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DBL%20Hendrix%20small.png College chemistry, 1983

Derek Lowe The 2002 Model

Dbl%20new%20portrait%20B%26W.png After 10 years of blogging. . .

Derek Lowe, an Arkansan by birth, got his BA from Hendrix College and his PhD in organic chemistry from Duke before spending time in Germany on a Humboldt Fellowship on his post-doc. He's worked for several major pharmaceutical companies since 1989 on drug discovery projects against schizophrenia, Alzheimer's, diabetes, osteoporosis and other diseases. To contact Derek email him directly: derekb.lowe@gmail.com Twitter: Dereklowe

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February 13, 2009

A Cure for the Common Cold? Don't. . .Ah, Hold Your Breath

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Posted by Derek

If you want a good example of the way that the popular media handle a drug discovery story, take a look at all the headlines this morning on the news of the sequencing of the common-cold rhinoviruses.

There are a couple of "Cure For the Common Cold Unlikely" ones, but most of the others seem to regard this as a big step forward. "Cure May Be Found", "Getting Closer" , "May Lead to Cure", "Could Help to Cure" - that's the sort of thing. The problem is, how many viral diseases can we cure? I mean, really cure with drugs after a person's been infected, wipe out and make go away? Right. Do I hear a zero? Viral diseases can be very difficult to get a handle on, because there aren't many moving parts in there. If none of them are amenable to small-molecule drug approaches, people like me are pretty well out of the game.

The best chance you have with a viral infection is with a vaccine. But what this genomics work is telling us, actually, is that a vaccine is going to be rather hard to come by. This paper sequenced ninety-nine different rhinovirus strains, and if there are that many, there are surely that many more. Or there will be, after the next cold season - just wait. These things are mutating all the time - which is, of course, why we get colds year after year. The team working on this project was able to bin the viral genomes into fifteen different classes, but what are we going to do, develop fifteen different (and simultaneous) vaccines? Against a scurrying, hopping, moving target like this one?

No, this is very interesting work, and it'll tell us a lot about how viruses do their nasty viral business out in the real world. But I wouldn't start throwing around the "C" word. All that can do is disappoint people, I'm afraid.

UpdateOK, so who's giving the wrong impression here? As per the comments to this post, here's one of the article's co-authors, Dr. Steve Liggett, as quoted in the New York Times:

"We are now quite certain that we see the Achilles' heel, and that a very effective treatment for the common cold is at hand," said Dr. Stephen Liggett, an asthma expert at the University of Maryland and co-author of the finding.

Say what? That's just a bizarre thing to say. But perhaps he was misquoted, because you can also find this, which seems to be a lot more grounded in reality:

There is hope that a careful study of the viral genomes will reveal one central point of attack that could be exploited by drug makers. "What we would like is a single Achilles' heel for all the viruses that we have found so far, and we could attack in that direction," Liggett said.

But the viruses are found to have impressive powers of change. The study shows that some human rhinoviruses result from the exchange of genetic material from two separate strains infecting the same person. Such recombination had not been thought possible for rhinoviruses.

That recombination is one reason why a vaccine against the common cold appears to be impossible, said Ann C. Palmenberg, director of the Institute for Molecular Virology at the University of Wisconsin, and lead author of the sequencing effort. The viruses just keep changing too much.

Comments (24) + TrackBacks (0) | Category: Infectious Diseases


COMMENTS

1. RB Woodweird on February 13, 2009 11:45 AM writes...

(Elly is helping Granny with making her cold cure by passing ingredients to her)
Granny: Corn squeezins’.
(Elly passes her the jug under the blanket, and the jug is opened and Granny drinks from it and comes up from under the blanket)
Granny: Elly, that’s the strongest batch I ever made.
Elly: It’ll cure cold in a hurry, huh?
Granny: I mean my corn squeezins. Won’t know about my cold cure till it works fer a spell.
Elly: Look Granny! It’s working now! (a shot of the blanket with a smokng hole in it) It’s eatin’ a hole right through the blanket!
Granny: That ain’t my cold cure! I forgot to put the cork back in my jug!

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2. Daniel Newby on February 13, 2009 11:52 AM writes...

Besides, isn't the common cold caused by a whole slew of upper respiratory tract viruses, of which the rhinoviruses are a minor subset?

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3. ItalianGuy on February 13, 2009 1:19 PM writes...

' really cure with drugs after a person's been infected, wipe out and make go away? Right. Do I hear a zero?'

PEG-Interferon plus ribavirin cures (sustained virological response 6 months after end of treatment) about 50% of HCV infected patients who complete treatment.

Not that you would want to take interferon for a cold....

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4. Dana H. on February 13, 2009 2:43 PM writes...

