Dr. Rhonda Patrick on How Viruses Affect the Immune System, Asymptomatic Coronavirus Patients

Thanks for being here. I really appreciate it. I am super always happy to come. Well, we've been talking and we've been talking about immune systems. And this is one of the main things that I wanted to talk to you about. Like what are the strictest? All we're hearing is shelter in place, wear a mask, don't touch anybody, don't go outside. We're not hearing what can you do to strengthen your immune system. And I think that as a public health, a public service health thing, this is one of the most important things that I think you can really focus and concentrate on and an actual thing that you could be proactive about during this weird time. Yeah. Well, definitely I think focusing on lifestyle factors that you can possibly modulate your immune system and strengthen it is important. What's interesting is that the immune system, after doing just so much, of course, the past couple of months, I've been nothing but reading about the immune system and trying to understand, of course, this new virus, SARS-CoV-2. But I've just learned so much over the past couple of months. I'm not an immunologist. I'm not an infectious disease expert. So while I've had some training in immunology, I definitely don't know everything there is to know. But just doing some reading about why are people's immune systems so different? That's the big thing. When you take a young population, as you get older, your immune system does decline. There's lots of changes that occur. But in general, people have different immune systems. And what's interesting is that there's been tons of genetic studies done on identical twins, and they're followed over time. And what's found is that genetics is not the major regulator of immune function. It's something in the environment. This is what surprised me, and it's not totally going to answer your question, but we can totally get to that. But one of the main things besides age that regulates the immune system is previous exposure to viruses. So I thought that was really interesting. And in particular, one virus, the cytomegalovirus, CMV. Did you know between 50% to 80% of the US population has it, at least by the time they're an adult? Has it permanently? Or has caught it? Yeah, it's a herpes virus, so it's a lifelong thing. And this is why it basically changes your immune system. What are the symptoms of it? Most people that are healthy don't ever know they have it, because there's no symptoms. Whoa. Yeah, unless you're immunocompromised. But most people that are healthy, they don't know that they're infected with it. Say it again. What is it called? The cytomegalovirus. It's CMV. Sounds like something Godzilla fights. There it is. But here's the interesting thing about this virus is that it... So this is one of the major things multiple studies have been looking at, just immune variability. And it's like CMV's been identified in multiple studies. And the reason it got me interested is because I was like almost 80%, I could have it, right? Totally have it. And it changes the immune function. It's totally different between young and old. So when you're younger, and if you have it, it actually enhances immune function. So they've done studies where they have given people influenza vaccine. And oftentimes, these vaccine studies are used to test the immune response and how robust your immune response is, because you're given a vaccine, and there's all different types of vaccines, pieces of an antigen, or all different types of ways that you can expose someone to bacteria or virus. But you have a response to it, and the response involves your adaptive immunity, what's called neutralizing antibodies that basically eventually bind to the virus and neutralize it, prevent it from entering the cell. So people that have CMV that are young have a really robust response to the vaccine, much better. But older people have the complete opposite, where it's deleterious. And the reason for that, scientists think, is because basically this virus, it's stuck with you lifelong, and it kind of reactivates every few years. And every time it reactivates, it kind of trains your T cells, which are part of your immune system, to become focused on that CMV. And so as you get older, your T cell population becomes more focused on fighting that virus and less so on other viruses that you're exposed to. But this virus doesn't have any symptoms? Most healthy people don't have any symptoms with it. I know. It's really weird. So what I'm wondering, and the reason I'm even going here, it has nothing to do with taking vitamin C or zinc, and we can talk about that stuff, and vitamin D. But I just thought it was so damn interesting, because we hear all these stories in the news where some people are asymptomatic. Some people are, you know, and some people are just really getting hard hit. And these people, let's say they're more age matched, right? We know that elderly people are more prone to severe form. But it just made me think, what if this previous viral exposure to something like CMV is kind of like also kind of shaping people's immune responses in some way? Surely, people are going to be looking at that. But I just thought that was a really interesting thing to come across. And then the other sort of along the same lines as previous, you know, previous virus exposure is like something that really seems to be something that is a main regulator of how people, like what your immune response is, you know? And so- So you mean by how many times you've caught the flu, how many times you've had- How you respond to it. How you respond to it, you know? Yeah. I mean, like, if you get the flu, is it going to not- is it like a three-day kind of thing or is it going to knock you out for two weeks kind of thing? That's what I mean, right? So I mean, if you get a sample, like there's been these sero surveys where they basically- that just means they'll get a sample of plasma and look for different antibodies, viral antibodies, and they'll find at any given points a person has like antibodies against 10 different viruses just randomly, you know? So you're constantly being exposed to viruses. You're not always- You just don't succumb to them. Right. You're sick. And so, you know, like another really interesting kind of thing is like, you know, there's- So the SARS-CoV-2 virus is part of a family of coronaviruses called the beta coronaviruses. So SARS-CoV-1, the virus that was responsible for the original SARS outbreak in 2002 or something, the MERS one in the Middle East, and then there's two different ones that are