The similarities found between SARS-CoV-2 and SARS-CoV, MERS-CoV, or human immunodeficiency viruses (HIV) can enhance the development of potential therapeutic approaches and advance the understanding of the virus mechanism of action – Nature Magazine
For once, the global scientific community is focused as never before. Their shared goal is the production of a vaccine to prevent Covid-19. Other segments of this community have been exploring treatments. A direct benefit of this shared journey is our understanding of influenza viruses, and this knowledge has grown exponentially in the last few months. Could his knowledge lead to a potential “cure” for the flu?
Co-existing with Influenza
With flu season nearly on the US, panic is spreading about a deadly combination — influenza and Covid-19— crippling America‘s already burdened hospital capacity. We don’t panic anymore about flu on its own. We’ve become accustomed to just dealing with the thousands of deaths that occur every year as a consequence of seasonal influenza. This year however, we’re already exhausted from dealing with a pandemic that is far from finished running its course.
Hospitals are packed to the rafters, spare beds, oxygen and respirators are in short supply and the tools we use to assist those who take seriously ill with influenza have been appropriated by the Covid-19 pandemic. America simply doesn’t have the resources to save everyone if this year’s influenza strains prove virulent. Getting the flu shot, particularly if you are at risk from influenza, is CRITICAL! Now, more than ever, that flu shot could end up saving your life.
Any costs involved in immunizing those at risk should be met by local health authorities. The money spent now could ensure we avoid potential chaos in the coming months.
Part of the problem is that influenza viruses have become a part of our day to day existence and no longer fill us with dread.
Unless of course, as with Covid, you happen to fall into a high risk category. For modern day, run of the mill, seasonal influenza, at risk categories are described as the aged, the immune compromised and those with respiratory issues, diabetes, cardiac related conditions, immune compromised individuals, pregnant mothers and those classified as morbidly obese. This group of individuals rely on seasonal influenza vaccines to keep them safe.
Each year, in America, influenza claims tens of thousands of lives. It’s difficult to accurately determine how many because, as with Covid, it’s the complications of the infection that lead to death. Official figures — with influenza listed as the cause of death on a death certificate— are more than likely not reflective of the actual death tolls,
People who died from the secondary, influenza related infections would not have died if not infected with influenza in the first place. This is an important fact that is difficult to factor into statistics because of the way in which deaths are recorded.
For instance, take the 2017–18 influenza season in the USA. Here are the figures as per the CDC website.
- Estimated Symptomatic Illness -45,000,000 people
- Estimated Medical Visits-21,000,000 people
- Estimated Hospitilizations-810,000 people
- Estimated Deaths 61,000 (possibly ranging from 46,000–95,000 people)
Clearly, influenza is a massive problem, particularly if considered for the financial burden it places on economies, lost working hours, the burden placed on health care and insurers and the obvious loss of life. Curing it, or rather preventing its ability to infect us, would radically change our lives.
The Limitations of Vaccines
Vaccines are targeted. They produce very specific responses in our bodies designed to provide us with immunity against a very specific virus. An existing vaccine becomes useless if the virus is able to produce a new strain. It’s one of the reasons we need to keep getting inoculated each year. The influenza virus mutates and produces new strains on a yearly basis, rendering last years vaccine useless.
Whilst this mechanism ensures the ongoing profitability of vaccines for pharmaceutical companies, it is obviously not the ideal solution for the general public. Vaccinating large numbers of individuals is costly and these programs often miss many in the at-risk segments of the population. Poorer people cannot afford a seasonal flu shot. In addition to this, increasing distrust in vaccinations is leading to individuals intentionally declining these yearly attempts to protect them.
These vaccines are also not foolproof, as other strains of influenza can still attack the inoculated individual. Influenza vaccines don’t provide life-long or blanket immunity, they simply reduce risk to the latest strains. What we are desperately in need of is a treatment that can stop the virus in its tracks.
It isn’t just the at-risk groups that are affected by influenza. Healthy individuals can also suffer long terms side effects, for instance damaging their heart muscle (myocarditis) or lungs as a result of a serious infection. We have been crying out for help for decades.
We are in need of a modern day medical miracle and we may well be on the verge of not just one, but many different breakthroughs in our fight against viruses, particularly those that cause influenza.
