Testing future pandemic vaccines in advance
December 8, 2020 3:09 PM Subscribe
"You may be surprised to learn that of the trio of long-awaited coronavirus vaccines, the most promising, Moderna’s mRNA-1273, which reported a 94.5 percent efficacy rate on November 16, had been designed by January 13."
"[T]he scientists I spoke to about the way this pandemic may reshape future vaccine development were more focused on how to accelerate or skip Phase I, which tests for safety. More precisely, they thought it would be possible to do all the research, development, preclinical testing, and Phase I trials for new viral pandemics before those new viruses had even emerged — to have those vaccines sitting on the shelf and ready to go when they did. They also thought it was possible to do this for nearly the entire universe of potential future viral pandemics — at least 90 percent of them, one of them told me, and likely more."
"[T]he scientists I spoke to about the way this pandemic may reshape future vaccine development were more focused on how to accelerate or skip Phase I, which tests for safety. More precisely, they thought it would be possible to do all the research, development, preclinical testing, and Phase I trials for new viral pandemics before those new viruses had even emerged — to have those vaccines sitting on the shelf and ready to go when they did. They also thought it was possible to do this for nearly the entire universe of potential future viral pandemics — at least 90 percent of them, one of them told me, and likely more."
None of the scientists I spoke to for this story were at all surprised by either outcome — all said they expected the vaccines were safe and effective all along. Which has made a number of them wonder whether, in the future, at least, we might find a way to do things differently — without even thinking in terms of trade-offs. Rethinking our approach to vaccine development, they told me, could mean moving faster without moving any more recklessly. A layperson might look at the 2020 timelines and question whether, in the case of an onrushing pandemic, a lengthy Phase III trial — which tests for efficacy — is necessary. But the scientists I spoke to about the way this pandemic may reshape future vaccine development were more focused on how to accelerate or skip Phase I, which tests for safety. More precisely, they thought it would be possible to do all the research, development, preclinical testing, and Phase I trials for new viral pandemics before those new viruses had even emerged — to have those vaccines sitting on the shelf and ready to go when they did. They also thought it was possible to do this for nearly the entire universe of potential future viral pandemics — at least 90 percent of them, one of them told me, and likely more.
There is a big difference between not being surprised by an outcome and willing to bet other people's lives on it, which this article downplays.
You've been able to go from character strings to physical DNA for decades, but it is now much faster (a few days) and error-free. Inserting it into a production vector takes a day once it's been produced. So taking 3-4 days from publication of a peptide coding sequence to a potential vaccine vector is totally possible barring pathological structure of the DNA sequence (which could require recoding to allow gene synthesis, or might create unwanted products).
For the other vaccines like the chimp adenovirus piggyback versions, the cost of getting the antigen wrong is much higher. The second time you inject the vector, your immune system reacts to the delivery system rather than the viral protein you are supposed to be immunizing against. So, if you're wrong there is a very large cost to being wrong, you can never use that particular delivery agent again in a useful manner. I still think it remains to be seen if multiple injections (e.g. >10) result in any kind of resistance to LNPs. We'll see as more vaccines are tried.
Generation of autoantibodies are a real concern in vaccines, and there is no reason to think that mRNA vaccines will be free of them. I think this is a very utopian article and downplays why vaccines were not rushed in the first month -- a low mortality rate makes it all the riskier to throw the kitchen sink at a virus. If SARS-CoV-2 had a 30% mortality rate people would have been injecting vaccines in March.
posted by benzenedream at 4:03 PM on December 8, 2020 [37 favorites]
There is a big difference between not being surprised by an outcome and willing to bet other people's lives on it, which this article downplays.
You've been able to go from character strings to physical DNA for decades, but it is now much faster (a few days) and error-free. Inserting it into a production vector takes a day once it's been produced. So taking 3-4 days from publication of a peptide coding sequence to a potential vaccine vector is totally possible barring pathological structure of the DNA sequence (which could require recoding to allow gene synthesis, or might create unwanted products).
