Immunity. What is it and how not to lose it

There are such medical terms that are used so often that people usually don’t even think about what they mean. One of these popular concepts is immunity. Everyone has heard about it and understands that it is about protecting the body from various diseases, but only experts understand what the immune system is and how it works. To clarify issues related to immunity, its disorders and methods of their treatment, we turned to Academician of the Russian Academy of Medical Sciences, Director of the Institute of Immunology, President of the Russian Association of Allergists and Immunologists Rakhim Musayevich KHAITOV.

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There are such medical terms that are used so often that people usually don’t even think about what they mean. One of these popular concepts is immunity. Everyone has heard about it and understands that it is about protecting the body from various diseases, but only experts understand what the immune system is and how it works. To clarify issues related to immunity, its disorders and methods of their treatment, we turned to Academician of the Russian Academy of Medical Sciences, Director of the Institute of Immunology, President of the Russian Association of Allergists and Immunologists Rakhim Musayevich KHAITOV.

- EXPLAIN clearly our readers what is immunity.

- In humans and animals, vertebrates and mammals, there is an immune system that protects the body from everything genetically alien: these can be viruses, bacteria, parasites, transplanted organs, and even their own, but changed, cells. The immune system surprisingly accurately and quickly recognizes and removes all genetically alien, even if the difference is only in one single gene.

What is the immune system? It, like many other physiological systems, consists of molecules, cells, tissues and organs. The main organ of the immune system is the thymus gland, or thymus, the organ that is located behind the sternum and produces specific cells, the most important cells of the immune system, called T-lymphocytes. These are white blood cells. The second main organ of the immune system is the bone marrow. It is known that the bone marrow produces many blood cells, among which are B-lymphocytes important for the immune system. These are the two main figures. Many other organs and cells are also involved in the formation of immunity. This is the liver, which produces the so-called macrophages. The skin also performs a number of auxiliary protective functions. In fact, cells of the immune system are formed or live in all organs and tissues of the body. Man has a lot of them. If this number is expressed in numbers, a number with 13 zeros will be released.

Signal flags

T-LYMPHOCYTES are regulator cells that act as knife switches: they turn on and off the action of the immune system. The teams they give, highlighting the signal molecules, which are called cytacines. These molecules carry signals from T-lymphocytes to other cells. B-lymphocytes produce special proteins - antibodies. The third general population is very diverse, these cells are everywhere and everywhere - in the intestine, in the liver, in the lungs. Why are they called antigen-presenting? When any microbes, viruses or parasites enter the body, these cells capture them, digest inside themselves and on their surface, and separate fragments of foreign protein (peptides) as signal flags are placed on the membrane. There are also specific immunity genes that control our immune responses, and it is the immune response genes that determine whether the response will be strong or weak, physiological, that is, aimed at protection, or pathological.

For example, an allergy is also an immune reaction, only it instead of protection brings tremendous harm. Why allergic antibodies are formed is a separate problem, the resolution of which many scientists are now busy with. Sometimes the immune system, figuratively speaking, "goes crazy" and attacks its own cells, tissues and organs - there are autoimmune processes, of which there are a lot of them, they lead to diabetes, kidney, heart and vascular diseases. If these immune disorders are not treated, the person may die.

It is very important that the immune system is able to recognize someone else at the level of an individual gene or a single protein molecule, since cells continuously multiply in the body and genetic material (DNA) is duplicated, but when reading the genetic information many errors occur, so about a million mutant cells. Most of them self-destruct due to protective genetic mechanisms, but many of them are destroyed by the immune system.

I have already said that auxiliary cells absorb viruses or bacteria and expose their peptides on their surface, but this is not enough for T-lymphocytes to recognize an alien one. These cells always have their own proteins, products of immunity genes. When two proteins, one's own and another's, are represented on any cell of the body, T-lymphocytes recognize foreign cells and kill them, which is why they are called "killers." Moreover, it is not just destruction, but a special process — the programmed death of another's cell, when it does not burst, pouring out its contents, which is harmful, but it collapses, and then its remains are removed outside the body. This is a very important defense mechanism that occurs extremely quickly.

