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1.媒體來源:
紐約時報

2.記者署名:
Apoorva Mandavilli
譯者Derek Hsu


3.完整新聞標題:
Some Covid Survivors Have Antibodies That Attack the Body, not Virus
一些Covid倖存者體內有攻擊身體而不是病毒的抗體


4.完整新聞內文:
New research found ‘autoantibodies’ similar to those in lupus and
rheumatoid arthritis patients. But patients may also benefit from treatments
for those autoimmune diseases.
新的研究發現，「自身抗體」與狼瘡和類風溼性關節炎患者體內的抗體類似。但患者也可
以從這些自身免疫性疾病的治療中獲益。

Some survivors of Covid-19 carry worrying signs that their immune system has
turned on the body, reminiscent of potentially debilitating diseases like
lupus and rheumatoid arthritis, a new study has found.
一項新的研究發現，一些Covid-19倖存者攜帶令人擔憂的跡象，表明他們的免疫系統已經
啓動，這讓人想起可能使人衰弱的疾病，如狼瘡和類風溼關節炎。

At some point,  the body’s defense system in these patients shifted into
attacking itself, rather than the virus, the study suggests. The patients are
producing molecules called “autoantibodies” that target genetic material
from human cells, instead of from the virus.


This misguided immune response may exacerbate severe Covid-19. It may also
explain why so-called “long haulers” have lingering problems months after
their initial illness has resolved and the virus is gone from their bodies.

The findings carry important implications for treatment: Using existing tests
that can detect autoantibodies, doctors could identify patients who might
benefit from treatments used for lupus and rheumatoid arthritis. There is no
cure for these diseases, but some treatments decrease the frequency and
severity of flare-ups.


“It’s possible that you could hit the appropriate patients harder with some
of these more aggressive drugs and expect better outcomes,” said Matthew
Woodruff, an immunologist at Emory University in Atlanta and lead author of
the work.



The results were reported Friday on the preprint server MedRxiv, and have not
yet been published in a scientific journal. But other experts said the
researchers who carried out the study are known for their careful, meticulous
work, and that the findings are not unexpected because other viral illnesses
also trigger autoantibodies.


“I’m not surprised, but it’s interesting to see that it’s really
happening,” said Akiko Iwasaki, an immunologist at Yale University. “It’s
possible that even moderate to mild disease may induce this kind of antibody
response.”
耶魯大學免疫學家巖崎明子(Akiko Iwasaki)說:“我並不感到驚訝，但看到它真的發生了
也很有趣。”“即使是中度到輕度的疾病也有可能引發這種抗體反應。”

For months it has been clear that the coronavirus can cause the immune system
to run amok in some people, ultimately wreaking more damage to the body than
the virus itself. (Dexamethasone, the steroid President Trump took after his
Covid diagnosis, has proved effective in some people with severe Covid to
tamp down this over-exuberant immune response.)
幾個月來，人們已經清楚地認識到，冠狀病毒會導致一些人的免疫系統失控，最終對人體
造成的傷害比病毒本身還要大。(川普總統在被診斷爲Covid後服用的類固醇地塞米松
(Dexamethasone)被證明對一些嚴重Covid患者有效，可以抑制過度活躍的免疫反應。)

Viral infections cause infected human cells to die. Sometimes the cells die a
quiet death — but sometimes, and especially in the throes of severe
infection, they can blow up, strewing their innards. When that happens, DNA,
normally cloistered in coiled bundles inside the nucleus, is suddenly
scattered and visible.


In the typical response to a virus, cells known as B immune cells make
antibodies that recognize pieces of viral RNA from the virus and lock onto
them.
在對病毒的典型反應中，被稱爲B免疫細胞的細胞產生抗體，識別病毒RNA片段並鎖定它們
。

But in conditions like lupus, some B cells never learn to do this and instead
produce autoantibodies that glom onto DNA debris from dead human cells,
mistaking them for intruders. Something similar may be happening in patients
with Covid-19, the research suggests.