For the other vaccines like the chimp adenovirus piggyback versions, the cost of getting the antigen wrong is much higher. The second time you inject the vector, your immune system reacts to the delivery system rather than the viral protein you are supposed to be immunizing against. So, if you're wrong there is a very large cost to being wrong, you can never use that particular delivery agent again in a useful manner. I still think it remains to be seen if multiple injections (e.g. >10) result in any kind of resistance to LNPs. We'll see as more vaccines are tried.
Generation of autoantibodies are a real concern in vaccines, and there is no reason to think that mRNA vaccines will be free of them. I think this is a very utopian article and downplays why vaccines were not rushed in the first month -- a low mortality rate makes it all the riskier to throw the kitchen sink at a virus. If SARS-CoV-2 had a 30% mortality rate people would have been injecting vaccines in March.
posted by benzenedream at 4:03 PM on December 8, 2020 [37 favorites]
(Correct me if I'm wrong, immunologists of Metafilter): One exciting use I have heard for mRNA vaccines is to cure cancer. The unique signature of a patient's cancer cells can be captured as mRNA instructions, leading to the immune system developing antibodies that kill specifically those cancer cells and no others. It fools your body into thinking your cancer is a germ to fight off -- you would become immune to that specific cancer.
posted by Harvey Kilobit at 4:07 PM on December 8, 2020 [1 favorite]
posted by Harvey Kilobit at 4:07 PM on December 8, 2020 [1 favorite]
Sounds like scientists are trying for VC money from the breathless prose
posted by scruss at 4:08 PM on December 8, 2020 [5 favorites]
posted by scruss at 4:08 PM on December 8, 2020 [5 favorites]
It's not a guarantee you'll get the 3D structure right every time with the mRNA approach, but obviously the ringing success in this case is a good sign. And there are obviously viruses (HIV most famously) that resist our vaccination efforts.
Given New York's generally abysmal science reporting the first paragraph filled me with dread, but at least they mostly stick to the truth that the "design" was never going to be the slow point of vaccine development (despite playing a bit coy in places).
The preventive approach is reasonable but maybe a bit oversold--we're doing constant influenza surveillance, especially looking at human southern hemisphere strains (during their flu season) to prepare our vaccines in the northern hemisphere. So I think it's optimistic the protection or speed (take your pick) would be as good for a novel strain that jumps species. (The cynic in me is also thinking, well, vaccines aren't a huge growth business so where do you go now if you're running a vaccine company? Convincing people to stockpile vaccine candidates for diseases that don't exist yet is one option.)
But for sure it makes complete sense--even if it doesn't work perfectly or you only trim 2-3 months off deployment that's hundreds of thousands of lives saved! And the return on investment is huge, just in government accounting standards for lives saved, forget the economic impact of a pandemic.
posted by mark k at 4:09 PM on December 8, 2020
Given New York's generally abysmal science reporting the first paragraph filled me with dread, but at least they mostly stick to the truth that the "design" was never going to be the slow point of vaccine development (despite playing a bit coy in places).
The preventive approach is reasonable but maybe a bit oversold--we're doing constant influenza surveillance, especially looking at human southern hemisphere strains (during their flu season) to prepare our vaccines in the northern hemisphere. So I think it's optimistic the protection or speed (take your pick) would be as good for a novel strain that jumps species. (The cynic in me is also thinking, well, vaccines aren't a huge growth business so where do you go now if you're running a vaccine company? Convincing people to stockpile vaccine candidates for diseases that don't exist yet is one option.)
But for sure it makes complete sense--even if it doesn't work perfectly or you only trim 2-3 months off deployment that's hundreds of thousands of lives saved! And the return on investment is huge, just in government accounting standards for lives saved, forget the economic impact of a pandemic.
posted by mark k at 4:09 PM on December 8, 2020
The unique signature of a patient's cancer cells can be captured as mRNA instructions, leading to the immune system developing antibodies that kill specifically those cancer cells and no others.
