Clinical immunology in the Covid era

well today we're going to be talking to professor robert clancy from australia and uh professor clancy was one of the first clinical immunologists in australia and developed the field in australia he's got a long academic record in medicine he's studied for a doctor of philosophy and supervised lots of research projects and robert i believe you're also a holder of the order of australia medal well it's the order of australia australia yeah so that's like an obe or a knighthood in england i'm not quite sure what it's about anyway i haven't got one so i'm i'm quite impressed you'll have to migrate to get one yeah so just tell us a bit about your background robert what's your sort of trade what have you done well i'm a consultant physician i trained initially in gastroenterology because there was no such thing as clinical immunology i did a phd in autoimmune disease went over to mcmaster university for five years established the clinical immunology unit there came back to australia and eventually had a foundation chair within the new medical school at newcastle which was the world's second problem-based learning medical school my professional interests are clinically immunology and i developed a special interest because of the gastroenterological background in the mucosal surfaces and my research has been over many years looking at the way in which the mucosal surfaces handle pathogens bad bacteria bad viruses that are attacking the airways or the gut so you're not really looking at any you started off as a gastroenterologist but but you're not looking at any sort of anatomical system at the moment what you're looking at kind of what describes the whole physiological processes yeah yeah that's true when i graduated the and when you graduated the medicine was very vertical you became if you became a specialist physician you became a specialist in brain in heart lung joints uh and i felt that you lost a lot by confining yourself and so and for a second reason i was particularly interested in understanding what was happening understanding process of disease so i felt that i needed a research background and a laboratory orientation and so the idea of being a specialist in something that went across all these specialties really appealed to me i can't say it appeal to many of my colleagues who are in the vertical specialties of course but they've come to be more tolerant with time so essentially when i came back to australia the idea was shared with others and three of us got together and we formed the clinical immunology clinical immunology as a specialty in australia it had already been established in canada and i had participated in some aspects of that interesting so immunology obviously to do with immunity protection against disease but you mentioned that you studied particularly autoimmune disease yes that's been the uh crux of of my interest clinically i'm interested in internal clinical immunology uh other people are more interested in allergy asthma high fever eczema and while in a sense we're responsible for teaching that my particular interest in clinical work has been in autoimmune disease abnormal host parasite relationships between different infectious organisms uh vasculitis and a whole range of of chronic inflammatory disorders but i thought the whole point of the immune system was to beat up on the pathogens and the invaders not beat up on our own bodies what's going on here that's absolutely true and in fact in 1900 um early the the great german scientist uh coined the term horror autotoxicus you know that being reactive against yourself was incompatible with life well landsteiner i think the following year uh described in the context of congenital syphilis auto antibodies against red cells in those unfortunate infants and so the whole idea went was turned over 180 degrees and progressively it was recognized that autoimmunity uh immunity against yourself uh is in fact a very common uh and often concerning disease process but so so to be clear this is a pathological process this shouldn't be happening but it is well that's a good point um your colleague uh some of your colleagues came up with the idea that a touch of autoimmunity is a good thing because it helps get rid of the dead tissues and various abnormal bits of pieces that you want to get rid of in the body so if you make an immune response and get rid of those and some of the so-called natural antibodies have been thought to uh to have that role but by and large uh it gets out of control pretty quickly so autoimmune disease is this uh sort of over exaggerated attack on the body it's it's kind of what you call a friendly fire incident suppose isn't it friendly fire is a good way of putting it when when i started uh in internal medicine uh mcfarland burnett the great australian nobel prize winners concept was that the forbidden clones and if people wanted to laugh at me which they did from time to time they say oh yeah he's the guy who talks about the forbidden clone but of course the whole movement of immunology in clinical immunology has been about the control of process so everything is about control and uh just the right amount not too much yeah a little bit of this and a little bit of that well what's the forbidden clone i didn't get that though well if we've been playing with a wonderful idea that burnett had that there were autoimmunity came about because of a sequence of somatic mutations and it got to a stage where uh this horrific clone would appear that was reactive against i see right but that's now considered less than accurate but it was very important stage in the