Kurapa uye Kubaya: Iyo yeEuropean COVID-19 yekubudirira nyaya

Njodzi yekufa paCoronavirus? Swiss Research Mhedzisiro inotaura chokwadi
rufu

Kwete chete majekiseni asiwo mishonga yekurapa COVID-19 iri kugadzirwa. Chirevo ichi chakavakirwa pakutsvagisa kwakaburitswa muEurope uye chinopihwa chakadudzirwa uye chisina kugadzirirwa kuitira ruzivo.

Chirevo ichi chakagadzirirwa iyo pharma indasitiri, asi iri kupa yakadzama tsananguro uko kudzingirira kwekurapa kana kubaiwa mushonga kwakamira muEurope.

Kunyangwe hazvo kuvandudzwa kwemishonga yekudzivirira hutachiona hutsva hwecorona kuri kufambira mberi zvisina mukare akamboona, hazvigoneke kuti ichave ichiwanikwa pakubayiwa nhomba panosvika gore ra2020. Naizvozvo, tarisiro ndeyekuti zvichakurumidza kuwana kurapwa pamberi pekudzivirira.

Zvirikuenderera mberi zvirongwa zvekumiswazve kwemishonga yekurapa

Iko kutarisisa kuri kunyanya pamushonga zvigadzirwa izvo zvakatobvumidzwa kune chimwe chirwere kana zvirinani mukukudziridzwa. Kuzvidzorera zvinogona kubudirira nekukurumidza kupfuura kwekutanga nyowani budiriro.

Mishonga yakati wandei iripo parizvino iri kuongororwa kuti yakanakira chirwere checorona Covid-19. Ivo vanowanzove veimwe yemapoka matatu anotevera:

  • Antiviral zvinodhaka izvo zvakatanga kugadzirirwa hutachiwana hweHIV, Ebola, hepatitis C, furuwenza, SARS kana MERS (zvirwere zviviri zvinokonzerwa nemamwe macoronaviruses). Izvo zvakagadzirirwa kudzivirira kuwanda kwemavhairasi kana kuzvidzivirira kupinda mumaseru emapapu. Mushonga wekare wemalaria urikuedzwawo, uye kushanda kwawo kurwisa mavairasi kuchangobva kuwanikwa.
  • Immunomodulators , semuenzaniso B. kurwisa rheumatoid arthritis kana kuzvimba ura zvirwere zvakagadzirwa. Izvo zvakagadzirirwa kudzikamisa kuita kwekudzivirira kwemuviri kuitira kuti irege kukuvadza kupfuura mavhairasi pachawo.
  • Mishonga yevarwere vemapapu , semuenzaniso B. zvakagadzirwa zvichipesana nediopathic pulmonary fibrosis. Izvo zvakagadzirirwa kudzivirira mapapu emurwere kubva mukukwanisa kuendesa ropa neoksijeni yakakwana.

Nekudaro, kuchine mapurojekiti ekuvandudzwa kwezvinodhaka.

Kuwana kujekesa nekukasira pamusoro pekukodzera kwemushonga

Mune ongororo dzinoverengeka umo mishonga yakadaro yaive uye iri kuongororwa kuti yakaringana here muChina nekumwewo, varwere vashoma chete ndivo vaibatanidzwa; uye kazhinji hapana kuenzaniswa kwakananga nevarwere vanongogamuchira kurapwa kwekutanga pasina imwe mishonga. Zvidzidzo zvakadaro zvinogona kumisikidzwa nekukurumidza, asi mhedzisiro yavo inowanzo kuve isinganzwisisike. Kune zvekare varwere vazhinji veCovid-19 mumakiriniki epasi rese, asi kwete akawanda zvekuti anogona kushandiswa kuyedza zvizere mishonga yese iri kurongwa parizvino.

IEuropean Medicines Agency (EMA) saka yakumbira kumakambani nemasangano ekutsvagisa kuronga nyika dzakawanda, dzakawanda-dzakashongedzwa, dzakadzorwa uye dzakasarudzika zvidzidzo zvevarwere zvemishonga yavo sezvinobvira:

  • "Marudzi mazhinji" zvinoreva kuti masangano ekurapa munyika dzinoverengeka anobatanidzwa.
  • "Multi-armed" uye "controlled" zvinoreva kuti varwere vakapatsanurwa kuita zvikwata zvinopihwa zvakasiyana kurapa: vese vanowana kurapwa kwakaenzana, asi boka rega-rega kunze kwemumwe chete rinogamuchira mumwe wemishonga kuti uongororwe. Muboka rekupedzisira (boka rekutonga), zvakadaro, kurapwa kwekutanga kunosara.
  • "Randomized" zvinoreva kuti varwere vanozvipira vanopihwa rimwe remapoka.

