Cuba Might Have the Best COVID Antiviral Yet
It’s The Masters vs Team Corona; Team Corona's interception, first down at the 50 yard line. Team Corona is fast & wily, but The Masters, all over 60, have a plan, a code of whistles they call interferon. Huddles break, the defensive line takes their positions, Team Corona spreads out across the field; it’s not clear whether they even have a quarterback! As mist rises from the field The Masters tackle, Clayton, notices the ball is gone; the hike has already occurred! He puckers to whistle in interferon, but his lips are dry and he can’t get it out. As he wets his lips to try again a safety, Lung, calls out “over here!” The defensive linemen turn, rush in Lung’s direction, and all collide. By the time The Masters have extracted themselves, Team Corona is in the end zone setting up the next play.
The relationship between interferons and other cytokines in people's early reaction to SARS-COV-2 infection is not in the ratio expected of a healthy immune response, implying that interferon levels are being suppressed by the virus, either actively or by stealth, especially in older individuals.
Against a background of no deaths and no new critical cases for thirteen days, a group of prominent Cuban scientists discussed the epidemiology of COVID-19 and the treatments that proved effective. Their comments indicate the importance of early testing and the drug that Cuba has found to work in treating carriers of the virus.
Speaking on the Cuban flagship television and radio program Mesa Redonda, Dr. María Guadalupe Guzmán, Head of Research at the Pedro Kourí Institute of Tropical Medicine, said that the viral load was high in both symptomatic and asymptomatic individuals who had just tested SARS-COV-2 positive.
Cuban tests indicated that the while the infection normally became apparent after five to seven days, there were significant variations in some individuals tested. A number, she said, remained asymptomatic for much longer periods leading to them being discharged after testing even though they were carriers of the virus.
Speaking about treatments, the Director of Biomedical Research at the Centre for Genetic Engineering and Biotechnology (CIGB), Dr. Gerardo Guillén, said that one very important decision that had been taken was to introduce Interferon alfa-2b very early in Cuban treatment protocols due to the evidence of its antiviral and immune-enhancing capacity. Clinical studies “carried out with extreme speed during the epidemic itself” compared the effectiveness of an Interferon alfa-2b treatment, to a combined application of Interferon alfa-2b and Interferon gamma (HeberFERON). Studies showed, he said, that after starting treatment with Interferon alfa-2b, 50% of those treated tested negative for the virus on the fifth day. When treated with HeberFERON, 50% of patients took only three days to test negative. This led the medical team to accelerate the taking of PCR samples in June and July, testing on the first day. Subsequent PCR samples were then taken on the ninth and tenth day to confirm and discharge a patient if the result was negative.
In the human body interferon gamma is produced by white blood cells, while alpha and beta interferons are produced by infected cells of other types. Based on research carried out with China, it was decided not to treat asymptomatic cases with chloroquine, but only with interferon. “Interferon alfa-2b was given to asymptomatic patients who did not have comorbidities, and HeberFERON was given to those who did have it.” Guillén said that in Cuba, asymptomatic patients were also treated because those without symptoms had a high capacity to reproduce the virus. This decision, he said, influenced the speed at which Cuba had been able to control the spread of the virus.
Cuba has seven institutions dedicated to COVID-19 research. Four new laboratories are planned for Ciego de Ávila, Holguín, Matanzas and the Isle of Youth to improve surveillance of COVID-19 as well as other diseases.
REFERENCES
Interferons in the human body and the cells that produce them:
https://pubmed.ncbi.nlm.nih.gov/11256746/
List of interferons:
https://www.medicinenet.com/interferon/article.htm#what_are_the_available_interferons
Peginterferon lambda, an additional investigational agent:
Washington Post story on interferons:
https://www.washingtonpost.com/science/2020/08/31/interferons-coronavirus-immune-boost/
These studies are cited by the article above:
https://science.sciencemag.org/content/369/6504/718
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7227586/
An additional paper of interest:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7255347/
Including this notable graphic:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7255347/figure/fig2/
Paper author Akiko Iwasaki's lecture:
https://www.mskcc.org/videos/science-spotlight-lecture-akiko-iwasaki-phd
US Clinical Trials involving Interferons
Outpatients:
https://clinicaltrials.gov/ct2/show/NCT04331899
https://clinicaltrials.gov/ct2/show/NCT04344600
https://clinicaltrials.gov/ct2/show/NCT04379518 (cancer patients)
Hospitalized patients:
https://clinicaltrials.gov/ct2/show/NCT04492475
https://clinicaltrials.gov/ct2/show/NCT04388709
HeberFERON is a Cuban brand of combination interferon alpha-2b and interferon-gamma. It’s notable that in the human body interferon-gamma is produced by white blood cells, while alpha and beta interferons are produced by infected cells of other types. It may also be possible to use lectin to stimulate interferon production.