Overweight, obese men at higher risk of severe liver disease, liver cancer

Men with more than normal body weight from an early age (17-19 years) are at higher risk of developing severe liver disease and even liver cancer in later life. The risk is increased when such men develop diabetes.

The association between body weight and higher risk of severe liver disease has become clear in a study based on data of more than 1.2 million Swedish men enlisted for military conscription between 1969 and 1996. Compared with men who have normal weight, those who are overweight (body mass index more than 25 kg/m²) have about 50% greater risk and obese men (BMI greater than 30 kg/m²) are more than twice likely to develop liver disease and even liver cancer in later life.

An earlier study involving nearly 50,000 men showed an association between high BMI in early age was associated with increased risk of end-stage liver disease. The study was based on data collected between 1969-70, when overweight and obesity were relatively uncommon — only 0.8% were overweight. So the study was not statistically powered to confirm an association between high BMI and increased risk of end-stage liver disease.

But a paper published today (March 21) in the journal Gut found a statistically significant association between BMI and severe liver disease. Men who have higher BMI even at an early age are at higher risk of developing severe liver disease and liver cancer as the “duration of being exposed to a high BMI” increases the risk.

Compared with men with BMI 18.5-22.5 kg/m², men with higher BMI had higher risk of severe liver disease, with the greatest risk in those with BMI greater than 30 kg/m². The non-alcoholic fatty liver disease is likely to be the “main driver” of severe liver disease in adolescent men, the study says.

Consumption of alcohol and smoking were taken into account and those who had developed alcoholic liver disease were excluded from the final analysis, but this did not change the overall finding. But the risk of severe liver disease was “highly affected” by development of type 2 diabetes during follow-up across all BMI categories.

It is well known that people with high BMI are at increased risk of developing diabetes, which in turn is associated with heightened risk of developing severe liver disease. Yet, increased risk of severe liver disease was seen even in overweight men who did not have diabetes. As the data was restricted to men, the researchers could not study the association between BMI and severe liver diseases in women. But they say that earlier studies of middle-aged women in the UK have shown found an association; but the risk was “uncertain” for younger women.

Therefore, even if the risk is increased in overweight and obese men who develop diabetes, the association of high BMI at an early age and severe liver disease at a later date “cannot solely be explained” by type 2 diabetes, the study says.

There should be targeted intervention to prevent diabetes and more than normal BMI at an early age.

Published in The Hindu on March 21, 2017

CCMB: Can alpha chain of clusterin protein control weight, fat gain in animals?

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Dr. Ramakrishnan (left), Dr. Mohan Rao (centre) and Suvarsha Matukumalli studied rats injected with beta chain and found fat accumulation from day two onwards.

The two chains of clusterin protein, which are normally expressed in several tissues and can be found in several body fluids, when present together tend to lower lipid levels but administration of one of its chains — alpha or beta — results in completely different outcomes. Cells treated with a recombinant beta chain tend to accumulate fat while cells treated with an alpha chain showed no increase in lipid accumulation. Rabbits administered with a recombinant beta chain showed nearly 40% increase in weight while animals given an alpha chain showed no such increase. The results were published in the journal Scientific Reports.

“Two chains of clusterin when present together tend to decrease body weight but one of the two chains (beta clusterin) increases body weight. This is quite unusual,” says Dr. Ch. Mohan Rao from the Centre for Cellular and Molecular Biology (CCMB), Hyderabad, and the corresponding author of the paper. “So the alpha chain should ideally be compensating for increase in body weight. But the alpha chain does not do that.”

Rats gained lean mass not fat

“While excess energy gets accumulated in the form of fat when beta chain was injected into rats, we did not see this in the case of alpha chain. One possibility is that the alpha chain helps in the metabolism of food in such a way that fat does not accumulate,” he says. “Dissected rats that were given alpha chain showed increased levels of lean mass.”

Apparently, there was no difference in the food intake between animals treated with alpha or beta chain. “It means that weight increase can happen even when there is no increase in food intake. It is the energy management by the body that is important. And alpha chain seems to modulate metabolism in such a way to promote energy expenditure and thus prevent fat accumulation,” he says.

The effect of alpha and beta chains were tested on myoblast cells, fibroblast and cancer cells. The individual chains were injected into rabbits as well. “In my lab we study the effect of small heat shock protein on health and disease. To raise antibody for clusterin we injected the chains separately into rabbits. One set of rabbits was gaining weight while the other did not. That’s when we investigated the reasons. The animal-house in-charge noticed the change in the animals,” recalls Dr. Rao.