Zvidzidzo zvakadaro, sekureva kweEMA, zvingangotungamira mukujekesa mhedzisiro yekukodzera kwemishonga zvichienzaniswa nezvidzidzo zvidiki, izvo zvaizobvumidzawo mishonga inopesana neCovid-19 kuti igamuchirwe.

World Health Organisation (WHO) nguva pfupi yadarika yakazivisa ongororo yakadai: ongororo iyi, inonzi SOLIDARITY, inoitirwa kuenzanisa marapirwo mana nemishonga inokodzera shanduko inoshanda pamwe chete uye nemushonga wakachena. Chidzidzo ichi chichava neinotevera "mawoko ekudzidza" (= mhando dzekurapa) umo zviuru nezviuru zvevarwere zvinotarisirwa kutora chikamu - zvichingoendeswa.

  1. Kurapa kwekutanga chete
  2. Basic kurapwa + Remdesivir (inhibitor yeiyo RNA polymerase yehutachiona)
  3. Basic kurapwa + ritonavir / lopinavir (HIV mushonga)
  4. Basic kurapwa + ritonavir / lopinavir (mushonga weHIV) + beta interferon (MS mushonga)
  5. Basic kurapwa + chloroquine (malaria drug)

Masangano ekurapa anobva kuArgentina, Iran neSouth Africa anofanirwa kutora chikamu muchidzidzo ichi. Dare rekutarisa rinogara richiongorora zvenguva pfupi zvechidzidzo uye kupedza maoko ekudzidza umo varwere vasiri nani (kana kutonyanya) kupfuura muboka rinodzora. Izvo zvakare zvinokwanisika kuwedzera mamwe mawoko kuchidzidzo, mune mamwe marapirwo ekuwedzera anozoedzwa.

Panguva imwecheteyo, iyo DZIDZO yekudzidza yakatanga muEurope neUK ine chimiro chakafanana, chakarongedzwa nesangano reFrance rekutsvaga INSERM 3,200 varwere vanobva kuGerman, Belgium, France, Luxembourg, Netherlands, Spain, Sweden neUK vanofanira kutora chikamu. Panzvimbo yechloroquine, yakafanana malaria drug hydroxychloroquine inofanira kushandiswa.

Antiviral zvinodhaka

zvivai yakatanga kugadzirwa na Girasi Sciences kurwisana nehutachiona hweEbola (iyo isina kuratidzwa), asi yakaratidzirwa kuve inoshanda kurwisa hutachiona hweMERS murabhoritari. Mushonga une ichi chinoshanda chiripo wave kuyedzwa muzvidzidzo zvinoverengeka zvichipesana neSARS-CoV-2.

CytoDyn ndizvo kuyedza kana iri antibody drug Leronlimab inoshanda kurwisa iyo coronavirus. Yakagadzirwa kwenguva yakareba ichipesana neHIV uye katatu-isina kenza yemazamu, iyo yatove yakaedzwa muzvidzidzo. Chikamu chechipiri II kutongwa kweCovid-19 chavepo.

AbbVie ane mumwe mushonga weHIV ne Kusanganiswa yezvinhu zvinoshandiswa lopinavir/ritonaviryakaitwa kuti iwanikwe yekuongororwa seCovid-19 yekurapa. Zvidzidzo nevarwere zviri kuenderera, kusanganisira kudzidza mune varwere zvakare inhale Novaferon kubva Beijing Genova Biotech . Iyi alpha interferon inogamuchirwa muChina yekurapa hepatitis B. Mushonga uyu wave kuzoedzwa muzvidzidzo zvikuru pasirese.

Iyo kambani Ascletis Pharma inosangana ritonavir pachinzvimbo neyakagamuchirwa muChina yehepatitis C mushonga pamwe nechinhu chinoshanda Danoprevir . Zvidzidzo zviri kuenderera mberi.

