After about 3 months of spread of Covid 19 in Italy one thing was understood: that the disease did not manifest itself according to the more frequent patterns of a "classic" pneumonia. The complications of this infection represent something new and unexpected which - only now can we say - starts from a powerful inflammation of the organism, in which the virus has found fertile ground to take root, proliferate and cause even lethal damage that is very different from that of normal pneumonia.
We asked ad Attilio Speciani, immunologist Milanese and profound scholar and connoisseur also in the field of inflammation of the body which causes many diseases, how the virus behaved and what are the factors that have offered the most fertile ground for it.
Doctor Speciani, after three months of observing the virus, what did you understand about it, what surprised you and how it acted on organisms, saving some and decimating others?
“Knowledge of this new virus, cause of Covid-19 is progressing day by day. In many cases, the manifestations can be minor, often comparable to those of a flu. For the complications, however, at first it was thought of a direct action of the virus on the lung, as if it made it difficult for oxygen to pass through. But is not so. It was soon understood that the virus acts by causing an inflammatory storm linked to the activation of numerous cytokines, which act on the immune system, altering some of its actions. And here is the novelty compared to a classic pneumonia. In fact, there is an increase in coagulation and the production of microclots and pulmonary microthrombi, due to the inflammation of the vessels, which alter the blood flow and the distribution of the relationship between blood and air in the lungs involved".
So in a decidedly different way than what doctors are used to seeing in an infectious disease…
"Exactly. In a classic pneumonia some lung areas or the whole lung fill with purulent secretions and the amount of healthy lung that can breathe is reduced. Here instead an immunological inflammatory process is activated which changes the function of the vessels. Understanding this was fundamental in order to gradually change the approach and modality of therapy. Now - with only two months of knowledge of the virus - it is already possible to define protocols that are still partial, but innovative and effective, and the path in this direction continues unabated. For example, it was understood that antivirals were not decisive, while anticoagulants were".
So the keyword is inflammation. She has always studied the effects of inflammation on the body and studies its causes. Can the same criteria also be applied in the case of Covid 19?
“There are three well-defined causes that also pave the way for the complications of the Coronavirus: inflammation, glycation and excess sugar, alterations in insulin sensitivity and being overweight: important risk factors that manage to complicate the course of the disease, even seriously, of which it is essential to take this into account in order to implement true prevention”.
And can these kinds of inflammatory processes be controlled by the food you choose?
“It has been known for some time now that the action of food on the body goes far beyond the effect of the calories introduced or the balanced intake of minerals. Food-induced inflammatory signals are much more powerful. The most recent studies have made it possible to understand that there is a direct and profound relationship between what you eat and your own personal food profile e any cytokines produced".
More specifically, how does the chain from food to inflammation to disease develop?
“As we already had visa, the repeated intake of a food belonging to the same food group or the excessive introduction of a food, can lead to the production of particular cytokines such as BAFF - strongly related to immunological activation - which can be a triggering factor, together with other substances inflammatory, of many of the immunological and reactive phenomena (such as vasculitis) involving the pulmonary vessels during a Coronavirus infection. The PAF (Platelet Activating Factor, equally correlated to some dietary habits) has proved to be a possible coagulation activator and its high level can facilitate the formation of micro-clots as well as maintaining a high inflammatory level of the whole organism. Therefore, keeping the inflammation of the whole body under control through some personalized food choices can help improve the ability to adapt to negative environmental stimuli, including viruses and Coronaviruses. In part, it is possible to go back to being the 'architects of one's own destiny'”.
How does the process of transforming sugars take place in the body?
“The individual excess of sugar intake (all of them! Also including fructose and substances with analogous metabolism, such as alcohol) can cause inflammation and glycation phenomena. With glycation (whose clinical significance was only understood in 2017) numerous substances called glycotoxins or alarmins are formed in the body. The best known is methylglyoxal (or methylglyoxal or MGO), an oxidative substance, which generates inflammation, induces insulin resistance and is unfortunately also carcinogenic, being capable of damaging DNA. Fructose is a key substance in its formation”.
Fructose? What seems to most so harmless and natural?
"Depends. Fructose - as well as sucrose (glucose + fructose) - are among the products that we believe to be "natural" and which instead outside their "true" context (fresh and whole fruit for example) generate the formation of glycation products dangerous. Rising blood sugar or peaks in fructose or alcohol or polyols lead to the easy glycation of some proteins and their transformation into harmful products.
These are crucial for triggering allergic reactions, increasing the level of inflammation”.
Leaving the Covid19 context for a moment, what are the latest discoveries about the inflammation-disease connection?
“After we have seen more and more relationships between inflammatory processes and cancer, these same products are put by many authors in close correlation with the onset of Alzheimer's disease for example, but also with the induction and maintenance of the majority of autoimmune diseases (from rheumatoid arthritis to Hashimoto's thyroiditis), with inflammatory bowel diseases (Crohn's and ulcerative colitis) and also with the simple but widespread colitis”.
It is therefore important to know the degree of inflammation of our body. How can we measure it? What are the most effective tests?
"L 'food-induced inflammation e from sugars can now be measured to arrive at a personalized therapeutic setting. PerMe test (which studies inflammation from food and sugar together), Recaller 2.0 (BAFF, PAF, genetic predisposition to autoimmune diseases and Personal Food Profile) and GlycoTest (Methylglyoxal, glycated albumin and genetic predisposition to obesity and diabetes) are now part of a diagnostic possibility that can be used by anyone. Understanding your personal profile and the level of inflammation allows you to re-phase the aspects of discomfort from food imbalance. And this is particularly useful in this period in which many have exceeded with unregulated foods and allows you to regulate your metabolism, reducing the insulin resistance deeply connected with inflammation. Proper dietary management allows you to put the body in the best conditions for responding to possible Coronavirus infection. And this seems to be an important "plus", certainly support for life in the coming months".
