Cooperation Moves Research Forward

Alan Landay, PhD, never ceases to be impressed by the dedication he and his colleagues within the AIDS Clinical Trials Group (ACTG) Network have to HIV research.

“You might be on a conference call and hear a lion’s roar,” Landay says with a laugh. “Someone is on safari, but committed to being on that call. We have a great team.”

Trained as an immunologist, Landay was working as a post-doctoral fellow in the lab of world-renowned immunologist Max Cooper, MD, at the University of Alabama Birmingham (UAB) in the early 1980s. A hematologist came to the lab asking for assistance in diagnosing a mysterious disease plaguing people with hemophilia, a rare bleeding disorder in which the blood doesn't clot normally. That disease turned out to be HIV, which hemophiliacs acquired through blood transfusions.

“We were treating one of only three known people with hemophilia and an AIDS diagnosis at the time, so essentially we were caring for one-third of all cases,” Landay says. “I remember reporter Geraldo Rivera came down to UAB to film a segment for Good Morning America.”

In 1983, Landay left Birmingham for Chicago, where he became the Director of the Clinical Immunology Labs at Rush University Medical Center and an assistant professor in the Immunology/Microbiology Department. In 1985 he was a part of another HIV research milestone as he worked with Abbott Laboratories to develop the first antibody and antigen tests for HIV diagnosis.

Rush became an ACTG site in 1988. More than 25 years later, ACTG study A315 remains Landay’s favorite trial to have worked on because it was the Network’s first foray into how highly active antiretroviral therapy (HAART) impacted the immune system.

“We were investigating new ways of reconstituting the immune system,” Landay says. “A315 kickstarted our immunology focus.”

In 2003, Landay became chair of the ACTG’s immune-based therapy research agenda committee. He currently serves on the ACTG’s End-Organ Disease and Inflammation Transformative Science Group (TSG) and is Chair of the Immune Activation Focus Group of the Inflammation TSG. Landay believes controlling inflammation is critical to the health of people living with HIV.

“Inflammation drives end-organ disease and we have so many questions we need to answer,” Landay says. “Why does inflammation persist in some people? Is it because HIV is persisting or is this inflammation due to a co-infection? How are other people living with HIV able to keep it in check? And if we can block inflammation, can we block a non-HIV co-morbidity like cardiovascular disease? More research into inflammation is needed and these studies have implications for other fields, too. There is a real opportunity for collaboration and potential synergy.”

Cara Wilson, MD, is an investigator at the ACTG’s University of Colorado Clinical Research Site. She serves with Landay on the End-Organ Disease and Inflammation TSG and is Vice Chair of the Immune Activation Focus Group of the Inflammation TSG.

“Alan is tireless in his efforts to push the envelope in clinical HIV research, and his longstanding commitment to the pursuit of novel therapies for HIV disease is inspiring,” says Wilson. “His outgoing nature, endless enthusiasm for science and uncanny ability to multitask have allowed him to bring together investigators with diverse expertise to collaboratively address important questions in HIV research. He is truly a leader in this field.”

Michael Lederman, MD, is Principal Investigator of the ACTG’s Case Western Reserve University site. He is Chair of the End-Organ Disease and Inflammation TSG and worked with Landay on the A315 study. He admires Landay’s belief in collaboration to tackle global health problems.

“In another age and another venue, Alan would have been a shidduch (a matchmaker),” says Lederman. “He’s a catalytic character who gets enormous satisfaction from getting scientists to work together, and within the ACTG has been the driving force behind a number of highly successful collaborative projects.”

Landay has worked in the past with the National Institutes of Health (NIH), the Centers for Disease Control and Prevention (CDC), the Word Health Organization (WHO), the Clinton Foundation, the Gates Foundation and the World Bank. He recently completed a research sabbatical at Utrecht University in the Netherlands.

“I ask myself ‘what can I do for global health?’ And the answer is to collaborate with colleagues everywhere,” Landay says. “I feel it is a tremendous opportunity to take our research findings and apply them to impact the lives of our patients. We are really moving bench to bedside and working with our study participants to show the importance of our research outcomes. And many of our studies have implications for other diseases. That’s the most exciting part – being able to bring immunology research into other disciplines.”