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A research team from the University of Arkansas for Medical Sciences has identified a potential cause of long-lasting symptoms experienced by COVID-19 patients, often referred to as “long-haul.”
At the heart of the team’s findings is an antibody that appears weeks after an initial infection and attacks and disrupts a key regulator of the immune system, said lead researcher John Arthur, MD, Ph.D., professor and chief of the Division of Nephrology at the College of Medicine of UAMS, Department of Internal Medicine.
Up to 30% of COVID-19 patients experience persistent fatigue, brain fog, and shortness of breath. Scientists have missed the cause of the long COVID-19, but the UAMS team’s discovery sheds important new light on the molecular-level mechanisms behind it.
“Everything we’ve found is consistent with this antibody as the instigator of the long COVID, so it’s an exciting development,” Dr Arthur said.
The antibody creates problems for the immune system by attacking the angiotensin 2 converting enzyme (ACE2). The ACE2 enzyme helps regulate the body’s response to the virus by metabolizing a peptide that activates the immune system.
The attacking antibody interferes with the work of ACE2, making the antibody a prime suspect for long-term illness.
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The multidisciplinary research team came together quickly this spring to test the hypothesis that developed through discussions between Arthur and Terry Harville, MD, Ph.D. of UAMS, professor in the department of pathology and director medical laboratory histocompatibility and immunogenetics.
Researchers tested plasma or serum for ACE2 antibodies in 67 patients in Arkansas and Oklahoma with known SARS-CoV-2 (the virus that causes COVID-19) and 13 without a history of infection. In 81% of blood samples from patients with a history of COVID-19, the samples contained the antibody that attacked ACE2. In participants with no history of COVID-19, no antibodies were created to attack the ACE2 enzyme.
“If we show the whole hypothesis to be true, that this interference from ACE2 is really causing a long COVID, then that opens up a lot of potential treatments,” Arthur said. “There are drugs that should work to treat them. “
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The next step would be to test drugs that could relieve the symptoms that people have.
Little Rock scientists published their findings this month in the journal, Science ONE Public Library (PLOS ONE).
“It’s real team science,” said Arthur. “We have assembled a large group of investigators who have never worked together to produce these very exciting results.”
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