The host immune response in COVID-19 and beyond

MeMed CEO Dr. Eran Eden explores the relationship between the host immune response and SARS-CoV-2 infection and how technology could help personalise treatment strategies.

The entire healthcare sector experienced a steep learning curve after the outbreak of COVID-19. The pace of work in the industry reached almost ludicrous speeds. Decisions that used to take months were made in days. Studies that might have taken years to plan and fund were carried out in weeks.

Those of us already working in the fields of infectious disease, respiratory disease or inflammatory disease in particular analysed our technology and know-how to see if there was anything we could do to tackle the global health crisis unfolding.

We needed advances in medical testing that could have a significant impact on time to results, ease of use, access and cost-effectiveness.

As the pandemic continued on, terms like ‘PCR testing’ entered the common vernacular as these technologies became part of routine testing regimes around the world. However, at the same time other novel solutions began to emerge for the fight against COVID-19.

One of these involves listening to what the body’s own immune system can tell us.

Translating the complex signals of the immune system in response to infection has the potential to help physicians make better informed treatment decisions, which could then transform patient outcomes.

This is made possible using ‘Advanced Host Immune Response Technologies’. These technologies analyse biomarkers expressed by the immune system at a certain time to determine how the body is grappling with the infection. The immune response biomarkers can reveal insights such as whether the infection is bacterial or viral, how the body is coping and even how severely it could affect the patient in the coming days.

There are multiple advantages to using the human immune system as the main disease sensor, or as a complimentary approach alongside more conventional methods such as molecular or rapid antigen testing.

Host immune response technologies have extremely high levels of accuracy and are rapid (especially those based on host-immune proteins), returning results in minutes as opposed to hours or even days. Listening to the immune system can diagnose infection even when the infection site is not readily accessible or is unknown, via immune markers circulating throughout the body. This would be the case with pneumonia or fever without source.

There are of course many unknowns when we consider how treatment for COVID-19 will evolve in the future, and how testing, therapeutics and vaccines will interact as we attempt to end the pandemic.

This uncertainty means there are many possible avenues for host immune response testing that are yet to be explored. For example, no one yet knows how long the protection from the various COVID-19 vaccines in use will last, or how much these vaccinations actually prevent the spread of the virus. It’s also yet to be established to what degree previous infection with SARSCoV-2 will have a protective effect against re-infection by evolving new strains.

These uncertainties serve to underline the importance of rapid, easy to use tests suitable for use at the point of need, outside of the laboratory.

These tests therefore can play a vital role in patient management. For example, we are currently developing an assay intended to help physicians predict earlier how severely a patient will respond to COVID-19. This means it could help predict which patients are likely to require ventilation, and which can be safely discharged for self-isolation.

This could be invaluable in assisting with patient management and resource-allocation by healthcare systems, reducing their burden.

The knowledge and experience we’ve gained from this pandemic, hard-earned though it is, will help guide us in the future to respond better and faster to future outbreaks of disease.

The cutting-edge technologies that really, deeply listen to the immune system and help us understand its reactions will be a core part of the future clinical care landscape for infectious diseases. And of course, there are many other possible applications for this technology.

This is the case for one particular biomarker found in the immune system, called IP-10. IP-10 is showing promising early signs of being a useful biomarker to help identify hyperinflammation, an excessive immune response to infections that can be dangerous to patients, caused by a surge of proinflammatory cytokines and chemokines in the body. By identifying this, IP-10 could help drive more personalised treatments with corticosteroids, which help manage inflammation. This may have future applications in treatment that go beyond infectious diseases, including in oncology.

Navigating the COVID-19 pandemic has been challenging for us all, but in the worlds of research and development, the lessons we’ve gained have opened doors, giving us a wealth of data to study on how the immune system responds to diseases.

We’ve made great strides so far but we’re only just scratching the surface. There is plenty more the immune response can teach us yet, and it will be invaluable in helping researchers, healthcare systems and governments turn the tide against COVID-19 and better cope with pandemics of the future.

About the author

Eran Eden has been the CEO of MeMed since its inception in 2009, leading it from an idea to a rapidly growing company. He has 15 years of combined business and academic experience pioneering the development of cutting-edge multidisciplinary technologies that synergise data-science & machine learning, molecular biology and clinical applications.