Elite Controllers

Some people contract HIV and never get sick. These people are called “controllers,” and studying them has long been a focus for researchers seeking a cure for the disease.

Now, an ambitious plan called The Immunity Project has released a white paper outlining how they plan to create an HIV vaccine—free for the entire world population—based on the computerized analysis of blood from HIV controllers.

Although their work has created some eye rolls in the HIV research community, big names have stepped up with funding. Microsoft has donated $1 million toward the effort, for example. But The Immunity Project has turned to crowdfunding to come up with the more than $400,000 needed to keep its work moving forward. With 15 days to go, more than $130,000 still is needed to advance trials using human blood in mice.

A non-profit organization, The Immunity Project has partnered with Until There's a Cure, and also receives support from Y Combinator, an incubator for innovative start-up companies.

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Who Are the Controllers?

Dr. Reid Rubsamen, who founded a drug delivery company called Aradigm, Inc., serves as CEO of The Immunity Project. Aradigm specializes in inhaled medications, which is how Rubsamen would like to see The Immunity Project's vaccine administered.

The Immunity Project uses a computerized method to figure out how controllers evade AIDS. The key is the way the controllers' cells manage to alert their immune systems to attack the HIV virus.

By expressing certain proteins, the controllers' cells send out a signal showing the immune system the best location to attack on the surface of HIV cells.

“These beneficial targets have been identified by researchers in university laboratories and private industry who have used computer-assisted statistical analysis to essentially reverse engineer the targets on the HIV virus preferred by the controller's T-cells,” Rubsamen told Healthline. “We believe that controllers are an important part of moving forward with vaccine development because they are clearly doing something right in defending against the virus.”

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Although everyone's patterns of protein expression are different, The Immunity Project intends to create a “cocktail” based on some of the most popular genotypes from people who are able to withstand the virus long-term.

Some people have greater natural control over the HIV virus than others.

Dr. Jay Levy, a scientist at the AIDS Research Institute at the University of California, San Francisco, has been studying controllers for many years. Some go two years without much of the virus being detected in their blood, while others go 10 years or more, he said. Some patients have “blips” where the virus appears and then disappears.

Levy said that less than 1 percent of people with HIV are "elite" controllers who never get sick, while as many as 5 percent are virus controllers to a lesser degree.

Taking Advantage of the 'Innate Immune System'

Levy believes researchers should turn their attention to the “innate immune system,” which is the non-specific immunity every person is born with and uses to fight off infections.

Levy wants to better understand how “natural killer,” or NK, cells limit HIV infection and disease. In his laboratory, he is examining cell non-cytotoxic anti-HIV responses, or CNAR.

After studying people infected with HIV who have remained healthy for 10 years or longer, he determined that they all have white blood cells called CD-8 lymphocytes. Now, Levy's laboratory wants to find the protein the lymphocyte naturally produces and use it to create treatments for HIV and other diseases.

It's not an easy task. Levy likened it to trying to find biomarkers for cancer, although companies have sprung up nationwide for just that purpose.

“It's such a communication system,” Levy said of the immune system. “It's the beauty of nature.”

The problem, he said, is that companies simply aren't funding research into immune therapies. He likened our knowledge of such therapies to being in “third or fourth grade.”

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