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Yoshihiro Kawaoka, DVM, PhD
University of Wisconsin-Madison
In my presentation:
1. Loss-of-function research
2. Use of low pathogenicity viruses
3. Phenotypic analyses
1. Loss-of-function research
researchviruses
does not always provide answers.
2. Loss-of-function
Use of low pathogenicity
3. Phenotypic analyses
LOF research
An example in which loss-of-function research fell short
1918 virus
LOF mutations
1918 virus
LOF mutant
Receptor specificity
HA-D190E
Transmission
No transmission
GOF mutations
GOF mutant
Growth in
mammalian cells
No transmission
PB2-E627K
Receptor specificity
HA-N224K, HA-Q226L, HA-N158D
HA
HAstability
stability
Transmission
HA-T317I
HA-T317I
1. Loss-of-function research
2. Use of low pathogenicity viruses
3. Phenotypic analyses
1. Loss-of-function research
2. Use of low pathogenicity viruses
3. Phenotypic analyses
Highly pathogenic
avian influenza viruses
Low pathogenic
avian influenza viruses
10
10
Infectious units/ 10
g lung
3
10
1
Seasonal H1N1
10 avian influenza
Hours post-infection
Highly pathogenic
viruses differ from low pathogenic viruses
in their kinetics of virus
tissue
24 30
36 48tropism.
60 d3 d5 d7
0 3replication
6 9 12 18and
Highly pathogenic
avian influenza viruses
Low pathogenic
avian influenza viruses
10
10
Infectious units/ 10
g lung
3
10
Seasonal H1N1
10
Data obtained
withHours
lowpost-infection
pathogenic viruses
can be misleading.
0 3 6 9 12 18 24 30 36 48 60 d3 d5 d7
1
1. Loss-of-function research
2. Use of low pathogenicity viruses
3. Phenotypic analyses
1. Loss-of-function research
2. Use of low pathogenicity viruses
3. Phenotypic analyses
Alternative approaches
Safer approaches to studying human adaptation of influenza A viruses
Modeling
Receptor specificity, Fusion activity
Replication complex
Sequence comparison
Sequence and phenotypic comparison of natural isolates
Use of seasonal influenza viruses for transmission
Host factors
Lipsitch and Galvani, PLoS Med 2014
Alternative approaches
Safer approaches to studying human adaptation of influenza A viruses
1. Loss-of-function research
2. Use of low pathogenicity viruses
3. Phenotypic analyses
We cannot rely solely on alternative approaches.
What did we learn from the ferret transmission H5N1 GOF research?
Vaccine stockpile
Anhui
10 million people
Expired and
discarded
Qinghai
10 million people
Vietnam + Indonesia
10 million people
Anhui
10 million people
Qinghai
10 million people
Vietnam + Indonesia
10 million people
Anhui
10 million people
2005 2006 2007 2008 2009 2011 2012 2013 2014 2015 2016 2017
Anhui
10 million people
Expired and
discarded
Qinghai
10 million people
Vietnam + Indonesia
10 million people
74 million US dollars
to produce each
H5N1 stockpile vaccine
for 10 million people
Anhui
10 million people
Qinghai
10 million people
Vietnam + Indonesia
10 million people
Anhui
10 million people
2005 2006 2007 2008 2009 2011 2012 2013 2014 2015 2016 2017
What did we learn from the ferret transmission H5N1 GOF research?
Vaccine stockpile
It has been 17 years since the emergence of H5N1 viruses,
yet they have not caused a pandemic.
Questioned the pandemic potential of H5N1 viruses
H5N1 vaccine stockpiles are needed (important for policy makers)
What did we learn from the ferret transmission H5N1 GOF research?
Vaccine stockpile
It has been 17 years since the emergence of H5N1 viruses,
yet they have not caused a pandemic.
Questioned the pandemic potential of H5N1 viruses
H5N1 vaccine stockpiles are needed (important for policy makers)
Strain selection for stockpile vaccines
*September, 2014
http://www.who.int/influenza/vaccines/
virus/characteristics_virus_vaccines/en/
Transmissible virus
We now know
which H5N1
viruses have
pandemic
potential.
Useful information
for vaccine
candidate selection
Implications
Vaccine stockpile
It has been 17 years since the emergence of H5N1 viruses,
yet they have not caused a pandemic.
Questioned the pandemic potential of H5N1 viruses
H5N1 vaccine stockpiles are needed (important for policy makers)
Strain selection for stockpile vaccines
Vaccines would ideally be produced by using a virus that is
closely related to viruses of high pandemic potential.
Policy makers, not vaccine companies, select vaccine strains.
Naturally, vaccine companies will say no when asked if GOF
research of concern has helped vaccine production.
Implications
Vaccine stockpile
It has been 17 years since the emergence of H5N1 viruses,
yet they have not caused a pandemic.
Questioned the pandemic potential of H5N1 viruses
H5N1 vaccine stockpiles are needed (important for policy makers)
Strain selection for stockpile vaccines
Vaccines would ideally be produced by using a virus that is
closely related to viruses of high pandemic potential.
Risk assessment of circulating strains
Kawaoka
N158D
Fouchier
T160A
G228S
Q226L
Q226L
N224K
H110Y
T318I
100%
China
31/49
Egypt
265/352
63%
Vietnam
33/130
75%
Other
56/137
41%
25%
Mutation (-)
30%
Mutation(+)
Mutation(+)
70%
2009-2011 birds
100%
2009-2011 humans
Implications
Vaccine stockpile
It has been 17 years since the emergence of H5N1 viruses,
yet they have not caused a pandemic.
Questioned H5N1 vaccine stockpile
H5N1 vaccine stockpiles are needed (important for policy makers)
Strain selection for stockpile vaccines
Vaccines would ideally be produced by using a virus that is
closely related to viruses of high pandemic potential.
Risk assessment of circulating strains
Surveillance of H5N1 viruses may be limited.
But, this is changing, e.g., H5N8 viruses in wild birds across Europe and
Asia.
Implications
Vaccine stockpile
It has been 17 years since the emergence of H5N1 viruses,
yet they have not caused a pandemic.
Questioned H5N1 vaccine stockpile
H5N1 vaccine stockpiles are needed (important for policy makers)
Strain selection for stockpile vaccines
Vaccines would ideally be produced by using a virus that is
closely related to viruses of high pandemic potential.
Risk assessment of circulating strains
Important information!
Imai et al., 2012, Nature