Project Description Dr. Kamen has devoted her career to conducting patient-oriented research in rheumatology with a focus on lupus and to mentoring the next generation of clinical investigators. Starting in residency, she has made continuous progress toward her goal of uncovering the natural history of autoimmune disorders in order to design preventive and therapeutic strategies around identified risk factors. While conducting highly interdisciplinary and collaborative research projects she has mentored 48 students, post-doctoral trainees and junior faculty. Dr. Kamen teaches medical students and residents as the co-Director of the Rheumatology Curriculum and oversees the clinical research operations as Director of Clinical Research for the Division of Rheumatology. Her dedication and track record for teaching and research mentoring were recognized in 2011 when she received the MUSC Developing Scholar Award and in 2012 when she received the Mary Betty Stevens Young Investigator Prize from the Lupus Foundation of America. This K24 Midcareer Investigator Award would ensure continued protected time for Dr. Kamen's research and mentoring. The proposed research project titled “Environmental Determinants of Lupus among African Americans” includes new aims which build upon ongoing work. This project explores the role of gut microbiota in the development of lupus-related autoimmunity. The proposed research has the strong support of the Sea Island Gullah African American community, with whom we have an established ongoing longitudinal cohort and a community-academic partnership. Participants for the proposed research project will be recruited from the existing ongoing longitudinal SLE in Gullah Health (SLEIGH) study to take advantage of genetic and clinical data already collected since the study's inception in 2003. Dr. Kamen's investigations have been continuously NIH funded, including a 5-year K23 Career Development Award from NIAMS that led to a 4-year R21 from NIEHS and a 5-year P60 project from NIAMS under Dr. Kamen's leadership. The vast amount of accumulated past exposure data, wealth of existing stored biospecimens, and enthusiasm from study participants to take part in a study of an autoimmune disease common in their community, present a unique opportunity to address the role of the gut microbiota in the development of autoimmunity.

Public Health Relevance Statement Systemic lupus erythematosus (SLE) is a devastating disease of unknown cause primarily affecting young African American women. Identification of gut microbial factors capable of modulating autoimmunity, either as triggers or regulators of the autoimmune response, is crucial in contributing to our understanding as to why autoimmunity arises and progresses and, very importantly, will create opportunities for interventions that could lessen disease incidence and severity. Additionally, Dr. Kamen's research and mentoring activities will help increase the presence of well-trained clinical investigators in the field of lupus research.