Quest for edible malaria vaccine falls short but method may work against some viral and bacterial infections.

The edible algae Chlamydomonas, seen here at UC San Diego, can be grown in ponds anywhere in the world.

Can scientists rid malaria from the Third World by simply feeding algae genetically engineered with a vaccine?

That’s the question biologists at UC San Diego sought to answer after they demonstrated last May that algae can be engineered to produce a vaccine that blocks malaria transmission. In a follow up study, published online today in the scientific journal Applied and Environmental Microbiology, they got their answer: Not yet, although the same method may work as a vaccine against a wide variety of viral and bacterial infections.

In their most recent study, which the authors made freely available on the Applied and Environmental Microbiology website at http://aem.asm.org, the researchers fused a protein that elicits an antibody response in mice against the organism that causes malaria, Plasmodium falciparum, which afflicts 225 million people worldwide, with a protein produced by the bacterium responsible for cholera, Vibrio cholera, that binds to intestinal epithelial cells. They then genetically engineered algae to produce this two-protein combination, or “fusion protein,” freeze dried the algae and later fed the resulting green powder to mice. The researchers hypothesized that together these proteins might be an effective oral vaccine candidate when delivered using algae.

The result? The mice developed Immunoglobulin A (IgA) antibodies to both the malarial parasite protein and to a toxin produced by the cholera bacteria. Because IgA antibodies are produced in the gut and mucosal linings, they don’t protect against the malarial parasites, which are injected directly into the bloodstream by mosquitoes. But their study suggests that similar fusion proteins might protect against infectious diseases that affect mucosal linings using their edible freeze-dried algae.

“Many bacterial and viral infections are caused by eating tainted food or water,” says Stephen Mayfield, a professor of biology at UC San Diego who headed the study. “So what this study shows is that you can get a really good immune response from a recombinant protein in algae that you feed to a mammal. In this case, it happens to be a mouse, but presumably it would also work in a human. That’s really encouraging for the potential for algae-based vaccines in the future.”

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UCSF study on T-cell behavior sheds light on how vaccines work.

Matthew Krummel, UC San Francisco

The immune system’s T cells, while coordinating responses to diseases and vaccines, act like honey bees sharing information about the best honey sources, according to a new study by scientists at UC San Francisco.

“In the morning, each bee goes looking individually for a sugar source, then comes back to the hive and does a dance in front of the other bees describing the location of what it’s found, which helps the hive decide collectively where the best source is,” said senior scientist Matthew Krummel, Ph.D., a UCSF professor of pathology.

They don’t bust the same moves as bees, but T cells gather together and communicate essential information to each other in a similar way, Krummel said, thereby helping to coordinate immune responses directed against invading pathogens. This discovery might lead to useful therapeutic interventions to fight disease, according to Krummel.

Results of the study were published online March 10 in Nature Immunology.

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Findings suggest patients with untreated depression poorly protected by shingles vaccination.

Michael Irwin, UCLA

Can an individual’s state of mind effect how well a vaccine may work? In the case of seniors and shingles, the answer is yes.

Reporting in the current online edition of the journal Clinical Infectious Diseases, Dr. Michael Irwin, a professor of psychiatry at the Semel Institute for Neuroscience and Human Behavior at UCLA, demonstrates a link between untreated depression in older adults and decreased effectiveness of the herpes zoster —or shingles — vaccine.

Shingles is a painful, blistering skin rash that can last for months or even years. It’s caused by the varicella–zoster virus, the same virus that causes chickenpox. It’s thought to strike more than a million people over the age of 60 each year in the U.S.

Every year, health officials urge individuals 50 and older to get vaccinated against the virus. The vaccine boosts cell-mediated immunity to the virus and can decrease the incidence and severity of the condition.

But in a two-year study, Irwin, the first author of the research and director of the UCLA Cousins Center for Psychoneuroimmunology, and his colleagues measured immune responses to the shingles vaccination among 40 people aged 60 or older who suffered from a major depressive disorder and compared these responses to similar levels in 52 control patients matched by age and gender. Measurements were taken at the beginning of the study, and then at six weeks, one year and two years after the patients received either the shingles vaccine or a placebo.

Depressed patients not being treated with antidepressants showed a weaker immune response to the varicella–zoster virus — and thus were less able to respond to the shingles vaccine — than patients who were not depressed and patients who suffered from depression but werereceiving treatment with antidepressants.

