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Speaking about Nahlen’s appointment, Notre Dame’s Vice President for Research said, “I, along with the wider research and scientific community here at Notre Dame, am thrilled to have a global health leader like Bernard join our team. His vast scientific experience, program management success and international network in the global health field will bring exciting new opportunities to the Eck Institute for Global Health, as well as to a broad range of other research and education programs at the University.”

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In addition to his extensive experience serving the PMI, Nahlen’s career, which began as an undergraduate at Notre Dame, has been committed to recognizing health as a fundamental human right and serving those most in need. A medical school graduate of the University of Arkansas, Little Rock, he completed his residency in family practice at the University of California, San Francisco, as well as a second residency in preventive medicine at the Centers for Disease Control and Prevention (CDC). His career has been spent working to address the many diseases that disproportionately impact people in low- and middle-income countries, including AIDS, malaria and tuberculosis.

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“From his time working in the Los Angeles County AIDS Epidemiology Program, to serving as director of the CDC field research station in Kenya, to his new role here at Notre Dame, Bernard has dedicated his career to being a force for good in the world,” said Mary Galvin, William K. Warren Foundation Dean of the College of Science. “His genuine passion for science at Notre Dame, combined with his commitment to students and his transformative vision for global health research at Notre Dame, will help to take our programs to the next level.”

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Nahlen’s appointment is effective Dec. 1, 2017. For more details, please visit .

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Contact: Sarah Craig, communications specialist, 574-631-2665, craig.20@nd.edu

Alex Perkins’ lab researched how a fever can affect mobility, a topic that has rarely been examined.

Read more: .

Human malaria, uniquely transmitted by a handful of anopheline mosquitoes, continues to attack nearly 200 million people and claims the lives of 600,000 each year. Africa bears the biggest burden due to its dominant vector, Anopheles gambiae. Ever since the groundbreaking Anopheles gambiae genome sequencing project was published in 2002, efforts have been underway to harness genomics for novel vector-based malaria control strategies.

, O’Hara Professor in the and member of the at the University of Notre Dame, assembled a diverse and multinational team of scientists to crack the genetic code of the Y chromosome in malaria mosquitoes for the first time.

The Y chromosome is a crucial element in anopheline reproductive biology, as it carries an unknown primary sex determination signal. Although this chromosome comprises an estimated 10 percent of the total genetic material, it was never successfully assembled and has almost completely eluded genomic analysis until now. Indeed, the Y chromosomes of many, if not most, organisms with heteromorphic sex chromosomes are resistant to assembly and genomic analysis because they are dense with repetitive DNA. As a result, scientific understanding of Y chromosome organization, content and evolution across the tree of life is based on a very small set of model organisms, mainly the fruit fly and mammals.

The research team leveraged emerging genome sequencing technology and applied it to extensive genomic DNA and mRNA data sets, including the . The researchers extended their analysis of Anopheles gambiae to closely related species, providing a unique glimpse into Y chromosome evolution in this group of malaria mosquitoes.

Their study finds that the Y chromosome mainly consists of only a few types of repetitive sequences that are massively amplified. It contains very few genes, and the genic content does not overlap between closely related species, with the sole exception of one gene, YG2, that this study implicates in male determination. Surprisingly, their data suggest that the Y chromosome may have crossed species boundaries in this group of mosquitoes, complementing the findings of extensive introgression of other chromosomes published in January 2015 in Science.

The study provides a long-awaited foundation for studying mosquito Y chromosome biology and evolution and also lays the groundwork for exploiting the Y chromosome to control disease transmission.

The multidisciplinary team included leading computational biologists, molecular biologists, cytogeneticists, genome scientists and vector biologists from nine institutions, including Notre Dame, Virginia Tech, Imperial College London, University of Perugia, National Biodefence Analysis and Countermeasures Center, National Human Genome Research Institute, Indiana University Bloomington, Tomsk University and the University of California, Riverside.

