̽��ֱ�� of Cambridge - Nicholas Matheson

‘Ageing’ immune cell levels could predict how well we respond to vaccines

cjb250 — Tue, 27 Jun 2023 09:00:30 +0000

During the COVID-19 pandemic, it has become clear that some patients are better protected by vaccination than others. Many studies have shown that SARS-CoV-2 vaccines are less effective in people with weakened immune systems, but also that this effect is not uniform.

Vaccination involves priming the immune system to look for – and get rid of – invading pathogens, such as viruses and bacteria. In part, this involves stimulating the production of antibodies uniquely programmed to identify a particular invader. These antibodies are themselves produced by a type of immune cell known as a B cell.

One specific subset of B cells is known as age-associated B cells (ABCs). While, on average, less than one in 20 of a healthy individual’s B cells is an ABC, the proportion gradually increases as we get older. ̽��ֱ��reasons for this increase are not yet fully understood, but may include previous infections. Certain people with weakened immune systems accumulate ABCs still faster.

A team from the Medical Research Council (MRC) Toxicology Unit at the ̽��ֱ�� of Cambridge, led by Dr James Thaventhiran, examined ABCs from two very different patient groups – one comprised of people with an inherited condition that impairs the activity of their immune systems and a second group comprised of cancer patients taking immunotherapy drugs – as well as from healthy individuals.

Emily Horner, from Thaventhiran’s lab, explained the aim of this research: “By looking at patients’ B cells, we hoped to learn how we could stratify vulnerable patients – in other words, work out whether some patients were at greater risk from infection, even after vaccination, than others.”

̽��ֱ��researchers measured the relative proportion of ABCs compared to healthy B cells, and used a technique known as single cell RNA sequencing to look in detail at the activity of cells. They also teamed up with Dr Nicholas Matheson, from the Cambridge Institute of Therapeutic Immunology and Infectious Disease, to test how these factors influenced the ability of a vaccinated individual’s immune system to neutralise live SARS-CoV-2 virus.

Dr Juan Carlos Yam-Puc, also from the MRC Toxicology Unit, said: “What we found, much to our surprise, was that the age-associated B cells in these very different groups looked the same. ̽��ֱ��key difference was in the amount of these cells – the greater the proportion of ABCs in an individual’s blood, the less effective that individual was post-vaccination at neutralising the virus.”

This could help explain the variability seen within particular patient groups in responses to the vaccine: people with fewer ABCs are likely to respond better to vaccines.

Although the researchers examined ABCs in the context of responses to the SARS-CoV-2 vaccine, they believe that this phenomenon will almost certainly apply more widely, for example to the annual influenza vaccine.

Dr Pehuén Pereyra Gerber, who performed the experiments with live SARS-CoV-2 virus in Matheson’s lab, added: “Looking at blood levels of ABCs could tell us that person A should respond well to a vaccine, while person B might need a stronger vaccine or to be prioritised to receive a booster.”

Thaventhiran added: “Ultimately, this research could lead to the development of a clinical test to predict vaccine efficacy for immunodeficient patients, and for the population more generally.”

̽��ֱ��research was funded by the Medical Research Council, the Medical Research Foundation, and ̽��ֱ��Evelyn Trust.

Reference
Yam-Puc, JC et al. Age-Associated B cells predict impaired humoral immunity after COVID-19 vaccination in patients receiving immune checkpoint blockade. Nat Comms; 27 June 2023; DOI: 10.1038/s41467-023-38810-0

Cambridge scientists have identified a signature in the blood that could help predict how well an individual will respond to vaccines. ̽��ֱ��discovery, published today in Nature Communications, may explain why, even among vulnerable patient groups, some individuals have better responses to vaccines than others.

By looking at patients’ B cells, we hoped to learn how we could stratify vulnerable patients – in other words, work out whether some patients were at greater risk from infection, even after vaccination, than others

Emily Horner

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Vaccination

̽��ֱ��text in this work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Images, including our videos, are Copyright © ̽��ֱ�� of Cambridge and licensors/contributors as identified. All rights reserved. We make our image and video content available in a number of ways – as here, on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms.

