Kunlin Jin, Ph.D.
Permanent URI for this communityhttps://hdl.handle.net/20.500.12503/21594
Professor, Pharmacology & Neuroscience
Member, Institute for Healthy Aging
Email: Kunlin.Jin@unthsc.edu
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Browsing Kunlin Jin, Ph.D. by Author "Chakrabarti, Sankha Shubhra"
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Item COVID-19 in India: Are Biological and Environmental Factors Helping to Stem the Incidence and Severity?(JKL International, 2020-05-09) Chakrabarti, Sankha Shubhra; Kaur, Upinder; Banerjee, Anindita; Ganguly, Upsana; Banerjee, Tuhina; Saha, Sarama; Parashar, Gaurav; Prasad, Suvarna; Chakrabarti, Suddhachitta; Mittal, Amit; Agrawal, Bimal Kumar; Rawal, Ravindra Kumar; Zhao, Robert Chunhua; Gambhir, Indrajeet Singh; Khanna, Rahul; Shetty, Ashok K.; Jin, Kunlin; Chakrabarti, SasankaThe ongoing Corona virus (COVID-19) pandemic has witnessed global political responses of unimaginable proportions. Many nations have implemented lockdowns that involve mandating citizens not to leave their residences for non-essential work. The Indian government has taken appropriate and commendable steps to curtail the community spread of COVID-19. While this may be extremely beneficial, this perspective discusses the other reasons why COVID-19 may have a lesser impact on India. We analyze the current pattern of SARS-CoV-2 transmission, testing, and mortality in India with an emphasis on the importance of mortality as a marker of the clinical relevance of COVID-19 disease. We also analyze the environmental and biological factors which may lessen the impact of COVID-19 in India. The importance of cross-immunity, innate immune responses, ACE polymorphism, and viral genetic mutations are discussed.Item Of Cross-immunity, Herd Immunity and Country-specific Plans: Experiences from COVID-19 in India(JKL International, 2020-12-01) Chakrabarti, Sankha Shubhra; Kaur, Upinder; Singh, Anup; Chakrabarti, Suddhachitta; Krishnatreya, Manigreeva; Agrawal, Bimal Kumar; Mittal, Amit; Singh, Amit; Khanna, Rahul; Gambhir, Indrajeet Singh; Jin, Kunlin; Chakrabarti, SasankaIndia has witnessed a high number of COVID-19 cases, but mortality has been quite low, and most cases have been asymptomatic or mild. In early April, we had hypothesized a low COVID-19 mortality in India, based on the concept of cross-immunity. The presence of cross-immunity is presumed to lead to a milder course of disease and allow the time necessary for the development of adaptive immunity by the body to eliminate the virus. Evidence supporting our hypothesis has started showing up. Multiple studies have shown the generation of different T cell subsets and B cells responding to epitopes of viral proteins, especially of the spike protein, as a part of adaptive immunity against SARS-CoV-2. Cross-reactive T-cells have been demonstrated in patients who have been previously exposed to endemic coronaviruses. The interplay of cross-immunity and herd immunity is apparent in the COVID-19 scenario in India from the presence of a large number of asymptomatic or mild cases, a low infection-fatality ratio and a generally flat curve of percentage positivity of cases with respect to total testing, both in periods of strict lock-down and step-wise unlocking. It seems that cross-immunity resulted in faster generation of herd immunity. Although the initial restrictive measures such as lockdown prevented the rapid spread of the outbreak, further extension of such measures and overly expensive ones such as enhanced testing in India will result in a huge burden on the health economics as well as the society. Hence, we propose a restructuring of the health services and approach to COVID-19. The restructured health services should move away from indiscriminate testing, isolation and quarantine, and instead, the emphasis should be on improving facilities for testing and management of only critical COVID cases and the replacement of complete lockdowns by the selective isolation and quarantine of susceptible persons such as the aged and those with co-morbidities. In the process of describing India-specific plans, we emphasize why the development of country-specific plans for tackling epidemics is important, instead of adopting a "one policy fits all" approach.Item Rapidly Progressive Dementia with Asymmetric Rigidity Following ChAdOx1 nCoV-19 Vaccination(JKL International, 2022-06-01) Chakrabarti, Sankha Shubhra; Tiwari, Ashutosh; Jaiswal, Sumit; Kaur, Upinder; Kumar, Ishan; Mittal, Amit; Singh, Anup; Jin, Kunlin; Chakrabarti, SasankaItem The Pathogenetic Dilemma of Post-COVID-19 Mucormycosis in India(JKL International, 2022-02-01) Chakrabarti, Sankha Shubhra; Kaur, Upinder; Aggarwal, Sushil Kumar; Kanakan, Ahalya; Saini, Adesh; Agrawal, Bimal Kumar; Jin, Kunlin; Chakrabarti, SasankaThere has been a surge of mucormycosis cases in India in the wake of the second wave of COVID-19 with more than 40000 cases reported. Mucormycosis in patients of COVID-19 in India is at variance to other countries where Aspergillus, Pneumocystis, and Candida have been reported to be the major secondary fungal pathogens. We discuss the probable causes of the mucormycosis epidemic in India. Whereas dysglycaemia and inappropriate steroid use have been widely suggested as tentative reasons, we explore other biological, iatrogenic, and environmental factors. The likelihood of a two-hit pathogenesis remains strong. We propose that COVID-19 itself provides the predisposition to invasive mucormycosis (first hit), through upregulation of GRP78 and downregulation of spleen tyrosine kinase involved in anti-fungal defense, as also through inhibition of CD8+ T-cell mediated immunity. The other iatrogenic and environmental factors may provide the second hit which may have resulted in the surge.