The results of their research were on March 29.

The research was funded in part by the Eck Institute for Global Health, a University-wide enterprise that recognizes health as a fundamental human right and endeavors to promote research, training and service to advance health standards for all people, especially people in low and middle-income countries, who are disproportionately impacted by preventable diseases.

Contact: Nora Besansky, Nbesansk@nd.edu, Sarah Craig, Eck Institute, 574-631-2665, Craig.20@nd.edu

Insect-borne diseases — such as malaria, dengue, West Nile and the newly emerging chikungunya — infect a billion people every year; more than a million die each year and many more are disabled. The effects of climate change, according to , professor of biological sciences and member of the at the University of Notre Dame, mean these deadly diseases are no longer reserved for the developing world.

Michael is working with an international team of researchers to project how climate change will affect mosquitoes, flies and ticks that carry diseases afflicting humans. Recently published in a special issue of , a peer-reviewed publication of The Royal Society, the collective research from this international consortium delivers the bad news that insect-borne diseases are emerging and, in some regions, having a resurgence. The research highlights and points to the critical need to take into account the interactive, contributory roles that climate, epidemiological, environmental and socioeconomic factors play in disease transmission when forecasting the future impact of these diseases around the globe.

According to Michael, “There is no easy fix, and the complex problem is getting worse. Different vectors respond differently to changing weather and climate patterns. Human societies also demonstrate variable vulnerability to this change. We, however, now have numerous resources including the mathematical models we have developed as tools to predict, assess risk and map how different vectors and disease patterns are likely to alter due to changing climates.”

The spread into regions including Europe and the United States will cause and force significant public health interventions to address this emerging global problem.

“The results of this research will have real and profound impacts on the mitigation of the spread of mosquito-borne diseases that is currently being exacerbated by climate change,” said , vice president for research at the University of Notre Dame. “I applaud Edwin Michael and his international colleagues for taking on this challenge and look forward to the positive, real-world outcomes of their research.”

Mosquitoes are known to be very sensitive to temperature changes and rainfall. Researchers agree that climate changes will affect many, if not all, of these diseases. According to Michael’s collaborator, Paul Parham, University of Liverpool, the next step includes determining “the extent to which climate impacts will be important compared to many other factors that contribute to the risk of becoming infected in certain regions.”

Additional findings in the special issue “” — compiled by Michael, Parham and other scholars — include:

• Many areas of Europe, including the U.K., could become highly suitable for mosquitoes that transmit dengue and chikungunya over the coming decades.
• The potential for climatic changes to affect the effectiveness, cost-effectiveness and policy decisions of whether to scale up future vector control programs against malaria.
• Evidence that vectors may evolve in under a decade to changes in temperature.
• The need for better data on the links between vectors, diseases they carry and the environment.
• The conclusion that one of the most effective ways of protecting human health against climate change in the long term is to further strengthen current disease control efforts.

Michael said, “We now have a great deal of knowledge and tools for determining how to best protect ourselves from insect-borne diseases. It is up to policymakers to recognize the significant role that climate change can have in affecting current global efforts to reduce the burden of these diseases and to prevent their emergence in new risk areas. We need to implement the required adaptation and climate-resilient measures in the most cost-effective way. Research support is vital, and with the potential of joint projects between The Eck Institute for Global Health, the , its (ND-GAIN) and other centers within the University, I expect the University of Notre Dame to play an increasingly important global role in this vital field.”

Contact: Sarah Craig, Eck Institute, 574-631-2171, craig.20@nd.edu

New research at the University of Notre Dame looks more closely at the effects of the influenza vaccine on the elderly, who are considered the highest-risk group for influenza-related mortality.

