Jen Eliuk

📢 𝐖𝐡𝐲 𝐕𝐚𝐜𝐜𝐢𝐧𝐞𝐬 𝐂𝐚𝐧 𝐃𝐞𝐯𝐞𝐥𝐨𝐩 𝐏𝐚𝐭𝐡𝐨𝐥𝐨𝐠𝐢𝐞𝐬 𝐒𝐢𝐦𝐢𝐥𝐚𝐫 𝐭𝐨 𝐏𝐞𝐫𝐬𝐢𝐬𝐭𝐞𝐧𝐭 𝐂𝐎𝐕𝐈𝐃 𝐚𝐧𝐝 𝐏𝐨𝐬𝐭-𝐈𝐧𝐟𝐞𝐜𝐭𝐢𝐨𝐮𝐬 𝐌𝐄/𝐂𝐅𝐒? 📢 🔬 𝐂𝐨𝐦𝐦𝐨𝐧 𝐌𝐞𝐜𝐡𝐚𝐧𝐢𝐬𝐦: 𝐔𝐧𝐜𝐨𝐧𝐭𝐫𝐨𝐥𝐥𝐞𝐝 𝐈𝐦𝐦𝐮𝐧𝐞 𝐀𝐜𝐭𝐢𝐯𝐚𝐭𝐢𝐨𝐧. Both persistent COVID and post-infectious ME/CFS and post-vaccine syndrome share a common basis: an overactive immune response. In our study, we propose the presence of: 1️⃣ 𝐏𝐞𝐫𝐬𝐢𝐬𝐭𝐞𝐧𝐜𝐞 𝐨𝐟 𝐕𝐢𝐫𝐚𝐥 𝐀𝐧𝐭𝐢𝐠𝐞𝐧𝐬 𝐨𝐫 𝐀𝐝𝐣𝐮𝐯𝐚𝐧𝐭𝐬: ▪️ 𝐂𝐡𝐫𝐨𝐧𝐢𝐜 𝐯𝐢𝐫𝐚𝐥 𝐢𝐧𝐟𝐞𝐜𝐭𝐢𝐨𝐧: after a viral infection, such as SARS-CoV-2 or Epstein-Barr virus (EBV), viral antigens may remain in the body, triggering a continuous immune response. ▪️ 𝐕𝐚𝐜𝐜𝐢𝐧𝐚𝐭𝐢𝐨𝐧: Vaccines contain adjuvants designed to stimulate the immune system. In genetically predisposed individuals (HLA-DRB1), this stimulation may be excessive, leading to uncontrolled immune activation similar to a viral infection. In addition, the introduced viral antigens could have molecular mimicry with ACTH, exacerbating the immune response and potentially contributing to the development of autoimmunity against ACTH. 2️⃣ 𝐀𝐮𝐭𝐨𝐢𝐦𝐦𝐮𝐧𝐢𝐭𝐲 𝐀𝐠𝐚𝐢𝐧𝐬𝐭 𝐭𝐡𝐞 𝐀𝐝𝐞𝐧𝐨𝐡𝐲𝐩𝐨𝐩𝐡𝐲𝐬𝐢𝐬: * Both conditions can lead to autoimmune inflammation of the adenohypophysis (autoimmune hypophysitis), resulting in hormonal dysfunction, especially ACTH production. 3️⃣ 𝐇𝐲𝐩𝐞𝐫𝐜𝐨𝐫𝐭𝐢𝐬𝐨𝐥𝐞𝐦𝐢𝐚 𝐚𝐧𝐝 𝐇𝐏𝐀 𝐀𝐱𝐢𝐬 𝐇𝐲𝐩𝐨𝐟𝐮𝐧𝐜𝐭𝐢𝐨𝐧: * Chronic inflammation and proinflammatory cytokine production can alter the hypothalamic-pituitary-adrenal (HPA) axis, leading to low cortisol levels, which exacerbate fatigue and other symptoms. 🔄 𝐂𝐲𝐜𝐥𝐞 𝐨𝐟 𝐇𝐲𝐩𝐞𝐫𝐚𝐜𝐭𝐢𝐯𝐚𝐭𝐢𝐨𝐧 𝐚𝐧𝐝 𝐈𝐦𝐦𝐮𝐧𝐞 𝐃𝐞𝐩𝐥𝐞𝐭𝐢𝐨𝐧: ▪️ 𝐈𝐧𝐢𝐭𝐢𝐚𝐥 𝐇𝐲𝐩𝐞𝐫𝐚𝐜𝐭𝐢𝐯𝐚𝐭𝐢𝐨𝐧: Initial immune response is excessive, with high cytokine production and CD8 T-cell activation. ▪️ 𝐈𝐦𝐦𝐮𝐧𝐞 𝐞𝐱𝐡𝐚𝐮𝐬𝐭𝐢𝐨𝐧: Over time, this hyperactivation leads to T-cell exhaustion, decreasing the body's ability to control infection and exacerbating the pathology. ▪️ 𝐇𝐲𝐩𝐨𝐜𝐨𝐫𝐭𝐢𝐬𝐨𝐥𝐢𝐬𝐦: Insufficient cortisol maintains the state of immune hyperactivation, perpetuating inflammation and hindering resolution of the immune cycle. 📊 𝐄𝐯𝐢𝐝𝐞𝐧𝐜𝐞 𝐚𝐧𝐝 𝐂𝐥𝐢𝐧𝐢𝐜𝐚𝐥 𝐒𝐢𝐦𝐢𝐥𝐚𝐫𝐢𝐭𝐢𝐞𝐬: ▪️ 𝐒𝐡𝐚𝐫𝐞𝐝 𝐒𝐲𝐦𝐩𝐭𝐨𝐦𝐬: chronic fatigue, muscle and joint pain, sleep disturbances, cognitive problems, and post-exertional malaise. ▪️ 𝐂𝐨𝐦𝐦𝐨𝐧 𝐆𝐞𝐧𝐞𝐭𝐢𝐜: Polymorphisms in the HLA-DRB1 gene predispose to an exaggerated immune response to both viral infections and vaccine components. 🔍 𝐂𝐨𝐧𝐜𝐥𝐮𝐬𝐢𝐨𝐧: Our review suggests that both Long COVID and post-infectious ME/CFS and post-vaccination syndromes could be considered as part of the autoimmune/autoinflammatory syndrome induced by adjuvants (ASIA). These findings underline the need for a personalized therapeutic approach that takes into account the genetic predisposition and immune status of the patient. 🌍💉 𝐇𝐨𝐰 𝐂𝐚𝐧 𝐒𝐨𝐦𝐞 𝐕𝐚𝐜𝐜𝐢𝐧𝐞𝐬 𝐓𝐫𝐢𝐠𝐠𝐞𝐫 𝐏𝐞𝐫𝐬𝐢𝐬𝐭𝐞𝐧𝐭 𝐇𝐞𝐚𝐥𝐭𝐡 𝐏𝐫𝐨𝐛𝐥𝐞𝐦𝐬? 💉🌍 1️⃣ 𝐌𝐞𝐜𝐡𝐚𝐧𝐢𝐬𝐦 𝐨𝐟 𝐀𝐜𝐭𝐢𝐨𝐧: ▪️ Vaccines contain adjuvants and antigens designed to stimulate robust immune responses. ▪️ In some cases, this stimulation can lead to a dysregulated autoimmune response, similar to that seen in diseases such as systemic lupus erythematosus. 