One universal antiviral to rule them all?

(cuimc.columbia.edu)

229 points | by breve 10 hours ago ago

84 comments

  • abeppu 8 hours ago

    > When he and his colleagues looked at the individuals’ immune cells, they could see encounters with all sorts of viruses—flu, measles, mumps, chickenpox. But the patients had never reported any overt signs of infection or illness.

    Given that the article goes on to talk about mild persistent inflammation, is it possible that these individuals are sometimes asymptomatic but still capable of carrying/transmitting viruses at least temporarily? The article talks about potentially immunizing healthcare workers during a future pandemic, but if this was just allowing people to never develop symptoms (and not have to leave work) while having low-grade infections, would we accidentally create a work-force of Typhoid Marys?

    • etiam 4 hours ago

      Excellent point, and it seems plausible in my opinion.

      https://www.frontiersin.org/journals/immunology/articles/10....

      • etiam 4 hours ago

        Oh, and it's probably worthwhile pondering what the viruses will do if this mechanism comes into widespread use.

        While I was looking for the reference above this also came up:

        https://www.sciencedaily.com/releases/2020/02/200210144854.h...

        when bat cells quickly release interferon upon infection, other cells quickly wall themselves off. This drives viruses to faster reproduction

        Quite a way from whole-animal physiology in the referenced research, by all means, but it's a fair point, right.

      • echelon 3 hours ago

        Even worse, that type of chronic inflammation might cause premature death. Or cancer. Or other disease states.

        > “In the back of my mind, I kept thinking that if we could produce this type of light immune activation in other people, we could protect them from just about any virus,” Bogunovic says.

        This sounds terrifying. There's a reason our bodies do not regulate like this.

    • thinkingtoilet 2 hours ago

      I would imagine the worker would be wearing protective gear. They're not walking around mask-off. Also, if you know you have gotten this treatment, you would obviously have to take different precautions.

    • devmor 8 hours ago

      I am not a medical expert, but from what I read the last time I saw this being discussed, ISG15 deficiency also causes something called "infernopathy" that leads to inflammation across the entire body. I don't believe it's related to viral activity at all.

      • mapontosevenths 8 hours ago

        From TFA: "We only generate a small amount of these ten proteins, for a very short time, and that leads to much less inflammation than what we see in ISG15-deficient individuals,” Bogunovic says. “But that inflammation is enough to prevent antiviral diseases."

        It seems that the goal is to learn to trigger the benefits, without triggering the bad parts. Which, should probably have been obvious to you without even bothering to read the article.

        • Windchaser 4 hours ago

          The weird thing about this quote: is the inflammation enough to prevent viral diseases, or antiviral diseases?

          • etiam 2 hours ago

            To the extent the disease is due to factors hurting the virus, I guess it's viable as a perspective, but I'd be surprised if it's deliberate in this case.

  • mcculley 5 hours ago

    I always wonder this and maybe people in the comments here know the answer: If humans had the technology to eliminate all viruses on Earth, what would be the outcome? Do viruses keep other bad things in check? Would there be bad consequences if we eliminated all viruses?

    • fritzo 5 hours ago

      The world of viruses is wide and beyond our current understanding. 50 years ago one might have dreamily wondered whether "eliminating all bacteria" would improve the world. Now we know we'd all die quickly without bacteria (e.g. gut biome). I think we're about at that level of understanding today regarding viruses.

    • asdff an hour ago

      Loss of genetic diversity overtime will happen as well as a different path of evolution. Much of what you see on earth today is the result of virus-host interactions shaping evolutionary outcomes. Viruses are capable of providing horizontal inheritance of genetic material.

    • ocfnash 5 hours ago

      Most viruses are bacteriophages, so I imagine bacteria would run wild!

    • Lalabadie 3 hours ago

      Eliminate all viruses: Population issues in other organisms down to bacteria is my guess. We break a link in a significant food chain, basically.

      Eliminate human-tropic viruses: We have to monitor for outbreaks when new viruses mutate and jump species to successfully infect humans. If there's zero mass immunity across the population at every outbreak, we're still in a high-risk situation.