Rats too gained weight

Though the effects of the two chains were seen in rabbits, the researchers turned to rats as more animals were required for investigating the effect of individual chains on animals.

“We could see fat accumulation in cells from day two onwards. We observed for 10 days and fat accumulation continued for all the 10 days; we could study cells continuously only for 10 days,” says Suvarsha Rao Matukumalli from CCMB and the first author of the paper. “In the case of animals injected with beta chain, fat accumulation continued for four-five months. The controls and animals given alpha chain did not show weight or fat gain.”

When cells were administered both the chains simultaneously, the cells did not accumulate fat for two-three days but started thereafter. “Fat accumulation was not as much as when only the beta chain was given but fat accumulation nevertheless continued,” says Ms. Matukumalli. But the effect of both the chains in animals was quite different. “When we introduced both alpha and beta chains together in animals we did not see any weight gain. The animals were very much like the controls,” she says. “Only large-scale, in-depth studies can reveal if alpha chain prevents weight gain.”

Published in The Hindu on March 19, 2017

Without a magic wand, India cannot eliminate TB by 2025

GeneXpert

Only 93,000 MDR-TB cases have been diagnosed till 2015 in India.

At the end of 50 years of tuberculosis control activities, the disease remains a major health challenge in India. As per new estimates, the number of new cases every year has risen to 2.8 million and mortality is put at 4,80,000 each year. These figures may go up when the national TB prevalence survey is undertaken in 2017-18. Against this backdrop, the Ministry of Health and Family Welfare, in its national strategic plan for tuberculosis elimination (2017-2025), has set a highly ambitious goal of “achieving a rapid decline in burden of TB, morbidity and mortality while working towards elimination of TB by 2025.”

Though the Revised National Tuberculosis Control Programme (RNTCP) has treated 10 million patients, the rate of decline has been slow. Providing universal access to early diagnosis and treatment and improving case detection were the main goals of the national strategic plan 2012-17. But the RNTCP failed on both counts, as the Joint Monitoring Mission report of 2015 pointed out. Going by the current rate of decline, India is far from reaching the 2030 Sustainable Development Goals — reducing the number of deaths by 90% and TB incidence by 80% compared with 2015. Yet, the latest report for TB elimination calls for reducing TB incidence from 217 per 1,00,000 in 2015 to 142 by 2020 and 44 by 2025 and reduce mortality from 32 to 15 by 2020 and 3 per 1,00,000 by 2025.

Incidentally, nearly 50% of people in India are latently infected with TB. According to CDC, 5-10% of infected people will develop TB disease at some time in their lives. “About half of those people who develop TB will do so within the first two years of infection,” the CDC says. With the latently infected people acting as a reservoir, it will be nearly impossible to eliminate TB in India by 2025.

Radical approaches are needed to come anywhere close to reaching these ambitious targets. Most importantly, the TB control programme plans to do away with the strategy of waiting for patients to walk in to get tested and instead engage in detecting more cases, both drug-sensitive and drug-resistant. The emphasis will be on using highly sensitive diagnostic tests, undertaking universal testing for drug-resistant TB, reaching out to TB patients seeking care from private doctors and targeting people belonging to high-risk populations.

The other priority is to provide anti-TB treatment — irrespective of where patients seek care from, public or private — and ensure that they complete the treatment. For the first time, the TB control programme talks of having in place patient-friendly systems to provide treatment and social support. It seeks to make the daily regimen universal; currently, the thrice weekly regimen is followed by RNTCP, and the daily regimen has been introduced only in five States. There will be a rapid scale-up of short-course regimens for drug-resistant TB and drug sensitivity testing-guided treatment. In 2013, India “achieved complete geographical coverage” for MDR-TB (multi-drug-resistant tuberculosis) diagnosis and treatment.  Yet, only 93,000 people with MDR-TB had been diagnosed and put on treatment till 2015; several MDR-TB cases are simply not diagnosed.

What next?

Though Bedaquiline, the drug for people who do not respond to any anti-TB medicine, is provided in six sites in the country, the number of beneficiaries is very small. It has been a battle to get the drug for treatment, as in the case of an 18-year-old who had to approach the Supreme Court for help. Yet, the report envisages a countrywide scale-up of Bedaquiline and Delamanid.

