How research in Hull York Medical School is supporting development of a malaria vaccine

Acute leukaemia patients undergoing intensive chemotherapy face a high risk of infections, particularly invasive fungal infections, which can be fatal.

Currently, all patients are typically given antifungal medication throughout the course of chemotherapy. However, only a minority of them will actually develop a fungal infection, leading to overuse of antifungals, potential adverse effects, and fuelling the emergence of antifungal resistance.

Professor Gavin Barlow, Professor of Infection at Hull York Medical School and Consultant in Infection at Hull University Teaching Hospitals NHS Trust, is co-lead for the trial.

He says: “The drugs used to treat fungal infections can have side effects and may interact with other drugs, including chemotherapy. So we want to find better ways of deciding which patients do have a fungal infection, so we can target treatment at these patients.”

In collaboration with the York Trials Unit, the trial involves randomising patients into two groups: the diagnostics approach and the standard care approach.

In the diagnostics approach, patients do not receive any antifungal preventative treatment but undergo weekly blood tests to detect biomarkers of invasive fungal infection.

If these biomarkers show signs of infection, additional tests and assessments are conducted. The goal is to reduce overall antifungal use while providing early and effective treatment to those who need it.

Professor Barlow explains: “We want to find out if by utilising biomarkers to guide antifungal therapy, we can minimise unnecessary medication exposure and potential side effects for patients.”

The study is among a huge amount of research that takes place via the Hull York Medical School. As well as clinical research testing treatments for patients, the centre is also involved in biomedical research, which can then support the discovery of the therapies of tomorrow.

Gavin Wright, Professor of Microbial Biochemistry at Hull York Medical School, for example, works on research into different molecules that are found on the surface of cells.

Some of the science in his lab has focused on malaria and how the parasite recognises and invades human red blood cells. That science has gone on to inform trials to support the development of a malaria vaccine.

“If we can stop the infection of our red blood cells, then that would be a good way of stopping (malaria) infection,” explains Prof Wright.

“We looked at which molecules on the surface of human red blood cells that the parasite that causes malaria actually recognises in order to infect and invade that cell.

“It was about ten years ago now, but we identified a molecule on the surface of human red blood cells that was absolutely required by the parasite to infect them. We also identified what the parasite molecule was that was involved in this process.

“That particular parasite protein (RH5) is an important vaccine target.”