    • Tagbert 2 hours ago

      Viruses kill a lot of bacteria. We might trade viral infection for increased bacterial infections

    • djmips 2 hours ago

      Viruses have had a lot to do with the evolution of life and specifically us, where perhaps our distant ancestors were bestowed with a system of transcribing short term memory into long term memory via the hijacked machinery from a virus. This is only one example that I could remember off the top of my head, there are surely many more. Would that matter going forward? I feel like we'd better be sure that we aren't causing more problems than we are solving.

    • lotsoweiners 5 hours ago

      Population control.

      • aurizon 5 hours ago

        Race/subrace control = malevolent action between races???

        • olddustytrail an hour ago

          Not really. Races don't exist biologically. There are certainly traits within populations but that's a bit like my cousins tend to be fatter than my family. It's not something that can be accurately targeted.

          • lmz 2 minutes ago

            If there was ever a race targeting disease they will exist by definition. Those it inaccurately targets are just not pure-blooded enough.

          • asdff an hour ago

            You'd be surprised. There is quite a bit of polymorphism within the human species that is very much distinguishable per population. E.g. haplogroup analysis or microsatellite analysis is remarkably accurate in this regard due to a lack of interaction between far flung populations until quite recently in human history. Now, does this imply all the bullshit eugenicists and other racists tend to preach about with race? Hell no, social factors are responsible for most of that variance, but to suggest there would be no biomarker for "race" in its colloquial definition as proxy for population of origin is inaccurate.

            This is also why there is a big focus now to seek out underrepresented populations in genetic analysis, because there may be population specific biomarkers that are relevant in disease that you miss if you limit yourself to the handful of widely sequenced homogeneous populations (e.g. there are Utah and Iceland datasets that are popular to use for this).

            • lanstin 16 minutes ago

              What there isn't is a small number of distinct subgroups that are more related to each other than to the other subgroups.

              • asdff 4 minutes ago

                There is, due to the way humans migrated and geographically isolated themselves over human history where founder effect, genetic drift, and evidence for introgression (both within our species and from hybridization with other species of hominids) is easily appreciated among populations even today.

  • Geee 6 hours ago

    It was already invented [0], but the patents were bought by a small company in New Zealand (some kind of big pharma shell company?) who isn't seriously developing it and now appears to be defunct.

    [0] https://en.wikipedia.org/wiki/DRACO

    • carlsborg 5 hours ago

      Both are broad spectrum antivirals, but completely different mechanism.

      DRACO "is a chimeric protein with one domain that binds to viral double stranded RNA (dsRNA) and a second domain that induces apoptosis when two or more DRACOs crosslink on the same dsRNA." (Ridder et al 2011). This article is about packaging mRNA for a set of 10 interferon-stimulated genes that express multiple proteins that target various stages of viral replication.

    • ajmurmann 6 hours ago

      Doesn't sound all the bad from the linked wiki:

      """ In March 2024 Kimer Med announced it has signed a contract valued at up to USD$750,000 (NZD$1.3 million) with Battelle Memorial Institute (Battelle), the world’s largest independent, nonprofit research and development organization. The contract is focused on the discovery and development of new antiviral drug candidates for the treatment of alphaviruses. """

      • forgotpwagain 6 hours ago

        The cynical part of me wonders: if this has been a promising approach for 10+ years, why weren't they able to secure VC funding years ago (or nonprofit biomedical research funding from places like the Gates Foundation that care a lot about infectious disease)?

        • ajmurmann 2 hours ago

          Definitely! However, the parent made it sound like the pharma industry put it in a giant warehouse next to the arch of the covenant

        • Alex3917 6 hours ago

          This. Claims of a universal antiviral are as old as western medicine itself. Literally the only reason anyone knows what the Hippocratic oath is is because Hippocrates was already famous at the time for promoting elderberry as the universal antiviral.

          • abeppu 39 minutes ago

            My understanding is that the _concept_ of a virus wasn't even established until the late 19th century, because we first needed the germ theory, and then we needed to understand bacteria well enough to have a filter whose pores were known to be smaller than bacteria could pass through, but which some _other_ infection agent could still pass through.

            https://en.wikipedia.org/wiki/History_of_virology#Discovery

            Hippocrates could recommend elderberry for a bunch of ailments, but he didn't have the concept of a "universal antiviral".

        • Spooky23 4 hours ago

          There’s alot of promising approaches and investments made.

