Anglo-Turkish Society

  • image courtesy of Kübra Yildirim, Yunus Emre Centre
  • image courtesy of Kübra Yildirim, Yunus Emre Centr
  • image courtesy of Kübra Yildirim, Yunus Emre Centr
  • image courtesy of Kübra Yildirim, Yunus Emre Centre

A talk by Prof Dr Oya Alpar on ‘Needle-free administration of vaccines and drugs’, 23 March 2016, Yunus Emre Institute – London.
Oya Alpar is Emeritus Professor of University College London School of Pharmacy.

>> read lecture summary

I have a vaccine story

I love history, and I of course love women’s history in particular. So I have to begin with a woman’s story.

An unsung heroine, Lady Mary Montague. History is full of intelligent, masterful and interesting women whose names are generally rarely known.

Lady Mary, born in 1689 and the daughter of an Earl was totally self-taught. As a young girl she set her own curriculum, including Latin. As a result, she wrote poetry, she wrote novels and even wrote letters to Bishops which was a pre-cursor to the ‘woman of letters’ she would later become.

While a prominent member of the Royal Court in London, Lady Mary contracted smallpox. Although she survived, she sadly lost her famous beauty from the permanent scarring of the disease. However, her dear brother was not so lucky and died soon after from this horrible disease.

Smallpox is a very ancient disease.

It ravaged the world touching every section of society. Including, as early as 1200 BC, Pharoah Ramses V, Elizabeth I, Mozart, George Washington, Abraham Lincoln are amongst the names that experienced its terror.

Portraits of Lady Mary Wortley Montagu

Lady Montague, after her illness, led a more secluded life, until her husband, Edward Wortley Montague, was appointed as British Ambassador to the Ottoman Empire in 1716. This was the fortuitous opportunity that would make her name throughout history. Living in Turkey, in Constantinople and visiting the women-only places, she first witnessed the practice of fighting smallpox in the city. Writing of it enthusiastically to her friend Sarah Chiswell in 1717, the letter here starts by saying:

“I am going to tell you a thing that will make you wish yourself here. Smallpox, so fatal, and so general amongst us, is here entirely harmless, by the invention of Engrafting, which is the term they give it.”

“Engrafting” or variolation, as it was called, was a process in which the elder women would rub small amounts of fluid from the pox into superficial scratches on the skin. After experiencing low level of smallpox symptoms, people become immune to the disease.

Lady Montague was so confident in the procedure she had allowed variolation to her own 5 year old son, in Istanbul, and the child was successfully immunised before returning to England, in 1718.

She wrote to Sarah saying: “I will take all the pains to bring this useful invention into fashion in England”. Having lost her brother to the disease and suffered from it herself, she brought the procedure back as promised.

Soon, in 1721, yet another smallpox epidemic broke out and Lady Mary swiftly had her 4-year-old daughter inoculated.

Meanwhile, following the demonstration of its safety, she convinced George I and the Royal Family to treat their children in the same fashion. All of the royal children and grandchildren that were subjected to the process recovered and became immune. Following these successes, the Royal Family were very helpful in promoting the process throughout Europe. Lady Mary’s own children survived long into adulthood in an age where 60% of the population would catch smallpox and 36% of them would die from it.

But there were serious roadblocks, mainly coming from English physicians. For them, the procedure of variolation was seen as Eastern folklore and the method was too simplistic. It would remove the monopoly of the trained professional. Western medicine tried to mutilate the process introducing severe bloodletting starvation and making deeper cuts, so that it could only be performed by a qualified physician.

This made the process less safe and a very prolonged procedure.

For some 70 years the practice of variolation continued in this way for immunisation, until a country doctor, Edward Jenner, who called smallpox: “the most dreadful scourge of the human species” refined the process (in the 1790s).

Consequently, Edward Jenner is commonly referred to as “the father of vaccination” for his work on the development of the world first vaccine against smallpox. Yet, by now as you will appreciate, it could not have happened had he NOT been standing on the shoulders of others, most of all Lady Montague. Her stubbornness and courage was to fight opposition, mainly from doctors.

Edward Jenner’s vaccine, which was based on the same principle, involved the inoculation of humans with a less virulent relative of ‘variola’ virus. That is cowpox, and it will prevent smallpox infection.

Jenner made the observation that milkmaids that had been exposed to cowpox were protected against infection from smallpox.

Therefore he decided to inoculate his gardener’s 8-year-old son, James Phipps, - in the arm – with cowpox blisters from the milkmaid, Sarah Nelmes. Her cow, Blossom, is commemorated in the library of St. George’s medical school, in Tooting.

