Project aims to improve care for patients with Zika, dengue and chikungunya

International initiative enables group of Brazilian and French researchers to seek biomarkers for early identification of people with propensity to develop severe manifestations of the three arboviruses.

By Karina Toledo  |  Agência FAPESP – For most people, contact with viruses transmitted by the mosquito Aedes aegypti results merely in the temporary discomfort caused by such symptoms as fever, headache and joint pain. In some cases, however, there may be more serious, and even fatal, complications.

Project Arbobios has been launched with the aim of finding biomarkers that can help physicians with the earliest possible identification of individuals with a propensity to develop severe manifestations of dengue, Zika or chikungunya. The initiative is expected to last four years and is supported by FAPESP, the University of São Paulo (USP) and the French company bioMérieux under the aegis of FAPESP’s Research Partnership for Technological Innovation Program (PITE).

“We plan to monitor a large number of people who’ve been infected by one of these three viruses, collect blood samples, and then separate them into two groups comprising individuals with and without severe manifestations. We estimate that some 2,000 patients will have to be included in the study,” said Ester Cerdeira Sabino, a professor in the Department of Infectious Diseases at USP’s Medical School (FM-USP), director of the university’s Tropical Medicine Institute (IMT-USP) and principal investigator for the project.

The blood samples will be transcriptomically analyzed to identify all RNA and microRNA molecules expressed in both groups. “Once the samples have been very well characterized, we’ll try to find a pattern that can pinpoint individuals who develop severe manifestations of these arboviruses,” Sabino said.

In the case of dengue, the goal will be to obtain a biomarker capable of showing which patients most risk progressing to the hemorrhagic form of the disease and therefore need to be hospitalized. In the case of chikungunya, the idea is to detect individuals with a propensity to develop chronic joint inflammation, which is considered incapacitating. 

“In the case of Zika, today, we know not all infected pregnant women give birth to babies with microcephaly or other central nervous system problems,” Sabino said. “Our goal is to find biomarkers that enable physicians to know if a child will have problems even before they show up on an ultrasound scan of the fetus.” 

The groups of patients, or cohorts, will be established in several Brazilian cities where epidemics are highly likely to occur. The first locality to be chosen is Divinópolis, in Minas Gerais State, where patients will be monitored in collaboration with researchers at the Federal University of São João Del-Rey (UFSJ).

“If we succeed in finding these markers, the next step will be to transfer this knowledge to the production of a test that can be used in clinics. It will be a great opportunity to work in partnership with bioMérieux. FM-USP and IMT-USP are very keen to maintain this relationship with the private sector,” Sabino said during an event held to launch the project on October 26 at FM-USP. 

Public-private partnership

Considered a global leader of in vitro diagnostics, bioMérieux is one of six companies controlled by Institut Mérieux, the group’s holding company headquartered in Lyon, France. bioMérieux is present in more than 150 countries through 41 subsidiaries and a large network of distributors.

Marc Bonneville, Institut Mérieux’s Vice President for Medical & Scientific Affairs, recalled during the ceremony held at FM-USP that the organization has had ties with Brazil since the 1970s, when the National Program to Combat Meningitis was implemented.

“The success of this major vaccination campaign fostered many other actions that strengthened our group’s relationship with Brazil, one of the first countries where we set up research and development centers. The joint program between bioMérieux, USP and FAPESP whose launch we’re celebrating today is another example of this privileged partnership,” Bonneville said.

According to Alexandre Pachot, head of bioMérieux’s Department of Biomarker & Medical Diagnostics Discovery, Project Arbobios is “at the heart of the company’s strategy” and embodies founder Alain Mérieux’s vision of investing in developing countries.

“Few biomarkers are used routinely in clinical medicine today,” Pachot said. “We believe this is a field that needs to be professionalized via links between research and development.”

FAPESP Vice President Eduardo Moacyr Krieger highlighted the foundation’s mission of supporting research of all kinds performed in São Paulo State, both in basic science and in fields with applications in the near or long run.

“Today, we’re in the process of approving a project that has direct implications for the health of the population, and in a field in which Brazil is internationally recognized, which is infectious diseases,” he said.

For Aluisio Segurado, Chair of USP’s International Relations Committee, the project represents a major achievement for FM-USP and IMT-USP. “It gives us an opportunity to develop research in a critical area for public health in Brazil and is also important in terms of internationalization [of research],” he said.

José Eduardo Krieger, USP’s Research Provost, said the Zika epidemic had surprised Brazilian society but not scientists. “FAPESP promptly organized a task force to study different aspects of the problem,” he recalled. “FAPESP has also looked beyond the funding of basic research for ways to enable studies to advance into the private sector.”

Also according to Provost Krieger, actions such as the creation of Engineering Centers by FAPESP in partnership with companies “are tools that strengthen relations between the public sector, private enterprise, and researchers in Brazil”.

FM-USP Director José Otávio Costa Auler Junior said the institution he represents has also supported innovation and interaction with private enterprise since 2011. “This is the first agreement signed between IMT-USP and a global company, and the partnership is the best possible,” he added. “We expect it to be the first step in a fruitful collaboration.” 

The ceremony at which FAPESP, USP and bioMérieux signed the agreement was also attended by Gérard Perrier, Science & Technology Cooperation Attaché at the Consulate of France in São Paulo; FAPESP Scientific Director Carlos Henrique de Brito Cruz; and FAPESP Administrative Director Fernando Menezes de Almeida.

Anyone interested in collaborating with Project Arbobios should contact the researchers by email at: [e-mail].