This Week in PLOS NTDs and Pathogens: Advancing Neurocysticercosis Research; Ivermectin vs. Onchocerciasis; Rhoptries Revealed; and HCV-Induced Liver Disease

By Matt Lopez
Posted: April 25, 2013
Figure 3. Malhotra S, Yen JY, Honko AN, Garamszegi S, Caballero IS, et al. (2013) Transcriptional Profiling of the Circulating Immune Response to Lassa Virus in an Aerosol Model of Exposure. PLoS Negl Trop Dis 7(4): e2171. doi:10.1371/journal.pntd.0002171


Malhotra S, Yen JY, Honko AN, Garamszegi S, Caballero IS, et al. (2013) Transcriptional Profiling of the Circulating Immune Response to Lassa Virus in an Aerosol Model of Exposure. PLoS Negl Trop Dis 7(4): e2171. doi:10.1371/journal.pntd.0002171

The following new articles are publishing in PLOS NTDs this week:

Neurocysticercosis (NCC) is the most common cause of adult acquired epilepsy worldwide and one the most frequent parasitic infections associated with chronic morbidity encountered in the United States, but study of the disease remains underfunded. Here Dr. Theodore Nash and colleagues discuss the importance of NCC as a preventable and treatable infection, as well as advancements, goals, reasons for lack of material support and a roadmap for advancement.

Studies in Mali, Nigeria and Senegal have shown contradictory results concerning the efficacy of long-term ivermectin distribution for onchocerciasis elimination. Dr.

Hugo Turner and colleagues explore how assumptions regarding aspects of treatment effects can affect temporal projections of infection load and prevalence in highly endemic African savannah settings.

Despite the significant public health issues and potential biodefense risks posed by the Lassa virus (LASV) little is known of the human immune response to this hemorrhagic fever. Dr. Shikha Malhotra and colleagues outline here an unbiased genomics approach to map the temporal host response in the peripheral blood mononuclear cells of non-human primates exposed to LASV. Their results provide a picture of the host’s circulating immune response to LASV exposure and demonstrate that gene expression patterns correlate with specific stages of disease progression.

The following new articles are publishing in PLOS Pathogens this week:

As with many intracellular infectious agents, the protozoan Toxoplasma gondii has a quiver of effectors that it uses to co-opt host cell functions including several from a paralogous family of protein kinases and pseudokinases that are injected into the host cell from the apical secretory organelles known as rhoptries (ROPs). In this Pearl, Dr. John Boothroyd presents how these ROPs were found and the current state of knowledge about their function.

Hepatic inflammation during chronic HCV infection is considered to be the primary catalyst for progressive liver disease and development of liver cancer but the underlying molecular mechanisms are not well understood. The results from Dr. Amina Negashand and colleagues identify HCV-induced IL-1b production by hepatic macrophages as a critical and central process that promotes liver inflammation and disease.

Emerging evidence suggests that the p65 family of guanylate-binding proteins (GBPs), which is upregulated by interferon gamma, play an important role in host defense against intracellular pathogens. Dr. Elizabeth Selleck and colleagues provide findings that demonstrate that Gbp1 plays an important role in the IFN-c-dependent, cell-autonomous control of toxoplasmosis and predict a broader role for this protein in host defense.

Category: General, Neglected Diseases | Leave a comment

Malaria: Targets and Drugs for All Stages

By Kasturi Haldar and Margaret Phillips
Posted: April 25, 2013

More drugs for malaria: time to expand the antimalarial portfolio

Malaria is an ancient enemy. Its treatments predate modern drug discovery, most notably the use of the Qinghao plant in ancient China (2nd century BC to 340 CE) and Peruvian bark in the early 17th century, the medicines from which are now known to be artemisinin and quinine respectively. Calls for the eradication of malaria have brought renewed focus on tools to control malaria.  Yet, although disease burdens have been lowered in the last five years, malaria remains endemic in over 100 countries and, with an estimated seven hundred thousand deaths in 2010, is still a leading cause of mortality and morbidity worldwide.

