Immunostimulants. How can I reinforce immunity?

March 29, 2020

What is immunity and how can I reinforce it?

What is immunity? Generally, it is the body’s internal capability that helps it fight infection. However, it is not as simple as it seems. Immunity is one of the most complex and intricate systems in the human body that has been developed throughout the evolution of mankind.

«My House is my Castle» – this expression is perfectly suited to the human body. Every day, the gates of our house are attacked by bacteria, viruses, fungi, etc. They are everywhere: in water, food, air, on the surface of any object. Probably, we would not be able to live another day if we were not protected by a powerful, specially trained army – our immune system.

There are two types of immunity: innate and acquired. The settling of the body, especially the mucous membranes of the gastrointestinal tract, by resident microbes begins during childbirth and is especially intense in the first two years of the baby’s life. This process largely determines the age-related evolution of the immune system. An example of the innate immune system is the natural activity of the body’s protective cells against any foreign agents. Acquired immunity is formed throughout life when we face various viruses and bacteria.

Enemies of the immunity!

The entry gate for a viral infection is the mucous membrane of the nasal cavity and upper respiratory tract. As soon as a foreign agent (for example, coronavirus) enters the mucous membranes of the nasopharynx, the body starts reacting. White blood cells are immediately sent to the invasion site and begin to destroy the pathogenic agent, which means that the nonspecific cellular immunity is turned on. This process is manifested in the form of copious nasal discharge, sneezing, coughing, and other well-known symptoms, the purpose of which is to mechanically flush the virus particles out of the body.

In addition, there are other protective mechanisms, such as, for example, fever. At elevated body temperature (above 37.5 °C or 99.5 °F), viruses are much less active and more vulnerable than in a healthy person. Therefore, fever is a kind of mechanism that helps the body recover faster. You may also feel manifestations of thirst and dry mouth, since drinking plenty of fluids is one of the most important aspects in the treatment of colds.

If viruses penetrate the blood and with its flow spread throughout the body the immunity responds by producing various antibodies that are on the surface of protective cells (lymphocytes). Humoral immunity is triggered; the production of antibodies specific to this agent begins. They bind to viral particles and help remove them from the body. This non-quick process takes up to two weeks. If the body is weakened and cellular immunity is not strong enough, the virus penetrates further, for example, into the lungs; pneumonia may begin, which is more difficult to cope with. A bacterial infection may add up, aggravating the person’s condition. In this case, a more serious treatment is required.

Immunostimulants

All human infections are divided into 1) bacterial, 2) fungal and 3) viral. Antibiotics are used to treat bacterial infections, antimycotics are used to treat fungal ones, and antiviral drugs and immunostimulating drugs are used to treat viruses.

Antibiotics are broad-spectrum drugs that are effective against a number of bacterial microorganisms. Antiviral agents are strictly specific and act only on viruses of a certain type. There are still many viral infections that have no specific antidote. Therefore, drugs with immunostimulating effects are used for their treatment. They enhance and accelerate immune responses and allow the body to fight a viral infection. When properly prescribed and taken, these drugs help accelerate recovery, avoid complications, and avoid the transition of the disease to the chronic stage.

A therapeutic strategy based on modulation of the immune response (immunostimulation) has several advantages over traditional antiviral treatment:

1. Firstly, without directly affecting the pathogen, immunostimulants do not cause the development of multidrug resistance among viruses. Due to this, their use may become a possible solution to the problem of the rapid spread of antimicrobial resistance.
2. Secondly, immunostimulation can significantly expand approaches to the treatment of patients with immune disorders in which antibacterial drugs are often not effective enough.
3. Thirdly, immunostimulants, having a potentially wide spectrum of action against viruses, bacteria, and fungi, and can be used as a non-specific “emergency treatment” when a new pathogen or biological attack (for example, coronavirus) appears.

There are various approaches to the classification of immunostimulants, depending on which parameter is the basis of the principle of division. Preparations that modulate and stimulate the immune system can contain various active ingredients, so before use, it is important to study how effective and safe they are for health. By origin, these drugs are divided into exogenous, synthetic, and endogenous ones:

1. Endogenous immunostimulants. The main substance has a natural origin and is produced by the human body to fight infection. This group also includes synthetic analogs. For example, Grippferon (interferon alfa 2b), etc.
2. Exogenous immunostimulants. These include bacterial and natural (plant, animal, and mineral) immunostimulants. Their action is based on antioxidant, general strengthening, anti-inflammatory, and vitaminizing properties. For example, Licopid, Derinat, etc.
3. Synthetic immunostimulants. They make up the most extensive list and include drugs obtained in the laboratory by streamlined chemical synthesis and containing artificial components. For example, Thymogen, Isoprinosine, Cycloferon, Lavomax, Immunofan, etc.

