Some good news on the Covid treatment front. Cytokine therapy trials, for mild and moderate symptoms in asymptomatic individuals and early-stage symptomatic Covid-19 infections, will begin from Monday. Though approvals are awaited, doctors are optimistic
Starting Monday, HCG Cancer Centre will start conducting cytokine therapy trial on humans, which can treat patients with mild to moderate Covid-19 infection. Cytokines are cell signalling molecules that activate immune response and direct movement of cells towards the infection/inflammation site. The therapy involves injecting this cocktail of chemicals into patients with compromised immune systems. Doctors expect the cytokines to activate the immune response in Covid-19 patients. At least 10 people have volunteered and pre-screening is currently going on at HCG. Dr US Vishal Rao, regional director of head and neck surgical oncology and robotic surgery, HCG Cancer Centre, explains the mechanics of the therapy.
Why cytokines? How do they help?We found that children with immature immune system recover very well from Covid-19 infection and tend to have milder symptoms; but those in the 65+ age bracket with a more mature immune system are at higher risk. A logical explanation to this could be the active thymus gland which is well developed in children in the mothers womb itself and gets active soon after birth. In the age group 65-plus, the thymus has degenerated.
Most people who are dying (due to Covid-19) are dying between the 8th and the 27th day (of the infection). This is because in the initial days the body has some reserve cells to fight the virus (innate immunity).
But by the 5th to 7th day, they need to start recruiting new people in this fight, for which they need the thymus. But in the 65+ age group, the thymus degenerates because the body says I have seen all the viruses I need to. So we went back to our labs and started finding out how to activate this immunity (active immunity).
Dr Jyothsna, who has worked with a Nobel Prize winner and has had a great experience with Rockefeller, and Dr Gururaj, a cell biologist with immense knowledge of these procedures, are working on this cytokine therapy.
How do you extract cytokines?We take 2ml of blood from healthy individuals and get a buffy coat (the froth generated when the blood is spun at a high velocity) full of thymic cells. We take the buffy coat and identify the specific thymus cells which are active in the immune system. We then simulate a virus attack on these cells in the laboratory. Due to this, the cells start secreting these special hormones called cytokines.
What next?There are four to five cytokines and one among them is the interferon. The word interferon means to interfere; so, when a cell is dying due to the virus, it releases interferons which are called messenger proteins. These messenger proteins quickly reach out to the neighbouring cells and inform them that there is an impending viral attack, so please get prepared.
When this happens, several other cells start getting ready with the anti-viral engine in their own blood cell machinery which will kill the virus, whenever it infects this cell.
So what did you create?We created a concoction of cytokines which we believe will reactivate the immune system completely when the virus is about to enter and attack (the system) and not at the terminal stage.
Who all can benefit from this therapy?It can be given to a Covid-19 patients primary contacts, or someone who is developing cough or cold (due to the infection). If you inject the cytokines, their immune system will be reactivated to such a level that when the virus attacks, their body will be prepared significantly to fight back. What we have done is given the body a special power to kill the virus.
How is it different from a vaccine?Vaccines prevent normal individuals from contracting the virus. Here we are trying to help people infected by the virus to kill the virus by reactivating the immune system. Will this therapy prevent viral infection again? We still do not know.The experiment on animals is successful. We wanted to see whether the animal was going to get a cytokine storm.
Cytokine storm? Whats that?Covid-19 patients who are terminally ill go through a storm, where the immune system becomes hyperactive. At this juncture, if interferons were to be given when the person is dying, the system is already releasing so many immune cells and the cells are fighting and there are multiple reactions happening. This is when the immune system gets frustrated. Then, these interferons which went to contact the thymus cells are getting surplus of the immunity and that is when it starts a storm.
In the second stage - a stage of severe illness we need to prepare the patient with plasma when the patient shows breathlessness and is not on a ventilator.
In the last stepwhen the person is on the ventilator we believe the mesenchymal stem cells are one of the best therapy and China has already given results and we are waiting for the approvals. They are doing it in the US too.
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