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With more men than women developingsevere illness and dying from COVID-19, sex differences that influence theimmune system may offer answers.

The bias in COVID-19 deaths appearedin the first reports out of China and has also been revealed in countries thatbreak down their mortality data by sex. Of Italys 21,551 deaths recorded as ofApril 20, 64 percent were men. In Spain, 59 percent of the 12,634 deaths as of April 21 occurred in men. Germany had recorded 4,598deaths by April 21, with 58 percent in men.

The United States does notseparate out national COVID-19 mortality by sex, but some states do. New York hasthe highest number COVID-19 deaths in the country, and as of April 21, 60 percent of 15,302 deaths were in men.

Some of that discrepancycould be because men are more likely than women to have other health problems,such as hypertension and diabetes. These are among the underlying conditionsthat raise the risk for severe COVID-19 disease, the U.S. Centers for Disease Control and Preventionreported April 3.

Another possible culprit isthe immune system itself. The many proteins that work together to defend thebody against viruses do not operate exactly the same way in males and females. Thosebiological differences, driven by sex hormones and genes, may be guarding somewomen from the deadliest complications of COVID-19.

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In general, females mount astronger immune response than males, studies have found. This makes womenoverall less susceptible to viral infections than men, although how each individualfares is another matter. A stronger immune response also means females are morelikely to develop autoimmune diseases, when the immune system attacks ones owntissue; conversely, a toned down immune response makes males more prone tohaving a host of malignant cancers.

The sources of the stronger femaleimmune response can be found in both the innate and adaptive immune systems,says Sabra Klein, a virologist at the Johns Hopkins University Bloomberg Schoolof Public Health. The innate system provides the first response against a virus,while the adaptive systems contribution is slightly delayed by the time neededto ramp up antibody production against a new intruder.

One component of the innateimmune system is called toll-like receptor 7. This protein can recognizemolecules found on viruses, thereby outing the pathogens as foreign. The genefor toll-like receptor 7 resides on the X chromosome. Because females have twocopies of the X, the body silences one (SN: 4/8/03),allowing for the right dose of X chromosome genes. But some genes escape the shutdown, and there is evidence that this is true for the gene for toll-likereceptor 7, researchers reported in Science Immunology in 2018. That canlead to more of the protein being made, giving females more guards looking outfor intruders.

Having more toll-likereceptor 7 can help jump start and enhance the next steps of the innate immune system.You want fast recognition, you want fast responses, Klein says. This is howyou start to activate the army of immune responses that are going to be neededto clear an infection. One of those steps is the release of interferons,proteins that direct major factions of the bodys immune response. In studiesthat measure levels of interferons in blood or in cells grown in a dish, researchersoverall see greater production of these interferons in females as comparedwith males, says Klein.

As the adaptive immunesystem gears up, women can get a boost over men again. The amount of antibodyproduced, as well as the quality of those antibodies, or the strength withwhich they bind to the virus, tends to be greater in females compared withmales, Klein says. Female mice produced more neutralizing antibodies the type which stop an infection by preventing thevirus from entering cells and more total antibodies against influenza A virus after infection comparedwith males, Klein and colleagues reported in Vaccine in 2011.

The female hormone estrogenalso influences the innate and adaptive immune systems. The hormone can regulatea variety of different genes for immune system proteins. For example, estrogen canstimulate the production of interferons, says Klein. And some of the genes thatare associated with directing the response of B cells, which make antibodies,are regulated by estrogen.

All of these findings comefrom research with other viruses, and havent yet been studied in the contextof COVID-19, Klein says, but they provide us with some clues. At this point,some of the best clues as to why there are discrepancies in how men and womenfare with COVID-19 may come from a study of the disease SARS in mice. The virus that causes SARS shares similarities with the culprit behind COVID-19,SARS-CoV-2 (SN: 2/3/20). And there isevidence that during the SARS epidemic of 2002-2003, which had close to 800deaths, men had a higher case fatality rate than women.

Its helpful to study sexdifferences in mice because it takes behavioral influences out of the equation,says Stanley Perlman, a virologist at the University of Iowa in Iowa City. Forexample, as reports from China indicated that more men than women were havingsevere cases of COVID-19, some also noted this could be due to the fact thatmore Chinese men than women smoke. China was also among the five countries thatSARS cases were concentrated in.

Perlmans team compared how male and female mice did when infected with a mouse-adapted version of SARS-CoV,the virus that causes SARS, and reported the results in the Journal of Immunology in 2017. Among middle-agedmice, those 8 to 9 months old, all of the males died within eight days of beinginfected, but only 10 percent of the females did by day 12. Males had higheramounts of the virus in their lungs than females did, suggesting the maleswerent clearing the virus effectively. The males also had a prolonged,unhelpful inflammatory response.

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When the research teamremoved the ovaries from 12 female mice to prevent estrogen from being made, about85 percent of the mice died after infection, compared with close to 20 percentof 12 females with their ovaries. Without estrogen, the female mice were nowas sensitive to the infection as male mice, Perlman says. While I wouldntclaim its the whole story, estrogen is a big part of the story.

Klein and Perlman both haveplans to study differences in the male and female response to COVID-19. In caseswhen the bodys own immune response contributes to a viral disease, it might beexpected women would fare worse, Klein says, because a strong immune responsecan lead to too much damaging inflammation. And with COVID-19, theres a lot ofconcern about the detrimental effect of increased inflammation in the lungs.

But what happens during COVID-19might be different. This aberrant inflammation might be higher in males thanfemales, Klein says.

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COVID-19 kills more men than women. The immune system may be why - Science News

The Covid-19 coronavirus meets its most formidable foe the moment it enters the human body.

The immune system is waiting, ready for action, and it determines who dies and who survives. It is why the vast majority of the infected have recovered from the disease.

Yet one of the most important unknowns is why some peoples immune systems are up to the task of clearing out the virus while others are sluggish or overreact, leading to death. Just as vexing:

Its helpful in thinking through these unanswered questions to understand how the immune system works (collectively and in individuals), how immunity testing works, and how immunity to similar viruses changes over time. Its also comforting to know that if you get Covid-19, your body will try very, very hard to save you. And if it doesnt, it could be because it tried too hard.

So here is a guide to the immune system: antibodies, serological tests, reinfection, and immunological memory, explained.

The first thing to know about the immune system is that it is not simple. At all.

A huge array of cells and chemicals your body produces work in concert to clear a foreign invader from your body. Theres a lot of elegance to this whole system, Akiko Iwasaki, an immunologist at the Yale School of Medicine, says. Its like an orchestra. All these cells and chemicals have to work in concert each with a different part to play to defeat the virus.

A viral infection begins when a virus enters a cell of your body. In the case of Covid-19, which is transmitted mostly by respiratory droplets, maybe that takes place somewhere in the lining of your nose or in the area of your lungs directly in contact with the air you inhale.

The virus then attaches to a cell via a protein on the cells surface called ACE-2 and lets itself in.

There, it begins to wreak havoc. The virus hijacks the cells machinery to make copies of itself. Those copies break out of the cell and then spread around your body. The copies enter more of your cells, make more copies, and so on. This is going viral, in the literal sense, and its a process your body works furiously to stop.

If the immune system is an orchestra in concert, its music can be broken down into two movements.

First, the opening: the innate immune response. This is the base-level protection you have to defend against infections even those your body has never seen before.

Iwasaki explains that every cell of your body has something of its own immune system in miniature. Your cells have a mechanism to detect virus infection, she says. Every cell is looking out for telltale genetic signs of viral replication. Once thats found, your cells start secreting these cytokines [signaling molecules] to tell the neighboring cells that theres a viral infection, she says. It will signal that cell to make a lot of antiviral proteins. Every part of the viral life cycle is targeted by hundreds of genes that are induced by this.

The innate immune response will then try to stop the virus in its tracks there, but it can fail, as we know. Viruses those sneaky bastards have evolved ways to counter this initial response. The viruses might encode proteins that degrade some of these signaling molecules, Iwasaki says. Even though we have this amazing system, viruses try to circumvent it.

If the innate immune system cant get rid of the infection, the second movement in this orchestration begins: the adaptive immune system. It has a vast array of instruments, each tuned to a specific task.

There are dendritic cells, which act as messengers from the innate immune system and tell the adaptive immune system which viral proteins it should seek out and destroy. There are killer T-cells, which hunt down and kill cells that have been infected. There are helper T-cells, which stimulate killer T-cells and recruit yet another class of cells called macrophages to gobble up infected cells, and they also stimulate B-cells, which bring this whole concert to a crescendo.

B-cells are critically important because they produce antibodies. These are little proteins that bind, specifically, to a single distinct part of a virus or pathogen and make it unable to hijack your cells. Antibodies can also identify invaders for other immune cells to destroy, and they can mark infected cells for destruction before a virus can burst out. And after an infection fades, the antibodies that linger can prevent the same virus from rising again.

But this process takes time.

When you first get infected with SARS-Cov-2, it usually takes anywhere from 10 to 14 days to make antibodies that are effective, says Vineet Menachery, an immunologist who studies coronaviruses at the University of Texas Medical Branch. That immunity actually peaks between four and eight weeks after youve been infected. The antibodies are really powerful at that point.

It takes a long time because an antibody has to be unique for the virus its trying to protect against. It takes a while and some trial and error to both build an antibody that can perfectly bind to the contours of the virus and to produce millions of copies of that antibody. The magnitude of potential antibodies is somewhere in the neighborhood of quadrillions or quintillions, Angela Rasmussen, a Columbia University virologist, says. But your immune system can narrow the choices down to the right formulation to clear the virus from your body.

The process isnt simple, but you can be in awe of it, like you can be in awe of a timepiece constructed from hundreds of delicately selected parts. I teach an entire semester course on this, Iwasaki says. This is the delicate process that a vaccine is trying to replicate artificially.

This antibody construction process can backfire, however. In some cases, antibodies bind to the virus, Iwasaki explains, and instead of blocking the virus, theyre taken up by white blood cells. Those white blood cells then go haywire, producing molecules called cytokines. Ordinarily, these chemicals promote inflammation throughout the body.

Inflammation is something that makes us feel sick, but it also helps us survive. People often think of swelling when they think of inflammation, Rasmussen says. Swelling occurs because cells from your immune system are rushing into the site of the infection. These immune cells have to get out of your blood vessels, she says, in order to corral the infection. Its a lovely process called rolling extravasation, she says. Your tissue gets inflamed because the balance of fluid is being changed.

But sometimes, so many cytokines are released that they trigger white blood cells to turn against healthy cells. That can then lead to organ failure and death. And that ultimately makes the disease as bad as it is, Iwasaki says.

Its unclear why a cytokine storm, as this reaction is called, might impact some people severely and not others, though there are indications that aging is a factor, as are underlying conditions like high blood pressure and diabetes. Researchers are also now looking for genetic clues to see who is most at risk. Thankfully, though, doctors do have some insights into how to treat this overreaction.

This whole orchestra ends when the immune system neutralizes all the virus in the body. That doesnt always mean the virus is purged; many viruses can linger in a latent state in the body without reproducing or causing symptoms. These latent viruses can flare up when the immune system is weakened, causing opportunistic infections. At the same time, youll be left with antibodies circulating in your blood.

But for reasons scientists dont quite understand, for some infections and notably, in other types of coronavirus infections antibody levels can wane over a period of years.

So how do doctors and scientists know if this process has been successful? How can they know if someone is now immune to the virus that causes Covid-19?

They test for it.

In particular, blood tests, also known as immunity tests or serological tests, can reveal who possesses antibodies to the virus. Deploying these tests will help answer a lot of questions. Most basically, it can help a person know if they have had Covid-19.

On a larger scale if deployed in well-designed studies serological tests could reveal the complete picture of the pandemic. They can also help scientists answer basic questions like:

Serological tests could also potentially allow people who have immunity to return to work. That could be a huge boost to front-line health workers who may have been exposed to the virus but are desperately needed back in action.

Just finding the antibodies isnt always enough, though. Scientists also need to do additional tests to make sure those antibodies are potent.

There are two main types of antibody tests, Menachery explains. The first just looks for antibodies and can be completed in a few hours. This is called an ELISA test (short for Enzyme Linked Immunosorbent Assay). And it doesnt provide the most complete picture of immunity.

The second test is more involved, and rarer. Its called a serum neutralization test, and it takes a few days to process. It not only looks for antibodies, it then exposes those antibodies to a virus in a cell culture to see how effective the antibodies are in stopping the virus.

Ideally, scientists will correlate the two tests and figure out which concentrations of antibodies confer the highest level of immunity. This work is ongoing, Menachery says. Its still not known what levels of antibodies are needed to have lasting, protective immunity. (What also remains to be shown: that the presence of antibodies also means you cant give the virus to someone else.)

