Tuesday, April 20

“To be prepared for the next pandemics, we must invest more in basic research”


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The immunologist Akiko Iwasaki @VirusesImmunity has become one of the most active researchers on Twitter when it comes to speaking on social media about the SARS-CoV-2 coronavirus pandemic without sacrificing scientific rigor. Professor at Yale University (USA) and occasional collaborator with The New York Times, together with a group of scientists, helped create a plan to address Covid-19. He has published articles in «Nature» O «Science» about SARS-CoV-2. In addition, she is a great activist against the glass ceiling of women in science. Last month he participated in a Online seminar organized by the National Center for Cardiovascular Research (CNIC).

How should we prepare for the next pandemics?

The fact of having managed to design vaccines in such a short period of time should not fall on deaf ears. It has followed a great triumph in the field of vaccines, and scientific research in general, and has been a boost for basic scientific research for the next few years. However, as I have said, once we have overcome this pandemic, we cannot stop. More investment is needed in basic scientific research if we are to be better prepared for the next pandemics.

More and more cases of reinfection by SARS-CoV-2 are being reported. What effects can it have in the course of the pandemic?

It is true that the number of reinfection cases are increasing. The causes? It may be because the immunity acquired from the original infection is decreasing and / or the increase in the number of new variants that seem to be able to escape the existing immunity in these people. But we have to bear in mind that it is possible that there are simply more people exposed and re-exposed to the virus around the world. What we still have to find out is whether the reinfections are causing a more or less serious disease, and what determines this result. This is a key issue that we still need to resolve.

In this sense, how concerned should we be about these new strains of Covid-19 that are appearing around the world?

Currently there are some variants that are worrying because they have a greater capacity for transmission, to evade antibodies and innate immune resistance mechanisms. To stop the spread of these variants, vaccines must be given to as many people as possible and as quickly as possible. But we must not forget other essential measures and we have to redouble the use of masks and physical distancing measures.

Is it normal that so many variants have appeared in so few months?

It’s a bit surprising that all of these variants are popping up in different parts of the world at the same time. This situation could reflect the time required for the virus to select variants among the population, especially in immunosuppressed patients who are carriers of the virus for a prolonged period of time.

His work looks at people with long-term Covid who cannot get rid of symptoms such as fatigue and mental confusion.

Could you give us a clue as to why these symptoms persist and if there is a definitive profile?

I think there are three possible ways that you can produce a prolonged Covid. One is that the long-term symptoms are caused by a persistent viral infection. Second, these symptoms are caused by viral remains that remain in the body but are not infectious viruses, but RNA and / or viral proteins.

Third, prolonged Covid could be caused by autoimmune responses against autoantigens. These three possibilities are not self-exclusive. In some people with persistent covid-19 there may be a single cause or two or three coincide. It is important to understand which of these situations are happening in each patient so that we can provide the appropriate therapy.

One of his jobs during the pandemic was to demonstrate that amount of virus in saliva can predict the severity of the disease. How does it work?

In collaboration with Aaron Ring’s lab, at the Yale university, we found that saliva viral load is a much better predictor of disease severity and outcome than nasopharyngeal viral load.

We suspect this is because saliva accumulates viruses from organs such as the lower respiratory tract, where SARS-CoV-2 can cause much more damage than the upper respiratory tract (detected by nasopharyngeal swab). Viruses in the lower respiratory tract can travel up the mucociliary escalator of the airways and end up in the oral cavity.

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