Hadassah breakthrough can predict
post-traumatic stress disorder
by David Brinn, Israel21C
Whether you’ve been involved in a traffic accident or a terror attack, the most important thing to determine is that you haven’t been injured. Emergency rooms are built specifically to take care of a patient’s physical injuries. But what about emotional fallout due to the traumatic event that just took place - especially the delayed reaction of post-traumatic stress disorder (PTSD)?
Israeli researchers at the Hadassah University Medical Center in Jerusalem have determined that a simple blood test might enable psychiatrists to predict if a person will develop PTSD. The test can be conducted while the patient is still in the emergency room, only hours after the traumatic event occurred. Post-traumatic stress disorder is a severe mental condition that can be severe, persistent and disabling, and occurs in a significant minority of trauma survivors beginning at the moment of the traumatic event, according to Prof. Arie Shalev, head of Hadassah’s Department of Psychiatry, who led the research with Dr. Ronen Segman of the Psychiatric Laboratory at Hadassah University Hospital-Mt. Scopus. However, the symptoms brought on by PTSD - like sleeping disorders, difficulty in concentrating, irritability, nightmares and flashbacks to the traumatic event - may not emerge sometimes until four months after the event, and may persist months and years later.
The researchers discovered unique biomarkers in blood taken from patients treated in at the Hadassah emergency room just hours after being exposed to a traumatic event. This physiological “signature” has been found to accurately identify the 12 percent or so of patients will develop PTSD. The results of the team’s findings were published in the journal Molecular Psychiatry.
Using an innovative methodology, they simultaneously examined thousands of possible biomarkers using microarrays (gene chips). Microarrays, which have been used to measure the activity of thousands of genes at one time in cancer or immune cells, have given scientists “snapshots” of gene activity that lead to better understanding of the cells and genetic machinery. The researchers believe that after some improvement in the testing process, it will be possible to predict the PTSD symptoms. Hadasit, the Hadassah subsidiary in charge of promoting and commercializing intellectual properties generated at Hadassah, has already patented the findings of the research and is in advanced stages of developing a commercial diagnostic kit for PTSD.
“Research is like climbing the Himalayas - the further one gets into the mountains - the steeper the slope becomes, the view gets better and better, and one has to be supplied with more oxygen. Thus the challenges ahead of us are major on both organizational and hypothesis testing levels,” Shalev said.
Vaccine enables recovery of AIDS
patients’ immune systems
by David Brinn, Israel21C
A Hadassah University Medical Center research team has developed a vaccine that significantly strengthens the body’s immune system against the autoimmune aftereffects of HIV infection, a breakthrough that could dramatically make an impact in the treatment of AIDS patients. The researchers found that although treatment with the widespread AIDS cocktail of medications kills the virus, the immune system continues to kill healthy cells; this research focuses on developing a vaccine that would arrest this autoimmune destructive process. The results of this study were published in the Journal of Clinical Virology.
“The HIV virus starts killing white blood cells in the body,” said lead researcher Dr. Rivka Abulafia-Lapid. “The AIDS cocktail has been proven to be effective at fighting and treating the virus, but we realized three or four years after patients received the cocktail that their immune system does not always recover. We investigated what was behind this, and found that there’s an autoimmune process that continues unabated despite the fact that the patient is taking the cocktail.”
New drugs called protease inhibitors, which first approved in 1995, revolutionized the treatment of patients infected with the AIDS virus. These drugs usually are taken with two other drugs called reverse transcriptase inhibitors. The combined drug “cocktail” - also known as highly active antiretroviral therapy (HAART) - has helped change AIDS in the last few years from being an automatic death sentence to what is now often a chronic, but manageable, disease. However, while the virus disappears in many patients, their immune systems remain dangerously ineffective against foreign elements, and many of the patients end up dying due to related complications.
“In about 50 percent of the cases, despite the disappearance of the virus, or at least the virus being below detection level, the immune system does not bounce back,” said Abulafia-Lapid. HIV, the human immunodeficiency virus, infects a type of white blood cell called CD4, an integral component in the body’s immune system. As HIV attacks and destroys CD4 cells, the weakened immune system becomes less able to fight infection and disease. HIV can also cause AIDS, the last and most severe stage of HIV infection.
The Hadassah study was conducted between 1998 and 2002 with an additional two-year monitoring period. Seven patients participated in the study; five of the seven patients responded positively to the vaccine developed by the research team. Abulafia-Lapid was assisted by Yael Keren-Zur, at the Human Biology Research Center directed by Prof. Henri Atlan, associated with the Department of Biophysics and Nuclear Medicine, Ein Karem, Jerusalem. The study was conducted in collaboration with Prof. Zvi Bentwich, and Prof. Irun Cohen from the Weizmann Institute of Science.
For most AIDS patients, the central immune system does not recover even if the HIV virus is almost eliminated through treatment with the cocktail of medications. The Hadassah vaccine was designed to stop the continuation of the autoimmune process.
“We were able to locate the white blood cells responsible - which were programmed to kill the good cells in the body and we were able to isolate them in clinical trials,” said Abulafia-Lapid. Seven patients were treated with the new therapeutic vaccine. Each received between three and four injections in a six-month period. Following treatment, the patients CD4 cell count was continually monitored for another two years from their initial vaccination to determine if the number of CD4 cells increased in the peripheral blood, and subsequently, reinforced the strength of the immune system. In five of the seven vaccinated patients, the CD4 cells increased by more than 50 percent.
The researchers are continuing to develop the vaccine funded by a grant from Hadasit, the Hadassah subsidiary that promotes and commercializes the intellectual properties generated at Hadassah and by the Center for the Study of Emerging Diseases.