The immune system protects us, but in the most serious cases of coronavirus it seems to be overreacting and counterproductive, as it happens in other diseases
From the cases that go unnoticed because they do not give symptoms until death: the range of reactions caused by SARS-CoV-2 is wide and perplexing. Why does the same infection have such disparate effects? If statistics tell us anything, it is that age has a lot to do with it. In the first decades of life, there are hardly any complications, although some specific cases are difficult to explain. On the other hand, as the years of the patient’s increase, hospital admissions, cases in the ICU and deaths multiply.
Can everything be explained by the existence of previous pathologies? Hypertension, diabetes and cardiovascular diseases have been identified as risk factors, but there is a more basic question: what does the immune system do when attacked by an external enemy. In the face of an unknown virus, an innate response occurs, and, later, when our defenses already recognize the pathogen, the adaptive response arrives, which acts specifically against that threat. However, something seems to be failing in the most serious patients of this new coronavirus in this second phase: an exaggerated response that ends up causing damage to the body and does not prevent the virus from multiplying.
Be very careful with the Covid-19 if you already suffer from these diseases
The SARS-CoV-2 coronavirus causes more serious cases and deaths in people suffering from other pathologies, but the mechanisms by which it occurs are unclear
“It is striking that there is a lot of heterogeneity in the clinic of this virus, and this may be related to a wide variety of immune responses, some are more effective and neutralize the virus, and others lead to the disease, ” José Manuel told Teknautas Bautista, a molecular biologist from the Complutense University of Madrid, “but we really still know very little, each virus can behave differently even if there are common characteristics among those of the same family.”
“Viruses behave differently in each individual and challenge their immune system, ” explains virologist Raúl Ortiz de Lejarazu, former director of the National Flu Center in Valladolid. “What happens in each body has to do with individual factors that we do not know well, we know in the flu and in other diseases already studied, but not in this coronavirus,” he admits.
As an example of the heterogeneity in the response to viruses, this expert gives an example he knows well: “ In the 2009 influenza A pandemic, it was soon seen that the obese reacted worse, among this group there were many more people who fell ill with seriously because they had a different inflammatory profile than people with normal weight. ”
How the immune system reacts
At the beginning of an infection, the innate response occurs — it is called that because it is common to all people against a pathogenic microorganism, even if we have not been exposed before. This works “by a very primary system: I know you or I don’t know you, you are strange or you are not .” If we do not recognize it, a series of mechanisms are set in motion, for example, we secrete proteins called interferons and cytokines. “If this occurs normally, the result is a good physiological response that tends to heal the individual,” explains the expert.
The next step is the adaptive response. “It is a response adapted to the new pathogen as if the tailor had already taken the measurements and made the right suit against the aggression, ” he says. That is why, in almost any infection, antibodies (substances to combat it) are generated from day 12 or 13, which makes the primary and innate response more effective.
However, severe cases of coronavirus appear to be related to an exaggerated response by the immune system, which experts call a “cytokine storm.” This term was coined around 15 years ago when serious cases of avian influenza in Asia were being investigated. People who reacted badly and died had secreted many inflammatory cytokines, that is, a type of protein that generates inflammatory phenomena indiscriminately in the lung and other organs. Instead of collaborating with each other, they “ generated friendly fire damage ”.
Ortiz de Lejarazu’s research group observed that the same was true in severe cases of influenza A, according to articles they published in 2011 and 2012. That cytokine storm also happens again in severe Covid-19 cases. “ Our immune system, in the effort to eliminate the virus, damages cells and organs. The end result is that it does not control the virus, which continues to multiply, “he says.
In very different diseases, it also occurs. Bautista knows the case of cerebral malaria thoroughly. “There are many people who become infected in Africa, but only a specific population group dies, children who react aggressively with their immune response. All this is very similar to what is being described ”, he points out.
Does exposure influence gravity?
Other external factors do not influence the fact that a patient reaches this serious situation, such as having been in greater contact with the disease, as happens to health professionals, according to Ortiz de Lejarazu, who warns about the confusion that is generating the viral load concept. “It is only a parameter used in medicine as if we were talking about fever. What the viral load tells us is whether a virus is multiplying too much or too little in an organism. For example, in HIV, the viral load is used to know if the person who is infected is responding well to treatments or if, on the contrary, the amount of virus in their body increases. ”
When one acquires the infecting dose, one becomes infected. If you buy three doses, 10 or 20, you get the same infection but you will not be more serious
However, in this crisis, this concept is being misrepresented, and some are implying that the virus can accumulate through continued exposure. “The toilets do not go with a backpack carrying viruses,” he clarifies, “a person becomes infected because they acquire an infectious dose, that is, a certain amount of microorganism.” Scientists calculate what viral load is needed for contagion in mouse experiments.
