Path Breakers

Three medical breakthroughs last year had a common Kashmiri thread in them. Be it brain tumour, AIDs or TB, Kashmiri researchers redefined the global fight against these medical emergencies, reports Bilal Handoo

Raiees-Andrabi-with-the-team
Raiees Andrabi with the team.

Inside Srinagar’s bulldozed Pratap Park, intriguing scenes unfolded on December 1, 2015. A silent sitting bunch of kids were seen holding placards: “Fight AIDS. End Discrimination”. In the melee of mundane routine, not everyone could discern that those soundless kids making a bow shape (a symbol for solidarity with HIV-positive people) were Kashmir’s own Ryan White.

An American teenager, White became a poster child for HIV after being expelled from school when found infected. A contaminated blood treatment infected him in December 1984. After emerging a struggling face of new-age disease White died a silent death in April 1990—not before altering public perception towards the patients and the disease.

But unlike Ryan, the kids inside Pratap Park weren’t expelled from schools. Still most of them conveyed a sense of discrimination they are facing in the society for being the kids of AIDS patients. By coming out open with their ‘taboo campaign’ on World AIDS day, they recreated ‘Ryan moment’—striking a perceptible change in the state where the disease consumed 628, infected 5000 patients officially since 1999. While pleading for their plight in silence, the tender ones were unaware that a Kashmiri researcher in America had already boosted global hopes in fight against AIDS.

13 days ago, California, America—almost 15,000km away from the spot where the kids held a silent sit-in…

HIV Antibodies
HIV Antibodies

A team of scientists from The Scripps Research Institute (TSRI) were rejoicing over a vital discovery termed as a game changer in fight against AIDS. The happy moment came after a backbreaking research appearing on the cover of Journal Immunity on November 17. The study described four prototype antibodies targeting a specific weak spot on the virus.With these antibodies—proteins generated by immune system as a defence against infections—the researchers mimicked the molecular structure of a protein on HIV when designing their own potential HIV vaccine candidate.

Among the team was a Kashmir-born Raiees Andrabi – the major force behind the study shortly making it to front pages: “Scientists at TSRI have new weapons in fight against HIV”, “Young Kashmiri Scientist Helps Discover Fast-Acting HIV Antibodies”…

Raiees working with a senior researcher Prof Dennis R Burton was the first author of the study on HIV, a virus causing a spectrum of health conditions. After initial brief influenza-like illness, the infection progresses and interferes more with immune system. It makes the person susceptible to common infections, like tuberculosis and tumours. The late symptoms are referred to as AIDS, a pandemic disease.

Even though AIDS can be treated with anti-retroviral therapy medications, there is no cure, vaccine for the disease that devoured 1.2 million people worldwide in 2014 besides making 36.9 million people sick. With number of infected individuals rising annually, Raiees and the team are now eyeing to engineer an HIV vaccine that stimulates production of the powerful antibodies against HIV. The research has already been recognised as an important advance in the field of antibody-based HIV vaccine development.

Once HIV vaccine will become eventuality, the global fight against HIV (the virus believed to have transferred to humans from African non-human primates in early 20th century) will redefine the current treatment for good. But cracking one of the biggest medicinal riddles was no cakewalk.

The researchers had to conduct a series of experiments involving virus modifications, protein, antibody engineering. After rigorous efforts, the team found that four antibodies targeted a single spot on HIV’s surface called the V2 apex – the region that stabilizes the virus. The team were delighted to know that a vaccine targeting this region could protect against many forms of the virus.

But before becoming global face in fight against HIV, 32-year-old Raiees was an avant-garde among his tribe at Srinagar’s SP College where he studied biochemistry. This Ratnipora researcher, a cricket buff, was never a book worm, but his “curiosity” flourished inside Kashmir’s oldest college having a motto: Ad adhere tendons (sour high in sky).

Three years later, a different Raiees came out of the campus: positive, passionate, probing. He shortly had his Masters done from Delhi’s Jamia Hamdard University before pursuing his PhD in immunology from AIIMS. During his doctorate degree, he was awarded Fogarty International Fellowship and flew to US where he met his idol, Dr Dennis Burton. Under Burton’s guidance, Raiees managed to achieve the ‘unachievable’.