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‘Programmable molecular scissors’ could help fight COVID-19 infection

cjb250 — Wed, 16 Nov 2022 10:00:18 +0000

Enzymes are naturally occurring biological catalysts, which enable the chemical transformations required for our bodies to function – from translating the genetic code into proteins, right through to digesting food. Although most enzymes are proteins, some of these crucial reactions are catalysed by RNA, a chemical cousin of DNA, which can fold into enzymes known as ribozymes. Some classes of ribozyme are able to target specific sequences in other RNA molecules and cut them precisely.

In 2014, Dr Alex Taylor and colleagues discovered that artificial genetic material known as XNA – in other words, synthetic chemical alternatives to RNA and DNA not found in nature – could be used to create the world’s first fully-artificial enzymes, which Taylor named XNAzymes.

At the beginning, XNAzymes were inefficient, requiring unrealistic laboratory conditions to function. Earlier this year, however, his lab reported a new generation of XNAzymes, engineered to be much more stable and efficient under conditions inside cells. These artificial enzymes can cut long, complex RNA molecules and are so precise that if the target sequence differs by just a single nucleotide (the basic structural unit of RNA), they will recognise not to cut it. This means they can be programmed to attack mutated RNAs involved in cancer or other diseases, leaving normal RNA molecules well alone.

Now, in research published today in Nature Communications, Taylor and his team at the Cambridge Institute of Therapeutic Immunology & Infectious Disease (CITIID), ̽��ֱ�� of Cambridge, report how they have used this technology to successfully ‘kill’ live SARS-CoV-2 virus.

Taylor, a Sir Henry Dale Fellow and Affiliated Researcher at St John’s College, Cambridge, said: “Put simply, XNAzymes are molecular scissors which recognise a particular sequence in the RNA, then chop it up. As soon as scientists published the RNA sequence of SARS-CoV-2, we started scanning through looking for sequences for our XNAzymes to attack.”

While these artificial enzymes can be programmed to recognise specific RNA sequences, the catalytic core of the XNAzyme – the machinery that operates the ‘scissors’ – does not change. This means that creating new XNAzymes can be done in far less time than it normally takes to develop antiviral drugs.

As Taylor explained: “It’s like having a pair of scissors where the overall design remains the same, but you can change the blades or handles depending on the material you want to cut. ̽��ֱ��power of this approach is that, even working by myself in the lab at the start of the pandemic, I was able to generate and screen a handful of these XNAzymes in a matter of days.”

Taylor then teamed up with Dr Nicholas Matheson to show that his XNAzymes were active against live SARS-CoV-2 virus, taking advantage of CITIID’s state-of-the-art Containment Level 3 Laboratory – the largest academic facility for studying high risk biological agents like SARS-CoV-2 in the country.

“It's really encouraging that for the first time – and this has been a big goal of the field – we actually have them working as enzymes inside cells, and inhibiting replication of live virus,” said Dr Pehuén Pereyra Gerber, who performed the experiments on SARS-CoV-2 in Matheson’s lab.

“What we’ve shown is proof of principle, and it’s still early days,” added Matheson, “It’s worth remembering, however, that the amazingly successful Pfizer and Moderna COVID-19 vaccines are themselves based on synthetic RNA molecules – so it’s a really exciting and rapidly developing field, with enormous potential.”

Taylor checked the target viral sequences against databases of human RNAs to ensure they were not present in our own RNA. Because the XNAzymes are highly specific, this should in theory prevent some of the ‘off-target’ side-effects that similar, less accurate molecular therapeutics may cause, such as liver toxicity.

SARS-CoV-2 has the ability to evolve and change its genetic code, leading to new variants against which vaccines are less effective. To get around this problem, Taylor not only targeted regions of the viral RNA that mutate less frequently, but he also designed three of the XNAzymes to self-assemble into a ‘nanostructure’ that cuts different parts of the virus genome.

“We’re targeting multiple sequences, so for the virus to evade the therapy it would have to mutate at several sites at once,” he said. “In principle, you could combine lots of these XNAzymes together into a cocktail. But even if a new variant does appear that is capable of getting round this, because we already have the catalytic core, we can rapidly make new enzymes to keep ahead of it.”

