Jeff Gilchrist Profile picture
Jan 6, 2023 39 tweets 12 min read Read on X
How #COVID actively suppresses and evades your immune system [Part 1]

This thread highlights multiple methods that the virus uses to help keep reinfecting people including MHC-I and interferon suppression, evasion of Natural Killer (NK) cells, and reprogramming of monocytes.🧵1/ AI generated image of immun...
An unrolled one-page web view for this long thread that may be easier to read or share can be found here ( ). 2/
COVID has been doing this to varying degrees since the beginning which further reinforces that a vaccine only policy is not enough to stop the cycle of sickness, long term disability, and death. 3/
Some people have the privilege of clean drinking water so they do not have to boil their own water for it to be safe because the infrastructure was put in place to clean the water. 4/
We need similar changes in infrastructure now to provide clean indoor air for people, not just from pathogens but from other pollutants as well ( ). 5/
First some simplified background info, CD8+ T-cells and Natural Killer (NK) cells are both immune system cells with similar goals to kill (cytotoxic) infected and transformed cells but their recognitions and memory mechanisms are very different ( ncbi.nlm.nih.gov/pmc/articles/P… ). 6/
Cells express MHC-I molecules on their surface as a surface recognition element to signal the cell's physiological state to immune cells such as T-cells and NK cells ( pubmed.ncbi.nlm.nih.gov/11256571/ ). 7/
When a cell is infected for example, it will present parts of the virus (antigen) on the surface using MHC-I as a way to alert the immune system for help. 8/
The T-cells look for specific antigens they have been "trained" to find and will bind to a cell that matches and then activate their response such as killing the cell. 9/ Diagram showing activating ...
With NK cells however, there is no single dominant receptor for NK cell recognition but they express an array of innate activating and inhibitory receptors to sense their environment and respond to alterations caused by infections, stress, and transformation. 10/ Diagram showing activating ...
Innate immunity cells are the first responders to sites of infection and NK cells are much quicker to establish a robust response than CD8+ T-cells ( ncbi.nlm.nih.gov/pmc/articles/P…). NK cells can also recruit T-cells and other adaptive responders to the sites of infection. 11/
You can learn more watching this @VirusesImmunity "Immunology 101 for non-immunologists video" ( ) and @Kurz_Gesagt "How your immune system actually works video" ( ). 12/
Now that you have a little background, how does the COVID virus try to avoid the immune system? The newer Omicron variants exhibit an even greater ability to suppress surface MHC-I expression in cells the virus infects ( biorxiv.org/content/10.110… ). H/T: @VirusesImmunity 13/
That means CD8+ T-cells can't as easily "dock" with the infected cell and kill it. The study found multiple variants BA.1, BA.2.12.1, BA.4, and XAF all had significantly higher MHC-I suppression than the original WA1 strain but had no impact in MHC-I on the surrounding cells. 14/ Graph showing Increased sup...
This allows infected cells to be more "invisible" to CD8+ T-cells that otherwise would have been able to find and destroy the cell which lets the virus continue to replicate. 15/
Another study found that COVID virus also suppresses the danger signals that are supposed to help NK immune cells recognize (with their NKG2D receptor) and kill infected cells ( cell.com/cell-reports/f… ). H/T: @m_janelee 16/ Diagram showing NK immune c...
COVID virus causes NK cells to exhibit poor cytotoxic (killing) responses to infected cells and instead preferentially target and kill uninfected bystander cells. 17/
The researchers found that NK cells are actually really good at killing COVID infected cells before the virus has had a chance to replicate and suppress NKG2D-L compared to 48 hours after infection ( ). 18/ Diagram showing NK immune c...
The part of the virus that suppresses NKG2D-L to prevent NK cells from killing the cells they infect is Non-Structural Protein 1 (Nsp1). 19/
The researchers found that just putting Nsp1 inside the cell without any other part of the virus was enough to both suppress NKG2D-L and stop NK cells from killing it. 20/
