TSRI receives fund to develop new field test for Onchocerciasis

Philanthropist, businessman and community leader John Moores has given The Scripps Research Institute (TSRI) approximately $2 million to fund the development of a new field test for Onchocerciasis, or river blindness, a parasitic infection that affects tens of millions of people in Africa, Latin America and other tropical regions.

"We are grateful for John's generosity and foresight," said Michael A. Marletta, president and CEO of TSRI. "This gift has the potential to revolutionize treatment of a disease that causes widespread suffering in the developing world. We are fortunate to have John as a long-time supporter who recognizes the impact our science can have to improve human health."

Moores, former chair of the TSRI Board of Trustees, has been a leader in the fight against worm-carried conditions. In 2005, he founded the Worm Institute of Research and Medicine (WIRM) at TSRI with a $4 million gift. Previously, Moores founded the River Blindness Foundation to distribute a treatment in developing countries, principally in sub-Saharan Africa; in 1997, the foundation was absorbed into The Carter Center of Atlanta, where Moores is trustee emeritus.

Breakthrough Results

Moores's new gift to TSRI follows the publication of breakthrough results from the laboratory of Professor Kim D. Janda, who is director of WIRM, Ely R. Callaway, Jr. Chair and member of the Skaggs Institute for Chemical Biology at TSRI. In the new study (PNAS, February 25, 2013, doi: 10.1073/pnas.1221969110) [http://www.pnas.org/content/early/2013/02/21/1221969110.abstract], the team identified a biomarker, detectable in patients' urine, that is secreted by Onchocerca volvulus worms during an active infection.

"For this to be of value in Third World countries we need to morph this biomarker into something that's inexpensive, simple to use, tolerant of extreme temperatures and portable-basically distilling our finding to a test that can be carted around in a backpack," said Janda. "This new gift will make that possible."

A leading cause of vision loss, Onchocerciasis infections are transmitted among humans by river-dwelling blackflies in tropical regions. The vast majority of cases occur in sub-Saharan Africa, although pockets of endemic infection exist in Yemen and in Central and South America. The major symptoms of the disease, including blindness, result from the spread of O. volvulus "microfilariae"-early-stage larval worms-to the eyes and other tissues, where they trigger damaging inflammatory reactions.

Mass treatment campaigns, begun in the 1990s, have used the anti-worm drug ivermectin, as well as the antibiotic doxycycline, which kills a symbiotic bacterium within the worms. But Onchocerciasis treatment is seldom effective immediately, and often spares adult worms. The latter can remain in protected nodules under the skin of a patient and secrete microfilaria for a decade or more.

Current diagnostic methods include the painful cutting of "skin snips" from patients for microscopic analysis and an ELISA antibody test for microfilariae, which may yield positive results even for non-active infections. Health agencies need better diagnostic methods to track the progress of Onchocerciasis treatment campaigns and to wisely monitor the use of ivermectin and doxycycline to reduce the risk of resistance.

Janda envisions the new diagnostic test, which he hopes to develop over the next two years, as a simple, accurate and painless urine dipstick test, much like a home pregnancy test. The diagnostic would indicate the amount of the O. volvulus biomarker present in the sample to guide treatment decisions and assist global health leaders in their quest to eradicate the disease.

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