
‘AeroNabs’ – Inhalable Protection Against Covid-19 - cmlars
https://www.ucsf.edu/news/2020/08/418241/aeronabs-promise-powerful-inhalable-protection-against-covid-19
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fabian2k
It's really annoying that press releases tend to overhype research so much. As
far as I understand from skimming the paper, they created a synthetic antibody
against the Spike protein of SARS-CoV2 that binds very tightly.

There is no clinical data in the paper, they measured how tightly the nanobody
they designed binds to the Spike protein and they did some neutralization
assays against SARS-CoV2.

The advantages of the nanobodies compared to full antibodies sound
interesting, for sure. But this is still a paper pretty solidly in the basic
research area, and quite far from clinical use.

I found an article about this research that puts it into a bit more context:

[https://www.statnews.com/2020/08/11/scientists-create-
potent...](https://www.statnews.com/2020/08/11/scientists-create-potent-anti-
coronavirus-nanobody-inspired-by-llamas/)

> While the lab results look promising, experts in the field advise caution
> because important work has not been done to test the compound in animals.
> “The critical thing is animal data. We’ve found things that are very potent
> in vitro that do nothing in vivo,” said Dimiter Stanchev Dimitrov, a
> professor of medicine who directs the Center for Antibody Therapeutics at
> the University of Pittsburgh and has created antibody-based therapeutics for
> numerous viruses including SARS and MERS, two other coronaviruses. He said
> it can take months to collect the needed data in animals. “Once these are
> tested in animal models, then I can get excited.”

~~~
Duller-Finite
Normally I agree that press releases way oversell the research, but I don't
think that was the case here. Their camelid nanobody approach seems to be a
fairly novel idea with some nice benefits over traditional antibodies, and
most of the linked article actually does a nice job of walking you through the
figures in the preprint.

Sure there's not any clinical data, but they actively admit that and I'm sure
that's something they're working on. Furthermore, there have been multiple
Nature papers published on SARS-CoV-2 neutralizing antibodies and antibody
cocktails that use the same experiments (e.g. Vero cells) without testing in
animal models or in humans. One step at a time!

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vikramkr
Camelid nanobodies aren't _that_ new, but this is still overselling stuff. I
don't like reporting on preprint in general, and this article really doesn't
explain the complexities of actually getting some early stage technology like
this approved and developed. That's where you end up with the constant barrage
of "oh look, another biomedical technology we'll never hear about again"
comments, and the amount that this article tries to sell the tech in the
headline and article really overstated the readiness of the tech and the near
term impact it could have

~~~
derefr
If you take it as _science_ reporting, mainly intended to be of interest _to
scientists_ or _to people who follow the progress of science_ , then it's
sensible. It's similar to the materials-science reporting they do for battery
technologies.

These releases coming from University PR departments (this one's from UCSF)
aren't really supposed to make it into _newspapers_ for wide consumption.
Their target audience is:

1\. the people working in the same field—in other Universities, or in
industry—who maybe don't have time to read journals, so you've gotta get their
attention actively with a "billboard" announcement, rather than putting it in
a journal they have to explicitly decide to read;

2\. the people who fund the university, who want to see what sorts of neat
things their money is being spent on.

Pop-science journalists sometimes glom onto these releases and make them more
than they are, "retargeting" them for public consumption. You can certainly
object to that. But _as originally delivered_ , these publications are
blameless for that.

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fabian2k
I've never seen any scientists reading press releases instead of papers, they
are certainly not targeted towards scientists. And you also don't have to read
a full journal to notice an individual paper, it's quite common to have
keyword-based alerts on Pubmed or something like that.

The level of detail in a press release makes it usually pretty useless to a
scientist, it hides the important details behind language intended for non-
scientists. The abstract of a paper is much more useful if you need to decide
whether it is of interest for you at all.

~~~
jrumbut
I think you're right that the UCSF public relations team is doing neither hard
hitting investigative journalism nor the sort of critical pre-Phase 1 analysis
that prevents wasted effort in medical device development.

I enjoyed hearing about this new approach to infection control that is its
infancy regardless. I felt a little hope for a creative solution to our
current crisis and I didn't have to wade through the literature on camelid
antibodies to do it.

New technology has always relied on a certain underlying optimism that you can
do something that's new and better against the odds (since most fail).

Would you like this better if there was a disclaimer explaining in vitro/in
vivo or just the long road from basic research to wide spread deployment?

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fabian2k
The Statnews article I linked is a good example of reporting for this kind of
very early result. It does clearly mention that this is at an early stage and
that no clinical data has been collected yet. I think this is certainly
interesting, it's just so tiring to see this kind of stuff turn up again and
again in extremely misleading articles in mainstream media.

Though I think it would have been better to wait until peer review before
making a press release. This is not a paper that has immediate clinical
applications, and the peer review might still turn up some problems with the
paper.

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xmjw
Anyone remember the Benzites from Star Trek TNG? I guess we know what that gas
they breathe in is for...

