News (Updated September 25, 2011)

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Gene therapy shows promise in reducing HIV

Sep 19 2011

By Deena Beasley

(Reuters) - An early stage trial of Sangamo BioSciences Inc's HIV treatment found that the gene therapy reduced levels of the virus and even eliminated it in one patient with a naturally occurring gene mutation.

The very small Phase 1 trial tested the SB-728-T gene therapy, which is designed to disrupt the CCR5 gene used by HIV to infect cells of the immune system.

If shown to be safe and effective, the treatment could end the need for the antiretroviral drugs now used to keep the virus that causes AIDS in check by suppressing viral replication in the blood.

Trial results presented in Chicago on Sunday at the Interscience Conference on Antimicrobial Agents and Chemotherapy show a "statistically significant relationship between estimated modification of both copies of the CCR5 gene and viral load," said Dr. Carl June, trial investigator and director of translational research at the University of Pennsylvania 's cancer research institute.

In a statement, June said the results suggest the need to increase the frequency of the modified cells in HIV-infected patients, which could lead to a "functional cure" for AIDS, but the means of achieving this have not been clarified.

Sangamo said earlier this year that a single infusion of the treatment improved immune system damage in nearly all of the subjects analyzed in the first trial of the therapy in humans.

The 10 patients in the trial were on antiretroviral therapy when the study began. After four weeks, six of them went on a "treatment interruption," during which they stopped taking antiviral medication for 12 weeks.

Viral load decreased in three of the six subjects, with one patient's viral load reduced to undetectable levels. That patient carried a naturally occurring mutation in one copy of his CCR5 gene.

Humans contain two copies of each gene, one from the father and one from the mother, which sometimes are referred to as the alleles of a gene.

"Since one copy of his gene was already disrupted naturally, twice as many of his cells were 'biallelically' modified," Sangamo Chief Executive Officer Edward Lanphier said in a telephone interview, meaning that both members of the CCR5 gene pair were knocked out.

He estimated that between 5 percent and 10 percent of HIV patients carry the genetic mutation.

Around 33 million people worldwide have the human immunodeficiency virus (HIV) that causes AIDS.

Lanphier said Sangamo will move ahead with a strategy to maximize the number of cells that can be "biallelically" modified by SB-728-T. Options include targeting only the small segment of patients with mutated CCR5 genes or using "strategies that boost the amount of engraftment of modified cells."

 

Gilead : Second trial of 4-drug AIDS pill meets goal

Sep 19 2011

(Reuters) - Gilead Sciences Inc's four-drug experimental HIV pill worked as well as a regimen containing protease inhibitor Reyataz in the second pivotal trial of the drug, the company said on Monday.

Although the trial succeeded, it did not show the experimental pill, called the Quad, was superior to the Reyataz regimen and Gilead shares fell less than a percentage point.

"Overall the data are good ... mostly in line with investor expectations," said Cowen and Co analyst Philip Nadeau.

"I think there might of been a little bit of expectation for statistical superiority, but only from a few outliers."

The trial found that 90 percent of patients taking the Gilead drug achieved target levels of HIV in the blood, or viral load, compared with 87 percent of patients on ritonavir-boosted Reyataz, which is sold by Bristol-Myers Squibb Co.

The four-drug pill -- which combines experimental integrase inhibitor elvitegravir and boosting agent cobicistat with Truvada, a pill consisting of Gilead's older HIV drugs Emtriva and Viread -- is seen as the biotechnology company's most important pipeline product.

Gilead said 5.1 percent of Reyataz patients dropped out of the trial, mainly due to elevated bilirubin levels, compared with a drop-out rate of 3.1 percent for patients treated with the Quad pill.

The company said it plans to file for U.S. regulatory approval of the Quad by the end of this year -- earlier than its previous estimate of a first-quarter 2012 filing.

Gilead Chief Operating Officer John Milligan, speaking on a conference call, said the company will request a "priority review" by the Food and Drug Administration, which could clear the way for an approval as early as mid-year 2012.

Gilead shares, which fell less than one percent to close at $40.05 on Nasdaq, were slightly lower at $39.81 after hours.

(Reporting by Deena Beasley in Los Angeles ; editing by Tim Dobbyn and Andre Grenon)

 

Scientists find way to "disarm" AIDS virus

Sep 20 2011

By Kate Kelland

LONDON (Reuters) - Scientists have found a way to prevent HIV from damaging the immune system and say their discovery may offer a new approach to developing a vaccine against AIDS.

