COVID-19 Clinical Care: Researchers Warn As To How And When Type III Interferon Should Be Used In COVID-19 To Prevent Harmful Effects
Source: COVID-19 Clinical Care Jul 08, 2020 4 years, 4 months, 6 days, 7 hours, 38 minutes ago
COVID-19 Clinical Care: A new study by researchers from Boston Children’s Hospital warns about how and when type III Interferons should be used in the treatment of COVID019 as using it in later stages of severity can do more harm.
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The research findings were published in the journal: Science.
https://science.sciencemag.org/content/early/2020/06/10/science.abc3545
The human immune system makes interferons and other cytokines to help fight viruses but in the COVID-19 crisis, it has been seen that they can also contribute to damaging, potentially life-threatening lung inflammation
Initial evidence suggests that type III interferon or interferon lambda (λ), can fight viral infection while also limiting inflammatory damage. That has led to at least two clinical trials to test them as a treatment for COVID-19.
However this new study raises a caveat. Researchers at Boston Children's Hospital, with collaborators in Italy, provide evidence that type III interferon increases the risk of life-threatening bacterial "superinfections" in the lung.
These superinfections can happen in both influenza and COVID-19.
The investigators caution that type III interferons given later in the course of COVID-19 could do more harm than good.
Professor Dr Ivan Zanoni, Ph.D., an immunologist at Boston Children's and the study's senior investigator told Thailand Medical News, "Our data indicate that the new coronavirus, SARS-CoV-2, inhibits interferon production in the upper airways. This weakens the immune response and helps the virus survive. But when the virus reaches the lower airways, there is an exuberant immune response, including an increase in type III interferons that we think is harmful."
The study team first tested samples from patients with severe COVID-19 and healthy controls. Interferon III was not much increased in the patients' nasopharyngeal swab samples. But it was markedly elevated in their lung fluid.
The researchers next exposed mice to synthetic viral RNA to mimic the effects of SARS-CoV-2 infection in the lower airways. Interferon III levels rose markedly in the animals' lungs as compared with control mice. Continued production of interferon III prevented the lungs from maintaining their protective surface barrier.
Significantly, this in turn, made the mice more susceptible to lethal bacterial infections from Staphylococcus aureus. Experiments showed increased amounts of bacteria in the lungs and higher mortality as compared with control mice.
Dr Zanoni stressed, "There's still a lot to understand, but it looks like location and timing of interferon production are key. Early during SARS-CoV-2 infection, when the virus is in the upper airways, it might be important to intervene with recombinant interferons and other antivirals. But later on, when inflammation increases in the lower airways, it will be important to block the signaling cascade initiated by interferons and other inflammatory cytokines, possibly with the anti-in
flammatory drugs."
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