When they tried using various other components of the virus instead, the NK cells kept killing the cells, with most increasing the chance of the cell being killed. 21/
This is yet another way for COVID to get around the immune system with methods to make infected cells more "invisible" to both immune CD8+ T-cells and NK cells. 22/
The researchers point out that the Nsp1 protein in the virus is highly conserved and needed for viral replication so it may make a good target for therapeutics against other families of coronaviruses as well. 23/
Due to genetic variation about 4% of a population studied lacked the NKG2C receptor on NK cells and 30% have the receptor only partially available which had a significant impact on the development of severe COVID infections ( gimjournal.org/article/S1098-… ). H/T: @0bj3ctivity 24/
The study found people without the NK receptor or having a partial receptor were significantly overrepresented in hospitalized patients, particularly in patients requiring intensive care compared to those with mild symptoms. 25/
These multiple methods of immune suppression and evasion by COVID help explain why viral loads can get high enough again in people that are previously infected/vaccinated to become contagious and transmit the virus to others before the body can get the infection under control.26/
Part 2 will look at how the COVID virus reprograms innate immune functions such as white blood cells (monocytes) that increase the risk of blood clots and suppresses innate immunity to other viruses and bacteria increasing risk of secondary infections. 27/
To add some context to tweet 26/ for people who are vaccinated or previously infected, even though your immune system has seen a COVID variant before and you already have T-cells that can recognize the virus... 28/
...the new variant you are exposed to can suppress the mechanism that those T-cells (and NK cells) use to identify and kill COVID infected cells giving the virus time to replicate a lot before other parts of the immune system notice and start fighting off the virus. 29/
That is why people can't "vax and relax" forgoing all other precautions because exposure again can still give the new virus infection a chance to replicate enough to cause trouble in your own body and also potentially infect other people too. 30/
Some people are asking, why does this immune suppression happen to people who have been vaccinated and never infected before as well as people who have been infected already? Click "Show replies" 👇 to continue. 31/
It is happening to all people because the mechanism to evade and suppress the immune system that I describe in this thread is the ability of the virus itself to turn off/reduce the ability of CD8+ T-Cells and NK immune cells from detecting the cells it has infected. 32/
This allows the virus to fly under the radar, vaccinated or not. If you get infected, among many things, your body develops T-cells that recognize the virus Spike protein. When you get vaccinated, you also develop T-cells but without getting attacked by a functional virus. 33/
When you get infected again (or first time after vaccination) those T-Cells are trying to specifically hunt down and kill COVID infected cells it already learned about but they can't easily find them and kill them because... 34/
...the new virus infection is blocking the ability for the T-cell to do that. So this happens in both scenarios. 35/
Without needing to know about the COVID virus specifically, immune NK cells also try to hunt down and kill any infected cells, but again COVID developed a way to prevent NK cells from finding them and doing this effectively. 36/
The evasion is a property of the virus itself so it happens with all people who get exposed, the virus hides from the immune system whether you are vaccinated or not, previously infected or not. 37/
Think of the COVID virus as a Ninja, it can sneak into your castle and hide even if the guards have seen Ninja before and defeated them. The guards can't fight them unless they know they are there in the first place and where to find them. 38/ AI generated image showing ...
Part 2 which looks at how mild and moderate #COVID infection reprograms white #blood cells (#monocytes) to reduce #innate #immune functions and how it evades the mucus layer in our #nose is now available ( ). 39/

