Severe COVID-19 Can Stimulate an Immune Response Akin to Lupus

Severe COVID-19 cases can stimulate an "exuberant" overreaction of immune cells in which the body's immune responses could be compared to a "rushed riot" rather than a well-organized army.

In their new research, scientists focus on how such a reaction is startlingly similar to the severe outbreaks observed in people with lupus. During this long-term autoimmune illness, the immune system of the body attacks healthy tissue by mistake.

Atlanta-based Emory University immunologists investigated the B cells' activation patterns, an essential type of immune cell that generates antibodies "to target and neutralize entering pathogens."

Specifically, the immunologists studied 19 patients with COVID-19, four of whom died later, and compared them to 37 healthy individuals.

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The B cells are abnormally stimulated and prevent this quality control, generating “auto-antibodies” that respond from cells in the body.

Study Findings

Authors of the study said their findings "go some way to explaining why some COVID-19 patients" generate antibodies to the virus, but still encounter poor outcomes.

In their report in the Nature Immunology journal, the study authors noticed that in individuals with COVID-19, B cells promptly flooded the body through what they described as an "extrafollicular pathway," a fast-track pathway type for the production of antibodies.

The immunologists also explained that B cell mutation could take weeks at times, which is quite long when the body experiences an aggressive inflammation so that the immune system can react with this pathway in time for an emergency.

The study also found that while pumping the body with fast-acting antibodies is beneficial for fighting infection, it seems that some of the antibodies are susceptible to attack the host's healthy cells.

Essentially, the research specified, "B cells miss some of their training and fast-track antibody response skims" on quality control, enabling the badly-trained B cells' production that can wrongly target the own tissue of the body.

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Response Seen in Lupus

Immunologists also noted that their finding is highly indicative of the reaction seen in SLE systemic lupus erythematosus, also known as lupus.

In this condition, the B cells are abnormally stimulated and prevent this quality control, generating "auto-antibodies" that respond from cells in the body.

This leads to symptoms like fatigue, joint aches, skin rashes, and kidney disease, which worsen when the body is faced with a flare-up.

Based on results, the study authors say, it confirms the understanding that immunomodulatory drugs, drugs that modify immune reactions, are essential tools in treating COVID-19 cases.

The 'Cytokine Storm'

This said research is the most recent to show how COVID-19 can activate an uncoordinated immune reaction, which can help explain why the illness impacts people so severely.

Most remarkably, several clinical studies have described what's called "cytokine storms" in which there is an overreaction of the immune system, trying to control the infection and discharge a lot of pro-inflammatory cytokines.

Such an attempt can result in hyper inflammation, leading to dangerous blood clots and multiple organs' inflammation. Nonetheless, it stays unclear the reason SARS-CoV-2, the virus accountable for COVID-19, aggravates this unfamiliar body reaction.

After all, numerous disgusting inflammations do not have such an effect. It is uncertain too, why some individuals have this unusual immune reaction.

According to Emory University's Ignacio Sanz, the study's co-senior author, not all severe inflammations do this. Sepsis, for one, "Does not look like this."

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