Don't raise your immunity unnecessarily

Doctor, raise my eyelids immunity!
Tatiana Tikhomirova, immunologist-allergologist, Ph.D.

What is reduced immunity, how and why does it fall? In what cases should I take immunostimulants and when should I not?

So, what is immunity? This is the body's system that provides protection from everything alien. Immunity can be different: innate and acquired, specific and nonspecific, as well as humoral and cellular. The basic level theory can be read in Wikipedia.

Signs of a decrease in immunity are completely non-specific and, if you try, everyone will find such a thing. For example:

– frequent colds, or with the same frequency, but the current ones are longer, more severe and with more complications;
– the transition of the course of an inflammatory disease into a chronic one, with frequent relapses, difficult to treat;
– the change, in fact, of any inflammation from acute to prolonged: the wound on the skin does not heal, but becomes inflamed, slightly suppurates, becomes covered with a crust, there is a red inflamed roller around, the crust comes off, but there is no healthy skin, and again we see inflammation and so on.

It is not surprising that everyone who finds something of the described will think that his immunity has fallen, which means that he needs to be raised. Then dietary supplements, homeopathy will be bought, or folk remedies or immunostimulants will be used… How lucky will you be in the end with the result? If he's not lucky, he'll try something else. While it is unknown what will not pass by itself, or will not deteriorate to the state of "still to the doctor", or until something of the accepted will not work. Or until the reception of the next means of "lifting" does not coincide with the fact that "something" has passed by itself.

And all this would be wonderful, if not for one "but". Immunity is not something that falls and therefore needs a periodic rise. Well, like an object from the floor. And immunostimulants that really work are not a harmless thing without side effects and dangers.

The immune system is an active balance of two multidirectional forces. There are pro–inflammatory forces whose task is to cause inflammation, destroy a microbe/virus / tumor cell, even by damaging the tissues around, but in war as in war. If only this force existed (and that is how most of us naively believe), then we would live very little and very unhappily. Because the inflammatory process does not stop by itself. Generally. It grows exactly "by leaps and bounds": 10 macrophages, having eaten microbes, present their fragments to 100 lymphocytes (this is called the presentation of antigens), lymphocytes are activated, stimulate each other and other cells, go to the nearest lymph node, multiply there (this is called clonal expansion), mature and return back in the activated state by thousands. B-lymphocytes turn into plasmocytes, which produce antibodies. Antibodies also do a lot of things, for example, they cling to a stranger, attracting the attention of other cells of the immune system to him, inactivate microbial toxins, prevent the microbe from attaching to the cell or penetrating into it, and activate a whole system of proteins whose task is to make holes in the cell membrane, killing it in this way.

T-lymphocytes kill cells infected with a virus or microbe in their own ways, and some of the T-lymphocytes stimulate other cells of the immune system. All this time, neutrophils (and they usually come to the site of inflammation first) release pellets with "chemical weapons" – active enzymes that melt both strangers, neutrophils themselves, and tissues around, including healthy ones.

That is, speaking briefly (and in detail, if you are interested, read for yourself), a real war is going on in the place of inflammation. Meat grinder. At the site of inflammation, fragments of cells and pieces of microbes accumulate, various chemical signals fly in all directions, stimulating the continuation and intensification of the inflammatory reaction, causing other cells to help. And this, if there were no second force, would continue until the organism destroyed itself.

The second force is anti–inflammatory. It includes a bunch of proteins that transmit stop signals, as well as specialized cells, mainly regulatory T-lymphocytes. Also, a bunch of protective mechanisms can be attributed to this system. For example, causing suicide in an activated cell of the immune system, if it has not received a reverse signal from another cell (most often an antigen-presenting one). It works like this: "reinforcement" has come to the place of inflammation, but the microbes have all been killed and a bunch of cells are busy only cleaning up the consequences and repairing the destruction. Then the reinforcement cells, having already received activation (they were called), do not receive a second signal allowing. And they end up with apoptosis.

Even single defects and errors of this anti-inflammatory system are terrible in their consequences.

If the microbe contained an antigen very similar to the structural element of the organism itself, then after the invasion of such a microbe, the immune system may mistakenly decide that strangers are still inside. And start a war against the heart, joints, skin. A classic example: acute rheumatic fever.

If the immune system became hyperactive and could not stop itself in time, an infectious-toxic shock will occur and a person may die.

Mistakes in recognizing one's own-another's and activation of the immune system against one's own also lead to the development of autoimmune diseases. They are not treated, more precisely, all treatment is only suppression of the immune response and / or replacement of the function of the destroyed organ or tissue.

In addition, errors in the assessment of harmless-harmful in the recognition of antigen lead to the development of allergies. I also advise you to look for the details of all of the above to begin with on Wikipedia. And since the question has come up, here is my post for allergy sufferers. 