XNAzymes could potentially be administered as drugs to protect people exposed to COVID-19, to prevent the virus taking hold, or to treat patients with infection, helping rid the body of the virus. This sort of approach might be particularly important for patients who, because of a weakened immune system, struggle to clear the virus on their own.

̽��ֱ��next step for Taylor and his team is to make XNAzymes that are even more specific and robust – “bulletproof,” he says – allowing them to remain in the body for longer, and work as even more effective catalysts, in smaller doses.

̽��ֱ��research was funded by the Wellcome Trust, the Royal Society, the Medical Research Council, NHS Blood and Transplant, and Addenbrooke’s Charitable Trust.

Reference
Pereyra Gerber, P, Donde, MJ, Matheson, NJ and Taylor, AI. XNAzymes targeting the SARS-CoV-2 genome inhibit viral infection. Nature Communications (2022). DOI: 10.1038/s41467-022-34339-w

Cambridge scientists have used synthetic biology to create artificial enzymes programmed to target the genetic code of SARS-CoV-2 and destroy the virus, an approach that could be used to develop a new generation of antiviral drugs.

XNAzymes are molecular scissors which recognise a particular sequence in the RNA, then chop it up

Alex Taylor

Jordan Siemens (Getty Images)

A 3d animation of the COVID-19 Virus or Coronavirus being broken apart

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Cambridge students urged to take part in innovative COVID-19 screening programme

cjb250 — Thu, 28 Oct 2021 11:17:58 +0000

This is particularly important as UK cases continue to rise, and evidence shows that even people who have been fully vaccinated or previously infected are at risk of infection.

At the start of Michaelmas term in October 2020, the ̽��ֱ�� of Cambridge introduced a free weekly asymptomatic screening programme for all students resident in its Colleges, later extended to include students living in private accommodation. It is complemented by a testing programme for staff and students with symptoms of possible COVID-19. Both programmes use PCR tests – still considered the gold standard. For asymptomatic screening, up to ten students pool their swabs in a single sample tube – making the available tests go further.

According to the latest report from the team, in the week 18-24 October 2021, around 5,200 students contributed swabs to pooled sample collection and registered their tests. However, the actual number of students taking part is thought to be higher – about 7,000 students each week – because a significant number of students contribute unregistered swabs. Those swabs are still tested, but it makes the task of contacting students in positive pools take more time.

In that same week, preliminary analysis suggests the Asymptomatic COVID-19 Screening Programme identified eight positive cases from across the student population. A further four were identified by the ̽��ֱ��’s symptomatic testing programme. These numbers are down from 16 asymptomatic and 13 symptomatic positive cases the previous week.

Dr Nicholas Matheson, from the Cambridge Institute of Therapeutic Immunology and Infectious Disease (CITIID), designed the screening programme. He said: “It’s great that so many students are taking part every week, but we’d like to encourage even more to join in. ̽��ֱ��number of COVID-19 cases among our students is still, thankfully, relatively low – but across the UK, we’re seeing numbers increase. None of us can afford to be complacent – even if you’re fully vaccinated, it’s still possible to get infected with the Delta variant, and pass it on to others.

“Young people are at risk of ‘long COVID’, with some people experiencing symptoms lasting weeks or months. We are also seeing a small number of young people with COVID-19 admitted to our hospital – even to intensive care. It’s therefore incredibly important that we do everything we can to keep numbers low.”

By identifying infected students early, before they develop symptoms, Dr Matheson and colleagues can help students avoid unwittingly infecting others. This breaks chains of transmission, reduces the risk of outbreaks, and limits disruption to ̽��ֱ�� and College life. By participating in the programme, students can therefore help keep their friends, colleagues, and the wider community safe – this is especially important for those people who remain vulnerable to COVID-19, despite being vaccinated themselves.

Dr Isobel Ramsay, Clinical Lead for the screening programme, is keen to allay concerns about the risk of unnecessary self-isolation. “Because we use PCR tests and a two-step testing strategy, with individual confirmatory tests for positive pools, you’re exceptionally unlikely to test positive unless you’re genuinely infected. And if you do test positive, your friends and contacts won’t be required to self-isolate if they’ve been fully vaccinated by the NHS.

