In our focus on Italian research, Paul Bompard reports on new efforts to shake up an unequal and underfunded system. Below, he looks at the agonies and the ecstasies of medical researchers
The research on a vaccine for Aids under way at the Istituto Superiore di Sanita (ISS) in Rome, the main national medical research institute, has been internationally acknowledged as one of the more promising paths along which Aids research is now moving.
Much of the credit has gone to Barbara Ensoli, a biologist who spent 12 years working in the United States at the National Institutes of Health in Bethesda, Maryland. Three years ago decided to return to Italy when she won a competitive exam for a post as director of virological research at the ISS.
"For the past decade," said Professor Ensoli, "research strategy has focused on the proteins of the 'shell' of the virus, to induce an immune response to stop the virus getting in. This has largely failed, for a variety of reasons, but particularly because of the constant variations of the proteins of the viral 'shell'. So instead we tried another approach."
The tactic is to catch the virus as it enters and to control the infection and prevent the onset of illness.
Professor Ensoli said: "The virus gets into the organism, but we try to induce an 'abortive' infection. We want an immune response that checks the virus as it is getting in and reduces it to a minimum so that the host can control it and illness does not develop.
"We are using a viral protein called TAT, produced by the virus immediately after it enters the cell. It is one of the first proteins produced by the virus and is essential to viral replication."
Professor Ensoli said the host organism could remain HIV positive, but could possibly turn negative. "We are still looking on this in our experiments on animals. We innoculated seven monkeys with this TAT protein to prompt an immune response. In five out of seven, the Aids infection was minimal and the virus did not replicate. Protection proved to be very strong.
"After more than a year the target cells for the Aids virus are absolutely normal and the monkeys are completely protected. The three monkeys in the control group all became highly infected. This is a vaccine that could be therapeutic as well as preventive, since it blocks replication." Professor Ensoli forecasts that trials on humans will begin in about a year.
She is enthusiastic about working in Italy, with only a few reservations. "What is lacking in Italy is administrative support for research, offices that work to co-ordinate with other countries, that take care of the office work involved. We also have to order supplies long in advance, because the bureaucracy is so slow."
Professor Ensoli also laments the lack of a strong domestic pharmaceuticals industry. "This means that all our materials have to be imported, which raises costs, and that there is no industry with which we can collaborate in the production of drugs, in experimentation, and so on."