Protease inhibitors: from clinic to canvas

The Stanford Positive Care Clinic -- like many health care clinics -- has artwork hanging on its walls. But the paintings that decorate this HIV treatment and research facility in Atherton, California, are more than just pleasing to the eyes -- they mean something. The three-panel series by abstract artist linkurl:David Putnam,;http://www.daveputnamart.com/daveputnam/ titled "Miracle of Hope," depicts protease inhibitors (PI), an integral class of antiretroviral drugs, conquering HIV in the body.

The "Miracle of Hope" series with artist,
David Putnam, at the Positive Care Clinic
Image: Martha Putnam

Optimism is a vital part of therapy at the Positive Care Clinic, says linkurl:Andrew Zolopa,;http://med.stanford.edu/profiles/actu/faculty/Andrew_Zolopa/ director of the center and principal investigator for Stanford's AIDS Clinical Trials Unit. Zolopa, who started the clinic in 1994, says he's witnessed the "miracle" of positive thinking first hand. "When the body can no longer fight the virus and the drugs no longer work, some AIDS patients continue to hold on with the hope that a new drug will be developed.""When you look at this art, it's beautiful but it also has an educational role," adds Zolopa. "Even with well educated patients, it's hard to explain to them what's going on in their bodies. The paintings help me teach them the steps in simplified terms."This April, the Positive Care Clinic opened the doors to its new location after moving from the Veteran's Affairs Medical Center in Palo Alto. Despite the emphasis on optimism and inspiration at the center, its decor was lackluster, says Antonio Massimo Massa, a volunteer at the clinic and mutual friend of Putnam and Zolopa. So together Putnam, Zolopa and Massimo Massa brainstormed about what kind of art would best mesh with the clinic's ideals. "I just thought we were going to get some pretty art for the walls," says Zolopa. "As an artist I just didn't expect [Putnam] to care that much about the science, but that's where he got his inspiration." After speaking with Zolopa, Putnam, who says he's now obsessed with the human immune system, began reading about protease inhibitors, a class of antiretroviral drugs that, when paired with other treatments in 'drug cocktails,' dramatically improves AIDS patients' prognoses.Protease inhibitors prevent the enzyme protease from breaking HIV proteins into smaller peptides, a step needed for the virus to infect new cells."Before PI drugs, HIV positive people in the gay community were quitting their jobs, selling their homes, and writing their wills," says Massimo Massa. Living in San Francisco in the 1980s, Massimo Massa witnessed the rise of the AIDS epidemic. Back then researchers knew very little about the disease. But in the mid 1990s, "when the [PI] medication was introduced, from one day to another, there was hope again." Almost immediately after starting treatment with PI drugs, his friends applied for jobs again and took their homes off the market, he adds.With Zolopa's scientific guidance and Massimo Massa's emotional insight, Putnam created a series of three 36x48 inch acrylic paintings that use a vivid array of colors and textures to portray the process of protease inhibition and the silencing of HIV replication. Blue dots, clustered at the center of the canvas in the first panel but gradually spread out in the next two paintings, represent protease inhibitors. Black dots, which progressively disappear by the last panel, symbolize the enzyme protease.By the third and last painting of the series, only the protease inhibitors remain in the cell, "like sentinels or guardians forever on duty," according to Putnam.

	Miracle of Hope By David Putnam

"I think that sometimes the vast knowledge that scientists and doctors have can be a barrier between them and average people," says Putnam. "The idea of the paintings is to help with visualization techniques." Putnam and the doctors at the Positive Care Clinic want the patients to visualize the drugs working in their bodies even before any physical benefits of the therapy appear. "Hope is a powerful thing," Zolopa says.Putnam says he plans to continue portraying different aspects of the immune system through his art. "I didn't have any idea how massively complicated and beautifully organized [the immune system] is." In fact, he's painted seven more pieces depicting natural killer cells, a type a white blood cell that plays a vital role in killing cancer and virally-infected cells.As for the HIV patients themselves, linkurl:Philip Grant,;http://stanfordhospital.org/profiles/physician/Philip_Grant Positive Care Clinic physician, says he has certainly heard their murmurs of acceptance. One patient's statement has stuck with him: "Despite having lived through the days prior to good medication, and having lost many friends to AIDS, the artwork reflects the optimism I am now able to feel about my life moving forward," recalls Grant.
**__Related stories:__***linkurl:Templates for a vaccine?;http://www.the-scientist.com/article/display/57706/
[October 2010]*linkurl:New antibodies block HIV;http://www.the-scientist.com/blog/display/57549/
[8th July 2010]*linkurl:More hope for genetic fix for HIV;http://www.the-scientist.com/blog/display/57496/
[16th June 2010]