MBW labb Foto: Niklas Björling
MBW lab Photo: Niklas Björling

 

Anna-Lena Spetz Foto: Ludwig Holmgren
Anna-Lena Spetz
Photo: Ludwig Holmgren

Experience of viruses

Anna-Lena Spetz is a professor of immunology at the Department of Molecular Biology, Wenner-Gren Institute, Stockholm University. She has a long experience working with viruses such as HIV, swine flu and RSV.
"I have been concerned that something like this could happen since the swine flu outbreak in 2009", she says.

Why are the effects of this particular virus so serious?

“What makes SARS-CoV-2 special is that it’s a new type of virus for which the majority of the population has no immunity. Viruses always need to attach to cells in order to enter and use them as virus factories. More research is needed to understand why SARS-CoV-2 spreads so easily and there are many factors that should be taken into account such as:

  • Data shows, for example, that SARS-CoV-2 is very good at attaching to cells in the airways compared with SARS-CoV from the 2012 outbreak, which may have affected transmission.
  • Another cause of the wide dissemination can be that many people have rather mild symptoms when they are infected with SARS-CoV-2, so the risk is greater that the infection will spread further. We need more knowledge about how many actually had these mild symptoms and how long they remain infectious.
  • A third factor that impacts transmission is how long the virus remains contagious, i.e. “viable”, on surfaces where it can continue to spread. It’s also important to know the amount of viable virus that’s required to transmit the infection.

Many viral outbreaks appear when a viral infection is transferred from animals to humans.

Why does the virus transfer from animals to humans?

"Animals in nature carry many different viruses that have not yet been transferred to humans and caused pandemics. When infected animals and humans are in close contact there’s a risk of transmission. But for transmission to take place the virus must change its genetic material (mutate) and adapt to the receptors on human cells, in the worst-case scenario, this mutated virus can cause an infection in the new host."

"A good advice is to use gloves when you clean your summer house attic or storage areas. You should also wear gloves when handling sick or dead birds, mice or bats, and as always wash hands before cooking and eating."

What will you do with the EC grant within "Fight-nCoV"?

"We will set up a system in the lab to identify potential medicines that have the capacity to hinder SARS-CoV-2 from multiplying, i.e. demonstrate an antiviral effect. The next step is to evaluate the compounds in animals, to measure the antiviral effect using doses that do not serious side effects."

How quickly can something be produced that can slow down COVID-19?

"Right now there are many parallel studies in the world to produce a medicine to fight COVID-19. They are in different phases, but many have gotten to the stage where they test the efficacy  in patients who would receive the treatment, called phase 3 clinical trials."

"In China and the US there are a number of phase 3 studies of medicines that were developed for other diseases like Ebola, and are now being “re-purposed” because they were proved to have anti-SARS-CoV-2 activity in the lab. Results from these studies are expected during April or May 2020. The WHO is leading a large study where many different medicines will be compared."

What do you think the “Fight-nCoV” project will lead to?

"The goal is to identify a compound or a combination of compounds that have the ability to inhibit SARS-CoV-2. Our goal is that the treatment we develop can be effective also against other respiratory viruses."

"The medicines we work with are meant to hinder the virus from entering the cell. The ‘gates’ that respiratory viruses use to enter the cell is often shared by several types of viruses. Our goal is to "stop the virus at the gate". By arresting a step in the viral lifecycle, which is shared by many different viruses we can develop broad spectrum antiviral medicines. Our vision is that we can have broad spectrum antivirals at hand before the next time a virus transfers from animals to humans in order to put an early stop to the outbreak of a larger pandemic."

 

MBW labb Foto: Niklas Björling
MBW lab Photo: Niklas Björling

 

Phases of pharmaceutical development:

  1. Before a medicine can be approved it must first be evaulated in phase 1 clinical trials, with a small number of voluntary subjects. Phase 1 studies focus on safety and adjusting the dose.
  2. After phase 1, phase 2 clinical studies can begin. A larger number of voluntary patients are involved. The goal of phase 2 is to get an indication that the medicine is effective and appropriately safe.
  3. Before the medicine can be approved it goes through phase 3 clinical studies, to provide evidence that the medicine is effective in the target patient group. An inventory of potential side effects is also done.
  4. When the product goes to market the process continues with phase 4 studies which catalogue unusual side effects and oversee the treatment’s safety, effectiveness and optimal use.

 

Project: “Fight-nCoV”

In January the European Commission announced research grants, totally ten million euros, to meet the need for research on COVID-19 vaccine development, treatment and diagnostics. Because of the acute need for new knowledge, an additional 37.5 million euros was released and 17 projects with 136 research teams have been chosen.

The project "Fight-nCoV" in which Stockholm University is participating received 2.8 million euros from the EC to develop a new type of antiviral treatment effective against the new corona virus.

"Fight-nCoV" is expected to last two years and builds on many years of earlier research. Research teams in Germany, Denmark, France and Sweden are collaborating to test potential medicines that would be effective against the new corona virus SARS-CoV-2 which causes the COVID-19 illness.