The Peter Doherty Institute for Infection and Immunity
What do you see as the more promising, efficacious or affordable treatment/therapy for SARS-CoV-2?
I am not too optimistic about any of the antivirals currently being evaluated for COVID19. If repurposed antiviral drugs have any impact on viral replication in vivo or on clinical endpoints, I suspect it will be modest. We will almost certainly need to do better. We still need to determine whether blocking virus replication early in disease will lead to a reduced chance of progressing to severe disease and mechanical ventilation. The role of immunomodulation during severe disease is also evolving. Again, there are many approaches being tested including blocking IL-6, GM-CSF, JAK STAT pathways etc but to date the lack of any controlled studies limits our ability to draw any conclusions of what might be of benefit. I am convinced both antivirals and immunomodulators will each have a role to play in the clinical management of COVID19 but unfortunately more work is urgently needed to develop highly specific and potent antivirals, to determine the optimal time to use these drugs and to fully understand the pathogenesis of severe COVID19 pneumonia. Our work has only just begun!
What are you and your institution currently working on regarding SARS-CoV-2?
As a joint venture between the University of Melbourne and the Royal Melbourne Hospital, The Peter Doherty Institute for Infection and Immunity (Doherty Institute) is engaged across a spectrum of COVID-19 research, clinical and public health activities. The Doherty Institute acted immediately when the outbreak began in early January, developing a sensitive and specific PCR test to diagnose SARS COV2 infection. This resulted in our diagnostic laboratory diagnosing the first case of COVID19 in Australia on January 24th., 2020 as well as being the first laboratory outside of China to isolate and rapidly share the virus [Caly et al., MJA 2020]. Our diagnostic lab supported all reference laboratories around Australia to establish an accurate test for COVID19 resulting in Australia having one of the highest testing rates in the world. Our lab alone has performed over 30,000 PCR tests for SARS COV2. Using pre-approved protocols that were in place to capture information and biological samples on patients who present with a new infectious disease, the Doherty Institute were able to map the immune response to the virus following clearance showing the appearance of plasmablasts which persisted well beyond clinical recovery [Thevarajan et al., Nat Med 2020]. Since this time, we have COVID19 programs in diagnostics, epidemiology and modelling, antivirals drugs and vaccine development. Some highlights include being the lead investigator and sponsor of a platform trial for hospitalized patients which will initially assess the effects of kaletra and hydroxychloroquine either alone or together in 2400 participants across Australia and New Zealand. Our mathematical modellers have developed a range of models that have guided the Australian government’s response resulting in Australia having a very well controlled outbreak with a real likelihood of achieving full suppression or even elimination. Finally we are pursuing a range of vaccine strategies – including the use of viral like particles and developing neutralizing antibodies as well as working in partnership with the University of Queensland to develop a clamped protein vaccine.
Leading infectious diseases expert, Professor Sharon Lewin, is the inaugural Director of the Doherty Institute. She is also a Professor of Medicine at The University of Melbourne and a National Health and Medical Research Council (NHMRC) Practitioner Fellow. As an infectious diseases physician and basic scientist, her laboratory focuses on basic, translational and clinical research aimed at finding a cure for HIV and understanding the interaction between HIV and hepatitis B virus. Her laboratory is funded by the NHMRC, the National Institutes of Health, The Wellcome Trust, the American Foundation for AIDS Research and multiple commercial partnerships. She is also the Chief Investigator of a NHMRC Centre of Research Excellence (CRE), The Australian Partnership for Preparedness Research on Infectious Diseases Emergencies (APPRISE) that aims to bring together Australia’s leading experts in clinical, laboratory and public health research to address the key components required for a rapid and effective emergency response to infectious diseases.
The Doherty Institute for Infection and Immunity
Finding solutions to prevent, treat and cure infectious diseases and understanding the complexities of microbes and the immune system requires innovative approaches and concentrated effort. This is why the University of Melbourne – a world leader in education, teaching and research excellence – and The Royal Melbourne Hospital – an internationally renowned institution providing outstanding care, research and learning –partnered to create the Peter Doherty Institute for Infection and Immunity (Doherty Institute); a centre of excellence where leading scientists and clinicians collaborate to improve human health globally.