Defects and errors of the pro-inflammatory system are no less terrible. The body becomes to one degree or another, depending on the degree of violation of immunity, defenseless against any microbes, viruses, parasites. And even harmless and conditionally harmless microorganisms that live with us and on us always can cause a lot of serious problems in such conditions. Gross manifestations of immunodeficiency (AIDS, hereditary defects) are fatal without treatment. Defects of the pro-inflammatory system (and at the same time hyperactivation of the anti-inflammatory system) are the main reason for the inefficiency of immunity in the recognition and destruction of tumor cells.

So, very dangerous (and potentially deadly) both the state of hyperactivation of the immune system and the state of immunodeficiency. We normally live only in a state of balance.. If you repeatedly and successfully "increase your immunity", shifting the balance towards pro-inflammatory forces, then this may end with hyperactivation of the immune system, pathological inflammation, the launch of immune aggression on a healthy organ / tissue, and even the appearance (theoretically, as an extreme situation) of an autoimmune disease. But fortunately, for an ordinary person, if he does not have any predisposing factors, it is extremely difficult to stimulate the immune system in such a way as to seriously harm himself. Because most of the available immunostimulants do not work at all or almost do not work. Some of them are ineffective, some are a common scam. And only a part can change something, and not at all and not always.

Now let's try to figure out when immunostimulants are still needed, what they are and how they work.

So, you began to suspect that you need an immunostimulator.

1. It is best that it is suspected not by you, but by the doctor. I repeat once again: all the symptoms of "reduced immunity" are nonspecific. And practice shows that in the vast majority of cases these are not symptoms of the fact that for some reason your immunity suddenly dropped, but symptoms of the fact that you have now developed or worsened another disease. For example, you may think that a child needs to activate immunity because he has frequent snot and colds, but in fact his adenoids have grown, blocking part of the respiratory tract and disrupting the work of local immune system cells, and naturally, it is now easier for infections to settle there. And until the cause is removed, nothing will change for the better from any of your attempts to raise his immunity.

You think that your immunity has gone down because you get terribly tired and feel constantly weak, get sick more often, gain weight, you start drinking stimulants and immunostimulants, but it turns out that you have a subclinical form of autoimmune thyroiditis with thyroid hypofunction.

You think that you need to drink live yogurts, because something is wrong with your stomach, and treat your dysbiosis (oh, this is a separate song), but you have Helicobacter Pylori and slowly eats your stomach until the first ulcer, when you are already in the hospital.

I have given the simplest and most obvious examples. Many infectious diseases (bitten by a tick a year ago, and you didn't notice, tuberculosis, parasites), endocrine disorders, heart disease, joint problems, autoimmune diseases, neurological – all this can give the very symptoms that are listed in any article and in any advertisement about reduced immunity.

Therefore, rule number one is to be examined. Make sure you don't have anything new. Check all your chronic sores. Immunity in an adult NEVER "falls" by itself, without a specific reason. And this reason in 99% of cases will NOT be in the immune system. If it turns out to be a real defect of immunity, then you will treat it with very serious drugs, only with a doctor.

2. Take a close look at the list of autoimmune diseases.

The frequency of major autoimmune diseases in the United States (data for 1996)

(S.V. Lapin, A. A. Totolyan. Laboratory diagnostics of autoimmune diseases // Terra Medica nova No. 3-2007)

If you or your relatives, including grandparents and uncles, have something from this list, then remember the rule. If the doctor does not prescribe the opposite, you should never, in any case, take any immunostimulants. If you are healthy, but your relatives are sick, then you have an increased probability of an immune system disorder If this probability does not present an opportunity to prove yourself, you can live healthy all your life. But if you persistently and rudely try to stimulate your immune system by swinging the balance towards pro-inflammatory forces, you may end up with the debut of some autoimmune disease. I repeat, if a doctor who sees and knows you (unlike me) he does not prescribe you immunostimulants. Only then – accept and not be afraid, he knows better what is needed now.

3. Let's say that you already have a familiar sore or weak spot, and the situation is not new to you at all. Someone has chronic tonsillitis, when any acute respiratory viral infection threatens to end with angina (by the way, running to the doctor, there is a risk of acquiring a heart defect). Someone's tonsils have already been removed, and any cold crawls down to the bronchi. Chronic bronchitis. Chronic pyelonephritis. Recurrent cystitis. Chronic adnexitis. And a bunch of chronic, ending in "it" (i.e. inflammatory). These conditions are typical in that there is a "weak spot" in which, for various reasons, the balance of PRO- and anti-inflammatory forces is disturbed. The body cannot completely get rid of infection / inflammation, this process is only silenced during remission and comes out again. It's okay, but it's not pleasant either. So, these processes are what immunostimulants may be needed for.

4. And the last point – you have an acute inflammatory disease for the first time and the doctor prescribes immunostimulants for the main treatment. Take it. Just in case, tell him about point 2, if it applies to you. If you just have SARS / flu and you are being treated yourself, then by default you can alleviate the condition if you take immunostimulants. They, however, do not work on everyone and not always, but sometimes they help.

