Covid19 needs no introduction....but can this virus trigger Autoimmunity?
It is well known that infections can act as an environmental trigger in the complex pathophysiology of Autoimmune diseases. This is especially true in genetically susceptible individuals, through mechanisms such as molecular mimicry.
Molecular mimicry is when the immune system mistakes the molecular structure of a micro-organism's surface antigens for the body's own cells and tissues, and starts to attack 'self-tissue' causing Autoimmunity. In a recent research paper, Vojdani et al. (2020) identified cross reactivity of the SARS-CoV-2 coronavirus with 28 out of 55 human tissues. This suggests that antibodies generated in response to SARS-CoV-2 coronavirus may be cross reacting with human 'self tissue', these are called autoantibodies. Other studies have identified 'organ specific' or 'systemic' autoantibodies in patients after Covid-19 infection. Examples include; Antinuclear antibodies, Rheumatoid Factor and Phospholipid antibodies, which are implied in Autoimmune diseases such as Lupus, Antiphospholipid Syndrome and Rheumatoid Arthritis. Common Autoimmune conditions seen in patients after Covid-19 infection include; Guillain-Barre syndrome, Kawasaki disease and Antiphospholipid syndrome.
Current research has also identified that inflammation and dysregulated immune responses following SARS-CoV-2 infection may impair immune tolerance and prompt other environmental triggers to cause Autoimmunity. There are more and more cases becoming apparent of patients developing Autoimmunity after Covid-19 infection and there is increasing concern voiced by world-leading immunologists that we could see a devastating epidemic of autoimmune diseases in the near future.
Covid-19 Vaccine
Patients with Autoimmune diseases may be wondering if the vaccine is safe? Or even if being on immunosuppressants, would they respond to the vaccine? The answer to these questions will always be 'each patient's biology must be analysed in detail to ensure the correct measures are taken for them'. You cannot take two different people with different immunotypes and apply the same treatment, especially in Autoimmunity.
Vaccine-associated autoimmunity is already well researched. Not only the vaccine antigen itself but also the adjuvants included in vaccines, can trigger Autoimmunity. An ingredient in the vaccine could trigger an inflammatory response, which could stimulate a flare of existing autoimmunity. This isn't high risk, as patients with autoimmunity are always at risk for inflammation-mediated flare activation from food, stress, etc.
The main concern maybe that antibodies to the spike protein that the vaccine induces could cross-react with self-tissue. However, if instead the patient was infected with the actual SARS-CoV-2 virus this would bring with it not only the spike protein but all other protein sequences (all other epitopes) of the virus. Hence the patient would be exposed to the risk of cross-reactivity from every one of those epitopes, not just the spike protein epitopes. The risk of getting the full blown disease v the risk and benefits of being exposed to vaccine must be weighed up and considered individually for people with dysfunctional immune responses such as Autoimmunity.
For those that are immunosuppressed, the bottom line is to test for SARS-CoV-2 S1/S2 IgG antibodies or continue social distancing measures. These are neutralising antibodies against the spike protein. The absence of these antibodies doesn’t prove the patient doesn’t have immunity. However, if the patient is taking T or B cell inhibitors, they may be less likely to have competent T and B cell mediated immunity.
On a final note, it is recommended that any vaccinations should be preferably made when Autoimmune disease activity is under control and when there is no known concurrent infection, as adding to the pot when the patient is having a flare, could exacerbate symptoms.
Working with an experienced practitioner can help you to understand your underlying Autoimmune mechanisms allowing you to assess your individual risk/benefit to getting the vaccine or recovering from Covid. Also, recommendations to naturally support your antiviral response through the prevention, infection and recovery stages of the disease and in preparation of the vaccine, can be extremely useful. Please get in touch today, if you would like support www.autoimmunutrition.com.
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