Research Roundup: Diagnostics for malaria, premature birth, and women’s health

Schistosomiasis, the second most common parasitic disease, infects more than 240 million people each year, and can result in liver failure, bladder cancer, and even death. Schistosomiasis is treated using the antiparasitic drug Praziquantel, however, resistance to the drug has been reported in Kenya and Uganda. Despite its efficacy, the mechanism of action of Praziquantel remains a mystery; scientists don’t understand how it combats schistosomiasis. By comparing the genomes of parasites that are sensitive and resistant to the drug, researchers at the Texas Biomedical Research Institute and the University of Texas have identified genes that are associated with resistance, and have received a US$3.5 million grant from the US National Institutes of Health to further examine the individual genes and mutations that confer resistance. The team will collect parasite eggs from patients in Kenya and Uganda before and after treatment with Praziquantel; the eggs from patients who are cured and those that remain infected will be classified as sensitive and resistant to the drug, respectively. They will then sequence the parasites’ genomes, honing in on the genes and mutations linked to resistance, with the goal of better understanding how resistance develops. This information is critical to developing drugs that are effective against Praziquantel-resistance parasites and diagnostics that can detect resistance. Researchers at the All India Institute of Medical Sciences (AIIMS) have completed successful animal trials of an oral vaccine against hepatitis B using a nanotechnology platform that could be adapted for other viruses. Oral vaccines are challenging to develop, as the key components are often degraded in the stomach before they can be absorbed through the intestines. However, they offer significant advantages: they don’t require needles and consequently there’s no risk of blood contamination, many don’t need to be kept cold, and they often spread more thoroughly throughout the immune system. The existing vaccine against hepatitis B is injectable and requires three to four doses, whereas the vaccine under development at AIIMS could be potent enough to require just a single dose. The team used nanoparticles to house the antigen—the part of the vaccine that triggers an immune response—and covered the nanoparticles in a protective surface that can survive the stomach. The vaccine will next be tested in human clinical trials, which the team hopes to complete by 2021. The World Health Organization (WHO) is proposing new guidelines for yellow fever vaccination in emergencies, as alarming outbreaks in Angola, Uganda, and Peru intensify due to a limited global supply. Clinical trials suggest that the vaccine is effective at much smaller doses, and the WHO is expected to recommend that member states use just one fifth of the standard dose. However, the studies were conducted exclusively in adults, raising concerns that the fractional dose might not be enough to protect children. It’s also unclear if the smaller dose would provide lifelong immunity, and the WHO’s proposal will likely recommend a booster to be administered at a later time. Once complete, the proposal will be submitted to the WHO’s Strategic Advisory Group of Experts on Immunization for review, and if approved, will be implemented if the outbreak reaches emergency levels.

US Navy Lt. Kimberly Edgel, left, and Christian Baldeviano examine a positive malaria blood smear at Naval Medical Research Unit (NAMRU) 6 in Callao, Peru.This afternoon, the US Senate voted to protect critical medical research programs at the Department of Defense (DoD). In a vote of 66 to 32, the Senate approved Senator Durbin’s (D-IL) Amendment 4369 to the Fiscal Year 2017 National Defense Authorization Act (FY17 NDAA), which strikes sections 898 and 756 in the underlying bill, designed to enact enough restrictions and red tape on DoD medical research to effectively end all existing programs. With this vote, the majority of the Senate signified that medical research is a critical function of the DoD, and must continue to be a priority. Infectious disease and other medical research at DoD plays a vital role in serving the Department’s overarching mission: supporting our military men and women. Not only does DoD infectious disease research directly benefit service members overseas—who experience neglected infectious diseases alongside local communities—but it also plays a key role in domestic health preparedness initiatives that prevent, detect, and respond to infectious diseases that threaten the health of American civilians at home. Beyond threat reduction to Americans, DoD research can often be translated for other contexts, and serves as an important component of US global health efforts to address HIV and AIDS, tuberculosis, malaria, and neglected tropical diseases in low-income countries.For example, malaria, which threatens the lives of nearly 3.2 billion people in tropical and poor regions of the world, is also a significant threat to the operational readiness of the US military. More person-days were lost among US military personnel due to malaria than to bullets during every military campaign fought in malaria-endemic regions during the 20th century. Thanks to ongoing research at DoD, nearly all of the most effective and widely used antimalarials—used to protect our service members overseas and adapted for widespread use in endemic regions—were developed in part by US military researchers. DoD medical research is also critical to medical advances that directly benefit US civilians at home: One of every four vaccines approved by the US Food and Drug Administration in the last century was developed with the participation of DoD. The 2014 Ebola epidemic in West Africa offers yet another example: the Department’s quick work to advance the development of Ebola countermeasures and safety protocols during troop deployment to West Africa was vital to protecting lives of service members and civilians in the region and remains vital to ongoing response efforts.On May 25th, GHTC sent a letter to members of the Senate, urging them to uphold the DoD’s critical medical research programs and oppose provisions in Sections 756 and 898 of the FY17 NDAA, which would limit our nation’s ability to develop medical countermeasures necessary to protect our troops and save lives around the world.GHTC commends Senator Durbin’s leadership on a bipartisan effort to remove these troubling provisions and extend our thanks to the co-sponsors of Amendment 4369: Cochran (R-MS), Reid (D-NV), Blunt (R-MO), Mikulski (R-AK), Murkowski (D-MD), Murray (D-WA), Collins (R-ME), Feinstein (D-CA), Shelby (R-AL), Casey (D-PA), Gillibrand (D-NY), Baldwin (D-WI), Bennet (D-CO), Markey (D-MA), Brown (D-OH), Leahy (D-VT), Hirono (D-HI), Reed (D-RI), Menendez (D-NJ), Tester (D-MT), Coons (D-DE), Kirk (R-IL), Klobuchar (D-MN), Udall (D-NM), Boxer (D-CA), Schatz (D-HI), Moran (R-KS), Sanders (D-VT), Warren (D-MA), Cardin (D-MD), Schumer (D-NY).