In this installment of our Hope Behind the Headlines series, we look at the latest scientific advances that offer hope in the fight against SARS-CoV-2, the new coronavirus, including promising therapeutic finds and the most recent steps toward vaccine development.
All data and statistics are based on publicly available data at the time of publication. Some information may be out of date.
Even as the world remains uncertain about how the coronavirus pandemic will evolve, scientists have been working tirelessly to stop the spread of SARS-CoV-2.
In our previous Hope Behind the Headlines feature, we highlighted some of the most promising advances in coronavirus vaccine developments.
Researchers around the world continue to test new approaches to SARS-CoV-2 immunization and promising therapeutic options for COVID-19, the disease that the novel coronavirus causes.
In this feature, we present the most recent efforts to tackle the virus behind the ongoing pandemic.
One of the key necessities in controlling the spread of the new coronavirus is efficient testing.
To this end, a team of researchers at the University of Colorado Boulder have developed a test that, they claim, can give a result in as little as 45 minutes.
The researchers say that sample collection for this test is simple and does not require the delicate and potentially unpleasant process of swabbing that is typical of currently available tests.
Instead, all a person has to do is spit into a tube, add a special solution to this sputum sample, and return the sealed tube to the laboratory for analysis. The laboratory testing requires only readily available materials, according to the test’s developers. This helps save a lot of time in processing the results.
The main question concerns accuracy: Will the test give a significant number of false-negative or false-positive results?
No, according to the researchers. “The test predicted with 100% accuracy all of the negative samples, and 29 of [the] 30 positive samples were predicted accurately,” says lead author Nicholas Meyerson, Ph.D.
However, the research has yet to be peer reviewed and validated through the replication of the findings, though the team has coopted a second set of investigators to verify their initial, promising, results.
Such fast-turnaround tests could help detect asymptomatic carriers of SARS-CoV-2, who may contribute to the spread of the virus without realizing it.
Prof. Roy Parker, the director of the university’s BioFrontiers Institute and senior author of the study paper, has commented that:
“Our modeling showed that whether a test is sensitive or supersensitive is not that important. What is important is frequent testing, with the test results returned as fast as possible, which identifies more infected people faster and can limit new infections.”
Nitric oxide is a gas that doctors sometimes use to treat people with very low blood oxygen levels.
Though researchers have noted that this approach does not appear to improve mortality rates among these patients, nitric oxide has demonstrated a surprising ability that has caught the eye of investigators at The George Washington University School of Medicine and Health Sciences.
Previous experiments in cell cultures have shown that nitric oxide is able to stop the replication of SARS-CoV, the coronavirus that causes SARS.
Given the genetic similarity of SARS-CoV and SARS-CoV-2 — the nucleotide sequences of which have approximately 79% similarity — the researchers suggest that nitric oxide may also be able to inhibit the new coronavirus.
In a review of the available evidence published in the journal Nitric Oxide, the investigators argue that the gas might help relieve some potentially fatal symptoms of COVID-19, the disease that SARS-CoV-2 causes.
Thus, they encourage other scientists to look into the therapeutic potential of nitric oxide in the context of the current pandemic.
“Nitric oxide plays key roles in maintaining normal vascular function and regulating inflammatory cascades that contribute to acute lung injury and acute respiratory distress syndrome,” explains review co-author Dr. Adam Friedman.
And, he adds, “Interventions that are protective against acute lung injury and acute respiratory distress syndrome can play a critical role for patients and health systems during the pandemic.”
In the conclusion to their paper, Dr. Friedman and his colleagues state emphatically that:
“Nitric oxide has demonstrated promise in similar respiratory disease models in modulating the prominent inflammation, and the early reported proofs of concept urgently call for randomized control trials in treating COVID-19. […] If its efficacy is illustrated as therapeutics firms seek its indication for COVID-19, nitric oxide treatment can be pivotal in the world’s fight against this immediate threat to public health.”
Many research teams are looking to develop targeted therapies for COVID-19, but creating a new drug from scratch can take a very long time indeed.
