The Update

1. Artificial Kidney Implant Achieves Preclinical Milestone
 

• The Kidney Project is a national research project with a goal to create a small, surgically implanted, and free-standing bioartificial kidney to treat end stage renal disease.
• The implantable device being developed by The Kidney Project consists of two components: a blood filtration system called the hemofilter, which removes toxins from the blood, and a bioreactor, which contains cultured human kidney cells intended to perform other kidney functions, such as maintaining adequate fluid volume and blood pressure, adjusting salt levels, and producing essential hormones.
• At the American Society of Nephrology Kidney Week 2019, the project announced that a prototype kidney bioreactor containing functional human kidney cells was successfully implanted in large animals without significant safety concerns. The device, which is about the size of a deck of cards, did not trigger an immune reaction or cause blood clots in the animals, an important milestone on the road to future human trials.
• In contrast to kidney transplant, the implantable device will not require the patient to be on immunosuppressive therapy.
• Treatment of end stage renal disease (ESRD) patients by renal transplant is severely limited by shortage of donor organs, while dialysis is expensive, and confers significant morbidity and mortality. Therefore, The Implantable artificial kidney could serve as a bridge-to-transplant or destination therapy for end-stage renal disease.
• Following promising studies in large animals, The Kidney Project's hemofiltration system is currently awaiting FDA approval for an initial clinical trial to evaluate its safety

2. Phage Therapy Shows Promise for Alcoholic Liver Disease

• A team of researchers led by King’s College London and the University of California San Diego School of Medicine have reported in an article published in November 2019, the use of bacteriophages to target gut microbiota to eradicate alcoholic liver disease in mice.
• Compared with non-alcoholic individuals or patients with alcohol-use disorder, patients with alcoholic hepatitis have increased faecal numbers of E. faecalis.
• E. faecalis, in particular produces a toxin known as cytolysin, which causes injury and cell death in the liver.
• Researchers were then able to isolate 4 bacteriophages that can target cytolysin-secreting E. faecalis bacteria.
• It was found that humanized mice treated with bacteriophages that target cytolytic E. faecalis had less liver injury and inflammation compared to controls, and the administration of E. faecalis-targeting bacteriophage also significantly reduced levels of cytolysin in the liver, and abolished ethanol-induced liver disease in the mice.
• Clinical trials with a larger cohort is required to validate the relevance of these findings in humans, and to test whether this therapeutic approach is effective for patients with alcoholic hepatitis.

3. WHO Details First Large-scale Malaria Vaccine Trials for Africa

• The world’s first malaria vaccine, known as “RTS,S” - or as “mosquirix” has been shown to have a protective effect against malaria among young children.
• The vaccine acts against Plasmodium falciparum, one of the causative parasites globally, and the most prevalent in Africa.
• Three countries – Ghana, Malawi and Kenya – are currently participating in the MVIP. Vaccinations began in Malawi on 23^rd of April and in Ghana on the 30^th of April in 2019, and Kenya introduced the vaccine in September 2019.
• A 4-dose schedule is required, with the first dose given as soon as possible after 5 months of age followed by doses 2 and 3 at approximately monthly intervals and the fourth dose near the child’s second birthday. The vaccine should be used alongside other preventative measures such as bed nets, insecticides, repellents and anti-malarial drugs, as recommended by the World Health Organization.
• The MVIP is expected to continue through 2022. During this time, the MVIP will provide data on the feasibility of delivering the vaccine in real-life settings, the safety profile of the vaccine, the context of routine use, and the vaccine’s impact on child survival. Taken together, these results will inform future decisions on the wider-scale deployment of the vaccine.