Prof. Akiko Iwasaki Profile picture
We study innate and adaptive immunity to #viruses and #cancer. #COVID19 #longCOVID #immunology #vaccines @HHMINEWS @YaleIBIO @YaleMed @YaleEMD @YaleSPH.
Ross Grayson, MPH, CIH Profile picture phyron Profile picture DocM55 🌈🧬 Profile picture Perry Ismangil Profile picture No One You Know ♥️ Profile picture 52 added to My Authors
May 18 8 tweets 5 min read
Please read our latest review by @jan_choutka et al. on “Unexplained post-acute infection syndromes”.

What a privilege to work with Jan Choutka, who is an #MECFS patient, expert and advocate. Grateful to @mhornig on her expertise/insights 🙏🏼 (1/)

nature.com/articles/s4159… With millions of #longCOVID patients, it is becoming better known that even a mild infection can lead to longterm debilitating health problems. SARS-CoV-2 joins the long list of other pathogens that cause post-acute infection syndrome (PAIS). (2/)
May 7 16 tweets 6 min read
In this study, @MiyuMoriyama et al investigate how well SARS-CoV-2 variants of concern (VOC) suppress MHC I needed for recognition by cytotoxic T cells. This question is important to understand how well the virus limits CD8 killing 🧵(1/) @biorxivpreprint
biorxiv.org/content/10.110… CD8 T cells help fight off viral infection by detecting and killing infected cells. CD8 T cells detect MHC I + viral peptide on infected cells. One of the common tricks viruses use to avoid killing is to inhibit MHC I expression and presentation. (2/)

pubmed.ncbi.nlm.nih.gov/19498380/
Apr 16 7 tweets 4 min read
A Phase 2 clinical trial of oral camostat mesylate during early phase of COVID-19 in outpatients reduced illness course (including fatigue) and prevented loss of smell and taste!
Work of fantastic colleagues at @YaleMed. (1/)

medrxiv.org/content/10.110… This randomized double-blind placebo-controlled phase 2 trial gave patients (within 3 days of testing PCR+) either oral camostat mesylate or placebo pills, 4x/day for 7 days. Note the lower smell/taste scores (meaning better ability to smell and taste) in camostat group (2/)
Mar 27 11 tweets 5 min read
This new preprint by Stadler et al. integrated data from 37 randomized controlled trials to ask how the timing and dose of passive antibodies (monoclonal Ab & convalescent plasma) predict protection from SARS-CoV-2 disease. A short 🧵 (1/)

medrxiv.org/content/10.110… Timing: the study found that the earlier the patients were treated with monoclonal antibodies (mAb) or convalescent plasma (CP), the more effective the passive antibodies were in preventing the clinical outcome measured (indicated by right end of line). #TheEarlierTheBetter (2/)
Mar 2 10 tweets 5 min read
What immune cell features are most predictive of COVID outcomes?
@mkuchroo @JcsHuang Patrick Wong et al used ML algorithm Multiscale PHATE to assign each immune cell type in COVID patients a mortality-likelihood score. Latest from @KrishnaswamyLab 💪🏼 (1/)
go.nature.com/3K0QCqi Image Based on the flow cytometry data on 54 million cells from COVID 168 patients, the low density granulocytes (neutrophils and eosinophils) were the most enriched cell types in patients who had fatal COVID, followed by inflammatory monocytes and certain B cell subsets. (2/) Image
Feb 28 10 tweets 6 min read
“COVID toes” are swollen discolored toes (and fingers) that were seen in areas with high incidence of COVID-19, but the cause is unknown. This new study by @JeffGehlhausen et al shows lack of association between covid toes and SARS-CoV-2 infection. 🧵(1/)

pnas.org/content/119/9/… We enrolled 23 pandemic chilblains (PC) patients. While there is an association with community COVID cases (blue line) and PC (red bars), only 2 PC patients had evidence of infection by PCR or antibodies. We wondered if people may have missed the time window for testing +ve. (2/)
Jan 27 18 tweets 9 min read
Vaccines that reduce infection & disease are needed to combat the pandemic. Here, @tianyangmao @BenIsraelow et al. describe our new mucosal booster strategy, Prime and Spike, to induce such immunity via nasal delivery of unadjuvanted spike vaccine 🧵 (1/)

