Investigational Three-Month TB Regimen Is Safe but Ineffective, NIH Study Finds

The first clinical trial of a three-month tuberculosis (TB) treatment regimen is closing enrollment because of a high rate of unfavorable outcomes with the investigational course of treatment. Advancing Clinical Therapeutics Globally for HIV/AIDS and Other Infections (ACTG) 5362, also known as the CLO-FAST trial, sought to evaluate the safety and efficacy of a three-month clofazimine- and high-dose rifapentine-containing regimen. An interim data analysis showed that participants taking the investigational regimen experienced ongoing or recurring TB at rates above thresholds set in the study protocol.

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Promising Advances for Antibody Treatment of Viruses that Cause Neurologic and Arthritic Diseases

NIAID Now |

NIAID scientists and colleagues are one step closer to developing a safe and effective therapy against alphaviruses with the identification of SKT05, a monoclonal antibody (mAb) derived from macaques vaccinated with virus-like particles (VLPs) representing three encephalitic alphaviruses.

Spread by mosquitos, alphaviruses primarily affect people in one of two ways: causing severe neurological impairment such as encephalitis (brain swelling) or crippling muscle pain similar to arthritis. Western, eastern and Venezuelan equine encephalitis viruses (EEV) are examples of the former, while chikungunya and Ross River viruses are examples of the latter.

Building on studies from the past decade, scientists in NIAID’s Vaccine Research Center and colleagues knew that macaques produce dozens of different protective antibodies when experimentally vaccinated against the EEVs. In a new study published in Cell, the research team identified 109 mAbs in macaques immunized with the experimental western, eastern, and Venezuelan EEV VLP vaccine. All antibodies were individually tested for binding and neutralization against the three EEVs, with the best ones also assessed against arthritogenic alphaviruses not included in the vaccine. Collaborators included scientists from NIAID’s Laboratory of Viral Diseases, USAMRIID’s Virology Division, and Columbia University.

Their work identified SKT05 as the most broadly reactive antibody – remarkably, it also provided protection against both types of alphaviruses, those that cause encephalitis and those that cause arthritic-like disease. High-resolution structural studies further revealed that the way SKT05 binds to alphaviruses could make it resistant to surface changes that can occur in viruses – which means the mAb is likely to have lasting effectiveness.

Further studies are planned to investigate potential clinical development of SKT05. They aim to better define how SKT05 interacts with viruses and whether it can confer protective benefits against additional alphaviruses.

References:
M Sutton et al. Vaccine elicitation and structural basis for antibody protection against alphaviruses. Cell DOI: https://doi.org/10.1016/j.cell.2023.05.019 (2023).

EE Coates, et al. Safety and immunogenicity of a trivalent virus-like particle vaccine against western, eastern, and Venezuelan equine encephalitis viruses: a phase 1, open-label, dose-escalation, randomised clinical trial. Lancet Infectious Diseases (2022).

SY Ko, et al. A virus-like particle vaccine prevents equine encephalitis virus infection in nonhuman primates. Science Translational Medicine (2019).
 

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Initiative Takes International Approach to Infectious Diseases

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Are you an international investigator in a resource-constrained country? Can you propose high-priority, regionally relevant infectious diseases research? If so, consider applying to the notice of funding opportunity (NOFO) International Research in Infectious Diseases (R01, Clinical Trial Not Allowed), which continues our longstanding committment to infectious diseases research abroad.

Applicant organizations must be headquartered in foreign (non-U.S.) resource-constrained countries (i.e., low-income economies, lower-middle-income economies, and upper-middle-income economies by World Bank Classification). Eligibility status of applicant organizations will be determined by the World Bank Classification list at the time of application submission.

You may propose studies on any aspect of infectious disease research (except clinical trials), including but not limited to: basic biological studies of pathogens and vectors; the epidemiology, natural history, pathogenesis, immunopathogenesis of infectious diseases; epidemiologic studies to define the incidence, clinical presentations, and outcomes of diseases; identification of resistance mechanisms and patterns; characterization of susceptible cohorts for a particular pathogen; pilot and feasibility studies in preparation for larger studies; and studies focused on the effects of climate change on the incidence, prevalence, and severity of infectious diseases.

