Enhancing innate immunity against virus in times of COVID-19: Trying to untangle facts from fictions
Désirée Larenas-Linnemann, Noel Rodríguez-Pérez, Alfredo Arias-Cruz, María Virginia Blandón-Vijil, Blanca E Del Río-Navarro, Alan Estrada-Cardona, José E Gereda, Jorge A Luna-Pech, Elsy Maureen Navarrete-Rodríguez, Ernesto Onuma-Takane, César Fireth Pozo-Beltrán, María Isabel Rojo-Gutiérrez
World Allergy Organization Journal, doi:10.1016/j.waojou.2020.100476
Introduction: In light of the current COVID-19 pandemic, during which the world is confronted with a new, highly contagious virus that suppresses innate immunity as one of its initial virulence mechanisms, thus escaping from first-line human defense mechanisms, enhancing innate immunity seems a good preventive strategy. Methods: Without the intention to write an official systematic review, but more to give an overview of possible strategies, in this review article we discuss several interventions that might stimulate innate immunity and thus our defense against (viral) respiratory tract infections. Some of these interventions can also stimulate the adaptive T-and B-cell responses, but our main focus is on the innate part of immunity. We divide the reviewed interventions into: 1) lifestyle related (exercise, >7 h sleep, forest walking, meditation/mindfulness, vitamin supplementation); 2) Nonspecific immune stimulants (letting fever advance, bacterial vaccines, probiotics, dialyzable leukocyte extract, pidotimod), and 3) specific vaccines with heterologous effect (BCG vaccine, mumps-measles-rubeola vaccine, etc). Results: For each of these interventions we briefly comment on their definition, possible mechanisms and evidence of clinical efficacy or lack of it, especially focusing on respiratory tract infections, viral infections, and eventually a reduced mortality in severe respiratory infections in the intensive care unit. At the end, a summary table demonstrates the best trials supporting (or not) clinical evidence.
Conclusion: Several interventions have some degree of evidence for enhancing the innate immune response and thus conveying possible benefit, but specific trials in COVID-19 should be conducted to support solid recommendations.
Ethical approval and IRB board submission As there are no patients involved: does not apply.
Declaration of competing interest All authors declared or they have no potential conflicts of interest. The following authors, indicated relations with the pharmaceutical industry:
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