Interferons as antivirals: translating basic research into clinical application
A selection of talks on Clinical Practice
Behavioral medicine: what it is and what it does
- Dr. Gina Touch Mercer
- University of Arizona College of Medicine - Phoenix, USA
The history and foundations of medical research ethics
- Prof. Dr. Christian Lenk
- Ulm University, Germany
I'm Eleanor Fish, a senior scientist at the Toronto General Research Institute University Health Network in Toronto, and a professor in the department of immunology at the University of Toronto. This presentation, as the title suggests, will describe how interferons are broad-spectrum antivirals, and hopefully provide some insights into how we can translate basic research findings into clinical application.
In the 20th century a major health concern surrounded bacterial infections. Fortunately, antibiotics allowed us to deal with those bacterial infections. Now, in the 21st century, I would argue that our major concern surrounds viruses.
If we consider HIV, currently there are anywhere between 35 and 42 million people living with AIDS around the globe. Notably (where I've taken this particular photograph) in Kenya, there are currently two million people suffering with AIDS and concomitantly about anywhere from 5 to 10 percent of them also infected with TB. Next, if we look at hepatitis (hepatitis B virus infection), two billion people are infected around the globe, and 350 million chronically each year. In terms of HCV (hepatitis C virus), we know there are about 170 million people infected, 3 to 4 million each year being newly infected. West Nile virus, as its name suggests, originated in the West Nile. Again, a virus infection which has now come to North America, and we are acutely aware of the neurological sequelae that accompany this virus infection, there are no current antiviral therapies for West Nile virus. With hepatitis C virus infection, we have interferon treatment currently, for hepatitis B virus there is a vaccine, with HIV, although we are looking for a vaccine there's not one available, and currently people who are chronically infected with HIV carry on thanks to the highly active antiretroviral therapies, HAART treatment. Lassa fever next, this is another virus infection (perhaps one that we're not familiar with in the western world) affecting 500,000 individuals per year alone in West Africa. There's no treatment for this particular virus infection other than supportive care. In the late 2000s (I think around about 2007) there was an enterovirus outbreak in China where thousands of children were infected, again there was no treatment just supportive care, and the only reason why this didn't hit the headlines was because of the earthquake in China. Dengue virus is another virus which is emerging as a serious global threat. There are approximately 50 million cases per year, and again, no treatment beyond supportive care. If we look at poliovirus, you might argue poliovirus has vaccines against it and yet it is endemic in 2011 in Afghanistan, in India, in Nigeria, in Pakistan and most recently in Sierra Leone. Again, there is no treatment for acute infection. Ebola virus is another virus infection which does not raise any alerts in the western world, but has 50 to 90 percent fatality rates in the African continent for those infected. If we look at influenza A virus, we're all becoming acutely aware of the potential for pandemics. This is because of the most recent one, I'll also draw your attention to smallpox virus in the bottom left-hand corner of this particular slide. Again, you might argue that this is not a concern because we've eradicated smallpox, and yet we know that there are stocks of smallpox virus that are not accounted for around the globe, so that those of us in our 50s and 60s who were vaccinated are no longer protected from smallpox virus infection, and there are generations of young people who have never been vaccinated and are completely vulnerable. Notably, smallpox is one of those viruses that is being weaponized, and again, there is no treatment for smallpox. Rift Valley fever virus, again perhaps not of concern in the western world, and yet a serious virus infection in Africa, specifically in Kenya. The point is with each of those viruses (which you may argue are not of concern to those of us in the 'first world'), the reality is that now with travel around the globe these viruses can emerge anywhere around the globe, and should be of concern to all of us.