Further Details

The scientific scope of this NOFO is sufficiently broad to cover the full range of infectious diseases research prioritized by NIAID’s Division of Microbiology and Infectious Diseases (DMID) and Division of AIDS (DAIDS), with the exception of clinical trials. Note that HIV/AIDS studies must address NIAID priorities as described in the Division of AIDS Overview.

While the program is open to institutions located in any foreign, resource-constrained country, we especially encourage applications from institutions located in countries classified as low- and lower-middle-income economies.

We encourage potential applicants to build collaborations, whether with U.S. institutions or other institutions within the host country or region, although this is not a requirement for funding.

To be eligible, a principal investigator must not have had (or currently have) an R01-equivalent award other than a current or expiring International Research in Infectious Diseases award.

NIAID will hold a virtual program kick-off meeting for award recipients in early 2024 and annual meetings thereafter to facilitate communication and collaboration.

Application Requirements

There is one receipt date per year: August 2, 2023; August 2, 2024; and August 1, 2025. All applications submitted in response to the first receipt date (August 2, 2023) must be new applications; resubmission or competitive renewals are not allowed.

Application budgets should not exceed $125,000 in annual direct costs and should reflect the actual needs of the project.

The scope of the proposed project should determine the project period. The maximum project period is 5 years. 

Additional Resources

Frequently asked questions concerning this NOFO are available at Questions and Answers for RFA-AI-23-023.

NIAID staff will host an informational webinar on July 7, 2023. Registration details will be listed on the Questions and Answers page linked above.

If you are interested in applying, we strongly encourage you to contact one of NIAID’s scientific/research contacts to discuss our research priority areas: Dr. Glen McGugan, Jr., DMID, at gm233g@nih.gov or 240-627-3314; Melanie Bacon, DAIDS, at mbacon@niaid.nih.gov or 240-627-3215; or Dr. David McDonald, DAIDS, at david.mcdonald@nih.gov or 301-761-7815. Direct questions related to application review to NIAID’s peer review contact Dr. Soheyla Saadi at saadisoh@nih.gov or 240-669-5178.

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International Awards—Part III. Build Collaborations

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In the third and final installment of our series, we focus on international researchers establishing collaborations with domestic principal investigators (PIs). Previous newsletter issues covered Part I—Determining Eligibility and Part II—Foreign Projects.

Ideally these relationships are built before an application is submitted. Assuming that is the case, you as the international researcher should provide a letter of support to be included in the grant application affirming your commitment to the research project. See Letters of Support for more information.

In general, biomedical research is undergoing a culture shift toward transdisciplinary, team-based science. It’s not unusual to cultivate partnerships with scientists in other fields or at other institutions. Some notices of funding opportunities (NOFOs) even require collaborators. Other reasons to collaborate include:

  • Investigate common research questions and share resources and information.
  • Access unique study populations or resources.
  • Bolster a grant application by demonstrating comprehensive expertise.
  • Provide distinct perspectives that complement one another.

While there are possible drawbacks to partnerships, there are also options for dealing with or mitigating them. For example:

  • You will have less autonomy, e.g., you may need the group's approval to proceed in a new research direction.
  • You will need to accept the group's processes and culture, including possibly spending time in team meetings and discussions with team members.

Collaborators may use different types of agreements to facilitate partnerships, including research collaboration agreements, material transfer agreements, and data transfer agreements (which the recipient is responsible for overseeing). It is also necessary for collaborators to develop data management and sharing plans that take into account laws and regulations in all the countries where the research will be conducted. For an active award, NIAID’s prior approval is required to add a new foreign collaborator to the research team.

How to Find Collaborators

You have a few options for finding potential collaborators, such as the following:

World RePORT is an interactive, open-access database and mapping of global research investments from some of the world’s largest biomedical funding organizations. World RePORT helps foster and facilitate funding analysis and visualization of global biomedical research networks, linking investigators and institutions collaborating on research projects.

