Seeks to boost immune response to Trump’s Kovid-19 treatment

Experimental infusion doctors have seen President Trump attempt to combat a problem affecting several chronic Kovid-19 patients: an ineffective immune response.

Among other treatments, Mr. Trump has taken a drug cocktail from Regeneron Pharmaceuticals Inc.

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  It has not been approved for widespread use, but aims to initiate an immune defense by supplying antibodies to help fight the coronaviruses that cause Kovid-19.  The company says its results suggest that the infusion may help people infected with coronovirus who have not yet produced their antibodies.</p><div> <p>The approach makes sense in elderly patients, whose bodies are often capable of fighting pathogens, said Joko Nicolaich-Jugich, an immunologist and gerontologist who is a professor at the University of Arizona.  "You don't control the virus quickly with older patients", he said.

  A growing body of research cites the immune system as an important reason why the elderly are susceptible to severe cases of Kovid-19.  As a person ages, the system undergoes "immunocranescence", gradually losing its ability to mount a response to infection as it once did.  Complex mechanisms of the immune system do not work together, leading to slower and less potent defense.

  Except for the age of 74, m.  Trump's weight may also cause concern about his immunity, as obesity is tied to the attenuated response.  And a study published this August in the journal Nature also highlighted the possibility that older men, in particular, may mount a less-robust immune response to the virus.

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Medical treatment of president


  According to death-proof data from the Centers for Disease Control and Prevention, about 80% of deaths in the US are in those 65 and older, and about 31% of deaths occur in people at least 85 years of age.  This is partly because the elderly are often frollers, and they also have higher rates of conditions such as heart disease and diabetes that are risk factors for severe effects from Kovid-19.

  But his immune system is another important factor, the researchers say.  "When you challenge a body with a virus or vaccine, there is simply no vigorous reaction," Carrie Levy, a pediatrician who is a professor at the University of Colorado.

  Older people often produce fewer, and less-effective, antibodies.  These Y-shaped proteins are signaling to bind invading pathogens, neutralize them, and destroy the body.

  "It's slow, it's incredible - you probably don't make as much" said Peter Chin-Hong, professor of medicine at Antibodies, University of California, San Francisco.  The hope is that treatments such as Regeron's experimental cocktail can help quickly fill that gap in the infection process, possibly slowing the initial spread of the virus.

  The elderly immune system often has problems generating powerful troops known as T-cells, which supply a main line of defense against invaders.  The production of these cells, from a gland in the chest known as the thymus, rapidly declines during a person's life.  They may also lose some of their function.

  A recent study suggests that older people have a harder time getting their T-cells to action.  New research published this August Nature looked at 98 patients infected with coronovirus and found evidence that the immune response differed by sex.

  "There was a lot of impaired, especially regarding older male T-cell activation," said Akiko Iwasaki, a professor of immunobiology at Yale University, who led the study.  He said that those who had the least T-cell response worsened the Kovid-19 results.

  She said that there is currently no treatment available that will help Kovid-19 patients with T-cells.  Potentially future vaccines may do so, but vaccines are often less effective in older patients.

  But even with significant portions of an elderly person's immune system performing sluggishly, another reaction can cause trouble with too much firing.  As the body fails to contain the virus quickly, the immune system can produce lots of proteins called cytokines.  They can damage blood vessels and allow fluid to leak into the lungs.

  It is unclear why this "cytokine storm" effect is triggered in some patients, but not others.  But elderly people have a higher level of inflammation, and cytokines, said molecular biologist Amber Muller, a postdoctoral research fellow at Harvard Medical School.

  This baseline level of inflammation is one of the reasons that GI T-cells are less effective, and it sets the stage for dangerous overproduction of cytokines, she said.

  President Trump remained hospitalized in the early hours of Monday after doctors offered conflicting signals.  The President attempted to show confidence and vigor over the weekend.

  <p class="articleTagLine">—John Kemp contributed to this article.</p>

  <strong>Write </strong>Anna Wilde Matthews at [email protected]

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