Faults in a certain part of the immune system might be at the root of some long covid cases, new research suggests.
For many people, covid is a disease that moves in and out of our lives as the instances rise and fall. But for tens of millions more, a case of covid is the beginning of a chronic and rarely debilitating disease that persists for months or even years. What differentiates Americans with long covid from those who are inflamed and recovering?According to a new paper, an overlooked component of the immune formula is unusually active in those people.
A team of researchers from Switzerland compared protein levels in blood samples taken from patients who had never had covid, those who had recovered from covid, and those who had developed long covid. “We wanted to understand what drives long covid, what keeps long covid active,” says Onur Boyman, an immunologist at the University of Zurich and an author of the study.
Scientists have found that people with long Covid show changes in a set of proteins involved in the supplement’s formula, which helps the immune formula destroy microbes and remove cellular debris. The effects echo what at least one other organization discovered.
None of the existing studies prove that these adjustments cause the disease. But they open up a new avenue for exploring treatments by helping doctors select the best people to test certain drugs. “There are actually effective therapies,” says Aran Singanayagam, a respiratory medicine specialist who studies lung infections at Imperial College London. “We’re pretty desperate and it’s a big deal. “
The researchers began by looking for the levels of more than 6,500 proteins in the blood of another 113 people who tested positive for SARS-CoV-2 and another 39 people who had never had inflammation. Six months later, they took more blood samples. By then, 73 inflamed people had recovered and 40 had developed long Covid. Many proteins increased in people with long covid and also increased in other people who had recovered from severe covid. But markers that were unique to long covid groups indicated activation. of the supplement system.
What is the complementary formula? Good question. ” We never hear about this as non-immunologists,” Boyman says. But it plays an important role in the body’s defense against microorganisms. The supplement formula is made up of more than 30 proteins produced through the liver that circulate in the blood and acts as an immune surveillance formula. Activation of the supplement’s formula triggers a cascade of reactions that recruit immune cells for infection, signal pathogens to destroy them, or even destroy microbes through holes in them. The formula, as the call suggests, complements the activity of antibodies. But when it doesn’t work well, it can cause widespread inflammation and damage blood cells and vessels.
When the effects indicated abnormal activation of the supplement’s formula as a hallmark of long covid, “we suddenly said, ‘Oh, that makes a lot of sense,'” Boyman says. “The formula of the supplement is very central, it communicates not only with the immune formula, but also with the blood clotting formula: with endothelial cells, with platelets, with red blood cells and in all organs. This may be why some researchers have found small clots in other people with the disease.
It’s unclear why the supplement’s formula can go awry after a covid infection. “To me, when you see a supplement activation like this, it suggests you have a persistent infection,” says Timothy Henrich, an immunologist at the University of California. San Francisco. This residual virus may simply keep the supplement’s formula active. It’s also possible that persistent tissue damage keeps the formula active. Or maybe it’s something else entirely. ” The basic challenge we have now with the lengthy Covid studies is “We have a lot of partnerships, but we don’t have a lot of proven reasons,” Henrich says.
While millions of young people may suffer from this mysterious disease, researchers are still debating the extent of the problem.
This isn’t the only paper to point to complement dysregulation as a feature of long covid. Back in October Paul Morgan, an immunologist at the Cardiff University School of Medicine, and his colleagues posted research—not yet peer-reviewed—that also found abnormal complement protein levels in people with long covid. Their group wasn’t able to follow patients over time, from acute covid through to the development of long covid. Both groups identified a set of markers that seem predictive of long covid, although not the same markers. Singanayagam is skeptical that any of these markers could offer a definitive diagnosis.
But if the supplement’s formula is to blame for some of the symptoms of long covid, there could be a solution. Companies already have drugs to block formula activation. They are approved to treat certain rare genetic and autoimmune diseases. Some of those treatments have already been tested on other people with severe covid, with combined results. But that may simply be because the researchers had no way of finding solely other people with symptoms of supplement dysregulation, Morgan says. If a company were to start a trial of these treatments in people with long-term covid, it could use some of these markers to recruit others who could reap the most benefits. “Treatment with antisupplemental drugs can provide us, for the first time, with an effective treatment against long Covid,” he says. Morgan’s team has already begun talking to corporations that have developed those treatments.
But even if those drugs work (and that’s still a big “if”), they probably won’t work for everyone. Long Covid is “such a heterogeneous set of conditions,” Singanayakam says. “It’s brain fog, it’s fatigue, it’s chest pain, and other patients have other degrees of each of those symptoms. “In Morgan’s study, only one-third to one-half of long covid patients had obvious and obvious dysregulation of supplements.
Henrich says the document provides vital information. But the mystery of what drives Covid in the long term is far from solved. “It’s a 1,000-piece puzzle and you’ve finished a head start,” he says. “It’s a smart start, but it’s not the whole puzzle. “
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