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Published on: Nov 13, 2020
1 minute read
By: Dr Rajan ( Medical Second Opinion Cell)

Using The Cellular Handshake Against The Virus

Using the cellular handshake against the virus

In early November an interesting study was published in The Lancet Respiratory Medicine, describing the treatment of a severe COVID-19 patient with human recombinant soluble angiotensin-converting enzyme-2. By using the treatment, it was possible to see the disappearance of the virus swiftly from the patient's serum, nose, and lungs, as well as a reduction in the patients’ inflammatory markers. How was this achieved? And why is this so intriguing.

When we look at treating viruses, there are several strategies at work. You can prevent its spread by the use of social distancing or masks, you can use medications that prevent its replication (such as Tamiflu). Or you can stop the virus from entering the cells, the first step in viral replication.

SARS-CoV-2 appears to enter human cells through the ACE2 receptor. ACE2 is a protein in the cell membrane found across the human body, especially the lungs, heart, kidney and small intestine. It function is related to the Renin-Angiotensin System, a mechanism by which the kidneys control your blood pressure.

Angiotensin-Converting Enzyme converts angiotensin 1 to angiotensin 2, a hormone that causes blood vessels to constrict. ACE 2 instead converts it to a protein that causes dilation of blood vessels. This likely protects these critical organs and ensure they receive sufficient blood to perform their tasks. ACE2 is being investigated as a possible target for blood pressure medications.

The study used a genetically modified soluble form of ACE2 that mimics the protein found on human cell membranes. By increasing its availability in the blood, the SARS-CoV-2 virus binds to this protein, resulting in its inactivation, rather than entering lung cells and causing lung injury. Lab studies have shown that it can reduce viral growth by as much as 1000 to 5000 times, and phase 1 studies show it to be safe to use in people.

The actual described case was in a 45-year-old woman, hospitalized with COVID, suffering from severe shortness of breath, cough and fatigue. She was first treated with hydroxychloroquine and anticoagulants, but this proved ineffective, and the virus was causing increasing damage to her lungs. Nine days after her symptoms started, she received the ACE2 treatment for a week, with no side effects. This resulted in an increase in ACE2 activity (seen from her blood results), but also a marked decrease in multiple inflammatory markers associated with COVID-19, as well as a sharp decrease in COVID 19 numbers. Indeed, the viral load dropped from 32,000 per mL to just 270 per mL two days after treatment started. She was also able to produce antibodies against the virus, so this did not impair her from getting immunity.

It is certainly a very interesting case, though questions remain on how feasible it would be (as well as how expensive) to manufacture large quantities of this protein receptor for treatment use, as well as how it fairs in clinical trials.

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Tuberculosis Symptoms and Treatment: Early Signs, Diagnosis, and Recovery

Tuberculosis (TB) is one of the oldest known infectious diseases and continues to be a major public health concern, especially in developing countries. India accounts for a significant proportion of global TB cases, despite advances in diagnosis and treatment. The good news is that tuberculosis is preventable, treatable and curable when detected early and managed properly.

Understanding tuberculosis symptoms and treatment is critical for reducing disease spread, preventing complications and achieving complete recovery.

What Is Tuberculosis?

Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis. It primarily affects the lungs (pulmonary TB) but can also involve other parts of the body such as:

lymph nodes
bones and joints
kidneys
brain

TB spreads through the air when an infected person coughs, sneezes or speaks.

Why Tuberculosis Remains a Major Health Issue

According to the World Health Organization and ICMR data:

millions of new TB cases are reported annually
delayed diagnosis increases transmission
incomplete treatment leads to drug resistance

Early detection and treatment are key to TB control.

Common Tuberculosis Symptoms

TB symptoms often develop gradually and may be mild in the early stages, leading to delayed diagnosis.

Persistent Cough

A cough lasting more than two to three weeks is a hallmark symptom of pulmonary TB.

The cough may:

be dry or productive
worsen over time
sometimes produce blood

Fever and Night Sweats

Low-grade fever, especially in the evenings, is common.

Night sweats that soak clothing or bedding are a classic TB sign.

Unexplained Weight Loss

TB increases metabolic demand and reduces appetite, leading to significant weight loss.

Fatigue and Weakness

Persistent tiredness and reduced stamina occur due to chronic infection.

Chest Pain

Chest discomfort or pain may occur during coughing or breathing.

Symptoms of Extra-Pulmonary TB

When TB affects organs outside the lungs, symptoms depend on the site involved and may include:

swollen lymph nodes
bone or joint pain
headaches or neurological symptoms
urinary issues

Why TB Symptoms Are Often Ignored

Many TB symptoms resemble common infections or general weakness.

This leads to:

delayed medical consultation
prolonged transmission
disease progression

Awareness improves early detection.

How Tuberculosis Is Diagnosed

Diagnosis involves a combination of:

sputum tests
chest X-ray
molecular tests such as CBNAAT
blood tests and imaging for extra-pulmonary TB

Early and accurate diagnosis is essential for effective treatment.

Tuberculosis Treatment Explained

TB treatment involves a combination of antibiotics taken over a fixed duration.

Standard TB Treatment

For drug-sensitive TB, treatment typically lasts:

6 months

The regimen includes multiple antibiotics taken in phases to ensure complete bacterial clearance.

Importance of Treatment Adherence

TB bacteria are slow-growing and resilient.

Stopping treatment early can result in:

incomplete cure
relapse
drug-resistant TB

Completing the full course is essential.

Drug-Resistant TB

If TB bacteria become resistant to standard drugs, treatment becomes longer and more complex.

Drug-resistant TB requires:

specialised medications
longer treatment duration
close medical supervision

Prevention of resistance depends on correct treatment from the start.

Side Effects of TB Treatment

Some individuals may experience side effects such as:

nausea
loss of appetite
mild liver enzyme changes

Most side effects are manageable with medical guidance and do not require stopping treatment.

TB and Public Health

TB is not just an individual health issue but a community concern.

Effective TB control requires:

early diagnosis
treatment adherence
contact tracing
public awareness

India’s national TB elimination programmes focus on these strategies.

Preventing Tuberculosis

Preventive measures include:

early detection and treatment of active TB
improving nutrition and immunity
adequate ventilation in living spaces
screening close contacts

BCG vaccination offers partial protection, especially in children.

Living With and Recovering From TB

With proper treatment:

symptoms gradually improve
infection becomes non-contagious
normal life can be resumed

Regular follow-up ensures complete recovery.

When to Seek Medical Help

Consult a healthcare provider if experiencing:

cough lasting more than two weeks
unexplained weight loss
persistent fever or night sweats
blood in sputum

Early action saves lives and prevents spread.

Long-Term Outlook After TB Treatment

Most individuals who complete treatment:

recover fully
regain normal lung function
return to daily activities

Long-term complications are rare with timely care.

Conclusion

Tuberculosis symptoms and treatment must be understood clearly to combat this preventable and curable disease. Persistent cough, fever, night sweats and weight loss should never be ignored. Early diagnosis, complete treatment adherence and regular follow-up are essential for curing TB and preventing transmission. With proper medical care and public awareness, tuberculosis can be effectively controlled and eliminated as a public health threat.

References

Indian Council of Medical Research (ICMR) – Tuberculosis Epidemiology and Treatment Guidelines
World Health Organization (WHO) – Global Tuberculosis Report
National Tuberculosis Elimination Programme (NTEP) – Government of India
Lancet Infectious Diseases – TB Diagnosis and Treatment Outcomes
National Family Health Survey (NFHS-5) – Infectious Disease Indicators
Statista – Global Tuberculosis Burden and Trends

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