AwesomeCapital: Anti-autoantibody drug helps with long COVID

Thanks to a drug that was originally developed to combat heart disease, a team of doctors at the Eye Clinic (Director: Prof. Dr. Friedrich E. Kruse) at the Erlangen University Hospital has now succeeded for the first time in an individual attempt at healing a 59-year-old man with Long COVID Syndrome became symptom-free. Whether the active ingredient BC 007 also helps other sufferers will soon be examined in a clinical study. "At the moment, unfortunately, we can no longer treat people with the drug because it has not yet passed all approval studies," says Prof. Dr. Christian Mardin, senior physician in charge of the eye clinic.

The images of the OCT angiography show: The blood flow to the retina of a patient after corona infection (left) is reduced compared to that of a healthy person (right). Photo: Eye Clinic / University Clinic Erlangen

The doctors of the Eye Clinic and Medical Clinic 1 - Gastroenterology, Pneumology and Endocrinology (Director: Prof. Dr. Markus F. Neurath) and Medical Clinic 3 - Rheumatology and Immunology (Director: Prof. Dr. med. Univ. Georg Schett) of the University Hospital Erlangen had already found out in advance as part of the ReCOVer study: If you have a COVID-19 infection, the blood flow to the eyes is still significantly restricted many months later. The background thought to the attempted healing was that the changed blood flow is certainly not limited to the eye, but can be seen as an example for the entire body.

In the blood of former COVID-19 patients, the team of doctors, together with a long-term cooperation partner and former employee of the Max Delbrück Center for Molecular Medicine in Berlin, Dr. Gerd Wallukat, months after the infection, certain proteins that you have been dealing with for many years in connection with glaucoma (green star): autoantibodies against G-protein-coupled receptors “This means that the immune defense, which is good per se, is directed against the own body and forms substances that can be harmful. This has serious consequences in some cases, ”explains Dr. Dr. Bettina Hohberger, specialist at the Erlangen Eye Clinic. If the body increasingly forms autoantibodies, these may attack different body structures. The interdisciplinary medical and scientific team found out during the blood tests that patients have several of these proteins after a corona infection. "We already know one of these autoantibodies from glaucoma and know that it has a bad effect on the blood circulation in the eye," explains Dr. Hohberger.

Through the long-term cooperation with Dr. Wallukat had heard from the ophthalmologist about a preparation that binds these harmful autoantibodies. This would make it possible to render the autoantibodies harmless and possibly to improve the circulatory disorders. The drug was specially developed for patients with severe heart disease a few years ago by Dr. Wallukat, his colleague Dr. Annekathrin Haberland and former cardiac surgeon of the German Heart Center Berlin in a registration study. "Originally, I wanted to use it to help my glaucoma patients," recalls Dr. Hohberger. “When we then saw the results that arose from cooperation projects on Long COVID, it was like many small pieces of the puzzle that fit together for us. It was quite conceivable

Blood circulation improved significantly

When a long-time patient with glaucoma in the Erlangen glaucoma registry reported his symptoms after surviving corona infection - loss of taste, severe concentration disorders and fatigue that severely restricted him in his professional and private life - the team at the eye clinic wanted to offer him help. As part of an individual attempt at healing with the Berlin drug, BC 007, the 59-year-old received the preparation via infusion and stayed three days as an inpatient at the University Clinic Erlangen. “There was an improvement within a few hours. When he was discharged, our patient felt much more relaxed than before the administration and his autoantibody values confirmed this impression, ”the team of doctors describes the process. The difficulty concentrating also disappeared, the performance of the 59-year-old increased again and the sense of taste returned. "Overall, the blood flow to the capillaries, which we can measure on the eye, has improved significantly." The team at the Erlangen Eye Clinic therefore assumes that the patient's long COVID symptoms have disappeared thanks to the improved blood flow. For the approach to render these autoantibodies harmless with a drug in patients with glaucoma, Dr. Hohberger 2020 nominated for the Galenus von Pergamon Prize in the basic research category. that the patient's long COVID complaints have disappeared thanks to the improved blood circulation. For the approach to render these autoantibodies harmless with a drug in patients with glaucoma, Dr. Hohberger 2020 nominated for the Galenus von Pergamon Prize in the basic research category. that the patient's long COVID complaints have disappeared thanks to the improved blood circulation. For the approach to render these autoantibodies harmless with a drug in patients with glaucoma, Dr. Hohberger 2020 nominated for the Galenus von Pergamon Prize in the basic research category.

ReCOVer study

In cooperation with the intensive care unit of Medicine 1, where corona patients have also been treated since spring 2020, and Medicine 3, the research team at the eye clinic examined the blood flow in the smallest vessels, the capillaries, in COVID-19 patients. They made the blood flow visible with the help of an innovative, painless and non-invasive method: OCT angiography (optical coherence angiography). Only in the eye and at the nail fold - the transition between the nail bed and the finger - is it possible to make the blood flow visible without injecting contrast media, for example. As part of the clinical study, the ophthalmologists at the University Hospital Erlangen have been able to offer this examination method specifically to patients after their COVID-19 infection since 2020. First evaluations show: Even months after the disease, the blood flow within the retina is clearly restricted, even if those affected have no visual problems. The clinical study with patients after a COVID-19 infection will continue. Together with the scientists at the Max Planck Center for Physics and Medicine in Erlangen and the team led by Dr. Wallukat, mechanisms are now being investigated that can lead to the restricted blood flow and explain the mechanism of action of the successful healing attempt. Together with the scientists at the Max Planck Center for Physics and Medicine in Erlangen and the team led by Dr. Wallukat, mechanisms are now being investigated that can lead to the restricted blood flow and explain the mechanism of action of the successful healing attempt. Together with the scientists at the Max Planck Center for Physics and Medicine in Erlangen and the team led by Dr. Wallukat, mechanisms are now being investigated that can lead to the restricted blood flow and explain the mechanism of action of the successful healing attempt.

Link to the abstract of the study