          The miracle of the mRNA covid vaccine and the use of that framework to treat cancer is a good example.

          As we wind down research in the US, there will be lots of churn as the market finds new approaches to development.

        • codr7 5 hours ago

          Because curing profits isn't really on their priority list at all, it's all virtue posturing.

  • giancarlostoro 9 hours ago

    Wont viruses just adapt and now we've got worse viruses as a result? Isn't this kind of why doctors don't like to prescribe antibiotics too often, because they become ineffective in the long run.

    I'm genuinely asking, I'm a simple software dev not a doctor.

    • thyristan 9 hours ago

      Maybe, maybe not. Antibiotic resistance develops because antibiotics are only somewhat deadly to bacteria, so natural selection can occur and bacteria develop resistance over time. There are some antibiotic/bacteria combinations where this doesn't happen, because the respective antibiotic is so deadly to that special kind of bacteria, that no survivors can pass on their slightly increased resistance.

      And bacteria self-replicate, whereas a virus needs to infect a cell and be reproduced by that cell. Some antiviral mechanisms attack the reproduction proteins that the human cells use, which the virus cannot do without. And the human cells don't have reproductive pressure to replicate viruses, quite the contrary.

      • francisofascii 7 hours ago

        Is a fair analogy, antibiotics kill, whereas antivirals use birth control? So viruses would have to find a way to circumvent the replication inhibitors or potentially find a noval way to replicate.

        • strbean 3 hours ago

          Some classes of antibiotics use birth control - rather than killing bacteria directly, they inhibit reproduction.

          I think the biggest difference is that bacteria can react to a treatment, while viruses don't have the capacity to react. If you've stopped a virus from replicating, it's essentially dead. A bacterium may have defensive measures it can take. It could form an endospore and try to wait things out. If you've stopped it from reproducing, as it ages it might start accumulating free radicals that increase DNA damage, leading to a higher chance of it mutating to resist the antibiotic. Etc.

      • jojobas 2 hours ago

        Antibiotic resistance costs bacteria dearly. The proteins they lose (typically related to cell membrane building) are honed by millions of years of evolution. The resistance mutations end up being inferior, slowing down growth and perhaps other capabilities.

    • kristjank 9 hours ago

      Antibiotics are related to bacteria, which have different mutation mechanisms than viruses. I'm also a tech guy, so someone may correct me. Also, this seems to influence the human end to make protective material, not act on the viruses directly.

      • busyant 9 hours ago

        Viruses can acquire resistance by mutation. This has been well established for decades.

        FWIW, I was trained as a bacterial geneticist and routinely used bacteriophage (viruses that infect bacteria) with various resistance mutations.

        Viral mutations are not restricted to viruses that infect bacteria.

        edit: in fact, fundamental aspects of the genetic code were determined by analyzing and exploiting viral mutations.

        https://en.wikipedia.org/wiki/Crick,_Brenner_et_al._experime...

        • busyant 6 hours ago

          OT: Just replying to myself to ramble a little bit more.

          The Crick, Brenner et al. paper that I cited above

          * studied mutations in a viral gene called "rIIB"

          * the authors used those rIIB mutations to determine that the genetic code was a non-overlapping triplet (now called codons) -- a pretty fundamental discovery.

          * What's amazing to me is that they still have NO IDEA what the rIIB gene actually _does_, mechanistically.

          It's like learning a little bit about God using an enigma machine (sorry, shitty simile).

    • etiam 2 hours ago

      Correct.

      And the really, really bad part about abusing natural parts if the immune system to provoke pathogen resistance against them is that the resistance will target part of natural immunity.

      See also https://news.ycombinator.com/item?id=35700881

    • quotemstr 8 hours ago

      Of course. Given unlimited time, viruses will develop resistance. Resistance = evolution = descent + modification + selection. You can quibble about whether viruses are alive, but they definitely evolve.

      But so what? Anti-pathogen drugs are useful in the period during which resistance hasn't become universal, and if and when it comes a problem, we'll have other drugs.

