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An Appreciation for Viruses

7 October 2021 by Gertrud U. Rey

by Gertrud U. Rey

EV-D68

Most people associate viruses with illness and suffering. After all, the word “virus” is derived from the Latin word for “poison.” However, considering that the vast majority of viruses cause no illness and are actually beneficial to humans and the planet as a whole, this sentiment is largely misplaced. Let me explain.

The ability of viruses to enter cells by attaching to host cell receptors and releasing their genome into the cell can be exploited for various purposes. For example, viruses can be used as vectors for delivering vaccines, healthy copies of defective genes (i.e., for “gene therapy”), and therapeutic drugs to specific cells.

Several SARS-CoV-2 vaccines, including those made by AstraZeneca and Johnson & Johnson, consist of a “vector virus” (an adenovirus) that contains a gene for the SARS-CoV-2 spike protein. Upon injection into a vaccine recipient, the vector virus should enter cells and serve as a code for host proteins to synthesize the encoded spike protein. Genes that regulate replication of the vector virus are removed to ensure that the vector itself cannot cause an infection in human cells. Other genes not needed for purposes of vaccine delivery are also typically removed to create more room inside the vector for the inserted antigen gene. Adenoviruses are particularly suitable for delivering foreign genes into cells because they have a double-stranded DNA genome that can accommodate segments of foreign DNA and because they infect most cell types without integrating into the host genome. However, poxviruses, retroviruses, vesicular stomatitis virus, and other viruses can also be used for vaccine delivery. As of today, six viral-vectored vaccines have been authorized for use in humans: four SARS-CoV-2 vaccines (two of which were previously described here and here) and two Ebola virus vaccines.

Viruses may also serve as vectors for targeted gene therapy to treat genetic disorders caused by mutations in the sequence of a person’s DNA. By replacing the mutated, non-functional portion of DNA with its healthy counterpart, the function of the defective gene could potentially be restored. Some viruses, like retroviruses, already insert their genetic material into the host genome as part of their replication cycle, making them suitable for delivering such functional genes to target cells. Recent advances in technology may even allow for the delivery of CRISPR-mediated gene editing tools to edit the target genome in the cell by excising the defective gene and replacing it with a functional version. One such targeted therapy aimed at treating genetic muscle disease by specifically targeting muscle cells was recently discussed on TWiV 812. Another exemplary gene therapy method for potentially deleting integrated HIV-1 from the genomes of infected individuals using CRISPR technology was described in a previous post.

A similar vector approach can also be used for cell-specific delivery of therapeutic drugs. For example, replication-incompetent viruses (viruses that have been engineered so they can’t replicate) can be further modified. These modifications may allow the viruses to specifically target dividing tumor cells or cells that display surface proteins that are unique to cancer cells, and deliver chemotherapeutic drugs only to those cells. Alternatively, replication-competent viruses can be manipulated to directly target and kill cancer cells in a mechanism known as oncolytic virotherapy. An example of this mechanism described previously involves a herpes simplex virus engineered to target a receptor that is practically absent in healthy brain cells, but is specifically expressed on glioblastoma multiforme tumor cells. The engineered virus also encodes a gene for a cytokine that increases the effectiveness of oncolytic viruses by recruiting cytotoxic T lymphocytes, which cause the tumor cells to burst. An accumulating body of evidence suggests that the cancer-specific antigens that emerge from burst cancer cells may also trigger additional downstream immune responses, further enhancing the potency of oncolytic viruses.

Considering that we are on the brink of a major antibiotic resistance crisis, viruses may just come to our rescue in this regard as well. Bacteriophages (“phages” for short) are viruses that only infect bacteria, and as it turns out, they can be used to treat pathogenic bacterial infections. There are numerous potential advantages to phage therapy compared to traditional antibiotic therapy. Phages are equally effective against antibiotic-sensitive and antibiotic-resistant bacteria. They are also more specific than antibiotics, and this specificity leads to reduced impact on commensal bacteria, which are typically obliterated by conventional antibiotics. Unlike most antibiotics, phages are capable of disrupting bacterial biofilms, and their use would lead to reduced incidence of opportunistic infections and reduced toxic effects of bacterial infection. Although bacteria can become resistant to phages, phages can likewise evolve to overcome this resistance, making bacterial resistance to phages less of a challenge than their resistance to antibiotics. Furthermore, scientists have found that the efficacy of phage therapy can be improved by combining phages with an antibiotic treatment regimen, or by combining several phages in a “phage cocktail.” In a highly publicized phage therapy success story, infectious disease epidemiologist Steffanie Strathdee describes how she recruited the help of an international team of physicians to cure her husband of a life-threatening multi-drug-resistant Acinetobacter baumanii infection using an intravenous phage therapy cocktail.

