A strong immune system for protecting against the new type of coronavirus (COVID-19) has become more important during the epidemic process. İstanbul University Aziz Sancar Experimental Medicine Research Institute (Aziz Sancar DETAE) Director and Head of Immunology Department, Prof. Dr. Günnur Deniz pointed out that the immune system plays a role as a shield against viruses. And she talked about some important points to be considered before the beginning of the month of Ramadan; which is April 24.​

The immune system is the organism which perceives the structures different from itself such as virus, bacteria, fungi, parasites. And this system protects the organism by activating various defense mechanisms to detect foreign pests and get rid of it. Prof. Dr. Deniz said: "The immune system's most important characteristic is that it has the ability to distinguish what is and is not from itself. The first task of the immune system is to prevent the entry of foreign substances into the body, and to prevent the spread of them and destroy those who manage to enter in any way. The second most important characteristic of the immune system is that it has a memory. Thanks to this trait, we never catch the same disease for a short or long time again.”

The factors that disrupt the immune system can be summarized as; stress, malnutrition, alcohol, insomnia, radiation, air pollution, smoking or tobacco use, some drugs (such as steroids) and genetic factors. Prof. Dr. Deniz said: “Different diseases arise as a result of excessive, incomplete or faulty functioning of the immune system. Although an effective immune system is protective against many diseases, diseases such as AIDS and cancer arise when the system is insufficient. On the other hand, in case of excessive action, allergies, anaphylaxis, diseases such as autoimmune are seen.” Viruses are very small organisms that cannot be seen by the eye, cannot replicate themselves, and need a suitable host cell for their reproduction. Prof. Dr. Deniz made the following explanations: “These tiny organisms, which are even a question mark, reproduce continuously using the genome of the cell into which they enter. Viruses range in size from 0.003 to 0.5 microns and need a cell to continue their generation. If the virus runs away from the barrier of natural resistance, this time it encounters the defense system called acquired immunity and it is destroyed. " Prof. Dr. Deniz added that if the natural and acquired defense systems cannot eliminate the virus, the number of cells that the virus enters increases and consequently, different diseases emerge.

“This Condition Is More Dangerous for the People with Chronic Diseases”

“Vaccines are important for keeping the immune system ready for virus-borne diseases.” Prof. Dr. Günnur Deniz said: “When immunisation is carried out with the vaccine, the person is protected against infectious disease, and transmitting the disease to other people is also prevented, albeit indirectly. If the number of people that are vaccinated against the disease in the society is higher; the probability of occurrence of the disease in the society is getting lower. Even, it may be possible to eradicate some diseases. And, thanks to the successful vaccination programs, smallpox, measles, polio (polio) diseases were almost entirely destroyed or reduced to negligible levels.”

“Coronaviruses are RNA viruses that can infect people and a wide variety of animal species, and they cause a wide variety of respiratory infections in people.” Prof. Dr. Deniz said: “COVID-19 disease, caused by SARS-CoV-2, the new type of coronavirus enters the body of living things through the eyes, nose or mouth. And afterwards, it tries to link to the cells such as the ones in the lung respiratory tract, through ‘ACE-2 receptor’. In order to survive and reproduce, infected cells release certain proteins that will keep the immune system away. At the same time, these cells produce millions of copies of the virus before they die, causing more cells to become effected. Today, COVID-19 is known to cause respiratory infections such as respiratory syndrome or pneumonia.”

“If our immune system is unable to eliminate viruses and continues to fight them, in this process fever arises in the body”. Prof. Dr. Deniz said: “The emergence of fever in healthy people without a chronic disease is an indication that the immune system is healthy, doing its job and fighting to destroy germs. However, for the elderly and especially for people with chronic diseases, this situation is more dangerous. The gradual deterioration of the immune system during the normal aging process is called immune aging (immunocenesence). As people get older, their immune system weakens, their ability to respond to infections, their ability to fight against viruses and bacteria diminishes. That is why people over the age of 70 stand out as the most at-risk group. In particular, the immune ages of smokers and the obese have been noticed to be greater than their chronological ages. In addition, a sedentary lifestyle is also recognized as an important risk factor.”

“One of the Most Important Factors that Strengthen the Immune System Is a Balanced Diet”

In order to avoid viral diseases or survive in the course of the disease in the mildest way, it is important to have a strong immune system. Prof. Dr. Deniz said that, the immune system plays a role as a shield against viruses, and many positive and negative factors may affect it. She listed them as follows: “Genetic predisposition is the first of these factors and the environment follows it. Factors such as stress, malnutrition, alcohol, insomnia, radiation, air pollution affect the immune system negatively. Stress alone suppresses the immune system and facilitates the reproduction of infection factors. Stress is one of the most important risk factors. On the other hand, one of the most important factors that strengthens the immune system is a balanced diet. Malnutrition disrupts the immune system, suppresses its functions and increases the risk of infection. Malnutrition is an eating disorder that occurs as a result of insufficient nutrition and it needs to be monitored. Overeating, such as limited or one-way nutrition, negatively affects the immune system. It has been understood that continuous limited nutrition increases the severity of influenza infection in people and the incidence of infection in obese individuals. In addition, smoking and tobacco use is one of the most important factors that disrupt the immune system. It is important not to be an active or passive smoker because it causes premature aging and makes the body vulnerable. For this reason, it is important to avoid smoking and to avoid environments where people smoke.”