This treatment produced no serious illness. Two weeks later, he injected James with variola material and no disease followed and many other successful inoculations followed to many other subjects, many times. Jenner indeed succeeded in proving his hypothesis correct and ultimately paving the way for the technique to be deployed nationally and internationally, in spite of the opposition from the medical elite and the church.

Cowpox vaccine was made the official vaccine against smallpox.

300 million people died from smallpox during the 20th century. Following mass vaccination programmes after 1966, the WHO announced, 14 years later in 1980, that the world is free of smallpox!

>> read Prof Alpar’s biography

H. Oya Alpar is Emeritus Professor at the UCL School of Pharmacy, University of London and Head of the Department of Pharmaceutical Technology at the University of Kemerbugaz. Previously, Prof Alpar was the Head of Centre for Drug Delivery Research (CDDR) running a large multi-disciplinary research group at The School of Pharmacy. Prof Alpar has extensive experience and a proven track record spanning over nearly four decades in the area of investigation and development of protein and DNA based vaccine micro and nano encapsulation technologies. Professor Alpar is a progressive expert in the field of micro and nanoparticle technology and their use in vaccination and delivery of other challenging biotherapeutics including siRNA. She has pioneered nasal particulate vaccine delivery and demonstrated the importance of formulation, processing and physicochemical characteristics for effective immune responses. These are now widely accepted and used in vaccine and gene delivery applications. Professor Alpar was also the first investigator to show the potential of adsorption concept and both mucosal and parenteral use of micro and nano particulate carriers for delivery of DNA. Research carried out by her group in collaboration with industry and international academic institutions contributes significant know-how and demonstrate expertise includes the development of novel formulations for pulmonary delivery of macromolecules such as biodefense vaccines and antibodies, enzymes, antibiotics, anti-TB drugs and non-viral gene therapy vectors for transcutaneous delivery of vaccines. She also acted as an advisor to a pan-European consortium including European Space Agency on nano and microencapsulation technologies in microgravity conditions, and member of the Austrian scientific advisor board on nanotechnology. Pursuance of a number of technologically advanced and strategically different approaches for the generation of protective immunity by use of polymeric carrier antigen delivery systems has resulted in a number of formulations reaching clinical trials, the award of 9 patents and the publication of over 150 articles. Her work has later also focused on the stabilization and development of vaccines for veterinary use as well, leading to protection as demonstrated with Blue tongue and Strangles disease. Her research has generated millions of pounds of funding in recent years that has enabled the development of many candidate delivery systems for use in drug and vaccine delivery.

Previously, she was the Head of the Department of Pharmaceutics and Industrial Pharmacy at the University of Hacettepe, Ankara, Turkey, where she was appointed to set up the above mentioned department upon her return to Ankara after obtaining her PhD degree from the University of London and where she later also became full professor of Pharmaceutics.

Professor Alpar received her undergraduate degree in pharmacy at the Ankara University, Turkey. Subsequently, she obtained a Ph.D. at the University of London, School of Pharmacy. Her Ph.D. project was in the area of compression physics. She then turned to the University of Hacettepe, Ankara, later becaming full Professor of Pharmaceutics and Industrial Pharmacy at this institution. Her strong interest in novel micro-nano dosage form design started in those days and she has encouraged her group at Hacettepe to work in these areas.

Professor Alpar returned to the UK where she joined the Pharmaceutics Department at Aston University in Birmingham. She taught at Aston from 1982 onwards, where she obtained the status of Senior Lecturer and then Reader in Pharmaceutics. Meanwhile, she developed a large multidisciplinary research group in vaccine delivery area.

Professor Alpar re-joined the University of London, School of Pharmacy on 1 st May 2001 as a Professor and head of (CDDR).

Her recent and current research work continues to be centred on the delivery of new and rigorously challenging biotherapeutics such as siRNA and designing nano-carriers systems by utilising novel technologies including Supercritical Fluid Technology with strong potential to bring about their utilisation as therapeutic agents in clinical testing and uses in the future.

Advances in drug delivery and tissue engineering are revolutionizing medical therapies. New drug delivery technologies, such as the ones she has developed and is developing, promise to create new treatments for cancer, infectious diseases, heart diseases and many other illnesses.

So far she has contributed a great deal both to Turkish and worldwide science in the investigation and promotion of these systems especially in the non-invasive delivery vaccine area.

Professor Alpar has been awarded with the ‘2015-TÜBİTAK (The Scientific and Technological Research Council) Special Award’ in the field of Health Sciences because of contribution to science at an international level.