Not just antibodies, but short segments of RNA can also be used to turn off or "silence" genes ("RNA interference"). Certain genes are expressed more or "turned on" more highly in cancer cells, than in healthy tissue. These genes help cancer cells proliferate and evade the immune system. A good example of such a gene is VEGF, which spurs blood vessel growth to tumors, feeding them. So far, silencing VEGF helps slow the progression of tumors in mice, which suggests a promising therapy for humans down the road.
posted by They sucked his brains out! at 4:21 PM on December 8, 2020 [5 favorites]
Not just antibodies, but short segments of RNA can also be used to turn off or "silence" genes ("RNA interference"). Certain genes are expressed more or "turned on" more highly in cancer cells, than in healthy tissue. These genes help cancer cells proliferate and evade the immune system. A good example of such a gene is VEGF, which spurs blood vessel growth to tumors, feeding them. So far, silencing VEGF helps slow the progression of tumors in mice, which suggests a promising therapy for humans down the road.
posted by They sucked his brains out! at 4:21 PM on December 8, 2020 [5 favorites]
(Correct me if I'm wrong, immunologists of Metafilter): One exciting use I have heard for mRNA vaccines is to cure cancer. The unique signature of a patient's cancer cells can be captured as mRNA instructions, leading to the immune system developing antibodies that kill specifically those cancer cells and no others. It fools your body into thinking your cancer is a germ to fight off -- you would become immune to that specific cancer.
It's a little more complicated than that, but here's a good article: Individualized Neoantigen Vaccines
posted by benzenedream at 4:22 PM on December 8, 2020 [8 favorites]
It's a little more complicated than that, but here's a good article: Individualized Neoantigen Vaccines
posted by benzenedream at 4:22 PM on December 8, 2020 [8 favorites]
Most of what I know about the immune system comes from an old edition of Sompayrac, and I don't remember any points at which mRNA is presented to the adaptive immune system. I'll obviously have to do some reading to catch up on how all this works.
posted by clawsoon at 4:29 PM on December 8, 2020 [2 favorites]
posted by clawsoon at 4:29 PM on December 8, 2020 [2 favorites]
clickbait BS and I'm ultra-dissapointed in NY Mag for publishing such an irresponsible piece, especially with that headline.
Read benzenedream's analysis why. We're rolling this particular vaccine out to probably a minimum of ~500 million people in the next two years. If there was even a hint of 0.05% serious side-effects above background, that's 250,000 people in hospital - or worse.
We needed this to be slow and we are STILL going too quickly; it's only because the fact that many countries, (and their politico-economic systems & populaces) have failed to keep the virus in check , and others are on the point of failing, that we needed to speed things up.
posted by lalochezia at 4:33 PM on December 8, 2020 [11 favorites]
Read benzenedream's analysis why. We're rolling this particular vaccine out to probably a minimum of ~500 million people in the next two years. If there was even a hint of 0.05% serious side-effects above background, that's 250,000 people in hospital - or worse.
We needed this to be slow and we are STILL going too quickly; it's only because the fact that many countries, (and their politico-economic systems & populaces) have failed to keep the virus in check , and others are on the point of failing, that we needed to speed things up.
posted by lalochezia at 4:33 PM on December 8, 2020 [11 favorites]
What do y'all think of the article's central idea, of testing a whole bunch of vaccines for safety long before any pandemics that the vaccines would be needed for come along?