Phages can also be used as an alternative energy source by powering the electrodes in batteries. As repeatedly demonstrated by materials scientist Angela Belcher at MIT, biological scaffolds composed of M13 phages that display the negatively charged peptide sequence glutamate-glutamate-alanine-glutamate (E-E-A-E) inevitably attract nickel phosphide molecules, and the resulting nanostructures can be used directly as freestanding negative electrodes in batteries. These “virus batteries” have multiple advantages over traditional batteries. They are more environmentally friendly because they’re made from non-toxic materials. Their synthesis requires relatively little equipment, so they are inexpensive to produce. They are lightweight and flexible and can thus be woven into fabrics, which makes them suitable for military clothing. They also have higher conductivity than conventional lithium-ion batteries, making them extremely useful for portable electronics, medical implants, and various aerospace applications. It is even possible that they could one day be used to power electric cars.

The examples described so far are ones in which people have capitalized on virus functions for the benefit of humans. However, viruses have other benefits that just relate to their natural functions. For instance, phages are also an essential component of our environment, where they help control pests and recycle nutrients. If phages didn’t exist, some bacterial populations would explode and outcompete other populations, causing them to disappear completely. This imbalance would be especially disastrous in the oceans, where microbes make up more than 70% of the total biomass. Phages kill a large portion of oceanic bacteria every day, allowing the organic molecules released from the dead bacterial cells to be recycled as nutrients for other organisms. Perhaps the most important organisms to benefit from these recycled nutrients are microscopic plants called phytoplankton, which produce oxygen by removing carbon dioxide from the atmosphere. In fact, phytoplankton are a crucial element of the global carbon cycle and one of the largest contributors to our atmospheric oxygen. This means that without viruses, we would not have air to breathe.

Viruses are deeply integrated in life on earth, and their functions in sustaining environmental equilibrium and our ongoing survival are too numerous to describe in a single blog post. Moreover, our current appreciation of what can be accomplished using viruses is cursory, at best. Future research will lead to a deeper understanding of how viruses can be utilized to do more good.

[This post was written in honor of Virus Appreciation Day, which occurs annually on October 3]

Filed Under: Basic virology, Gertrud Rey Tagged With: adenovirus-vectored vaccine, bacteriophage, crispr, gene editing, gene therapy, microbe, oncolytic vector, oncolytic virotherapy, phage, phage therapy, phytoplankton, retrovirus, vaccines, vector, viral oncotherapy, virus battery, virus vector

Heterologous Vaccine Regimens Might be Better

5 August 2021 by Gertrud U. Rey

by Gertrud U. Rey

Have you ever wondered if you can “mix and match” SARS-CoV-2 vaccines? For example, would it be ok to boost a first dose of the vaccine produced by AstraZeneca with a dose of the vaccine produced by Pfizer/BioNTech? The latest science shows that such a vaccine regimen actually induces a stronger immune response than a regimen consisting of two doses of the same vaccine.

The occasional incidence of thrombosis in people under the age of 60 after receiving an adenovirus-vectored vaccine like the ones made by AstraZeneca and Johnson & Johnson has prompted several European governments to recommend the use of these vaccines only in people over 60. Because many people under 60 had already been vaccinated with a first dose of the AstraZeneca vaccine and still needed a second dose, they had to decide whether they should continue their regimen with another dose of the same vaccine (i.e., a homologous regimen), or receive an mRNA vaccine instead (i.e., a heterologous regimen).

