21 October 2002 16:34 GMT

by Thomas S. May

[caption and credit]

Peaceful coexistence and cooperation between the United States and the countries of the former Soviet Union (FSU) have, undoubtedly, contributed to a greater sense of security throughout the world over the past decade. Now it seems that this cooperative atmosphere may also help conquer one of the deadliest and most widespread diseases - tuberculosis (TB).

Among infectious diseases, TB is the second greatest contributor to adult mortality, responsible for approximately two million deaths per year worldwide, according to statistics from the World Health Organization (WHO). WHO estimates that one-third of the world's population is infected with Mycobacterium tuberculosis.

Although TB can sometimes be cured with antibiotics in about six months, various forms of multidrug-resistant TB (MDR TB) have been on the rise in certain areas of the world, and people infected with MDR TB often require extensive chemotherapy for a period of up to two years. In Russia, for example, after decades of gradual decline, the incidence of TB - especially MDR TB - has been increasing steadily over the past ten years, largely as a result of widespread poverty and homelessness.

Migration from parts of the FSU with high TB rates has exacerbated the problem. Furthermore, "a shrinking health budget resulted in an erratic supply of anti-TB drugs and laboratory supplies, reduced quality control in TB dispensaries and laboratories, and inadequate treatment led to drug resistance."

One possible approach to defeating TB, besides the use of antibiotics, is to try to strengthen the immune system of infected people. This is the approach taken by a small US company, SciClone Pharmaceuticals.

SciClone claims to have developed a drug that stimulates the immune response by activating Th-1 cells. The drug is a novel synthetic dipeptide, -D-glutamyl-L-tryptophan, dubbed SCV-07.

In cooperation with a Russian biotechnology company, Verta, Ltd., SciClone has recently tested the effectiveness of SCV-07 in a phase II clinical trial. In addition to standard anti-tuberculosis therapy, 44 patients with TB (60% with MDR TB) received 10-100 µg/day of SCV-07 for five days. As controls, 27 other patients received standard therapy only.

Among patients treated with SCV-07, 57% had negative sputum cultures after one month and 80% were negative after three months. Among controls, cultures were negative for only 19% and 37%, respectively. These results imply that SCV-07 may be able to reduce the time of TB treatment, according to Cynthia Tuthill, SciClone's vice president for scientific affairs. "The real benefit, however, is that by reducing the time that patients are contagious, there is less opportunity to spread the infection," she explained.

Although its results are encouraging, this was a relatively small study, warns Martin Bachmann, chief scientific officer of Cytos Biotechnology AG. "Side effects are always a major concern with non-specific stimulators. It is quite possible that problems may be encountered when patient numbers are increased," he cautioned.

Even though it is yet to be tested in phase III clinical trials, the development of SCV-07 could be a significant step in the continuing fight against TB - and perhaps some other infectious diseases as well. This progress might never have occurred without the help of the US Civilian Research & Development Foundation (CRDF), which has provided funding for the project and facilitated cooperation between SciClone and its Russian counterpart, Verta.

CRDF is a nonprofit charitable organization that promotes scientific and technical collaboration between the US and the countries of the FSU. One of its main goals is to give opportunities to scientists and engineers in the FSU, many of whom used to work for the military, to do "real" science and engineering work, so they wouldn't have to leave their country or their profession in order to survive, says Tom Owens, a Senior Advisor with CRDF.

The SCV-07 trial was a project that helped accomplish this goal, because it utilized the expertise of former defense scientists. But CRDF has supported many other successful projects as well, Owens points out. As an example, he mentions an American company that tried to develop a special cooling system to refrigerate large trucks delivering perishable food, such as fresh produce or raw meat.

Initial attempts had failed, due to hot spots and cold spots in various parts of the truck. Eventually, however - with the help of some Ukrainian scientists who were specialists in cooling technology used for ICBMs, as well as a $50,000 grant from CRDF - the company was able to develop a cooling system providing even heat distribution.

According to Owens, any US company is eligible for financial assistance from CRDF "as long as it has a serious interest and wishes to develop a new relationship with a group in the former Soviet Union on a project in which there could be a decent chance for commercial application in the future."

"We fund projects up to the time of being commercial," Owens said. Funding may be in the form of travel grants or awards for experiments and other R&D activities that can help people make a decision to enter the commercial market, he explains.

Picture caption:
Scanning Electron Micrograph of Mycobacterium tuberculosis, NIAID/NIH.

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See also:
Mycobacterial persistence: adaptation to a changing environment
[Review]
Kerstin Höner zu Bentrup and David G. Russell
Trends in Microbiology, 2001, 9:12:597-605

Mycobacterium tuberculosis in the post-genomic age
[Review]
Pilar Domenech, Clifton E. Barry, III and Stewart T. Cole
Current Opinion in Microbiology, 2001, 4:1:28-34
 

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