Covid-19 is undoubtedly an important enabler, making the need for research and implementation more urgent.
Compile the | Ling Jun
Source | "Medical Community" public account
Over the past two years, the COVID-19 pandemic has sparked an unprecedented global campaign against the pandemic.
Business shutdowns, patient quarantines, border closures... Hundreds of millions of dollars have been invested in public health, scientific research and other fields in a short period of time, which is the first time in the history of human medicine that such a large amount of energy has been invested to jointly contain the virus.
The price is tragic, according to statistics, the number of deaths in the new crown world is currently close to 6 million. But just last week, The Guardian published an article titled "How Covid changed medicine for the future," saying the "costs" were also having an unexpected impact on the medical and scientific communities:
"Without COVID-19, the development of the past two years would not have been possible – it has become a huge catalyst, leading different technologies and research to provide insights into human medicine."
The new crown virus is affecting and changing the future development of human medicine.
The pandemic has redefined the rules of the game for vaccines
In July 2021, researchers at the University of Oxford in the United Kingdom announced a phase one clinical trial of a plague vaccine, and Tom Pooley, 21, became the first person to use a trial plague vaccine.
The whole painless dosing process took only 5 seconds, and Tom Pooley felt slightly unwell that night, but after 3 hours it was fine. Since then, the trial has continued to counter the thousands-year-old bacterial threat: in 2017, the plague killed 171 people in Madagascar.
The vaccine was developed based on the same technology as the COVID-19 vaccine ChAdOx. This is just one example of the covid-19 vaccine being derived into other disease areas: a vaccine study against Ebola has entered human trials, while vaccines against dengue, Zika and a host of other pathogens are also being tested.
"COVID-19 has accelerated the process of translating early knowledge into practice." Professor Deenan Pillay, professor of virology at University College London, said. In fact, medical progress is by no means overnight, and eventual landing also requires an opportunity, including a trade-off between policy and economic factors.
But COVID-19 is undoubtedly an important enabler, making the need for research and implementation more urgent, while providing a more research-friendly environment, including easier case tracking, data collection, and easier regulatory environment.
Take the mRNA vaccine, for example.
Prevent disease by synthesizing molecules that allow human cells to produce specific proteins? Five years ago, there was widespread hesitation about putting a lot of energy and cost into the field, and never approved a product based on mRNA technology, but covid-19 has successfully changed the game.
Before the epidemic, Pfizer in the United States has cooperated with BioNTech in Germany to study mRNA technology to deal with influenza. Professor Deenan Pillay said that before a new vaccine or drug could take a decade or more to complete all the development and review, but under the COVID-19 pandemic, it landed quickly within a year.
In addition, relying on the success of the MRNA technology platform of the American Modena Company under the epidemic, in 2022, Modena announced that the mRNA AIDS vaccine began human trials, and once successful, the vaccine can provide lifelong protection for those who have been vaccinated.
Professor David Diemert, an immunologist at George Washington University, said: "The COVID-19 pandemic has demonstrated mRNA vaccines, so the process from discussing the use of mRNA vaccines to prevent HIV to conducting Phase I clinical trials has accelerated. "It is reported that this vaccine is unique and very novel for vaccines by stimulating cells in the lymph nodes to trigger an immune response to HIV.
Rabies, Zika virus, colon cancer, skin cancer, breast cancer... Modena alone has developed at least 30 mRNA-based therapeutic trials in six different areas of medicine.
In addition to the success of mRNA technology, the health crisis caused by the epidemic has also accelerated the focus of scientific research into the next frontier - RNA-based treatments.
Professor Richard Bucala, chair of the Department of Rheumatology, Allergy and Immunology at Yale School of Medicine, said: "This is an unexpected benefit, RNA and mRNA vaccine technology has been studied for at least 10 years, but it was not until the COVID-19 pandemic that the field of RNA technology was really invested heavily. ”
Professor Richard Bucala believes that the development of vaccines costs tens of millions of dollars and takes a long time, but it is difficult to determine whether it will eventually succeed and whether it will occupy the market, so few people are willing to take risks. But the accidental success of RNA technology in the epidemic has changed all this:
Malaria, an ancient disease that killed 409,000 people worldwide in 2019. Last year, Professor Richard Bucala's team worked with companies to patent a saRNA vaccine that prevents malaria. The vaccine is currently in preclinical trials and will be tested in humans within two years.