biorxiv.org/content/10.110… Current COVID vaccines are given intramuscularly. This induces robust circulating antibodies and systemic T & B cell responses that block viral spread and disease. However, to better block infection, immunity has to be established at mucosal surfaces. (2/)
annualreviews.org/doi/10.1146/an…
Jan 16 17 tweets 11 min read
So excited to be a part of this important study led by @michelle_monje on how significant longterm neurologic damage can occur after a mild respiratory-only SARS-CoV-2 infection. My own🧵on the findings of this study with relevance to #longCovid (1/)

biorxiv.org/content/10.110… How can a mild respiratory SARS-CoV-2 infection lead to longterm neurological symptoms? Possibilities include 1) direct infection of 🧠, 2) autoimmunity, and 3) inflammatory impact of infection distal to the 🧠. In this study, we focused on 3) 👇🏽 (2/) Image
Dec 30, 2021 11 tweets 5 min read
CoronaVac is an inactivated SARS-CoV-2 vaccine approved for use in 48 countries. In collaboration with the Ministry of Health in Dominican Republic, we tested whether CoronaVac (2x) + Pfizer booster induces neutralizing Abs to Delta and Omicron. (1/)

medrxiv.org/content/10.110… We analyzed plasma samples from 101 participants in Dominican Republic (DR) who received the BNT162b2 booster >4 weeks after the 2x of CoronaVac. We compared them to samples from people at Yale who received 2x of BNT162b2.
⬆️ ⬆️ Ab induced by heterologous prime & boost.(2/)
Dec 20, 2021 15 tweets 8 min read
This thread is about our new preprint on transposable element called long interspersed nuclear elements (LINE-1/L1). When expressed excessively in the cerebellum, L1 causes ataxia (impaired coordination).

A fascinating finding by @taka_takehiro 👇🏽 (1/)

biorxiv.org/content/10.110… Human genome is occupied in large part by transposable elements or jumping genes. LINE-1 occupies ~20% of our genome, compared to only 1.1% by exons. Some evolutionarily young LINE-1 are still active and are a rare cause of genetic diseases. (2/)

nejm.org/doi/full/10.10…
Dec 11, 2021 14 tweets 9 min read
Our new study by @JieunOh9 @ericsongg @MiyuMoriyama et al shows that immune priming via intranasal route provides superior protection against heterologous respiratory virus challenge. The key is in inducing local secretory IgA with broader coverage. (1/)

science.org/doi/10.1126/sc… Mucosal surface epithelium expresses polymeric Ig receptor (pIgR), which transports dimeric IgA + J-chain secreted from plasma cells within the tissue, across to the luminal side. IgA dimer + J-Chain + part of pIgR is released as ‘secretory IgA’. Figure by @BioRender. (2/)
Dec 1, 2021 6 tweets 3 min read
Today is #WorldAidsDay2021

Sharing our new review on "Impact of Chronic HIV Infection on SARS-CoV-2 Infection, COVID-19 Disease and Vaccines” by @YYexin. A short thread (1/)

link.springer.com/article/10.100… Despite a number of studies, whether HIV infected individuals are at higher risk of COVID-19 diagnosis, hospitalization, and mortality remains unclear due to variable results found in the population studies, cohort studies, and case series. (2/)
Nov 23, 2021 9 tweets 4 min read
A preprint by Michael Simon et al @ArcadiaHealthIT shows that COVID vaccines given before or AFTER infection can reduce incidence of #longCOVID, based on a retrospective analysis of the health record of 240,648 COVID-19-infected people. 🧵(1/)

medrxiv.org/content/10.110… People who received at least one dose of any of the 3 COVID vaccines in the US prior to COVID diagnosis were 8.8x less likely to report >1 long COVID symptoms between 12-20 weeks after diagnosis. (2/)
Nov 10, 2021 15 tweets 8 min read
Our latest study is about an immunocompromised patient with persistent COVID ➡️ treated with remdesivir but developed resistant mutation ➡️ was then cured by monoclonal Ab cocktail. Study by @gandhisk @sneakyvirus1 @epidememeology @marioph13 et al. (1/)

medrxiv.org/content/10.110… This patient received a course of rituximab (B cell depleting Ab) and bendamustine (chemo agent) for the treatment of Stage IV Non-Hodgkin's lymphoma. As a result, patient had extremely low number of T cells and low lymphocyte counts overall. Analysis by @peowenlu (2/)
Oct 31, 2021 4 tweets 3 min read
Our study on immune profiling of a solid organ transplant recipient with SARS-CoV-2 reinfection is now published.

