How variable is our immune function?

[Creekside]

A lot of theories seem to assume that an immune-related disease will show some factors deviating from "normal", or that a study showing such a deviation means that it's related to the disease they're studying. Our immune systems are really complex, and interact in complex fashions, and interact with other organs in complex ways, and with external factors and state of mind, and whatever else.

So, in a "normal, healthy human", how much do the measurable factors of the immune system vary? Is it just a few percent during a year? Is it 25% over a day? 500% over a year? Can IFN-g increase 5x at soem point in a day for no identifiable reason? I really have no idea how variable it is, and thus how much meaning to ascribe to a study's findings regarding immune factor numbers.

What started me thinking about this is that while I have what I think is fairly good oral hygiene, I occasionally have minor gum inflammation, sometimes in different spots in my mouth at the same time. So, Is that due to exposure to a different strain of microbe, or is it variation in immune function? Surely immune response in the gums is affected by nutrient levels, stress, physical activity levels, etc, as well as time since last combating a similar microbe or being busy fighting some other infection elsewhere in the body.

So, just curious about how much our immune function varies over various time frames, and how that might affect our ME day-day, and how that should affect our judgement of studies involving immune system factors.

 

[Jonathan Edwards]

So, just curious about how much our immune function varies over various time frames, and how that might affect our ME day-day, and how that should affect our judgement of studies involving immune system factors.

The answer to that would need a textbook. But in very simple terms I would say that for any one person a lot of immune measurables remain rather constant, at least in the absence of an overt infection. When studying people with rheumatoid we measured lots of different things repeatedly month in month out. Antibody levels tend to remain very constant (unless you interfere with a drug). B and T cell numbers similarly. In vitro responses of cells, producing cytokines, tend to be more variable but a lot of that probably relates to variation in experimental conditions.

There are quite big differences between individuals, though. Some people normally run a CRP level about ten times higher than others. Proportions of B cells vary widely in blood.

I ma not sure that there is good reason to link variations in ME/CFS day to day with 'immune function' if that is taken as immune capabilities. I think it is very likely that intercurrent viral infections, which people may come into contact with maybe once a month, often with only minimal symptoms such as sore throat, will alter ME/CFS symptoms. Once I had damaged a dic in my lumber spine I got much more pain there every time I had a minor infection. I think there is a systemic cytokine response that sensitises areas that are already not 100% healthy. In ME/CFS that sensitisation may amplify all the symptoms.

But I doubt you would find very much sampling blood for cytokines. Most cytokines actually operate locally in microenvironments with a tiny amount showing up in blood.

When it comes to reports of immune function showing differences I think it is essential to make sure that a statistically significant difference is seen across reasonaby good numbers. That should take account of natural variations as long as samples are not cherry picked. But even if there are statistically significant differences, those differences are unlikely to point to directly causal steps unless there is fairly black and white separationf rom normal values. We almst never see that in ME/CFS studies. In rheumatoid you do for CRP or rheumatoid factor, at least with 70-80% separation.

It is a very complicated story but my impression is that a group of members on the forum are pretty good at picking through to see what studies are likely to mean. Some are trained in immunology. Others are just good at checking detail and applying basic reasoning. We often start out with slightly different takes but usually end up with agreement on what we think things mean. Sometimes it is very hard to judge what to make of a finding - like the NK cell plot in the pilot daratumumab study. It might be nothing. It might be crucial. But we need more data, for sure.

 

[Kitty]

What started me thinking about this is that while I have what I think is fairly good oral hygiene, I occasionally have minor gum inflammation, sometimes in different spots in my mouth at the same time. So, Is that due to exposure to a different strain of microbe, or is it variation in immune function? Surely immune response in the gums is affected by nutrient levels, stress, physical activity levels, etc, as well as time since last combating a similar microbe or being busy fighting some other infection elsewhere in the body.

There might be a genetic component to it as well, as some families seem a lot more prone to gum disease than others. Ours seems to be split into the half that gets gingivitis for the first time in their 20s and then keeps getting it, and the half who live entire lifetimes with no sign of gum problems.

My ex-partner's family featured several generations of people who had both gum problems and cardiac disease.

 

[NelliePledge]

My dentist told me recently there is a genetic element in susceptibility to gum disease

 

[AliceLily]

I think I could be high risk for sepsis in the future. I need to find out whether I can buy home test kits for CRP.

 

[Creekside]

I think I could be high risk for sepsis in the future.

I recently saw a news item about a device for people at high risk of sepsis. It monitors various factors that would reveal it early. I think it was intended for hospitals to provide to patients at high risk. I expect that treating late-detected sepsis is expensive, so early detection is cost-effective.

 

[Kitty]

I recently saw a news item about a device for people at high risk of sepsis.

Yes, it's a new NHS initiative. They're starting to roll it out to people living at home who're at high risk due to cancer treatment, PICC lines, etc. Can't seem to find the story now, but if I remember rightly it monitors vital signs like heart rate and temperature. Sounds like a good project.