“In short, the more students that participate, the less transmission and fewer cases we’ll see, and the less likely students will be to have to self-isolate. It’s a win-win situation.”

̽��ֱ��Asymptomatic COVID-19 Screening Programme is supported by Cambridge Students’ Union (SU), whose Undergraduate and Postgraduate Presidents are part of the team running the programme.

“ ̽��ֱ��level of participation from Cambridge students is something that we’re really proud of,” said Anjum Nahar, Postgraduate President of Cambridge SU. “Everyone wants to have the best possible experience during their time at Cambridge, and that means keeping the number of cases as low as possible. We all need to do our bit. We’re taking part not just because it protects us, but because it helps protect everyone around us.”

Students who have not yet signed up to the programme can do so on the ̽��ֱ�� website. Further information about the programme is available on the Asymptomatic COVID-19 Screening Programme pages.

An estimated 7,000 students are already taking part each week in the ̽��ֱ�� of Cambridge’s Asymptomatic COVID-19 Screening Programme, but the team running the programme are encouraging as many students as possible to join in, and help keep Cambridge safe.

̽��ֱ��more students that participate, the less transmission and fewer cases we’ll see, and the less likely students will be to have to self-isolate. It’s a win-win situation

Isobel Ramsay

Nordin Ćatić taking a COVID-19 test

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Upgrading PPE for staff working on COVID-19 wards cut hospital-acquired infections dramatically

cjb250 — Tue, 29 Jun 2021 07:20:09 +0000

̽��ֱ��findings are reported by a team at the ̽��ֱ�� of Cambridge and Cambridge ̽��ֱ�� Hospitals (CUH) NHS Foundation Trust. ̽��ֱ��research has not yet been peer-reviewed, but is being released early because of the urgent need to share information relating to the pandemic.

Until recently UK Infection Protection Control guidance recommended that healthcare workers caring for patients with COVID-19 should use fluid resistant surgical masks type IIR (FRSMs) as respiratory protective equipment; if aerosol-generating procedures were being carried out (for example inserting a breathing tube into the patient’s windpipe), then the guidance recommended the use of an FFP3 respirator. ̽��ֱ��guidance has recently been updated to oblige NHS organisations to assess the risk that COVID-19 poses to staff and provide FFP3 respirators where appropriate.

Since the start of the pandemic, CUH has been screening its healthcare workers regularly for SARS-CoV-2, even where they show no symptoms. They found that healthcare workers caring for patients with COVID-19 were at a greater risk of infection than staff on non-COVID-19 wards, even when using the recommended respiratory protective equipment. As a result, its infection control committee implemented a change in respiratory protective equipment for staff on COVID-19 wards, from FRSMs to FFP3 respirators.

Prior to the change in respiratory protective equipment, cases were higher on COVID-19 wards compared with non-COVID-19 wards in seven out of the eight weeks analysed by the team. Following the change in protective equipment, the incidence of infection on the two types of ward was similar.

̽��ֱ��results suggest that almost all cases among healthcare workers on non-COVID-19 wards were caused by community-acquired infection, whereas cases among healthcare workers on COVID-19 wards were caused by both community-acquired infection and direct, ward-based infection from patients with COVID-19 – but that these direct infections were effectively mitigated by the use of FFP3 respirators.

To calculate the risk of infection for healthcare workers working on COVID-19 and non-COVID-19 wards, the researchers developed a simple mathematical model.

Dr Mark Ferris from the ̽��ֱ�� of Cambridge’s Occupational Health Service, one of the study’s authors, said: “Healthcare workers – particularly those working on COVID-19 wards – are much more likely to be exposed to coronavirus, so it’s important we understand the best ways of keeping them safe.

“Based on data collected during the second wave of the SARS-CoV-2 pandemic in the UK, we developed a mathematical model to look at the risks faced by those staff dealing with COVID-19 patients on a day to day basis. This showed us the huge effect that using better PPE could have in reducing the risk to healthcare workers.”