These tests are useful, but they dont answer everything. As noted earlier, it takes days, if not weeks, for the body to produce antibodies. So a negative antibody test doesnt mean the virus isnt present. And since antibodies are produced during an infection and linger after its cleared, a positive antibody test doesnt mean that the virus is no longer active.

Confirming whether someone can still spread Covid-19 requires a separate genetic test like an RT-PCR test that detects the active virus.

Even if people do become immune, one thing we dont know about still is how long that immunity would last, Rasmussen says. And thats unfortunately not something we can determine until we wait months or years in the future, and test again and see if those antibodies are still there.

For reasons scientists dont quite understand, for some infections, your immunity never wanes. People who are immune to smallpox, for example, are immune for life: Antibodies that protect against smallpox have been found as long as 88 years after a vaccination.

Less reassuring here is that scientists have observed antibody levels to other coronaviruses (there are four coronavirus strains that infect people as the common cold) can wane over a period of years. A few weeks after an infection, antibody levels will be at their highest. But a year from now, that number is likely going to be a little bit lower, and five years from now its likely to be potentially a lot lower or a little bit lower, and we dont know the factors that change that, Menachery says.

However, even if you lose the antibodies, it doesnt mean you are again completely susceptible to the virus. Yes, none of this is simple.

There have been a few experiments where volunteers were willingly exposed to a coronavirus strain that produces a common cold. These studies show its common for the antibodies to these other coronavirus strains to decline after a year or so.

The majority of people that dont have serum neutralizing antibodies [i.e., antibodies that take out the virus], they get infected again, but they didnt get that sick, Menachery says. You couldnt do this type of test for Covid-19, he adds; its too dangerous.

There have been reports of a few patients out of China who had mild symptoms of Covid-19 who did not have detectable neutralizing antibodies after recovery, though they did have another form of antibody that binds to the virus. Its unclear whether they have protective immunity, Nature reports. Yes, there is more than one type of antibody, and they do different things, because none of this is simple.

Luckily, even if your antibodies against a coronavirus decline, your body has a backup plan.

Certain types of B-cells recall, these are the ones that make antibodies become memory B-cells. These save the instructions for producing a particular antibody, but they arent active. Instead, they hide out in your spleen, in your lymph nodes, perhaps at the original site of your infection waiting for a signal to start producing antibodies again.

With the memory B-cells in reserve, instead of waiting two weeks or more to get antibody production going, youll only have to wait maybe two or three days, Menachery says. So that means, yes, you can get infected again, but you may not even know youre sick. If you do get sick, maybe its a very minor infection.

Generally, he says, the more severe your infection, the more antibodies your immune system will produce, and the longer theyll stay in your bloodstream post-infection. So, he says, there is some concern that if you had a mild infection that your level of protection may not last long.

You may have seen some reports of people testing positive a second time for Covid-19 after recovering. The experts we spoke to say these reports are likely due to flaws in testing. I think the risk of being infected more than once from SARS-CoV-2 is nil, says Gregory Gray, an infectious disease epidemiologist at Duke University, in an email.

That may be because as you progress in the illness, the testing for Covid-19 becomes more inconsistent.

Often at the time that virus diseases present themselves, its fairly far into the replication of that virus in that person, says Diane Griffin, a professor of microbiology and immunology at the Bloomberg School of Public Health at Johns Hopkins University. Many symptoms of virus disease are actually manifestations of the immune response to the disease. Often things are starting to get better at the time youre starting to figure out someone even has a virus infection.

At least in the short term, its probably more the case that the people who have tested positive after recovering havent completely cleared the virus from their system or that a prior negative test was inaccurate.

Over the long term, the immune system itself becomes less effective with advancing age. And as people get older, they can acquire more chronic illnesses that can hamper the response to a virus, even if its one the immune system recognizes. It will be years, though, before scientists can understand what aging means for immunity to Covid-19.

The Centers for Disease Control and Prevention is now conducting serological surveys for Covid-19 antibodies in several places across the US.

Its an attempt to figure out who was previously infected with the virus, particularly if they never exhibited symptoms. A survey like this can show the actual background rate of infection and answer critical questions like what proportion of people have been infected without showing symptoms and where the virus has spread in a population, and quantify the overall rates of severe complications. Knowing these variables can help health officials better target interventions.

Many people who may have been infected also want to know if they are immune so they can safely leave lockdowns. Countries like Germany are even considering granting immunity passports so individuals can return to work.

Such testing could make a difference in a handful of cases, like for doctors and nurses who were infected or may have been exposed but are desperately needed back in action. But serological testing is unlikely to be a wholesale solution to reopening the economy.

Again, scientists are still uncertain about the robustness and duration of immunity that a Covid-19 infection confers, so a positive antibody test at this point doesnt guarantee that one can safely end social distancing measures. If immunity does fade after a year or two, the same person could be vulnerable to reinfection.

Meanwhile, to reopen schools, shops, and offices across the board, large numbers of people would have to have immunity. Without a vaccine, that would mean that the virus would have to infect vast swaths of the population, in the process sending thousands to the hospital and to their graves. That is exactly what measures like lockdowns and social distancing are trying to avoid.

While this outbreak has been ghastly, it has not been so bad as to bring about herd immunity in any quick time frame. There have been some imperfect serological studies that suggest the virus has infected more people than previously estimated. But even if true, the studies dont mean were anywhere close to achieving herd immunity.

So its unlikely that immunity can be a benchmark for when its okay to go back to normal across the population, and even in individual cases, it requires careful consideration of risks and benefits.

For those who have not yet contracted the virus, the main form of protection from Covid-19 right now is prevention. But there are several options scientists are studying that could help those who were never infected fend off the illness.

Chief among them is a vaccine. A vaccine can take various forms, including a weakened version of the virus itself, a small piece of the virus, or genetic material that prompts the immune system to manufacture antibodies to the virus.

Developing a vaccine for SARS-CoV-2 would be the ideal solution to the Covid-19 pandemic since its a form of prevention that would also hasten the end of costly measures like lockdowns, quarantines, and social distancing.

But its a time-consuming approach. Many experts estimate that it will take at least a year to develop a vaccine for the new coronavirus.

Vaccines can also pose risks. A small number of people can have dangerous adverse reactions to a vaccine, like severe allergies. In rare cases, vaccines can cause a phenomenon called immune enhancement, where the vaccine makes the recipients immune system overreact to the virus target, leading to a more severe disease than in those who were unvaccinated.

Though these risks are small, vaccines have to be delivered to millions of people. Thats why vaccine development focuses so much on safety and reducing the risks of complications as much as possible. Researchers are looking into various ways to speed up development, including human challenge trials where volunteers are deliberately exposed to the virus to test their immunity with and without a vaccine.

Another tactic under investigation is using convalescent plasma. The idea is to harvest the liquid part of blood, including proteins used for clotting, from people who have survived Covid-19. This plasma contains antibodies to the virus, so scientists are seeing whether it can help people with active infections get better. Researchers are also studying whether convalescent plasma can be used as a prophylactic to prevent Covid-19 in the first place.

Companies are also developing antibodies to SARS-CoV-2 using mice genetically engineered to have human immune systems. These antibodies can also be used to treat or prevent the disease.

But antibody transfusions, whether they come from Covid-19 survivors or were created in a lab, only confer protection against the virus for a few months.

The long-term strategy is to get enough people in a population immune to the virus so that it no longer spreads easily. This is known as herd immunity. It usually requires between 70 and 90 percent of a group of people to be immune in order to be effective, depending on the contagiousness of the virus.

With a large enough share of immunity in the population, even the remaining people who are not immune face a much lower likelihood of being infected. With few susceptible hosts in close proximity, pockets of infection quickly fade out. The question is whether this herd immunity is attained through vaccination or through infection.

The latter would not be ideal since it would involve millions getting sick from Covid-19. The United Kingdom was pursuing this approach back in early March but backed off its herd immunity strategy of limiting restrictions on movement and allowing people to be exposed. The country changed course when forecasters revealed that millions would likely contract the virus, overwhelming the UKs health system. Sweden has adopted a similar approach and is now facing vastly more Covid-19 cases than its neighbors.

Its also hard to gauge how close any country is to herd immunity since many people have likely been infected with the virus without knowing it. Figuring this out would require extensive testing for antibodies. And not everyone develops the same level of immunity from an infection. So vaccinating people against Covid-19 is the safer strategy.

Until then, widespread testing to identify the infected, isolating them, and tracing their contacts could help ease some of the pandemic control measures in place now.

How about what we can do as individuals?

Short of drugs like interferons, there isnt much a person can do to boost their immune system or their response to Covid-19, despite what various supplements promise.

The best Covid-19 approach for individuals is healthy habits maintain good hygiene, exercise, eat a balanced diet, get plenty of sleep, stay hydrated, manage any chronic health conditions like diabetes, and limit exposure to pollution.

Though the Covid-19 pandemic has been raging for several months, a lack of key information from how many people were infected to the origins of the disease continues to hamper the response.

More science on almost every aspect of this new virus is needed, but in this pandemic, as with previous ones, decisions with great consequences must be made before definitive data are in, wrote Harvard epidemiologist Marc Lipsitch in a column in the New York Times.

But the unknowns around immunity to the disease may be the most critical because they stand between the untenable present and a return to normal. Meanwhile, pressure is mounting to relax restrictions on movement to allow life to continue. With incomplete information, policymakers still have to make decisions that depend on immunity, but this can be done in ways that reduce risk.

The best approach is to construct a conceptual model a set of assumptions about how immunity might work based on current knowledge of the immune system and information about related viruses, and then identify how each aspect of that model might be wrong, how one would know and what the implications would be, Lipsitch wrote.

This is no easy task. It still might be the case that what we learn about immunity may not be enough for everything to go back to normal. We may need to wait, patiently, for a vaccine.

One advantage scientists have in the Covid-19 pandemic that they didnt have in prior outbreaks is an unparalleled level of information-sharing among researchers around the world. Researchers are posting their preliminary findings online for the world to scrutinize and working across borders, collaborating on an unprecedented scale.

That has led to unknowns becoming known faster than ever. But the disease is continuing to spread, and the drastic pandemic response measures cant continue forever, so some difficult choices lie ahead.

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Covid-19 immunity and testing, explained - Vox.com

There has been a suspicion for some time that the immune system is somehow involved in the development of certain psychological disorders. Now a new study from Queen Mary University in London and led by Fulvio D'Acquisto has identified in mice a specific autoimmune protein that may trigger OCD's anxiety and stress in humans. "Our findings overturn a lot of the conventional thinking about mental health disorders being solely caused by the central nervous system," says D'Acquisto.

The study is published in Brain, Behavior, and Immunity.

Image source: Hanna Xu/unsplash

"There is mounting evidence that the immune system plays an important role in mental disorders," easy D'Acquisto. "And in fact, people with auto-immune diseases are known to have higher than average rates of mental health disorders such as anxiety, depression and OCD."

These potential linkages can be difficult to definitively affirm. Depression and anxiety, for example, may just as easily be understandable reactions to the autoimmune conditions' onset and not mental disorders. Still, as the study notes:

Image source: Kuttelvaserova Stuchelova/Shutterstock

At the heart of the new study's findings lies a protein the researchers call Immuno-moodulin, or Imood. An excess of this protein produced unusually anxious mice.

D'Acquisto and his colleagues stumbled across Imood by accident. Their intention was to investigate the role of another protein, Annexin-A1, in the development of multiple sclerosis and lupus. To that end, the researchers bred mice in which Annexin-A1 was being over-expressed in their immune systems' T-cells. Unexpectedly, these transgenic mice seemed more than typically anxious. Curious, the team analyzed the T-cells' genes and found one protein that was particularly active Imood.

The researchers' hunch was confirmed with the administering of an Imood antibody the mice calmed down in a few days.

Image source: Priscilla Du Preez/unsplash

Obviously, such findings in mice wouldn't necessarily apply to human beings. D'Acquisto's team decided to look for Imood in 23 OCD outpatients from the OCD tertiary outpatient Clinic of the University Department of Psychiatry of Milan, Policlinico Hospital. There were also 20 "normal" patients tested as a control group.

The researchers found the Imood amounts in the OCD patients were roughly six times higher than in the control group.

According to a Queen Mary University press release, D'Acquisto's research joins that of other scientists who identified the same protein as being over-expressed in patents with Attention-Deficit/Hyperactivity Disorder.

