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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. 

Bengaluru, Apr 30: The Karnataka government on Thursday decided to allow migrant workers, tourists, students and others stranded in different parts of the state due to the ongoing lockdown to return to their native places, a day after the Centre issued guidelines for the process.

This will be a one-time movement and the government would arrange buses for those in need but they should bear the expenses, Law and Parliamentary Affairs Minister J C Madhuswamy said. He also said people willing to return to the state would have to undergo tests for COVID-19. The decision was taken at the state cabinet meet and it might come into effect from Friday as the Chief Secretary will have to issue an official order, he said.

"Prime Minister Narendra Modi had taken decision on movement of people and the Centre had issued a circular in this regard. Following this we have decided to permit interstate and inter-district movement," he told reporters here.

Travel expenses should be borne by those willing to return and if they want the government can provide buses from the state transport corporations. The Union Ministry of Home Affairs on Wednesday issued orders allowing migrant workers, tourists, students and other people stranded in different parts of the country to move to their respective destinations with certain conditions, giving a big relief to the distressed people. Decision on opening of salons and liquor shops will be taken after May 3, he said.

Madhuswamy said permission would be given for one-time movement of labourers and others who want to go from one district to other for work or any other purpose. Those operating industry or establishment and want to move from place to place for management purpose will be given passes with strict scrutiny and through checks.

Responding to a question, the minister said, "we don't know yet how many are willing to go, where they will go, if some one asks for permission, we will permit." "One family or two or three people want to go, they can use taxi. If too many people want to go, we will provide facility through transport corporation buses," he said.

Mangaluru, Jun 12: A pregnant woman who returned from Maharashtra and tested positive for coronavirus on Wednesday, gave birth to a child at the Wenlock COVID-19 hospital in Mangaluru. After she experienced labour pain, a team of expert doctors performed the delivery through the caesarean section on Thursday.

Both the woman and the new born are safe, hospital sources said. The woman, who belongs to Kinnigoli in Dakshina Kannada district, had arrived in the city on Monday. She was in an advanced stage of pregnancy and was taken to another hospital the next day after she complained of weakness.

As she came from Maharashtra, she was shifted to a separate ward at the Wenlock hospital and quarantined. Her throat swab samples tested positive on Wednesday. A COVID-19 test will be done on the baby after a few days, district health officer Ramachandra Bairy said.