https://jvi.asm.org/content/90/5/2162


 

Commentary

European Academies Advise on Gain-of-Function Studies in Influenza Virus Research

Robin FearsVolker ter Meulen
R. M. Sandri-Goldin, Editor
DOI: 10.1128/JVI.03045-15

ABSTRACT

Gain-of-function (GoF) studies to understand factors affecting transmissibility of potentially pandemic pathogens are controversial. The European Academies Science Advisory Council (EASAC) recently published consensus recommendations relating to GoF research review and management on self-regulation and harmonization; bioethical considerations; benefit-risk assessment; biosafety, and biosecurity advisory options; and publication of sensitive information. A layered approach to integration of responsibilities must include conforming to the stringent rules and guidance already existing. Further commitment is essential to extend the debate on issues worldwide.

The views expressed in this article do not necessarily reflect the views of the journal or of ASM.

TEXT

Results from gain-of-function (GoF) research may help in understanding the pandemic potential of the influenza virus and may yield health benefits, including the prioritization and development of prepandemic vaccines. Relevant research on fundamental biology of the influenza virus includes studies on transmissibility, host range, resistance, immunogenicity, pathogenicity, and virulence. However, experiments to modify the transmission potential of avian influenza and thereby to elucidate factors affecting animal virus spread by the aerosol route to humans and between humans have been controversial. Concerns have been expressed about the risk of GoF studies for researchers and the public with regard to biosafety (the accidental release of the pathogen from containment) and biosecurity (deliberate misuse). It should also be emphasized, however, that potentially dangerous research is already subject to stringent regulations and that biorisks associated with novel pathogens were reviewed in detail in previous investigations by U.S. national academies (1). It is critically important to be precise about terminology of GoF research so that attention is henceforth focused on those studies of greatest concern.

There is continuing robust debate among virology researchers (see, for example, references 234, and 5) about the conceivable benefits and risks of GoF research on potentially pandemic pathogens. In addition, however, it is also essential for researchers to articulate and debate their views in the wider scientific community and, through the activities of these larger communities, to policymakers and the public. The debate is widening as illustrated by recent publications from clinical practitioners (6) and the Infectious Diseases Society of America (7). As part of their ongoing activities, the U.S. National Academies organized a workshop on GoF research in 2014 (http://www.nap.edu/catalog/21666/potential-risks-and-benefits-of-gain-of-function-research), observing that the challenges were international, that researchers and their institutions must accept responsibility, and that risk-benefit calculation is not simple.

In Europe, the European Academies Science Advisory Council (EASAC) has recently published a report on GoF research issues and the options for management of such research and its outputs (8). EASAC is formed by the national science academies of European Union member states to enable them to collaborate in giving advice to European policymakers and has previously published extensively on public health and innovation issues relating to infectious disease (see, for example, reference 9). The EASAC report (8) brought together scientists with a wide range of expertise and views to advise on how to address some critical questions, including the following. Does GoF research raise new issues for biosafety and biosecurity procedures? Are there gaps in the current approaches to managing experiments of highest impact? If there are gaps, is there a need for more regulation, more ethical guidelines, or more communication about risks?

Various issues remain controversial, but the EASAC recommendations represent a consensus in the Working Group (see Acknowledgments for membership) and among EASAC member academies. Key topics, examined in detail in the report (8), are summarized here.

SELF-REGULATION AND HARMONIZATION

All scientists should acknowledge and accept responsibility for the safety of themselves, their colleagues, and the community at large. “Self-regulation” means that there are checks and balances within the scientific community, not that each researcher is free to decide unilaterally which procedure to follow. The EASAC report describes several examples of self-regulation and the options for harmonizing procedures to spread good practice in research design, review, and management across the European Union. Good practice requires conforming to established regulations, codes of conduct, and agreed procedures for biorisk management (see Fig. 1 for the current situation in the European Union).

FIG 1

Components in the European Union framework governing GoF research. Further details are in EASAC 2015 (8).

