When the coronavirus SARS-co-v2, a devastating communicable disease, descended upon the global population in December 2019, it became clear early on that there was a wide spectrum of illness, ranging from almost nothing to diarrhea, severe pneumonia, stroke, and death. By May of 2020, it became even more clear that there are particular conditions (“comorbidities”) that markedly increase the disease severity and death rate, and that these conditions had in common an immune system dysfunction with the shared characteristic of chronic inflammation. We have learned that people with chronic inflammation have higher levels of furin and that furin acts as a facilitator to allow better binding of the viral spike protein to our ACE2 receptors. Harboring chronic inflammation turns us into something like Velcro, attracting more virus, secreting more furin, and allowing more severe disease states to evolve.
But what causes chronic inflammation? Let’s focus on the most common non-communicable disorder in the world… metabolic syndrome. This is less of a distinct disease and more of a syndrome or condition, characterized by increased blood pressure, increased triglycerides, high BMI (larger waist), and always an “under the hood” impairment of insulin sensitivity. We can more simply call it “carbohydrate intolerance”. Another term we use for this constellation is “inflammaging” because the connection of metabolic syndrome to a chronically overstimulated and damaged immune system is now accepted. Dr. Jeffrey Bland, one of the “founding fathers” of Functional Medicine writes “What happens when the world’s most prevalent non-communicable health condition and a highly infectious viral disease collide? We find ourselves in our new reality: a COVID-19 pandemic within a pandemic of metabolic syndrome.”
It can be confusing sometimes when apparently healthy people become quite ill with COVID-19. But even in apparently healthy people, there is a large variation in immune age. In another article (referenced below), Dr. Bland points out a North Carolina/Stanford collaborative study in the journal Cell from 2015, where healthy individuals’ immune systems are more deeply characterized that almost 58% of the “functionality” in their immune system are non-heritable and determined by environment, lifestyle, and diet. That means we do not really “inherit” our immune systems, we sculpt our own. This study suggested to him and others that immune cells can suffer mutational injury (genetic damage) and damaged processing of DNA (epigenetic damage) which could explain the increased inflammation state in some people.
In a way, this is good news. If diet and lifestyle factors, more than heredity, can cause inflammaging, maybe diet and lifestyle factors can renew or refresh our immune systems. Dr. Bland goes on to discuss the difference between “immune support” and “immune-rejuvenation”. If we amplify or turn on a damaged system (for example with a mushroom tea) it may ramp up the overall response in the short term, but it may contribute to the long-term immune hyper-signaling we call “cytokine storm”. And the cytokine storms may lead to immune exhaustion and depletion of stem cells. What we really want to do is get rid of the damaged, “geriatric” immune cells and make the system more functional so it doesn’t have to work so hard, doesn’t allow so much intrusion, and has stem cells left for a rainy day. That would leave the immune system with more reserves to fend off cancer, inflammation in the blood vessels, and possibly protect the brain for longer.
In our functional medicine and longevity practice, we do pay a lot of attention to immune aging, working hard to reverse damage and increase vitality, with improved physical fitness, reduction of obesity, and tracking sleep parameters very carefully. We also optimize nutritional status by tuning up diets, measuring vitamins and trace elements, and measuring omega-3 fatty acids. But the additional steps we might need to take are not as intuitive. By encouraging “autophagy”, the destruction of damaged cells, we make sure we have a core surveillance system that is young and fresh and can dispatch with infections more expeditiously, therefore sparing our “reserves” for another fight.
How we refresh our immune system and reverse what we call immunosenescence, is an area under very active study. Many specific phytonutrients (plant compounds) will turn out to be important, various forms of fasting, possibly heat and cold exposure, and other newer modalities are being studied. The future is more exciting than just vitamin C or zinc. Right now, we are able to measure the biological age of your immune system with a test called Glycanage. That’s a start! Because this will not be the last infection or pandemic you will see, and the sooner you start, the more successful this work will be.