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More from @jeffgilchrist

Apr 29
People are rightfully concerned about the high case fatality rate (CFR) of the H5N1 influenza virus but did you know fatalities from COVID infection (which already spreads easily between humans) with the elderly are as high as 40% ( )? 🧵1/
Virus infection can damage the body, we have seen this with Long COVID and this can happen with other viruses as well such as Influenza causing increased risk of cardiovascular events among other things. 2/
This study tries to indirectly measure the impact of influenza infection by looking at cardiovascular events and then measuring the risk people had if they received the influenza vaccine or not( … ). 3/ H/T: @JaninePaynterncbi.nlm.nih.gov/pmc/articles/P…
Read 12 tweets
Apr 28
#Variant update for #Ontario, #Canada (to Apr. 17, 2024)

The JN.1.* +FLiRT variants now make up 20% of sequences and XDK.* which is recombinant of JN.1.1.1 and XBB.1.16.11 has made an appearance at 5%. Graph tools by @Mike_Honey_ 🧵1/
Sankey graph (height of each bar is # of sequences for that variant) showing top variants and their lineages over the past couple of months from PCR test genomic sequencing in Ontario, Canada. Visualization tool was created by @Mike_Honey_ ( https://app.powerbi.com/view?r=eyJrIjoiNzE5YzczODItMDQzMS00M2EzLWFjNWYtMjg3OTY3NTNhZDM3IiwidCI6ImRjMWYwNGY1LWMxZTUtNDQyOS1hODEyLTU3OTNiZTQ1YmY5ZCIsImMiOjEwfQ%3D%3D&pageName=ReportSection32240d6b62ba73667e98 )
Graph of top 7 COVID variant clans from PCR test genomic sequencing in Ontario, Canada. Visualization tool was created by @Mike_Honey_ ( https://app.powerbi.com/view?r=eyJrIjoiNzE5YzczODItMDQzMS00M2EzLWFjNWYtMjg3OTY3NTNhZDM3IiwidCI6ImRjMWYwNGY1LWMxZTUtNDQyOS1hODEyLTU3OTNiZTQ1YmY5ZCIsImMiOjEwfQ%3D%3D
FLiRT is a nickname for variants with F456L & R356T mutations which seem to provide an advantage over the JN.1 Pirola variants without them. You can see the current FLiRT variants here from @dfocosi. 2/ Chart of BA.2.86* variant convergence and latest FLiRT mutations. Chat by @dfocosi ( https://twitter.com/dfocosi/status/1780183036853690596 )
JN.1 #Pirola has dropped to around 20% frequency and JN.1.4 is hovering at 14% while the FLiRTs are gaining: KS.1 at 10%, KP.1.1 at 4%, KP.2 at 3% and XDK.1 at 4%. 3/ Graph of top 8 COVID variants (JN.1, JN.1.16.1, JN.1.4, KP.1.1, KP.2, KS.1, XDK.1) from PCR test genomic sequencing in Ontario, Canada. Visualization tool was created by @Mike_Honey_ ( https://app.powerbi.com/view?r=eyJrIjoiNzE5YzczODItMDQzMS00M2EzLWFjNWYtMjg3OTY3NTNhZDM3IiwidCI6ImRjMWYwNGY1LWMxZTUtNDQyOS1hODEyLTU3OTNiZTQ1YmY5ZCIsImMiOjEwfQ%3D%3D )
Read 17 tweets
Apr 20
#Variant update for #Ontario, #Canada (to Apr. 9, 2024)

The regular BA.2.86.*/JN.1.* #Pirola clan of variants as you know them are starting to go down in Ontario. This is because descendants are picking up two very useful FLiRT mutations. Graph tools by @Mike_Honey_ 🧵1/
Sankey graph (height of each bar is # of sequences for that variant) showing top variants and their lineages over the past couple of months from PCR test genomic sequencing in Ontario, Canada. Visualization tool was created by @Mike_Honey_ ( https://app.powerbi.com/view?r=eyJrIjoiNzE5YzczODItMDQzMS00M2EzLWFjNWYtMjg3OTY3NTNhZDM3IiwidCI6ImRjMWYwNGY1LWMxZTUtNDQyOS1hODEyLTU3OTNiZTQ1YmY5ZCIsImMiOjEwfQ%3D%3D&pageName=ReportSection32240d6b62ba73667e98 )
Graph of top 7 COVID variant clans from PCR test genomic sequencing in Ontario, Canada. Visualization tool was created by @Mike_Honey_ ( https://app.powerbi.com/view?r=eyJrIjoiNzE5YzczODItMDQzMS00M2EzLWFjNWYtMjg3OTY3NTNhZDM3IiwidCI6ImRjMWYwNGY1LWMxZTUtNDQyOS1hODEyLTU3OTNiZTQ1YmY5ZCIsImMiOjEwfQ%3D%3D
FLiRT is a nickname for variants with F456L & R356T mutations which seem to provide an advantage over the JN.1 Pirola variants without them. You can see the current FLiRT variants here from @dfocosi. 2/ Chart of BA.2.86* variant convergence and latest FLiRT mutations. Chat by @dfocosi ( https://twitter.com/dfocosi/status/1780183036853690596 )
Now that most variants with FLiRT have designations, you can see that JN.1 has dropped to 20% frequency while the new KP.3 FLiRT has jumped to 17.5%. The KS.1 FLiRT variant has also increased to 11% and KP.2 FLiRT is in the mix as well. 3/ Graph of top 8 COVID variants (JN.1, JN.1.13.1, JN.1.4, JN.1.7, JN.1.8.1, KP.2, KP.3, KS.1) from PCR test genomic sequencing in Ontario, Canada. Visualization tool was created by @Mike_Honey_ ( https://app.powerbi.com/view?r=eyJrIjoiNzE5YzczODItMDQzMS00M2EzLWFjNWYtMjg3OTY3NTNhZDM3IiwidCI6ImRjMWYwNGY1LWMxZTUtNDQyOS1hODEyLTU3OTNiZTQ1YmY5ZCIsImMiOjEwfQ%3D%3D )
Read 13 tweets
Mar 25
PHO is reminding HCWs, even those who have been vaccinated, to wear an N95 while providing care to people with confirmed or suspected cases because they know N95s can prevent infection from infectious aerosols. Works for other airborne viruses as well and non-HCW too.
Respirators protect individuals who are healthy and help reduce the chance of individuals who are sick from infecting others even in well ventilated places where short-range transmission is a concern. 2/
Yes, respirators actually work, read this thread to learn how ( ). 3/
Read 7 tweets
Mar 25
Virus update for Ottawa, Canada (Mar 25, 2024)