“When you get the infectious dose, you become infected. If you get three infectious doses, 10 or 20, you get the same infection, and that does not have any significance on what will happen next, because in reality on the second or third day of being infected, a person produces millions of infective doses. In the body, we amplify the infective dose a lot of times and there we do talk about the viral load. The only consequence of viral load is that a person who is producing more viruses has a greater ability to transmit them, “he adds.
On the other hand, José Manuel Bautista does not rule out that prolonged exposure to the virus could have something to do with severe cases. “If only a few units of the virus infect you, they could reach a few cells and perhaps the immune response would be activated progressively so that it could contain itself better,” he says. However, “this is only a hypothesis because no experiment has been done to prove it, to see if this is the case, it would be necessary to subject mice to different viral loads and that, as they increase, there comes a time when the answer immune was not efficient. ”
The coronavirus viral load appears to peak in the first week of illness, and in mild cases, it would clear rapidly. However, seriously ill patients tend to have a high viral load and a longer period of virus shedding, according to an article published in ‘The Lancet ‘. Therefore, the viral load could be a marker to assess severity and prognosis (although this is not related to the possibility that viral load is related to prolonged exposure).
In any case, in the absence of experiments that can confirm or deny this idea, the researcher at the Complutense University considers that the reason why health professionals get sick is more likely due to other factors, such as stress decreases their immune response.
4 Tips for walking your dog this winter
A short harness and leash, cleaning the legs of antifreeze residue, and drying the dog when it gets home are tricks for safe walks this winter
The cold and snow also pose dangers for dogs . Did you know that dogs also get colds and that they can get sick due to low winter temperatures? Luckily, there are tips and tricks to protect your dogs this winter and walk safely despite the cold. Any ideas? Use a harness and short leash , use coats and boots, clean the legs of antifreeze residues, as they are toxic, and dry the animal very well when you get home.
1. Ice? Be careful because the dog is in danger!
Walks in snowy areas love dogs . The reason is that the snow transforms the entire landscape into a new environment, all of it to be discovered. These outings, however, involve certain risks that must be known. One of them, the icy surfaces so slippery for the dog.
“When we walk with the dog in winter, we must avoid icy areas, such as lakes or ice puddles. We do not know if the ice will support the weight of the dog , so it represents a huge danger for the animal,”
2. In winter, protect the dog with a leash
In winter, harnesses are very useful to walk the dog safely. A trick for a safe ride in the snow? Never walk without a leash with the dog, as this rope can be life insurance for him. “Animals do not always know which part of the ground is solid or when the ice is a risk, so it is best not to let the dog off the leash and avoid dangerous areas.
A short leash will also help to be closer to the dog, to control it better and to be able to stop it in case it is in danger. A slip on the ice or a thin layer of ice are certain risks for the four-legged friend. Therefore, you should avoid stretch straps, which provide little control.
3. Hot dogs in winter: watch out for waiting
Each season has its own dangers for dogs. And winter is no less. The guideline is to ensure that the dog is always warm and protected . This article is also important when walking into a store to run an errand or a quick purchase. “Something as simple as leaving the dog outside waiting, sitting on the cold floor, can make it cold, give it a cold or make arthritis worse.
What to do if you shiver Without wasting time, it is important to get the dog to regain lost heat. The best thing to do is to go home, use a warm blanket and dry any moisture that sticks to the fur of the four-legged friend.
4. Cold? Antifreeze is a danger to dogs
Winter forces you to take special care of the dog’s legs. And not only to protect them from the cold, because you also have to protect them from poisons such as antifreeze. This product, so used to protect car engines from the cold, often falls to the ground. The problem? The antifreeze liquid is very toxic to the dog. “A little bit of antifreeze on the paws can be life threatening from poisoning to the dog if it sucks on the paws,” explains veterinarian Ross Allan . The advice? Always clean your furry friend’s paws when you get home.
