共同无尽的变体和RA免疫抑制

肢瘤炎

这是《自然》杂志的一篇有关文章：

https://www.nature.com/articles/d41586-022-01613-2

就在我以为安全出去安全时...

对于我们的社区来说，有多个戳戳每个人都有可能引发爆发的潜力。我们确实需要针对不会突变太多的零件进行疫苗接种。

有人听说过这个方向有任何进展吗？

Frogmorton

你好@Arthuritis你去哪儿了？我希望一切顺利吗？

在斯塔福德郡，我们的人物正在上升。Best keep our masks on I think.

小心

托尼X

stickywicket

我敢肯定我读过一些以前的东西，即，因为我们被免疫抑制了，我们有可能比其他人更长的covid（nb。Covid，IE仍然被感染，而不是“长期covid”）感染会发生，但健康问题仍然存在）这种疾病可能会在我们体内突变。这似乎是合乎逻辑的，但是从好的方面来说，经常发生许多突变，这并不重要。另外，我认为这是抗病毒药出现之前的。

jamiea

你好@Arthuritis

我上周阅读了一篇有趣的CNN文章，着眼于寻找更长的持久疫苗。

https://edition.cnn.com/2022/05/20/health/mrna-vaccine-technology-covid-covid-19-durability/index.html

就我个人而言，如果医务人员开处方，我将继续服用疫苗。我的前4个疫苗是辉瑞，第五疫苗是现代疫苗。除了在现代之后几天，除了一个轻度疼痛的手臂外，我对他们没有任何反应。三月份，我的妻子有库维德（Covid），在库克（Cook），服务员和普通狗（General Dogbody）的房子里与我一起测试了10天，然后在五月，我儿子拜访我后的早晨，我儿子的测试阳性。我定期使用LFT进行测试，并且没有在任何一次情况下收缩，因此希望疫苗能够产生预期的作用。我的妻子有一个朋友，他在上个月受到免疫抑制和测试阳性。她联系了当地的卫生管理局以寻求抗病毒药，当晚她得到了抗病毒药，现在很好，所以这似乎有效。

作为@frogmorton说进入任何商业场所时，我仍然戴口罩，并且不使用公共交通工具。我每周至少进行两次测试，并在拜访我之前的家庭测试。

尽管最新的ONS数字显示6月的第一个周的死亡率是去年同一周的数字的两倍（211 vs 108），但公众似乎认为Covid已经结束。

Moiraa

刚刚听说苏格兰的Covid感染率在本周的BA4和BA5驱动下，已经上升至1:30。我相信英国的价格也在上升。

有谁知道当前的增强疫苗是否包括这些新的亚varinats，因为春季助推器开始时是BA1和BA2？

认为现在是时候重新引入一些限制，不仅保护免疫受到损害的人，而且如果感染的上升持续，也是更广泛的社会。

肢瘤炎

@frogmorton是的，仍然挂在那里，但是，由于免疫受到妥协和老年人的变体，covid上升了，假装它不在那里的力量。的确，健康SEC表示，“向年轻人增加更多现金是不公平的”，这与不承认在ICU床紧张时不承认60岁以上的人的政策。从财务的角度完全了解，老年人和长期生病是对年轻和健康纳税人的消耗，并选择了治疗排水或将来的税收来源……他们忘记的是这些人已经支付了税款即使是连续的政府浪费的终身时间，也照顾脆弱的是使文明与不弥补的原因。

@stickywicket我认为这篇文章本来可以写得更好，但简而言之是：

1. 如今，所有批准的疫苗都会根据更频繁地改变其“面膜”（尖峰头）的部分来准备您的免疫反应，例如流感。随着尖峰突变，疫苗刺激的抗体仅与其弱结合，这意味着您需要越来越高的抗体浓度才能使该病毒努力进行涉水。这就是为什么您需要相同VAX抗原的重复疫苗以保持高浓度的原因。药物无法尽快适应不断变化的尖峰面膜，因为它可以突变并交换它们。
2. The longer you host a virus, esp an RNA virus the higher the chance of developing a mutation by random chance that will bypass a healthy vaccinated carer’s defences and go on to replicate, either as a mild illness or something more serious, however the milder one is more likely to spread as humans treat mild covid as “a cold”, and something that knocks them out as “maybe its flu or covid”. The length of time needed to evolve an effective mutation is quite long, is months, usually in a hospital. The evolution is through random chance, so most mutations will fail.

抗病毒药并不是那么好，molnupiravir几乎无法起作用，并且通过FDA批准，因为几乎没有其他批准，并且通过加速突变引起更多失败后代而起作用。Remdesivir works a little better by halting viral RNA synthesis, however these drugs, like all drugs, are not free of side effects and we don’t know how well they will be tolerated as they are new, but hey, when its life or death best to take whats available.