Despite the fact that the elderly are more susceptible to falling ill, very little is known about how well the influenza vaccination performs for those older than 65 years of age. The new study, which looks at the effects of the influenza vaccine in Canada, is the largest to date in terms of numbers of individuals studied and duration. Seniors “age 65 and older are among those at highest risk of serious outcomes following influenza infection,” said lead author , assistant professor of biological sciences and a member of the at Notre Dame, in a manuscript being published this week. While annual flu vaccines are recommended for the older population in the United States, Canada and many other developed countries, debate remains on the effectiveness of the vaccines for this older at-risk group.

The study, published in , titled, “Effectiveness of inactivated influenza vaccines in preventing influenza-associated deaths and hospitalizations among Ontario residents aged ≥65 years: Estimates with generalized linear models accounting for healthy vaccinee effects,” questions the effectiveness of influenza vaccines in older adults. The researchers’ findings indicate that previous estimates of influenza vaccine effectiveness may be upwardly biased because of difficulties identifying and adjusting for confounders of the vaccine-outcome association. The authors said, “We estimated vaccine effectiveness for prevention of serious influenza complications among older persons by using methods to account for underlying differences in risk for these complications.”

Benjamin Ridenhour

In their central findings of the research, the authors said, “By combining health data with climate data and developing novel statistical analyses, we found that vaccination was 19 percent effective at preventing pneumonia- or influenza-related hospitalizations and 25 percent effective at preventing death occurring subsequent to a pneumonia- or influenza-related hospitalization.”

The results indicate that, over a long time period, the influenza vaccine has performed worse than expected in elderly individuals, thus proving the need for improvements in influenza vaccine development.

Annually, influenza kills approximately 25,000 people in the United States, according to the Centers for Disease Control and Prevention. Likewise, the World Health Organization estimates that nearly 500,000 deaths per year occur globally due to influenza.

Ridenhour specializes in the evolution and ecology of infectious diseases. His research focuses on understanding their spatial and temporal dynamics with particular interest in understanding disease transmission to reduce global burden.

Contact: Ben Ridenhour, 574-631-9450, ridenhour.1@nd.edu

In work published this week in , a team of researchers from the University of Notre Dame’s , led by Associate Professor and Assistant Professor of the Department of Biological Sciences, revealed that the major malaria vector in Africa, the Anopheles gambiae mosquito, is able to smell major human host odorants better at night.

The study reports an integrative approach to examine the mosquito’s ability to smell across the 24-hour day and involved proteomic, sensory physiological, and behavioral techniques. The researchers examined the role for a major chemosensory family of mosquito proteins, odorant-binding proteins (OBPs), in the daily regulation of olfactory sensitivities in the malarial mosquito. It is thought that OBPs in the insect antennae and mouth parts function to concentrate odorant molecules and assist in their transport to the actual olfactory receptors, thereby allowing for odorant detection. The team revealed daily rhythmic protein abundance of OBPs, having higher concentrations in the mosquito’s sensory organs at night than during the day. This discovery could change the way we look at protecting ourselves from these disease-carrying pests.

The team also included Matthew M. Champion, Eck Institute for Global Health Research Assistant Professor in the Department of Chemistry and Biochemistry, who specializes in proteomics.

Zain Syed, left, Sam Rund, Matt Champion and Giles Duffield synchronize their research

This study utilized mass spectrometry to quantify protein abundance in mosquito sensory organs, and electroantennograms to determine the response induced by host odorants at different times of the day. The coincident times of peak protein abundance, olfactory sensitivity and biting behavior reflect the extraordinarily fine-tuned control of mosquito physiology. Olfactory protein abundance and olfactory sensitivity are high when needed (at night) and low when not required (daytime).

, a doctoral candidate in the laboratory of Duffield and a former Eck Institute for Global Health Fellow, and Nicolle Bonar, a visiting undergraduate student from Queens University of Ontario, Canada, were the lead authors on this research. The Notre Dame team also included then-undergraduate student John Ghazi, Class of 2012; undergraduate Cameron Houk, Class of ’14; and graduate student .

