Amy Proal, PhD Profile picture
Feb 13, 2020 11 tweets 8 min read Read on X
Glad to see #ME/CFS mentioned as a disease potentially connected to immunometabolic reprogramming of host cells. But #pathogen activity in ME/CFS is severely understudied. For example, no team has yet searched for organisms in patient cerebrospinal fluid
2/ Further, numerous outbreaks of the disease have occurred that were directly linked to #enterovirus/coxsackie #viruses + autopsy studies of patients w/ ME/CFS have identified enteroviruses in patient brain tissue + stomach biospy samples: ncbi.nlm.nih.gov/pubmed/17872383
3/ Moreover early studies on #microbiome activity in ME/CFS indicate dysbiosis of #bacterial communities in patients w/ the #disease, w/ one study noting an increase in bacterial phyla in patient blood after a symptom-provocation challenge: ncbi.nlm.nih.gov/pubmed/26683192
4/ Or this team found that the prevalences + median values for serum IgA against the LPS of enterobacteria were significantly greater in patients with ME/CFS than controls: ncbi.nlm.nih.gov/pubmed/17007934
5/ Those and related studies matter greatly, b/c a growing range of intracellular #viruses + #bacteria are capable of driving potential immunometablic (Warburg-associated) changes in immune cells of patients with ME/CFS.
6/ Even #LPS itself has been shown capable of directly inducing a Warburg-like metabolism in host cells (often via activation of TLR4): ncbi.nlm.nih.gov/pubmed/29603622 Image
7/ The paper I linked to above further discusses how a range of intracellular #bacteria (mycobacteria, chlamydia etc) can reprogram + remodel host cells to Warburg-like #metabolic state. This shift allows them to better create nutrients needed for their survival/replication.
8/ A range of #viruses - EBV, Dengue - etc also shift host cells towards a Warburg metabolism, which provides such viruses w/ increased pools of free nucleotides for rapid replication, viron assembly etc: ncbi.nlm.nih.gov/pubmed/25812764 Image
9/ That means we must continually study Warburg/immunometabolic reprogramming of host cells in the context of the #organisms/pathogens present in any patients’ microbiome/#virome communities (in all chronic conditions!)
10/ Keep in mind this @BrodinPetter paper which found variation in the human immune system is largely driven by non-heritable influences like pathogens. We must always factor these environmental influences into the "immune" component of "immunometabolism": ncbi.nlm.nih.gov/pubmed/25594173 Image
@BrodinPetter What do you think @mhornig, @DrMaureenHanson? Any feedback appreciated! 😀

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More from @microbeminded2

Apr 13
@BaszkoM @RorPreston @polybioRF That is not correct. We are working very hard on ME/CFS projects in addition to LC, and almost every day we work with teams to determine how more of our LC projects can be pivoted to ME/CFS in the future
@BaszkoM @RorPreston @polybioRF 2/ ME/CFS projects include this collaborative study determining immune activity, microclotting and other infectious parameters in ME/CFS patients with peripheral neuropathy: polybio.org/projects/immun…
@BaszkoM @RorPreston @polybioRF 3/ This study of neuroinflammation via PET imaging and imaging to document changes in cognitive control (brain fog) in ME/CFS: polybio.org/projects/5272/
Read 10 tweets
Apr 9
For more context: The team found #SARS-CoV-2 proteins indicative of viral persistence in 25% of people up to 14 months after #COVID. They controlled for vaccination + reinfection. There were very few false positives in the pre-pandemic samples, confirming accuracy of the methods
2/ The viral proteins were found in participant blood. Where did they come from? As described in our paper below, it’s possible that at least some of the proteins “leak” into blood from persistent reservoirs of SARS-CoV-2 in tissue (gut, lungs etc): pubmed.ncbi.nlm.nih.gov/37667052/
3/ This means the new Lancet findings could even be underestimating SARS-CoV-2 reservoirs in people after COVID, since protein from reservoirs deep in the #brain or #nerves might not have made it into blood to be measured by the ultra-sensitive test used in the study
Read 15 tweets
Jan 17
Tell @ChrisCuomo that 33 scientists from 14 institutions joined forces to write this paper documenting evidence for #SARS-CoV-2 persistence as a potential driver of #LongCOVID. We call for more clinical trials of drugs capable of clearing persistent virus: pubmed.ncbi.nlm.nih.gov/37667052/
2/ We have formed a global #Consortium to study SARS-CoV-2 persistence: to determine if reservoirs of the #virus in LongCOVID tissue can drive widespread dysfunction including clotting, #microbiome, and neuroimmune abnormalities: polybio.org/longcovid
3/ Thus far, members our Consortium or our colleagues (including at NIH) have found persistent #SARS-CoV-2 RNA or proteins in tissue/nerve samples collected from dozens of human body & brain locations: pubmed.ncbi.nlm.nih.gov/36517603/
Read 18 tweets
Dec 1, 2023
I want to add that I see #SARS-CoV-2 persistence as part of a larger picture in which other latent pathogens and/or #microbiome organisms also harbored by a patient play an important role in the ultimate set up symptoms they develop
2/ Pathogens harbored by a patient at the time of SARS-CoV-2 #infection may serve as a predisposing factor to either persistence of the virus or increased disease in the acute phase
3/ E.g. Bartonella is a persistent #bacteria that drives blood vessel dysfunction by infecting #vascular endothelial cells. So someone with Bartonella may be more susceptible to SARS-CoV-2’s detrimental impact on blood vessels, and have more trouble clearing virus from such sites
Read 12 tweets
Nov 28, 2023
Incredible to see the technology being developed openly here - not just to mitigate #COVID-19 but to create an innovative global infrastructure that positions humanity in excellent shape to combat the next airborne #virus pandemic
2/ To advance this movement in which novel tools to study & contain airborne #pathogens are actively being built, one must reject the narrative that there are only two paths forward 1) To 'care' abt airborne #infection means lockdowns 2) Freedom means ignoring airborne infection
3/ It's 2023 and many intermediate solutions are possible. We can install UV light and filter #technologies in schools, airports, even homes - to remove viruses from the air. With enough of these tools in a room, people may be able to interact freely without getting infected
Read 13 tweets
Nov 3, 2023
Incredible new paper demonstrating #SARS-CoV-2 persistence + associated immune modulation in macaque monkeys. The team found replication competent SARS-CoV-2 virus in macaque lung alveolar #macrophages beyond 6 months postinfection: nature.com/articles/s4159…
2/ IFN-γ production was impaired in NK cells from macaques with persisting virus. Moreover, IFN-γ also enhanced the expression of major histocompatibility complex (MHC)-E on lung alveolar macrophages, possibly inhibiting NK cell-mediated killing
3/ In the lab, increasing SARS-CoV-2 levels during culture corresponded to ongoing viral replication and were accompanied by #virus-induced morphological changes including filiform extensions that connected multiple macrophages, with viral proteins detected in these extensions.
Read 6 tweets

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