(60-min interview)
Columbia Invents, 4/13/22: “
Ian Lipkin”
“The advantage for people with ME/CFS…is that we may get a better understanding, more insights - into how ME/CFS develops as a function of long COVID”
“some people with post-acute COVID syndromes appear to have something that looks very, very much like ME/CFS. But it's not going to be all people. We need to be able to see whether or not there are things that we've learned in ME that can give us insights into long COVID & vice versa.”
“And with ME/CFS, we've found specific abnormalities that are, for example, we found that there are differences in the people who have people who are women and men as a function of estrogens, right, they're very clear links to specific sex hormones. We know this not only because there's a sexual dimorphism, but in addition, there are differences in people who pre-impose menopause. And those abnormalities that we find in blood include responses to bacterial and viral triggers that most people would shrug off that they can't.
And these are manifest not only with immunological abnormalities, but metabolomic disturbances as well. So we find abnormalities in what's known as the Krebs cycle, the respiratory cycle, which is essential for energy production. But not just energy as we think in terms of being fatigued, but the same systems are likely involved in the brain.
So this may account for brain fog…As far as I'm concerned, it's all about trying to find, it's all experimental pathology. What can we learn about causes of disease? Infections are very, very useful in thinking about disease.
I envision we're going to be able to use viruses as vectors to treat disease, too. So there are lots of different ways of looking at that…So I still have a lot of work to do”
“I think that, you know, long COVID..these post-acute syndromes…requires some dissection. Right now, we're lumping them all together. And I think that's not appropriate.
There are at least two groups. One is those people who have structural damage, and the structural damage accounts for the problems that we see. And I described one example of how that might occur.
Right? If you have somebody who has a mismatch between oxygenation and removal of carbon dioxide and the vascular supply to that portion one, that's one possibility. Or people who have renal dysfunction or hepatic dysfunction or cognitive dysfunction as a result of infection of blood vessels that supply certain organs.
That's sort of in one basket. And the other basket, and I'm talking about extremes here, are those people who have some sort of different response, which is presumably triggering innate and adaptive immunity that results in this damage. And there's always going to be a challenge in recognizing the overlap, because you don't necessarily have just one or the other.
So you have to tease these things apart, because the approach to management is probably going to be different. And so one of the things that I really want to do is to find support to investigate this. And because, as you mentioned earlier, we've been doing a lot of work with myalgic encephalomyelitis / chronic fatigue syndrome for several years now.
Actually, I've been doing this really since 1997.”