development of understanding of autoimmunity it's rather scary to think that i've i've worked through a process where we began with the forbidden clone and now we have uh reg cells and suppressor cells and helper cells and a whole range of uh of regulatory processes operating at many different levels yeah so what sort of diseases are we talking about autoimmune diseases what might people have heard of well classically there are two broad types there is where the autoimmune response picks out a particular organ uh the commonness would be thyroid many people have an underactive thyroid called hashimoto's disease where the immune response destroys the thyroid and it's it's simple you you just treat it with thyroxine the there are many other examples involving the gastric linol lining cells and you get pernicious anemia adrenal gland pituitary gland you name it then there's the second type of autoimmune disease which is systemic in other words the targeting autoimmune response is not targeting a specific organ but rather it creates a process which can deposit throughout the body and cause multiple organ disease and these are often mediated by antibody antigen complexes you can imagine a little bit of your self antigen combining with that antibody forming an immune complex and that might go to the joints causing joint pain the skin causing a rash the brain causing a fit uh the heart causing myocarditis and the commonest example of that is systemic lupus erythematosus or most people know it as sle or lupus yes because because it moves around the body yes exactly and it can be a whole and this makes of course the intriguing challenge for an immunologist to sort out exactly whether the person fits that picture uh what pattern they have what progress they might have what treatment is most appropriate so you get an antigen which is something the body is recognizing as being foreign you get the body's response to that which is the antibody and that forms this complex and it's kind of lodging in various tissues and that's stimulating and inflammatory response interesting yeah so you you've been studying uh crohn's disease for example what's that crohn's disease was considered a rare disease it was first described in 1935 by burrell crone and it was to distinguish against tuberculosis of the bowel it's an inflammatory process at any level in the bowel most frequently the bottom part of the small bowel or any part of the large bowel and it involves the full thickness of the bowel most people have heard of colitis which is a more superficial inflammatory problem crohn's disease is different ulcerative colitis is more an autoimmune type of problem crohn's disease seems to be an inappropriate inflammatory response to the leakage of bacteria antigens from inside the bowel into the wall of the bowel and it it probably is related most to a failure of the mucosal tissues of the bowel to get rid of that antigen in a effective way leaving it uh amenable to a grossly exaggerated inflammatory response so just it just becomes basically very sort of red swollen inflamed absolutely and that will cause ulcers it can cause obstruction uh you can get penetration with fistula it's actually a very common disease and it's interesting because if you look at the way in which we've thought about the disease a bacterial component has always been thought to be there commonly people use individual antibiotics uh but uh most people have said well wait a second this is a chronic inflammatory disease without realizing that the cause is in a sense the failure to get rid of the infection and so the response of over-inflammation has been treated traditionally with anti-inflammatory drugs corticosteroids and most recently very expensive monoclonal antibodies whereas i think the most exciting thing that's happening is recognition of the micro microbial the bacterial origin and the use of multiple antibiotics which has been recently trialled in north america with really quite outstandingly interesting results i think we're going to we're on the edge of a very new era in in crohn's disease i hope so because it's a horrible disease it can be it can be so you've got this antigen which is the the bacteria the antibody which is the body's response that's causing the inflammation yes it probably involves cytokines and t cells and various other components of the of the immune system but in essence it's an antibody against microbial antigens and in the past we've been trying to suppress the inflammation but the inflammation is just a natural response of what's going on is it exactly so you're trying to treat the cause i think rather than treat the symptoms we're trying to treat go upstream and get the bacteria the cause is probably a failure to properly eradicate that that bacteria because the phagocytic cells these cells that should be gobbling them up and destroying them appear to have often genetically influenced abnormalities it's a little harder to treat those but that'll happen one day yeah now you've also been working on lung diseases [Music] chronic obstructive pulmonary disease chronic chronic lung diseases and you develop some sort of treatment for that that i'm intrigued by can you sort of sketch out because i believe this treatment's cheap and i believe it's uh potentially fairly it's curative too strong a word uh i'm pretty sure you're referring uh john to work i've been involved in for a long period of time when i had finished my postgraduate medical training and a phd in autoimmune disease i went to work with john bieninstock in canada now john is quite an extraordinary person i know he'll be tuned in on this so uh yeah