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Patients Who Have Recovered From COVID-19 Likely To Have Some Immunity To Reinfection

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A study from researchers at the La Jolla Institute for Immunology offers the first detailed look at the immune response of patients who contracted and recovered from SARS-CoV-2, which is causing the coronavirus pandemic.

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Research findings published today by San Diego scientists have good news in the worldwide race to develop a vaccine against the deadly Kovik 19 disease. Research done at the La Hoya Institute for Immunology is the first detailed look at the immune response of patients who contracted and recovered from Saras Kobe two, which is causing the Corona virus pandemic. Joining me to discuss the findings are Shane Crotty and Alex Setit, professors at the Center for Infectious Disease and Vaccine Research at the La Hoya Institute for Immunology.

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Welcome to you both.

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Thanks for having us. Thanks for having us. NIE. So to be clear, you and your colleagues were not working on a vaccine. Shane, explain the questions you were trying to answer questions critical to eventually developing a vaccine against this virus.

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This has been very rapidly moving pandemic in a severe situation like that. It's made sense for people to go ahead and start trying to develop a vaccine. And in fact, there are at least 90 different efforts ongoing right now to develop. And so we've covered 19 vaccines. But one of the problems there is that the normal way you would want to make a vaccine would be to look at the normal immunity to that virus and then develop a vaccine that that looks like what you already know is is good immunity.

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So, you know, most people that catch measles, they get over it. They do well. So what is that immune response look like? And unfortunately for a coconut team, we haven't had that because things are moving so quickly. And one of the problems there is that there are many different parts of the immune system that have different jobs and different infections. So if you don't know which part of the immune system is important in this particular infection, you could make a very wrong guess about what might be a good vaccine strategy.

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And luckily, Alex Setit at Ogi is a top expert in the world at so epitopes and city for NCDOT cells are two major parts of the immune system. You need to understand if you need to develop a rational vaccine. And so he and his lab had the foresight to realize early on it could be 19 was was a problem when it was an epidemic, not a pandemic, and started trying to figure out how to predict t cell responses. And that's where the study is both.

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And Alex, how does this specifically help scientists around the world, these these various ones, as Shane was saying, who are trying to develop a vaccine against Cobert, 19? Yes. So as Shane was saying, we're very excited. The fact that we have now the capacity to accurately measure immune responses and this gives you a way to put immune responses in context because there are different qualities of immune responses. And as Shane was saying, we want a vaccine that can reproduce the immune response that is successful in controlling the virus.

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This is what a vaccine should do. So we purposely started here, people that had recovered from a Corbitt and had a relatively mild case. So this is a snapshot of the good immune response. But successfully controlled the virus. And so now we can also ask the question, so how does immune response, different people that that, ah, have an infection we still buy? They don't even know it. How does that differ from people that have a more severe case?

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And how does that differ from the people that actually end up in the hospital or in the ICU at intubated, but different types of immune response to be able to measure? Is the key to be able to understand what kind of immune response we want is what kind of immune response we don't. Well, there are some cases where the immune response is overzealous and actually is causing more problems than it solves. And so this is really important to be able to study different patient populations.

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And among these patients, the real good news, Alex, was in in reading the news about this is that the it was a robust TSL response. And for us laypeople explain what that means and why that's important. Yes, Sobig response was robust in a sense that the number of sales that we saw be ready to combat the virus and develop a immune memory was similar to what we see in other cases where the immune system successfully fights viruses. And another measure of being robust is to be wide ranging.

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So the virus has actually made up 25 pieces and most vaccine concepts right now and then designs target one particular big important piece of a virus, which is the spike protein. Our data showed that the spike is important in it by immune response. What about several other key proteins that are also targeted by the immune responses, particularly also from Big C, eight T cells for killer cells, which are one wants to eliminate that, infect the target sales. So the immune response is very broad.

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And this also suggests that there may be opportunities to further improve and broaden the design of vaccines by incorporating some other pieces that may give an extra kick to be immune response.

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Shane, does this mean people who've contracted COBA 19 won't fall ill from it again? Yes. So that's where that's where we can't make firm conclusions, right. Our data is a first piece of the puzzle. It's up to up to today.