In a marked departure, the report underscores the need to prevent the emergence of TB in susceptible populations. One such segment is those in contact with a recently diagnosed pulmonary TB. Incidentally, active-case finding is already a part of the RNTCP programme but rarely implemented. It wants to increase active case finding to 100% by 2020. Since RNTCP expenditure has increased by 27% since 2012 and is inadequately funded, the Ministry proposes to increase funding to ₹16,500 crore.

Acknowledging that the business-as-usual approach will not get the Health Ministry anywhere close to the goals, it has earmarked critical components that will be addressed on priority. These include sending customised SMSes to improve drug compliance, incentivising private doctors to notify cases and providing free medicines to patients approaching the private sector, facilitating nutritional support to TB patients, including financial support, rewarding States performing well in controlling TB, and using management information systems to monitor all aspects of TB control. “The ultimate impact of this national strategic plan will be transformational improvements in the end TB efforts of India,” the report says. It plans to take a “detect-treat-prevent-build approach” in its war against TB.

Published in The Hindu on March 19, 2017

Can health spending of 2.5% of GDP only by 2025 help achieve the goals set by India’s National Health Policy?

BLOG - NHP

The National Health Policy wants to reduce infant mortality rate to 28 per 1,000 live births by 2019.

The long awaited National Health Policy announced a few days ago proposes to raise public health expenditure as a percentage of GDP from the current 1.15% to 2.5% by 2025. The resource allocation to individual States will be linked with their development indicators, absorptive capacity and financial indicators. “There will be higher weightage given to States with poor health indicators and they will receive more resources. The Policy aims to end inequity between States. But at the same time, States will be incentivised to increase public health expenditure,” says Manoj Jhalani, Joint Secretary — Policy, Ministry of Health and Family Welfare.

The catch

While public health expenditure as a percentage of GDP will reach 2.5% only by 2025, many of the goals listed in the Policy have a deadline of 2025 and some of them even earlier.

The Policy stresses on preventive healthcare by engaging with the private sector to offer healthcare services and drugs that are affordable by all. It wants to reduce out-of-pocket “catastrophic” health expenditure by households by 25% from current levels by 2025.

The focus is on providing free, comprehensive care in primary care for the most prevalent communicable and non-communicable diseases, and increased affordability of care at secondary and tertiary care services by a combination of public and not-for-profit private providers wherever necessary. It wants to increase the utilisation of public health facilities by 50% from the current levels by 2025.

Health card roll out

The Centre is working on introducing a health card — an electronic health record of individuals. “The health card will be for retrieving and sharing health data by lower [PHC] and higher [secondary and tertiary] healthcare facilities. It will be helpful when patients move from primary to secondary or tertiary healthcare facilities,” says Mr. Jhalani. “It will be launched in six months to one year’s time. It will be launched in those States that show interest to roll it out in certain districts or across the State.”

Disease control and elimination

Like the Health Ministry’s National strategic plan for tuberculosis elimination 2017-2025 report, the Policy wants to reduce incidence of new TB cases to reach elimination by 2025. In a similar vein, the policy has set 2017 as the deadline to eliminate kala-azar and lymphatic filariasis in endemic pockets, and 2018 in the case of leprosy. In the case of chronic diseases such as diabetes, cancer, cardiovascular diseases, it envisages a 25% reduction in premature mortality by 2025.

The Policy “aspires” to provide secondary care right at the district level and reduce the number of patients reaching tertiary hospitals. For the first time, there is any mention of public hospitals and facilities being periodically measured and certified for quality.

Pipe dream

The Policy has sharpened its war on tobacco by indicating a 15% relative reduction in tobacco use prevalence by 2020 and 30% by 2025. But the most ambitious target is providing access to safe water and sanitation by all by 2020. As per January 2016 Ministry of Drinking Water and Sanitation country paper, sanitation coverage was only 48%.

Reducing IMR and MMR

Other challenging targets set by the Policy include reducing infant mortality rate to 28 per 1,000 live births by 2019 and under five mortality to 23 per 1,000 live births by 2025. According to the National family Health Survey 4, IMR was 41 in 2015-16; it took 10 years to reduce IMR from 57 to 41. Similarly, under five mortality was 50 in 2015-16 and it took 10 years to reduce it from 74. Over 38% children under five years were stunted according to the NFHS-4 report. The Health Policy wants to reduce this by 40% by 2025.

