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Published on: Nov 13, 2020
1 minute read
By: Dr Rajan ( Medical Second Opinion Cell)

Using The Cellular Handshake Against The Virus

Using the cellular handshake against the virus

In early November an interesting study was published in The Lancet Respiratory Medicine, describing the treatment of a severe COVID-19 patient with human recombinant soluble angiotensin-converting enzyme-2. By using the treatment, it was possible to see the disappearance of the virus swiftly from the patient's serum, nose, and lungs, as well as a reduction in the patients’ inflammatory markers. How was this achieved? And why is this so intriguing.

When we look at treating viruses, there are several strategies at work. You can prevent its spread by the use of social distancing or masks, you can use medications that prevent its replication (such as Tamiflu). Or you can stop the virus from entering the cells, the first step in viral replication.

SARS-CoV-2 appears to enter human cells through the ACE2 receptor. ACE2 is a protein in the cell membrane found across the human body, especially the lungs, heart, kidney and small intestine. It function is related to the Renin-Angiotensin System, a mechanism by which the kidneys control your blood pressure.

Angiotensin-Converting Enzyme converts angiotensin 1 to angiotensin 2, a hormone that causes blood vessels to constrict. ACE 2 instead converts it to a protein that causes dilation of blood vessels. This likely protects these critical organs and ensure they receive sufficient blood to perform their tasks. ACE2 is being investigated as a possible target for blood pressure medications.

The study used a genetically modified soluble form of ACE2 that mimics the protein found on human cell membranes. By increasing its availability in the blood, the SARS-CoV-2 virus binds to this protein, resulting in its inactivation, rather than entering lung cells and causing lung injury. Lab studies have shown that it can reduce viral growth by as much as 1000 to 5000 times, and phase 1 studies show it to be safe to use in people.

The actual described case was in a 45-year-old woman, hospitalized with COVID, suffering from severe shortness of breath, cough and fatigue. She was first treated with hydroxychloroquine and anticoagulants, but this proved ineffective, and the virus was causing increasing damage to her lungs. Nine days after her symptoms started, she received the ACE2 treatment for a week, with no side effects. This resulted in an increase in ACE2 activity (seen from her blood results), but also a marked decrease in multiple inflammatory markers associated with COVID-19, as well as a sharp decrease in COVID 19 numbers. Indeed, the viral load dropped from 32,000 per mL to just 270 per mL two days after treatment started. She was also able to produce antibodies against the virus, so this did not impair her from getting immunity.

It is certainly a very interesting case, though questions remain on how feasible it would be (as well as how expensive) to manufacture large quantities of this protein receptor for treatment use, as well as how it fairs in clinical trials.

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How Poor Hydration Affects Joint Health: Why Water Matters for Mobility

Water is essential for nearly every function in the human body, yet many people underestimate its importance for joint health. While hydration is commonly associated with digestion and skin health, it also plays a crucial role in maintaining smooth and pain-free joint movement.

Understanding how poor hydration affects joint health can help prevent stiffness, discomfort and long-term mobility issues.

The Role of Water in Joint Function

Joints are where two bones meet, allowing movement and flexibility. Healthy joints rely on:

Cartilage
Synovial fluid
Ligaments
Tendons

Cartilage, which cushions bones, contains a high percentage of water. Synovial fluid acts as a lubricant, reducing friction during movement.

Proper hydration ensures these components function effectively.

What Happens When You Are Dehydrated?

When the body lacks sufficient water:

Synovial fluid production may decrease
Cartilage may lose elasticity
Joint cushioning becomes less effective

This can result in stiffness and discomfort.

1. Reduced Joint Lubrication

Synovial fluid requires adequate hydration to maintain volume and viscosity.

Without enough water:

Friction between bones increases
Movement becomes less smooth
Risk of wear and tear rises

2. Increased Joint Stiffness

Dehydration may cause joints to feel tight, especially:

In the morning
After prolonged sitting
During physical activity

Stiffness may limit flexibility.

3. Higher Risk of Injury

Poorly lubricated joints may be more prone to:

Sprains
Strains
Cartilage damage

Hydration supports tissue resilience.

4. Worsening of Existing Joint Conditions

Individuals with conditions such as osteoarthritis may experience increased discomfort if hydration is inadequate.

While water does not cure arthritis, it supports overall joint function.

5. Reduced Nutrient Delivery

Water helps transport nutrients to joint tissues.

Dehydration may impair circulation and nutrient exchange, slowing tissue repair.

Signs of Dehydration That May Affect Joints

Dry mouth
Dark urine
Fatigue
Headaches
Muscle cramps
Joint stiffness

Recognizing early dehydration signs prevents complications.

How Much Water Do You Need?

Hydration needs vary depending on:

Body weight
Climate
Physical activity level
Health conditions

On average, adults may require 2–3 liters of water daily.

In hot climates such as India, higher intake may be necessary due to increased sweating.

Tips to Maintain Proper Hydration

1. Drink Water Regularly

Do not wait until you feel thirsty.

2. Eat Water-Rich Foods

Include:

Cucumbers
Watermelon
Oranges
Tomatoes

3. Limit Excessive Caffeine and Alcohol

These may contribute to fluid loss.

4. Carry a Water Bottle

Keeping water accessible encourages consistent intake.

5. Hydrate Before and After Exercise

Physical activity increases fluid loss through sweat.

Hydration and Joint Health in India

In India’s hot and humid climate, dehydration is common, especially during summer months.

Outdoor workers, athletes and elderly individuals are particularly vulnerable.

Maintaining adequate hydration supports not only joint health but overall wellbeing.

When to Consult a Doctor

Seek medical advice if you experience:

Persistent joint pain
Swelling
Limited range of motion
Redness or warmth around joints

These may indicate underlying joint disorders requiring evaluation.

Conclusion

Poor hydration can negatively affect joint health by reducing lubrication, increasing stiffness and raising injury risk. Since cartilage and synovial fluid depend heavily on water, maintaining adequate hydration is essential for smooth movement and long-term mobility.

Drinking sufficient water daily is a simple yet powerful step toward protecting joint health. Combined with regular exercise and balanced nutrition, proper hydration supports active and pain-free living.

Small daily hydration habits can make a significant difference in how your joints feel and function.

References

Indian Council of Medical Research – Hydration Guidelines
World Health Organization – Water and Health Resources
Indian Journal of Orthopaedics – Joint Health Studies
National Institute of Nutrition India – Fluid Intake Recommendations
Journal of Sports Medicine – Hydration and Musculoskeletal Health Research

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