RE: Prevalence of Neutralizing Autoantibodies Against Type I Interferon in a Multicenter Cohort of Severe or Critical COVID-19 Cases in Shanghai12 Mar 2024 19:12
Thanks Brand - another good study in the exact area of Synairgen's current interest. Shame the study didn't include Ifn B but your quote shows there a reasonable chance that the data reads across in a positive way with fewer Chinese having the auto-antibodies against Ifn-b and it therefore potentially being a useful therapeutic.
Confiming the 10% of Auto-ab for IFNs in the most severely ill Covid patients - which was found in the very large 2022 Bastard et al post-hoc study in the States, which I've posted about before.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9803887/#:~:text=Auto%2DAbs%20neutralizing%20100%2Dfold,of%20critical%20patients%20%5B8%5D.
Concerningly both studies found that the presence of Auto-abs for Ifns had no impact on mortality.
Bastard " Conclusion. In ICU patients, auto-Abs against type I IFNs were found in at least 10% of patients with critical COVID-19 pneumonia. They were not associated with day 28 mortality. "
Shanghai " Unexpectedly, we were unable to detect a significant correlation between a higher level of interferon-neutralizing antibodies (neutralizing IFN-α2 and IFN-ω at 10 ng/ml) and an increased risk of life-threatening COVID-19. We believe that the limited sample size might be the possible reason for this discrepancy, and we anticipate that enrolling a larger cohort in future investigations will help clarify this aspect. "
In the first American study they surmised that other causes of mortality - principally age and co-morbidities were such powerful indicators and determinants of outcome that the aab-ifn effective was masked and unreadable. It didn't matter. In the Shanghai study they said the low trial numbers made it impossible to tell the true effect.
My reading of all this work continues to be that assays for aab-ifns will form an important but not decisive part of the trial designs - except perhaps in ventilated patients - which almost always meet the other criteria of >80 and with existing and serious co-morbidities anyway but have the highest levels of aab-ifns. And I'm still unconvinced that UNIVERSAL will produce anything that adds hugely to the sum of human knowledge. It will show that once you're very ill you'll do badly regardless of which virus brought you to ICU.
Will it produce a test or suite of tests that will identify arriving patients beyond the 2 obvious signalsof age and illness (with a side order of Auto-abs - which kmay or may not affect outcomes ) ? I doubt it. The science still does not exist. Our P2s will be based on what the Sprinter deep dive revealed and Universal will hopefully add generic applicability of this across all the other viruses.
Remembering that they're not really trying to save lives - just to get the old croakers out of those expensive beds - and if possible to find a way to stop them going from the general respiratory ward into the land of no return.