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Research Roundup: Flu vaccines, HIV in kids, and a cross-continental R&D partnership

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National Institute of Allergy and Infectious Diseases

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week.

October 9, 2016 by Kat Kelley

Each year, a new flu vaccine is developed, containing proteins from three to four strains of influenza. These proteins train the immune system to recognize different versions of the virus, enabling a rapid response in the case of infection. For the past eight years, the same strain of H1N1 (swine flu) has been included in flu vaccines globally, however, the World Health Organization has recommended this strain be replaced with a more recent version of the ever-changing virus. Normally, flu vaccines prompt the greatest immune response in healthy adults, however, since 2013, their efficacy has been decreasing in adults aged 30 to 60. The theory? Many of these adults were first exposed to H1N1 between 1977 and 1985, and the strains circulating at that time shared one critical component with those circulating between 2009 and 2013. Consequently, those who had been exposed to H1N1 between 1977 and 1985 responded to the flu vaccine as if it were a booster shot. Rather than producing entirely new antibodies tailored to the new version of the virus, their immune systems ramped up production of the existing antibodies tailored to the old version. In 2013, the virus mutated further, losing the component it shared with older strains, and thus, adults who experienced the booster shot phenomenon were no longer protected by the vaccine. Fortunately, experts have identified a new version of the virus, retrieved from a patient in Michigan, which should provide broader protection against H1N1 for future flu vaccines.

A recent study out of South Africa suggests that one in ten children who are infected with HIV have no immune response to the virus and consequently experience none of the symptoms associated with HIV and AIDS. The researchers analyzed blood samples from 170 children who are HIV positive and have not received treatment, but nonetheless have not developed AIDS. The samples confirmed high volumes of the virus in the blood, and the lack of either an immune response or symptoms demonstrates, “HIV disease is not so much to do with HIV, but with the immune response to it,” according to Dr. Philip Goulder, an author of the study. This response—or lack thereof—has also been reported in more than 40 nonhuman primate species, but has not been seen in adults, who often have more aggressive immune reactions to pathogens. While limited, existing research indicates that some children with this protective attribute develop AIDS as they age, while others continue to display no symptoms. However, treatment may still be needed to prevent further transmission of the virus.

SciDev.Net took an in-depth look at the European & Developing Countries Clinical Trials Partnership (EDCTP) and how its second iteration (EDCTP2) could be a catalyst for increased investments in health research and development (R&D) by African governments. EDCTP was launched in 2003 and ran through 2014, during which time it invested US$425 million into 254 collaborations between African and European scientists. The Partnership funded phase 2 and 3 clinical trials for HIV and AIDS, malaria, and tuberculosis. In 2014, EDCTP2 was established, expanding the scope to cover phase 1 and phase 4 (postmarketing surveillance) and to include other neglected infectious diseases. In just two years, EDCTP2 has mobilized nearly US$115 million. The role of the African member countries has been elevated in the second iteration—they have voting rights in the EDCTP General Assembly and have each pledged EUR€200,000 (US$224,000) to the Partnership.

Categories: HIV/AIDS, Vaccines

About the author

Kat KelleyGHTC

Kat Kelly is a senior program assistant at GHTC who supports GHTC's communications and member engagement activities.

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Research Roundup: Ebola treatment, black widow virus, and Zika syndrome

