News & numbers
“The brutal reality for staff and patients is that this Easter in the NHS is as bad as any winter.” Matthew Taylor, chief executive of the NHS Confederation
Powerful antiviral for Ebola virus
New research suggests the combination of two potent antibodies could make a powerful antiviral therapy to treat two prominent ebolaviruses. The study, conducted by scientists from La Jolla Institute for Immunology (LJI) and the National Institute for Allergy and Infectious Diseases, discovered that two human antibodies can target two ebolavirus species at once: Ebola virus and Sudan virus. The well-known Ebola virus is just one species of the Ebolavirus genus, which includes the Sudan virus, Bundibugyo ebolavirus, Reston ebolavirus, Taï Forest ebolavirus and Bombali ebolavirus – but the Ebola virus and Sudan virus are responsible for biggest, deadliest outbreaks. “Finding antibodies with this breadth is important because we don’t know which virus in the genus of ebolaviruses is going to break out next,” said LJI president and CEO Erica Ollmann Saphire. To learn how these antibodies neutralise ebolaviruses, LJI Postdoctoral Fellows Xiaoying Yu and Jake Milligan spearheaded the use of an imaging technique called cryo-electron microscopy. “This antibody might punch above its
weight,” said Saphire. “The antibody is able to block three sites on the virus at the same time using different loops and structures to anchor into each one. That is remarkable.”
Meanwhile, the paired antibody 1C11 binds to the fusion machinery the virus would normally use to enter and infect host cells. As Saphire explains, because the fusion machinery has such a critical job, it looks very similar between Sudan virus and Ebola virus. “This is a site of very broad recognition and resistance to any antibody escape,” she said. “That’s how this antibody gets its breadth.” While there are antibody therapies against Ebola virus, some antibodies in these therapies don’t neutralise the virus. Instead, the antibodies home in on a decoy protein, called soluble glycoprotein, that the virus makes. Fortunately, 1C3 and 1C11 ignore the decoy and go straight for the virus’s actual surface glycoprotein structure. Researchers could then use fewer antibodies to target Ebola virus and Sudan virus. “If 80-90% of what’s there is some kind of smokescreen, having antibodies that can target the vulnerable spot is valuable,” Saphire said.
Coronavirus battle plans
Immunologists from Trinity College Dublin, who have worked on coronaviruses for the past decade, have just unravelled new secrets behind how this genus of virus evades the immune system.
Led by Dr Nigel Stevenson, assistant professor in Viral Immunology at Trinity, the researchers have discovered how SARS and MERS proteins block the induction of antiviral proteins, which prevents us from mounting a strong innate immune response against infection. “Our current research has discovered that SARS and MERS prevent key proteins from being activated and entering the nucleus in our cells,” said Stevenson. “The nucleus is where our DNA is stored and where genes are switched on, to generate a proper immune response.” The coronaviruses SARS and MERS emerged
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in 2002 and 2012, respectively. Both had higher fatality rates than Covid-19 (around 10% and 40%, respectively), but both infected far fewer people (about 10,000 and 3,000, respectively). The ambition behind the research is that designing new drugs to inhibit the ability of coronaviruses to suppress the Interferon pathway – which produces specific proteins that switch on hundreds of anti-viral genes – could lead to more effective treatments for all coronaviruses. Although different, these two coronaviruses bear many similarities to SARS-COV-2 (Covid-19), and thus drawing up blueprints of their battle plans provides insights with the potential to provide new therapeutic options for treating Covid-19 and future deadly coronaviruses that have yet to emerge.
Patient influencers Two academics have published a paper about the pros and cons of using patient influencers to market drug products. Co- authors Erin Willis, associate professor of Advertising, Public Relations and Media Design at University of Colorado Boulder and Marjorie Delbaere, a professor of marketing at the University of Saskatchewan, framed patient influencers as the “next frontier” in direct-to-consumer (DTC) pharmaceutical marketing. “This is a growing phenomenon, but there is virtually no research on it and very little regulation,” said Willis, who is interviewing dozens of patient influencers for a new study. “Is it going to help patients be better informed? Or is it going to get patients to ask their doctors for drugs they don’t really need? We just don’t know, because no one has studied it.” The controversial form of marketing, legal only in the United States and New Zealand, enables drug companies to target consumers directly, rather than through physicians.
Since the first DTC ad ran in the 1980s, the practice has expanded, leading patients to ask their doctors about drugs they see on TV or in print. According to Willis, about 44% of those who ask their doctor about a drug, get it. One of the dangers discussed in the paper is that a patient influencer operating via social media might omit crucial information. The Federal Trade Commission (FTC) requires that patient influencers disclose whether they are being paid (influencers can use #ad or #sponcon). And the FDA has published rules about what can be said on social posts. The rules are open to interpretation and hard to enforce, added Willis. All that said, Willis also sees many upsides to the patient influencer revolution, given that patients often know more than their doctors about what it’s like to experience a health condition. “If an influencer recommends a drug, there is an entire community of voices that get to weigh in and support it or share their negative experiences,” she said. Thus far in her interviews with patient influencers, Willis said she has found that only a small number are paid to post. Some get free trips to conferences or are paid to sit on advisory boards, but some aren’t paid at all. “They all say they are really doing this so that other patients have information and can have a better life,” said Willis. “That is their number one motivation and I think that’s awesome.” The paper from Willis and Delbaere was published in the Journal of Medical Internet Research.
World Pharmaceutical Frontiers /
www.worldpharmaceuticals.net
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