Dr Rose: The immune system during the pandemic

During a coronavirus outbreak, in terms of the development of symptoms it is very important whether our immune system is working properly or not. Regarding conditions for the proper functioning of the immune system and what we can do to maintain our health, we ask chief physician Professor Dr. Kristóf Nékám, Dr. Rose Private Hospital’s immunologist and allergist. 

Kristóf Nékám

How do our immune systems work? 

The basic function of the immune system is to preserve individual’s physiology in an ideal state in a given environment. The main threats to this ideal condition are bacteria and viruses, as well as various infectious diseases. One of the functions of our immune system is to protect us from external infections, and the other is to be able to block changes within the body with the same concept. This is seen, for example, in autoimmune diseases and the development of tumor cells that endanger individuals. 

Can we assume that a healthy person has a healthy immune system? 

We know of congenital genetic causes that weaken the immune system, in which case the fetus can die in the womb due to genetic factors. However, we often see that the immune system is inhibited by a combination of environmental effects and pollution, but this also includes smoking.  

In connection with the coronavirus, the role of the immune system’s function has come to the fore. However, this keeps the layman in doubt as we can see no connection between who develops which strong symptoms. For example, we have heard of cases where a person with a healthy lifestyle, although surviving the disease, needs hospital treatment with severe symptoms. Why do you think this is? 

As they say, the devil is in the details, but the fact is that most infected people actually have the infection without significant subsequent consequences and then enjoy protection for a time. In the case of a single patient, it would take much courage on our part to try to say specifically what might be behind the more severe symptoms without knowing the precise details. However, if we were to follow this up, I think there would be a pretty high probability that the reasons would still be revealed: some kind of chronic illness, an eating disorder, or a lifestyle problem. 

What solution do you see for COVID-19 prevention? 

It is clear that the antidote to this coronavirus is the vaccines now being used in Hungary and around the world. Another means of prevention is to avoid direct personal contact, to keep your distance, and to use protective equipment. Just days ago, I read an Australian survey, Australians recognized the severity of the pandemic in time and actually completely shut down the continent and so there are hardly any cases of infection in the country. 

So, I think keeping a distance and using protective gear is what the average person can do best and naturally the vaccine that will be available soon! 

In the case of third-generation modern vaccines, can it be expected that its effect may be weaker in certain patients and age groups? 

A disease that would directly affect the effect of the vaccine is rare, but other factors, such as deterioration in lung function, smoking, and air pollution, may cause the vaccine to become less effective. 

Can people's immune response be measured? 

In the case of active vaccinations, it is constantly examined whether the protection they are aiming for is developing in the given population at the given time. 

An interesting issue is the role of the microbiome, i.e., intestinal bacteria, in regulating the immune response in its proper immune function. Do intestinal bacteria play a role in preventing a coronavirus infection? 

The microbiome is the recognition of the last ten to fifteen years. Any factor that inhibits the function and workings of the microbiome - such as malnutrition, smoking, and certain medications or tumor conditions - also inhibits the immune system. 

So, can we say that in non-chronic patients, nutrition greatly affects the functioning of the immune system? 

If the functioning and regulation of our immune system is not perfect, then food allergies develop, the frequency of which nowadays reaches 10% of the total population. A well-functioning microbiome also inhibits the immune response to food. 

A common question is, should we use dietary supplements and vitamins in order to boost our immune system? 

I believe, and all the research supports this, that a healthy person, in a healthy environment, with proper nutrition, does not need to affect the functioning of their immune system. 

What you should consider is that if infectious diseases develop in a given population that is at real risk, the solution is to create and apply the appropriate vaccines to help our immune systems prepare for exposure to these viruses or bacteria. It is important to know what infectious diseases exist in a given environment and to develop protection against them. 

Another important task of the immune system is to make the protection against structurally altered cells or tumor cells as effective as possible. Tumor cells may often form throughout our lives, but the normal, well-functioning immune system can protect us from these rare cellular states. 

Is the winter sunshine enough to replenish our vitamin D supply? 

We can still take vitamin D now, and stop taking it from the end of March. The optimal amount of vitamin D can help us to avoid infectious diseases.