[HN Gopher] BioNTech CEO applies Covid-19 vaccine's mRNA tech to...
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       BioNTech CEO applies Covid-19 vaccine's mRNA tech to multiple
       sclerosis
        
       Author : miljen
       Score  : 133 points
       Date   : 2021-01-12 17:31 UTC (5 hours ago)
        
 (HTM) web link (www.fiercebiotech.com)
 (TXT) w3m dump (www.fiercebiotech.com)
        
       | syntaxing wrote:
       | I really hope this mRNA train keeps going and companies succeed
       | executing on it. Does anyone know the status for CRISPR medical
       | technology? I remembering hearing about all these great
       | applications using CaaS-9 and 13 but I haven't really heard any
       | new medical breakthroughs recently (though the hemophilia "cure"
       | was awesome!).
        
       | klmadfejno wrote:
       | Can anyone comment on where we would be if COVID-19 hit a few
       | years earlier and mRNA wasn't ready for primetime?
        
         | vondur wrote:
         | I'd assume the traditional route of using virus particles for
         | the vaccine would be used. In fact, I think that's what the
         | Chinese and Russians are using.
        
         | pstrateman wrote:
         | Pretty screwed for at least another year.
        
         | spchampion2 wrote:
         | Using a vaccine created by one of the many other mechanisms
         | that are in the pipeline, like the Oxford or J&J vaccines.
         | 
         | https://www.nytimes.com/interactive/2020/science/coronavirus...
        
         | thehappypm wrote:
         | We'd be much happier with Astra-Zeneca.
        
       | WillPostForFood wrote:
       | Great news! I wonder how much industry resistance there will be.
       | Treating MS patients is a massive industry. Drug treatments are
       | $100k a year currently, replacing that with a single $20 vaccine
       | would be disruptive in the best way.
        
         | pkaye wrote:
         | Wouldn't insurance companies love a lower cost one time
         | treatment?
        
           | djbebs wrote:
           | Doubtful. Insurances dont run at a loss, every penny that
           | goes into them they take a cut as profits. If the treatment
           | is expensive, great! More demand for their product, and even
           | if their cut is the same, their profit and revenue will be
           | greater.
        
           | rflrob wrote:
           | I'm sure they would, but bear in mind that the costs are
           | likely going to be much higher for an MS vaccine than for
           | nCov2, due to the economies of scale that the latter has.
           | Insurance companies will still probably love a one-time
           | $20,000 (or whatever number they can justify) treatment
           | compared to ongoing costs.
        
         | belltaco wrote:
         | Where does it say it'd be only $20 ?
        
         | maxerickson wrote:
         | Given that it doesn't suppress the immune system as much as
         | existing treatments, other parties will likely tell them to go
         | away (patients, doctors, insurance, etc.).
        
         | phnofive wrote:
         | Avonex is off patent - still profitable, but drug companies are
         | not entirely insensitive to being displaced by breakthroughs.
        
       | NickM wrote:
       | I've re-read the article a couple of times but I'm having trouble
       | understanding how this works. I understand how an mRNA vaccine
       | can teach the immune system to recognize a virus, but in the case
       | of an autoimmune disorder, the challenge is to teach the immune
       | system to _stop_ attacking something, right?
       | 
       | How can an mRNA vaccine cause the immune system to "forget"
       | something that it thinks is harmful?
        
         | folli wrote:
         | Derek Lowe, as usual, explains this quite nicely:
         | https://blogs.sciencemag.org/pipeline/archives/2021/01/12/mo...
         | 
         | To quote:
         | 
         | One goal has been to try to selectively affect autoreactive T
         | cells, but that's a lot easier said than done. The regulatory T
         | cells and regulatory B cells are key players in immune
         | tolerance, the "friend or foe" recognition system that keeps
         | our own immune systems from attacking everything in sight. If
         | you could present some of the antigens involved to those cells
         | in a way that they accepted them as normal human proteins
         | rather than as an external threat, you could presumably turn
         | down their response.
         | 
         | BioNTech and others have been trying to target the population
         | of lymphoid antigen-presenting cells, known to be very
         | important in immune tolerance mechanisms, but without setting
         | off any of the general inflammation pathways. They have a
         | liposomal formulation that when injected into the muscle tissue
         | seems to end up almost entirely in the lymphatic system, and
         | they've been doing all sorts of modifications to the RNA
         | payload (such as replacement of uridine with
         | methylpseudouridine) to make it as non-immunogenic by itself as
         | possible. The liposome lipids themselves are also chosen to be
         | as non-immunogenic as possible, too - the coronavirus mRNA
         | vaccines actually get an adjuvant boost from such properties,
         | but you don't want that in this case.
        
         | altarius wrote:
         | It reads like the immune isn't forgetting anything, they just
         | "flood" the system with the proteins that the antibodies would
         | normally attack in nerve cells or brain, thus giving the
         | antibodies another target to "keep them busy".
         | 
         | It sounds like they are creating large quantities of the
         | "offending" protein via the vaccine mNRA mechanism in normal
         | cells. Normally the antibodies/T-cells would attack the myelin
         | coating of nerves and the brain but with the protein being
         | abundantly available anywhere the immune cells are "kept
         | occupied" and leave nerves and brain alone.
         | 
         | If this treatment works as I understand, you would need
         | continuous refreshers each time the mRNA injection is depleted.
        
           | zionic wrote:
           | Not an expert, but wouldn't the abundance of target proteins
           | cause a dangerously elevated immune response?
        
             | ceejayoz wrote:
             | Not an expert, but wouldn't the experts have thought of
             | that too, and wouldn't it likely show up in animal studies?
        
