What is the exit strategy?

This is a question many athletes ask numer-ous times whenever they find themselves in a position of endless defending during a match.

It is the same question, the world is asking itself about the COVID-19 pandemic, especially now that many countries are opening from lock-downs and curfews.

Athletes, just like all other people, will need an exit strategy. No athlete wants a repeat of the pandemic and its subsequent lock-downs and curfews.

The pandemic has caused immeasurable disruption to the 2020 sporting calendar. For some athletes, the pandemic has been career defining.

With sports now a globalised activity, where an athlete can be in all the five continents for sports related events in a span of one month, they are at a risk of exposing themselves to various infectious diseases.

From time to time, the infections put them off activities for a couple of weeks but most of the time, they protect themselves through pro-phylactic (preventative) medicines or the use of vaccines.

Unsuitable for athletes

However, not all vaccines are suitable for athletes, especially the elite, who are constantly being monitored by anti-doping agencies.

Why then would an athlete worry about the contents of a medically approved vaccine that is safe for human use?

Allow us to teleport you to a biotechnology class. Since there is no definitive anti-viral treatment for the COVID-19 disease, vaccine development is currently being considered as the best mitigation strategy among the masses who are yet to contract the virus.

However, what is the principle of vaccine development?  Vaccines are classified as either whole virus vaccines,  subunit and nucleic acid vaccines where a whole virus vaccine  uses  the entire virus particle that has been   fully d e s t r o y e d using  heat, chemicals, or radiation; a sub-unit vaccine is a fragment of the virus, typically a surface protein while nucleic acid vaccination involves the injection of a plasmid (naked) DNA or messenger RNA (mRNA) to elicit an immune response against the virus.

With the advancement in biotechnology in the last 30 years, nucleic acid vaccines have become immensely popular.(Nucleic acids are basically DNA and RNA, which are the genetic material that carry infor-mation in cells needed for protein formation and transfer of inherited characteristics).

For COVID-19, these vaccines will work by modifying the binding location of the virus in the lung.

This location is known as the angiotensin converting enzyme type 2 receptor (ACE2); and that is where the fear for most elite ath-letes lies. ACE2 is needed in the relaxation of blood vessels (veins and arteries) and lowering of blood pressure.

A lower blood pressure makes elite endurance athletes such as marathoners not to get fatigued very fast, and so run for a longer period.

Previous studies done among 64 endurance athletes (rowers) in Australia reported that they had significantly higher proportions of ACE1 and ACE2 genotypes compared to the normal population.

In Israel, deletion of the ACE genotype was associated with elite endurance athletes.

Although the reported studies have not conclusively associated ACE2 with elite performance, it is not clear whether modification of this gene by the COVID-19 vaccine could influence elite athletic performance.

Zika virus vaccine

Recently, the scientific world was elated to hear the development and subsequent successful patenting of the vaccine against the Zika virus that almost derailed the Rio 2016 Olympics.

The Zika virus vaccine developers have pre-sented to the world both the nucleic acid and whole virus versions.

Some of the drug companies behind  Zika virus  vaccine  such as  Inovio. Pharmaceuticals are also developing a DNA based vaccine for COVID-19.

The remaining front-runners are packing their vaccine with mRNA, the genetic material that comes from DNA and makes proteins.

Even though the demand for the COVID-19 vaccine is urgent and real, it portends a chal-lenge in clean sports as mentioned above where; intentional or unintentional use of any gene altering product is prohibited.

This prohibition has been fueled by scien-tific reports which have demonstrated that certain genetic traits do improve muscle strength, health-related fitness, training volume and ultimately athletic performance.

These genetic benefits can be added to a person who originally did not have them through gene editing, gene silencing and gene transfer technologies administered commonly by injections.

The world anti-doping agency (WADA) calls this gene alteration for purposes of enhancing athletic performance – gene and cell doping, which it defines as: “the use of nucleic acids or nucleic acid analogues that may alter genome sequences and/or alter gene expression by any mechanism.”

In the ultra-competitive sports world where success is defined by world records and super-human performances, temptations for gene doping are getting stronger.

It will be crucial that the gene alterations associated with the COVID-19 nucleic acid vaccines are well considered.

Between a rock and a hard place

Athletes will be caught between a rock and a hard place should the vaccine do alterations that will be considered gene and cell doping.

Although WADA and its affiliate federation-specific anti-doping agencies allow for thera-peutic use exemptions (TUEs) among various medical products and interventions on their prohibited list, there could be need for a more explicit clarification.

This is because, the risk of viral and other infections increases the probability of vaccine use among the populace, including athletes.

Secondly, the availability of whole-virus and sub-unit vaccines option should be seriously considered to avoid wading through the murky waters of gene-doping.

As for now, we can only hope for both a nucleic and whole virus vaccine while the sporting world continues training from the confines of their homes.

 

This article was written by Paul Ochieng’, a Sports Economist and Dean of Students at Strathmore University and Gerald Lwande, a Biomedical Scientist. 

 

It was first published in The Standard.