A separate place in immunology is taken by dietary supplements and vitamins. They have a general strengthening effect on the body and activate its processes, including protective functions. Vitamins E, A, C, D, and group B are of great importance for the normal state of the immune system. Useful health-promoting elements are found, for example, in extracts of echinacea, ginseng, citruses (vitamin C), algae (vitamin B12), etc.

What may we use?

Almost all of us have had an ARVI or flu. Hundreds of different viruses can trigger these diseases: coronaviruses, picornaviruses, adenoviruses, rhinoviruses, and so on. Human coronavirus was first isolated in 1965 from patients who were suffering from acute respiratory viral infections. In the past few months, people started talking about this virus again in light of the outbreak of pneumonia that began in December 2019 in the Chinese city of Wuhan. High tropism (i.e. attachment) to the tissues of the lower respiratory tract is specific for this virus. Simply put, when coronavirus enters the body, pneumonia may develop, which is unlikely for other acute respiratory viral infections. The high likelihood of pneumonia in coronavirus explains the high mortality rate. So far, the effectiveness of any drugs against coronavirus 2019-nCoV has not been reported.

However, the National Health Commission of the People’s Republic of China published the sixth version of the preliminary plan for the diagnosis and treatment of the disease, which included the drug with the active substance Umifenovir (ARBIDOL®). You can read the article about ARBIDOL® and its use in the treatment of coronavirus following this link.

Another Russian antiviral drug that is said to have the potential of treating the novel virus is RIBAVIRIN^®. The Ministry of Health of the Russian Federation has published a temporary guideline for the prevention and treatment of the new 2019-nCoV coronavirus. In this guideline, in particular, it is recommended to use RIBAVIRIN^® in combination with interferon or lopinavir/ritonavir. RIBAVIRIN^® is an antiviral agent used to treat hepatitis C. This medicine has been used in the treatment of SARS in China, Singapore, and several other countries. It is recommended that you use it with caution because of possible side effects. Commonly reported side effects of RIBAVIRIN^® include: hemolytic anemia, decreased hemoglobin, insomnia, dyspnea, lack of concentration, emotional lability, and irritability. The recommended treatment is 0.2 g (200 mg) of the drug 2-4 times per day for 1-2 weeks. The solution for intravenous administration is only used in the hospital. The use of RIBAVIRIN^® in patients who require artificial lung ventilation must be carried out by specialists with experience in resuscitation.

Since the effectiveness of the drugs against coronavirus is yet to be proven it is important to try and prevent the infection. And again the feasibility of using immunostimulants is one more time at the question.

The use of immunostimulants in ARVI caused by the virus is perhaps the most difficult and controversial topic in modern pharmacology. Existing scientific data contain a wealth of information about various drugs of this group, and these data are in fact very contradictory. Some experts are of the opinion that immunostimulants may not bring any real good to the body. Others on the contrary point to the results of various clinical studies, where the effectiveness of some of the drugs has been proven. One thing is clear: their use in acute respiratory viral infections or colds is necessary if the protective reactions are weak and the immune response is insufficient. In other words, if your own immunity for some reason is weakened or cannot do its job on its own, immunostimulants may help.

If a person is sick, the treatment should be symptomatic, that is, conditions must be created under which the body can cope with the infection itself. If a person is subject to workloads and stresses, it is much more difficult for the body to target its efforts to fight the infection. It is difficult to recover if the body is weakened by chronic diseases, which is why older people usually suffer from colds more. Experts say that it is the elderly who are at the main risk group for the new virus because they usually suffer from severe chronic diseases such as hypertension, cerebral arteriosclerosis, coronary heart disease, diabetes mellitus, etc. Immunity is busy fighting these diseases. Its power is simply not enough for everything else, so any infection may break through the defense and lead to serious complications. That is why there are so many records of fatal cases from coronavirus in elderly patients with a large number of concomitant diseases. The immune system simply does not have the capability to respond effectively to multiple crises. This is what doctors call the “decrease in immunity.”

Modern immunostimulants are available in every pharmacy; they are actively advertised on television and on the Internet. However, it is important to remember that the regular use of such drugs is possible only on prescription for disorders in the immune system, confirmed by laboratory tests. As a means of prevention or treatment of influenza, immunostimulants are not recommended to be used more often than 2 times a year. Unregulated treatment with immunostimulants is fraught with negative consequences. If the immunity is “over-stimulated”, it may trigger autoimmune disorders. Immunostimulants can not be taken in case of tumor processes, autoimmune diseases, during pregnancy and lactation. In all these cases, additional intervention in the immune system should be prescribed and strictly monitored by a physician.