Congrats to lead authors @sneakyvirus1 @AndersonBrito_ Paul Trubin @peowenlu and senior authors Marwan Azar & @BenIsraelow 👏🏼 👏🏼 (1/)

academic.oup.com/jid/advance-ar… For description of this study, please see my thread from when we first posted the paper in @medrxivpreprint in March 👇🏽 One of the deepest immune profiling that captures reinfection in a longitudinal manner. (2/)

Oct 11, 2021 6 tweets 4 min read
In our study published today, we show;

1) mRNA vaccines (2 shots) induce robust antibodies & T cells to SARS-CoV-2
2) certain mutations in VOC ⬆️ Ab escape
3) prior infection + 2 mRNA shots produce very high neutralizing Ab against most VOC 🦠(1/)

nature.com/articles/s4158… If the link above does not work, here is a full text access of our paper. (2/)

rdcu.be/czi6G
Oct 2, 2021 8 tweets 6 min read
An important new study looks at how COVID vaccines impacts symptoms in #LongCovid patients. @thitran3’s team used data from ComPaRe long COVID cohort to emulate a target trial (1:1 matched vax:unvax) measuring outcome at 120 days after baseline. (1/)

papers.ssrn.com/sol3/papers.cf… The study found that the rate of complete remission from long COVID symptoms doubled in vaccinated patients compared to unvaccinated long COVID patients. Wow, vaccines appear to be helping long haulers with recovery 👏🏼 (2/)
Sep 6, 2021 6 tweets 4 min read
I am very proud of @marioph13, @peowenlu and @ValterVSM for participating in #scicomm. They explained viral plaque assay, flow cytometry and ELISA to news reporter from WAPA TV 🇵🇷 via @dacolon

Me: Cloro no, vacuna sí! (1/)

wapa.tv/programas/cuar… Here is @Marioph13 explaining viral plaque assay en español 🤩 (too bad his excellent explanation did not make it into the video clip) (2/)
Sep 2, 2021 15 tweets 7 min read
Excited to share our work by @BenIsraelow et al published today. We asked what are the roles of antibodies vs. T cells in controlling primary infection, reinfection, and vaccine-mediated protection? (1/n)

science.org/doi/10.1126/sc… First, we asked if B cells are needed to control primary infection. We used muMT mice (devoid of B cells) transduced with AAV-hACE2. These mice had only a slight delay in viral clearance. Thus B cells are not necessary for controlling primary SARS-CoV-2 infection. (2/n)
Aug 10, 2021 11 tweets 10 min read
In this new Neuroview in @NeuroCellPress, I discuss "How COVID-19 has transformed my science”. Recounting my personal journey of how I responded to the pandemic, and how the pandemic has transformed the way I do science. Some lessons learned. (1/n)

cell.com/neuron/fulltex… Glad to highlight my amazing colleagues who made team science possible. The Yale IMPACT team, Albert Ko, @SaadOmer3 @NathanGrubaugh @ShelFarFar @CharleszYaleMed @EllenFoxman Allison Nelson & many others. @wade_schulz opened my 👀 to the power of data science (2/)
Jul 19, 2021 17 tweets 9 min read
How do the various mutations within the SARS-CoV-2 variants impact vaccine-induced immunity? The amazing @carolilucas @VogelsChantal @InciYildirim11 led this study with with help from others to tackle this question - using 18 CoV-2 variants. (1/n)

medrxiv.org/content/10.110… The study was designed to measure antibody and T cell immunity from people who were previously infected or not infected with SARS-CoV-2, before and after the 1st and 2nd doses of mRNA vaccines. Amazing effort by @InciYildirim11 @SaadOmer3 (2/n)