World AIDS Day 2009 and the promise of an HIV vaccine

More than a year ago I had highlighted my husband, Sudhir Paul's research in developing a vaccine against HIV. The HIV / AIDS epidemic which in the west was confined almost exclusively within the male gay community and IV drug users in the early days, has now extended its lethal reach well into the heterosexual population. In fact in less developed nations, AIDS is now  mostly a disease of straight men and women.  Currently there is no viable vaccine against the Human Immunodeficiency Virus. 

Today marks the 21st anniversary of World AIDS Day, a reminder that the scourge of AIDS is still with us. On this occasion, Mary Carmichael, the editor of the Health / Life section of Newsweek has an interesting and provocative report about the promise and the challenges of Professor Paul's efforts in developing an effective vaccine against HIV. In the article, Carmichael also describes the role of CIF, a foundation launched by a group of young enthusiasts who wish to see the putative vaccine traverse the successful path from the test tube to a medicine vial.  

Please read the full article, enjoy the video and let me know what you think. (Another more technical article about the research in last summer's Washington  Post)

Last summer, while watching a news program about a possible AIDS vaccine, Zach Barnett had a "Eureka!" moment. The show was describing a Texas scientist's unorthodox approach to vaccine-making, a strategy that involved superantigens and covalent bonds and a lot of other words that weren't in Barnett's vocabulary. That didn't matter; the science turned him on anyway. "It was just so cool," he says. "I was like, 'lightbulb!' "

For years, Barnett, a fashion publicist, had been trying to get involved in AIDS activism, but mainstream organizations had told him there wasn't much for him to do, save passing out brochures. "That was a waste of my talent," he says. Here he saw a use for his skills. He wrote to the scientist, Dr. Sudhir Paul of the University of Texas, to tell him that "if what he was saying was true, he was doing a bad job of publicizing it." To show he was serious, he offered Paul $50 out of his own pocket to support the research.

In the past decade, private groups have started funding not just causes but specific researchers. The phenomenon may have started with autism—private organizations raise $78 million each year, or 35 percent of the country's funding, some of it for research that isn't completely in line with mainstream thinking—but it's seeping into other fields too, including AIDS research. It's tempting to write off Paul's supporters: what makes them think they know something the NIH doesn't? On the other hand, if they're right and Paul really does have a way to vaccinate against HIV, they're funding one of the most important projects in contemporary medicine. The question they have to ask themselves is whether they're wasting their money or shifting a paradigm.

The AIDS vaccine field could use a shift. For more than two decades, scientists have mounted campaigns to vaccinate against the virus, only to lose each one, watching as their vaccine candidates have failed (and, in one case, may have made people more susceptible to the disease). In September, researchers announced some of the most encouraging results in years, but even that success was quickly undercut by an argument over how the data were analyzed. "It's been so tough to solve this problem," says David Montefiori, director of the Laboratory for AIDS Vaccine Research and Development at Duke University. "That may be because a lot of the approaches have just been the same old, same old. People keep repeating the same tactics over and over again with minor variations."

At first glance, Paul's HIV vaccine looks familiar; it uses the "neutralizing antibody" strategy, which calls on the body's B cells to make proteins that fight the virus. This approach is how all existing vaccines for other diseases work, but it hasn't succeeded against HIV. The virus is too smart to fall victim to the human immune system. It hides many of the identifying proteins on its outer coat, cloaking them from the prying eyes of B cells, and thus no antibodies are made.

A few proteins on the outside of the HIV virus remain naked and exposed. They have to, in order to bind to human cells and kill them. Paul has his eye on one of these proteins, called gp120. According to his theory, it is a superantigen, a protein related to a fragment of a retrovirus that wormed its way into the human genome hundreds of thousands of years ago and stayed there.
 

 

Comments

[Dean C. Rowan]

What a remarkable achievement, Ruchira and Sudhir! This is exactly the kind of publicity it seems Barnett was recommending.

I guess I don't get the depiction of the NIH. Afraid to gamble? Too novel? What do risk and innovation have to do with scientific inquiry? (As I ask it, that becomes a rhetorical question.)

The video is a little unsettling, although it's nice to watch and listen to your husband. If "AIDS is now mostly a disease of straight men and women," then why is CIF milking the drag queen vibe?

[Ruchira]

Many among the CIF activists are gay Americans. Although the mode of transmission of HIV is largely through the heterosexual route in Asia and Africa, the rate of infection in the US is still 55% among gay men. The straight HIV patients here belong overwhelmingly to the lower socio-economic bracket. So the mindset among the older, wealthy Americans about AIDS has become "It is the disease of the poor and the homosexuals; we need not worry. Let's spend our money on cancer and Alzheimer's cure." (Sudhir is doing some very good work on Alzheimer's vaccine also but that is still in its early stages.)

That is perhaps the reason why CIF designed its fundraising appeal to resonate with the gay community which compared to the straight AIDS patients here, is far more educated and wealthy. But Zachary Barnett is fully aware of the other victims of HIV in the rest of the world. You can check out the Global Mission page of the CIF website.

Since you found the Newsweek video unsettling, I am embedding a different, more straightforward one in the post. It was designed in Sudhir's lab for the university website and over which Sudhir had more artistic control. This one explains the mechanism of how the vaccine is supposed to work.

[Sujatha]

Congrats, Ruchira and Sudhir!
You've hit the big time for sure, since Dr.Paul's research is the sole focus of the HIV article in the Newsweek online special. In light of the overall good article, I'm willing to forgive the bad headline of 'revolutionary—or it could be a waste of time and resources'- that is over the top, considering that all true scientific research can never be biased as to its outcome, or it wouldn't be scientific.
May the research continue, and soon!

[Dean C. Rowan]

I recall that longer, more informative video. I got to thinking it must have had its share of views at YouTube, so I viewed it there. Fewer than 1100! Isn't this the sort of object we'd expect to go...viral?