Derek, while I am no fan of the mainstream media, you can't really blame them when you get quotes like this from an author of the study:

"'We are now quite certain that we see the Achilles' heel, and that a very effective treatment for the common cold is at hand,' said Stephen B. Liggett, an asthma expert at the University of Maryland and co-author of the finding."

Scientists themselves are to blame for many of the problems with science reporting. When speaking to the press, many scientists chronically exaggerate both the significance and the certainty of their own research findings.

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5. You're Pfizered on February 13, 2009 3:34 PM writes...

C'mon, Derek, you know that pharma has the cures for everything, we're just not going to share them with the public...

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6. CMC Guy on February 13, 2009 3:57 PM writes...

Dana H I don't disagree that Scientists are frequently guilty of the exaggeration you well note and more so are often incapable of translating to understandable terms/contexts. I can also see how Liggert's proclamation would lead to some of the Cure headlines. At the same time shouldn't a journalist immediately question such statements and dig deeper to get the whole picture or seek 2nd/3rd opinions as verification or clarification. Unfortunately the public will possibly believe such statements without knowing the implications that a long way to go.

I will say some of the headlines I saw do seem to temper the view that this is immediate application to Cure and a couple articles did provide some cautionary statements about future. I knew on scanning reports/seeing on News that although interesting and of potential great value there would be a long hard road to translate to vaccines/drugs treatments because I have seen/experienced this before. Perhaps we'll know in 8-15 years would be my guess.

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7. CMC Guy on February 13, 2009 4:03 PM writes...

Dana H another thought is that headlines are probably written by some Editor to the author in many cases and are intentionally made to attract readers not necessarily express full story. Sounds alot like what too often happens with drug Marketing/Sales it seems.

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8. John Harris on February 13, 2009 6:06 PM writes...

Sorry to burst the hype bubble but a cure for the common cold is already in clinical trials, and from the same people that did the research that produced Relenza and was "borrowed" to develop Tamiflu.

Rhinoviruses access nasal cells by attaching to a receptor on the cell surface. Canyon-like clefts on the surface of the virus attach to the receptor and allow the virus to infect the cell. Biota is developing antiviral compounds which are designed to bind to these evolutionarily conserved clefts of HRV's capsid shell and interfere with virus attachment to the targeted cell's receptor.

Biota completed Phase I (single & multi-dose) clinical trial of its HRV drug, BTA798 in 2007 and is currenty conducting Phase IIa trials.

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9. Anonymous BMS Researcher on February 13, 2009 10:38 PM writes...


As another poster noted above, the common cold is not a single disease but a syndrome that can be caused by many viruses including rhinoviruses, coronaviruses, adenoviruses, and some others.

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10. RNAi poster on February 14, 2009 12:38 AM writes...

Small molecules may or may not work on all strains and variants...but RNAi will. As described, there are enough constant regions to target. Furthermore, once targets are identified an RNAi cocktail could be developed to anticipate common/likely mutation points.

On a practical level rhinoviruses have single-stranded positive-sense RNA genomes and so are amenable to RNAi approaches just like Ebola (single-stranded negative-sense RNA).

http://finance.yahoo.com/news/Alnylam-and-Collaborators-bw-14335523.html

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11. Pfizerite on February 14, 2009 1:07 AM writes...

Agouron/Pfizer had a drug for the common cold Rupintrivir that unfortunately failed a Phase 11/111 clinical trial. A problem with it was that it needed to be given within 24 hours of the onset of infection.

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12. processchemist on February 14, 2009 3:33 AM writes...

about media hype: there's a conjunction of interests between science related people and journalists: media need scientific news of this kind, academia and business people need the hype to raise money. A vicious circle.
How many analysts have the strong scientific background to judge if a pipeline worths something or not? Their valuation is based almost exclusively on IP strenght and value of the target market. So a good amount of hype is crucial to influence their decisions.

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13. Tok on February 14, 2009 9:30 AM writes...

Or I could get the sniffles and sneezes for a week or so, maybe take a day off work if it's really bad, and get on with my life. Of course, we'll see how I feel the next time I get one...

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14. Pat Pending on February 14, 2009 2:58 PM writes...

Processchemist, most analysts do not even have the legal background to assess the IP strength of a pipeline and are unwilling to spend the money required to get an opinion of IP strength. So instead they rely on the representations of the business person.

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15. Seerak on February 14, 2009 11:33 PM writes...

**Agouron/Pfizer had a drug for the common cold Rupintrivir that unfortunately failed a Phase 11/111 clinical trial. A problem with it was that it needed to be given within 24 hours of the onset of infection.**

IIRC that's the main problem with any treatment for colds: by 24 hours after the initial onset of symptoms, the virus load is already dropping; the bulk of sniffles, coughing, congestions etc. are a consequence of the immune response and damage from the battle. The first 2 days of a cold are actual infection, the remaining 5-10 are just for healing up (occasionally complicated by opportunistic bacteria in the sinuses :P )

I can't recall the source of where I saw that, though.

