COVID-19: Terms, Topics, and an Intro to Immunology
The following is a compilation of some terms and topics that come up in conversations and current research studies. I have been reading voraciously, perpetually listening to a webinar or podcast, and inhaling information to understand what makes this particular entity tick. The microcosm reveals truths about the macrocosm which is why I am fascinated by how the virus acts on a molecular level.
Knowledge is power and I must admit compulsively collecting information is one of my coping mechanisms. Yet the more I learn, the more empowered I feel. Please excuse the jargon and do let me know if anything is unclear.
I would also like to formally make myself available as a judgement free resource for questions, resources, or to hold space. There have been a variety of opposing views and beliefs about this biomedical topic, something that is supposed to be objective and straightforward but is more complex and enigmatic than we could have imagined.
I am a scientist and researcher by training but have never been one to dismiss the esoteric or unknown. Let’s explore together.
What would you like to learn more about? Shoot me a message and we can learn.
Please continue to physically distance, remain social through creative ways, prioritize self-care, and take all the precautions in your power so we can come out of this thing together, stronger, sharper, and more unified on the other side.
HOW IS COVID-19 DIFFERENT FROM THE FLU? HOW IS IT DIFFERENT FROM OTHER CORONAVIRUSES (i.e. SARS OR MERS)?
COVID-19 is different from the flu for many reasons, one is that their targets are different
Influenza primarily targets surface proteins hemagglutinin (HA) and neuraminidase (NA); minor changes in these surface glycoproteins is why the flu is so good at evading immunity from previous infections and causes annual epidemics.
COVID-19 binds to the cellular receptor ACE-2. ACE-2 receptors are found commonly in the lungs, the kidneys, the GI tract, as well as the nervous system. I have heard personal reports from colleagues treating COVID-19 cases with regards to presentation including gastrointestinal upset, as well as neurological symptoms including nerve pain.
COVID-19 is different from other coronaviruses (such as SARS and MERS) because of its furin cleavage site which is able to gain proximity to receptors and cut them off. Once they are cleaved, the virus can get into them.
WHAT ARE SPIKE PROTEINS:
Spike proteins are what makes the coronaviruses specific for a particular tissue. The spike protein of COVID-19 binds to ACE-2 receptors. The spike proteins are also the reason our current antivirals do not work on this virus.
WHAT ARE INFLAMMASOMES:
Inflammasomes are a collection of protein receptors and mediators involved in inflammation.
The ability to get inside the cell and set inflammasomes off is what makes COVID-19 especially virulent.
This is what is causing the uncontrolled inflammation, largely in the lungs, but can be anywhere that gets infected. This goes hand in hand with the “cytokine storm” which is when a pathogen causes the immune system to release cytokines like crazy. The overproduction of IL-1 beta in particular is what is being seen with this virus in particular.
The main two ways this virus is leading to mortality is 1) cytokine storm and 2) double pneumonia
WHAT IS THE DIFFERENCE BETWEEN TH1 AND TH2 IMMUNE RESPONSE:
TH1 is involved in defense of viruses and bacteria
TH2 is involved with allergies and asthma, pregnancy puts you in a TH2 state which keeps TH1 in check, this could help explain the potential protective effects of pregnancy in the case of COVID-19
WHAT IS ANOSMIA:
Anosmia is the loss of sense of smell. Many case reports note loss of sense of smell and loss of taste as part of clinical presentation of COVID-19.
WHAT IS VIRAL LOAD:
Viral load refers to the number of viral particles being carried by an infected individual and shed into their environment. It is still unclear whether a higher viral load is associated with more severe symptoms with regard to COVID-19
WHAT IS THE RELATIONSHIP BETWEEN THE NERVOUS SYSTEM, HORMONES, AND OUR IMMUNE SYSTEM? DOES NUTRITION PLAY A ROLE:
The interconnectedness of our nervous system, hormones, and immune function is well documented and becoming increasingly clear.
The neuroendocrine system responds to external stimuli such as temperature, pain, and stress, whereas the immune system is our defense against bacteria, viruses, and injury to tissues.
We are learning about how stress can dampen our immune system.
The role of nutrients such as vitamins, minerals, and amino acids are also supported in the literature for supporting and optimizing immune function.
References:
Zwickey, H. “Important Clarifications Regarding COVID-19 and Natural Medicine: Dispelling Myths and Misconceptions” March 18, 2020. Natural Medicine Journal. Podcast
Dawood, F. et al. Influenza Viruses. Principles and Practice of Pediatric Infectious Diseases (4th ed) 2012. 1149-1159.
https://doi.org/10.1016/B978-1-4377-2702-9.00231-2Xia H, Lazartigues E. Angiotensin-converting enzyme 2 in the brain: properties and future directions. J Neurochem. 2008;107(6):1482–1494. doi:10.1111/j.1471-4159.2008.05723.x
Joynt, G and Wu, W. Understanding COVID-19: what does viral RNA load really mean? The Lancet: Infectious Diseases. March 27, 2020. DOI:https://doi.org/10.1016/S1473-3099(20)30237-1
de Jonge WJ. Neuronal regulation of mucosal response, in mucosal immunology. 2015. Elsevier, 929–942. https://doi.org/10.1016/B978-0-12-415847-4.00046-X
Institute of Medicine (US) Committee on Military Nutrition Research. Military Strategies for Sustainment of Nutrition and Immune Function in the Field. Washington (DC): National Academies Press (US); 1999. 1, A Review of the Role of Nutrition in Immune Function. Available from: https://www.ncbi.nlm.nih.gov/books/NBK230969/