RESEARCH AREA
Neuroinfection , Neuro-metabolic diseases and Neuro-inflammation
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Bacterial Meningitis
CIIMS ARC has developed advanced molecular diagnostic approaches for diagnosis of Bacterial meningitis infection. One of the major breakthrough was development of semi nested PCR assay for simultaneous genus specific detection of 8 causative pathogens associated with causing bacterial meningitis at our hospitals. Other developed diagnosis test included duplex PCR for simultaneous identification of TB and other bacteria in meningitis infection.
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Viral encephalitis
Similar to bacterial Meningitis, CIIMS ARC through cutting edge research developed advanced molecular diagnostic approaches for detection of viral encephalitis infection which includes Multiplex RT PCR for detection of Neuroviruses (VZV, HSV, CMV, Chandipura, Dengue, JEV, West Nile) along with peptide based immunoassays for rapid and cost effective diagnosis.
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Evaluating utility of mNGS in Meningoencephalitis infection (ME)
CIIMS ARC has under Grand challenges funding by Bill Gates foundation & Chan Zuckerberg Initiative is first Research Institute in India working on CSF metagenomics for diagnosis of ME of unknown etiology using mNGS. CIIMS has been working on optimizing NGS based protocol for detection of pathogens through NGS which are often not diagnosed using conventional gold standard approaches. For the same, CIIMS is only Institute in Nagpur having Illumina Benchtop sequencing facility for mNGS.
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Vector borne infection in CNS infection:
CIIMS has been regularly screening vector borne infection in CNS. CIIMS ARC was first to demonstrate neurological complication associated with Chikungunya virus during its epidemic peak in Maharashtra in 2008. CIIMS has also identified antigen based biomarkers for Chikungunya viral infection through advanced proteomic tools and developed rapid ELISA based immunoassays (antigen and peptide based) for detection in CSF and blood samples of suspected cases.
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Stroke and Brain edema
Apart from neuroinfection, researchers at CIIMS ARC have worked extensively on non-infectious diseases such as stroke and Brain edema. CIIMS has developed in vitro cell line models for stroke for evaluation of neuroprotective efficacy of Ayurvedic drugs. CIIMS ARC also identified various markers such as ITIH4 for early prediction, diagnosis and prognosis of stroke using advanced proteomic tools. The ITIH4 marker was extensively evaluated in longitudinal samples of stroke patients and further developed into peptide based immunoassay for rapid diagnosis & prognosis of stroke. CIIMS ARC also developed and evaluated rat model of stroke for protective efficacy of therapeutic drugs. In addition to stroke, CIIMS ARC has worked extensively on markers of Brian edema such as MMP-9, Aquaporin and also developed animal model for it.
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Neuro-inflammation
One of major interest of researcher at CIIMS ARC is to investigate neuro inflammatory cytokines and their role in pathogenies of patients with CNS infections. CIIMS ARC has investigated and shown role of certain anti-inflammatory cytokines like IL-6, IL-10 having protective and prognostic role in CNS infection cases in patients with meningitis and encephalitis infection and even in non-infectious cases like stroke.
Zoonotic infections
Tuberculosis
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Biomarkers for Tuberculosis
Investigating novel biomarkers for tuberculosis has been key priority area for CIIMS ARC since its inception. One of the earliest biomarker research carried out by research wing was identification of novel M. tuberculosis Ag85 complex in Cerebrospinal fluid (CSF) of tuberculous meningitis patient which is still used as adjunct diagnostic test for diagnosis & differentiation of Tuberculous meningitis from bacterial meningitis at CIIMS along with other gold standards. Over the past two decades, CIIMS ARC has identified several novel diagnostic markers for TB (under funds provided by ICMR, DBT, DST) which includes host and pathogen markers and established several multiplex panels for rapid diagnosis for pulmonary and extra-pulmonary TB.
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Epidemiology of TB infection
CIIMS ARC in collaboration with TB stake holders from time to time has carried out several serological and molecular epidemiologic studies for both Latent and active TB infections in high TB endemic regions of Nagpur and tribal regions of Melghat, Amravati. Through its epidemiology studies, CIIMS ARC has shown high prevalence of latent TB among TB index cases living in high TB endemic areas which subsequently showed servo conversion to active cases. Through Molecular epidemiology studies ARC has shown prevalence of various serovars of TB such as H37Rv, Beijing strain linked with active TB in pulmonary and Brain TB patients.