The mechanism behind the connection between Imood and OCD isn't yet clear. D'Acquisto suspects it's less a matter if direct alteration of brain function, and is more likely to be some influence exerted over brain cells already linked to mental disorders. He says, "This is work we still have to do to understand the role of Imood. "We also want to do more work with larger samples of patients to see if we can replicate what we saw in the small number we looked at in our study."

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A possible new link between OCD and the immune system - Big Think

Immune health is on our minds these days, which means you've probably been seeing lots of supplements, fancy foods, and special drinks touted as effective or natural ways to boost your immunity. The truth is that scientists haven't found a direct link between lifestyle changes and increased immune capacity, at least not yet. But there are still some intriguing correlations to explore, especially when it comes to exercise.

"Your immune system can improve when you work out," said Aruna Subramanian, MD, an infectious-disease doctor and clinical medical professor at Stanford. It's true: though research is still emerging, there's a link between increased immune health and exercise. One comprehensive 2019 review concluded that moderate to vigorous exercise, done in sessions of less than an hour, has a positive impact on your immune system, that moderate exercise is associated with a decreased risk of illness, and that exercise overall has an anti-inflammatory effect on your body. While the exact connection and reason are still considered inconclusive, working out regularly is clearly helpful to your body's line of defense.

The same review did note that unusually intense exercise could have the opposite effect, making you more susceptible to illness. In other words, it's better to stick with a more moderate routine if you're trying to follow the best path for your immune system, particularly if you're not used to high-intensity exercise. If you're a true beginner, start within your abilities and ramp up slowly. (This will also help prevent injuries.)

Exercise is also known to have significant psychological benefits, said Dean Winslow, MD, an infectious-disease doctor at Stanford Health Care, which can itself be good for your immunity. That's because chronic stress suppresses your immune system by increasing inflammation and creating an emotional strain that keeps you from your usual healthy habits (think: adequate sleep and eating healthy). Exercise of all kinds is recommended to relieve intense stress, another win-win way it can help your immune system.

So while the science is still being sorted out, keeping up your normal fitness routine, or slowly easing into a new one, can certainly be a positive for your immune system and your overall health. Try this month-long at-home workout plan to get started.

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There's an Emerging, Promising Link Between Exercise and Your Immune Health - POPSUGAR

In the race to develop a safe, effective treatment for COVID-19, biotech companies like Regeneron and Vir Biotechnology, led by Cornell alumni, have turned to antibodies which are naturally created by the human immune system as a form of therapeutic treatment.

But what are antibodies, and how can they be repurposed into drugs to help people recover from COVID-19?

Prof. Avery August, immunology, researches how the immune system responds to infection, and broke down each companys approach to antibody treatments and why they might work as a treatment for the coronavirus.

Antibodies are proteins made by specific cells in the immune system. The immune system produces antibodies when it comes into contact with something foreign to the body and then tries to identify that molecule or pathogen for the future, August said. These antibodies are used to target and stop any infections.

The antibodies are produced and then circulate in the blood, and act to protect you if you get exposed to that [foreign] thing again, August said. Antibodies are also what an individuals immune system produces in response to vaccines, which are dead or altered forms of a pathogen.

August noted that antibodies are especially useful because they can be collected from blood and used for antibody treatments.

Since antibodies are so large, they are difficult to chemically synthesize in a lab. So, antibodies produced for drug therapies are usually made by either bacteria or cell lines both have been genetically engineered to produce antibodies, according to August. Often, these antibodies are integrated into a mixture, usually referred to as antibody cocktails, that can be used as a treatment for viral infections.

Theyre made in these huge vats where the cells are grown andsecrete the antibodies, August said. The [secreted] fluid is collected, and the antibodies are then purified from that fluid and packaged as drugs.

August explained that since mice have an immune system similar to humans, scientists can utilize this similarity by exposing mice to a specific target, allowing the mice to develop an immune response, and then collecting the mices B cells.

B cells, or antibody-producing immune cells can then be grown in a culture, and antibodies specific to the desired target can be purified from the cells and used as a therapeutic.

However, this method of antibody production has one caveat.

The problem with using antibodies from mice is that a mouse antibody is slightly different from a human antibody, Avery said. You can use [them] as a drug, but eventually, humans start to make an immune response against the mouse antibody. So it stops working.

To overcome this hurdle, Regeneron and a few other biotech companies have genetically engineered mice to have a human immune system, so mice can directly produce human antibodies in response to a target.

According to Regenerons website, this is accomplished by replacing the genetic coding for a specific part of mouse antibodies with counterpart genes that are expressed in humans, allowing for the rapid and robust production of fully human antibodies.

Although this process of identifying, testing and producing antibodies as therapeutics can sometimes take years, Regenerons approach of using mice with human immune systems significantly accelerates the process because any identified antibodies can then be quickly converted into drugs for humans, August added.

In the pastwhen we didnt have these mice that have human immune systems, we had to generate the antibodies in mice, and then genetically engineer those antibodies so they look like human antibodies, which can take some time, and then make them into drugs, August explained.

In developing treatments for COVID-19, Regeneron is currently selecting antibody candidates to test a mixture of two antibody treatments for human clinical studies. The studies are slated to begin by early summer. Regeneron is also currently conducting clinical trials to evaluate the use of its drug Kevzara in the potential treatment of critical COVID-19 patients based on clinical data from China.

Vir Biotechnology has a different approach to developing antibody treatments. Instead of combining two antibodies in a mixture, Vir is selecting one antibody candidate and modifying it to allow for the antibodies to last longer in the body and produce white blood cells, which can lead to long-term immunity. In the search for antibody candidates, Virs goal is to find pan-coronavirus antibodies that could work in most future coronavirus outbreaks.

Regeneron and Vir also adopted the approach of isolating antibodies from the blood of humans who have already recovered from COVID-19.

According to August, there are two reasons for collecting blood from recovered coronavirus patients. One reason is that antibodies can be purified from the blood of those individuals and then be used to treat other humans.

However, using antibodies from recovered coronavirus patients has its limits. This treatment method is extremely expensive and it takes approximately two to four donors to treat one person, August said.

The second reason is that since the blood from recovered COVID-19 patients contain the B cells producing antibodies against the virus, those B cells can be identified and purified from the blood. Antibodies can then be genetically engineered in the lab to produce a drug people can use.

Although costly, antibody treatments are still a key player in the search for a drug that can treat COVID-19.

Small-molecule drugs are cheaper to make and easier to administer in the form of pills, but run the risk of losing their effectiveness if the virus mutates, August said. Antibodies are more likely to provide effective, longer-term protection since they specifically target the non-mutating regions of the virus, but need to be administered through injections.

While the course of this pandemic is uncertain, there is promise in antibody treatments. Mixtures of antibodies, usually referred to as antibody cocktails, have been instrumental in combating viral infections and have been the focus of Ebola treatment research.

Continued here:
Harnessing the Human Immune System: Why Antibody Treatments Might Just Work Against COVID-19 - Cornell University The Cornell Daily Sun

30 April 2020

12:00 p.m. ET

Register now!

Andrea Cossarizza, M.D., Ph.D.

University of Modena and Reggio Emilia School of MedicineModena, Italy

Maurice OGorman, Ph.D., M.B.A., (D)ABMLI

Children's Hospital Los Angeles,Los Angeles, CA

Lishomwa (Lish) Ndhlovu, M.D., Ph.D.

Weill Cornell MedicineNew York, NY

Sean Sanders, Ph.D.

Science/AAASWashington, DC

The COVID-19 pandemic has struck the global population with unparalleled speed and ferocity. Researchers around the world are scrambling to learn about the biology, pathology, and genetics of SARS-CoV-2the novel coronavirus responsible for COVID-19while clinicians are seeking treatments, old and new, that might slow its infectivity and deadliness. In this webinar, we will explore what scientists are learning by using flow cytometry to study patients with COVID-19 in order to elucidate risk and disease severity. These experts are global leaders in cytometry and infectious disease, working on the frontlines of the COVID-19 outbreaks. They will provide concrete examples of how flow cytometry has been harnessed to provide key laboratory evidence that can be used in the fight against SARS-CoV-2 and COVID-19. Viewers will have the opportunity to put their questions to the expert panel during the live broadcast.

During the webinar, attendees will:

This webinar will last for approximately 60 minutes.

University of Modena and Reggio Emilia School of MedicineModena, Italy

Dr. Cossarizza completed his M.D. degree at the University of Padova in Italy before receiving a Ph.D. in oncology from the University of Modena and Reggio Emilia (UNIMORE) and the University of Bologna, also in Italy. After specializing in clinical pathology at UNIMORE, he obtained an associate professorship there. In 2005, he was appointed a professor in the international Ph.D. program at the University of Valencia in Spain, where he later became a research professor. In 2010, he became a full professor in pathology and immunology in the Faculty of Medicine at UNIMORE. He is a member of several editorial boards of international journals, and in 2016 was elected president of the International Society for Advancement of Cytometry. His primary research focus is identifying the molecular and cellular basis for the involvement of the immune system in diseases and infections, including HIV/AIDS and sepsis, as well as its role in pathophysiological conditions related to aging and neurodegeneration. Dr. Cossarizza has notable experience in the development and use of new flow cytometry approaches in immunological research.

Children's Hospital Los Angeles,Los Angeles, CA

Dr. OGorman earned his Masters and Ph.D. at the University of British Columbia before completing a postdoctoral fellowship at the University of North Carolina at Chapel Hill. He then joined the faculty at the Feinberg School of Medicine at Northwestern University, during which time he earned his MBA from Northwestern and served as vice chair of Pathology and Laboratory Medicine and director of Diagnostic Immunology and Flow Cytometry at Childrens Memorial Hospital in Chicago. He is currently chief of laboratory medicine, as well as director of the Clinical Lab and the Diagnostic Immunology and Flow Cytometry Laboratory at Childrens Hospital Los Angeles, and a professor of pathology and pediatrics at the Keck School of Medicine of the University of Southern California. Dr. OGormans research interests include immunopathogenesis of immune systemrelated disorders, investigation of immune mechanisms of immune suppression withdrawal in liver transplant patients, and the development of novel immune-related diagnostic laboratory tests. Additionally, he provides ad hoc reviews for multiple journals, including Cytometry,Journal of Leukocyte Biology, Journal of Immunological Methods, Clinical and Diagnostic Laboratory Immunology, and Archives of Pathology & Laboratory Medicine.

Weill Cornell MedicineNew York, NY

Dr. Ndhlovu is a professor of immunology at Weill Cornell Medicine in New York and principal investigator of the HIV and Emerging Pathogens Immunopathogenesis Laboratory in the Division of Infectious Diseases, also at Weill Cornell. A translational immunologist, he leads a research team dedicated to confronting the challenges of HIV and aging, with an emphasis on limiting disease complications and developing curative strategies. His program is now bringing the same urgency and focus to the COVID-19 pandemic, using both single-cell and epigenetic approaches to resolve molecular mechanisms regulating viral entry of SARS-CoV-2 infection across different tissues and cell types. His work seeks to identify therapeutic host targets and future therapies that reduce morbidity and mortality, and relieve the burden of this disease on society. Dr. Ndhlovu completed his undergraduate degree at the University of Zambia, his medical training at the University of Zambia Medical School, and his doctorate at Tohoku University School of Medicine in Japan.

Science/AAASWashington, DC

Dr. Sanders did his undergraduate training at the University of Cape Town, South Africa, and his Ph.D. at the University of Cambridge, UK, supported by the Wellcome Trust. Following postdoctoral training at the National Institutes of Health and Georgetown University, Dr. Sanders joined TranXenoGen, a startup biotechnology company in Massachusetts working on avian transgenics. Pursuing his parallel passion for writing and editing, Dr. Sanders joined BioTechniques as an editor, before joining Science/AAAS in 2006. Currently, Dr. Sanders is the Director and Senior Editor for Custom Publishing for the journal Science and Program Director for Outreach.

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Monitoring the immune system to fight COVID-19: CD4 status, lymphopenia, and infectivity - Science Magazine

Does strong immunity help you fight off COVID-19?

COVID-19 is caused by the SARS-CoV-2 virus. Just like any foreign bug, the body will defend itself against the invader. Strong immunity is built on a healthy gut microbiome and an army of white blood cells. If someone is consuming a healthy diet based on an array of fruits, vegetables and wholefoods (foods in their whole and unprocessed form - e.g. a potato instead of fries), the immune system should be better-equipped to fight off the virus - or any illness, according to the Heart Foundation.

Hence, maintaining healthy immune function cannot be achieved by scoffing chips, biscuits and packaged dinners every day, "balanced" by a probiotic, Berocca and lemon water. It's built through a healthy lifestyle.

