Novel Strategies for COVID-19: Plasma Transfusion

April 19, 2020

References: Frontiers Immunology, Sahlgrenska Academy, Jr Clinical Investigation, Mole Cellular Immunology, Immune Aging, Hematology

When you were born, your immune system was a clean slate.  It had no antibodies, no T cells, no memory B cells, nada.  But you had a secret weapon: a full dose of Mom's antibodies.  Newborns don't get sick for about 5-6 months as they coast on Mom's protection.  As those antibodies fade away, newborns gradually start getting little fevers and colds.  The average baby gets some 14-16 fevers in the twelve-month period of age 6-18 months.  Many of those fevers are real doozies with temps of 104, but the baby otherwise looks just fine.  A fever before 6 months is concerning!  That's how important memory antibodies are.

COVID-19 is a new virus to humans.  Hence the term "novel".  None of us have antibodies to it, and apparently the antibodies we have to other carona viruses that cause common colds just don't overlap enough to provide protection.  When we get a new virus, we are like newborns.  We get a robust immune response and make a robust fever.  IF, we have a competent immune system. IF.   Newborns have a huge thymus gland that mediates and directs the ballet of competent immune response to the tidal wave of new infections that the new baby has to navigate.   Guess what happens if you take out the thymus gland (like when you have to save a baby's life with open-heart surgery)?  Follow those kids until age 18 and their immune function at 18 is on par with a 70-year-old.  Without a thymus, they are in trouble.  Guess what happens to us as we age?  You got it.  Our immune competency plummets.  So, who is getting sick with COVID-19?  Old foggies.  You and me.  Over 40 starts the deadly climb.  By the 60s, men are reaching 10% mortality and 80-year-olds get into the 20% range.  Throw in something to damage your immune function and you can double your risk.  Diabetes is an inflammatory disease with huge amounts of inflammatory cytokines being put out by excess fat tissue.  Lack of Vitamin D makes it worse as D allows the maturation of stem cells to mature cells.  African Americans have skin pigment, blocking the natural production of D.  African Americans living up north in northern cities have even less D, and subsequently worse immune function.  Who is dying from COVID-19?  Vulnerable African American men living in Detroit and Milwaukee.  And finally, men don't age as gracefully as women.  Bummer. 

What's the plasma deal?  Well, harken back to your childhood.  Were you ever given a tetanus shot with horse serum?  I was.  Twice.  The first one was as a 10-year-old and I got a dose of horse serum.  Not the DPT toxoid you get today. That is the tetanus bacteria protein that gives your body specific antigens to make antibodies to.  No, the horse serum was an idea of collecting tetanus immune globulins from horses and then giving them to humans.  Guess what a human does in response to horse immune globulin?  You got it.  You make antibodies to the "horse".   You get away with it once.  Second time, not so lucky.  Your immune system makes antibodies to the horse proteins.  I got very ill and had serum sickness with hives all over my body.  That strategy is called "passive immunity" and was not really successful as there were many cases of serum sickness.  You want active immunity.  You want to make your own antibodies.

What happens if you don't have time?  Is there a situation in which "passive immunity" with someone else's antibodies helps?  Probably yes! Right now, with COVID-19.  What do those antibodies do?  The antibodies help reawaken old plasma cells that remember the prior infection. If you don't have antibodies from a prior infection, what do they do?  What role does passive immunization have?  Well, we don't know for sure but it appears to buy a little bit of time.  It creates the template of antibody-antigen off which your immune system gets a faster start.  And you inactivate some of the virus.  It appears to work.

What do we know and how can it work?  The Chinese did it with some success.   New York hospitals have been doing it with an emergency research approval.  The Mayo Clinic has jumped in to help mediate plasma donors with recipients.  UW has done it in Madison.  Unfortunately, we are starting backwards.  We are giving it to super sick people as a last resort. That's not when it works.  Those folks have overwhelming viral loads.  You can't turn it off easily.  You want to really use it with folks at the very, very beginning.  But that is what research is all about, finding out when it works best.  

So, here are the three or four key strategies to boost your immune response against COVID, right now.

a). Make sure you are on Vitamin D.  If you haven't been taking it, take 100,000 IU today, then 5,000 a day thereafter.  If you are African American, Asian or anyone with some pigment in your skin, take 100,000 IU two days in a row.

b). Stimulate stem cells with a fast mimicking diet of 5 days, 800 calories.  The best way to reboot your immune system and get a 600% boost in stem cells.  Nothing else does that.  (Do it every month if you really want optimal results)

c). Lose weight.  No excuses. Get your average blood sugar down. As fast as possible.  You want to live?  Do it.  

d). Consider Thymosin A administration.  Reboot your immune response to viruses. It's the peptide infants make in abundance and 60 year olds don't make at all.  Thymosin A has been proven to cure chronic hepatitis B.  Nothing else does that.  You can buy it!   

e). Plan to get someone who will give you their plasma if you get sick.  Has to be the same blood type.  And plan to share yours if you get sick.  Until we have a vaccine, this may be our best shot.

WWW: What will work for me.  I'm taking my D.  I'm on Thymosin A.  Next week I do my 5 days fast.  I've ordered antibody testing kits - and am waiting.  Hope the place I ordered them from isn't a post office box in the Caymen Islands.  

Pop Quiz

1.   Getting someone else's antibodies works to slow COVID-19?    Answer:  Well, not proven by our standard of scientific study but comes along with over 100 years of clinical use of serum treatment.  It's the top of the list of hopeful treatments until a vaccine gets here. 

2.   What type of immunity do we call giving someone else's antibodies?   Answer:  Passive immunity.

3.   Do you get any protection with passive immunity?   Answer:  Yes, you slow down the spiraling tornado of unbridled immune reaction long enough to give your own immune system a chance to make its own antibodies, if you give enough, early enough.   Works better is you start early.  Be prepared to volunteer to get it early.  

4.   How long does your immunity to COVID last?   Answer:  The common cold form of COVID antibodies appear to last only about 40 weeks.  Not very robust.  Crafty little virus.  We haven't had COVID-19 around long enough to know. Stay tuned.

5.  What can you do to protect yourself?   Answer: Wash your hands, don't touch your face, sneeze into your elbow, wash your hands, stand 6 feet away.  Wear masks in public.  Lose weight.  Take D.  Fast.  Thymosin A. Did I mention wash your hands?