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BRIAN
DEER: THE VAXGEN EXPERIMENT Page 3
When
Francis returns from his trips to Bangkok, it's
to Brisbane, a community on the San Francisco
peninsula, midway between the city and its
airport. His home and workplace both looks
eastward across the bay: towards Oakland and,
beyond that, America. His home is on a hill and
lined with Chinese paintings. His office is by
the shore, in black glass.
He
huddles weekly with his senior colleagues:
VaxGen's vice-president, Dr Phillip Berman, and
its chairman, Dr Robert Nowinski. Berman, aged
49, is a molecular biologist. He's heavy set with
curly hair and has laboured on the science for 15
years. Nowinski, 52, is bald and wears glasses.
He's a biotechnology entrepreneur from Seattle.
His main claim to fame is having founded and sold
a company, ICOS, which boasts Microsoft's Bill
Gates as an owner.
The
key document at many of their sessions is a
"special issue" of a prestigious
journal, called Aids Research and Human
Retroviruses. It's dated last October. Twenty
papers are inside and they're a rave for VaxGen's
ideas. Dr Seth Berkley, the International Aids
Vaccine Initiative's president, declares that
politics and economics are bigger obstacles to
progress than "a scientific barrier".
Dr Mary Lou Clements-Mann, a researcher for a
rival company's vaccine (and who died in a
Swissair plane crash off Nova Scotia last year),
shrugs off pessimistic
"misperceptions". Dr William Heyward,
the CDC's Aids vaccine chief, argues that
"only through such trials" as the
Bangkok project "will further knowledge be
gained".
When
visitors drop by, Berman outlines his own paper.
It sets out how AidsVax is meant to work.
"Many lines of evidence suggest that a
strong antibody response to the HIV-1 envelope
glycoprotein," he explains, "will be an
essential feature of any Aids vaccine."
Berman sketches what this means on a board in the
conference room, across the corridor from
Francis's office. The billions spent on Aids have
produced unparalleled insights on HIV, which are
the platform on which he builds. The virus
infects. The immune system checks it with, among
other things, specially-tailored antibodies. But
the virus mutates around these adversaries. So
the immune system tailors new defences. The virus
then mutates and immunity responds. It's like a
leapfrog competition. Eventually, the immune
system tires of all this leaping, packs up and
then it's Aids.
Of
all the different parts of HIV, the envelope
glycoprotein gp120 is the part that mutates the
most. This sits in blobs around the virus, like
loose balls of wool, on the tips of protruding
spikes. Berman zooms on the moment a blob meets a
cell, which is 1m times bigger than the virus.
Part of the blob's surface locks onto a receptor
(like a data-port where cells get information).
The blob then unravels and locks another of its
parts onto a second sort of receptor on the cell.
This cues the cell to pull the virus inside.
Infection is complete.
Here,
Berman argues, is where AidsVax helps: by
blocking this double-lock connection. Summoned in
advance, due to earlier vaccination, antibodies
stick to key parts of the blob and so stop it
from locking on the cell. If the virus is a
burglar, these antibodies are bullterriers,
waiting for a leg to appear through the window on
which to snap their jaws. Once they've got hold,
the virus is paralysed, to be disposed of by
other kinds of cell.
He
makes things sound simple. Visitors are
impressed. Investors wonder: why dither in
Bangkok? But the science expounded in the journal
issue doesn't convince many people who grasp the
detail. "It's a waste of time," Dr
Robert Gallo, America's pre-eminent
retrovirologist, told me. Prof Andrew McMichael,
Aids vaccine chief at Oxford's Institute of
Molecular Medicine, said: "I wouldn't have
the belief that this will work." And Dr
Jean-Paul Levy, head of France's vaccine
programme, spat: "It forgets one century of
science."
For
all the plausibility of the journal's special
issue, the most detailed analysis of VaxGen's
approach was published in February last year in
the Journal of Virology, an even more influential
publication. More than 500 people - mostly
American gay men - took part in preliminary tests
of gp120 in the mid-1990s but experts at seven of
America's leading research centres found that,
despite the shots, 16 vaccine recipients became
infected with HIV. That's more than 3% of those
getting vaccine, roughly the same percentage as
those on placebo.
Molecular
biologists were not surprised, although their
critique is extremely technical. What it boils
down to is that if HIV leapfrogs the immune
system - with all its astounding complexity - it
will easily do the same with antibodies induced
by an off-the-shelf manufactured product.
Inducing antibodies to one B strain, or two E
strains, or five, or fifty XYZ strains, is like
buying insurance against being hit by cars with
specified license plates.
VaxGen's
answer is to develop products from strains it
claims provide "cross-protection"
against others. In Bangkok, for instance, the
vaccine is AidsVax B/E, including gp120 clones
from one B and one E strain. The B strain was
isolated from a six-year-old New Jersey boy in
1984, while the E strain was collected from a
soldier in Chiang Mai about nine years ago. The
plan is to mix 'n' match vaccines in this way to
suit the subtypes in different parts of the
world. Berman zooms closer and claims that parts
of gp120 stay sufficiently constant between the
mutating strains to offer a point of attack. Like
all proteins, the blob is made from amino acid
molecules, which string together like beads in a
necklace to make the loose balls of wool. Each
bead is made from one of a possible 20 amino
acids. Letters are used to denote these acids: G
stands for glycine, for instance, R for arginine
and Q for glutamine.
Berman
says that the vaccine needs to copy the amino
acid sequence at a key point in this string. Near
to where gp120 locks onto the cell, there is a
loose loop of "wool" - not 100
millionth a cell's size - which biologists call
V3. Berman zooms again: to the tip of this loop,
a string of just six necklace beads. Here, he
argues, is a segment that remains more constant
than most and induces antibodies which will stick
and stop the double-lock connection with the
cell. All it needs is for the vaccine and the
virus to have the same acids at the tip of this
loop.
Using
this argument, Berman deduces that the early
tests of gp120 offer hope for the experiment
after all. Mostly, volunteers studied for the
Journal of Virology were injected with gp120
cloned from the New Jersey strain, in which the
necklace in the V3 loop's tip has the beads
GPGRAF (meaning: glycine, proline, glycine,
arginine, alanine, and phenylalanine). It's a
common configuration in North American strains.
But Berman argues that some of the volunteers who
became HIV-positive despite being vaccinated were
infected with strains in which the loop was
different: say, GPGRVL (ending with valine and
leucine instead). This, he suggests, was why the
gp120 didn't protect them. With the commoner
strains he believes it did.
At
VaxGen's offices, this bottom-line is dazzling.
The "special issue" paper quickens
pulses. But additional information reveals an
oddity, which Berman's presentation overlooks. At
the American government's Los Alamos National
Laboratory, in New Mexico, staff track amino acid
sequences for thousands of HIV strains. And when
I asked them to print their data from Thailand, a
startling contradiction emerged. The B component
in AidsVax B/E - the shots being given to the
junkies - has the New Jersey V3 loop tip
sequence. It goes: GPGRAF.
According
to Berman's argument, the local B strains would
need to have the same string of beads. But only
10% of Thai B strains have the New Jersey amino
acid sequence. Far more often - in nearly half
the strains - there are two different beads in
the loop's tip: glutamine (Q) and tryptophan (W).
They are GPGQAW. By Berman's own reasoning, the
Bangkok junkies are being injected with the wrong
vaccine.
*****
This
report is copyright, Brian Deer. Responses,
information and other feedback concerning this
resource on VaxGen and AidsVax and the
"world's first Aids vaccine" are
appreciated - via the briandeer.com homepage.
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