Drugs mimicking effects of cigarette smoke reduce Covid's ability to enter cells | Hacker News Reader

Drugs mimicking effects of cigarette smoke reduce Covid's ability to enter cells

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142 pointsmooreds69 comments

I recall someone on HN mentioning how smoking inhibits production of ACE2 proteins on this forum at least a year ago. Also recall a French study noting the -significantly- lower number of smokers showing up with Covid, at about the same time. Hopefully this phenomenon leads to more preventives.

I always thought the most likely explanation of the French findings was that smokers were more likely to be outside (smoking), and thus got the disease less than those sitting inside in less well-ventilated places.

Speaking as a smoker, respiratory illness hitting us less is definitely not generally the case ;)

Also speaking as a smoker, it may protect you from accidental exposure to covid, but not when sharing an office or bed with someone who has it. Source: personal experience of getting it from the missus who got it from work.

Oh definitely. I think that I may have had it near the start of the pandemic (fatigue/flu like symptoms for a few weeks) but my wife didn't have any antibodies (but I did wear a mask everywhere for the first while I had symptoms).

It's a very odd disease in terms of spread, there's super high variance in transmissibility.

For some it's the exact opposite, the, are forced to meet up in small 'badly' ventilated rooms to have their cig.

At least one study making such a claim was retracted for not disclosing the authors’ financial ties to the tobacco industry.

https://erj.ersjournals.com/content/57/3/2002144

Knowing the industry is secretly pushing favorable coverage, I’m treating claims like this with more skepticism.

Netflix is owned by tobacco industry, no secrets here.

What are your thoughts on the Pharmaceuticals Industry’s ties to the Democrat Party?

Even twenty years ago, nicotine was so vilified (for good reason probally) scientists didn't do non-biased studies.

I remember Dr. Dean Edell always yacking about this.

(antidotally--I have know smokers, who didn't eat much, never seemed to get sick. My best friend of twenty years never got sick. I used to say, you smoke 4-5 packs/day. I don't get it. I even had him go in to check his Coronary arteries because I just assumed the worse. His arteries were clean. He practiced calorie restriction, but not on purpose. He just didn't eat much. And yes--at that much tobacco, how do you eat? He made it to 65. He died do to smoking. His lungs finally gave up one night. Now--smokers who ate a lot seemed like they were always sick.)

Nicotine is a strong appetite suppressant.

With cigarettes, I don't think the worst aspect is nicotine but everything else like tar, burning material, etc.

Nicotine itself is pretty similar to caffeine.

Likely the worst component of cigarettes is Polonium 210. This apparently comes from phosphorus rich fertilizers.

This is quite an interesting rabbit hole to jump into.

https://www.google.com/search?q=pubmed+polonium+tobacco

One of the more interesting ones: “Waking a Sleeping Giant: The Tobacco Industry’s Response to the Polonium-210 Issue“

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2509609/

My hot take: Tobacco seems like the most important product to consume from “organic” growers.

Yep.

And a lot of this is made worse by using mined phosphate fertilizers which are formed geologically such that transuranic daughter elements are concentrated into the phosphate. Tobacco itself also concentrates them.

Nicotine also has nootropic effects (just like amphetamine and cocaine).

This is why vaping may actually be a good alternative.

It's just nicotine and food-grade VG/PG/flavor.

The "vaping lung" illnesses seemed to center around THC vape oil made from Vitamin E acetate which caused the damage. Not nicotine vapes.

This is in the case of smoking/nicotine, I am unsure about any ACE2 binding interaction with regards to Covid-19.

Do agree - the lesser damage is definitely vaping.

And Pareto -ranked risk analysis should be the ONLY way to decide such things.

The societal veto is "Yeah, we want cars despite being highly Pareto-ranked for death!" in which case NOTHING with lower rank should be worried about or allowed to be regulated more than what is spent on that particular risk!

People who are particular about what they put in their bodies should note, you almost never know the details of what is in the flavors. Vaping pure VG+nicotine or VG+PG+nicotine is extremely safe if the nicotine is at normal doses. Flavors are probably mostly safe, but you don't know for sure. Nicotine itself is highly toxic (contact, even on skin, with 0.5mg per pound of body weight is lethal). Also inhaling heated glycerin vapor is not good for you, it doesn't cause anything remotely resembling what cigarettes do and thus far is not thought to cause any long term illness. PG is used in asthma inhalers, although not heated, so that should give you some idea of how inert these compounds are in your lungs.

