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Ask the Expert: What Are Antibodies?

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Published on August 19, 2021

What You Need to Know About Antibodies

What are antibodies? What is their role within the immune system? Keep watching to hear Chancellor Professor Emeritus Jim Griffith, PhD, CLS (NCA), and Chancellor Professor Emerita Susan Leclair, PhD, CLS (NCA), from the University of Massachusetts Dartmouth explain antibodies, how they work, and how we are able to measure them. Dr. Griffith explains it as “an analogy to a war.” They are joined by co-hosts and co-founders of Patient Power Andrew Schorr and Esther Schorr.

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Transcript | Ask the Expert: What Are Antibodies?

Andrew Schorr: Hello and welcome back to Patient Power. I'm Andrew Schorr with Esther Schorr.

Esther Schorr: Yes.

Andrew Schorr: And for our viewers who are just trying to figure out what is the immune system now that we're not just worried about the flu every year or other things, but now, of course, COVID-19. And we hear so much about immunity or lack of it. So, joining us from Dartmouth, Massachusetts, two of our favorites, Jim Griffith, microbiologist, Susan Leclair, laboratory science cell specialist, a couple. Thank you. So, let's ask Jim.

Esther Schorr: Yeah. So, Jim, some of this is really about terminology and helping people understand, especially ones who were immune compromised. When we're talking about being protected from a virus, we hear about antibody protection, and then we hear about T cell protection. Can you help us sort out what the difference is?

What Are Antibodies? What Is Their Role Within the Immune System?

Dr. Griffith: Let me go back just a half a step. Any time a human comes in contact with some invading life form, it could be a bacteria, a parasite, a virus in this case, part of the dynamic is that the invader gets a foothold, starts to do whatever it does, and you are utterly unaware of it. Your immune system doesn't do a thing, because you come in contact with outside microorganisms almost every minute of every day. You're breathing them in, they go to your lungs, they end up in your GI tract because you eat food. None of the food you eat is sterile. I don't care how much you boil it, it's not sterile by the time you're eating it, and blah, blah, blah.

So your immune system does not ring the fire alarm every time you come in contact with a microorganism. In the case of this virus, it gets in there somehow, probably through the nasopharynx. We have some evidence that we process antigens through the GI tract and definitely through the respiratory tract. So, we can end up with these viruses all over our body, the coronaviruses. In this case, your immune system, maybe not Andrew's, but most people's immune system will detect that something that shouldn't be there is there. Your immune system then kicks in. You have nonspecific parts of your immune system; you have specific parts of your immune system. It's evolved over, at least, a couple billion years to the point that we get to humans where it's really very, very sophisticated. So here we are. We now come in contact with this virus, it invades a few cells, copies itself, a bunch of them come out, they invade other cells.

While they're in between the cells, invading one cell or another, your immune system, at some point, maybe not when there's one or two, but maybe when there's a hundred or a thousand, your immune system says, oh my God, what the heck is this thing? It's complex, and I can't emphasize enough how complex this immune system is. Most people think of the antibody response. That's the cavalry coming to the aid of the wagon train. In the case of the vaccines that we're using, even putting the virus in, a wounded virus, or a part of a virus, or only the nucleic acid of the virus, that's what Moderna and Pfizer do, that's not enough. Your immune system doesn't get it. And both Moderna and Pfizer are what are called adjuvanted vaccines. We put stuff in there that sort of wakes up your immune system because it wouldn't wake up by itself with those. So, we have to get it awake.

We then hope that we make antibodies. If you don't make antibodies or you don't make a lot, and that would be the case for Andrew, I don't know how many antibodies you make when you get a vaccine. You might make some but they're not detectable, or maybe they are. You're not testing it all the time, so you don't know how many antibodies you make.

There is also the activation of virus specific CD4 and CD8 T cells. Now, the T cells are sort of the traffic cops of your immune system, and they sort of wake up what I think is a earlier evolved part of our immune system, and say, "There's something here you should be paying attention to, get on the stick." They help to process the antigens. I'm sure Susan will clarify that. They help to process the antigens, and from that, you should get longer-lasting immunity, six months, a year, longer than that. And then we have immune modulatory cytokines, like interferon gamma, that work with type 1 interferons. Those have decreased the SARS replication. And so those things are happening.

