Serena Spudich, MD, MA

  • Dr. Harry M. Zimmerman and Dr. Nicholas and Viola Spinelli Professor of Neurology
  • Division Chief, Neurological Infections & Global Neurology
  • Co-director, Center for Neuroepidemiology and Clinical Neurological Research
Research interests
Acquired Immunodeficiency Syndrome; Antiviral Agents; Cerebrospinal Fluid; Dementia; HIV; Nervous System; Neurology; Magnetic Resonance Spectroscopy; Biomarkers, Pharmacological
Research summary

Our group’s clinical and translational research focuses on characterization of the central nervous system in HIV-infected patients in an effort to understand and treat the processes underlying damage to the nervous system by HIV, as well as establishment and reduction of potential central nervous system reservoirs for infection.

Our current program employs a multidisciplinary approach to patient-oriented research in neuro-HIV, through active collaborations with researchers in immunology, radiology, neuropsychology, virology, and molecular biomarkers. We apply these methods to novel studies of patients that may inform about neuroprotection and neuropathogenesis in HIV, including individuals with acute or early HIV infection, patients at different stages of treatment with antiretroviral therapy, and individuals with cerebrospinal fluid HIV escape (detected HIV in the central nervous system despite effective treatment in the blood). We are also performing clinical studies aimed to examine and/or reduce early establishment of central nervous system reservoirs for HIV infection.

Our studies focus on subjects recruited in urban centers in the US and international sites including Bangkok, Thailand. Broader involvement with the design and implementation of multicenter studies relevant to neuro-HIV is facilitated by Dr. Spudich’s position within the international AIDS Clinical Trials Group (ACTG), facilitated by an affiliation with the Cornell AIDS Clinical Trials Unit.

Specialized Terms: HIV; AIDS; Central nervous system inflammation; Viral compartmentalization; Acute infection; HIV reservoirs; Magnetic resonance spectroscopy; Diffusion tensor imaging; Neural markers; Cerebrospinal fluid biomarkers

Education
  • MD, University of California at San Francisco, 1997
  • MA, Stanford University, 1992
  • BA, Stanford University, 1991
Publications
  • Spudich S, Robertson KR, Bosch RJ, Gandhi RT, Cyktor JC, Mar H, Macatangay BJ, Lalama CM, Rinaldo C, Collier AC, Godfrey C, Eron JJ, McMahon D, Jacobs JL, Koontz D, Hogg E, Vecchio A, Mellors JW. Persistent HIV-infected cells in cerebrospinal fluid are associated with poorer neurocognitive performance. The Journal Of Clinical Investigation 2019, 129:3339-3346.
  • Hellmuth J, Slike BM, Sacdalan C, Best J, Kroon E, Phanuphak N, Fletcher JLK, Prueksakaew P, Jagodzinski LL, Valcour V, Robb M, Ananworanich J, Allen IE, Krebs SJ, Spudich S. Very Early Initiation of Antiretroviral Therapy During Acute HIV Infection Is Associated With Normalized Levels of Immune Activation Markers in Cerebrospinal Fluid but Not in Plasma. The Journal Of Infectious Diseases 2019, 220:1885-1891.
  • Farhadian SF, Mehta SS, Zografou C, Robertson K, Price RW, Pappalardo J, Chiarella J, Hafler DA, Spudich SS. Single-cell RNA sequencing reveals microglia-like cells in cerebrospinal fluid during virologically suppressed HIV. JCI Insight 2018, 3.
  • Chan P, Patel P, Hellmuth J, Colby DJ, Kroon E, Sacdalan C, Pinyakorn S, Jagodzinski L, Krebs S, Ananworanich J, Valcour V, Spudich S. Distribution of Human Immunodeficiency Virus (HIV) Ribonucleic Acid in Cerebrospinal Fluid and Blood Is Linked to CD4/CD8 Ratio During Acute HIV. The Journal Of Infectious Diseases 2018, 218:937-945.
  • Sanford R, Ances BM, Meyerhoff DJ, Price RW, Fuchs D, Zetterberg H, Spudich S, Collins DL. Longitudinal Trajectories of Brain Volume and Cortical Thickness in Treated and Untreated Primary Human Immunodeficiency Virus Infection. Clinical Infectious Diseases : An Official Publication Of The Infectious Diseases Society Of America 2018, 67:1697-1704.
  • Burbelo PD, Price RW, Hagberg L, Hatano H, Spudich S, Deeks SG, Gisslén M. Anti-Human Immunodeficiency Virus Antibodies in the Cerebrospinal Fluid: Evidence of Early Treatment Impact on Central Nervous System Reservoir? The Journal Of Infectious Diseases 2018, 217:1024-1032.
  • Rahimy E, Li FY, Hagberg L, Fuchs D, Robertson K, Meyerhoff DJ, Zetterberg H, Price RW, Gisslén M, Spudich S. Blood-Brain Barrier Disruption Is Initiated During Primary HIV Infection and Not Rapidly Altered by Antiretroviral Therapy. The Journal Of Infectious Diseases 2017, 215:1132-1140.
  • Kessing CF, Spudich S, Valcour V, Cartwright P, Chalermchai T, Fletcher JL, Nichols C, Josey BJ, Slike B, Krebs SJ, Sailsuta N, Lerdlum S, Jagodzinski L, Tipsuk S, Suttichom D, Rattanamanee S, Zetterberg H, Hellmuth J, Phanuphak N, Robb ML, Michael NL, Ananworanich J, Trautmann L. High Number of Activated CD8+ T Cells Targeting HIV Antigens Are Present in Cerebrospinal Fluid in Acute HIV Infection. Journal Of Acquired Immune Deficiency Syndromes (1999) 2017, 75:108-117.
  • Hellmuth J, Fletcher JL, Valcour V, Kroon E, Ananworanich J, Intasan J, Lerdlum S, Narvid J, Pothisri M, Allen I, Krebs SJ, Slike B, Prueksakaew P, Jagodzinski LL, Puttamaswin S, Phanuphak N, Spudich S. Neurologic signs and symptoms frequently manifest in acute HIV infection. Neurology 2016, 87:148-54.
  • Sturdevant CB, Joseph SB, Schnell G, Price RW, Swanstrom R, Spudich S. Compartmentalized replication of R5 T cell-tropic HIV-1 in the central nervous system early in the course of infection. PLoS Pathogens 2015, 11:e1004720.
International activities
  • Investigations in CNS HIV Reservoirs and HIV Cure
    Bangkok, Thailand (2013-Present)
    A range of project in collaboration with investigators at SEARCH Thailand as well as from multiple US and international institutions to assess potential reservoirs for HIV in the nervous system as well as the impact of therapeutic interventions aimed to reduce HIV in the brain.

    Thai Red Cross HIV Research Centre, Chulalongkorn University, Thai Red Cross HIV Research Centre, Chulalongkorn University

  • Effects of Acute HIV Infection in the Central Nervous System
    Bangkok, Thailand (2011-Present)
    Clinical and translational research investigating the nervous system during acute HIV infection, and the impact of early antiretroviral therapy.

    Thai Red Cross/AFRIMS/Chulalongkorn University, Thai Red Cross/AFRIMS/Chulalongkorn University