9/6/24, The NIH Catalyst, by Michael Tabasko: '
The Autoantibody Hunters'
'From PANDAS to Long COVID, Defining and Treating Infection-associated Conditions That Aren't So Black and White'
Excerpts:
'Nath and Walitt now hope to launch a clinical trial to identify patients with long COVID and T-cell exhaustion and treat them with a
PD-1 inhibitor, a checkpoint inhibitor drug sometimes used to treat cancer. According to Walitt, they hope to find out whether the treatment might help restore immune function and clear the viral material, perhaps having downstream effects on the central nervous system and other symptoms.'
“It's the intervention most open to scientifically testing the clinical impact of the observed immune exhaustion that we have right now,” he said.'
'Another trial underway is treating long COVID patients with IVIG, a nonspecific immunotherapy that delivers a concentrate of antibodies. “Some people have a dramatic response, and some people don’t,” said Walitt. “The idea is to understand who the responders are and who are not so that we can predict response and know who to give it to.”
'According to Nath, the present time is a golden opportunity to study these diseases. “We’ve made certain breakthroughs, but there is a lot that remains unknown about a whole host of diseases that look very similar phenotypically but have different names,” he said. “If you find a treatment for one of them, then you might just find a treatment for all of them. There’s room for specialists to really study them, apply their expertise, and make a real difference.”'
'Long COVID has been dominating the news. One theory on how long COVID perpetuates is that bits and pieces of the COVID virus—shards of RNA and proteins—remain in the body and continue to fuel a slow-burning immune response, contributing to inflammation and resulting in symptoms such as cognitive difficulties and fatigue.'
'To answer these questions, Walitt and
Avindra Nath, NINDS clinical director and senior investigator at the Section of Infections of the Nervous System, are launching a new study to analyze biopsies from tissue all over the body in living individuals. They intend to compare healthy participants after recovering from COVID with individuals with long COVID and look for remnants of SARS-CoV-2 RNA or proteins.
'Data from the long COVID protocol have shown a dysregulation of antibody-producing B cells and infection-fighting T cells in some participants, and the investigators hope to determine whether some of that immune dysregulation might be due to the inability of some people to clear viral material.'