Science & technology | Global health

Vaccine researchers are preparing for Disease X

They hope to be able to create new vaccines in just four months

LAST YEAR the World Health Organisation published a plan to accelerate research into pathogens that could cause public-health emergencies. One priority was the bafflingly named “Disease X”. The X stands for unexpected, and represents concern that the next big epidemic might be caused by something currently unknown.

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Preparing for such an eventuality is challenging, but not impossible. That, at least, is the view of the Coalition for Epidemic Preparedness Innovations (CEPI), a charity in Oslo, Norway. Over the past few years CEPI has spent more than $250m trying to accelerate progress in vaccines for Lassa fever, MERS and Nipah virus. Work on Rift Valley fever and Chikungunya should start soon.

Dealing with Disease X, however, requires a novel approach, so CEPI is sponsoring attempts to find quicker ways of making vaccines in general. At the moment, says Melanie Saville, the organisation’s director of vaccine development, it takes two or three years from the isolation of a previously unknown virus to the clinical availability of a vaccine against it. The coalition is therefore dividing almost $20m between two groups who are working on ways to speed up the process.

The first hails from Imperial College, London. Its members are trying to develop a reliable way of making “self-amplifying” RNA vaccines. Conventional vaccination involves injecting into a recipient’s body either pieces of protein from a virus’s outer surface or whole viruses that have been weakened in some way. That lets the immune system learn what the virus looks like. However, a similar effect can be achieved by injecting, in the form of RNA, a molecule similar to DNA, genes that encode the relevant protein. The body’s own cellular machinery can then create the target protein from these instructions. The vaccine is termed self-amplifying because, along with code for the protein, further code is injected that will amplify the amount of RNA.

The second new approach CEPI is sponsoring is called a “molecular clamp”. This is being developed at the University of Queensland, in Australia. It is a way of synthesising viral-surface proteins with particularly high fidelity. Typically, these proteins are unstable and tend to change shape easily. If the immune system learns the wrong shape, it will not generate the necessary immunity. The Queensland process clamps viral proteins as they are synthesised, using a special molecular scaffold. That means they do not go wonky.

Success by either group promises to reduce the interval between identifying a virus and running the first clinical trial to a mere 16 weeks. Moreover, because both approaches synthesise the vaccines chemically rather than involving live viruses in the process, a vaccine that did emerge from one of them could then be manufactured rapidly. All this may then eliminate the fear, surprise and ruthless efficiency of unexpected viruses.

This article appeared in the Science & technology section of the print edition under the headline "The X factor"

The mother of all messes

From the January 19th 2019 edition

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