Rund noted, “This was an exciting opportunity to bring many people and techniques together to make some really fascinating findings on the mosquito’s ability to smell humans, its host. Just think, during the day the mosquito is sleeping and doesn’t need to smell you. But when the sun goes down, the mosquito’s olfactory system becomes extra-sensitive, and she is ready to smell and then bite you.”

The project was a follow-up to their earlier work that utilized genomic tools to reveal 24-hour rhythmic patterns of gene expression, including many genes involved in olfaction.

Anopheles gambiae mosquito (credit: CDC)

Rund and Duffield’s earlier work with collaborator from Notre Dame’s Department of Computer Science and Engineering, “Extensive circadian and light regulation of the transcriptome in the malaria mosquito Anopheles gambiae,” helped lay some of the foundation to their findings. The paper, published in in April, further examined the regulation of rhythms in gene expression at the molecular level, highlighted important differences in biological timing between Anopheles gambiae and the important dengue vector, Aedes aegypti, and highlighted the important role of light in organizing and modifying gene expression.

Anopheles gambiae is the primary species that is responsible for the transmission of malaria in sub-Saharan Africa, with approximately 300 million infections and 1 million deaths annually. The fact that these studies were conducted in Anopheles gambiae mosquitoes has important implications for the development of novel insect control methods with the potential to reduce the transmission of malaria parasites and thus the morbidity and mortality associated with malaria disease. This work provides the first comprehensive evidence of the important role of daily rhythms in the sensory biology of Anopheles gambiae and the implications for developing new control methods.

In addition to funding from the Eck Institute for Global Health, the team received support from the National Institutes of Health-funded Indiana Clinical and Translational Sciences Institute, and the University of Notre Dame’s .

The Eck Institute for Global Health is a University-wide enterprise that recognizes health as a fundamental human right and endeavors to promote research, training and service to advance health standards for all people, especially people in low- and middle-income countries, who are disproportionately impacted by preventable diseases.

Contact: Giles Duffield, 574-631-1834, Giles.E.Duffield.2@nd.edu

Biting mosquitoes are not only annoying but can be dangerous, even deadly. A new study involving researchers at the University of Notre Dame explores a potential biological mechanism through which disease virus can alter the behavior of mosquitoes. In a previous , led by Alexandre Peixoto of Fiocruz in Brazil, disease-infected mosquitoes were found to fly around more than uninfected mosquitoes, increasing their ability to spread chronic and deadly diseases.

The new study indicates that drug-treated mosquitoes behave differently than those not treated, flying farther or for a longer duration. While this initially is not good news for humans and animals, the research indicates that with this knowledge researchers can develop better intervention tools to stop disease transmission. Results of the study were published this month in the .

“What we found was that when the mosquitoes are manipulated with a compound thought to be modified by the dengue virus, it is like they are hyped up on caffeine,” states one of the authors, , Notre Dame associate professor of biological sciences and member of the Eck Institute for Global Health. “These findings will help our global effort in searching for better ways to control and address mosquito-transmitted illnesses.”

The study also involved University of Notre Dame doctoral candidate Samuel Rund and then-undergraduate student Samuel Lee, Class of 2013, and was in collaboration with researchers at the University of Wisconsin 91��Ƶ of Medicine and Public Health, headed by Rob Striker. The team looked at two species of mosquitoes to see if there were changes in their flight activity following pharmacological manipulation that mimics a dengue virus infection. The work at Notre Dame was based on flight activity measured with infrared beam breaks, while the work at Wisconsin was based on microphones to measure the insects’ wing beats. The mosquitoes were exposed to a compound that activates protein kinase G, or PKG, a substance that modifies a particular behavioral pathway in mosquitoes, which then increased their activity. The pathway was known to regulate the behavior of non-disease-carrying insects, but had never been used in experiments with mosquitoes. The results showed increased flight activity in two different species of mosquito, Anopheles gambiae, the night-active and major malaria vector, and Aedes aegypti, a day-active species responsible for transmitting dengue, yellow fever and West Nile virus.

