Ashley Bell | November 30, 2020
Testing a cell therapy for efficacy in treating COVID-19
A life-saving treatment for the vulnerable patients vaccines may not help
Illustration | Anita Bilan
While most of the world eagerly awaits a COVID-19 vaccine, Lili Yang, PhD, has her sights set on finding treatments, especially for vulnerable individuals.
“We’ll achieve the best possible outcomes by having not only a vaccine, but also viable treatments,” Dr. Yang explained. “We know that some older individuals don’t react to a flu vaccine because their weakened immune systems can’t trigger a protective mechanism. That experience tells us a COVID-19 vaccine might not keep our most vulnerable populations from getting serious or deadly cases.”
Dr. Yang believes a therapy based on a powerful type of immune cell could help even the most vulnerable COVID-19 patients.
Often considered an evolutionary marvel, the invariant natural killer T (iNKT) cell can recognize, from the moment they’re born, a variety of pathogens and effectively terminate their replication machinery.
They can also modulate the immune response, helping infected individuals avoid the overzealous inflammation that can make them even sicker.
Furthermore, iNKT cells recognize viruses even as they mutate.
“iNKT is born to handle these kinds of things,” Dr. Yang said, explaining how an iNKT cell therapy might handle a novel virus whose basic behavior, let alone mutations, we don’t fully understand. This therapy could help mitigate consequences if, for example, the coronavirus mutates after we’ve developed and administered a vaccine.
Unfortunately, we don’t naturally have many iNKT cells; they likely make up less than 1% of all cells in the human body. As people age, their already low count of iNKT cells may dwindle even further.
A cell therapy would enhance patients’ immune systems, even those too weak for a vaccine, with the additional iNKT cells they need to mount an optimal immune response against threats breaching their other defenses.
Dr. Yang and her team already use an iNKT-based cell therapy for cancer. When COVID-19 cases spiked and the world closed down, they wondered if their premade therapy might also be capable of fighting a novel virus.
The team knew from previous clinical trials that iNKT cells do not attack healthy cells and tissues. They knew the therapy could be safely administered regardless of age, gender, or genomic background. They knew these cells could effectively treat cancer and infectious disease. However, they didn’t know what effect the cells would have on COVID-19.
“Every disease is different,” Yang said. “So when COVID-19 surfaced, we realized we had to get some research data to see if a cell therapy would have any effect.”
Dr. Yang and her team quickly set up an infection model testing the efficacy of stem cell-derived iNKT in fighting COVID-19, moving one step closer to identifying a safe and effective treatment for a currently untreatable virus.
Their early preclinical tests show promising antiviral effects. The therapy will next move to clinical trials.
As Dr. Yang faces a world-changing pandemic, she pulls strength and optimism from a decade of inspiring progress she’s observed in immunotherapy, gene therapy, and cell therapy. Standing at the forefront of science and medicine, testing a therapy that would have seemed impossible ten years ago, Yang has no doubt we will innovate, adapt, and overcome COVID-19.
“The coronavirus is not the first of these types of viruses in history, and it probably won’t be the last. Yet we’ve dealt with all the previous emerging viruses,” Yang said. “With our own immune systems working with vaccines and therapies, we will overcome this one.”
Ashley Bell | October 01, 2020
Arash Naeim, MD
Lynn Vavreck, PhD
Weekly nationwide surveys and COVID19-focused surveys every 2 months pinpointing the complex array of factors influencing COVID-19 behaviors and perceptions.
Informed, targeted health messages people accept with respect to COVID-19 accounting for underlying political, psychological, and social attitudes.
Illustration | Anita Bilan
We all know it is difficult to change others’ opinions, especially when it comes to politics.
So what happens when a pandemic hits and we’re depending on individuals, each with unique beliefs and perceptions, to follow public health recommendations that have become politicized?
Arash Naeim, MD, Lynn Vavreck, PhD and their collaborators have turned that question into a systematic study.