Vitamin C is widely touted for its immunity benefits, but if you're consuming enough fruit and veg, a supplement is unnecessary. Scientists in China are currently looking into whether ultra-high doses of vitamin C can help COVID-19 patients fight infection, but results will not be available until later this year.

In the meantime, the daily recommended intake can be achieved through citrus fruits, capsicum and greens such as broccoli and spinach. Unlike a pure vitamin C supplement, these foods also contain other vitamins and minerals that play an important part in keeping your immune system strong.

There are also three tried and trusted methods to supporting your immune system - reducing stress, getting enough sleep and exercising regularly.

Kombucha tastes great, it's trendy and there are a number of options on the market that are relatively inexpensive. However, it's not a magic tonic - and drinking it by the litre is not going to ward off COVID-19.

Like probiotics, kombucha contains live microorganisms. However, no studies have ever confirmed whether the drink has a high enough concentration to be considered a probiotic, and there is currently no evidence that kombucha can treat or prevent any illnesses.

To strengthen one's gut health and immunity, a far more pragmatic bet is opting for probiotic foods such as plain, unsweetened yoghurt, which is full of live cultures, and fermented products such as kefir and sauerkraut.

"There is no evidence to suggest that supplements labelled as immune-boosting such as green tea, zinc, elderberry or echinacea will provide any protection against COVID-19. Its more important to have a healthy lifestyle overall," Hursthouse wrote.

However, a vitamin D supplement can prove useful, particularly in parts of the world where sunshine is limited. Several studies have linked low vitamin D levels to a higher risk of respiratory infections. Vitamin D deficiencies are fairly common, and can be discovered through a blood test.

But again, if there isn't a deficiency, a supplement is not entirely necessary. As BBC Future reported in 2016, vitamin supplements typically don't provide any benefits in already healthy people.

And of course, prevention is always a good place to start. To minimise your chances of contracting COVID-19, follow the Ministry of Health's guidelines:

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Coronavirus: Does 'boosting' your immune system really help fight off COVID-19? - Newshub

A great deal of discussion is taking place regarding antibody testing for the COVID-19 coronavirus. A basic discussion of immunology is helpful to understand the value of such testing.

What are antibodies? How do we develop antibodies? How do antibodies work? What is an antibody test? What are the clinical and public health benefits of antibody testing?

Antibodies are specialized humoral proteins made by the immune system. They help the body fight against infections and disease by "recognizing" viruses, bacteria and infected cells. Each antibody binds to a specific antigen associated with a danger signal in the body. This antigen is also known as the antibody's target. When a foreign protein like a virus enters the body, the immune system responds to this antigen. Specific proteins are developed to fight off and hopefully neutralize or kill the invader. This is technically called humoral immunity.

There are three ways to obtain immunity to various disease agents. Each of these will play a role as an antibody test for the COVID-19 coronavirus becomes widely used.

First is natural active immunity. This immunity is derived by naturally becoming infected by a pathogen, such as a virus or a bacteria. When infection occurs, humoral immunity kicks in, developing antibodies specific to this disease. When the body is exposed to this same pathogen (antigen) in the future, the immune system releases those specific antibodies to attack the pathogen before infection can take place. An example is a person developing a case of measles from exposure to the virus in the natural environment. This type of immunity is usually long-lasting. Unfortunately, not every infection with a pathogen results in developing antibodies that are protective or "neutralizing." For example, infection with the bacteria that causes Lyme Disease does not result in the development of protective antibodies, thus we can become reinfected with this bacteria upon repeated exposure.

Second is artificial active immunity. This type of immunity is developed by artificially exposing a person to a pathogen and causing the immune system to actively develop antibodies against this specific pathogen. This is accomplished through the process of immunization or vaccination. A vaccine, which is either a killed or very weakened version of the pathogen is introduced into a person, via injection, orally, nasal mist etc. When the vaccine (antigen) enters the body, the immune system actively begins to develop protective neutralizing antibodies against this specific pathogen (antigen). Normally, immunity begins about two weeks after immunization. With immunization, it may take multiple doses of the vaccine over time to develop a sufficient level of antibodies to confer full immunity. This type of immunity may not be long-lasting, requiring booster immunizations in the future. An example is tetanus, where after the initial series if immunizations to develop adequate immunity, this immunity may wane over the years requiring a booster "shot" every 10 years.

Third, and the least used method of providing immunity, is artificial passive immunity. This type of immunity is obtained when a serum collected from individuals who were naturally infected by and recovered from a specific disease and contains the antibodies against that disease, is administered to a non-immune person. The individual receiving this serum does not actively produce their own antibodies, but passively accepts and uses the artificially introduced antibodies from the donors serum to attack the pathogen and prevent infection. An example is the administration of immune globulin to susceptible individuals exposed to Hepatitis A. If given soon after exposure, this immune globulin containing antibodies against Hepatitis A will prevent infection and disease. This type of immunity is shorted-lived, usually providing only a few months of protection.

Each of these three methods of gaining immunity are being and will be utilized in various ways to combat the COVID-19 pandemic once a reliable antibody test is widely available to the medical and public health community. The FDA has recently licensed a number of these tests. The test must reliably be able to detect antibodies to the COVID-19 coronavirus, and that the level of antibodies in the person tested is sufficient to provide immunity. It usually takes about four weeks after infection to develop detectable antibodies to the COVID-19 coronavirus. Since this virus is so new, it is not yet fully understood how long such immunity will remain active, and if it will protect against the virus as it changes. If this virus behaves like similar coronaviruses, it is expected that immunity will develop for some period of time and that it will also be conferred against a changing virus.

The antibody test is already being used to identify individuals whom have developed immunity to COVID-19. This information will allow individuals, especially those in critical occupations such as health care, first responders and public safety to return to work more safely and quickly after infection and recovery. This will be expanded to other occupations as the testing becomes more widely used, to allow greater re-opening of the economy.

The test is also being used to identify individuals with antibodies to the COVID-19 coronavirus who would donate serum to be used to develop an immune globulin as described above. This serum globulin is being administered to critically ill COVID-19 patients to reduce symptoms and prevent death. Once available on a larger scale, more people with COVID-19 coronavirus antibodies will be recruited to donate serum to make larger quantities of this immune globulin that could be administered to susceptible individuals exposed to the virus, such as health care workers treating COVID-19 patients.

This antibody test will be used for public health surveillance and to determine how widely the COVID-19 epidemic has spread throughout the nation. Studies called sero prevalence studies will be conducted by testing large numbers of blood samples taken from people across the nation to better understand how much immunity to this virus exists. Blood will be tested from samples taken at blood donation centers, other clinical settings, and by recruiting a sufficiently large representative sample of the nation to volunteer. This information will determine which parts of the country have lower rates of immunity and may be more at risk if a second wave of disease strikes. This would provide information that will be used to prepare these at-risk areas before a second wave becomes a reality. This will allow better targeting and stockpiling of needed supplies and equipment in the areas where it may be most needed.

SEACOAST CORONAVIRUS NEWS IS FREE: This content is being provided for free as a public service to our readers. Sign up for our free daily or breaking email newsletters and Seacoast Health newsletter to stay informed. Please support local journalism by subscribing to Seacoastonline.com or by subscribing to Fosters.com.

Lastly, the antibody test will be used to evaluate the effectiveness of any vaccine developed for the Covid-19 coronavirus. As trial vaccines move through the safety and effectiveness stages for final approval, humans will be administered the trial vaccine on a voluntary basis. The antibody test will be used to determine if these trial vaccines develop sufficient protective antibodies to safely prevent infection. The test will also be used to determine how many doses of the vaccine will be required, at what intervals will doses be administered, how long immunity lasts, and if booster "shots" will be required and, if so, how long after initial immunization.

Unfortunately, all these steps will be taking place for at least the next year or two. We must expand diagnostic testing for the virus, conduct contract tracing to identify sources of community transmission, isolate cases and quarantine contacts. Face coverings must be required for everyone working or entering public places of business, and good hand hygiene must be maintained. In the meantime we will need to live with reasonable but necessary limits on our daily lives. The better we manage the crisis now, the better of we will be down the road.

Rich DiPentima of Portsmouth spent more than 30 years as a public health official and epidemiologist, including service as deputy public health director in Manchester and chief of communicable disease epidemiology at the New Hampshire Division of Public Health. His column on coronavirus will appear weekly in Seacoast Health during the coronavirus public health crisis.

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Coronavirus This Week: What is antibody testing and how it may impact the COVID-19 pandemic - Foster's Daily Democrat

People who think theyve been exposed to the novel coronavirus are clamoring for antibody tests blood screens that can detect who has previously been infected and, the hope is, signal who is protected from another case of Covid-19.

But as the tests roll out, some experts are trying to inject a bit of restraint into the excitement that the results of these tests could, for example, clear people to get back to work. Some antibody tests have not been validated, they warn. Even those that have been can still provide false results. And an accurate positive test may be hard to interpret: the virus is so new that researchers cannot say for sure what sort of results will signal immunity or how long that armor will last.

They caution that policymakers may be making sweeping economic and social decisions plans to reopen businesses or schools, for example based on limited data, assumptions, and whats known about other viruses. President Trump last week unveiled a three-phased approach to reopen the country; he said some states that have seen declining case counts could start easing social distancing requirements immediately. And some authorities have raised the idea of granting immunity passports to people who recover from the virus to allow them to return to daily life without restrictions.

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Before we embark on huge policy decisions, like issuing immunity certificates to get people back to work, I think its good that people are saying, Hold up, we dont know that much about immunity to this virus, said Angela Rasmussen, a Columbia University virologist.

To be clear, most experts do think an initial infection from the coronavirus, called SARS-CoV-2, will grant people immunity to the virus for some amount of time. That is generally the case with acute infections from other viruses, including other coronaviruses.

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With data limited, sometimes you have to act on a historical basis, Anthony Fauci, the head of the National Institute of Allergy and Infectious Diseases, said in a webcast with JAMA this month. Its a reasonable assumption that this virus is not changing very much. If we get infected now and it comes back next February or March we think this person is going to be protected.

Still, the World Health Organization has stressed that the presumed immunity can only be proven as scientists study those who have recovered for longer periods. The agency is working on guidance for interpreting the results of antibody tests, also called serologic tests.

Right now, we have no evidence that the use of a serologic test can show that an individual is immune or is protected from reinfection, the WHOs Maria Van Kerkhove said at a briefing last week.

Below, STAT looks at the looming questions about antibodies and immunity that scientists are racing to answer.

What are antibody tests? How widely available are they? And how accurate?

The tests look for antibodies in the blood. Because antibodies are unique to a particular pathogen, their presence is proof the person was infected by the coronavirus and mounted an immune response. The hope is that the presence of the antibodies is an indication that the person is protected from another infection.

These are different from the tests used to diagnose active infections, which look for pieces of the virus genome.

Commercial antibody tests are starting to appear on the market, but so far, the Food and Drug Administration has only cleared a few through Emergency Use Authorizations. And already, health regulators are warning that the ones on the market may vary in their accuracy.

I am concerned that some of the antibody tests that are on the market that havent gone through FDA scientific review may not be as accurate as wed like them to be, FDA Commissioner Stephen Hahn said on Meet the Press earlier this month. He added that no test is 100% accurate, but what we dont want are wildly inaccurate tests.

Even the best tests will generate some false positives (identifying antibodies that dont actually exist) and some false negatives (missing antibodies that really are there). Countries including the U.K. have run into accuracy issues with antibody tests, slowing down their efforts for widespread surveys.

The fear in this case with imprecise tests is that false positives could errantly lead people to think theyre protected from the virus when they have yet to have an initial infection.

Serology testing isnt a panacea, said Scott Becker, the CEO of the Association of Public Health Laboratories. When its used, we need to ensure there are good quality tests used.

One specific concern with antibody tests for SARS-CoV-2: they might pick up antibodies to other types of coronaviruses.

Globally, there have only been a few thousand people exposed to the other coronaviruses that have caused outbreak emergencies, SARS and MERS. But there are four other coronaviruses that circulate in people and cause roughly a quarter of all common colds. Its thought that just about everyone has antibodies to some combination of those coronaviruses, so serological tests for SARS-CoV-2 would need to be able to differentiate among them.

What can be gleaned from serological results?

Detecting antibodies is the first step. Interpreting what they mean is harder.

Typically, a virus that causes an acute infection will prompt the bodys immune system to start churning out specific antibodies. Even after the virus is cleared, these neutralizing antibodies float around, ready to rally a response should that virus try to infect again. The virus might infect a few cells, but it cant really gain a toehold before the immune system banishes it. (This is not the case for viruses that cause chronic infections, like HIV and, in many cases, hepatitis C.)