      Besides: sometimes you get lucky and the virus goes extinct before it can develop resistance (e.g. smallpox)

      • MengerSponge 7 hours ago

        That's not really true. Evolution is constrained by physics, so while bacteria can evolve to live in 100C water, they can't evolve to live in molten magma, or the surface of the sun. Similarly, they can evolve to live off of isopropyl alcohol, but they can't evolve resistance to sufficiently concentrated bleach (sodium hypochlorite).

        • capitainenemo 7 hours ago

          I'm not sure what you consider "sufficiently concentrated" but some existing viruses (which form spores) can already survive a 1% sodium hypochlorite solution cleaning, which is pretty crazy-high. At that point you're risking damage to surfaces/skin. Doesn't seem impossible it could go higher if bleach exposure was consistently selected for.

          • glenstein 5 hours ago

            Surviving in 1% bleach doesn't demonstrate the supremacy of evolution over physical constraints, and it's important to keep the eye on the ball of what this whole point was about. There are circumstances such as the temperature of the Sun, where DNA, or any molecular structure, or even atoms, can't hold together, and so there's no evolutionary pathways that can iterate toward survival. You can't have molecular biology without molecules.

            It's an extreme example, but it demonstrates a fundamental constraint that can't be evolved around. Ideally vaccines can find an equivalent in the space of mechanistic interactions that cut off any evolutionary pathway a virus could reach, either exterminating the virus before it has enough time to complete the search, or by genuinely leaving no pathway even with infinite searching.

            Contrary to what you may have heard from Jeff Goldblum life does not always find a way.

            • capitainenemo 4 hours ago

              Yeah, wasn't disagreeing with fundamental premise, just picking on the bleach bit.

    • aredox 9 hours ago

      1) Viruses don't adapt instantly nor perfectly - that's why viruses can be animal-specific. Influenza (or recently SARS-CoV) are famous because they are malleable enough to adapt to new hosts, human or animal, within a few months or years, but not all viruses have this ability.

      2) To further illustrate, some viruses have been nearly eliminated with a single vaccine. Polio didn't manage to adapt before going almost extinct. And a good reason why is:

      3) Viruses can only evolve inside contaminated hosts. If you find a cure that stops quickly the virus from multiplying and contaminating, you are also curtailing its ability to adapt. A contaminated host is a giant casino machine, allowing the virus to mutate until it hits a new evolutionary step. A strong enough vaccine or treatment is like throwing out the virus before it has time to play much.

      • tialaramex 9 hours ago

        Two viruses have been entirely eliminated in the wild, one (Smallpox) still exists in government research facilities the other (Rinderpest) I believe is just gone because it wasn't useful as a direct weapon (humans aren't affected) and nobody actually wants Rinderpest, it was just killing cattle and while poor farmers need their cattle or they'll starve the rich want to drink milk and eat steak so they weren't keen on this virus either and helped fund its eradication.

      • mschuster91 6 hours ago

        > A contaminated host is a giant casino machine, allowing the virus to mutate until it hits a new evolutionary step.

        And even worse, some viruses can swap genes if a host has multiple infections at a given time. Bats in particular are known as "hot pots".

    • grapesodaaaaa 9 hours ago

      Is it really true that we have “worse” viruses, or that they are adapting to our modern antibiotic regime & reverting to the status quo?

      • XorNot 9 hours ago

        Antibiotics have never killed any viruses ever. They are exclusively for treating bacterial infections (which are generally worse by a lot).

        • tiahura 8 hours ago

          Azithromycin (rhinovirus, influenza A, Zika), clarithromycin (influenza A, rhinovirus), doxycycline (dengue, Zika), minocycline (West Nile), teicoplanin/dalbavancin (Ebola, MERS/SARS-CoV and SARS-CoV-2), rifampin/rifamycins (orthopoxviruses), aminoglycosides (HSV-2, influenza A, Zika), salinomycin/monensin (influenza A/B, coronaviruses incl. SARS-CoV-2), nanchangmycin (Zika, West Nile, dengue, chikungunya), nitroxoline (mpox), and some fluoroquinolones have all shown antiviral properties.

          And no, strep throat is not worse than ebola.

          • bee_rider 7 hours ago

            I think they used “generally” on purpose, to make a general observation. Of course, there exist viral infections that are worse than the most common bacterial ones.

            There’s some ambiguity in their comment because it isn’t obvious what we’re sort of… averaging over, but I think they clearly don’t mean that there no serious viral infections exist.