MuChina, kambani Zhejiang Hisun Mishonga Zvidzidzo zvekiriniki paCovid-19 kurapwa nemushonga wehutachiona hune chinhu chinoshanda favilavir yakatenderwa. Parizvino, favilavir yakangobvumidzwa kurapwa kwechirwere (muJapan neChina).

Zvakare chaizvo zvinopesana nefuru iri mukusimudzira ATR-002 , kinase inhibitor yekambani Atriva Therapeutics muTübingen. Iyo kambani yava kuongorora kana chinhu chinoshanda chinogona zvakare kudzivisa kuwanda kweSARS-CoV-2.

APEIRON Biologics (Vienna) neUniversity yeBritish Columbia vanoda mushonga APN01yedzo yakabuda mukutsvaga kweSARS uye yatove yakaedzwa muzvidzidzo zvevarwere kupokana nezvimwe zvirwere zvemapapu. Inodzivirira mamorekuru ari pamusoro pemapapu maseru anoshandiswa nemavhairasi sechinangwa chekupinda mumasero.

Chloroquine rave kunyatso kuzivikanwa sechinhu chinoshanda mumushonga wemalaria, asi rakangotemerwa zvishoma kwazvo mumakore apfuura. Nekudaro, ikozvino zvave kuzivikanwa kuti chinhu chinoshanda chinogona kushandiswa zvakare antivirally. Mushure mekuvhenekwa kwakanaka kwerabhoritari kurwisa SARS-CoV-2. VaChinese vaongorori panguva iyi vakawanawo nhau dzekuti chloroquine yakaratidza kuti inoshanda muchidzidzo chekiriniki. Kambani yeBayer yakazotangazve kugadzirwa kwayo kwekutanga kugadzirira ne chloroquine. Zvidzidzo pa

marariya zvinodhaka zvine zvakafanana zvinoshanda hydroxychloroquine iri kuongororwa izvozvi. Kambani Novartis yakabvuma kutsigira izvi nekupa mune zvisarudzo zvakanaka nevakuru vezvekutonga mukupera kwaMay kusvika pamamirioni zana nemakumi matatu emayero ayo ekurapa vanhu pasi rese. Zvakare, Sanofi kupa mushonga wemalaria nemushonga unowanikwa.

Kubva kumunda wapfuura wekushandisa, Camostat Mesilat hachisi chaicho antiviral mumiriri - chinodhaka nacho chakatenderwa muJapan nekuda kwekuzvimba kwepancreas. Zvisinei, vaongorori vanobva kuGerman consortium yemasangano ekutsvagurudza anotungamirwa neGerman Primate Center kuGöttingen vakaona kuti inodzivirira enzyme kubva mumaseru emapapu murabhoritari yakakosha pakupinda kwehutachiona hweSARS-CoV-2. Iwe saka urikuronga kuyiyedza muzvidzidzo zvekiriniki.

Zvakare chinhu chinoshanda Brilacidin kubva iyo kambani Innovation Pharmaceuticals haina kutanga kugadzirirwa kurwisa hutachiona. Asi, izvozvi zviri kuongororwa kurapwa kwezvirwere zvemuviri uye kuzvimba kwemukanwa mucosa. Zvisinei, zvinotarisirwa kuti inogona kurwisa envelopu yekunze yehutachiwana hweSARS-CoV-2. Izvi pari zvino zviri kuongororwa mumasero tsika.

Kambani yeSpain PharmaMar inoda kuyedza mushonga wayo neplitidepsin muchidzidzo chakanangana neCovid-19 mushure mekukurudzira bvunzo dzevarabhoritari. Mushonga, uyo unobvumidzwa chaizvo muAustralia nekuSoutheast Asia kurapwa kweakawanda myeloma (chimiro chekenza yemongo wemapfupa), inofanirwa kutadzisa hutachiona kuwanda nekuti inovhara protein inodikanwa EF1A mumasero akabatwa.

