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Reported by Marilynn
Larkin | posted Mar 17, 2005
Smallpox, anthrax, dengue, plague, hantaviruses, and lassa fever, diseases
that many thought had been put to rest—or at least confined to discrete areas of
the world—are now emerging as potential threats. That includes the growing
threat of bioterrorism.
RCEs are one line of defense against bioterrorism and
emerging diseases.
In response, in 2003 the National
Institutes of Health (NIH) and the National Institute of
Allergy and Infectious Diseases (NIAID) earmarked $350 million for five
years to establish eight Regional Centers of Excellence (RCEs) for Biodefense
and Emerging Infectious Diseases Research. Their shared mission is to provide
the resources to defend against bioterrorism and emerging infectious
diseases—including vaccines, diagnostics, therapeutics, and trained personnel.
On December 6, 2004, the centers inaugurated the Trans-RCE Biodefense Seminars, a series of lectures using video—and web-conferencing technologies. The 2004-2005 program was seen at more than 30 institutions throughout the United States, including the New York Academy of Sciences. Reports on each of the 13 lectures are now available on these web pages.
 A collective mission
According to Jennie L. Lovett, projects manager for the Midwest RCE (MRCE)
and series coordinator, each regional
center consists of a lead institution and affiliated institutions
located primarily in the same geographic region. Each RCE has developed its own
vision of how best to carry out the collective mission, Lovett explained.
Regions face different pathogens and require different
approaches.
For example, the Washington, Wyoming, Alaska, Montana, Idaho RCE (WWAMI)
focuses on bacterial pathogens, while other RCEs have broader interests in
select agents of viral or parasitic origin. The MRCE's identity is based on a
strong focus on smallpox and related pox viruses.
"There is logic in the different approaches, because not all pathogens are
represented in all regions," Lovett continued. Tularemia, for example, is not
found in all regions.
Because of the diversity of approaches, NIAID has a strong interest in
supporting Trans-RCE projects. They offer opportunities for the various RCEs to
showcase their talents, while providing resources that all centers can use.
A focus on major pathogens
Until now, most Trans-RCE projects focused on providing core facilities, such
as the Small Molecule Screening Core run by the New England RCE (NERCE). By
contrast, the Trans-RCE lecture series aims to present information on major
pathogens that would benefit clinical and basic research professionals—including
graduate students, and laboratory and hospital staff—at all participating
institutions.
The series was presented through videoconferencing technology at the eight leading institutions and about two dozen associated institutions. Detailed reports, most with full audio, are now available as part of this Academy eBriefing to anyone interested in viewing them, regardless of whether the individual is a member of an RCE.
"Given that well-known researchers are experts on particular pathogens, we
reasoned that, rather than having them take the time to travel around to give
the same talk to multiple institutions, we could invite them to give a single
talk to a larger audience," said Lovett. "NIAID funded our proposal primarily
because it truly has a wide reach."
Clinical and research perspectives
Topics include clinical and research perspectives on critical diseases. A key
goal is to provide context for evaluating some of the current problems in
thinking about vaccinology, such as when vaccines are best used and whether
current vaccines need to improved or if vaccines for selected agents are needed.
Reports on the following lectures are now available:
Gregory A. Poland of the Mayo Clinic gave an introduction to the threat
of bioterrorism. He made the point that the threat is real and growing. Using smallpox and anthrax—the "poster children" of bioterrorism—as examples, he emphasized that in addition to their physiological effects, these agents can induce panic and devastating psychological effects, as was seen after the anthrax letter attacks in the United States.
Donald A. Henderson of the
University of Pittsburgh Medical Center offered clinical perspectives on
smallpox. Where once health authorities considered smallpox eradicated, he
explained, it is now a real and present threat as a bioterrorist agent.
R. Mark Buller of the Saint Louis University School of Medicine in St. Louis provided a succinct look at our current knowledge of how smallpox is spread, the course of the disease, and vaccines and treatments in development. He noted that the virus' potential use as bioweapon has revitalized interest in smallpox research, and has spurred the development of a number of vaccines and antivirals to combat the disease.
Mary E. Wright of NIH/NIAID offered insights into the clinical course of anthrax. She emphasized that new clinical tools, including imaging, PCR, immunofluorescence, and other techniques, are now available to aid in diagnosis. Several novel vaccines to treat the disease are in various stages of testing.
Theresa Koehler of the University of Texas, Houston Medical School offered a fascinating view of current basic research on anthrax. She presented an overview of b. anthracis virulence factors and new models that are being used to study virulence gene expression and function, and their implications for disease detection, treatment, and prevention.
David W. Vaughn of the US Army Medical Research and Material Command offered a detailed overview of the clinical aspects of dengue disease. Noting that the incidence of dengue has “increased dramatically” since World War II, he focused on current knowledge of dengue diagnosis and treatment, as well as the status of vaccine development.
Alan L. Rothman of the University of Massachusetts Medical School gave a thought-provoking presentation on the current status of dengue virus research. He emphasized that researchers are making significant headway in understanding dengue virology, immunology, and pathogenesis, laying the groundwork for vaccine development.
Paul Mead of the Centers for Disease Control and Prevention in Fort Collins presented a comprehensive view of the clinical effects and management of bubonic, septicemic, and pneumonic plague. He noted that much of the current interest in plague comes from its potential use as a biological weapon, and that pneumonic plague, which is highly lethal, would be the most likely form of plague following an intentional release.
Robert D. Perry of the University of Kentucky College of Medicine presented a comprehensive overview of the major areas of plague research. He then described in detail his laboratory's ongoing work on iron and heme acquisition systems and on biofilm formation and its role in bubonic plague transmission.
Joseph B. McCormick of the University of Texas Health Science Center at Houston provided a comprehensive and provocative view of Lassa fever infection, transmission, and the clinical sequelae of the disease, as well as insights into pathogenesis and treatment. He noted that although an effective vaccine now seems feasible, no company has yet expressed interest in developing it.
Maria S. Salvato of the University of Maryland Biotechnology Institute presented a fascinating look at the molecular structure of Lassa virus and our current knowledge of Lassa fever pathogenesis. She also gave an overview of studies by numerous groups involved in Lassa fever vaccine research.
C. J. Peters of the University of Texas Medical Branch presented a compelling picture of hantaviruses, which occur worldwide and are responsible for both hemorrhagic fever with renal syndrome and hantavirus pulmonary disease. He reviewed the clinical manifestations of hantavirus diseases as well as the viruses' bioweapon potential. With respect to prevention of naturally occurring disease, he emphasized, "rodent control is the only answer we have."
Erich R. Mackow of Stony Brook University presented compelling data to support connections between b3 integrin usage and hantavirus pathogenesis. He suggested that the locus of the interaction between the virus and the b3 integrin could serve as a target for future therapies.
"My hope is that the lectures will serve as a take-off point for subsequent
discussion by student groups," Lovett concluded. "It should provoke new
interactions among researchers and give credibility to distance-based learning
and conferencing technologies." |
