Vaccine against MAC?

Posted by Armando @bolso1, Nov 19, 2020

Does anybody know about a vaccine against MAC? I found the paper ["Protection against Mycobacterium avium by DNA Vaccines Expressing Mycobacterial Antigens as Fusion Proteins with Green Fluorescent Protein" (INFECTION AND IMMUNITY, Aug. 1999, Vol. 67, No. 8 p. 4243–4250)] that claimed to be "…first report of successful DNA vaccination against M. avium", but nothing else.

@sueinmn

The only problem with your comparison is that all of the diseases you mention, except tetanus, are infectious person-to-person, which MAI and the related infections are not. Tetanus was included in vaccine research because it was 99% fatal if you got it. Again, MAI is not.

@windwalker Terri – unfortunately, even when you add together the number of people with bronchiectasis and Cystic Fibrosis, we was talking about less than 1/2 of 1% of the population, so the combination – low occurence, not fatal, and not contagious, keep this research from rising to the top of the priority list.

Sad, but unfortunately true.
Sue

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Interesting answer Sue

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@bolso1

I'm sorry, but I cannot see why not being person-to-person contagious is an obstacle to developing a vaccine.
You have a segment of the population that is highly vulnerable to MAI that could be protected by a vaccine, and you would not do it because MAI cannot be transmitted person-to-person?
In the estimation of "market size" you should include the world, not just the USA. How important is it globally?

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Sorry, but the harsh reality is that health research and care funds are limited and developing a vaccine is extremely expensive, and in many cases "iffy" proposition. Dollars are allocated where drug companies and/or the government will get the most return on investment. Both my husband and niece have been involved in health care research, through a university that gets grants from the government and drug companies. Promising projects are abandoned all the time because the money isn't available and/or the perceived demand is inadequate.

As for global reach, I think you are still talking about a relatively small percentage of the population, and the number of places that even recognize and treat MAI are not huge. The sad fact is that a lot of the world population is still worried about keeping babies alive to grow into adulthood, providing adequate food and safe water and vaccinating for contagious diseases. Problems like MAI are not even on their radar.

I'm not trying to be argumentative, just pointing out that in the face of scarce resources, things that are worthwhile to small parts of the population fall by the wayside. This is even true of subsets of "headline" diseases like cancer – the rare ones don't get the same research as common ones.

Sue

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I understand your reasoning. Nevertheless, I still think that we need to raise awareness that other – more humane and rational – means of handling disease exist and keep struggling for a change.

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@bolso1

I understand your reasoning. Nevertheless, I still think that we need to raise awareness that other – more humane and rational – means of handling disease exist and keep struggling for a change.

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This is a very interesting discussion. Thank you to those who participated. I agree with Sue that there just isn't enough monry available for the research needed to develop a vaccine (assuming one is possible) for our comparatively small number of patients

It is important to remember that the bacteria is around everyone, but the vast majority of people do not become infected. One must have a problem with the lungs making them unable to clear any inhaled bacteria. For most of us, the problem is bronchiectasis. If we had a cure for that, we would be like the rest of the world and be able to inhale and exhale MAC or any other mycobacteria or bacteria and be just fine. We could even sit in a hot tub.

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@rits

This is a very interesting discussion. Thank you to those who participated. I agree with Sue that there just isn't enough monry available for the research needed to develop a vaccine (assuming one is possible) for our comparatively small number of patients

It is important to remember that the bacteria is around everyone, but the vast majority of people do not become infected. One must have a problem with the lungs making them unable to clear any inhaled bacteria. For most of us, the problem is bronchiectasis. If we had a cure for that, we would be like the rest of the world and be able to inhale and exhale MAC or any other mycobacteria or bacteria and be just fine. We could even sit in a hot tub.

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A promising event recently occurred that some day may bring help to us. On November 13, Insmed, the pharmaceutical company behind Arikayce, received a PRIME designation from the European Medicine Agency for their drug BRENSOCATIB. This drug is an oral med that stops the release of a protein that actuates neutrophils which release an enzyme that damages the lungs of people with bronchiectasis.

A PRIME designation supports continuing research to bring promising treatment to patients.

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@rits

A promising event recently occurred that some day may bring help to us. On November 13, Insmed, the pharmaceutical company behind Arikayce, received a PRIME designation from the European Medicine Agency for their drug BRENSOCATIB. This drug is an oral med that stops the release of a protein that actuates neutrophils which release an enzyme that damages the lungs of people with bronchiectasis.

A PRIME designation supports continuing research to bring promising treatment to patients.

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Wow! Thanks for the update – I'll be watching this.
Sue

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@rits

A promising event recently occurred that some day may bring help to us. On November 13, Insmed, the pharmaceutical company behind Arikayce, received a PRIME designation from the European Medicine Agency for their drug BRENSOCATIB. This drug is an oral med that stops the release of a protein that actuates neutrophils which release an enzyme that damages the lungs of people with bronchiectasis.