Pfizer iri parizvino kuyedza kuwedzera antiviral vamiririri murabhoritari iyo kambani yakambogadzirirwa yekurapa zvimwe zvirwere zvehutachiona. Kana imwe kana dzakawanda dzadzo dzikazviratidza pachavo mumayedzo erabhoritari, Pfizer yaizozviisa pasi penyaya dzakakodzera dzehutachiona uye yotanga kuyedzwa nevanhu pakupera kwa2020 MSD pari zvino uchiongorora ndeipi yayo antiviral zvinodhaka kupesana neSARS-CoV-2 inogona kushanda. Novartis ari kuongorora kuti ndezvipi zvigadzirwa uye ndezvipi zvinhu kubva muraibhurari yayo yezvinhu zvekugadzira zvinodhaka zvinogona zvakare kukodzera kurapwa kwevarwere veCovid 19 - kungave semushonga wehutachiona kana kungave neimwe nzira (ona pazasi).

Kuderedza immunomodulators

Maitiro ekudzivirira muviri anodiwa zvakanyanya muvanhu vane hutachiona; iwo haafanire kuve akawandisa zvekuti anokonzeresa kukuvara kupfuura rubatsiro mumapapu.
Nechikonzero ichi, kuwanda kwekuzvidzivirira mumuviri muvarwere vanorwara zvakanyanya kunoderedzwa muzvirongwa zvakati.

Sanofi naRegeneron saka vari kuyedza yavo immune modulator sarilumab mune chidzidzo nevarwere vakaremara Covid-19. Uyu interleukin-6 anopikisa anotenderwa kurapa rheumatism.

Roche arikuedza interleukin-6 antagonist tocilizumabneCovid-19 varwere vane pneumonia yakaoma. Mushonga uyu watove wakabvumidzwa kurapwa kwerheumatoid arthritis. Vanachiremba veChinese vanga vachichiyedzawo kune varwere vane hutachiona nenguruve kwemavhiki mashoma.

Chinese vanachiremba vari kuyedzawo iyo fingolimod immunomodulator nevarwere. Yakagadziriswa naNovartis yekurapa kweakawanda sclerosis uye inotenderwa kwayo.

MuCanada, colchicine iri kuyedzwa muchipatara kuyedzwa ku kurapa kunyanyisa immune mhinduro, inotungamirwa neMontreal Heart Institute. Mushonga unobvumidzwa kurwisa gout (uye mune dzimwe nyika zvakare kurwisa pericarditis).

Mupfungwa yakafara iwe unogona zvakareSodium metaarsenite (NaAsO 2 ) ndeimwe yeanodzivirira immune nekuti inokanganisa kugadzirwa kweimwe nhume zvinhu zvemuviri wemuviri (iwo ma cytokines), ayo anogona kukonzeresa kuita kwakanyanya kwekudzivirira muviri. Iyo South Korea kambani Komipharm yakagadzira mushonga wekurwadziwa kwakabatana nebundu (zita rerojekiti PAX-1-001). Izvozvi yakumbira miedzo yekiriniki kuyedza mushonga pavarwere veCovid-19.

Mishonga yevarwere vemapapu

Chinese vaongorori vanoda kuyedza mushonga weRoche nechinhu chinoshanda pirfenidone yakatobvumidzwa kune varwere vane idiopathic pulmonary fibrosis. Mushonga uyu unopokana nekushaiwa kwekukuvara kwemapapu tishu.

Kambani yekuCanada Algernon Pharmaceuticals inoronga kuyedza mushonga wayo NP-120 nechinhu chinoshanda Ifenprodil kuti ikwane. Ifenprodil parizvino haina patent muJapan nekuSouth Korea kurwisa chirwere chetsinga. Algernon anga achigadzira mushonga wekupokana nediopathic pulmonary fibrosis nechinhu ichi chinoshanda kwenguva yakati.

Iyo Viennese biotech kambani Apeptico inoda kwayo inoshanda chinhu Solnatidekupokana nezvazvino kukundikana kwemapapu (ARSD) yekukodzera kwevarwere veCovid-19 vane kukuvara kwakanyanya kwemapapu. Izvo zvakagadzirirwa kudzoreredza kuomarara kwembambo mumatumbu emapapu.

Kambani yeUS Bioxytran parizvino iri kugadzira mushonga nechinhu chinoshanda BXT-25 kune varwere vane ARDS. Zvinotarisirwa kugadzirisa kukanganiswa kweoksijeni mumapapu akakuvara uye kubatsira varwere vanogona kungopihwa zvakakwana neoksijeni kuburikidza nemapapu ekugadzira. Iyo kambani inodawo kuyedza mushonga wayo nemumwe wayo kune vanorwara zvakanyanya neCovid-19.

