Im not a geneticist but as I understand there is probably more nuance to it. I assume your friend knows this but was trying to condense down to Twitter size. In humans, RNA is not normally reverse transcribed to DNA, so I don’t think something that only interferes with RNA replication would be directly mutagenic for our cells. That said, if it causes us to produce defective ribosomes and proteins that could certainly cause the type of damage that eventually results in cancer.
The pathways for RNA production are also different. Humans produce RNA from DNA with DNA dependent RNA polymerase. RNA viruses like sars-cov-2 bring their own gene for RNA dependent RNA polymerase. So it is entirely possible that the drug interferes with one and not the other. There are also RNA retroviruses like HIV that instead reverse transcribe their genome to DNA and could then use a “standard” RNA transcriptase.
Anyway I am really curious about this, and how this works. Broad spectrum antivirals are something of a holy grail. That said one issue with covid is that the worst symptoms often occur well after peak viral load after you immune system has the virus itself largely under control. The lung damage and inflammation can continue well after that. That’s why you have to treat with monoclonal antibodies quickly. If you wait until you are in the ICU it may be too late.
I was wondering about that. It works by “introducing errors” into the genetic code of the virus. So if one million people take it, is there a chance that in a few of them the virus will mutate into something worse than SARS-CoV-2? (Which is already a possibility with the virus in the first place.)
Yeah, the first thing that popped into my head was similar but less scifi. I thought we were worried about mutations (i.e. “errors in the viral genome”) as there lies the path to the next deadly variant. The explanation by Frank_Farmer1 only notched the concern down a little.
Frank_farmer has a helpful link to the article below but interestingly it does not appear to have an effect on host (us) RNA. (I’m pleasantly surprised).
It is very exciting to see a new antiretroviral given the disappointing efficacy of remdesevir.
For evolution to work you must incorporate only a small number of mutations that can pass on to the next replication. Too many variants and the probability of breaking things increases dramatically.
This drug (dosed properly) is more akin to passing a book through every language in Google translate than sneaking a single typo past the editor.
Oh yes, he went into far more detail than I, I just shortened it for brevity’s sake.
I had the same question myself, but currently I don’t know. They seem to think it will cause it to mutate into something safer, but (shrug). Beyond my pay grade.
(At best, it may end up being prescribed to people past child-conceiving age? or as a drug of last resort, when it’s too late to ask for that vaccine shot because the patient now begging for that is about to be intubated / put on a vent…)
This has a kick-the-can-down-the-road potential.
Man, that Nature article had a way ominous final few sentences there in the conclusion.
Out in the wild, all kinds of unlooked-for, off-label uses even.
I realize you are well aware, but for the amusement and edification of anyone who hadn’t been tracking, say, how Viagra came to be used for ED, which is what most people think it was originally created for, among these other well-known pharmaceuticals (there are others):
This could be good news for the people who can’t (as opposed to won’t) get vaccines. For the others, though, it means they get a chance to avoid the consequences of their sociopathic actions while remaining free to spread disease and misery everywhere they go. Not wild about that.
Breakthrough cases are a real thing too. The State of Oregon just put out a report showing that in August alone they had 94 fatal cases in fully vaccinated people. There’s also huge portions of the world population who are unlikely to have the opportunity to get fully vaccinated in the immediate future, or who are fully vaccinated but received one of the less effective vaccines that have been used outside of the US. There are a lot of people out there could benefit from an effective treatment.