The infection is basically stopped in its tracks before it can go anywhere, said Stephen Goldstein, a University of Utah virologist. But, Goldstein added, the durability of that protection varies depending on the virus.

Scientists who have looked at antibodies to other coronaviruses both the common-cold causing foursome and SARS and MERS found they persisted for at least a few years, indicating people were protected from reinfection for at least that long. From then, protection might start to wane, not drop off completely.

The experience with other viruses, including the other coronaviruses, has encouraged what Harvard epidemiologist Marc Lipsitch summed up as the educated guess in a recent column in the New York Times: After being infected with SARS-CoV-2, most individuals will have an immune response, some better than others. That response, it may be assumed, will offer some protection over the medium term at least a year and then its effectiveness might decline.

But many serological tests arent like pregnancy tests, with a yes or no result. They will reveal the levels (or titer) of antibodies in a persons blood. And thats where things can get a bit trickier. At this point, scientists cant say for sure what level of antibodies might be required for a person to be protected from a second Covid-19 case. They also cant say how long people are safeguarded, though its thought that a higher initial titer will take longer to wane than low levels.

Further investigation is needed to understand the duration of protective immunity for SARS-CoV-2, a committee from the National Academies of Sciences, Engineering, and Medicine wrote in a report this month.

Its not just whether someone is immune themselves. The next assumption is that people who have antibodies cannot spread the virus to others. Again, that hasnt been shown yet.

We dont have nearly the immunological or biological data at this point to say that if someone has a strong enough immune response that they are protected from symptoms, that they cannot be transmitters, said Michael Mina, an epidemiologist at Harvards T.H. Chan School of Public Health.

The challenge, as the National Academies report highlighted, is that no one knew about this virus until a few months ago. That means they havent been able to study what happens to people who recover from Covid-19 and if and how long they are protected for more than a short period of time.

One key uncertainty arises from the fact that we are early in this outbreak and survivors from the first weeks of infection in China are, at most, only three months since recovery, the report said.

What else can antibody tests show?

In addition to identifying those who have been infected, antibody tests can also suggest at a broader level how widely the virus has spread. These data have implications for how severe future outbreaks of cases might be and what kind of restrictions communities might need to live under. If more people have been infected than known a strong likelihood, given the number of mild infections that might have been missed and testing limitations in countries including the United States then more people are thought to be protected going forward.

In the United States, the Centers for Disease Control and Prevention and the National Institutes of Health have both launched serosurveys to assess how many people might have contracted the virus. Even employees of Major League Baseball teams have been enlisted in a study enrolling thousands of patients.

What have data from serosurveys shown thus far about antibody generation?

A number of countries have launched large serosurveys, so hopefully well have a better sense soon of the levels of antibodies being generated by individuals who recover from Covid-19 and among the general population. For now, though, there have only been limited data released from a couple small studies.

Scientists in Europe have pointed to strong antibody production in patients within a few weeks of infection. One study found that people were generally quick to form antibodies, which could help explain why the majority of people do not develop severe cases of Covid-19.

But one preprint released this month complicated the landscape. (Preprints have not been peer-reviewed or published yet in a research journal.) Researchers in Shanghai reported that of 175 patients with confirmed Covid-19, about a third had low antibody levels and some had no detectable antibodies. The findings suggest that the strength of the antibody response could correlate to the severity of infection, though thats not known for sure. They also raised concerns that those with a weaker antibody response might not be immune from reinfection.

But outside researchers have said that conclusions about immunity cant be drawn from what the study found. For one, there are different kinds of antibodies, so some might exist that the test wasnt looking for. Secondly, studies in other coronaviruses have shown that antibody responses vary from person to person, without clear implications for how protected someone is from another infection.

And, researchers say, antibodies are not the only trick the body has to protect itself. Immune cells also form memories after an initial infection and can be rallied quickly should that same pathogen try to strike again, even without antibodies or after antibody levels fade.

People that lose that serum neutralization it doesnt mean necessarily that theyre not going to have some level of immunity, said virologist Vineet Menachery of the University of Texas Medical Branch. Your immune system hasnt forgotten. It may just take them a couple of days to generate that immune response and be able to clear a virus.

He added that its likely that if and when protection starts to wane and people contract the coronavirus a second time, its likely to cause an even milder illness.

Ive heard reports of reinfection or reactivated virus. Whats going on there?

Health officials in some countries have said theyve seen examples of people recovering from Covid-19 only to test positive for the virus again what theyve taken to calling reactivation, to differentiate it from a second infection.

But experts are skeptical that either is occurring.

While no possibility can be eliminated at this early stage of the outbreak, they say that there are more likely explanations for a positive diagnostic test coming after a negative test.

For one: The tests used to diagnose Covid-19 look for snippets of the virus genome, its RNA. But what they cant tell you is if what theyre finding is evidence of live virus, meaning infectious virus. Once a person fights off a virus, viral particles tend to linger for some time. These cannot cause infections, but they can trigger a positive test. The levels of these particles can fluctuate, which explains how a test could come back positive after a negative test. But it does not mean the virus has become active, or infectious, again.

And two: the diagnostic tests typically rely on patient samples pulled from way back in their nasal passages. Collecting that specimen is not foolproof. Testing a sample that was improperly collected could lead to a negative test even if the person has the virus. If that patient then gets another test, it might accurately show they have the virus.

As Jana Broadhurst, the director of the Nebraska Biocontainment Units clinical laboratory, said, garbage in, garbage out.

Sharon Begley contributed reporting.

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Everything we know about coronavirus immunity, and plenty we still don't - STAT

There are a lot of myths out there about how to fight the novel coronavirus, and many of them are going to prove to be really harmful. Its important to ensure you have access to accurate information before making any decisions about your health or well-being, especially during a pandemic. If something sounds too good to be true, investigate. But even if something sounds reasonable, investigate that, too. Right now its important not only to protect and bolster your immune system, but also to understand how your immune system actually works so you can make reasonable adjustments to your lifestyle and diet to protect it.What Does Novel Mean?You may have noticed some people calling the new coronavirus novel. This doesnt mean its special or amusing, but rather it means its a brand new virus that has never occurred within humans before, so humans have zero immunity to it at this point. Thats an important distinction because its not like a strain of influenza that looks like other strains of influenza that weve been exposed to in the past and our immune systems have at least some blueprint for fighting off. This is a virus that our immune systems have no blueprint for, which is one of the reasons it is so virulent and so deadly.How Does Immunity Work?Your immune system works to block antigens like bacteria, fungi, parasites, and viruses from entering your body and making you sick. When one of these antigens does successfully get through, your body produces white blood cells to fight them off. After your immune system fights off an antigen, it produces antibodies as a sort of blueprint to fight off similar things in the future. For some of the population, COVID-19 will result in antibodies in their immune system that could help them fight off future mutations of this virus (its too soon to tell, though). For people with compromised immune systems, however, the risk of death or serious complications is very high.What Does Immunocompromised Mean?For some people this is an especially scary time because they have an immune system that has been damaged or compromised. Problems with your immune system can come from certain diseases, such as diabetes, which can cause your wounds to heal more slowly and infection to set in more easily. People with autoimmune disorders have immune systems that overreact to normal stimuli, which can lead to exacerbations in their disorders if they arent being treated. If they are being treated, oftentimes the treatment is to suppress the immune system to prevent exacerbations, which leaves them open to more infections and more severe infections. A similar thing happens when someone undergoes an organ transplant - in order to ensure their body doesnt reject the transplanted organ, they have to be immunosuppressed for the rest of their lives, which also makes it easier and more devastating for infections to take place. Diseases like AIDS and HIV, cancer, and anything that requires chemo or radiation therapy can decimate a persons natural defenses, leaving them extremely vulnerable to viruses like COVID-19.Keeping Your Immune System StrongThe myths about your immune system are persistent. No, heavy doses of vitamin-C arent going to make everything better. Your immunity is about achieving balance. Too much stress, too much sugar, too little water, and too little sleep can all affect your immunity. Too many or not enough nutrients can affect your immunity, and not getting the right combination of nutrients can affect your immunity. Also read: The Future Of Space-Age Digital Therapeutics (infographic)Something else that is important, especially right now, is to make sure you are up to date on vaccinations. This isnt because a flu vaccine can help you fight off COVID-19, but rather there are two more important reasons. First, preventing other illnesses right now takes strain off the medical system. Second, not being sick already when you come in contact with COVID-19 gives your immune system one less thing to fight off.

Learn more about protecting your immune system below.

Read next: Practicing Social Distancing Without Feeling Isolated (infographic)

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Protecting Your Immune System (infographic) - Digital Information World

One of the many unknowns about the novel coronavirus SARS-CoV-2 is how we might become immune to it. When you get infected with viruses, along with other baddies like bacteria, your immune system fights back by producing proteins called antibodies. These stick around for the long haul, and your body is prepared to churn out more of them if you come into contact with the pathogen again.

It's how vaccines work: By introducing a dead or weakened version of a virus to your immune system, you trick it into producing antibodies in response. Then if you come into contact with the real virus, your body will be ready.

Viruses vary widely in terms of the immune response they elicit. For instance, if you got chicken pox as a kid, you are likely to be immune to reinfection for the rest of your life. With whooping cough, immunity might last for up to 20 years, and for the H1N1 flu strain, up to 10. With the seasonal coronaviruses that cause the common cold, immunity fades after a few months, which is why you can pick up new infections year after year.

But when it comes to SARS-CoV-2, because this is such a new infection, were not sure how long those antibodies hang around for, says Dr. Seema Yasmin, director of the Stanford Health Communication Initiative.

Our best bet may be to compare it to the original SARS coronavirus, SARS-CoV. In patients infected with this virus, antibody levels peaked between two and four months after infection and offered protection for two to three years. I think the glimmer of hope might be that theres so much genetic similarity between SARS-CoV-2 and SARS-CoV, adds Yasmin.

Read all of our coronavirus coverage here.

Speaking of genetics, another virus to consider as a comparison is HIV. This virus is so difficult to treat because it mutates like mad as it multiplies. The human body might develop an antibody, but it's one that will become less effective as the virus changes. Some good news on the coronavirus front is this virus does not seem to mutate anywhere near as frequently as HIV mutates, says Yasmin. That means it stays much more consistent, and it means we have far less of a moving target.

Discovering more about how immunity to this new coronavirus works will be key to fighting the pandemic. The more people who become immuneeither from beating an infection or from receiving a vaccinethe closer we get to herd immunity, or the point at which most members of the population have antibodies. Then well start to slow and eventually stop the pandemic.

To learn more about how antibodies work, and how they might help in the fight against the coronavirus pandemic, check out our video with Yasmin above.

WIRED is providing free access to stories about public health and how to protect yourself during the coronavirus pandemic. Sign up for our Coronavirus Update newsletter for the latest updates, and subscribe to support our journalism.

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Here's How Covid-19 Immunity Compares to Other Diseases - WIRED

The immune system. Nutritional Therapist Maxine Johnson explains it as A very complex system that is made of multiple sub-systems containing: the innate immune system (the one you were born with), the acquired/adaptive immune system (remembers and catalogues pathogen exposure), the lymphatic system (re-circulation and waste disposal), the gut biome with trillions of beneficial bacteria, the virome containing trillions of viruses in us and on us, and the gut brain axis.

If youre thinking that sounds like a lot, youre not alone. In her nutritional therapy practice, TempleFit, in Olympia she helps you make sense of the bodys complex systems and can help you bring them to optimal health, holistically, through a whole foods diet and exercise, among other things.

Nutritional therapy is part of the growing field of alternative medicine, says Maxine. Like acupuncture, naturopathy, chiropractic, and biofeedback, it is holistic in nature, meaning that the whole body is acknowledged while supporting the strengths and strengthening the weaknesses rather than just chasing symptoms.

Nutritional Therapy protocols were developed from the work of pioneer thinkers and practitioners of the past century, such as Dr. Royal Lee, Dr. Weston A. Price, and Dr. Frances Pottenger. Maxines own work includes her certification as a nutritional therapist, and NRT Practitioner, but also as a fitness trainer and coach. Her extensive background of over three decades in fitness, and as a former NPC Figure Champion, uniquely positions her to have a deep understanding of diet and exercise.

The body knows full well how to protect itself, she says. It just needs you to give it the tools to do it with. However, when its weakened, it will continue to respond to invader viruses and bacteria, but the problem here is that it will often over-react, attacking healthy tissue anywhere that it thinks its finding pieces of the invader. Maxine says. Whether caused by genetics, epigenetics, nutritional deficiencies from eating fake food most of your life, too much sugar, some other underlying health condition, or your age, all of those factors can compromise your immune system.