~~~
learc83
I know that this is a joke, but the gas they breath is supposed to be
chlorine, moisture, and mineral salts to replicate their home world's
atmosphere.

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michieldotv
As far as I know, there's only one nanobody-based drug on the market today,
caplacizumab, and it isn't administered through aerosols, but rather
subcutaneously.

I know Ablynx was working on an inhaled one as a treatment for RSV, but I
don't think it made it to the market (yet). This noveldelivery method probably
needs lots of scrutiny from regulators before it can enter the market.

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mc32
Looks interesting but so far only talks about using it as prophylactic via
inhalation; however the virus is known to enter via mouth, eyes and anus as
well (breaks in skin probably). Even so inhalation and touching to mouth are
likely the most common vectors of infection, so seems promising.

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elil17
It doesn’t have to be 100% effective for it to end the pandemic - it just has
to be effective enough that it blocks most transmissions and gets the viruses
reproduction rate under 1.

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shadowgovt
Well at the same time proving to not have any side effects, such as passage
into the bloodstream followed by formation of molecules that the liver cannot
break down and the kidneys cannot flush.

It's promising early research, but it's not even in laboratory animal trials
yet.

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o_____________o
Anyone know about potential human immune responses to these?

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craftinator
That was my first thought as well, followed closely by "I wonder which
interesting new cancer these might cause". Gotta love biomed.

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dekhn
UCSF is my alma mater but this wave of press about aeronabs is just
ridiculous. This is research lab level work, far from the clinic. It should
not even have been announced via PR, just publications.

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trixie_
It feels like a large amount of that research went into creating a marketable
product name.

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smiley1437
Oh great...

"Hey why aren't you wearing a mask?"

"No worries I'm using inhalable protection"

 _rolls eyes_

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EricE
Speaking of eyes I wonder if you can "inhale" it into your eyes too.

Viruses can enter the body more than just orally and even though we think it's
primarily through the respiratory system, we aren't sure yet.

Even having expressed doubt, something is better than nothing. And if it
eliminates requiring face masks it would be worth it alone for that.

~~~
smiley1437
I’m guessing any mucous membrane (eyes, mouth, nasal passages and I swear some
other posts here said anus) is a risk but apparently lung cells are the most
vulnerable

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eigenvalue
Won't this take too long to run human trials on for safety/efficacy for it to
really matter? My understanding is that a vaccine will likely come out within
6 months or so. They mention that it's an older compound, but sounds like they
made some novel changes to it. Since this situation is so much a race against
time, we are probably better off focusing on older, better-understood
compounds that don't need to be tested for as long.

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beervirus
A vaccine would be great, but it’s far from certain we’ll have one in 6
months. It makes sense to keep pursuing multiple lines of research.

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djaque
That's really exciting. It reminds me of PrEP which is a pill you take that
can prevent you from contracting HIV with like 99% success rate. It's really a
game changer since there isn't an HIV vaccine.

I also don't want to get my hopes up since research like this is bound to be
overhyped. I want to see where it goes like a month or two from now.

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prepend
“Llama inspired design” is quite amazing for being a conscious design choice.
It does look like a llama, but is that a good thing?

Are llamas in the UX toolkit as an animal that is both semi-exotic yet
familiar enough to elicit positive reactions.

I encountered a bunch on Peru trails and they were pretty ornery (compared to
yaks or sheep) and the 30 or so different Quechua locals I talked with said
they were pretty bad as pack animals. So they seemed pretty normal to me and
not really some cool animal.

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HumblyTossed
This has to be a bot, right?

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prepend
Not a bot, I think the inhaler looks like a llama and that’s what I meant.

