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Cell therapy could help patients with ARDS from severe Covid-19, study involving ARU shows

A new type of cell therapy could improve the prognosis for those critically ill with acute respiratory distress syndrome (ARDS) resulting from severe Covid-19, trial results suggest.

Called agenT-797, it has the effect of rescuing exhausted T cells and prompting an anti-inflammatory cytokine response.

A patient on a ventilator
A patient on a ventilator

It is thought this potentially activates anti-viral immunity to help critically unwell Covid-19 ARDS patients receiving intensive care to fight infection and reduce severe, pathogenic inflammation of the lung.

Prof Justin Stebbing, of Anglia Ruskin University (ARU), is the joint senior author of a new study of MiNK Therapeutic’s allogeneic, unmodified invariant natural killer T (iNKT) cell therapy.

He said: “During this small, exploratory study we observed that MiNK’s iNKT cell treatment, which is also being advanced for people with cancer, triggered an anti-inflammatory response in ARDS patients.

“Despite a poor prognosis, critically ill patients treated with this therapy showed favourable mortality rates and those treated at the highest dose also had reduced rates of pneumonia, underscoring the potential application of iNKT cells, and agenT-797 in particular, in treating viral diseases and infections more broadly.

“AgenT-797 was manufactured rapidly and as opposed to using patients’ own cells, it is ‘off-the-shelf’ and made from healthy donors’ cells. The potential of this therapy to be used across a number of severe infections warrants randomised controlled trials.”

The research was carried out at three medical centres and found agenT-79 had a tolerable safety profile. It involved 20 mechanically-ventilated patients with severe ARDS secondary to Covid-19, of whom 14 survived (70 per cent) at 30 days (compared to a control group of 10 per cent). There was an 80 per cent lower occurrence of bacterial pneumonia among those who received the highest dosage of agenT-797, compared to those who received fewer cells. One other patient received the therapy under compassionate use.

Five of the 21 patients were also receiving veno-venous extracorporeal membrane oxygenation (VV-ECMO) - the most aggressive salvage therapy for critically ill patients with ARDS, which involves deoxygenated blood being pumped through a membrane lung and returned to the body via a cannula.

The trial is believed to be the first immune cell therapy of any type to be used in critically unwell patients undergoing VV-ECMO.

Survival of the VV-ECMO cohort was 80 per cent after 30 and 90 days, and 60 per cent after 120 days, compared to 51 per cent for patients with Covid-19 treated with just VV-ECMO at the same institution, during the same timeframe.

Dr Marc van Dijk, chief scientific officer at MiNK and co-author of the study, said: “These published findings reinforce the unique power and potential of iNKT cells to mitigate severe acute respiratory distress.

“The data demonstrate agenT-797’s encouraging survival benefit, ability to help clear secondary infections, and tolerable administration in ventilated patients and those on VV-ECMO support.”

The study can be read in journal Nature Communications here.

The trial was funded by MiNK Therapeutics, and patients were treated at Weill Cornell Medicine, New York; The Norton Cancer Center, Louisville; and Providence Saint John’s Health Center, Santa Monica.

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