Makakm remdesivir helped vc not people. Mli lpe set lbu

The primtech test indicated that l remdesivir should be innj, if used otherwise, it is not bn today. The question is when and to what extent it will be mon.

Gilead remdesivir is considered to be the most promising drug against SARS-CoV-2. When you look in more detail at its results, they are mostly positive, but at the same time they cannot be considered revolutionary.

For example, at the end of April, the results of a test known as ACTT in the United States, which received perhaps the most mediocre attention, showed that patients with a severe course of covid-19 had remdesivir recovered rapidly.

Tm o tetin invited the patient to peit. In the groups that received lk, the mortality was about 8 percent, in the groups that received only placebo, it was about 11 percent (more about the study in our previous line). At the end of May, the NEJM magazine published detailed results.

So the results of the remdesivir are not dazzling. It is decided from the first data that there would be a maturation of the disease against the disease. A closer look shows that the situation is especially better, it could not seem from the results of clinical trials in humans.

Research on the invites is not for everyone

The favorable data come from a study in monkeys conducted in the USA, specifically at the Rocky Mountains Laboratories in Hamilton, Montana. It is a specialized state work dedicated to the study of the most dangerous viruses and bacteria, from the plague to Ebola, in recent months, especially SARS-CoV-2.

Against many other laboratories, it has a great advantage that I can work with various experimental invitations, so-called animal models, including primt. Research on the outside is closely monitored, regulated and a huge administration is associated with it. If scientists want to experiment with human diseases, especially the most dangerous ones, they are allowed to go through the actual experiment.

At Rocky Mountains Laboratories, such attempts were made quite quickly, and so soon after the discovery of SARS-CoV-2, they set out to find a suitable model. Aspects of the disease that cannot be analyzed by the people can be examined on the invitations: for example, an autopsy can be performed on the invasion, in which the illness was only a small course.

Otzka was, as he invited handcuffs. Ferrets are often used to study respiratory diseases, but they are not very suitable for coronavirus research. The virus makes them ill. In our case, the infection does not manifest itself unless it is a genetically modified mouse that has the human ACE2 receptor on its cell surface. Tenvirus is used to enter human cells.

Based on the experience with the MERS and SARS viruses they have worked with in the Rocky Mountains in the past, the scientists decided to look for a suitable primate. Some previous coronaviruses cause a disease similar to that of a hunter, which opens up new possibilities for research.

Appropriate invitations are relatively easy. Coincidentally, a group of rhesus macaques were available at Rocky Mountains Laboratories, said Emmie de Witt in the TWiV podcast. It was a positive coincidence, because like a number of other products, the monkeys for drug research came to the United States from a large scale. The limited air connection between the two countries meant that deliveries would be difficult and impossible.

In rhesus macaques, SARS-CoV-2 acts similarly to hunting. Most infected monkeys are mild and moderate in their disease, according to a paper published in the May issue of Nature.

Like pomh makakm

The scientists from Rocky Mountains Laboratoriesvyuili gave their unique experience: in recent years, the laboratory has been working with the now well-known remdesivirus. First, there were some studies examining his promises against the MERS-CoV virus, coronavirus, which appeared in 2012 and causes respiration. with much he does not SARS-CoV-2, and so failed to cause in the wave of disease. Natst, because mod you mortality not SARS-CoV-2.

The results suggested that remdesivir could be generally relatively small against coronary heart disease. This was confirmed in experiments on monkeys at Rocky Mountains Laboratories (the study was published in Nora 2020 in the PNAS magazine). The laboratory was in an ideal position to start researching the new virus. It was enough to repeat a similar experiment as with MERS, as soon as there is enough medicine and a suitable invitation.

The result summarizes the study, which is available in the form of a so-called preprint on the server bioRxiv.org (preprint is a work that has not been published in a scientific journal and does not go through a scholarly collection with that connection). It follows that remdesivir very significantly reduces the amount of virus in the body of the infested animal.

Taxis

The most famous patient who received remdesivir in R is Robert Mark.