She further reports that As we age, our thyroids dont produce enough vitamin A, which acts like a hormone and literally builds walls around our cells to protect them from invaders trying to get in. Additionally, if youre not getting enough vitamin D from the sun (best source), or fish fat, your body is not able to create cathelicidins which are like little bullets that blow holes in viruses and destroys them.

Fortunately, there are many ways to support this very complex and vital system. Maxine gives her best tips for supporting our immune systems:

Life is stressful. If you need help getting on track, staying on track, losing weight, or you have an underlying health condition that wont go away, contact Maxine at TempleFit. She is now providing virtual visits for long distance clients, and those who cannot make it to the office.

Your body is your temple, Maxine says, Keep it fit for life.

TempleFitMaxine Johnson, CCWFN605 11th Avenue SE, Suite 202, Olympia360-338-0481206-276-3534 voice/textmaxine@templefit.com

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Maxine Johnson from TempleFit Talks About the Amazing Immune System and How To Keep It Strong - ThurstonTalk

The truth is, the best strategy to safeguard yourself against sickness is prevention

ABOVE VIDEO: With the public health crisis were all facing with COVID-19, many of us are wondering what we can do to protect ourselves and our loved ones.

BREVARD COUNTY. FLORIDA With the public health crisis were all facing with COVID-19, many of us are wondering what we can do to protect ourselves and our loved ones.

Beyond social distancing and staying at home, is it possible to boost our immune systems?

In the latest installment of Health Firsts Healthy at Home video series, theyre offering some smart but simple tips on how to stay as healthy as possible during this pandemic.

The truth is, the best strategy to safeguard yourself against sickness is prevention.

Here are some helpful tips:

Follow a healthy diet. This may consist of leafy greens, fruit and lean meats, such as chicken and fish.

Stay hydrated. Drinking plenty of water throughout the day and staying away from sugary, carbonated drinks will help to flush your body of toxins.

Controlling chronic diseases. Staying in touch with your primary care provider is important to maintain any other diseases that may compromise your immune system.

Get plenty of sleep. On average, an adult should try to get seven to nine hours of sleep per night, and children should get 11 to 13.

Try to reduce your stress. An easy way to do this could be keeping a daily routine and trying to stay positive.

Health First hopes these tips help you and your family during this trying time.

Remember, theyre here for you when you need them during this public health crisis and beyond. Stay safe and be well.

CLICK HERE FOR BREVARD COUNTY NEWS

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Health First Healthy at Home: Tips on How to Boost Your Immune System and Protect Yourself | - SpaceCoastDaily.com

Eating a "diverse and varied" diet provides the best chance of boosting the immune system to fight Covid-19, according to a scientist.

Philip Calder, a professor of nutritional immunology at the University of Southampton, has produced a report advising the public to ensure they eat a mixed diet to help combat the virus.

His research also shows that supplements are a "safe, effective and low cost way to support an optimal immune system".

A university spokesman said: "A diet with a diverse and varied mixture of vegetables, fruits, nuts, seeds and pulses, along with some meat, fish and dairy products provides the vitamins, minerals and other nutrients the immune system needs for optimal function."

Prof Calder said: "The strength of somebody's immune systems will not influence whether they get coronavirus; handwashing and social distancing are the best ways to avoid that.

"However, the immune system helps the body deal with the virus if they are infected and what we want is a system that functions properly when it's challenged with bacteria and viruses."

The university spokesman added: "Among the foods Professor Calder recommends are a variety of fruits and vegetables which are a good source of vitamins and minerals that are important for supporting the immune system.

"Foods that are high in fibre are also important as some of the undigested fibre in the gut can promote the growth of good bacteria which interact with the immune system to make it work better.

"The third recommendation is oily fish which is a source of omega 3 fatty acids that help to regulate and control the immune system.

"Finally, meat is important as a good source of nutrients such as iron and vitamin B12, so people who do not eat meat should consider supplements.

"Whilst consuming commercial probiotic products can have a role to play - by seeding good bacteria in the gut - Professor Calder recommends plant-based food and fibre as an alternative as these provide an environment to grow the good bacteria that are already in the large intestine."

Professor Calder added: "The present situation with Covid-19 shows that we cannot just rely on vaccinations to limit the impact of respiratory infections.

"Improving our nutrition is a very straightforward step that we can all take to help our bodies deal with infections and limit the emergence of new, more virulent strains of viruses.

"We therefore strongly encourage public health officials to make sure nutritional strategies are included in all their messaging about coping with viral infections."

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Top foods that will help boost immune system in coronavirus outbreak - Mirror Online

Your immune system is probably more prepared to fight COVID-19 than you think. But how does it fight a virus that our body has never even seen before? Adam Berry/Adam Berry/Getty Images hide caption

Your immune system is probably more prepared to fight COVID-19 than you think. But how does it fight a virus that our body has never even seen before?

We hear a lot about how the novel coronavirus affects the world around usthe economy, our health care system, the education of our children. But how exactly does it affect the world inside us? How do our bodies fight this virus?

Americans aren't exactly the greatest at helping out our immune systems, even in the best of times.

We sleep too little, or we change our sleep patterns day-to-day. We don't eat enough or we eat too much junk food. And right now, most of us are stuck inside, making it that much harder to exercise and stick to a routine.

Given these less-than-stellar conditions, how do our immune systems fight a virus that our body has never even seen before?

Matt Richtel helped us get to the bottom of this question. He's a Pulitzer-prize-winning reporter with the New York Times who covers business, technology and health. He's also the author of "An Elegant Defense: The Extraordinary New Science of the Immune System."

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The Battle Within: Coronavirus And The Immune System - NPR

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Scientists only became aware of SARS-CoV-2, the novel coronavirus that causes Covid-19, late last year. Most of our immune systems, meanwhile, have still never heard of it. For now, the millions of people who have been infected with the novel coronavirus have to rely on their bodiesrather than a vaccine or targeted medicationto fight off the virus.

The good news: Evolution designed the immune system to do just that. The bad news: Its response isnt always predictable. The immune system is complex in its own right, and it varies tremendously from person to person. This makes it hard to know how and when to intervene when its overwhelmed.

In order to slow the spread of Covid-19, it will be crucial to understand exactly how the immune system tackles the disease.

Scientists have the basics of the immune system down pat. With any new viral infection, the body first deploys T cells, called CD4 and CD8, which find and kill infected cells. After about a week, the adaptive immune system kicks in, using B cells to make antibodies that can flag sick cells for annihilation even faster. Those antibodies stick around after an infection is over in case of a future invasion.

That general framework can help us understand a common feature of Covid-19. A lot of people with Covid-19 have gotten sick in two waves: First, they felt tired and fatigued, but then they seem to bounce back. Basically, your T-cells kick in so people start feeling better, says Juanita Mora, an immunologist practicing in Chicago and a volunteer medical spokesperson with the American Lung Association.

That brief recovery can provide a false sense of security. T-cells may be able to keep the virus at bay for a while, but if the infection persists, the body will need to make moreeven if the specific antibodies are ready for action. When this happens, the immune system will unleash its version of a body slam: a cytokine storm, named for the chemical signals that kick-start a fever to kill off the virus. But all that heat and inflammation can be tough on vital organs, too, which can lead to especially severe reactions in people with underlying health conditions.

For all we know about this immune response, theres a lot that we still dont. We dont know how well T cells can do their jobs (age tends to make them sloppier), or when theyll deplete during an infection. We also dont know when exactly B cells will get SARS-CoV-2-specific antibodies ready to go, what level of antibodies might provoke a severe immune reaction, and how long theyll stick around in a meaningful way to fight future infections.

Knowing those details will be critical for designing the right tools to help us manage the spread and the death toll of Covid-19: tests, treatments, and vaccines. Below, we get into the immune system science guiding their design so farand what other knowledge is needed to perfect each part of the anti-coronavirus arsenal.

One of the first ways scientists can begin to understand the immune response to SARS-CoV-2 is through serology testing, blood tests that look for the telltale antibodies produced by B cells.

The tests work like this: A diluted blood sample passes over a surface studded with molecules that mimic antigens, the parts of the virus our immune system can identify. If there are antibodies in the blood, theyll bind to the antigens and cause the test to reveal a color.

Designing a test like this involves a balance between sensitivitythe ability to detect any antibodies whatsoeverand specificity, the ability to detect antibodies to this virus alone. An early Chinese-made test distributed in the US, for example, had 87.3% sensitivity and 100% specificity, meaning it wouldnt show any false positives but would miss 12.7% of cases. The first test to receive official FDA authorization, produced by Cellex, has a sensitivity of 93.8% and a specificity of 95.6%.

Regardless of accuracy, these tests are not ideal for diagnosing current infections; it can take at least a week after symptoms arise for antibodies to become detectable. But they can identify past infections, which will be key to knowing when we can relax social restrictions.

Serology surveys will be very important in understanding the extent of population immunity, and the extent to which immunity wanes over time, said Yonathan Grad, an immunologist at Harvards T.H. Chan School of Public Health. And what will happen with incidence in the coming years. The CDC and others are beginning such surveys.

But its not yet clear how long immunity to SARS-CoV-2 will last, or whether it will be the same for everyone. Studies of the coronaviruses behind SARS and MERS showed that antibodies remained in the blood for a couple years, though their power to neutralize pathogens deteriorated over time.

Data from China on SARS-CoV-2 has already shown a wide range of antibody responses. In a group of 175 patients, 70% produced a high concentration (known as a titer) of antibodies. The rest managed to fight off the infection with a minimal titer, suggesting they beat the virus with their T cell response or other parts of the immune system. Which is finebut those people may not have long-lasting immunity.

Because the concentration of antibodies detectable by a test may not be the same that can confer lasting immunity, so-called immunity passports could be difficult to implement. And even if we designed a test that reflected true immunity, its results still might not be accurate enoughthanks to a fluke of epidemiological statistics.

Zachary Binney, an epidemiologist at Emory University, explained it this way: Imagine a group of 100 people, 10 of whom are infected. You have a test that, similar to most of the serology tests being marketed today, is 90% effective in correctly identifying both positive and negative cases. That means youll get: 9 correct positives and 81 correct negatives, plus 9 false positives and 1 false negative. Of your 18 total positives, only 9 actually have the virus (and youve given the all-clear to one person who is actually infected). So a positive result is only accurate half the time. But try the math again when 40 people are infected, and the accuracy jumps to 89%.

In other words, frustratingly, more people need to catch the virus before we can have a better sense of how widespread immunity really is.

Antibodies can also be used to develop treatments for those who get sick. Last month, a hospital in Houston became the first in the United States to treat a seriously ill Covid-19 patient with plasma therapy, which delivers antibody-packed plasma from recovered patients to those still sick. Trials are now gaining steam at a handful of other hospitals in the US. As of last week, Mount Sinai Hospital in New York had accepted 125 plasma donations and administered 37 transfusions to critically ill patients.

Its still too soon to say for sure how effective those treatments have been, says Michael Joyner, a Mayo Clinic physiologist who is leading the effort. But one key benefit of plasma therapy is that you dont need to know details about the bodys immune response in order for it to work: You just trust the body to do its job, only for someone else.

But plasma donations are hard to come by at the volume needed right now. So a number of pharmaceutical companies are working to develop drugs that would replicate certain antibodies at a huge scale and pack them into shots.

The first step in that process is to study the antibodies in plasma donated from recovered patients. Some antibodies, known as binding antibodies, attach to the virus only in order to flag it for destruction. Others, known as neutralizing antibodies, attach in a way that physically prevents the virus from entering human cells and replicating.

Drugmakers usually want to focus on neutralizing antibodies. Based on their fit to the unique protein structure of the virus, some neutralizing antibodies will perform their role better than others. Some companies are choosing to hone in on one specific neutralizing antibody they think works best; others are mixing a cocktail, which may also help prevent the treatment from becoming obsolete if the virus mutates.

We also dont know which combination and concentration of antibodies could trigger the very cytokine storm and massive inflammation that patients want to avoid. That kind of reaction was documented last year in a study of lab monkeys that were given antibody drugs after being infected with the older SARS. Many of the drug companies developing antibody treatments are aiming to begin trials over the next several weeks, in the hope that a safe, effective option could be available by the fall.

Ideally, well eventually be able prevent Covid-19 infections with the help of a vaccine. Vaccines preemptively prompt the body to create specific antibodies against pathogens. When an infection occurs, the vaccine will have already eliminated the lag between the innate immune system response and the adaptive one, which targets one infection and one infection only.

