As the worldwide Covid-19 epidemic continues after nearly two years, scientists continue to study Molecular and genetic characteristics of patients who develop severe forms of the disease. So far, scientific data do not allow us to determine the reasons for the development of some young patients who do not have any particular health problem into a critical form of the disease that requires especially focused care. Recently, work carried out jointly by French and American researchers has made it possible to shed light on Gene imprinting of dangerous forms in young patients without co-morbidities, thanks to the power of artificial intelligence. explanations.
Covid-19, a clinically highly heterogeneous disease
Over the weeks and months, researchers are still discovering more about the pathogenetic mechanisms of Covid-19. A key point is to understand how to accurately distinguish patients, especially young people and those without risk factors, who will develop a severe form of the disease likely to require admission to intensive care and intubation, from those who will present only the asymptomatic, mild or moderate form.
While some comorbidities or age are clearly risk factors for developing a severe form, some young patients without health problems will progress unfavorably and justify invasive intensive care. However, the mortality rate among these patients remains high even today. It is therefore essential for healthcare teams to be able to identify these patients very early, in order to prevent worsening of symptoms, particularly respiratory symptoms.
Young patients who do not have comorbidities, but are in intensive care
In this context, French and American researchers used the latest techniques Artificial intelligence For analysis of complex genetic, viral, immunological and serological characteristics Among the 72 patients hospitalized with Covid-19:
- Patients with severe forms, especially acute respiratory distress syndrome, are hospitalized in intensive care (47 patients);
- Patients without severe forms, stay in the conventional hospital (25 patients).
Choose to compare patient data All young people (under 50 years of age) and those without co-morbidities, that is, he was not initially considered to be at risk of developing an acute form of the disease. Data from these patients were compared with those from 22 so-called healthy control patients. Unsurprisingly, the analysis of the data initially confirmed that ARDS is linked to a runaway immune system — which researchers call a cytokine storm — and an exacerbated inflammatory response.
Identifying a prognostic marker or even a new therapeutic target?
The power of artificial intelligence then made it possible to identify a network of 600 genes, which would be involved in the evolution into a severe form of Covid-19. Among these genes, five genes were said to be specifically overexpressed in patients admitted to intensive care for acute respiratory distress syndrome. One of these genesADAM9 جين gene, interacts with SARS-CoV2. Overexpression of this gene would be directly implicated in the development towards acute respiratory distress syndrome.
through experiences in the laboratoryThen the researchers found that Blocking the ADAM9 gene in infected lung epithelial cells is allowed :
- decrease in the presence of SARS-CoV2 virus in cells;
- Reduction in viral replication.
So this gene can form therapeutic goal Interesting to reduce the risk of contracting severe forms of Covid-19. Monoclonal antibodies targeting this gene have already been developed and are currently being tested in oncology. If their benefit against Covid-19 is confirmed, it will be possible to test them in this new indication.
This study made it possible to establish a true genetic fingerprint for patients who develop severe forms of the disease, without any previous risk factor. It has also shown a potential therapeutic target against the disease.
Estelle B. Doctor of Pharmacy
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