At present, the outbreak of new coronary pneumonia is in a critical period of prevention and control. In the face of rampant disease, although there is no special medicine to fight it, but this does not mean that we are helpless. The State Council’s joint prevention and control mechanism revealed the latest progress in drug research and development and clinical treatment at a press conference on the 15th. Global Times reporter on the 16th asked a number of experts to interpret this.
By Li Sikun, Special Correspondent of this newspaper, Wu Yan
Statistics from the National Health and Reform Commission show that as of February 15, 11,272 cases of severe new coronary pneumonia have been confirmed nationwide, including 10,396 cases of severe pneumonia in Hubei Province and 8530 cases in Wuhan. This means that the treatment of seriously ill patients is in a serious situation, how to reduce the mortality rate of these seriously ill patients is an urgent task.
Wang Peiyu, vice dean of Peking University’s School of Public Health, told the Global Times on the 16th that because there is no special treatment for new coronary pneumonia, there is no particularly effective treatment for seriously ill patients, basically supporting therapy or treatment mainly. For example, the main symptoms of pneumonia are breathing difficulties and inflammation, so need to go to the respiratory department, take the respiratory machine, oxygen absorption, intensive care and other treatment. It is also possible to have secondary bacterial infections, so antibacterial treatment is also needed for some patients with severe illness.
Professor Yang Zhanqiu of the Virus Research Institute of Wuhan University Medical Department explained that because the role of the alveoli is to exchange oxygen with the outside world, the virus attacks the lungs of patients with severe diseases in large areas, the loss of alveolar function caused a sharp drop in blood oxygen levels in patients. So many patients need to use oxygen to improve the oxygen supply of the alveoli. Patients with heavier conditions, even the function of inhaling is not, must use artificial ventilators instead of their own breathing.
Zhang Xinmin, director of the Biological Center of the Ministry of Science and Technology of China, said at a press conference of the State Council’s Joint Defense and Control Mechanism on the 15th that effective treatment for seriously ill patients is a key way to reduce the mortality rate. One of the current technical routes is the collection of healing patient seqm plasma for the treatment of seriously ill patients. He says there are a large number of protective antibodies in the plasma of patients in the recovery period that can be used to treat patients with severe illness. Up to now, in Wuhan Jiangxia District First People’s Hospital, Wuhan Jinyintan Hospital and other hospitals for a total of 11 serious patients “plasma treatment”, after treatment clinical symptoms significantly improved, the detection indicators are all-round good, there are no obvious adverse reactions.
Since Wuhan Jinyintan Hospital President Zhang Dingyu said on the 13th, Jinyintan Hospital is carrying out rehabilitation of patients in the recovery period plasma infusion antibody serum, and achieved results, there have been repeated calls in the community to promote this antibody serum on a large scale, and even declared that “the virus has been completely defeated is not far away.” But many of the experts interviewed were cautious. Wang Peiyu said that the use of antibody serum as a medical means has a long history, the human body infected with the virus, their own immune system will produce antibodies against the virus. The serum of the recovered patient is extracted and fed into the patient’s body, which can theoretically play a role.
But she stressed that because the number of rehabilitation patients is limited, and to cure a seriously ill patient, need to be extracted from multiple patients to extract enough antibody serum, objectively decided that this method can not be applied on a large scale, let alone “help the people of the country to fight the virus.” In addition, there are risks of using “plasma therapy” in rehabilitation patients, such as inconsistent serum antibodies in different rehabilitation patients, infections that may contain other potentially dangerous sources in the serum, etc.
In addition to directly using antibody serums in recovered patients, the more commonly used industrial method is to mass produce immunoserums in animals. But Yang Zhanqiu said that animal immunoserosserum may cause allergic reactions in the human body, it will take a certain amount of time to test and verify, if the start of large-scale production will take a considerable amount of time to prepare, and time is the current most scarce.
Huang Bo, a professor in the Department of Immunology at the Beijing Concord Medical College of the Chinese Academy of Medical Sciences, said in an interview with the media that since each infected patient produces more than one antibody, or even as many as 10 kinds, only one can become a neutral antibody, which is the key to preventing the virus from entering the cells. When other antibodies enter the body of a patient who is treated, they may even have adverse reactions to the body. The Pasteur Institute of the Chinese Academy of Sciences in Shanghai also said there was uncertainty about whether “plasma therapy” would cause other problems because of the complex composition of the serum.
