Reinventing the Common Cold Institute for the 21st Century

July 30, 2015 2:09 pm

Reinventing the Common Cold Institute for the 21st Century
Dr Robert Lambkin-Williams
Since Edward Jenner performed the first documented Human Viral Challenge (HVC) study with smallpox on the 14th of May 1796 the utility of such studies has been apparent. In 1931 Sir Christopher Andrews returned from the US where he had observed the use of chimpanzees in the study of influenza. However, as his return coincided with the great depression, funding for similar work in the UK was extremely limited. Sir Christopher therefore decided to enrol students from St Bartholomew’s Hospital. He explained to them that as he could not get chimpanzees, he considered the next best thing would be a “Bart’s” student. Despite the comment that “they were cheaper than chimpanzees”, over 100 students immediately enrolled, but the students had to continue their studies and were not isolated in the same way the chimpanzees had been in the USA]. This confounded any analysis of the data as the investigators could not be certain that the symptoms were not due to any other respiratory viruses acquired in the community. The UK’s Medical Research Council (MRC) terminated the work just a year later.
After the conclusion of World War II, a new approach was pioneered by Dr David Tyrell at the Common Cold Institute (CCI). From 1946, volunteers were inoculated by instilling small quantities of virus into their noses. The CCI housed healthy volunteers in relative isolation from other people, thereby reducing the risk of contact with natural sources of infection or of passing on the virus to members of the public. During its time, the unit attracted 20,000 volunteers until its closure in 1989.
The HVC Model using healthy volunteers provides a unique opportunity to describe the viral lifecycle as: the time point of infection is known with certainty, nasal virus shedding can be measured, symptoms are recorded prospectively, and participants are selected with low pre-haemagglutination inhibition (HAI) antibody titres to ensure a statistically significant infection rate with a relatively small number of volunteers.
Post 1989 experimental infection studies continued, with small motels and hotels in the USA substituting for the wooden huts on Salisbury Plain. Such studies contributed to the significant development of the new neuraminidase inhibitors during the 1990’s.
We restarted HVC studies in the UK in 2001 and since then we have conducted multiple studies with over 1900 volunteers inoculated with Influenza, Respiratory Syncytial Virus (RSV) or Human Rhinovirus (HRV). We have advanced research for vaccine and antiviral drugs that could save thousands of lives every year.

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