posted by clawsoon at 4:37 PM on December 8, 2020 [1 favorite]
posted by clawsoon at 4:37 PM on December 8, 2020 [1 favorite]
One thing I remember from a half-listened to episode of "This Week in Virology" is that it's entirely possible that there are broadly-acting antivirals that would work against coronaviruses generally (I guess like Tamiflu, but for coronaviruses), but nobody developed them for lack of money (since until 2019, all known coronaviruses weren't deadly). We could have had an antiviral that had been tested for safety already if we'd done that:
VR: So speaking of antivirals, let’s say we did have some amazing antivirals that have been developed in a time between SARS and now. Maybe we should have been doing that. And they were broadly acting against coronaviruses. How would you use those if you have now a patient who has tested positive?posted by BungaDunga at 5:36 PM on December 8, 2020 [7 favorites]
DG: Now, I feel like that was a plug for you virus researchers, or us virus researchers, wanting funding so that we would be in this situation because that would be quite the godsend, right?
VR: Well I think as you would probably agree, we should have been doing this after SARS 1.0 went away. There has been a little bit of research, but we should have had broadly anti-coronaviral antivirals and I don’t think that’s too much to ask because the RNA polymerases are all conserved among all of them.
The ethics around organizing a safety trial for a vaccine for a disease that doesn't exist yet seems a bit tricky. You're risking, say, tens of thousands of people's health in order to prove that a vaccine is safe, with no idea when or if that vaccine would ever be used, or how many lives will be saved if it is.
I'm not saying it's automatically a bad idea, but it seems like an issue.
posted by BungaDunga at 5:45 PM on December 8, 2020 [6 favorites]
I'm not saying it's automatically a bad idea, but it seems like an issue.
posted by BungaDunga at 5:45 PM on December 8, 2020 [6 favorites]
This is probably borderline alarmist, but do mrna vaccines open up a new avenue for bad actors to cause harm? Like, if someone could deliver an mrna coding for a common allergen, or a slight variant of a native protein, could they get your immune system to overreact fatally? I know the dose is difficult to administer, but it sounds like it's getting easy to create. Easier than Polonium maybe?
posted by Popular Ethics at 5:51 PM on December 8, 2020
posted by Popular Ethics at 5:51 PM on December 8, 2020
If you want to kill somebody by injecting something into their body, I'm pretty sure there are many other substances that are easier to get your hands on and will do the job more effectively than a synthesized mRNA vaccine.
posted by teraflop at 6:05 PM on December 8, 2020 [9 favorites]
posted by teraflop at 6:05 PM on December 8, 2020 [9 favorites]
It's ironic that the world's worst pandemic in a century is going to usher in a new golden age of protection against infectious diseases.
Some fucking asshole wished for a cure for the common cold around September last year.
posted by showbiz_liz at 6:37 PM on December 8, 2020 [13 favorites]
Some fucking asshole wished for a cure for the common cold around September last year.
posted by showbiz_liz at 6:37 PM on December 8, 2020 [13 favorites]
the dose is difficult to administer
RNA is fragile. The vaccines have to be chilled for delivery, at temperatures that require infrastructure. There are enzymes everywhere ("RNase"s) that break down RNA, on your skin, on surfaces. Contamination with RNase is such a problem that labs that do Covid tests can generate false positives, if they're not careful. RNA would be difficult to administer as a naked molecule. Viruses are a way to spread them, but you'd need a state-level actor to create a bioweapon of that kind. Russia would be a probable source of that kind of weapon, but they'd be breaking many international conventions if they got found out, and biological weapons can be difficult to control (which is one reason why they are proscribed, and another reason why nation-states avoid them).
posted by They sucked his brains out! at 6:48 PM on December 8, 2020 [5 favorites]
RNA is fragile. The vaccines have to be chilled for delivery, at temperatures that require infrastructure. There are enzymes everywhere ("RNase"s) that break down RNA, on your skin, on surfaces. Contamination with RNase is such a problem that labs that do Covid tests can generate false positives, if they're not careful. RNA would be difficult to administer as a naked molecule. Viruses are a way to spread them, but you'd need a state-level actor to create a bioweapon of that kind. Russia would be a probable source of that kind of weapon, but they'd be breaking many international conventions if they got found out, and biological weapons can be difficult to control (which is one reason why they are proscribed, and another reason why nation-states avoid them).
