World Malaria Day Twitter ChatCommunications
Posted on Apr 27th, 2018
CIDR Hosted a Twitter Chat on World Malria Day, April 25th, 2018.
As the largest independent nonprofit organization dedicated to
infectious disease research, we have a lot to say about the state of
malaria in 2018 – but we wanted to know what YOU think. We answered your
questions and shared the latest research about malaria. Our chat was
hosted by CIDR scientists Dr. Brandon Sack, Dr. Maria
Bernabeu, and Dr. Erika Flannery, as well as Dr. Katharine Collins of
Radboud University Medical Center.
Dr. Brandon Sack, PhD, Research Assistant Professor (Top Left)
Brandon focuses on understanding how our immune system can best control the malaria parasite and how we can translate this into potent malaria vaccines.
Dr. Maria Bernabeau, PhD, Post-Doctoral Scientist (Top Right)
Maria is trying to understand why some individuals are able to survive malaria and why other individuals get severe disease and die. To answer this question, she is implementing systems biology approaches and developing new bioengineered models.
Dr. Katharine Collins, PhD, Post-Doctoral Fellow (Bottom Left)
Katharine’s research focus is to understand the factors that influence the transmission of malaria parasites from humans to mosquitoes, with the aim of using this information to design novel approaches that can stop transmission and accelerate malaria elimination.
Dr. Erika Flannery, PhD, Visiting Scientist (Bottom Right)
Erika studies malaria parasite biology, how it forms dormant stages that can emerge months to years after infection, and how we can develop new drugs and treatments to stop the parasite in its tracks.
To set the stage for the conversation, we provided provided a few facts on the state of malaria. Check them out before you dive into Twitter Chat discussion! See the full conversation in our Twitter Moment.
Q1: What do you see as the top challenges to achieving a malaria-free world?
Dr. Brandon Sack and Dr. Erika Flannery: One species of the parasite, Plasmodium vivax, because it becomes dormant in the liver and we cannot detect it. It is also extremely difficult to study in the lab or in humans, often requiring developing new tools to make even basic observations.
Dr. Maria Berabeu: The lack of funding. According to WHO, the current funding invested in malaria only represents 41% of what is needed to achieve malaria eradication. Some of the current tools are insufficient and we need to develop new ones.
Dr. Katharine Collins: A highly protective vaccine would be an extremely valuable tool for elimination efforts, but unfortunately the complexity of the parasite is making vaccine development very difficult. There are many challenges to eliminating malaria, the most significant at the moment are the malaria parasites becoming resistant to the available drugs, the mosquitoes becoming resistant to insecticides and difficulty of deploying the tools we have effectively.
Q2: Who are some of the organizations combating those major challenges to achieve a malaria-free world? What are they doing?
Dr. Maria Bernabeu: Medicines for Malaria Venture invests in new drugs. Gates Foundation invests in the development of new tools. US Government NIH funds basic research to understand malaria.
Dr. Katharine Collins: There are many fantastic organisations all over the world doing some excellent malaria research with a strong focus on developing new tools to help continue our progress reducing the global burden of malaria; these include developing new drugs to replace the ones that no longer work, improving how we diagnose infections so we can treat people more effectively, learning how to best deploy new drugs to have the biggest impact, and developing different types of malaria vaccines to either stop people getting infected or to stop them from passing on the parasites to mosquitoes and then to other people.
Q3: Dr. Brandon Sack: What questions can I answer for you about our research?
Shawna Stronum: How successful have the trials been?
Dr. Brandon Sack: Here at CIDR we're testing our Genetically Attenuated Parasite (GAP) vaccine. Our previous first-in-human trial showed it was safe & gave an impressive immune response after just a single dose. Right now we are 1/2 through our 2nd trial in which we will give.
Janna Armstrong: Have you been able to repeat that protection with same antibodies? And what stage of the parasite life cycle is it protecting against (liver, blood)?