“Those Who Have Insufficient Immune System Are Prone to Virus Infections”

Prof. Dr. Günnur Deniz underlined the following points: “Immune system deficiency – immunodeficiency arises as a result of the inability to fight against any microbe entering our bodies in cases where the immune system is inadequate.” Prof. Dr. Deniz said: “Around 10 million people in the world are thought to have immunodeficiency, which means that approximately one in every 500 people has immunodeficiency. The immune disorders observed as a result of innate genetic disorder or predisposition are called primary immunodeficiency. In children with disorders of the immune system, growth and development is paused, even simple upper respiratory tract infections are long and severe. These children are often hospitalized for long periods of time due to pneumonia, ear infections, severe intestinal tract infections (diarrhea), and if the deficiency is not resolved, they are lost at an early age.” Prof. Dr. Deniz added that the most important symptoms in the diagnosis of primary immunodeficiency diseases in adult patients were listed as follows: “Two or more than two times ear infections in a year; two or more than two times in a year a non-allergic sinus infection, a pneumonia once a year, diarrhea that will result weight loss, repeater virus infections (common cold, herpes, warts), repeating deep tissue, or organ abscesses, fungal infections on skin or any part of the body that continues for a long time and the need for intravenous antibiotics to cure the infection, formation of some new infections in the body (tuberculosis-like bacteria), a family history of primary immunodeficiency and so on.”

Prof. Dr. Günnur Deniz said that people with insufficient immune systems particularly show predisposition to virus infections and should not be present in closed and crowded places in order to avoid infection. Prof. Dr. Deniz made the following explanation: “ Virus infections are mainly transmitted by droplet infection, cough, sneeze, speech, breathing of the resulting droplets, kissing, handshake or contamination can occur as a result of contact with the infected product and food. Viruses can remain alive where they are contaminated like doorknobs and telephones. It is important to remember that virus infections are more severe in children and adults with insufficient immunity.”

“Some Viruses Wait for the Immunity To Drop, Nutritional Deficiencies Or Stress Status To Emerge”

Prof. Dr. Deniz said: “When someone sneezes, about 20 thousand small particles containing the virus are dispersed in the air and viruses have specific target tissues and the target of coronaviruses is the lungs.” Prof. Dr. Günnur Deniz made the following explanation: “Some viruses are dormant and wait for people to age, weakness of immunity, nutritional deficiencies or a state of stress to emerge. That is the answer to the question of why viruses appear in most people in a state of stress and why people are sick.” Deniz pointed out that there are some important things to do for the well functioning of the immune system: “Eating vegetables and fruits, exercising regularly, being in ventilated areas, washing hands regularly and thoroughly, sleeping regularly, staying away from sick people, avoiding kissing and touching the face.”

“Nutrition is the most important element to be considered. Our bodies need different nutrients, grouped into proteins, carbohydrates, fats, vitamins, minerals and water.” Prof. Dr. Günnur Deniz said: “In general, for a healthy diet; sugar and carbohydrate-heavy choices should not be consumed. Protein intake should be kept at a sufficient level and plenty of water should be consumed. Fiber-rich, pickles, fermented foods such as yoghurt should be consumed, (if possible home-made ones) or should be preferred. Gut flora is also another way to strengthen immunity. Probiotics (fermented foods) are known to make gut flora healthier.”

“Vitamin D Is an Important Boost to the Immune System”

“The human body needs Vitamin D to produce anti-microbial proteins that kill viruses and bacteria.” Prof. Dr. Günnur Deniz said: “Vitamin D, synthesized in the body by natural means by sunbathing, can have low levels during the winter months. If the body does not produce enough Vitamin D, it remains weak in the fight against viruses and bacteria. Therefore, Vitamin D is an important supplement that strengthens the immune system, but excessive consumption is toxic. Water-soluble Vitamin C, which is not stored in our bodies, should be taken daily, helps to remove harmful substances from the body and strengthens the defense system. Zinc is a mineral that strengthens immunity in viral infections. Studies show that the appropriate dose is critical for Zinc to benefit, and that immunity is suppressed when overdosed. Zinc should also be used considering that it reduces the level of copper in the body.” Prof. Dr. Günnur Deniz said: “This is why attention should be taken in the intake of vitamins and minerals.”