Understanding the molecular mechanism by which flavivirus, such as dengue, yellow fever and West Nile, can manipulate the behavior of the mosquito — thereby increasing the odds that the mosquito will encounter another human host and thus transmit the disease — is important to combating disease transmission.

People infected with the West Nile virus develop symptoms but may not even know they have the illness. In severe cases, the virus may cause dramatic and dangerous symptoms leading to death. Nearly 5,700 people in the United States were diagnosed with West Nile virus in 2012, resulting in 286 deaths.

Globally, dengue fever, a tropical disease that may cause a high fever, severe pain in the joints, muscles and eyes, headaches and bleeding, are increasing. It is thought at least 100 million dengue infections occur annually, resulting in 12,000 deaths, most of them women and children.

There are currently no vaccines to prevent West Nile virus or dengue fever.

The is a University-wide enterprise that recognizes health as a fundamental human right and endeavors to promote research, training and service to advance health standards for all people, especially those in low- and middle-income countries, who are disproportionately impacted by preventable diseases.

An international team of researchers from the University of Notre Dame’s and Imperial College London has recently published its work on a malaria-filaria co-transmission model, where the same mosquito transmits both diseases together. Found in large areas of sub-Saharan Africa, one mosquito genus, Anopheles, carries both the malaria parasite Plasmodium falciparum and the microfilarial worm Wuchereria bancrofti, which causes lymphatic filariasis, which can develop into elephantiasis.

According to lead researcher , professor of biological sciences specializing in epidemiology at the University of Notre Dame, “This has major implications for the transmission of each disease in endemic settings, and, of course, for developing better control interventions that ensure that removal of one disease does not have a profound (a worse health impact) outcome for diseases caused by the other pathogen.”

The manuscript, titled “,” is being published in PLOS Computational Biology. The findings indicate that mosquito co-infection is more prevalent than expected from single prevalence, meaning two parasites facilitate each other’s invasion. Looking for ways to address co-infection is vital to addressing the considerable public health burden of these major vector-borne diseases afflicting humans today.

Since these two infections are transmitted by the same mosquito species, important questions about optimal control strategies in co-endemic regions need to be answered. The effect of the presence of each infection on the endemicity of the other leads to the need for comprehensive, reliable and dynamic pathogen co-infection modeling studies.

Edwin Michael

Michael, who studies the spread and control of tropical infectious diseases, leads the team. Much of his research addresses the next generation of critical questions regarding the population ecology, epidemiology and control of neglected diseases and vector-borne diseases including malaria, dengue and lymphatic filariasis. Team members include Imperial College postdoctoral researcher Hannah Slater and Dr. Manoj Gambhir, both from the Department of Infectious Disease Epidemiology, and Dr. Paul E. Parham, currently at Bangor University in Wales.

Malaria is a mosquito-borne infectious disease in humans and other animals. There are five forms of malaria, which can cause symptoms ranging from a headache to death. More than 1 million people, many of whom are children in Africa, die every year from the disease. Currently, there is no vaccine for malaria, though researchers around the world, including many at Notre Dame, are working on understanding the complexities and working toward vaccine development.

Filarial worms, which reproduce and occupy the lymphatic system in humans, cause lymphatic filariasis, which can develop into elephantiasis. Early stages can go undetected for years. Once the damage to the lymphatic system is done, it cannot be reversed.

The Eck Institute for Global Health is a University-wide enterprise that recognizes health as a fundamental human right and endeavors to promote research, training and service to advance health standards for all people, especially people in low and middle-income countries, who are disproportionately impacted by preventable diseases.

Contact: Sarah Craig, Craig.20@nd.edu

The University of Notre Dame’s and the Indiana University 91��Ƶ of Medicine (IUSM) have announced a new opportunity for IUSM medical students to receive global health training through a joint Medical Doctor/Master of Science in Global Health (M.D./M.S.) integrated dual degree program that will begin in August.

