Dr Joanna Kirman finds 'her place in the world'

It is with mixed feelings that Infectious Diseases Group Leader Dr Joanna Kirman takes down the photo and death certificate of her great-grandfather from the wall above her Malaghan desk.

For the past ten years it has served as a daily reminder of why she dedicated her career to fighting the deadly infectious disease tuberculosis (TB). Although Dr Kirman’s great-grandfather survived being a Gunner in the Royal Garrison Artillery in World War I, he wasn’t so fortunate with his battle against the lethal bacteria that cause TB, and died from the disease at the early age of 29.

Next week the photo of Dr Kirman’s great-grandfather will find a new home in Dunedin, as Dr Kirman relocates to the University of Otago to take up a senior lectureship position at the Department of Microbiology and Immunology.

Dr Kirman says the major drawcard for her move to Dunedin is the Biohazard 3 facility that was craned onto the top of the Otago Microbiology building in a shipping container, last year. This will be the first time in her research career that she will have access to a biohazard facility that can accommodate TB in the same building that she works in.

Dr Kirman first came to the Malaghan Institute as Prof Graham Le Gros’ PhD student back in the mid-1990s, having just completed her undergraduate study at Otago. It was at the Malaghan Institute’s old facility in the Wellington School of Medicine, Newtown, that Dr Kirman first started her work into the development of an improved TB vaccine.

After a successful PhD Dr Kirman was awarded a Fogarty Fellowship to pursue her work in vaccine development at the National Institute of Allergy and Infectious Diseases, in the USA, where she worked for three years. In 2002 Dr Kirman returned to the Malaghan Institute to establish her own Infectious Diseases research group. In the ten years since Dr Kirman and her team have worked tirelessly to develop an improved vaccine for TB.

“Although given to more than three billion people worldwide, the current vaccine used to protect against TB called BCG simply doesn’t work in adults,” says Dr Kirman. “Developing a new vaccine is more critical than ever due to the emergence of highly drug resistant strains of TB.”

Dr Kirman is one of those to have received the BCG vaccine. Up until the mid-1980’s it was common practice for all children attending high schools in Auckland to be immunised with BCG.

“Before getting the vaccine we all had to be tested first to see if we had already been exposed to TB. A positive reaction, as indicated by an inflamed area at the test site on the skin, meant that we would not be immunised. So before the skin-test was read we all stood in line slapping our arms hard until they turned red to try to fool the nurses into thinking we had reacted to it.”

The scar Dr Kirman bears on her upper arm from where she received the BCG vaccine suggests the nurses saw through their imaginative ruse!

Today in New Zealand only newborn children in ‘at risk’ families or areas where TB predominates are vaccinated with BCG. TB presents very differently in children, which is probably why the BCG vaccine works better in children than adults.

Dr Kirman’s approach to developing a vaccine against TB that actually works in adults is to understand the so-called memory cells of the immune system, which do the job of fighting disease. Life-long immunisation against diseases such as the measles, polio, and tetanus is possible because the immune system is very good at remembering infections with particular viruses or bacteria. Dr Kirman hopes to have the same success with TB.

“Our approach is unique because it is a rational design strategy. We are studying how the immune system works against TB and then applying this knowledge to the design of a vaccine,” says Dr Kirman.

Dr Kirman believes that this is the most effective way to make a good vaccine because they are getting back to basics and working their way up.

“There are multiple approaches to designing a vaccine, most of which are ‘shot-in-the-dark’ strategies whereby a vaccine is made, tested, then redeveloped and tested again until a winning formula is determined,” said Dr Kirman. “With TB this is hard to do and prohibitively expensive because unlike acute viral infections that happen very quickly, TB is a chronic infection – an individual might be infected with the bacteria but the disease might not manifest for many years.”

While Dr Kirman will move her core tuberculosis research programme to Dunedin, she plans to continue the many collaborative research projects she is working on with other group leaders at the Malaghan Institute, so regular trips to Wellington are definitely on the cards.

On behalf of everyone here we thank Dr Kirman for all that she has done for the Malaghan Institute and wish her every success for the future.