i've got to say that i think no he really is uh john had come up with the idea that there is a commonality between the protection mechanisms of the different mucosal surfaces of the body be it the lung the gut the eye and when i arrived he was on the verge of proving this by showing with transfer of cells in rabbits uh from palace patches as a major factory of cells to various mucosal tissues particularly in the lung and so i got particularly interested in that uh communication between the past patch which are little little factories of cells in the small bowel the lining of the small bowel and we developed these ideas to include t lymphocytes as well as b lymphocytes so all the different armor material of the so-called adaptive or specific immune response were generated and the interesting thing is they weren't generated in the lungs they were generated in the past patch by the antigens be they virus bacteria being swallowed into the gut uh as we sit here we sit here for 24 hours and i do that to you yeah but if we did um you would swallow at least a cup full of secretions normally yeah and in those secretions any bacteria virus covered virus bacteria would be deposited and they would activate the past patch and there was this loop where from the past patch there'd be t lymphocytes in particular some b lymphocytes making antibody with little postage stamps saying take me to the lung and it would go back to the lung and the whole idea is to let the lung do what it does best take up oxygen get rid of carbon dioxide don't get confused with uh inflammatory responses uh let the protective immune response be delivered to you when and how you want it well that's how it began and when we looked at this uh we i realized that we needed to have a model system and i thought well what's a good model system and i thought well chronic bronchitis you know australians being good brit trained people we know about chronic bronchitis and there's a lot of it everywhere now these are people mainly smokers but not uh 20 of our chronic bronchitis are non-smokers and which is interesting but uh having said that these are people who have got abnormal bacteria in their microbiome in the in the airways and that's causing cough and sputum so that when they get a virus infection that becomes exaggerated and they become quite sick and if they've already got damage to their lungs like emphysema chronic obstructive lung disease then that is what puts them in hospital and of course can kill them it's a very serious disease our awards are full of these absolutely absolutely and uh at the moment there's really no effective treatment that prevents them going to hospital um you know there's huge studies being done and maybe there's some marginal benefit here and there but it's been pretty disappointing so we took that as a model and we looked and found that if we uh if we made this delivery system of bacteria from the lungs optimal we really encapsulated very large numbers of bacteria we inactivated them in a special way we sorted out the dose and particularly the periodos periodicity of giving this infect giving this treatment we end up publishing i think was eight randomized controlled trials uh noticed that randomized controlled trials um private joke uh that we could actually reduce hospitalization in these patients with chronic lung disease and chronic productive sputum by 50 percent and that was done in repeated uh repeated studies reduced the amount of antibiotics usage and it was beyond my imagination when we got those the first results this going back back into the mid 1980s but the interesting thing was that we also looked at normal people and we found that the normal process of this this circulating of antigens down into the gut is pretty inefficient and uh if we took normal people and we gave them this uh specialized form of kiln just very simple kill bacteria we're just making people swallow a lot more than they normally swallow they're just taking ordinary bacteria killing them off yeah people to swallow so you still got the antigen abso absolutely but it's not the absolutely so the bugs are dead this is massively stimulating these patches uh and we could prick the cells migrating from the the gut to the lung we could show the inflammatory changes uh we had a lot of animal studies at the same time so i think there's about 250 papers all together so it was a long-term study but we can completely stop the pathogens like uh bacteria and viruses we work mainly with flu but i'm sure that well i'm certain the same would occur with covert we could stop them getting out of the passages the bronchial passages where the mucosal immune system operated into the gas exchange apparatus which recruits that systemic immune response which is the reason that cobot is such a nasty that's the advantage the respiratory distress syndrome they yeah exactly exactly because they fill up with fluid yeah and uh which uh when we looked at normal people uh we found that uh they were leaking pathogens to some degree all the time whereas if you optimize that protective mechanism so the idea is you beat up the viruses in the upper part of the lungs and the upper respiration rather than going down into the lower parts to clog up your abdomen exactly exactly and when you think about it the a bad flu or a bad corona virus like covered is simply one that's mutated to allow it to escape from the confines of a bronchus into the areas where they're going to get a systemic immune response to them well i've worked on a e recently robert and i don't remember carrying out this treatment but what's gone wrong here you you've discovered something