While COVID-19 as a coronavirus variant is novel, the vaccines and treatments developed to fight it are anything but.
In a year marked by millions of deaths and the suffering of millions more from the disease’s worst effects, scientific researchers, including some in the Boulder area, repurposed previous medical ideas to make multiple vaccines in record time amid one of the modern world’s most pressing public health crises.
The first two COVID shots approved by the U.S. Food and Drug Administration use messenger RNA (mRNA), a concept that’s decades old but redeveloped by Pfizer Inc. (NYSE: PFE) and Moderna Inc. (Nasdaq: MRNA) to face a modern problem.
A traditional vaccine like the one developed by Johnson & Johnson (NYSE: JNJ) injects a weakened portion of the COVID-19 virus into the patient, with the hope that the patient’s immune system develops antibodies against it and remembers how to generate that response in case of live infection.
But messenger RNA-based vaccines don’t include a weakened piece of the virus. Instead, it provides the genetic code needed to make the spike proteins that identify the virus that causes COVID-19 but without the material that causes the illness.
Once those proteins are produced in the body, the person’s immune system fires up and develops a response at levels where both the Pfizer and Moderna vaccines produced immunity rates of more than 90% in final rounds of testing.
Scientists are still racing to fully understand how COVID-19 affects the body and if the current crop of vaccines will protect against mutated strains first found in Britain, Brazil and South Africa. However, there’s hope that mRNA’s rapid development could be a breakthrough in preventing and treating diseases by teaching the body to target the genetic codes that cause illness ranging from cancers and AIDS to more specific protection against that year’s dominant strain of the flu.
Dr. Thomas Flaig, the vice chancellor of research at the University of Colorado Anschutz Medical Campus, said while studies need to keep happening to determine how long the mRNA vaccines provide immunity, the idea behind how to deploy mRNA could transfer to other areas of medical research.
“We’re learning a lot about how to stimulate and train, if you will, the immune system to fight infectious diseases, and hopefully cancer,” he said. “I’m optimistic that there’ll be some positives out of this very difficult period in terms of understanding vaccines and how to move this forward.”
While COVID-19 is a novel form in the family of coronaviruses that cause a range of illnesses from common colds to SARS, many of the drugs in use or in the pipeline to treat the disease aren’t.
Remdesevir, for example, is the first antiviral medication approved for treating severe cases of COVID-19. It started life as a potential treatment for Ebola in 2016 and was approved faster than most because it already had preliminary safety trials completed before the pandemic emerged.
ARCA Biopharma Inc. (Nasdaq: ARCA), a Boulder company that focuses on genetic treatments for heart issues, is developing a similar drug. In the early days of the pandemic, COVID patients were dying due to inflammation and damage done to other vital organs, and no one was quite sure what was happening.
That caught the attention of Dr. Michael Bristow, a cardiologist and Arca’s founder and CEO. His research group at CU Anschutz applied for funding to study the disease’s effects on the heart when he saw that many of the patients with heart problems were suffering from blood clotting, possibly from an overreaction from their immune systems.
As it happened, Arca was in development of AB-201: a drug to treat the affliction in the heart by inhibiting the tissue factor that when activated starts the process of clotting. The company began developing AB-201 amid the rising Ebola pandemic in western Africa in 2014 and public worry that the disease would make its way to the U.S. When that didn’t manifest, Arca pivoted the drug toward cardiac arrest patients.
Six years later, another public health crisis emerged where some patients showed signs of high tissue factor activity. AB-201 seemed like a drug ahead of its time. As of late January, Arca’s trial is recruiting and is expected to produce initial results after the second half of 2021.
“We seem to have a perfect biologic or pharmacologic match for what could be going on, so we basically hit the gas pedal on that,” he said.
Although AB-201 in theory won’t be approved for use until well into this year, Bristow said the drug could be of use in patients who refused to get vaccinated or had a pre-existing condition that made them unable to get the shot.
It’s also possible that a future variant of COVID could be resistant to the current crop of vaccines, a nightmare scenario made a little easier due to having more time to develop treatments against them.
Applying to other diseases
The pandemic is still raging across the world as of this story’s publication, with thousands of Americans dying each day. But as the rate of vaccinations increases, albeit slowly, the country could soon see a day where COVID-19 is not the driving force of how lives are led.
At that point, the herculean amount of medical research in the past few months could begin to pivot toward treating other ailments.
Bristow said the clotting seen in COVID-19 patients has some overlap with patients with antiphospholipid syndrome, a condition where the antibodies that increase the chance of clots forming are overproduced.
The company is measuring counts of those antibodies in the patients within its current trials, with the hope that the data could transfer into another orphan drug designation down the road.
At CU, the medical school’s COVIDome Project is storing tissue samples of patients who consented in a publicly-available database for researchers across the world to access.
That’s a small part of what Flaig hopes will be a continued public interest in funding research and broader scientific collaboration after a year where the entire world was focused on one singular problem, a public health effort response with no match in scope other than perhaps the eradication of smallpox.
“I wouldn’t think that science is a terrible place a year ago, but I think we’re in a better place today to think about what we can do together,” he said.