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Two scientists have just won the Nobel Prize for their work with a technology that was unthinkable a decade ago: using mRNA to introduce into the body viral particles that help the body generate antigens against the germ.

This idea, which had already been planted in the minds of scientists in the 1980s, came to fruition in 2020, when safe and effective mRNA-based vaccines were finally developed in record time, turning the tide against the COVID-19 pandemic.

This public health tool not only made it possible to control the coronavirus. It also opened a door to the production of new vaccines, such as against Respiratory Syncytial Virus (RSV).

But this immunological race for new preventive or therapeutic vaccines has many challenges ahead, in order to produce vaccines for a wide range of communicable diseases that have not yet been brought under control. 

The following are some of the avenues that have been opened.

Cytomegalovirus infection

Cytomegalovirus (CMV) is a common virus. Once a person is infected, its stays in the body for life. Most people do not even know they have it, because it causes no symptoms. However, in some cases it can be serious and even fatal:

• When the infection occurs in fetuses, known as congenital CMV, it can cause severe birth defects. It is the most common vertically transmitted infection, with an incidence of 0.5% to 0.7% of pregnancies in developed countries and 2% in developing countries.
• In newborns, it can cause disability and deafness.
• In people with weakened immune systems.

For 50 years, cytomegalovirus has eluded scientific research, which has sought to develop a vaccine to prevent it.

The US pharmaceutical company Moderna is conducting a CMV vaccine clinical trial, called CMVictory, to test the mRNA-1647 vaccine. This research could yield results within one to three years.

MRNA against cancer

Messenger RNA technology is not only useful in the field of infectious diseases, but also potentially for treating non-communicable diseases.

For years, scientists have been working on an mRNA vaccine that will “train” the immune system to fight tumors. However, this has been difficult to achieve, because the bad cells that make up a tumor mutate rapidly.

That is why a clinical trial now underway is studying a new form of personalized cancer vaccine that uses mRNA to target a group of mutated proteins found in an individual’s tumor. Preliminary results from this study were presented at the annual conference of the American Association for Cancer Research.

Moderna is testing therapies that deliver mRNA instructions to produce immune-stimulating molecules, such as cytokines, inside cells to see whether they can amplify the effects of existing cancer immunotherapies. And Germany’s BioNTech is developing similar mRNA therapies that encourage cells to generate antibodies that can help stimulate an immune response.

Modifying DNA

As fascinating as it is controversial, mRNA technology could also be applied to the field of genetics.

A person’s genetic makeup, the set of genes known as the genome, can reveal important, intimate insight into his or her biology, and even clues to potential future diseases.

Now, scientists are showing that RNA, DNA’s lesser-known molecular cousin, is powerful in its own right and can provide information about rare human diseases that DNA cannot provide.

While DNA sequencing of the genome can reveal certain genetic mutations or abnormalities that are present from birth, RNA transcriptomes show what happens when these genes are activated or expressed. And they can offer a red carpet toward therapeutic treatment.

MRNA acts fast and disappears without a trace. This characteristic was a hurdle to overcome in producing vaccines; the mRNA messenger needed time to train the immune system against the virus. Yet it can be a virtue in modifying or designing DNA and preventing or treating rare diseases with a genetic origin.

The hypothesis that scientists have been testing is that mRNA can help produce proteins that the body was failing to produce naturally, which caused the rare disease. Simply put, the gene’s ability to mutate and eventually “trigger” the development of the disease could be eliminated.

This story was produced using content from original studies or reports and from other medical research, as well as health and public health sources, highlighted in related links throughout the article.