“We are excited about this joint effort that will prepare students to make a big impact on the health of some of the world’s most underserved populations,” says , dean of the at Notre Dame.

“This effort capitalized on the shared relationship the South Bend campus and Eck Institute have built around several shared research projects,” says , associate dean and director of (IUSM-SB), noting that most IUSM-SB faculty are members of the Eck faculty.

This new academic collaboration is offered to medical students from any of the IUSM campuses who plan to practice medicine in underserved settings. Students will take a leave of absence during their third year of medical studies to join students at Notre Dame for a 12-month program. Upon completion of the M.S. in Global Health degree, students will resume their medical degree studies with the option of finishing at the IUSM-SB campus for their third and fourth years.

“The new joint effort will better prepare our graduates for highly competitive global health careers at places like the World Health Organization, the U.S. Centers for Disease Control and the National Institutes of Health,” says , Eck Institute for Global Health director. “This program will strengthen Notre Dame’s tradition of placement in these international organizations as well as the thousands of nongovernmental organizations such as Catholic Relief Services, with whom we have existing relationships.”

The program was organized by members of the Eck Institute and IUSM-SB staffs and subsequently reviewed by both the graduate school and provost’s office of Notre Dame and the medical education administration of IUSM.

The one-year supplemental, science-centric training program consists of 30 credit hours over two semesters and summer (fall, spring and summer sequentially) involving a six- to eight-week field experience in an international resource-poor location. All students complete a required master’s research project, a scholarly report based on original research or literature-based research. “We are only in the second year of the existing one-year master’s program,” says Joseph Bock, director of global health training, “and the demand has been more than we expected.”

August will be the initial transition for incoming IUSM students to begin the integrated dual degree program. Although other leading universities offer similar five-year programs, this degree program will be the first dual degree of its type from two collaborating universities.

For information, please contact the Eck Institute for Global Health at 574-631-5617.

Contact: Sarah Craig, 574-631-2665, craig.20@nd.edu

The University of Notre Dame’s is now a full member of the Academic Model Providing Access to Healthcare (AMPATH) Consortium, led by Indiana University.

The Consortium works in collaboration with Moi University 91��Ƶ of Medicine and Moi Teaching and Referral Hospital in Eldoret, Kenya to help build the care, education and research capacity of these institutions with the goal of providing access to health care for all persons throughout western Kenya. The Eck Institute will serve as the central coordinating body for Notre Dame activities within the AMPATH Consortium.

Notre Dame will specifically be involved in this partnership to expand the basic science research capacity at Moi University 91��Ƶ of Medicine. Notre Dame has a unique niche in the Consortium in that it is the only member not focused on clinical care and brings a history of expertise in vector control and tropical disease research.

Notre Dame scientists are excited to participate in the partnership knowing they bring a history of experience and global leadership in the fight against tropical diseases including leishmania, malaria, dengue fever and lymphatic filariasis in addition to communicable diseases, tuberculosis and Ebola.

“The University of Notre Dame is committed to the ideals and goals of the existing partnership," said David Severson, the Eck Institute’s director. "We hope to bring our unique faculty and facility resources to the consortium to expand our research opportunities on the African continent and to bring Kenyan researchers to campus for academic exchange and collaboration. We strongly believe that lab to field research partnerships are critical to the institute’s mission.”

The Eck Institute will lead and coordinate research and training activities for Notre Dame that address constraints to health care in western Kenya, and simultaneously contribute to building scientific research capacity. Joint research activities, participation in seminars and academic meetings, student and faculty exchanges, and special short-term courses will be used to advance the mission of the Consortium. Members of the partnership are committed to observance of equity and mutual respect with a desire of common values resulting in maximum benefit for all involved.

The AMPATH Consortium is comprised of Brown University, Duke University, Indiana University, Lehigh Valley Health Systems, Providence Portland Medical Center, Purdue University, University of Utah, University of Toronto and now the University of Notre Dame.