The second mechanism is provided by antibodies. For it is necessary that the protective cells process the alien bacteria or viruses, put some of their proteins on the surface. As a result, T-lymphocytes, leaders, give the command to B-lymphocytes, working cells, to produce antibodies, for example, against the influenza virus, any bacteria, parasites or against a transplanted organ.

Antibodies are special proteins, which with surprising accuracy - like a key fitted to a lock - will recognize the substrate against which they are directed. Antigens are proteins or fragments of proteins that carry signs of foreignness and cause an immune response when introduced into the body. All cells of the immune system - both T-lymphocytes, and B-lymphocytes, and macrophages - have the ability to migrate very quickly throughout the body. T-lymphocytes and auxiliary cells move best, B-lymphocytes are somewhat worse. This migration goes through the lymph nodes, which are scattered throughout the body and are also peripheral organs of the immune system. In one lymph node there are more than a million cells, and this population is renewed more than half a day, so quickly the cells move around the body through blood and lymph. What is the purpose of these movements? These cells probe all tissues, all organs in search of alien. They communicate by touching membranes and getting to know each other. There is a huge teamwork. And this is not passive, but very active protection.

Surprisingly, alien microbes also change all the time, adapting to the environment. There is a very complex and reciprocal process. Mechanisms for the removal of alien are very numerous. When microbes enter the body, they are first detected by auxiliary cells, phagocytes, but not all microbes are destroyed by them. Then T-lymphocytes come into play: they recognize a piece of the virus and their antigen on the surface of the virus-infected cells and destroy this cell. The microbe immediately finds a way to protect itself and produces special molecules that suppress the appearance of any proteins on the surface of the infected cell, and the alien's sign disappears. Then the so-called natural killers come to the rescue. The fact is that T-killers must prepare: to recognize someone else’s, change something in their internal apparatus and only then attack. And natural killers are always ready to destroy everything else. All the time they "feel" cells and see proteins - products of their genes. As soon as they discover a foreign or altered protein, they immediately kill such cells. In the meantime, the virus is preparing for a new attack: it produces other molecules, there are no manifestations of viral protein on their surface, but proteins that are signs of "their own" for "natural killers" are exhibited, and they do not destroy viruses. Further, the immune system must take a new step, and it always wins, otherwise life on Earth would have ceased. The immune system protects us from external aggression, from everything that surrounds us. This very amazing process of fighting infection and immunity was created as a result of evolution, which took many thousands and maybe millions of years.

Strength and weakness of the immune system

- Is this a single system acting against viruses, and against bacteria, and against foreign protein, or several of them?

- The system is one, but the mechanisms are different. The virus is an intracellular parasite. To kill him, the antibodies must either circulate in the blood, as it happens as a result of vaccination or after a previous illness, then they neutralize the virus still in the bloodstream, or when the virus has got into one of its cells, T-killers must kill the infected cell. And bacteria do not all live inside cells. Therefore, the mechanism of protection against bacteria works by antibodies, or phagocytes.

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In the body, there are also internal enemies, the "fifth column", when their cells change monstrously and turn into cancer under the influence of viruses or some other factors that accelerate the process of mutagenesis. Very numerous cells are constantly being formed in the body, which should potentially turn into cancer cells, but this does not happen in a person with a full-fledged immune system. Here, "natural killers" act primarily, and if cancer cells are caused by division, T-killers destroy them and prevent tumors from developing. As soon as the immune system weakens, there is a lot of trouble. In severe cases, children are born with various defects: without the thymus, without B-lymphocytes, or macrophages do not function in the body. Such children have continuous infections and a huge number of tumors - thousands of times more than normal people. A large number of infections that do not threaten people with normal immunity, and therefore called opportunistic, it becomes deadly for people with a weakened immune system.

- What factors have a destructive effect on the immune system?

- There are a lot of them. For example, stress. Short-term depression of the nervous system is not terrible, the body is quickly restored, but prolonged stress entails the release of specific hormones that suppress the immune system, and this is dangerous. Chronic infection, tumors, allergies, and other disorders may occur. Prolonged fasting and lack of protein, injuries, burns, environmental pollution also lead to damage to the immune system.

- Is the strength or weakness of the immune system genetically determined or not?