“Anytime you have that combination of inflammation and cell death, there is
the potential for autoimmune disease and autoantibodies, more importantly, to
emerge,” said Marion Pepper, an immunologist at the University of Washington
in Seattle.
西雅圖華盛頓大學(University of Washington)的免疫學家馬里昂，佩珀(Marion
Pepper)說，“任何時候你出現炎症和細胞死亡的結合，都有可能出現自身免疫性疾病和
自身抗體，這是更重要的。”

Dr. Woodruff and his colleagues reported earlier this month that some people
with severe Covid-19 also have such unrefined B immune cells. The finding
prompted them to explore whether those B cells make autoantibodies.
伍德拉夫博士和他的同事本月早些時候報告說，一些嚴重的Covid-19患者也有這種未經提
煉的B免疫細胞。這一發現促使他們探索這些B細胞是否能產生自身抗體。

In the new study, the researchers looked at 52 patients within the Emory
health care system in Atlanta who were classified as having either severe or
critical Covid-19, but who had no history of autoimmune disorders.


They found autoantibodies that recognize DNA in nearly half of the patients.
They also found antibodies against a protein called rheumatoid factor and
others that help with blood clotting. Among the top half of the most
seriously ill patients, more than 70 percent had autoantibodies against one
of the targets tested, Dr. Woodruff said.


“It’s not just that these patients have an autoimmune-like immune response,
” he said. “It’s that those immune responses are coupled with actual true
testable clinical auto-reactivities.”
他說:“這些病人不僅僅具有自身免疫性免疫反應。”“這些免疫反應與真正可測試的臨
床自身反應相結合。”

Some of the autoantibodies the researchers identified are associated with
blood flow problems, noted Ann Marshak-Rothstein, an immunologist and lupus
expert at the University of Massachusetts, Worcester.
伍斯特馬薩諸塞大學的免疫學家和狼瘡專家Ann Marshak-Rothstein指出，研究人員發現
的一些自身抗體與血流問題有關。

“It’s very possible that some of the coagulation issues that you see in
Covid-19 patients are being driven by these kinds of immune complexes,” she
said.
她說:“你在Covid-19患者身上看到的一些凝血問題很可能是由這些免疫複合物引起的。
”

If the autoantibodies do turn out to be long-lasting, she said, they may
result in persistent, even lifelong, problems for Covid-19 survivors.
她說，如果這種自身抗體確實能夠持久，它們可能會給Covid-19倖存者帶來持續的、甚至
是終生的問題。

“You never really cure lupus — they have flares, and they get better and
they have flares again,” she said. “And that may have something to do with
autoantibody memory.”
她說:“你永遠無法真正治癒紅斑狼瘡，它們有耀斑，它們好轉後又有耀斑。”“這可能
與自身抗體記憶有關。”

Dr. Marshak-Rothstein, Dr. Iwasaki and dozens of other teams are closely
studying the immune response to the coronavirus. Given the ease of testing
for autoantibodies, it may soon become clear whether the antibodies were
identified only because the researchers went looking for them, or whether
they represent a more permanent alteration of the immune system.


“It’s not clear to me what it all means at this point,” Dr. Pepper said. “
It’s going to take a little bit of time to understand if this is something
that’s going to lead to downstream pathology.”
“在這一點上，我不清楚這一切意味着什麼，”佩珀博士說。“我們需要一點時間來了解
這是否會導致下游的病理。”

5.完整新聞連結 (或短網址):
https://www.nytimes.com/2020/10/27/health/covid-antibodies-autoimmunity.html


6.備註:
此新聞在發文同時台灣媒體以抗體、攻擊的關鍵字還沒有報導。

這消息對許多醫學專家來說都並不意外，因為SARS也有類似的狀況，而且目前COVID-19
嚴重。但是經過這醫療團隊的長期追蹤證實，COVID-19的長期後遺症可能不只來自於病毒
而來自於抗體，重要的是現代醫學無法根除自身抗體的影響，而造成類似紅斑性狼瘡的
結果。

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