But one day in 2009, while Mascola was sitting in the laboratory eating a sandwich, one of his scientists restrained him with a big smile on her face: they found the glow they were looking for. .
The antibody comes from a man known as Donor 45. Doria-Rose, who met with the participants in the study meeting when they regularly came in for their investigations, says that Donor 45 was an extraordinary private gay black man in his sixties from the Washington, DC area. . They call the antibody VRC01 – the first from the Vaccine Research Center.
It has taken almost a decade to develop a drug from this antibody and set up a clinical trial to make sure it is safe and effective. Other HIV-positive researchers have come up with antiretroviral drugs – the famous “triple cocktail” – that effectively treat and prevent HIV infections by interfering with the virus’ ability to make copies of itself. The crisis was not over yet. People still contracted HIV, but with the antiretroviral drugs, they were able to lead mostly normal lives. As access to these drugs expanded, the effort to use antibodies to make HIV drugs became less urgent. It started, a clinical trial started, but not so many people paid much attention to it.
And then came Covid-19. That day in January 2020, Mascola immediately saw that everything he and his colleagues had learned from studying HIV antibodies could be mobilized to treat the new pathogen. That would be ‘the highlight of a life’s work’, he says.
Mascola is a restrained old man. He communicates with economics. “If he puts one exclamation point in an email, you know you did something phenomenal!” Doria-Rose wrote to me. So when he got to her office, they started working straight. Doria-Rose started asking team members to fire up the sorting machines and fill the small muffin tins and engineering test cells that glow. They revamped their work schedules and put everything in place.
Even in front of you born, your immune system has made antibodies to fight potential pathogens. They are incredibly diverse: the average person has billions of B cells that can produce between 9 and 17 million different antibodies. Antibody molecules are Y-shaped and their tips have nooks and crannies that can get caught on specific viruses or bacteria. When binding occurs, the antibodies prevent the invaders from attaching to and discarding healthy cells. The real ingenious thing, however, is not only that an antibody can seek its enemy for destruction, but that the act of attaching to the pathogen is also a signal to the immune system to make more of the specific form. Even one antibody can summon the troops, allowing your immune system to wage war against an invading army.
Unfortunately, when an entirely new pathogen such as HIV or the new coronavirus emerges, a well-matched form is rare, even in our massive existing natural repertoire of antibodies. Vaccinations, which usually consist of an attenuated virus or fragments of a virus, train the body to develop a binding antibody – one that will bind and neutralize the real pathogen when we encounter it in the world. This is known as active immunity. The body’s immune system goes to basic training, and it emerges with a suitable fighting force. In contrast, antibody therapies such as those that Mascola worked on for HIV offer you passive immunity: a mercenary is brought into the body to do the work temporarily for you.
The discovery of passive immunity dates back to the end of the 19th century, when Emil Behring, a German scientist with sad eyes with a hood and a fine beard, began injecting 220 children with animal blood. The children all contracted diphtheria, a gruesome disease that slowly suffocated the victims. Behring tried to treat the disease and experimented with rabbits, guinea pigs, goats and horses and gave infected animals the blood of recovered animals. He did not know why, but the sick animals improved. He thus gave the children the blood of animals exposed to diphtheria, and in 1894 he published the results: About twice as many children as would normally be expected to survive survived. Behring’s serum therapy ‘approach is considered so successful that he later received the very first Nobel Prize in Physiology or Medicine.