hi youtubers, Dr. Sun here, I updated
my first video two days ago and talking
about why I will not be surprised
if Remdesivir fails its clinical trial and
in the past 48 hours that video has been
clicked more than hundred times which I
think it's pretty good for my first
video and I'd like to think I everyone who
watched and supported me and most
importantly I get many valuable
comments, like somebody commented that
my hairstyle is terrible and I know I
have been losing a lot of hair recently and
somebody commented that I appeared to be
very rigid during the video. well I
think the covid-19 is not a very happy topic
so that's why so I have to be serious
and somebody said that well you need to
show some evidence supporting your
theory okay I think I will accept
this advice and find ways to
improve and make my videos more
attractive and so in my last video I
emphasized the importance of targeting
immune system of the host rather than
the pathogen itself during the
COVID19 infection. however I need to
clarify that I am not saying that in all cases targeting pathogens is not
effective. that not only will make my
microbiologist and virologists colleague
not happy but it is also not true.
in history, there are numerous cases
where targeting the pathogen itself can be effective for example
the penicillin treatment of bacterial
pneumonia and also the anti-HIV drugs
treating AIDS patients so these
treatments are proved to be effective I
think it really depends on the
inflammation status.
some infections are mild so even they
trigger some immune response but
these immune responses are not
lethal but in some other cases like in
this COVID-19 case so the inflammation is
too much and this too much inflammation
is lethal to the host, so that's why so
in this case targeting the
inflammation has a priority over
targeting the pathogen, the virus itself
if you can remember, 17 years
ago, when we have the SARS outbreak the
steroid drug, which is a
immunosuppressive drug, it did save a
lot of people's lives, although this drug
has a significantly side-effects but it
did worked. so for Remdesivir,
although it may not work for patients in
critical and serious conditions but I
still hold hope that it may help to
prevent that disease progression at the
early stage. so now I will discuss the
top five approaches that in my opinion
will benefit the COVID-19
treatment from the immunology side.
so before I start please NOTE this is
not medical advice so if you are not
feeling comfortable
call your doctor and make an appointment
I'm a researcher I'm not a medical
doctor. my wife is I am NOT and also I
believe many of these points that I
present in here are being
studied by my immunology colleagues don't
think I'm the first to propose these
points I am NOT that genius. so the
number one point targeted the cytokine
storm. the cytokine storm usually
accompanies severe infections it can be
triggered by bacterial infection and it
can also be triggered by a virus
infection, so it is a situation that your
immune response gets really crazy and
don't know what to do so your immune
system just use all its energy to
produce a huge amount of inflammatory
cytokines, these cytokines will included for example
Interferons, interleukins and the tumor
necrosis factors and etc. however the
overproduction of these cytokines is not
protective in this case, just like if you
give your puppy a lot of commands and
your puppy will not know what on earth you
would like her to do. so eventually your
immune system will get exhausted not
only your immune system got exhausted
but the cytokine storm is also harmful
for other orders and lead to multiple
organ failures. Cytokine storm is the biggest
bad guy in my opinion that causes
mortality. There is also a LANCET paper
emphasizing the importance of
inhibiting cytokine storm. but the
difficult thing is that so we are
talking about cytokine storm, you are
not talking about who my cytokine so you
are talking about probably a dozen or
dozens of cytokines so this makes the
situation very complex and what is
the most critical cytokines that is a
contributing to the mortality
still need more investigation.
the number two point
Targeting the immune cells
so just now we mentioned that so you
have dozens of cytokines
that  contributed to the cytokine storm but
comparing to those cytokines, you have less
immune cell types that you can target
but as we know most of cytokines come
from the immune cells. These immune cells 
like the monocyte- derived
macrophages or T cells
those are very good producers of proinflamatory cytokines.
but what kind of
roles these cells are playing
during the COVID-19 case is not
completely understood. so I am NOT going
to make predictions but I think these
cell types are highly suspicious
Point three, boosting the immune
regulatory mechanism
many immune cells have regulatory functions
by either producing anti-inflammatory
cytokines or through direct down-regulation of activated immune cells
but this
involves very complex pathways and also
related there is a lot of professional
terms and I'm not going to any details
here. anyway boosting the regulatory
cells could be beneficial in this case
Point four, scavenging damage associated molecular patterns or
DAMPs. infections will induce tissue
damage and immune response that produces
a lot of inflammatory molecules the
production of the molecules is basically
telling in the body
hi we have a problem here so please help
deal with it. but too much of these
DAMPs will cause lethal effects.
One example oxidize phospholipid can
be released during a viral infection
like during influenza infections. see the
title of this cell paper so the oxidized
the phospholipids are generated through
oxidizing of the phospholipids
contents in the cell membrane by
reactive oxygen species. so in their
paper they have a mouse which is not
able to produce reactive oxygen
species and that mouse is resistant to
influenza infection this concept I
believe many people have heard about
it. that's why people run to the
grocery store and buy vitamin C and orange juice. Vitamin C is a well known
antioxidant which in theory can lower
reactive oxygen species but please note
this is only by reasoning, although it
seems logical but I don't think aware
the clinical research  evidence supporting
this theory so I'm not going to
make any recommendations here if you
want to take vitamin C that is
the your own choice.  to confirm this
concept I'm showing you another science
paper, so the authors also come from the
University of Maryland but they are from
our medical school. we used to invite
the first author Dr. Kari Ann to our
department to present her research on
this study. they found a toll-like
receptor 4 antagonists
called Eritoran
protect the mouse from lethal
influenza infection. look at their
histology pictures from their paper. I
think it is a very dramatic, even without
professional expertise. I believe that
you can easily see that on the left is
the normal Mouse Lung there isn't too much
inflammation and in the middle is influenza
infected Mouse lung. on the right
if the Eritoran treated mouse after
influenza infection. you can see the
result is very dramatic
the Eritoran treatment almost reduced the
inflammation to normal status. so the authors
concluded and I quote based on our data that
Eritoran blocks oxidize the phospholipid
induced TLR4 signaling thereby
mitigating the cytokine storm and a
subsequent potentiation a phospholipid
oxidation induced by reactive oxygen
species. after the corona virus outbreak
I wrote letters to the first author
Korea and the senior author Dr. Stephene
Vogel and they told me they are working
to test the effect of this drug
during corona virus infection but please
note this drug has not been FDA approved.
Point five, antibiotics. I know you are
dealing with virus infection but yes
to inhibit the bacteria, I believe is also
very important, as I mentioned in my last
video the time into the barrier function
can boost the growth of your commensal bacteria and this bacteria has a
chance to cause secondary infections.
The said thing is that we do not know what
kind of bacteria is causing the
infection, we can only use broad-spectrum
antibiotics but the use of
broad-spectrum antibiotics is somewhat
aimless.
the antibiotic may not work for all
bacteria this area still needs further
study.
hopefully my immunology colleagues
will help with this issue. actually that
one last thing that is not listed here
and that is related to one of my own
projects but I am not supposed to
disclose any information from my project.
otherwise my PI will get very mad at me,
but I hope this work published as soon
as possible.
so in the end I listed five
potential COVID-19 treatment
approaches from immunology aspect so I
did not include antibodies here but in
the future, I'd like to make videos specifically
talk about antibodies during
corona virus. you can subscribe to my
channel if you want to get my updates. if
you found this video informative, please
hit the "like" button and give me some
support. thank you for watching this
video please leave your comments below
and again I have to repeat, the
information this video does not provide
medical advice.