- There are, of course, genetically determined defects of the immune system, but there are also acquired disorders. For example, during a flu epidemic, some people suffer severely and even die, others easily tolerate it, and still others do not get infected at all. Similarly, during vaccination: one has a strong and durable immunity, the other has a weak one, the third has a medium one. There are people who do not develop immunity at all after vaccination. All this is predetermined genetically.

Formula Drugs of the Future

- Is it possible to get rid of defects of the immune system?

"We comprehended this important problem twenty years ago and decided that if a person has weak immunity genes, if his body cannot respond effectively to the invasion of a microbe or vaccine, it is necessary to look for ways to compensate for these weaknesses. And we found a solution. In collaboration with chemists from Moscow State University, we synthesized special molecules that functionally or structurally would be similar to molecules that activate cells of the immune system. These are polymers with multiple charges that have amazing abilities: when they enter the body, they can interact with lymphocytes at many points, activate them as if they were affected by their own cytokines, and stimulate an immune response.

It turned out that these molecules can functionally do the same thing that the products of the genes of the immune response do. In fact, this is a way around the natural mechanism of genetic regulation of immunity. In this way, new vaccines can be made, for example against influenza. There are infections for which there are no vaccines at all, for example against tuberculosis or AIDS. We decided to make brand new vaccines in this way. The most primitive vaccine is a live attenuated virus, as a result of its introduction there may be serious complications, it has low efficacy, and a new vaccine is required for modifications of the virus. Another option - destroyed, killed vaccine with a huge amount of ballast. We acted differently - we took well-purified viral proteins and chemically combined with one of these polymers, called polyoxidonium. It is completely harmless to humans, as has been proven in numerous experiments, and very well stimulates a weakened immune system. This is the formula for the drugs of the future. You enter a healthy drug - it does not work, it is easily and simply excreted from the body. Enter the patient - he sightingly affects the defective link and corrects it. Moreover, it is possible to precisely program its disintegration time, it can work for a day or more, or maybe an hour, it all depends on the task set. The first such vaccine was created against the flu. They took several proteins of almost all variants of the influenza virus, combined with polyoxidonium, a very powerful vaccine, completely harmless and very effective, because it is directed against all types of flu. This vaccine is called influenza, it is very well known, millions of people have already been vaccinated with it. It is the only vaccine in the world with an integrated immunostimulant.

AIDS vaccine

- WHAT is polyoxidonium?

- Of the many polymers, we chose such that it can be completely harmless to enter a person. Here there are opportunities to solve the problem of combating such infections that simply destroy the immune system, for example, the well-known HIV infection, AIDS. Now there are about fifty vaccines against AIDS in the world and no effective one. Let's say you made another one. The question is: who to vaccinate? A healthy person will simply refuse: I am not at risk, and after vaccination I will have antibodies, and everyone will think that I am infected. Scientists at our institute have made their own vaccine against the AIDS virus and are faced with problems: it is difficult to select volunteers for testing. And if the vaccine could not only prevent but also cure, then there would be a lot of volunteers.

The AIDS vaccine should not only be prophylactic, it should also be treated as the hepatitis vaccine. There are a lot of people in the world infected with the AIDS virus, but also millions of people are infected with the hepatitis C and B. These diseases manifest themselves in a few years: AIDS - in 10-20 years, hepatitis C - from 5 to 15 years, hepatitis B - a little earlier. And the most dangerous are healthy, but infected people, because they infect others. There is a terrible risk group - these are drug addicts, when no one suspects that they are infected. Just them and need to be vaccinated. We made a vaccine with an integrated immune stimulant that activates the immune system, even if it is weakened, and we believe that this vaccine will cure AIDS. Now she is being tested in humans.

Experiments on mice gave excellent results. We take a mouse, we remove the thymus from it, a kind of model of AIDS is obtained, and it is useless to vaccinate such mice, immunity is not formed. If we introduce them a protein cross-linked with polyoxidonium, a powerful immunity arises. On this principle, we made a whole range of vaccines: after the flu, we created a vaccine against typhoid fever, and now we are preparing a vaccine against AIDS and hepatitis C.