The findings suggest that patients with untreated depression were “poorly protected by the shingles vaccination,” Irwin said.

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Tips from UC San Diego to help keep the flu from spreading.

It’s that time of year again: flu season. The epidemic this year is widespread, afflicting millions in every state across the country. This year’s flu strain has been reported as particularly virulent, but there are essential steps that the UC San Diego community is encouraged to take to prevent contracting and spreading the flu.

Flu vaccines

“The first line of defense for preventions is getting the flu shot,” said Kim Delahanty, director of infection prevention/clinical epidemiology at UC San Diego’s School of Medicine. “It prevents healthy people from coming down with the flu and or prevents severe influenza illness. The sooner you get the vaccine, the better because it takes two weeks for your immunity to develop.”

UC San Diego’s Student Health Services has administered about 3,000 flu vaccines during the 2012-13 academic year, according to Dr. Regina Fleming-Magit, director of Student Health Services. “Until recently, the flu rate on campus has been low; however, there has been an increase in cases in recent weeks,” Fleming-Magit said.

Unvaccinated students are encouraged to get the flu shot from their health care provider and/or search this link to find flu vaccine sites near them.

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Related links:

• UC Davis tips for avoiding the flu
• UCSF: The 2013 flu season: How to protect yourself

The Berkeley Wellness Letter offers tips for flu season.

Each year the flu puts more than 200,000 Americans in the hospital and causes anywhere from 3,000 to 49,000 deaths. With the exception of the H1N1 flu (also called swine flu) in 2009, most of these deaths occur in people over 65. But even for healthy younger people, the flu — characterized by high fever, body aches, headaches and coughing — can be rough.

The CDC recommends that everybody over 6 months of age get vaccinated. It’s especially important for people 65 and older, anyone who has a chronic condition (such as lung or heart disease, diabetes, cancer or HIV infection), pregnant women, people on immunosuppressive drugs and health care workers. Mid-October through November is a good time to get it. Flu epidemics usually begin in January or February, and it takes a few weeks to develop immunity from the vaccination. Besides the familiar injection, a nasal spray flu vaccine is also approved for people under 50.

Still, the vaccine doesn’t guarantee that you won’t get the flu. An analysis of 31 studies covering 12 flu seasons, reported in Lancet Infectious Diseases this year, found that the most widely used flu vaccine in the U.S was just 59 percent effective, on average, for people 18 to 65. There were not enough data about older people, but there’s reason to believe the vaccine may be even less effective in them.

Unfortunately, many media reports interpreted this to mean that the flu vaccine is no good. But the results weren’t too surprising given that every year scientists have to predict months in advance which strains of flu virus will predominate in the next flu season in order to develop the vaccine in time (flu viruses are constantly mutating, even within a current flu season). If Mother Nature outwits the prediction — that is, if there isn’t a close match between the strains of the virus selected for the vaccine and the actual circulating viruses — the effectiveness of the vaccine drops. Then again, as shown in a study in Vaccine in 2010, even when the match is incomplete, the vaccine still reduces the chance of getting infected and, if you do get sick, the severity of the illness — as well as hospitalizations from the flu and pneumonia (a life-threatening complication of the flu).

What’s more, how well the flu vaccine works varies from person to person. It causes your body to develop antibodies against the virus — but people who are old and frail, are immune-compromised, and/or have a chronic illness don’t have as robust an immune response to the vaccine and thus may not be as well protected. Being overweight may also decrease your vaccine response and make you less able to fight the flu if you do get infected. On the other hand, some research has shown that getting the vaccine annually may provide cumulative benefits in older people — more reason not to skip a year.

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Vaccine trains immune system to target remaining tumor cells after surgery, chemo.

Daniela Bota, UC Irvine

UC Irvine oncologists are looking for new ways to treat glioblastoma multiforme, the deadliest type of brain cancer. While surgery followed by chemotherapy and radiation is the current standard of care, it doesn’t fully eliminate the cancer. The goal is to develop an additional therapy that seeks out and destroys the cancer cells that inevitably remain.

Dr. Daniela Bota is testing whether enlisting the immune system to fight the tumor can complement surgery, drugs and radiation and improve a patient’s odds of surviving. Nearly 14,000 Americans are diagnosed each year with glioblastoma multiforme, and only 10 percent will survive more than five years, according to the National Cancer Institute.

