Autoimmunity & COVID-19
What is Autoimmunity?
While the medical community at large does not recognize an exact etiology of autoimmune disease, the research is clear that there are many variables that have the potential to contribute to autoimmune disease including genetic expression, internal and external environmental triggers, and hormonal changes. Seasons of stress and trauma have also been correlated with manifestations of autoimmune disease. All of these factors have the ability to disrupt the immune system and trigger autoimmune disease.
To understand autoimmunity we need a foundational understanding of the immune system. The immune system is an intricate system of various immune cells, organs, and chemical messengers that work together to protect the body from foreign invaders from the surrounding environment. Some of these foreign invaders include viruses, bacteria, parasites, environmental toxins, food, mold, and mycotoxins. When the body comes in contact with any of these threats, the immune system responds with an attack to overcome the threat. This is the body’s innate, natural defense mechanism often referred to as the inflammatory response.
In normal physiology, the body easily differentiates between your own cells and tissues and foreign invaders. Autoimmunity occurs when the body’s immune system can no longer distinguish between itself and the threats of the outside world. When an individual has permeable barriers within the gut, lungs, or brain, certain proteins are able to pass through these damaged barriers. The immune system then starts producing antibodies against these foreign invaders. In situations of autoimmunity, the body starts attacking its own tissue.
Viruses & Autoimmunity
The misfiring of the immune system can look different for each individual and oftentimes there are many factors that impact the immune response. We know that viral illness can trigger autoimmunity. Research shows the link between autoimmunity and viruses including Parvovirus B19, Epstein-Barr-virus (EBV), Cytomegalovirus (CMV), Herpes virus-6, HTLV-1, Hepatitis A, Hepatitis C, West Nile Virus, and Rubella virus. There is a strong correlation with these viruses and the onset of various autoimmune conditions including rheumatoid arthritis, systemic lupus, Sjogren's syndrome, multiple sclerosis, Hashimoto’s autoimmune thyroiditis and many others. There are various mechanisms within the immune system that can initiate a misguided immune response due to a viral illness including molecular mimicry, epitope spreading, bystander activation, and cryptic signaling. Let’s take a deeper look into one of the most common initiators of autoimmune disease.
In a process called molecular mimicry, the body initiates an autoimmune response because it sees similar amino acid sequences between foreign invaders and its own tissue. This situation results in a case of mistaken identity because the immune system thinks that specific tissues in the person are the problem. The autoimmune condition that manifests is determined by what tissue(s) are being attacked. For example, when the body has an immune response against the thyroid tissue, the result could be Hashimoto's thyroiditis or Grave’s disease. These amino acid sequences or partial proteins are able to been by the immune system if one of the barrier systems in the body is broken down and the partial proteins get into the blood stream. The most common barrier to be broken down would be the single cell layer making up the epithelial lining of the intestines. If the gut remains “leaky”, an individual can develop more autoimmunity as this process perpetuates itself over time.
COVID-19 and the Immune System
COVID-19 is the disease caused by the virus SARS-CoV-2. The immune system is the best defense against COVID-19 because it helps the body’s natural ability to resist infections. Once the body becomes aware of the viral invasion, it mounts the immune response that we discussed above creating a cascade of chemical messengers and an inflammatory response within the body.
Most often, people experience a mild case of COVID-19 where the immune system is able to quickly and efficiently fight the virus and restore normal function. Some people develop severe cases of COVID-19 where the body has an exaggerated, sometimes uncontrolled response to the infection. In these circumstances, an abundance of pro-inflammatory cytokines and other immune factors are released very aggressively. This causes a state of hyper-inflammation, oxidative stress, and has the potential to injure various tissues within the body and cause respiratory failure. These individuals that have a heightened immune response and more severe symptoms due to COVID-19 sometimes fall into Post Viral Syndrome for many months after their initial illness.