posted by They sucked his brains out! at 6:48 PM on December 8, 2020 [5 favorites]
it's entirely possible that there are broadly-acting antivirals that would work against coronaviruses generally (I guess like Tamiflu, but for coronaviruses), but nobody developed them for lack of money (since until 2019, all known coronaviruses weren't deadly). We could have had an antiviral that had been tested for safety already if we'd done that
It took decades and dozens of billions of dollars to develop the current great drugs we have against HIV and HCV. It is possible to develop these drugs but nontrivial. It is also nontrivial to further make them effective against a whole class of viruses. I think it was Ralph Baric who was being interviewed for the small molecule research, and I think he was being a bit optimistic about how easy it was to go from screening candidates to orally delivered small molecules. Remdesivir is an illustrative example of a drug that actually is a pan-coronavirus inhibitor; it works great in the lab but delivery is complicated but it doesn't seem to do much for the progression of the disease in those already sick, since by the point of going into the ER viral replication is no longer the thing making you sick (Tamiflu has the same timing problem). Getting to the point of having a small molecule drug which is as safe as water and is generally effective as a prophylactic (e.g. PrEP) for every virus family would take conservatively ~ $1 billion per drug, and you need a drug for all the major virus families in the "likely culprits for next pandemic" groups (maybe 10?).
tl;dr - finding small molecule inhibitors is the cheap and easy part, making them so safe that millions can take them as a contingency bet before a pandemic starts is the hard part.
I think this would be money well spent compared to several trillion dollars in pandemic bailout money, but it's always hard convincing people to pay for preparedness. Vaccines by comparison can be made cheaply and stored in the freezer; the expensive part is doing 100x animal studies to derisk them up front.
posted by benzenedream at 7:07 PM on December 8, 2020 [11 favorites]
It took decades and dozens of billions of dollars to develop the current great drugs we have against HIV and HCV. It is possible to develop these drugs but nontrivial. It is also nontrivial to further make them effective against a whole class of viruses. I think it was Ralph Baric who was being interviewed for the small molecule research, and I think he was being a bit optimistic about how easy it was to go from screening candidates to orally delivered small molecules. Remdesivir is an illustrative example of a drug that actually is a pan-coronavirus inhibitor; it works great in the lab but delivery is complicated but it doesn't seem to do much for the progression of the disease in those already sick, since by the point of going into the ER viral replication is no longer the thing making you sick (Tamiflu has the same timing problem). Getting to the point of having a small molecule drug which is as safe as water and is generally effective as a prophylactic (e.g. PrEP) for every virus family would take conservatively ~ $1 billion per drug, and you need a drug for all the major virus families in the "likely culprits for next pandemic" groups (maybe 10?).
tl;dr - finding small molecule inhibitors is the cheap and easy part, making them so safe that millions can take them as a contingency bet before a pandemic starts is the hard part.
I think this would be money well spent compared to several trillion dollars in pandemic bailout money, but it's always hard convincing people to pay for preparedness. Vaccines by comparison can be made cheaply and stored in the freezer; the expensive part is doing 100x animal studies to derisk them up front.
posted by benzenedream at 7:07 PM on December 8, 2020 [11 favorites]
If you want to kill somebody by injecting something into their body, I'm pretty sure there are many other substances that are easier to get your hands on and will do the job more effectively than a synthesized mRNA vaccine.
insulin
posted by benzenedream at 7:12 PM on December 8, 2020 [2 favorites]
insulin
posted by benzenedream at 7:12 PM on December 8, 2020 [2 favorites]
If there was even a hint of 0.05% serious side-effects above background, that's 250,000 people in hospital - or worse.