Hyperbaric Therapy Benefits: 5 Sports Personalities Who Used HBOT to Improved Recovery
Due to the hectic travel and rigorous training schedules, athletes put a lot of strain and stress on their bodies. For this reason, athletes usually have access to transforming therapeutic treatments such as hyperbaric oxygen therapy. Athletes who are under intense training schedule for the Olympics or NBA usually have access to this non-invasive oxygen therapy. It helps in accelerating wound healing and tissue regeneration.
The type of athletes who can receive hyperbaric therapy benefits are runners, basketball players, rock climbers, weightlifters, tennis players, CrossFit athletes, skiers, and bicyclists.
This article will discuss hyperbaric therapy benefits and 5 sports players who were able to gain assistance from this therapy.
Working of Hyperbaric Therapy
Hyperbaric oxygen therapy is a treatment that delivers 100% oxygen to the human body at high pressure for accelerated self-healing. Since oxygen has the power to enhance cell functioning, HBOT therapy has become a treatment option for multiple complex medical procedures. For example, when the body has damaged tissues.
During the HBOT therapy, the patient in the hyperbaric chamber inhales 100% oxygen at increased pressure. When the pressure increases, the oxygen can be carried through body fluids such as cerebrospinal fluids, lymph nodes, plasma, etc.
Under normal circumstances, our body carries oxygen only through RBC or red blood cells of the body. When oxygen dissolves in other fluids, more oxygen is delivered to the damaged tissues. Due to which, proper healing function is carried out in the body of athletes.
Hyperbaric Therapy Benefits
Till now, FDA has approved hyperbaric therapy for multiple health ailments such as decompression sickness, necrotizing fasciitis, etc. Let’s see what the hyperbaric therapy benefits are:
From competition to conditioning, everything stresses the athlete’s body. Hence, recovery is an integral part of an athlete’s routine. For instance, mountain climbers need to rest to allow the recovery of the body.
However, improving performance through enhanced recovery is not as easy as it sounds. The passive time can also mean decreased performance. This is why athletes want active recovery through therapies like HBOT.
Hyperbaric therapy benefits in recovery are:
- Improved stem cell activation.
- Decreased exhaustion and fatigue.
- Accelerated cartilage and bone regeneration.
Sports injuries, whether minor or major, are inevitable for almost every athlete. Regardless of the sports, an individual is playing, when joints are strained and stressed, you are likely to suffer injury.
The traditional method for these injuries is resting. It is evident that this method of healing can also decrease performance and reduce the efficiency of the athlete.
When this injury is supported by regular hyperbaric oxygen therapy sessions, it is possible to enhance healing in the body. In a study, injured athletes were given HBOT therapy at 2.4 ATA for 60-90 minutes. This helped injured tissues to absorb more oxygen for increased healing.
- Healing of ligament injuries.
- Healing of fatigue and major strains.
- Healing of cartilage damage.
TBI and Concussion
Multiple athletes are not at risk of suffering the traumatic brain injury or concussion. However, some like NFL players can suffer from TBI and concussion. The optimal healing route for these issues is HBOT therapy. The increase in pressure increases oxygen and helps in healing TBI and concussion.
5 Sports Personalities Who Use HBOT Therapy
Although the list of sports personalities who use or have used hyperbaric therapy benefits is increasing, here are some of the former players who utilized HBOT therapy.
LeBron James was an amazing basketball player, who was often referred to as ‘King James’ by many. LeBron is a successful sportsperson, who maintained his health through proper training and recovery.
This sportsperson is known to spend a significant amount of his income on his health, which includes proper diet, HBOT therapy, and personal training.
From every sports personality using HBOT therapy, Joe Namath is most commonly known. When he was suffering a cognitive decline, he chose hyperbaric treatment. He had 5 or fewer concussions after which he worked with a team of doctors to heal his head’s left side that was not getting proper blood supply; proper oxygen supply.
After 120 HBOT sessions, his left brain was healthy and healed.
Today, Michael Phelps is a known athlete who has surpassed the preceding record-breaker with 10 extra medals. This is because, in 2012, he found a way to boost his recovery. He used to spend regular time in the HBOT chamber to improve his training recovery, which helped him get back to training sooner.
Rashad Jennings, now a formal player of NFL, had incorporated HBOT therapy as a regular routine for recovery. When he used to play, he had secured 12 touchdowns with Giants. He believes that HBOT therapy helped him on a cognitive level as well. It improved his energy and helped him rejuvenate.
