key: cord-1023957-97apbd7o
authors: Padela, Aasim I.
title: Porcine‐derived medical therapies for SARS‐CoV‐2: Traversing Muslim bioethical concerns and assuring equity
date: 2021-09-22
journal: Xenotransplantation
DOI: 10.1111/xen.12714
sha: be933ec95d16d5766e6ce6121843c0c3a0226de1
doc_id: 1023957
cord_uid: 97apbd7o

nan

Dear Editor,

In the June issue of the European Journal of Immunology, Vanhove et al.

shared promising results using novel swine glyco-humanized polyclonal antibody, XAV-19, to combat severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infectivity. 1 In their studies, immunized animals developed a rapid polyclonal hyperimmune response that inhib- therapies that can be related to pork. Should XAV-19 prove to be an effective therapy against SARS-CoV-2, its usage in Muslim communities will likely run up against these norms and attitudes. Consequently, a targeted strategy of religiously tailored education and communication that addresses points of religious concern while promoting informed choices will need to be enacted in order to ensure healthcare equity.

Given that religious permissibility depends on the absence of alternative efficacious regimens and a potential life threat, XAV-19 will have to be proven to be significantly more efficacious than convalescent plasma in treating specific SARS-CoV-2 related ailments that are lifethreatening. Such data will need to be furnished to Islamic jurists so that they can authorize contingent usage for Muslim polities. At the same time, at the community level, religiously tailored communiqués that include decision aids noting religious permissibility under lifethreat may prove useful. Beyond this, educational seminars or podcasts that bring together clinicians and religious scholars to dispel myths about the science, discuss the diverse religious edicts on the usage of porcine in medical therapy, and encourage informed decision-making may be appropriate.

A model for such religiously tailored and ethically balanced resources and programming was recently implemented in the United States and addressed the topic of organ donation. Organ donation is controversial in Muslim public circles given histories of distrust of the biomedical establishment, disquiet over the entity of "brain death," and religious values around the dignity and sanctity of the human body. Islamic jurists hold different positions on the matter as well. 6 As a result, Muslim attitudes are more negative than that of their counterparts, and Muslims are noted to be reticent to receive as well as donate organs. 7 To address this context, my research team partnered with the Fiqh Council of North America and the International Institute for Islamic Thought to investigate the religious, clinical, social scientific, and bioethical dimensions of the issue. Ultimately, we joined together to furnish a religious edict that specified conditions of permissibility. 8 We also partnered with multiple organ procurement Xenotransplantation. 2021;e12714.

wileyonlinelibrary.com/journal/xen 1 of 2 https://doi.org/10.1111/xen.12714

High neutralizing potency of swine glyco-humanized polyclonal antibodies against SARS-CoV-2

XAV-19, a novel swine glyco-humanized polyclonal antibody against SARS-CoV-2 spike, efficiently neutralizes B. 1.1. 7 British and B. 1.351 South-African variants

Evaluation of the safety and efficacy of XAV-19 in patients with COVID-19-induced moderate pneumonia: study protocol for a randomized, double-blinded, placebocontrolled phase 2 (2a and 2b) trial

Pork gelatin: permissible or not?

Dire necessity and transformation: entry-points for modern science in Islamic bioethical assessment of porcine products in vaccines

The ethics of organ donation, donation after circulatory determination of death, and xenotransplantation from an Islamic perspective

A quantitative survey of Western Muslim attitudes to solid organ donation

The moral status of organ donation and transplantation within Islamic law: the Fiqh Council of North America's position

Organ donation: A guide to medical and religious considerations for American Muslims. Initiative on Islam and Medicine. Brookfield

The impact of religiously tailored and ethically balanced education on intention for living organ donation among Muslim Americans