Since the omicron variant has rapidly increased covid infections, the focus is once again on antibodies, and rightly so.
Antibodies play a critical role in fighting viruses and are important in preventing coronavirus from infecting our cells.
This is the reason why some countries have mounted booster vaccination campaigns in response to recent covid surges, in order to increase antibody levels.
But there’s a problem. Antibodies against covid do not persist as wellHence the need for reinforcements.
In fact, while these additional injections maintain good protection against severe COVID, it is estimated that people who receive a third dose of Pfizer’s vaccine will see their protection against developing COVID symptoms (of any degree) drop. 75% to 45% for ten weeks after your boost.
Scientists have questioned whether permanently recharging antibodies, only to see them decline soon, is a sustainable strategy.
If we want to develop lasting immunity to covid, it may be time to take another look at our broader immune response.
Antibodies are just one part of our intricate and intertwined immune systems. Specifically, maybe it’s time we turned our attention to T cells.
How Different Immune Cells Work
When the body is infected, say with a virus, it responds by producing white blood cells called lymphocytes. The main types of lymphocytes are B cells, that produce antibodies, and purpose T, which support the production of B-cell antibodies or act as killer cells to destroy the virus.
Some T cells and B cells also become long-lasting memory cells that know what to do if they encounter the same infection again.
B cells and T cells “see” the virus in different ways.
Generally speaking, B cells recognize shapes on the outside of the virus, creating antibodies that lock or dock with them (a bit like two matching puzzle pieces).
However, T cells recognize fragments of the amino acids that make up the virus, including fragments normally found inside.
Each virus has many unique characteristics, both inside and out. A person’s immune response can end up producing a variety of T cells and B cells that, together, attack a wide range of these traits.
This is sometimes called “response amplitude“A good range of response involves many different lymphocytes seeing different parts of the virus, making it very difficult for the virus to hide completely.
Ómicron worried many researchers because a key part of its external structure that antibodies target, the spike protein or spike (in red in the first image above), it has many mutations, which reduces the ability of antibodies to bind to the virus and neutralize it.
But nevertheless, Because T cells target other parts of the virus, such mutations may not prevent identification.
In fact, preliminary data still pending peer review suggests that this is the case.
This is reassuring, because the spike protein of the virus has changed a lot during the pandemic, suggesting that it could always be mutating outside the reach of antibodies.
However, T cells should be less susceptible to viral mutation. T cells designed to fight COVID also appear to last much longer in the human body than antibodies.
But do T cells have a major effect?
We already know a lot about the critical role of T cells in other viral infections.
This knowledge suggests that, against COVID, a good T-cell response is not only necessary to help B cells produce antibodies, it should also create killer T cells that can widely recognize the coronavirus, protecting against multiple variants.
Evidence on covid and T cells is still being collected. However, it is gradually becoming clear that T cells appear to play an important role in this disease.
The generation of widely reactive T cells, which recognize a variety of viral characteristics, has been shown to be associated with a strong response against disease.
In particular, generating good numbers of widely reactive killer T cells appears to make COVID less severe.
Conversely, a poor T-cell response is associated with worse outcomes for patients. In fact, some people who have had severe COVID have been found to have persistent defects in their T-cell response.
Many studies that demonstrate the efficacy of T cells in the case of covid have a common characteristic: the need for a wide range of responses, with T cells (and B cells) recognizing multiple features of the virus. This is believed to be the key to experiencing a milder illness.
This breadth could even extend beyond this specific coronavirus. The virus that causes covid is a betacoronavirus, and there are several betacoronaviruses that already infect us, including those that cause the common cold.
The shared characteristics between these cold and covid viruses may mean that the T cells we already had against the cold are now protecting us against covid. Signs of this are being discovered in both adults and children.
What does this mean for vaccines?
Many of the vaccines designed to date, including those from Moderna, Pfizer and AstraZeneca, have focused on a single primary target of the coronavirus: its spike protein.
These vaccines have been tremendously effective in generating antibodies. They also stimulate a T-cell response to the spike protein.
But now that we understand more about the role of T cells, the importance of having a broad response of these cells, and the problem of lowering antibodies, perhaps we should consider refocusing our vaccination strategies and direct them to generate T cells and to target more than one protein.
There is research in this direction. The first clinical trials of vaccines that can elicit much more reactive T-helper and killer cell responses have been completed, and several other T-cell vaccines are also entering the clinical trial stage.
These T-cell vaccines could be the key to strengthening existing immunity and generating long-lasting protection against severe symptoms generated by variants of the virus that causes covid.
If this is so, those vaccines would be a fundamental contribution to help the world live with covid more safely.
* This article was originally published on The Conversation. You can read the original version here.
Sheena Cruickshank is Professor of Biomedical Sciences at the University of Manchester in the UK.
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