2️⃣ 𝐕𝐚𝐜𝐜𝐢𝐧𝐞𝐬 𝐈𝐧𝐯𝐨𝐥𝐯𝐞𝐝: ▪️ COVID-19: Cases of prolonged symptoms after infection or vaccination, known as Long COVID or post-COVID syndrome, have been reported. ▪️ Hepatitis B and C, HPV: Some individuals develop ME/CFS after vaccination, related to autoimmunity and immune alterations. 3️⃣ 𝐑𝐢𝐬𝐤 𝐅𝐚𝐜𝐭𝐨𝐫𝐬: ▪️ Genetic predisposition such as polymorphisms in the HLA-DRB1 gene may increase susceptibility to abnormal immune responses. ▪️ Viral persistence or chronic antigen exposure may trigger a continuous and pathologic immune response. 🌍💉 𝐃𝐢𝐝 𝐲𝐨𝐮 𝐤𝐧𝐨𝐰 𝐭𝐡𝐚𝐭 𝐯𝐚𝐜𝐜𝐢𝐧𝐞𝐬 𝐝𝐞𝐬𝐢𝐠𝐧𝐞𝐝 𝐰𝐢𝐭𝐡 𝐚𝐝𝐞𝐧𝐨𝐯𝐢𝐫𝐮𝐬𝐞𝐬 𝐦𝐚𝐲 𝐡𝐚𝐯𝐞 𝐚 𝐬𝐥𝐢𝐠𝐡𝐭𝐥𝐲 𝐢𝐧𝐜𝐫𝐞𝐚𝐬𝐞𝐝 𝐫𝐢𝐬𝐤 𝐨𝐟 𝐭𝐫𝐢𝐠𝐠𝐞𝐫𝐢𝐧𝐠 𝐩𝐫𝐨𝐥𝐨𝐧𝐠𝐞𝐝 𝐢𝐦𝐦𝐮𝐧𝐞 𝐫𝐞𝐬𝐩𝐨𝐧𝐬𝐞𝐬 𝐜𝐨𝐦𝐩𝐚𝐫𝐞𝐝 𝐭𝐨 𝐦𝐞𝐬𝐬𝐞𝐧𝐠𝐞𝐫 𝐑𝐍𝐀 𝐯𝐚𝐜𝐜𝐢𝐧𝐞𝐬? Adenoviruses used as vectors may persist longer in the body, exposing the immune system to viral components for extended periods. 🦠Adenoviruses are linear double-stranded DNA viruses and remain in an episomal condition in the nucleus. The mechanism of adenovirus vector persistence has not yet been elucidated. But they can persist for a long time in the organism. It is thought that it could be by their integration into the genome or by episomal gene duplication facilitated by the transcription machinery of the host cells. That is, it could happen that it transmits episomes to its cells as occurs in Epstein-Barr virus without lytic phase. During mitosis, EBV episomes are bound to chromosomes in metaphase through EBNA-1, allowing efficient segregation of episomes into daughter cells. 🔬 This theoretical phenomenon could predispose certain genetically susceptible individuals to develop chronic autoimmune or inflammatory disorders, as discussed in the context of ASIA syndrome. In contrast, messenger RNA vaccines, by rapidly degrading after inducing the desired immune response, limit this prolonged exposure. 💉⚠️ Regardless of the type of vaccine against COVID-19 or other pathologies, whether messenger RNA or adenoviral vector, there is a theoretical possible risk of developing autoimmune disease only in individuals with certain genetic alleles, such as HLA-DRB1. The key lies in prolonged exposure to viral antigens, which could trigger persistent autoimmune responses. 🔬 mRNA vaccines are characterized by rapidly degrading after inducing the desired immune response, thus limiting prolonged exposure to viral components. In contrast, adenoviral vector-based vaccines can persist in the body longer, potentially increasing the risk of a longer-lasting autoimmune reaction in susceptible individuals. 💡 It is crucial to remember that these risks are rare when compared to the total number of vaccinated individuals and that all vaccines, including adenovirus and messenger RNA vaccines, are critical to combat pandemic diseases such as COVID-19 at the species level. However, understanding these differences may help improve future vaccine design and surveillance for potential adverse effects in these susceptible individuals. 