@moiraa我不知道对当前变体定制的任何批准的疫苗。沃尔特·里德（Walter Reed）陆军医院研究中心（美国陆军）正在努力开发一种针对病毒基本部位的疫苗，例如无法突变，例如您可以交换伪装面膜，但不能交换您的血型逻辑。但是，该病毒是聪明的，并且可以很好地掩盖这一脆弱的部分。这种类型的研究非常昂贵，也没有出售政府多剂量的前景，因此在商业上不吸引人，也不是由政府或非利润来运行的。

@jamieA很好的CNN文章，我可能在我的帖子中介绍了类似的观点。

The vaccines are generally well tolerated by older people, ie over 45, in fact the older you are the more likely it will be a non event, and you need the help, as older immune systems are fairly weak with age already and won’t go nuts on a marauding rampage like a young person’s, shooting at everything in sight and over reacting.

因此，对于您来说，这是一个非事件，我想您已经超过45岁了，拥有世俗的免疫系统，但是如果我得罪的话，我很抱歉！

就我个人而言，如果我的抗体在我的mRNA vax之后我的抗体掉落了，我宁愿对同一病毒没有无数的VAX刺激。我曾在世界各地的某些地区工作，因此有一张非常漫长的疫苗接种记录卡，但当我的免疫系统更大，我的免疫系统更有可能与每种兴奋剂一起发疯！

jamiea

@frogmorton<\/a> Still hanging in there, yes, covid rising, however as the variant mainly deadly to immune compromised & elderly, the powers that be are pretending its not there. Indeed, the health sec said unkindly “adding more cash to the NGS would be unfair to the young”, echoing the policy of not admitting anyone over 60 at the height of covid when ICU beds were tight. Fully understand from a financial perspective, the elderly & chronically sick are a drain on the young & healthy taxpayers, and given a choice to treat a drain or a future source of taxes… What they forget is these people have already paid their tax dues over a life time, even if squandered by successive govts, and looking after the frail is what makes the difference between the civilised & not. <\/p>

@stickywicket<\/a> I think the article could have been better written, but in short the main points are:<\/p>

1. All the approved vaccines today prepare your immune response against the part that changes its “mask” (spike head) most frequently, like the flu. As the spike mutates the vaccine stimulated antibodies bind only weakly to it, which means you need increasingly higher concentrations of antibody to make the virus struggle to wade through. This is why you need repeated vaccinations of the same vax-antigen to maintain high concentrations. The pharmas can’t adapt to the changing spike mask as quickly as it can mutate & swap them.<\/li>
2. The longer you host a virus, esp an RNA virus the higher the chance of developing a mutation by random chance that will bypass a healthy vaccinated carer’s defences and go on to replicate, either as a mild illness or something more serious, however the milder one is more likely to spread as humans treat mild covid as “a cold”, and something that knocks them out as “maybe its flu or covid”. The length of time needed to evolve an effective mutation is quite long, is months, usually in a hospital. The evolution is through random chance, so most mutations will fail. <\/li><\/ol>

   The antivirals are not that good, Molnupiravir barely works and passed FDA approval because there was little else, and works by accelerating mutations to cause more failed progeny. Remdesivir works a little better by halting viral RNA synthesis, however these drugs, like all drugs, are not free of side effects and we don’t know how well they will be tolerated as they are new, but hey, when its life or death best to take whats available. <\/p>

   @MoiraA<\/a> I am not aware of any approved vaccine customised to the current variants. The Walter Reed Army hosp & research centre (US Army) are working on developing a vaccine against the essential parts of the virus that it cannot mutate eg you can swap your disguise mask but you can’t swap your blood type kind of logic. However the virus is smart, and hides this vulnerable part well. This type of research is very expensive and there’s no prospect of selling govts multiple doses, so not commercially attractive and best run by a govt or non profit. <\/p>

   @jamieA<\/a> Good CNN article, I might have covered similar points here in my post. <\/p>

   The vaccines are generally well tolerated by older people, ie over 45, in fact the older you are the more likely it will be a non event, and you need the help, as older immune systems are fairly weak with age already and won’t go nuts on a marauding rampage like a young person’s, shooting at everything in sight and over reacting. <\/p>

   So for it to be a non event for you, I’d guess you are over 45, with a worldly wiser immune system but my apologies if I offended! 😉<\/p>

