{"id":1201,"date":"2022-08-15T16:03:57","date_gmt":"2022-08-15T20:03:57","guid":{"rendered":"https:\/\/www.allergy-associates.com\/?p=1201"},"modified":"2022-08-15T16:03:57","modified_gmt":"2022-08-15T20:03:57","slug":"dear-dr-k-11","status":"publish","type":"post","link":"https:\/\/www.allergy-associates.com\/?p=1201","title":{"rendered":"Dear Dr. K \u2013"},"content":{"rendered":"\n<p><strong><em>My husband has intrinsic asthma and I have extrinsic asthma.&nbsp; Despite having our COVID vaccines he caught COVID and I didn\u2019t.&nbsp; What\u2019s up?<\/em><\/strong><\/p>\n\n\n\n<p>Well, first of all I\u2019m impressed that you know the difference between intrinsic and extrinsic asthma phenotypes.&nbsp; To try and simplify what is a complex science most asthma can be categorized as high TH2 (extrinsic) or low TH2 (intrinsic).&nbsp; TH2 is a type of lymphocyte that can cause inflammation.&nbsp; In high TH2 asthma the main mediators of inflammation are IL4, IL5, and IL13.&nbsp; IL means \u201cinterleukin\u201d a chemical that communicates to cells (cytokine).&nbsp; In low TH2 the main cytokines are IL-1B, IL17, IL8, and IL6.&nbsp; The inflammatory cells that cause the mischief are eosinophils (in high TH2) and neutrophils (in low TH2).&nbsp;<\/p>\n\n\n\n<p>OK, I know that was a lot to throw at you but it is extremely relevant.&nbsp; It\u2019s not just you and your husband that have had different outcomes but asthmatics worldwide.&nbsp; As it turns out extrinsic (allergic) asthma (high TH2) causes high levels of IL13.&nbsp; IL13 seems to have three protective effects for corona virus infection.&nbsp; First of all, IL-13 increases the density of the cilia lining our airway cells.&nbsp; These microscopic hairs are a natural clearance mechanism to sweep microbes out of our bodies.&nbsp; IL-13 also dials back production of a surface protein ACE2 which is the portal of entry for corona virus to cause infection.&nbsp; Finally, IL-13 ramps up production of a protective carbohydrate called keratin sulfate.&nbsp; Think \u201cTeflon coating\u201d.&nbsp; The keratin provides a physical barrier to the corona virus.&nbsp; You produce extra IL-13 and your husband doesn\u2019t.&nbsp; Hence the different outcome.&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>My husband has intrinsic asthma and I have extrinsic asthma.&nbsp; Despite having our COVID vaccines he caught COVID and I didn\u2019t.&nbsp; What\u2019s up? Well, first of all I\u2019m impressed that you know the difference between intrinsic and extrinsic asthma phenotypes.&nbsp; To try and simplify what is a complex science most asthma can be categorized as high TH2 (extrinsic) or low TH2 (intrinsic).&nbsp; TH2 is a type of lymphocyte that can cause inflammation.&nbsp; In high TH2 asthma the main mediators of&#8230;<\/p>\n<p class=\"read-more\"><a class=\"btn btn-default\" href=\"https:\/\/www.allergy-associates.com\/?p=1201\"> Read More<span class=\"screen-reader-text\">  Read More<\/span><\/a><\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[582,581],"class_list":["post-1201","post","type-post","status-publish","format-standard","hentry","category-uncategorized","tag-extrinsic-asthma","tag-intrinsic-ashtma"],"_links":{"self":[{"href":"https:\/\/www.allergy-associates.com\/index.php?rest_route=\/wp\/v2\/posts\/1201","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.allergy-associates.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.allergy-associates.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.allergy-associates.com\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.allergy-associates.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1201"}],"version-history":[{"count":1,"href":"https:\/\/www.allergy-associates.com\/index.php?rest_route=\/wp\/v2\/posts\/1201\/revisions"}],"predecessor-version":[{"id":1202,"href":"https:\/\/www.allergy-associates.com\/index.php?rest_route=\/wp\/v2\/posts\/1201\/revisions\/1202"}],"wp:attachment":[{"href":"https:\/\/www.allergy-associates.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1201"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.allergy-associates.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1201"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.allergy-associates.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1201"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}