Monday, June 22, 2009

Unraveling the Mysteries of AIDS

New research institute focuses on harnessing the power of the immune system to develop vaccine


HIV virus particles

Over the course of nearly three decades of research, Massachusetts General Hospital physician-scientist Bruce Walker, MD, has noticed a fascinating trend emerge: Some patients infected with HIV are able to control the virus without taking medication. What’s more, these patients are still alive nearly 30 years later.

Earlier this year, the search to unravel the virus’ mysteries received a major boost with the establishment of the Ragon Institute of MGH, MIT and Harvard. Formed to find new ways to prevent and treat human disease, the institute will focus initially on solving one of the most pressing global health crises today, the need for an effective vaccine against AIDS.

“The transforming aspect of this gift,” says Walker, who heads up the institute, “is that it’s allowing us to bring together the brightest scientists and engineers from MIT and Harvard who have never worked on HIV into the field. By removing the traditional boundaries between disciplines, top researchers can apply their full potential to developing a vaccine.”

The $100 million gift to establish the institute is the largest in Mass General’s history.

Three Decades on the Frontlines

Dr. Walker in South Africa

An early pioneer in AIDS research, Walker saw his first HIV-infected patients in 1981 at Mass General. “Although it took nearly 15 years to develop drug combinations, known as antiretrovirals, to treat HIV effectively, when it finally happened it was the most stunning transformation of an illness I had ever seen,” recalls Walker. “Patients went from their death beds to recovery within weeks, and most of these patients are still alive today.”

Today approximately 5.4 million people are living with AIDS in South Africa. Walker’s research, both at Mass General and in South Africa, where he oversees a state-of-the-art research facility he helped establish in 2003, focuses on how some individuals are able to keep the virus in check, similar to the way humans deal with a host of other viruses.

Hear Dr. Walker continue the story


“The immune system is incredible,” says Walker. “You see that when it is taken away from someone with AIDS, and it’s horrible. A major focus of our work both here and in South Africa is understanding why not every exposure leads to HIV infection, why some people can be repeatedly exposed and not get infected and how the human body initially tries to deal with the HIV virus once it is exposed.”

Understanding how the immune system controls the virus will be critical for developing treatments that can replicate those responses. A recent article in Nature, to which Walker contributed, details work identifying antibodies that appear to neutralize the virus and protect against infection.

Such knowledge could lead not only to the prevention and treatment of AIDS but also to the treatment of other diseases, such as influenza and cancers. “We’ve picked the most difficult pathogen to work on first,” he says, “but the things that we’re going to learn will have broad-reaching implications for other diseases, including cancer.”

Hear Dr. Walker continue the story

Fresh Perspectives Through New Collaborations

Susan M. Ragon and Phillip T. Ragon

Susan M. Ragon and Phillip T. Ragon

The Ragon Institute offers researchers an extraordinary opportunity to change how academic research is conducted. “We’ve been at this problem for 25 years and we haven’t solved it, so how are we going to do it? Well, we’re going to push the envelope and bring in other people who can provide a fresh perspective,” says Walker.

Unlike most grants, which come with guidelines for how the support can be used, the Ragon gift offers Walker and his team the freedom to work with researchers from across disciplines — from cancer biology to bioengineering.

Walker believes the next phase of AIDS research will take place at the intersection between science and engineering. “So much of medical advancement is driven by technology development. Through the Ragon Institute, we’re now linked in with engineers who can develop new technologies to answer scientific questions that have never before been addressable.”

Setting the Stage for Vaccine Development

The new collaborations have brought with it real optimism for advancing understanding and for ultimately developing a vaccine.

“I think HIV is a solvable problem, and the reason I think it’s solvable,” he says, “is because that is what nature is telling us. There are people who don’t get sick and don’t transmit the virus to other people. That tells me that we can conquer this virus. We need to know how that is happening and then we need to be smart enough to figure out how to reproduce that in everybody.”

And here in Boston, with its immense medical and technological resources, Walker believes, where many of the advances in AIDS research have been made, is where the next steps in vaccine development will occur.

“What better place in the world to try and achieve new ideas and perspectives than here, where we have some of the best scientific minds in the world? Many have never had the opportunity to think about this problem but are now thinking about it on a daily basis,” he says. “It’s just absolutely incredible what Susan and Terry Ragon have done.”

In addition to vaccine development, Mass General is involved in several grassroots efforts to help address the AIDS crisis in South Africa, including iTEACH, a program based at Edendale Hospital where Mass General residents provide training and treatment throughout the region.


Learn More

In Africa, stigma is one of the biggest factors affecting whether people seek testing and treatment for HIV.

Listen to what Krista Dong, a Mass General employee living in South Africa, and her colleagues are doing to help overcome this stigma

Through iTEACH, a program based at Edendale Hospital in South Africa, Mass General residents experience firsthand how medicine is practiced globally in resource-scarce settings.

Listen to how Mass General residents work through different models of health care delivery to provide outstanding care

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