Monday, October 12, 2020

He was right all along - How an Immune System Imbalance May be Exacerbating COVID19

As we’ve grown more familiar with our coronavirus foe, the data is starting to tell us that there’s more to the picture than first meets the eye. Beth Daley, an immunologist at Emory University, described findings of an immune system imbalance in patients with severe COVID-19. In the article that she and her colleagues published, they found that patients who went on to develop severe COVID-19 had a rapid onset of extrafollicular B cell activation. Extrafollicular B cell activation is one means by which the body initiates an immune response during the interim between infection and the production of highly specific B cells. B cells activated in this manner bypass many of the checks the immune system has in place to make sure they don’t target the body’s own tissues. In a normal immune reaction, this response is short lived, so risk of targeting one’s own tissue is mitigated, and is later replaced by a more targeted immune response.

Some autoimmune diseases, such as Lupus, are caused by chronic activation of this extrafollicular response. Some COVID-19 patients experience a rapid onset of this autoimmune-like B cell activation. Potentially due in part to non-specific antibodies that target their own cells, these patients experience high incidences of organ failure and death during the course of infection. This research could provide physicians important clues into how they can more effectively treat COVID-19 using targeted immunosuppression. 

Patients who have long-term continued symptoms after supposedly recovering from COVID-19 are referred to as COVID long-haulers, and recently they have been gaining public attention and concern. Daley hypothesizes that ongoing autoreactive response may be the cause of these persistent symptoms. 

- Renata

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