responsible for the common cold. Now coronaviruses are only responsible between like 15 to 30% of common cold cases. So it's not like the common cold is the illness you get, but there's lots of different viruses that can cause it. But what's interesting is that there's been studies showing that these two beta coronaviruses that are responsible for some of the common cold cross-react with- so there's one that cross-reacts with the SARS-CoV-1, which has a very- it's very- the sequence is very homologous to SARS-CoV-2 virus. And it's also been showed that the SARS-CoV-1- the antibodies against the SARS-CoV-1 can neutralize the common cold one. So there's like cross-immunity happening between these other viruses, right? And so there's been some studies by the CDC on SARS-CoV-2 where they found basically that people that are infected with SARS-CoV-2 also boost their antibodies against the common cold one. You know, there's certainly, I think, a good hypothesis to be made that potentially, you know, one or two of these common cold viruses could- the antibodies you make against them could also somehow maybe interact with the SARS-CoV-2 virus, potentially neutralize it. I mean, that's a big open question that seems possible without- we don't have any answer to that. I think we will. Like there's large-scale sero surveys being done. I know at least three that- I think his name is Dr. Michael Bush. He's at UCSF. He's like- he's doing like really large surveys where they're going to be analyzing sero from people from like, you know, blood donors and stuff and like following him over the course of several years to see, you know, just basically understand more. So- Now, what is the speculation, if there's any sort of uniform speculation as to why when you hear about prisons where a lot of these prisoners- I don't know if you've seen the video, there's a video going around where one prisoner had SARS-CoV-2, COVID-19, whatever, and spitting into a cup and then passing it around to all these other inmates so they could all get it so that they get released. So these- because they're releasing people, especially California, which is so wacky, they're releasing sex offenders. And there's been some really high profile releases of these horrible people that should be in jail probably forever and they're releasing them. It's like it's really disturbing. But what would cause, other than something like that, what would cause all of these prisoners to not just be positive, that makes sense, but to all be asymptomatic. Is there any speculation as to why these large groups- there was another one that was a meat packing plant where most of the people were asymptomatic as well? I wasn't aware of the meat packing one being asymptomatic, but I did read about the one in prison and it was like blowing my mind. 98%. Like what's going on? That's insane. It's kind of like you read these stories. So this is like- there's one thing that's important to keep in mind when we say asymptomatic. There's asymptomatic in a person that never actually gets symptoms, right? And then there's asymptomatic. So there was a study done at the CDC, I don't know, a month ago, maybe a little more, where they measured like- they did the Nigel Ferringale swab test in a nursing home, 70 something people, and 13 of them tested asymptomatic. They had no symptoms, but they tested positive. But then they went back a week later and 10 of those people had symptoms and three were asymptomatic. So unless there's another- if you test someone and they're asymptomatic at that time of testing, they could be pre-symptomatic, right? In other words, you have to go back a week later and see if they have symptoms because that's really important. So let's say even 60% were asymptomatic. I don't know if they went back and tested a week later if it was just like a single time. But that's what- this is what got me thinking about this whole thing was, you know, in the prisons and jails, I mean, they're in close quarters and you got one virus that someone's exposed to and they all get it, right? So like what if there's- I don't know the CMV, you know, percentage there, but what if the coronaviruses are going around there? What if some common cold coronavirus has gone around and those antibodies that they've made to neutralize that coronavirus- beta coronavirus are somehow helping with the SARS-CoV-2? Like I would love to see that tested. Do you know if they immunize people, did vaccinate people when they go into jail? I was trying to figure that out as well because like the tuberculosis- tuberculosis, one of the types of vaccines they do for TB, I think they do it in like Japan and some other countries where they've got a really low death rate. And so they're kind of- that's a test that's a clinical trial that's now going on where they're trying to test. But I was trying to figure out, is there a vaccination? Is there something like- So I would imagine it would be simple for them to do that. You're entering into prison, they just vaccinate you just to- I couldn't come to an answer. I was searching for that the other day. I was trying to figure that out. But I think that's also a really good- I mean, there's a ton of theories, right? Right. I mean, it's just you could go on and on and on. But the whole- the thing that- I just think that I would like to see more research and I'm just hoping that CDC and other people are investigating these other- the cross immunity, right? Like if there's antibodies that you're making against another coronavirus, beta coronavirus, that's in the same family as this SARS-1. No one's had SARS-1 in the United States. So like that one doesn't- that's not as relevant as- but the common cold, that's very common, right? So if 15 to 30% of the common cold is composed of coronaviruses, we know at least two- of those coronavirus are in the same family that have been identified to make- at least in one case there's been neutralizing antibodies, so there has been cross immunity, then you'd think why not test that? Like let's get some animal studies started on that, you know? Speaking of animal studies, there was an article that I was reading yesterday that was saying that they're hoping that they found some antibodies in llamas that they're hoping they're going to be able to- because of- see if you can find this. Because of these antibodies in llamas, they're hoping they can either transfer them to people or learn something about how these antibodies are created, but llamas seem to be- here it is. Lamas could be the key to fighting new coronaviruses. Research says- we'll make that larger- it says it may sound bizarre to most, but llamas could