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Therapeutic Areas

The Vaccine and Immunotherapy Center seeks to accelerate the efficient and effective early-stage development of new vaccines and immunotherapies for cancer, infectious diseases and immune-mediated diseases. Currently, VIC is conducting active research and development on candidates with application in six therapeutic areas.

Cholera

Candidates
  • OSP-Containing Conjugated Cholera Vaccine

Cholera is an acute diarrheal disease caused by a bacterium Vibrio cholerae, which infects the gut after ingestion. It is typically contracted by drinking contaminated water. Cholera has been responsible for numerous pandemics throughout history, including an ongoing pandemic that originated in the 1960s. On a global scale, it is likely that 3-5 million people a year are infected and, of these, 100,000 to 120,000 die, with the majority being infants and young children or the elderly. Cholera is a constant presence in over 50 countries in the world. As the lack of access to clean water and sufficient sanitation are likely to remain chronic problems in many nations for the foreseeable future, cholera is also likely to continue to afflict humanity for years to come. Infants and young children are particularly at risk from this diarrheal disease.

A person infected with cholera can be properly treated with the application of rehydration therapy, and this treatment is usually effective. However, access to the right medical care is not always possible because many areas that lack access to clean water and sanitation also lack sufficient access to the health care infrastructure and services necessary to treat cholera. While changes in the quality of water and sanitation available to many living in resource-limited areas of the world can make a big impact on these diseases, vaccination is another public health approach that can make a significant difference. The ability to mount sustained vaccination campaigns for children has helped turn the tide globally against a number of childhood killers such as measles and polio. Vaccine campaigns against rotavirus, another diarrheal disease that is a killer of children in the developing world, have been successful in areas of Africa and South America where they have been implemented. While a number of oral vaccines have been developed for cholera, these vaccines are not long-lasting and do not provide very good protection for very young children. VIC is supporting the development of a new cholera vaccine that has the potential to give children long-term protection from the disease.

Influenza

Candidates
  • Laser Vaccine Adjuvant

Influenza is one of the most common infectious diseases and has a significant health impact in the world. Influenza (and pneumonia related to infection) are the sixth leading cause of death in the United States and the fifth leading cause among adults age 65 years and older. Influenza related deaths average about 36,000 per year and about 225,000 patients are admitted each year to hospitals as a result of infection.
Unlike some infectious diseases where exposure provides long-term immune protection, people are at risk to get influenza repeatedly during their lives. This is because multiple different strains of virus can cause influenza, and these viruses can change over time. As these viruses reproduce in the cells of the body, mutations in the proteins of the virus can occur that can change the immune fingerprint of the virus. With seasonal influenzas, these changes will be significant enough from year to year that immune protection from one influenza virus, either through exposure or vaccination, may not be good enough to provide adequate immune protection from another.

In addition, different influenza viruses can swap genetic material if two different viruses infect the same cell, which can significantly change their protein makeup and resultant immune profile to be very different than before. These changes may mean there is little immune protection in the population based on past exposure to influenza. In such cases, many people in the population can come down with the new strain of influenza. This kind of flu is called “pandemic” because it spreads widely through the human population. If the pandemic flu strain is also very dangerous, millions of people across the world could die. The last time a dangerous pandemic flu broke out was in 1918. Over the two years of the pandemic an estimated 50 million people across the world died.

Influenza vaccines have been developed to protect people from seasonal influenza as well as from specific pandemic influenza. Seasonal influenza vaccines are made each year to match the changes in the flu strains. They provide reasonable protection to the population, but often do not work as well in the very young and the elderly. VIC is working on a novel laser system to help improve the response to the influenza vaccine.

Mesothelioma

Candidates
  • Jantibody
  • AMD3100

Mesothelioma is a cancer of the lining of the lung (called the mesothelial layer) that is caused by breathing in asbestos. It is a relatively rare cancer that often takes decades to develop. About 3,000 people a year are diagnosed with mesothelioma; many of these are in their 60s and 70s at the time of diagnosis. Exposure by Americans to asbestos was highest in the period from 1920s to the 1970s, after which the use of asbestos was sharply curtailed as a building material. However, asbestos has remained a feature of many older buildings for years afterward. More recently, it is likely that active duty military service personnel are being exposed to asbestos in areas of the world such as Iraq and Afghanistan where the mineral continues to be used as building material and where asbestos is released as buildings are damaged or destroyed by combat. Historically, mesothelioma has disproportionately affected military personnel—often as a result of their involvement in ship construction and repair. While veterans represent 8% of the nation’s population, they make up almost one third of all known mesothelioma deaths that have occurred in the U.S.