As of April 8, there are over 100 Covid-19 vaccines in development, using a variety of tactics to prompt the immune system into action. Vaccines show the immune system a biological mugshot of the pathogen: Some use proteins and peptides, others use bits of genetic material encapsulated in other viruses, and others use weakened or immobile bits of the pathogenic virus itself.

Most of these targets are inspired by vaccines against similar pathogens that have worked safely in the pastor at least been heavily researched. Vaccine candidates that use benign viruses to transport bits of SARS-CoV-2s spike protein into the body were mobilized when scientists were developing an Ebola and MERS vaccine. Nanoparticles that were made to deliver lab-made antigens to target the spike proteins for SARS are being resurrected by the drug companies that abandoned them when the crisis was no longer imminent.

In theory, both of these strategies should prompt B cells to make antibodies against SARS-CoV-2, and keep them in the body long enough to prevent infections from sickening us.

But ultimately scientists dont know the details of how B cells mount immunity to the new virus. Some of the SARS-CoV-2 vaccine candidates have begun phase I trials, which look out for any dangerous side effects, but others are still in the pipeline or going through animal safety tests.

The resulting race likely wont have a single winner, but rather a handful. Its possible that out of the 50 or 80 candidates, there could be three or four that could be effective, says Mark Poznansky, an immunologist and director of the vaccine and immunotherapy center at Mass General Hospital. This is the best case scenario: More kinds of vaccines mean that more people can receive them, safely.

But testing, treatments, and vaccine development will all need to stay abreast of continual updates in our understanding of the virus.

Were after a moving target, said Poznansky. Fundamentally viruses have been infecting humans for millions of years, so its unlikely this represents a new type of battle. But because theres a lack of immunity in most of the population of humans, its like a vast, horrendous experiment on our immune systems.

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Covid-19 immunity insights will help scientists fight the virus - Quartz

Healthy immune systems can help ward off infections, health experts say.

As the coronavirus spreads across the United States, people may think about giving their bodies an extra boost.

Building a strong immune system can start at the dinner table, health experts say.

Thats because a healthy gut is key in the fight against infections, according to Orlando Health.

Adults should eat about five daily servings of produce, each one being roughly the size of a piece of fruit, the hospital system wrote on its website.

Doctors recommend eating spinach, mushrooms, strawberries and other foods packed with nutrients, such as vitamins A, C and D, according to CNBC.

Getting enough sleep is another step toward a bolstered immune system, according to AARP.

Your immune system is like your computer it needs moments of rest so it doesnt become overheated, Dr. Mark Moyad of the University of Michigan Medical Center told the organization. Sleep reboots the system.

Adults should sleep at least seven hours each night, according to the Centers for Disease Control and Prevention.

During the coronavirus pandemic, the CDC recommends people who are stressed take breaks from news about the virus, make healthy choices and talk to others they trust.

Another immune system boost can come from exercising, according to AARP. Health experts recommend working out in 30-minute sessions for five days a week.

Though gyms have closed to help slow the spread of the coronavirus, stay-at-home orders have allowed people to stay fit in outdoor spaces.

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Practical ways to give your immune system a boost - Boston Herald

This transmission electron microscope image shows SARS-CoV-2-also known as 2019-nCoV, the virus that ... [+] causes COVID-19-isolated from a patient in the U.S. Virus particles are shown emerging from the surface of cells cultured in the lab. The spikes on the outer edge of the virus particles give coronaviruses their name, crown-like. (Photo by: IMAGE POINT FR - LPN/BSIP/Universal Images Group via Getty Images)

When we get sick we trust our immune system to protect us, but what happens when that system goes awry and ends up killing patients? COVID-19 is shedding new light on how viruses can kick some patients immune system into overdrive to deadly effect in what is known as a cytokine storm syndrome.

In short, our immune system by and large is incredibly effective at working around the clock to keep a myriad of infections and diseases at bay while simultaneously being able to identify between outside invaders and our own cells and effectively prioritise what to attack and what to protect. However, occasionally, either due to genetic factors or rampant viral infections like COVID-19, our immune system can become overzealous and go rogue - attacking and killing everything in sight, including healthy cells in the body. When that happens it is referred to as a cytokine storm and it may be killing around half of severe COVID-19 patients.

Cytokines are inflammatory immunologic proteins that are there to fight off infections and ward off cancers, says Randy Cron, M.D., Ph.D, at theUniversity of Alabama at Birmingham, But when they are out of control, they can make you very ill.

It is important to note that many things have to happen before a potential COVID-19 related cytokine storm is triggered, which is why the majority of COVID-19 patients will never have to deal with the syndrome. According to the Centers for Disease Control (CDC), This first preliminary description of outcomes among patients with COVID-19 in the United States indicates that fatality was highest in persons aged:

Which means that odds are if you contract COVID-19 you will be able to ride it out at home. You can thank the immune system for that because it does not just have one means for defending you against disease, but many many tools in its tool belt to keep you alive.

Dr. Randy Cron, of the University of Alabama, is a leading researcher of cytokine storm syndrome. He explains The data out of China, as well as elsewhere, suggests that about 80% of patients can ride COVID-19 out at home because they are either asymptomatic or feel like their having something like a horrible case of the flu. Continuing, However, about 20% require hospitalization and of those 20% that are being hospitalized, it's entirely unknown what percentage have a cytokine storm so it makes it hard to gauge the mortality of COVID-19 related cytokine storms.

Dr. Cron goes on to explain that the typical mortality rates in adults who develop the syndrome ranges from 50% to 80%. Until further research is done to track COVID-19 related cytokine storm indicating symptoms along with positive cytokine indicating tests we will not yet know just how prevalent cytokine storms are in COVID-19 patients.

Our immune systems are far from simple and have a number of safe guards to keep invaders out. This can be broken down into our innate immune system and our active immune system, which is contributes to our adaptive immune response, as well as our passive immune system, which is "borrowed" from another source and lasts for a short time (for example, antibodies in a mother's breast milk give a baby temporary immunity to diseases the mother has been exposed to).

Put (very) simply, the innate immune system response relies on the use of physical barriers like our skin and mucous membranes, coupled with our first responder defenders like phagocytes, antimicrobial proteins, and attack cells. The innate immune system response is why, for example, we get a stuffy nose and sneeze when we have a cold, or why a scrapped knee gets red, hot and inflamed, as well as sometimes filled with pus. By and large, this first defense is effective and may be why many people who contract COVID-19 are asymptomatic.

However, when the innate immune system isnt enough it calls on our second line of defense; the active immune system. This is typically when the inflammatory response gets kicked into higher gear and you develop a fever, which triggers a number of your bodys chemical alarms that call the active immune system to action and increases the metabolic rates in cells, thus allowing them to heal faster, as well as making it easier for a variety of immune response cells and proteins to do their jobs faster and more effectively. This is also when people start feeling body aches associated with COVID-19 and other viral infections.

The active immune response is both complex and elegant and (again put very simply) not only identifies and fights off viruses like COVID-19, it also remembers these viruses so it can quickly and effectively combat and neutralize them in the future, thus creating immunity. This is why vaccines are one of the more amazing developments of modern medicine. So if all goes well (or relatively well), then our immune system will protect us and we will live to tell the tale, but what happens when things start going awry?

Viruses like COVID-19 have a devious trick up their sleeve when it comes to making us sick; in a sense, they use human cells to shelter and reproduce. When COVID-19 is searching the body for a cellular host to attach to it is fairly exposed and it is easier for our active immune response to target and kill them. COVID-19 wants to do three things when it enters our body; find protection, reproduce and spread. Our cells offer the perfect environment for COVID-19 to do all three. So COVID-19, which targets the respiratory system, attaches and infiltrates our respiratory cells where it can more effectively hide from our immune system early on and reproduce. The infected cell will then spit out more of the COVID-19 virus that will repeat the process. This is where the battle royale of our immune response kicks off with our cellular immune response.

Yet again put very simply, our body has a special cell called the T-Cell, which has a variety of forms that it exists in to combat infection. When T-Cells are activated they release cytokines (yes, that cytokine), which trigger additional T-Cells to be made, which then release even more cytokines. One type of T-cells that are created are called cytotoxic T-cells. Cytotoxic T-cells are the cells that are able to roam the body and mercy kill infected cells who are chemically calling out to be killed and ideally to stop the increased production of viruses like COVID-19.

When your body responds the way it is supposed to, the cytotoxic T-cells will only target infected cells to be killed and move along. Additionally, the immune response also has a chemical indicator that ideally tells overzealous immune response cells to stand down once the threat has been neutralized. It is when we are in the throes of a cytokine storm that those systems start to get overwhelmed and malfunction. In essence, our bodys immune response gets so amped up that it stops differentiating between infected and healthy cells and attacks everything in its path. For obvious reasons, this is very bad for patients because not only is the COVID-19 virus killing the cells in our bodies, now our immune system is too.

Dr. Randy Cron and his colleagues began recognizing instances of cytokine storm syndrome in the early Chinese reports of COVID-19. The way we are seeing cytokine storms manifest in COVID-19 patients are that we are typically seeing a fever and some degree of respiratory distress. He says, However, we are also seeing patients who look like they're in septic shock and become hypotensive as they get sicker. He explains that many COVID-19 patients also have bleeding or clotting abnormalities as well saying, COVID-19 seems to have a really high propensity to lead to clots either in deep veins or in the brain or in the lungs, for example.

Cat Scan. Pneumocystosis In Right Lung. Pneumocystis Carinii Interstitial Pneumonia. (Photo By ... [+] BSIP/UIG Via Getty Images)

However, most notably, COVID-19 patients are most often dying of acute respiratory distress syndrome (ARDS), which indicates that COVID-19 related cytokine storms, like the virus, are focused in the lower lung. This leads to the instances of acute pneumonia and the need for intubation and ventilator use. It also means that patients are dying of cytokine storms faster in instances of COVID-19 than other infections.Most cytokine storm related deaths happen as a result of multi-organ failure, which is why it has such a high mortality rate. Says Dr. Cron, However, with COVID-19 we are seeing people die from pulmonary complications typically before the multi-organ failure can set in. It may just be that patients are getting so sick with their lungs that they're already deathly ill before the rest of the syndrome develops. No one really knows.

Our understanding of cytokine storms is relatively young within the medical field and most of the literature around the syndrome did not take off until the 1990s. There are a lot of people who, both in the lay community and the medical community (particularly if they were trained a longer time ago), that are unfamiliar with cytokine storm syndrome. says Dr. Cron, This syndrome occurs unfortunately every day in ICUs, both in pediatrics and adults across the planet, as a result of a whole variety of conditions that go under-diagnosed and therefore under-treated. However, COVID-19 is changing that.

Luckily, the tests to diagnose cytokine storms are often cheap and readily available in hospitals. Dr. Cron explains that when patients are in throes of a cytokine storm, You will notice an elevation in the serum ferritin, a protein in the blood. Usually the value is less than 200 nanograms per ML and for COVID-19 related cytokine storms, it tends to run between 500 to the low thousands. The test to measure serum ferritin is cheap, readily available in most hospitals, and has a fast turn-around time. If a patients serum ferritin results are elevated, then it is a good early indicator that further testing is needed.

A complete blood count or CBC is a really common standard test. says Dr. Cron, And COVID-19 patients, for whatever reason, seem to be very lymphopenic, meaning their lymphocyte count tends to be less than a thousand per microliter. Continuing that, We don't know if it's more of a cytokine storm feature or just the virus itself, but it certainly suggests that you're not going to do well.

Cytokine storms also can be indicated by liver enzyme abnormalities. The liver gets very unhappy with the cytokine storms and as a result liver enzymes will go up, says Dr Cron, We see also an increase in a protein called D dimers and lactate dehydrogenase (LDH) levels also tend to go up as well. So luckily, despite the relative youth of the field, there are relatively straightforward indicators to diagnose and therefore treat cytokine storms.

There are also a few effective treatments for cytokine storms despite the fact that we still do not know exactly which treatments will ultimately be developed and recommended across the board for COVID-19 related cytokine storms. There's always kind of this push pull between doing no harm and trying therapies that haven't been tried for this disease because it's new to mankind. says Dr. Cron, It's hard to watch people dying in front of you so if you can intervene in some way to help stop that, then that's what doctors are going to do and why some of our colleagues are trying to treat COVID-19 related cytokine storms with just any approach that seems reasonable based on how theyve treated other cytokines storms in the past.