RePORT Expenditures and Results (RePORTER) 

  • Its Advanced Projects Search provides a deeper dive into NIH's free and publicly available database of funded projects, investigators, publications, and patents.
  • Users can customize queries to find potential collaborators for future projects, identify research areas that are underrepresented or highly supported, and much more.
  • Matchmaker tool allows you to paste in text (e.g., a scientific abstract or other keyword-rich text) to find similar projects or NIH program officers.

PubMedCentral

Get help identifying collaborators who are conducting similar work and discover who is publishing in your scientific area.

Pilot Option

Another option to find collaborators is through Researcher Discovery via Scopus. It is currently in a pilot phase, but it may be useful to foreign scientists.

Have Questions?

Go to Global Research—Contacts for answers to your inquiries, additional resources, or help with navigating RePORTER.

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NIAID Marks World Malaria Day

World Malaria Day is an opportunity to reflect on continuing challenges posed by malaria and reaffirm a commitment to overcoming them. The National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, joins with the global health community in recognizing this year’s theme of “Time to Deliver on Zero Malaria: Invest, Innovate, Implement.”

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Universal Influenza Candidate Vaccine Performs Well in Phase 1 Trial

NIAID Now |

Universal Influenza Candidate Vaccine Performs Well in Phase 1 Trial
mRNA Version of NIAID Vaccine Begins Similar Testing 

Scientists at NIAID’s Vaccine Research Center (VRC) report in two new studies that an experimental influenza vaccine, designed to elicit immunity against a broad range of influenza viruses, performed well in a small trial of volunteers. In fact, the vaccine has advanced to a second trial led by scientists at Duke University through NIAID’s Collaborative Influenza Vaccine Innovation Centers (CIVICs).

In a phase 1 clinical trial of 52 volunteers, the vaccine developed by the VRC – known as H1ssF (influenza H1 hemagglutinin stabilized stem ferritin nanoparticle vaccine) – was safe, well-tolerated, and induced broad antibody responses that target the hemagglutinin stem. The two new studies assessing the nanoparticle vaccine published April 19 in Science Translational Medicine.

Healthy volunteers ages 18-70 enrolled at the NIH’s Clinical Center and were given either a single 20-microgram dose or two 60-microgram vaccine doses. Boosters were given 16 weeks after the initial dose. The trial enrolled between April 1, 2019, and March 9, 2020. 

Trial participants did not experience any severe adverse events; the most common vaccine reactions included mild headache, tenderness at the vaccine site, and temporary general discomfort.

As anticipated based on preclinical study results, H1ssF generated binding antibodies to the stem of the influenza H1 hemagglutinin (HA) protein. Antibody responses were observed regardless of dose or participant age. “These responses were durable, with neutralizing antibodies observed over one year after vaccination,” the authors stated, suggesting this vaccine prototype can advance further universal influenza vaccine development.

The H1ssF vaccine using an mRNA delivery system also began testing in a phase 1 clinical trial being overseen by scientists at the Duke Human Vaccine Institute, a part of NIAID’s CIVICs network. 

HA is composed of head and stem domains and enables the influenza virus to attach and enter a human cell. The immune system can mount an immune response to HA, but most of the response is directed toward the head. Influenza vaccines must be updated each year because the HA head constantly changes – a phenomenon called “antigenic drift.” The new vaccine candidate consists only of the HA stem. The stem is more conserved than the head between influenza strains and subtypes, and thus is less likely to change every season. Scientists predict that targeting the HA stem without the distraction of the HA head could induce stronger and longer-lasting immunity.

Influenza A viral HA can be divided into groups 1 and 2, and further subdivided into multiple subtypes based on their sequences. Scientists used the stem of an HA from a group 1 influenza virus to create the nanoparticle vaccine. Both group 1 and group 2 influenza viruses are among those responsible for seasonal influenza as well as the sporadic and deadly outbreaks of avian influenza viruses with pandemic potential. The H1ssF vaccine elicited responses that broadly neutralized group 1 influenza A viruses. Additional clinical trials are underway to test a ferritin nanoparticle-based vaccine designed to elicit group 2 influenza A viruses, and to test the H1ssF and the group 2 vaccine together in a cocktail aimed at approaching universal influenza vaccine coverage.

