For over 15 years, Dr Anthony Shum, a pulmonologist at the University of California, San Francisco has been studying a rare genetic disorder called the COPA Syndrome. It stands for coatomer subunit alpha and is a rare, inherited disorder that affects the lungs, joint, and kidney. The National Organization for Rare Disorder also notes that it is a genetic autoimmune disorder that is caused by mutations in the COPA gene. This disease affects families unpredictably—some individuals with the mutation develop severe lung damage early in life, while others remain completely healthy. Now, Shum’s team has discovered a protective genetic variant that may offer new hope for treatment.

A Breakthrough

Researchers found that some relatives of COPA Syndrome patients stayed healthy despite carrying the same COPA gene mutation that causes the disease. The key difference? These unaffected individuals had a protective version of another gene called HAQ-STING.

When scientists introduced HAQ-STING into diseased lung cells from COPA patients, the cells returned to a balanced state, suggesting that this gene could be used as a therapy.

“We really think HAQ-STING could be a gene therapy tool and a step toward a cure,” said Shum, whose findings were published in the Journal of Experimental Medicine.

Families Who Solved The Mystery

Shum’s journey into COPA Syndrome research began in 2011 when he treated a young woman, Letasha, who had severe lung bleeding. Her mother, Betty Towe, mentioned that Letasha’s sister, Kristina, had suffered from similar symptoms. Over the years, Betty had taken both daughters on a four-hour trip to UCSF for treatment. After tracing their family history, Shum discovered that their distant relatives in Texas and Oakland also had lung problems and arthritis. In 2015, Shum, along with scientists from Baylor College of Medicine and Texas Children’s Hospital identified the COPA gene mutation. They realized that it was the common factor behind the illness. However, only some of the 30 individuals with the mutation actually developed symptoms, leaving a major question unanswered.

The Domino Effect

It was established that it occurs when a mutated COPA gene causes another gene STING to go overdrive. The STING that helps fight infections in COPA patients, remain permanently active, which leads to chronic inflammation that damages the lungs, kidneys, and joints. In 2020, while studying STING’s role in the disease, researchers discovered a key variation: HAQ-STING. This version of STING, present in about one-third of the population, appeared to neutralize the harmful effects of the COPA mutation.

To confirm their theory, the scientists needed both affected and unaffected family members to participate in the testing. Letasha, Kristina and Betty immediately volunteered. The researchers then analyzed DNA samples from 26 COPA patients and their healthy relatives. They also conducted CT scans and blood tests to ensure that unaffected members did not have any hidden symptoms. When the findings were all clear, it was revealed that all the healthy individuals had HAQ-STING, while none of the COPA patients did. This was the first known case of a common gene variant completely protecting against a severe genetic disease.

Encouraged by this discovery, researchers tested HAQ-STING’s effects in a lab setting. They introduced it into diseased lung cells from COPA patients, and the cells returned to normal function.

Way Ahead

Shum believes HAQ-STING could lead to game-changing treatments, including:

• Prenatal gene therapy for babies diagnosed with COPA Syndrome before birth
• Aerosol delivery of HAQ-STING for adults, directly targeting the lungs

Before publishing their findings, Shum called Betty with the news—her own HAQ-STING gene had protected her from the disease. He also informed Letasha and Kristina, who were overwhelmed with relief and joy.

“We always believed Dr. Shum would get to the bottom of it,” said Letasha. “This discovery is going to change lives.”

Delhi's AQI on Tuesday morning seemed to be doing somewhat better than Monday morning. The AQI has brought some relief to the residents who had been dealing with 'severe' pollution levels, with visibility being hit. As per Tuesday's AQI, according to Central Pollution Control Board (CPCB), Delhi's air pollution stood at 381 AQI as of 6.30 am. This has placed the air quality in the 'very poor' category.

While it has become a habit of many to check AQI before stepping out of the house, how many of us actually understand what AQI really means?

Recently, Delhi's Chief Minister Rekha Gupta claimed that AQI and temperature are the same. At a summit hosted by a news channel, Delhi CM Gupta referred to AQI as "temperature".

Such statements could further lead to misconceptions, and add to everyday confusions. Health and Me is breaking down what AQI really means and why is it not the same as temperature.

