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Rogue antibody could be cause of long covid, UAMS study finds

UAMS researchers studying antibody that attacks enzyme by Lara Farrar | September 19, 2021 at 3:58 a.m.
Dr. John Arthur (left) and Dr. Terry Harville, associate professor of pathology at the University of Arkansas for Medical Sciences, talk about the levels of antibodies in specimens Thursday. (Arkansas Democrat-Gazette/Staci Vandagriff)

Before Courtney Robinson contracted the coronavirus in November of 2020, she was a fitness enthusiast, exercising almost daily, lifting weights, doing intense cardio workouts, hiking miles every week.

Now, almost a year later, Robinson can barely exercise at all. In fact, she can barely do anything at all. Some days, she cannot get out of bed. If she manages to get up, she can go to work for only a couple of hours before having to return home, collapsing from exhaustion.

The 50-year-old who lives in Hot Springs said she feels like she's become a shell of her former self. She's depressed and desperate for some type of answer as to why her health has dramatically deteriorated after becoming ill with covid-19. Not only is she battling extreme fatigue, she also has had heart and lung issues alongside chronic pain.

"It's been extremely mentally, physically and emotionally exhausting," Robinson said via a phone interview with the Arkansas Democrat-Gazette during which she was short of breath and frequently paused to cough, her lungs still weak months after becoming ill.

"I am an optimistic person, but this has definitely given me depression," said Robinson, who contracted covid-19 a second time over the summer even after she'd been vaccinated. "I have gotten past being scared. I think now I am going more through cycles of grief." (Robinson contracted her first bout of covid before vaccines were approved for emergency use authorization at the end of last year).

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Robinson is one of untold numbers of individuals who continue to cope with debilitating symptoms that last for months after contracting the coronavirus. The condition has become known as "long covid." Patients who suffer from it are sometimes referred to as "covid long-haulers."

There may be some hope emerging for those who are battling this condition.

Researchers at the University of Arkansas for Medical Sciences announced this month that they have identified an antibody that shows up weeks after an infection of the coronavirus that could be the cause of long-haul covid-19. This antibody, called an autoantibody, could be triggering an autoimmune disease in some people who contracted the coronavirus.

Their findings were published at the beginning of September in the journal The Public Library of Science One.

Dr. John Arthur, one of the lead researchers, said his team discovered that some patients who contract covid-19 have responses where their bodies produce a second antibody that "attacks and disrupts a key regulator of the immune system."

This second antibody could be what is causing protracted severe symptoms for some 30% of people who become infected with the coronavirus and continue to be sick for months after, Arthur said.

Essentially an individual's immune system responds to the coronavirus by producing an antibody to fight off covid-19. The immune system response to covid-19 is what produces mild to severe symptoms, even death, in infected individuals. Yet researchers found that in some patients the body then produces a second antibody in response to production of the first antibody.

The immune system does not recognize the antibodies and begins attacking itself, potentially resulting in the wide range of symptoms experienced by people suffering from long-haul covid, Arthur said.

"Your body's initial response was to make antibodies against the virus," Arthur said. "That is what it is supposed to do, that is part of the healing process. But then as sort of a pathological response, your body makes a second antibody, and it is the second antibody that is actually the problem."

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This second antibody attacks an enzyme called ACE2 that helps regulate the body's response to the coronavirus, according to the study. Because the ACE2 enzyme is not able to function properly because of interference from the second antibody, individuals likely continue to be sick.

"This could be the cause of all of the symptoms of post-covid or it could be the cause of none of the symptoms of post-covid," Arthur said. "But it makes physiologic and pathologic sense that this could be the cause."

"We are the first to identify this antibody, and it all fits together," Arthur said.

The study said there is anecdotal evidence indicating that individuals who are suffering from long-covid illness experience some improvement after receiving a covid-19 vaccine. Robinson of Hot Springs said she did feel better for a while after being vaccinated, but then her health deteriorated again and nose-dived after she contracted the virus a second time in August.

The UAMS researchers say it is unclear why some individuals develop this second antibody and why some do not. Robinson said she has mild rheumatoid arthritis but otherwise no other health conditions before contracting covid-19.

Arthur said he and his colleagues will continue to study the prevalence of the second antibody in individuals who are experiencing long-covid symptoms, hoping to further pinpoint whether it is the cause of ongoing illness. Eventually, he said, they hope to identify effective ways to treat the condition.

The doctor said he has received dozens of emails from individuals who are suffering.

One was from a student who had to quit medical school because of "severe fatigue and depression and just could not go on."

Another was from a university professor who had to quit working.

Another was from a recovering alcoholic who feared the addiction might take over again because it has been so hard to cope.

"It is pretty heartbreaking all of the emails I get," Arthur said. "It's heartbreaking the stories that people tell."

Robinson said she has volunteered to take part in the next phase of the UAMS study.

"Maybe I can help somebody else," Robinson said. "Hopefully I can help make something good out of something bad."

Print Headline: Covid long-haulers get bit of hope


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