back in 85 that could have carved our admissions by 50 percent i mean surely all the big fights i think you have a limit to the amount of time for an interview like this but i think anyone who's worked in clinical research will tell you how hard it is to get a good idea and a lot of very good people have worked in my team over the years uh professor alan cripps who ended up going on to great things in queensland uh a number of many other my phd students uh so it's it's not an isolated event it's a team event and uh it's involved a lot of people and it's involved commercial development i don't think we always picked the the best of our advisors and whatever's we're we're basically biomedical scientists we're not we're not commercial people um but it will happen it will happen it will happen and in fact you've got plans to do something we have some players private or can you talk about that um look i i probably prefer not to talk too much about it okay that's fine but uh you haven't given up well no no but i think what we've done is we've we've changed we've become very interested in the concept of wellness yeah and we've changed the the product into one which i think is far more effective and um uh and one which i i think will be quite interesting and one which uh can apply not just to the lungs so and should be available yeah we we're very keen to do some studies in crohn's disease for example yeah yeah so getting on to that idea um i mean surely what doctors are into is just waiting for someone to get sick then giving them a pill for it or giving them a treatment for it or do you think that there should be a a sort of more holistic improvement of health as well as as well as a pill for every ill sort of it's it's it's as you get towards the end of your career you start looking at it and you ask a lot of questions and one of the things that i've noticed working in with mainly sick people for a long period of time is that medically we're not too bad at looking after serious illness uh you've got to get there but when you get that be serious we're pretty good we're we've got good intensive care units good surgeries undergone amazing transformations but we're not so good at the day-to-day issues issues that worry people if you stop someone in the street and say look just write down 10 things that upset you it's not going to be coronary artery disease it's going to be fatigue energy aches and pains and i think that uh we talk about preventative help which is to me just the first sentence in a long paragraph uh that we need to pay attention to the uh what the patient wants uh what is needed and using uh we we get befuddled by 10 000 a year monoclonal antibodies that have pretty marginal effect in many cases you know i i i see a lot of patients with crohn's disease and we can treat those patients extremely effectively now with with multiple antibiotics which is is on the probably not well known by many people but certainly the early starting and double blind control studies are very very exciting and i've certainly been using these for about 10 years and um i think you're going to see uh huge changes that we get better understanding of the microbiome better ways of manipulating the microbiome using very simple technologies what we're doing is trying to promote if you like airways wellness and health to prevent the sort of problems that create disease uh you and i were talking earlier about some very exciting ideas that you have in in terms of brain pathology and i was talking to tess laurie two days ago about some of her ideas of of if you like i hate the word holistic but you know what i mean holistic wellness and and i think people are gathering around and saying wait a second patients need to be more involved better understanding what's going on i think covert has put into relief the disastrous state that medicine has gotten into and some of us are extremely concerned that i think family doctors have been left out on a limb and treated extremely shabbily probably across the western world that's the perception i have and that's part of because the structure of medicine has changed we've allowed bureaucrats and big pharma companies to make the decisions for us on their terms often very wrong terms on the whole my experience with big pharma they haven't got a clue about the broad-based biology outside of the narrow limits of their product and people with a lot of knowledge and information are not involved in the decision-making processes so there's a lot of issues i think we can we can look at so pharmaceutical modern pharmaceuticals tend to be um quite specifically targeted at a particular molecule in the body a particular receptor in the body they tend to have a fairly sort of specific target which is necessary sometimes we're not saying it's not medicines are necessary but what we seem to be missing out on is this whole idea of promoting health overall making sure we haven't got nutritional deficiencies making sure we've got exercise making sure we've got the diet making sure we've got the thing that promote the microbiome in the gut and and in the respiratory mucosa so you think you think that a lot of modern research is overly focused on specific molecular mechanisms that could transpose into particular pharmaceuticals which of course could be patented for a period of time does this come into it i think it's the total story isn't it if it comes into the total story it's the total story uh look you're absolutely right they're pharmaceutical companies and you know they're a business and the way they would argue we won't get involved unless we can patent that drug and we can make a lot