The frenetic search for the miracle that will rid the world of    COVID-19 is branching out in a thousand directions, and a large    part of the microbial treasure hunt is going on in the Bay    Area, where major progress has been made in the 100 days since    residents were ordered to shelter in place.  
    Scientists at universities, laboratories, biotechnology    companies and drug manufacturers are     combing through blood plasma taken from infected patients    for secrets that will help them fight the disease.  
    The key is likely a     super-strength antibody found in some patients. But    researchers must first figure out how those antibodies work and    how they can be harnessed and used to stop the     many health problems associated with COVID-19, particularly    acute respiratory distress syndrome, or ARDS, which has killed    more people than any other complication connected to the    disease.  
    Other developments showing promise include     injections of mesenchymal stem cells, found in bone marrow    and umbilical cords, that doctors are studying to battle    inflammation caused by ARDS. And a steroid called dexamethasone        reduced the number of deaths by halting the overreactive    immune responses in seriously ill patients in the United    Kingdom.  
    In all, more than 130 vaccines and 220 treatments are being    tested worldwide.  
    What follows is a list of some of the most promising elixirs,    medications and vaccines with ties to the Bay Area:  
    Monoclonal antibodies / Vir Biotechnology, San    Francisco: Scientists at Vir and several institutions,    including Stanford and UCSF, are studying monoclonal    antibodies, which are clones of coronavirus-fighting antibodies    produced by COVID-19 patients.  
    The idea is to utilize these neutralizing antibodies  which    bind to the virus crown-like spikes  and prevent them from    entering and hijacking human cells.  
    Only about 5% of coronavirus patients have these super-strength    antibodies, and those people are believed to be immune to a    second attack.  
    The trick for scientists at Vir is to identify these    neutralizing antibodies, harvest, purify and clone them. If    they succeed, the resulting monoclones could then be used to    inoculate people and  it is hoped  give them long-term    immunity against the coronavirus. The company recently signed a    deal with Samsung Biologics, in South Korea, to scale up    production of a temporary vaccine in the fall after clinical    trials are complete.  
    Another monoclonal antibody, leronlimab, is     being studied in coronavirus clinical trials by its    Washington state drugmaker, CytoDyn. The companys chief    medical officer is in San Francisco, and the company that does    laboratory tests of leronlimab is in San Carlos.  
    Interferon-lambda / Stanford University:    Doctors at Stanford are     running a trial to see if interferon-lambda, which is    administered by injection, helps patients in the early stages    of COVID-19. Interferon-lambda is a manufactured version of a    naturally occurring protein that has been used to treat    hepatitis. Stanford doctors hope it will boost the immune    system response to coronavirus infections.  
    Dr. Upinder Singh, a Stanford infectious-disease expert, said    the trial has enrolled more than 50 patients and is halfway    finished. We have noted that patients tolerate the drug very    well, she said.  
    Mesenchymal stem cells / UCSF and UC Davis Medical    Center: UCSF Dr. Michael Matthay is leading a study    about whether a kind of stem cell found in bone marrow can help    patients with ARDS. Matthay hopes that the stem cells can help    reduce the inflammation associated with some of ARDS most dire    respiratory symptoms, and help patients lungs to recover.  
    Matthay is aiming to enroll 120 patients in San Francisco, the    UC Davis Medical Center in Sacramento and hospitals in a    handful of other states. He said the trial, which includes a    small number ARDS patients who dont have COVID-19, should have    results within a year. So far 17 patients are enrolled in the    trial, most of them in San Francisco.  
    Remdesivir / Gilead Sciences (Foster City):    Remdesivir, once conceived as a potential treatment for ebola,    was the first drug to show some promise in treating COVID-19    patients. The drug interferes with the process through which    the virus replicates itself. A large study led by the federal    government     generated excitement in late April when officials said    hospitalized patients who received remdesivir intravenously    recovered faster than those who received a placebo.  
    A later study looking at dosage showed some benefit for    moderately ill COVID-19 patients who received remdesivir for    five days, but improvement among those who got it for 10 days    was not statistically significant. Gilead, a drug company,    recently announced that it will soon launch another clinical    trial to see how remdesivir works on 50 pediatric patients,    from newborns to teenagers, with moderate to severe COVID-19    symptoms. More than 30 locations in the U.S. and Europe will be    involved in the trial, the company said.  
