Inborn errors of type I IFN immunity in patients with life-threatening COVID-19 science.sciencemag.org/content/early/…
The ability to control the initial infection through type I IFN may be so important in COVID and also many other acute viral infections - Flu, Dengue, Yellow Fever, Chik, and others.
Idea that these infections are characterised by inability to control initial infection. As a result of a poor early immune response. Followed later by an exaggerated & uncontrolled response.
Identifying & proving treatments work has proved so difficult because need to know where in very dynamic changing immune cascade the infection is. At one time point may need “enhance” immune response & then very quickly later “suppress” it. Get it wrong & would make things worse
Has implications for treatment as so difficult to change the immune cascade with such precision & timing. But also for transmission. Those who do not control that initial infection will have higher viral loads and be more likely to transmit- which is an evolutionary advantage.
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