   Personally I’d rather not have an endless series of vax stimulation for the same virus if my cellular response after 2 jabs is adequate, even if my antibodies have dropped off after my mRNA vax. I have worked in some grotty parts of the world so have a very lengthy vaccination record card, but accutely aware that until I am a bit older my immune sys is more likely to go nuts with each stimulant!<\/p>","bodyRaw":"[{\"insert\":{\"mention\":{\"name\":\"frogmorton\",\"userID\":10897}}},{\"insert\":\" Still hanging in there, yes, covid rising, however as the variant mainly deadly to immune compromised & elderly, the powers that be are pretending its not there. Indeed, the health sec said unkindly “adding more cash to the NGS would be unfair to the young”, echoing the policy of not admitting anyone over 60 at the height of covid when ICU beds were tight. Fully understand from a financial perspective, the elderly & chronically sick are a drain on the young & healthy taxpayers, and given a choice to treat a drain or a future source of taxes… What they forget is these people have already paid their tax dues over a life time, even if squandered by successive govts, and looking after the frail is what makes the difference between the civilised & not. \\n\"},{\"insert\":{\"mention\":{\"name\":\"stickywicket\",\"userID\":15071}}},{\"insert\":\" I think the article could have been better written, but in short the main points are:\\nAll the approved vaccines today prepare your immune response against the part that changes its “mask” (spike head) most frequently, like the flu. As the spike mutates the vaccine stimulated antibodies bind only weakly to it, which means you need increasingly higher concentrations of antibody to make the virus struggle to wade through. 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你好@Arthuritis

没有冒犯了——我66。每个人都是不同的nd I can appreciate your point regarding endless vaccines. I wish there were developments in a longer lasting solution but it doesn't seem that any time soon it will appear.

Since covid appeared in the UK in March 2020 I've had at least 10 chest infections - possibly as a result of contracting covid just when the UK had stopped testing in March 2020. Three of these required hospitalisation for pneumonia, the first of which occurred 3 weeks after my PsA diagnosis and my PsA went on the rampage at the same time. So my CRP level peaked at 340 and they didn't know whether it was the pneumonia or the PsA or both - one of the nurses told me later that if it were down to the pneumonia then that's above sepsis levels. I spent the best part of a week on a full face oxygen mask, getting pumped full of steroids - not something I'd wish to repeat if I can avoid it. I've ended up with a patch on my right lung so any protection is gratefully received.

Baloo

Thats interesting. So am I right or wrong in thinking that immunosuppressants are reversible, you stop taking them if you want to, and your immune system returns to the strength it was before? In the case of steroids I had to taper off, and still this time I suspect I got a flare up, but its maybe settling down afterwards, and maybe I would be better off toughing out the remaining aches without any steroids?

jamiea

Thats interesting. So am I right or wrong in thinking that immunosuppressants are reversible, you stop taking them if you want to, and your immune system returns to the strength it was before?<\/p>","bodyRaw":"[{\"insert\":\"Thats interesting. So am I right or wrong in thinking that immunosuppressants are reversible, you stop taking them if you want to, and your immune system returns to the strength it was before?\\n\"}]","format":"rich","dateInserted":"2022-06-18T11:26:00+00:00","insertUser":{"userID":118493,"name":"Baloo","url":"https:\/\/community.versusarthritis.org\/profile\/Baloo","photoUrl":"https:\/\/wb.vanillicon.com\/v2\/bd5c3d73e1fbbf9c2b9343ddce32daa7.svg","dateLastActive":"2022-10-16T16:15:27+00:00","banned":0,"punished":0,"private":false},"displayOptions":{"showUserLabel":false,"showCompactUserInfo":true,"showDiscussionLink":false,"showPostLink":false,"showCategoryLink":false,"renderFullContent":false,"expandByDefault":false},"url":"https:\/\/community.versusarthritis.org\/discussion\/comment\/696231#Comment_696231","embedType":"quote"}"> https://community.versusurthritis.org/discussion/comment/696231#Comment_696231

你好@baloo

我想是这样。对我来说，告诉我的细胞因子蛋白告诉我的免疫系统如何以及何时发挥作用，导致免疫系统攻击我的关节。据我了解，免疫抑制剂不会消除引起其抑制或阻止其问题的细胞因子。

肢瘤炎

@balooIts as@jamieA描述，免疫抑制剂（准确）暂时禁用复杂机器的一部分是您的免疫系统。更现代的版本和类固醇会干扰信号过程。因此，您可能会喜欢巨大的白细胞蜂巢，具有攻击的可能性，但是它们无法收到攻击信号，因此什么也不会发生。像MTX这样的较旧的人通过防止新的速度生产新的细胞来耗尽战士细胞的供应，因此RA大大减慢了。（MTX与叶酸竞争，对于新细胞生产至关重要，这就是为什么儿童和孕妇不能接受这一点的原因）。当您停止服用这些“ dmards”时，它们被委婉地称为（它们抑制了您的免疫系统，有用的副作用可缓解RA，但是它们并没有直接修改引起疾病的破木细胞，但Pharma喜欢称呼他们为他们。“疾病修饰抗疾病药物”，因为它的销售量比“ nuke nuke solune Systems缓解疼痛”更好。

不幸的是，当您停止服用它们的那一刻，您的免疫系统将在横冲直撞地破坏它认为不合适的任何东西，包括您的关节和存在的任何其他疾病，这会更像愤怒的大黄蜂的巢穴刺激它。