The NICHD devotes a significant portion of its research portfolio to developing new ways to prevent a wide array of diseases and conditions, and finding new ways to keep us healthy. The investment is paying off. In the past year, NICHD-supported scientists made significant advances that have the potential to significantly reduce disease burden and save millions of dollars spent on medical treatment.

New Class of Antimicrobial Agents Found in Human Milk. One of the most common causes of infant mortality worldwide is diarrhea, which is commonly caused by the bacterium Campylobacter jejuni. [1][2] To infect a child, the bacterium must go through a series of steps, the first of which is to be ingested and bind to the cell surface. From there the bacterium can invade the cell and produce toxins that cause illness and diarrhea. Through a series of experiments, NICHD-supported researchers not only identified how the bacterium attaches to cells, but also identified a long-chained sugar molecule in breast milk that inhibits the attachment.

Furthermore, the investigators showed that these sugar molecules also protect infants from infections from other bacteria and a virus that cause intestinal and respiratory infections. This finding could significantly help to reduce infant mortality worldwide by providing a strong scientific basis to strengthen policies that support breastfeeding, especially in non-hygienic environments. Equally important, this discovery suggests a promising new class of antimicrobial agents that could help prevent and treat bacterial and possibly viral infections. Unlike other antibiotics, these milk sugars work by blocking the bacterium's ability to attach to a cell, rather than by interfering with the bacterium's replication and protein synthesis, the way that many antibiotics work. This suggests that new drugs derived from these natural antibiotics would be unlikely to induce bacterial resistance, a phenomenon that has reduced the usefulness of a number of antibiotics over time.

Innovative Technology Can be Used to Improve Anthrax Vaccine. Soon after the September 11, 2001, attacks, the U.S. mail was contaminated deliberately with Bacillus anthracis (anthrax) spores and 22 people were infected.[3] This spurred national interest in developing a new vaccine to protect against a bioterrorist attack with anthrax. Although safe and effective, the current anthrax vaccine was developed over 50 years ago. When bacteria invade the body, the immune system responds in a number of ways, one of which is by producing antibodies to specific bacterial components, rendering the bacteria harmless. Vaccines work by stimulating production of cells that produce these antibodies. The cells retain the ability to produce the antibodies, should the bacteria return. As a first step in developing a new vaccine, NICHD scientists targeted a surface protein, (-D-glutamic acid, as a new point of attack, and applied a revolutionary "conjugate" technology they developed. This technology is especially useful when developing vaccines for infants and younger children, as it helps their immature immune systems develop antibodies. By systematically synthesizing, evaluating, and testing (-D-glutamic acid "conjugates" in mice, the researchers successfully induced a new type of anthrax antibody. In the course of developing the conjugates, the researchers also developed a way to measure and standardize the amount of conjugate antigen needed to produce optimal antibody levels. Overall, these discoveries can help to determine the lowest level of vaccine required, thereby reducing the number of injections needed to reach a desirable and long-lasting immunity level, and minimizing undesirable side effects. This, in turn, increases the potential that more children, families, and communities can be protected against the deadly anthrax infection.

Food Fortification with Folate: Helping the Young and the Elderly. . Sometimes measures taken to prevent or treat one disease can have unintended adverse consequences. For example, researchers have long known that high levels of the B-vitamin, folic acid or folate, can mask a deficiency of another essential nutrient, vitamin B12. A vitamin B12 deficiency can result in a type of anemia and irreversible neurological damage. Normally, vitamin B12 deficiency is diagnosed using a blood test for the anemia; however, high levels of folic acid mask the anemia without preventing the neurological damage. Nonetheless, when a decision was made to fortify the nation's supply of bread and cereal products with folic acid to reduce the risk for neural tube defects, without knowing what level of folate intake would mask a B12 deficiency, scientists began to question whether individuals (especially the elderly) with B12 deficiency who consume large amounts of grain products would fail to have the condition diagnosed. After reviewing the medical records of over 1500 veterans, scientists concluded that fortifying cereal grains with folate, which can lead to a two-to-three fold increase in blood folate levels, did not increase the number of undetected cases of vitamin B12 deficiency. These findings reaffirm the value of fortifying the nation's food supply with folic acid to help prevent birth defects in babies and heart disease in adults.