The COVID-19 pandemic may be over, but our immune systems are still feeling the impact. After years of battling constant viral threats, from COVID-19 to seasonal flu and other infections, our body’s defense system is exhausted. Many people continue to experience lingering inflammation, frequent illnesses, and slower recovery times. This extended state of immune stress has compromised us further to chronic illness, including autoimmune diseases and even neurodegenerative diseases such as Parkinson's. So why is our immune system still in trouble? And how do we give it its power back? Understanding immune exhaustion is the beginning of rebuilding our body's natural immunity.

A weakened immune system makes people more susceptible to disease, mental illnesses, and even sleep disorders. Now, new research indicates that immune system depletion may play an important role in the onset of Parkinson's disease, a degenerative neurologic disorder that compromises movement and cognition.

Role of Inflammation in Parkinson's Disease

Dysfunctional immune response is a leading cause of long-standing inflammation within the body, that has been found to contribute towards a multitude of conditions, including cardiovascular conditions, diabetes, depression, and neurodegenerative diseases such as Alzheimer's.

As people age, their immune system naturally becomes less effective. This deterioration, referred to as immune exhaustion, may be a key contributor to the onset and progression of Parkinson’s disease. Rebecca Wallings, a Parkinson’s Foundation Launch Award grant recipient and senior postdoctoral fellow at the University of Florida, believes that an accumulation of exhausted immune cells could be driving neurodegeneration in Parkinson’s patients.

How a Tired Immune System Might Affect Parkinson's?

Parkinson's disease is most commonly linked with the degeneration and loss of dopaminergic neurons—motor nerve cells that produce dopamine, an essential neurotransmitter for movement. While researchers have long suspected inflammation is involved in this neurodegeneration, the mechanisms are not yet well understood.

Wallings' study is on immune cell exhaustion, a process by which aging immune cells fail to control immune responses effectively. Her research indicates that instead of dampening inflammation in Parkinson's patients, attempts should be made to rejuvenate the immune system to regain its functionality.

Energy Deficiency in Immune Cells

One of the major findings of Wallings' work is the function of mitochondrial impairment in immune cell exhaustion. Mitochondria are commonly called the powerhouses of cells, as they are vital for generating energy. As mitochondria age and become inefficient, immune cells fail to function well, potentially accelerating neurodegeneration in Parkinson's disease.

Wallings has found that mutations in the LRRK2 gene, a recognized genetic risk factor for Parkinson's disease, are linked with defective mitochondrial function and immune cell exhaustion. Her current work includes testing various therapeutic approaches to restore mitochondrial function in immune cells with the potential to enhance the immune system and potentially prevent or treat Parkinson's disease.

Will Rejuvenating the Immune System Help in Treatment?

For decades, the standard practice in treating Parkinson's has been to suppress brain inflammation. Yet Wallings' work indicates that instead of slowing down immune responses, restoring the immune system could be a more successful strategy. By addressing mitochondrial impairment and immune resilience, researchers can potentially reverse or slow down Parkinson's disease.

Wallings is now looking into how to rejuvenate immune cells by fixing mitochondria. She studies immune cells from patients with Parkinson's as well as from healthy subjects and performs experiments on animal models to determine if rejuvenation of the immune system could result in improved disease outcomes.

Lifestyle Factors That May Affect Parkinson's Risk

While there is no cure for Parkinson's disease, some lifestyle adjustments may decrease the chances of developing the illness. Since neurodegenerative diseases are associated with chronic inflammation and immune dysfunction, developing habits that enhance immune function might prove helpful.

Diet: There is evidence to suggest that eating in accordance with the Mediterranean or MIND diets, both high in antioxidants, healthy fats, and anti-inflammatory foods, can encourage brain wellness and reduce Parkinson's risk.

Avoiding Dangerous Substances: Restricting alcohol and nicotine use can maintain a robust immune system and suppress inflammation.

Reducing Stress: Chronic stress weakens immune function, so methods such as meditation, exercise, and sufficient sleep can lead to improved overall well-being.

In a shocking viral trend, women in Kenya are reportedly inserting cetirizine, an allergy medication, into their vaginas in an attempt to achieve vaginal tightening and enhance sexual pleasure.