Researchers from the United States and Europe working in laboratories on the human immunodeficiency virus (HIV) found it is unable to damage the immune system if cholesterol is removed from the virus's membrane.

"It's like an army that has lost its weapons but still has flags, so another army can recognize it and attack it," said Adriano Boasso of Imperial College London, who led the study.

The team now plans to investigate how to use this way of inactivating the virus and possibly develop it into a vaccine.

Usually when a person becomes infected with HIV, the body's innate immune response puts up an immediate defense. But some researchers believe HIV causes the innate immune system to overreact. This weakens the immune system's next line of defense, known as the adaptive immune response.

For this study -- published on Monday in the journal Blood -- Boasso's team removed cholesterol from the membrane around the virus and found that this stopped HIV from triggering the innate immune response. This in turn led to a stronger adaptive response, orchestrated by a type of immune cells called T cells.

AIDS kills around 1.8 million people a year worldwide. An estimated 2.6 million people caught HIV in 2009, and 33.3 million people are living with the virus.

Major producers of current HIV drugs include Gilead Bristol Myers Squibb, Merck, Pfizer and GlaxoSmithKline.

Scientists from companies, non-profits and governments around the world have been trying for many years to make a vaccine against HIV but have so far had only limited success.

A 2009 study in Thailand involving 16,000 volunteers showed for the first time that a vaccine could prevent HIV infection in a small number of people, but since the efficacy was only around 30 percent researchers were forced back to the drawing board.

An American team working on an experimental HIV vaccine said in May that it helped monkeys with a form of the AIDS virus control the infection for more than a year, suggesting it may lead to a vaccine for people.

HIV is spread in many ways -- during sex, on needles shared by drug users, in breast milk and in blood -- so there is no single easy way to prevent infection. The virus also mutates quickly and can hide from the immune system, and attacks the very cells sent to battle it.

"HIV is very sneaky," Boasso said in a statement. "It evades the host's defenses by triggering overblown responses that damage the immune system. It's like revving your car in first gear for too long -- eventually the engine blows out.

He said this may be why developing a vaccine has proven so tricky. "Most vaccines prime the adaptive response to recognize the invader, but it's hard for this to work if the virus triggers other mechanisms that weaken the adaptive response."

HIV takes its membrane from the cell that it infects, the researchers explained in their study. This membrane contains cholesterol, which helps keep it fluid and enables it to interact with particular types of cell.

Normally, a subset of immune cells called plasmacytoid dendritic cells (pDCs) recognize HIV quickly and react by producing signaling molecules called interferons. These signals activate various processes which are initially helpful, but which damage the immune system if switched on for too long.

Working with scientists Johns Hopkins University , the University of Milan and Innsbruck University , Boasso's team found that if cholesterol is removed from HIV's envelope, it can no longer activate pDCs. As a result, T cells, which orchestrate the adaptive response, can fight the virus more effectively.

 

 

Online gamers crack AIDS virus enzyme puzzle at University of Washington

ONLINE gamers have achieved a feat beyond the realm of Second Life or Dungeons and Dragons: they have deciphered the structure of an enzyme of an AIDS-like virus that had thwarted scientists for a decade.

The exploit was published yesterday in the journal, Nature Structural & Molecular Biology, where - exceptionally in scientific publishing - both gamers and researchers are honoured as co-authors.

Their target was a monomeric protease enzyme, a cutting agent in the complex molecular tailoring of retroviruses, a family that includes HIV.

Figuring out the structure of proteins is vital for understanding the causes of many diseases and developing drugs to block them.

But a microscope gives only a flat image of what to the outsider looks like a plate of one-dimensional scrunched-up spaghetti. Pharmacologists, though, need a 3-D picture that "unfolds" the molecule and rotates it in order to reveal potential targets for drugs.

This is where Foldit comes in.

Developed in 2008 by the University of Washington , it is a fun-for-purpose video game in which gamers, divided into competing groups, compete to unfold chains of amino acids - the building blocks of proteins - using a set of online tools.

To the astonishment of the scientists, the gamers produced an accurate model of the enzyme in just three weeks.

Cracking the enzyme "provides new insights for the design of antiretroviral drugs", says the study, referring to the lifeline medication against the human immunodeficiency virus (HIV).