Increasing immunisation coverage

As against 62% children 12-23 months old who were fully immunised in 2015-16 according to the NFHS-4 data, the Policy has set a target of 90% by 2025. “Going up to 70% coverage is hugely a challenge of reaching the community. But beyond 70% coverage, other factors come in and it becomes a very big challenge,” says Dr. Pradeep Haldar, Deputy Commissioner — Immunisation, Ministry of Health. According to J.P. Nadda, the Union Health Minister, the Mission Indradhanush has increased the annual increase in full immunisation from 1% to 5-7%.

Published in The Hindu on March 19, 2017

Academics can change the world – if they stop talking only to their peers

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What’s the point of academics producing amazing research if they don’t share it widely with the general public? Shutterstock

Savo Heleta, Nelson Mandela Metropolitan University

Research and creative thinking can change the world. This means that academics have enormous power. But, as academics Asit Biswas and Julian Kirchherr have warned, the overwhelming majority are not shaping today’s public debates. The Conversation

Instead, their work is largely sitting in academic journals that are read almost exclusively by their peers. Biswas and Kirchherr estimate that an average journal article is “read completely by no more than ten people”. They write:

Up to 1.5 million peer-reviewed articles are published annually. However, many are ignored even within scientific communities – 82% of articles published in humanities [journals] are not even cited once.

This suggests that a lot of great thinking and many potentially world altering ideas are not getting into the public domain. Why, then, are academics not doing more to share their work with the broader public?

The answer appears to be threefold: a narrow idea of what academics should or shouldn’t do; a lack of incentives from universities or governments; and a lack of training in the art of explaining complex concepts to a lay audience.

The ‘intellectual mission’

Some academics insist that it’s not their job to write for the general public. They suggest that doing so would mean they’re “abandoning their mission as intellectuals”. They don’t want to feel like they’re “dumbing down” complex thinking and arguments.

The counter argument is that academics can’t operate in isolation from the world’s very real problems.

They may be producing important ideas and innovations that could help people understand and perhaps even begin to address issues like climate change, conflict, food insecurity and disease.

No incentives

Universities also don’t do a great deal to encourage academics to step beyond lecture halls and laboratories. There are globally very few institutions that offer incentives to their academics to write in the popular media, appear on TV or radio, or share their research findings and opinions with the public via these platforms.

In South Africa, where I conduct research and teach, incentives are limited to more “formal” publication methods. Individual institutions and the Department of Higher Education and Training offer rewards for publishing books, book chapters, monographs or articles in accredited, peer-reviewed journals.

The department pays universities more than R100,000 per full publication unit – for example, one journal article. These funds are given to universities, which then use their own subsidy disbursement schemes to split the funds between the institution, the faculty in which the author works and the author. In some cases, academics receive more funding for articles published in international journals than in local journals.

Catriona Macleod of Rhodes University in South Africa has argued that these financial incentives are an example of the “commodification of research” and that this is “bad for scholarship”. Macleod told University World News:

The incentive system is a blunt instrument that serves the purposes of increasing university income rather than supporting scholarship and knowledge production in South Africa.

There is nothing in the department’s policy that urges academics to share their research beyond academic spaces. There’s no suggestion that public outreach or engagement is valued. And this situation is not unique to South Africa: the “publish or perish” culture is a reality at universities all over the world.

Academics have no choice but to go along with this system. Their careers and promotions depend almost entirely on their journal publication record, so why even consider engaging with the general public?

Learning to write

There is a third factor holding academics back from writing for broader lay audiences: even if they’d like to, they may not know where to start and how to do it.

Writing an article for an academic journal is a very different process to penning one for those outside the academy. Naomi Wolf and Sacha Kopp, in an article examining the issue, wrote:

Academic writing has the benefit of scholarly rigour, full documentation and original thinking. But the transmission of our ideas is routinely hampered … by a great deal of peer-oriented jargon.

Universities have a role to play here by offering workshops and courses to their academics and students. This can help develop creative non-fiction writing skills.

Time for a change

Academics need to start playing a more prominent role in society instead of largely remaining observers who write about the world from within ivory towers and publish their findings in journals hidden behind expensive digital paywalls.

Government and university policies need to become more prescriptive in what they expect from academics. Publishing research in peer-reviewed journals is and will remain highly important. But incentives should be added to encourage academics to share their research with the general public.

Doing this sort of work ought to count towards promotions and should yield rewards for both universities and individual academics.

