TRICK or TREATment 2021

TRICK or TREATment? Earlier this year, the US Food and Drug Administration (FDA) approved the first universal flu vaccine to protect against virtually all strains of seasonal and pandemic influenza, negating the need for annual flu shots.

 

If you received your flu shot this fall, then you should know that this one is a TRICK. However, scientists hope to one day develop such a solution and are achieving small scientific victories toward that goal. Every day, researchers are discovering new, creative ways to attack the structure of influenza viruses, and there are currently several vaccine candidates that are in or soon entering clinical trials. While many experts, including Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, believe a truly “universal” flu vaccine—one that protects against all strains of flu and confers lifetime immunity—may prove elusive, the hope is to develop a vaccine that is highly effective against strains from both major influenza subgroups and that yields protection for several years.

TRICK or TREATment? To combat malnutrition, scientists have created a naturally bred variety of corn that is rich in vitamin A.

 

This one is as good as gold…or orange. Vitamin A corn—also known as orange corn for its distinct hue—was developed by HarvestPlus through biofortification, a natural process of improving the nutritional quality of food through plant breeding. Starchy staple crops like white corn are a major source of food in poor regions, but these crops often lack the micronutrients people need for good health. In developing countries, 25 percent of children under the age of five suffer from vitamin A deficiency, which increases their risk of blindness, measles, pneumonia, and diarrhea. Supplements can be beneficial but are often too expensive or unavailable in low-resource settings. Vitamin A corn is a sustainable approach that provides up to 25 percent of a child’s daily vitamin A intake, providing a healthy, well-nourished foundation for a child to survive and thrive.

TRICK or TREATment? To combat drug-resistant infections, scientists have enlisted germ-eating microbes that invade harmful bacteria and eat them from the inside out.

 

One could say it’s a bacteria-eat-bacteria world out there, but the science still has a long way to go on this one. Early studies have found that so-called “predatory” bacteria can be harnessed to attack resistant germs. In lab studies funded by the Defense Advanced Research Projects Agency, an organism called Bdellovibrio preyed upon 145 of the 168 human pathogens tested by invading larger bacteria, latching on tight, and eating them from the inside out. Researchers collected remaining “survivor” bacteria, allowing them to reproduce to see if they were able to mutate and resist attacks from Bdellovibrio; however, no direct mutants ever became resistant. Pathogens beware when Bdellovibrio is around!

TRICK or TREATment? Adding to the growing arsenal of COVID-19 diagnostic options, the FDA recently authorized a test that deploys an “electronic nose” to sniff out whether someone is positive or negative for COVID-19.

 

There are a growing number of approved options for COVID-19 diagnostic tests—including at-home smartphone-based nasal swab tests and over-the-counter options—but “electronic nose” tests are not yet among them.

 

The electronic detection of infectious diseases with a “nose” is a long-standing concept that research labs have attempted to adapt for use against COVID-19 over the past year. The technique relies on the characterization and detection of metabolites by devices that can identify the “smell” produced by the metabolic processes of infections. However, COVID-19 has proven difficult to detect, and this method has not been fully developed, let alone authorized.

TRICK or TREATment? An exciting new HIV prevention product—a vaginal ring, similar in look and feel to a contraceptive ring, that can be inserted monthly and reduce a woman’s risk of HIV infection—was approved this year for use in its first country.

 

After receiving a positive scientific opinion from the European Medicines Agency (EMA) and a recommendation by the World Health Organization (WHO) over the past year, the dapivirine microbicide vaginal ring—a discreet, self-initiated, long-acting tool to reduce a women’s risk of HIV infection—received its first country approval in July when it was greenlit by Zimbabwe’s medicines control authority. Women insert and replace the flexible ring each month as the ring slowly releases an antiretroviral drug called dapivirine. In large-scale clinical trials, the dapivirine ring was found to reduce a women’s HIV risk. The ring’s developer, the International Partnership for Microbicides, is continuing to pursue regulatory approval of the device in several additional African nations with the hopes of making the ring more broadly available.