Mishonga mitsva inopesana neSARS-CoV-2

Huwandu huri kukura hwemapurojekiti ari kuyedzawo kugadzira mishonga mitsva kurwisa Covid-19. Kune matatu marudzi emapurojekiti:

  • Zvirongwa zveantibhakitiriya ekudzivirira
  • Zviripo zviripo mumatanho ekutanga emishonga antiviral
  • Zvirongwa zvekuvandudzwa kwezvakakodzera zvinoshandiswa zvinoshandiswa

Heano mimwe mienzaniso yemapurojekiti kubva munzvimbo idzi:

Maantibodies ekudzivirira hutachiona

Imwe yemaitiro ekare ekurapa kurwisa utachiona ndeyekubaya varwere ma antibodies kubva muropa serum revanhu (kana mhuka) vakatopona chirwere ichi. Iyo diphtheria antiserum naEmil von Behring kubva muna 1891 yaive yatove nemhedzisiro iyi, kunyangwe dai paive pasina aiziva chero chinhu nezve ma antibodies panguva iyoyo. Mumwe muenzaniso majekiseni ekudzivirira ("vacive vaccination") evanogona kunge vakatapukirwa ne tetanus nekuti havana kubayiwa nhomba yacho. Munguva pfupi yapfuura, akati wandei antibody-ane Ebola mishonga yakaratidzirwa kuve inoshanda kwazvo muzvidzidzo.

Mazhinji emapurojekiti ekugadzirwa kwemishonga mitsva inopesana neSARS-CoV-2 saka tarisa pane serum yeropa yevaimbove varwere veCovid 19, iyo inonzi "convalescent serum". Tariro ndeyekuti mamwe ma antibodies aainayo anokwanisa kupa SARS-CoV-2 isingakwanise kubereka mumuviri.

Ichi chikonzero chinoteverwa nechirongwa nekambani yeTakeda: Mukati megadziriro yeiyo TAK-888 chirongwa, chinangwa ndechekuwana musanganiswa weantibody kubva muropa plasma revanhu vakapora kubva kuCovid-19 (kana gare gare kubva kuvanhu vakabayiwa nhomba yeCovid-19). Musanganiswa wakadai unonzi anti-SARS-CoV-2 polyclonal hyperimmune globulin (H-IG) ; kurapwa ne "passive immunization".

Mamwe makambani nemapoka ekutsvagisa munyika anoteverawo pfungwa iyi yakakosha, asi enda nhanho imwe zvichienda mberi maererano nebhaotechnology: Dzinotangawo nesekamu yesikarudzi, asi yosarudza masoja ekudzivirira muviri zvakanyanya wozo "teedzera" nenzira dzebhiotechnical kugadzira nzira zvinodhaka. Imwe yeaya mapurojekiti ari kuteverwa neSweden Karolinska Institute. Imwe kambani, AbCellera naLilly, vazivisa kuti mukati memwedzi mishoma inorwisa mishonga inopfuura mazana mashanu yakawanikwa ichashandiswa kugadzira mushonga unogona kuongororwa varwere. Zvakare AstraZeneca (UK), Celltrion (South Korea) uye (sekureva kwenhau) Boehringer Ingelheim uye yeGerman Center yeInfection Research (DZIF) vari kushanda kugadzira mushonga nenzira iyi.

Mubatanidzwa wemasangano ekutsvagisa muUSA unoenda nhanho imwe kumberi sechikamu cheDARPA Pandemic Kugadzirira Platform. Mukupedzisira, mushonga wavo haufanire kunge uine makemikari anoshanda zvakanyanya kubva kune convalescent plasma pachayo, asi pachinzvimbo magene ayo - muchimiro mRNA. Chero ani anobayiwa jekiseni neiyi mRNA anogadzira masoja ekudzivirira muviri mumuviri wake kwechinguva uye anodzivirirwa. Kubatsira kweiyi nzira: Zvichida zvinokwanisika kuburitsa huwandu hwakawanda hwezvinodhaka nekukurumidza kupfuura kana waifanirwa kugadzira maantibhakitiriya biotechnology. Izvo zvisina kunaka: Parizvino, hapana mumwe mushonga unoshanda seizvi. Iyo purojekiti inotungamirwa, pakati pevamwe, naJames Crowe, Vanderbilt University, Tennessee, uyo akagashira iyo future Insight Prize kubva kukambani yeGerman Merck mu2019 nekuda kwebasa rake rekupayona mundima iyi.