In most cases, the outcomes after diagnosis of this cancer are poor, with most patients dying within a year of diagnosis. These patients, typically elderly, experience significant losses of quality of life related to the effects of cancer: chest pain, shortness of breath, cough, fever, and night sweats. Current therapy in the form of surgery and chemotherapy has improved quality of life but offers little hope of improved survival.

Because a number of studies have shown that mesothelioma has a potential to respond to treatments that support and direct the patient’s immune system to respond to the cancer, VIC is working on a number of immune-based treatments to improve patient survival with mesothelioma.

Ovarian Cancer

Candidates
  • Jantibody
  • AMD3100

Ovarian cancer is a tumor that arises mostly in the lining of the ovaries, and often spreads gradually through the tissue linings in the abdomen. The tumor is often characterized by scattered small focal areas that are poorly vascularized. Up to now, there has not been a reliable screening test for ovarian cancer. Because of this, it is often not caught until it has reached a metastatic stage, which is the case in nearly 70% of the 25,000 new cases found each year in the U.S. A combination of surgical removal of visible tumor and the use of chemotherapy are the standard treatments for ovarian cancer. This approach is highly effective at earlier stages, but less so at the more advanced stages when the disease is typically diagnosed. Therefore, in spite of developments in surgery and chemotherapy over the last forty years, there has not been a significant reduction in the mortality rate and long-term survival (more than five years) remains below 25%.

Since ovarian cancer cells can be recognized by the immune system, use of immunotherapy, which mobilizes the body’s immune system to attack a tumor, is a reasonable approach to supplement conventional surgery and chemotherapy. VIC is exploring a number of approaches to target ovarian cancer more effectively for the immune system.

Q fever

Candidates
  • Q-VaxCelerate Vaccine

Q fever, a disease caused by a bacterium called Coxiella burnetii, is highly infectious; a single inhaled organism can result in acute and chronic disease in humans which can be severe. Coxiella typically infects certain types of livestock, where it can spread to humans. It therefore presents some risk to people who work with livestock. However, it occasionally spreads into the greater population. Q fever outbreaks have been documented in several countries including Australia and the Netherlands. There is also an indication that a significant portion of military personnel serving in Iraq have had some exposure.

In many cases people who are infected by Coxiella C. burnetii infection clear the infection without even knowing it. In other cases they have what is a limited and mild bout of illness that is somewhat like the flu. Q fever can also be treated with antibiotics including tetracycline, but a vaccine is considered to be critical to the control of this disease in occupational and biodefense settings. There is currently no approved vaccine for Q fever. VIC has established a collaboration with a number of other organizations to develop a new Q fever vaccine.

Type 1 Diabetes

Candidates
  • Immunomoisolating Islet Microbeads

Type 1 diabetes (T1D, formerly called juvenile diabetes) is an autoimmune disease where the body’s immune system attacks and destroys a specific type of cell found in the pancreas called a beta cell. Beta cells are responsible for producing insulin, a protein that helps the cells in the body store glucose for later use. When beta cells are destroyed, the body loses this storage ability and glucose will remain in circulation. This has a negative effect on many parts of the body. People with T1D develop a number of symptoms over time like vision loss, loss of limbs due to insufficient circulation, and the development and exacerbation of many other kinds of conditions like heart disease. People with T1D have shorter lives and many more medical problems than healthy people.

While T1D has an important genetic component, environmental factors also play an important role in the onset of the disease. About 3 million people in the U.S. live with T1D, but the rate at which people develop T1D has been rising significantly, and may be linked to the significant increase in obesity in the country.

Advanced Wound Healing

Candidates
  • B cell immunotherapy

Injury to the skin that leaves a wound is a common occurrence, and many of these are addressed by basic wound care and non-adherent bandaging. However, a proportion of wounds are more serious, resulting in the need for more advanced approaches. This is especially true in the case of people who experience wounds that are difficult to heal. People with diabetes can develop wounds on their extremities, often on the legs, that are hard to heal. For severe dermal injuries like venous or diabetic ulcers, burns, or trauma wounds, the first-line treatment approach of debridement and non-adherent bandaging is frequently insufficient for wound closure and scar mitigation, creating a need for advanced care options. To address this issue, wound treatment technologies such as biosynthetic skin substitutes have been developed, but have proved to be both costly and limited in efficacy.

The demand for new advanced wound healing approaches is growing due to demographic and technological drivers. The trend towards a higher diabetic population, both numerically and by percent of overall population, increases the incidence of chronic wounds associated with diabetes. The high cost of treating these wounds and in many cases performing associated lower limb amputations increases demand for cost effective therapies to treat wounds and prevent amputation. In 2012, 29.1 million people had diabetes compared with 25.8 million in 2010. In 2013 diabetes-related foot ulcers and amputations were estimated to cost US health care payers $17 billion.