By investigating an African patient’s HIV infection, researchers have traced the development of an antibody that is effective at neutralizing many strains of HIV, according to a study published today (April 3) in Nature. The researchers—who identified the original HIV variant as well as the broadly neutralizing antibody, and pieced together their evolution over the course of infection—hope that a vaccine mimicking this process could encourage the development of such effective HIV-fighting antibodies.

The new research provides “really in-depth information on how a particular type of broadly neutralizing antibody emerges over the course of a natural HIV infection,” said Leonidas Stamatatos, an immunologist at Seattle Biomedical Research Institute who did not participate in the study.

Broadly neutralizing antibodies—able to block many strains of HIV from binding target cells—are notoriously rare: only about 20 percent of HIV-positive people ever generate such antibodies. One of the most attractive neutralizing targets is the HIV envelope protein (Env) that binds T cells, which is present on every variant of HIV. But Env is covered in sugar molecules that often mimic host structures, making it hard for the immune system to distinguish virus from self. In order to avoid an adverse autoimmune reaction, the body produces few B cells whose antibodies can recognize these common structures. One approach to developing an effective HIV vaccine is to stimulate these rare B cells, but because Env’s sequence can vary widely between HIV strains, researchers didn’t know much about the right Env variant for the job.

In order to find an Env that could stimulate an antibody with broadly neutralizing potential, Barton Haynes at Duke University and researchers at the Center for HIV-AIDS Vaccine Immunology (CHAVI) set up eight acute infection clinics in Malawi, South Africa, Tanzania, Uganda, and one in North Carolina, where they could watch antibody and virus develop within weeks of infection.

Haynes and his team found one patient who developed a broadly neutralizing antibody within 3 years of infection. The antibody, dubbed CH103, could block infection of target cells by 55 percent of the HIV virus particles they tested, which expressed a total of 196 different types of Env. Because the team had blood samples from the patient starting 4 weeks after infection, they could isolate the original antibody, CH103’s predecessor, as well as determine the sequence of the original Env protein that first spurred the antibody’s production.

As HIV proteins accrue mutations during an infection, antibodies evolve to increase specificity and adapt to changing targets. Finding the antibody that bound the original Env allowed researchers to identify which mutations conferred broadly neutralizing activity to CH103 and identify mutations in Env that could have contributed to CH103’s development. Haynes and his colleagues hope to recreate the evolution of CH103-like antibodies using the right combination of Env variants in a vaccine.

“The study provides important information on how one might design a rational vaccination strategy,”Dennis Burton, an immunologist at The Scripps Research Institute who did not participate in the study, wrote in an email to The Scientist. “[It’s] a significant leap.”

An effective vaccine will need to elicit more than one type of antibody to block HIV infection, so Haynes and his team are also examining the evolution of broadly neutralizing antibodies and their corresponding HIV proteins in other patients, as well.

Indeed, the bulk of the work is just beginning, said Stamatatos, who noted that the possible combinations of Env “are nearly infinite.” It’s also not clear yet whether the Env mutants should be given together, or provided sequentially in a fashion more akin to a natural infection. Haynes and his colleagues are currently beginning to test both strategies with different Env combinations in macaques and mice engineered to express human antibodies.

H.-X. Liao et al., “Co-evolution of a broadly neutralizing HIV-1 antibody and founder virus,”Nature, doi:10.1038/nature12053, 2013.

On 3 April 2013, the China Health and Family Planning Commission notified WHO of an additional four cases of human infection with influenza A(H7N9). The four patients are from Jiangsu province in eastern China. There is no link between the cases.

To date, the total number of confirmed cases of human infection with influenza A(H7N9) virus in China is seven. Three confirmed cases were reported earlier from Shanghai and Anhui provinces, including two deaths.The patients include a 45-year-old woman with illness onset on 19 March 2013; a 48-year-old woman with illness onset on 19 March 2013; an 83-year-old man with illness onset on 20 March 2013; and a 32-year-old woman with illness onset on 21 March 2013. All of these patients are in a critical condition.

More than 160 close contacts of these four cases in Jiangsu province are being closely monitored. Thus far, none of them have developed any symptoms of illness. Retrospective investigation is ongoing into two contacts of one of the cases reported earlier from Shanghai. Both of these contacts developed symptoms of illness; one died and the other recovered. No laboratory confirmation is available for these two contacts.

The Chinese government is actively investigating this event and has heightened disease surveillance for early detection, diagnosis and treatment. Infection prevention and control has been strengthened in health-care settings. Communication efforts between human and animal health and industry sectors have increased. The government has advised the population to maintain good personal hygiene, including frequent handwashing and avoiding direct contact with sick or dead animals.

WHO is in contact with national authorities and is following the event closely. The WHO-coordinated international response is also focusing on work with WHO Collaborating Centres for Reference and Research on Influenza and other partners to ensure that information is available and that materials are developed for diagnosis and treatment and vaccine development. No vaccine is currently available for this subtype of the influenza virus. Preliminary test results provided by the WHO Collaborating Centre in China suggest that the virus is susceptible to the neuraminidase inhibitors (oseltamivir and zanamivir).

At this time there is no evidence of ongoing human-to-human transmission.

WHO does not advise special screening at points of entry with regard to this event, nor does it recommend that any travel or trade restrictions be applied.

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A single drug may be an effective therapy for a number of different viral diseases such as Ebola and rabies, a new study published in Cell Chemistry and Biology.

John Connor - a virologist at the University of Boston, USA, and co-author of the article, explains that his research team study the vesicular stomatitis virus, a close relative of the Ebola virus, but not as deadly. It turns out that several viruses, including rabies, mumps, vesicular stomatitis virus and NICA (deadly pathogen spread by bats) use the same method to reproduce in human cells. This led scientists to start looking for a substance that can stop the replication process of these viruses.

The result - the first broad-spectrum antiviral compound that stops the playback of a variety of viruses through disruption of the synthesis of viral ribonucleic acid. Although up to a medicinal product used in humans will probably take at least several years of laboratory research and as many clinical studies, the discovery is a major breakthrough in anti-infective and, in particular - antivirus, therapy with the potential to change the treatment of many of the most serious viral diseases.

FDA issued a permit for use of the new product Tenex Health - TX1 - a system to remove damaged or necrotic tissue. This application will allow a wide range of surgical procedures and interventions - abdominal surgery, orthopedic surgery, laparoscopy, Plastic and Reconstructive Surgery.

The company currently offers products for the treatment of damaged tissue in the tendons in chronic tendon pain. INSTRUMENTS is the size of a pen and allows surgeons to supply energy in the form of ultrasonic waves through a needle that cuts and removes only the dead tissue. The whole procedure was carried out for 20 minutes under local anesthetic.

Each year in the U.S. alone, the number of operations in tendon pain is over 10 million. Extending the testimony of multiple device will increase its applicability and convenience for physicians and patients, and the quality of the manipulation.

According to Jill Foosball - Executive Director of Tenex Health, the device allows surgery at an early stage of the disease, allowing for faster, easier and more effective treatment and faster return patients to their daily activities. He said TH1 offers unique advantages - minimum invasiveness, which means speed, efficiency and safety of the procedures with minimal recovery time.

The company designs and other products for minimally invasive surgery for the treatment of soft tissue injuries when bursitis, carpal tunnel surgery syndrome and post surgical adhesions.