Ankara, Turkey – Prof Dr Batu Erman, a member of the Department of Molecular Biology and Genetics at Bogazici University, made important statements about the Covid-19 mutation that appeared in the UK and sat on the agenda of the whole world.

For many years, she continues to work in the field of genetics and immunology of cancer after working abroad and in the US National Institutes of Health NIH for about 7 years, returning in 2004 to continue their research in Turkey Sabanci University Prof Dr Batu Erman joined the staff of Bogazici University Molecular Biology and Genetics Department last month. Stating that he will continue his studies in the field of cancer immunology and treatments, Prof Dr Batu Erman also explained the drug studies for Covid-19. Speaking about the B117 mutation, which emerged in the UK and caused great concern all over the world, exactly when Kovid-19 vaccines were introduced in millions of people. Prof Dr Batu Erman Stating that the most feared thing is that a serious mutation happens before large-scale vaccinations, but that has not happened for now, he said,

“Of course, all these vaccination studies didn’t start from scratch. There was a vaccine study against the SARS virus, but it was not concluded because it did not turn into a pandemic. Which approaches will be used in the vaccine is more or less known against viruses. The critical point here was how quickly this virus spread, was a virus that could turn into a pandemic, and mutated. But many viruses are already mutating. This mutation in England also appeared before the widespread application of the vaccine. Because the most feared thing was that new mutations would appear after vaccines were introduced. But of course, it doesn’t mean that after vaccinations, there won’t be a new mutation that could escape the vaccine. That’s why anti-virus drug studies are as important as vaccines. “

“Millions of cases increase the rate of mutation”

Pointing out that viruses use the human body like a test tube, Prof Dr Batu Erman gave the following information: “When a person is infected by a virus, the virus uses the human body as a test tube. He wants to reproduce himself. For example, if a person was exposed to 10 thousand virus particles the moment they were infected, assuming that this infection also lasts for about two weeks; During that time the virus continues to replicate in the body. In fact, when we look at the genome of the virus that came out of the body with the first virus entering the body and infects another person, we can see that there are differences. In other words, the virus is mutated inside the human body. Under pandemic conditions, when millions of people in the society are infected, the mutation rate also increases. Because everyone is a test tube and everyone creates different mutations and infects others. That’s why drug studies are important. In fact, when we say coronavirus, we should not only focus on vaccination studies. Because it is necessary to develop drugs that will minimize the time the virus spends in the body and suppress itself from reproducing in the body. “

Will FMF drug be a cure for Covid-19?

Explaining that they are conducting drug studies against Covid-19 with the support of TUBITAK, Prof Dr Batu Erman said that they used a drug with the active ingredient “anakinra”, which is currently used in rheumatic diseases such as Familial Mediterranean Fever (FMF) and rheumatoid arthritis, to prevent the deadly cytokine storm created by Covid-19, and the patent expired. he said with the indigenous capabilities of the molecule that are intended to be produced in Turkey. Prof Dr Batu Erman summarized the details of the drug study as follows:

“We received support from a TUBITAK project related to this. This is an interdisciplinary study. We are working together with Prof Dr Ahmet Gül from Istanbul University and our colleagues from Koç University and Bezmialem University. What we want to do is to suppress the inflammation (cytokine storm) in the lung cells caused by the virus in Covid-19 disease and caused by the excessive reaction of the immune system. This is actually a protein called ‘anakinra’ and a molecule previously on the market as a medicine. It is currently used for various inflammatory diseases. But we think this will have a new goal, and there are clinical studies on this subject in different countries around the world. Our goal this protein and similar proteins and Bogazici University in Turkey, as well as using the facilities of other universities and also by establishing a partnership with two pharmaceutical companies can manage to produce on an industrial scale. “

Explaining that the cytokine storm occurs as a result of excessive secretion of the protein called “Interleukin-1 (IL-1)” released from the blood in the body against infections and it is aimed to suppress this protein with anakinra, Prof Dr Batu Erman said, “As we have seen so far, this “We can make similar molecular.” Prof Dr Batu Erman, who also carried out a study to strengthen the immune system with another project they conducted jointly with Slovenia supported by TUBITAK, said that they aimed to produce “nano-body” (antibodies) obtained from llamas or camelids synthetically and use them against Covid-19. punctuated,

“We are working on llamas obtained from animals and proteins called nanobodies (antibodies) from camelids. We can produce them in the laboratory using different systems, using both bacteria, yeasts and human cells. In nature, llamas actually make these antibodies biologically. But we are trying to make biotech products. In other words, we produce and purify these nanobodies made by llamas in the laboratory. We focused on similar goals with these nanobodies. Because they also target the IL-1 receptor, which makes cytokine storm. Thus, we aim to be able to use these synthetic antibodies for similar purposes. “

Naim Akhtar Khan confirms anakinra and tocilizumab be used as a combination therapy with corticosteroids in the treatment of severe SARS-CoV-2 infection.

Anakinra for severe forms of COVID-19
Naim Akhtar Khan
DOI:https://doi.org/10.1016/S2665-9913(20)30273-3

There is an urgent need to seek new therapeutic approaches to combat the infective and post-infective stages of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The Article by Thomas Huet and colleagues on the clinical use of the interleukin-1 (IL-1) receptor antagonist, anakinra, to treat patients with COVID-19 is very interesting. The main hypothesis of the study was based on hyperinflammation caused by an increase in proinflammatory cytokines, such as IL-1β, IL-6, and tumour necrosis factor (TNF), triggered by SARS-CoV-2 infection. The recruited participants in this study did not have any other infection, but what if the patients did have another proinflammatory condition, such as obesity, rheumatoid arthritis, or other autoimmune disease?

The strategy to block peripheral inflammation as a treatment is not new. Humanised antibodies raised against TNF have been very promising for the treatment of inflammation-associated pathologies, such as rheumatoid arthritis. Tocilizumab, another humanised antibody which blocks the action of circulating IL-6, has been shown to increase survival in patients with COVID-19. At the start of the COVID-19 pandemic, there was controversy regarding the use of classic anti-inflammatory drugs, such as glucocorticoids, because these drugs might exacerbate the pathogenesis. However, corticosteroid therapy along with tocilizumab is associated with improved clinical outcome of patients with COVID-19.

Can anakinra and tocilizumab be used as a combination therapy with corticosteroids in the treatment of severe SARS-CoV-2 infection, in the presence of inflammation-associated pathologies? A subgroup of patients with COVID-19 have a cytokine storm, characterised by a large increase in proinflammatory cytokines. Therefore, the use of combination therapy might be justified for improved protection and treatment of patients with severe COVID-19 associated with systemic hyperinflammation. However, one should be careful; corticosteroids exert not only an anti-inflammatory effect but also immunosuppression, and the aforementioned cytokine storm is also followed by an immunosuppression. SARS-CoV-2 infection in patients with obesity is associated with an increased rate of pneumonia, artificial ventilation, and respiratory tract illness. The pathology of obesity is also marked with a cytokine storm, with high concentrations of IL-6 and TNF, largely from inflamed adipocytes. Inflamed adipocytes provide a favourable habitat for infiltrated macrophages and can cause some of the adipocytes to be transformed into macrophage-like cells, which can result in immunosuppression. Obesity with known increased viral shedding and hyperinflammation might lead to life-threatening outcomes in case of SARS-CoV-2 infection. The question regarding the use of anti-inflammatory drugs in patients with COVID-19 patients remains open.