Attention to key biosafety issues is imperative at all stages of the research endeavor from first formulating a research idea through to the publication of results. Grant applicants should discuss the potential risks involved in proposed experiments, and funders should consider, on a case-by-case basis, whether research proposals have scientific merit and whether the research can be safely conducted. Justification of the choice of biosafety category to be used in research should be an explicit part of the application for funding. Researchers also need to justify to funders and to their peers the claim that the information they need can be obtained only by doing GoF experiments in this way. Furthermore, part of the exercise of individual responsibility is the recognition that certain research can be conducted only in certain laboratories in certain countries with appropriate facilities. Academies of science, together with others in the scientific community, have a continuing role to play in promoting and increasing understanding of biosafety norms, which include, for example, the clarification of the level of biocontainment required.

BIOETHICAL CONSIDERATIONS

The moral principles and duties that govern experimentation are relevant to issues for transparency of decision-making, public participation, confidence and trust, responsibility, and vigilance in protecting society. GoF studies on potential pandemic pathogens require ethical scrutiny regarding the acceptability of risks of accidental or deliberate release and of global spread of pathogens. In the view of EASAC, ethical issues need to be considered at all stages of the research—from the point of funding through to preparation for publication. EASAC recommended that ethical review be part of the rigorous impartial assessment of proposed research at the institutional level.

BENEFIT-RISK ASSESSMENT

Evaluating benefit and risk is challenging because of the many uncertainties in the data available but also because of differing personal value systems applied in assessing the data. Incommensurable parameters measuring risk and benefit do not allow a value-free determination to be made. Whether benefits should be quantified in terms of prospective public health gains or described in terms of the generation of scientific knowledge is a matter for continuing debate.

EASAC suggested that analysis of the benefit-risk balance cannot be seen as a “once and for all” calculation but rather as a continuing effort to understand and communicate the issues. Academies and learned societies must engage in a process to share data and perspectives and to promote discussion, across the scientific community and involving all stakeholders, to identify and agree to the critical factors underpinning quantitative and qualitative assessment of risks and benefits. It is important to answer other related questions. For example, who should do the assessment, and how should subjectivity be acknowledged? How should the results of assessment be taken into account in informing policy development?

BIOSAFETY AND BIOSECURITY ADVISORY MECHANISMS

EASAC has suggested that there is no need for a new advisory body at the European Union level but has recommended that all European Union member states must have a clear national advisory approach to governance, with statutory powers. In sharing and implementing good practices, countries should adapt the principle of a layered approach so as to integrate responsibilities at the researcher, institution, funder, and national levels.

One concern raised related to the potential proliferation of technologies and information about pathogen sequences. Even if excellent biorisk management procedures are in place in the laboratory initiating GoF research, there can be no similar guarantee relating to the use of the research outputs in other settings with lower levels of regulation or skill. If potential risks are more widely distributed, should there be a higher threshold for delivery of benefits? In the view of EASAC, for such issues of competence and biosecurity, options should be explored by which sequences are made available only from restricted access sources, following permission to experiment provided by national regulatory authorities.

PUBLICATION OF SENSITIVE INFORMATION

Scientific freedom is not absolute, and the members of the scientific community realize that some information is sensitive. EASAC reaffirms the responsibility for researchers and their institutions to make decisions about publishing sensitive information and, together with funders, ethics committees, and others, to take account of these issues from the time of initiation of the research proposal. EASAC recommendations on early oversight of the implications for sensitive information are compatible with the one reached recently by U.S. journal editors (10).

EASAC also asserted that the European Commission's Export Control Regulation, designed to control the export of dual-use technology, is an inappropriate and ineffective vehicle with which to block scientific publication of sensitive information (see reference 2 for further discussion of how this regulation has been used to delay publication of GoF research).

PUBLIC ENGAGEMENT AND THE GLOBAL CONTEXT

The scientific community can do more to participate actively in public dialogue, communicating the objectives of GoF research, the potential benefits and risks, and the biorisk management practices adopted. Ethics review of research proposals should have lay involvement. Scientific accountability and public engagement need to extend worldwide.