The H1ssF vaccine is unique in that it only displays the stem part of the influenza HA protein on the surface of a nanoparticle made of nonhuman ferritin. Ferritin spontaneously self-assembles into an eight-sided nanoparticle. When designed to display a part of the HA protein, the ferritin-HA proteins form particles displaying HA spikes on their surface, mimicking the natural organization of HA on the influenza virus. Displaying influenza HA surface proteins on the outside of the nanoparticle makes them easily accessible to immune cells that encounter the nanoparticle. The immune system can then learn to develop antibodies against displayed proteins. 

References:
A Widge, et al. An Influenza Hemagglutinin Stem Nanoparticle 1 Vaccine Induces Cross
Group 1 Neutralizing Antibodies in Healthy Adults. Science Translational Medicine DOI: 10.1126/scitranslmed.ade4790 (2023).

S Andrews, et al. An Influenza H1 Hemagglutinin Stem-Only Immunogen Elicits a Broadly Cross-Reactive B Cell Response in Humans. Science Translational Medicine DOI: 10.1126/scitranslmed.ade4976 (2023).

ClinicalTrials.gov search identifier NCT03814720.

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World TB Day 2023 – ‘Yes! We Can End TB!’

Each year, on March 24, the National Institute of Allergy and Infectious Diseases (NIAID), part of the NIH, joins people and organizations from around the globe in marking World Tuberculosis Day. On this day, more than 140 years ago, Dr. Robert Koch announced his discovery that most human tuberculosis (TB) is caused by the bacterium Mycobacterium tuberculosis (Mtb). Although our scientific insight into this disease has grown over the past century, TB is still one of the deadliest infectious diseases on the planet. Today, NIAID joins the world in a message of hope: “Yes!

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International Awards—Part I. Determining Eligibility

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With this article, we kick off a three-part series on International Awards. We begin with a look at how to determine eligibility for a Funding Opportunity Announcement (FOA) or Notice of Special Interest (NOSI).

Note that the eligibility of a principal investigator (PI) differs from that of an institution. This is particularly important in the context of fellowships and career development awards, where non-citizens may be working at U.S. institutions, or U.S. citizens may be working at international institutions. Applicants should refer to the eligibility requirements for the specific announcement they are interested in.

FOA Eligibility

If you find a FOA to which you want to apply, go to Section III Eligibility Information where you’ll find a section on Foreign Institutions. As an example, you may see one or more of the following:

  • Non-domestic (non-U.S.) Entities (Foreign Institutions) are eligible to apply.
  • Non-domestic (non-U.S.) components of U.S. Organizations are eligible to apply.
  • Foreign components, as defined in the NIH Grants Policy Statementare allowed. 

If you are ineligible to apply for an opportunity but the opportunity allows foreign components, consider seeking a partner in the United States with whom you could collaborate. Foreign investigators can identify potential U.S. collaborators by using the “Matchmaker” search on NIH RePORTER to view scientists conducting similar research.

NOSI Eligibility

You should find eligibility information within a NOSI, such as the Notice of Special Interest (NOSI)—Research on Gender Measurement (Admin Supp, Clinical Trial Optional).

Its Eligibility section states: Individual(s) must hold an active grant or cooperative agreement from NIH. This NOSI will support supplements for all activity codes. Individuals are encouraged to work with their organizations to develop applications for support. Only electronically submitted applications will be accepted.

As another example, the Notice of Special Interest (NOSI)—Administrative Supplement for Continuity of Biomedical and Behavioral Research Among First-Time Recipients of NIH Research Project Grant Awards has the section heading Eligible Individuals (Program Director/Principal Investigator).

If the NOSI does not have eligibility information, check the eligibility information of the FOA through which the NOSI directs applications.

Small Business Opportunities

Foreign institutions are not eligible to apply for Small Business Innovation Research (SBIR) or Small Business Technology Transfer (STTR) awards. Foreign components collaborating with U.S. organizations are also not eligible to be included in the application.

All work on SBIR or STTR projects must be conducted in the United States, per statute. However, in rare or unique circumstances, NIH may allow a small portion of the research work to be performed outside of the United States when it is not possible to perform domestically. Some examples might include supplies, materials, or patient populations that are not available in the United States.

