Autism Spectrum Disorder: Progress Toward Earlier Diagnosis

Sleeping baby

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Research shows that the roots of autism spectrum disorder (ASD) generally start early—most likely in the womb. That’s one more reason, on top of a large number of epidemiological studies, why current claims about the role of vaccines in causing autism can’t be right. But how early is ASD detectable? It’s a critical question, since early intervention has been shown to help limit the effects of autism. The problem is there’s currently no reliable way to detect ASD until around 18–24 months, when the social deficits and repetitive behaviors associated with the condition begin to appear.

Several months ago, an NIH-funded team offered promising evidence that it may be possible to detect ASD in high-risk 1-year-olds by shifting attention from how kids act to how their brains have grown [1]. Now, new evidence from that same team suggests that neurological signs of ASD might be detectable even earlier.

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Snapshots of Life: Portrait of Zika Virus

Cross section of the Zika virus


Credit: David Goodsell, The Scripps Research Institute

This lively interplay of shape and color is an artistic rendering of the Zika virus preparing to enter a cell (blue) by binding to its protein receptors (green). The spherical structures (pink) represent two Zika viruses in a blood vessel filled with blood plasma cells (tan). The virus in the middle in cross section shows viral envelope proteins (red) studding the outer surface, with membrane proteins (pink) embedded in a fatty layer of lipids (light purples). In the innermost circle, you can see the viral genome (yellow) coiled around capsid proteins (orange).

This image was sketched and hand-painted with watercolors by David Goodsell, a researcher and illustrator at The Scripps Research Institute, La Jolla, CA. Goodsell put paint and science to paper as part of the “Molecule of the Month” series run by RCSB Protein Data Bank (PDB), which NIH co-supports with the National Science Foundation and the Department of Energy. The PDB, which contains structural data on thousands of proteins and small molecules, uses its “Molecule of the Month” series to help students visualize a molecule or virus and to encourage their exploration of structural biology and its applications to medicine.

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Resurgence of Measles, Pertussis Fueled by Vaccine Refusals

Baby getting a vaccine

Credit: Centers for Disease Control and Prevention

I was born in 1950 and was home-schooled until the 6th grade. Thus, I missed exposure to several childhood illnesses that affected most of my generation. I never gave it much thought until, as a medical resident in North Carolina in 1979, I came down with a potentially life-threatening febrile illness that required hospitalization. Only after four days of 105 degree fever did a rash appear, and the diagnosis was made: measles. That was the sickest I have ever been. It turned out that one of my daughter’s school friends had developed measles in a small outbreak of unvaccinated kids in Chapel Hill, and I had been exposed to her. I was born too early to have been vaccinated.

But for most people born in the United States after the 1960s, they have never had to experience the high fever and rash of the measles or the coughing fits of pertussis, commonly known as whooping cough. That’s because these extremely contagious and potentially life-threatening diseases have been controlled with the use of highly effective vaccines and strong vaccination programs. And yet, the number of Americans sickened with measles and pertussis each year has recently crept back up.

Now, an NIH-funded report confirms that many of the recent outbreaks of these vaccine-preventable diseases have been fueled by refusal by some parents to have their children vaccinated [1]. The findings, published recently in JAMA, come as an important reminder that successful eradication of infectious diseases depends not only on the availability of safe and effective vaccines, but also on effective communication about the vaccines and the diseases they prevent.

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Vaccine Research: New Tactics for Tackling HIV

HIV-infected Immune Cell

Caption: Scanning electron micrograph of an HIV-infected immune cell.
Credit: National Institute of Allergy and Infectious Diseases, NIH

For many of the viruses that make people sick—think measles, smallpox, or polio—vaccines that deliver weakened or killed virus encourage the immune system to produce antibodies that afford near complete protection in the event of an exposure. But that simple and straightforward approach doesn’t work in the case of human immunodeficiency virus (HIV), the virus that causes AIDS. In part, that’s because our immune system is poorly equipped to recognize HIV and mount an attack against the infection. To make matters worse, HIV has a habit of quickly mutating as it multiplies.That means, in order for an HIV vaccine to be effective, it must induce antibodies capable of fighting against a wide range of HIV strains. For all these reasons, the three decades of effort to develop an HIV vaccine have turned out to be enormously challenging and frustrating.

But now I’m pleased to report that NIH-funded scientists have taken some encouraging strides down this path. In two papers published in Science [1, 2] and one in Cell [3], researchers presented results of animal studies that support what most vaccine experts have come to suspect: the immune system is in fact capable of producing the kind of antibodies that should be protective against HIV, but it takes more than one step to get there. In effect, a successful vaccine strategy has to “take the immune system to school,” and it requires more than one lesson to pass the final exam. Specifically, what’s needed seems to be a series of shots—each consisting of a different engineered protein designed to push the immune system, step by step, toward the production of protective antibodies that will work against virtually all HIV strains.

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NIH Ebola Update: Working Toward Treatments and Vaccines

Ebola virus and development of therapeutics

Credit: National Institutes of Health

Updated Oct. 22, 2014: The National Institutes of Health (NIH) today announced the start of human clinical trials of a second Ebola vaccine candidate at the NIH Clinical Center in Bethesda, MD. In this early phase trial, researchers from NIH’s National Institute of Allergy and Infectious Diseases (NIAID) are evaluating the vaccine, called VSV-ZEBOV, for its safety and ability to generate an immune response in healthy adults who receive two intramuscular doses, called a prime-boost strategy.

The Walter Reed Army Institute of Research is simultaneously testing the vaccine candidate as a single dose at its Clinical Trials Center in Silver Spring, MD. VSV-ZEBOV, which was developed by researchers at the Public Health Agency of Canada’s National Microbiology Laboratory, has been licensed to NewLink Genetics Corp. through its wholly owned subsidiary BioProtection Systems, both based in Ames, Iowa.

Early human testing of another Ebola vaccine candidate, co-developed by NIAID and GlaxoSmithKline, began in early September at the NIH Clinical Center. Initial data on that vaccine’s safety and ability to generate an immune response are expected by the end of 2014.

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We are all alarmed by the scope and scale of the human tragedy occurring in West African nations affected by the Ebola virus disease epidemic. While the cornerstones of the Ebola response remain prompt diagnosis and isolation of patients, tracing of contacts, and proper protective equipment for healthcare workers, the National Institutes of Health (NIH), led by its National Institute of Allergy and Infectious Diseases (NIAID), is spearheading efforts to develop treatments and a vaccine for Ebola as quickly as possible.

For example, NIAID has supported and collaborated with Mapp Biopharmaceutical, Inc., San Diego, in its development of the product known as ZMapp, which has been administered experimentally to several Ebola-infected patients. While it is not possible at this time to determine whether ZMapp benefited these patients, NIAID is supporting a broader effort to advance development and clinical testing of ZMapp to determine if it is safe and effective. In addition, the U.S. Biodefense Advanced Research and Development Agency (BARDA) has announced plans to optimize and accelerate the manufacturing of ZMapp, which is in limited supply, to enable clinical safety testing to proceed as soon as possible.

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