It is believed to be the first time that gamers have resolved a long-standing scientific problem.

"We wanted to see if human intuition could succeed where automated methods had failed," Firas Khatib of the university's biochemistry lab said in a press release.

"The ingenuity of game players is a formidable force that, if properly directed, can be used to solve a wide range of scientific problems."

One of Foldit's creators, Seth Cooper, explained why gamers had succeeded where computers had failed.

"People have spatial reasoning skills, something computers are not yet good at," he said.

"Games provide a framework for bringing together the strengths of computers and humans. The results in this week's paper show that gaming, science and computation can be combined to make advances that were not possible before."



Edinburgh
and Cambridge scientists make virus discovery

22 September 2011

(BBC news) Scientists have gained new knowledge into how viruses such as flu and HIV jump between species.

The research, by Edinburgh and Cambridge universities, should help predict the appearance of new diseases.

The scientists wanted to understand how viruses such as bird flu infect distant species like humans.

They found they were better able to infect species closely related to their typical target species than species that were distantly related.

However, the research also suggested that when diseases make a big leap they may then spread easily in species closely related to the new victim, regardless of how closely related these are to the original target species.

Dr Ben Longdon, of Edinburgh University 's school of biological sciences, who led the study, said: "Emerging diseases such as Sars, HIV and some types of flu have all got into humans from other species.

"Understanding how diseases jump between different species is essential if we want to predict the appearance of new diseases in the future."

More susceptible

By infecting more than 50 species of flies with three different viruses, the researchers showed that species closely related to a virus's usual target species were more susceptible than distantly related flies.

They also showed that groups of flies that were closely related were similarly susceptible to the same viruses.

The study, funded by the Biotechnology and Biological Sciences Research Council, Natural Environment Research Council, the Wellcome Trust and the Royal Society, was published in the journal PLoS Pathogens.

 

Antibody HIV Therapy Has Mixed Results


By Michael Smith, North American Correspondent, MedPage Today
Published: September 23, 2011
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California , San Francisco

Action Points  


CHICAGO -- An antibody approach to HIV treatment was safe and well tolerated, but reduced viral loads in less than half of treatment-experienced patients, a researcher said here.

The compound, dubbed ibalizumab, is a humanized monoclonal antibody that binds to CD4-positive T cells and blocks the entry of HIV, according to Stanley Lewis, MD, of TaiMed Biologics USA of Irvine , Calif. , which is developing the drug.

It's the first monoclonal antibody to be tested as an HIV therapy, Lewis reported at the Interscience Conference on Anti-Microbial Agents and Chemotherapy.

Other so-called entry inhibitors have been developed and one – maraviroc (Selzentry) – is approved, but they have been aimed at the CCR5 co-receptor on CD4 cells and are not antibodies.

Ibalizumab, on the other hand, binds to part of the CD4 receptor itself, rather than CCR5 or CXCR4, the other co-receptor used by HIV to enter cells. Lewis said the exact mechanism of action is not yet clear, although ibalizumab does not stop HIV from attaching to target cells.

A previous study showed ibalizumab was better than placebo at suppressing the virus and this study was aimed at comparing safety, tolerability, and efficacy of two different doses of the compound -- 800 milligrams every two weeks or 2,000 milligrams every four weeks, delivered intravenously.

The primary endpoint was the proportion of patients with a plasma viral load of less than 50 copies of HIV RNA per milliliter after 24 weeks of treatment, Lewis said.

The researchers enrolled 113 patients, all of them with resistance to at least one drug in each of the three main HIV medication classes, and all with a plasma viral load of more than 1,000 copies of HIV RNA per milliliter.

"They were all failing their regimens," Lewis said.

After 24 weeks of treatment, Lewis reported:

The proportion of those meeting the primary endpoint was 44% for the 800-milligram dose and 28% for those getting the higher dose, although the difference was not statistically significant.

The median drop in viral load was 1.6 log for the low dose and 1.8 log for the high dose, again without statistical significance.

There were 15 serious adverse events, but investigators found they weren't related to the drug. No patient stopped therapy because of adverse events related to therapy and there were no clinically meaningful laboratory abnormalities.

The most common treatment-emergent side effects were rash, diarrhea, headache, and nausea – mostly mild or moderate -- with no significant difference between the doses.

Still, the drug may have difficulty finding a place in treatment, even if later clinical trials confirm these results, Jean-Michel Molina, MD, of University of Paris Diderot in Paris, a member of the conference program committee who also moderated the session at which the study was presented.

