceptual framework, design, methods, and analyses adequately developed, well-integrated, and appropriate to the aims of the project? Does the applicant acknowledge potential problem areas and consider alternative tactics? (3) Innovation: Does the project employ novel concepts, approaches or method? Are the aims original and innovative? Does the project challenge existing paradigms or develop new methodologies or technologies? (4) Investigator: Is the investigator appropriately trained and well suited to carry out this work? Is the work proposed appropriate to the experience level of the principal investigator and other researchers (if any)? (5) Environment: Does the scientific environment in which the work will be done contribute to the probability of success? Do the proposed experiments take advantage of unique features of the scientific environment or employ useful collaborative arrangements? Is there evidence of institutional support? In addition to the above criteria, in accordance with NIH policy, all applications will also be reviewed with respect to the following: o The adequacy of plans to include both genders, minorities and their subgroups, and children as appropriate for the scientific goals of the research. Plans for the recruitment and retention of subjects will also be evaluated. o The reasonableness of the proposed budget and duration in relation to the proposed research o The adequacy of the proposed protection for humans, animals or the environment, to the extent they may be adversely affected by the project proposed in the application. Schedule Letter of Intent Receipt Date: March 1, 2000 Application Receipt Date: April 12, 2000 Peer Review Date: May/June 2000 Council Review: September 7-8, 2000 Earliest Anticipated Start Date: September 29, 2000 AWARD CRITERIA Award criteria that will be used to make award decisions include: o scientific merit (as determined by peer review) o availability of funds o programmatic priorities. INQUIRIES Inquiries concerning this RFA are encouraged. The opportunity to clarify any issues or questions from potential applicants is welcome. Direct inquiries regarding programmatic issues and requests for sample budget pages to: Luiz H. Barbosa, D.V.M. Division of Blood Diseases and Resources National Heart, Lung, and Blood Institute 6701 Rockledge Drive, Room 10146, MSC 7950 Bethesda, MD 20892-7950 Telephone: (301) 435-0075 FAX: (301) 480-0868 Email: lb30o@nih.gov Direct inquiries regarding fiscal matters to: Ms. Jane Davis Grants Operations Branch National Heart, Lung, and Blood Institute 6701 Rockledge Drive, Suite 7174, MSC 7926 Bethesda, MD 20892-7926 Telephone: (301) 435-0166 FAX: (301) 480-3310 Email: jd53j@nih.gov This program is described in the Catalog of Federal Domestic Assistance No. 93.839. Awards are made under authorization of the Public Health Service Act, Title IV, Part A (Public Law 78-410, as amended by Public Law 99-158, 42 USC 241 and 285) and administered under PHS grants policies and Federal Regulations 42 CFR 52 and 45 CFR Part 74. This program is not subject to the intergovernmental review requirements of Executive Order 12372 or Health Systems Agency review. The PHS strongly encourages all grant and contract recipients to provide a smoke-free workplace and promote the non-use of all tobacco products. In addition, Public Law 103-227, the Pro-Children Act of 1994, prohibits smoking in certain facilities (or in some cases, any portion of a facility) in which regular or routine education, library, day care, health care or early childhood development services are provided to children. This is consistent with the PHS mission to protect and advance the physical and mental health of the American people.
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