Written by Kat Kelley / GHTC
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In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. During the recent Ebola epidemic in West Africa, an experimental drug, ZMapp, showed promise in treating the disease, but with only enough doses to treat seven people, the drug’s true impact remained unknown. Now, results of a randomized control trial conducted during the outbreak indicate that ZMapp likely increases a patient’s chance of survival, but fall just short of statistical significance. The researchers hoped to enroll 200 patients across Liberia, Sierra Leone, and Guinea, however, as the number of new cases waned, so too did eligible participants for the trial. Ultimately, the team recruited only 72 participants, all of whom received the standard care for Ebola and half of whom also received ZMapp. Further complicating the results, many of the patients were enrolled after the virus had already caused irreparable tissue damage and did not survive long enough to receive all three doses of ZMapp. The results suggest high probability—91.2 percent—that ZMapp is effective against the virus and confirm the drug’s safety. ZMapp is composed of three antibodies against Ebola, and research is underway to develop improved antibodies which could enhance the drug’s efficacy. Viruses are constantly mutating, and often incorporate genes from the organisms they infect—viruses that infect bacteria often have bacterial DNA and viruses that infect animals often have animal DNA. The WO virus targets the bacteria Wolbachia, which in turn targets spiders and insects. Consequently, when researchers at Vanderbilt University sequenced the genome of WO, they expected to find snippets of Wolbachia DNA. Instead, they found that one third of WO’s genes came from the arthropods that Wolbachia infects. Further, WO contains genes for latrotoxin, the chemical cornerstone of the venom found in black widow spiders, a particularly surprising discovery as latrotoxin has never been reported outside of spiders. The scientists suspect WO’s unique evolution relied on the way Wolbachia intertwines itself with animal cells, requiring WO to drill through the animal cell membranes to reach the bacteria. Zika virus, first discovered in 1947, was long considered innocuous, rarely reported in humans and associated with a mild infection. The virus raised concern, however, when scientists discovered its connection to microcephaly—a birth defect in which an infant’s brain does not develop properly, resulting in an abnormally small head. Now, one year after a spike in microcephaly cases in Brazil led to this important discovery, infants with what’s been deemed congenital Zika syndrome are coping with a range of devastating symptoms not usually reported in infants with microcephaly, including seizures, impaired vision and hearing, difficulty swallowing, and arm and leg deformities. Additionally, some infants have presented with neurological and physical defects despite having normal-sized heads and others still have developed microcephaly after birth, as the growth of the head has not kept up with that of the body.
TB Alliance
October 2, 2016

Research Roundup: Kid-friendly TB treatment, drug manufacturing on-the-go, diarrheal disease, and more

Written by Kat Kelley / GHTC
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This weekend, Kenya became the first country to roll out the world’s first and only pediatric tuberculosis (TB) medicines. TB infects one million children each year, resulting in 140,000 deaths, and yet, children have historically been treated with crushed up pills in estimated doses. The new formulations, which were developed by TB Alliance, are not only appropriately dosed for kids, but they are fruit-flavored and dissolvable—making them much more kid-friendly than a handful of bitter pills that must be swallowed. Kids must remain on treatment for six months, and the improved dose, flavor, and delivery are expected to have a significant impact on adherence to the regimen, preventing the development of drug-resistant strains. An additional 17 countries have placed orders and plan to introduce the medicines in the coming months. Vaccines and drugs could soon be manufactured on-the-go with the use of a portable, handheld kit developed by researchers at Harvard University. The kit contains all the ingredients needed to produce biologics (medical products derived from biological, rather than chemical sources): both the DNA that triggers the production of proteins to fight disease and the proteins that synthesize the final product. The DNA and proteins are freeze-dried into pellets, making them easy to store and transport, and with just the addition of water, the vaccine or therapy is ready to use. The team put the kit to work, successfully producing four different biologics, however, the vaccine candidate had to be purified before use. More research and testing is needed, and it could be more than a decade before such a system would be safe and appropriate for use in low-resource settings. Diarrheal diseases are a leading cause of death among children under five, and a new study suggests that 89 percent of cases are caused by pathogens. Further, 78 percent of cases are caused by just six pathogens, including rotavirus, Shigella, enterotoxigenic Escherichia coli (ETEC), Cryptosporidium, Campylobacter, and adenovirus. The researchers analyzed stool samples from more than 10,000 children under five, half of whom had diarrhea, to determine the leading causes of childhood diarrhea. Of the six, there is currently only a vaccine against rotavirus, however, GHTC member PATH is currently developing vaccines against Shigella and ETEC. Scientists are exploring whether the powerful antimicrobials created by certain species of ants could be used to fight infection in humans. Over the past 15 million years, more than 200 ant species have evolved to farm fungi—a symbiotic relationship in which the ants collect plants, feed them to fungi, and in turn, the ants feed off of the fungi. However, some ant species are vulnerable to hostile fungi that attack the ants’ nests and farmed fungi and have consequently adapted to fight off pathogens. These species cultivate bacteria—which appear as white patches along the ants’ bodies—that produce antibacterial and antifungal compounds. So far, the results have been encouraging: 1 in every 15 of these antimicrobial agents have proved promising in the lab, compared to just one in a million of those discovered through soil sampling.