According to their model, the risk of direct infection from working on a non-COVID-19 ward was low throughout the study period, and consistently lower than the risk of community-based exposure.

By contrast, the risk of direct infection from working on a COVID-19 ward before the change in respiratory protective equipment was considerably higher than the risk of community-based exposure: staff on COVID-19 wards were at 47 times greater risk of acquiring infection while on the ward than staff working on a non-COVID-19 ward.

Crucially, however, the model showed that the introduction of FFP3 respirators provided up to 100% protection against direct, ward-based COVID-19 infection.

Dr Chris Illingworth from the MRC Biostatistics Unit at the ̽��ֱ�� of Cambridge, said: “Before the face masks were upgraded, the majority of infections among healthcare workers on the COVID-19 wards were likely due to direct exposure to patients with COVID-19.

“Once FFP3 respirators were introduced, the number of cases attributed to exposure on COVID-19 wards dropped dramatically – in fact, our model suggests that FFP3 respirators may have cut ward-based infection to zero.”

Dr Nicholas Matheson from the Department of Medicine at the ̽��ֱ�� of Cambridge, said: “Although more research will be needed to confirm our findings, we recommend that, in accordance with the precautionary principle, guidelines for respiratory protective equipment are further revised until more definitive information is available.”

Dr Michael Weekes from the Department of Medicine at the ̽��ֱ�� of Cambridge, added: “Our data suggest there’s an urgent need to look at the PPE offered to healthcare workers on the frontline. Upgrading the equipment so that FFP3 masks are offered to all healthcare workers caring for patients with COVID-19 could reduce the number of infections, keep more hospital staff safe and remove some of the burden on already stretched healthcare services caused by absence of key staff due to illness. Vaccination is clearly also an absolute priority for anyone who hasn’t yet taken up their offer.”

̽��ֱ��research was funded by Wellcome, the Addenbrooke’s Charitable Trust, UK Research and Innovations, and the NIHR Cambridge Biomedical Research Centre.

Reference
Ferris, M, Ferris, R et al. FFP3 respirators protect healthcare workers against infection with SARS-CoV-2. DOI: 10.22541/au.162454911.17263721/v1

When Addenbrooke’s Hospital in Cambridge upgraded its face masks for staff working on COVID-19 wards to filtering face piece 3 (FFP3) respirators, it saw a dramatic fall – up to 100% – in hospital-acquired SARS-CoV-2 infections among these staff.

Healthcare workers – particularly those working on COVID-19 wards – are much more likely to be exposed to coronavirus, so it’s important we understand the best ways of keeping them safe

Mark Ferris

Cambridge ̽��ֱ�� Hospitals NHS Foundation Trust

Healthcare worker wearing FFP3 mask

Yes

How mass testing helped limit the spread of COVID-19 at the ̽��ֱ�� of Cambridge

cjb250 — Tue, 01 Jun 2021 10:49:36 +0000

A combination of testing programmes for staff and students, infection control measures and genomic surveillance helped reduce the number of cases of COVID-19 at the ̽��ֱ�� and keep the wider community safe.

Safety screens

cjb250 — Wed, 03 Feb 2021 10:52:24 +0000

Since the start of October, a dedicated team drawn from across the ̽��ֱ�� and its Colleges has been running an innovate programme to screen its students for COVID-19. Getting it up and running in time may have been a Herculean task, but its success has been remarkable.

Remdesivir likely to be highly effective antiviral against SARS-CoV-2 for some patients

cjb250 — Mon, 14 Dec 2020 10:00:18 +0000

̽��ֱ��response to the COVID-19 pandemic has been hampered by the lack of effective antiviral drugs against SARS-CoV-2, the coronavirus that causes the disease. Scientists had pinned hope on the drug remdesivir, originally developed to treat hepatitis C and subsequently tested against Ebola. However, results from large clinical trials have been inconclusive, and in early October the World Health Organization (WHO) announced that the drug did not significantly reduce mortality rates. ̽��ֱ��question is more complicated, however, and a clinical team have now used a different approach to determine the effects of the drug on COVID-19 in a closely monitored patient.

