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Principal Investigator: Roxana Cristina Chicas
Organization: EMORY UNIVERSITY
Fiscal Year: 2024
Award: $148,339
Funding agency: National Institute of Nursing Research
PROJECT SUMMARY
Roxana Chicas, PhD, RN is a 1st generation bilingual Latina and her goal is to become an independent NIH-
funded nurse scientist developing a sustainable research program in the area of
glucose metabolism and
kidney disease. Support from the K23 award will provide the dedicated research time that will enable
fundamental training and mentorship to further her understanding of: 1) the relationship of
glucose metabolic
pathways and heat exposure and the development of
kidney disease in farmworkers using a metabolomics
approach; and 2) the design and management of community-engaged intervention trials to decrease the risk of
heat stress, renal dysfunction, and glucose dysregulation in vulnerable populations. Heat is the leading cause
of weather-related deaths in the US, and farmworkers comprise an occupational sector particularly vulnerable
to heat-related illness (HRI). Between 2-3 million workers in the US agricultural industry are at risk of heat
related mortality at a rate that is 35 times greater than that of the general workforce population. In the last
decade a number of investigations have shown a link between heat exposure and the risk of acute kidney
injury (AKI). The chronic effects of the insidious and unexplained uptick of AKI among farmworkers, and the
disproportionate burden of HRI and repetitive heat stress-induced dehydration are not well understood. The
role that predisposing health conditions such as prediabetes may play in the risk of AKI has not been
examined. While studies have documented heat-related risk factors and the body’s physiologic response to
heat, few investigations have considered whether glucose metabolism and high environmental heat conditions
are a risk factor for acute kidney injury, and less is known about the metabolic pathways underlying the body’s
response to heat stress. The goal of this project is to characterize the physiologic phenotypes of farmworkers
across seasons and exposures (indoors v. outdoors), using non-targeted, high-resolution metabolomics (HRM)
to compare metabolomic profiles, and examine the associations between HRI clinical profiles (including core
body temperature, heart rate, dehydration, HRI symptoms); inflammation biomarkers (IL-10, IL-6, IL-8, IL-1β,
TNF-α, HSP72, HSP90); renal biomarkers (serum creatinine, BUN, eGFR, proteinuria, uric acid; aldosterone,
and copeptin); and glucose clinical profiles (HbA1c, AM fasting blood glucose, and PM blood glucose levels).
This proposed study will explore interplay of glucose metabolism and HRI and advance our understanding of
the physiologic underpinnings of AKI and renal function. The incorporation of metabolomic profiles will add to
the state of the science by indicating the underlying metabolic mechanisms and consequences of the
physiologic response to heat stress.
Terms: <(TNF)-α><3-10C><AMCF-I><Acclimatization><Acute Renal Failure with Renal Papillary Necrosis><Adult-Onset Diabetes Mellitus><Age><Agriculture><Aldosterone><Area><Automobile Driving><Awareness><B cell differentiation factor><B cell stimulating factor 2><B-Cell Differentiation Factor><B-Cell Differentiation Factor-2><B-Cell Stimulatory Factor-2><BCDF><BMI><BMI percentile><BMI z-score><BSF-2><BSF2><Beta Proprotein Interleukin 1><Big Data Analytics><Big Data Methods><Big Data Tools><Bio-Informatics><Bioinformatics><Biological Markers><Biological Monitoring><Blood><Blood Glucose><Blood Plasma><Blood Reticuloendothelial System><Blood Serum><Blood Sugar><Body Temperature><Body mass index><CSIF><CSIF-10><CXCL8><Cachectin><California><Cardiac Chronotropism><Cell Communication and Signaling><Cell Signaling><Cessation of life><Chronic><Chronic Kidney Failure><Chronic Renal Disease><Chronic Renal Failure><Clinical><Community Health><Complex><Creatinine><Cytokine Synthesis Inhibitory Factor><D-Glucose><Data><Death><Dedications><Dehydration><Development><Dextrose><Diabetes Mellitus><Disease Progression><Doctor of Philosophy><Early Intervention><Environment><Fasting><Florida><Funding><Future><GCP1><Generations><Glucose><Glycated Hemoglobins><Glycohemoglobin