“Cancer cells are like crabgrass: Once they take root, they’re hard to eradicate,” says Bota, a neuro-oncologist and medical director of UC Irvine’s Comprehensive Brain Tumor Program. “The immune system is powerful, but it must be trained to recognize these cancer cells before it can do its job.”

Enter the experimental glioblastoma vaccine. Think of it as a personal brain cancer smoothie: Pulverized pieces of a patient’s surgically excised tumor are blended in a laboratory with his or her own white blood cells. When injected back into the body, the concoction programs the individual’s immune system with new targets – any remaining cancer cells.

“The lab becomes like a training camp outside the body,” Bota says.

She and Dr. Jose Carrillo plan to test several experimental immunotherapies and are now enrolling patients at UC Irvine’s Chao Family Comprehensive Cancer Center in a trial of a dendritic cell vaccine. Dendrites are a type of white blood cells that, once trained, can paint bull’s-eyes on cancer cells. A previous trial demonstrated that this vaccine is safe and, in some cases, doubled patients’ median survival after diagnosis from 15 months to about 31 months.

“The current standard of care prolongs survival, but it does not fully destroy the cancer,” Bota says. She believes the vaccine can help get rid of remaining tumor cells and further extend patients’ lives.

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Vaccine made with patient’s own cells targets tumor for destruction.

Daniela Bota, UC Irvine

UC Irvine doctors are enrolling patients with the deadly brain tumor glioblastoma multiforme in a clinical trial of a vaccine that may prevent the cancer’s return or spread after surgery.

“Our goal is to train the immune system to recognize and attack the cancer,” said Dr. Daniela Bota, neuro-oncologist and co-director of UC Irvine’s Comprehensive Brain Tumor Program. She will lead the Phase II trial at UC Irvine of DCVax, which was associated with increased survival in a previous study.

The vaccine is prepared in a lab and combines protein antigens extracted from the patient’s tumor with some of his or her white blood cells. These grow into dendritic cells that, when injected back into the patient, target the protein antigens and prompt the immune system’s T cells to identify and attack remaining cancer cells.

“Cancer cells are like crabgrass: Once they take root, they’re hard to eradicate, even after brain surgery,” Bota said. The current treatment for patients with glioblastoma multiforme involves surgery to remove as much of the tumor as possible, followed by radiation and chemotherapy.

“The standard of care prolongs survival, but it does not fully destroy the cancer,” Bota said. She believes the vaccine can help eliminate remaining tumor cells and further extend patients’ lives. Only 10 percent of the 12,000 to 14,000 people annually found to have glioblastoma multiforme survive five years.

Patients 18 to 70 newly diagnosed with this brain tumor (also called grade IV astrocytoma) may be eligible to enroll in the trial. For more information, call UC Irvine toll-free at 877-UCSTUDY (877-827-8839) or email ucstudy@uci.edu. Please refer to protocol UCI-08-16.

Additional information also is available at http://clinicaltrials.gov/show/NCT00045968.

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Clinic addressing new state requirements for families with personal belief exemptions.

Pediatric infectious disease experts at UC Davis will establish a new clinic where parents who decline to vaccinate their children because of their personal beliefs can receive immunization information, in response to a new state law requiring a signature from a health-care professional before such children enter school.

Dean Blumberg, chief of pediatric infectious diseases at UC Davis, said the law – and the new clinic – will give parents a chance to discuss their concerns about vaccinations with a health care professional.

All children in California must be immunized before starting school, unless they have a health condition that prohibits vaccination. Parents also may decline vaccination because of their personal beliefs. A new state law requires that such parents submit a California Department of Public Health form signed by a health care provider attesting to their decision, starting in January 2014.

The legislation, signed into law by Gov. Jerry Brown on Sept. 30, requires parents who decide not to vaccinate their children to obtain a signature from a medical doctor, doctor of osteopathy, physician’s assistant, nurse practitioner, naturopath or school nurse before enrolling their child in school. The legislation was sponsored by UC Davis pediatrician and California Assemblymember Richard Pan (D-Sacramento).

Blumberg said parents who do not vaccinate because of their personal beliefs fall into three broad categories: those who have researched vaccinations (often using alternative sources) and are firm in their conviction not to vaccinate; parents who are unsure if they should vaccinate and have general or specific concerns and need more information; and parents who are not vaccinating out of convenience.