What has coronavirus changed beyond vaccines?
Some seemingly unrelated disease areas are also being affected by the coronavirus – the pandemic has deepened the attention paid to common diseases in academia and the public.
Statistics show that during the 2020 epidemic, 78% of COVID-19 hospitalized patients in the United States were overweight. Obesity, from a daily topic to a high-risk factor associated with COVID-19 infection, has intensified the emphasis on tackling obesity.
In June 2021, the U.S. FDA approved Semaglutide, the first drug to target obesity since 2014. A study of nearly 2,000 patients found that participants lost an average of 15 percent of their weight, potentially twice as effectively as previous weight-loss drugs.
Semaglutide was originally used to treat type 2 diabetes, but there is growing evidence that weight loss reduces the severity of COVID-19 infection, and regulators have approved new indications for it.
The COVID-19 pandemic has also revealed potential benefits of vitamin D. Norway, Finland and Iceland, three countries that previously emphasized adequate "sunbathing" to maintain vitamin D levels in their bodies, may be one of the reasons for their lower COVID-19 deaths.
Although a number of subsequent research papers have suggested that vitamin D and the prevention and treatment of the new crown can not be directly linked, this undoubtedly indirectly attracted the attention of the academic community to vitamin D. The Lancet sub-journal published a paper co-authored by dozens of experts suggesting that vitamin D deficiency may be associated with the development of many diseases.
"For participants with vitamin D deficiency, genetic analysis of vitamin D deficiency was directly linked to all-cause mortality." The article calls for broader trials and a re-examination of disease prevention strategies. "Vitamin D can reduce cardiovascular disease mortality through several potential mechanisms, and there are other potential mechanisms that suggest that vitamin D can treat cancer."
At the same time, in the continuous in-depth study of the sequelae of the new crown, the long-term hazards of some other diseases have gradually emerged, such as chronic fatigue syndrome.
The formation of microclots in the blood may be a key factor in this. Professor Resia Pretorius, Head of the Department of Sciences at Stellenbosch University in South Africa, has been exploring this area for a long time, and after the outbreak of the new crown epidemic, the urgent need to further accelerate research.
Professor Resia Pretorius found that microclots in capillaries prevent oxygen from reaching tissues, leading to long-term COVID-19 symptoms and concluded that anticoagulant therapy can help and alleviate "Long Covid".
She further explained that for many patients with chronic fatigue syndrome, if not treated early in the onset of the disease, inflammatory molecules can cause significant damage to the body, which may be similar to the reasons for the "Long Covid".
Also standing out is digital health.
Including "flow tone", the concept of public health, epidemiological-related data and knowledge have spread to the public, and the frequency of use of related software on smartphones is also increasing. Professor Deenan Pillay said: "People are becoming more accustomed to obtaining clinical advice through online remote consultations, while health information collected on apps can also be sent to medical professionals. ”
"Covid-19 prevention and control gives us confidence in the further application of science to health issues." Professor Deenan Pillay said that at the same time, the public's acceptance of medical-related "black technology" is also increasing.
Like many scientists, In the context of COVID-19, Professor Resia Pretorius has been impressed by the increased level of academic and research collaboration. "COVID-19 has united the world on a sustainable common goal." She said.
Professor David Braun, an oncologist at Yale University, empathizes. Currently, his team is working on the application of RNA technology to cancer treatment. "I hope that scientific advances during the pandemic can help humanity treat other diseases, and after more than two years of 'darkest hours,' this is the turnaround we want to see." Professor David Braun said.
bibliography:
1.How Covid changed medicine for the future，The Guardian，https://www.theguardian.com/world/2022/feb/20/how-covid-created-a-vision-for-treating-disease
Source: Medical community
Editor-in-charge: Tian Wei
Proofreader: Zang Hengjia
Plate making: Xue Jiao
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