Don't throw in the towel
The other day a friend of mine sent me this link to an somewhat somber article in the UK's Independent, which wondered if we should stop looking for an AIDS vaccine, following the failed Merck trial of a few months ago.
The article polled 35 British and American AIDS researchers and found that, in general, they were markedly less optimistic about the short-term prospects of finding an HIV vaccine than they were five years ago. The Independent published the results of their poll one month after a US government-sponsored summit on HIV vaccine research, about which our very own Roxanne Khamsi wrote in the new issue of Nature Medicine.
I don't know that one has to be so pessimistic. In fact, it seems that the meeting was very helpful in pointing to the limitations of the existing animal models as predictive of efficacy in humans, something that, sadly, is the rule rather than the exception when it comes down to creating models of human disease. In the context of the Merck trial, this past December we wrote this editorial, in which we indeed agreed that the field faces serious problems, but tried to conclude on an optimistic note pointing to the fact that the development of the polio, measles and hepatitis B vaccines took 47, 42 and 16 years, respectively.
Sure, the failed trial was a setback and one must take a hard look at the direction in which the AIDS vaccine field is going (in fact, very soon we'll publish a Perspective on this topic), but this is hardly enough of a reason to call it a day. Paraphrasing Mark Twain, I'd say that rumors of this field's death are being greatly exaggerated.
Bust of Mark Twain. (Image by wallyg)
Comments
I donot know...Thanks for good advice
Posted by: Nadi | December 23, 2008 12:57 AM
Don't throw in the towel is very useful advice but is it the right advice to the people who have failed to deliver a vaccine by subverting a search for a rational basis for the design of a vaccine against HIV based on immune correlates of protection. Instead a better advice is REVERSE TRANSLATION and going back to the basics to understand how the virus has evolved to be such a formidable and clever foe. This will require some real thinkers and a new breed of researchers and only when sufficient knowledge and understanding has been gained should translation be resumed and vaccine research can be expected to achieve success. A possible new direction would be in understanding viral intelligence. We normally look at a virus as an assembly of nucleic acids, proteins, lipids and carbohydrates capable of directing the host to provide the virus with the essentials for its replication. HIV has clearly shown that it goes far beyond this narrow scope of our characterization of its limits. We have failed to fully understand the biology of this nature's most skillful and intelligent lethal weapon of mass destruction (WMD). Scientists set off on a mission of producing a vaccine based on conventional warfare against viruses and used empirical methods that have contributed to the eradication of smallpox and the near eradication of polio from the planet. HIV happens to be very different from every other virus that we have overcome, its intelligence in terms of its interaction with its host, encoded in its genetic material has evolved to stay one step ahead of our immune system and as an ultimate parasite is endowed with an ability to exploit our immune system to the fullest, residing in the very cells that are supposed to clear viruses and protect us. After trying to translate the limited and general information that was available, researchers tried to develop a vaccine. We need to spend millions to eradicate the scourge of HIV that has currently infected a world population equivalent to the fifth of the population of US, but not in developing a vaccine but in just gaining an understanding of the sum total of expression of its own genes that cause specific up-regulation of numerous host genes to sustain viral persistence or what can be termed “viral intelligence”. Alternate strategies to curb spread of AIDS as suggested in the most recent (June 2008) editorial in Nature Medicine will certainly improve prospects for HIV prevention, if they can be realistically implemented. But in regions that will be the biggest beneficiaries, are also the regions where they would be difficult to implement but such strategies certainly have a key role in any multi-pronged strategy to control HIV.
Posted by: Girish Kotwal, Ph.D. | June 5, 2008 11:45 PM
Is it the argument between just giving up and forging on in research? Because there is absolutely no contest...
Posted by: Itamar | May 13, 2008 07:26 AM
All around the world is exaggerated physicians concern about the death caused by HIV, surely less large than cancer and CVD deaths. In addition, although scientific research is ruled by drugs industry, that try to influence also outstanding peer reviews, in my opinion, honest research in the field of HIV therapy, including HIV vaccine, has to continue more intense then before, as well as the research in ameliorating Primary Prevention of common human diseases, nowadays possible in rationalized individuals, involved by related biophysical-semeiotic constitutions and inherited real risks.
Posted by: Sergio Stagnaro MD | May 13, 2008 04:54 AM