How the SARS vaccine effort can learn from HIV-speeding towards the future, learning from the past

Abstract

A remarkable collaborative effort coordinated by the severe acute respiratory syndrome (SARS) team at WHO resulted in discovery of the etiologic agent of severe acute respiratory syndrome less than 2 months after the announcement of global alert. The development of a vaccine to prevent SARS should be pursued with the same urgency and cooperative spirit, as SARS is highly lethal and, if not controlled during the first few generations of transmission, is likely to become endemic in regions of the world where health-care infrastructure is underdeveloped and epidemiological control measures are weak. The scientific community already learned many important lessons from HIV vaccine development; these should be heeded. For example, consideration should be given to the development of a vaccine that will protect across regional strains of SARS, as the newly emergent coronavirus SARS-coronavirus (SARS-CoV) is proving to be variable and may be mutating in response to immune pressure. SARS-specific research reagents should also be collected and shared. These would include SARS peptides, adjuvants, DNA vaccine vectors and clinical grade viral vectors. Rapidly developing a collaborative approach to developing a SARS vaccine that will be both effective and safe is the only way to go. This article reviews parallels between HIV and SARS and proposes an approach that would accelerate the development of a SARS vaccine.

Fig. 1

Coronavirus classification (reprinted with permission from The Lancet 2003, 361 (9371), 1779–1785 [7]). The Coronaviridae family contains the genuses coronavirus and torovirus. The genus coronavirus is broken down into three groups. SARS-CoV has been assigned to a fourth group. Group 1 includes canine coronavirus (CCV), feline coronavirus (FIPV), human coronavirus 229E (HCoV-229E), porcine epidemic diarrhea virus (PEDV) and transmissible gastroenteritis virus (TEGV). Group 2 species are bovine coronavirus (BCoV), human coronavirus OC43 (HCoV-OC43), murine hepatitis virus (MHV), porcine hemagglutinating encephalomyelitis virus (HEV) and rat coronavirus (RCV). Group 3 species are avian infectious bronchitis virus (IBV) and Turkey corona-virus (TCoV).

Fig. 2

SARS evolution (reprinted with permission from The Lancet 2003, 361, 1779–1785). Mutations mapped in 14 SARS isolates associated with a single point source (Hotel M). Upward arrows indicate recurrent variations. Black arrows indicate variations in a single isolate.

Fig. 3

SARS Epidemiology. Source: Communicable Disease Surveillance & Response (CSR), http://www.who.int/csr/alertresponse/en/.