One of the Main Ways to Keep the Immune System Strong: Regular Sleep

Regular sleep is one of the main ways to keep the immune system strong. Prof. Dr. Günnur Deniz pointed out that it is important to sleep during nighttime hours, when levels of melatonin spreading during sleep are highest. Prof. Dr. Deniz said: “Melatonin is reported to have a positive affect on the immune system against cancer, reduce depression and stress, increase life expectancy and reduce signs of aging. People who sleep less than 6 hours per day are 4.2 times more likely to catch a cold than people who sleep more than 7 hours per day, while people who sleep less than 5 hours show an increased risk. Other effective methods are: Accurate and effective hand washing, to be in ventilated environments, to eat a lot of fruit and vegetables, to avoid eating a single type of food, to consume the right nutrients, to give attention to personal hygiene, regular sleep, exercise, and stress prevention are the most important factors to stay away from the disease. “Besides, the effects of being a positive person and loving nature, people and animals should not be forgotten.”

Coronavirus and Fasting

The most curious issue before the month of Ramadan, which starts on April 24, is whether to fast while there is an outbreak of coronavirus. Prof. Dr. Günnur Deniz said: “A study showing the positive effects of fasting does not exist; however, some studies have shown that changes in nutrition (intermittent nutrition) have positive effects to immunity. For example, eating during only 8 hours a day and (instead of eating during 16 hours) has positive effects on the immune system because it enables the correct functioning of intracellular sensors called mTOR, and intermittent fasting practices have also indicated to reduce inflammation and especially vascular adverse effects.”

Prof. Dr. Günnur Deniz said; “While fasting, it is important to avoid eating too much in the evening mealtime and avoid fasting without getting up in the evening mealtime of Ramadan. On the other hand, it is important to have a balanced and correct diet in iftar (evening mealtime) and sahur (meal eaten before fasting), and to consume plenty of liquid. Proteins are one of the essential nutrients for the body to maintain its basic functions. Therefore, protein should be taken, but carbohydrate, fatty and sugary foods, refined foods with additives in it should be avoided.”

Prof. Dr. Günnur Deniz stated that feeding with fresh and seasonal vegetables, protein-rich foods, and fruit positively affects the immune system. Prof. Dr. Günnur Deniz emphasized that it is important to pay attention to sleep pattern while fasting and not to stress the body in terms of immunity. Prof. Dr. Günnur Deniz said: “We should not forget that fasting is a religious obligation only for healthy people. On the other hand; people with chronic diseases (such as diabetes, heart, immune deficiency, cancer), the elderly, pregnant or breastfeeding women, health workers who are concerned about the disruption of their health and health services, heavy workers, people who are diagnosed with COVID-19, and people are not found convenient for fasting by their doctors should not fast. In addition, cancer patients, those who use medicines constantly (steroids) or people with immune deficiencies should not disrupt their regimens and drop routines. Additionally, to maintain social distance, it is important to avoid mass iftar meals during the month of Ramadan, not to give an iftar invitation at home and not to go to invitations to avoid the corona epidemic.”

While the Pandemic Process Continues...

Prof. Dr. Deniz said that pandemics such as plague, cholera, and AIDS, which were seen at different periods throughout human history, caused many people to die. Prof. Dr. Günnur Deniz said: “People's habits and routines are affected during a pandemic process, increasing awareness of social isolation, enabling people to understand the importance of healthy eating and the immune system. On the other hand, it is said that there is enough food for everyone when viewed globally, but some disruptions can be seen due to the pandemic process. Since it will take time to develop the vaccine or alternative drugs, everyone will understand that they need to keep their immune systems strong and try to eat a balanced and regular diet.”

Prof. Dr. Deniz said that crop cultivation is an activity that brings people closer to nature. Prof. Dr. Deniz said, “Growing plants and getting crops from it keeps the individual in shape spiritually as well as physically. In recent years, farming in the garden or even on the balcony, harvesting jam, tomato paste, canning has become quite popular. People who are trapped in their homes during the pandemic are happy to make their own bread and be autonomous with their skills. This reminded us of the importance of proper agriculture and native seed.” Prof. Dr. Deniz said that diseases-resistant ancestral seed and animal lineages are present in our own lands. Prof. Dr. Günnur Deniz underlined the importance of this subject with the following statements: “In order to feed our growing population in a healthy way, agricultural areas must be prevented from being sacrificed to urbanization and tourism. And our natural beauties should be protected. Consequently, the immune system of happy people who feed with healthy food and who live in nature will become stronger and these people can cope with diseases.”

“Positive thinking allows the brain to release endorphins and serotonin, which are healing happiness hormones. Studies show that optimistic people's immune system is stronger, they are less caught in chronic diseases.” Prof. Dr. Günnur Deniz concluded her speech by stating that it is not impossible to get what we want in life. We should never stop thinking with a positive point of view and look at the positive side of the process without losing hope during this pandemic period.

News: Hande Nur OCAK

Translation: Yasemin UĞURLU

İU Department of Corporate Communication