On the cusp of a cure?
A tree in Samoa may be the crucial link to a cure for HIV, but money is needed to move research and development along
For years the AIDS Research Alliance in California has been at the forefront of researching a cure for HIV. And now they think they may have found it - prostratin.
The compound was first discovered in the Pacific island nation of Samoa by native healers in the 1800s. They would make tea with it and use it to treat viral hepatitis.
Technically the compound is a non-tumor-promoting phorbol ester derived from the Mamala tree (Homalanthus nutans).
"We’ve got HIV treatment down. Now we need a cure. The stumbling block to a cure are the reservoirs and we think prostratin is part of that answer. As a long-term survivor myself, I’m very excited about this," said Art McDermott, vice president of development for ARA. "We’re the only ones with a drug in the pipeline. But we need the public’s help to move this research forward. Because of budget cuts we’ve had to rely more and more on private giving."
It wasn’t until 1997 when researchers first discovered that HIV can lay dormant and hide in pockets called reservoirs throughout the body for decades escaping even the most powerful anti-HIV drugs and springing to life as soon as treatment stops. That’s one of the major reasons HIV has been so difficult to treat and why those infected must stay on drugs for life.
"As soon as you get off meds the HIV comes roaring back and starts the infection all over again," McDermott said.
Researchers at the National Cancer Institute were the first ones to discover that prostratin could possibly be used as an anti-HIV drug. In the early 90s they began testing their large repository of chemicals gathered from all over the world to see if any of them could be used as anti-HIV drugs. Prostratin popped up as a possible one, however, after some testing they found that, while it did stop HIV from infecting healthy cells, it also increased the virus production in cells that were already infected, but dormant. Because of the increased viral production they put further research and testing on hold.
But it’s the increase that researchers would later find to be beneficial. Because prostratin activates the dormant HIV hidden in the reservoirs it also allows the newly activated HIV to be attacked by anti-HIV drugs.
When Dr. Stephen Brown, vice president and medical director of ARA, took the job in 1997 one of the things the board decided upon is that they wanted him to start looking for things useful in attacking those reservoirs.
"No one knew much about the reservoirs at that time and this was way before anyone was thinking about them," he said.
It wasn’t until 1999 when Brown first learned of prostratin in a presentation addressing whether or not the compound should be reconsidered in the era of Highly Active Antiretroviral Therapy (HAART).
"I was absolutely thrilled because this was exactly the thing we were looking for," he said.
Research, however, moved slowly because of the difficulty in getting prostratin, since it was only found in the bark of the Mamala Tree. It wouldn’t be until 2008 when Dr. Paul Wender of Standford discovered how to synthetically create the compound. ARA now holds the exclusive National Institute of Health license to develop it.
"Every two people that access HIV treatment another five people become infected," McDermott said. "We’re never going to be able to treat our way out of the epidemic."
But in order to continue the testing and get clinical trials in humans the organization needs funding. McDermott said unfortunately the federal government is focusing their resources on a vaccine rather than a cure, so there isn’t much money to be had there.
If ARA had all of the money they needed Brown said it would take about 1 to 2 years to complete the human trials. Realistically though, he said, they’re still about 5 years away from any sort of drug making it to the pharmacy. Besides reaching out to new donors they’re also looking to form a partnership with a drug company to speed up the process.
McDermott estimates ARA needs another 2 million to get the clinical trials in humans.