How Air Quality Index Work And What It Means

As the Delhi CM claimed that AQI is like temperature and could be "measured using any instrument", is not true. Though it is understandable why such comparisons may have been drawn as you can easily check the AQI report on your phones, like we do with temperature.

However, in real sense, AQI or the air quality index is a tool used for communicating outdoor air quality and health. The AQI includes six-color coded categories, each of which corresponds to a range of index values. The higher the AQI value, the greater the level of air pollution and the greater the health concern.

Air quality is made of dust and small particles like PM2.5 and PM10, along with gases like nitrogen dioxide from car exhaust, sulphur dioxide from factories, and carbon monoxide from vehicles. The levels are measured through specialized machines. In India, the standard of the machines are carried out by the Central Pollution Control Board or CPCB.

What Makes Delhi So Polluted?

As per a review of Delhi's air quality from 1990 to 2022, published in Sustainability (MDPI), an open access journal, these are the following sources of Delhi's Air Pollution:

• Transports emit around 10 to 30% of pollution. This includes all road, rail, and aviation modes and combustion of petrol, diesel, and gas.

• Dust make up another 10 to 30% of pollution. Dust from resuspension on the roads and construction activities.

• All industries, including small, medium, and large industries, including power plants and brick kilns lead to 10 to 30% of pollution.

• In summers, all residential activities, including cooking, lighting, and heating activities lead to 10% of pollution, whereas in winter, it makes up for 30%.

• Waste burning, including residential sides and landfills leads to 5 to 15% of pollution.

Power plants from outside the city leads to less than 7% of pollution. Dust storms contribute to less than 5% of pollution. Agricultural residue burning, which is a seasonal source of pollution leads to less than 3% of pollution, whereas firecrackers, another seasonal source, leads to less than 1% of pollution.

Earlier in November, the Public Health Ontario's (PHO) data revealed that Ontario and Canada as a whole could be in a "very tough" flu season this year, thanks to the Influenza A or the flu A. The PHO data revealed a 1.8% rise in influenza cases in the last week of October. Now, amid the influenza A outbreak, 3 children have died from the same in Ottawa and Eastern Ontario region.

Influenza A: Can Flu Kill People?

As per the infectious physician at the Johns Hopkins University Center for Health Security, as reported in Scientific American, "Dying from the flu is not like dying from a bullet or a black widow spider bite. The presence of the virus itself isn't going to be what kills you. An infectious disease always has a complex interaction with its host.”

Once the virus enters someone's body usually via their eyes, nose, or mouth, the influenza virus begins hijacking human cells in the nose and throat to make copies of itself. This triggers a strong response from the immune system, and sends battalions of white blood cells, antibodies and inflammatory molecules to eliminate the threat.

T cells work by targeting and destroying virus-infected tissue, especially in the respiratory tract and lungs where the infection usually settles. In most healthy adults, this response clears the virus and leads to recovery within days or weeks. In some cases, however, the immune reaction becomes excessive, damaging large areas of lung tissue and impairing oxygen delivery to the blood, which can cause hypoxia and, in severe cases, death.

What Is Influenza A?

As per the National Institutes of Health, US, influenza viruses that contains single-stranded RNA that are classified into three types: A, B, and C. Type A and B cause annual epidemics and even pandemics, while type C is a less common disease.

As per the Centers for Disease Control and Prevention (CDC), Influenza A viruses are descendants of the 2009 H1N1 pandemic virus that emerged in the spring of 2009 and caused a flu pandemic. These viruses, scientifically called the "A(H1N1)pdm09 virus," and more generally called "2009 H1N1," have continued to circulate seasonally since 2009 and have undergone genetic and antigenic changes.

Influenza A(H3N2) viruses also change genetically and antigenically. Influenza A(H3N2) viruses have formed many separate, genetically different clades in recent years that continue to co-circulate.

It is a fast-spreading respiratory virus responsible for seasonal flu outbreaks and, at times, global pandemics. It changes quickly through genetic shifts, which makes new strains harder to predict and control. The virus is grouped based on surface proteins called hemagglutinin and neuraminidase, with H1N1 and H3N2 among the most common strains in circulation. It spreads mainly through coughs, sneezes, or close contact and often comes on suddenly, causing fever, cough, body pain, and extreme tiredness. In some cases, it can lead to serious complications, especially in vulnerable groups.