In the global context, clarification of the opportunities and challenges for oversight and action by intergovernmental bodies requires further attention. EASAC recommends that further consideration could also usefully be given to the 2004 recommendation by the U.S. National Academies (1) for an international forum to sustain dialogue between the life sciences and policymaking communities and with other stakeholder involvement. This dialogue will have to cover both biosafety and biosecurity issues and can capitalize on work already begun by the InterAcademy Partnership on the biosecurity implications of pathogen research (http://www.interacademies.net/ProjectsAndActivities/10880/27693.aspx).

Further information on all of the EASAC analysis and conclusions is in the EASAC report (8) and also in the summary of an event to launch the report, held in Brussels in October 2015 (http://www.easac.eu/home/easac-news/detail-view/article/summary-of-t.html). This launch summary also discusses how the European Commission has welcomed EASAC recommendations and how the European Union conclusions relate to the themes emerging from the interim National Science Advisory Board for Biosecurity (NSABB) conclusions (11).

There is much still to be done to sustain global discussion and to agree on standard setting and verification procedures: we hope that the EASAC report will serve as a resource to inform and stimulate debate and action, not just in the European Union but also more widely.

ACKNOWLEDGMENTS

We thank all members of the EASAC Working Group: Goran Hermeren (Sweden), Ursula Jenal (Switzerland), Hans Klenk (Germany), Andre Knottnerus (The Netherlands), Maria Masucci (Sweden), John McCauley (United Kingdom), Thomas Mettenleiter (Germany), Giorgio Palu (Italy), Gyorgy Posfai (Hungary), Bert Rima (Ireland), John Skehel (United Kingdom), and Simon Wain-Hobson (France).

FOOTNOTES

    • Accepted manuscript posted online 23 December 2015.
  • Address correspondence to Volker ter Meulen, Volker.termeulen@mail.uni-wuerzburg.de.
  • Citation Fears R, ter Meulen V. 2016. European academies advise on gain-of-function studies in influenza virus research. J Virol 90:2162–2164. doi:10.1128/JVI.03045-15.

REFERENCES

  1. 1.
  2. 2.
  3. 3.
  4. 4.
  5. 5.
  6. 6.
  7. 7.
  8. 8.
  9. 9.
  10. 10.
  11. 11.

A novel gain-of-function mutation in ORAI1 causes late-onset tubular aggregate myopathy and congenital miosis

 https://pubmed.ncbi.nlm.nih.gov/27882542/

A novel gain-of-function mutation in ORAI1 causes late-onset tubular aggregate myopathy and congenital miosis

Affiliations 

Abstract

We present three members of an Italian family affected by tubular aggregate myopathy (TAM) and congenital miosis harboring a novel missense mutation in ORAI1. All patients had a mild, late onset TAM revealed by asymptomatic creatine kinase (CK) elevation and congenital miosis consistent with a Stormorken-like Syndrome, in the absence of thrombocytopathy. Muscle biopsies showed classical histological findings but ultrastructural analysis revealed atypical tubular aggregates (TAs). The whole body muscle magnetic resonance imaging (MRI) showed a similar pattern of muscle involvement that correlated with clinical severity. The lower limbs were more severely affected than the scapular girdle, and thighs were more affected than legs. Molecular analysis revealed a novel c.290C>G (p.S97C) mutation in ORAI1 in all affected patients. Functional assays in both human embryonic kidney (HEK) cells and myotubes showed an increased rate of Ca2+ entry due to a constitutive activation of the CRAC channel, consistent with a 'gain-of-function' mutation. In conclusion, we describe an Italian family harboring a novel heterozygous c.290C>G (p.S97C) mutation in ORAI1 causing a mild- and late-onset TAM and congenital miosis via constitutive activation of the CRAC channel. Our findings extend the clinical and genetic spectrum of the ORAI1-related TAM.

Keywords: CRAC channel; ORAI1; Stormorken syndrome; congenital miosis; muscle MRI; tubular aggregate myopathy.