In an effort to evaluate the efficacy of a heterologous SARS-CoV-2 vaccine regimen, the authors of this Brief Communication engaged the participants of an ongoing clinical trial, which aims to monitor the immune responses to SARS-CoV-2 in health care professionals and individuals with potential exposure to SARS-CoV-2. All study participants had already received a first dose of the AstraZeneca vaccine (referred to as “ChAd” in the study) and were given the option of receiving a second dose of the same vaccine or a dose of Pfizer/BioNTech’s mRNA vaccine (referred to as “BNT”). Although both of these vaccines encode the gene for the full-length SARS-CoV-2 spike protein, it is housed slightly differently. In the ChAd vaccine, the spike protein is encoded in an adenovirus vector of chimpanzee origin, while in the BNT vaccine it is surrounded by a lipid nanoparticle.

Out of the 87 individuals who participated in the study, 32 chose a second dose of ChAd and 55 chose to be vaccinated with BNT instead. Participants who chose a homologous ChAd/ChAd regimen received their second dose of ChAd on day 73 after the initial dose and donated a blood sample for analysis 16 days later. Participants who chose a heterologous ChAd/BNT regimen received their dose of BNT 74 days after their initial ChAd dose and donated a blood sample 17 days later. All results obtained from the analyses of the blood samples from these two groups were compared to results obtained from a group of 46 health care professionals who had been vaccinated with two doses of BNT (i.e., a homologous BNT/BNT regimen).

Briefly, the findings were as follows. Relative to the antibody levels induced by the first dose, homologous boosting with ChAd led to a 2.9-fold increase in IgG antibodies against the SARS-CoV-2 spike protein. IgG antibodies are mostly present in the blood and provide the majority of antibody-based immunity against invading pathogens. In contrast, heterologous boosting with BNT led to an 11.5-fold increase in anti-spike IgG, within the range observed in BNT/BNT-vaccinated individuals. A similar pattern was observed with anti-spike IgA antibodies, which are predominantly found in mucus membranes and their fluids. Boosting with BNT induced significantly higher increases in anti-spike IgA than did boosting with ChAd, suggesting that a heterologous boosting regimen induces better antibody responses. Interestingly, although the booster immunization induced an increase in neutralizing (i.e., virus-inactivating) antibodies in both vaccination groups, only heterologous ChAd/BNT vaccination induced antibodies that neutralized all three tested variants (Alpha, Beta, and Gamma), similar to what was observed in BNT/BNT vaccine recipients.

The authors also analyzed the effect of the two different boosting regimens on spike-specific memory B cells, which circulate quiescently in the blood stream and can quickly produce spike-specific antibodies upon a subsequent exposure to SARS-CoV-2. All vaccinees from both the ChAd/ChAd and ChAd/BNT groups produced increased levels of spike-specific memory B cells after receiving their booster shot, with no significant differences observed between the two groups. These results emphasize the importance of booster vaccination for full protection from SARS-CoV-2 infection.

ChAd/BNT recipients also had significantly higher levels of spike-specific CD4+– and CD8+ T cells compared to ChAd/ChAd recipients. CD4+ T cells are a central element of the adaptive immune response, because they activate both antibody-secreting B cells and CD8+ T cells that kill infected target cells. Compared to the ChAd/ChAd regimen, ChAd/BNT vaccination also induced significantly increased levels of T cells that produce spike-specific interferon gamma – a cytokine that inhibits viral replication and activates macrophages, which engulf and digest pathogens. Overall, these results suggest that a heterologous ChAd/BNT regimen induces significantly stronger immune responses than a homologous ChAd/ChAd regimen.

The study did have several limitations. First, it was not a randomized, placebo-controlled trial where each participant was randomly assigned to an experimental group or a control group. Randomizing trial participants eliminates unwanted effects that have nothing to do with the variables being analyzed, so that the only expected differences between the experimental and control groups are the outcome variable studied (efficacy in this case). Subjects in a control group receive a placebo – a substance that has no therapeutic effect, so that one can be sure that the effects observed in the experimental group are real and result from the experimental drug. Second, the authors were unable to test the antibodies for their ability to neutralize the Delta variant, which has recently become the predominantly circulating variant in many parts of the world. Third, the study mostly included young and healthy people, making it difficult to extrapolate the data to other specific patient groups outside of this category. Fourth, the data only show the results of assays performed in vitro, which may not necessarily manifest a clinical significance. Extended studies aimed at determining the practical importance of the observed immune responses are needed to validate the relevance of these responses. 