of money out of it and so what can you patent well you can't patent uh can i mention that uh you cannot pay you mention it or you can't pay you you can't patent either mechanic which is just an example of a drug just an example out of patent out of patent uh absolutely and other aspects but what you can patent is something that uh identifies a particular chemical process a specific chemical process uh a specific receptor uh that you can make a particular cytokine uh and these incredibly expensive drugs uh have dominated the field very often uh forgetting that they should be sitting on top of a whole process of health producing disease reversing activities and we all know many examples of this and it seems that i mean for example i have to take now blood pressure's gone up now i have to take a blood pressure medicine every day basically so do i forever for the rest of my life so that's good because the the getting absolutely i should take a supposed doctor told thomas my father had high blood pressure and took respeen and he couldn't breathe through his nose and it drove him crazy yeah uh you and i take uh uh probably one of the ice inhibitors or something like that i'm taking and we don't even know we're taking it and we're keeping our blood pressure at 120 over 80. huge advantage i have no problem there definitely is but i much prefer to take one pill once you cure it the than than to take one every day for the rest of my life yeah and that seems one of the thing about about this what should we call it uh uh the the attenuated bacterial challenge of the immune system that you developed i mean presumably i just need to take that once a year or something with it well a couple of times a year but not not often well that's okay that's better than every day oh certainly not every day certainly not every day i look i think we're moving into what we're starting to talk about the microbiome now everyone probably listening here knows that the microbiome is that particular collection of bugs that you have in all your mucosal surfaces the particular focus has been the gut but the respiratory tract has a microbiome the eye has one all the mucosal surfaces do and this is such an exciting area you know i really wished i was uh 20 or 25 and know what i know now i'd be i'd be microbioming that applies to a few areas of worlds well as you possibly know one of my phd students was tom barodi who is the guy that discovered triple therapy for peptic ulcer triple therapy for crohn's disease tom's got quite a list but now he's got triple therapy for covert but he also is the person who introduced uh in test uh fecal microbiome transplantation now that sounds awful but it has transformed the life of so many patients and it's becoming now highly sophisticated i mean there's exciting work in in people with um autism little children with autism ulcerative colitis it's the treatment of choice for c difficile which has killed so many people around the world nasty bacteria but the interesting thing these are all local diseases well not all but people with parkinson's with terrible constipation have been treated and suddenly in a number of patients their parkinson's has improved now this is all early days and requires much more study but the idea of the gut lung the the gut brain axis and the way in which the microbiome interferes with systemic aspects of biology is very exciting and we're going to see so much more i can understand the way that the microbiomes affecting the coal on the the gastrointestinal tract maybe even the organs around about it but how the heck does bugs in your colon affect your mental health well uh i wished i knew all i i don't think anyone knows all the answer but but the the idea of course is that uh we now talk about the intestinal microbiome as being the new organ and so you've got this highly controlled uh bacteria mainly bacteria uh that you can only grow one percent of them they're not easy to study now they have a relationship they talk to the bowel and the bowel modifies them and they modify the bowel they secrete all sorts of various factors you feed them different foods you can get different outcomes you've got molecules circulating around in the blood and affecting the brain and every other system and we're just on the edge of really coming to understand this exciting area it is absolutely amazing isn't it and i i think it's worth stressing that you and me were talking about this before we believe that all of these things need to be related to the science and related to empiricism so even though this sounds almost incredible we are actually speaking within the within the levels of reasonable science at the moment this is not this is not hippie stuff this is not not about stuff this is based on hard biological physiological just just observing this area of the last decade we now have much better tools to to analyze the microbiome uh initially of course if you could only grow one in a hundred of the bacteria you really couldn't get a handle on it but now you know with simple pcr technology molecular biology that's getting better all the time we're starting to dissect into different groups the bacteria what's high and low and this how's it going to affect the outcome what products do they secrete a lot it's very complicated because there are so many variables so it it's it's not as if we could replace a particular single bacteria this is about the whole sort of interacting ecosystem isn't it so what we need to do is rather than specific interventions we need more generalized interventions that are improving the health of the microbiome generally so a diverse um plant-based to