Trump mask
POST-TREATMENT: President Donald Trump pulls off his protective face mask as he poses atop the Truman Balcony of the White House after returning from being hospitalized at Walter Reed Medical Center, October 5, 2020. Image Credit: REUTERS/Erin Scott/File PhotoREUTERS

DUBAI: US President Donald Trump is back on his feet after being infected with COVID-19. The same disease has killed more than 1 million around the world, of which 215,000 are in the US. And the world isn’t out of the woods yet vis-a-vis the deadly virus. Flights aren't back to normal, UK cases are expected to rise and France is risking a second lockdown.

According to White House doctors, Trump had a fever "Thursday into Friday” (October 1-2, 2020). At 4pm, on October 2, Trump was given a dose of Regeneron’s experimental drug. Two hours later, he was flown to a military hospital. On October 8, 2020, he was back in the While House from hospital, and went back to work, thanks to what he has extolled as "miracles coming down from God.”

What is he talking about? Manufactured antibodies, that's what. They are touted as the next big COVID-19 treatment.

What “miracle” drug did President Trump get?

It is called REGN-COV2, a therapy known as “monoclonal antibody cocktail”. The cocktail was developed by US biotech firm Regeneron. It’s currently labelled as an “experimental drug”. It was given under what is called a “compassionate use” exemption.

Before being admitted to Walter Reed National Military Medical Center, he was quickly given REGN-COV2. The new treatment — a pair of monoclonal antibodies — promises to potentially change the way doctors treat people with COVID before they are admitted to a hospital. Trials show it appears to help the “seronegative” patients.

What other drugs were given to President Trump?

About 48 hours after his COVID-19 diagnosis, President Trump was flown to Walter Reed. On his second day of hospital stay, the US leader received the anti-viral drug remdesivir, according to his doctors. Many hospitalised COVID-19 patients do take remdesivir, but likely for more severe infections. Two days after his diagnosis, US media reported that President Trump had also received the widely available, affordable steroid dexamethasone.

How many people have received the 'miracle' therapy?

Trump received it as part of a treatment regimen for COVID-19. Outside of clinical trials, only a few patients had received REGN-COV2. It has reportedly been used on only 2,000 people in studies as of early October 2020.

What does it do?

The cocktail is credited for “powerfully reducing the amount of virus found in nasopharyngeal swabs and alleviating symptoms more quickly,” Science reported, quoting study results. Since then, the landscape of therapies for COVID-19 has dramatically changed.

Antibodies form the basis of "adaptive" immunity. In a way, they are genetically "engineered" by the human body to recognise certain pathogens (disease-causing agents). This genetic engineering occurs within white blood cells called B cells. The B cells manufacture and display the proteins on the cell surface, whereby genes sort of rearrange like a set of numbers rearranging to form different sequences or patterns.

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One fascinating thing about this phenomenon: B cell goes on to clone itself through a process called "clonal expansion", which then helps mount a fight (immune response) by spawning vast quantities of antibody and memory B cells. These memory B cells remember the encounter for any future infections from similar pathogens. It also activates other immune cells.

SERONEGATIVE
Giving a negative result in a test of blood serum, for example, for the presence of a virus.
Antibodies vs antigens
Image Credit: Gulf News / Jay Hilotin

Why is it called a “cocktail”?

The cocktail consists of two monoclonal antibodies that “stick” to the SARS-CoV-2 spike protein. Scientists explain that it’s not a really complicated mixture. Rather, the cocktail is just two monoclonal antibodies (labelled as REGN10933 and REGN10987).

How does it work?

Alina Baum, and other Regeneron investigators, explained in a study published in Science that the treatment with two monoclonal antibodies works to defeat “viral escape” that can occur when viruses mutate. This way, they are no longer recognised — and are thwarted by a single monoclonal antibody.

In the Science paper, published June 15, 2020, Baum and co also explained that their results show that two monoclonal antibodies are more effective when they stick to distinct “noncompeting areas” of the spike protein of the SARS-CoV-2 virus — rather than overlapping ones.

Antibodies form the basis of "adaptive" immunity. In a way, they are genetically "engineered" by the human body to recognise certain pathogens (disease-causing agents).

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Why is it controversial?

Pro-life Republicans are against human embryonic stem cell and any research on fetal tissue. For decades, fetal tissue from abortions has been crucial to scientific research into treatments for conditions from birth defects to Ebola to cancer. And fetal tissue has been particularly important for studying the immune system, a key to designing treatments and vaccines for infectious diseases like COVID-19.

Promoting the dignity of human life from conception to natural death is one of the very top priorities of President Trump’s ͵羺istration.=

- Department of Health and Human Services statement in 2019

The use of vaccines prepared from cells derived from aborted human fetuses has re-emerged as a major talking point. Scientists, ethicists and religious leaders  have added to the mix, raising salient facts and issues.