Allergies can be treated for real

- MANY important questions are related to allergies - this is also an immune disorder. What is the mechanism of its occurrence? How to deal with it, can it be cured?

- Yes, it is an immune reaction when antibodies are also formed in the body. But if a person with a normal genetic response to the invasion of someone else produces special protective antibodies, then for allergies - antibodies of another class. They also very accurately recognize the alien, in this case any allergen, and cause protective reactions. What is an allergen: the pollen of almost all plants, many foods, medicines, house dust, animal excreta, cockroaches, ticks that live in any apartment, mosquitoes and bee stings all cause allergies. There is a riddle: why does one person get allergic and another doesn’t? Nobody knows that yet.

I, like many other scientists, believe that this is also due to certain genes, they simply have not yet been identified. Allergy is the plague of our century, according to some estimates, about a third of the population of any country suffers from it. And it seems that pharmacies are full of drugs for this disease, everyone thinks that allergies can be cured. In fact, no one really treats allergies. All the pills from her are just "umbrellas." When the allergen first enters the body, antibodies appear, initially they are completely harmless and passive, when the allergen is re-injected, allergens and antibodies unite on the cell membrane and break the membrane, and many molecules like histamine are released from the cell, which cause the disease.

If this occurs in the skin, urticaria occurs, in the mucous membrane of the eye - conjunctivitis, in the mucous membrane of the nose - pollinitis, in the lungs - bronchial asthma. All of this can have dire consequences, ultimately pulmonary edema can develop and death occurs.

Scientists have come up with some kind of protection - antihistamines, which have an affinity for the histamine receptor, they sit on the cells, and histamine does not work, because the receptors for it are closed. As soon as they stop taking the pills, the allergy returns. This is not a treatment, but a temporary blockage, just an open umbrella. And we have developed a new method of treatment - made a vaccine against allergies. We took the same polyoxidonium and began to combine it with allergens, as a result we have a powerful stimulator of immunity: instead of allergic antibodies, protective ones are formed, there are no allergies at all.

I must say, at the core of this method is a well-known method, it is called allergy vaccination or immunotherapy: it is necessary to take an allergen, clean it and make numerous injections - up to 60 painful for several months in ascending order. This is a painful procedure, not always successful and very dangerous, as a result of which it can be a shock. And our drugs, which we called allergodrapinami, require only five injections. We still have about a dozen of these drugs, but in principle they can be made from all allergens. Now they are completing their clinical trial in humans. This is a very effective means - they give a 100% cure for any allergy.

How to recover lost

- HOW to fight immune lesions? Are there any effective treatments for them?

- Yes there is. There is a lot of progress in this area in our country. In due time serious extensive programs on immunology were adopted, our institute was formed. Thank God, in our government they understood that immunology is a very important science, which is directly related to the country's biological safety. Our studies have found that in Russia a huge number of people suffer from various disorders of the immune system.

The immune system is very complex, there is no total damage, but defects can occur at any level of its hierarchy: in organs, tissues or at the level of molecules. So you must first determine where the defect occurred. To do this, we have everything: beautiful instruments, such as laser cytometer, just take a drop of blood, process it with special marks, and after three minutes the device shows which cells are affected, where, how and how much, all this will automatically print the computer.

If we are talking about the function of cells, they are placed in special cells, where cells live and do what they have to do in the body, and in two or three days you can register what they are sick with. After this, the problem arises - how to restore the destroyed. We have developed a number of drugs called immunomodulators that restore the function of the immune system. For the creation of these drugs, the scientists of our institute received two awards from the government of the country. One of them is polyoxidonium already known to you, the other is mielopid.

Our institute has developed about a dozen drugs, in Russia there are more than twenty of them. The immune system needs to be treated pointwise. If you take a powerful immunostimulant and enter into the body, you can cause severe allergies or autoimmune process. Are complex analyzes that can only be done at the Institute of Immunology or in specialized laboratories? Of course, not always. According to the WHO classification, frequent respiratory tract infections are the first sign of weakness of local immunity. Just in this case, soft, completely non-toxic immunomodulators like polyoxidonium can be safely recommended for use without detailed analysis. If a person has more severe injuries - say, pneumonia or severe allergies, and medications do not help, then an immunologist will need to intervene to investigate at what level of the defense system pathological changes have occurred.

