Immune Dysregulation and Disrepair
"Doctor, I ran a 5k 8 months ago and my legs won't stop running."
There has been a watershed moment this winter when the vow of silence on mentioning immune harm from SARS Cov 2 was lifted as it became both obvious and necessary as an explanation for the preponderance of strange infections. As I have built a significant notoriety from bringing up the harm to the T cells that covid brings, eyes did turn to me in the form of a Canadian television interview and a news interview. Now, we see prominent physicians and scientists alike bringing up the harm to the immune system, which was previously an “academic” debate (and I use the term loosely) fraught with outright slander, strawmen, ad hominem, and sophistry.
I’d like to recount the strategy I took and the chain of events to you all. The television interview can be found here, and I did minor preparations for it but it was important to strategize. I was told I was going to be with Colin Furness and two other individuals, of whom would be debating whether or not “immunity debt” or an immunity gap was to blame versus immune dysregulation for the severity of RSV and other infections.
I knew one of the greatest criticisms of myself was that I would try to apply the pathophysiology of severe covid-19 to the standard experience. This is a seemingly valid criticism, but is actually false. I do not conflate severe Covid, mild covid, and chronic covid. I did however, strategize according to this strawman. I let “leak” in a few chats that I would be going on television and claiming “SARS COV 2 infects and kills T cells, simple as.” as a sort of nuclear option on the panel. When the panel actually came, however, I had known about the ubiquitous immune dysregulation, remaining at follow up at least 7 months, from even mild cases of covid and explained how this would have consequences from RSV. Some other panelists started, “We shouldn’t overstate the immune events that only happen in certain cases…” but I had already planned for this.
In mild cases of Covid, plasmacytoid dendritic cells, which are an essential component of the immune system, are all but wiped out of the blood. These dendritic cells are one of the predominant sources of Interferon alpha, and Interferon alpha has a key role in both modulating the severity of RSV and even preventing infection with RSV altogether. So we have a clear mechanism from covid to immune dysregulation. It was a pleasure being with the other panelists, but it felt like too easy an argument. The rationale was clear. I did not even need to go into the why or how these populations were still missing, which suggests turnover. I also did not need to talk about the harm to the T cells, other than their chronic activation that occurs when they are persistently stimulated from a virus that partially evades them. When there is evasion, you will actually stimulate the T cells more, on the whole, because there is more biomass and a more durable infection. So the conflation of a robust T cell response and effective immunity becomes even more disparate. Not an easy concept to grasp, but I see some have caught onto it.
A recent publication has elaborated upon the T cell harm. Of course it was downplayed. One person chimed, “Doctor, my legs hurt from this marathon...” This analogy is actually incorrect. You are not looking at merely hurting legs, but it is as if the legs are hurting AND still running. This would actually describe the missing Naive T cell subset well. There is continued and chronic activation from the “marathon” they ran many months ago.
Now we are seeing the immune dysregulation wielded as a strong argument against the people who advocate for infection-based immunity to covid, and people are thinking of the ramifications of seasonal immune-harming “boluses” of a lympholytic. Like a Krampus present that happens several times a year. ‘Tis the season, indeed.
Merry Krampus, everyone,
AJ
Thanks Dr Leonardi. Very informative and easy to understand, especially for those who were filing nails and reading novels during biology class. Appreciate your time to educate with clarity and a touch of humor and sarcasm. Great stuff!
You make learning fun Dr Leonardi!