      Coronavirus crisis: 100 days    
      Editors note: Its been 100 days since the Bay Area      sheltered in place, protecting itself from the coronavirus      pandemic. What have we learned in that time? And what does      the future hold for the region and its fight against      COVID-19? The Chronicle explores the past 100 days and looks      to the future in this exclusive report.    
    Favipiravir / Fujifilm Toyama Chemical (Stanford    University): This antiviral drug, developed in 2014 by    a subsidiary of the Japanese film company to treat influenza,    is undergoing numerous clinical studies worldwide, including a    Stanford University trial that began this month. Unlike    remdesivir, it can be administered orally, so it can be used to    treat patients early in the disease, before hospitalization is    necessary.  
    Stanford epidemiologists want to see if favipiravir, which has    shown promising results in other trials, prevents the    coronavirus from replicating in human cells, halts the shedding    of the virus and reduces the severity of infection. The    Stanford study, the only outpatient trial for this drug in the    nation, is enrolling 120 people who have been diagnosed with    COVID-19 within the past 72 hours. Half of them will get a    placebo. People can enroll by emailing treatcovid@stanford.edu.  
    Colchicine / UCSF (San Francisco and New    York): The anti-inflammatory drug commonly used to    treat gout flare-ups is being studied in the U.S. by scientists    at UCSF and New York University. The drug short-circuits    inflammation by decreasing the bodys production of certain    proteins, and researchers hope that it will reduce lung    complications and prevent deaths from COVID-19. About 6,000    patients are receiving colchicine or a placebo during the    clinical trial, dubbed Colcorona, which began in March and is    expected to be completed in September.  
    Selinexor / Kaiser Permanente: Kaiser    hospitals in San Francisco, Oakland and Sacramento are studying    selinexor, an anticancer drug that blocks a key protein in the    cellular machinery for DNA processing, as a potential COVID-19    treatment. The drug has both antiviral and anti-inflammatory    properties, and its administered orally, according to Kaisers    Dr. Jacek Skarbinski. The trial aims to enroll 250 patients    with severe symptoms at Kaiser and other hospitals that are    participating nationwide.  
    VXA-COV2-1 / Vaxart, South San Francisco: The    biotechnology company Vaxart is testing this drug to see if it    is as effective at controlling COVID-19 as trials have shown it    to be against influenza. VXA-COV2-1, the only potential vaccine    in pill form, uses the genetic code of the coronavirus to    trigger a defensive response in mucous membranes. The hope is    that the newly fortified membranes will prevent the virus from    entering the body.  
    Its the only vaccine (candidate) that activates the first    line of defense, which is the mucosa, said Andrei Floroiu,    Vaxarts chief executive, noting that intravenous vaccines kill    the virus after it is inside the body. Our vaccine may prevent    you from getting infected at all.  
    The drug was effective against influenza and norovirus in    trials and appears to work on laboratory animals, Floroiu said.    He expects trials of VXA-COV2-1 on humans to begin later this    summer.  
    VaxiPatch / Verndari (Napa and UC Davis Medical    Center): Napa vaccine company Verndari makes a    patented adhesive patch that can deliver a vaccine instead of a    shot. Now, the company is trying to make a vaccine for COVID-19    that they can administer through that patch. At UC Davis    Medical Center in Sacramento, Verndari researchers are     developing a potential vaccine that relies on the    coronavirus spike-shaped protein. When injected into a person,    the substance would ideally train their body to recognize the    virus and fight it off without becoming ill.  
    A spokeswoman told The Chronicle that the companys preclinical    tests have shown early, positive data in developing an immune    response. Verndari hopes to move into the next phase of    testing in the coming weeks and start clinical trials in humans    this year.  
    If the vaccine is proved effective and safe, patients could    receive it through the mail, according to company CEO Dr.    Daniel Henderson. The patch would leave a temporary mark on the    skin that patients could photograph and send to their doctor as    proof they have taken the vaccine, Henderson has said.  
    Peter Fimrite and J.D. Morris are San Francisco Chronicle    staff writers. Email: pfimrite@sfchronicle.com,    jd.morris@sfchronicle.com    Twitter: @pfimrite,    @thejdmorris  
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Efforts at coronavirus vaccines and treatments abound in the Bay Area - San Francisco Chronicle