Vaccination, antibodies, immunity: the professor answered the most common questions about COVID-19
Even a year after the start of the COVID-19 pandemic, we still know little about this virus. Edition LEAGUE decided to talk to Professor Viktor Dosenko and ask him a few questions that concern the minds of all mankind.
Victor Dosenko, a pathophysiologist, geneticist, head of the department of general and molecular pathophysiology at the Bogomolets Institute of Physiology of the National Academy of Sciences of Ukraine, spoke about how our immunity reacts to coronavirus and tries to fight it, where antibodies come from, and why re-infection is quite possible.
At the first encounter with a virus, according to the professor, our body is not at all ready and cannot recognize it, so it tries to “get to know”.
“It enters our cells and begins to synthesize its parts, its proteins, of which it consists, its RNA,” explains Dosenko.
The body, in response to the virus, tries to recognize it and form an immune response. The expert notes that this is a common reaction for all viruses.
“The immune system is perfect for most people. Without problems, even sometimes without symptoms, it frees the body from virus-infected cells, the professor emphasizes. - Here it should be noted right away that it is impossible to get rid of the virus without destroying the cells into which it got. They are doomed. The virus-infected cell must be destroyed. Special lymphocytes turn into blast cells, which multiply, there are a bunch of them, and the virus has no chance. In any cell where he got, he will be found and destroyed along with this cell. "
After recognizing the virus, our body turns on cellular immunity to fight intracellular infection.
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“The virus needs us only as factories for the production of its copies. He does not know how to reproduce without us, - explains Dosenko. - Therefore, only T-lymphocytes can destroy this intracellular parasite. Or T-killers are also called them, they work together with T-helpers. "
According to the expert, the fact that people carry the virus in different ways is quite normal and is due to various factors such as heredity, concomitant diseases and others.
“People are all different - both hereditary and acquired problems. Recent studies by American scientists have shown that people with AIDS, acquired immunodeficiency syndrome, are much harder to tolerate and much higher mortality. Of course, on antiretroviral therapy they are compensated, but all the same, the T-cell link in them suffers, ”the professor specifies.
“From other somatic diseases, among other things, the immune system suffers, antigenic presentation, learning, and lymphocyte division are impaired. This is not surprising in the case of diabetes mellitus, coronary heart disease, atherosclerosis, arterial hypertension. Just in old age, ”he said.
Our immune system, according to the scientist, undergoes "a kind of menopause" with age, so different groups of the population suffer from COVID-19 in different ways.
Another problem in the fight against the virus, according to the expert, is that when the immune system does not work properly, the body begins to connect other systems to fight, and they are often not only powerless, but can also aggravate the situation.
“First of all, there are complications of the disease associated with hyperactivation of neutrophilic leukocytes,” explains the professor. - These cells have practically nothing to do with viral immunity. They can't do anything. The virus is inside the cell. But if they are mistakenly activated, they come into the lungs and destroy them, not the virus. Overactive nonspecific immunity is what is called cytokine storms. These people end up in hospitals, in intensive care units, and, unfortunately, do not always recover. "
There are mainly two types of tests for COVID-19 in the world - PCR and antigen tests. Dosenko supports the conduct of both, but believes that the second is not very accurate.
“Definitely the whole world, the recommendations of the World Health Organization, CDC, the American authoritative organization, clearly say that the diagnostic method is real-time PCR diagnostics. You need to take a shrub, extract RNA from there, turn it into DNA and determine if there are genes for this particular virus, '' says the professor. - This is followed by an antigen test, which was developed much later. This is a quick test, but not as accurate. However, speed is his advantage. In 15-20 minutes it is possible to determine if there are virus proteins in the analysis material. "
But it should be borne in mind that many people are sick with COVID-19 and often do not have antibodies. Almost 20% of patients who did PCR-confirmed tests did not have antibodies.
“Vaccine manufacturers, by the way, are also obsessed with antibodies, but none of them forgot about cellular immunity. They studied the presence of specific T-lymphocytes. And they have shown that yes, these lymphocytes appear in the case of vaccination and remain for a long time. Throughout the study, these lymphocytes remained in the blood, says Dosenko. - Antibodies could be, could disappear, could appear. This is a very volatile and imprecise indicator. The fact that a person was sick is an inaccurate indicator. "
According to the expert, cellular immunity is a much more evidence-based component.
In addition, it is the cellular immunity that helps to detect and destroy it faster during subsequent encounters with the virus.
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But the information that the more a person has been ill with COVID-19, the easier he will transfer it next time, according to the professor, is very controversial. After all, a severe course of the disease is an indicator of an incorrect immune response.
