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In the worst case, covid-19 ends in fatal pneumonia. But by countering HMGB1, a frequently overlooked protein, you can theoretically alleviate inflammation significantly, according to Ulf Andersson, a professor at the Karolinska Institute.
Almost 300 | 000 people have died from the coronavirus. But an overlooked protein may be the key to alleviating pneumonia, which often occurs in severe cases of covid-19.
– If we knew it works, it would change everything radically, he says.
Along with his American colleague Kevin Tracey, professor of neurosurgery and molecular medicine, Ulf Andersson has identified a protein in the body as one of the causes of pneumonia in severe viral infections.
By treating the protein with specific antibodies, developed by both researchers, it is hoped that the inflammation in sick patients can be alleviated.
– With the crown, it often starts off slightly with a cold and after a few days melts away. Then a strong inflammation has developed. It is in this situation that you want to put something as powerful as increasing inflammation, says Ulf Andersson, a professor in the Department of Women’s and Children’s Health at the Karolinska Institute in Solna.
The protein goes by the elusive name HMGB1, and the two scientists have spent two decades studying its properties, often in headwinds.
Andersson and Tracey are part of a small but dedicated core of researchers who have taken an interest in HMGB1. Also, the commitment to protein is much fresher.
– It is a complicated biology and there are hundreds of molecules that have to do with inflammation and all scientists have their little favorite. The competition for attention is fierce, he says.
Since the crown eruption, more than 289,000 people have died worldwide from viral disease. According to the World Health Organization, there are no effective vaccines or treatments to delay the course of the disease.
Therefore, it is hoped that research on HMGB1 may play a key role in reducing mortality rates in pneumonia.
– I have spent the last 20 years on this protein and no one has understood why. But if this is what I hope it can be a breakthrough. I believe in it, says Andersson.
And that’s precisely the inflammation you want to reduce to reduce the death rate from covid-19.
– You do not die from the virus itself, it is because the inflammation is too strong. So HMGB1 is one of the many inflammatory molecules that help make you seriously ill. And the special thing is that it stays in the lungs, says Ulf Andersson.
TT: How much relief could this treatment provide for inflammation?
– In theory, of any size.
Tests have been done in both mice and rats with positive results, but an approved treatment that can be used in humans is at least 18 months away.
– More animal studies, a toxicology study would be needed, and then large-scale antibodies would need to be produced, Andersson says.
Another problem is the lack of money. In turn, large pharmaceutical companies have been involved in patent development without resulting in any finished medication.
– That’s where it fell. It is annoying, he says.
At the same time, Andersson believes there are many reasons to investigate the treatment method that could have a scope that extends beyond alleviating pneumonia.
“This is probably not the last pandemic to emerge in the future, so there are many reasons to try to understand each other about inflammation itself,” he says.
HMGB1
HMGB1 is a protein found in the cell nucleus of all animal and human cells. In the cell nucleus, HMGB1 upregulates chromatin.
A cell that is sick or dying sends HMGB1 into the environment as an emergency signal to induce inflammation, which is basically a good thing. But too strong inflammation is dangerous and causes cells to die, therefore too much HMGB1 is dangerous.
HMGB1 has two types of receptors, RAGE and TLR4, one of which is found only in the lungs. That is why the protein is particularly interesting in lung diseases.
Severe respiratory symptoms
The new coronavirus is called sars-cov-2.
The virus can cause covid-19 coronavirus disease, which causes various respiratory symptoms. Symptoms often include fever, dry cough, and pneumonia.
In rare cases, the disease can also cause severe breathing difficulties, as a result of organ failure and acute lung injury, called pulmonary shock.
To date, more than 26,000 Swedish cases of coronary infection have been identified.
The number of people who have died in Sweden is around 3,200.
The figures are updated on May 11, 2020.
Sources: Public Health Authority and The Lancet
