There are new reports of an outbreak of Ebola virus disease in the Democratic Republic of Congo. This news comes just two years after international control efforts eventually contained an Ebola outbreak in West Africa, though before control was achieved, more than 11,000 people died—the largest known Ebola outbreak in human history . While considerable progress continues to be made in understanding the infection and preparing for new outbreaks, many questions remain about why some people die from Ebola and others survive.
Now, some answers are beginning to emerge thanks to a new detailed analysis of the immune responses of a unique Ebola survivor, a 34-year-old American health-care worker who was critically ill and cared for at the NIH Special Clinical Studies Unit in 2015 . The NIH-led team used the patient’s blood samples, which were drawn every day, to measure the number of viral particles and monitor how his immune system reacted over the course of his Ebola infection, from early symptoms through multiple organ failures and, ultimately, his recovery.
The researchers identified unexpectedly large shifts in immune responses that preceded observable improvements in the patient’s symptoms. The researchers say that, through further study and close monitoring of such shifts, health care workers may be able to develop more effective ways to care for Ebola patients.
Tags: adaptive immune system, Africa, blood, Congo, critical care, Ebola, Ebola epidemic, Ebola treatment, Ebola Virus Disease, global health, hemorrhagic fever, immunity, immunology, infectious disease, innate immunity, NIH Clinical Center, organ failure, pandemic, Sierra Leone, virology, West Africa
About a year ago, Tom Glover began sifting through a stack of applications from prospective students hoping to be admitted into the Master’s Degree Program in Human Genetics at the University of Michigan, Ann Arbor. Glover, the program’s director, got about halfway through the stack when he noticed applications from two physicians in West Africa: Charlotte Osafo from Ghana, and Yemi Raji from Nigeria. Both were kidney specialists in their 40s, and neither had formal training in genomics or molecular biology, which are normally requirements for entry into the program.
Glover’s first instinct was to disregard the applications. But he noticed the doctors were affiliated with the Human Heredity and Health in Africa (H3Africa) Initiative, which is co-supported by the Wellcome Trust and the National Institutes of Health Common Fund, and aims in part to build the expertise to carry out genomics research across the continent of Africa. (I am proud to have had a personal hand in the initial steps that led to the founding of H3Africa.) Glover held onto the two applications and, after much internal discussion, Osafo and Raji were admitted to the Master’s Program. But there were important stipulations: they had to arrive early to undergo “boot camp” in genomics and molecular biology and also extend their coursework over an extra term.
Tags: Africa, chronic kidney disease, genomics, global health, H3Africa, human genetics, Human Heredity and Health in Africa Initiative, kidneys, molecular biology, nephrology, research training, sub-Saharan Africa, West Africa
In the early 1960s, reports began to surface that some children living in remote villages in East Africa were suffering mysterious episodes of “head nodding.” The condition, now named nodding syndrome, is recognized as a rare and devastating form of epilepsy. There were hints that the syndrome might be caused by a parasitic worm called Onchocerca volvulus, which is transmitted through the bites of blackflies. But no one had been able to tie the parasitic infection directly to the nodding heads.
Now, NIH researchers and their international colleagues think they’ve found the missing link. The human immune system turns out to be a central player. After analyzing blood and cerebrospinal fluid of kids with nodding syndrome, they detected a particular antibody at unusually high levels . Further studies suggest the immune system ramps up production of that antibody to fight off the parasite. The trouble is those antibodies also react against a protein in healthy brain tissue, apparently leading to progressive cognitive dysfunction, neurological deterioration, head nodding, and potentially life-threatening seizures.
The findings, published in Science Translational Medicine, have important implications for the treatment and prevention of not only nodding syndrome, but perhaps other autoimmune-related forms of epilepsy. As people in the United States and around the globe today observe the 10th anniversary of international Rare Disease Day, this work provides yet another example of how rare disease research can shed light on more common diseases and fundamental aspects of human biology.
Tags: Africa, antibody, autoimmune disease, autoimmunity, childhood infectious diseases, cognitive dysfunction, epilepsy, global health, immunity, infectious disease, ivermectin, leiomodin-1, neglected tropical diseases, neurons, Nodding Syndrome, Onchocerca volvulus, Onchocerciasis, parasite, parasitic worm, rare disease, Rare Disease Day, River Blindness, seizures, South Sudan, Tanzania, Uganda, worm
When I volunteered several years ago as a physician in a small hospital in West Africa, one of the most frustrating and frightening diseases I saw was sleeping sickness. Now, an investigator supported by the NIH Common Fund aims to figure out how this disease pathogen manages to evade the human immune system.
Monica Mugnier’s fascination with parasites started in college when she picked up the book Parasite Rex, a riveting, firsthand account of how “sneaky” parasites can be. The next year, while studying abroad in England, Mugnier met a researcher who had studied one of the most devious of parasites—a protozoan, spread by blood-sucking tsetse flies, that causes sleeping sickness in humans and livestock across sub-Saharan Africa.
Tags: 2016 NIH Director’s Early Independence Award, Africa, African trypanosomiasis, antigenic variation, CRISPR/Cas9, fat, gene editing, genomics, glycoprotein, immunology, neglected tropical diseases, parasite, protozoan, skin, sleeping sickness, sub-Saharan Africa, T. brucei, Trypanosoma brucei, tsetse fly, variant surface glycoprotein, VSG
Happy New Year! While everyone was busy getting ready for the holidays, the journal Science announced its annual compendium of scientific Breakthroughs of the Year. If you missed it, the winner for 2016 was the detection of gravitational waves—tiny ripples in the fabric of spacetime created by the collision of two black holes 1.3 billion years ago! It’s an incredible discovery, and one that Albert Einstein predicted a century ago.
Among the nine other advances that made the first cut for Breakthrough of the Year, several involved the biomedical sciences. As I’ve done in previous years (here and here), I’ll kick off this New Year by taking a quick look of some of the breakthroughs that directly involved NIH support:
Tags: 2016, Africa, aging, All of Us, astronaut, atherosclerosis, Breakthroughs of 2016, Breakthroughs of the Year, chronic kidney disease, custom-designed proteins, designer proteins, DNA analysis, DNA sequencing, embryos, evolution, genomic analysis, genomics, hemagglutinin, human development, human embyos, human evolution, human migration, International Space Station, kidney dysfunction, longevity, nanopore sequencing, osteoarthritis, Out of Africa, portable laboratories, precision medicine, Precision Medicine Initiative, proteins, pulmonary fibrosis, Science's Breakthroughs of the Year, senescent cells, senolytic drugs, Simons Genome Diversity Project, universal flu vaccine, Zika vaccine