The practice has prompted warnings from pharmacists and health authorities, who caution that the drug is not meant for vaginal use and could pose health risks.

The Pharmaceutical Society of Kenya (PSK) has warned against the practice, stating that the medicine is not intended for vaginal use.

"Cetirizine is an allergy medicine, taken by mouth. It is not approved or tested for any other purpose, and definitely not for vaginal use," the PSK said in a statement issued on Thursday.

It advised women who had tried the practice to stop and seek medical attention if they experienced pain, bleeding, burning, itching, unusual discharge or fever.

What Is The Cetirizine Vaginal Tightening Trend?

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Posts circulating on Kenyan social media, particularly TikTok, claim that cetirizine can reduce vaginal moisture and create a sensation of tightness during sex, BBC reported.

The claims have sparked online debate, with some users endorsing the practice and others questioning its safety.

The trend has also reportedly increased demand for the drug, with local media reporting price rises and shortages at some pharmacies in Nairobi.

What Is Cetirizine And Why Is Its Misuse Dangerous?

Cetirizine is an oral antihistamine used to relieve allergy symptoms such as sneezing, runny nose, itchy eyes and hives.

Kenya's Pharmacy and Poisons Board (PPB) clarified in a public safety alert issued on November 4 that cetirizine is used to treat allergic rhinitis and urticaria. It is intended for oral use and should be taken only as directed by a healthcare professional.

The Board stressed that "the drug is not approved for vaginal use or tightening and that no established scientific evidence supports such claims".

On the other hand, inserting the tablets may cause vaginal irritation, burning, soreness, pain and discomfort. It may also disrupt the vagina's natural protective environment and increase infection risk.

The PSK cautioned against confusing dryness with tightening.

"Dryness is not tightness... instead, it may increase friction, discomfort, and the risk of tissue injury," it said.

Taking more than the recommended cetirizine dose can also cause excessive sleepiness, dizziness, restlessness, confusion, shaking, a rapid heartbeat and difficulty passing urine, the PPB warned.

Kenya's Health Ministry Raises Concern

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Kenya's health ministry had also flagged the trend a day earlier. Ouma Oluga, a senior health official, expressed concern that social media users were dismissing medical warnings without considering the consequences, the BBC reported.

He suggested that authorities could introduce a system to monitor medicine distribution and purchases to identify potential misuse. No formal decision has been announced.

Pharmacists Warn Of Shortages And Misuse

The PSK said it had received reports of increased cetirizine demand, rising prices and shortages at some pharmacies.

It urged retailers not to exploit the trend, warning that people who need the drug for allergies could struggle to access it. Pharmacists were also advised against knowingly dispensing medicines for misuse.

The PPB urged women not to insert cetirizine or other oral medicines into the vagina and to consult healthcare professionals about vaginal dryness or sexual health concerns rather than follow unverified online advice.

Delhi's air quality remained in the Very Poor category on Thursday, with an AQI of 369 as pollution levels continued to rise across the Capital. With Diwali celebrations with firecracker fuel smoke to an already polluted city, concerns about respiratory health are mounting. The timing is alarming as it also coincides with the flu season, when respiratory infections are also circulating.

While air pollution and influenza both affect the respiratory system, it can put additional stress on the lungs. Pollutants can irritate the airways, trigger inflammation and weaken the lungs' natural defence mechanisms, while the influenza virus infects the respiratory tract.

Together, they can aggravate respiratory symptoms and make breathing more difficult, especially in people with pre-existing lung conditions.

According to Dr. Arup Halder, Consultant Pulmonologist at CK Birla Hospitals, CMRI Kolkata, prolonged exposure to air pollution can weaken the respiratory system's immunity.

“Exposure to air pollution, especially for long durations, can weaken the respiratory system's immunity. Fine particulates can become lodged in airways and damage the mechanisms the body has to protect itself. This makes respiratory infections much more likely, especially if viral in nature,” he told HealthandMe.

Dr. Suresh Sagadevan, Senior Interventional Pulmonologist at Gleneagles Hospital, Chennai, told HealthandMe that pollution can also interfere with the lungs' natural cleaning mechanisms.

He said that the respiratory tract contains tiny hair-like structures called cilia, which help remove dust and germs. Polluted air can affect their functioning, making it easier for respiratory viruses to infect the airways. However, pollution does not directly cause influenza nut it can compromise the respiratory system's ability to defend itself against such infections.