The most dangerous aspect of vaping IMO is the content of the metals used to make the heating coils. Currently I'm not aware of any sort of assurance that manufacturers can give as to where they source coil wire, and if you make your own coils you should do it with wire that you know is inert when heated, which isn't as easy as it sounds. Two materials used for coils, Nickel Chromium alloy and Titanium, are known to release toxic oxides when heated too much, but these aren't very popular, and 2 other alloys that are common, Kanthal A1 and stainless steel are inert when heated so long as they're made of what they're supposed to be made of and have no impurities.

I wonder if this is purely from combusting tobacco or if marijuana could have a similar effect.

When I used to smoke, I seldom got sick. When I quit, i’ve been sick a lot more. I’m not sure this is just protection against COVID, either way the outcome is death, probably best to try your luck with COVID.

We have to add cigar smoking to Joe Rogan's successful medication package.

Ivermectin infused cigars!

Cigar? Let's go full on and do ciggies. You don't inhale cigars so how is the good stuff supposed to get into your body? Gotta inhale that sweet sweet smoke and get it in there real good.

Don't get too excited about this — activation of the aryl hydrocarbon receptor is the mechanism of toxicity of things like tetrachlorodibenzodioxin:

http://en.wikipedia.org/wiki/2,3,7,8-Tetrachlorodibenzodioxi...

It's possible that the inherent toxicity will preclude use as a treatment. On the other hand, it would be ironic if one of the most toxic substances known turns out to treat COVID-19.

The dose makes the poison[1].

[1] https://en.m.wikipedia.org/wiki/The_dose_makes_the_poison

That model is not accurate as BPA has illustrated.

Is that in regards to this thread[1]?

[1] https://news.ycombinator.com/item?id=28500508

It’s true that sometimes the toxic dose is tiny, like for example dimethylmercury. I don’t see how that invalidates the principle though.

As a precautionary measure though I do agree with avoiding BPA among other things.

I think the exceptions to the rule are substances that aren’t eliminated by the body: small, “harmless”, doses can then accumulate with chronic exposure into a dangerous dose.

Not just that, but anything that is persistent in the environment and readily absorbable fits the bill.

It so happens that BPA and pthalates as part of the plastics made with these substances are persistent - they contain a high total and release the dosage extremely slowly into the environment.

A good example for that is also a slow toxic spill (of e.g. azo dyes) from a factory giving many bladder cancer. (See Pakistan.) The release is persistent due to persistent manufacture of clothing using the toxic substance.

Chronic exposures have a way of overwhelming or slipping by our internal detoxification - even though single dosage may be low and substance might not bioaccumulate, the damage does or probabilities get skewed towards certainty.

  > a slow toxic spill (of e.g. azo dyes) from a factory giving many bladder cancer.

It should be noted in context that azo dyes are what the general public call "food colourings", at least the common, bright, inexpensive food colourings. And their accumulation in the body cause other types of damage as well, which is why there is no safe dose.

I didn't say it invalidated the model. All models are wrong, some are useful.

But what we've discovered is classes of chemicals that cause more damage at small doses, because they interfere with subtler communication pathways in the body such as hormones, and those effects diminish at higher accumulations. There are other categories, like 'no dose is safe', which GP is implying may be the case for this compound, in which case 'the dose is the poison' is a divide by zero error.

You can't assume that the model works just because it worked (or we ignored the data that didn't fit the model) for 450 years. But the original quote is:

"All things are poison, and nothing is without poison; the dosage alone makes it so a thing is not a poison."

In the full quote it's clear we aren't talking about pesticides or arsenic. You can poison yourself with enough iron, or vitamin E. Somewhere along the way it became about how much perchlorate you can have in water before half the fish die.

> But what we've discovered is classes of chemicals that cause more damage at small doses

That's fascinating. Would you please give an example of a chemical whose toxicity decreases with increased dosage?

> In the full quote it's clear we aren't talking about pesticides or arsenic.