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UCLA explains the need for the vaccine for girls and boys.

Human papillomavirus (HPV) is a common sexually transmitted disease that is associated with several types of cancer. Parents need to make an informed decision about whether their children should be vaccinated.

When the HPV vaccine first came out in 2006, the Federal Drug Administration (FDA) recommended it for girls only, since the disease was most closely associated with cervical cancer. But additional studies linking HPV to cancers that also affect men prompted the FDA to approve the vaccine for boys in 2009.

Although national health authorities now recommend that 11-year-old girls and boys receive either the Gardasil or Cervarix vaccine, only 36 percent of teenage girls and 1 percent of teenage boys have received the full, three-dose series — mostly because parents mistakenly think their children don’t need the vaccine if they aren’t sexually active.

“The reason we give it so early is we want to protect boys and girls from the disease before there is any sexual contact,” says Martin Anderson, M.D., director of adolescent medicine at Mattel Children’s Hospital UCLA. “Also, the vaccine is more likely to be effective when children are younger because their immune systems respond better to it.”

There are many strains of HPV but the most common are divided into two types: those that cause visible genital warts and those that do not cause visible warts but are associated with a higher incidence of cancers of the cervix, mouth, anus and genitals. Because some types of HPV do not cause visible signs of the disease, many people who become infected with the virus don’t know they have it.

Why vaccinate boys

“There are many reasons we want to give HPV vaccine to males,” Anderson says. “The vaccine decreases their risk of contracting oral, penile and anal cancers related to HPV, as well as the possibility of contracting hard-to-treat warts. And since less than 40 percent of girls are getting the vaccine, we can ensure more people are protected against the disease by also vaccinating boys.”

Statistics

About 20 million Americans, mostly teenagers and young adults, have HPV, making it the most common sexually transmitted disease in the nation. The disease, which can be spread by any kind of sexual contact, including oral sex, is so common that 75 percent of adults will be exposed to it sometime in their lives.

Read more UCLA health tips for parents

Information on keeping up with vaccinations for children.

Sending kids back to school means it's time to ensure their immunizations are up to date.

As another school year begins, it is important for all school-aged children to be up to date with all of their immunizations, because they will be interacting with a larger group of children and therefore at greater risk of exposure to preventable infectious diseases.

The number of vaccines available and required has grown significantly over the years, from under five in 1900 to 16 in 2000 to nearly two dozen today. It can be frustrating to parents and children that so many shots are recommended, but it is important to remember that each inoculation is meant to protect against diseases that pose significant health risks. These inoculations all are great advances in ensuring children’s health, now and into the future.

“Many people are concerned that the number of shots may be too much, and that too many vaccine constituents may be harmful,” said Dean Blumberg, chief of the division of pediatric infectious diseases in the Department of Pediatrics in the UC Davis School of Medicine. “However, even though more injections occur now, the vaccines we use today are highly purified and include only those components necessary to provide protection,” Blumberg said.

Types of vaccines

There are two main types of vaccines, inactivated and live. Inactivated vaccines contain purified but dead components of pathogens, such as tetanus. When the body encounters these components, the immune system is in charge of making antibodies against them. Then if one were to encounter the real thing, the immune system is primed to fight it off. The first polio vaccine introduced by Jonas Salk in 1955 was of this variety.

Live vaccines are weakened forms of the pathogens, like measles vaccine. Although they are not as strong as the strains that occur in nature, they are able to multiply and cause a subclinical infection mild enough that there are usually no symptoms. The immune system fights it off, and then the person is protected if they encounter the natural pathogen.

Vaccines may cause local reactions, such as pain and redness at the site of the injection, and can cause fever as well, but are otherwise generally well-tolerated. There continues to be no scientific evidence that vaccines “overwhelm the immune system,” cause autism or other allegations. These concerns have been studied extensively and are unfounded.

Immunization schedule

This childhood inoculation schedule is recommended by the American Academy of Pediatrics (AAP), in consultation with the Advisory Committee on Immunization Practices of the U.S. Centers for Disease Control and Prevention (CDC) and the American Academy of Family Physicians.

