Is plasma therapy straw or magic medicine? Experts: be cautious, optimistic and respect science

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 Is plasma therapy straw or magic medicine? Experts: be cautious, optimistic and respect science


That night, novel coronavirus pneumonia, Zhang Dingyu, President of Wuhan golden silver hospital, said that the new crown pneumonia patients had a large number of comprehensive antibodies against the virus after rehabilitation, and urged patients who had recovered from their rehabilitation to donate plasma actively.

For a time, convalescent plasma therapy as heavy news has become a hot topic.

Shi Zhengli, a researcher at Wuhan Institute of Virology, Chinese Academy of Sciences, said: some patients have very high neutralizing antibodies to the new coronavirus in their sera during the recovery period.

In the absence of specific drugs and vaccines, can plasma therapy be a life-saving straw for many diagnosed patients?

In an interview with China Science Daily, two immunologists said they were cautiously optimistic.

China Science Daily: it is reported that the new crown plasma has been applied to more than 10 patients in clinical practice, and has achieved good results in a short time. What role do you think plasma therapy can play in this epidemic?

u25b2 Huang Bo, Professor, Department of immunology, Peking Union Medical College, Chinese Academy of Medical Sciences:

Now its too early to conclude that the effect is particularly obvious, and the plan needs to be further optimized. It can be tried, but not necessarily popularized in a large area.

The principle of plasma therapy is very simple. The recovered patients plasma is collected for treatment.

But in fact, not every recovered patients plasma is a useful antibody, we must pick out the most effective plasma and the best antibody.

Maybe only one or two of the 10 patients antibodies are effective, the others are not, if mixed, the effect may be weak. It takes a lot of time, energy and money to do more tests.

Im supportive and Im looking forward to it, but Im cautiously optimistic.

Plasma therapy has a long history in convalescent period. It has a history of more than 100 years to extract antibodies from animal plasma, but it is not commonly used in clinic in the past 50 or 60 years. If there are other good drugs and methods, plasma therapy will not be used generally.

It has been used in the fight against Ebola virus and has been successful in a few cases.

Because there is no specific drug, plasma therapy has been added to the fifth version of the treatment plan guide for severe patients.

Now it is only used on a small scale to ensure safety and efficacy. But I dont think its likely to be used on a large scale.

The concept of large-scale preparation and small-scale application is totally different, and there are many constraints.

If it is one-on-one treatment of plasma, the treatment level is difficult to maintain the same; if it is mixed, although it can improve the stability, if there is a person with hepatitis B or HIV and other viruses, it may lead to infectious diseases.

Historically, both tetanus and diphtheria have been prepared by mixing large quantities of plasma. Once the plasma is mixed, it is difficult to ensure the uniformity of the effect.

China Science Daily: novel coronavirus pneumonia is a new way to treat pneumonia?

Huang Bo:

Life saving straw is not very accurate. Its not as described in the movie. One shot is effective. If there are such miraculous effects, they have been widely used before.

For example, before Ebola virus infection, there was also plasma therapy, which had some effect, but it was not as good as expected.

u25b2 anonymous expert:

Its a life-saving straw. It can save lives, but its just straw. Its very difficult to use it on a large scale. It cant be a myth. Dont regard it as a magic medicine.

China Science Daily: novel coronavirus pneumonia is still very old and mature. What problems should we pay attention to in the treatment of new crown pneumonia? What other research work is needed?

Huang Bo:

The first is to deepen the understanding of antibody from the perspective of immunology.

We must note that novel coronavirus pneumonia is an immune disease, and ultimately control and destroy the bodys virus is the bodys immune cells.

Antibody, as one of the most important weapons against virus infection, is expected to be very high.

However, it is novel coronavirus pneumonia that can be controlled by antibodies in some cases.

The novel coronavirus infected individuals can produce various antibodies against viruses, neutralizing antibodies and non neutralizing antibodies.

The combination of neutralizing surface antibody and virus prevents the virus from entering the cell; the combination of non neutralizing surface antibody and virus mediates the phagocytosis and virus clearance of immune cells.

If the entry time is not right, the virus may instead activate macrophages, promote inflammation storm, and lead to lung immune damage in the middle and late stage.

Therefore, it is a challenge to screen patients plasma for different virus antibodies, and this work needs to be done in detail.

u25b2 anonymous expert:

The recovery plasma may have therapeutic effect on some severe patients.

But the overall benefit is still to carry out immunology research, the first is to supplement basic research.

The treatment, which began on February 8, has now published results, and progress is still very fast. We may skip the steps of basic research and try it out on a large scale.

I think this is an urgent measure and needs further improvement. There are many uncertain factors in plasma therapy, which need solid basic research.

For example, the type and content of effective antibodies in the plasma of convalescent patients are unknown. Are there any other antibodies? Does antibody have other safety risks to human body?

In addition, there is a lack of control experiment between convalescent plasma and normal human plasma. For severe patients, there are various physiological and immune disorders and nutritional failure in the later stage, even if the normal human plasma is input, it may also play a role in relieving.

We also need to remind you that those who have just left hospital, the elderly and the frail should donate their plasma according to their ability.

Especially in some people with severe infection, the cytokine storm may not have passed, the immune system has not fully recovered, and they are not suitable for donation.

Huang Bo:

All kinds of attempts should be encouraged, but no matter drugs, vaccines or plasma, they must have scientific basis and not be too extensive.

There is a basic common sense in the scientific community about how long it takes to make drugs, vaccines and antibodies. Nothing can go beyond the laws of science. Unless we use non classical and unconventional methods, we can only follow the basic laws of science.

In particular, we need to deepen our understanding of the complexity of antibodies. It is very easy to vaccinate and produce antibodies, but it is not easy to produce such protective neutralizing antibodies, which brings great challenges to vaccine research and development. We should take a cautious attitude and carry out in-depth and detailed work.

u25b2 anonymous expert:

Its really good to try, and Im looking forward to it. But this time, it seems that the whole thing is not prudent enough. Its a little urgent to go to the doctor. Whether its medicine or vaccine, I personally think its difficult to make significant progress in a short time.

Coronavirus has existed for a long time, but there is no commercial coronavirus vaccine on the market in the world, so we must take an objective view of this problem.

Of course, the new coronavirus may also develop into a common virus that coexists with human beings for a long time, that is to say, we cant completely eliminate it, we can only control it.

If we plan to do this, we should now have a transition plan, from high-pressure state to general prevention and control, to reduce the threat. It also requires preparation of drugs, vaccines and other aspects.

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