Therefore, experts generally agree that “plasma therapy” is a risk, not recommended for patients with light use, but for patients with severe illness, this is a necessary choice, its risk is much less than the benefits. Experts call on new coronary pneumonia practitioners to participate in plasma donation, but also recommended that after two weeks of treatment should participate in the donation, to ensure that the virus in the body has been well removed.
Another technical route for seriously ill patients is stem cell technology, Zhang said. Stem cell therapy suppresses overactivation of the immune system, he says, and promotes endogenous repair by improving the microenvironment, which inhibits the progression of acute inflammation in the lungs and relieves respiratory distress. After strict preclinical safety, effectiveness evaluation, as well as strict quality verification, stem cell products in accordance with the current clinical application norms of stem cells and drug clinical trial regulations on the premise of the treatment of a number of patients with serious illness, but also initially shown to be safe and effective. But experts acknowledge that stem cell therapy is still in the research stage and is a way to explore it. I’d
Why the vaccine has been developed so long
A common scenario in movies is that in the event of an outbreak, scientists can quickly develop targeted vaccines. So after the outbreak of new coronary pneumonia, many people are asking: Why hasn’t special vaccines been produced yet? Yet the reality is brutal. When Chinese and foreign experts talked about the issue, it was generally agreed that the new vaccine was likely to “catch up” before the outbreak of new coronary pneumonia was over.
Zhang Xinmin 15 at the State Council joint defense and control mechanism release revealed that the new coronavirus is a new pathogen, vaccine research and development is relatively difficult, the cycle is relatively long. To ensure early research and development success, we have now arranged a number of technical routes in parallel, including inactivated vaccines, recombinant protein vaccines, nucleic acid vaccines, etc. Some of these vaccine varieties have entered the stage of animal experimentation. But he says the safety of vaccines, a special product for healthy people, comes first. “Vaccine research and development must follow scientific laws and strict management practices, to give researchers a certain amount of time. “
Yan Jinghua, a researcher at the Institute of Microbiology of the Chinese Academy of Sciences, revealed that among the several relevant technical routes of vaccine development, the Chinese Academy of Sciences is undertaking a recombinant protein vaccine. Recombinant protein vaccine is to take out the most effective antigen component gene of a pathogen, perform in vitro recombinant expression protein, and then make a vaccine. The vaccine is progressing very well and is now being tested in animals, as well as safety evaluations. Yan Jinghua stressed that there is no marketed vaccine for coronaviruses in the world, both inexperience and lack of risk assessment of vaccines, so the new coronary pneumonia vaccine is a challenge for researchers. Vaccines are used in healthy people, so safety is a top priority, and hopefully it will be available as soon as possible with the support of all parties, but only if it is safe.
Wang Peiyu explained that the difficulty of vaccine development is mainly that effectiveness and safety must be both. According to reports, the development of new vaccines first need to extract the virus strain, after a number of research centers in China have completed this step at an alarming rate. But this is only the beginning of vaccine development, followed by the cultivation of strains, virus modification, detoxification, animal experiments, human clinical trials, etc. , the whole process usually takes several years. Wang Peiyu said that in order to stimulate the body to produce the corresponding antibodies, the vaccine in many characteristics must be consistent with the virus, but this “very virus-like” vaccine into the human body, in addition to the production of antibodies, will not cause side effects, how safe it is, to be clear. Therefore, in order to test the safety and effectiveness of the vaccine, its clinical trials in particular take time.
Yang Zhanqiu also said that now, the duration of the new coronary pneumonia outbreak should not be too long, during which it is difficult to develop and mass produce new targeted vaccines. Or, by the time the new vaccine is developed, the outbreak has been brought under control. So this time the public may not be able to wait for the vaccine to prevent everyone.
Such assertions have also been endorsed by foreign experts and pharmaceutical companies. The new coronavirus vaccine “is expected to be ready within 18 months, ” Who’s Director-General Tan Desai said at a news conference in Geneva on February 11.