What Happens When Particulate Matter And Flu Affect The Lungs Together?

Also read: Delhi Air Pollution: Feeling Anxious As AQI Rises? Experts Explain The Mental Health Toll Of Breathing Toxic Air

Particulate matter and influenza together can intensify inflammation in the respiratory system.

Fine particulate matter, like PM2.5, can penetrate deep into the lungs. It can cause inflammation and oxidative stress. At the same time, influenza viruses infect the cells lining the respiratory tract.

"When both exposures occur together, the existing inflammation can become more intense, potentially worsening coughing, breathing difficulty and airway irritation. In simple terms, the lungs are dealing with two different stresses at the same time," said Dr. Sagadevan.

Dr. Halder added that PM2.5 can also interfere with the body's ability to ward off irritants from the respiratory tract, while influenza can make breathing challenging.

Facing both together can be challenging for people whose respiratory or immune systems are already compromised.

Can Diwali Pollution Make Flu Symptoms Worse?

Also read: Air Pollution In Delhi: Experts Warn Of Red Eyes, Itching, Watering In Children

Firecracker smoke can aggravate an already infected and overwhelmed respiratory system. People with flu may experience excessive coughing, wheezing, chest tightness and breathlessness when they get exposed to high levels of pollution.

"Increased Diwali-related pollution will definitely worsen respiratory symptoms for individuals with the flu, especially during this period. The gases and particulate matter from firecracker smoke can lead to chest congestion and difficulty in breathing. In some cases, the pollution can worsen existing asthma and other lung-related conditions and trigger respiratory issues," said Dr. Halder.

Dr. Sagadevan said that people with asthma, chronic obstructive pulmonary disease (COPD) and other pre-existing respiratory conditions need to be particularly careful by limiting exposure.

Who Is Most Vulnerable When Flu Season Coincides With High Pollution?

Certain groups of people may face a greater risk when respiratory infections coincide with elevated pollution levels. These include:

• Children: Their lungs are still developing, making them more vulnerable to air pollution.

• Older adults: Age-related changes can reduce respiratory capacity and make it harder to cope with added stress on the lungs.

• Pregnant women: They need to take extra precautions against respiratory infections and environmental pollutants.

• People with asthma or COPD: Pollution can trigger flare-ups, worsen airway inflammation and aggravate breathing difficulties.

• Immunocompromised individuals: A weak immune system can make it harder to fight infections and increase the risk of severe illness.

Dr. Halder explains that older adults and people with weak immunity may be more susceptible to more serious flu symptoms. Meanwhile, those with existing lung conditions may experience worsening respiratory symptoms even with short periods of pollution exposure.

Pollution Effects Vs Flu: Symptoms

Also read: Supreme Court Allows Green Crackers In Delhi-NCR Ahead Of Diwali: Are They Really Safe For Your Health?

Pollution-related respiratory irritation and influenza can lead to similar symptoms, making it difficult to distinguish between the two. However, their onset and symptoms can differ.

Pollution-related irritation develops shortly after exposure to polluted air. Common symptoms include:

• Throat irritation or discomfort
• Burning or watering eyes
• Dry cough
• Sneezing
• Wheezing
• Chest discomfort

Flu, on the other hand, is a viral infection that mostly causes a sudden onset of symptoms, including:

• Fever
• Body aches and muscle pain
• Headache
• Fatigue
• Cough
• General weakness

"However, both can occur together, and symptoms may overlap. Persistent fever, worsening breathlessness or significant weakness should prompt medical evaluation," says Dr. Sagadevan.

Dr. Halder also recommends consulting a medical professional when symptoms make it difficult to determine whether the problem is pollution-related irritation or an infection.

How To Protect Your Lungs During Diwali And Flu Season

Reducing exposure to polluted air and taking precautions against respiratory infections can help protect lung health during the festive season.

Both doctors recommend the following measures:

1. Limit outdoor exposure: Avoid spending long periods outdoors, especially after firecracker bursting and during periods of heavy smoke.

2. Wear a well-fitting N95 mask: If you need to step outside when pollution levels are high, use a properly fitted N95 mask to reduce exposure to fine particulate matter.