There is no such program abroad to cure the immune status of large groups of the population that we have developed and are now implementing. In large immune centers, only lesions in AIDS are studied, but in other diseases this is not the case. I regularly attend all sorts of conferences and congresses and I know that hundreds of drugs have been developed in scientific laboratories in the USA, Canada or Japan that stimulate the immune system perfectly, but they did not go beyond the experiment, they are not used in the clinic. And simply because they do not have the specialty "immunologist". Americans only recently organized a society of clinical immunologists, and we have it for a very long time.

The president of the American society, Professor Jonas Aide, said that they do not have such a specialty and therefore their doctors sometimes completely ignore the state of the immune system. In many research centers we have the opportunity to test your immune system. If it is changed, medications are available that have long been approved by the Ministry of Health and are available at the pharmacy. In this area we are ahead of the whole world.

- Can natural products play the role of immunomodulators and replace them in the treatment and restoration of immunity?

- How can I replace products of my own immune system? Antibodies can not replace. You can only enter other people's antibodies from another person or drugs such as immunoglobulin - in extremely severe cases, when a person dies, donor antibodies are injected into him. There are some natural molecules that we call cytokines. However, some synthetic drugs are able to perform the functions of some cytokines.

- Now such opinions are spreading that all drugs and vaccines are evil and it is necessary to be treated with natural home remedies. What is your opinion on this?

- This is a very serious question. Often, non-specialists, not just non-immunologists, not even doctors, but simply illiterate people, are actively promoting vaccination. Such propaganda was conducted about fifteen years ago and brought enormous harm. As a result of the refusal to vaccinate, there have been several serious epidemics for infections that have not been seen for a long time. These people do not understand that science has gone far ahead. And vaccines are completely different now. Old vaccines did cause a lot of complications. Today, subunit vaccines are used. That is, not destroyed, not killed viruses, but harmless vaccines. They have no side effects. I am totally against weakened transitional vaccines. This is an anachronism, which has been preserved only here and in China, everywhere they are prohibited. Our influenza has been used for eight years now, and so far no adverse side effects have been found. You can make the perfect vaccine, which will have absolutely no complications. Take even protein, and its fragments - a peptide. The same is the medication. Modern medicines should have an absolutely controlled structure: only a molecule and nothing more, no impurities and foreign substances.

A huge amount of drugs causes a side effect. There are sad statistics: every year thousands of people die from side effects of drugs. This should not be. Medicines of the future, like modern weapons, must have a pinpoint, very specific effect. They must act only where the defect is and nowhere else. There are such drugs: some synthetic drugs, peptide drugs, they do no harm.

- Is it possible to replace the drugs of the immune system by some other means - a special diet, the effects of natural factors? There are healers who claim that it is starvation or raw foods that strengthens the body's immunity.

- In fact, fasting is one of the causes of acquired immunodeficiency. It is established as a result of many studies. As a result, various infections arise and the most terrible disease is cancer. Proper lifestyle, which includes a balanced diet, the obligatory presence of proteins and vitamins, contributes to the normal functioning of the immune system. However, in the case of serious damage to the immune system without drugs.

Everything must obey common sense. Now a huge number of people are sick and even die from uncontrolled intake of various drugs for weight loss. Recently, a worldwide incident caused a judicial incident, as a result of which an American was disconnected from artificial nutrition and her brain had not been working for fifteen years. She fell ill because she took some biological supplements to lose weight, and as a result received a severe heart failure.

You can not take drugs that are not officially authorized, which did not pass the required tests. I would like to warn our readers: do not trust false advertising, which is fraught with serious consequences. Now there are a lot of drugs that are tricked out for drugs, a lot of fake drugs. Many companies in our country do not produce drugs themselves, import substances from abroad, sometimes of dubious quality and origin, and only pack them up or make pills of them. Until we start producing our medicines, as well as our own machines and machines, we will remain a backward country.

- Do you think, Rakhim Musaevich, that some immune stimulants and modulators are too expensive?

- Immunomodulators - not the cheapest, but still not the most expensive drugs, taking into account the cost of their production. Nothing can be done, this is a market.

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