Treating Covid-19: Antibiotics, Antibodies, Vaccines

Treating Corona Virus

The Story of Antibiotics, Antibodies, Biologics and Vaccines.

The medical establishment is racing to find a cure for the corona virus or to at least find ways to lessen its impact and to prevent another epidemic next year.

During the extensive coverage of the corona virus pandemic, we are hearing much talk about Antibiotics, Biologics, and Vaccines. Let’s take a closer look at these modalities.

Antibiotics are drugs that work against organisms such as bacteria, viruses and fungi and are referred to as antibacterial, antiviral or antifungal respectively.

Antibacterial Antibiotics: A well-known example of an antibacterial antibiotics is penicillin.

Antifungal Antibiotics: Many of us have used these for fungal infection of the feet such as the athlete’s foot.

Antiviral Antibiotics: The patients with AIDS are treated with antiviral drugs that target the HIV (human immunodeficiency virus). The antiviral antibiotics often work by interfering with important enzymes (such as proteases) that are needed by viruses to grow and replicate.

Most of the antibiotics are made by mixing various chemicals and are classified based on either their chemical structure or the types of germs they kill. In order to kill the germs, these drugs act by blocking their metabolic functions, by disrupting the membrane of the organisms or simply by being toxic to the germs.

At present, we do not have any anti-viral antibiotics for coronavirus, but research is on full speed. Since we do have FDA approved antiviral drugs that work against HIV, clinical trials are being conducted to see if any of these or similar antiviral drugs will work against the corona virus. The report of one such study was just published yesterday—March 18, 2020. Here is the link:

https://www.nejm.org/doi/full/10.1056/NEJMoa2001282

There are reports from France of some benefit of the anti-malarial drug chloroquine. The US FDA has initiated safety and dose finding trials. It is a prescription drug with its own side effects; and should not be taken for Covid-19 illness without a knowledgeable physician's supervision.

Biologics are a new category of drugs used for killing germs. These are not made by mixing chemicals, rather are manufactured by using living organisms and ingredients.

The drug development of the biologics has been accelerated by the recent advancements in technology and genomics. Just like the microscope revolutionized bacteriology, the genomic science has changed how we develop biologic drugs.

To understand that, think of the living cell as a small factory. The factory has many doors that are locked. Each lock has its own special key. Inside, the machinery is humming along, making products as ordered. Supplies, raw material and power supply come in through separate doors. In biological terms, these locked doors are known as “receptors”. Each receptor (locked door) needs a special key (called ligand) to activate and open it. Once the receptor is activated (door is unlocked) with the right key (ligand), the molecular signal tells the machine what to make.

In the case of corona virus, let’s say a specific door (receptor) is programmed to ramp up the duplication of millions of new coronaviruses. Once that receptor is activated (unlocked), virus’s machinery starts making baby viruses. Millions on them.

Back to the example of the cell factory: Once we have identified the particular receptors (locked doors) on the surface of the coronavirus, we can develop drugs that can prevent the activation of receptors ( unlocking the doors) and intercept the process of virus duplication at various points of its metabolism

For example, we can make a fake key that enters the keyhole but cannot open the lock. That prevents the real key (ligand) from unlocking and activating the receptor. We can gum up the surface of the receptor with small protein molecule so that key cannot insert itself into the keyhole of the lock (receptor). These are just two examples of the many other molecular ways by which the receptor activation can be blocked.

Monoclonal Antibodies:
Monoclonal antibodies are another form of biologic agents used to treat disease. Antibodies are proteins made by special cells in the body when invaded by germs. After an individual fully recovers from the coronavirus infection, some of these cells are taken from the blood, purified and then grow them in the laboratory. Once a critical mass of cells have been achieved, they are challenged by the coronavirus genome to stimulate them to make the anti-coronavirus antibodies. These antibodies called monoclonal antibodies, because these are specific for the coronavirus are then used to treat infected patients. The process is cumbersome, and it takes time to prepare such monoclonal antibodies.

Vaccines, such as flu vaccine or the polio vaccine, do not cure those who are already infected. They are preventive and protect us from catching specific viral illnesses in the future. The coronavirus vaccine when developed, will protect us if the virus comes around next winter.

I join my family and friends to pray that you, your community, our community and all of us remain safe and suffer none or as little harm as possible from the corona virus. Amen