Malaria vaccine has potential to save millions

After more than 30 years of work, researchers have for the first time succeeded in creating a vaccine against malaria, a deadly disease that kills nearly 800,000 a year, most of them children.

The experimental vaccine, still in the testing phase, only protects about 50% of children who receive it, but even that could "potentially translate into tens of millions of cases of malaria in children averted annually," says Tsiri Agbenyega, the principal investigator for the vaccine trials at Agogo Presbyterian Hospital in Agogo, Ghana.

"This is remarkable when you consider there has never been a successful vaccine against a human parasite nor against malaria."

Malaria is one of the most devastating diseases on the planet. Half the world's population is at risk of malaria. There are about 225 million cases yearly and more than 780,000 deaths, according to the World Health Organization. In Africa, one in five children die from malaria, one every 30 seconds, WHO says.

The vaccine was tested on 15,460 children in two age groups, 6 to 12 weeks old and from 5 to 17 months of age in seven African countries.

It was given in three doses. In children 5 to 17 months, the vaccine was 50% protective against the Plasmodium falciparum malaria parasite, which is carried by mosquitoes. Results in children 6 to 12 weeks old will be released in 2012.

Researchers hope to improve the effectiveness of the vaccine over time, but even at 50% effectiveness it means that for every 1,500 children vaccinated, 750 won't get malaria, says Andrew Witty, the CEO of GlaxoSmithKline, one of the vaccine's developers. "This is a very meaningful start."

Not all vaccines are 100% effective, even in the United States, says William Schaffner, chair of the Department of Preventive Medicine at Vanderbilt University School of Medicine in Nashville.

For example, the meningitis vaccine given to teens "doesn't have the staying power we anticipated it would, so we have to give a booster." But they still prevent disease and will be "great stimulus for further work."

The vaccine may be available in Africa "perhaps as early as 2015," Witty says.

The project is a collaboration between GlaxoSmithKline, the PATH Malaria Vaccine Initiative and the Bill & Melinda Gates Foundation.

It is being funded in part by more than $200 million in grants from the Bill & Melinda Gates Foundation and $300 million from GlaxoSmithKline.

An exact cost for the series of three vaccination is not known, but GlaxoSmithKline will supply the vaccine at the lowest possible cost, Witty says: the cost of producing it plus 5%, which will go to researching other neglected diseases. "We have no intention of making a profit," he says.

The vaccine is being produced in Europe and will go through licensing there for production and use in Africa, says Mary Hamel of the Centers for Disease Control and Prevention. It will then need to undergo market authorization for each African country.

GlaxoSmithKline says its expects the initial production capacity to be about 30 million doses, enough for 10 million children a year. It hopes to scale up manufacturing capability in both Europe and later in Africa and perhaps India, to lower costs.

The vaccine will not be available in the United States because being developed in Europe there is no way for it to undergo the Food and Drug Administration's licensing process.

The vaccine is meant to be used alongside long-proven malaria protections such as insecticide-impregnated bed nets and indoor spraying, both of which have begun to lower malaria rates in Africa in the past decade.

When both are in place "we could expect hundreds of thousands of lives to be saved," CDC's Hamel says.

The way the vaccine was developed is exciting, says Seth Berkley, CEO of the Global Alliance for Vaccines and Immunisation. In the past, such work would be done either by a government or a large company.

In an indication of the weight of expectation around this vaccine, still known only as RTS,S , the results were announced at a malaria forum in Seattle called by Bill and Melinda Gates, with World Health Organisation director general, Margaret Chan, and the UK development secretary, Andrew Mitchell, present. They were published at the same time online by the New England Journal of Medicine.

Alzheimer’s: Experimental vaccine development

Researchers at UT Southwestern Medical Center have created an experimental vaccine against beta-amyloid, the small protein that forms plaques in the brain and is believed to contribute to the development of Alzheimer’s disease.

Compared with similar so-called DNA vaccines that the UT Southwestern researchers tested in an animal study, the new experimental vaccine stimulated more than 10 times as many antibodies that bind to and eliminate beta-amyloid. The results appeared in the journal Vaccine.

Future studies will focus on determining the safety of the vaccine and whether it protects mental function in animals, said Dr. Roger Rosenberg, director of the Alzheimer’s Disease Center at UT Southwestern and senior author of the study.

