Remember the landmark RV144 study in Thailand a decade ago that was the first clinical trial to show any efficacy of a vaccine for preventing HIV infection? Now, a team of scientists led by the Fred Hutchinson Cancer Research Center and the University of the Witwatersrand in Johannesburg has found the same regimen can also induce promising immune responses in South Africans, suggesting the vaccine may have the potential to protect against multiple strains of HIV.

In Thailand, the predominant HIV strain is clade B, while clade C is the most common subtype in South Africa. In the new trial, scientists found the RV144 vaccine—containing constructs of HIV clades B and E inserts—showed even higher cellular and humoral immune responses in healthy people in South Africa than in RV144’s Thailand vaccines, according to results published in Science Translational Medicine.

HIV is notorious for its diversity and tendency to mutate, which already makes treating the virus difficult. The same challenge holds true for vaccine development. That’s why the Fred Hutchinson-led team set out to test the RV144 regimen in South Africa and compared immunogenicity data to those from the Thailand study.

One hundred healthy adults participated in the trial, and 91 received all four vaccinations. The researchers evaluated the magnitude and frequency of several immune responses that correlate to infection risk.

Specifically, the vaccine induced strong CD4+ T cells directed at HIV envelope proteins in 51.9% of South Africans, significantly higher than the 36.4% seen in the Thailand trial. And the South Africans’ T cells also scored better on a functionality assay that evaluates how good the cells are at producing cytokines.

They looked at the immunoglobulin G (IgG) antibody responses, and participants in the current trial performed better across the board than those from the original RV144 study. They also examined the antibody-dependent cellular cytotoxicity (ADCC), in which immune cells rupture the target cell. Previously, the efficacy of RV144 was correlated with ADCC. Turns out, 72.6% of the trial participants in South Africa responded in the current trial, versus 58.5% of those in Thailand

Back in 2009, RV144 showed just 31.2% effectiveness by month 42. Since then, a variety of research teams have been trying to achieve better protection against as many strains of HIV virus as possible. Scientists led by Duke University previously built on the regimen by adding three more targets to the vaccine construct, making it a pentavalent vaccine. In a study in monkeys, the vaccine achieved 55% protection. Johnson & Johnson recently started testing a different HIV vaccine in a 3,800-person late-stage clinical trial.

The newly reported trial was a precursor to a trial that tested an adapted regimen including subtype C antigens and an adjuvant from GlaxoSmithKline in 252 South African participants. Based on positive interim results from HVTN 100, the National Institutes of Health pushed the new regimen into a large-scale trial that aims to enroll 5,400 men and women, also in South Africa.

The Fred Hutchinson and Johannesburg team did report that the T-cell and antibody responses dropped over time during the trial, “suggesting the utility of additional boosts,” they argued in the study.

But the vaccine’s ability to provide protection against multiple strains of HIV was key, they added. “Our data suggest that the breadth of immune responses elicited by this vaccine regimen may allow for vaccine protection that could extend beyond the clade used for immunogen development, and potentially function as a more global vaccine,” they wrote in the study.

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Based in Newport Beach, California, The Rhinoplasty Center is pleased to invite members of the public to avail themselves of the clinic’s top-tier plastic surgery services. The center’s renowned lead surgeon, Dr. Aaron Kosins, has already treated many local patients who describe their results as both outstanding and extremely satisfactory

Dr. Kosins has many years of experience in the field, having performed and studied over 6,000 procedures. Until the year 2016, he was under the tutelage of Dr. Rollin Daniel, who was an acclaimed and well known surgeon in the community, but retired to leave the Rhinoplasty Center in the care of Dr. Kosins. Having taken over the prestigious leadership role at the clinic, he is said to be an expert at the nasal form, having perfected the art of rhinoplasty and becoming one of the best surgeons in Newport Beach for this specialty.

Under the guidance of Dr. Kosins, The Rhinoplasty Center has continued to provide outstanding rhinoplasty results to patients from around the world. Many allude to his dedication and skills, commenting that he has a deep understanding and respect for natural beauty. The doctor has chosen to dedicate his plastic surgery skills to meet all his patients’ individual desires for nose enhancement.

Thanks to Dr. Kosins’ remarkable efforts, The Rhinoplasty Center has become the go-to destination for local, national, and international patients seeking rhinoplasty. The center is known for looking after their patient’s convenience and privacy, having carefully designed state of the art premises so they may benefit from a discreet and personalized experience.

Considered one of the best rhinoplasty specialists in the field, Dr. Kosins attributes his expertise to the wealth of experience both he and his staff are able to gain while working at the clinic. He explains that, “The average plastic surgeon in the United States performs less than a half dozen nasal surgeries per year. At The Rhinoplasty Center, we study and perform hundreds of operations every year on patients from all over the world. This allows us to accumulate an immense amount of experience, being able to study and prepare for any unique cases that come to us.”

Notably, fewer than 1% of plastic surgeons specialize in rhinoplasty. The Rhinoplasty Center firmly believes that being a specialist does not only mean dedicating one’s practice to excellence in a particular operation but also being a pioneer, teacher, and continuous student of nasal surgery. This is exactly the approach that Dr. Kosins takes to rhinoplasty, as he has traveled nationally and internationally to learn new techniques and procedures from other cultures, in addition to lecturing them on rhinoplasty on a monthly basis.

Furthermore, many new surgery techniques like Piezosurgery are only done in the United States by Dr. Kosins at The Rhinoplasty Center. This special procedure allows him to perform rhinoplasty without breaking any bones, and is an innovative technique that many surgeons are trying to learn. He has also pioneered in other aspects of rhinoplasty by using principles of skin health, oral medication, and lasers to achieve excellent results with patients who, in the past, could not achieve true definition of their nasal tips.

The rhinoplasty center showcases a few of their many success stories on their website, where patients have shared their experiences, along with reference pictures. One of the most recent stories concerns a 22 year old female who came to the center presenting discomfort with a hump on her nose, as well as a bulbous tip and a very skinny middle third of the nose. She wanted a more refined nose that also did not plunge when she smiled.

Dr. Kosins states that, through surgery, he was able to remove the hump on her nose and correct the plunging tip by rotating it while simultaneously shrinking her nostril. The specialist states that the patient was able to recover quickly, and she was back to full form only three months after her surgery.

The procedures performed at The Rhinoplasty Center include Primary Rhinoplasty, Secondary Rhinoplasty, Ethnic Rhinoplasty, and Persian/Middle Eastern Rhinoplasty. The Rhinoplasty Center invites all those interested in learning more about their cutting edge procedures to visit their website, where further information can be found regarding the innovative techniques performed only at this center.

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