Mapurojekiti akati wandei emishonga mitsva anosiyana "convalescent serum" nzira. Saka Vir Biotechnology kare antibodies kubva muropa serum yevarwere yakadzorerwa yakanaya kubva kuhutachiona hweSARS hwa2003. Kambani iyi yave kuongorora nemasangano eU.S.NIH neNIAID kuti vanokwanisa here kumisa kuwanda kweSARS-CoV-2. Vir Biotechnology iri kushandira pamwe nekambani yeUS Biogen nekambani yeChinese WuXi Biologics yekugadzira biotechnological kugadzirwa kwe "makopi" emaa antibodies aya.

Musayendisiti anobva kuYunivhesiti yeUtrecht (Netherlands) akaedzawo masoja ekudzivirira chirwere kubva muropa serum reSARS convalescents kubva muna 2003. Vakawana antibody inogona kutadzisa kuwanda kweSARS-CoV-2 mutsika. Ikozvino inofanirwa kuyedzwa kumberi. Regeneron ndiye  ichiita chirongwa chakafanana: Iyo kambani iri kuyedza mushonga ne monoclonal ntibodies REGN3048 uye REGN3051 muchikamu chandinodzidza nevanozvipira. Aya ma antibodies akagadzirwa kuti arape MERS coronavirus, inoenderana neSARS-CoV-2. Zviripo zviripo mumatanho ekutanga emishonga antiviral Chikwata chekutsvaga paYunivhesiti yeLübeck chiri kutsvaga imwe nzira

Kwemakore anga achigadzira zvinonzi alpha-ketoamides seantiviral agents kurwisa corona uye enteroviruses (ayo anokonzeresa kuora kwemuromo pakati pezvimwe zvinhu). Mukuyedzwa kwerabhoritari, zvinhu zvitsva zvekuyedza zvinotadzisa kuwanda kwehutachiona uhu. Imwe yadzo, inonzi "13b", yakagadziridzwa kurwisa hutachiona hwekona. Ikozvino ichaedzwa mumasero etsika uye nemhuka uye, mune chiitiko chemhedzisiro yakanaka, kuyedzwa muzvidzidzo nevanhu pamwe nekambani yemishonga.

Mapurojekiti matsva ekuvandudza zvinodhaka

Makambani akati wandei emakemikari akabatana kugadzira mishonga mitsva yekurapa (senge majekiseni uye diagnostics) kurwisa Covid-19. Mune nhanho yekutanga, ivo vanozo gadzira yavo pachavo maunganidzwa ema mamorekuru anowanikwa, ayo mamwe data pamusoro pekuchengetedza uye maitiro ekuita atove aripo. Izvi zvinofanirwa kuongororwa nenzvimbo ye "Covid-19 Therapeutics Accelerator", iyo yakatangwa neGates Foundation, Wellcome neMastercard. Kune mamorekuru akarongwa sekuvimbisa, kuyedzwa nemhuka kunofanira zvakare kutanga mukati memwedzi miviri. Boka remakambani rinosanganisira BD, bioMérieux, Boehringer Ingelheim, Bristol-Myers Squibb, Eisai, Eli Lilly, Gilead, GSK, Janssen (Johnson & Johnson), MSD, Merck, Novartis, Pfizer neSanofi.

Iwo makambani ari kutsvaga rakasiyana chirongwaVir Pharmaceuticals uye Alnylam Pharmaceuticals. Iwe wakazivisa kuti iwe unozogadzira izvo zvinonzi siRNA vamiririri vanovharira hutachiona nekukonzeresa mamwe emajini ayo kumira kushanda. Maitiro acho anonzi geni kunyarara.

Kutsanya kwakadii?

<

Nezvomunyori

Juergen T Steinmetz

Juergen Thomas Steinmetz akaramba achishanda muindasitiri yekufambisa uye yekushanya kubva achiri mudiki kuGerman (1977).
Iye akatanga eTurboNews muna 1999 sebhuku rekutanga repamhepo pamhepo yepasirese yekushanya indasitiri yekushanya.

Govera ku...