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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4709283/


Logo of elifeLink to Publisher's site
. 2015; 4: e13035.
Published online 2015 Dec 30. doi: 10.7554/eLife.13035
PMCID: PMC4709283
PMID: 26716473

What next for gain-of-function research in Europe?

Robin FearsDirector of the Biosciences Programme* and Volker ter MeulenChair of the EASAC working group on gain of function*

Infectious diseases continue to be responsible for a substantial proportion of deaths worldwide and there is evidence for a significant increase in the number of outbreaks over the past 30 years. Although some of this increase may be due to improved detection and reporting, animal diseases that can be transmitted to humans are among the major causes of human infection ().

Influenza outbreaks are a particular concern: in the UK, for example, the potential impact of an influenza pandemic has been identified as the highest priority in the UK Government Risk Register for 2015. Our current inability to predict which specific virus subtypes will trigger the next influenza pandemic highlights the vital importance of addressing gaps in the knowledge base. Research on a wide range of topics—including the study of virus transmission, host range, drug resistance, infectivity, immunity and virulence—is urgently needed to fill these gaps. In this article we focus on the issues raised by proposals to use ‘gain-of-function’ experiments to fill some of these gaps. Such experiments have a long history of providing useful information in virology.

Gain-of-function experiments involve modifying a virus and analysing the link between modified genotype and phenotype. However, proposals to modify the H5N1 variant of the influenza virus in order to affect its transmission potential, and thereby understand the factors that determine the ability of an animal virus to spread to humans (and between humans) by the aerosol route, were controversial (), and there is still a de facto moratorium on such research in the US.

Self-regulation is a necessary first step for gain-of-function research, but this does not mean that each researcher is free to decide for themselves what procedures to follow.

Experiments are of concern if they have the potential to cause serious disease, and these concerns encompass biosafety (relating to the accidental release of a pathogen from containment), biosecurity (relating to intentional misuse; see ), and bioethics (the principles and their place in research review procedures). Although potentially dangerous research studies are already subject to stringent regulations in many countries, recent controversies prompted the European Academies Science Advisory Council (EASAC) to set up a working group to examine the issues raised by gain-of-function research and to make recommendations for the management of such research and its outputs in the EU. This working group contained the present authors and other scientists with a wide range of relevant experience. Here we discuss some of the recommendations made by the working group (see  for the full report).

Scientific responsibility and benefit-risk assessment

Self-regulation is a necessary first step for gain-of-function research, but this does not mean that each researcher is free to decide for themselves what procedures to follow. Everyone involved must conform to existing regulations, codes of conduct and established methods for biorisk management (see  for a list of existing regulations in Europe, and details of work by the World Health Organisation and the OECD in this area).

Moreover, proposals for gain-of-function studies—particularly those that intend to alter virus transmission, host range, drug resistance, infectivity, immunity and virulence—have to be justified by their authors to a wide range of bodies (the institutions where the work will be carried out, the agencies that will fund the work, the relevant ethics committees, and the relevant national authorities), as well as their peers, on a case-by-case basis. This process must involve a thorough analysis of the risks and benefits of the research being proposed. Researchers also need to demonstrate that the information they need can only be obtained from gain-of-function experiments.

A clear theme in both Europe and the US is the need for the scientific community to engage more broadly with the public, explaining the reasons for doing gain-of-function research.

There are many uncertainties in the data used to evaluate benefit and risk, and this can lead to controversy. It should also be acknowledged that potential benefits of research are sometimes overstated by scientists: however, it is also true that the benefits of research might only become clear much later. Views vary on whether benefit should be quantified in terms of future public health impact or described in terms of the generation of knowledge, and on the extent to which benefits may be lost if research is not allowed. There have been concerns that research that could help to streamline the production of vaccines might suffer if gain-of-function experiments are banned (). Because of the multiple challenges involved in assessing risk and benefit, the EASAC report concludes that any benefit-risk analysis cannot be regarded as a ‘once and for all’ calculation, and that all the relevant parties need to understand and communicate the issues on an on-going basis.

