The Perfect Storm

This is a picture of the "Perfect Storm" in 1991, the one the movie was based on. This is a picture of a lung after infection with the Bird Flu Influenza, H5N1 strain. It is known as a Adult Respiratory Distress Syndrome (ARDS) and it is brought on by a Cytokine Storm:

When the lungs are infected with the flu virus, the T cells release chemical signals that cause them to stay longer in the lungs. However, more T cells are always arriving, and they in turn release more signal and stay longer in the cells, leading to a build up of T cells and chemical signals. This is called a "cytokine storm" and it is thought that this causes damage to the lungs.

The most interesting thing about a cytokine storm is that it can inflict itself on anyone, maybe even more so on someone who is in good health. Sort of interesting, that.

When the immune system is fighting pathogens, cytokines signal immune cells such as T-cells and macrophages to travel to the site of infection. In addition, cytokines activate those cells, stimulating them to produce more cytokines. Normally this feedback loop is kept in check by the body. However, in some instances, the reaction becomes uncontrolled, and too many immune cells are activated in a single place.

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It is theorized that cytokine storms were responsible for many of the deaths during the 1918 influenza pandemic, which killed a disproportionate number of young adults. In this case, a healthy immune system may have been a liability rather than an asset.

Let me repeat, the deaths caused by the flu epidemic of 1918 were caused by ARDS which was, in turn, a result of a Cytokine Storm which was caused by the H5N1 flu strain, the one we presume will be the cause of bird flu.

Ergo, we should be doing something about Cytokine Storms. We aren't doing a damn thing as best as I can see. The only thing we are doing is stocking Tamiflu. It is possible that Tamiflu will damp down the response of the body to bird flu and prevent Cytokine Storm. Then again, given our other hypotheses about health (e.g. AIDS is cause by the way you live), I wouldn't bet on it.

There is only one potential treatment for Cytokine Storm out there. It is an antibody.

Ways to stop the cytokine storm have focused on blocking all T cells, but this stops the patient's immune system from clearing the virus and leaves the body open to other infections. The goal is to prevent the storm forming without stopping the T cells attacking the flu virus. To acheive this, the researchers developed a way of down-regulating one of the T cells signalling chemicals (called OX40).

"OX40 sends out a survival signal instructing activated T cells to remain in the lungs for longer to help fight the infection," explained lead researcher, Dr. Ian Humphreys. "Inhibiting this signal therefore allows T cells to vacate the lungs earlier whilst leaving behind a sufficient immune presence."

The researchers blocked the action of OX40 by using a fusion protein (OX40:Ig)....

The whole interaction is fairly complex. It has to do with Tumor Necrosis Factor and receptors:

Tumour necrosis factor (TNF)-receptor-associated factors (TRAFs) form a family of cytoplasmic adapter proteins that mediate signal transduction from many members of the TNF-receptor superfamily and the interleukin-1 receptor.

But this doesn't mean we shouldn't be focusing a major research effort in this direction.

No, we are stockpiling Tamiflu.

Let me remind you one more time, Donald Rumsfeld has made over a million dollars on the stockpiling of Tamiflu. So, there!