The approval of foreign involvement will be considered on a case-by-case basis and must be thoroughly justified in the application. Whenever possible, non-SBIR or non-STTR funds should be used for work outside of the United States that is necessary to the overall completion of the project.

Keep in mind that international commercial organizations may be eligible to be a foreign component for research grants (e.g., P01) based on the FOA eligibility criteria.

Additional Information

Check the following webpages:

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December’s ACD Meeting—Featuring Bill Gates and Dr. Anthony Fauci

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NIH’s Advisory Committee to the Director (ACD) held a hybrid meeting on December 8 and 9, 2022. As detailed in its Charter, ACD Members provide recommendations on program development, resource allocation, NIH administrative regulation, and other aspects of NIH policy.

For daily agendas and the full list of meeting materials, check the December 8-9, 2022 section of the ACD Meetings page. Find video recordings of the ACD presentations at:

NIAID’s extramural research community may be especially interested in the following topics:

The meeting also covered the following topics:

The next ACD meeting has not yet been scheduled but will likely occur in June 2023. Monitor the ACD Meetings page for updates.

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Novel Study Model Reveals New Understanding of Fatal Familial Insomnia

NIAID Now |

Novel Study Model Reveals New Understanding of Fatal Familial Insomnia
Cerebral Organoids Show NIAID Investigators Disease Characteristics

Fatal familial insomnia (FFI) is a little-known yet horrific disease in which people die from lack of sleep. A protein mutation in the brain prevents sleep, and the body gradually deteriorates. Fortunately, the disease is extremely rare. Fewer than 1,000 people in the United States are estimated to have FFI, according to the NIH’s Genetic and Rare Diseases Information Center. Unfortunately for those with the disease, it can be hereditary – thus the “familial” aspect in the name and importance of developing diagnostic tests and treatments. 

FFI is among a group of unusual neurologic conditions known as prion diseases – those caused by normally harmless prion protein that can malfunction and kill brain cells. Because FFI is found in the brain (suspected origin is the thalamus) studying its spread is not possible until a patient has died. But at that point, valuable disease information is not available because the brain no longer functions. Likewise, studies in rodents and laboratory glassware only have provided limited information.

In a new study published in PLOS Genetics, scientists from the National Institute of Allergy and Infectious Diseases (NIAID) developed a cerebral organoid model to study the exact protein mutation that causes FFI. Human cerebral organoids are small balls of brain cells ranging in size from a poppy seed to a pea; scientists use human skin cells to create organoids. Cerebral organoids have organization, structure, and electrical signaling systems similar to human brain tissue. Because they can survive in a controlled environment for months to years, cerebral organoids also are ideal for studying nervous system diseases over lengthy periods of time.

In the new study using the FFI organoids, NIAID scientists working at Rocky Mountain Laboratories in Hamilton, Mont., compared cell functions – primarily in neurons – between the FFI model and organoids without the FFI protein mutation, making several important observations about the mutation’s effect on brain cells.

They believe the abnormalities likely are features of asymptomatic FFI that may lead to disease.

They surprisingly did not observe spontaneous change in shape or spread of the FFI protein to additional prion protein. Such spread typically is a trademark of prion disease – changing prion protein throughout the brain from the normal shape to the malfunctioning folded shape.

“Our findings show that the mutation causes brain cells to dysfunction without the need for misfolding,” the study states. “We could confirm that most changes were caused by the presence of the mutation” rather than interacting with prion protein lacking the mutation.

Further, the group found that neurons in the FFI organoid model were impaired because of damaged mitochondria – which typically produce energy to keep the brain cells healthy. In future studies they hope to establish a relationship between impaired mitochondria function and the mutated FFI prion protein, and whether neurons attempt to stay healthy and avoid harm from the mutated FFI prion protein by switching from mitochondria as an energy source.

They also plan to explore relationships between the mutated FFI prion protein and neurons associated with “wakefulness,” sleep and rapid eye movement in the brain.

Reference:
S Foliaki et al. Altered energy metabolism in Fatal Familial Insomnia cerebral organoids is associated with astrogliosis and neuronal dysfunction. PLOS Genetics DOI: (2023).


 

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