“The severe course of the disease is an indicator of defective specific immunity, a lack of lymphocytes that worked on time, and the reaction of nonspecific factors of the immune system, which led to the predominance of the destructive component of inflammation in the protective one,” says Dosenko.
But with an asymptomatic course, T-lymphocytes are formed, which will be fully equipped to meet the virus the next time.
Immunity after illness
After a person has been ill with COVID-19, after a while, immune cells commit "suicide." And only a small part of them remains to become "memory cells".
“Cells remember this information in different ways. For some infections - for years, for others - for a year, or even less. This is an interesting question, why our immune system remembers information about one virus or one bacterium for so long, despite the fact that it is not very dangerous, and forgets about another in six months or a year, ”says Dosenko.
It is difficult to say how it will be with SARS-CoV-2. After all, only 1,4 years have passed since the start of the pandemic.
It is these cells that take part in the creation of herd immunity; each time they recognize the virus and destroy it. And due to this, the virus in the population decreases and decreases, it does not find unprepared bodies for its reproduction.
But as for SARS-CoV-2, it is difficult to say anything for sure, except to predict.
We are moving towards this, and in this we are primarily helped by cellular immunity.
“For us, this is an unexplored field, scientists try to explain it to us in different ways. New research is emerging. But we do not understand, it will or will not be, or it will be only for one strain of the virus, and then another will come, and in principle there will be no such thing as herd immunity from SARS-CoV-2, ”explains the professor.
“Collective immunity will surely be formed. There are no other options. But the question is when, how quickly and with what sacrifices, he added. "But anyway, any infection ends in herd immunity."
Cellular herd immunity, according to the expert, is our future, and vaccination is a civilized way to accelerate the formation of this herd immunity.
Vaccination and immunity
The professor does not exclude such an option as is now happening with the flu: it mutates very often, which is why it is not easy to achieve herd immunity.
“The flu is such a parasite that has taken root under us and deceives the immune system, even if not every year, but certain pandemic outbreaks often occur, although they manage to get a vaccine,” says Dosenko. - Science can handle it. We'll see. So far, I see no reason for SARS to become seasonal. "
He notes that even with frequent mutations, it will be possible to vaccinate several times a year to cope with the virus.
“At the population level, our immune system can handle any challenge. And it is up to scientists and doctors to create conditions so that as few people as possible die from the severe course of this or that disease, until collective immunity is formed. "
There are many theories in the world now that it is better to get sick or get vaccinated. Dosenko noted that there is still a difference, but if a person is at risk, then it is better not to wait for natural immunity and get vaccinated.
“When infected, you will receive all the variety of antigens of this virus, you will learn everything about it, all its proteins will enter your body and form an immune response. This will be a wide range of different lymphocytes capable of recognizing this particular virus, - comments Dosenko. - Artificial immunity is the introduction of information about just one protein. And there is no information about others. But in fact, it turns out that knowing only a few fragments already reduces the likelihood of infection. "
The professor says that the virus can infect absolutely everyone, and the course of the disease and its degree depend on the amount of the virus in the cells and the reaction of the body.
“We all have special proteins called hers2. This is the main beacon, the bait for this virus. It recognizes our cells, if they have such a protein. All people, without exception, have this protein on the surface of various cells. In particular, the lining of the epithelium of the upper and lower respiratory tract, explains Dosenko. “Therefore, everyone can become infected, and then the question is how many particles got, how efficiently the virus will multiply.”
Our cells have nonspecific defense mechanisms against any virus.
“We are currently studying this process of the so-called RNA editing. When a virus creates its RNA, the immune response replaces the information in it, the scientist clarifies. - The efficiency of RNA editing may make it possible that certain people do not develop the disease. Everyone will surely have infections, and whether a disease will occur - this can be explained by the presence and effectiveness of these primary nonspecific defense mechanisms against viruses. "
But it must take 10-12 days to produce antibodies. And about 14 days after the ingestion of the antigen, so that it gives cellular immunity. That is, in two weeks, our new mRNA vaccines should provide protection.
Immunity problems due to antibiotics
Dosenko notes that the widespread antibiotic therapy used by doctors to treat COVID-19 is pointless and can harm the immune system and disrupt its work.
“There are bacteria in our body and should be. And antibiotics will definitely find them and will kill them. Killing our microflora will immediately affect the state of the immune system, the professor notes. - And imbalance will lead to the fact that the immune system begins to respond inadequately. She may not react, or, on the contrary, she may react powerfully to something that does not need to be noticed at all. And this balance is upset when antibiotics are used. ”
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