Dr James Thaventhiran from the MRC Toxicology Unit at the ̽��ֱ�� of Cambridge said: “There have been different studies supporting or questioning remdesivir’s effectiveness, but some of those conducted during the first wave of infection may not be optimal for assessing its antiviral properties.

“Mortality is due to a combination of factors, likely including unchecked viral replication and, importantly, the response of the immune system. A clinical trial that looks only at remdesivir’s impact on mortality will have difficulty distinguishing between these two factors. This limits our ability to ask the simple question: how good is remdesivir as an antiviral?”

To answer this question, a team led by scientists at the ̽��ֱ�� of Cambridge and Barts Health NHS Trust examined the case of a 31 year old man with XLA, a rare genetic condition that affects the body's ability to produce antibodies and hence fight infection.

̽��ֱ��patient’s illness began with fever, cough, nausea and vomiting, and on day 19 he tested positive for SARS-CoV-2. His symptoms persisted and on day 30 he was admitted to hospital, where he was given supplemental oxygen due to breathing difficulties.

Unusually, his fever and inflammation of the lungs persisted for longer than 30 days, but without causing severe breathing problems or spreading to other organs. ̽��ֱ��researchers say this may have been due to his inability to produce antibodies – although antibodies fight infection, they can also cause damage to the body and even lead to severe disease.

At first, the patient was treated with hydroxychloroquine and azithromycin, which had little effect, and the treatments were stopped on day 34. ̽��ֱ��patient then commenced a ten-day course of remdesivir. Within 36 hours, his fever and shortness of breath had improved and his nausea and vomiting ceased. Rising oxygen saturation allowed him to be taken off supplemental oxygen.

This dramatic clinical response was accompanied by a progressive decrease in levels of C-reactive protein (CRP), a substance produced by the liver in response to inflammation. At the same time, doctors saw an increase in the number of his immune cells known as lymphocytes, and chest scans showed that his lung inflammation was clearing. ̽��ֱ��patient was discharged on day 43.

A week after discharge, the patient’s fever, shortness of breath and nausea returned. He was readmitted to hospital on day 54 and given supplemental oxygen. He again tested positive for SARS-CoV-2, was found to have lung inflammation, and his CRP levels had increased and his lymphocyte count fallen.

On day 61, the patient began treatment with a further ten-day course of remdesivir. Once again, his symptoms improved rapidly, his fever dropped and he was taken off supplemental oxygen. His CRP and lymphocyte count normalised. Following additional treatment with convalescent plasma on days 69 and 70, he was discharged three days later and is no longer symptomatic.

̽��ֱ��team found that the patient’s virus levels fell progressively during his first course of remdesivir, corresponding with the improvement in his symptoms. His virus levels increased again, as did his symptoms, when the first course of the treatment ceased, but the effect of the second course of remdesivir was even more rapid and complete. By day 64, he was no longer testing positive for the coronavirus.

̽��ֱ��patient’s inability to clear his infection without antiviral medication is very likely to be due to his lack of antibodies, say the researchers. However, there are other immune cells that contribute to fighting infection, including those known as CD8+ T cells. ̽��ֱ��team observed that the patient was able to produce CD8+ T cells that responded to the ‘spike protein’ on the surface of the virus – spike proteins give the virus its characteristic crown profile (hence the name coronavirus). While insufficient to clear the infection spontaneously, this likely contributed to the clearance of virus during the second course of remdesivir.

Dr Nicholas Matheson from the Cambridge Institute of Therapeutic Immunology and Infectious Disease (CITIID) at the ̽��ֱ�� of Cambridge added: “Our patient’s unusual condition gave us a rare insight into the effectiveness of remdesivir as a treatment for coronavirus infection. ̽��ֱ��dramatic response to the drug – on repeated challenge – suggests that it can be a highly effective treatment, at least for some patients.”

̽��ֱ��team further suspect that remdesivir is likely to be most beneficial when administered early in infection, before the virus is able to trigger a potentially catastrophic immune response. They say that the course of their patient’s disease also underscores the important – but often conflicting – roles that antibodies play in protecting us from infection.

