As vaccines for COVID-19 reach the end of their clinical trials and begin the approval process for rollout, a Cornell professor is researching a drug that could protect individuals from infection — one that is comparable to Tamiflu.
Prof. Christopher Alabi, chemical and biomolecular engineering, released a study for peer review on a mechanism that successfully blocked the transmission of SARS-CoV-2 in ferrets. Alabi’s co-authors on the study are now applying for a patent that would make use of this discovery in a drug.
From the start, Alabi said the goal of the study was to create “a post-exposure drug that will prevent the spread of the virus.”
The drug is a nasal spray composed of lipoproteins that coat the epithelial tissue lining the respiratory tract, preventing the virus’s ability to dock and enter a cell to proliferate and hijack the immune system.
In contrast to antibody therapies and vaccines, the researchers hope to make a nasal inhibitor that could serve as a tool to protect anyone.
“It’s a dry powder, [and] if it works should be cheap and easy to manufacture and [prescribe],” Alabi said.
Co-authors at Columbia University, including Dr. Anne Moscona, are pursuing a patent for the mechanism that fueled this study.
Similar to Tamiflu, the drug functions as a preventative measure, and it can be used to protect people who take care of individuals who test positive, such as frontline workers, family members or even students and their roommates, Alabi said.
Tamiflu, a relatively inexpensive drug, inhibits the proliferation of the influenza virus in the body and prevents its spread. The drug is intended to act prophylactically, disabling pathogens after infection but before there is enough viral load to cause symptoms.
The study arrived at a critical point in the pandemic, as U.S. COVID-19 infection rates continue to shatter daily infection numbers. The week of Nov. 9, when the study was released, the United States topped off at more than 140,000 cases. Since then, infection rates have continued to climb to record highs. A month later, the U.S. was treating a total of 100,266 patients after a week in which more than a million new COVID-19 cases were detected.
While Operation Warp Speed, which aimed to create a vaccine in record time, has been a focal point in the media, Alabi argued that management of COVID-19 will require many approaches, as vaccines and therapies are not a one-size-fits-all.
“Think about the cohort of Americans that are immunocompromised… either [they] have AIDS or [another RNA virus], Alabi said. “Vaccines [will not work for them].”
Patients with AIDS would not benefit from vaccines because prominent therapies like the Pfizer vaccine only provide patients with messenger RNA, which serves as a blueprint for the body to construct the necessary components to digest and clear out foreign pathogenic COVID-19 particles.
Diseases that leave patients immunocompromised are unable to develop an immune response to the mRNA — which is necessary to gain immunity, Alabi explained.
And while there are antibody therapies based on expensive monoclonal antibody assays, like the ones President Donald Trump received in October, the virus still mutates at a high rate, making antibodies an insufficient form of treatment.
On top of these genetic barriers, access to alternative treatments is another issue. The Regeneron monoclonal antibodies, for example, are expensive, costing $1,500 per treatment, which Alabi described as an “elite” drug.
The international study depended on collaboration, piecing together the resources and expertise of many researchers.
Alabi said that the Geluman lab in Wisconsin was instrumental in refining the sequence of peptides to maximize its efficiency as a drug. Meanwhile, researchers at Columbia University worked on applying it to skin cells in test tubes, while the Erasmus Center in the Netherlands introduced the drug to live ferrets.
“The lipopeptide itself was made in my lab, we did the conjugation [linkage of cholesterol and protein regions],” Alabi said.
While the study is in its infant stages and scientists are cautious, it is promising.
“Ferrets, [are] a great model, they do show all the same signs of viral proliferation as humans do,” Alabi said.
The study, which started in early April, is still eight months out from full publication, let alone clinical research in the U.S. However, given the timeline and severity of the pandemic, the research needs to address the long-term issue of coping with the disease as a new norm, Alabi said.
“We have to arm ourselves with everything that we can,” Alabi said.
Alabi emphasized that it will be critical to develop an arsenal of similar drugs for future pandemics.
“[I believe] masks really will be a thing of the future and not just a temporary thing,” Alabi said. “[The next pandemic will be a] matter of when, not if.”