"I was surprised by the overall low response rate," Molina told MedPage Today. "Less than 50% achieving a viral load of below 50 is not a good response."

The compound, while apparently relatively well tolerated, still has some side effects, he said, and it must be delivered either intravenously or subcutaneously. At the same time, many newer drugs deliver much better responses, he added.

"So you wonder what's the real benefit of this drug (and) which patients might be able to use it," Molina said.

 

Could Engineered Fatty Particles Help Prevent AIDS?

BOSTON , Sept. 19, 2011 /PRNewswire via COMTEX/ -- Liposomes block HIV infection in early tests; could be a cost-effective preventive for developing countries

HIV vaccines are in their infancy, and effective microbicides to prevent sexual transmission of HIV still don't exist. Protection is especially needed for women, who make up nearly half of all global cases. Researchers at Children's Hospital Boston envision a new way for women to protect themselves before sex: an applicator filled with specially formulated fatty particles called liposomes.

In tests led by Daniel Kohane, M.D., Ph.D., director of the Laboratory for Biomaterials and Drug Delivery at Children's Hospital Boston, liposomes inhibited HIV infection in cell culture and appeared safe in female mice when injected intravaginally. The findings are reported in the November issue of the journal Biomaterials, published online September 19.

Liposomes are spherical particles with a double outer layer of lipids (fats) and hollow centers. They are relatively easy and cheap to engineer, and thus present a viable option for developing countries, where the cost of anti-HIV drugs bars access for most people.

Liposomes can be filled with drugs or other compounds, but in this case, Kohane and colleagues found, to their surprise, that the liposomes alone were effective in blocking infection.

"We had been planning do much more complex things, like putting ligands on the surface to increase binding to HIV," says Kohane. "It was a surprise that liposomes alone worked so well. Simplicity is always better - if liposomes work by themselves, we may not need anything else, and it would be cheaper and potentially much safer."

Kohane and colleagues hope to conduct further tests to better understand how the liposomes are blocking infection. They bind to HIV, perhaps interfering with the virus's ability to fuse with cell membranes, the first step in infection.

"The idea, simplistically, is that liposomes look like cell membranes," says Kohane, "so maybe we could use them as decoys to prevent HIV infection."

Kohane and colleagues formulated a range of liposomes using various naturally occurring and synthetic lipids and screened them systematically in cell cultures. Several formulations showed a good therapeutic profile, protecting the cells from HIV infection without being toxic. Especially effective were liposomes containing cardiolipin, a fat that was first found in animal hearts; performance was further improved by adding a synthetic phospholipid.

Tested in female mice, these formulations caused little or no inflammation, which can compromise the vaginal lining and increase the risk of HIV transmission. Imaging confirmed that the liposomes remained in place or left the body, but did not travel beyond the vagina.

"This research makes an important contribution towards creating a safe and effective form of HIV prevention for women," says Nikita Malavia, Ph.D., the study's first author, who worked in Kohane's lab and in the lab of Robert Langer, ScD, of MIT. "Women in areas such as sub-Saharan Africa often cannot control their male partners' use of condoms, making them three times more likely to be HIV-positive than men. This technology could enable women to take control in their own hands."

Though some intravaginal compounds are in the pipeline, none are available yet. The advantage of using liposomes is that they are inexpensive, easy to formulate into ointments or gels, and stable for long periods of time, making them a particularly good option in resource-poor settings.

Kohane hopes to get further funding to test liposome formulations in other animal models.

The study was funded by the Grand Challenges in Global Health initiative and the National Institutes of Health.

About Children's Hospital BostonChildren's Hospital Boston is home to the world's largest research enterprise based at a pediatric medical center, where its discoveries have benefited both children and adults since 1869. More than 1,100 scientists, including nine members of the National Academy of Sciences, 11 members of the Institute of Medicine and nine members of the Howard Hughes Medical Institute comprise Children's research community. Founded as a 20-bed hospital for children, Children's Hospital Boston today is a 396 bed comprehensive center for pediatric and adolescent health care grounded in the values of excellence in patient care and sensitivity to the complex needs and diversity of children and families. Children's also is the primary pediatric teaching affiliate of Harvard Medical School . For more information about research and clinical innovation at Children's, visit: http://vectorblog.org .

 

 


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