Please note the diagram only presents an outline, not the whole thing.
Neutralising antibodies form only a tiny fraction of our TOTAL antibody response. Most antibodies are produced AFTER the attack occurs, helping eliminate virus.
(Labs measure Ab’s ALREADY in circulation)
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In other words, neutralising antibodies aren’t everything.
And, importantly, a “loss of neutralisation” (‼️🔴alarmist language that lab researchers love to use while describing their work to a clueless public) doesn’t mean “we have lost against the virus”.
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The virus has so many other parts that our system recognises.
In fact even after delta arrived, upto 97% of the T cell epitopes haven’t been altered (the mutations affect only about 3%)
Epitopes are parts of the virus that the body picks up as specific “identifying marks”
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Specifically, epitopes are ultra short sequences of 4-17 amino acids (basic building blocks of protein).
❗️If antigen is a mango tree, epitopes are the mangoes.
T cells and other parts of our immune system learn to recognise specific epitopes of specific viruses.
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Our immune system learns about these epitopes after vaccination (when we introduce harmless components of the virus) or through natural infection or both.
Note: There are 100’s of epitopes that get recognised for each infective agent. (A few are on the RBD of spike protein)
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❗️The virus will NEVER be able to change ALL of these epitopes (or even 20% of ‘em) because it will “lose fitness”. In other words, some parts are ESSENTIAL for the virus to work.
(For example, a plane cannot take off if its propeller blades are cut in half by some mutation)
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The spike protein itself has 1273 amino acids, and many immovable or unchangable epitopes on it.
Antibodies target these areas too, and help eliminate infection in many ways (not just by neutralisation).
Eg. they flag our infected cells to be killed by immune cells (ADCC)
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Ab’s can also tag infected cells to be eliminated by a series of destroyer proteins called “C”or “Compliment system” (C is gun powder)
Ab’s can directly flag the virus by attaching to parts of it, hanging on tight and then inviting our immune cells to come and swallow them.
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There are other ways by which antibodies work.
And then there are our CD8 T-cells which come & destroy infected cells, preventing the virus from getting any further.
It is like bombing the building where some real bad thugs are huddled together, so that they don’t get out.
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Our CD4 T cells work like choirmasters, coordinating the immune response in a seamless manner, they also boost other players into action.
After the action settles, some of these B and T cells retire and live peacefully forever as memory cells in remote parts of our body.
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These normally peace-loving memory cells get activated at the slightest hint of a future infection, losing absolutely no time in recreating the original task force (only 10 times bigger and meaner), thus taking out the offender without breaking a sweat.
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And the best part is that our immune system is continuously learning and upgrading its skills, even after the infection or vaccination period is over, so that the next time around, the antibodies stick better and work faster.
This process is called affinity maturation.
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Immunology is fascinating and complicated. I have given the highlights above.
Just to show that our systems are well-equipped to handle the virus regardless of alarmist messaging based on lab studies.
Authors believe that factors such as antigen availability, type of antigen-presenting cells, and cytokine milieu – might influence the type of memory formed.
Note: T cell memory cells are of multiple categories, not all of which are detected in peripheral blood.
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Some memory cells live in tissue and others in lymph nodes.
This study looked only at peripheral blood, and hence is not a description of T rm or T cm memory cells.
T rm’s live in tissues and do not move out. They defend tissues (e.g. lungs & mucosa) when an attack occurs.
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When a group under observation has a fixed advantage at the outset.
In heart transplantation VS non heart transplantation studies, this bias was first described (those who got the transplant had the opportunity to survive till they got operated)
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That is, the transplanted group were the healthier of the lot, they survived longer than those who died while waiting for surgery.
This was projected as an apparent outcome of transplant in some studies.
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No waning of immunity against severe disease: New York data NEJM
Note the effectiveness is calculated by comparing with unvaccinated group, which is gradually acquiring immunity from natural infection. Hence, there will be a decrease in the difference as time moves forward.