Laboratory Coordinator:
William Graham, PhD
LT, MSC, USN
Infectious Diseases Directorate (IDD)
Viral and Rickettsial Diseases Department (VRDD) Navy Medical Research Center
503 Robert Grant Avenue
Silver Spring, MD 20910
william.d.graham8.mil@mail.mil
The mission of the Naval Medical Research Institute is to enhance the health, safety, performance and deployment readiness of Navy and Marine Corps personnel. NMRI conducts basic and applied biomedical research, development, testing and evaluations in the areas of biological defense, bone marrow, combat casualty care, and infectious diseases. NMRI invites the contributions of scholars and research specialists into its scientific regimen so as to develop and provide state-of-the art research methodologies to enhance Force Health Protection and Deployment Readiness.
Biological Defense Research Directorate
A recognized leader in the rapid and confirmatory detection and identification of biological threat agents in clinical and environmental samples, the directorate explores basic and applied scientific research methodologies for the development of diagnostic assays for the detection of biological and chemical agents during peacetime and wartime. Research personnel have designed, developed, and tested a new prototype immunochromatographic assay device which enables multiple assays to be performed simultaneously. In addition, researchers have been instrumental in the advancement and refinement of confirmatory identification of threat agents utilizing polymerase chain reaction (PCR) methodologies in tandem with innovative, state of the art biosensor technologies. Other departments develop rapid genomics sequencing capability and are involved in vaccine and therapeutics development.
Bone Marrow Research Directorate
A research leader in the Department of Defense Marrow Donor Department (C.W. Bill Young Marrow Donor Recruitment and Research Directorate), the Bone Marrow Research Directorate provides military contingency support for casualties with marrow toxic injury due to radiation or chemical warfare agents. The Directorate performs laboratory research which supports technology innovations to make highly reliable and cost-effective DNA-based typing for marrow transplants.
Combat Casualty Care Directorate
The Combat Casualty Care Directorate conducts medical research, development, testing, and evaluation to develop new information and technologies to enhance the health, safety, performance, and deployment readiness of Navy and Marine Corps personnel. The Directorate consists of three departments: Trauma and Resuscitative Medicine, Undersea Medicine, and Regenerative Medicine.
Trauma and Resuscitative Medicine Conducts research on a variety of topics pertinent to the resuscitation of combat casualties, primarily those occurring in austere circumstances with anticipated delay to definitive care. Specific issues being explored contribute to the search for an optimal resuscitation fluid, prolongation of “the golden hour? and the development of blood component substitutes. Other areas of focus are the development of hemostatic agents, blast biophysics and treatment, and mitigating the negative operational impact of environmental stressors.
Undersea Medicine focuses on interventions to improve performance and reduce injury in deployed Naval forces engaged in undersea occupations. The undersea medicine program has a unique mission area within DoD, providing the capability to perform advanced undersea medicine research using animal models…the only program of its kind in all of DoD. Undersea medicine develops cutting-edge technologies to prevent and treat decompression illness (DCS), as well as pulmonary and central nervous system toxicity associated with exposure to hyperbaric oxygen.
Regenerative Medicine specializes in the development of treatment strategies for radiation injuries and burns, as well as assessing technologies to improve the engraftment of transplanted tissue. New imaging methodologies, utilizing visible and infrared light, are being advanced to help the surgeon assess organ viability and provide state-of-the-art care to wounded warfighters. World-class collaborations are maintained with the transplantation programs at the National Institutes of Health and Walter Reed Army Medical Center.
Infectious Diseases Directorate
Malaria Research Department:
Malaria is endemic in nearly every tropical country, and in many cases extends into subtropical regions, such as Afghanistan and Korea. Worldwide, there are 500 million cases of malaria each year, resulting in approximately 1 million deaths. The malaria parasite, which is transmitted by the bite of the female anopheles mosquito, is a particular threat for travelers, including deployed military personnel, who have generally sustained high malaria attack rates during military campaigns in the tropics. In every engagement this past century that took place where malaria was endemic, more person-days were lost by military personnel to malaria than to enemy fire. For example, in WWII 12,000,000 person-days were lost and in the Vietnam conflict more than 1 million person-days were lost. For this reason, preventing malaria in military personnel is a leading objective for military research.
The mainstay of defense is prophylactic drugs and personal protective measures, such as bednets and insecticide-impregnated uniforms. However, compliance with medications (all of which have troublesome side effects), the emergency of drug resistance by the malaria parasite, and the encumbrances imposed by personal protective measures all lead to poor compliance and the need for a "fire and forget" prevention such as a highly effective vaccine. For this reason, the primary objective of the Navy's Malaria Program (now part of the U.S. Military Malaria Vaccine Program, a joint forces effort) is to develop vaccines that prevent malaria infection in military personnel. Combining the Navy's pioneering work in genetic vaccine technologies with the Army's expertise in protein-based vaccines, promising subunit vaccines have now been developed that are currently undergoing testing in the clinic. More recently, novel approaches for generating attenuated whole parasite vaccines have been developed, and we are poised to test these in the clinic as well. Many of the technologies developed or refined by our investigators are applicable to other disease threats in addition to malaria, serving as platform technologies with wide application. The US Military Malaria Vaccine Program works closely with colleagues from the U.S. Agency for International Development, The National Institutes of Health, Navy and Army overseas laboratories in Indonesia, Thailand, Kenya, Ghana and Peru as well as with industrial partners and academic centers to develop strategies for preventing this most important infectious disease threat.
Enteric Diseases Department:
Globally, diarrheal diseases are a major cause of morbidity and mortality. Research in the Enteric Diseases Department is focused on development of vaccines to prevent illness caused by Campylobacter and diarrheagenic E. coli. This includes basic studies of bacterial pathogenesis and the immune response to these pathogens, development of candidate vaccines, as well as clinical trials and epidemiologic studies. Investigators in the Enteric Disease Department are co-located and work closely with colleagues at the Walter Reed Army Institute of Research, as well as Navy and Army investigators in the overseas laboratories in Egypt, Thailand, Indonesia, and Peru.
Viral and Rickettsial Diseases Department:
Efforts focus primarily on two major diseases of military importance: Dengue Fever and Scrub Typhus. Dengue fever is an important acute viral disease that is widely distributed throughout the tropical and sub-tropical areas of the world. Research efforts concerned with the development of an efficacious vaccine against dengue fever have employed molecular genetic approaches to define the genetic sequences of the virus that are actually responsible for human virulence and to develop "naked" DNA vaccine by expressing subunits of the dengue virus RNA genome as copy DNA for direct inoculation into laboratory animal models. Also with recent discovery by our laboratory that primary human dendritic cells (DC) are highly permissive to dengue virus replication, research efforts have expanded to elucidate the role of DC in pathogenesis of dengue fever/dengue hemorrhagic fever. Scrub typhus research focuses on the development of improved diagnostic assays and the characterization of antibiotic resistance. Another key research focus is the development and evaluation of field-deployable diagnostic assays for the detection of infectious disease agents. Deployed warfighters are exposed to a wide variety of infectious diseases in theater, and a rapid and accurate diagnosis can greatly facilitate the administration of timely and appropriate care. Research efforts have currently focused on diagnostics for dengue and rickettsial diseases. The approaches used include detection of the pathogen itself (antigen or nucleic acids) or the detection of pathogen specific antibodies in human clinical samples using immunological or molecular methods.