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Long COVID: Is autoimmunity to blame?

0 2 years ago

A group of researchers recently hypothesized that complex immune responses to the SARS-CoV-2 virus might explain the long-term effectsTrusted Source of COVID-19.

They also suggest these immunologic mechanisms may contribute to the rare, serious side effects of the COVID-19 vaccine.

In a recent New England Journal of Medicine article, co-authors Dr. William J. Murphy and Dr. Dan L. Longo explain how autoimmunity may be the mechanism causing these two distinct complications of the worldwide SARS-CoV-2 pandemic.


When our bodies are exposed to a virus — or any infection — it recognizes proteins and other molecules on the invading virus as “not us.” Scientists refer to this as an antigen.

We then ramp up our immune systems to attack that antigen. Therefore, we try to neutralize infectious invaders, such as the SARS-CoV-2 virus.

Once we use our antibodies to attack the invading viral protein, parts of these neutralizing antibody-antigen complexes can also be viewed as “not us” by our bodies. We can also form secondary antibodies, called anti-idiotype antibodies.

Anti-idiotype antibodies

What is the purpose of anti-idiotype antibodies? After the initial benefits of first-line immunity, our body has natural processes to try to flatten our response to challenges. These processes are known as downregulation.

Anti-idiotype antibody production is one of our body’s methods of achieving downregulation. However, the presence of anti-idiotype antibodies can have unexpected negative effects.

Firstly, they can neutralize our infection-fighting first-responder antibodies, so they interfere with our body’s ability to fight the infection if it persists.

Secondly, they can mimic the original invading organism and bind to our cells in the same way. This instigates the same symptoms as the infection or causes an immune-cell attack on our healthy cells.

Drs. Murphy and Longo report that this mimicking behavior by anti-idiotype antibodies has been demonstrated already in models, such as viral diarrhea in bovine animals.

For Medical News Today, Dr. Murphy elaborated:

“This concept of anti-idiotype antibodies mediating effects and limiting efficacy could have a profound impact in understanding how to increase effectiveness and duration of protective antibody responses,” he explained. It might also help us “determine if patients are at risk, based on their anti-idiotype responses or allow for therapeutic interventions to be developed.”


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