Influenza A: Common Signs And Symptoms

• Fever or chills
• Dry cough
• Sore throat
• Headache
• Fatigue
• Some people could also get symptoms like diarrhea or vomiting, especially kids.

The symptoms usually appear 1 to 4 days after exposure and could linger for a week.

Hemoglobin is a key protein found in red blood cells. Its main job is to carry oxygen from your lungs to the rest of your body. When hemoglobin levels drop, the body may not receive enough oxygen to function well. Low hemoglobin can happen for several reasons, including health conditions, blood loss, or gaps in nutrition.

What Is Low Hemoglobin?

Hemoglobin is the oxygen-carrying protein in red blood cells. Adequate hemoglobin levels are essential for keeping organs and tissues properly supplied with oxygen. Without enough of it, the body begins to struggle to meet its basic energy needs.

Low hemoglobin is usually identified through a blood test. It is most often measured as part of a complete blood count (CBC), which checks different components of the blood, including red and white blood cells and platelets, as per Healthline.

While exact reference ranges can vary slightly between laboratories, healthy adult hemoglobin levels usually fall within the ranges listed below. These values are different for babies, children, and teenagers.

Normal Hemoglobin Count in Grams per Deciliter (g/dL) | Normal Hemoglobin Count in Grams per Liter (g/L)

Adult Males: 13.8–17.2 | 138–172

Adult Females: 12.1–15.1 | 121–151

Any reading below these ranges in adults is considered low hemoglobin and suggests that oxygen delivery in the body may be reduced, as per Mayo Clinic.

Is Low Hemoglobin Ever Dangerous?

Low hemoglobin is not always an emergency. In many cases, it develops gradually and can be managed with treatment. That said, very low levels can be dangerous. A hemoglobin level below 5.0 g/dL has been linked to serious complications, including heart failure and even death. Levels under 6.5 g/dL may be considered life-threatening and require urgent medical care.

What Causes Low Hemoglobin?

One of the most common reasons for low hemoglobin is anemia. Anemia occurs when the body does not have enough healthy red blood cells. The most frequent type is iron-deficiency anemia, which develops when the body lacks enough iron to produce hemoglobin.⁵

Other forms of anemia include pernicious anemia, which occurs when the body cannot properly absorb vitamin B12, and hemolytic anemia, where red blood cells are destroyed faster than they are produced.¹

Low hemoglobin can also be caused by:

• Blood loss or internal bleeding
• Certain cancers, including leukemia, lymphoma, multiple myeloma, and cancers that spread to the bone marrow
• Chronic kidney disease
• Deficiencies of folate or vitamin B12
• Hypothyroidism
• Liver disease
• Poor nutrition or malnutrition
• Myelodysplastic syndrome (MDS)
• Sarcoidosis
• Sickle cell disease and other inherited blood disorders
• Systemic lupus erythematosus
• Thalassemia, a genetic condition that reduces hemoglobin production
• Excess fluid in the body
• Cancer treatments such as chemotherapy and radiation can also lower hemoglobin levels, particularly in adults over the age of 65.

What Does Having Low Hemoglobin Feel Like?

Some people with mildly low hemoglobin may not notice any symptoms at first. Others may begin to feel unwell as levels drop further or remain low over time.

Common signs and symptoms include:

• Feeling dizzy or lightheaded, sometimes fainting
• Muscle weakness
• Ongoing fatigue or low energy
• Pale or washed-out skin
• Frequent headaches

How Is Low Hemoglobin Treated?

Treatment depends entirely on what is causing the low hemoglobin. A healthcare provider will first identify the underlying reason before recommending treatment.

Possible treatment options include:

Blood transfusion: If hemoglobin is low due to heavy blood loss, a transfusion may be needed to restore levels quickly.

Vitamin supplements: When nutritional deficiencies are the cause, iron, folate, or vitamin B12 supplements are often prescribed. Hemoglobin levels usually begin to improve within six to eight weeks.

Intravenous (IV) therapy: In cases where iron or B12 levels need to be raised rapidly, IV infusions may be recommended.

Bone marrow transplant: This may be required when low hemoglobin is linked to certain cancers or bone marrow disorders.

If a long-term illness is responsible, managing that condition becomes the key part of treatment, alongside monitoring hemoglobin levels regularly.