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The immunologist Gustavo Cabral grew up selling fruit at the Tucano fair, in the interior of the interior of Bahia. Born in Creguenhem, established in the city countryside, he only finished primary school at the age of 21. Today, at 38 years old, he is responsible for directing research to develop a vaccine against the new coronavirus at the Instituto do Coração (Incor) of the USP School of Medicine. After raising money for three years, Cabral managed to move to the city of Senhor do Bonfim (BA) to graduate in biological sciences from Bahia State University (Uneb), which opened the door to a master’s degree in immunology at the Federal University da Bahia (UFBA), in Salvador, a doctorate from USP and a post-doctorate in Oxford, England, and in Bern, Switzerland, where he studied immunology applied to the vaccine.
It was from there that he returned four months ago, at the invitation of Jorge Kalil, a leader in vaccine research, to carry out his research at Incor. When Cabral saw the first news about the new coronavirus, he did not imagine that he would need to adapt his working methodology, focused on chikungunya and streptococci, to develop a vaccine for covid-19. “At first, I imagined that the virus would be concentrated in China, since there is a global surveillance system. This is what happened to Ebola, for example, that it did not spread. When, in February, on the eve of Carnival, the virus continued to spread, I thought ‘now, it was ruined,’ he says. Bahian
Now Cabral and his team work tirelessly as society waits for a silver bullet against the pandemic. At the same time, it reflects, and criticizes, investment policies in education, science and technology. “Do you know when there is interest in investing in science and technology to create magic bullets? When it affects rich countries and classes. The Zika virus, for example, has been known since the 1950s, but has never been widely studied. It aroused public interest when it affected large countries. [entre 2014 e 2015]. And science is a very expensive thing, who says that science is done only with good management does not know what he is talking about, ”he says in an interview with EL PAÍS.
During graduation, the immunologist organized a research project to work with communities of quilombolas and parasitic diseases, investigating how socio-environmental factors affected the evolution of these problems. Thousands of kilometers inland, he still thinks of the most vulnerable people as he does his job. “If the coronavirus has caused so much damage in the countries of the first world, with better social and economic structures, what will it do when it enters the most vulnerable communities in Brazil, the interiors, the favelas? When I see people on the street, I think of the most vulnerable and I wonder if they don’t have empathy, ”he says.
Question How do virus vaccines work?
Answer. The purpose of the vaccine is to make the virus incapable of inducing disease in the person. This is what happens, for example, in flu vaccines. We can use the entire virus, just a part of it, a piece of DNA, or a piece of protein from that virus to put it in the body and make that body recognize it as something foreign and trigger an immune response. When our body attacks a foreign body, it generates an immune memory, which causes us to create antibodies against these viruses. That is what we do with vaccines. For a virus to infect a cell, it needs some proteins to bind to it. In the vaccine, we can use a part of this protein and induce the immune system to respond only to that part, but it will no longer be able to enter the cell.
Q. What is the difference between the Incor project and the research carried out in other countries?
R. Before answering, it must be said that each country or company has its own interests. For example, if a company has a patent for a methodology, it doesn’t matter if there is a better one, it will invest entirely in the one that will generate profits. Here in Brazil we already have some freedom regarding this. At Incor, we work without this pressure. When I was called to lead the project, the first thing I explained was that our priority would be to ensure a safe vaccine, since we know next to nothing about this new coronavirus. We will focus on the safety and efficacy of the vaccine at full speed. We decided not to use the genetic material of the virus, because we still do not have enough information about it. We use the methodologies I learned in the last five years in England and Switzerland: instead of using the genetic material of the coronavirus, we work with particles that are responsible for entering human cells. They are the crowns of the virus, called “spike protein.” We link these fragments with synthetic particles, similar to viruses, but without genetic material, that is, holes, to avoid multiplication. They are the VLPs [da sigla em inglês Virus Like Particles], a tangle of proteins. Because VLPs mimic a virus, the immune system is uncomfortable and reacts both to these particles and to the piece of coronavirus that is placed on them.