give the to give the bugs lots of things these are the exciting directions that are going to be taken i i have probably been more interested in the microbiome of the airways now we know we can control in a pretty crude sense that microbiome and make it less disease producing by simply making the delivery system of the stimulus coming down into the through the mouth and down into the gut by by giving uh tablets containing different uh bugs yeah now we don't know if we use another bug or that bug or this bug or add a touch of this and that to the bug whether we're going to get a better outcome and these uh each one well each one up to now has taken a lot of money and a lot of time to sort but now with some of the new methods that we have we can do this in a matter of weeks uh in a very simple and cheaper way so infinite area of research and of course we don't need to add we don't need to culture bacteria so much now we can do it like a genomic analysis and just of course to tell what's there by the by the genetics of exactly exactly yeah it's just mind-blowing isn't it well when you think of it the technology was sorted out uh 70 years ago we've just got well the the the the idea is sorted out but the technology has changed so that we can do overnight what yeah we couldn't do 20 or 30 years ago i mean i think most people are now probably familiar with the idea of the microbiome in in the gastrointestinal tract because we know that there's a lot of bugs there anyway but i must say i wasn't really aware until talking to you about the microbiome in the respiratory mucosa much less understood at much earlier stage but it's certainly extremely important we are getting to know that certain bugs are really of incredible importance for health as opposed to disease we know for example that if you get a viral infection a bed covered or flu ordinary coronavirus uh what it does it it talks to those bacteria in the airways and depending on what bacteria you've got they either shout a response or they shut up and do nothing so um we we there's lots of really interesting things that we're going to find out so there's actually there's actually protective bacteria in the respiratory mucosa yeah absolutely absolutely yeah and and as far as we know some of those may be producing uh just as many cytokine type molecules as the epithelial cells they sit upon because the talking is done through molecules yeah cytokines are simply the term we use for molecules that move between cells it's the conversation piece the the dialogue yeah wow and and and in the respiratory mucosa you've got your own immunological protective cells as well so you've got presumably you've got macrophages lymphocytes that they have an innate immune system now the innate immune system is just if you we used to think of them as the foot soldiers but we now know they're very smart and they actually feed back and tell the adaptive or the specific immune response the igg part of immunology tell them what to do half the time so uh it's a two-way two-horse race and but the innate system in the lungs is quite different the innate system in other parts of the body and there's a new concept now it's called learned innate immunity where the the innate immune system learns as a result of activation and there's a lot of misinformation that's passed on particularly in in the covert arena because one has to understand that while the innate immune system is critically important it is always influenced by the adaptive system and the innate system's defective it's you don't have to look very far to see if they're not being driven properly by the right uh the right type of adaptive immunity so the simplistic thing i've been teaching all these years is that the innate immune system is is is uh it's there as a result of your natural anatomy and physiology and it's active against a wide range of organisms in a non-specific way and it doesn't have to be acquired as opposed to the specific immune system where the immunity does have to be acquired that's just simplistic now isn't it there's an you'll be pleased to know john you've been teaching good stuff but but but it's it's more complicated i think the change came when uh the antigen presenting cells dendritic cells uh were really sorted out and at the end of the the 20th century and led to uh two three you know a number of uh nobel prizes and uh that led to the idea that when an antigen comes along it gets processed by one of these innate dendritic cells and that processing passes on to the t cell which can either up regulate or down regulate help or suppress outcomes and so you have a set of t cells which do all sorts of things depending on how that just how they're told to behave by the dendritic cell which is processing the antigen i mean it's such an exciting concept you couldn't make it up could you so you've got these dendritic cells that are looks literally like different whole capital there's a capital of the whole the just means branching doesn't it did you yeah so so they all physically collect up any antigens that are floating by because they've got like tentacles all over the place they'll then process these antigens send the relative cytokine messages to the relative t cell exactly to the obtain the t t helper cells while up regulate this a bit the suppressor cells down or you're a t reg cell you down regulate and yeah this is really important to understand because uh people have can't understand why it is if you get shot after shot after shot of a covert vaccine why is it that we're seeing a turn off of the specific immune response why are people who are getting too many uh boosters getting