Shortlist of immunostimulating agents

Grippferon (spray) is recombinant interferon, obtained by a synthetic, genetic-engineering method. Thus it is much safer than human leukocyte interferon obtained from donated blood. In this regard, it can be prescribed to pregnant women and newborns. It immediately enters the site of the infection (nasal mucosa), where viruses enter the body. It is practically not absorbed into the general bloodstream. Grippferon is used to prevent and treat flu and other acute respiratory viral infections.

Lavomax is an immunomodulating and antiviral drug used to treat and prevent respiratory and other diseases of a viral nature. It belongs to the group of synthetic interferon inducers. The active substance of Lavomax – tilorone – activates the production of interferons – proteins necessary to protect the body from viruses, and it also controls the immunity at all stages of influenza and ARVI.

Thymogen belongs to the group of synthetic immunomodulators, analogs of the natural hormones of the thymus. Thymogen is a synthetic dipeptide consisting of amino acid residues – glutamine and tryptophan. According to the indications for use, it is similar to other thymic immunomodulators. It has a mild effect, mainly associated with an increase in the number and functional activity of T-lymphocytes, and it is used in the complex treatment of adults and children with acute and chronic infectious diseases, accompanied by a decrease in cellular immunity, and inhibition of reparative processes after severe injuries (bone fractures), necrotic processes, as well as other conditions of immunodeficiency.

Cycloferon (tablets, injections). The active ingredient is meglumine acridone acetate, which is effective against not only viruses but also bacteria and fungi. Meglumine acridone acetate is an inducer of endogenous interferon, which has an antiviral, immunomodulating effect, as well as anti-inflammatory, antiproliferative, and antitumor effects. Cycloferon is included in the List of Essential and Important Medicines in the Russian Federation, as well as in the treatment standards for influenza of varying severity, both in adults and in children. Cycloferon is a drug that has been used in the pharmacological practice since 1992 due to its effective antiviral and immunomodulating activity and few adverse reactions.

Derinat (drops) is an exogenous preparation of animal origin that contains sodium deoxyribonucleate, obtained from specific cells of fish of the sturgeon class. The drug activates both cellular and humoral immunity, increasing the immunity of cells to viruses, bacteria, and fungi. It is prescribed to children from the first months of life, which indicates its low toxicity and safety.

General rules for immunostimulating therapy:

• Treatment with immune preparations begins at the first symptoms of viral disease (first 3-4 days);
• The drug is taken regularly, in age doses;
• The course of treatment should be complete (early discontinuation of the drug is not advisable);
• You should not extend the course of administration without indications;
• Combination with other medicines should be made with caution (if you take other medications on a regular basis, please inform your doctor).

Almost all immunostimulants have one main contraindication – individual intolerance. If at the very beginning of the therapy you feel weakness, nausea, vomiting, rash and other symptoms of an allergy, it is necessary to discontinue the drug administration. One of the common side effects of immunostimulants is a short-term worsening of the patient’s condition. Weakness and drowsiness may be manifested more intensely, runny nose intensifies, and body temperature may rise. The condition should stabilize within 3 days. If it does not, or if after 7 days of the treatment, the general condition does not improve, you need to consult your doctor.

To sum it up we would like to say that the benefits of immunostimulators are, of course, undeniable. The treatment of many diseases without the use of these drugs would become less effective. Strengthening the body’s defenses is also necessary in the period of recovery from serious illnesses, after injuries and operations. However, the useful properties of immunostimulants are fully manifested only when all individual characteristics of the body are taken into account, and the dosage is carefully selected. Whatever the purpose of the immunostimulation, the key to its effectiveness is the individual approach. Identification of biomarkers reflecting the immune status and other characteristics of the patient and the disease will help to better predict the final effect of using immunostimulating agents. Before interfering in the subtle mechanisms of our immunity, you should consult your doctor on whether any additional drug stimulation is needed.

If your immunity is weakened and the intake of immunostimulants is required, especially in the light of the new viral infection, which is spreading rapidly around the world, it is necessary to conduct a comprehensive analysis of the state of the body and find the cause of the immunodeficiency state. Otherwise, the effect of taking an immunostimulant will be short-term.

Reconsidering your lifestyle is another way of improving immunity. In addition to medicines, one should not forget about the traditional advice of doctors to maintain general health. Doctors do not recommend neglecting any disease. It is necessary to treat or minimize the chronic infection right away because even minor tooth cavities will distract the body’s defenses from the fight against foreign agents. Moderate physical activity, regular sleep, rest, and good nutrition are desirable.

We remind you that preventive self-treatment with any drugs does not guarantee that a person will not become infected with the coronavirus. The most important thing is to follow strict hygiene rules. And if you feel unwell, please consult your doctor.