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Kevin von Duuglas-Ittu

Study Suggests COVID-19 Might Be Slowed By Fasting and perhaps Keto Diets (Autophagy)

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There is not a lot of meat on this bone so don't put too much into this, but this reference article of a study (A new treatment strategy against MERS) details the way that the coronavirus MERS works to inhibit autophagy to promote its propagation in the body. It suggests that pro-Autophagy treatments might work at retarding the replication of coronaviruses SARS and MERS. Covid-19 (more properly SARS-CoV-2) is in this family of viruses. And while the subject of the study is focused towards drugs that might induce autophagy, we know that regular fasting and even some ketogenic approaches can promote autophagy. Autophagy is a process of cell breakdown, and a kind of cleaning house at the cellular level. The thinking is that the process also may out the building blocks of some coronaviruses.

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The term autophagy refers to a type of cellular recycling process which enables cells to dispose of damaged materials and waste products, while retaining intact components for incorporation into new cellular structures. This autophagic degradation, or 'auto-digestion', is also capable of identifying pathogen-derived components, such as the building blocks of viruses, which are treated as waste products and eliminated. A range of viruses are known to have developed strategies to dysregulate or inhibit autophagy. PD Dr. Müller and his colleagues therefore set out to determine whether the MERS virus is capable of modulating autophagic degradation. As a first step, and using stringent biosafety conditions, the researchers infected cells with the MERS virus. Subsequent observations revealed a disruption to the cellular recycling process in cells infected with the virus. "This result clearly indicated that the MERS pathogen benefits from an attenuation of the cellular recycling process," explains PD Dr. Müller.

The researchers also succeeded in identifying a previously unknown molecular switch which regulates the process of autophagic degradation: the SKP2 protein. The researchers discovered that the MERS virus activates this molecular switch in order to slow down the cell's recycling processes and avoid degradation. Using these new insights, the researchers treated MERS-infected cells with various SKP2 inhibitors in order to stimulate the degradation process. This strategy proved successful, the autophagy-inhibiting substances reducing viral replication by a factor of 28,000. Among the substances used to elicit this effect were licensed drugs such as niclosamide, a treatment for tapeworms which had previously been identified as an SKP2 inhibitor. Importantly, niclosamide was shown to be capable of drastically reducing the replication of the MERS virus in cell culture.

"Our results reveal SKP2 to be a promising starting point for the development of new substances capable of fighting the MERS virus, and potentially even other autophagy-dependent viruses," says PD Dr. Müller. SKP2 inhibitors do not target the virus directly. For this reason, the research group leader expects their use to be associated with a reduced risk of resistance. "However, SKP2 inhibitors will need to be tested in vivo before they can be used as drugs. Furthermore, one has to properly evaluate the risks and benefits for their in vivo use, since even drugs that have already been approved can have side effects," says the virologist. The researchers will also test whether SKP2 inhibitors could be effective against other coronaviruses such as SARS or the novel coronavirus (2019-nCoV) which is currently emerging in China.

- from the article

I've read that autophagy proper is thought to begin after about 36 hours of fasting (I think there is great variability in this, proponents of Intermittent, Time Window fasting like to say it starts at 18 hours, there are no real numbers), but it is thought to be promoted by things like exercise, black coffee, and a ketogenic diet. A quick highlight article on this.

Bottom line: MERS doesn't like Autophagy and tries to switch it off. Other coronaviruses like SARS also probably don't like Autophagy, and Covid-19 is related to these [IMPORTANTLY SARS-CoV-2 or Covid-19 is NOT mentioned in the study]. Fasting (and keto, and exercise, and coffee, etc) promotes what these viruses don't really like. This isn't to say that fasting or other forms of Autophagy pursuit might not have other adverse effects in fighting coronaviruses, or differing effects at different stages of infection. This is not a diet or lifestyle suggestion, it's only putting forth an interesting piece of information. The study, SKP2 attenuates autophagy through Beclin1-ubiquitination and its inhibition reduces MERS-Coronavirus infection, was published in 2019.

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Somebody asked on the Facebook share of this thread, what Kevin and I eat on a daily basis. We're in quarantine at a place that doesn't allow for home cooking, but our diet hasn't changed too much from what we regularly eat. So here's an example: 

Fasting Day: water, black coffee, electrolytes

Eating Day: Chicken and Cashew with bacon (Kevin), avacado with poached egg and bacon (Sylvie), or bunless burgers with cheese and bacon plus a large salad with olives and feta cheese (both); coffee with cream.

   Snacks: macademia nuts and swiss cheese, maybe some cold cut meats, dark chocolate

Dinner is some kind of meat and vegetable. Last night was grilled chicken and somtum salad, some garlic deep fried pork ribs (me), and stir-fried morning glory, sundried pork, coleslaw (Kevin).

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There have been some concern reactions to the posting of this information. To be clear, this is not to claim or state that particular diets will have demonstrative effects on what is really a world wide crisis, but it is putting out there the idea that if indeed this virus, and very possibly others like it in the future could be a lasting danger for everyone, pro-autophagy approaches to diet and behavior are certainly worth looking into, both in terms of research and personal choice. Autophagy has in many ways been oversold as a kind of miracle state by those that promote certain lifestyles. As one who diets in a fairly extreme way (fasting every other day, eating more or less ketogenically for a year now) I'm drawn to the prospective benefits to be sure. In fact I discovered this study just out of curiosity Googling "autophagy pneumonia" just thinking about the relationship. What I am saying is that Autophagy pursuit COULD BE an important thing to be thinking about in the larger scale, in the landscape of these viruses. It strikes me that if millions of years engineered a protein switch to turn off autophagy in these viruses, we should probably in some way be trying to turn that switch on. This could be just bro science, it could even lead to adverse, or unintended effects (over fasting, over exercising, adhering to diets that don't even produce autophagy in significant ways), but at least ballpark it is for me a constructive or at least interesting framework.

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