New facts about how our body fights COVID-19, cell-based immunity and vaccinations

Essays > Health

An essay by Puri (Puri Rüdiger Fey MD) that sheds light on immunity and the vaccines that are being researched.

Tuebingen covid research

Due to the nature of the subject and ongoing changes in scientific results, please note the date of publication of this article.

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Research study of the University Clinic in Tübingen

This article is based on the research study of the University Clinic in Tübingen, Germany which is freely available at researchsquare.com. I have tried to put the abstract into a language for non-medical readers, adding a few basic facts necessary to understand it, and provide some information about the three types of vaccines that I know of, out of the many that are in preparation.

The publication of this study, previewed on June 16, seems to have changed our understanding of our immune reaction to SARS-CoV-2 (Severe Acute Respiratory Syndrome CoronaVirus 2). These same researchers had already come to the conclusion, while studying SARS-1 (another coronavirus that had caused outbreaks in South East Asia in 2002–2004), that immunity via antibodies against coronaviruses is short-lived – which is a huge problem for vaccinations – and have therefore focused their research on the cellular immune response.

Short introduction to our immune system

First a short general orientation to what a virus is, how our immune system is structured and about the difference between antibodies and cellular immune response in a very simplified manner:

A virus is not a living thing like other germs are; it cannot produce energy by itself and to reproduce it needs a host, an alive cell. It takes part in an alive process only while it is hosted by a cell.

Our immune system consists of

1) Mechanisms we are born with. This innate immune system works

a) with soluble substances in an unspecific way, similar to disinfectants and

b) with microphages, the cells that make up the majority of our white blood cells which work in a way similar to a garbage company.

Macrophages have the task of coordinating these two parts of our immune system. They are present mostly everywhere in the body (in the blood they are called monocytes).

Chronic diseases and advanced age weaken the innate immune system. There is strong evidence from field research that live vaccines boost it, while inactivated vaccines have a depressing effect. (You can read about Peter Aaby on Wikipedia. Also available is a recent comment by him on these observations: www.sciencedirect.com)

2) Secondly, there is another mechanism, the adaptive immune system that can learn to fight in very specific ways against things alien to our body like viruses, bacteria and other microbes as well as transplants and cancer cells. This system needs training and that’s why as toddlers we fall ill again and again until this part knows all the stuff that’s around us. A vaccination is meant to train this system in a less challenging way. This adaptive immune system consists of

a) B-cells that are able to produce antibodies, which are the soluble response to an infection, and

b) T-cells that carry out the cellular response.

B-and T-cells are lymphocytes.

Antibodies are the first line of defense in the body. They mostly consist of proteins that can tie two viruses together. If there are enough antibodies, the viruses will be linked together in clots and can therefore no longer be infectious. In the case of coronaviruses, the antibodies aim at the proteins that make up the spikes. A few weeks after the initial infection is over, the concentration of antibodies will decrease and we can again be infected by a high virus load.

When there are no antibodies present or not enough to ward off the infection, the body uses a different strategy to prevent the virus from spreading inside the body: the cellular defense through T-cells. We have two kinds of T-cells: the helper cells and the killer cells.

In the course of an infection both types of T-cells are being imprinted by parts of the virus – and they have a long-term memory! Their imprints however, do not only come from the spike proteins, but also from areas on many proteins that are produced during the reproduction of the virus. The imprint on the T-cells can of course not be seen in the blood serum since they do not produce antibodies.

Whenever a cell makes proteins it will always produce ‘garbage’ and will put it outside, just as we do. If the cell has been infected and is now reproducing the virus’s RNA and its proteins, then this garbage will clearly tell us that there has been a virus infection. The helper cells are the ones to check this garbage; it’s their job.

If, because of its imprint, a helper cell recognizes the garbage as virus material, it uses chemical messengers to call its partners, the T-killer cells with the same imprint, out of their ‘barracks’ in the spleen or sometimes in the lymph nodes. The T-killer cells will also recognize the sick cells that have in fact become virus factories and will destroy them. Thus the virus production is stopped.