  • ggm 2 hours ago

    Persisting inflammation is not kind to bodies. All kinds of things could go wrong, and longterm consequences are easy to hypothesise.

    Not saying this isn't worth researching but I'd expect big question marks around risk/reward.

    • GTP an hour ago

      It seems to me that the point is to induce the inflammation only when someone is exposed to a virus or developed a viral infection, not to have a persisting one. Just like you take antibiotics if you get a bacterial infection, but only for the time needed to treat the infection. You don't take antibiotics every day "just in case".

    • andrewflnr 2 hours ago

      I'm guessing the deployment ends up being less mass-population and more "oops, this guy with a viral disease just coughed on me." Though I can easily see long-term, preemptive use being worth the risk for people dealing with, say, ebola patients.

    • jonny_eh 2 hours ago

      Exactly my thought. There must be a reason that evolution didn't auto-optin us to these proteins. Everything is a trade-off. It's possible with the prevalancy of viruses in the modern world that we would, on balance, benefit from a more vigilant immune system.

  • inka 8 hours ago

    And the part where he says people with this mutation are more prone to bacterial infections is not worrying, because…? In a world of more and more antibiotic resistant bacteria, that does not seem like a good trade-off…

    • lotharcable 6 hours ago

      One of the effects of ISG15 deficiency is a disease called "Type I interferonopathy".

      Among the symptoms of this disease includes things like necrotic lesions and severe multi-systemic damages.

      From what I gather the fact that these people are not more susceptible to viral infections was a surprise. Which probably relates to why the doctors in the parent article were investigating its possible anti-viral properties.

    • empath75 7 hours ago

      Probably the issue is microphages being wiped out which allows bacteria to thrive. But you wouldn't take this _all the time_, only when you had a specific viral infection to get rid of.

  • yablak 9 hours ago

    Sounds like the first few scenes of every Zombie movie and TV show ever...

    • oaiey 8 hours ago

      Indeed. Or an Utopia. But sentencing on that is still open

      • jihadjihad 8 hours ago

        I like the turn of phrase "sentencing" here. The jury gave its verdict, guilty as all hell, and now we're ready for the sentencing hearing, Your Honor.

        • IIAOPSW 8 hours ago

          There are things that are wrong and there are things that are crimes and it is up to those on the bench to appreciate the difference.

  • carlsborg 7 hours ago

    Paper appears to be paywalled. It is however an update to this preprint which is available on Biorxiv: "Broad-spectrum RNA antiviral inspired by ISG15-/- deficiency" https://www.biorxiv.org/content/10.1101/2024.06.24.600468v1

    My summary for programmers:

    When you get a viral infection, immune cells make a signalling protein called a IFN-1 (Type I Interferon) cytokine, and this flips a boolean flag to True on a bunch of genes (interferon-stimulated genes or ISGs) that produce a bunch of proteins (hundreds) that control the infection. ISG15 is one of them and its role appears to be to downregulate and to limit the inflammation.

    The paper title refers to a ISG15 deficiency, meaning if you are dificient in ISG15 that inflamation limitation goes away. But the paper is actually about how in people that naturally have a ISG15 deficiency, there is an always-on low level expression of some of these pro-inflamation genes. So they take that as a safe level.

    The did RNA sequencing on experimental ISG15 deficient cells and from heatlhy individuals, identified the mutations, narrowed down to 10 genes (antiviral ones not inhibitors) that in combination significantly inhibited viral replication. They stuck the RNA for such genes in lipid nanoparticles such that they enter host cells, whose ribosomes happily read the RNA like a turing head reads a tape in base 20 and produce proteins encoded by these genes, similar to how the mRNA vaccine works.

    So why not dose with the IFN-I directly? Three referenced papers show its "poorly tolerated with significant side effects" and all those downregulators that get expressed limit the inflammation response.

    Disclaimer: IANAB (not a biologist) corrections might be due..

    • zoeysmithe 6 hours ago

      This is typical of "why not just one drug/treatment" for something big like viruses, cancer, etc.

