As time advances, humans get better at playing god. The hubris of that statement is obvious, but also true. Most diseases used to spell doom for a human just over a century ago, and today we’re battling viruses by extracting some of their genetic code and training our immune system to fight against them. Not only are the mRNA vaccines against COVID-19 the fastest and most efficient vaccines developed yet, but scientists aim to use the mRNA technology to fight more than just COVID. Before we dive into the future uses of the mRNA technology, first let’s take a look at why they’re game-changers, to begin with.
There are a few reasons why messenger ribonucleic acid (mRNA) technology is particularly suited to vaccines. The cells in our bodies use the mRNA as a set of instructions to follow, synthesizing dynamic proteins that can treat a spectrum of diseases. The single-stranded molecule is naturally present in our cells and carries these instructions to our cells for execution. For instance, the COVID-19 vaccines contain mRNA (it cannot “infect” us), which is then “read” by the cells upon vaccine administration. The cells that the mRNA vaccine is administered to generate the spike protein of the COVID virus, which subsequently leads to a robust immune response (in the form of neutralizing antibodies). Your body then stores the memory of producing those antibodies in case it needs to deal with the spike proteins again. This is how it wakes up quickly when infected with live COVID, and fights off the infection faster than a body whose immune system was not trained this way.
Perhaps, most importantly, mRNA can be engineered specifically not only to create antigens for viruses but also to encode cytokines and other immune system-related proteins. Once the desired mRNA is known, the creation process is relatively easy – even faster than the traditional process for vaccines. A computer lays out the sequence of the mRNA, after which a DNA template that can synthesize the aforementioned sequence follows. Very similar to software coding. Plus, another benefit is ending our reliance on animal/cell culture processes involved in vaccine creation – growing it in cells, or chicken eggs.
Partnering with the non-profit International AIDS Vaccine Initiative (IAVI), Moderna announced recently that it had entered Phase I of its mRNA vaccine trials against HIV, with the first participants having been successfully dosed.
It has been more than four decades since HIV was first discovered, and though successful therapies currently exist to make living with HIV manageable, a vaccine against it is an elusive goal.
The current trial will use Moderna’s mRNA tech to provide instructions for immunogen creation, which the cells will then utilize to create the protein. Researchers are also testing an additional boosting immunogen to see if it can assist in generating the desired immune response.
The goal would be to stimulate the development of B cells that can produce antibodies that target and neutralize a large range of HIV variants. HIV shows immense genetic diversity, which is a major hurdle that vaccine development will need to tackle. Also, HIV intertwines with the human genome within 72 hours of infection, at which point it is an irreversible, life-long infection.
Moderna has dozens of prospective mRNA vaccines and therapies in its current pipeline, ranging from vaccines against the Zika and Nipah viruses, to even potential treatments for cancer. BioNTech too has an equally large repertoire of mRNA projects in the works for various cancers, the flu, and even tuberculosis.
Even notoriously difficult pathogens to target – such as the ones that cause Dengue, infecting hundreds of millions of people every year, especially those in the developing world – could potentially be worked on using mRNA vaccines. Dengue consists of a group of four different viruses (DEN-1/2/3/4) that cause similar diseases. Targeting all four dengue viruses is very important, as a subsequent infection with a different Dengue virus can actually end up being more severe. It is thus imperative to neutralize all of them with just one vaccine, which is no easy feat.
A cure for cancer has been a collective human goal for decades. There are two ways in which mRNA can be immensely helpful in anti-cancer treatment. The first way would be by introducing a person’s own antigens to the immune system – ones that are usually shut down in healthy cells, but expressed by cancer in question. An anti-cancer vaccine would, therefore, induce an attack on the cells carrying these antigens at this point. This could be extremely effective, albeit in specific cases – for instance, four antigens can cover up to 90% of melanoma patients, and BioNTech has such a multivalent vaccine in clinical trials as well!
The second way is even more ambitious – but one that the adaptability of the mRNA technology is particularly well suited to. The vaccines could also target the mutations that occur in cancer. Though mutations are often personalized to a particular patient, by analyzing the profile, multi-mutation vaccines could be a tangible reality.
The future of mRNA tech has far more than the current pandemic in its sights. The future of healthcare itself might rest on the success of mRNA and similar medical technologies. After all, hacking into our own body to reprogram our immune systems to be able to fight illness, new and old, is the stuff science-fiction used to fantasize about. What a time to be alive!