Words by Isabel O’Brien
Since mRNA technology enabled the creation of two of the leading COVID-19 vaccines, the technology has experienced a surge of interest from vaccine developers. What is the future outlook for mRNA and what other diseases could it help to control?
The world’s vocabulary is constantly evolving. As generations are born and die, the meaning of old words drift, morph, and are borrowed. In times of crisis, terms that were once used in minutiae can enter the mainstream. In 2020, ‘lockdown’ was named as the word of the year by Collins English Dictionary, and companies like Pfizer, BioNTech, Moderna, and AstraZeneca, became household names. But another term has also infiltrated public discourse: messenger ribonucleic acid, otherwise known as mRNA.
A graduate student, called Robert Malone, performed a milestone experiment in 1987 at the Institute for Biological Studies in La Jolla, California, which unveiled mRNA as an effective technology for the creation of vaccines and drugs. “The messenger RNA technology used in the current COVID-19 mRNA vaccines from Pfizer and Moderna have been under development for over 30 years,” says Professor Erwin Loh, Group Chief Medical Officer, Group General Manager of Clinical Governance, St Vincent’s Health Australia. “The landmark experiment by Robert Malone was in 1987, but research on mRNA goes back to the 1960s.” While mRNA technology is nothing new, it has undoubtedly never had a moment like this. It is experiencing a surge of interest in the wake of COVID-19, but what lies ahead for the technology, and what are the most prominent disease areas it could impact?
The future of mRNA technology in medicine is bright
“Research has been ongoing to see if mRNA vaccines and therapeutics can be used to treat other infectious diseases like influenza, malaria, dengue fever, tuberculosis (TB) and HIV,” says Loh. “It is of possible but unknown benefit for some difficult ‘non-classical’ pathogens. These are ones for which the immune response does not clear the pathogen or where large quasispecies complicate the choice of antigens, such as HIV, TB, hepatitis C, or where the targeted ‘final immune response’ is complex, such as broadly neutralizing anti-HIV responses,” affirms Dr Jerome Kim, Director General, International Vaccine Institute.
Earlier this year, one year after the novel coronavirus first reared its head, Gilead Sciences partnered with Gritstone Oncology, Inc, a clinical-stage biotechnology company, to find a curative treatment for HIV infection. This was followed by announcements from COVID-19 vaccine developers, BioNTech, Moderna, and AstraZeneca, who said they would be exploring further uses for mRNA in the realms of oncology and influenza. The ball is well and truly rolling, and the boom in mRNA is set to be big business. According to research by Nature, by the end of 2019, the combined market capitalisation of the five companies using mRNA platforms was $15 billion. As of August 2021, that capitalisation was over $300 billion.
mRNA and lipid nanoparticle technology have the ability to be disruptive
The only snag centres around certain impracticalities of the technology. “We do still need to work on presentation, cost, and scalability,” says Kim. While difficulties do still exist, the COVID-19 pandemic has demonstrated what is feasible under the right conditions, accelerating solutions to these challenges, and therefore increasing the allure and viability of the technology. “The pandemic has definitely accelerated the development of mRNA technologies in health, not because the clinical trials were shorter or corners were cut, but due to the fact that red tape was reduced, funding was provided, and there were a lot of trial candidates due to the many numbers of people around the world infected with COVID-19, allowing for rapid recruitment of trial participants,” says Loh.
The test lies with whether positive results can be generated outside of a crisis scenario. “It is amazing to see what science can do when the whole world comes together against a common enemy,” says Loh. However, Kim believes the outlook for this technology is promising: “mRNA and lipid nanoparticle technology have the ability to be disruptive.”
While it has waited in the wings for over 30 years, mRNA technology has undoubtedly earned its moment in the limelight. “The future of mRNA technology in medicine is bright,” Loh concludes. Global awareness has spread beyond the confines of the lab, and with the right investment and targeting, mRNA could be set to play a leading role in the future of vaccinations.