The COVID 19 pandemic has hit us all like a real life fast-paced mystery spy thriller. Medical news has never gotten the media attention like this virus and the hoopla around it. Regardless of your opinions on the source of the virus, motives of the players, or response to COVID, we can all agree that the public has gotten a better view of the scientific process. We have seen the fits and starts, the flips and flops, and the side steps, mis-steps, and back-steps of scientists. All are trying to understand different aspects of this COVID 19 disease so collectively we can find a solution leading to health and the “old normal”. In regards to why this viral disease and its vaccines sometimes triggers autoimmunity, researchers have an old suspect in their sights, anti-idiotype antibodies.
When any antigen (foreign material which triggers an immune response) induces our B cells to produce antibodies, the primary goal targets the eradications of the antigen and whatever brought the antigen, like bacteria or viruses. The B cells make these antibodies (proteins designed to attach to the antigen and trigger further immune responses) in large numbers and as the process continues, they make stronger and stronger antibodies until the job is complete. After the antigen is gone we want our immune systems to turn off so that no further inflammatory damage occurs.
Today, we will focus on one mechanism called anti-idiotype antibodies without going into all the details of the biochemical processes involved in ending this response. The first antibody made targets the enemy antigen. It binds, enables our other immune cells to identify and attack then enemy. These antibodies can themselves serve as an antigen to our immune system, thus triggering another antibody to be produced against the first antibody. Once the original antigen is gone, this anti-idiotype antbody helps clear out the first antibody. While this is a little confusing, the basic gist remains that we produce a second antibody against the first antibody and we think this is part of the down regulation process.
Prior research into anti-idiotype antibodies does indicate that these antibodies can play a role in some experimentally induced autoimmunity in animals (Plotz, 1983; Paque et al, 1991; Cleveland et al, 1983). In some cases, the anti-idiotype antibody even mimics the original antigen’s toxic effects (Xue 1991). Research indicates that the anti-idiotype antibodies produced to the first antibody can possess similar shapes and structures to the original antigen. Antibodies use lock-and-key-like mechanism to bind to their targeted antigen. The anti-idiotype antibody formed may bind the similar part of the antibody as the antigen and thus must be structurally similar in those cases. With this similar structure, the anti-idiotype antibody can trigger further immune responses.
Taking into account the possible contributions of anti-idiotype antibodies to COVID 19 and COVID vaccine reactions, I agree with the article authors that further research to fully understand our immune response to COVID is critical. The reality of such post COVID and post vaccine conditions acknowledged by this New England Journal of Medicine article further emphasizes this need. We cannot afford to ignore this potential root cause of autoimmunity as it relates to the frequency of COVID 19 nor the expected widespread use of the vaccine. From one or the other, we may have a wave of autoimmune conditions as the next real pandemic. Helping patients restore healthier more abundant lives includes prevention of autoimmunity rather than just treating after it happens.
William J. Murphy, Dan L. Longo. A Possible Role for Anti-idiotype Antibodies in SARS-CoV-2 Infection and Vaccination. New England Journal of Medicine, 2021; DOI: 10.1056/NEJMcibr2113694
Thanks to Science Daily:
University of California – Davis Health. “Antibodies mimicking the virus may explain long haul COVID-19, rare vaccine side effects, study suggests.” ScienceDaily. ScienceDaily, 24 November 2021. <www.sciencedaily.com/releases/2021/11/211124172159.htm>.
Other referenced articles:
Plotz, P H. “Autoantibodies are anti-idiotype antibodies to antiviral antibodies.” Lancet (London, England) vol. 2,8354 (1983): 824-6. doi:10.1016/s0140-6736(83)90740-7
Paque, R E, and R Miller. “Autoanti-idiotypes exhibit mimicry of myocyte antigens in virus-induced myocarditis.” Journal of virology vol. 65,1 (1991): 16-22. doi:10.1128/JVI.65.1.16-22.1991
Cleveland, W L et al. “Monoclonal antibodies to the acetylcholine receptor by a normally functioning auto-anti-idiotypic mechanism.” Nature vol. 305,5929 (1983): 56-7. doi:10.1038/305056a0
Xue, W et al. “Anti-idiotypic antibodies mimic bovine viral diarrhea virus antigen.” Veterinary microbiology vol. 29,3-4 (1991): 201-12. doi:10.1016/0378-1135(91)90128-3
Sanctuary Functional Medicine, under the direction of Dr Eric Potter, IFMCP MD, provides functional medicine services to Nashville, Middle Tennessee and beyond. We frequently treat patients from Kentucky, Alabama, Mississippi, Georgia, Ohio, Indiana, and more... offering the hope of healthier more abundant lives to those with chronic illness.