COVID-19 and the Cytokine Blast – Prevention mechanism - By Meenakshisundaram Ezhil
COVID-19 and the Cytokine Blast – Prevention
mechanism
The functioning
of immune defense system in a person’s body determines the course of the
disease caused by a virus, especially a virulent one like COVID-19.
Once the virus
enters a body the first level of auto immune defense is the release of proteins
called as interferons that interfere with the ability of a virus to replicate
inside a cell. Interferons fight the battle alone with certain viruses which
are simple to control and they also recruit other immune response cells to join
the battle when the going gets tough. Since the virus has its own defense
mechanism the battle gets tougher over a period of time. Finally this all out
battle sends out signal to us by way of symptoms like fever, cough or diarrhea,
in the case of the Corona virus. When the corona virus infects the eyes, it
will result in ocular symptoms before passing on to the body.
Mostly the
symptoms are fever and cough or fever and diarrhea and sometimes both. The
difference in response depends on where the virus gets to settle down. Once the
virus gets into a human body it has to settle itself on a cell. The Corona
virus finds a willing receptor in a protein called ACE2 receptor, which is on
the surface of a cell. The ACE2 receptor is most abundant in the lungs and the
second highest availability of ACE2 receptors are in the Intestines.
When the virus
enters into a body through the nose it generally gets transmitted to the lungs.
When the virus enters the mouth, from the pharynx it can go down to the lungs
or the stomach because there are tubes connecting both. If someone has a
swallow reflex there are high chances of the virus travelling to the stomach /
intestines.
Once the virus
settles down and before it starts to replicate, the second and final level of
defense is initiated by the auto immune response. This comprises of the T-Cells
and B-Cells, which are major cellular components of the adaptive immune
response.
B cells are a type of white blood cell. They
make important proteins called antibodies. These molecules act
as “flags” to trigger specific destructive mechanisms and trap viruses and
bacteria by engulfing them. Without this line of defense, the body would not be
able to fight most infections.
T cells are critical
to the adaptive immune system, wherein they act as
weapons against infected or cancerous cells. They also produce cytokines, which act as messengers for the immune
system and regulate body’s response to an attack. Both these cells working
together form the last stage of auto immune defense system.
In some cases the immune system is brought down
by a deluge of virus as in the case of Health care workers who are continuously
exposed to the virus. Age is not a factor.
The other and more common incidence of the
immune system losing out to the virus is in the case of vulnerable population
comprising of elders and those under prolonged medication for other illness. In
these cases, the response of the immune system is suppressed. It results in a
weaker interferon response and a delayed antibody response which allows the
virus to multiply without impediments.
In
most other cases, if the antibody response is effective in neutralizing the
virus. After passage of time, the body is cleared of the virus and the patient
recovers. However these patients can very well pass on the virus to others
during this incubation period.
The
final stage in the fight against corona virus is reached when the virus settles
down in the lungs or the intestine. In the event of residence in the lungs it
can proceed to develop into pneumonia as more and more cells are infected and
inflamed resulting in the filling the lungs with fluids.
Here
also the immune system does not give up easily. There are two directions. In
most cases the immune response system remains stable and regains control over
the virus through continued T-cell and B-cell activity. In other cases the
immune system goes haywire and freaks out by generating more and more cytokines
in desperate attempt to destroy the virus. This auto immune disorder mechanism
results in the antibodies destroying the good cells and spreading the
infection. This eventually results in the lungs filling up with fluids,
developing widespread sepsis and difficulty in oxygenating or in supporting
blood pressure.
At this stage the task becomes two fold – first
to eliminate the infection and second to control the immune systems auto
response. In most cases there is little possibility of reprieve from this
stage.
This is where preparation for the worst may be
helpful, not by taking drugs or medicines but in strengthening the auto immune
system through scientifically valid and tested alternative option, which will
not have any side effect. This is a preventive measure suggested not for
patients but for those in good health with the intent of boosting the
functioning of the auto immune system.
The following is an extract from
a research paper on the biological and clinical activity of anti-malarial drugs
in autoimmune disorders published in 2013 by the Department of Medicine,
Division of Rheumatic Diseases, Cleveland, OHIO, USA:
“Chloroquine and
hydroxychloroquine are 4-aminoquinoline compounds commonly employed as
anti-malarial drugs. Chloroquine and its synthetic analogue, hydroxychloroquine
also belong to the disease-modifying anti-rheumatic drug class because these
drugs are immunosuppressive. The immunosuppressive activity of chloroquine and
hydroxychloroquine is likely to account for their capacity to reduce T-cell and
B-cell hyperactivity as well as pro-inflammatory cytokine gene expression.”
The
following is a relevant extract from a Research paper on curcumin and
autoimmune disease published in 2007 by Neuroscience Research Laboratory,
Indianapolis, USA:
“The immune system has evolved to protect the
host from microbial infection; nevertheless, a breakdown in the immune system
often results in infection, cancer, and autoimmune diseases.
Although the etiology is not known and a cure is
still wanting, the use of herbal and dietary supplements is on the rise in
patients with autoimmune diseases, mainly because they are effective,
inexpensive, and relatively safe. Curcumin is a polyphenolic compound isolated
from the rhizome of the plant Curcuma longa that has traditionally been used
for pain and wound-healing. Recent studies have shown that curcumin ameliorates
multiple sclerosis, rheumatoid arthritis, psoriasis, and inflammatory bowel
disease in human or animal models. Curcumin inhibits these autoimmune diseases
by regulating inflammatory cytokines such as IL-1beta, IL-6, IL-12, TNF-alpha
and IFN-gamma and associated JAK-STAT, AP-1, and NF-kappaB signaling pathways
in immune cells.”
Curcumin
is familiar to a large number of Indians because it is an extract from turmeric
powder and curcumin has magical properties as regards the regulation of auto
immune disorders. Regular intake of turmeric powder containing curcumin is
bound to have a very positive impact on the immune system. There are three very
important points that have to be noted in this regard.
First
the turmeric powder purchased and used in most homes contains waste and remains
of curcumin. The quality of turmeric is bound to have an impact on the ultimate
benefit and results to be derived from curcumin.
Second
and more important fact is what is known for centuries in traditional medicine.
Turmeric powder is always mixed with crushed pepper as a cure for common cold.
The important fact that has to be clearly understood is that curcumin is poorly
absorbed into the bloodstream unless it is mixed with piperine, which is
derived from Pepper.
This can be confirmed
from the research paper published in 1998, by the Department of Pharmacology, St.
John’s Medical College on the Influence of piperine on the
pharmacokinetics of curcumin in animals and human volunteers.
Third and most important is to reiterate the
disclaimer regards consumption of curcumin, contained in the research paper
published in 2007:
“Although the
beneficial effects of nutraceuticals are traditionally achieved through dietary
consumption at low levels for long periods of time, the use of purified active
compounds such as curcumin at higher doses for therapeutic purposes needs
extreme caution. A precise understanding of effective dose, safe regiment, and
mechanism of action is required for the use of curcumin in the treatment of
human autoimmune diseases.”
The objective of this article is not to
propose any cure or alternative treatment for any disease but rather to provide
information about the mechanism of the disease and also the efficacy and
advantages of prevention through strategic inclusion of certain commonly
available ingredients in our regular diet.
- Meenakshisundaram Ezhil
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