Remaining Vigilant Against COVID-19 and Future Pandemics Means Opening Our Eyes to the T-Cell Immune Response
This July, I had the pleasure of attending and participating in the second annual Disease Prevention & Control Summit (DPCS) along with Adaptive’s Chief Medical Officer Lance Baldo and Chief Business Development Officer Sharon Benzeno. The summit brought together leaders from global public health agencies, governments, academia, and the biopharma industry to discuss the progress made against COVID-19, next steps in ending the pandemic, and preventing future pandemics. The discussions covered a range of topics including SARS-CoV-2 vaccine development and manufacturing, novel therapeutics, better diagnostics, and the work we need to do now to prepare for future pandemics. As decisions about COVID vaccine boosters loom and concerns about the Delta variant continue, what I heard during the summit seems even more relevant today.
As we have seen since March 2020, combatting pandemics requires speedy collaboration and communication across countries, business sectors, national government agencies and global public health organizations. Meetings like DPCS provide an opportunity for these critical conversations to continue and even for new partnerships to form. As Dr. Jay Butler of the Centers for Disease Control said, “During a crisis is a terrible time to exchange business cards.”
As both a participant and attendee, I came away from DPCS with several ways in which we could both address the current pandemic and prevent future ones.
Reading the Entire Immune Response
To address a challenging problem, we should look at all sources of information that can be part of a solution; understanding the protective response conferred by vaccines from the adaptive immune system requires us to look at both antibody and T cell responses. Studying only the antibody response to vaccines is like reading every other word in a book. You may have an idea of what is going on, but you miss out on the full story. This assessment of T cells and antibodies is needed at every stage of vaccine research and development. It also means incorporating T-cell assessment into regulatory guidelines for vaccine makers to help them incorporate it into trials. As peer-reviewed data mounts, we know that COVID-19 vaccines elicit a T-cell immune response even when antibody levels are low. As we see variants like Delta emerge in the population, understanding the T-cell response becomes even more critical in the long term.
Updating Clinical Trials and Regulatory Guidelines
We don’t understand the complete immune response to this virus. Using antibodies alone as the primary means to measure protection has gotten us far, but it’s indisputable that T cells are another important part of the equation. This has been shown in many peer-reviewed studies, including a recent study published in Immunity by John Wherry and a group out of Penn Medicine. It has also been shown in multiple studies, including a recent study published in Nature, that T cells provide protection against variants, even when levels of neutralizing antibodies are much lower, showing that we need to look beyond this important marker.
Despite this mounting evidence about the role of T cells, many academics, government researchers and pharma companies are not including T-cell metrics in their studies. As a result, this critical component of assessing the adaptive immune response is missing from research. We need support from government agencies on incorporating T-cell response into clinical trials and regulatory guidelines to support the development of SARS-CoV-2 vaccines and therapeutics.
Merging Biology and Technology
This pandemic has made it clear that outsmarting a virus requires harnessing the power of high-performance computing (HPC) and artificial intelligence (AI). For public health organizations such as the Centers for Disease Control, this has meant using AI technologies to improve detection of current infections as well as modeling future spread and emergence of variants.
In pharma and biotech, using HPC and AI can quickly turn massive datasets into actionable insight and therapeutics. Early in the pandemic, we turned to Microsoft Azure to help us tap into the full value of the massive clinical immunomics database generated by our immune medicine platform, including data generated by our COVID-19 research, which we shared with the world through our open public database ImmuneCODE.
As we combat COVID and prepare for future pandemics, we need to continue to combine biology and technology to both understand current outbreaks in real-time and predict the emergence of new diseases.
The COVID-19 pandemic has shown that if we work together and across industries, we can do what was previously thought to be impossible. To end this pandemic and prevent future pandemics, we need to remain vigilant of both current and emerging viral threats. To develop effective vaccines quickly, we need to fully understand the complete adaptive immune response. This can be done by going beyond traditional ways of measuring immune response, bringing biology and technology together, especially advances in AI/machine learning, and modernizing clinical trials and regulatory guidelines to include advances in measurements of the adaptive immune system.
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