Thursday, December 23, 2010

Research of Patricia L Hibberd, MD, PhD

Patricia L Hibberd, MD, PhD
Patricia L Hibberd, MD, PhD, Chief, Division of Global Health; MassGeneral Hospital for Children.

The Global Network for Women’s and Children’s Health Research at Massachusetts General Hospital for Children, is one of 7 NIH-funded locations across the world that is focusing on developing evidence to address the alarming rates of morbidity and mortality in women and children and the lack of research expertise and infrastructure in the developing world. The network which began in 2001 as a unique private-public partnership between NICHD and the Bill and Melinda Gates Foundation conducts studies to improve health outcomes by building research partnerships to conduct research on feasible, cost-effective, sustainable interventions to address the major causes of morbidity and mortality of women and children through 36 months of age in the developing world.  The goals of the Global Network are:

  • To address pressing public health problems to improve the outcome of mothers and children in the developing world;
  • To build sustainable public health, multidisciplinary scientific capacity and multi-level research training opportunities infrastructure in the developing world
  • To collaborate with governments, communities, maternal-child health  organizations, advocacy groups, other funding agencies, and donors to maximize cost-effectiveness of research
  • To disseminate research findings as the basis for local, national and international health policy.

The MGH Global Network site involves a partnership between Dr Hibberd, Chief of the Division of Global Health, Principal Investigator of the Global Network Grant and Dr Archana Patel, Vice President of the Lata Medical Research Foundation and Chair of Pediatrics at the Indira Gandhi Government Medical College, Nagpur, India.  Drs Hibberd and Patel have been collaborating on producing high quality evidence to reduce the rates of neonatal sepsis and childhood pneumonia (the two major killers of children under 5 years of age) for almost 15 years.  Their work has previously been funded by the World Health Organization (WHO) and USAID and has contributed to changes in policy by the WHO. Their most important contributions have been the on the early recognition of severe hypoxemia and treatment with oxygen in children with pneumonia in resource constrained settings.1,2  Recent research, in collaboration with Dr Patel, includes development of point of care diagnostics, suitable for resource poor settings to diagnose neonatal sepsis led by Dr Miriam Haverkamp and Dr Hanno Steen at Children’s Hospital Boston, innovative approaches to reduce mortality due to neonatal asphyxia led by Dr Brett Nelson and use of cell phones to detect abnormal vital signs consistent with pneumonia in collaboration with Dr Richard Fletcher at MIT.  If interested in joining the Division’s Global Health work please contact  All levels of trainees are invited to participate.  There are international opportunities as well as US based opportunities for those studies that are in the proof of concept stage of development.         

Dr Hibberd also has 3 U01 NIH grants that support her research on mechanisms of action of probiotics and their immunomodulatory properties to prevent infectious disease complications in neonates and young children, both in the US and globally. A particular focus in the US is to evaluate whether probiotics can impact colonization by multidrug resistant bacteria in young children exposed to multiple courses of antibiotics.  The international focus is on probiotics to prevent neonatal sepsis,3 pneumonia and diarrhea and as vaccine adjuvants, particularly for mucosally administered vaccines for which there is a suboptimal vaccine response in resource poor settings. This has included work supported by a Gates Grand Challenge Grant on genetic engineering of probiotic bacteria for “needle free and cold chain free” vaccine delivery, in collaboration with Dr A Sonenshein at Tufts.  

Probiotics are marketed in the United States as dietary supplements but are increasingly being used as drugs to prevent and treat a wide range of conditions.  Dr Hibberd’s group is conducting research on the widely studied probiotic Lactobacillus GG (LGG) as an investigational new drug, regulated by the Food and Drug Administration (FDA).   Ongoing research includes a Phase I safety study of LGG vs. placebo in healthy adults in which we are using novel technologies (particularly metagenomics using 454 pyrosequencing) to determine whether probiotics can alter the gastrointestinal and respiratory human microbiota using non-culture based methods.  This research is being done in collaboration with Dr Fraser-Liggett’s group at the University of Maryland’s Institute for Genome Sciences and the NIH’s Human Microbiome Project.  The research also involves studies of the polymorphisms and gene expression associated with immunological consequences of the exposure to LGG.  Specifically we are measuring cytokine production in response to bacterial stimulation using real time PCR by following the kinetics of mRNA expression of pro and anti-inflammatory genes and different signaling pathways in subjects receiving LGG vs. placebo.  This work is being done in collaboration with Dr Solano-Aguilar at the Beltsville USDA-ARS.  Other ongoing studies include evaluating the patterns of humoral cellular immune responses to influenza immunization (TIV and LAIV) in the elderly in subjects exposed to LGG vs. placebo, based on promising responses in healthy adults.4   All the translational probiotic studies are being conducted in MGH’s Clinical Research Center that is supported by the Harvard Catalyst. If interested in joining the Division’s Probiotic translational research work please contact  All levels of trainees are invited to participate. 

Our website is

  1. Fu LY, Ruthazer R, Wilson I, Patel A, Fox LM, Tuan TA, Jeena P, Chisaka N, Hassan M, Lozano J, Maulen-Radovan I, Thea DM, Qazi S, Hibberd P. Brief hospitalization and pulse oximetry for predicting amoxicillin treatment failure in children with severe pneumonia. Pediatrics, 2006; 118(6):e1822-e1830. PM:17142503.
  2. Haverkamp M, Asghar R, Banajeh S, Egas J, MacLeod W, Maulen-Radovan I, Mino G, Saha S, Santosham S, Singhi S, Madan J, Davidson L, Thea D, Qazi S, Hibberd P.  Predictors of Early Mortality in Children Aged 2-59 Months with Very Severe Pneumonia in International Settings – Pediatric Academic Societies, Vancouver, BC – Platform 5/2010
  3. Madan J, Saxena D, Davidson L, Sogin M, Moore J, Jambulingam N, Edwards W, Palumbo P, Hibberd P.  The Developing Premature Infant: The Microbiome in Sepsis Pediatric Academic Societies, Vancouver, BC – Platform 5/2010
  4. Davidson LE, Fiorino AM, Snydman DR, Hibberd PL.  Lactobacillus GG as an Immune Adjuvant for Live Attenuated Influenza Vaccine in Health Adults – a randomized double blind placebo controlled trial.  European Journal of Clinical Nutrition, 2011, in press.



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