Drug research in malaria often focuses on blood stage parasites because they are responsible for the symptoms of the disease and are easier to manipulate in the laboratory.   The assembled PLOS Collection describes multiple parasite and host processes engaged in infection in blood, the blocking of which could stop human illness. However, control and eradication of malaria will also require the development of drugs against stages responsible for mosquito transmission and those that remain latent in the liver, also summarized in the collection. Although these selected papers represent significant research at the highest levels, they are only a fraction of the malaria drug discovery literature.

Despite research, a significant historical hurdle was the market failure of the pharmaceutical industry to invest in the discovery and development of new antimalarials.  Thus new partnerships have arisen that bring together academic and pharmaceutical work.  For example, the not-for-profit product development partnership Medicines for Malaria Venture (MMV) was established in 1999 to discover, develop and deliver new antimalarials in collaboration with both the public and private sector.  They are joined by the Bill and Melinda Gates Foundation , multiple agencies including the National Institutes of Health , the Wellcome Trust, Medical Research Council and others. Never before have philanthropic, public and large Pharma resources been better integrated for antimalarials, progressing research in early stages to testing drugs in humans, subsequent registration and delivery to patients.
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Seasonal Malaria Chemoprevention: Good News in a Year Marked by Malaria Emergencies

By Médecins Sans Frontières
Posted: April 25, 2013

Estrella Lasry from Médecins Sans Frontières reflects on the roll out of seasonal malaria chemoprevention in Mali and Chad.

In 2012, MSF projects in several countries saw an important increase in cases of malaria, a prolonged peak in areas of seasonal transmission, and more than 6 emergency interventions were launched to fight this increase.

Image Credit: Estrella Lasry/MSF

Image Credit: Estrella Lasry/MSF

While the past decade has seen drastic improvements in the response to malaria (rapid diagnostic tests, affordable artemisinin-based combination therapies, and strategies relying on trained community health care workers) this 2012 experience showed that several challenges remain, including the scaled-up use of injectable artesunate for severe cases, outbreak response, and addressing malaria in areas of high seasonal transmission.

In the latter case, recent studies in West Africa have shown how seasonal malaria chemoprevention (SMC) can be effective at reducing cases of both simple and severe malaria.
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Should the Alcohol Industry Inform Evidence-Based Health Policy?

By Paul Simpson
Posted: April 24, 2013

In a Policy Forum article published in this week’s PLOS Medicine Jim McCambridge and colleagues analyze submissions made by Alcohol Industry actors to the Scottish Government’s 2008 consultation on ‘Changing Scotland’s relationship with alcohol.’ The Scottish Government’s report was significant because it was the first government report within the UK to adopt a whole population approach to alcohol policy rather than considering alcohol misuse simply as an individual choice, and it included measures to introduce minimum unit pricing.

In their PLOS Medicine article Jim McCambridge and colleagues found that submissions to the Scottish Government’s consultation that were included in their case study, “ignored, misrepresented, and otherwise sought to undermine the content of the international evidence base on effective policies in order to influence policy” and they concluded “we suggest that the public interest is not served by industry actors’ involvement in the interpretation of research evidence.”

Speaking on BBC Radio 4’s Today programme Dr McCambridge noted, “What is very striking about the submissions made in this case is
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Eliminating Neglect and Neglected Tropical Diseases

By Peter Hotez
Posted: April 23, 2013

PLOS NTDs Editor-in-Chief, Peter Hotez, highlights progress in the elimination of neglected tropical diseases through mass drug administration and other measures.

This month, a landmark paper was published in PLOS Neglected Tropical Diseases.  A group of scientists and public health experts from the ministry of health of Togo and Togo’s Université de Lomé, together with Norway’s Health & Development International and the Georgia-based Mectizan Donation Program, Rollins School of Public Health at Emory University, and the United States Centers for Disease Control and Prevention (CDC), reported that Togo will soon become the first sub-Saharan African country to eliminate lymphatic filariasis [1]. Their approach to elimination relied on mass drug administration (MDA) with ivermectin and albendazole donated by Merck & Co. and GlaxoSmithKline, respectively, together with programs of morbidity management – lymphedema management and hydrocele surgeries – and monitoring and evaluation [1].