And since time is of the essence in putting a stop to the current coronavirus pandemic, some investigators have decided to take a different approach, by reevaluating the potential of existing drugs.
The main benefit of testing readily available medications is that these drugs have already passed human safety trials —all that is left is to demonstrate their effectiveness in tackling the new coronavirus and COVID-19.
With this in mind, researchers from Yale University set out to comb through approximately 12,000 drugs that had already received Food and Drug Administration (FDA) approval or were at the clinical stage of testing. Their aim was to find whether any might be successfully repurposed to treat COVID-19.
They pared that enormous initial list down to 100 potentially promising drugs, then to 21, and finally to the 13 drugs most likely to show activity against SARS-CoV-2.
Of the top 13 drugs, the researchers hold out the most hope for LAM-002A, or apilimod, which treats follicular lymphoma, a type of blood cancer, and various autoimmune diseases.
They have reported the process of arriving at this promising candidate in a study paper featured in the journal Nature.
The team has now started a collaboration with the biopharmaceutical company AI Therapeutics to start a phase II clinical trial of LAM-002A’s potential against SARS-CoV-2.
“LAM-002A holds promise to be a powerful new therapy for COVID-19 patients to prevent progression of the disease, hopefully avoiding the need for hospitalization,” comments Prof. Murat Gunel, chief scientific adviser at AI Therapeutics.
Research into vaccines also continues at full speed. Two weeks ago, researchers from The University of Texas at Austin reported — in a Science paper — that they had developed a modified version of SARS-CoV-2’s spike protein, which could ultimately help speed up vaccine production.
Spike proteins allow viruses to attach to and infect healthy cells, but scientists use them in vaccines to “teach” the immune system to detect the viruses associated with the spike proteins.
The research team had previously described the structure of SARS-CoV-2’s spike protein. With their recent efforts, they aimed to create a more stable spike protein that would be more resistant to heat stress and easier to transport.
After looking at 100 modified versions of the SARS-CoV-2 spike protein, the scientists were able to pinpoint the 26 most stable ones.
Finally, they combined four of the top 26 modifications to obtain the final protein version, which they have dubbed “HexaPro.”
HexaPro, the team says, could eventually help bring coronavirus vaccines to more people, faster.
“Depending on the type of vaccine, this improved version of the protein could reduce the size of each dose or speed up vaccine production. Either way, it could mean more patients have access to vaccines faster.”
– Senior author Prof. Jason McLellan
The researchers have now granted a nonexclusive license to manufacture and resell HexaPro to the biotechnology company Sino Biological, and they have also filed a United States patent application for the product.
Other researchers are looking at different experimental vaccines and their potential to keep SARS-CoV-2 at bay.
Last week, investigators from the Beth Israel Deaconess Medical Center, in Boston, MA, working in collaboration with the Johnson & Johnson corporation, reported some preliminary successes with their vaccine candidate.
In a study paper published in Nature, they explain that their vaccine candidate is based on an adenovirus — a common cold virus — carrying the SARS-CoV-2 spike protein.
The team worked with 52 rhesus macaque monkeys. They immunized 32 of the macaques with single shots of various versions of their experimental vaccine, and they injected the rest with a placebo.
Only six of the macaques received a shot of the vaccine version that the researchers believed to be optimal. After 6 weeks, the scientists exposed all of the monkeys to SARS-CoV-2, to see whether the vaccines had any effect.
Of the six that had received a shot of the vaccine believed to be optimal, none presented SARS-CoV-2 in their lungs, and only one had traces of the virus in its nose, suggesting that the vaccine had repelled the virus.
“A single-shot immunization has practical and logistical advantages over a two-shot regimen for global deployment and pandemic control, but a two-shot vaccine will likely be more immunogenic, and thus, both regimens are being evaluated in clinical trials,” notes study co-author Dr. Dan Barouch.
At present, the researchers have started clinical trials in humans to further test their vaccine.
“We look forward to the results of the clinical trials that will determine the safety and immunogenicity and, ultimately, the efficacy of the [experimental] vaccine in humans,” adds Dr. Barouch.
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