      I think we'll never have this "one shot," but continue to find tailored treatments for individual conditions. There's no way out of this complexity with "one simple trick," which seems really appealing to the people who determine what gets popular in social media and seemingly politics now. Its just going to be boring and grueling academia and medical trials that are hard for the layperson to understand, hence the important of funding these programs. The recent right-wing election wins and thus a right-wing government cutting all manner of medical grants is supported by the "one weird trick" crowd. Hopefully, the USA will have better leadership in the future to get us back to actual science and to find actual new treatments.

      Already, even on HN, the top comments are conspiracy-culture coded, "but, but this one company bought the patent and disappeared with it!" Sigh.

  • vprcic 9 hours ago

    The prospect of being able to use this against viruses like the one causing rabies is pretty exciting!

    • account42 8 hours ago

      Don't we already have treatments for the rabies virus but the problem is that it's too late once the virus gets to the central nervous system which is when symptoms show? How would this new antiviral be different?

      • throw73738484 5 hours ago

        Problem are antivaxerz who refuse to treat and test dogs! They prefer random street dogs over children !

      • lotharcable 6 hours ago

        Rabies anti-virus require very carefully handling and refrigeration and thus can be extremely expensive for hospitals to keep in stock.

        And, yes, it needs to be applied before symptoms start to appear. Otherwise death is almost for certain.

        I doubt this research will lead directly to a better vaccine, but having a better vaccine could save a lot of lives.

  • pelorat 4 hours ago

    I don't think this is a good idea.

  • user214412412 20 minutes ago

    rfk gonna ban hammer this so fast

  • tovej 9 hours ago

    Interesting, and potentially very good. But I can't help but wonder, like at least one other commenter, that this might have unexpected effects if applied at a larger scale. I know some viruses kill bacteria for instance. I don't know, something about universal applicability makes me a little uneasy.

    • XorNot 9 hours ago

      Bacteriophages don't infect things which aren't bacteria.

      In fact they're so absurdly specific that while you could bathe in a solution of them and not get sick, they also frequently fail to infect slightly different members of the same species, which is why ultimately they never become antibiotic alternatives: having the right one on hand ranges from difficult to impossible.

      • unddoch an hour ago

        Yes, some phages are very specific - but not all of them! And we're slowly getting better at this: https://www.nature.com/articles/s41564-024-01832-5

      • tovej 6 hours ago

        Are you saying that this antiviral would not kill bacteriophages? Or are you saying you think the effect would be small because the population in our bodies is small?

    • throw73738484 5 hours ago

      It is well established vaccines are totally safe and have zero to neglected side effects!

  • hyperliner 7 hours ago

    What is the “current” scientifically approved and unbiased understanding about the negative effects of the COVID vaccines?

    There seems to be a lot of information, misinformation, conspiracy theories, and information hiding at least in the perception, if not in reality.

    I cannot imagine what society at large will have to deal with or what the reaction will be for or against an “everything” therapy, given what happened with Covid.

    • estearum 5 hours ago

      The current understanding is that you're 15 to 20 times more likely to suffer severe eye damage from taking Viagra than even the highest risk group (young men) is to encounter a serious adverse effect from the COVID vaccine.

      The information has not changed dramatically since a few months after its release, and the myocarditis risk was not detected in clinical trials because it is an unbelievably rare event. Detecting it would've required trials orders of magnitude larger than any clinical trial ever.

    • lawlessone 5 hours ago

      >about the negative effects of the COVID vaccines?

      The biggest negative effect is i've been hearing "you'll be dead in six months from this vaccine" for about 5 years now.

      It's been 5 years. have you nothing else going on in your life?

  • quotemstr 8 hours ago

    Broad-based inflammation delivered by lipid nanoparticle chock full of mRNA: what could possibly go wrong? I'll stick with monoclonal antibodies, thanks.

    Oh, and here's what the ISG15 deficiency (the condition these mRNAs are there to simulate) does:

    > Patients present...with infectious, neurologic or dermatologic features. Basal ganglia calcification is observed in all patients... The basal ganglia calcifications may cause epileptic seizures... The IFN-I inflammation may also manifest early in life as ulcerative skin lesions in the armpit, groin and neck regions. Finally, ISG15-deficiency leads to mendelian susceptibility to mycobacterial disease... [t]hese infections present as fistulizing lymphadenopathies and respiratory symptoms following BCG vaccination.

    Yeah, about those antiviral superpowers...