"All things" makes it pretty clear what we're talking about. I feel comfortable asserting that both pesticides and arsenic are members of the set of all things, along with vitamins, iron, and perchlorates. I think one might go so far as to say that an organism can be poisoned by any substance its body is capable of absorbing in sufficient quantity. Water poisoning is a fun example. Despite our bodies largely being composed of it, ingest too much and your cells swell up to the point it can cause brain failure. Even the non-reactive noble gasses can cause narcotic effects.

I thought the main benefit from smoking (in regards to covid) was the nicotine itself. The nicotine gets oxidized and turned into nicotinc acid.

If I wanted to mimic the benefits of smoking, I would take a nicotinic acid pill (flushing niacin)

Good thing I just smoke cigars.

I've found they mellow out me after a long, hard day. Maybe it's the atmosphere in which I immerse myself... on my patio, listening to music, reclining in a chair, but they seem to help me unwind.

It'll certainly be the atmosphere that's primarily calming you, however I recall reading years ago (so don't quote me) about the catch-22 of smoking. When you're smoking - or rather in the breaks between smoking - the vascular system undergoes hypertension, which then is marginally reduced by the relaxation that another hit of nicotine provides. So your baseline 'stress' increases as a result of smoking, and having another cigarette/cigar temporarily reduces that. So the net effect of not smoking plus your relaxing environment would be more relaxing without the cigars in the first place.

That has nothing to do with nicotine and everything to do with monoamine oxidase inhibitors in tobacco smoke.

> When you're smoking - or rather in the breaks between smoking - the vascular system undergoes hypertension, which then is marginally reduced by the relaxation that another hit of nicotine provides. So your baseline 'stress' increases as a result of smoking, and having another cigarette/cigar temporarily reduces that. So the net effect of not smoking plus your relaxing environment would be more relaxing without the cigars in the first place.

This theory was popularised by Allen Carr in his Easy Way to Stop Smoking (or at least that's where I heard it, and the book was published in the early 80s).

That's not what this article says. Apparently the aryl hydrocarbon receptor downregulates ACE2.

Serious covid complications seem to be the result of inflammation on organs, and nicotine is an immunosuppressant. The only episode of Dr. House where it was actually sarcoidosis, the patient had just quit chewing tobacco, so at least doctors on TV have known for decades. (Sarcoidosis is condition where your organs get inflamed very similarly to covid.) Notably, HCQ is also an effective treatment for sarcoidosis.

>The only episode of Dr. House where it was actually sarcoidosis

Thank you for this comment. It seems like every episode has a moment where they say, "Sarcoidosis? Porphyria? Lupus?"

Its never Lupus

I saw an episode of a TV series about a small-town GP recently where in the end it turned out to actually be porphyria. guess he didn't watch enough Dr. House...

I'm pretty sure Lupus was a running joke, almost every episode they would say "It could be Lupus" and it was never Lupus

Nicotine, like caffeine, is a vasoconstrictor, which is part of the addiction characteristics. Don't drink your coffee and you get a headache due to swelling.

I assume they put smokers on nicotine patches when they are in the ICU for COVID, yeah? Otherwise that's a double whammy of inflammation.

I have ulcerative colitis (an autoimmune disorder) and my doctor said that there are some correlation with smoking and reduced symptoms. I asked if nicotine gum was an option since I didn't smoke and she said that gum or patches showed no such correlation.

All in all she did not recommend that I start smoking.

I wonder if snus products correlate with reduced symptoms. I've read lay theories around that it may be the carbon monoxide in the smoke?

Anecdotally, I have not found snus, gum or lozenges to have any impact on symptoms, ie ideally as an emergency measure during flare-ups. Next time I will try smoking and track my symptoms.

PS: I'm not sure if there is any overlap between vape and cigarette smoke, but THC edibles never helped me, while vaped THC is a godsend. I especially like Delta-8, as it gives less of the negative subjective effects.

Omeprazole is already an approved drug. In fact, I was about to swallow a pill as I was reading this.

To be clear this is just smoking related and not related to nicotine? E.g. nicotine patches wouldn't have an effect?