TRICK or TREATment? Administering the measles-rubella vaccine to children worldwide recently became a lot easier and pain-free with the use of microneedle patches—small Band Aid-like stickers with an array of small dissolvable needles that deliver a vaccine into skin without the pain of an injection.

 

In the future, getting a vaccine or taking your medicine could be as easy as putting on a Band-Aid. While there is no such product on the market today, researchers are currently evaluating the use of microneedle patches, or microarray patches, for administering vaccines and drugs against a number of infectious diseases. Micron Biomedical has begun trialing a microneedle-based measles-rubella vaccine in Gambia, with the hope that the technology will be a key component of measles and rubella control efforts in sub-Saharan Africa and elsewhere, given its ease of delivery, reduced cold-chain requirements, and absence of sharps waste. Microneedle patches would also reduce pain and minimize the amount of vaccine needed to confer immunity. In the context of a pandemic, these patches could even enable self-administration of vaccines, given they would not require advanced medical training or expertise to apply.

TRICK or TREATment? Adults traveling to a tuberculosis (TB) endemic country need not worry, as they can head to their doctor or local clinic to receive a vaccine to protect them against this deadly disease.

 

Unfortunately, this is not the case. While there is a TB vaccine on the market today, the Bacille Calmette-Guerin (BCG) vaccine, there are significant limitations to its effectiveness and use. The BCG vaccine is largely effective at protecting infants and young children from the most serious forms of TB, but has little effect in preventing pulmonary TB, the most common form in adults. TB is currently the world’s leading infectious disease killer. New vaccines are urgently needed to bring this epidemic under control. While it could be several years until a new vaccine is available, there is reason for hope. Fifteen years ago, there was only one vaccine candidate in the clinical pipeline. Now, there are several.

TRICK or TREATment? While patients suffering from sleeping sickness used to have to rely on lengthy, infusion-based treatments, there now exists an all-oral treatment.

 

Approved by the FDA this summer, fexinidazole is the first all-oral treatment for sleeping sickness. It cures both stages of the disease in just ten days. About 65 million people in sub-Saharan Africa are at risk of sleeping sickness, a neurological disease which is almost always fatal if left untreated. Fexinidazole—developed by a partnership between the Drugs for Neglected Diseases initiative, Sanofi, and national sleeping sickness programs of the Democratic Republic of Congo and Central African Republic—replaces previous treatments that required two weeks of intravenous injections at a hospital.

TRICK or TREATment? Earlier this month, WHO endorsed the world’s first malaria vaccine.

 

Talk about a new TREAT: the WHO endorsement of a new malaria vaccine, for use among children in regions with moderate to high disease transmission, is a groundbreaking development, as the quest for a malaria vaccine has been underway for a hundred years. The vaccine, known as RTS,S or Mosquirix, is not only a first for malaria—it is also the first for any parasitic disease, which are much more complex than viruses or bacteria. With more than 260,000 African children under the age of five dying from malaria annually, the vaccine is an important new tool to combat this deadly disease. Used alongside other interventions, this long-awaited vaccine, which was developed by GSK and PATH with funding from the US government and Bill & Melinda Gates Foundation, has potential to contribute substantially to malaria control interventions and save tens of thousands of young lives.

TRICK or TREATment? Palatable, fruit-flavored, child-friendly treatments for TB are now on the market to aid the 1 million children worldwide who develop active TB each year.

 

Until recently, children diagnosed with TB had to rely on six months of foul-tasting, improperly formulated adult medicines to fight off the disease. This all changed with the introduction of child-friendly, fixed-dose combinations of first-line TB treatments. Developed by TB Alliance, these medicines are dissolvable in water, fruit-flavored to be palatable to children, and come in WHO-recommended doses. Since these medicines were first launched in 2016, more than 116 countries have ordered over 1 million treatment courses. These countries represent 75 percent of the estimated childhood TB burden globally.