Companies looking to use mRNA to treat cystic fibrosis include ReCode Therapeutics, Arcturus Therapeutics, and Moderna and Vertex Pharmaceuticals, which are collaborating. The companies' goal is to correct a fundamental defect in cystic fibrosis, a mutated protein.
Rather than replace the protein itself, scientists plan to deliver mRNA that would instruct the body to make the normal, healthy version of the protein, said David Lockhart, ReCode's president and chief science officer.
None of these drugs is in clinical trials yet.
That leaves patients such as Nicholas Kelly waiting for better treatment options.
"Nobody wants to be hospitalized," said Kelly, who lives in Cleveland. "If something could decrease my symptoms even 10%, I would try it."
Predicting Which Covid Patients Are Most Likely to Die
Likewise, funding for AIDS research has benefited patients with a variety of diseases, said Dr. Carlos del Rio, a professor of infectious diseases at Emory University School of Medicine. Studies of HIV led to the development of better drugs for hepatitis C and cytomegalovirus, or CMV; paved the way for successful immunotherapies in cancer; and speeded the development of covid vaccines.
"We never dreamed we could have a PCR test that could be done anywhere but a lab," James said. "Now we can do them at a patient's bedside in rural Oklahoma. That could help us with rapid testing for other diseases."
The discovery of interferon-targeting antibodies "certainly changed my way of thinking at a broad level," said E. John Wherry, director of the University of Pennsylvania's Institute for Immunology, who was not involved in the studies. "This is a paradigm shift in immunology and in covid."
The discovery "goes far beyond the impact of covid-19," Michelson said. "These findings may have implications in treating patients with other infectious diseases" such as the flu.
Bastard and colleagues have also found that one-third of patients with dangerous reactions to yellow fever have autoantibodies against interferon.
International research teams are now looking for such autoantibodies in patients hospitalized by other viral infections, including chickenpox, influenza, measles, respiratory syncytial virus, and others.
Overturning Dogma
Today it's clear that the coronavirus and all respiratory viruses spread through a combination of droplets and aerosols, said Dr. Michael Klompas, a professor at Harvard Medical School and infectious disease doctor.
"It's not either/or," Klompas said. "We've created this artificial dichotomy about how we think about these viruses. But we always put out a mixture of both" when we breathe, cough, and sneeze.
Knowing that respiratory viruses commonly spread through the air is important because it can help health agencies protect the public. For example, high-quality masks, such as N95 respirators, offer much better protection against airborne viruses than cloth masks or surgical masks. Improving ventilation, so that the air in a room is completely replaced at least four to six times an hour, is another important way to control airborne viruses.
Still, Klompas said, there's no guarantee that the country will handle the next outbreak any better than this one. "Will we do a better job fighting influenza because of what we've learned?" Klompas said. "I hope so, but I'm not holding my breath."
Fighting Chronic Disease
Lauren Nichols, 32, remembers exactly when she developed her first covid symptoms: March 10, 2020.
It was the beginning of an illness that has plagued her for nearly two years, with no end in sight. Although Nichols was healthy before developing what has become known as "long covid," she deals with dizziness, headaches, and debilitating fatigue, which gets markedly worse after exercise. She has had shingles a painful rash caused by the reactivation of the chickenpox virus four times since her covid infection.
In fact, research suggests that "the two conditions are one and the same," said Dr. Avindra Nath, clinical director of the National Institute of Neurological Disorders and Stroke, part of the National Institutes of Health. The main difference is that people with long covid know which virus caused their illness, while the precise virus behind most cases of chronic fatigue is unknown, Nath said.
"Anything that shows promise in long covid will be immediately trialed in ME/CFS," said Jarred Younger, director of the Neuroinflammation, Pain and Fatigue Laboratory at the University of Alabama-Birmingham.
"There is a lot of frustration about being written off by the medical community, being told that it's all in one's head, that they just need to see a psychiatrist or go to the gym," said Dr. David Systrom, a pulmonary and critical care physician at Brigham and Women's Hospital in Boston.
That sort of ignorance seems to be declining, largely because of increasing awareness about long covid, said Emily Taylor, vice president of advocacy and engagement at Solve M.E., an advocacy group for people with post-infectious chronic illnesses. Although some doctors still refuse to believe long covid is a real disease, "they're being drowned out by the patient voices," Taylor said.
"In a very dark cloud," Nichols said, "a silver lining coming out of long covid is that we've been forced to acknowledge how real and serious these conditions are."
KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.
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