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16. Jonadab the Unsightly One on February 16, 2009 7:36 AM writes...

> The problem is, how many viral diseases can we
> cure? I mean, really cure with drugs after a
> person's been infected, wipe out and make go away?

Well, the human immune system does that, so I guess all we'd really have to do is study the immune system until we fully understand all the details of how it works, and then figure out how to do what it does, only better and faster.

Yeah. Why don't you guys get started on that, and I'll be over here, not holding my breath.

> shouldn't a journalist immediately question
> such statements and dig deeper to get the
> whole picture or seek 2nd/3rd opinions as
> verification or clarification.

You're very confused about what journalism is. For a journalist, accuracy is at best a tertiary concern. I mean, yes, they'd (well, many of them would) like to be accurate, if possible, but there are other factors that make that difficult. Writing stuff that people will actually want to read is a fairly big deal (that's where the raises and promotions are), but even that is a secondary concern. The BIG thing in journalism is the time constraint. Everything has to be done by the deadline. There is no time for digging deep enough to get the whole picture. That would take hours, maybe days, or even longer, and the thing has to go to press before then, and meanwhile there's the actual *writing* to do.

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17. You're Pfizered on February 16, 2009 10:21 AM writes...

Unless a drug/treatment for the common cold is dirt cheap, no-one's going to buy it, and I'd be very interested to see what insurance companies do with something like this, considering the cost to them.

RNAi cocktail for a cold? How much would that cost?

Just take the 'tussin and some chicken soup.

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18. DevicesRUs on February 16, 2009 12:42 PM writes...

Both Hepatitis C and B are curable with interferon plus ribavirin, Hep B is curable with a couple of small molecules (lamivudine is one). RSV is being treated with RNAi/siRNA but it is hard to claim a cure there since it often resolves on its own.

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19. medicnman on February 16, 2009 1:24 PM writes...

On the topic of curing the common cold, I seem to recall a gentleman from the old Burroughs Wellcome days (IIRC, a Nobel laureate) who, with his group, had pieced together a small-molecule cure for the common cold... It posessed an unfortunate trait... carcinogenicity. Tisk Tisk, but a wonderful find for the sake of "finding/discovering". One can only hope and plan for the best outcomes sometimes.

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20. pfizerite on February 16, 2009 5:40 PM writes...

A thought on the project team was that people with asthma who have serious medical issues when they have a cold, would be prescribed rupintrivir at the start of the season to use if they thought they were catching a cold. Otherwise the problem would be getting to the doctor for the prescription followed by a trip to the drugstore within 24 hours of when they think they are coming down with a cold.

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21. David on February 16, 2009 10:41 PM writes...

Journalists working for general interest publications (daily newspapers and weekly magazines) assigned to the medical science beat have immense challenges: from the ever present deadline, to lack of investigatory resources, to a general lack of interest among the lay readership. Any story – like this one – that is likely to catch the attention of a reader who would otherwise gloss over a medical science article, is, naturally, going to get a lot of attention from editors, and, accordingly, enthusiasm and hype. I think perhaps we should be grateful that some significant number of people is now aware that scientists are comprehensively sequencing and analyzing the genomes of virus strains. If the story were about the sequencing of some uncommon or exotic virus it would, of course, be ignored. At least this way some degree of information from the forefront of bio research has, however briefly and partly inaccurately, captured the attention of the general public. I think we all agree that medical science journalism for the general public is vital for our society as a whole. Stories like this are, like it or not, one of the few communications bridges between the insular (and accelerating) world of biology and the scientifically illiterate general public. Luckily we have the Internet, so any person who read the story in the local paper and had his or her interest piqued, could easily learn more, and with just a few seconds on Google, find, for example, this blog, and then really learn something, and maybe tell friends. . .

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22. Chan on February 22, 2009 12:01 PM writes...

Thanks for posting this. I have the cure for the cold, no really. I even went into painful details explaining my cure in terms of current immunology science. There's talk about how innate and adaptive immunity work together but most of the bright people completely ignore this and go to work on the harder science along the line of developing a vaccine. There are a large number of diseases that inflict suffering by way of the body's response to antigens. The common cold is one of those diseases.

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23. Sue on July 1, 2009 11:56 AM writes...

Another safe alternative measure is walking! A recent study showed you are 3x less likely to contract a cold if you walk on a daily basis. How much walking? How can you fit walking into a busy life?
Read the details at http://www.trekdesk.com/Treadmill_Desk_Info/Common_Cold.html

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