Actually, the article is not 100% clear - they first write about polycyclic aromatic hydrocarbons (PAHs) that are contained in cigarette smoke and are likely to be the "active ingredient" which decreases the coronavirus' ability to enter cells, but later they write that the scientists used "cigarette smoke extract" (CSE) for their study, and it remains unclear what this CSE contained exactly. But apparently it is the PAHs, because these can bind to and activate aryl hydrocarbon receptors (AHRs), and two drugs which do the same have the same effect...

Anecdotal, but per a relative who deployed to multiple care center and nursing homes - smokers never seemed to get symptomatic Covid, those who chewed dip (including him) seemed as likely as anyone else to do so.

Interesting that they may have found a physiological explanation for this effect.

Just to note: the public health field has not availed itself well on this issue. From the earliest days of the pandemic, it was observed that current smokers were less prone to Covid infection than never/former smokers. This result played out again and again, in literally hundreds [1] of studies across the world.

[1] https://twitter.com/phil_w888/status/1279973073811197952

But virtually every time, public health folks would deny that smoking had any protective effect on Covid-19 infection at all. They called it a myth [2], insisted that some sort of statistical bias explained the discrepancy, and accused anyone who said otherwise of being in the pay of the tobacco industry [3].

[2] https://www.nature.com/articles/s41533-021-00223-1 [3] https://www.bmj.com/content/373/bmj.n1303

I can understand having strong priors like "smoking worsens respiratory disease" that would make one skeptical. I can understand being reluctant to inject any nuance into anti-smoking messages. But eventually you have to concede. Hopefully this is the tipping point.

I'm waiting to see how this turns out, but it'd be a real shame if the politics of smoking research meant that we missed out on a prophylactic that was right under our noses the whole time.

So they’re reducing the expression of ACE2 receptors and that gives the virus less opportunities to enter the cell. If this is true, why was it found that people who use ACE inhibitors (which up-regulate ACE2 receptors) don’t have an increased risk of severe Covid?

In theory, that sounds like it means it wasn’t the limiting agent (for severity), but can be made a limiting factor (for infection rate). Different measures going in different directions is quite feasible for an optimization-type problem, and perhaps likely, without any actual knowledge of this domain.

I believe hypertension was consistently found to be a big risk factor. Not sure if anyone has controlled for those on ACE inhibitors or not.

Anecdotally, one of my friends had a small family gathering at some point and everyone got Covid except for the smokers. Could easily be a coincidence given the sample size of like 7 people, but interesting nonetheless.

Why don't people just take angiotensin receptor blockers or ACE2 inhibitors? I recall studies showing benefits for people who are on BP lowering meds from the categories above.

So I guess, in this one particular instance, vaping is helping my health.

Might not be, the effects are apparently attributed to some of the substances in the cigarette smoke - the otherwise dangerous gas that vaping and nicotine patches eliminate.

There were so many senseless studies that I am not sure this one was real, but at least one study a out a year ago claimed vaping makes it worse, while cigs didn't.

waw. so now everyone should smoke?

in me country we non-smokers live in a cloudy hell anyway, no smoker respects non-smokers, be them babies or children or whatever..

hah

Smoking kills, but war is more effective.

Scientific articles and research published on forums like hacker news or Reddit just end up in cringe contrarian conversations. It’s better to read the headline and then run

Smokers more likely to express ACE2 protein that SARS-COV-2 uses to enter human cells - https://medicalxpress.com/news/2020-05-smokers-ace2-protein-...

They can't both be true

They can. Smokers that contracted covid tended to have worse outcomes than average, but on average smokers were less likely to contract covid.

Your linked study explored a possible reason for the former while this explores the latter.

Do you perhaps have a source for this claim?

It's literally the first sentence of TFA.

...lower numbers of COVID cases have appeared amongst smokers compared to non-smokers, even as other reports suggest smoking increases severity of the disease.

you’re totally right, i missed that

Smoke induces mucus secretion which can trap viral particles before they reach the epithelium

IMO, the main benefit of smoking as a measure to reduce COVID transmission risks is the cash profit that tobacco companies get.

Cigarettes are already know pre covid, they are off patent, availabe in generic form and big pharma are not pulling the strings. That goes a long way to making them a viable cure for some.

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