Fetus foetus
EMBRYONIC AND FETAL CELLS: The use of embryonic and fetal cells from aborted babies in the pharmaceutical industry and in medical research is well-documented. Its re-emergence for use against COVID-19 has made the issue a major ethical talking point. Scientists, ethicists and religious leaders have added to the mix, raising salient facts and issues.

What is the US government’s stance on cell-line-based therapies?

In 2019, the Trump ͵羺istration suspended federal funding for most new scientific research projects involving fetal tissue derived from abortions. At that time, officials argued that whatever the scientific benefits, there was a pressing moral imperative to find alternative research methods.

U.S. President Donald Trump, who is being treated for the coronavirus disease (COVID-19) in a military hospital outside Washington, speaks from his hospital room, in this still image taken from a video supplied by the White House, October 3, 2020. The White House/Handout via REUTERS THIS IMAGE HAS BEEN SUPPLIED BY A THIRD PARTY.
U.S. President Donald Trump, who is being treated for the coronavirus disease (COVID-19) in a military hospital outside Washington, speaks from his hospital room, in this still image taken from a video supplied by the White House, October 3, 2020. The White House/Handout via REUTERS THIS IMAGE HAS BEEN SUPPLIED BY A THIRD PARTY. Image Credit: Reuters

“Promoting the dignity of human life from conception to natural death is one of the very top priorities of President Trump’s ͵羺istration,” the Department of Health and Human Services said in a statement released at the time. Experts said the cocktail used on President Trump was made possible by human embryonic stem cell and fetal tissue research, using what are called “cell lines”.

GLOSSARY: THERAPY
A therapy or medical treatment is the attempted remediation of a health problem, usually following a diagnosis.

The root word can be traced all the way back to the Greek "therapeutikos" (from therapeuein, meaning “to attend” or “to treat”).

What are cell lines?

Cellular biologists grow cells in the laboratory all the time. Cells from humans, animals, plants and micro-organisms are isolated and cultivated to develop “cell lines” for research and medical treatment. Growing cells helps them unlock the secrets cell activity, both normal and abnormal (like cancer, which results from an abnormal multiplication of cells).

The “cell lines” used to develop monoclonal antibodies, as well as remdesivir and vaccines, began with fetal tissue decades ago. The use of embryonic and fetal cells (or cell lines) from aborted babies in vaccines and in medical research is well-documented. Several (Science reports "at least four") coronavirus vaccine candidates reportedly use the same method.

Which one came from aborted fetuses? 

The cells used by most of the companies now trying to find a COVID-19 treatment, called the 293T line, were derived from the kidney tissue of a fetus aborted in the 1970s. A similar cell line, Per.C6, was obtained in 1985 from the retinal cells of an aborted 18-week-old fetus.

Does the monoclonal cocktail antibody therapy work on everyone?

No. Science, citing a new study, has reported that the monoclonal cocktail showed little effect on people who already had antibodies against the virus.

Would it work as a preventive treatment?

There’s at least one study being conducted involving scientists from the University of North Carolina, Chapel Hill, to test Regeneron’s monoclonal cocktail as a preventive treatment against COVID-19.

Who else is developing this kind of monoclonal antibody cocktail?

Besides Regeneron, other biotech companies (including Eli Lilly, Vir) are reportedly developing their own monoclonal antibody cocktail against COVID-19

ANTIBODIES
When the human body is invaded by a foreign pathogen – be it a bacteria, virus, fungi or parasite – Y-shaped proteins called “antibodies" are formed. They circulate through the body to sequester and alert other immune chemicals and cells to destroy the pathogen, much like a search-and-destroy system.

Was the fetal cell lined used in the therapy aborted just recently?

No. The therapy received by President Trump was developed using human cells derived from a fetus aborted decades ago. At least two companies racing to create a vaccine against the coronavirus, Moderna and AstraZeneca, are also relying on the cells. Johnson & Johnson is reportedly testing its vaccine in another so-called cell line originally produced from fetal tissue.

On Friday (October 9, 2020) Trump said antibody cocktail drugs developed by Regeneron Pharmaceuticals Inc and Eli Lilly and Co approved quickly and out to hospitals after his own positive coronavirus treatment experience, according to a Reuters report.

Is Trump contradicting himself by using REGN-COV2?

A Trump ͵羺istration official argued that the president’s embracing of the treatments was not a contradiction. The ͵羺istration’s policy on fetal tissue research “specifically excluded” cell lines made before June 2019, said the official, who did not wish to be identified because he was not authorized to speak about the matter.

Scientific products made using cell lines that existed before then “would not implicate the ͵羺istration’s policy on the use of human fetal tissue from elective abortions,” the official said. Dr. Deepak Srivastava, a pediatric cardiologist who led the International Society for Stem Cell Research until July, said, “If they oppose this research, they should be willing to not take a drug that was developed using that.”

How many vaccine candidates against COVID-19 rely fetal cell lines?

One analysis identified 13 vaccine candidates for the coronavirus that rely on fetal cell lines.

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