The EASAC report also recommends that there is no need for a new advisory body at the EU level. Rather, all EU Member States should have a clear national advisory mechanism on procedures for assessing and managing biosafety and biosecurity risks. In the UK, for example, the Health and Safety Executive has statutory powers, but other EU Member States have different mechanisms and not all have statutory powers. There is need to harmonise the implementation of good practice in these respects. All countries should also adopt a ‘layered’ approach with researchers, research institutions, research funders and national authorities all being responsible for the regulation of gain-of-function research. Such a layered approach at the country level will spread good practice, increase accountability, and help to improve public trust in research.

Researchers and institutions also have to recognise their responsibility to make decisions about publishing sensitive information and, together with funders, ethics committees and others, need to consider these issues throughout the research process, starting when the research is first proposed, rather than delaying the decision until a manuscript is ready for submission to a journal. The oversight within the scientific community must involve journals and professional societies, as well as researchers, their funders and institutions (and national advisory bodies in complex cases). Journal editors in the US recently came to a similar conclusion (). Regarding the question of what to do when European researchers submit a manuscript to a journal that is not based in Europe, EASAC advises that the use of the EU’s export control regime is an inappropriate and ineffective vehicle to block such submissions.

Many of EASAC’s recommendations have been welcomed by the European Commission, who will now consider how to incorporate EASAC advice into guidance for Horizon 2020 research grant applicants and evaluators.

The EASAC report resonates with the themes that are emerging from discussions in the US involving the National Academies, the National Science Advisory Board for Biosecurity (NSABB) and the National Institutes of Health. A National Academies workshop in December 2014 observed that the challenges involved in regulating gain-of-function research were international, that attention should be focussed on those experiments of greatest concern, that researchers and their institutions must accept responsibility, and that analysing the risks and benefits is not straightforward. Since then, a quantitative risk-benefit analysis has been initiated (), and the NSABB has set up a working group to look into the issues surrounding gain-of-function research (). In its interim report the NASBB working group noted that the US already has a robust policy framework for the regulation of research, and any future policies should build on this framework.

Challenges for wider engagement

A clear theme in both Europe and the US is the need for the scientific community to engage more broadly with the public, explaining the reasons for doing gain-of-function research, discussing the potential risks and benefits of this research, and explaining the biorisk management practices adopted. Engagement with public interests can be considered at three levels. First, on the global scale, the scientific community has to ensure that the public health benefits that arise from innovation based on gain-of-function research are made available to everyone. Second, on the national level, scientists need to convince the public that taxpayer funds are being spent wisely. Third, on a local level, scientists must engage with those who live near research facilities to reassure them about safety.

Another clear theme is the need for the regulatory authorities, funding bodies and professional societies in different countries to work together to share expertise in the regulation of gain-of-function research and in risk-benefit analysis. Academies of science have a clear role to play at the national level, and international networks of academies can bring scientists from different countries together to study and make recommendations on specific issues: the working group on biosecurity set up by the InterAcademy Partnership is an example of this.

Influenza pandemics are currently unpredictable. However, we still need to be ready for the next pandemic, and that includes being in a position to perform gain-of-function research if that is the only way to obtain the information needed to deal with the pandemic. And, as should be clear from above, this means that many different stakeholders—scientists, institutions, funding agencies, ethics committees, national regulatory authorities, scientific societies and journals—need to work together to ensure that we are prepared.

Acknowledgements

We thank all the members of the EASAC Working Group: Goran Hermeren (Sweden), Ursula Jenal (Switzerland), Hans Klenk (Germany), Andre Knottnerus (The Netherlands), Maria Masucci (Sweden), John McCauley (UK), Thomas Mettenleiter (Germany), Giorgio Palu (Italy), Gyorgy Posfai (Hungary), Bert Rima (Ireland), John Skehel (UK), and Simon Wain-Hobson (France).

Competing interests

The authors declare that no competing interests exist.

Contributor Information

Robin Fears, 

Volker ter Meulen, 

References

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