Subject: Who's News: French AIDS Researcher in Storm's Center Date: Published: 6/8/87 158 lines Source: WALL STREET JOURNAL. Copyright Dow Jones & Co. Inc. Who's News: French AIDS Researcher in Storm's Center --- By Marilyn Chase Staff Reporter of The Wall Street Journal "When there is a fire, you don't check to see if the water has calcium in it," says French researcher Daniel Zagury. "You just throw it on the fire." The fire this time is AIDS, which now infects an estimated five million to 10 million people world-wide, including as much as a quarter of the young adults in some African cities. But Dr. Zagury's firefighting methods have ignited a furor because he used himself as an experimental animal to test an experimental AIDS vaccine. In so doing, he breached scientific rules calling for prior published animal testing -- usually in a peer-review journal. He also challenged ethical and safety traditions that discourage self-experimentation. Whether it was heroism or folly, a scientific leap of faith or private moral impulse, his act thrust him into the headlines earlier this year, as well as into a highly visible role at the Third International Conference on AIDS in Washington last week. There he delivered a brief talk and then fled with reporters in pursuit, without answering questions. Joining Dr. Zagury in the experiment were 10 African AIDS patients whom he injected to determine if he could boost their immune system and thus allay the ravages of the disease. He also injected 10 Africans and a French colleague who, like himself, were uninfected and healthy, to measure their bodies' response to the vaccine. Born in Casablanca, Morocco, and educated in Paris, Dr. Zagury's career has been peripatetic and dramatic. In the early 1950s, he worked at a Harlem hospital, and later was a surgeon in French Indochina before settling in Paris. He now conducts his research at the Pierre and Marie Curie University there, and flies down to Kinshasa, Zaire, during academic holidays at Christmas and Easter to monitor his African experiment. He says he loves working "la main dans la main," or hand in hand, with his African patients, and obviously identifies with them. As such, he shows clearly the schism among AIDS researchers -- between those who believe the highest good lies in delivering scientifically impeccable studies and those who pursue empathy and compassion as healing tools, identifying strongly with their patients. Says one senior scientist, "Daniel's a passionate guy." Adds another: "Yes, but he broke about 140 rules." Most institutions discourage self-experimentation because it can cloud a scientist's objectivity, and his or her judgment of results. Dr. John Fletcher, chief bioethicist at the National Institutes of Health, says the institutes don't ban researchers from practicing on themselves, but discourage it on a practical level by holding them to the same rules governing all human subjects. They must register like any other patient, give their informed consent and receive neutral evaluation to protect them from their own egos. Some scientists feel Dr. Zagury's experiment was scientifically meaningless. Others confide they frankly admire his boldness. "While we're waiting on the Food and Drug Administration, he just went out there and did it," says Joyce Zarling, a vaccine researcher at the Oncogen unit of Bristol-Myers Co. Kathelyn Steimer, a vaccine researcher at Chiron Corp., says the meaning won't be known until someone is exposed to a viral challenge. But danger and ethical constraints prevent many from such an exposure now. Still, other scientists doing their elegant molecular dissections, following all the rules, feel neglected by the press and public for their pains. These include several fellow scientists upstaged by Dr. Zagury's Washington appearance, and ignored by reporters who seemed to care only about the dashing Frenchman and his beau geste. Dr. Zagury's scientific leap of faith, while controversial, has a powerful precedent in the early polio vaccine work of Jonas Salk. Dr. Salk, who injected himself with polio vaccine in the 1950s, and with flu vaccine in the forties, sees such an act as "ritual and symbolic... . You wouldn't do unto others, that which you wouldn't do unto yourself." Dr. Zagury, less given to self-analysis, simply says any talk of heroism is "stupid." He cringes at the aura of spectacle. It was simply, he says, a necessary act. Another sore point is that Dr. Zagury used a vaccine supplied to him by Bernard Moss of the National Institutes of Health. It was Dr. Moss who stitched the gene for the outer coat of the AIDS virus into vaccinia, a staple vaccine used for small pox. Dr. Moss, a quiet scholarly researcher colleagues describe as prudent, cerebral and intensely shy, sent his vaccine to Dr. Zagury on the understanding it would be used for animals, and was taken aback by the switch. Today, he doesn't rest on such assumptions, sending Dr. Zagury research materials only with conditions clearly outlined. But the progress report filed at the AIDS conference by Dr. Zagury seems to have bolstered his credibility among some fellow scientists. He said he succeeded in sparking a potent titer of antibodies and T-helper cells that attacked the virus in the test tube, and thus may be able to kill an invading AIDS virus particle or infected cell in the body. He also used the vaccine to create a booster shot by removing his own blood, infecting his own blood cells with the recombinant vaccine, killing and then reinjecting them. So far, though he cannot claim it as a successful vaccine, he says it hasn't caused any "untoward effects" in any of the volunteers, and emphatically adds he himself feels fine. One cautious note of admiration came from Dani Bolognesi, a cancer virologist at Duke University. "The data he presented were very straightforward, good solid virological and immunological data," he said. "This is just a start, but I was surprised to see the breadth and specificity of the immune response," he added, referring to the prototype vaccine's apparent ability to spark immune protection ability to protect against several strains of the AIDS virus. Dr. Zagury is first to admit "we don't have a vaccine yet," and many prominent researchers believe a successful immunization program will be at least five years away. But his near-term challenges, if successfully met, could advance the state-of-the-art several steps. First, he must repeat his self-test with chimpanzees, following up with exposure to live virus. Second, he must observe the reactions of the African patients with acquired immune deficiency syndrome that he innoculated, to see if his shot boosts their immune system and allays their disease. Third, he plans to inject special antibodies raised by the vaccine into newborn infants of infected African mothers. Such a post-exposure vaccination program, if successful, would be like those currently used for rabies and hepatitis-B. This is a tall order. "Though we are reasonably hopeful, we don't want to give false hopes," he says. Early on in the controversy, before Dr. Zagury's own guinea-pig role was disclosed, many accused him of exploiting his African subjects. This cast a pall over the project, despite his having had a prominent African collaborator, Dr. Z. Lurhuma of the University of Kinshasa, and the blessing of Zairean authorities. Dr. Zagury says suggestions of racism wounded him all the more because he himself has been a target of discrimination. "I'll tell you a significant event that happened to me," Dr. Zagury recently told a reporter. "In 1941, when I was 13 and a schoolboy in Casablanca, they ordered all Jews out of the schools. I am of Jewish origin, so I had to finish in a Jewish school," he said. "That is why it hurt me so much last December when they said I was using the Zaireans as chimpanzees," he said. "They didn't know that the first chimp was me." [This article is made available here by Dow Jones Co. for the personal and non-commercial use of callers to this bbs, in the hope that it will be of some help to those who are suffering from the disease and others who are seeking to help them.]