“The antibody is specific; it binds to plaque in the brain. It doesn’t bind to brain tissue that does not contain plaque,” Dr. Rosenberg said. “This approach shows promise in generating enough antibodies to be useful clinically in treating patients.”

A traditional vaccine – an injection of beta-amyloid protein itself into the arm – has been shown in other research to trigger an immune response, including the production of antibodies and other bodily defenses against beta-amyloid. However, the immune response to this type of vaccine sometimes caused significant brain swelling, so Dr. Rosenberg and his colleagues focused on developing a nontraditional DNA vaccine.

The DNA vaccine does not contain beta-amyloid itself but instead a piece of the beta-amyloid gene that codes for the protein. In the current study, the researchers coated tiny gold beads with the beta-amyloid DNA and injected them into the skin of the animals’ ears. Once in the body, the DNA stimulated an immune response, including antibodies to beta-amyloid.

The next step in the research is to test long-term safety in animals, Dr. Rosenberg said.

“After seven years developing this vaccine, we are hopeful it will not show any significant toxicity, and that we will be able to develop it for human use,” he said.

H1N1: Thailand Reports First Human-to-Pigs Transmission of Swine Flu

Thailand confirmed Thursday its first case of a pig infected with swine flu spread from humans, senior officials said.

Agriculture minister Thira Wongsamut said that one of 80 pigs in a sample group tested for the virus at Kasertsart University farm in the central province of Sara Buri had contracted A(H1N1) influenza.

"It was only in one sample that we found the A(H1N1)," Thira said.

The ministry has quarantined a five kilometre-radius around the farm, where university research is carried out, as a precautionary measure, he said, adding that new helth checks would be conducted at the farm every three days.

The ministry's permanent secretary Yukol Limlamthong said that none of the 132 workers at the university farm had contracted swine flu. He could not confirm if a research student had brought the virus in.

"We can not prove that, but the test results show the pigs contracted the virus from a human," Yukol said.

Thira said that eating pork did not pose a danger.

"The virus spread from human to pigs, as in several countries. We've had no case of it spreading from pigs to humans," he said.

Since the swine flu outbreak began in April, the ministry said it has tested more than 26,000 pigs for the virus.

It has confirmed 29,741 human cases of the flu and 190 of those were fatal.

The Thai government has a one-million dollar fund set aside to combat swine flu.

Cancer: A Shot in the Arm or a shot in the Dark?

In 1999, two researchers at the National Cancer Institute (NCI) received a long-awaited green light to launch separate studies on cancer care.

Six months apart, Dr. Douglas Schwartzentruber and Dr. Larry Kwak (what an unfortunate name for a doctor! Change it now, to Dr Cure-all) began enrolling patients/subjects to test an entirely novel weapon in the war on cancer, one which they hoped would bypass the toxic effects of chemotherapy and give patients a new edge in halting the spread of tumours.

Both had the blessings of Dr. Richard Klausner, then NCI director. But even Klausner, a well-respected researcher, had to be persuaded at first. "I came to the NCI being quite skeptical about it," he says of the new strategy.

Unfortunately, he wasn't the only one. What Schwartzentruber and Kwak were hoping to do was prove they could vaccinate a patient against cancer — educate a body to, in essence, recognise and round up tumour cells the same way it polices viruses and bacteria.

It certainly made good biological sense: the immune system is the body's built-in defense mechanism, after all, so why not turn it against one of the most persistent diseases?

One of the problems, is that a tumour is not exactly a pathogen. What it is, at its core, is a collection of aggressively growing cells that can't stop dividing. It is not entirely foreign, in the same way that a virus is; it does not infect healthy cells, as bacteria and viruses do.

Turning the immune system against cancer cells would involve turning the body's defense mechanisms against a part of itself. Designing a vaccine to do this entails creating the biological version of a stealth weapon encased in a smart bomb equipped with a guided missile.

All this was proving to be a bit too challenging. Hundreds of researchers in hundreds of trials had attempted to solve this and nothing had worked. While the vaccine idea made logical sense, the immune system, it seemed, just wasn't designed to battle cancer this way.

Eventually, in June this year, after nearly a decade of carefully inoculating patients suffering from either advanced melanoma or a type of lymphoma, both Schwartzentruber and Kwak announced positive outcomes of their trials, at the American Society of Clinical Oncology meeting in Orlando, Fla.

Their results, along with those of a trial vaccine against prostate cancer and an early candidate against a type of brain cancer, suggest that we might finally be on the way to unleashing the immune system against the disease.