3. Keep windows closed: Close doors and windows during periods of heavy smoke to limit the entry of outdoor pollutants. Ventilate indoor spaces when outdoor air quality improves.

4. Avoid outdoor exercise: Vigorous physical activity increases the amount of air you breathe in, increasing exposure. Avoid exercising outdoors when air quality is poor.

5. Avoid firecrackers and second-hand smoke: Staying away from firecracker smoke can reduce exposure to harmful pollutants.

6. Get vaccinated against influenza: Stay up to date with flu vaccinations to reduce the risk of influenza and its complications.

7. Maintain hand hygiene: Wash your hands regularly for infection prevention.

8. Seek medical attention: Do not ignore worsening fever, cough, wheezing or breathing difficulties, especially if you have an existing respiratory condition.

Dr. Sagadevan concludes, "Air pollution and influenza can independently affect respiratory health, but their coexistence can place additional stress on the lungs. During the festive season, protecting our lungs through pollution avoidance, vaccination and timely medical care should be a priority."

Metformin is the first-line treatment for type 2 diabetes in adults and children aged 10 years and above. The drug has also found applications in managing Polyendocrine Metabolic Ovarian Syndrome (PMOS), formerly known as Polycystic Ovary Syndrome (PCOS). But a recent study says that it may have some potential use in a non-metabolic health condition: Long COVID.

Researchers found that people who were prescribed metformin shortly after testing positive for COVID-19 had a significantly lower risk of developing Long COVID than those prescribed other medications.

How Was The Study Conducted?

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The study, titled Metformin at the Time of COVID-19 Infection and Risk of Long COVID: A Target Trial Emulation Study, was published in the Journal of Medical Virology recently.

Researchers have been exploring metformin's antiviral and anti-inflammatory effects, especially during the early stages of COVID-19 infection. They are specifically investigating if metformin could reduce the risk of Long COVID if taken soon after contracting the infection.

The researchers examined health records of more than 21 million people from the US National COVID Cohort Collaborative (N3C). They identified adults who had tested positive for COVID-19 between March 2020 and September 2023. They compared two groups:

Metformin group: People who received a new prescription for metformin within six days of their documented COVID-19 infection.

Comparison group: People who received prescriptions for other medications, including fluvoxamine, fluticasone, ivermectin or montelukast, during the same period.

The researchers excluded people who were already taking metformin or had conditions like diabetes, PCOS or gestational diabetes that could explain why they were prescribed the drug.

After statistical adjustments to make the groups more comparable, the researchers compared 248 people in each group. They then tracked the development of Long COVID or death over the following 180 days (six months).

Also read: Can Low-Dose Naltrexone Ease Long COVID Symptoms? New Study Examines The Evidence

Can Metformin Help Reduce The Risk Of Long COVID?

People who were prescribed metformin within six days of a COVID-19 infection had a 53% lower relative risk of Long COVID or death compared to those on other medications.

“Metformin prescription within the week following documented SARS-CoV-2 infection was associated with a 53% reduction in LC/D [long COVID or death] over 6 months in this primarily Omicron-infected sample,” wrote the authors, led by researchers from the University of Minnesota Medical School.

The study found that the risk of Long COVID or death within six months was 4.0% in the metformin group as 10 out of 248 people developed symptoms.

In the comparison group, the number was 8.5% as 21 out of 248 people presented symptoms of Long COVID. Overall, the weighted chance of Long COVID or death in patients on metformin or control treatment within six days of diagnosis was 6.3%. The absolute difference between the two groups was 4.5 percentage points.

“These results are also consistent with a recent sequential target trial analysis in the United Kingdom that assessed metformin started within 90 days of infection, HR [hazard ratio] 0.36,” the authors wrote. “The replication of results in clinical trials is important for informing treatment guidelines.”

More About Long COVID

Long COVID refers to symptoms that occur after a SARS-CoV-2 infection and cannot be explained by another diagnosis.

Symptoms may include brain fog, fatigue, cognitive difficulties, breathlessness, sleep disturbances and problems with everyday activities. These symptoms may last for months or even years.

Research has also suggested that brain inflammation may persist even after the virus is no longer detectable.

Some people improve over time, while others experience prolonged illness that affects their ability to lead routine lives.