The importance of the paper stems from the fact that it provides further proof of principle that sub-Saharan African nations are building on their previous successes in elimination or eradication of selected neglected tropical diseases (NTDs) including dracunculiasis (guinea worm) in most of the region, onchocerciasis (river blindness) in two countries, and human African trypanosomiasis (sleeping sickness) in more than a dozen countries. In addition, the article highlighted the roles of morbidity management alongside MDA and essential financial support for the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) [1].

I previously reviewed the success stories achieved to date for eliminating 11 of the high prevalence NTDs using MDA and other measures [2], which can now be updated to include information from the World Health Organization’s (WHO’s) 2020 Roadmap on NTDs included in the Second WHO Report on NTDs [3], together with new information on eliminating onchocerciasis in Guatemala and southern Mexico [4] and trachoma elimination [5]. The six diseases listed in Table 1 are those specifically targeted for elimination in 2012 by a London Declaration on NTDs in collaboration with a consortium of donors and industrial partners [6].
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Category: General, Global Health Metrics, Neglected Diseases, Policy | 1 Comment

This Week in PLOS Medicine: Atherosclerosis & Air Pollution, Non-melanoma Skin Cancer, & the Scottish Alcohol Industry

By Laura Ray
Posted: April 23, 2013
Image Credit: Flickr Jennifer Barnard

Image Credit: Flickr Jennifer Barnard

This week PLOS Medicine published articles ranging from research on the link between air pollution and atherosclerosis to a case study of the Scottish alcohol industry’s effect on public policy.

In a prospective cohort study, Sara Adar and colleagues found that decreasing levels of fine particulate matter in multiple US urban areas are associated with slowed progression of intima-medial thickness, a surrogate measure of atherosclerosis. Nino Künzli contextualized these findings as some of the first human evidence for the impact of air pollution on the development of atherosclerosis.

In a prospective study, Jiali Han and colleagues found a modestly increased risk of subsequent malignancies among individuals with a history of non-melanoma skin cancer, specifically breast and lung cancer in women and melanoma in both men and women.

Jim McCambridge and colleagues analyzed industry submissions to a Scottish Government consultation on whole population approaches to alcohol policy. The authors noted that studies of the nature of alcohol industry and other corporate influences on public policies can be informed by work already conducted on the tobacco industry.

In honor of the WHO’s World Immunization Week, the PLOS Medicine homepage features a selection of recent research and policy articles on vaccination.

Remember you can comment on, annotate and rate any PLOS Medicine article and see the views, citations and other indications of impact of an article on that articles metrics tab.

 

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Vaccines in Developing Countries: Why the High Prices?

By Médecins Sans Frontières
Posted: April 23, 2013

Kate Elder and Jennifer Cohn from Médecins Sans Frontières question why new vaccines are so expensive. 

Global health leaders will gather in Abu Dhabi on April 24-25 for a Vaccine Summit to discuss recent accomplishments and seek ways to expand the impact of childhood vaccination under the Decade of Vaccines (DoV), an initiative for collective action announced by Bill Gates at the 2010 World Economic Forum.  Promoting greater affordability and accessibility—key tenets for increasing immunization coverage—should be at the top of the agenda.

The past few years have brought many positive developments, with childhood vaccination now saving an estimated 2-3 million lives each year. But huge gaps remain. In 2011, over 22 million children—20% of the global birth cohort—did not receive the full WHO-recommended package of basic vaccines. Teams from Doctors Without Borders/Médecins Sans Frontières (MSF) see the consequences of these gaps every day in the children we treat—among refugee populations, people caught in conflict, or in more routine settings of maternal and child health clinics.

