Will the Concept of Immunity Give Rise to a Vaccine

A recent study conducted by Peter Doherty Institute of Infectious and Immunity and the Royal Melbourne Hospital in Australia mapped the immune system’s fight against COVID-19 and how this can help in giving rise to a vaccine. A 47 year old woman with moderate symptoms of COVID-19 was hospitalised in the Royal Melbourne Hospital. Her blood sample was collected at four different time points and the immune response was observed. While she looked ill, her body was fighting back well and that proceeded to a clinical recovery. This was similar to the recovery seen in Influenza which also happens to belong to the same family of Coronaviruses. This understanding of the immune response is a blessing indeed and it can help in the preparation of a vaccine and will help to further understand why some outcomes are fatal.

Sharon Lewin, director of the Doherty Institute said, “"It shows that the body makes a very good and powerful immune response to the virus and it is associated with symptom clearing”.

The immune system is the body’s army with various cells acting at various levels to protect the body from a foreigners attack. Now the body has two different types of immune systems- Innate and Adaptive immune system. Innate, as the name suggests is what you are born with. Adaptive is what you develop in response to pathogens you encounter in your life. For example, Chicken Pox. The body fights the virus and creates a memory of how it fought, that the next time you encounter the virus, the body knows how to deal with it. From the above study, it is clear that our immune system has the ability to protect one from COVID-19. It is therefore important to keep the immune system strong.

When the body is attacked, the front line of the immune system being the leukocytes fights the pathogen and this fight can last for a few minutes to hours. The second line of attack is the B and T cells (those that produce the antibodies).

Older people generally tend to have low immunity compared to the younger crowd due to the reduced production of T and B cells and cytokines. With COVID-19, there is an increased rate of death occurring among the older generation. One of the reasons behind this is comorbidities. Also, a young person can die due to COVID-19 if he has other health issues which means he already has a weakened immune system and thus his body is unable to fight the virus. The other reason is the fact that they have reduced B and T cells, the frontline attack lasts for too long and thus the system goes on an overdrive. When this happens, the system is unable to distinguish between the body and the enemy and ends up attacking the body causing an auto-immune attack.

George A Kuchel, the Chief of Geriartic Medicine from University of Connecticut says “With the flu, younger people have a stronger immune memory than older people — their T cells and B cells primed to attack if a flu virus they contracted decades ago returns. If immune memory for coronavirus resembles that for flu, then young people will be much more protected when it comes back.”

There are certain factors that contribute to a healthy immune system such as eating a balanced meal, sleeping enough, maintaining an active lifestyle.

Inclusion of vitamins in your food is crucial. Vit D was used in the treatment of tuberculosis in the early 1950’s (1). Vit D is used to treat many respiratory illnesses, especially influenza. Vit D deficiency predisposes children to respiratory infections. Vit D is able to stimulate the expression of antimicrobial peptides in neutrophils, monocytes, natural killer cells and the cells that line the respiratory tract. Vit A is known as an anti-inflammation vitamin because of its critical role in enhancing immune function. Vit A is involved in the development of the immune system and plays regulatory roles in cellular immune responses and humoral immune processes (2). Vit C deficiency is associated with pneumonia. Vit C can shorten the periods of cold (3). Vitamin deficiency is not just the non-inclusion of vitamins in food but the inability to absorb the vitamins in the food. A well nourished person can suffer from vitamin deficiency. So this relates to lack of proper digestion. Those who have irritable bowel syndrome suffer from vitamin deficiency. Zinc is crucial for normal development and function of cells mediating innate immunity, neutrophils, and NK cells. Macrophages also are affected by zinc deficiency (4).

Vit A rich foods- Sweet Potatoes, carrots, spinach, broccoli,
Vit C rich foods- Citrus fruits, cauliflower, brussel sprouts, capsicum, papaya, strawberries
Vit D rich foods- Kale, Okra, dairy products like milk and curd, oatmeal, white bean.

