Personal Statement

          Regarding to my personal interests in the fields of immuno-nephrology and tropical diseases, I have chosen the following topics to pursue as my future research.

Basic science research

1) Tropical diseases and sepsis
Currently I have studied about the immunological, omics and genomics in tropical diseases particularly the biomolecular markers for differentiating and stratifying the prognosis of dengue infection, immunoglobulin A (IgA) nephropathy, and lupus nephritis. I also wish to determine new, early biomarkers of sepsis—particularly sepsis from intraabdominal infections—by using animal sepsis models. The blood and gut microbiomes currently are promising indicators for sepsis detection and prognosis. Of note, I have experience with studying gut leakage after antibiotic administration, and gut bacterial translocation, in a Clostridium difficile mouse model.

2) Antibody-mediated rejection in kidney transplantation (KT)
Recurrent glomerular diseases and allograft rejection are the main topics of my interests. I seek to evaluate the immunological mechanisms of antibody-mediated rejection, such as complement fixation and vascular endothelial antibodies, in KT in a rabbit model and to study the challenging methods for inducing host immune tolerance.

Clinical research
1) Sepsis and septic shock
My research area of interest regarding the clinical syndrome of sepsis includes the role of blood purification in both renal indication and non-renal indication renal replacement therapy in patients who develop sepsis or septic shock. I hypothesize that using sorbent devices for immunomodulation in septic shock would help control hyperinflammatory process immune dysfunction in the early stages of sepsis. My previous research has already found that urinary exosomal activating transcription factor 3 (ATF3) is an interesting sepsis-acute kidney injury (AKI) biomarker. As such, I wish to further investigate this idea in a large, clinical trial in the near future. I also hypothesize that urinary exosomal ATF3 is better than urinary neutrophil gelatinase-associated lipocalin (NGAL) as a sepsis-AKI biomarker.

2) Glomerular diseases
Glomerular diseases are the top-five causes of end-stage renal disease in young adults. As the area of Samut Prakan Province comprises a high ratio of working adults with a high incidence of IgA nephropathy and lupus nephritis, I would use this to develop my research aiming at comprehensive care and in-depth study for diagnosis, treatment, and prevention of IgA nephropathy and lupus nephritis. Accordingly, I would like to research a correlation of occupation, environment, host immune, and genetics complexes, which might be an interesting aspect of both IgA nephropathy and lupus nephritis. Monocyte function associated with lupus nephritis activity is my current, ongoing research. Meanwhile, in IgA nephropathy, I am interested in mucosal immunity and the roles of Peyer’s patch B cells for disease activity and treatment response.

3) Vascular immunology
Inflammation has emerged as a critical factor in several vascular diseases, especially atherosclerosis in coronary artery disease and thrombosis in dialysis vascular access. An understanding of the immune cells involved in the initiation and progression of vascular inflammation may facilitate identifying important pathways to target for future therapeutics.