DURHAM — The work that has earned Sallie Permar national attention centers on the tricky business of passing disease from mother to child.
While HIV can be transmitted through breast milk, for instance, only 10 percent of babies breast-fed by mothers who have the virus will get it. And though up to 4 percent of mothers contract cytomegalovirus while pregnant, only a third of them pass it on to their children.
Permar, a Duke researcher, is working to figure out how nature stops these diseases from being passed on, in hopes of putting natural processes to work in preventing disease among the world’s children.
Last week, Permar was honored as one of the nation’s top young researchers in a Washington, D.C., ceremony. Afterward, she met the president and spoke to staff at the National Institutes of Health about her research.
Last fall, she won another national award for research that isolated a substance in breast milk that stops HIV from being transmitted to babies – a finding that could be used to stop transmission of the virus by breast-feeding or perhaps by other means as well.
The Raleigh native and Davidson College graduate says her work is all about helping children start life with “a clean slate.”
“A healthy start for all infants is what I want to help achieve,” says Permar, 38.
Barton Haynes, director of the Human Vaccine Institute at Duke’s Department of Medicine, says Permar has made important strides in a crucial area.
“The work Sallie Permar is doing is central to our goals of making vaccines to prevent childhood diseases,” Haynes says. “Sallie works incredibly hard, and in addition to being a terrific scientist, is also a wonderful mentor to those that work in her laboratory.”
Difficult double degree
Permar grew up in Raleigh, where she attended public schools. She says it was her ninth-grade teacher at Broughton High School who inspired and fostered her interest in biology.
She knew when she started at Davidson that she wanted to go into medicine, whether as a doctor or researcher. Her interest in vaccines was piqued during a summer in Zambia as an undergraduate, during the height of the AIDS epidemic.
“You couldn’t escape seeing or feeling the impact of AIDS,” she says. “Hospitals were overflowing, and you could tell there was this missing generation, with lots of children being cared for by their grandparents.”
At the same time, the village was experiencing an outbreak of measles, a shock to Permar since an effective vaccine is ubiquitous in developed countries.
She went on to study infectious disease immunology at Johns Hopkins, with a focus on HIV/AIDS.
While earning her doctorate, she decided she would benefit from understanding the medical side of developing vaccines in addition to the research side, so she also enrolled as a medical student at Harvard University.
Harvard officials balked when they realized she was pursuing both degrees, she says, but eventually relented.
Early in her research career, Permar traveled to Malawi, where she collected breast milk samples from HIV-positive mothers that she used to study how the virus is transmitted – and not transmitted – to babies.
The transmission of HIV through breast milk creates a difficult public health choice, because recommending that mothers avoid breast-feeding can leave babies open to a host of other infections, as well as starvation.
The substance Permar and her colleagues isolated in breast milk, called Tenascin C, could be given to the children of HIV-positive mothers, or even possibly used to stop transmission by sexual contact.
AIDS is less of a problem than it used to be in Africa, but access to expensive retroviral drugs and other issues leave some gaps in dealing with the disease that she hopes her research can help fill.
“We’re studying what is the natural protection that’s already protecting 90 percent of these babies,” she says. “The good thing is that if it’s a component of breast milk, it should be very safe.”
Meeting with Obama
The research that earned her the White House honor applied a similar approach to cytomegalovirus, a common virus that can cause birth defects when passed from mother to child. It is believed to be responsible for a fourth of infant hearing-loss cases nationwide.
The virus doesn’t produce symptoms in most people, and most babies who contract it from their mothers aren’t harmed. Permar and her colleagues are working to figure out how this natural immunity works, so that they can mimic it in a vaccine.
She recounts how after the vaccine for measles and rubella became widely used, schools of the blind and deaf started to close because of lack of enrollment.
“We could essentially eliminate these problems,” she says. “That’s my hope and dream.”
Her work involves studying women who do and don’t transmit the virus in hopes of finding a chemical that could suppress it. Once formulated, the vaccines are tested in primates.
Earlier in her career, her medical practice was also focused on HIV and AIDS. But newer treatments have made these conditions easier to treat; she now deals with a variety of complex infections, particularly in children whose immune systems don’t function properly.
The White House honor was also based on work in the community. Permar, who moved back to Raleigh shortly after her sister’s death in 2011, is active in the National Charity League, a mother-daughter volunteer group that she attends with her nieces.
Among her outreach efforts through that group was to talk with mothers about the importance of vaccinating children.
During her visit to the White House, Permar says the president urged the 102 scientists and engineers who were honored to do more such outreach in what she characterized as a pep talk – offering congratulations for what they’ve done, and advice for moving forward.
Obama said he was happy to see so many women in the room, she recalls, but dismayed to see so few minority groups represented. He urged the group to reach out to and mentor promising minority students, and to engage more with the public.
But mainly, he told them to get back to work.
“It was very inspiring,” she says. “They told us that we are the future leaders who have the ability to change the face of science.”
Know someone who should be Tar Heel of the Week? Contact us at email@example.com or find Tar Heel of the Week on Facebook.