A chemist displays hydroxychloroquine tablets in Kolkata,India on April 10,2020. Amidst concerns ... [+] over domestic shortage, India has lifted the ban on some drug exports including hydroxychloroquine. (Photo by Debajyoti Chakraborty/NurPhoto via Getty Images)

Among other therapies, a few that have recently gotten attention (controversially or otherwise) are hydroxychloroquine and a drug called Actemra. While hydroxychloroquine has been touted by President Trump repeatedly, hospitals have reported mixed results. As Forbes contributor, Anita Bartholomew explains, One of the mostdramatic press reports of apparent successcame from a skilled nursing facility for veterans in Lebanon, Oregon. A doctor treated eight elderly veterans with a combination of hydroxychloroquine and azithromycin (an antibiotic thats been used in tandem with the anti-malarial, and in a French study, showed better results than hydroxychloroquine alone). One died, but the others recovered, including a 103-year old who was seriously declining prior to getting the medication, and survived to celebrate his 104thbirthday on April 1, 2020.

Actemra is a drug that was designed to treat rheumatoid arthritis, but was also approved in 2017 to treat cytokine storms in cancer patients. Actemra was recently successfully used to save a Seattle emergency room doctor who was near death after he contracted COVID-19.

Additionally, There are both broadly immunosuppressive approaches, such as high-dose corticosteroids, and more novel targeted approaches that go after inflammatory cytokine proteins, Dr. Cron said in a Q&A, While we are attempting to develop vaccines for COVID-19 and are trialing novel or re-purposed anti-viral therapies for COVID-19, let us also not forget to treat the patient with all we have to offer to help save lives. We need to address the immediate needs for the significant numbers of patients becoming critically ill in the current pandemic.

While cytokine storms are admittedly terrifying, there is still some hope for COVID-19 patients who develop the syndrome. Now that physicians are more aware of the syndrome and how to identify and treat it we are on track to develop more effective therapies and fail safes that can save more and more patients as the COVID-19 pandemic develops and (eventually) subsides.

Full coverage and live updates on the Coronavirus

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What Is The Cytokine Storm And Why Is It So Deadly For COVID-19 Patients? - Forbes

PALM BEACH, Fla.--(BUSINESS WIRE)--Stress is a part of life for many of us especially now more than ever. Whether we are having trouble adjusting to working from home, caring for a sick relative or home-schooling children, it seems everyone is experiencing some form of stress during this global health crisis. However, science tells us that extreme amounts of stress and sleeplessness can suppress our immune system and make us more vulnerable to illnesses.

Its well established, scientifically, that chronic stress and sleeplessness can significantly blunt the immune system. Right now, Americans are experiencing extraordinary stress at a time when compromised immunity can be devastating, said Dr. Richard Cartledge, Chief of Cardiovascular Surgery at Boca Raton Regional Hospital and inventor of Xen by Neuvana. One of the most remarkable ways known to combat your bodys stress response is through electronic vagus nerve stimulation. We created Xen by Neuvana to make this previously inaccessible technology available to everyone.

People are feeling the effects of stress more than ever

Chronic stress, worry, and lack of sleep negatively impact our immune system, throwing it off balance and increasing the risk for development or worsening of diseases. In these challenging times, people are experiencing new stressors from job security to taking care of children out of school and adjusting to working from home. In a recent survey by Neuvana, more than half (51%) of Americans said working from home adds to their feelings of stress.

Isolation can take its toll, as well. Social interaction may indirectly strengthen immunity, as friends typically help with encouragement of healthy behaviors and help buffer the stress of negative events. Studies have shown that individuals who are socially isolated are approximately 2-2.5 times more likely to have clinically high levels of C-reactive protein, which measures inflammation as a sign of stress in the body, as opposed to those who are socially well integrated.

The chronic stress we are experiencing these days can have many short- and long-term effects suppressing immunity, decreasing the number of immune cells and increasing the number of immunosuppressive cells. In the short and medium term, it can create social anxiety, sensitivity to pain, disrupted sleep, chronic pain, depressed mood and social withdrawal. And in the long term, individuals under chronic stress are more likely to experience susceptibility to infection, inflammatory diseases, accelerated aging and early mortality. Cortisol, the bodys primary stress hormone, is produced in abnormally high amounts during chronic stress, which can depress the immune system.

Managing stress and getting enough sleep can help us to fight off illness, to lower the risk of diseases and may even help enhance our response to vaccinations. One way to help boost your immune system, right now, at home, is through vagus nerve stimulation (VNS).

What is Vagus Nerve Stimulation (VNS)?

Your brain and body are designed to self soothe during or after stressful moments. Your parasympathetic nervous system kicks in to balance the stress response and promote relaxation by slowing your heart rate and breathing and the vagus nerve plays a key role in coordinating this response. While stimulation of the vagus nerve has become a more common topic in recent years, humans have practiced forms of vagus nerve stimulation for centuries through meditation, yoga, mindfulness and deep breathing exercises. When toned or strengthened just like a muscle, the functions of the vagus nerve can be amplified bringing on feelings of calm, boosted mood and better sleep.

Neuvana brings the benefits of VNS home

Neuvana a team of physicians, expert engineers and wellness practitioners has found a way to bring the calming effects of VNS through Xen a new wellness device that safely and gently tones the vagus nerve for better sleep and reduced stress and anxiety.

Xen by Neuvana works by sending a gentle, calming electrical signal via patented earbuds to the part of the vagus nerve located in the ear. This promotes relaxation during any activity - even while social distancing - like working from home, after a yoga session, reading a book to the kids before bed, or listening to music. Regular use delivers maximum benefits, often with just two 15-20-minute sessions a day.

In light of Aprils Stress Awareness Month and this global health crisis, the team at Neuvana want to make VNS more accessible and are offering the Xen Box Set for $329, a $70 discount off MSRP through May 15, 2020. Additionally, for every unit sold, Neuvana will donate $20 to Feeding Americas COVID-19 Response Fund. For more promotional information, and other stress relieving and wellness tips, please visit http://www.neuvanalife.com.

Xen by Neuvana is available for order today with an optional monthly premium app fee of $3.99. All users will receive a 60-day free trial of the premium app, which includes additional waveforms and signals. Neuvana offers a 30-day money-back guarantee if not fully satisfied.

Media members interested in more information or executive interviews may contact Neuvana@maxborgesagency.com. Press kit can be found here. Detailed feature and tech spec list can be found here.

This product is for healthy users interested in potentially improving their general wellness. Individual results may vary. Neuvana offers a 30-day money-back guarantee if not fully satisfied.

About Neuvana LLC.

Neuvana is a South Florida-based brand at the intersection of wellness and technology, continually striving to improve peoples lives through accessible Neuroscience. Founded in 2014 by Dr. Richard Cartledge, an avid inventor and Chief of Cardiovascular Surgery at Boca Raton Regional Hospital, the company is made up of physicians, intellectual property experts, engineers, experienced business professionals and a world-class scientific advisory board with a shared goal: a platform to make the wellness benefits of neuroscience safe, easy and accessible to everyone.

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Lack of Sleep and Chronic Stress Hurt the Immune System: Here's How Vagus Nerve Stimulation Can Help During a Global Pandemic - Business Wire

Most of us actually already know how we can strengthen our immune system, by simply eating foods that are high in nutrients, getting regular movement and exercise, getting enough vitamins, and so on. We are living in a very toxic world and we need to protect ourselves and eliminate any disease by taking better care of ourselves. Sometimes it takes an extreme situation like we have right now to make us more aware of our health.

Viruses and bacteria are two types of potentially disease-causing (pathogenic) particles. Viruses are much smaller than bacteria and can be transmitted in a variety of ways. Coronaviruses are a group of viruses that usually cause mild illnesses, such as the common cold. However, certain types can infect the lower airway, causing serious illnesses like pneumonia or bronchitis. Most people will get infected with a coronavirus at some point in their lives and the majority of these infections are harmless.

There are countless things that can weaken our immune systems and prevent our bodies from fighting off viruses. For example, being sedentary, consuming a lot of added sugar (such as in baked goods or sodas), being overweight, having type 2 diabetes or an existing disease such as heart or lung and respiratory conditions, autoimmune disorders, and issues related to gut health and nutrient deficiencies, especially protein, zinc, vitamin A and and vitamin D. All these high risks can weaken our immune system, as well as countless others including smoking, stress, and insomnia. In other words, a lot of people can suffer from a weakened immune system.

So how can we strengthen it?

Lets start first with exercise. Even without going to the gym, just being active during the day will help you boost your immune system. If youre able to get outside then, for example, simply going for a walk, maybe a 15 minute walk twice a day or a 30 minute brisk walk can have a very positive effect. If the current situation is preventing you from going outside then even in your home you can get some good exercise. You really dont need equipment, your own body weight is more than enough. You can also be creative and instead of weights and gym equipment you can use things like water bottles, bags of cat foods, a chair, a cushion etc. Start looking at your home as if it was a fitness center and you will be surprised what you can do!

The second major factor is our added sugar intake. I have talked a lot about this in my previous articles as sugar is one of the most important factors that can affect our immune system by damaging the gut. And in addition, of course, overconsumption of added sugar, over long periods of time, is associated with being overweight or obese which are risk factors for a wide range of health problems. But even if you are not overweight, excessive sugar consumption has been linked to chronic diseases including type 2 diabetes, heart disease and liver disease. Sugar is a simple carbohydrate (monosaccharide) and also comes in many different forms including glucose (which occurs naturally in fruits and plant juices), fructose (which occurs naturally in fruits, some root vegetables, cane sugar and honey), and galactose (which combines with glucose to form lactose). For example, eating a whole apple versus drinking apple juice will have two very different effects on the body (yes, eating the whole apple is definitely better!).

Other major factors include insomnia and stress, which are both equally important and really can not be separated from each other. When you are in high stress you will be restless and can often not sleep well either. On the other hand, if you have insomnia then eventually you will have stress by increasing cortisol levels, which is a stress hormone. When we stress the body we suppress the immune system because the body thinks that its the time to be alert, and not the time to repair and heal ourselves. When we are not getting enough rest or sleep, we can not repair our body to help keep it in balance or homeostasis.

What about nutrient deficiencies? Proteins are the building blocks that help our bodies repair. Protein deficiencies tend to be hidden for so many people, you may be thinking that you are getting enough protein but bioavailability (such as over-cooked plant based protein) or any digestion problems can impair the absorption. Finding yourself feeling tired often, or losing your hair, can be a sign of protein deficiency.

Zinc deficiencies are common, and zinc is necessary to build our bodys defenses, so a deficiency can increase the risk of infectious diseases. Also, zinc is necessary for the production of the hormone thymulin, which is important for the maintenance of various immune functions. Eggs, meat, shellfish and seeds are excellent sources of zinc.

Vitamin D, the sunshine vitamin or hormone, has well documented benefits, such as improving our bodys defenses, enhancing vitamin A, improving gut microbiota, reducing systemic inflammation, improving mood and sleep, improving muscle strength and reducing respiratory infection. So make sure that you are getting enough sunlight, and in addition you may need vitamin D supplementation. Beef liver, fatty fish, egg yolks and cheese, and of course sunshine, are good sources of vitamin D.

Vitamin A is crucial for maintaining vision and promoting growth and development, and is also known as an anti-inflammatory vitamin because it plays an important role in enhancing immune function. You can find it in foods such as beef liver, salmon, sweet potatoes and carrots.

And selenium is another important nutrient that we should not forget. It is a potent nutritional antioxidant and strongly influences inflammation and immune responses. Brazil nuts, sardines, tuna and shrimp are high in selenium.

The bottom line is that we can not control what is coming from outside, although we still can have an enormous control of our health by taking care of our body and our mind. Dont forget, taking action and preventing yourself from getting a disease or illness is so much better than waiting until you have something before you take action. We should all act now and change our lifestyle for better health.

Resources:

https://www.nhs.uk/conditions/coronavirus-covid-19/

https://www.medicinenet.com/viral_infections_pictures_slideshow/article.htm

https://www.sciencedirect.com/topics/immunology-and-microbiology/rna-viruses

https://www.ncbi.nlm.nih.gov/pubmed/16877062

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4763971/

http://sugarscience.ucsf.edu/

https://www.webmd.com/cold-and-flu/cold-guide/10-immune-system-busters-boosters#1

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1379072/

https://www.health.harvard.edu/staying-healthy/how-to-boost-your-immune-system

https://www.apa.org/research/action/immune

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6162863/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2759054/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3723386/

https://ods.od.nih.gov/factsheets/Selenium-HealthProfessional/

Ayda Ersoy, Nutritionist (Dip.C.N., Dip.S.N.), Master Trainer (CPT ACE, NCSF, CanfitPro), Registered Yoga Teacher, Founder, Health Angel Nutrition, Fitness and Wellness, Founder, SMS (Stability, Mobility Strength) Intuitive Training System.

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What could weaken your immune system, and how to strengthen it - Thegardenisland.com