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Wojna, Valerie
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overview
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I have been fortunate to work with my patients as a neurologist and as a clinical researcher. My clinical experience and personal commitment to help ameliorate health disparities, has led to me to the study of HIV-associated neurocognitive disorders (HAND). I have been the PI of the Hispanic/Latino Longitudinal NeuroAIDS women cohort for the evaluation of HAND as part of the NeuroAIDS Specialized Neuroscience Research Program (SNRP). My areas of research experience address the impact of sex hormones, insulin resistance, oxidative stress, chronic inflammation, and biomarkers on cognitive performance among HIV positive cisgender women. Recent scientific literature has evidenced that the chronic infection and increase survival of HIV-seropositive patients is associated with increase co-morbidities such as stroke, metabolic syndrome, and cancer. Since 2011 we have been studying the effect of insulin resistance and neurocognitive performance in patients with HIV infection. Since than we have obtained a R21 (R21MH095524) and a R01 (R01NS099036) to study further the mechanisms involved in the secretion of the insulin receptor and its effect on cellular insulin resistance and neurocognitive impairment. Our preliminary data shows that HIV tat alters the cellular splicing factors facilitating the release of the insulin receptor extracellularly. Since this receptor is functional (binds to insulin) it facilitates de development of cellular insulin resistance as determined by altered IRS-1 phosphorylation. We believe that the secretion of the soluble insulin receptor and its effects precipitates a continuous cellular (and neuronal) insulin resistance that eventually will synergize with other HIV pathological mechanisms such as chronic inflammation, oxidative stress, and neurotoxic effects of virotoxins with residual neuronal injury and cognitive impairment. At present I am enrolled in the NINDS R25 Clinical Trials Methodology Course where will like to develop a clinical trial with approved medications that affects splicing factors (i.e. resveratrol) and improves insulin resistance (i.e. intranasal insulin). Other areas of interest include neurodegenerative disorders, multiple sclerosis, and HIV-associated sleep disorders.
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