Immunity: How it works and whether it can be strengthened
Promises to “strengthen” immunity with vitamins, yogurt or magical food additives have no end in sight - and even those who do not believe in advertising, in the cold season, they begin to talk about “failures” in the immune system and look for ways to “fix” them. Immunity disorders explain a variety of ailments, and experiments with poorly studied tools designed to improve it, put not only on themselves but also on children.
Together with the candidate of medical sciences, a member of the European Academy of Allergologists and Clinical Immunologists (EAACI), an immunologist, Umar Khasanov, and an allergist, immunologist, Atlas Medical Center, Ekaterina Pushkova, we tried to figure out how the immune system works, is it easy to “undermine” "and whether to try to improve.
How does the immune system
When we are told in advertising about what else a new means of “fallen” immunity can be increased, it seems that the immune system has an equalizer and it is important to just move the lever in the right direction - but things are not so simple. According to Umar Khasanov, even a simplified schematic model of the immune system is dozens of cell types with almost four hundred different receptors. With the participation of special substances, cytokines, they perform an astronomical number of tasks - from the removal of a splinter in the skin to the destruction of tumor cells. This system has been forming for millions of years - and it does not work independently, but in close relationship with the nervous, endocrine and other systems of the body. In general, the concept of an equalizer, in which the immunity can simply be made "louder" or "quieter", does not work here.
In addition, this system is perfectly independently regulated: in the words of Ekaterina Pushkova, it is not so easy to “break” immunity simply by drinking some kind of traditional medicine or going outside in cold weather. But the chronic effects of fatigue, malnutrition, constant jet lag, intense stress are factors that can gradually "damage" the work of the immune system and increase susceptibility to infections.
What really can worsen the immune system
When the effectiveness of immune protection is reduced, a person's susceptibility to infections increases - and factors that may actually affect this can lead to this. One of them is smoking, in which not only the smoker himself suffers. Proved a negative effect not only in secondary (passive), but also tertiary smoking - the remnants of smoke on the skin and clothing can be the cause of increased susceptibility to disease in close smokers. The increased risk of respiratory infections has been proven for a number of toxic substances, primarily drugs.
The presence of certain diseases also reduces protection against infections - for example, people with rhinitis and asthma have acute respiratory infections more often. Gastroesophageal reflux - a condition where gastric juice is thrown into the esophagus - increases the frequency of laryngitis and pneumonia; if you correct this condition, the problem will be solved not only with the stomach, but also with frequent respiratory tract infections.
You can often hear about the so-called local immunity - we are talking about the very first immune barrier of the body, that is, the skin and mucous membranes. If the permeability of this barrier is increased, then the risk of infections increases. Local protection is impaired if a person has chronic foci of infection (for example, caries), and also because of tobacco and alcohol - they negatively affect the state of the mucous membranes. Pushkova notes that in this case it’s wrong to speak about immunodeficiency, but these factors do contribute to more frequent infections.
What is immunodeficiency
Immunodeficiency is a real disease, with a clear definition and specific changes in the results of tests - that is, you can not talk about immunodeficiency, for example, on the basis that a person often has a cold. Types of immunodeficiency more than a hundred, but in general it is divided into primary and secondary. Primary is genetically determined - that is, a person is born with a mutation of one or several genes that are important for the immune system. Most often, such immunodeficiency is found in childhood.
Secondary immunodeficiency is also called acquired - it can be viral, caused by HIV, or develops due to chronic diseases or their treatment. For example, this is the case with oncological or autoimmune diseases, or because of treatment aimed at suppressing the immune system: chemotherapy, radiation therapy, immunosuppressive drugs.
There are very specific signs of primary immunodeficiency - first of all, these are severe infections that are difficult to treat. For example, these symptoms include two or more pneumonia per year, more than two months of treatment with antibiotics without effect, deep recurrent skin abscesses - a key factor here is the severity of the disease. As Ekaterina Pushkova explains, if a person chronically coughs slightly and is not treated in any way, but goes to work or study, there is no talk about immunodeficiency. In addition, when these disorders in the immune system, other manifestations arise - for example, the development of opportunistic infections, that is, caused by microbes that normally live in the body and do not cause any reaction in a person with a healthy immune system.
What have the ARVI
According to Umar Khasanov, ephemeral promises to reduce the frequency of colds are the wheels of a powerful marketing machine for promoting questionable substances. We are led to believe that colds are a sign of weakened immunity, although in reality this is not the case. An uncomplicated cold is not terrible, there is no need to treat it (and there are no effective means for this), and the frequent incidence in children is a normal age-related feature. A child is born with an immature immune system and first receives antibodies from breast milk, and then the “training” and development of the immune system is largely due to viral infections. SARS is a small price to pay for the fact that we constantly live in close proximity to thousands of viruses.
