Tutanchamun: Evidenzbasierte Paleopathologie vs. „Fluch des Pharao“

Malaria & mRNA Vaccines: A Possible Salvation from One of the Most Relevant Infectious Diseases of the Global South

Malaria is one of the most dangerous infectious diseases in the world. It occurs in tropical and subtropical regions and affects about 40% of the world´s population. In endemic regions, an estimated 200 million people contract malaria each year. Three-quarters of all global deaths (about 600 per year) are children under 5 years of age. Thus, malaria is one of the most relevant tropical and also childhood diseases in the world. Thanks to various public health measures such as vector control through mosquito nets or the targeted use of insecticides as well as the use of antimalarial prophylaxis drugs, the incidence has already been successfully reduced in recent years. However, to reduce the risk of malaria and to protect children effectively, further measures are necessary. An important part of these measures is an effective vaccination against malaria. However, the history of research shows that the development of an effective malaria vaccine is not an easy undertaking and is associated with some complications. Research into possible vaccines began as early as the 1960s. However, the results achieved were rather sobering and the various vaccines fell short of their expectations. It was not until 2015 that the vaccine RTS,S/AS01 received a positive evaluation from the European Medicines Agency. Since then, the vaccine has been tested in Africa. However, with the COVID-19 pandemic, there are new developments in vaccine research that could also benefit malaria research. These include, among others, the so-called mRNA vaccines. Already in the early 1990s, an immune response triggered by an mRNA vaccine was described for the first time. Since then, mRNA vaccines have been researched and discussed for possible prophylaxis. However, it was not until the COVID-19 pandemic that these vaccines experienced a veritable progress. mRNA vaccines against SARS-CoV-2 were rapidly developed and achieved high efficacy in studies. Based on this success, it is not surprising that companies are also focusing on other diseases and pathogens. Besides viral diseases, such as influenza or AIDS, malaria is high on this list. Many pharmaceutical companies (including the German companies BioNTech and CureVac) have already confirmed that they are researching mRNA vaccines against malaria. However, this is not an easy task. The aim of this article is to describe and discuss possible antigens that could be considered for mRNA vaccination. However, this topic is currently still very speculative.

Malaria-Antigene in der Ära der mRNA-Impfstoffe

Bereits in den frühen 1990er-Jahren wurde erstmals eine durch einen mRNA-Impfstoff ausgelöste Immunantwort beschrieben. Seitdem wurden mRNA-Impfstoffe für eine mögliche Prophylaxe erforscht und diskutiert. Doch erst mit der COVID-19-Pandemie erlebten diese Impfstoffe einen wahren Boom. Die ersten mRNA-Impfstoffe wurden gegen SARS-CoV‑2 zugelassen und zeigten große Erfolge. Es ist daher nicht verwunderlich, dass sich die Hersteller auch auf andere Krankheiten und Pathogene konzentrieren. Neben viralen Krankheiten wie Influenza oder Aids steht Malaria weit oben auf dieser Liste. Viele Pharmaunternehmen (u. a. die deutschen Unternehmen BioNTech und CureVac) haben bereits bestätigt, an mRNA-Impfstoffen gegen Malaria zu forschen. Dabei ist die Entwicklung eines funktionierenden Impfstoffes gegen Malaria kein leichtes Unterfangen. Seit den 1960ern wird an möglichen Impfstoffen geforscht. Die Ergebnisse sind dabei eher ernüchternd. Erst 2015 erhielt der Impfstoff RTS,S/AS01 eine positive Bewertung der Europäischen Arzneimittel-Agentur. Seitdem wird der Impfstoff in Afrika getestet.

Computed Tomography-Detected Paleopathologies in Ancient Egyptian Mummies

OBJECTIVE

Computed tomography (CT)-based analyses of mummies have been performed since the 1970s but, until now, no systematic summary of PubMed®-published data has been performed. The aim was to perform a systematic review of previously published cases and summarize artificial changes and detectable paleopathologies.

MATERIALS AND METHODS

Data collection from publications on CT analyses of mummies from ancient Egypt until the Greco-Roman period (up to 700 ad) from the PubMed® database (1973-2013) and descriptive data analysis.

RESULTS

Forty-seven publications on CT-based analyses have been identified, which reported on 189 mummies. Commonly reported artificial changes were destruction of the nasal bone and left-sided lateral abdominal incision for removal of inner organs. Dental and jaw pathologies (n = 42), chronic degenerative changes of skeletal bones (n = 39), and arteriosclerosis (n = 36) were reported in a subfraction of cases while traumatic fractures (n = 16) and other diseases were less often identified. The cause of death was rarely detectable by CT, but a cut through the throat, arrowheads, and bone fracture could be verified by CT.

CONCLUSION

Standards in documentation of CT devices have changed over the past 40 years, and insufficient documentation limits the interpretation of findings. In ancient Egyptian mummies, most organs have been removed during the mummification process while teeth and jaws are often preserved. Dental pathologies were frequent in ancient Egypt and can indicate personal circumstances and diet. The cause of death is rarely verifiable, but CT scan could be the clue. Although well known in Egyptian mummies, artificial changes may lead to misinterpretation of CT findings.