Quality academic research and innovation are crucial. It is equally important, though, to get ideas out into the world beyond academia. It could make a real difference in people’s lives.

Savo Heleta, Manager, Internationalisation at Home and Research, Nelson Mandela Metropolitan University

This article was originally published on The Conversation. Read the original article.

‘Copy and paste’ content spotted in IISER Thiruvananthapuram director’s papers

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There is 68% similarity in content between this 2014 paper of Prof. Ramakrishnan and other papers.

Over 50 papers published between 1984 and 2014 by Prof. V. Ramakrishnan, formerly with the School of Physics, Madurai Kamaraj University and currently the Director of the Indian Institute of Science Education and Research (IISER) Thiruvananthapuram have varying degrees of content taken verbatim from or have very close similarity with other previously published papers. Large chunks of text have been reproduced verbatim from other papers and the sources have not been cited. In many instances where the sources have been cited, the content has been reproduced verbatim without paraphrasing.

In nearly 15 papers, where Prof. Ramakrishnan is the corresponding author, the extent of text similarity with earlier published papers (technically called similarity index) is as high as 60% and greater. At 68%, a paper published online in May 2014 in the journal Spectrochimica Acta Part A: Molecular and Biomolecular Spectroscopy has the highest similarity index.

An anonymous person has posted this paper on Pubpeer.com and highlighted the content that has been taken verbatim from other papers.

Most of the papers which have portions that are very similar to other papers have been published in the journal Spectrochimica Acta Part A: Molecular and Biomolecular Spectroscopy and the Journal of Raman Spectroscopy. Most of the papers have been published from Madurai Kamaraj University, where he was a Professor in Physics before joining IISER Thiruvananthapuram.

The Turnitin software that was used indicates text similarity by stating the percentage of similarity index. For several reasons, the “similarity index cannot be used as an indicator of whether plagiarism has occurred or not” when Turnitin software is used.

Five papers scrutinised 

So to ascertain if the similarity in content amounts to plagiarism, five papers, where Prof. Ramakrishnan is the corresponding author, were randomly chosen for closer scrutiny. These papers were published between 2003 and 2015. Three of these papers (here, here and here) were published in the journal Spectrochimica Acta Part A: Molecular and Biomolecular Spectroscopy and the other two (here and here) were published in the Journal of Raman Spectroscopy.

According to a scientist very familiar with scientific ethics and who cross-checked the five papers for plagiarism, one paper contains substantial verbatim use of material from papers by other authors without citing the sources. And where the sources of have been cited, the content has been reproduced verbatim without paraphrasing. The other papers have substantial verbatim use of material from their earlier published papers, technically called self-plagiarism.

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Comment in Pubpeer

Responding to the paper posted in Pubpeer.com, an anonymous person says: “I am based in the U.S. and usually look at Pubpeer once a month or so. Out of curiosity had a look at this one, and tried to look at both original papers and found exactly what the submitter has claimed, at least with one section. My comparison is pasted below. There are many highlighted sections, obvious from the rainbow colours. I don’t have time to verify this. May be the ctrl-copy, ctrl-paste business has gone into the results too, then the question is are the experiments really carried out or everything is fake?

The possible way forward are the following:

  1. Notify the sponsoring agency of this research
  2. Notify the University where this work was done
  3. Notify both journals and the senior author of Bilge et al 2009 paper
  4. Put other papers under scrutiny, if this is done once it must be a mistake done by the first author, but if it has happened across many papers, then the corresponding author has to take the responsibility.

Seems to be a major case of scientific fraud, maybe this person is in some obscure university in India, still one has to behave responsibly.”

“Even with citing (attribution), the source text must be used with quotes. Doing otherwise is misconduct as it is not clear that the entire text comes from the cited source. Even paraphrasing extensively even with references is not good practice,” another senior scientist from Delhi says in an email.

Self-plagiarism

Plagiarised content is found in the introduction section in the first paper. Unfortunately, it does not stop here — plagiarism extends to the experimental section and even to the results and discussion sections. The same trend is seen in the papers where self-plagiarism is rampant.

“There are two issues here — plagiarism from other authors’ work and self-plagiarism. Self-plagiarism in the introductory section is somewhat acceptable because scientific background underlying any author’s work is going to be largely similar. However, self-plagiarism in the results and discussion section is not acceptable at all because it is tantamount to cloning one’s own paper again and again ad nauseum so that it appears that the person has authored a very large number of papers. This is exactly what is prevailing in the present case,” a senior chemist from a reputed institute in India, who cross-checked all the five papers against the original papers, says in an email.