You don't stop safety monitoring just because you're deploying the vaccine in the field. You stop after the first million, when there are 50 people in the hospital.
posted by mark k at 7:14 PM on December 8, 2020 [4 favorites]
You don't stop safety monitoring just because you're deploying the vaccine in the field. You stop after the first million, when there are 50 people in the hospital.
posted by mark k at 7:14 PM on December 8, 2020 [4 favorites]
Getting to the point of having a small molecule drug which is as safe as water and is generally effective as a prophylactic (e.g. PrEP) for every virus family would take conservatively ~ $1 billion per drug, and you need a drug for all the major virus families in the "likely culprits for next pandemic" groups (maybe 10?)
So for $10 billion mankind could be free of disease?
posted by geoff. at 7:30 PM on December 8, 2020 [2 favorites]
So for $10 billion mankind could be free of disease?
posted by geoff. at 7:30 PM on December 8, 2020 [2 favorites]
If there was even a hint of 0.05% serious side-effects above background, that's 250,000 people in hospital - or worse.
You don't stop safety monitoring just because you're deploying the vaccine in the field. You stop after the first million, when there are 50 people in the hospital.
I agree. I guess the point is if we were managing the pandemic we would be rolling shit out much more slowly in phases to not expose ourselves to even that risk.
Given public pressure don't see us stopping at the first million nationally or internationally.....
Also, I really hope we (as in vaccine deployers) are on this with the same level of fervor using VAERS and other countries' mechanisms.
posted by lalochezia at 7:55 PM on December 8, 2020
since until 2019, all known coronaviruses weren't deadly
The SARS and MERS coronaviruses would like a word...
posted by Dysk at 9:30 PM on December 8, 2020 [7 favorites]
The SARS and MERS coronaviruses would like a word...
posted by Dysk at 9:30 PM on December 8, 2020 [7 favorites]
Hah, you're right of course. Neither of those went pandemic, but SARS certainly proved the principle...
posted by BungaDunga at 10:05 PM on December 8, 2020
posted by BungaDunga at 10:05 PM on December 8, 2020
Interesting how perspectives differ. I was living in Hong Kong in the early 2000s, and I definitely remember SARS going epidemic in much of Asia, which is probably more of the world covered than some middle-ages "pandemics" that only affected Europe...
posted by Dysk at 10:11 PM on December 8, 2020 [11 favorites]
posted by Dysk at 10:11 PM on December 8, 2020 [11 favorites]
So for $10 billion mankind could be free of disease?
No, for $10 billion you might have a decent number of lead compounds for the most easily spread virus families, and they could be mostly derisked for toxicity and compatible with oral dosing. There is another issue with scale up of synthesis, dosing a whole population with a drug to prevent spread of a disease means you also have to have contingency plans and contracts in place for on-demand chemical synthesis, since 500 million times 3 month of daily doses could be truckloads of pure drug compound.
posted by benzenedream at 12:00 AM on December 9, 2020 [3 favorites]
No, for $10 billion you might have a decent number of lead compounds for the most easily spread virus families, and they could be mostly derisked for toxicity and compatible with oral dosing. There is another issue with scale up of synthesis, dosing a whole population with a drug to prevent spread of a disease means you also have to have contingency plans and contracts in place for on-demand chemical synthesis, since 500 million times 3 month of daily doses could be truckloads of pure drug compound.
posted by benzenedream at 12:00 AM on December 9, 2020 [3 favorites]
I definitely remember SARS going epidemic in much of Asia, which is probably more of the world covered than some middle-ages "pandemics" that only affected Europe
Sars killed maybe 1,000 people, mostly in China/HK and Taiwan (and Canada). I'm not saying it wasn't a big deal- I know it was a huge deal where it hit, especially in Hong Kong. But to my knowledge it didn't spread through much of Asia, it infected maybe 10,000 people.
