Question about Vaccine Adjuvants and COVID-19

[Anon-C]

If anyone knows about vaccines; what about the use of common vaccine adjuvants, and aluminum hydroxide in particular, as an early treatment in COVID-19 cases. The idea being that the aluminum hydroxide administered will help stimulate a broader immune response to SARS-COV2 virus present in the body. Aluminum hydroxide is a common adjuvant in vaccines and much less toxic than quinine anti-malarials, so less risk to those at risk groups.

Apologies if a silly question.

v

[Warpy]

1. Not a silly question.

I'm sure doctors across the planet will throw everything including the kitchen sink at dying patients in a last ditch attempt to keep them alive. Eventually, something that works will come out of left field somewhere, proper trials will be done, and we'll have a better treatment.

In the meantime, don't drink aluminum hydroxide. It's a good antacid but it's constipating as hell in large amounts.

[Anon-C]

5. Thank you. In fact thats why I attempted some care in asking the question, I do not want to amplify.

...misinformation and have people drinking Mylanta unless for heartburn thinking its a treatment(I don't even have aluminum in my deodorant).

[Warpy]

9. The aluminum-Alzheimer's idea was overhyped and wrong

and deodorant isn't going to be absorbed in sufficient quantity to do anything, anyway. If your apocrine glands gush, it will slow them down nicely.

There is going to be a lot of crazy stuff out there, so my best advice is to watch those weasel words: "can," "might," "may," "could," and the list goes on. People pushing bogus cures will try to cover their asses with weasel words, but it's a dead giveaway that says "unproven," if not downright "crackpot."

/rant

[PoindexterOglethorpe]

2. What do you mean by vaccine adjuvants?

[Anon-C]

6. Vaccine adjuvants are substances added to a vaccine to stimulate a greater immune response...

... to the antigen(the virus, bacterium, fungus) you are targeting against. When you get a vaccine shot, and it swells or gets sore for a while, that is as i understand it mostly due to the vaccine adjuvants.

As a bad analogy, the adjuvant is a crook who drives a car through a store window, fires his gun into the air and blows the car horn to bring about an overwhelming police(body's immune) response. In a COVID-19 vaccine, perhaps inactive SARS-COV2 virus is like a patsy riding shotgun in the car, but thanks to the adjuvant, the patsy will be arrested on the spot(innate immune response) and taken to jail(Lymph node) where he will be booked into the system(adaptive immune response) so he can be dealt with more readily in the future.

[PoindexterOglethorpe]

7. Thank you for that.

[Mike 03]

3. Interesting question. What if a person is in that group of people whose

immune systems over-react and create the "cytokine storm"? Is there any way to predict whether a person's immune system is under-reactive vs. over-reactive? Would you have to be careful whose immune systems you stimulate?

This issue has been on my mind too, when I see articles about enhancing one's immune system. I always think, "What if it's better in some people to have an under-reactive immune system, and the last thing you want to do is enhance it?" But I don't know a way to distinguish between the two.

Or maybe one could say, as a general rule, it's better to stimulate your immune system and get it ready to fight.

If a person has allergies or an autoimmune disorder, or lupus for example, is that person's immune system overactive in general?

[Anon-C]

8. This is a question at present:

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30628-0/fulltext

Current management of COVID-19 is supportive, and respiratory failure from acute respiratory distress syndrome (ARDS) is the leading cause of mortality.2 Secondary haemophagocytic lymphohistiocytosis (sHLH) is an under-recognised, hyperinflammatory syndrome characterised by a fulminant and fatal hypercytokinaemia with multiorgan failure. In adults, sHLH is most commonly triggered by viral infections3 and occurs in 3·7–4·3% of sepsis cases.4 Cardinal features of sHLH include unremitting fever, cytopenias, and hyperferritinaemia; pulmonary involvement (including ARDS) occurs in approximately 50% of patients.5 A cytokine profile resembling sHLH is associated with COVID-19 disease severity, characterised by increased interleukin (IL)-2, IL-7, granulocyte-colony stimulating factor, interferon-? inducible protein 10, monocyte chemoattractant protein 1, macrophage inflammatory protein 1-?, and tumour necrosis factor-?.6 Predictors of fatality from a recent retrospective, multicentre study of 150 confirmed COVID-19 cases in Wuhan, China, included elevated ferritin (mean 1297·6 ng/ml in non-survivors vs 614·0 ng/ml in survivors; p<0·001) and IL-6 (p<0·0001),2 suggesting that mortality might be due to virally driven hyperinflammation.
• View related content for this article

As during previous pandemics (severe acute respiratory syndrome and Middle East respiratory syndrome), corticosteroids are not routinely recommended and might exacerbate COVID-19-associated lung injury. However, in hyperinflammation, immunosuppression is likely to be beneficial. 7Re-analysis of data from a phase 3 randomised controlled trial of IL-1 blockade (anakinra) in sepsis, showed significant survival benefit in patients with hyperinflammation, without increased adverse events.8 A multicentre, randomised controlled trial of tocilizumab (IL-6 receptor blockade, licensed for cytokine release syndrome), has been approved in patients with COVID-19 pneumonia and elevated IL-6 in China (ChiCTR2000029765).9 Janus kinase (JAK) inhibition could affect both inflammation and cellular viral entry in COVID-19.10
All patients with severe COVID-19 should be screened for hyperinflammation using laboratory trends (eg, increasing ferritin, decreasing platelet counts, or erythrocyte sedimentation rate) and the HScore11 (table) to identify the subgroup of patients for whom immunosuppression could improve mortality. Therapeutic options include steroids, intravenous immunoglobulin, selective cytokine blockade (eg, anakinra or tocilizumab) and JAK inhibition.
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[eppur_se_muova]

4. More of a question for the Health Forum. nt