A><Glycosylated Hemoglobin><Glycosylated hemoglobin A><Goals><Guatemala><HPGF><HSP-90><HSP90><Harvest><Hb A1><Hb A1a+b><Hb A1c><HbA1><HbA1c><Health><Heart Rate><Heat Stress><Heat Stress Disorders><Heat Stress Syndromes><Heat-Shock Proteins 90><Hemoglobin A(1)><Hepatocyte-Stimulating Factor><Hispanic><Hispanic Populations><Hispanic group><Hispanic individual><Hispanic people><Hispanics><Hybridoma Growth Factor><IFN-beta 2><IFNB2><IL-1 beta><IL-1 β><IL-1-b><IL-10><IL-1β><IL-6><IL-8><IL1-Beta><IL1-β><IL10><IL10A><IL1B Protein><IL1F2><IL1β><IL6 Protein><IL8><IL8 gene><Immigrant><Impairment><Industry><Inflammation><Inflammatory><Interleukin 10 Precursor><Interleukin 1beta><Interleukin-1 beta><Interleukin-10><Interleukin-1β><Interleukin-6><Intervention Trial><Interventional trial><Intracellular Communication and Signaling><Investigation><K23 Award><K23 Mechanism><K23 Program><K60><Ketosis-Resistant Diabetes Mellitus><Kidney><Kidney Diseases><Kidney Urinary System><Latina><Link><Longitudinal Studies><MGI-2><Macrophage-Derived TNF><Maturity-Onset Diabetes Mellitus><Mentored Patient-Oriented Research Career Development Award><Mentored Patient-Oriented Research Career Development Award (K23)><Mentorship><Metabolic><Metabolic Pathway><Monocyte-Derived TNF><Myeloid Differentiation-Inducing Protein><NIDDM><NIH><National Institutes of Health><Nephrology><Nephropathy><Network Analysis><Non-Hispanic><Non-Insulin Dependent Diabetes><Non-Insulin-Dependent Diabetes Mellitus><Nonhispanic><Noninsulin Dependent Diabetes><Noninsulin Dependent Diabetes Mellitus><Not Hispanic or Latino><Nurses><Occupational><Pathway Analysis><Pathway interactions><Ph.D.><PhD><Phenotype><Physiologic><Physiological><Plasma><Plasma Serum><Plasmacytoma Growth Factor><Play><Population><Prediabetes><Prediabetes syndrome><Prediabetic State><Preinterleukin 1 Beta><Prevalence><Proteinuria><Protocol><Protocols documentation><Quetelet index><Renal Disease><Renal function><Research><Resolution><Reticuloendothelial System, Serum, Plasma><Risk><Risk Factors><Role><SCYB8><Sampling><Science><Scientist><Seasons><Serum><Signal Transduction><Signal Transduction Systems><Signaling><Slow-Onset Diabetes Mellitus><Stable Diabetes Mellitus><Subgroup><Symptoms><T2 DM><T2D><T2DM><TNF><TNF A><TNF Alpha><TNF gene><TNF-α><TNFA><TNFα><TSG-1><Temperature><Time><Training><Trioxopurine><Tumor Necrosis Factor><Tumor Necrosis Factor-alpha><Type 2 Diabetes Mellitus><Type 2 diabetes><Type II Diabetes Mellitus><Type II diabetes><United States National Institutes of Health><Uric Acid><Vulnerable Populations><Weather><Work><access to health care><access to healthcare><accessibility of health care><accessibility to health care><accessibility to healthcare><acute kidney injury><adult onset diabetes><ages><b-ENAP><bilingual><bilingualism><bio-markers><biologic marker><biological signal transduction><biomarker><biomonitoring><body water dehydration><chronic kidney disease><clinical phenotype><cohort><community engaged intervention><community informed intervention><community-based health><community-partnered intervention><damage to kidney><design><designing><developmental><diabetes><disease risk><disorder risk><disparity in health><driving><early biomarkers><early detection biomarkers><early detection markers><farm worker><farmworker><fasted><fasts><glucose metabolism><health care access><health care availability><health care service access><health care service availability><health disparity><health equity><healthcare access><healthcare accessibility><healthcare availability><healthcare service access><healthcare service availability><heat-related illness><hemoglobin A1c><hot climate><hsp90 Family><interferon beta 2><ketosis resistant diabetes><kidney damage><kidney development><kidney disorder><kidney dysfunction><kidney function><long-term study><longitudinal outcome studies><longterm study><maturity onset diabetes><metabolic profile><metabolism measurement><metabolome><metabolomics><metabonome><metabonomics><mortality><nephrogenesis><novel><nurse><pathway><population health><pre-diabetes><pre-diabetic><prediabetic><programs><recruit><renal><renal damage><renal disorder><renal dysfunction><resolutions><response><sex><social role><success><type 2 DM><type II DM><type two diabetes><vulnerable group><vulnerable individual><vulnerable people>