In 2020, VUMC joined forces with the Aurum Institute, a nonprofit, public benefit organization based in Johannesburg, South Africa, to find new uses for existing drugs on the World Health Organization List of Essential Medicines.
The collaboration, called Project Remedi, or Repurposing Essential Medicines Internationally, has proposed the use of the antioxidant N-acetyl cysteine in acute liver failure, and the lipid-lowering drug simvastatin to treat polycystic ovary syndrome, a major cause of infertility, said VICTR’s manager of translational research, Rebecca Jerome, MLIS, MPH.
Through the Aurum Institute, researchers are also exploring new ways to treat tuberculosis, a chronic bacterial infection that attacks the lungs and other organs and which, until COVID-19 came along, was the world’s leading infectious cause of death.
“It is about to be again, I think,” said Robert Wallis, MD, Chief Scientific Officer, Host Directed Therapy, at the Aurum Institute. “In some countries, South Africa, for example, TB is actually the most common cause of death, period.”
TB treatment since the 1960s has focused on using antibiotics and antimicrobial drugs to kill the germ, said Wallis, one of five physician-scientists from Aurum currently on the adjunct or full-time faculty in the Department of Medicine at VUMC.
In the past decade, interest has shifted to the host cell that is invaded by TB, trying to find ways to activate human cell mechanisms to kill the germ and prevent organ damage. “This is where the work that I do and the work that’s going on at Vanderbilt overlap quite a bit,” Wallis said. “This question of host-directed therapy for TB is a terrific example.”
Drug repurposing also will have an important role to play in preparing for the next pandemic, he added. Worldwide surveillance of emerging pathogens continues to be crucial, but so is gaining a better understanding of how existing medicines might be used to thwart them.
In many ways, the repurposing work going on at VUMC can have a worldwide impact. “To me, that’s the most important thing,” Wallis said.