Having an active lifestyle with moderate exercises boosts the immune system. A study by Neiman et.al., shows that acute exercise is an immune system adjuvant that improves defence activity and metabolic health and that illness risk is increased in athletes during periods of intensified training and competition (5). However, an increase in carbohydrates and polyphenols in athletes' diets is a good nutritional strategy to enhance the immune system. An earlier study by him showed that adaptive immunity is not affected by intensive workout (6) Innate immunity was unaffected only with natural killer cells tending to be enhanced but the neutrophil population was affected. This imbalance in the immune system is a slight crack in the doorway for bacteria and viruses to barge in. Therefore habitual exercise will regulate the immune system and will delay the onset of immunosenescence (the death of the immune system).

I mentioned polyphenols. What are polyphenols and how are they better for the immune system? Polyphenols are pharmacologically active compounds and modulate the immune system. This category includes flavonoids, phenolic acids, and stilbenoids, which are ubiquitously produced in plants (7). They also have anti-inflammatory actions. Apples, Apricots, Berries, Lemons, Pomegranates, Broccoli, Carrots, Spinach, Potatoes, almonds, flax seeds, walnuts are rich in polyphenols.

Natural antivirals such as the flowers of Aloe Vera, the bulb of an onion, root of the brahmi plant, the seeds and leaves of neem, ginger plant have been used for a very long time and can be potent antivirals, although, scientifically they haven’t been proven to be so.

The last factor that affects the immune system in a negative manner is smoking. With COVID-19 causing difficulties in breathing, it is wise to stay away from cigarettes. Acrolein, a component in cigarettes, is a known respiratory irritant (8). Exposure to CS affects the respiratory immune system on several levels. Innate immune and inflammatory cells, such as neutrophils and macrophages, become activated and expand and can cause tissue damage in the lungs (9). Therefore, reading and adhering to the warning on the cigarette pack- “SMOKING KILLS” is only going to benefit and avoid health complications!

Now what is Ayurveda’s take on immunity? In Sanskrit, the word Vyadhikshmatva is split into two- Vyadhi and kshmatva, where Vyadhi means disease and Kshmatva means to suppress or overcome the disease. How does Vyadhi occur in the body? When there is an imbalance in the three doshas or the dhatus in the body. Therefore Vyadhikshamatwa means the factor which limits the pathogenesis and opposes the strength of disease (10).
There are two types of Vyadhikshmatva-
Vyadhi-balavirodhitvam
Vyadhi-utpadakapratibandhakatva

Vyadhi-balavirodhitvam is the body’s ability to resist the progress of the disease and Vyadhi-utpadak pratibandhak tva is the ability to resist the occurrence or recurrence of the disease (11). Ayurveda lists out nine contributing factors that lead the body to decreasing immunity:
1) Ati- Sthoola (Excessively obese persons)
2) Ati-Krisha (Excessively emaciated person)
3) Anivista-Mamsa (Individual having improper musculature)
4) Anivista-Asthi (persons having defective bone tissues)
5) Anivista-Shonita (persons with defective blood)
6) Durbala (Constantly weak person)
7) Asthma-Aahar Pachita (Those nourished with unwholesome food)
8) Alpa-Aaharopachita (Those taking diet in small quantity)
9) Alpa-Sattva (Individuals with feeble mind)

There is an interesting theory in Ayurveda that explains immunity in the form of the Bheej-Bhumi context. What is Bheej-Bhumi? Bheeja means seed and Bhumi means land. Now, the body is analogous to Bhumi and the pathogens that attack the body are the seeds. The body presents itself as a fertile ground for these seeds. When digestion is low, it means the digestive fire or agni is low and the body is filled with ama (toxins) and ojas is lacking in the body. This causes the body to succumb to diseases. When the agni is high and the ojas is better than the ama, the seeds of infection will not sprout in the body and cause disease.