Modus operandi

“It is cleverly done and different sections from different papers are stitched together. All the chemical systems in all the papers are very similar. It seems they just repeated the same kind of experiments with another sample, so the story goes the same way. The way in which the problem is formulated, the experimental details, the results, the discussion and the conclusions are identical,” says the chemist.

“Simple ‘copy and paste’ actually worked very well for him because he did not have to write anything new for his paper as his results had nothing new compared to the literature. You can generally expect this when the work in question is of the lowest standard and all the results would give the same conclusions (similar to the literature or his earlier papers). So I think he just had to change the names of the compounds and some other details, but rest is mostly the same from one paper to other of his own or that of literature work,” the senior chemist adds.

Denies wrongdoing

In a couple of emails to me, Prof. Ramakrishnan says: “Most of our experimental research publications include an amount of history and review of earlier research findings in the same area. All our supporting data are duly acknowledged and the source cited in the reference. Therefore, the question of plagiarism does not arise. As you have pointed out that from 1984 they have been in the public domain and so far no reviewer has pointed out that either our group has copied or stolen from others scientific data.”

On his request, two of the five papers (including the paper published online in May 2014 (see slide show) in the journal Spectrochimica Acta Part A: Molecular and Biomolecular Spectroscopy) and the original papers from where he had plagiarised were sent to him; the plagiarised portions were highlighted in his papers and the original papers. In response, he denies any wrongdoing saying: “The highlighted portion of the attached documents sent by you (markings on reprint of our works) shows the name of journal, author, affiliation, mobile number, email [address] etc as plagiarised one.” He then goes on to say: “Your basis of conclusion is scientifically baseless and ridiculous. In view of the same, it is evident that you have deliberately adopted the quantification contrary to the research methodology adopted by the scientific community.”

RELATED ARTICLE:

IISER Thiruvananthapuram Director: There’s more to it than meets the eye

Controling HIV-like virus in monkeys by early intervention

HIV photo-Optimized

The paper was published in Nature on March 13.

In an interesting study, the immune system of monkeys was found capable of controlling HIV-like virus (simian-human immunodeficiency virus (SHIV)) when treatment with a combination of two broadly neutralising antibodies was started three days after infection. The immune system of the animals was found to control the virus even after the anti-HIV antibodies were no longer present in the monkeys.

In a paper published on March 13 in the journal Nature, researchers from the National Institutes of Health and other institutes infected 13 macaque monkeys with SHIV virus. Unlike earlier studies where intervention began late, the researchers started treating the monkeys with two broadly neutralizing HIV antibodies from the third day of infection. The monkeys were infused with the two drugs three times over a two-week period.

Compared with controls, six monkeys were able to suppress the virus for 56 days to as long as six months; in one monkey the virus was below detectable level for 150 days. Once the antibodies level dropped to a very low in the animals, the virus resurfaced. The time taken to rebound was directly related to the concentration of the neutralising antibodies in the plasma.

Quite unexpectedly, five to 22 months after the virus resurfaced, the immune system of the six monkeys spontaneously regained control of the virus and brought it down to undetectable levels for another five to 13 months. Four other monkeys could never fully regain complete control of the virus but the viral load was “very low level” for more than two years. Of the 13 monkeys studied, 10 were able to benefit from two neutralising antibodies administered.

A particular kind of immune cells called CD8+ T cells were found to be higher in all the animals that were infected with SHIV virus. To ascertain if CD8+ T cells were responsible for mediating sustained suppression of virus replication, the researchers purposely depleted the CD8+ T cells in the six monkeys. What followed was a sharp increase in the viral load in all the animals. This helped the researchers conclude that the CD8+ T cells controlled the virus multiplication following the administration of the neutralising antibodies.

The study shows that a combination therapy of two neutralising antibodies given early after infection can control SHIV viral load for nearly six months and facilitate the emergence of potent CD8+ T cells that “durably suppress virus replication”.

Though SHIV infection in macaque monkeys differs from HIV-1 infection in humans in many ways, based on the study, the researchers suggest that immunotherapy should be explored to control the spread of virus, contain the damage to CD8+ T cells, mobilise a robust immune response and control HIV infection in humans.

Published in The Hindu on March 14, 2017