In February 2020, Dr. Naeim and Lynn Vavreck, the Marvin Hoffenberg Professor of American Politics at UCLA, began considering how health issues might influence voting behavior as part of a sweeping national series of surveys leading up to the 2020 presidential election that Dr. Vavreck is running with political science professor Chris Tausanovitch. Increasing collaboration between health and the social sciences is a strategic priority of the UCLA Center for SMART Health, a collaborative initiative between the Clinical and Translational Science Institute, Institute for Precision Health, and the Garrick Institute for Risk Sciences.
Shortly after their early conversations, COVID-19 hit the United States, shutting down the world as everyone knew it.
Dr(s). Naeim, Vavreck and the team (that includes Neil Wenger, MD in Internal Medicine and Annette Stanton, PhD in Psychology, as well as many others) added questions on COVID-19-related perceptions and behaviors. After all, the pandemic had rapidly metastasized into an election-skewing health issue—a health issue made more complex by the politicization of health recommendations, such as whether to shut businesses, issue stay-at-home orders, or wear face masks.
Dr. Naeim hopes the data will illuminate how psychosocial factors—including political beliefs and identities—influence public-health message receptivity, and consequently, health outcomes.
Survey questions cover straightforward attitudes and behaviors as well as nebulous mindset factors, such as beliefs, perceptions, and feelings. For example, the survey might ask people to rate their concern about COVID-19 or reveal if they agree or disagree with state and local actions to control the spread of the virus.
By asking these questions and analyzing the answers, Naeim hopes to better understand the complex interplay between behavior and mindset and ultimately leverage that understanding to develop targeted health messages people will receive, absorb, and adopt.
“We need to figure out how to construct a public health message in this politicized environment that people will be willing to hear,” Dr. Naeim explains. Dr. Vavreck adds that the goal is to learn how to “move people beyond just hearing the message, but to considering it and accepting it, without activating their political filter.”
As the team releases surveys in multiple waves, they plan to test messages intended for large-scale outreach.
For example, by using a survey to test a vaccine communication, the team might learn how to craft and deliver messages that actually increase adoption rates.
“Any effective strategy is going to require 75-80% of the population to become immune or get a vaccine,” Naeim said. “We have to figure out how to bridge gaps in peoples’ perspectives if we’re going to accomplish our goals.”
The team gathers interesting insights—a desire for caution bridges partisan lines, for example—as weekly results come in, but definitive answers about whether and how Covid-19 and other health issues influence voting behavior won’t be available until after the presidential election.
“It’s hard to think that one health issue could influence an election outcome,” Dr. Naeim said. “I think this election might show that one can.” Covid-19 is a unique presidential campaign issue. According to Dr. Vavreck, “Covid-19 is more than just a public health crisis because of how the President handled the immediate aftermath of the first spike in cases. It is his handling of the virus and associated economic fallout that is shaping the election, not attitudes about the virus itself.”
Dr. Naeim feels lucky to search for answers as part of an institution that supports tackling novel research.
“We can do these studies because UCLA is nimble enough to provide immediate funding opportunities through the Oversight COVID-19 Research Committee,” Dr. Naeim explains. “I think having this collaboration between political science and communication and the UCLA health system is novel, and it raises a lot of interesting questions.” The pilot funds from the Oversight COVID-19 Research Committee allowed the team to expand the project to a UC-wide initiative through funding via a PCORI Enhancement of the WISDOM Pragmatic trial focused on women undergoing breast cancer screening, called WISDOM During COVID.
The study will provide interesting answers about the connections between political beliefs and health – and what happens when the two collide in an unprecedented manner. No matter what patterns the team uncovers and what outcomes we see in the election, the insights Dr. Naeim and his team gather from this project will inform our understanding of human behavior, hopefully uncovering a set of health-related messages that work with people’s underlying social beliefs and habits while not activating their political instincts.
