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Conquering Ebola:  How They Did It

By Shlomo Maital

ebola

  As usual, the deaths and suffering from Ebola got far more media attention than the team of brave and creative people who have conquered it. (Global New York Times, Aug. 1-2, 2015, p. 6)

  It started in Canada.  Researchers at the Public Health Agency of Canada created an experimental vaccine (yup – that’s right,  a government agency!).  They took a piece of the virus’s covering and combined it with an animal virus (vesicular stomatitis virus), to set off an immune reaction against Ebola. I can only imagine the risks involved in working with such a virulent and often-fatal virus, in a lab. 

   A private biopharm company, NewLink Genetics, based in Ames Iowa, licensed the breakthrough vaccine, and last November, Merck, Big Pharma, did too. 

   The clinical trial was crucial.  It was led by the WHO,  Guinean Health Ministry, Doctors Without Borders, Epicentre Research and the Norwegian Institute of Public Health.

    Among the clinical trial innovations: a beer-keg-shaped storage device, the Arkteck, that kept the vaccines at minus 80 degrees without electricity, so that they could be transported.   The keg was invented by Global Good, a collaboration between an investment company Intellectual Ventures and Bill & Melinda Gates’ Foundation.

     None of those vaccinated in the trial,  about 4,000 people, contracted the disease, even when exposed to it.  The main use will be to vaccinate medical workers exposed to Ebola, rather than huge populations.

     What do we learn from this?  Simple.   To tackle a really hard problem, you need to put together global collaborations – governments, NGO’s, companies big and small, volunteers, African governments,   and they need to work together seamlessly, each contributing his or her own creativity and energy.  In the end, courageous lab workers did the job, but it took the whole ‘village’ to save a child, or many many of them. 

    The whole ebola virus vaccine eco-system deserves a Nobel.

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Scientists Who Endanger Their Lives:  The Case of Ebola

By Shlomo  Maital    

ebola

   Scientific papers published in Science rarely involve heroism, drama, and life-threatening courage.   This one does:

Gire, SK, Goba, A et al. Genomic surveillance elucidates Ebola virus origin and transmission during the 2014 outbreak. Science, 2014, online.

    Here is the story, as described in a dry press release by Harvard:

     “ n response to an ongoing, unprecedented outbreak of Ebola virus disease (EVD) in West Africa, a team of researchers from the Broad Institute and Harvard University, (MIT-Harvard),  in collaboration with the Sierra Leone Ministry of Health and Sanitation and researchers across institutions and continents, has rapidly sequenced and analyzed more than 99 Ebola virus genomes. Their findings could have important implications for rapid field diagnostic tests. The team reports its results online in the journal Science.”

       The research was led by Broad Institute researcher Pardis Sabeti, Augustine Goba, Director of the Lassa Laboratory at the Kenema Government Hospital in Sierra Leone, and Stephen Gire, first author,  a research scientist in the Sabeti lab at the Broad Institute and Harvard.  The team  shipped samples back to Boston, and then  20 people worked around the clock.   In one week:  they decoded gene sequences from 99 Ebola samples!  This is truly amazing. 

        What the team did was to act rapidly to collect samples of Ebola from a Sierra Leone hospital last April, when the outbreak began, and then gathered additional samples as the virus spread and mutated.  They did this under life-threatening conditions, especially those on the ground on-site, because at the time there was insufficient protective gear for hospital workers, and some indeed died. 

       They gathered 99 samples of Ebola in all. Then they decoded the genome of each sample.  This was unprecedented in its speed.   What they found was important.  The Ebola virus has only 7 genes (!) compared to the human genome, comprising more than 20,000 genes.  Like all viruses, Ebola penetrates the human cell and commandeers its DNA mechanism, to make more viruses rather than human DNA.  Ebola is fatal in 52 per cent of all cases.

      The Broad Institute researchers found that Ebola initially spread from an animal to a human.  BUT —  from then on, it ONLY spread among humans.  The initial call to avoid mangos and meat was uncalled for.  And like all viruses, they found that the virus evolved and mutated very quickly in humans.  So, we are in a race, between ‘brilliant’ humans with huge brains, and ‘stupid’ viruses with only 7 genes ..and at the moment, the viruses seem to be winning. 

   I salute the courageous scientists and their assistants on-site, for risking their lives to help save the lives of others.  Sometimes, not often, science is life-threatening,  and quickly, life-saving. 

     In this space, I’ve been fiercely critical of Big Pharma, which rips us off by charging scandalously high prices for drugs with minimal impact.  But for once,  Big Pharma is doing the right thing.   GSK Glaxo Smith Kline is helping the U.S. National Institutes of Health to develop an Ebola vaccine.  Only GSK’s huge productive capacity can do this quickly enough to combat the spread of Ebola. 

    

 

 

 

 

 

By Shlomo  Maital    

   Scientific papers published in Science rarely involve heroism, drama, and life-threatening courage.   This one does:

Gire, SK, Goba, A et al. Genomic surveillance elucidates Ebola virus origin and transmission during the 2014 outbreak. Science, 2014, online.

    Here is the story, as described in a dry press release by Harvard:

     “ n response to an ongoing, unprecedented outbreak of Ebola virus disease (EVD) in West Africa, a team of researchers from the Broad Institute and Harvard University, (MIT-Harvard),  in collaboration with the Sierra Leone Ministry of Health and Sanitation and researchers across institutions and continents, has rapidly sequenced and analyzed more than 99 Ebola virus genomes. Their findings could have important implications for rapid field diagnostic tests. The team reports its results online in the journal Science.”

