Rona writes:

Dear scientists, 71 was a great episode. 

I have a question about a widely used drug and how it can influence morbidity from SARS cov 2 infection. 

A family member takes dupilimab injections for exzema.  The serum contains IL 4 and IL13 blockers.  In theory, would dupilimab users have a more mild case of covid?  Have studies been done on this in humans or on mice models?

I have a separate comment. Perhaps you can invite as a guest, Moises Velasquez-Manoff?  You have heard of him right? He is a science writer who focuses on health, science and the environment. He is the author of the book, “An Epidemic of Absence: A New Way of Understanding Allergies and Autoimmune Diseases.”



Philip writes:

I loved this most recent episode! I worked with Nippo when I was studying ILC2s as an alternative model of activating innate type 2 responses. Cultivation of them involved purchasing stuff from the local garden store which I always thought was pretty cool.

Anyhow, to your questions about what role type 2 responses could play in modulating other infections (like SARS CoV2) I would direct you to a bunch of the work that my lab published in the late 2010s…

PMID: 29090959: we found that mice with activated type 2 responses in the lungs were protected against lethal Staph aureus sepsis AND we found that patients with sepsis were LESS likely to have allergic diseases (maybe suggesting that allergic diseases were protective?)

PMID: 30721149: we identified eosinophils and ILC2s as critical in mediating protection against Staph sepsis

PMID: 29695270: Survivors of Staph bacteremia had activated Th2 responses

PMID: 31599813: Hospitalized patients with infection who also had allergic diseases were much less likely to die in the hospital

PMID: 33571420: Activated type 2 responses in the lungs protected against pneumonia/lung injury

There’s lots of other stuff out there that hints at this… I wrote a whole K08 around testing this hypothesis, that type 2 responses are critical to counter regulate sepsis inflammatory responses. 

It’s really fun stuff!!! I’m glad you all are exploring this!

Thanks for all you do. 


Philip A. Verhoef, MD, PhD, FAAP, FACP, ATSF

Adult and Pediatric Intensivist

Center for Integrated Health Care Research

Kaiser Permanente Internal Medicine Residency Program

Honolulu, HI

Anne writes:

Dear Immune doctors,

I listened with interest to your recent episode about allergies and picky eating.  I appreciated the explanations of the allergic response, and how it is triggered after a second exposure.  I learned this after getting stung by bees several times one summer. 

While I am fortunate to not have serious allergies or allergic reactions, I do experience the negative effects of mast cells from what I believe is called histamine intolerance. About 10-15 years ago, I started to experience pretty annoying rhinitis on certain days, for which I could find no explanation.  I didn’t know what might be triggering the rhinitis. Then, after an evening with friends, sharing red wine and cheese, I finally made the connection that these foods were triggering the response (I was miserable for two days).  Fortunately, this was more annoying than serious, in my case.  It seems that isn’t true for everyone.

I’ve learned to avoid certain foods, and take fexofenadine (generic Allegra) when I feel symptoms starting, but I’m curious, especially as I didn’t experience symptoms with certain foodstuffs before, in my youth.  I wonder if more light could be shed on histamine intolerance, which I’ve seen referred to as a pseudo allergy.  It seems that genetics may play a role.