Comparing with the coronavirus, HIV does not have one, but many “Spikes” and the infection is so fast that the immune system is unable to activate itself in time
We are still a long way from formulating a vaccine against the human immunodeficiency virus (HIV), which causes AIDS. However, it is also true that, in almost forty years, we have improved communication on contagion prevention and revolutionized the management of the disease. How much time separates us from the vaccine and what difficulties stand in the way of this goal? A legitimate question on the occasion of World AIDS Day, the first of December every year.
The mechanism of vaccines
On the timing it is absolutely unlikely to give any date, however, especially in the last five years, the researchers have identified the furbe virus strategies. A challenge, still completely open, to be won for the oThe over one and a half million people who contract the infection every year around the world. The procedure for making a vaccine normally involves distinguishing a component in the virus, which in biomedical jargon is called “antigen”, capable of naturally promoting the synthesis of antibodies by our organism. This component is isolated, rendered harmless and reproduced in the laboratory, formulating a product to be administered to the patient to evoke the response of the immune system, in case his organism comes into contact with that virus. It is not the only strategy for making vaccines, although the one most used.
Because it is complicated to make an HIV vaccine
However, we know that in the case of HIV, everything is more complicated. To explain it is Stefano Vella, former president of the Italian Medicines Agency (AIFA), former director of the Department of Drugs and the Center for Global Health, both at the Istituto Superiore di Sanità, in the top ten of the list, by the journal Science, among the ten leading researchers in the world for the quality of publications on AIDS and HIV. «Around the middle of the last decade we have finally identified the HIV antigens – explains the doctor – able to stimulate the production of neutralizing antibodies. They were well hidden in a “bag” on the surface of the virus: at that point the problem was purely of a chemical-pharmaceutical nature. That is to say, devising a method to synthesize these structures that would finally constitute the raw material of the actual vaccine ». Yet, it does not end there, because the obstacles that separate us from the vaccine goal are numerous: “We have realized that HIV does not have a single antigen – Vella points out – but more than one ». Our immune system, therefore, should be itrained to recognize all HIV antigens and no less, to produce as many antibodies: many “policemen” each equipped with different and specific weapons.
GP120 protein as the coronavirus Spike
‘HIV antigens are all found in GP120 protein, key element of the virus to enter CD4 lymphocytes and infect them ». Compared to vaccines against COVID-19, the GP120 protein is equivalent to the “Spike” protein, the SARS-CoV-2 tool essential for taking root in the cells of our body. It’s a pity that in the case of HIV we have not one but many and different «Spike“. And that’s not all: «The integration of HIV with our cells is extraordinarily fast: from the infection, within a few minutes, the virus has already invaded the CD4 lymphocytes. Too fast for our immune system to activate. ” The effective vaccine should therefore be the one capable of recognizing all HIV antigens, in the GP120 protein, and consequently inducing the synthesis of all antibodies in a very fast, perhaps impossible, way to prevent the virus from entering its target cells.
Forty years of AIDS
It has been almost forty years since, in 1982, Robert Gallo, director of the cancer cell biology laboratory of the National Cancer Institute of Bethesda in America, ascertained the viral origin of the AIDS epidemic and since, in 1983, Françoise Barré-Sinoussi, in force at the Pasteur Institute in Paris directed by Luc Montagnier, for the first time looked at the HIV virus under the microscope. In the meantime, the development of triple therapy, around the end of the nineties, managed to stop, at least in the rich world, the fatal course of those who contracted AIDS. Although, in fact, one cannot recover from this disease, with the available drugs it is possible to make the infection chronic, preventing the replication of the virus to the point of compromising the functionality of the immune system to the point of causing death to the organism.
The history of the epidemic
The epidemic, however, was and is a massacre: by the end of 2018, more than 35 million people worldwide had died from AIDS, while 37.9 million people lived with HIV. Of the infected individuals, 36.2 million (96%) were adults and 1.7 million (4%) were children. With great differences between regions and countries. According to the World Health Organization, Africa is the most severely affected region, with nearly 1 in 25 adults (4%) infected with HIV. Overall, the continent is home to approximately 66% of HIV-positive patients worldwide. AIDS, however, is not just a matter of science and numbers, but is part of our social history. In the early part of the 1980s AIDS was considered the “pestilence” of homosexuals and drug addicts (only because they were exposed to a greater risk), until the tenacity of patient associations demonstrated to civil society and politics that we are all involved . With time and the softening of the taboo, the outing of rock stars and more generally of celebrities from the world of entertainment, managers but also ordinary people, has most of the prejudices cleared through customs. As did the public events of the San Francisco homosexual community, contributing to proper health education and teaching prevention.
The push for research from below
A push from below that has given the turbo to scientific research. “Before these experiences – recalls Vella – there were hardly any patient associations: they were born with the AIDS epidemic, the first disease in history to have witnessed to the world the absence of inequalities, only imagined by a class society”. Then came the nineties: it was the time of the rallies during the US presidential elections between Bill Clinton and George Bush senior. In those months, during the numerous demonstrations in front of the White House, friends and relatives of people who died of AIDS scattered the ashes of their loved ones on the lawn of the most important tenant in the world. We are talking about extreme but decisive mobilizations, convincing to the point of shifting the budget to biomedical research on the economic agenda of the president of the United States. A real (perhaps unconscious) Big Science project, as they call it in the Anglo-Saxon world: investing large amounts in economic capital and large numbers in human capital for an invaluable return. Remember vaguely the (unfulfilled) promise to defeat cancer within a few years, by former US President Richard Nixon. But that was just propaganda. The effectiveness of the Big Science model is instead witnessed by some of the best-known cases of our recent history: from the moon landing (NASA has calculated that for every dollar spent on its space program, since the 1950s, three have returned) to development of the Large Hadron Collider particle accelerator, at the plant in Geneva. And again the Human genome project, which made it possible to create the first map of the human genetic heritage, consisting of about 30,000 genes. As well as the Brain Activity Map (BAM) Project, again launched by the US government in 2013, then renamed the White House BRAIN Initiative. A plan worth about three billion dollars, with an estimated duration of between 10 and 15 years, with the aim of getting to know better how the human brain works, in order to defeat some of the neurological and psychiatric diseases that are still incurable. All these objectives have had a very high cost, and the use of thousands of people, including scientists, technicians and administrators, but have had invaluable repercussions, in terms of patents and knowledge. Similarly to a Big Science project, the scientific machine against AIDS, thanks to investments in economic and human resources, has evolved and has become extremely sophisticated. Nobody can now calculate its impact on technological progress in ten or thirty years, and what it will teach us beyond the disease, just for serendipity. Let’s leave the timing alone and follow the method: it is not said, but not denied, that the turning point is around the corner.
November 29, 2021 (change November 29, 2021 | 19:25)
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