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Posted 11-5-98
The National Institutes of Health has renewed funding for Cleveland's Center for Aids Research (CFAR) with a grant of more than $5 million to be awarded over five years.
Based at Case Western Reserve University's School of Medicine and closely linked with AIDS programs at University Hospitals of Cleveland, the center will also benefit from an additional commitment of $500,000 from CWRU and $250,000 from UHC over five years. The CWRU CFAR is one of 12 such centers in the nation.
Since its inception in 1994, the center has been dedicated to coordinating a constantly expanding spectrum of AIDS-related activities. Director Stuart Le Grice said that a productive relationship between the center, the CWRU/UHC AIDS Clinical Trials Unit, and the UHC John T. Carey Special Immunology Unit spearheads AIDS research and clinical care for the region.
"CFAR also benefits from cooperative and interactive ventures with several other centers on campus that work in the areas of cancer, skin diseases, tuberculosis, and fungal infections," said Le Grice. "A highly communicative and collaborative atmosphere allows us to coordinate efforts, avoid duplication, and build an exceptionally strong platform on which to develop AIDS research programs."
CWRU and UHC have about $13 million in total funding that supports more than 40 AIDS-related projects. The new grant will also incorporate researchers from nearby institutions, including MetroHealth Medical Center.
Michael Lederman, director of the AIDS Clinical Trials Unit, said, "Continuation of funding for the CWRU CFAR will ensure that the solid infrastructure that supports all AIDS basic and clinical research efforts here remains strong. The AIDS Clinical Trials Unit at CWRU that is part of the CFAR provides access to HIV treatments that define the state-of-the-art in HIV care."
The center's mission involves research, clinical work, training of health professionals, and community education endeavors. In research, the center is building on the 10-year relationship that CWRU has had with Makerere University in Uganda, one of the African nations hardest hit by the AIDS epidemic, as well as two decades worth of tuberculosis research at CWRU and UHC. (The spread of TB is closely associated with AIDS.) The renewal includes a new international clinical coordinating facility based in Uganda.
Since its inception, the center has also built its expertise in molecular and structural virology, a field which looks at the protein structures and mechanical processes of the AIDS virus to help determine how drugs may be designed to fight the illness.
Although patients have benefitted in the past year from drug "cocktails" which inhibit replication, the virus is notorious for developing resistance to drugs.
"The AIDS virus, by its very nature, does not copy its genetic material accurately," said Le Grice. This allows it to mutate easily and escape from drugs designed to latch onto and kill the virus. Work needs to continue in the development of drugs that would completely eradicate the virus.
Le Grice would like to see scientists "try to work, in a sense, backwards from a patient who becomes resistant to a drug, to the virus, to the protein that we're interested in, and to understanding drug resistance on the molecular level," he said.
"Molecular biology would really like to understand the structure and function of key HIV proteins and enzymes, and use this information to arrive at rationally designed drugs preventing the virus from mutating so easily that resistance would be less likely," he added.
Le Grice hopes to have the center become more actively involved in community outreach work in Cleveland and to further its education of health professionals combating the disease in Uganda. Since 1994, 15 master's and three doctoral students from Uganda have been trained by CWRU.
A long-term goal is to establish a satellite telecommunications link with Uganda, allowing CWRU faculty to deliver lectures from Cleveland to Ugandan medical students and healthcare professionals.
"It is 8,000 miles to Uganda. If a faculty member wants to deliver lectures there, it takes about two weeks of travel back and forth and adjustment to time changes. We'd like real-time discussions between Cleveland and Uganda," Le Grice said.
"We could also have microscopes on site in Uganda, hooked electronically to Cleveland, so we could see and discuss what they are seeing there. Ugandan health professionals could eventually talk to clinicians here for consultation," he added.
On the community education front, Le Grice will be working with the medical school's Urban Area Health Education Program, which sends medical, nursing, and dental students to public schools to teach health. Working with these students will help get the message out about AIDS prevention.
"This is a very important part of the efforts directed against AIDS. The community has to be aware that one way of not spreading AIDS is not catching AIDS," Le Grice said. "Educating the public about AIDS is as important as developing drugs against the virus."
The center will also continue to foster pilot research studies, an area Le Grice feels is of vital importance.
"The grant supplies funding for projects that at present would be less likely to receive NIH funding," he said. "It allows us to try new ideas that may potentially lead to funding in new areas. It allows us to try and take efforts from our basic research into the clinic and to use our clinical trials unit to channel some of its data back into basic research to understand the molecular biology of the virus."
The grant will involve more than 40 researchers from biochemistry, chemistry, epidemiology, hematology/oncology, infectious diseases, molecular biology and microbiology, pathology, pediatrics, and psychiatry.
CWRU also used a grant awarded earlier this year from the Mt. Sinai Health Care Foundation to recruit an AIDS virology researcher who will join the center later this month.
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