COVID-19 FYI #8

Thursday, April 9th, 2020     Timothy Browne     10 Comments

NOBODY, ANYBODY, ANTIBODY:

Well…that’s my feeble attempt at humor in this mind-numbing season of COVID-19 and also why the English language is such a mystery. (Say it out loud and you’ll see!) It is the reason I managed to flunk second grade in an unwillingness or inability to read. To this day, I can’t spell worth a darn.

And speaking of humor, today’s post involves humoral immunity, named for the substances founds in the humors (body fluids). Okay, let’s get serious (or serous if we continue with the puns). 

A reader posted a great question the other day about ANTIBODIES. I’ll try not to get too bogged down in the science, but in the end, you’ll see why this is such an important topic—one that you’ll hear in the news over and over.

A brief and simplified biology lesson:

You’ve probably all had your white blood cell count measured at one time or another. These specialized cells of our immune system called leukocytes are our natural defense against infection and disease. Even as a bone doc, this aspect of medicine is vitally important in many processes around the musculoskeletal system, including fracture healing. 

As the cells of the immune system, these leukocytes are typically divided into five primary types: neutrophils, eosinophils, basophils, monocytes, and lymphocytes. The lymphocytes are further divided into natural killer cells, T cells, and B cells, which circulate in the bloodstream with red blood cell and monitor for anything that shouldn’t be there.

The job of these T and B cells is to recognize foreign invaders called antigens (like bacteria and viruses). They respond in two separate ways: B cells produce antibodies that neutralized these invaders, and T cells produce cytokines. (I won’t talk about this here, but you may have heard the patients that get deathly ill with COVID-19 undergo a cytokine storm—the body’s overreaction to the illness.)

The antibodies that the B cell produce are glycoproteins known as immunoglobulins. (Remember our lesson on how proteins are made from the basic human code, DNA from COVID-19 FYI #1) https://www.authortimothybrowne.com/news/covid-19-fyi-1/

By now, all this biology may give you a headache, but we are almost there. These immunoglobulins come in five primary forms, IgA, IgD, IgE, IgG, and IgM. Each has differences in their function, but they all come as variations of a Y-shaped molecule. Each arm of the “Y” has a part that can bind with an antigen (the foreign invader, like a virus). Once the antibody is attached to the virus, it neutralizes it, and most often destroys it through another entire chain of events mediated by the white blood cells.

With the SARS-CoV-2 virus, our bodies produce the typical pattern of IgM and IgG. The IgM antibodies disappear at the end of week twelve, while the IgG antibody can last for a long time.

Antibody testing

Once your body makes these specific antibodies to SARS-CoV-2, the lab can measure these in the blood (serology—the study of body serum). So instead of detecting the virus itself, it measures the body’s response to the virus. Thus, the race is on by many companies to develop, get FDA approval, and market these tests. Once they go on the market, people will know with reasonably high accuracy if they have been exposed and mounted an immune response to SARS-CoV-2.

Future Immunity

This is a topic of great debate, and one that we want to know the answer to; if we’ve had COVID-19 once, can we get it again? Because this is another complicated topic, I will discuss it in the future. The answer is; the scientists hope that if you are infected once you are protected by those long-lived antibodies. But there are many factors, including if the virus mutates (why we get the common cold over and over again). No one is also sure how long this immunity will last—some are saying one to two years. So far, though, it looks like the virus mutates rather slowly- which is a good thing for immunity and vaccines.

Plasma Therapy

You have heard in the news about recovered patients donating their blood (plasma) to help others. Because these recovered patients have already mounted a successful antibody response, it is hopeful (and promising) that by infusing this plasma into the sickest patients, it will help them fight the virus. This is a treatment called convalescent serum.

Designer Antibody Drugs

If you can design these antibodies against SARS-CoV-2 in the lab, mass-produce and concentrate them, you MIGHT be able to inject them into infected patients. Not just valuable to the patients, but they estimate this market in the tens of BILLIONS of dollars. It’s no wonder the big companies are jumping in:(

Vaccines

There are several vaccine strategies against the SARS-CoV-2 virus that are being investigated: live-attenuated virus and inactivated virus (has the make-up of the virus but doesn’t cause the disease), viral vectors, recombinant DNA and protein vaccines, among others.

Takeaways:

1) It’s all about the antibodies!

2) The antibody test will be a game-changer.

3) A vaccine is twelve to eighteen months away.

Practical Tip of the Day:

I’m afraid I’ve presented you with way more science than humor. Find a humoral movie to watch…I’m serous:) My son pointed out that it’s just like a bone doctor to try to make things like this humerus!!!