🌟 Recall that vaccines save millions of lives and prevent serious consequences of infections in the majority of the population. However, it is crucial to recognize that they may also present risks in some susceptible individuals. 🧬💉 HLA-DRB1 genetic alleles play a crucial role in predisposition to diseases such as Long COVID, myalgic encephalomyelitis (ME/CFS) and ASIA syndrome, as well as in post-vaccine syndromes. 🔍 These HLA-DRB1 alleles are part of the HLA (human leukocyte antigen) system, which regulates how the immune system recognizes and responds to foreign antigens, such as viruses and vaccine components. In individuals with certain HLA-DRB1 alleles, the immune system may trigger excessive or inappropriate responses to these antigens, leading to autoimmune conditions and inflammatory syndromes. 🦠 This explains why some patients, after significant viral infection or vaccination, may develop persistent autoimmune reactions. In the case of Long COVID and ME/CFS, persistence of viral antigens could trigger an autoimmune response against self tissues, including the pituitary gland. 🔍✨ In a 𝐤𝐞𝐲 𝐬𝐭𝐮𝐝𝐲, patients who developed hypophysitis after infection with the first SARS-CoV recovered their health months after treatment with replacement corticosteroids. This finding underscores the importance of detecting hypophysitis early to prevent permanent damage.➡️ ncbi.nlm.nih.gov/pmc/article… 🧠 Hypophysitis can cause a decrease in ACTH production, crucial for adrenal function and immune response. Controlling ACTH levels is critical if symptoms such as chronic fatigue, orthostatic hypotension and sleep disturbances are present after a viral infection. 💊 Early administration of replacement corticosteroids can stop ACTH secretion and prevent autoimmunity against this hormone, thus protecting the pituitary from further damage. Over time, as hypophysitis and viral infection subside, the dose of replacement corticosteroids can be gradually reduced until normal pituitary function is restored. 🔍Challenges in HPA Axis Evaluation in Patients with Long COVID, ME/CFS and Post-Vaccine Syndromes. Studies are often limited to single morning cortisol measurements, ignoring diurnal variability and cortisol response to physical/mental stress, which may underestimate problems in the HPA axis. In addition, CRH or ACTH stimulation tests, crucial for assessing pituitary and adrenal function, are not frequently performed. It is crucial to detect HPA axis dysfunctions as early as possible to prevent adrenal atrophy due to low ACTH levels. Newly diagnosed patients may recover HPA axis function if autoimmune or direct damage by infection to the pituitary is detected early. Conversely, as time passes, the risk of pituitary damage from autoimmunity against ACTH increases, leading to further adrenal atrophy and the need for hydrocortisone replacement therapy. Early detection and treatment of these dysfunctions is crucial to improve the clinical management and quality of life of these patients. #Research #Health #Autoimmunity