In 1989, Indiana University 91��Ƶ of Medicine and Moi University 91��Ƶ of Medicine agreed to join together to develop leaders in health care for both the U.S. and Africa. That mission inspired this team to provide invaluable training to future generations of health care providers on both continents.

At the turn of the century, in the face of the deadliest pandemic in human history, Indiana University and Moi University responded by creating one of Africa’s largest, most comprehensive and effective HIV/AIDS control systems. This system is now expanding its scope to include delivery of essential primary care services and control of communicable diseases and non-communicable, chronic illnesses. The AMPATH Consortium in collaboration with Moi University, Moi Teaching and Referral Hospital, and the Kenya Ministry of Health delivers health services in more than 60 hospitals and clinics in rural and urban western Kenya, serving a population of 3 million people.

“As one of the premier universities in our nation with an outstanding commitment to health equity and a distinguished record of research in neglected tropical diseases, the University of Notre Dame complements the strengths of the other institutions in the AMPATH Consortium,” reported Bob Einterz, M.D., director of the AMPATH Consortium and the IU Center for Global Health. “My Kenyan and American colleagues and I welcome the students and faculty members of the University of Notre Dame, and we look forward to working with them to solve many of our world’s most vexing health problems.”

University of Notre Dame Professor , associate director of the and a member of the , is part of a team of researchers who received one of 10 new Grand Challenges in Global Health (GCGH) Grants from the Bill and Melinda Gates Foundation to identify biomarkers for the diagnosis of tuberculosis (TB).

TB is one of the world’s deadliest infectious diseases with an estimated 9 million individuals diagnosed and 1.6 million deaths every year. This makes TB the second leading cause of death by an infectious agent, behind only HIV. In 1993, the World Health Organization declared TB a global emergency. This realization has resulted in a significant push to develop new treatment and prevention strategies.

According to Schorey, "In order for existing as well as new antibiotics to be effective, we need to identify the TB patient population. Unfortunately, current strategies for diagnosis of TB are inadequate, particularly in impoverished regions of the world. An estimated 50 percent of TB patients go undiagnosed, in part due to the absence of a sensitive and effective diagnostic test.”

The Bill and Melinda Gates Foundation has recently identified TB diagnostics as a key area for development. "There is an urgent need to break through barriers in biomarker research in order to develop a highly sensitive point-of-care diagnostic to improve identification of active TB cases,” said Chris Wilson, director of Global Health Discovery at the foundation. “We hope these innovative ideas lead to effective and affordable TB diagnostics that can make an impact on one of the world’s deadliest infectious diseases.”

The Schorey laboratory at Notre Dame will work in conjunction with Karen Dobos at Colorado State University and collaborators at the University of California at San Francisco to identify and validate mycobacterial protein signatures present on small membrane vesicles released from M. tuberculosis-infected cells. These vesicles known as exosomes, are ideal for diagnostic development since they can be easily isolated from various body fluids including blood and urine. As pointed out by Schorey, “looking for mycobacterial proteins in serum of a TB patient is even harder then looking for a needle in a haystack; however, by first purifying the exosomes we greatly enrich for the mycobacterial proteins, allowing us to define which proteins correlate with active disease.” Once defined, antibody-based detection systems can be developed to identify active TB patients for antibiotic treatment.

This project falls under the Gates Foundation’s GCGH program to fund Biomarkers of Health and Disease, which was developed to foster scientific and technological innovation to solve key health problems in the developing world. The goal is to identify specific disease biomarkers and to couple this with new technologies for miniaturization and detection. This could enable radically new ways to diagnose disease in individuals, even in remote or impoverished settings. “The recognition by the Bill and Melinda Gates Foundation that diagnostics is a very important component of disease management deserves applause. The implementation of a rapid diagnostic test at the point-of-care for diseases such as TB will have a significant impact on disease prevalence and mortality, particularly in low- and middle-income countries, ” adds Schorey.

Contact: Sarah Craig, craig.20@nd.edu