0:01

Ted Audio Collective This

0:08

is Ted Health, and I'm Dr. Shoshana Ungerleiter.

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In medicine, we've found cures for

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so many diseases, which

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is astonishing and wonderful. But

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there still isn't a cure for the pesky

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common cold. Why is that?

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On today's show, science educator

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George Zidin explains why rhinoviruses,

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which cause up to 50% of all colds, remain

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impervious to vaccines and antiviral

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drugs. Are we doomed

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to sniffle forever? This

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Climate on Apple Podcasts, Spotify, or wherever

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you listen. In

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2000, a company called Viropharma ran clinical

2:58

trials of Pliconeril, a new pill designed

3:00

to treat the common cold. In

3:02

many patients, the pill helped, but in seven of

3:05

them, just a few days into the treatment, researchers

3:08

found mutated virus variants that were

3:10

almost completely resistant to Pliconeril. Viruses

3:13

are always mutating, but this one mutated so

3:15

quickly that it managed to outmaneuver years

3:17

of research and development in just a few

3:20

days. If you

3:22

didn't have an immune system and caught a

3:24

cold, the infection would quickly spread deep into

3:26

your lungs. Rampant viral replication

3:28

would destroy tissue there until your lungs

3:30

couldn't supply your body with enough oxygen

3:33

and you'd asphyxiate it. Unfortunately,

3:35

for millions of people around the world who

3:37

live with a less than fully functional immune

3:40

system or who are on immunosuppressant drugs, this

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is a real risk. Quote

3:44

unquote, minor infections can turn serious

3:46

or even deadly. But if

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you're fortunate enough to have a fully functional immune

3:51

system, a cold will probably give you

3:53

a few relatively mild symptoms. On

3:56

average, adults catch more than 150 colds

3:58

throughout their lives, and despite the fact

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that the symptoms are similar, the cause

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could be different each time. Common

4:05

colds are caused by at least eight

4:07

different families of virus, each of which

4:09

can have its own species and subtypes.

4:13

How can so many different viruses cause the

4:15

same illness? Viruses can only

4:17

invade our bodies in a few ways. One

4:20

is to come in on a breath, and we

4:22

have to breathe. So our immune system sets up

4:24

a bunch of frontline defenses, and these are actually

4:26

what produce many of the symptoms of a cold.

4:30

Your mucus-y dripping nose is your

4:32

immune system trapping and flushing out

4:34

virus. Your fever is your immune

4:36

system raising your body temperature to

4:38

slow down viral replication, and your

4:40

inflamed, well, everything. That's your

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immune system widening your blood vessels and recruiting

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its white blood cell army to help kill

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the virus. So if

4:49

a common cold is caused by many different

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viruses, is a cure even possible?

4:54

Here's one fact in our favor. A single

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family of viruses causes 30 to 50

4:59

percent of all colds, rhinovirus.

5:02

If we could eliminate all rhinovirus infections, we'd

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be a long way towards curing the common

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cold. There are two

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main ways to fight a virus, vaccines

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and antiviral drugs. The

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first attempt to create a rhinovirus vaccine

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was a success, but a short-lived one.

5:18

In 1957, William Price vaccinated 50

5:21

kids with inactivated rhinovirus and gave

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50 others a placebo. Soon

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afterwards, a rhinovirus outbreak spread throughout the

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kids. In the vaccinated group,

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only three got sick. In the

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placebo group, 23 did, almost eight

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times as many. And

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despite the small numbers, this was

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promising. The immune systems of vaccinated

5:40

kids were successfully recognizing and responding

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to rhinovirus. But later trials of

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the vaccine showed no protection at

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all, none. This wasn't

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Price's fault. No one at the time

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knew that rhinovirus had multiple subtypes. Price's

5:55

vaccine, for reasons we don't

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fully understand, didn't provide broad

5:59

protection, meaning it was only effective

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against one or maybe a few subtypes

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of rhinovirus, out of 169 subtypes and

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counting. Sometimes when we

6:09

make a vaccine, we get lucky. The

6:11

mRNA COVID vaccines, for example, effectively

6:13

protect us against severe disease and

6:15

death across the original virus and

6:17

variants too. But we have

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yet to create a broadly protective vaccine

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against rhinovirus or any other virus that

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causes the common cold. Okay,

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what about antiviral drugs? Viruses

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hijack human cellular machinery to

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replicate and spread. So

6:33

it's hard to make a molecule that's toxic

6:35

to the virus without also being toxic to

6:37

the human. And even if you manage

6:40

to do that, the virus could mutate out of reach

6:42

of the drug. Viruses

6:44

are slippery beasts. We have,

6:46

though, had some incredible successes. We eradicated

6:48

smallpox thanks to an effective vaccine, the

6:51

fact that it can't hide out in

6:53

other species and its relatively low mutation

6:55

rate. HIV, on the other

6:57

hand, mutates so quickly that in

6:59

an untreated individual, every possible single

7:01

letter mutation in the virus's genetic

7:03

code could in theory be produced

7:05

in a single day. Despite

7:08

trying for decades, we still don't have

7:10

a vaccine. But we do have an

7:12

effective cocktail of HIV drugs that the

7:14

virus can't easily mutate away from. Unfortunately,

7:17

we are stuck with colds for now.

7:19

But the last few decades have featured

7:21

some entirely game-changing medical breakthroughs like mRNA

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vaccines and CRISPR. CRISPR

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could be particularly promising as an

7:28

antiviral agent because it originally evolved

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in bacteria as an immune defense

7:32

against viruses. In fact, early

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in the COVID-19 pandemic, a research team showed

7:37

that a CRISPR system could degrade coronavirus

7:39

and influenza genomes in our lung

7:41

cells. They called their

7:43

system prophylactic antiviral CRISPR in human

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cells, or for short, Pac-Man.

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pendulumlife.com/TEDhealth. Thanks

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so much for listening today. This episode

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was produced by Joanne Deluna and Fact

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Shocked by TED. And

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special thanks to Anna Phelan,

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Grace Rubenstein, Maria Lajes, Michelle

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Quint, and Colin Holmes. I'm

9:38

Dr. Shoshana Ungerleiter. Stay well, and

9:40

I'll talk to you next week.