Childhood vaccine against heart disease planned

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Dr. Vijay KakkarLondon - Professor Vijay Kakkar has the gentle demeanour of a man into whose hands you would happily entrust your heart, should disease and circumstance require it. And you would be wise to do so. For the professor is a world-renowned vascular surgeon and research scientist whose career has spanned more than 40 years.

Now, approaching his 70th birthday, he is embarking on his most ambitious project yet a vaccine against heart disease that can be administered in childhood and he is confident he will achieve it before the decade is out.

By 2008, he and his team also hope to have developed a cheap, reliable urine test to identify those at high risk of heart disease.

Earlier this week, Kakkar, emeritus professor at London University and founder of the Thrombosis Research Institute in Chelsea, and his team took a step nearer to their goal with the opening of another branch of the institute in Bangalore, where, in the middle of a scrub wasteland, a "medical city" is fast being established with high-tech hospitals and research laboratories to rival any in the world.

The fact that the president of India, Dr A.P.J. Abdul Kalam, agreed to open the institute highlights the importance attached to Kakkar's project. While cancer might be the illness that many fear most, it is cardiovascular disease (including coronary heart disease and stroke) that is the bigger killer.

Some progress through lifestyle changes, improved surgical techniques and the use of statin drugs has been made, but a better understanding of the genetic causes is the key to preventive treatment.

According to Kakkar, South India is the ideal testing ground for such a project as South Asians have a marked genetic propensity to develop the disease. Many of the 2.7 million people it kills here every year have normal or even low cholesterol levels.

Studies have shown that infection with certain viruses and bacteria causes changes in blood vessels that create localised areas of thickness in arteries called atheroma. This happens early in life, around the age of two or three. A vaccine that worked against the pathogens could prevent the initial damage occurring. "We wanted to establish a highly focused resource at the centre of the problem," says Kakkar. The institutes in Chelsea and Bangalore will work together and the Anglo-Indian team is already making good progress. "We have identified a number of pathogens associated with heart disease. Now we want to find a way to prime the body's natural system to combat infection."

Research

The team has already synthesised a unique DNA vaccine aimed at conferring immunity to infection and is now looking at the best means of delivering it. "We're looking at using the BCG [TB vaccination] as a shuttle," says Kakkar. "The BCG is safe and production is cheap. In tests, we have successfully included our potential pathogen into the vaccine."

A prototype skin patch for drug delivery is also in development.

Touring the laboratories and lecture rooms at the new Thrombosis Research Institute, there is a sense of excitement about what lies ahead. The facilities are state of the art and the corridors are full of young Indian doctors, eager to make a mark in their own country, rather than move to Britain or America as is the tradition.

At 70, retirement is not an option for Kakkar. "I don't play golf. What else am I going to do? My hobby is thrombosis I am married to it."

Initially, Kakkar's focus is on developing a urine risk-assessment test, as easy to use as a home pregnancy kit and intended for worldwide distribution.

Another element of the research is large-scale population studies. Kakkar is aiming to enrol 12,500 people in a trial the largest of its kind in the world and has signed up 4,000 so far.

When he began his ground-breaking research into thrombosis, he was driven by the memory of a five-year-old girl in Kent who died in his operating theatre from a massive clot. "You start wondering if you can do something worthwhile," he says. "As a surgeon, I have spent many hours dealing with the problems of heart disease and I know surgery is not the answer. There has to be a better way."

source Gulf News