Biomedical Research and Covid-19 — Is More of the Same Enough?
Science must work with and not against nature
Nature has slapped us in the face and forced us to question our species’ scientific prowess. As most of the planet shelters in place, largely powerless in the face of the relentless advance of the Covid-19 pandemic, we put our faith in a brave army of healthcare workers and biomedical researchers to fight what will be a long and relentless war against this formidable and ruthless enemy. On the R&D front, the planet’s efforts are unprecedented with over 1200 clinical trials (clinicaltrials.gov) and hundreds of vaccine development initiatives underway. We all derive some comfort from the military analogies — the flattening of the epidemic curve is our Stalingrad or Battle of Britain or Midway, a turning point in a war against the viral forces of evil — the Churchillian “end of the beginning”. Given that a vaccine is certainly not months away and the few promising therapeutic options for Covid-19 (let alone FDA approved drugs), we all accept that the war will be long and that victory is certainly not assured.
Perhaps at the very moment when we are deploying our planet’s remarkable and substantial scientific resources and ingenuity against the Coronavirus, we need to start thinking differently and ask whether we can assure victory with the quantity of high quality science? Perhaps it is timely to heed the (loosely paraphrased) words of the French statesman, Clemenceau who in the face of the carnage of WW1 asked: “Why make war when it’s going to end with peace anyway?” Why are we in a battle against nature when at the end of the day, the only way to beat the pandemic is to work with nature?
In early February, as the Coronavirus began tightening its inexorable grip on the US, Mark McCarty and James NiColantonio, respected biomedical researchers, published a paper presenting the scientific case for using certain natural products (nutraceuticals or foods or dietary supplements that may prevent or assist in curing certain conditions) in the prevention and treatment of RNA virus infections including Coronavirus. There is indeed pre-clinical (laboratory) research supporting the antiviral, anti-inflammatory and immunomodulatory properties of a number of mineral, plant and algae-based products and this evidence may be sufficient to justify pursuing clinical trials.
Proposing to test some natural products in Covid-19 will certainly elicit immediate, visceral and justifiable criticism. Natural products are already painted with the “snake oil” brush and the almost daily FDA letters to parties making ridiculous, fraudulent and downright dangerous claims about the efficacy of assorted bizarre remedies against Covid-19 have certainly made this situation worse. Why test natural products when there are so many FDA-approved drugs already in clinical trials for Covid-19?
Let us take the example of Spirulina, a blue-green algae and one of the promising natural products referred to by McCarty and NiColantonio. In animal studies, Spirulina extract is indeed a potent antiviral and ant-inflammatory agent and has a mechanism of action similar to a number of drugs currently being tested to reduce the severity of the cytokine storm and respiratory distress syndrome in Covid-19. Spirulina extract is safe for human consumption and is already widely used as a food colorant. Unfortunately, Spirulina extract is not a drug; it is a potent, natural product. If Spirulina extract was a drug, then perhaps there would be clinical trials underway given its excellent safety profile and potential efficacy. Similarly, there has been little consideration of the potential of natural products such as Spirulina extract in primary prevention — for example, protecting essential workers and hospital personnel regularly exposed to the Coronavirus. This may help as a stopgap measure while vaccines are being tested and produced?
Natural products are falling by wayside as science goes into overdrive in the pandemic era. While biomedical research may be ignoring them, empty drugstore shelves attest to the fact that the public is now indeed consuming vast amounts of supplements, nutraceuticals and health foods. While there is currently no evidence that natural products protect against Coronavirus or mitigate the severity of Covid-19, this does not mean that the scientific community should simply ignore them. Many of our most effective drugs have their origins in natural products, and most were discovered through a combination of serendipity and dogged determination. Today, we have better and better tools to characterize and screen natural products, but this area of science is the poor stepchild of drug development — under-appreciated and under-resourced.
The time has come to broaden our efforts and use science to work with, and not against, nature. We have the opportunity to discover and manufacture new, potent and biologically active natural product formulations — true natural drugs. Applications range from the prevention and treatment of Covid-19 to the management of negative health impacts of the pandemic. For example, are there natural product therapeutic options to help healthcare workers suffering from PTSD linked to months spent on the Covid-19 frontline.
We are doing amazing things to fight the Coronavirus pandemic within the current biomedical R&D paradigm. There are innumerable examples of global scientific collaboration and previously unimaginable innovation. Perhaps it is time to consider how to include nature as an ally in the war against the Coronavirus?
Leonard Lerer MD MBA is founder and CEO of Back of the Yards Algae Sciences, a Chicago biotechnology company focused on sustainable algae-based solutions to our planets health and nutrition challenges.