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Why coronavirus affects young people much less severely than adults has a persistent mystery of the pandemic. The vast majority of young people do not get sick; when they do, they recover regularly.
The first study comparing the child’s immune reaction to that of the adult suggests an explanation of why for children’s relatively intelligent fortunes: in children, a branch of the immune formula that has evolved to oppose unknown pathogens temporarily destroys coronavirus before it hurts. to their bodies, according to research published this week in Science Translational Medicine.
“Ultimately, yes, young people react immunologically to this virus and it turns out it protects young people,” dr. Betsy Herold, a specialist in pediatric infectious diseases at the Albert Einstein College of Medicine who led the study.
In adults, the immune reaction is more suppressed, she and her colleagues found.
When the body encounters an unknown pathogen, it responds within a few hours with a wave of immune activity, called an innate immune response. The body’s defenders are temporarily recruited to fight and begin transmitting signals asking for reinforcements.
Children are more likely to find new pathogens in their immune system. His innate defense is swift and overwhelming.
Over time, as the immune formula finds a pathogen after a pathogen, it builds a repertoire of known villains. By the time the framework reaches adulthood, it is based on a more complicated and specialized formula adapted to combat express threats.
If the innate immune formula resembles the first lifeguards on the scene, the adaptive formula represents hospital specialists.
The adaptive formula makes biological sense, adults rarely find a virus for the first time, said Dr. Michael Mina, a pediatric immunologist at Harvard’s TH Chan School of Epidemiology in Boston.
But coronavirus is new to everyone, and the innate formula fades as adults age, making them more vulnerable. Over time it takes an adult framework to set up and run the adaptive formula, the virus has had time to do damage, according to Herold’s research.
She and her colleagues discussed the immune responses of 60 adults and 65 young people and young adults under the age of 24, all of whom were hospitalized at Montefiore Medical Center in New York from March 13 to May 17.
Patients included 20 young people with multisistmic inflammatory syndrome, severe and fatal immune overreaction related to coronavirus.
In general, young people were only affected by the virus, compared to adults, reporting mainly gastrointestinal symptoms such as diarrhea and loss of taste or smell. Only five youths required mechanical ventilation, compared to 22 adults; two youngsters died, compared to 17 adults.
Researchers found that young people had much higher blood levels of two specific immune molecules, interleucine 17A and gamma interferon. Molecules were more abundant in younger patients and decreased with age.
“We believe this protects these young children, especially from serious respiratory diseases, because that’s the main difference between adults and children,” Herold said.
In some adult patients with COVID-19, he added, the lack of an early reaction can also cause an intense and unregulated adaptive reaction that can lead to acute respiratory misery syndrome and death.
All viruses have tricks to escape the innate immune system, and coronavirus is especially expert. Produced early in the course of infection, interleucine 17A can help young people thwart attempts through the virus to escape the innate reaction and the next adaptive reaction.
“We believe it also prevents them from generating the most adaptive immune reaction related to this hyperinflmation,” Herold said.
Other experts said the study was conducted well but suffered, like maximum coronavirus studies, from recruiting patients too late in infection.
The innate immune reaction is triggered hours after exposure to a pathogen, however, other people do not arrive at the hospital until about a week after coronavirus infection, when symptoms are severe, said Akiko Iwasaki, an immunologist at Yale University.
It’s too much to examine how the innate immune formula reacts to the virus, he said, adding, “By the time other people are sick, this moment has passed. “
Still, new knowledge refutes some popular theories about why young people are from the virus, he said.
Some scientists suspect that young people are doing better because they tend to have been exposed more recently to the coronaviruses that cause the cold, possibly offering them some protection.
But the new discovery found no significant differences in immune responses to these viruses among groups, Iwasaki noted.
Another theory has argued that young people generate a more potent antibody reaction that eliminates the virus rather than adults, but the new study found that the sickest elderly produced the most potent antibodies.
This location would possibly verify a persistent fear among researchers that the presence of these resistant antibodies will contribute to the disease in adults, of helping them fight the virus, a phenomenon called antibody-dependent improvement. .
“It’s a topic everyone dances on,” dr. Jane C. Burns, pediatric infectious disease specialist at the University of California, San Diego. “Is it imaginable that the main titles of certain antibodies are really bad for you, rather than smart for you?”
Researchers also want to be informed about what happens in young people after the initial immune outbreak, Burns said. Children produce a strong immune response, but their bodies will have to temporarily shut it down once the danger has passed.
If this virus becomes endemic, such as the coronaviruses that cause the cold, young people will expand adaptive defenses so strong that they won’t revel in the disorders adults face lately,” Mina said.
“We’ll grow old with this virus. “
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