The SARS-CoV-2 and the Autoimmune Connection
Recently, brand new research shows that various proteins within the body are cross reactive with monoclonal anti-SARS-CoV-2 antibodies and polyclonal anti-SARS-CoV-2 antibodies. Through the mechanism of molecular mimicry, SARS-CoV-2 has the potential to trigger chronic disease. When cross reactivity, or similar amino acid structures were studied between SARS-CoV-2 antibodies and various proteins within the body, it was discovered that SARS-CoV-2 antibodies initiated reactions in various tissues including barrier proteins (gut, brain, and lungs), gastrointestinal proteins, thyroid proteins, neural tissues, and more. This research shows that the extensive immune cross-reactivity between SARS-CoV-2 antibodies and different tissues within the body likely influence the severity of illness, initiate an autoimmune disease in certain individuals, and exacerbate autoimmunity in those with pre-existing autoimmune conditions.
It may go without saying, but we clearly need more research to help us understand the long term impacts of COVID-19 on autoimmunity and overall health. Thankfully, there are many strategies that can protect you from both COVID-19 and autoimmune disease.
Strategies for Supporting the Immune System Against Autoimmunity
There are many dietary and lifestyle factors that go a long way in protecting yourself and your loved ones from succumbing to a viral infection or autoimmune disease. Making these changes can have a profound impact on the immune system.
Nutrition
Eating a clean, nutrient-dense diet is foundational to a properly functioning immune system. Focusing on quality fats, proteins, and phytonutrient-rich vegetables and fruits should be a high priority. Consuming probiotic-rich lacto-fermented foods, bone broth, and collagen help to maintain proper barrier function within the gut. Additionally, avoiding refined sugars, carbohydrates, and processed foods will drastically suppress immune function so it is important to stay away from these foods. We know that certain foods significantly contribute to immune system dysregulation. These include conventional gluten and dairy; however uncovering an individual’s unique food sensitivities can help immune system function.
Immune Support
Not only is eating an anti-inflammatory diet crucial for a strong immune system, supporting immune function through various supplements can also help to bolster it. While it is best to get some functional lab testing done to understand your body’s unique physiology, optimizing vitamin A, vitamin C, vitamin D, zinc, and glutathione status have been shown to not only support the body in the face of a COVID-19 illness, but also in preventing autoimmune disease. We cannot underestimate the importance that proper sleep, movement, diet, and stress have on the immune system.
Support Barriers
As mentioned above, proper barrier function is crucial for safeguarding the body from developing autoimmune disease. Foundational to ensuring proper barrier integrity is supporting the microbiota. The microbiome, or the overall microbial balance of the body impacts barrier function of the gut, lung, and brain. Eating an anti-inflammatory diet and supplementing with prebiotics, probiotics, and short chain fatty acids (SCFAs) have been shown to protect barrier function as well as nourish the microbiome. If there is an underlying infection within the body, identifying it and uprooting it will help to restore barrier function within gut, lungs, and brain.
Avoid Toxins
Exposure to harmful toxins is ubiquitous in our environment today. Environmental toxins include pesticides and herbicides, heavy metals, chemicals, molds, and mycotoxins. On-going exposure to these toxins causes systemic inflammation. Environmental toxins have been shown to negatively impact the microbiome, damage the gut, lung, and blood brain barrier, contribute to hormone imbalances, hinder phase one and phase two detoxification, and disrupt immune function.
Manage Stress
We know that both acute and chronic stress can greatly hinders immune function. Additionally, chronically elevated stress hormones can wreck havoc on the gut, lung, and blood brain barrier. Emotional trauma and adverse childhood experiences (ACEs) are intimately intertwined with the overall stress load on the body. Working with a skilled clinician to work through trauma can have a profound impact on the way you see the world, overall stress, and immune function.
We are just scratching the surface on how to prevent COVID-19, Post Viral Syndrome, and autoimmunity. Our next blog post will provide more detail on how to work through a viral illness. In the meantime, if you are experiencing Post Viral Syndrome or would like to put an autoimmune disease into remission, please contact the wellness center to set up an appointment to talk with one of our doctors!
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