FIND and partners initiate search for a Test of Cure for sleeping sickness
Seated: from left to right, Dr Joseph Ndung'u, FIND; Dr. Giorgio Roscigno, FIND; Dr. Jean-Charles Sanchez, Head of BPRG (HUG). Standing: Dr. Sylvain Biéler, FIND; Dr. Maina Ngotho, Head of Animal Sciences Department (IPR); Alexandre Hainard, Scientific Collaborator at BPRG (HUG)
FIND, the Biochemical Proteomics Research Group (BPRG) of the University of Geneva in Switzerland and the Institute of Primate Research (IPR) in Kenya have started research that could lead to the development of a simple method to confirm cure after treatment of sleeping sickness patients. After patients are treated, it is not easy to tell whether they are cured or not, and they have to come back every 6 months for up to 2 years to have their cerebrospinal fluid (CSF) examined for presence of parasites. As a result, many treated patients do not turn up for follow-up.
Scientists at the BPRG and IPR are hoping to identify unique molecules that disappear quickly from the body of a patient whose treatment is successful. In the event that such molecules remain detectable or reappear after treatment, this would be an indicator for potential relapses, and such patients would be monitored more closely. The research, which started in November 2009, is building on previous work supported by FIND on diagnostics for human African trypanosomiasis (HAT), and hopes to identify either parasite or host biomarkers with these characteristics. In one approach, animal models of the disease at the IPR will be used to determine how long trypanosome DNA takes to get cleared from the body after successful treatment. In another approach, biomarkers that the BPRG team have already demonstrated to be elevated in the CSF of HAT patients will be studied in both the animal models and treated patients.
In the event that the dynamics of the discovered biomarkers will be similar in the blood as in CSF, this would eliminate the need for the painful lumbar puncture.
Sleeping sickness or HAT is a stigmatizing tsetse-transmitted disease that affects poor rural communities in Africa, and is endemic in 36 countries. Diagnosis of the disease is difficult, and treatment is associated with potentially fatal, drug-related, toxic side effects. The disease can easily be confused with malaria, which is prevalent in all areas where it is found. Although FIND and partners have recently made significant progress towards improving diagnosis of HAT, treated patients are usually unwilling to come back for follow-up when they think about having to undergo another lumbar puncture. A test of cure that does not involve this invasive procedure would therefore have a major impact in the accelerated control of this disease.
The Foundation for Innovative New Diagnostics was established in 2003 in Geneva, Switzerland. FIND’s mission is to accelerate development, evaluation, and appropriate use of high-quality, yet affordable diagnostic tests for infectious diseases in developing countries.
The programme for development of HAT diagnostics was initiated in 2006, and has strengthened linkages between FIND and stakeholders involved in control of HAT.
FIND’s strengths include independence and flexibility in working with the private and public sectors, access to global policy-making bodies, leadership in the WHO TB and HAT Working Groups, and technical expertise in development, evaluation, and implementation of HAT, TB and malaria diagnostics. Strategic partnerships are a critical element of FIND’s overall strategy, and these have been formed with the widest possible range of institutions in academia, civil society, industry, and the public sector. The rigor of FIND’s project management has been recognised through ISO 13485:2003 and 9001:2008 certification, a recognised standard for In Vitro Device (IVD) manufacturing companies yet a rare achievement for a non-profit organisation.
FIND is conducting a number of evaluation studies of new diagnostic tests in settings in Africa, with expertise in clinical studies and state-of-the-art laboratories that are essential for high-quality diagnostic studies, and has established strong linkages with many of the HAT endemic countries through the ongoing diagnostics project.
Biochemical and Proteomics Research Group (BPRG) of the University of Geneva
From the time of its creation in 1559 by Jean Calvin, right up to the recent discovery by University astrophysicians of extrasolar planets, the University of Geneva has continued to grow and develop in a manner commensurate with its longstanding tradition of excellence and its international approach. Many international rating bodies have ranked Geneva as a leader in scientific research, in particular in the fields of molecular biology, astrophysics, social sciences and economics. The University of Geneva has been listed as one of the top 12 research universities in Europe and since 2002 is a member of the League of European Research-intensive Universities.
The Biomedical Proteomics Research Group (BPRG) at the Geneva Faculty of Medicine has a world-leading role in proteomics since 1984. BPRG researchers work in the two complementary areas of protein separation, detection and identification methods and their related computer sciences field. As a co-inventor of the proteome concept in 1994, BPRG has soon evaluated the great impact proteomics could have in biomarker discovery. Since then, its efforts have been concentrated to this goal and important results have been obtained in various types of diseases such as brain and infectious diseases. All these results permit to develop new diagnostic, therapeutic and predictive tools.
Dr. Jean-Charles Sanchez has been working since 1989 in the field of proteomics. He contributed to the development of proteomic strategies and related procedures and their application in Biomarker discovery research. Since 1995, he has been the head of the Biomedical Proteomics Research Group of the Faculty of Medicine at Geneva University. He is a founder and the president of the Swiss Proteomics Society (SPS) and the European Proteomics Association (EuPA).
Institute of Primate Research (IPR), Kenya
The Institute of Primate Research (IPR) is a semi-autonomous constituent directorate of the National Museums of Kenya (NMK) www.primateresearch.org. In July 2009 IPR was certified ISO:9001 2008 compliant committing the institution to sustained and continuous improvement in Quality Management Systems. At its Oloolua campus IPR’s infrastructure including research laboratories and dedicated animal facilities are thoughtfully positioned with minimal interference to the pristine setting of an indigenous and natural forest. IPR is dedicated to fostering scientific curiosity and creativity that encourages the utilization of scientifically-derived methods to solve global health problems. IPR is an internationally recognized center of excellence for biomedical research and is designated a World Health Organization (WHO) collaborating center. The Institute has a self control scientific and ethical review mechanism through the Institutional Review Committee (IRC). In collaboration with the EU-funded project EUPRIM-Net, IPR seeks to partner with established primate centers to foster linkages in positive reinforcement training, breeding and husbandry, animal welfare and staff education in non-human primates (NHPs). IPR has been a member of the European Union-supported Primate Vaccine Evaluation Network (PVEN), whose objective is to not only rationalize and optimise the use of NHPs in research but also to meet the highest standards regarding the animal welfare and ethical aspects of primates in captivity. IPR has three GLP and five project planning in biomedical research WHO accredited trainers who ensure a continuous improvement in the way research is conducted to optimise resources and obtain data that is reproducible, reliable and acceptable.
The department of Infectious & Tropical Disease has established non-human primate models for leishmaniasis and HAT (African Green or vervet monkey, Chlorocebus aethiops syn. Cercopithecus aethiops), malaria and schistosomiasis (Olive baboon, Papio anubis) and Simian human Immunodeficiency Virus (SHIV) (Olive baboon and African Green monkey). The Institute seeks to progressively address other emerging zoonoses and neglected diseases.
The HAT program at IPR is headed by Dr. Maina Ngotho, who is a trained immunopathologist and an expert in development of animal models for HAT, among other diseases. The HAT program is currently implementing several projects, including an EU-FP7 funded project on exploitation of nanobodies in development of new diagnostic tool and treatment methods for trypanosomiasis.