• Preschool children: Kids ages 2 to 4 should have received four doses each of DTaP (diphtheria, tetanus and acellular pertussis), PCV (pneumococcal conjugate vaccine) and Hib (haemophilus influenzae). They also should have received three doses each of IPV (inactivated polio vaccine), hepatitis B, and one dose each of the MMR (measles, mumps and rubella) and varicella (chicken pox) vaccines. The number of shots may vary depending on the combination of vaccines your health care provider uses.
• 4- to 6-year-olds: Children entering kindergarten should receive any immunizations that they’ve missed or receive a booster — a supplementary dose — of DTaP, IPV and MMR. Consult your provider.
• Pre-adolescents and teens: In California, adolescents are required to receive a Tdap booster before entering seventh grade. Adolescents 11 years old and up are required to receive the MCV4 (meningococcal conjugate vaccine). Those who never received the varicella vaccine or who have not had the illness should get that shot. Girls at this age should receive the HPV vaccine.

For children who have gotten behind on their vaccinations it’s not too late. Both the CDC and AAP offer guidelines on how to catch up. Families should contact their children’s physician for help getting them back on track.

Study raises awareness of connection between sleep and health.

Aric Prather, UC San Francisco

As moms have always known, a good night’s sleep is crucial to good health — and now a new study led by a UC San Francisco researcher shows that poor sleep can reduce the effectiveness of vaccines.

The study is the first performed outside a sleep laboratory to show that sleep duration is directly tied to vaccine immune response, the authors said.

The study, conducted while the UCSF researcher was a doctoral student at the University of Pittsburgh, will appear in the August issue of the journal SLEEP.

“With the emergence of our 24-hour lifestyle, longer working hours, and the rise in the use of technology, chronic sleep deprivation has become a way of life for many Americans,” said lead author Aric Prather, Ph.D., a clinical health psychologist and Robert Wood Johnson Foundation Health & Society Scholar at UCSF and UC Berkeley.

“These findings should help raise awareness in the public health community about the clear connection between sleep and health,” Prather said.

Research has shown that poor sleep can make one susceptible to illnesses such as upper respiratory infections. To explore whether sleep duration, sleep efficiency, and sleep quality — assessed at home and not in a controlled sleep lab — would impact immune processes important in the protection against infection, the researchers investigated the antibody response to hepatitis B vaccinations on adults in good health.  Antibodies are manufactured by the immune system to identify and neutralize foreign objects such as viruses.

The study involved 125 people (70 women, 55 men) between the ages of 40 and 60. All were nonsmokers in relatively good health, and all lived in Pennsylvania — the study was conducted at the University of Pittsburgh. Each participant was administered the standard three-dose hepatitis B vaccine; the first and second dose were administered a month apart, followed by a booster dose at six months.

Antibody levels were measured prior to the second and third vaccine injection and six months after the final vaccination to determine whether participants had mounted a “clinically protective response.”

All the participants completed sleep diaries detailing their bedtime, wake time and sleep quality, while 88 subjects also wore electronic sleep monitors known as actigraphs.

The researchers found that people who slept fewer than six hours on average per night were far less likely to mount antibody responses to the vaccine and thus were far more likely (11.5 times) to be unprotected by the vaccine than people who slept more than seven hours on average. Sleep quality did not affect response to vaccinations.

Of the 125 participants, 18 did not receive adequate protection from the vaccine. “Sleeping fewer than six hours conferred a significant risk of being unprotected as compared with sleeping more than seven hours  per night,” the scientists wrote.

The researchers stressed that sleep plays an important role in the regulation of the immune system. A lack of sleep, they said, may have detrimental effects on the immune system that are integral to vaccine response.

The National Sleep Foundation recommends seven to nine hours sleep a night. (Tips on a better night’s sleep)

“Based on our findings and existing laboratory evidence, sleep may belong on the list of behavioral risk factors that influence vaccination efficacy,” said Prather who in September will join the UCSF faculty as an assistant professor in the Department of Psychiatry. “While there is more work to be done in this area, in time physicians and other health care professionals who administer vaccines may want to consider asking their patients about their sleep patterns, since lack of sleep may significantly affect the potency of the vaccination.”

The study’s co-authors are Martica Hall, Ph.D., Jacqueline Fury, B.S., Diana C. Ross, M.S.N., R.N., Matthew Muldoon, M.D., M.P.H., and Anna Marsland, Ph.D., of the University of Pittsburgh; and Sheldon Cohen, Ph.D., of Carnegie Mellon University.

Financial support for the study was provided by a grant from the National Institute of Nursing Research (NR008237) and by a National Institute of Health fellowship to Prather.