The drive to destroy viruses
Meet TaiGen Pharmaceuticals. They are a Taiwanese Pharma company that focuses on new cutting edge drugs. They’ve just filed an IND (Investigational New Drug) application with the US FDA for their influenza antiviral TG-1000. a drug designed to address different strains of Influenza.
Their candidate, TG-1000 is a novel pan-influenza antiviral, which interrupts viral replication and transmission via a cap-snatching mechanism and is able to do this effectively against influenza-A, influenza-B, avian flu H7N9, and Tamiflu-resistant viruses. Kuo-Lung Huang, the Chairman and CEO of TaiGen made the following statement about the application;
“We are excited about the IND filing in the US for the internally developed TG-1000 which has the potential to be a single dose treatment for influenza. TG-1000 IND filing demonstrates yet again TaiGen’s capacity and experience in research and development of NCEs.”
NCE is a New Chemical Entity (NCE), a drug that contains no active moiety that has been approved by FDA in any other application submitted under section 505(b) of the act. In other words, a completely new, unique drug that doesn’t comprise existing compounds.
Exploring Monoclonal Antibodies
An antibody is a protein that sticks to another specific protein called an antigen. Antibodies circulate throughout the body until they find and attach to the antigen. Once attached, they can force other parts of the immune system to destroy the cells containing the antigen. It’s a targeted attack that is focused in a way we’ve never had access to previously. We have cancer to thank for the development of these drugs.
Researchers can now design antibodies that specifically target a certain antigen, such as one found on cancer cells. They can then make many synthetic copies of that antibody in the lab. These are known as monoclonal antibodies (mAbs or Moabs). Even diseases such as arthritis can now be addressed with Moabs.
If these drugs work by targeting specific antigens, how then do they prove useful against an adaptive virus like the influenza virus? Wouldn’t you require a new version with each new outbreak? Not necessarily.
Some Moabs used to treat cancer are referred to as targeted therapy because they have a specific target on a cancer cell that they aim to find, attach to, and attack. Other Moabs are different. They act like immunotherapy because they make the immune system respond better to allow the body to find and attack cancer cells more effectively. It is these “naked” Moabs that are currently under scrutiny for treating Covid-19. The potential exists for these to be developed further to provide ongoing protection against influenza strains.
Clinical trial results for efficacy against Covid-19 involving a pair of antibodies developed by Regeneron Pharmaceuticals were released in September. In the last few days, President Trump received the Regeneron Moab for the early treatment of his Covid infection. A separate effort from Eli Lilly could yield data later in the fall and early promise has been shown. Data from both trials appear to indicate efficacy in early treatment of the Sars-nCoV-2 virus.
mRNA based medicines
Using mRNA as a medicine is a fundamentally different approach than treating disease with other drug classes. It plays a fundamental role in human biology and mRNA is the set of instructions by which cells make all proteins and send them to various parts of the body.
These medicines take advantage of normal biological processes to express proteins and create a desired therapeutic effect. This enables the potential treatment of a broad spectrum of diseases, many of which cannot be addressed with current technologies. Their delivery mechanism and reduced or very limited side effects make mRNA medicines the perfect candidate for a safe and effective vaccine.
DNA is the gene and RNA gives instructions for certain proteins. So an mRNA vaccine contains the instruction for manufacturing a SARS-CoV2 protein. Once inside the cell, the protein is made and that triggers the bodies immune response. Similar to vector vaccines which use cold viruses to deliver the protein instructions, mRNA medicines deliver their instructions on their own. It’s another way of getting the virus protein safely made inside of you so your body can produce the required antibody.
Moderna and BioNTech/Fosun Pharma/Pfizer currently have mRNA Covid vaccine candidates in differing stages of trials. Pfizer initiated trials on its first cohort in Germany in May of 2020 and Moderna announced Phase 3 trials in late July in the US. Last month, their vaccine candidate mRNA-1273 was found to be safe and effective in Phase I participants aged 18–55 years.
mRNA medicines have the potential to safely address a host of diseases without the accompanying risks associated with traditional medicines, and our generic flu candidate may very well emerge from this group over the next two years.
In terms of Covid-19 these vaccine candidates may not make it through the gate in first place, but they should not be dismissed. Their safety profiles make them candidates of first choice. In the meanwhile, our efforts to find a magic bullet against Covid continue unabated and an inevitable consequence of this will be discovery. That discovery could very well lead to the last flu jab you may ever need. Let’s keep our fingers crossed.