People who become infected with COVID-19 experience a range of responses, from mild illness to death. The question of why some people are more severely affected then others may now have been answered. Researchers at Amsterdam UMC identified abnormal antibody responses as the main cause of critical illness.
The good news is that the scientists also discovered a drug that can counteract the aberrant immune reaction. The drug has already been approved by the Food and Drug Administration, according to Medical Xpress. The study results have been published in the journal Science Translational Medicine.
One of the researchers, immunologist Den Dunnen said: “During an infection, our immune system produces antibodies. Normally these antibodies protect your body against viruses.” Dunnen said that the same response applies to people who are infected with the COVID-19 virus.
“But in COVID-19 patients that become seriously ill, the antibody response is derailed. These patients not only make extremely high amounts of antibodies against the virus, but these antibodies also have an aberrant structure. This causes an extreme inflammatory reaction in the lungs,” he explained.
Dunnen’s co-researcher at Amsterdam UMC, Menno de Winther, went on to explain that antibodies form the shape of a Y, with the top binding to the virus and the tail attaching to the immune cells of the lungs. But in some people, the tail is abnormal and over activates the immune response.
“The immune system becomes completely over activated which is sometimes referred to as a cytokine storm,” says Dunnen, according to Medical Xpress. “The inflammatory response that was meant to attack the virus now destroys the patient’s own tissues.”
Dunnen added that blood vessels start to leak, the lungs fill up, and blood platelets begin to clump.
“Admission to the ICU if often unavoidable and the prognosis for these patients is generally not good,” he said.
Scientists say that cytokine storms occur when the body attacks its own cells and tissues rather than just fighting off the virus, according WebMD. In the case of COVID-19 patients, the cytokine storms triggered by the disease are gale-force.
While the researchers at Amsterdam UMC noted that seriously ill patients are often treated with antiviral drugs such as dexamethasone and tocilizumab, these medicines also suppress the immune system as a whole. The preferred treatment is a drug called fostamatinib, said Dunnen.
He said in his studies, fostamatinib “ensures that the immune cells in the lungs no longer react to the abnormal antibodies, but still react to the virus.” In clinical trials, the researchers found that in the group of people who received the drug, fewer died and there were fewer side effects. In the cohort that received fostamatinib, more people recovered.
Fostamatinib is already approved for use in other diseases so it may not require rigorous clinical trials before it is recognized as a COVID-19 treatment.
Dunnen and De Winther want to continue investigating drugs that combat serious illness from COVID-19.
“The goal is to find drugs that work just as well, or preferably better, than fostamatinib,” they said, according to Medical Xpress. “We have several already approved drugs that we suspect could work.”
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