Samples taken during the experiment showed that there was a decrease in virus levels at about twelve hours after the first two. The amount of virus in the lower respiratory tract after about a day was about a hundred times lower than in animals. It is not entirely favorable that the amount of the virus in the upper respiratory tract did not spread much, so even the skull could probably be according to the virus.

Twelve selected monkeys were exposed to an extremely high virus, which caused them to become ill almost immediately. The batches were so high that there was essentially no incubation time. Half of the twelve hours after being exposed to the virus received two remdesivir, which in response to the weight of the response of the yard in humans. Lk monkeys from this group received once a day for another six days. The other half of the invitations were the control group, which did not receive the day.

The researchers monitored the health of the animals and took samples of them, which were supposed to determine the amount of the virus in the airways (this is done essentially by lavage, so-called bronchoalveolar lav). Although the monkeys were kept in a relatively pleasant and stimulating environment (including video and music), their lives after the infection were not long. On the seventh day, all the invitations were sacrificed and the witnesses performed an autopsy. dn of them did not die during the experiment for the disease itself and from other pins.

The autopsy showed what the monkeys’ health observation indicated. Invitation to remdesivirus had a significant course of the disease. Plung lench invites, for example, have been much more damaged by me.

Due to the small sample, it is of interest only that, in most cases, viruses with mutations that would give it resistance to remdesivirus did not appear. On the other hand, twelve monkeys are moths. In the case of use in millions of patients, the probability of such a mutation is of course

Who dt lk?

As u try on bv invitations, the results just can’t penst to the hunter. However, this result supports the otherwise relatively long-established assumption that remdesivir has de facto failed to mislead human patients.

Due to the fact that it is untested and how small it is available, it was used mainly in hospitalized patients in this condition. It works much better if it falls below as soon as possible at a time when the disease is not fully developed. Even the results obtained on macaques suggest that then remdesivir could prevent its external course.

The product slows down the multiplication of the virus in the body, without symptoms, does not help with possible complications during the course of the disease (eg a rapid reaction of the immune system). Viruses can’t do it alone, they need a host beech to trick them into producing a new generation of virus. Remdesivir and similar preparations (more precisely, the so-called nucleotide analogues) are very simplified, but they serve as fake building blocks suitable for the construction of other copies of the virus. In fact, they contain an instruction to complete the construction, and the multiplication of the virus therefore stops the presence of the product.

Therefore, the people should be treated as soon as possible after the infection in order to prevent en vru in the body. It is unrealistic that this would happen after twelve hours as in the monkeys in the experiment. Even if it succeeded during the first week after the outbreak, the number of cases could be dreaming, and it would be very sharp.

The implementation of such an approach has its problems. The first is the availability of the drug, the second is the selection of those who should receive it. So far, it was assumed that during 2020 it could be available in millions of doors. It will definitely not be for anyone in whom the infection is revealed.

He will have to choose somehow. Today, we have relatively good information about who is at risk of the disease. There is a variant that remdesivir could be preferred for patients in this group, as soon as possible after the infection.

This is an endangered group, especially older people with some sweating (asthma, diabetes, cancer, kidney victims, etc.). In the countries of the First World, there were not many such people.

Model

The model of the state of health information and statistics (KIS) for the prediction of the risk of a severe course of infection with the SARS-CoV-2 virus applied to the population of the Czech Republic. About 3.8 percent of the population, ie about 400 thousand people, fall into the group most at risk.

The state of health information and statistics led to a turnaround, in the Czech Republic it includes less than three percent of the Czech population, ie about 400 thousand people (see the presentation from the May KIC conference). Of course, it is possible that the indicators can be turned off and patients who are really at high risk can be selected more accurately.

The whole situation is complicated by the fact that remdesivir is under infusion. The manufacturer has not yet developed a way to prepare it so that the eagle can be caught. There is no indication that he is going to make any breakthrough in this direction. Even if it is widely available, I can only be impressed by a trained staff. It seems to me that if it can be given to you, the impact of the drug on the course of the pandemic could be in the first place, not indicated by the first results.

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