Modern science has come to the conclusion that uncomplicated ARVIs indicate diseases of the immune system extremely rarely. The structure of the immune system is such that if the slightest "failure" appears, it will result in a series of bacterial complications - frequent pneumonia, skin infections, purulent otitis and sinusitis, - oncological and autoimmune diseases. So frequent uncomplicated colds are not a reason to contact an allergist-immunologist, it is enough to visit a pediatrician, general practitioner or family doctor.
Is it true that carriers of viruses have low immunity?
In Russia, it is difficult to find a person who has not been tested for herpes viruses, the idea of their detrimental effect on the immune system is deeply entrenched in the public consciousness. It is said that a frequently ill child or adult needs to exclude latent infections - namely, to find, for example, a cytomegalovirus, Epstein-Barr virus, herpes simplex virus and “treat”. On the Internet, you can find hundreds of theses and articles on the effect of these viruses on the immune system, but on English-language resources everything is much more modest, and the information dates mostly from the nineties of the last century.
In particular, at the international professional resource UpToDate only one small paragraph is devoted to the influence of viruses on the immune system with reference to the 1990 publication. In short, in the laboratory, it was true that some influence of viruses on immune cells was noted - but this is of practical importance only for people with already seriously impaired functioning of the immune system. For healthy people, there is no evidence of harm, and, for example, the US Centers for Disease Control and Prevention does not recommend the diagnosis of such viral infections for everyone. There is simply no point in this: it is difficult to find a person who would not be infected with them, but “guilty” of all ills, from insomnia to frequent colds, they are extremely rare.
How vaccines affect immunity
Immune protection is divided into congenital and acquired: the innate is aimed at combating a lot with what, but acquired is specific, that is, directed at specific foreign substances. Acquired immunity appears when the system has already “met” with the pathogen. And although, in general, all these processes work, sometimes there is simply not enough time to effectively “trigger” the cells: infections such as tetanus can lead to irreversible complications or death in a short time. It was in order to "acquaint" the immune system with the pathogen (in the most weakened form) or its components in advance, and vaccination was invented.
Vaccination is a gentle and safe way to "train" the immune system; subsequently, when confronted with a threat, the protection will work and protect a person, if not completely, then at least from life-threatening consequences. Khasanov notes that in the countries with developed medicine, the vast majority of patients with primary immunodeficiencies vaccinate quite easily - the vaccination schedule may differ, but only slightly. That is, even for children born without a significant part of the immune system, vaccination is important and must be timely - and it’s time to forget about contrived medical leads like snot.
Do I need to drink immunomodulators and vitamins
In Russia, more than four hundred OTC "immunomodulators" have been registered - but, according to experts, they have no significant effect on the immune system. Of course, drugs that are really active in relation to immunity exist - but these are already the means for the treatment of serious diseases prescribed by the doctor (for example, interferons in high doses are used in the treatment of multiple sclerosis). Side effects of these drugs are also pronounced - for example, allergic processes or a condition resembling the flu (flu-like syndrome).
It is often said that large doses of vitamin C help reduce the frequency and duration of ARVI - but in large studies it turned out that prophylactic vitamin C, although it may slightly shorten the duration of illness in healthy people, does not affect the frequency and severity of colds. Lack of vitamin C really bad for the immune system, but nowadays its deficit is difficult to earn. This also applies to other vitamins and microelements: if there is a proven deficiency of them, then it needs to be adjusted, but this does not mean that vitamin deficiency should be sought from anyone who often has a cold. If, however, vitamin deficiency has developed (and this happens, for example, for vegetarians or people with intestinal dysfunction), then it should be treated according to certain clinical guidelines, and not by independently selected multivitamins.
And yet how to strengthen it
No matter how much we would like to find a magic pill to strengthen the immunity, such means does not exist yet. Moreover, although modern medicine has learned to suppress the work of the immune system (for example, in autoimmune diseases), so far there are no ways to safely stimulate it. And you don’t need to do this - and in order to get sick less often, it’s enough to follow boring recommendations: keep an active lifestyle, eat a variety of foods, get the right vaccinations and don’t run chronic diseases. It is worth remembering that the quality of immune protection is negatively affected by alcohol, tobacco smoke and smog - so you should not look for a tool that will “spur” immunity, but to normalize your lifestyle and regimen.
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