The Power of a Cell Line: A Review of The Vaccine Race

When most people think of the challenges of vaccine development, the first thing that enter their mind is the serial passaging of a microbe to weaken it, the search for a microbial protein to prime the immune system, or the large clinical trials needed to show efficacy. What is almost taken for granted, in the modern era, is the ability to find suitable cells to grow the microbe in (for viral vaccines) and produce the vaccine in. The Vaccine Race: Science, Politics, and the Human Costs of Defeating Disease, a new book by Dr. Meredith Wadman, provides an exciting narrative that describes the intricacies of the development of one such cell line that has been employed to vaccinate millions upon millions of humans and contribute to their flourishing.

Snip20180528_56.png

The chief subject of Wadman's book is Leonard Hayflick, a scientist whose name is familiar to any student of biology as it was his work that demonstrated the limits of cell division -- their "Hayflick Limit" -- as their chromosomal telomeres shortened. However, that is just one thing Hayflick discovered. He is also responsible for identifying Mycoplasma as the cause of "walking pneumonia." However, the main thrust of this book is focused on understanding Hayflick's cell line WI-38, derived from an aborted Swedish fetus, that became the standard research cell line used in vaccines that range from measles to polio to rubella. Such a cell-line, because it was human derived, removed concerned with contamination with viruses such as the infamous tumor-virus SV-40 which was harbored by rhesus and cynomolgus monkey kidney cells. 

In telling this story, which if full of giants such as Hayflick, Stanley Plotkin, Joseph Smadel, and Hilliary Koprowski, the founding and development of the Wistar Institute is also explored in great detail as is the business of scientific research, interactions with pharmaceutical companies, controversial clinical trial design, the intellectual property rights of scientists, and controversies over using vaccines grown in fetal cells.

It is hard to encapsulate all the information contained in this notable book (and there is some controversy -- see Hayflick's list of inaccuracies he identified) but it is required reading for anyone who wants to understand the fight against infectious disease, the history of medicine, and the life-saving role of vaccines. 

The Characteristics of Pandemic Pathogens Report Released

Snip20180510_3.png

One of the perennial questions I am asked is "What's next?" in regard to infectious disease threats. Well, yesterday my colleagues and I released the report of a project I led for over a year whose aim was to understand the traits and characteristics of pandemic pathogens. We approached this project with active minds trying to jettison reliance on list-based approaches that are incomplete and almost guarantee surprise outbreaks. 

We did not limit ourselves to viruses as we embraced microorganisms of all classes. We also sought to integrate knowledge of astrobiology, plant infections, amphibian infections, prions, and even the bacteria at the limits of the earth's atmosphere into our thinking.

In the final analysis, we deemed a respiratory spread RNA virus to be the most likely pandemic pathogen for several reasons that include the fact that simple public health measures are likely to control a respiratory pathogen and an RNA genome allows a lot of mutability. While everyone may jump to influenza with this type of answer, there is a whole host of other viruses in this category that are often neglected as pandemic pathogens and for which no antivirals or vaccines are available.

One of my personal strongest recommendations is to end the satisfaction many doctors have with just calling something a "viral illness" and leaving the diagnosis as non-specific as that. This wastebasket diagnosis might contain potential pandemic pathogens making their first forays into humans and it is incumbent upon physicians -- in an era when a plethora of diagnostic tools are available -- to try to come to a specific diagnosis. This is true whether one practices in a major developed world city or in a rural clinic in Africa. Specific diagnosis leads to situational awareness and underlies preparedness.

This project was the most enjoyable and fun endeavors I engaged in as it allowed me to immerse myself in infectious disease and think deeply and widely. I hope that others find the report of value and it serves to generate deeper analysis of this field. 

Here's a link to a quick video I did explaining the report.