Bengaluru, Mar 28: Sun Tsu, in 'The Art of War' speaks of a skilful general who can subdue his enemy without any fighting. This constitutes the ultimate triumph which is referred to as stratagem. Today, we would need one such when we are faced with the '21-day corona challenge' for India.
Nearly four weeks back, Dr Jyothsna Rao, Dr Gururaj Rao and I sat across the OPD in the afternoon at HCG Bengaluru discussing our ongoing cancer immunology research. While on this topic, we drifted into the discussion on the coronavirus. During this engaging discussion, we wondered the similarity of the enigma between the virus and cancer. I paused to ask Dr Jyothsna and Dr Guru - how we wish we could do something against this virus.
Dr Jyothsna is a PhD from NCBS and had worked under Dr Ralph Steinman, physician and researcher from Rockefeller University, who won the Nobel Prize for his discovery of the dendritic cell and its role in adaptive immunity in 2011. Dr Gururaj is a molecular and cell biologist who did his PhD at the Chapel Hill, University of North Carolina and is the Director of iCrest.
Jyothsna while hearing our perplexing conversation on the covid intervened, "Yes, surely. I think we should take a break from cancer and focus on the innate and adaptive immunity role in COVID-19."
Thus began this sincere attempt to relook the human immune system from the eyes of the COVID-19.
We have 10 types of immune cells at the least which are widely dispersed in millions across the body. When our body is invaded by a foreign organism (bacteria, fungi or virus), these cells work with each other to destroy the invader.
Now, the question is - how do the immune cells talk to each other? They use small-molecule substances called cytokines (cyto means cells; kine means movement). There are many cytokines that are involved in work on the immune system. The most relevant for viruses are interferons.
Interferons (IFN) as the name reflects have an ability to interfere with the viral activity and stop their multiplication. These specialised signal proteins are released by our cells in response to a viral attack to forewarn other cells. They help build the antiviral proteins within the cells to kill the virus as it tries to invade the new cells.
Historically, interferons are a group of cytokines known to be potent antiviral agents against viruses and a hallmark cytokine induced by the host upon viral infections. Interferons possess unique immunoregulatory activities and are signature cytokines released by (TH1) T immune cells, which are crucial in viral infections.
As the outbreak of COVID-19 grapples us, an urgent need for finding strategies to combat the virus is growing. Coronaviruses (CoVs) are a group of RNA viruses. In patients infected with coronavirus, it was indicated that the activation of the IFN does not occur until 48 hours post-infection. Thus the delayed IFN-related antiviral response by the healthy cells leads to coronavirus evade the immune response.
Numerous studies have presented the success in defeating CoVs by the direct administration of IFNs. In a combination as a concoction, it was shown to synergistically inhibit the virus replication in vitro.
Moreover, it is understood that the earlier induction of IFNs in children although they have a less developed immune system could be the reason behind the children being least affected.
The key to success in reducing the disease fatality might be the stimulation of the immune responses to trigger IFN production at the very early stages of the disease, which might be done through the administration of IFN. Despite the evidence for the efficacy of IFNs in treating CoV-induced infections, the proper dosing and ideal timing for such interventions needs to be verified in clinical trials.
For the later stages of the diseases in advance stages where patients are on ventilator and have developed respiratory distress, we propose to utilise the mesenchymal cells derived from donor bone marrow that have been known to treat acute respiratory syndrome. Mesenchymal cells are known to possess anti-inflammatory activity and thus used often in autoimmune diseases.
With this scientific background, we have activated T cells from healthy donors, in a cGMP facility at iCrest - HCG hospital with an enriched cocktail of cytokines rich in Interferons. Injections of this cocktail we believe will result in a surge of cytokines in the body of the infected person and will boost his ability to fight the virus in the early phases. We are in the initial phases of this study and hope to be ready in the coming weeks with meaningful data on its potential utility.
Currently, it awaits government approvals (Union and state) and we have applied to central drugs authority for their initial evaluation and further directions.
As my Guru often expounded the philosophy of 'Seva' - the goal of education is knowledge, the end goal of knowledge is service. In this attempt to serve our fellow humans at this brink of unprecedented crisis, medical fraternity stands with you and promises to do our best for your safety.
We assure to exhaust every bit of our spirit in this fight against coronavirus. We have lost the sight of shores and travelled thus far, but that is the mandatory first step to cross the ocean. Are we going to succeed in this battle, is something only time will answer.
Comments
The actual FACT is during Independence and Partition of India & Pakistan, British as usual left a piece of land so that there will be no peace between India & Pakistan (in-case if they join Hands they will become Super Power of the World). The only solution for Peace to Prevail is leave Kashmir to their people. Let them decide which part of Kashmir they want to stay, make partition, I know this won't be done as for political GAINS, Let the families of Politician start living in Kashmir and feel how it is to lose a loved ones. Just by blaming Pundits and Muslims wont work. Killing innocent people by either side is just to brainwash the Public and to keep the rivalry alive on the basis of religion and country.
Malala , you have yourself experienced how inhuman and ruthlessly atrocious Pakistan Government is. As they manipulated you and your family’s circumstances to harass, they are exploiting and manipulating India’s freeness and all-inclusiveness to keep Kashmir and its denizens in constant turmoil to get pleasure from other’s pain. They are doing same to Baluchistanis since partition and the Kashmiries of Pakistan held area are extremely unhappy and are in totters due to this policy of Pakistan.
Its Pakistan's fault not Indians....Pakistan should stop sending terrorists to India ...which is not happening at all....that is why Kashmiris suffering around there...
Malala should advise Pakistan government first not to involve with our domestic problems....
It is good for Kashmiris if they stay with India as far as their security and economic developments are concerned...
True that Malala has suffered beyond our imagination and came out of it bravely. But that doesn't make her an expert in everything.
Dear Malala, Can you please talk about the inhumanity and heartbreak in Pakistan-occupied Balochistan?
Malala Request you to please stay peaceful and stay happy and not say things that don't fit into ur vocab pls.
I didn't really used to like her but now my respect for her has gone up a lot.
Do you live in delusional world..what should paramilitary forces do if someone is breaking law and order of any country
Lets hope this time her voice will be heard as she has won Noble Prize for PEACE. Lets wish that India will keep Human Life above her EGO and will look Kashmir with HUMAN eye before there is no solution left
Dear Malala, Surely New Delhi government and Kashmiri people need to work together. Your concern is respected.
India in committing a genocide in Kashmir by killing innocent people SC must take notice of this.
As much as I admire Malala, I hate to see her get into Politics and Indo-Pak disputes. There are enough noises being made, or have been made, to no end.
please advise the kids to stop pelting stones and focus on studies to snatch the opportunities from rapidly growing Indian economy.
Thank you Malala for raising your voice in our support.
Since you are an influential opinion maker, I hope the world listen to you and stop the perpetrator from committing these atrocities against us.
Malalaji, Welcome to politics.
Dear Malala we respect you. But it is not government of India or Pakistan decide the future of Kashmir. There are some third parties who really want disturbance or conflict in the valley.
Trolls across the border always loved everything Malala spoke about. I hope they do the same now and accept stark reality!
Thank You Malala, for your kind words and care about Kashmiris
She is a teenage girl with little understanding of the dynamics of terrorism inspite of being a victim of it herself. The valley has been infected by the terror virus with religion which drove away the natural inhabitants of Pandits from Kashmir being hounded from mosque sermons. Many got murdered and not so lucky to escape. No one thought of their rights, now a generation has spent the life as refugee. Neither India nor local Kashmir government or the world body cares to it. However Pakistan terror export looks working well, but it is always the civilian who pays the price.
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