Exclusive to Annasr, Algerian Immunologist Miriam Merad: I am working to stop the fatal inflammation caused by “Covid 19”

Interviewed by: Yasmine Bouldjedri May 14, 2020 Algeria

In her first interview with an Algerian media, Professor Miriam Merad reveals that her lab is working to find ways to stop the deadly inflammation caused by the "Covid19", she discusses the circumstances of her election to the National Academy of Science in USA, and talks about her researches and what offers to humanity, especially in the field of cancer immunotherapy. In addition to this, the graduate of the Faculty of Medicine in Algeria, speaks about other topics that you read in this interview with Annasr newspaper.

🔸 You are considered as one of the most famous researchers in USA in the field of myeloid biology and innate immunity, but Algerians heard about you after your recent election as a member of the National Academy of Sciences. Would you inform your readers more about your upbringing and early stages of your life?

I am the daughter of two well established scientists. My father, who is from Tlemcen, was the chair of cardiology department in Mustapha Basha hospital. My mother was the chair of the department of toxicology .

Both of them were very passionate about their work and expected the same of their 4 kids. My parents raised us to serve. Both of them did their medical studies in France and came back to Algeria as soon as the country became independent with the goal to build a strong academic program.

It is not surprising that my sister and I decided to go to med school. My sister is now the chair of clinical department in Institut Gustave Roussy one of the best cancer center in Europe.

I have studied all levels of education from primary to intermediate and secondary in Algeria, until I obtained my baccalauréat. I did my first 5 years of Medical school in Algeria where I became interested in cancer diseases and specifically I became fascinated by a treatment called bone marrow transplantation which was the only cure for a type of blood cancer called leukemia. This is when I decided to move to France to learn more about this treatment with the hope to come back to Algiers and work in a bone marrow transplant unit.

🔸 When did you move to France?

I moved to France in 1989 and took an exam called “internat des hopitaux“ which will allow me to do a medical specialty in France.

I passed the exam in 1992 and became an intern in oncology .At the same time as starting my medical specialty I started to take biology classes to learn about the basic principles of bone marrow transplantation (BMT)and what I learned was going to transform my medical carrier- I discovered that bone marrow transplantation consisted of injecting immune cells from a donor into patients and that immune cells were responsible for eliminating the cancer cells – this is what started my journey in immunology- . In addition to my medical studies, I took a master in immunology trying to understand how the immune system was able to recognize and kill cancer cells

🔸 How was the scientific research environment in Paris?

The medical Atmosphere in Paris was good - there is a big tradition in Immunology in France and I tremendously benefitted from it.

🔸 Why did you then decide to pursue your academic career in the USA?

One of my friend and mentor had just came back from the United states and she was urging me to spend some time there because she thought that American had the best approach to science

I moved to the USA in 1998 after finishing my medical specialty in oncology. I joined a laboratory at Stanford university specialized in cancer immunology and decided to a PhD in Immunology. I had to learn immunology from scratch because the immunology that is taught to medical students is very different from what PhD students needed to learn

🔸 What kind of research did you start there?

This is when I started to work on myeloid cells and their capacity to present cancer antigens to lymphocyte and mount a tumor specific response and mount also a memory response that could help prevent relapses.

🔸 What did America offer you in the beginning of scientific research?

It was extraordinary to move to Stanford University First there was a profound respect for scientific research and scientific discoveries- medical doctors were always coming to us to ask for collaborations, but also young PhD students were taken seriously. We were empowered to do well.

🔸 What does it mean to you to be a member of the National Academy of Sciences in the United States of America?

The NAS jury is likely the most difficult jury in the US. It means than hundred of immunologists thought that your work changed the way we think about immunology. I am very honored as a woman and as an Algerian scientist

🔸 You are the third Algerian person to be elected to this eminent scientific institution after Professor Elias Zerhouni and Professor Yasmine Belkaid. What represents this achievement for Algeria?

Elias and Yasmine are extraordinary scientists. Yasmine is a great friend and a fantastic human being, all of us started our carrier in Algeria and all of us decided to build a research lab in the US. I am very proud of them always and hope I have made them Proud, there is nothing more important for a scientist than to be recognized by people that we respect .

🔸 In a landmark study published in Science in 2010, you have shown the origin of macrophages. This study, cited several thousand times, has had important clinical implications. Could you tell us more about it and how it can help treat illnesses, especially cancer?

In this study we discovered a new lineage of immune cells called tissue resident macrophages and embryonic macrophages and we discovered that they play key role in organ physiology and pathophysiology. We have also identified drug targets that can reduce or activate these cells and we are currently testing these drugs in patients with cancer

🔸 You have been leading the cancer immunotherapy program for years. Where has the application of this revolutionary treatment been reached, and could you explain how it works to target immune, not cancerous, cells?,

It is now clear that immunotherapy is going to become standard of care in many cancer which is quite extraordinary as it means that targeting immune cells alone is sometimes sufficient to kill cancer cells. All the immunotherapy success was obtained with three immune target – PD-1 or PD-1 blockade or CTLA4 blockade and there are many more to discover

🔸 However, immunotherapy for cancer remains very expensive, and in Algeria, for example, it requires about $ 130,000 per patient. Can we see a decrease in its cost in the future, especially in developing and poor countries?

I really hope that the costs of these treatments will drop.

🔸 Cancer still kills hundreds of thousands of people around the world, even though it is an ancient disease. Why ?

I just think that immunotherapy will change that. Before we only attacked cancer outside cancer is a cell that has lost all control of its growth system and cancer cells arrive.

🔸 In a May 2020 study in Nature, you and your team revealed novel therapeutic targets to enhance dendritic cell-mediated antitumor immunity. How can this treatment change currently approved medical treatments?

This is a very important study for me .I have been working on this paper for many years. Here I identified many ways of targeting another group of immune cells that were discovered in my laboratory in 2007 to enhance antitumor immunity. I think there are several potential targets there that can definitely be transformative in patients.

🔸 With another team of researchers, you began working in your lab at Mount Sinai School of Medicine in Manhattan, to determine the immune response to Covid 19, how will your research permit the reduction and prevention of complications from this virus?

We are trying to understand why patients are dying of Covid 19, we think they are dying of excess inflammation mostly triggered by macrophages which are the cells I have been studying in my lab for many years. I am trying to find ways to stop the fatal inflammation.

🔸 Many Algerian scientists have emerged in the United States of America. Do you have an idea of their number in medicine and other fields, and are you in contact with them?

I am in close contact with Yasmine Belkaid another woman Algerian scientist that was elected to the academy two years ago- she is an extraordinary scientist and a close friend of mine. But I have met other phenomenal women scientists : yasmine Laouar , Professor at university of Michigan and few others.

🔸 Have you received offers to contribute to scientific research in Algeria?

No I was never offered to work in Algeria.

Y.B