Ph.D. Microbiology, Ohio State University, 1981
Accepting new MS students in 2019?: Yes
Accepting new PhD students in 2019?: Yes
Vaginal microbiome in health and disease
The vaginal mucosa is composed of perhaps hundreds of bacterial species, many of which have not yet been cultured or identified. These populations shift for unknown reasons, from healthy compositions to those that cause disease such as bacterial vaginosis (BV). Different profiles of species lead to complications ranging from recurrence, failed response to treatment, or risk of pre-term birth. Our project seeks to describe the dynamics of populations as they transition to disease, and to identify species or groups that pose the highest risk for complications, including those that impose greater risks for cervical cancer. We are testing models for causes of the microbial progression from BV to cure to recurrence. We are developing a BV diagnostic and prognostic device.
Extracellular vesicles (EV’s) and a subgroup of these called exosomes are subjects of a relatively new field of study that have cause a rethinking of how cells communicate and promote disease. Cells across all kingdoms generate EV’s, and they play important yet not fully understood roles in cancer progression, infectious diseases, such as tuberculosis, malaria, and mycoses, neurodegenerative disease, and many other areas. Candida, a major fungal pathogen, has recently been shown to generate EV’s with discrete protein and RNA cargo that may influence immune cells and survival in model systems. Their clinical potential for fungal infections is vast, because they may be produced in much larger numbers than the fungal cells themselves, because they likely disseminate to blood, saliva, urine for non-invasive detection, because they may carry RNA or protein cargo that distinguishes colonization from infection and possibly antifungal resistance information, and because they may be engineered to target antifungal therapies or for vaccine development. We are asking which stress conditions generate EV’s, whether they impact on the phenotype of other cells in the population, what protein and RNA cargo they carry, with the goal of defining diagnostic targets, and to begin testing whether vesicles in this fraction can be loaded with antifungals for targeted delivery to fungal cells.
Molecular fungal diagnostics
Fungal infections are prevalent and prone to recurrence (vaginal) or have high morbidity (systemic). Their diagnosis by conventional culture is a problem, due to poor culture efficiency, slow growth rates, and low titer, so that diagnosis often occurs too late for effective treatment. We are developing and are validating molecular tools for their high throughput, quantitative identification directly from samples.
Antifungal drug resistance in Candida albicans
This opportunistic yeast pathogen is resourceful and diverse in finding ways to evade inhibition by antifungal agents. These include mutation in target genes, mutational or regulatory activation of target and compensatory pathways, drug efflux, and unknown mechanisms. We are looking at mechanism by which this yeast induces high frequency loss of heterozygosity as an adaptive mechanism. We developed an overexpression system for identification of genes that alter antifungal susceptibility and are inventorying these genes and their effects by RT-qPCR and microarray.
1. Sobel, J. D. and Akins, R. A. The Role of PCR in the Diagnosis of Candida Vulvovaginitis-a New Gold Standard? Curr Infect Dis Rep. 2015 Jun;17(6):488. doi: 10.1007/s11908-015-0488-3.
2. Aguin T, Akins RA, Sobel JD. High-dose vaginal maintenance metronidazole for recurrent bacterial vaginosis: a pilot study. Sex Transm Dis. 2014 May;41(5):290-1. doi: 10.1097/OLQ.0000000000000123. PMID: 24722380. Roles: Statistical analysis, study design, manuscript writing and editing.
3. *Lambert, J., *John, S., Sobel, J. D. and Akins, R. A. Longitudinal analysis of vaginal microbiome dynamics in women with recurrent bacterial vaginosis: recognition of the conversion process. PLoS One. 2013 Dec 20; 8(12):e82599. doi: 10.1371/journal.pone.0082599. eCollection 2013. IF: 3.730. Roles: Corresponding author, study conception, design, implementation, data analysis, manuscript writing.
4. *Lambert JA, *Kalra A, *Dodge CT, *John S, Sobel JD, Akins RA. Novel PCR-Based Methods Enhance Characterization of Vaginal Microbiota in a Bacterial Vaginosis Patient before and after Treatment. Appl. Environ. Microbiol. 2013. 79:4181-4185. IF= 3.678, 3 citations. Roles: Corresponding author, study conception, design, implementation, data analysis, manuscript writing.
5. Aguin, TJ, Akins RA, Sobel JD. High Dose Vaginal Metronidazole for Recurrent Bacterial Vaginosis: A Pilot Study. J Low Genit Tract Dis. 2013 Aug 29. PMID: 23994951. IF= 1.207, 1 citations. Roles: Statistical analysis, study design, manuscript writing and editing.
6. Lazarovitch T, Shango M, Levine M, Brusovansky R, Akins RA. The relationship between the new taxonomy of Streptococcus bovis and its clonality to colon cancer, endocarditis, and biliary disease. Infection 41 (2), 329-337. IF= 2.440, 8 citations. Roles: Statistical analysis, manuscript writing and editing.
7. Lamont, RF, Sobel JD, Akins RA, Hassan SS, Chaiworapongsa T, Kusanovic JP, and Romero R. The vaginal microbiome: new information about genital tract flora using molecular based techniques. BJOG: an international journal of obstetrics and gynaecology 118:533-549, 2011. IF= 3.760, 103 citations. Roles: authored the molecular genetics section, manuscript editing.
8. Reddy T, Chopra T, Marchaim D, Pogue JM, Alangaden G, Salimnia H, Boikov D, Navon-Venezia S, Akins RA, *Selman P, Dhar S, Kaye KS. 2010. Trends in antimicrobial resistance of Acinetobacter baumannii isolates from a metropolitan Detroit health system. Antimicrob Ag Chemother 54:2235-8, 2010. Epub Mar 2010. IF = 4.565, 23 citations. Roles: Statistical analysis, manuscript writing and editing.
9. *Mandviwala T, *Shinde R, *Kalra A, Sobel JD, Akins RA. High throughput identification and quantification of Candida species using high resolution derivative melt analysis of panfungal amplicons. J Mol Diagn 12:91-101, 2010. epub Dec 2009. IF = 3.952, 12 citations. Roles: Corresponding author, study conception, design, implementation, data analysis, manuscript writing.
10. *Reichman O, Akins RA, Sobel JD: Boric acid addition to suppressive antimicrobial therapy for recurrent bacterial vaginosis. Sex Transm Dis 36:732-734, 2009. IF = 2.594, 16 citations. Roles: Study design, statistical analysis, manuscript writing and editing.