A PRIME designation supports continuing research to bring promising treatment to patients.

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@rits that is great news, thanks to Insmed.

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@sueinmn

Sorry, but the harsh reality is that health research and care funds are limited and developing a vaccine is extremely expensive, and in many cases "iffy" proposition. Dollars are allocated where drug companies and/or the government will get the most return on investment. Both my husband and niece have been involved in health care research, through a university that gets grants from the government and drug companies. Promising projects are abandoned all the time because the money isn't available and/or the perceived demand is inadequate.

As for global reach, I think you are still talking about a relatively small percentage of the population, and the number of places that even recognize and treat MAI are not huge. The sad fact is that a lot of the world population is still worried about keeping babies alive to grow into adulthood, providing adequate food and safe water and vaccinating for contagious diseases. Problems like MAI are not even on their radar.

I'm not trying to be argumentative, just pointing out that in the face of scarce resources, things that are worthwhile to small parts of the population fall by the wayside. This is even true of subsets of "headline" diseases like cancer – the rare ones don't get the same research as common ones.

Sue

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Hello Sue. I know that folks with bronchiectasis count as a small number, but I wonder if adding patients with CF and other lung diseases that also are prone to mac would be enough to push us out of the 'orphan disease' catagory?

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@windwalker

Hello Sue. I know that folks with bronchiectasis count as a small number, but I wonder if adding patients with CF and other lung diseases that also are prone to mac would be enough to push us out of the 'orphan disease' catagory?

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Hi Terri – That's an interesting question.
First, I looked up "orphan diseases" – in the US it is defined as less than 200,000 people affected.
Then I looked up the number of people in the US with bronchiectasis – the estimate is from 350,000 – 500,000 people – so not an orphan.
Then I looked up the number of CF patients in the US – 30,000 total – probably because the average life span for CF is still under 50 yrs.
Other people prone to NTM include ventilator-dependent, HIV positive and COPD patients among others.
And for NTM (all non-tubercular mycobacteria) infections in the US – 86,000 currently – includes all forms and all underlying conditions.
Finally, for comparison, I looked up the number of people in the US with TB – current estimate is 13 million, and the number of shingles cases per year is about 1.4 million.

So there are enough people at risk for NTM to make it "not an orphan" but since the actual number of cases is low, and it is not easily transmissible between people, I suspect only a concerted campaign and the ability to raise funds would be the only way toget vaccine research kick-started.

If anyone has the passion, time and energy for such an undertaking, that would be great.

Sue

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@sueinmn

Hi Terri – That's an interesting question.
First, I looked up "orphan diseases" – in the US it is defined as less than 200,000 people affected.
Then I looked up the number of people in the US with bronchiectasis – the estimate is from 350,000 – 500,000 people – so not an orphan.
Then I looked up the number of CF patients in the US – 30,000 total – probably because the average life span for CF is still under 50 yrs.
Other people prone to NTM include ventilator-dependent, HIV positive and COPD patients among others.
And for NTM (all non-tubercular mycobacteria) infections in the US – 86,000 currently – includes all forms and all underlying conditions.
Finally, for comparison, I looked up the number of people in the US with TB – current estimate is 13 million, and the number of shingles cases per year is about 1.4 million.

So there are enough people at risk for NTM to make it "not an orphan" but since the actual number of cases is low, and it is not easily transmissible between people, I suspect only a concerted campaign and the ability to raise funds would be the only way toget vaccine research kick-started.

If anyone has the passion, time and energy for such an undertaking, that would be great.

Sue

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In the meantime, I am interested in exploring more the possibilities of the already available BCG vaccine, based on the results that I shared a week ago.

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@sueinmn

Hi Terri – That's an interesting question.
First, I looked up "orphan diseases" – in the US it is defined as less than 200,000 people affected.
Then I looked up the number of people in the US with bronchiectasis – the estimate is from 350,000 – 500,000 people – so not an orphan.
Then I looked up the number of CF patients in the US – 30,000 total – probably because the average life span for CF is still under 50 yrs.
Other people prone to NTM include ventilator-dependent, HIV positive and COPD patients among others.
And for NTM (all non-tubercular mycobacteria) infections in the US – 86,000 currently – includes all forms and all underlying conditions.
Finally, for comparison, I looked up the number of people in the US with TB – current estimate is 13 million, and the number of shingles cases per year is about 1.4 million.

So there are enough people at risk for NTM to make it "not an orphan" but since the actual number of cases is low, and it is not easily transmissible between people, I suspect only a concerted campaign and the ability to raise funds would be the only way toget vaccine research kick-started.

If anyone has the passion, time and energy for such an undertaking, that would be great.

Sue

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@sueinmn Well, that is very interesting information Sue. Thank you for finding/sharing that. irene5

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@bolso1

In the meantime, I am interested in exploring more the possibilities of the already available BCG vaccine, based on the results that I shared a week ago.

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After rereading the article you posted, I suggest you contact the authors to learn the current status of their research.
Sue

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