         | pietjepuk88 wrote:
         | In a sense it sounds a bit like immunotherapy for allergies.
         | That is typically about injecting pathogens into your body
         | (e.g. under your tongue, under your skin, or in your lymph
         | nodes), and then over time teaching your body that these
         | pathogens are harmless.
         | 
         | As far as _why_ that works instead of sending someone into
         | anaphylactic shock... -\\_(tsu)_/- The immune system is weird
         | and complex, and I guess that's why they want a medical
         | specialist around in case you're one of the unlucky ones. (Only
         | the first time with sublingual tablets as far as I know)
        
         | maxerickson wrote:
         | The vaccine (or vaccine product, not sure which) targets the
         | cells that modulate the immune response.
         | 
         | If I understand correctly, it gets the cells to produce the
         | same autoantigen that they are misidentifying, which causes
         | them to slow that activity.
        
       | wittyreference wrote:
       | I came up with the same idea for treating autoimmune disease
       | years ago - in my first year of med school, actually. Back then
       | the platform for doing this elegantly via mRNA didn't really
       | exist, though, and I didn't want to drop out of med school to
       | spend a half-decade or more in grad school proving the concept
       | the clumsy way.
       | 
       | I'm really glad that it's finally come to fruition, but I
       | definitely feel a bit of regret that I have come to embody the
       | "ideas are cheap, execution matters" truism.
        
         | BitwiseFool wrote:
         | Don't feel too bad, the execution depended on a massive world-
         | changing pandemic where funding flowed freely and normal
         | economics just didn't apply.
        
           | Cu3PO42 wrote:
           | They were working on applying mRNA technology to other
           | diseases, including (and in particular) cancer, well before
           | the pandemic. While it is true that they have received
           | significant funding this year, they had a $7.6B market cap on
           | Dec 31, 2019 and were already conducting several clinical
           | studies for mRNA-based medicine [1].
           | 
           | [1] https://web.archive.org/web/20200128054759/https://bionte
           | ch....
        
             | stanford_labrat wrote:
             | Smaller companies here in the bay area as well, see:
             | Rejuvenation Tech.
        
           | darig wrote:
           | > normal economics just didn't apply.
           | 
           | It wasn't the economics that didn't apply... it was the
           | safety protocols and ethics surrounding the processes of
           | altering the genetics of human tissue.
        
           | fairity wrote:
           | IMO, the healthier coping mechanism is to realize that the
           | path you take in life will never be the most optimal. We all
           | make mistakes, and if all we care about is extrinsic
           | achievement, we'll be either steeped in regret (or perhaps,
           | blissfully ignorant). Instead of being outcome dependent, try
           | to value things that are by nature, intrinsic.
        
         | durpkingOP wrote:
         | Please provide a link to your thesis.
        
         | cosmodisk wrote:
         | Not to worry! When I was a little kid, I couldn't afford new
         | shiny magazines,so I had an idea of an online library hosting
         | all the magazines for a small monthly fee. Guess what, turns
         | out apps like Readly doing exactly that.
        
       | tcbawo wrote:
       | Does anyone know if this approach would work for food allergies?
        
       | zuhayeer wrote:
       | That undismissible popup that comes up on this page is the bane
       | of my existence
        
       | liquidify wrote:
       | Headline is a bit funky calling it "Covid-19 vaccine's tech",
       | since this tech has been studied and tested for many other
       | applications.
       | 
       | It seems backwards... Covid-19 vaccine is an instance of this
       | technology, the technology is not a derivative of what they did
       | in Covid-19 vaccine.
        
         | baq wrote:
         | Casually backwards but the audience can relate better this way.
        
       | waiseristy wrote:
       | I haven't yet seen anyone mention this, but will BioNTech's /
       | Modernas mRNA vaccine need to go through phase 1-3 trials when
       | encoding for other proteins?
       | 
       | The greatest advancement with mRNA is that you can have a vaccine
       | in under a month. But that doesn't help if for each new mRNA
       | encoding you need 9 months worth of health & safety trials.
        
         | okl wrote:
         | As I've understood, (correct me if I'm wrong) one of the main
         | concerns is that you end up with a protein that interferes with
         | other functions of the body in unexpected ways. So I guess it
         | would be prudent to go through phase 1-3 trials again.
        
         | pg_bot wrote:
         | Yes, they will have to go through health and safety trials for
         | each additional vaccine developed using this technology. No one
         | gets special treatment when it comes to FDA approval, and this
         | is the way it should be.
         | 
         | You can get fast tracked if you show superior effectiveness,
         | meet an unmet medical need, or get rid of serious side effects
         | of an existing therapy. We should look at ways to speed up this
         | process, (in the grand scheme of things 9 months isn't that
         | long to wait to cure a disease) not eliminate it altogether. If
         | we approved something that actually does harm, it will further
         | undermine efforts to widely vaccinate the public. We already
         | have issues with people trusting vaccines when there is no
         | evidence of negative effects, I can't imagine how hard it would
         | be if we had another thalidomide on our hands.
        
           | a-dub wrote:
           | > Yes, they will have to go through health and safety trials
           | for each additional vaccine developed using this technology.
           | No one gets special treatment when it comes to FDA approval,
           | and this is the way it should be.
           | 
           | true, but there are loopholes. the 510(k) loophole for
           | medical devices where any device that is "substantially
           | equivalent" to an existing approved device can get fast track
           | approval has proved problematic. this has been publicly
           | documented both in the press and in independent documentaries
           | for some time.
           | 
           | https://www.fda.gov/medical-devices/premarket-
           | submissions/pr...
        
         | jounker wrote:
         | Of course they will. The issue is with the things the mRNA
         | codes for, and not with the mRNA.
        
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       (page generated 2021-01-12 23:01 UTC)