Leaders in Abu Dhabi will call for funding the DoV at approximately US$57 billion over the next ten years, almost half of it for purchasing the vaccines.

While vaccines are often called a ‘best buy’ in public health, the overall cost of the vaccines package has skyrocketed in the past decade
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Earthquakes, Cyclones, Tsunamis, Floods and Volcanoes – assessing the human impact of each

By Virginia Barbour
Posted: April 19, 2013
Image Credit: jurvetson via flickr

Image Credit: jurvetson via flickr

This week PLOS Currents: Disasters publishes a set of five papers on the Human Impact of five different Natural Disasters: cyclones, floods, earthquakes, tsunamis and volcanoes.

These papers illustrate several interesting issues in attempting to assess data in this area; a key one of which is simply how hard it is to gather data in any systematic way. The papers review the published literature on each topic. In addition, each paper includes a historical review of events compiled from relevant databases in the specific field, dating back as far as 1900, which provide essential additional data.

What do these papers show? There are some fascinating highlights and some specific policy implications. For all of these natural disasters early warning seems to be key to preventing avoidable deaths such as those that occur in volcano eruptions (ie thermal injuries from pyroclastic flow) or in cyclones where drowning is, perhaps not surprisingly, the major cause of death.

These papers therefore tie into the disaster preparedness that rightly has such a high priority internationally with Hyogo Framework for Action (HFA) – a 10 year plan that has a focus on the building resilience of nations and communities to disasters.

Moving forward these papers will provide a baseline from which other researchers can build. We at PLOS Currents: Disasters encourage submissions that address any of the issues highlighted by these reviews, especially submission of short reports on specific issues where timely publication is of the essence.

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Year 2 MHTF-PLOS Collection on Maternal Health – 12 new articles added

By Jocalyn Clark
Posted: April 17, 2013

In November we called for papers for Year 2 of the Maternal Health Task Force (MHTF)-PLOS Collection on Maternal Health. We plan to regularly update the Collection throughout 2013.

Yesterday we launched the new Year 2 Collection page and added 12 research articles recently published in PLOS Medicine and PLOS ONE. We at PLOS Medicine and our partners at MHTF are delighted to share this first update with readers, and welcome your feedback and comments on the articles.

The theme of the current Year 2 Collection is “Maternal Health is Women’s Health,” recognizing that it is crucial to consider maternal health in the context of women’s health throughout their lifespans.

Image Credit: Jack Zalium and Richard Basset

Image Credit: Jack Zalium and Richard Basset

The call for papers is still open – but please submit soon so papers can be considered this year.

Follow the Maternal Health Task Force @MHTF and PLOS Medicine @PLOSMedicine

 

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Book Review: Designed to Allure, Engineered for Harm: The Creation and Marketing of Processed Food

By PLOS Guest Blogger
Posted: April 17, 2013

Bill Wiist from Northern Arizona University reviews “Salt Sugar Fat: How the Food Giants Hooked Us” by Michael Moss

Image Credit: John Seb Barber @ Flickr

In “Salt Sugar Fat: How the Food Giants Hooked Us” the reader “sits in” on interviews with processed food industry executives and scientists, “tastes” product formulations and “reads” confidential documents.  Through the engaging writing style the reader feels privy to an insider’s view of the industry’s decision-making, research and marketing processes.  We learn that the industry adjusts the amount of sugar in their products so consumers reach the “bliss point” and want more; adjusts the amount and type of fat so that the “mouthfeel” makes the consumer crave more. We learn that the industry insists that salt is essential for production and shelf life. The processed food companies hire specialized research firms to conduct psychological and neurologic research that enables them to fine tune their products to allure and keep the consumer eating their product lines. We learn how products are packaged for appeal and convenience, and how advertizing targets children and moms.  We learn where products are strategically placed in the supermarket to entice consumers.

Moss shows that the industry deliberately manipulates the level of sugar, salt and fat in their products so that consumers crave the products, or according to some scientists, become “addicted.”
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