From Brentwood Home Page

In the current issue of “Cell Host and Microbe,” Vanderbilt University Medical Center’s James Crowe, M.D., and his team report the first large panel of antibody treatments against the mosquito-borne chikungunya virus.

There have been almost 1.2 million cases of the disease in 44 countries or territories, including over 150 cases in the United States, which makes chikungunya one of the largest virus outbreaks in the world.

Mosquitoes can bite an already infected person and then spread the disease, which causes flu-like symptoms and then severe and chronic joint pain for years. There is no licensed vaccine to prevent it.

Crowe’s research takes blood from a previously infected person, and then tries to find the chikungunya antibody-secreting cells.

“Amazingly, even decades after an infection, people still have cells in their blood making antibodies for chikungunya,” Crowe said in a press release.

Once found, researchers process the cells to retrieve DNA and antibody genes. The team has isolated three dozen chikungunya antibodies so far.

The goal is to test one or more of the antibodies in human beings each year. Eventually, Vanderbilt will hand gene findings over to a drug company for mass manufacturing.

“It’s frustrating, because the outbreak is ongoing now,” Crowe said. “I wish we had the drug ready to test in humans now, but you need to be careful and prepare these materials correctly. It takes a long time to manufacture and test and prove that materials are safe for humans.”

He said that using antibodies and the body’s natural immune defense may be more effective as a synthetic drug.

“It’s not only a more natural way to make the drugs, it’s a more powerful way, because human beings make the most amazing antibodies,” he said. “Why didn’t we always do this? Because it’s not always easy to find the people, and the techniques didn’t exist in years past.”

The chikungunya virus was first identified in Africa 50 years ago. The disease had been mostly in Asia and occasionally southern Europe, until it hit the Caribbean this year.

“There are about 1 million people who travel to the Caribbean and back in the U.S. each year,” Crowe said. “If you go to Haiti on a mission trip, there’s a very high chance you’ll be infected with chikungunya if you are in an infected area.

“There are at least 30 organizations in Nashville that do development or mission work in Haiti, so while mosquitoes may only travel 50-100 feet their entire lives, there are a high number of people going back and forth between the U.S. and the Caribbean. We talk to groups who have a dozen people down there, and 10 come back infected.”

Crowe believes an outbreak could occur in the South. Two types of the Aedes mosquito, both of which are found in the southeastern U.S., pass the disease.

“We have mosquitoes over three-fourths of the country, so potentially, and definitely in the South, we could have just as brisk of an outbreak as they do in the Caribbean,” he said. “Public health experts argue we may not, because we love our air conditioning and we stay inside. But it’s a numbers game – are there enough people outside getting bitten at the same time? Once it starts it burns like wildfire. It’s very transmissible, very infectious.”

Crowe said eventually the drug could be given to infected people early, prior to the joint pain.

“This would be similar to what you do with flu drugs right now – you develop a fever for a day, you take the test, and take the drug a day or two after,” he said.

A vaccine with long-term protection could be more convenient and cost effective in the long run, but they take longer to produce.

“You’d have to have an injection of antibody every month if you lived in one of these endemic areas,” Crowe said. “But coming up with a vaccine that induces long-term protection will take longer to develop. We would definitely prefer a vaccine, but vaccine licensure historically has taken about 25 years.”

For more on this story go to: http://www.brentwoodhomepage.com/vanderbilt-researcher-publishes-study-of-chikungunya-virus-cms-21948#.Vb-C6ot-RId
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