COVID-19 #Wastewater levels in #Ottawa have finally declined significantly but lower does not mean gone as PCR test positivity rates are still at 7.6% ( ). 🧵1/ covid.gilchrist.ca/Ottawa.html
Graph of COVID-19 wastewater levels in Ottawa, Ontario. Weekly stats available at ( http://covid.gilchrist.ca/Ottawa.html )
RSV WW levels are 7.7x lower than the peak which was much lower than last year. Influenza had much higher peaks this year than last year and while Flu A levels are low, Flu B hit its peak at the beginning of March and is now declining but still above the peak from last year. 2/ Graph of RSV, Influenza A & B wastewater levels in Ottawa, Ontario. Weekly stats available at ( http://covid.gilchrist.ca/Ottawa.html )
Ottawa Public Health (OPH) stopped updating its COVID dashboard and now produces new stats on their updated respiratory virus dashboard ( ). 3/ottawapublichealth.ca/en/reports-res…
Read 12 tweets
Mar 24
#Variant update for #Ontario, #Canada (to Mar. 14, 2024)

The BA.2.86.* #Pirola clan of variants has made most other lineages extinct in Ontario. The SanKey shows the situation is now much simpler and almost exclusively JN.1 and descendants. Graph tools by @Mike_Honey_ 🧵1/
Sankey graph (height of each bar is # of sequences for that variant) showing top variants and their lineages over the past couple of months from PCR test genomic sequencing in Ontario, Canada. Visualization tool was created by @Mike_Honey_ ( https://app.powerbi.com/view?r=eyJrIjoiNzE5YzczODItMDQzMS00M2EzLWFjNWYtMjg3OTY3NTNhZDM3IiwidCI6ImRjMWYwNGY1LWMxZTUtNDQyOS1hODEyLTU3OTNiZTQ1YmY5ZCIsImMiOjEwfQ%3D%3D&pageName=ReportSection32240d6b62ba73667e98 )
Graph of top 7 COVID variant clans from PCR test genomic sequencing in Ontario, Canada. Visualization tool was created by @Mike_Honey_ ( https://app.powerbi.com/view?r=eyJrIjoiNzE5YzczODItMDQzMS00M2EzLWFjNWYtMjg3OTY3NTNhZDM3IiwidCI6ImRjMWYwNGY1LWMxZTUtNDQyOS1hODEyLTU3OTNiZTQ1YmY5ZCIsImMiOjEwfQ%3D%3D
Right now the JN.1 and JN.1.4 Pirola variant are still the most prevalent. The JN.1.11.1 variant, its descendants (KP.*) and other FLiRT variants will be the ones to watch as they start growing in Ontario and may be able to escape immunity from JN.1 infections. 2/ Graph of top 8 COVID variants (JN.1, JN.1.1, JN.1.11.1, JN.1.2, JN.1.22,, JN.1.4, JN.1.7, JN.1.8.1) from PCR test genomic sequencing in Ontario, Canada. Visualization tool was created by @Mike_Honey_ ( https://app.powerbi.com/view?r=eyJrIjoiNzE5YzczODItMDQzMS00M2EzLWFjNWYtMjg3OTY3NTNhZDM3IiwidCI6ImRjMWYwNGY1LWMxZTUtNDQyOS1hODEyLTU3OTNiZTQ1YmY5ZCIsImMiOjEwfQ%3D%3D )
The % positivity from viral tests is quite a mixture now, the original Coronavirus in lead at 8.2% with COVID-19 in 2nd (6.3%) then Entero/Rhinovirus (5%), Human metapneumovirus (4.6%), Influenza A (4%), Influenza B (3.8%), Parainfluenza (3.4%) ( ). 3/ publichealthontario.ca/en/Data-and-An…
Table showing percentage positivity of respiratory virus activity in Ontario. Table from: https://www.publichealthontario.ca/en/Data-and-Analysis/Infectious-Disease/Respiratory-Virus-Tool
Read 8 tweets

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