Summary of Key Points
- Currently available COVID-19 treatments have limitations and concerns.
- A new clinical trial shows promise for interferon lambda, effective against all variants and drops viral loads faster than other COVID-19 treatments.
- Interferon lambda is a “one-and-done” treatment.
- Interferon lambda has little interaction with other drugs, making it a safer treatment option for many individuals.
- The Food and Drug Administration has not approved interferon lambda as a COVID-19 treatment; emergency use authorization is still pending.
Limitations and Concerns With Current COVID-19 Treatments
The currently available treatments for COVID-19 have been far from perfect, with each presenting its limitations and concerns.Additionally, Omicron and its subsequent mutations have made all previously available monoclonals ineffective.
What Is Interferon Lambda?
Interferons (IFNs) are a group of proteins produced by the immune system in response to viral infections. These proteins have antiviral, anti-tumor, and immunomodulatory effects and regulate the immune system. There are three types of interferons: type I, type II, and type III.
This indicates that type III interferons provide targeted protection for skin, gut, and lung surfaces while minimizing the side effects.
Given the characteristics of interferons, especially considering the specificity of type III interferons, they are useful for treating acute and chronic viral infections.
Regarding the timing of infection and host defense, IFNλs are the first IFNs that defend at the epithelial barrier to inhibit the initial spread of viruses without triggering inflammation.
In the context of COVID-19, type III interferons are more appropriate for development as a treatment for three reasons.
Interferon Lambda Works Differently Than Other COVID-19 Treatments
While most COVID-19 treatments are exogenous, meaning they are produced outside the body and later introduced to the body, interferon lambda is endogenous, produced naturally by the body in response to viral infections.This means that interferon lambda, even if administered exogenously, is less likely to cause adverse effects, and is less likely to interact with other medications.
Interferon lambda works with your natural immune system, not against it. This differs from other COVID-19 treatments, such as vaccines, that aim to “hack” your immune system into working for you. The beauty of interferons is that your immune system can immediately use them. The idea is that we are letting our immune system do the work with a little boost from outside.
- Effective against all virus variants, including the Delta and Omicron variants.
- Drops viral loads faster than other treatments, making it an effective way to limit the spread of the virus.
- Interferon lambda is a “one-and-done” treatment.
- Little interaction with other drugs makes it a safer treatment option for many individuals.
Interferon Lambda Clinical Trial Shows Promise for COVID-19 Treatment
Two studies (1, 2) have reported the results of phase 2 clinical trials on the impact of pegylated interferon lambda on the viral load of SARS-CoV-2. Phase 2 clinical trials are small studies designed to test the safety and effectiveness of new drugs, whereas phase 3 clinical trials involve hundreds to thousands of participants.The phase 3 clinical trial recruited 2,617 participants, of whom 933 were randomly assigned the treatment of pegylated interferon lambda, while 1,018 received a placebo. The remaining 666 patients were assigned to other intervention groups.
The placebo group was given either a single subcutaneous injection or an oral placebo. The median age of all the patients was 43 years, ranging from 18 to 92.
Of the patients in the interferon group, 25 of 931 (2.7 percent) showed a primary-outcome event, meaning the patient suffered from hospitalization or emergency treatment, compared to 57 of the 1,018 (5.6 percent) placebo patients. The difference shows a reduction of 51 percent risk between the control and placebo.
Additionally, there were no differences in the incidence of adverse events between the control and placebo groups, showing that the interferon lambda therapy did not lead to, at least in the scope of this study, more side effects.
Our Genes Decide the Response to Interferon
It’s important to note that there are limitations to using interferon lambda injections. First, the COVID-19 patients were treated early—within 7 days after the onset of symptoms as defined in the NEJM clinical trial.Thirdly, not everyone responds to interferon therapy. Some intrinsic factors predetermine our response to interferons, such as our genes.
The study discovered that a common gene pattern of OAS1, called a haplotype, was linked to an increased risk of severe illness and reduced clearance of the COVID-19 virus.
Evaluation of the prevalence of this haplotype is warranted, yet the interplay between COVID-19 and specific genes raises a bigger question regarding the impact of our genes on disease.
Let’s take approaches to happiness as an example. Hedonic lifestyles prioritize pleasure and positive emotions, such as joy, excitement, and satisfaction, and may involve activities such as indulging in good food, entertainment, or material possessions.
In contrast, eudaimonic lifestyles prioritize meaning, purpose, and personal growth and may involve pursuing challenging goals, contributing to the greater good, and cultivating meaningful relationships. While both approaches can bring about positive feelings and experiences, eudaimonic well-being tends to be more sustainable and satisfying over the long term, as it is rooted in the sense of purpose and deeper fulfillment beyond the pursuit of immediate pleasure.
On the other hand, individuals living a hedonistic lifestyle showed higher expression of pro-inflammatory genes and downregulation of interferon gene expression.
The study suggests that the interconnectedness between mind and body is powerful and should be taken into account when trying to prevent or treat illness.
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