Dr-Khalid-Shah
Dr Khalid Shah

Back in Kashmir, many other ailments are threatening to snowball into a new health catastrophe. Among the new-age diseases, brain tumour is a ticking bomb. Already the rampant usage of chemicals in orchards has triggered malignant brain tumours in orchardists. Even Neurosurgery Department of SK Institute of Medical Sciences has found that out of 432 brain tumour patients admitted there between 2005 and 2008, 389 were orchardists or persons exposed to multiple types of neurotoxic and carcinogenic substances used in orchards as fungicides, insecticides.

The menace with brain tumour is its psychiatric symptoms including depression, mania, hallucinations, anxiety disorders confusing patients, thus delaying its treatment. What begins as a vintage headache soon progresses into unconsciousness, if allowed to breed.

Till last year, the classic method to combat the disease was chemotherapy, surgery and radiation therapy. But all these methods have proved ineffective to deal with the disease where brain gets separated from the blood by the blood-brain barrier. As scientists were struggling, sweating to flip the treatment, a Kashmir-born American neuroscientist came up with the path-breaking research.

Dr Khalid Shah’s study is based on an idea of turning stem cells into killing machines to fight brain cancer. In recent past, the researchers had recognised that stem cells could be used to continuously deliver these therapeutic toxins to tumours in the brain. But the challenge was to have a genetically engineer stem cells that could resist being killed themselves by the toxins. Once toxin-resistant stem cells were made and cultured to release cancer-killing drugs, Dr Shah led Harvard Stem Cell Institute (HSCI) scientists at Massachusetts General Hospital and experimented on mice.

He used genetically engineered stem cells for releasing the tumour killing poison without succumbing to its effects. During the tests, the main brain tumour was surgically removed before the stem cells were placed at the site of the tumour in a biodegradable gel to eradicate the remaining cancerous cells.

The path-breaking research made rapidly it to the prestigious Stem Cells journal besides bestowing flurry of awards, rewards to Dr Shah. “This is a clever study,” believes Chris Mason, professor of regenerative medicine at University College London. “It signals the beginning of the next wave of therapies… Cells can do so much. This is the way the future is going to be.”

A Kashmir-born, Dr Shah grew up as a boy-next door before going to study medicine in Europe. He later went to US where he eventually came up with a path-breaking research.

What makes Dr Shah’s discovery a wonder for medical science is the fact that since 1940, there had been very little progress to combat, cure the brain tumour. Dr Shah is now working to translate these therapies into Kashmir-based clinics.

Imtiyaz Yaseeen with the team.
Imtiyaz Yaseeen with the team.

Towards the end of 2015, another Kashmiri researcher came up with the path-breaking research in the disease declared as “global health emergency” by World Health Organisation in 1993. What a Kashmir-born Hyderabad-based researcher achieved, earned him swift global accolades—as the breakthrough came in the second most infectious killing disease after HIV of world.

Imtiyaz Yaseen, a researcher in his late twenties, discovered a crucial protein secreted by the bacteria. A widespread infectious disease caused by various strains of Mycobacterium tuberculosis, TB is spread through the air when infected persons cough. It generally affects lungs, but can also affect other parts of the body. The germ not only causes tuberculosis but also releases a protein reducing body’s capability to respond to that infection. “By targeting this particular protein we can produce drugs which can cure the disease,” said Yaseen in his research that appeared in prestigious Nature Communications journal.

Yaseen discovered the protein while working on the project as part of his doctorate research at Hyderabad’s Centre for DNA Fingerprinting and Diagnostics (CDFD). The idea came from his guide, Prof Sanjeev Khosla, motivating the young Kashmiri researcher to explore it for four years. When he finally zeroed in on a protein called RV1988, the targeted therapy for TB affecting nearly one-third of world’s population became a possibility.

Keeping the same therapeutic facts in view, the discovery was hailed by scientific community worldwide making CDFD to file a patent for the discovery naming Yaseen as an applicant. The Centre has now initiated talks with major drug companies that can produce drugs to cure TB based on Yaseen’s research.

On December 1, the kids of HIV infected parents while rubbing shoulders with normal children inside Pratap Park made certain sketches. Through those sketches, they displayed their tender creative to signal end the discrimination. One little girl drew a rough sketch of a girl standing near a colourful house. For them, the life was too easy to imagine. Now when a Kashmiri researcher has came up with his breakthrough in HIV, their world has every reason to stay the way they portrayed it on canvas: full of colour and innocence!

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