       The research was led by Broad Institute researcher Pardis Sabeti, Augustine Goba, Director of the Lassa Laboratory at the Kenema Government Hospital in Sierra Leone, and Stephen Gire, first author,  a research scientist in the Sabeti lab at the Broad Institute and Harvard.  The team  shipped samples back to Boston, and then  20 people worked around the clock.   In one week:  they decoded gene sequences from 99 Ebola samples!  This is truly amazing. 

        What the team did was to act rapidly to collect samples of Ebola from a Sierra Leone hospital last April, when the outbreak began, and then gathered additional samples as the virus spread and mutated.  They did this under life-threatening conditions, especially those on the ground on-site, because at the time there was insufficient protective gear for hospital workers, and some indeed died. 

       They gathered 99 samples of Ebola in all. Then they decoded the genome of each sample.  This was unprecedented in its speed.   What they found was important.  The Ebola virus has only 7 genes (!) compared to the human genome, comprising more than 20,000 genes.  Like all viruses, Ebola penetrates the human cell and commandeers its DNA mechanism, to make more viruses rather than human DNA.  Ebola is fatal in 52 per cent of all cases.

      The Broad Institute researchers found that Ebola initially spread from an animal to a human.  BUT —  from then on, it ONLY spread among humans.  The initial call to avoid mangos and meat was uncalled for.  And like all viruses, they found that the virus evolved and mutated very quickly in humans.  So, we are in a race, between ‘brilliant’ humans with huge brains, and ‘stupid’ viruses with only 7 genes ..and at the moment, the viruses seem to be winning. 

   I salute the courageous scientists and their assistants on-site, for risking their lives to help save the lives of others.  Sometimes, not often, science is life-threatening,  and quickly, life-saving. 

     In this space, I’ve been fiercely critical of Big Pharma, which rips us off by charging scandalously high prices for drugs with minimal impact.  But for once,  Big Pharma is doing the right thing.   GSK Glaxo Smith Kline is helping the U.S. National Institutes of Health to develop an Ebola vaccine.  Only GSK’s huge productive capacity can do this quickly enough to combat the spread of Ebola. 

Breakthrough:  Vaccine Against Cancer!

by Shlomo Maital

cancer vaccine

   Cancer immunology [use of the body’s own immune system to kill cancer cells] has been chosen as the “Breakthrough of the Year” by the editors of Science. A fascinating report was published in the December 20 issue. (This blog is longer than usual, because the topic is so important).

   For example: According to the U.S. National Institutes of Health: The photo shows an aspirin-sized disk, the first therapeutic cancer vaccine implanted beneath the skin. “We know it can eradicate melanoma in mice—the deadliest form of skin cancer—with impressive efficacy . Now, it’s being tested in human trials.”

One day, hopefully, chemotherapy may be replaced by immunotherapy. Instead of poisoning cancer (and our own body), we may be able to trick cancer cells, which are good at defeating the body’s own T-cell immune system, and enable our T-cells to kill cancer cells before they become tumors or even after.

What is the science here? According to the NIH, vaccines prevent illnesses, like smallpox, by introducing dead or weakened germs, to teach the body to create antibodies if it does appear. We already have vaccination against the human papilloma virus (HPV)—a powerful way to prevent cervical cancer. The new anti-cancer vaccines work differently. They’re given to patients who have already been diagnosed with cancer. Once given they “behave like traditional vaccines—by teaching the immune system how to seek out and destroy a target—in this case, a tumor. “

“ A couple of cancer vaccines have already been approved by the FDA. However, producing these vaccines is typically a cumbersome, time-consuming, and expensive process. First, immune cells are taken from a patient. The cells are modified and reprogramed in the lab, and then they are injected back into the patient. In the vaccines approved to date, this elaborate production line has extended patient life—but only slightly. And so, some researchers began to look for a simpler, and perhaps more effective, way to make therapeutic cancer vaccines. About four years ago, an NIH-funded, multidisciplinary team based in Boston and Cambridge came up with an approach that would modify and reprogram patients’ immune cells—inside the body, not in a lab!! The team first developed a porous polymer implant, made from the same material as biodegradable sutures and meshes. Then they infused the disk with a collection of three immune stimulants that recruit the immune cells, activate them, and imprint them with a chemical signature of the tumor that is targeted for destruction.

“The first of the three immune stimulants is a drug called leukine (also known as GM-CSF), which summons millions of dendritic cells, key immune cells, to enter the implant. The second is DNA that mimics viral and bacterial DNA and sends a danger signal that activates these cells. The third ingredient is the personalized part of the recipe: a combination of proteins made from the patients’ own tumor. It gives the dendritic cells the unique signature of that person’s tumor, which they share with the warrior T-cells. The “educated” T-cells are then primed to hunt and obliterate the tumor.”

The new approach is metaphorically like training cancer-killer cells to a) spot cancer, and b) kill it, by first teaching them to recognize the enemy and then, giving them ‘martial arts’ skills to destroy it.

Some of the most advanced work in the world on cancer immunology is done in my country, Israel. Prof. Leah Eisenbach, at the Weizmann Institute, Rehovot, has done breakthrough work. A company known as Compugen has developed antigens proven useful against cancer, and sold two of them for hundreds of millions of dollars to Bayer.

We know today that there are more than 120 different types of cancer. Each requires its own variant of chemotherapy. While survival rates have risen enormously, there has to be a better way than ‘tailored poison’. There is. Immunotherapy may point the way. If you know someone who has cancer, or whose loved ones have it, draw their attention to this new breakthrough. There is definitely hope, and the progress may be relatively rapid.

 

   

Blog entries written by Prof. Shlomo Maital

Shlomo Maital
October 2017
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