Spain has been one of the countries most affected by the SARS-CoV-2 (Covid-19) coronavirus pandemic, which continues to cause thousands of deaths worldwide.
The Germans Trias i Pujol University Hospital in Badalona (Barcelona), the Fight Against AIDS Foundation and the IrsiCaixa Institute for AIDS Research are working tirelessly to fight the pandemic in the short and long term.
The help that the initiative represents #YoMeCorono It is of great importance because it is allowing the scientific response to be accelerated, which without these resources would be much slower.
Our research focuses on conducting clinical trials with new drugs and developing treatments, antibodies, and a vaccine against the new coronavirus and other similar future threats.
Specialists from the Infectious Diseases Service of the Germans Trias i Pujol Hospital in Badalona and the Fight Against AIDS and Infectious Diseases Foundation participate in clinical trials. Regarding basic research, a consortium has been created between the Barcelona Supercomputing Center (BSC), IRTA-CReSA (Animal Health Research Center with long experience in the coronavirus), IrsiCaixa (with long experience in the development of vaccines and extensive knowledge of the immune system) and the pharmaceutical company Grifols.
SCIENCE WITHOUT BORDERS: SHARING KNOWLEDGE
The results that have been obtained so far have been made public in real time worldwide in order to collaborate with the rest of the research groups and laboratories to advance faster. We firmly believe that it is our duty to share all information as quickly as possible for the benefit of all.
STRATEGY "TEST & TREAT": START OF TREATMENT AS SOON AS POSSIBLE
On March 18, the team led by Dr. Bonaventura Clotet and Dr. Oriol Mitjà launched, with extreme rapidity, a pioneering worldwide study to find out the effectiveness of hydroxychloroquine as an immediate treatment for those infected and to prevent the contagion between his contacts. This clinical trial, the first approved by the Spanish Drug Agency, is based on the strategy called "Test & Treat" consisting of starting treatment at the time of diagnosis. In this way, it is desired to eliminate a large amount of virus from the body, not allowing the infection to continue to progress at the pulmonary level with the release of inflammatory substances (cytokines) and the appearance of bilateral pneumonia, which, followed by severe respiratory failure, is which ends up causing death in a high percentage of patients.
With 3.000 participants recruited and analyzed in record time, the clinical trial is over. The results are being carefully analyzed and the conclusions, which will help establish what the position of hydroxychloroquine should be in the treatment of the coronavirus, will be published in the coming weeks.
Intensive work is currently underway to identify other active compounds to fight the virus "in vitro" and to assess synergies between them. This will allow us to carry out new clinical trials that allow us to find increasingly effective, safe and economical treatments for coronavirus. Always in the context of “Test & Treat”, the trials will be carried out with a small number of patients (<200) in order to be able to carry out several at the same time and to test several strategies at the same time. This will speed up the process to find different effective therapeutic approaches that can fit the wide spectrum of patients with Covid-19.
If we can identify a combination of drugs that slows the progression of Covid-19, that prevents severe inflammation and consequent destruction of the lungs, we will be able to stop this health crisis: if the infection is no longer life-threatening, the fact that it is very Contagious will no longer pose such a significant threat.
BASIC RESEARCH: MOVING FORWARD IN PARALLEL
Thanks to #YoMeCoronOr we have been able to start and advance in many complementary lines at the level of basic research:
- Isolation of the circulating virus and its mutations.
- Development of an ELISA technique to detect Immunoglobulins (IgM / IgG) with high sensitivity and specificity (> 95%).
- Evaluation of the neutralizing activity of the serum of patients with positive serological tests in cell cultures faced with SARS-CoV-2. It has been observed that it may be that not all people who have passed Covid-19 are protected against possible new infections. Lack of protection is more frequent in individuals who have been asymptomatic.
- Efficient production of pseudoviruses that will speed up the evaluation of neutralizing antibodies and new drugs.
- Correlation between ELISA test results and presence of neutralizing antibodies.
- Screening of anti-coronavirus drugs in different cell culture models faced with SARS-CoV-2.
- Start-up of the new laboratory to work with coronaviruses at the Germans Trias i Pujol Hospital, specifically at the Center for Comparative Medicine and Bioimaging (CMCiB). This new center will make it possible to triple basic research on the coronavirus and therefore accelerate the production of the vaccine and the search for effective drugs against the virus.
- Design of therapeutic and preventive bispecific antibodies against coronaviruses. Characterization of its activity and small / medium scale production. Proof of concept in animal model scheduled for June.
- Isolation of sera very rich in neutralizing antibodies to be able to produce monoclonal antibodies to treat the infection.
- Trials in the murine model of the first designs of the Covid-19 vaccine have been started in early May.
HOW TO ACCELERATE THE NEW TREATMENTS
Anti-coronavirus drugs and immunomodulators:
To make the development of anti-coronavirus drugs more agile and effective, we need to test them in cell models that mimic the human lung, to confirm their effectiveness in a situation that reflects the anatomy where the infection takes place. This step will allow us to select those compounds that we have already identified and that, if they also protect in a pulmonary context, will have greater potential to become an effective therapy for patients with Covid-19.
It is also essential to develop a cellular model that allows evaluating drugs that modulate the inflammation caused by coronavirus infection. These drugs focus their action on stopping the damage that an exaggerated immune response against the coronavirus causes to the most seriously infected people. Such immuno-modulatory drugs can be evaluated in immune myeloid cells exposed to the new coronavirus, measuring their response by secreting cytokines such as IL-6, which we know can complicate the progression of the infection. This analysis will identify which treatments can best slow the hyper-activation of the immune response against the coronavirus.
Both types of drugs, both anti-coronaviruses and immuno-modulators, will be tested in animal models to demonstrate their efficacy and safety, and will help us find possible effective treatments that can improve the progression of COVID-19, or even prevent infection if taken preventively.
An alternative to drugs is the development of monoclonal antibodies. These antibodies can generate protection over a long period of time but they are more complex and therefore require more elaborate development.
Our work contemplates the identification of synthetic antibodies (designed in the laboratory) and the isolation of antibodies from infected and recovered individuals that have generated a broad neutralizing response to the virus. This requires extensive selection work for those with an optimal neutralizing response and subsequent identification of the cells that produce these antibodies. Once these cells are isolated, the antibody-producing gene present in the cell genome is obtained and introduced by molecular biology techniques into immortalized cells that will become factories of these antibodies. Once identified and isolated, the best antibody will be selected for therapeutic or prophylactic use.
In order to get results as quickly as possible, we need your help more than ever. Donate now and help fight the coronavirus.