Bench to Bedside: MUSC physician-scientist battles viruses in lab and clinic

by Amber Hazzard

Physician-scientists help bridge the gap between medicine and science by both conducting research and treating patients. Eric Meissner, M.D, Ph.D., Director of HIV and Hepatitis Patient Care and Research in the MUSC Division of Infectious Diseases is no exception.

In his outpatient clinic, Meissner provides care for individuals living with HIV, hepatitis C virus (HCV), and hepatitis B virus (HBV) infections. In his laboratory, he studies the interactions between HBV and the immune system with the goal of developing new and better treatments. He appreciates the opportunity to both care for patients and to conduct research into how the body fights off infections.

“I enjoy the diversity of experience and exposure that this career affords,” Meissner said.

Meissner has always been fascinated by the workings of the human immune system. “In most cases, the immune system can fend off infections while allowing us to return to functioning and feeling well,” he noted. However, there are instances where the body cannot clear the infection on its own. In these instances, chronic infection is established.

Chronic HBV infection can cause liver scarring, liver failure, and cancer and affects millions of people worldwide. Current treatments use antiviral medications to lower the ability of HBV to infect cells and multiply. This approach is called viral suppression.

“Suppressing the virus limits the damage it can cause to the liver,” Meissner added. While viral suppression treatments are helpful, they do not cure the infection.

Instead, Meissner hopes to combat HBV infections using the body’s oldest defense mechanism, the innate immune system.

 

The innate immune system consists of various pathways that help identify and neutralize foreign pathogens. Specifically, the Meissner laboratory studies the interferon lambda (IFNL) pathway which evolved to help the body respond to and eliminate viruses. “The liver uses lambda interferons to fight infections that occur within liver cells that comprise most of the organ,” explained Meissner.

Interestingly, IFNLs can sometimes help the body spontaneously clear certain viruses, like HCV, without causing liver damage. Meissner believes the key to understanding how the IFNL pathway affects viruses is to better understand the receptor that IFNLs use to function.

The liver makes different versions of IFNL receptor that may have different properties. “We’re interested in understanding how these different versions may work to fine tune the immune response in the liver,” he said. Understanding how these variants function could identify new ways to specifically target them to help combat HBV infection.

Additionally, Meissner is the Principal Investigator for several clinical trials that allow patients the opportunity to participate in research testing new medications for both HIV treatment and prevention.

The current methods for treating HIV are very similar to those for HBV; patients take a combination of viral suppressive medications. This treatment is known as antiretroviral therapy. “The treatment for HIV is also indefinite and serves to limit the damage that the virus can cause to the immune system,” said Meissner.

 

Medications being tested in the trials are also viral suppressants, but they either target a different part of the virus or are being tested in new combinations. This research has potential to expand treatment options for patients with HIV strains that have developed resistance to other antiretroviral therapies as well as options for people at risk of acquiring HIV infection.

Though Meissner leads these clinical and research activities, he is far from a one-man show. He highlights that this work would not be possible without the contributions of interdisciplinary teams.

“It takes a tremendous amount of support and collaboration from many hard-working individuals in order to be engaged in patient care, clinical trials, and basic research,” he emphasized.

From nurses and administrative staff to grant coordinators and research scientists to collaboration with patients, multiple people play pivotal roles in improving the care for individuals living with chronic HBV, HCV, and HIV infections.