Western pharmaceutical giants’ silence on the new coronary pneumonia vaccine also confirmed from the side of the “new coronary pneumonia vaccine developed may not catch up” speculation. According to reports, GlaxoSmithKline, Mercado, Sanofi and Pfizer four multinational pharmaceutical companies produced vaccines, a total of more than 90% of the global market share. But the BBC noted on the 14th, “the pharmaceutical four” of the new coronary pneumonia vaccine development and production attitude is cold. Some analysts believe that they are worried that if the new coronavirus and the 2003 flash of SARS virus, rapid epidemic and rapid disappearance, developed a vaccine useless, a huge investment will be “water drift”. After the SARS outbreak in 2003, researchers spent about 20 months developing a vaccine that could be used in human trials, but the outbreak was already under control and large-scale clinical trials were not possible. Thus, 17 years after the outbreak, no preventive drugs or vaccines have yet appeared in production. The same is true of merinmost Syndrome (MERS), a massive outbreak in 2013, which killed 2,506 people and 862 people, but has shown little interest in pharmaceutical companies because there have been no large-scale seizures since then. Until now, no specific drugs or vaccines for MERS have been approved, and isolation and treatment remain the only means of controlling the virus.
How the current treatment drug testing is progressing
For the national people most concerned about the progress of clinical trials of the new coronary pneumonia treatment drugs, Zhang Xinmin 15 at the State Council joint prevention and control mechanism launch edm.
Zhang Xinmin said that more than 70,000 drugs or compounds have been screened using computer simulation screening and in vitro enzyme activity testing to select 5,000 potentially effective drug candidates. The active test of the new coronavirus was then tested for the activity of the new coronavirus by using the cells infected with the normal coronavirus. On the basis of multiple rounds of screening, the research team focused on a few drugs such as chloroquine phosphate, redsiewe, fabilave, and so on, and some drugs have shown good clinical efficacy.
He detailed that chloroquine phosphate is a long-listed antimalarial drug, in the safety of a certain degree of protection, in vitro experiments show that the new coronavirus has a good inhibitory effect, is currently in Beijing, Guangdong and other more than a dozen hospitals to carry out clinical research, a total of more than 100 patients into the group. In the near future, Hunan Province will also launch a multi-center clinical trial of chloroquine phosphate. Clinical results show that chloroquine phosphate has a certain therapeutic effect on neo-coronary pneumonia. Fabilawe is an overseas-marketed drug for the treatment of influenza, currently in Shenzhen to carry out clinical trials, the number of patients in the group reached 70, the initial results of the more obvious efficacy and lower adverse reactions. The popular Redsiewe, a drug used to fight Ebola virus infection, has not yet been fully tested in clinical trials abroad. In vitro tests have shown that the drug has better inhibitory and safety effects on the new coronavirus, and it has also achieved successful treatment for a patient in the United States. At present, we are promoting clinical research in more than 10 medical institutions in Wuhan, has been enrolled in 168 cases of serious patients, light, common patients 17 cases.
Wang Peiyu said that because the emergence of the new coronavirus is very sudden, has not yet had time to carry out a deep study of it, so these drugs are mostly from the treatment of other viral diseases of the drug selected. The basic idea is that they are useful for other viruses and may also have an effect on new coronaviruses. Just like antibiotics, since it works for this bacteria, it may also be useful to other bacteria. Because Western medicine has not yet found a particularly effective anti-new coronavirus drugs, so Chinese medicine through some treatment of the disease, including comprehensive conditioning and other means, can also improve symptoms, improve lung function, eliminate inflammation, for patients with mild illness should be able to play a better role.
“When a new virus is discovered, targeted drugs can be found, but this requires a process that can be developed in the short term. Yang Zhanqiu stressed, “And all antiviral drugs have a characteristic: the virus has an effect, but also has a lethal effect on the human body, that is, toxic to the human body.” Therefore, all antiviral drugs have a toxic effect, only to weigh the therapeutic effect and toxic effects which is more conducive to human health. Two-interest power takes its weight, and two evils take its weight. “