Different coronaviruses are much more similar to each other in the way they reproduce themselves than they are in the way they connect to the host cells in order to infect them. That’s why the T-cells are able to recognize the garbage of SARS-CoV-2 proteins after they have been in contact with some of the other four types of coronaviruses that are able to infect humans. These other corona types are well-known and cause about 30% of common colds. The more of these four virus types the T-cells have met, the higher will be the immunity.


Back to the research study of the University Clinic in Tübingen

In their study, the researchers from Tübingen have isolated T-cells from the blood of individuals who had gone through a mild case of COVID-19 and then checked their reaction to SARS-CoV-2. As expected, close to 100% of these T-cells recognized the virus and reacted.

They then thawed blood samples, taken in 2007 and following years, when this new virus did not yet exist and isolated their T-cells. When they checked to assess if those T-cells could recognize SARS-CoV-2 they found that 81% of the T-cells were able to recognize the new virus and react. The strength of their reaction depended on the number of stimulated memories in the T-cells.

This fits beautifully with the observation that around 30% of people infected with SARS-CoV-2 have light symptoms and around 50% have none at all. Around 5% of cases need hospitalization and up to 1% need intensive care. In the most severe cases something that is called a cytokine storm can happen; and whenever patients die this is mostly the cause.

In a cytokine storm the macrophages apparently put out a flood of inflammation inducing chemical messengers, the cytokines, and inflammations flare up everywhere in the body. This means that these patients die in fact from an over-stimulation of their adaptive immune system. As long as the innate immune system is still functioning well, it seems is prevents a cytokine storm.


My conclusions at this level of understanding

1) Only individuals with several pre-existing chronic diseases can have a really serious course of the illness, especially if they are of advanced age.

Vaccinations should only be developed for this group, because for them the infection must be prevented. For all others this is not necessary since they are already protected by their T-cells. Vaccines for the high risk group need to be well tolerated and should not cause an additional health challenge. That’s why they should be thoroughly tested and safe and must have proven their value for this group. It’s not enough to test them on young male volunteers!

2) We should not just wait for vaccines against COVID-19 to become available but rather focus on medications that are able to:

  • attack the free virus (before it has docked onto a cell) or
  • prevent it from attaching itself to a host cell or
  • block the mechanism of virus reproduction or
  • block the mechanism of virus release from the cell

All this is certainly not in line with the interests of the pharmaceutical industry, but it makes much more sense medically than mass testing and mass immunization.


My view on the vaccines

Lastly, a comment on the many types of vaccines the pharma giants are racing after (about 300 labs are working on them). Some of them are absolutely unknown and nobody can tell what they will do in a human body. I can only talk about three methods I happen to know about.

1) There is the classical inactivated vaccine that takes parts of the spike protein and combines them to a toxic substance as an adjuvant in order to cause a reaction of the immune system that otherwise would not produce antibodies without this toxin. As told above, this goes with a depression of the innate immune system.

2) Then I heard of an absolutely new approach: genetic information for the spike protein of SARS-CoV-2 is transferred into the gene of a harmless cold virus, thereby producing a living virus of low pathogenicity that could be used as a vaccine. It needs thorough testing, of course, and that will take years, but it might be a way of getting away from inactivated vaccines.

3) The attempt out of Oxford to inject, as a vaccine, the piece of RNA that codes the spike protein of the coronavirus, thus forcing our muscle cells to produce it, appears very dangerous to me – and not only to me. Being alien to our body, the spike protein is supposed to cause the production of antibodies that should prevent infection. But what if the T-cells pick up on the protein and start attacking the muscle cells? I see a high risk in that it can cause an autoimmune disease. (The first tests of this vaccine caused, in 25% of volunteers, massive reactions with high fever, fatigue, heavy headaches, exhaustion and extremely painful effects on the spot where the injection was given. That’s why from then on the injections were combined with Paracetamol to cover up these side effects.)

I hope that this information may strengthen your trust in healthy living and your body’s immune responses, and relax any fear you may have absorbed from public discussion.

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Puri

Puri is a semi-retired GP with psycho-somatic focus. He is based in Germany.

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