How Viruses Fool The Immune System
The immune system protects us from the constant onslaught of viruses,
bacteria and other types of pathogens we encounter throughout life. It
also remembers past infections so it can fight them off more easily the
next time we encounter them.
But the immune system can sometimes
misbehave. It can start attacking its own proteins, rather than the
infection, causing autoimmunity. Or, it can effectively respond to one
variant of a virus, but then is unable to stop another variant of the
virus. This is termed the original antigenic sin (OAS).
OAS occurs
when the initial successful immune response blocks an effective
response when the person is next exposed to the virus. This can have
potentially devastating consequences for illnesses such as the mosquito-borne dengue.
There are around 400 million dengue infections
worldwide each year and no vaccine is available. Reinfection of someone
who has been exposed to dengue previously can result in
life-threatening hemorrhagic fever.
OAS is also thought to limit our immune responses to the highly variable influenza virus, increasing the chance of pandemics.
To understand why OAS occurs, we need to go back to basics about how immunity is formed.
The race begins
When
a virus enters the body, a race begins between responding immune cells
and the infecting pathogen. The pathogen replicates and finds a target
cell or organ that will allow it to thrive.
So, the effectiveness
of a response depends on the immune system winning the race to clear the
pathogen before it causes irreversible damage to the body.
Immune
cells called “B cells” make antibodies. A pathogen such as a virus is a
large molecule with different components, called antigens. When a B
cell recognizes an antigen, it is activated and interacts with other
immune cells to receive directions.
Quality control
B
cells then set out on two main paths. Some of the cells begin to make an
antibody early in the response. But this antibody is often not of
sufficient quality to rid the body of the infection.
The B cells
that choose the alternate pathway go through a process that improves the
quality of the antibody. This strengthens the binding between antibody
and antigen. Antibodies are also grouped depending on the way they help
eliminate the pathogen.
Some groups are better at clearing viruses
and other pathogens. So, the antibody group that is tailored to be most
effective at clearing the type of infection comes to dominate the
response over this period.
Although the increase in quality of
antibody can take weeks, there are two critical benefits. It means the
pathogen is cleared. And high-quality “memory” cells remain to provide
us with immunity to future infections.
Memory cells
Immune
memory cells consist of long-lived plasma cells and memory B cells.
Long-lived plasma cells live in the bone marrow and can continuously
pump out high-quality antibody, providing a first wave of protection
when we’re reinfected with a virus.
This is the same type of
antibody that is transferred from mother to a breastfed baby, providing
passive immunity against pathogens the mother has previously been
infected with. But this level of antibody may not be enough to clear the
infection.
This is where memory cells step in. Because memory
cells have already undergone quality improvement, they can respond
quickly after reinfection to produce a large number of plasma cells
secreting high-quality antibody.
Therefore, memory cells can clear
the infection much more rapidly than the initial infection. This means
the pathogen doesn’t have time to damage the body.
When the quality improvement process fails
The
quality improvement process that allows B cells to bind and clear the
pathogen more effectively is highly selective to the dominating antigen.
In
most responses to infection, this is critical to clear the infection.
But in the case of some pathogens, such as dengue, the virus may have
variant strains that can fool the immune memory response.
Dengue virus has four major variant serotypes. Within each major variant, one antigen dominates and is targeted by the immune system.
Infection
by variant A results in extremely selective targeting towards antigen
A. If the body is reinfected with the same variant (A), it can
effectively clear the virus.
However, after reinfection by a
second variant (in which antigen B dominates), immune memory cells
recognize the virus, but they make antibody specific for antigen A,
rather than the second variant, in which antigen B is now dominating.
So,
antibody is being made but is unable to bind and eliminate the virus.
To make matter worse, it appears that any new immune response to antigen
B is inhibited by the memory response, although the reasons why this
occurs are unclear.
Influenza is a highly variable virus, and these variations each season are why we require yearly vaccinations.
But the role of OAS in limiting our ability to respond to different variants of influenza is still highly controversial. Almost 60 years after OAS was proposed to describe the response to influenza infections, it is still a source of much current research.
How can we avoid OAS?
We
need to train our immune system to be more flexible and produce
antibodies that can adapt when viruses try to evade the immune system.
To this end, researchers are designing vaccines to respond to multiple variants
of pathogens. This has shown promising results and may be the way
forward to overcome OAS for potentially life-threatening viruses such as
dengue.
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