Rafael Soriano is an MLB pitcher who has worked with 5 teams. This was possible because he was able to improve his recovery through hyperbaric therapy. To feel energetic even after rigorous training, he used to take 90 minutes of HBOT sessions.
Hyperbaric therapy benefits are unparalleled in the sports world. Multiple sports personalities receive this therapy regularly, almost daily, to reduce the recovery phase and increase performance. Many athletes are even able to reduce recovery from an injury with HBOT therapy. This is why hyperbaric therapy is now becoming a common procedure for sportsmen.
Genes will decide how coronavirus will affect you seriously
Geneticists from all over the world intend to carry out hundreds of thousands of genetic analyzes to find out what distinguishes the patients who evolve worse
Since the start of the pandemic, everyone has been wondering why the same virus causes such different reactions. While many people do not even know they are infected, others end up in the ICU, and thousands are dying. Some risk factors are clear: advanced age and suffering from other diseases mean that we buy more ballots to suffer a more serious version of Covid-19, but being young and healthy does not guarantee that we will get rid of it either.
Geneticists have thought that their specialty has a lot to contribute, that the different faces of the disease could be related to genetic variability between some individuals and others, as it is in other diseases. Could it be the same with the new coronavirus? To find out, experts have created The Covid-19 Host Genetics Initiative, an international platform to push forward studies on coronavirus patients and share the results. Knowing whether genes make a patient more vulnerable can be key in prognosis and treatment, and would end up saving many lives.
Of these, there will be 7,000 Spaniards and another 1,000 from the United Kingdom, Mexico, Brazil, Argentina, Uruguay, and Colombia that will serve to identify whether the possible genetic markers found are characteristic of Spain or not. In principle, they will not study the complete genome of each individual but certain markers (what is technically called the ‘complete genome association study’ or GWAS). Later, they will sequence 300 complete genomes to analyze in detail the alterations found.
“When we talk about genes, one thinks of rare diseases or cancer, but all human pathologies are the result of the environment and of the person, and also in viral infections, genetics has a lot to say,” explains Pablo Lapunzina in statements to Teknautas. An individual’s genetic information “can make their response to an infection different and even prevent them from becoming infected.” The case of HIV is well known, especially since in November 2018 a Chinese scientist announced that he had genetically modified human embryos to make them resistant, which is why he was later convicted.
With respect to Covid-19, “we are facing a viral infection that should be banal because of every 100 people, close to 80% are asymptomatic, nor do they find out that they were sick, 10 or 15% feel greasy and only one 5% have a severe illness, so it is clear that the individual response is quite different, “says Pablo Lapunzina.
“Without a doubt, the genetic variants have to do with increased risks or protection against the disease, ” he says, although the answer will probably be very complex, the key will not be in a single gene. Many small differences may explain why some people who come in contact with the virus develop serious illness, while most have flu-like symptoms or not even that. “It is also quite likely that there will be people who will not directly become infected even if they are in contact with the virus because it cannot enter the cells, but this will be more difficult to prove,” he says.
As he explains, there is already some data that indicates that the European population could have a greater predisposition to be attacked by the virus, in particular, “variants in the ACE receptors of cells with respect to Asian populations.” The data says that mortality in China was very low compared to that recorded in Europe and, “apart from the fact that epidemiological policies to control the disease have been different, these receptors are likely to be decisive,” he says.
However, it will take hundreds of thousands of patients to confirm that these subtle genetic differences protect or make people more vulnerable. The international consortium aims to reach 150,000. The problem is to make a balanced and correct selection of the participants. “We need to have people who have been infected and have been asymptomatic, and this must be verified with antibody tests; also to others who have been regular, with fever and few more signs of illness, and others who, in the same situation, have been serious or have died, apparently without risk factors, “he explains.
The healthy young man who ends up in the ICU
All the projects included in The Covid-19 Host Genetics Initiative will provide minimal information that is useful for data sharing, but each one has its own particular characteristics. For example, another Spaniard focuses on patients under the age of 60 without other diseases. Led by the CSIC’s Barcelona Institute for Biomedical Research (IIBB), it will focus on 200 patients waiting to obtain more funding.
“We are interested in all patients, but obviously age and previous pathologies are more vulnerable even to the normal flu, so when doing a genetic study, they could lead us to confusion,” says Anna Planas, coordinator of this study. “In the normal population, there are polymorphisms or genetic variations that normally do not entail any pathology, but in the face of a viral infection, there may be people with a poorer response capacity and we can better identify this factor if we focus the study on people initially healthy ”, he highlights.
