NIAID Forms Network to Tackle Potentially Fatal Reaction to Smallpox Vaccine
The National Institute of Allergy and Infectious Diseases (NIAID),
part of the National Institutes of Health (NIH), today launched
the Atopic Dermatitis and Vaccinia Network (ADVN), a nationwide
research group that seeks to reduce the risk of eczema vaccinatum
(EV), a severe and potentially deadly complication of smallpox immunization.
EV occurs almost exclusively in people with a history of atopic
dermatitis (AD), a chronic, itchy skin condition commonly referred
to as eczema. While uncommon, EV can develop when AD patients are
given the smallpox vaccine or come into close personal contact with
people who recently received the vaccine. If untreated, EV can kill
between 1 to 6 percent of those affected. In children younger than
2 years of age, EV has been estimated to kill up to 30 percent.
"Millions of Americans have a history of atopic dermatitis,"
says Anthony S. Fauci, M.D., director of NIAID. "Launching
this network is an important step toward our goal of helping to
protect everyone against the smallpox virus without the risk of
life-threatening complications."
"Previous studies suggest that both innate and adaptive immunity
are impaired in patients with atopic dermatitis, but the specific
defects that increase the likelihood of eczema vaccinatum have yet
to be explained," says Daniel Rotrosen, M.D., director of NIAID's
Division of Allergy, Immunology and Transplantation. "The information
generated by this network will improve our understanding of the
immune responses of these patients and should greatly influence
the design of a safer smallpox vaccine."
The ADVN comprises three integrated components: a clinical studies
consortium, an animal studies consortium and a statistical and data
coordinating center.
The ADVN Clinical Studies Consortium will, among other activities,
seek to understand why people with AD have such severe reactions
to smallpox vaccine by evaluating their immune responses after natural
exposure to less harmful skin viruses such as herpes simplex. The
ADVN Animal Studies Consortium will establish animal models of AD
and investigate their immune responses to vaccinia the virus used
in smallpox vaccine and other skin viruses such as varicella, which
causes chickenpox and shingles. The ADVN Statistical and Data Coordinating
Center will support these clinical and animal studies by analyzing
research data, coordinating trials and regulatory activities, and
developing and maintaining a registry of AD patients.
The six institutions in the ADVN Clinical Studies Consortium and
the principal investigator at each are
- National Jewish Medical and Research Center, Donald Leung,
M.D., Ph.D.
- Oregon Health and Science University, Jon Hanifin, M.D.
- Children's Hospital Boston, Lynda Schneider, M.D.
- University of California at San Diego, Richard Gallo, M.D.,
Ph.D.
- Johns Hopkins Asthma and Allergy Center, Lisa Beck, M.D.
- University of Bonn, Germany, Thomas Bieber, M.D., Ph.D.
The five institutions in the ADVN Animal Studies Consortium and
the principal investigators at each are
- Children's Hospital Boston, Raif Geha, M.D., and Hans Oettgen,
M.D., Ph.D.
- National Jewish Medical and Research Center, Donald Leung,
M.D., Ph.D., and Erwin Gelfand, M.D.
- Harvard Skin Diseases Research Center, Thomas Kupper, M.D.,
and Robert Fuhlbridge, M.D.
- University of Illinois at Chicago, Lawrence Chan, M.D.
- La Jolla Institute for Allergy and Immunology, Toshiaki Kawakami,
M.D., Ph.D.
The ADVN Statistical and Data Coordinating Center will be operated
by Rho Federal Systems Division. The principal investigator is Susan
Lieff, Ph.D.
NIAID is a component of the National Institutes of Health, an agency
of the U.S. Department of Health and Human Services. NIAID supports
basic and applied research to prevent, diagnose and treat infectious
diseases such as HIV/AIDS and other sexually transmitted infections,
influenza, tuberculosis, malaria and illness from potential agents
of bioterrorism. NIAID also supports research on transplantation
and immune-related illnesses, including autoimmune disorders, asthma
and allergies. Press releases, fact sheets and other NIAID-related
materials are available on the NIAID Web site at http://www.niaid.nih.gov.
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