A potential game changer in the battle against flu

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Screen Shot 2015-07-22 at 2.49.38 PMIf you had to pick a hot button issue in medicine where nothing is simple, you would be hard-pressed to beat the topic of vaccination.

This is a function of a multitude of factors: fraud (the Andrew Wakefield debacle) and the ensuing panic over the made up connection between vaccines and autism, personal rights vs. public health (mandatory vaccination of children), and anti-vaccine zealots like Mike Adams and Robert F. Kennedy Jr.

In addition, although most vaccines that are recommended by the CDC are close to 100 percent effective, this cannot be said for the flu vaccine. In an average year, the vaccine is roughly 60 percent effective. At worst, especially this past season, the coverage was only 23 percent, which no doubt discouraged people from bothering to get it, even though 23 percent is still better than zero, and the downside is minimal. With such a poor match between the vaccine and the predominant circulating strains, it is not surprising that the CDC described the 2014 15 influenza season as moderately severe overall and especially severe in adults aged ¥65 years.

The mismatch between the vaccine and predominant circulating strains is no one s fault. Dr. Josh Bloom, the director of chemical and pharmaceutical sciences at the American Council on Science and Health says, There are inherent problems that are unique to the flu vaccine, most importantly the fact that the composition of the vaccine for the upcoming flu season must be determined six months in advance the time it takes for the vaccine to be manufactured. A lot can go wrong during this time interval, especially missing what turns out to be the predominant strain, or even picking it correctly, only to have it mutate so that the vaccine does not protect against the mutant virus. The blame lies with the virus, not the with the scientists who are charged with nearly impossible task of determining which flu strains will be most prevalent during the upcoming season.

All of this could change very dramatically because of a new technology that is based on virus-like particles (VLPs). VLPs are artificial constructs that contain only the shell of the virus, which produces the same (or similar) antigens that are present in the actual virus. But, unlike many other vaccines, VLPs do not contain any virus and therefore cannot be infectious (this is very rare even with traditional vaccines). Nor do they even require a sample of the virus. They are typically made in mammalian or plant cells using the DNA sequence of the actual virus.

VLPs are looking very promising in creating the holy grail of flu vaccines one that will cover multiple strains of flu, and won t need to be modified every flu season.

Scientists at the NIH s National Institute of Allergy and Infectious Diseases (NIAID) have come up with a cocktail of VLPs that provides extraordinary coverage against eight flu strains in mice. Ninety-five percent of mice that were subjected to a lethal challenge of these strains survived, while only five percent of the mice that received mock (inactive, control) vaccines lived.

Dr. Jeffery Taubenberger, the Chief of the Viral Pathogenesis and Evolution Section, Laboratory of Infectious Diseases at NIAID said, "What we have done is design a strategy where you don't have to think about matching the vaccine antigen to the virus at all...

The hypothesis was that the presentation of these different viral proteins would stimulate the development of cross-protective immunity that would provide broader protection against multiple subtypes ¦What that suggests is that this approach really gives us broad spectrum protection, and could serve as a basis for an effective pre-pandemic vaccine."

Dr. Bloom says, Rodent studies have different predictive value, depending on the disease that is being studied. For example, In the case of Alzheimer's and other neurological disorders, it is hit or miss at best. But in the case of infectious diseases, the results in mice or rats will very often translate into a similar result in humans. In a sense, you could view these results as comparable to those that would be seen in human clinical trials. I think that the NIAID may have hit the jackpot here. Time will tell, but this looks very promising.