UCSF is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care. For further information, please visit www.ucsf.edu.

Study of simian immunodeficiency virus yields insight into varied reaction to virus in humans.

Joseph McCune, UC San Francisco

After being infected with simian immunodeficiency virus (SIV) in a laboratory study, rhesus macaques that had more of a certain type of immune cell in their gut than others had much lower levels of the virus in their blood, and for six months after infection were better able to control the virus.

SIV is a retrovirus that infects primates. Strains of SIV that crossed over to humans resulted in the evolution of HIV. In rhesus macaques, SIV causes simian AIDS (though in many primates it is harmless) and studying the virus in these animals offers crucial insights into how HIV acts in humans, the researchers said.

The discovery by researchers at UC San Francisco may shed light on the mystery of why some people infected with HIV are better able to control the virus, live longer and have fewer associated health problems than others who have been infected as long, they said. It also provides a potential new target for developing therapies or vaccines.

The cells that have the protective effect, called Th17 (T helper 17) cells, are a subset of the type of disease-fighting immune cell targeted and killed by HIV and found in the gut of both primates and humans.

A prior study from the same UCSF team found that SIV infection causes a normally protective immune response to infection to go awry, leading to reduction in the protective activity in the gut of these Th17 cells and weakening of mucosal defenses against bacteria. Interestingly, in that study, Th17 cells were not affected by SIV in another primate, African green monkeys, in which SIV infection is harmless and does not cause disease.

“Animals with more of these Th17 cells were better able to control SIV and this was due in part to macaques developing a more effective immune response by producing more SIV-specific CD4-positive T-cells to fight the infection. Our next step is to see if we can augment the Th17 effect, perhaps by looking at interleukin 17 (IL-17), the cytokine released by these cells, and testing to see if it has an effect,” said the study’s primary investigator, Dennis Hartigan-O’Connor, M.D., Ph.D., assistant professor of medicine at the UCSF Division of Experimental Medicine.

“Further, if a treatment can be developed to increase Th17 cells in the gut, it may allow for a more effective immune response after exposure to an HIV vaccine or the virus itself,” he added.

The findings are being published in today’s (May 30) issue of Science Translational Medicine.

In the new study, the investigators first determined the levels of Th17 cells in the gut of sixteen rhesus macaques and then infected them with SIV. They found that the animals with more Th17 cells to begin with were better able to control the virus. They then gave animals drugs that deplete Th17 cells and found that reducing the number of Th17 cells made controlling SIV more difficult for those animals.

“We found great variation in the levels of Th17 cells, with as much as a five-fold difference in numbers between animals. We are not sure why this is the case. It could be genetically determined or perhaps due to a previous exposure to a type of bacteria that stimulates production of Th17 cells,” said Hartigan-O’Connor.

This study is part of a series of investigations undertaken by researchers at the UCSF Division of Experimental Medicine into how SIV, and by extension HIV, interacts with the immune system in the gut. The previous study was focused on chronic infection and persistent inflammation in the gut.

“The earlier study addressed the cause and consequence of inflammation after infection. We found that inflammation induces an enzyme that knocks out Th17 cells, which normally help to keep the gut intact, and that disease progression was faster. Reciprocally, we have now found that animals do better if they have many Th17 cells at the outset of infection. We are gradually increasing our understanding of this important aspect of the immune system and we are working to translate this understanding into an approach that benefits patients,” said study senior author, Joseph M. McCune, M.D., Ph.D., chief of the UCSF Division of Experimental Medicine.

Study co-investigators include Bittoo Kanwar from UCSF Division of Experimental Medicine and Kristina Abel and Koen K. A. Van Rompay from the University of California, Davis.

Funding for this research was provided by the National Institutes of Health, the Bill and Melinda Gates Foundation, the California National Primate Research Center, the National Center for Research Resources and the Harvey V. Berneking Living Trust.

The UCSF Division of Experimental Medicine (DEM) is affiliated with the AIDS Research Institute (ARI) at UCSF. UCSF ARI houses hundreds of scientists and dozens of programs throughout UCSF and affiliated labs and institutions, making ARI one of the largest AIDS research entities in the world.

UCSF is a leading university dedicated to defining health worldwide through advanced biomedical research, graduate level education in the life sciences and health professions, and excellence in patient care. For further information, please visit www.ucsf.edu.