Q. What stage of development are you in?
R. We can consider that we are starting, due to the urgency of the pandemic. But we are very advanced in terms of intellectual production, with the production of VLT and proteins, the vaccine formulation is already very advanced. In vitro work is also underway and we are already beginning preclinical testing on animal models in the coming weeks. With the race to see who creates the vaccine first, some countries want to skip direct in vitro experimentation on humans, but that’s crazy. Even with all the theoretical framework, the human body is very complex, it will always show us some surprise. It is essential to test animals first.
Q. If the research has advanced so much in a short time, why is it taking up to two years for the vaccine to reach the market?
R. When developing a vaccine, it is possible to advance the theoretical part with various virologists, infectious diseases and immunologists. This technical part is quick. But when we start experimenting with living things, things change. I need at least 15 days to assess how the animal’s body will react. We analyze this reaction and adjust the vaccine, in some way, until it is completely efficient. It takes a month or two. With the results, we are experimenting with other animal models until they neutralize the virus to the point where it is safe to test in humans. After that, come the studies on the toxicity of the vaccine. We will have to develop a large battery of information to justify sending the vaccine to specific analytical organisms. The bureaucratic question comes, which, due to urgency, can even run fast. But biology, unfortunately, we cannot rush. To find out if what worked for the animal will work in humans, we conducted clinical studies, in which we obtained a small amount of the vaccine to detect an immune response. If so, we test a larger amount until the virus is neutralized.
Q. Despite the different approaches in each country, has the scientific community exchanged information on this research?
R. For me, it doesn’t matter if I or another scientist will be the first to create the vaccine, what I want is for it to be developed. But, as a researcher, and speaking realistically, I will never exchange information with a company that does not invest financially in the project. Among scientists, yes, we talk a lot. Our team, for example, works a lot with Fiocruz de Minas Gerais. It is true that researchers have a great ego, but in this case, we are talking about saving human lives, so we exchange a lot of information.
Q. Does a vaccine developed by a public research center, such as Incor, meet pharmaceutical interests?
R. I personally don’t care if the investigation is against a company. What we want is to develop an extremely effective and safe vaccine that is published and produced.
Q. What does research like this show, during a global pandemic, about the need for public investment in education and research?
R. We had a peak of investment in science and technology in 2004. In 2014, public money invested in the sector fell below 2004 levels. And to lose investment in science and technology is also to lose the ability to monitor health. We had a recent example of this, with the Zika virus crisis. If we had learned our lesson at that time, we would be much better prepared to face the coronavirus now. Reducing investment is so obtuse that people talk about the economic importance of saving public funds without remembering that investing in science, technology and innovation means permanent savings. If it produces knowledge, we stop importing inputs, we produce internally and we will continue importing. This is what happens, for example, with antidode serum, which Brazil exports to all of Latin America. So investing in science and technology, especially right now, is an economic and public health strategy.
Another thing is that, for example, if you did not have a scholarship, you could not stop working, studying and researching. In other words, if we stop investing, we lose the most valuable thing we have, human talent.
Q. Besides the importance of this investment, what other lessons could Brazil have learned from the Zika virus crisis?
R. Countries have the ability to recover economically even from war, but there is no recovery of life. Brazilians who have been directly and indirectly affected by the Zika epidemic will live forever with these consequences. One thing that highlighted the crisis was the importance of social responsibility, which, at that time, had to do with the fight against Aedes aegypti. Today it has to do with quarantine: it is not the sole responsibility of the authorities to determine that people stay at home, it is everyone’s obligation.
There is also a responsibility for social pressure. After the Zika virus spike passed, all investment in producing a vaccine against it was cut off. Society needs to play this game, because in less than a year the coronavirus pandemic will not be as strong as it is now, the vaccine will be about to be tested on humans, and if there is no popular and political pressure, the same will happen, we will lose investment
Q. And what lessons will be left after the pandemic?
R. The best learning is that science and society have to go together. Without this, we will continue to depend only on political opinions to decide whether to take chloroquine against a virus or not, for example. This is not done based on opinions, it is a medical-scientific problem. If we stay in the political game, we will all lose.
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