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Latent TB
CIIMS ARC under funding supported by DBT and through in house funds worked extensively on latent TB epidemiology and identification of Latent markers such as Rv2623, Hsp 16 which on extensive evaluation and validation through clinical studies have emerged as promising diagnostic markers for Latent TB having better diagnostic accuracy than commercial Interferon gamma release assays such as QFT and age old TST tests
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Animal models of TB infection
CIIMS ARC has developed animal models of TB including aerosol, subcutaneous and intravenous models to study immune response against TB vaccine and biomarkers of protection against TB infection. One of the major work of CIIMS ARC was development of Brain TB model in collaboration with ICMR-JALMA for studies on strain dissemination and evolution of drug efficacy and pharmacokinetic studies in Brain TB infection.
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Designing and evaluation of TB vaccines
Apart from epidemiology and biomarkers of TB, researchers at CIIMS ARC worked extensively on boosting efficacy of TB vaccines using its heterologous combination with TB antigens and Its peptides in both animal and cell line models. Scientist from CIIMS also worked on development and evaluation of rBCG vaccines that engages in cytoplasmic immune response mimicking TB infection using animal models.
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Shortening anti-tuberculosis drug regimen using Bio-enhancers
CIIMS ARC has been working on use of bioenhancer to increase the bioavailability of TB drugs using cell line and animal models. Under project by Ministry of Ayush, Govt. of India, recently CIIMS has started work on evaluating bio-enhancing efficacy of Cow urine distillate using various models.
CIIMS-ARC started working on waste water surveillance from year 2020. The major project going on is detection of SARS-CoV2 and other pathogenic microbes. Our surveillance can compliment clinical diagnostic surveillance by providing early signs of transmission to enable more active public health responses. At present CIIMS-ARC has been at the forefront of sewage surveillance and working with the INSACOG consortium for SARS-CoV2 study leveraging their expertise in surveying different pathogens especially COVID 19. To comprehensively monitor the presence of COVID-19 in the community, the dedicated CIIMS-ARC team has been meticulously collecting sewage water samples from recognized sewage treatment plants and open nullahs across the city regularly. The team adheres to a weekly sample collection regimen, ensuring a consistent and up-to-date analysis of the city’s wastewater. Over the past 1 year, CIIMS-ARC’s remarkable efforts have yielded mesmerizing results.
CIIMS-ARC in collaboration with Gou Vigyan Kendra, Deolapar will study the bioenhancing activity of Cow urine distillate, CUD when used along with TB drugs for TB infection. This project comes under Ministry of Ayush, Government of India and this three year study will be undertaken under funds sanctioned by it. Through the present project, scientist will investigate CUD as bioenhancer for increasing the efficacy of TB drug for treatment. This will be first study in India to do in depth investigation of bioenhancing activities of Cow urine against TB infection. The studies will be undertaken in in-vitro models to evaluate bioenhancing effects of CUD. The scientific data obtained from this project can be used as metadata for developing effective treatment of M. tuberculosis which will also enable to cure within short period of time. The study if successful will have direct implication in drastically reducing the dosage of antibiotics and drugs by increasing the efficiency & absorption of bio active molecule thereby reducing the cost, toxicity and time duration of treatment.
CIIMS-ARC in collaboration with the University Of Nottingham, United Kingdom has worked intensively on an epidemiological study reflecting the need of understanding the complications of Clostridium difficile infection in Urbanized and Rural population. The objective of the studies had been very clear to establish a regional centre for studying the incidences of Clostridiodes difficile- an antibiotic associated diarrhoea causing pathogen in Central India. To set this goal, CIIMS has installed an Anaerobic culturing facility- DG250 by Don Whitley, which is one of its kinds in Central India. It’s a closed gas chamber inhibiting the growth of aerobes and solely allowing the anaerobic bacteria’s to grow. In the scientific community, culturing is considered as a Gold standard and so with this high throughput instrument, identification and diagnosis of gut microbiome could now be done with ease. The lab has reviewed that the incidences of clostridium difficile is not much studied in the Asiatic countries as compared to the west, but with a pilot study under the same banner, CIIMS has found around 10-15% positivity of C.diff in the Indian population. The true prevalence of CDI in India still remains largely unknown, despite the widespread use of antimicrobials. To survey this, CIIMS has installed this facility in its Research Laboratory.
The Gut-Brain Axis (GBA) research project aims to investigate the intricate and bidirectional communication system between the gut microbiota and the central nervous system. This project seeks to comprehend the impact of this dynamic relationship on various aspects of human health, including neurological function, mental well-being, and overall systemic homeostasis. Understanding the Gut-Brain Axis has the potential to revolutionize approaches to mental health and neurological disorders. Findings from this research may pave the way for innovative treatments, including personalized microbiome-based interventions, contributing to advancements in the fields of neuroscience, gastroenterology.