Dr. Brandon Sack: Great question! These antibodies protect against the “sporozoite” form of the parasite which are injected by the mosquito. We’ve tested multiple antibodies in “humanized liver mice” & they all are very potent at preventing liver infection. Next: trials in humans.
Lander Foquet: Can you provide information on how to join a clinical trial? Safety? Who can join? Where in the world are these being done?
Dr. BrandonSack: Definitely! @CIDResearch @radboudumc @UniLeidenNews @wrair @QIMRBerghofer @UMMC @HopkinsMedicine @UniofOxford conduct these trials in lab settings. @sanaria_inc is also conducting field trials with collaborators across the world.
Q4: Can you share with us any updates on what you’ve learned in respect to why some individuals survive and others don’t?
Dr. Maria Bernabeu: Malaria parasites stick to the brain blood vessels, and in some patients cause brain swelling. Every two minutes a child under 5 years old dies from cerebral malaria. It is the deadliest complication. In our latest research we found that patients with brain swelling present an expansion of a certain population of parasites. These parasites stick to a human protein known as EPCR. A tool that targets the parasite-EPCR interaction could improve the outcome of these patients and save thousands. If you want to know more about our research, you can check on this CIDR blog post from Dr. Selasi Dankwa: ow.ly/2b9m30jF7GZ.
Q5: What does this mean for the future of stopping the spread of malaria?
Dr. Katharine Collins: Although the current tools such as bednets and antimalarial drugs have been very effective at reducing malaria burden, they are not perfect, and parasites are becoming resistant to the drugs and mosquitoes are becoming resistant to the insecticides. In order to stop the spread of malaria, as well as treating people when they are sick, we need to develop novel tools such as drugs and vaccines, to stop malaria being passed from an infected person to a mosquito and then on to another person. This is not a new area of research, it’s been going in for a long time, and there are lots of new candidate drugs and vaccines that could potentially be really effective but what we currently lack is a system where we can rapidly evaluate how effective these new candidates are in humans, and then select only the best interventions for testing in Africa. With the human model that we started developing it would only take a month or 2 to test a new drug or vaccine and would only require a small number of people and we could very quickly screen new candidates and only take the best ones forward for further evaluation in the field, drastically improving the pipeline for development
Q6: What questions do you have for Dr. Erika Flannery about malaria parasite biology?
Shawna Stronum: Never realized the
parasite was so complicated. Does it have life cycles involving a cocoon or ...?
Dr. Erika Flannery: The parasite has @ least 7 different forms it can take in different tissues in the 2 hosts it infects, mosquitoes & humans. There's much to learn about the biology of the parasite life cycle that can help us discover new drugs & vaccines to eradicate malaria.
Q7: What's the state of funding for malaria research?
Dr. Brandon Sack: While funding from non-profits like the Gates Foundation, Wellcome Trust, Medicines for Malaria Venture, and Malaria Vaccine Initiative are making a huge difference, malaria funding pales in comparison to its global burden. The current funding invested in malaria only represents 41% of what is needed to achieve malaria eradication. For comparison, malaria receives 20 times less funding from the NIH than cancer or HIV. More funding would help us fill in critical gaps in basic parasite biology and move promising candidate drugs and vaccines through expensive clinical trials. Such low funding with so many opportunities makes malaria a great place to invest through private donations or government funding.
Thanks to all of the Twitter chat participants and those who followed along with our World Malaria Day Twitter chat. If you would like to learn more about the work CIDR is doing with malaria, check out our various blog posts:
Dr. Maria Bernabeu's Interview Series- Part One: https://www.cidresearch.org/blog/inside-a-cerebral...
Dr. Maria Bernabeu's Interview Series- Part Two: https://www.cidresearch.org/blog/inside-a-cerebral...
Dr. Selasi Dankwa's Cerebral Malaria Blog: https://www.cidresearch.org/blog/fighting-cerebral...
Research Associate Heath Kain's Mosquito Blog: https://www.cidresearch.org/blog/oh-mosquitoes-jus...