Already in the first coronavirus epidemic, the SARS epidemic of 2002-2003, some studies pointed out that having certain polymorphisms could increase the susceptibility to severe forms of the disease. However, they were performed with very few patients and almost primitive genetic tools compared to current means. “This encouraged us to think that with the advances of today, we could further explore this issue,” says the researcher.
In Granada, Marta Alarcón Riquelme, a scientist at the Center for Genomics and Oncology Research (Genyo), also wondered why young and middle-aged people developed bilateral pneumonia that characterizes the worst version of Covid-19 and, in particular, by that in the worst cases an inflammation occurs that complicates the condition of the patients.
The challenge of explaining decisive inflammation
In fact, physicians agree to observe a common characteristic among Covid-19 cases that have evolved poorly. Generally, in a first phase, patients have symptoms that could be assimilated to those of the flu, but after a few days, something goes wrong and the immune system overreacts, causing what is called a ‘cytokine storm’, proteins that they should fight the infection but in this case, they cause an inflammation of the organs, especially the lungs.
“We want to know if there is any type of predisposition that is not clinically evident, inflammatory processes that we can detect in DNA by looking for gene expression markers through what is called methylation, and identify possible genetic associations that tell us about a susceptibility to develop more severe disease, “says Marta Alarcón. For example, “I can have a gene with a variant that causes more cytokines to be produced, so the response is going to be greater.” Therefore, it is not about having or not having a gene, but about quantitative changes.
The key is to compare, among hospitalized patients, those who have a worse evolution with those who better overcome the disease. For this, the Genyo is already recruiting patients and the initial idea is to carry out the study with 1,300 participants, in collaboration with other geneticists from Valladolid, Barcelona, Malaga, and Milan.
Although within the international consortium ” 90% of the groups still do not have data “, because they are looking for patients who can participate, Alarcón regrets the bureaucratic obstacles that have prevented him from speeding up the process. “Unfortunately, I have a limit of 15,000 euros to buy material. From this figure, I have to open a public offer that may take a while and I cannot start at this time because we are with the administrative deadlines closed. ” Meanwhile, “in the United States, they are already ahead.”
The application of the results
With more or less Spanish input, experts are confident that the international consortium as a whole will provide decisive data to fight the new coronavirus and that the results can be applied on several fronts. For example, “if a person becomes ill, with a genetic study we would know in 24 hours if their risk is high or low, and based on that we could decide on their income, their follow-up or even analyze the risk that their relatives run”, Lapunzina comments.
On the other hand, genetic information can also be decisive in treatment. First, in the search for new compounds or drugs that are already on the market and can be reused. On the other, to guide the medication of each patient. In fact, something similar happened until recently with hepatitis C – before new treatments became available – patients’ genetic markers were studied to find out who would respond to available treatments. It was a simple study that cost 16 euros and anticipated the effect of the drugs.
“Today, a patient is admitted and ‘a priori’ it is not possible to know if after four days he will go home or have to be admitted to the ICU, there is nothing that can predict this, ” says Anna Planas. However, after these studies, “in an ideal situation, we would find a key gene and know that people who had some variants of it would be more likely to develop a more serious disease.” The reality will be more complicated, but the CSIC researcher believes that “a test could be carried out on the general population with a drop of blood”, knowing that “if a person has a certain polymorphism, he is part of the population that must be to protect”.
The researcher believes that this could also be revolutionary in relation to epidemiological policies. “At the moment, we are talking theoretically, but if we had the entire population studied, we would know what percentage is at risk,” he says. In this sense, it would be possible to develop an epidemiological strategy that would not go through “blind” confinement like the current one, since “we do not know which are the biomarkers that cause us to pass the infection asymptomatically and which are the ones that cause us to be at serious risk ”, but it could be done much more selectively.
However, not everything will be in the genes. For example, among the population differences, there is the fact that men accumulate many more serious cases and deaths. The researchers do not rule out that massive genetic analyzes give any answer, but they believe that it most likely has nothing to do with it. “There are many variables, men tend to be more overweight, hypertensive, and have diabetes. And surely there is a hormonal factor, it seems that women’s estrogens protect a little more. If you remove all those factors, it is likely that the genetic difference between men and women will not make much difference, “Lapunzina points out.
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