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Is BCG an effective treatment for Covid-19?

The current COVID-19 medical health emergency is a lethal threat to the most vulnerable in our society, namely the elderly and immunocompromised. In addition, evidence is now pointing that our healthcare workers fighting the disease at the frontlines are as well at heightened risk of severe and fatal disease by reason of very close contact and high amounts of direct respiratory virus exposure.

Beyond ever dwindling supplies of personal protective equipment like face masks and extreme hygiene measures, there are currently no approved medicines or vaccines available to protect human life. We need to act quickly and decisively to do everything we can to decrease the percentage of patients with critical or lethal disease; time is of the essence.

The highest priority should be placed on any means that can lessen the load on the healthcare system. This would be achieved by reducing the number of infected patients requiring ventilation and by reducing the severity of COVID-19 disease trajectory. Any patients enabled to be moved to fewer intensive services or even discharged from the hospital earlier would greatly aid the functioning of the hospital system.

While there are no specific vaccines available against COVID-19, the scientifically well-known and proven concept of decreasing severity of disease and improving immune function against disease by immune modulation through so called Trained Immunity-based Vaccines (TIbV) offers a unique opportunity to act now. Trained Immunity-based Vaccines are, unlike conventional vaccines, aimed to stimulate broader responses against unknown pathogenic microbes, including COVID-19.

It has been announced that academic hospitals in the Netherlands are starting to use this TIbV principle using a tuberculosis vaccine (BCG) to try to better protect hospital workers against COVID-19. BCG vaccine contains live attenuated Mycobacterium bovis. Immodulon Therapeutics Ltd (www.immodulon.com) is developing IMM-101 as a TIbV-based approach for the treatment of cancer. IMM-101 is a systemic immune modulator and contains heat-killed Mycobacterium obuense, a rapidly dividing, environmental, harmless saprophyte. Immodulon believes that IMM-101 is likely a safer alternative to BCG, especially in the elderly and immunocompromised, and may potentially be more effective than BCG.

It has recently been described that many vaccine approaches against COVID-19 will rely nearly exclusively on inducing antibodies, which is only one part of the normal immune response against viruses. Historically, it has been very challenging to make such antibody-based vaccines to work effectively for viruses, including Influenza, another respiratory virus. This is specifically the case in the elderly. So, there are concerns regarding the effectivity of the current vaccine approaches in development against COVID-19, and therefore, it may take longer than presently hoped before the right vaccine has been discovered and developed.

Therefore, Professor Dalgleish believes that IMM-101 should be considered as an emergency treatment option. IMM-101 has been safely administered to over 300 patients with advanced cancer in clinical trials and compassionate use programs. He believes that IMM-101 has a dual anti-COVID-19 potential: (i) prophylaxis against severe disease by changing the immune surveillance status and disease trajectory, and (ii) as a co-treatment of already infected patients, if given early.

BCG is not as effective, nor as safe, as IMM-101 in the context of immune-boosting clinical trials (unlike the BCG, an IMM-101 shot can be given again if the reaction fades; the BCG can also cause ulcers and infections at the injection site). Nonetheless, given its common basic properties with IMM-101, BCG does provide some fantastic statistical support for our proposal.

Please see below a copy of the article Professor Dalgleish had published in the Daily Telegraph on March 31st which explains why IMM-101 could be used in the fight against COVID-19.

Telegraph ICVI Coronavirus Vaccine (2)

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