posted by BungaDunga at 8:43 AM on December 9, 2020
Sars killed maybe 1,000 people, mostly in China/HK and Taiwan (and Canada). I'm not saying it wasn't a big deal- I know it was a huge deal where it hit, especially in Hong Kong. But to my knowledge it didn't spread through much of Asia, it infected maybe 10,000 people.
posted by BungaDunga at 8:43 AM on December 9, 2020
While we’re mentioning our favorite This Week in Virology moments I need to mention that sometime in the last few weeks they were talking about what it’s like to actually produce this mRNA. Apparently in a research lab they count it a good synthesis if they produce one microgram of mRNA. They calculated that administering the Pfizer/Moderna vaccines to 300M people in the US will require 50kg total of mRNA. I’m not sure there is another comparable ramp-up anywhere in human history. The closest comparison I can think of is the industrial enrichment of uranium during the Manhattan Project but I have a feeling a 50x10^9 scale-up dwarfs that.
posted by range at 11:07 AM on December 9, 2020 [7 favorites]
posted by range at 11:07 AM on December 9, 2020 [7 favorites]
I believe there were comparable scaleup synthesis feats for DNA oligos during the heyday of modified antisense oligonucleotide therapies (ISIS, now Ionis did much of this work). None of those therapies made it to the population scale that a general vaccine would. Some of that work probably paved the way for the current scaleup effort (esp. production of any modified nucleotides used in the vaccines).
posted by benzenedream at 12:51 PM on December 9, 2020
posted by benzenedream at 12:51 PM on December 9, 2020
I just want to plug this Nobel Laureate and his columns on the subject at hand:
https://www.doherty.edu.au/news-events/setting-it-straight
Especially the next page of articles has a lot of information on what vaccines are being developed and how the different vectors work.
It taught me a lot.
posted by MacD at 7:05 PM on December 10, 2020 [1 favorite]
https://www.doherty.edu.au/news-events/setting-it-straight
Especially the next page of articles has a lot of information on what vaccines are being developed and how the different vectors work.
It taught me a lot.
posted by MacD at 7:05 PM on December 10, 2020 [1 favorite]
mark k: It's not a guarantee you'll get the 3D structure right every time with the mRNA approach, but obviously the ringing success in this case is a good sign.
I'm not sure if any of the biologists of Metafilter are still listening, but do I remember correctly that the 3D structure doesn't matter, since the protein fragments (nine-ish amino acids long) are presented in stretched-out form by the MHC class I molecules? So as long as the sequence is correct it'll work?
posted by clawsoon at 8:16 AM on December 12, 2020
I'm not sure if any of the biologists of Metafilter are still listening, but do I remember correctly that the 3D structure doesn't matter, since the protein fragments (nine-ish amino acids long) are presented in stretched-out form by the MHC class I molecules? So as long as the sequence is correct it'll work?
posted by clawsoon at 8:16 AM on December 12, 2020
benzenedream: Insulin
Indeed. And as a diabetic who's too lazy to go to the doctor regularly, I can affirm that you can walk into any pharmacy in Canada and they'll sell you insulin over the counter without any ID or prescription.
posted by clawsoon at 8:45 AM on December 12, 2020 [1 favorite]
Indeed. And as a diabetic who's too lazy to go to the doctor regularly, I can affirm that you can walk into any pharmacy in Canada and they'll sell you insulin over the counter without any ID or prescription.
posted by clawsoon at 8:45 AM on December 12, 2020 [1 favorite]
Clawsoon, there are multiple mechanisms I believe. Antibodies against the spike protein on the surface of the virus while it's extracellular would need the 3D shape. Peptide fragments are used by e.g. T-cells to identify and kill infected cells.
posted by mark k at 12:10 AM on December 14, 2020 [2 favorites]
posted by mark k at 12:10 AM on December 14, 2020 [2 favorites]
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It's ironic that the world's worst pandemic in a century is going to usher in a new golden age of protection against infectious diseases.
posted by Your Childhood Pet Rock at 3:49 PM on December 8, 2020 [22 favorites]