Despite its limitations, the study provides information that could have some valuable practical implications. Most of the currently approved SARS-CoV-2 vaccine regimens involve two doses of the same vaccine. However, access to two doses of the same vaccine may be limited or absent under some circumstances, thus necessitating the use of a different type of vaccine to boost the first dose.

[For a more in-depth discussion of this study, I recommend TWiV 782.]

Filed Under: Basic virology, Gertrud Rey Tagged With: antibodies, AstraZeneca, ChAdOx, IgA, IgG, memory B cell, neutralizing antibody, Pfizer mRNA vaccine, SARS-CoV-2, T cells, vaccines, variant

TWiV 641: COVID-19 with Dr. Anthony Fauci

18 July 2020 by Vincent Racaniello

Dr. Anthony Fauci joins TWiV to discuss SARS-CoV-2 transmission, testing, immunity, pathogenesis, vaccines, and preparedness.

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Subscribe (free): iTunes, Google Podcasts, RSS, email

Become a patron of TWiV!

Dr. Fauci was previously on TWiV 219

Intro music is by Ronald Jenkees

Filed Under: This Week in Virology Tagged With: COVID-19, immunity, pandemic, pathogenesis, preparedness, SARS-CoV-2, transmission, vaccines, viral, virology, virus, viruses

An advocate for vaccines

11 April 2019 by Gertrud U. Rey

Rachel autismby Gertrud U. Rey

In 1998, a British doctor named Andrew Wakefield published a paper in the British journal The Lancet. In this paper, Wakefield implied that the measles, mumps, and rubella (MMR) vaccine may cause developmental disorders such as autism spectrum disorder (ASD). The paper received wide publicity, and subsequently, MMR vaccination rates began to decline, triggering the current anti-vaccine movement and the re-emergence of previously controlled diseases.

[Read more…] about An advocate for vaccines

Filed Under: Basic virology, Gertrud Rey, Information Tagged With: autism, measles, MMR, mumps, peter hotez, rubella, vaccines, viral, virology, virus, viruses

TWiV Special: Vaccines Did Not Cause Rachel’s Autism

19 December 2018 by Vincent Racaniello

Vaccine scientist, pediatrician, and autism dad Peter Hotez talks about his new book, Vaccines Did Not Cause Rachel’s Autism.

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Subscribe (free): iTunes, Google Podcasts, RSS, email

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Show notes at microbe.tv/twiv

Filed Under: This Week in Virology Tagged With: autism, MMWR, peter hotez, vaccines, viral, virology, virus, viruses

Paul Has Measles

20 November 2018 by Vincent Racaniello

Susana López, Martha Yocupicio, Selene Zárate, virologists from Mexico, together with graphic illustrator Eva Lobatón, have teamed up to produce Paul Has Measles, a children’s book about viruses and vaccines.

Paul Has Measles is available as a free pdf in 16 languages. It may also be purchased as a Kindle or paperback edition at Amazon:

  • English (download pdf) (Amazon Kindle or Paperback)
  • Spanish (download pdf) (Amazon Kindle or Paperback)
  • French (download pdf) (Amazon Kindle or Paperback)
  • Arabic (download pdf)
  • Chinese (download pdf)
  • Croatian (download pdf)
  • Danish (download pdf)
  • German (download pdf)
  • Hindi (download pdf)
  • Italian (download pdf)
  • Japanese (download pdf)
  • Mayan (download pdf)
  • Mixtec (download pdf)
  • Nahuatl (download pdf)
  • Portuguese (download pdf)
  • Romanian (download pdf)
  • Russian (download pdf)
  • Turkish (download pdf)

The Spanish and English versions are also available as videos (Spanish: YouTube link, English: YouTube link).

Please share!

pablotiene
Rougeole
paul_romanian
PTS Japanese

Filed Under: Basic virology, Information Tagged With: children book, measles, vaccines, viral, virology, virus, viruses

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