be the key to fighting new coronavirus. Researchers from Belgium- oh remember that's the big lady that I was showing you earlier? She's the health lady. And the United States published an article this week in the journal Cell that highlights the potential use of llama antibodies to prevent COVID-19 infections. Antibodies from a four-year-old Belgian llama named Winter show promise in blocking coronavirus from infecting cells according to research from the University of Texas, Austin, the National Institutes of Health, and the Ghent- how do you say that? Ghent? G-H-E-N-T University. During earlier forms of the coronavirus, researchers have found an antibody in winter that effectively attached itself in neutralized spike protein in SARS-CoV-1 and MERS-CoV. Researchers believe the particular antibody, which has been found in other llamas as well, can be injected into an uninfected individual to protect them from getting infected with the new coronavirus. That's very interesting. Yeah, so there- I think, you know, there's lots of avenues for, you know, therapeutics and, you know, in addition to like repurposing drugs, monoclonal antibodies, you know, being able to basically identify antibodies that do neutralize SARS-CoV-2 virus, whether they come from llamas or humans, you know, and basically identify the specific antibody that can bind to that spike protein that you just mentioned, which is that region. It's known that the antibodies bind there and neutralize it. It's also the region that is used to get inside of the cell. So monoclonal antibodies, I think, are a really big, you know, possibility for a promising therapeutic because you can then- I mean, the problem is growing, like, large-scale manufacturing them, right? So like, if you can identify these antibodies and then manufacture them, you can inject them in people and then potentially get some protection. The problem is that that's not- like, it's just going to be a short-lived protection. Like it's going to be- it's not like you can- it's not like a vaccine where your body's making its own antibodies and they're more longer-lived, you know? So, in areas where people are getting exposed, perhaps you could give it to them and it would stop them from getting- but how long will you say short-lived? Well, we don't- I don't know. I mean, how- so it's, you know, it's probably enough to- like, if you're a healthcare worker, your first-line, you know, health- you know, first responder, people that are definitely, like, being exposed to large doses of the virus, that could be a promising area. But also, I think even just treating patients, like, that have already been infected, you know? So that's also another- so, like, in combination with some of this other stuff, like, Remdesivir, which is, you know, it's not like a silver bullet, but it seems like it's also promising- promising probably with combination of other factors as well. But yeah, the monoclonal antibodies is a really- I know there's, like, Regeneron's a big company there. They're growing some large-scale ones. I think there's- they isolated from humanized mice or something, but there's other companies that have isolated them from humans that have been infected. So you know, that's definitely a promising area for sure. And a good thing about that is that- have you heard of antibody-dependent enhancement? Do you know? So that's a big concern. All right, so basically, when your body is exposed to a pathogen, like a virus, your innate immune system, you know, the first line of defense, like neutrophils, things like that, are making hydrogen peroxide, trying to kill the virus. But then in the background, your adaptive immune system- and I'm just totally generalizing- is also working in the background. And you know, part of that adaptive immune response is, you know, to produce antibodies. So you have memory B cells that are making antibodies that are specific to bind to different regions, epitopes on the virus, and neutralize them, prevent them from getting inside of the cell. And so that adaptive immune system usually takes about seven days after you're exposed to the virus, right? The problem is antibody-dependent enhancement. So sometimes a neutralizing antibody is an antibody that can bind to the virus and neutralize it, stop it from entering your cell, right? So it's doing its job. But you sometimes make antibodies that are non-neutralizing or don't do as good of a job, they don't bind as tight or something. And then you can have what's called antibody-dependent enhancement. And this was like a big problem for the RSV vaccine. Back in the, you know, like most kids get RSV, it's a respiratory tract infection, and most kids get it by the time they're two. Like there's no vaccine that's given. Back in the 60s, there was this antibody-dependent enhancement happening in some clinical studies with toddlers. And some toddlers got really, really sick and a couple died. But what happens is basically the antibody binds to the... There's a couple of things. The antibody binds to the virus and can basically change its conformation and allow the virus to get into the cell better. So then you become like, you know, you get like a higher viral load and then you don't have antibodies to neutralize it. And it just, you know, it could be more, it could lead to death. The other thing that happens is the antibody binds to the virus, it doesn't neutralize it, but it like makes this crazy immune complex that like activates your immune system to just go haywire and it causes all sorts of pathology. And that's what happened with the RSV toddlers. So there's a few viruses that this happens with. And unfortunately, coronavirus is one, like this has been identified with the SARS-CoV-1 virus and I think marriage as well, where... So this is also a problem with vaccines. So like people, like giving the vaccine people's immune response, some people can have that antibody dependent enhancement. And that's what was shown to happen with these, with the SARS-CoV-1. There was some non-human primate studies that did that and also animal studies as well. So you know, the thing with monoclonal antibodies, is they're a little more specific because you know they neutralize and you're like growing them up like you've done all that tests as opposed to just letting your immune system do its thing. And then potentially, you know, you may have this like non-neutralizing antibody that could cause problems. But that's kind of the concern. I know that the vaccine people that are working in vaccines are working on that. It's like they're concerned about that and completely trying to like figure that all out.