Stay safe and healthy…With love, Timothy

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10 Comments

  1. julia goolia says:
    April 9, 2020 at 8:19 pm

    so if someone has low white blood cell count and low T cell count (but not leukopenia) do you think his body might not create a cytokine storm if he gets ill?

    Reply
    • Timothy Browne says:
      April 10, 2020 at 8:25 am

      Hey Julia,
      This is a good question. And reveals what a fine balance our bodies are in. One needs the immune system working at optimal capacity to fight off the virus. Possibly why young people are fairing better. I believe there may be an understanding that those with leukopenia caused by the disease have a worse prognosis. But I have not seen any data on those that have a lower WBC count (and don’t fall into the leukopenia classification). I will do further research, but why some people are experiencing this cytokine storm is still somewhat of a mystery. There is a discussion on why some people groups seemed to be hit harder. Amazing how much we understand about the human body and how much we DON’T. Stay safe and healthy, Julia!!

      Reply
  2. Dar Merwin says:
    April 9, 2020 at 9:02 pm

    Thanks Tim! Hugely informative, a little biologically overwhelming for my person 😂.. but good to try and understand the inner workings of what’s going on. I appreciate your insight!

    Reply
  3. Myungju Seo says:
    April 9, 2020 at 9:44 pm

    I would like to tell you briefly the current news of South Korea. We are being careful that there will be a mass infection somewhere, although the number of confirmed cases is decreasing. In particular, young people in their 20s often seem to be asymptomatic and are generally cured, but the problem is their parents or grandparents. If corona is transmitted from them, it can lead to death in bad cases.
    The 31st confirmed woman is a believer in Shincheonji(pseudo-religion) and has been treated at a hospital for 51 days. It’s not getting better because of psychological factors.
    After the negative screening, 74 people were confirmed again.(Yesterday news)
    I go to work by bus and subway, which are public transportation, four days a week. My family wash our hands as soon as we get home. Also, be sure to wear a KF94 mask when go out. Fortunately, there are no confirmed cases around us.

    Reply
    • Timothy Browne says:
      April 10, 2020 at 8:14 am

      HI Myungju!
      Oh my gosh…thank you so much for the update from South Korea.
      This crisis brings us all closer even as we social distance.
      We continue to pray for you all and Julie and I send our love!

      Reply
  4. Diana Heinrichs says:
    April 13, 2020 at 9:51 am

    Good morning Tim, I have a couple of simple questions for you. Is there anything we can do, such as diet, exercise, sleep, Music, thoughts, things we fill our lives up with that can create a healthy immune system? If our loved ones do come down with symptoms, what can we do to care for them?

    Reply
    • Timothy Browne says:
      April 13, 2020 at 8:21 pm

      HI Diana,
      I hope this finds you and your family well. What a crazy time we are living in.

      So, you are right that we want to optimize our immune systems in this time of trial. The things you mention are truly the best (and sometimes hard to do in times of stress). Sleep, diet, and exercise are at the top of the list and something this darn virus is trying to rob from us. There are two excellent apps that are helpful for rest, meditation, and sleep: Headspace and Calm. Both have excellent stories and music to produce peace. My personal downfall has been diet and I’m eating way too much Vitamin C (Chocolate!)

      So for supplements, this is what I recommend: As always please consult your doctor as supplements can react to medications you might possibly be on or be affected by other health issues!
      1) Vitamin D…especially for us northerners. You should have your blood level checked and know what that is, but since that is hard to do, I personally take 2000IU per day. Make sure you are using D3 and best to use D3 with Vit K1 and 2
      2) Zinc…There is lots of discussion on zinc and how it may help battle the SARS-CoV-2 virus. Some hospitals are using high dose zinc to treat active infections, but be careful…you can overload on zinc. This is one of those things that a deficiency is very common. Taking zinc is typically safe for healthy adults, as long as the daily dose is under the sea upper limit of 40mg.
      3) Vitamin C…Supplemental daily doses typically range between 250 and 1,000 mg with the upper limit at 2,000mg.
      4) There are lists and lists of other things from elderberry to astragalus, to garlic, etc. I only recommend these if you have consulted with your physician or a naturopathic physician.

      As far as what to do if one of your family members begins to have symptoms, please check out this post from a couple of weeks ago:
      https://www.authortimothybrowne.com/news/symptoms-and-what-to-do/

      Lots of love to you and your family!

      Reply
  5. Rosanne and Dan Thompson says:
    May 30, 2020 at 8:22 am

    Thanks for lifting the cloud over the complex.
    Humerus too. Lol
    Rosanne

    Reply