5. In all other cases, if you are healthy (or you have a situation from point 1, but there is no situation from point 2), then taking immunostimulants, you will get zero effect. The balance of two opposing forces, for and against inflammation, is a pretty solid thing, and you have to try very hard to break it at least a little. Only your wallet will suffer in the end.

So now you know when you need an immunostimulator. What they are and how they work.

I will make a reservation right away, I will not advertise something specific, and also I will not write my opinion about various drugs. They are mysteriously individual, someone goes "with a bang", someone does not go in any way. There are no universal ones.

Immunostimulants (IS) are divided into three main groups:

a. Exogenous. Usually these are substances of microbial origin, may be vegetable. In the case of microbes, it's pretty simple. Microbial immunostimulators work on the principle of vaccinations, only not against a specific microorganism, but on the principle of "and now we will stimulate everyone who responds." A bunch of various fragments and fragments of microbes suddenly enter the body. This usually occurs at the site of inflammation when these microbes are destroyed, for example, by neutrophils. Well, then it got into the stomach and then into the intestines. Antigen-presenting cells picked up these pieces, and, as usual, began to show the rest of the cells of the immune system. Without explaining that no one was killed and no one attacked, just picked up from food. In response to this, the remaining immune cells are activated, the activation signal begins to spread, and since there is no specific place of inflammation, since no one attacked, then where, in fact, to run, and whom to save is unclear. Although a lot of cells are ready for rescue and really want to fight. Against this background, a weak signal for help, which was already almost indistinguishable, coming from a long-sick tooth, or from the amygdala, or from the cells of the bronchial mucosa, or from another focus of chronic inflammation, becomes audible, and stupidly, it is unclear to whom the activated cells rush there. Which can lead to a surge of fresh strength and to an improvement in the fight at the site of inflammation.

Plant ICS work on the same principle: some plants contain very similar to microbial (for the immune system) antigens. Also, plant ICS may contain components of endogenous ICS, as well as involve the principle of operation of synthetic ICS (see below). Also because of the random similarity of the structure. Since no one has ever figured out what exactly works there and how, the developers, if you convince yourself over and over again that it can work in practice, make a drug that, in addition to the active components, all parts of the plant, both necessary and unnecessary, fall into. Therefore, for allergy sufferers, note that vegetable IS can cause allergies.

b. Endogenous. They consist of those substances that have been discovered and studied in our body at the moment. These are usually signaling and regulatory molecules of the immune system. Or just a specially processed gruel from the organs of the immune system. By default, it will stimulate the immune system, not suppress it. But really powerful ICS, thank God, are not on open sale and are not known to anyone, and they are used extremely rarely. Medium strength and weak ones are quite accessible.

b. Synthetic. These are various compounds that inexplicably stimulate the immune system, mainly macrophages. For example, who knows why macrophages in a test tube are happy to devour latex balls or particles of special paint. But some immunological tests are based on this. And in the body, for some reason, some compounds lead macrophages to an active state with increased appetite, and activated macrophages already shake the rest of the immune system.

And finally, let's consider another condition in which you can harm yourself by taking working ICS. Let's say you have a sterile inflammatory process that should be stopped. Let it be just gastritis (may the therapists not beat me for such free handling of examples). And you decided to raise your immunity for some reason and accept IP. Having received a bunch of activated immune system cells that don't understand where to go. So where are they going? That's right, into the mucosa of the already long-suffering stomach, because there are signals of inflammation from there. What will happen? Most likely, nothing, but if you are not lucky, there will be a sharp exacerbation of gastritis. And the symptoms of an unknown "fallen immunity" at the same time, it's a shame, you will remain the same. Even sciatica, arthritis and other "itas" that occur without the participation of microorganisms, that is, aseptically, can also, if you are unlucky, worsen from the thoughtless use of IC.

Now, I hope you are aware of the basic facts:

– it is not necessary to stimulate the immune system unnecessarily. And if there are problems, look for the real cause of the condition;
– IS, most likely, will not cause harm (but only if you do not have immune system disorders and current chronic aseptic inflammation);
– in a healthy person who accepts IP for no reason, absolutely nothing happens.

Well, everyone knows how to improve their health without resorting to IP. Only it's very boring: eating right, sleeping, exercising regularly and all that. It's much easier to believe the advertisement, buy a super-effective pill or a bottle of an immunostimulator and wait for the result, right?

And finally: do not confuse immunostimulators with immunomodulators. Immunomodulator is a broader concept: these are drugs that change the activity of the immune system in any direction. Immunomodulators are divided into immunostimulants and immunosuppressants (-suppressants). But in ordinary speech, many people use the word immunomodulator precisely in the meaning of "stimulator".

And if you see in the advertisement of another miracle drug that it is an immunomodulator, and also that it can activate and suppress the immune system, depending on what is needed at the moment, then feel free to conclude: this is 100% a scam and nothing else.

Portal "Eternal youth" http://vechnayamolodost.ru02.07.2009