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There's just been a lot of worry out there that maybe people don't develop immunity and don't develop immune response if you don't develop an immune response. You can't develop injury. And so what Alex's group and our group have pushed really hard to do was make those first measurements. Are there measurable immune responses to this virus in average cases? And the answer is been yes. And across the board. Yes, yes, yes. And then yes, again. And dramatically been good.

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And so. To actually measure immunity, it takes a long time. Basically, right? You have to essentially wait and see when do people start getting infected again. It may be a five year, 10 year type progress project.

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But what we can do is we can take a look at the numbers, the magnitude of the immune response in which parts of the immune system have responded and say, based on those numbers, it seems likely to us that immunity is developed, that we some reasonable amount of immunity is present. It is developed by. By most people. And again, we would consider that good news.

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And largely fits with the expectations we would have for an antiviral immune response. Right, Alex?

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Yeah. And also, the other thing that is very important is it goes back to the fact that these are people that are local and from UCSD. And so we have now a capacity to go back to the same donors and see how their response is maintained over time. So now we are into obviously few weeks, but we will be able to study band for months. And so that will be another very important element to say. Yes, but immune response is there.

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And yes, the immune response is lasting. Like any other immune memory, immune response.

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And Alex, explain what your research means regarding those of us who have had the common cold. Might we have some protection already against Koban 19?

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So this was another element of a study, so to study people that were not exposed to corona virus. So because in some cases you might be affected by a coronavirus, not the Corbitt, and not really have strong symptoms. We studied blood draws samples from 2015 to 2018. So before but besides, Corona too was even fake. And we saw that in about half of the people there where reactions against the sum of the parts of the SARS copy to violence.

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This was really striking. What's actually unexpected and the most reasonable explanation for that is that that is some immune reactivity against originating from being exposed to a common cold corona virus.

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There's a number of more benign human coronavirus that are causing a common cold. So not these manifestations. And perhaps people that have this memory against some cases of the virus, if you wish, are the ones it's fared better. Still feel it's a mystery why some people have, such as a bad outcome and some people have very mild outcomes. So this is an area where we do investigating very, really strongly. But it's important to understand whether this pre-existing memory does impact the outcome and the change.

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You want to jump in and elaborate also on the implications for vaccines. Yeah, I think exactly as Alex said, this was a this was a surprise that about half of people already have a muted memory that can recognize the Kobe 19 virus. It was certainly possible that nobody would have any immune recognition at day zero. And so that leads us to the reasonable immune system, speculation that they're already having memory at time. Zero would make it so that you could have a faster and better immune response.

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And when you did get infected and for vaccines, we think that that's important until we started talking with with various groups that have candidate vaccines that they want to move forward. And it maybe it's conceivable that, you know, 50 percent of people already have some sort of memory that half of people might respond to your vaccine candidate different than the other half. And if you knew which half it was right. You could interpret those responses better and understand whether one vaccine was better, particularly if it turns out that if any of this relates to certain common cold coronavirus, it's OK.

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Cominco Coronaviruses like any common cold, right. They circulate through different communities at different times. So it might be that a group of people in Portland all got infected recently. Right. But in San Diego, there has been an outbreak and that might affect the way a clinical trial would go and train.

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Last question. What does your research mean for government and public health leaders designing social distancing guidelines for all of us in this pandemic? So this gets into some epidemiology and epidemiology definitely isn't our area of expertise, but obviously it's a big topic.

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And what we've seen are papers published by major epidemiologists that have said, well, if there is any evidence of cross protective immunity provided by other viruses, presumably come and go coronaviruses that would impact the future course of this pandemic, actually. And so being able to build in a better guesstimate of what that number might be and what that amount of Crouchback immunity might be actually affects the predictions for how long you need the social distance in certain scenarios. So it yeah, it's valuable in that way as well.

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I've been speaking with Shane Crotty and Alex Setit, professors at the Center for Infectious Disease and Vaccine Research at the La Hoya Institute for Immunology. Congratulations and thanks very much.

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Thank you.

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