Carlos Martín, microbiologist who develops the Spanish vaccine against tuberculosis: “We do not want to kill the bacteria, but rather train it”

Professor of microbiology Carlos Martín, and researcher at the IIS Aragón, leads the research seeking a Spanish vaccine for tuberculosis (Mycobacterium tuberculosis). After decades of research, a team from the University of Zaragoza is testing how to provide humans with immunity against Koch's bacillus, which has killed more than one billion people throughout history.

Microbiology professor Carlos Martín Montañés (Zaragoza, 63 years old) leads the research seeking a Spanish vaccine for tuberculosis (Mycobacterium tuberculosis). The first time she came across the disease was in 1987, when she traveled to the Pasteur Institute to train: “I went for a few months and stayed for five years,” she remembers. “At that time, the bacteria was only investigated in two laboratories in France and the United States.” After several decades of research, the vaccine that he develops at the University of Zaragoza is already in phase IV: “It is the first time in history that a vaccine derived from a strain of tuberculosis is tested in humans.” He recalls that the WHO predicted the eradication of the disease in the year 2000: “Current forecasts take it to 2050, but in 2030 it could be eradicated.”

Question. How does the vaccine you are working on work?

Reply. It is called MTB VAC: the idea is to create a strain that has the genes that give it virulence inactive to inoculate it and for the body to generate resistance. To do this, we start from an attenuated strain of human tuberculosis; That is, with infectious potential - very low, but it has it - which implies that it must be done in safety laboratories. Ours is in O Porriño.

P. Said like that, it seems simple.

R. The concept could not be more classic: Pasteurian and also based on gene inactivation. Keep in mind that when I started, we did not understand the gene deletion and inactivation procedure. The strain of tuberculosis currently used to generate immunity is derived from cows and, precisely, is missing a gene that attenuates the disease. We thought that this mechanism could work in a human variant. We do not want to kill tuberculosis, but rather train it.

“If left untreated, a tuberculosis outbreak can eliminate 50% of the future productive population”

P. How do they come to that conclusion?

R. We had some clues. In the early nineties, the outbreak of the AIDS epidemic caused a terrible synergy between both diseases. At that time, in Madrid, there was an outbreak of tuberculosis, in which the first multi-resistant variants were produced. It occurred in patients with HIV, with an affected immune system. In that case, a gene was responsible for virulence. This placed both infections as a priority. Thus, in the year 2000, after years of research, Europe put several teams to compete. They gave us funding and told us: kill yourselves or collaborate, but find something.

P. The competition must be voracious.

R. Not as much as that, but there are groups, researchers or people who do not want the process to be accelerated. From MTB VAC they said it would never be tested on humans. Well, we have already tested it on babies and now we are in the adult phase. We have been conducting safety clinical trials for 10 years. They didn't take into account that we are handy.

P. What does your family think about your relationship with this bacteria?

R. I've been doing this for almost 40 years. A long time. I don't know how I can work with such a slow bacteria, being a very impatient person. Microbes have always attracted me; Microbiology is the essence of everything. Furthermore, my wife is an epidemiologist. My family supports me a lot: returning to Spain was a consensual decision, although it is true that it was very motivated by the idea of ​​giving back to your university something of what you have learned.

P. Where are they testing the vaccine?

R. In African countries, such as South Africa, where the incidence is very high. It was said, and continues to be said, that in Africa they live with HIV and die from tuberculosis. In these nations there are no public health systems. Meanwhile, the subjects who are part of the trial have routine check-ups. This improves their general health and their socioeconomic expectations because tuberculosis, in addition to making people sick, causes poverty. The most affected are children from 1 to 5 years old, but then it affects adolescents. If left untreated, an outbreak can wipe out 50% of the future productive population.

“Right now, it is the most advanced vaccine in the world; It is the moment of truth"

P. Will this vaccine be public?

R. It is financed with public funds and developed by public entities. The agreement is that the vaccine patent is affordable, universal, moral. Furthermore, our idea is that it is a 100% Spanish vaccine: it was created at the Zaragoza university; It was developed in Bio Fabri, the Galician laboratory of O Porriño; and we can also reach the effectiveness phase with the little flag.

P. What do they need?

R. Right now we need investment, the support of organizations, companies, the Spain brand... For this we have promoted the T.End Foundation, a non-profit, which seeks to disseminate the scope of this disease; convey the importance of eradicating it or, at least, mitigating it; and channel the financial aid that arrives for research and development. If we succeeded, a Spanish product would have a notable impact on the most deadly and deadly disease in the world: an estimated one billion deaths have occurred throughout history, more than those caused by the plague or any other ailment.

P. What are the current figures?

R. The WHO estimates that 1,6 million people died in 2021 from the disease and 10,6 million contracted it. The incidence rate of the disease [new annual cases per 100.000 inhabitants] increased by 3,6% between 2020 and 2021, after having decreased by about 2% per year for much of the last two decades. Right now, eradicating tuberculosis is the hope that the entire team would have. For a researcher it is a dream that something you have produced in the laboratory works. Right now, it is the most advanced vaccine in the world; It is the moment of truth.

Source: El País