So we have three things in this case. They all happen not independently of one another. But if you have an immunocompromised disease, it might mean that your neutralizing antibodies don't ever, or don't under certain stimulatory invaders, come up to a protective. And Esther, you said this exactly correct at the beginning. We talk about protective antibodies. There are some disorders where we make antibodies, but they don't protect you against anything. In this case we're looking for antibodies to protect you, and that means the right antibodies that protect you. And it means antibodies that protect you, that there are enough of them. You have to have them at the right level.

So Andrew may have not quite the right level, but that doesn't mean he has zero. It also doesn't mean that his T cells aren't ticked off as heck and are trying to wake up the rest of the immune system. And it also doesn't mean that he doesn't have immune modulatory cytokines like interferon gamma. So that's all a complex part of the pie and any immunosuppressed patient — and there are several categories of those, Andrew would be one, CLL would be another one, but there are others — they're all in different specific circumstances.

Esther Schorr: It almost sounds like an analogy to a war that's mounted. And you might have swords, you might have guns, you might have tanks.

Andrew Schorr: Tanks, airpower.

Dr. Leclair: Yes.

Esther Schorr: But if you don't have skills, you have a problem if you go on the defense instead of the offense.

Dr. Griffith: What it would mean in that case is that your chance of winning the battle are less. But you don't know, in the scenario you just drew, you don't know if your Air Force is going to come in at the last minute and save the day. It doesn't mean you're going to lose. It just means that you have to do it differently.

Esther Schorr: Got it. Thank you.

Andrew Schorr: Well, Susan, when I hear Jim explain this, knowing that I have little or no antibody response so far, and I'm going to be retested next week.

Esther Schorr: You could have some.

Andrew Schorr: I could have some antibodies, whether it's enough or not. But I also could have, and they’re testing this too, a T cell response, and then maybe these other agents. So, I guess I'm not as depressed as I was.

Dr. Leclair: Well that's good.

Esther Schorr: Still wear your mask, honey.

What Do Immunocompromised Individuals Need to Know About Antibodies?

Dr. Leclair: Yeah, you're still going to wear that mask. So, in that sense, it's almost like you don't... I know people want numbers, but the numbers, like I said, we're good at counting. We're not really good at measuring function. We're good at counting things. You shouldn't also get this false sense of security of, “I have more antibodies than you do,” because we don't know if they function. I would rather have fewer that function than a whole lot of them that are wandering around going, "Hi, how are things?" I'd rather have something that's a little more focused.

I would also, if someone were to test me right now for whooping cough, that's a good one. I actually had it, so I know I have antibodies. Do I have measurable antibodies now? Probably not. The memory cells that I have are very well aware that I had whooping cough. They're very well aware of what it was like, but they don't have to make antibodies now, because, well, I'm not near any whooping cough bacteria. So, it could very well be that you have the manufacturing plant. They're not really willing to work 24 hours a day, 7 days a week, but you have the plant. And you're putting out enough of this for everybody to remember, but not so it's measurable. We never say you have zero antibodies. We say the antibodies are not measurable because we can't count that low.

Andrew Schorr: I got it. Okay.

Esther Schorr: It helps a lot.

Andrew Schorr: Well, thank you so much for explaining this. So much now is, “Will we need boosters? How sophisticated is the testing? What can we count? How much is enough?” Right? But I think for those of us, people like me, who were either taking a medicine or have a condition where they've been told they're not producing a lot of antibodies, or maybe not a measurable amount, maybe there's other stuff going on. So, I'm hopeful.

Esther Schorr: But you also have to keep patient.

Andrew Schorr: Yeah. And be careful, and be patient, and let science inform us. Jim Griffith, thank you so much for joining us. Susan Leclair, thank you once again.

Dr. Griffith: You are very welcome.

Dr. Leclair: You're welcome.

Esther Schorr: Thanks.

Andrew Schorr: Andrew and Esther here in San Diego and being protective. Hopefully the immune system is doing that one way or another as well. Thank you for joining us, and knowledge can be the best-

Esther Schorr: Can always be the best medicine of all.

Andrew Schorr: Best medicine of all. We'll see you.

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