By Ninsiima Racheal
KAMPALA —The COVID-19 pandemic has underscored the urgency to better understand the human immune system and how to unleash its power to develop vaccines and medicines. According to scientific publications accessible e.g. ‘The science and medicine of human immunology’ by Pulendran and Davis, 2020, accessible in PubMed, a medical research database, much of our knowledge of the immune system has accrued from studies in mice, yet vaccines and drugs that work effectively in mice do not always translate to humans.
Furthermore, the above paper states that the basic workings of the human immune system are complex and have required the development of animal models, such as inbred mice, to define mechanisms of immunity. However, recently, new strategies and technologies have been developed to directly explore the human immune system with unprecedented precision. For example, COVID-19 is being detected using the polymerase chain reaction (PCR) test which can detect all types of infections due to bacteria, parasites, viruses and fungi in one’s sample.
All thanks to the emergence of immunology and molecular biology sciences that are revolutionizing healthcare management. Immunology has its roots in understanding protection of the host from germs/pathogens, leading to the development of vaccines and subsequently identification of soluble and cellular components of the immune system. On the other hand, molecular biology explores and studies the structures and functions of cells in context of the molecules that are essential to life i.e., nucleic acids (DNA & RNA) and proteins.
Uganda is facing many a disease burden through epidemics such as HIV-AIDS, tuberculosis and malaria. Currently, the country is confronting the COVID-19 pandemic which has circumambulated the globe. Most of these diseases have similar symptoms but if undiagnosed can lead to devastating consequences. According to Dr. David Patrick Kateete, the Acting Head of Makerere University’s Department of Immunology and Molecular Biology, infectious diseases can be efficiently combated if countries like Uganda could fully embrace modern immunology and molecular approaches as they offer rapid and more accurate diagnosis of diseases, and better treatment options e.g., gene therapy and precision medicine.
“Both disciplines i.e., Immunology and Molecular Biology play a vital role in the understanding of disease in the human body. One major advance is that doctors are now able to analyze a patient’s DNA in totality (or call it the ‘genome’) and make treatment decisions based on it (precision medicine). For example, by simply knowing the particular genetic traits of a patient, clinicians are able to recommend more targeted treatment plans,” Dr. Kateete said in an interview.
Grafting Immunology & Molecular Biology studies into medical education
In 2016, Makerere University established a new Department of Immunology and Molecular Biology with the goal of nurturing new and emerging disciplines relevant to the practice of medicine such as genomics, immunology and molecular biology. The department has its roots in the Department of Medical Microbiology and currently consists six state-of-the-art laboratories namely: mycobacteriology; immunology; molecular biology; molecular diagnostics; whole genome sequencing and analysis, and a biorepository.
“The department’s main mandates are to foster cutting-edge research in the fields of immunology, bioinformatics, genomics and molecular diagnostics and to train graduate students to be able to conduct research in these fields,” Dr. Kateete explained.
The department prides itself on the quality of its teaching. It has its own vibrant graduate program and participates in teaching students at the graduate level in the interdisciplinary programs of MSc in Immunology and Clinical Microbiology; MSc in Bioinformatics; PhD in Bioinformatics and PhD in Immunology and Molecular Diagnostics. Currently, there are 120 continuing graduate students in the department. Additionally, it boosts of eight faculty members competent to train advanced students in areas that include human genetics, medical microbiology, molecular biology, immunology, and virology.
Faculty and students of the department have strong independent research programs funded by the Ugandan government and donor agencies such as Wellcome Trust, African Academy of Sciences and the US National Institutes of Health.
These grants amount to about $5M (approximately UGX18B). Recently, faculty at the department were awarded the Ministry of Science, Technology and Innovation (MOSTI) and Makerere University Research and Innovations Fund grant from government to conduct in COVID-19 and develop new molecular tests for this pandemic.
Flattening the COVID-19 curve
As the COVID-19 pandemic has demonstrated, knowledge and skills must always adapt to current needs of the populace. Thus, the department’s faculty are currently involved in clinical diagnosis through a number of mechanisms. One of these is the PCR test to detect SARS-CoV-2 infection.
According to Edgar Kigozi, manager of the molecular biology lab, the PCR test is the “gold standard” test for diagnosing COVID-19 because it’s the most accurate and reliable test. It detects the genetic material (RNA) from SARS-CoV-2, the coronavirus that causes COVID-19.
“The test requires a swab from your nasopharynx or throat as a sample and this is what is sent to the lab where it is heated and cooled using special reagents to convert the virus’s RNA into DNA, and then make millions of copies of the DNA, which allows for the identification of the organism,” Kigozi explained.
The available PCR machines in the lab are able to test 96 samples in one go and this process takes approximately one and a half hours. In a day, Kigozi notes that his lab is able to conduct about 600 tests.
Furthermore, the department’s immunology lab is currently conducting research to develop a rapid diagnostic kit for COVID. Dr. Rose Nabatanzi, the lab manager said that an eight-member team led by Dr. Misaki Wayengera is in the process of developing Uganda’s first rapid kit, also known as an antigen test.
“With the antigen test, one will be able to get his or her results within 30 minutes compared to the six hours of the PCR test. Moreover, the process doesn’t require a lab,” she said.
Upon completion, each kit will cost about $19 (about UGX70,000), making testing affordable especially in areas which often lack laboratory capacity or expertise.
Given the rapidly changing and continuously evolving nature of the molecular biology and immunology field, this five-year-old department’s impact on sciences is far from over.