Each season prescribes a diet, which when not followed leads to the accumulation of ama in the body. The changes in the temperature between seasons can affect the digestive agni. If one does eat the right food and follow the prescribed ayurvedic principles, it leads to the build up of ama thereby creating a suitable environment for pathogens. The transitions in seasons especially during fall and spring, the chances of respiratory issues are high. When spring begins, the accumulated ama from winter melts and blocks the passages and causes difficulties in breathing. All these factors can overburden the immune system and not allow it function to its maximum capacity.

Ayurveda mentions many ways to boost our immunity. One is to see food as medicine. How? Freshly cooked vegetables are better to consume than raw veggies as it supports easy digestion. As Dr Ahalya, the principal of the Government Ayurvedic Medical College has mentioned, ginger can increase appetite and digestion, thus keeping the digestive agni burning bright. Many of the aromatic herbs and spices have anti-inflammatory, antiseptic and antifungal properties.

Pranayama is a great way to reduce the occurence of respiratory disorders. Practising Suryabheda pranayama is great to improve digestion. Anuloma-Viloma pranayama helps to regulate the three doshas in the body and reduces the chronic sinus problems. Meditation also helps to better our psychological immunity and when this is healthy, it is easier to fight any infection.

Dr David Frawley states - “Outer difficulties push us back on our inner strength. We have been relying too much on external factors for our wellbeing. We must recognize that our ultimate strength lies within our own consciousness for which this current human life is but one episode in a greater cosmic existence.”

The ministry of AYUSH recommends a few measures that one can adopt during this pandemic such as drinking warm water, practising yoga and pranayama (as mentioned above), including spices like turmeric, garlic in our everyday cooking as they are natural antivirals. As children, we all consumed Chyawanprash, let's get that habit back into our routine. Herbal teas or milk with turmeric is also recommended.

Most of you would have heard of the concept of oil-pulling. It is the practise of swishing two to three tablespoons of oil (preferably coconut) in your mouth for 10-15 minutes. This has profound benefits such as better skin, hormone balance, whitens teeth, fresh breath, healthier gums, strengthens your jaws and clears sinuses. It also helps to improve our immunity. How? There are multiple microbes living in your teeth and not all our normal flora of the mouth. Some are itching to get into our bloodstream and cause havoc. Oil pulling helps to get rid of these microbes. Our immune system is constantly at war with the various toxins entering your system. Oil pulling provides a helping hand and keeps the microbes at bay and lessens the load on the immune system. Coconut oil is available in every household and it takes 10 minutes. Let us get to it and keep those nasty microbes away.

The number of cases in India are increasing along with the number of deaths, but we should also remember COVID-19 can be defeated. All one can do is work on their immunity and fight the pandemic, until we have a vaccine ready. Stay safe one and all!

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Huang Z, Liu Y, Qi G, Brand D, Zheng SG. Role of Vitamin A in the Immune System. J Clin Med. 2018;7(9):258. Published 2018 Sep 6. doi:10.3390/jcm7090258

Hemilä H. Vitamin C and Infections. Nutrients. 2017;9(4):339. Published 2017 Mar 29. doi:10.3390/nu9040339

Prasad AS. Zinc in human health: effect of zinc on immune cells. Mol Med. 2008;14(5-6):353–357. doi:10.2119/2008-00033.

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Y. Ma, A. Kosińska-Cagnazzo, W. L. Kerr, R. Amarowicz, R. B. Swanson, and R. B. Pegg, “Separation and characterization of soluble esterified and glycoside-bound phenolic compounds in dry-blanched peanut skins by liquid chromatography–electrospray ionization mass spectrometry,” Journal of Agricultural and Food Chemistry, vol. 62, no. 47, pp. 11488–11504, 2014.

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Charaka. Charaka Samhita (Ayurveda Dipika Commentary by Chakrapanidatta) Yadavaji Trikamji, editor. 1st ed. Varanasi: Chaukhambha Surbharti Prakashana; 2014. Sutrasthana, 28. p.178.