a story between pandemics, from AIDS to COVID-19

In 1995, lhe AIDS pandemic was wreaking havoc around the world, killing more than 2 million people a year due to the disease and its consequences. Aware of the importance of finding a solution, IrsiCaixa It was inaugurated thanks to the impulse of the ”la Caixa” Foundation, with Josep Vilarasau as director at that time, and the Department of Health of the Generalitat of Catalonia, with Xavier Trias as Minister of Health.

Twenty-five years later, and having achieved that the daily life of people with HIV is equal to that of the rest of the population, new challenges appear. «IrsiCaixa has become a world benchmark in AIDS virus research, and the ”la Caixa” Foundation It did not hesitate to support it from the beginning to respond to the pandemic in which society was immersed in the 1990s.

A quarter of a century later, a new virus has appeared, SARSCoV-2, which has highlighted, more than ever, that the commitment to research is crucial to face the great health challenges of today and the future, and constitutes a key element for the well-being and health of people “, he explains Àngel Font, Corporate Director of Research and Health of the ”la Caixa” Foundation.

Climate change and globalization have made the planet more vulnerable to emerging viruses, and have led to the SARS-CoV-2 pandemic in 2020. This serious health emergency has required a quick and immediate reaction from the scientific world, in which IrsiCaixa has been able to collaborate thanks to all the knowledge generated in the field of HIV and the immune system.

Nowadays, IrsiCaixa works against the clock in 26 research projects on COVID19. These projects aim to develop a vaccine, seek effective treatments and design rapid tests to detect the disease. “We have relived the horrible feeling of impotence, of not having treatments to cure or prevent a disease,” explains Bonaventura Clotet, director of IrsiCaixa.

“We needed the research to deal with SARSCoV-2 and luckily now we have the necessary tools, we just have to adapt them,” he adds. As of today, HIV persists, and 2019 ended with 1.7 million new infections caused by this virus worldwide. “HIV is still a reality for many people. A reality, however, that has nothing to do with that of 1995, ”says Clotet. The great advances made so far allow a possible cure to be closer every day.

IrsiCaixa has seen this evolution and has been part of it, with milestones such as the discovery of how HIV spreads through the body, the design of a therapeutic vaccine that has promoted the creation of the spin-off AELIX Therapeutics, the development of a second spin-off (AlbaJuna Therapeutics) focused on the development of synthetic antibodies against HIV, and the coordination of the international consortium IciStem , who has achieved two cases of HIV cure through bone marrow transplantation.

Now, IrsiCaixa studies the resistance of the virus to antiretroviral treatments, the efficacy of the therapeutic vaccine designed in the laboratory, and how to eliminate the reservoir, the niche where the viruses hide and the main obstacle to ending this disease. To speed up the research, scientific patronage has been key for IrsiCaixa, which has gone from an initial capital of 14 million pesetas (84,000 euros) to 7.5 million euros, thanks to the endowment sustained over time of the ”la Caixa” Foundation and the Generalitat of Catalonia, and money from European funds.

HIV Research Today Since the beginning of the HIV pandemic, research has changed a lot. It has gone from seeking treatment urgently to save the lives of people with the infection to aspiring to cure or complete eradication of the disease.

IrsiCaixa has been a participant in this progress and has contributed 1,011 scientific articles to it. During this time, the team has analyzed more than 110,000 samples from almost 25,000 patients participating in clinical trials, which has made it possible to understand HIV infection in detail and search for therapeutic alternatives for those who live with the infection.

Although IrsiCaixa began with the impulse of 7 workers to fight AIDS, today it has 107 enthusiastic researchers, as well as the support of 60 external collaborators around the world. This expansion has enabled the training of health professionals —who have had access to state-of-the-art experimental infrastructures— and representatives of the community affected by HIV, as well as secondary, high school, and training students. Although HIV / AIDS infection today can be considered a chronic disease, the goal now is to cure it, to ensure that people living with HIV do not need to take antiretroviral medication.

“Designing a therapeutic vaccine against HIV is a great challenge, since, unlike SARS-CoV-2, it mutates a lot and evades the response of our immune system, which is gradually being depleted”, explains Beatriz Mothe, researcher and coordinator of clinical trials of vaccines and immunotherapies. “Currently, we are carrying out two clinical trials promoted by AELIX Therapeutics in order to evaluate the safety and efficacy of therapeutic vaccines, designed at IrsiCaixa.

The COVID-19 pandemic has been a huge challenge to keep the trials active, but, with a lot of effort and motivation, we have managed to move the projects forward, “he adds. Replicate preventive and curative strategies IrsiCaixa, together with the Barcelona Supercomputing Center – Centro Nacional de Supercomputación (BSCCNS) and the Animal Health Research Center (CReSA) of the Institute for Agrifood Research and Technology (IRTA), and thanks to the support of Grifols , has formed a consortium to develop a vaccine that generates defenses against SARS-CoV-2 and its variants.

“We have been able to use innovative platforms that we previously designed for the preventive HIV vaccine”, explains Julià Blanco, principal investigator in charge of the project at IrsiCaixa.

“We have two prototype vaccines that generate neutralizing antibodies in the animal model. Now, it is necessary to see if these protect of the infection and to study how to happen to the industrial production “, adds. All preventive strategies, to be effective, must go hand in hand with an early diagnosis and treatment of infections. In the case of HIV, during early years of the pandemicSince available antiretrovirals had significant toxicity, treatment was not started until the immune system began to show signs that it might be weakening.

Fortunately, current treatments have been shown to have very little toxicity, improve the health of all people living with HIV, regardless of their immune status, and at the same time prevent the transmission of the virus to other people where they are. few weeks after starting treatment. “In the case of COVID-19, proceed in a similar way: you have to do many tests and not wait for the person to have pneumonia to treat it”, claims Clotet.

Research on emerging viruses, a necessary bet More than a year ago, before the COVID-19 pandemic arrived, IrsiCaixa created a new research group dedicated to the study of new emerging diseases, like ebola. Now, the world has been caught up in a new pandemic, and the importance of investing in research in the field of emerging viruses has become clear. “Globalization, and, therefore, the interconnection between the animal, human and environmental world, makes us increasingly vulnerable to possible emerging pathogens, such as viruses”, explains Nuria Izquierdo-Useros, the leader of this new group.

“These pathogens conquer new geographic regions, compromising global health and generating serious consequences, such as pandemics”, Add. For this reason, IrsiCaixa has expanded its field of research and has opted for the One Health concept, that is, understanding health as an interactive sum of animal, environmental and human health.

Parallel, IrsiCaixa continues to work to cure HIV infection and improve the quality of life of people living with this virus, as well as combating the associated stigma. The expansion of IrsiCaixa has led the institution to explore new fields of research related to HIV, such as the study of the microbiome, aging, cancer, neurodegenerative diseases and emerging pathogens. “There are many challenges that we still have ahead, but, as always, we face them with strength and enthusiasm”, concludes Clotet.