“ ̽��ֱ��fact that our patient was unable to fight off the disease without treatment suggests that antibodies contribute to the control of SARS-CoV-2,” explained Dr Matthew Buckland from the Department of Clinical Immunology, Barts Health, London. “But this lack of antibodies may also have prevented his COVID-19 from becoming life-threatening, because he had no antibodies to trigger a damaging immune response.

“All of this suggests that treatments will need to be tailored for individual patients, depending on their underlying condition – for example, whether it is the virus that is causing the symptoms, or the immune response. ̽��ֱ��extended viral monitoring in our study was clinically necessary because in April 2020 we didn’t know if this drug would be effective. Adopting this approach more widely could further clarify how best to use remdesivir for clinical benefit.”

̽��ֱ��research was supported by the Medical Research Council, the NIHR Bioresource, NHS Blood and Transplant, Wellcome and the European Union’s Horizon 2020 programme.

Reference
Buckland, MS et al. Successful treatment of COVID-19 with remdesivir in the absence of humoral immunity, a case report. Nat Comms; 14 Dec 2020; DOI: 10.1038/s41467-020-19761-2

̽��ֱ��drug remdesivir is likely to be a highly effective antiviral against SARS-CoV-2, according to a new study by a team of UK scientists. Writing in Nature Communications, the researchers describe giving the drug to a patient with COVID-19 and a rare immune disorder, and observing a dramatic improvement in his symptoms and the disappearance of the virus.

Our patient’s unusual condition gave us a rare insight into the effectiveness of remdesivir as a treatment for coronavirus infection

Nicholas Matheson

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Creative rendition of SARS-COV-2 virus particles

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Everyone should wear masks in COVID-19 crisis, say Cambridge researchers

cjb250 — Thu, 09 Apr 2020 17:11:33 +0000

More and more evidence suggests that SARS-CoV2, the virus that causes COVID-19, may be commonly transmitted before individuals show symptoms.

Professor Babak Javid, a consultant in infectious diseases at Cambridge ̽��ֱ�� Hospitals NHS Trust, as well as a professor at Tsinghua ̽��ֱ�� in Beijing, China, said: “We know that a lot of transmission of the coronavirus occurs before people show any symptoms. Wearing masks is primarily to protect others, as well as offering some degree of protection to the wearer.”

Writing in an editorial for the BMJ, the team argue that the potential benefits vastly outweigh the possible downsides associated with mask use. Studies performed prior to the current emergency were of variable quality, and didn’t take into account how likely individuals were to comply with wearing a mask. ̽��ֱ��authors argue that in the midst of a pandemic, people are much more likely to follow guidelines.

̽��ֱ��evidence for masks is no worse than other widely adopted and promoted behaviours, such as handwashing, they say. Even if masks are only 20% effective at reducing transmission, previous models for an influenza pandemic suggested that substantial numbers of cases may still be prevented. Widespread education campaigns, such as those promoting handwashing at present, could help ensure the masks are used properly and mitigate some of the concerns over their proper use.

Due to shortages of medical masks for our healthcare workers, the researchers recommend cloth masks for the public. Dr Michael Weekes from the Cambridge Institute of Therapeutic Immunology and Infectious Disease (CITIID) said: “ ̽��ֱ��evidence to support the use of masks in non-clinical settings may be limited, but the mass manufacture and use of cloth masks is cheap and easy, compared to the societal economic costs associated with isolation and social distancing measures.”

Dr Nicholas Matheson, also from CITIID, and a consultant at Cambridge ̽��ֱ�� Hospitals NHS Trust and NHS Blood and Transplant added: “As we prepare to enter a ‘new normal’, wearing a mask in public may become the face of our unified action in the fight against this common threat, and reinforce the importance of social distancing measures.

Reference
Covid-19: should the public wear face masks? BMJ; 9 Apr 2020; DOI: 10.1136/bmj.m1442

Governments and health agencies should reconsider the current guidelines with regards to widespread mask use in the COVID-19 pandemic and recommend that masks be worn by everyone, argue a team of researchers at the ̽��ֱ�� of Cambridge

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Men in masks

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