infection and getting serious infections and it's because it hasn't been recognized by the people who should be recognizing it that it's a bit like desensitization which we do for allergy it's exact you you actually use this system to turn off over reaction to allergens causing aspara and hay fever so it's possible for an antigenic stimulus for example a vaccine to upregulate yeah the t suppressor cells absolutely actually reduces exactly and that's what being proven i think the the the british government has done this perfectly by bringing out weekly results which have shown and as it goes down they've decided not to publish the weekly results and i can understand they say oh it's being misunderstood well it's not being misunderstood because it's been repeated in denmark israel uh scotland many other places it seems seems to me part of the problem is when we we discuss this objectively and scientifically uh this will be picked up by people who are anti-vaxxed and say oh they're there we are these guys i think that's very sad and this is a problem isn't it we seem to have a we seem to have a sort of um a dichotomy really yeah in in attitudes to medicine now um i am very grateful for my tetanus logical vaccine because i've seen people with tetanus i've seen children yeah i've seen adults with tetanus and all the other desi i'm very grateful not to have a polio for deficiency right you know i'm glad i haven't got you know all these infectious diseases that once wants curses of humanity but think about what you're talking about there john you're talking about systemic infections measles mumps tetanus all of these are going through the circulation so what you want is a very good protective immune response and this is where vaccines are fantastically valuable when it comes to the infections of those mucosal surfaces as with flu and covered these stimulate first and foremost the mucosal immune response which brings in the suppressor cells in a much heavier way accounting for the down regulation if you over stimulate it with injections simple nothing new uh and uh the same as uh we mentioned with desensitization uh so when no one said i'm certainly not god i'm an immunologist i can't be an antibacter i love vaccines yeah me too yeah i've given thousands putting my kids through school yeah yeah but um the what we're talking about is sensible vaccination and with the covert vaccine with any with the flu the same uh it's all about spacing spacing the by hitting people with vaccine after vaccine every month or two months a third fourth booster you ask people to put their hands up if they've had three four boosters and still got covered and often very severe covert and there'll be a forest of hands um what is needed is some common sense and understanding of the biology which sadly sadly is not well understood uh and it's because the main thing is that you you are you are boosting the suppressor cells exactly exactly you're seeing the net effect of positive and negative stimulation the more you stimulate the more likely to have a dominant negative and and we know that uh with desensitization it lasts five years so if you really effectively turn off the response to coronaviruses with booster after booster then you're possibly looking at years of non-responsiveness now that's very different to the idea some people are promoting about destroying the innate immune system i don't think there's that makes no sense to me might be wrong but i don't think so it's hard to see how you would destroy this no you're you're suppressing a specific component of the immune response but that limits the use of say seasonal coronavirus vaccines which i think we're moving towards um we look the vaccines have done a lot of good with covert they've stopped a lot of people dying they've kept people out of hospital but as we move along the way as we become an endemic infection then we need to develop a little bit more scientific sense and and we need to be honestly looking at effective cheap early uh treatments uh which have been um paralyzingly neglected shall we say indeed yeah yeah well we've covered quite a lot there um certainly plenty to think about my mind's uh buzzing already so um thank you for that uh and thank you for coming through to england to to talk about it and it's been a great great pleasure other things there but uh that's exciting times are hit though isn't it it really is i mean the the it's just the sheer complexity of the human body and the way it's interacting with this ecosystem that we live in yeah is well i think that to me to me it's very frustrating getting towards the end of my clinical and research career because i've always wanted to be able to have effective cancer immunotherapy and here we are you know we're we're not quite there but we've got these incredible new uh monoclonals really exciting that can unblock those t cells waiting to kill cancer cells and that's really working we've got to learn how to be a bit more selective but that'll happen uh on one hand and secondly mucosal immunology is just beginning with our very crude understanding at the moment of uh of the uh the various uh bacterial populations that populate mucosal surfaces so there's a lot of terrific areas for young people to get involved in absolutely yeah professor robert clancy thank you very much my great pleasure thank you no

Channel: Dr. John Campbell

Views: 273,300

Keywords: physiology, nursing, NCLEX, health, disease, biology, medicine, nurse education, medical education, pathophysiology, campbell, human biology, human body

Id: q8jVEpB1ieE

Length: 44min 30sec (2670 seconds)

Published: Fri Jun 17 2022