ROME. Infects more and escapes vaccines. Sos for the Japanese variant E484k. Compared to the mutations identified so far, it resists both vaccines and the antibodies produced by Covid. The alarm was raised by the immunologists who sequenced it in Tokyo. “The mistakes of a year ago must not be repeated, we must immediately run for cover or the intensive care will go into further suffering – he explains to the Stampa.it Professor Patrick Franzoni, internist and emergency doctor, responsible for the vaccination plan and rapid tests in South Tyrol-. With indirect flights from Asia, this dangerous variant threatens to arrive immediately in Italy, further aggravating the situation of hospital admissions ».
The killer sequence
«The Sars-Cov-2 changes in its favor, that is, it assumes a more advantageous form that allows it to accelerate its replication – explains Professor Franzoni-. The more the virus circulates, the more likely random mutations are in the amino acid sequence regulated by a protein. In evolution, the variant able to circulate faster wins because it is the most performing one. That is, it allows the virus to replicate in the organism in conditions that are more favorable to it. The more aggressive mutation prevails, the others succumb, regress when the more effective variant arrives. This is how the threat that our immune system fails to recognize it increases, weakening or even invalidating the action of vaccines. This inevitably has repercussions on the overload of intensive care ”.
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The urgency to vaccinate
“The identification of mutations must lead us to speed up the vaccination campaign as much as possible,” he stresses Stampa.it the infectious disease specialist Roberto Cauda (director of the Gemelli Operational Unit), engaged at the forefront in the sequencing of the variants of Sars-Cov-2 in collaboration with Professor Massimo Ciccozzi, head of the Medical Statistics and Epidemiology Unit of the Campus Bio- Doctor. Professor Cauda adds: «The more the virus circulates, that is, the more it affects an increasing number of people, the statistically greater the possibility that replicating will undergo variations. In the replications of Sars-Cov-2, those that infect the most subjects are naturally selected ”.
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Parameters to update Professor Cauda was commissioned by the government to deal with the parameters for the assessment of epidemiological risk. And for the review or update of monitoring in light of the new variants of Covid. The infectious disease specialist points out: «Almost all of the thousands of virus mutations do not have a clinical impact. From an epidemiological point of view, however, 90% of current cases are due to the English variant which is the best scientifically studied so far. Now, in addition to the Japanese mutation, in the international scientific community we are deepening the Brazilian, South African, Nigerian and Californian ones. The more a form is transmissible, the greater is the affected audience and consequently the incidence of serious cases requiring hospitalization increases. Therefore the clinical problem of gravity is directly linked to the spread of the virus ».
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How Sars-Cov-2 changes
The director of the Complex Operative Unit of the Gemelli Polyclinic and ordinary of Infectious Diseases of the Catholic University of the Sacred Heart adds: «Each variant brings with it specific epidemiological and clinical criticalities. We can count on four vaccines that act on the Spike protein, that is, the component of the virus that binds to the cell through the Ace2 receptor, allowing Sars-Cov-2 to enter the human body. It is possible to block the entry of the virus through the antibodies produced by the Spike vaccine or with the monoclonal antibodies that we inject on people who have contracted Covid. The problem is that monoclonal antibodies were also produced by recognizing the Spike protein. Therefore the danger is that if the Spike protein changes, the antibodies recognize it less and their effectiveness is considerably reduced ».
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Race against time
Professor Cauda highlights: «The history of diagnostic tests and anti-Covid vaccines began on 10 January 2020 when the Chinese health authorities provided the sequence of the Sars-Cov-2. From there, the swabs were prepared and the vaccine race began. The ones we now have were produced on the virus circulating in Europe rather than on the original Chinese one. We have ascertained that the English variant is “covered” by vaccines. Now it is a question of seeing for the others what the loss of effectiveness of mass immunization campaigns is, mutation by mutation. The epidemiological situation does not yet allow us to establish whether a variant affects the vaccinated or those who have contracted the disease and are cured of it. Our focus now is on reinfections and this happens by putting the mutated virus in contact with the antibodies produced in the vaccinated subjects. This is how we see if the neutralizing capacity of a vaccine changes. For example, in the case of the South African variant, it can be assumed that there is a reduction in the efficacy of the vaccine even if there is still no validated scientific study in this regard. It can be reasonably hypothesized that even if the vaccine cannot totally block the infection in the case of a variant, it can still prevent the most serious forms of the disease “.
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Adaptation of vaccines
“For each variant that has a relevant epidemiological impact, it is possible to work on updating the vaccines. The World Health Organization (WHO) indicates to vaccinate in the presence of variants- points out the UOC director of Gemelli-. This is because the greater the portion of the population vaccinated, the smaller the number of severe cases that develops. That is, the vaccine maintains its effectiveness, while its revision is carried out on the basis of the Sars-Cov-2 mutation. Immunizing, in fact, stimulates the polyclonal response, i.e. not only the one that acts on the Spike protein but on other components of the virus such as the nucleoprotein and the membrane. And this could lead to significant effectiveness. This is how, for example, the Chinese vaccine works, which is a traditional type vaccine, ie obtained from the inactivation of the virus. In other words, we work on polyclonal stimulation, not towards a single antigen ».
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