Brief Summary:Isotretinoin (13- Cis-Retinoic Acid) Versus Spike Protein Based Vaccine for Providing Complete Protection Against COVID-19 and Preventing the expected long term serious side effects caused by Spike protein based Vaccine In a limited period of time, Spike Protein-based Vaccines were granted emergency approval and are now rolling out. Spike Protein-based vaccine offers guidance and signals for our cells to express a component of what is called the "viral spike protein.". The strong interaction between Angiotensin-converting enzyme 2 (ACE2) and the Receptor Binding Domain(RBD) of the Spike protein(SP) produced by COVID-19 vaccine or found on the Spike protein of viral particles is with affinity (~10 nM), and this binding affinity is equivalent to many monoclonal antibodies (MAbs). As such, association of Angiotensin-converting enzyme 2 (ACE2) with the binding domain of the Spike protein is likely to be strong and long lived interaction , and is expected to result in Angiotensin-converting enzyme 2 (ACE2) entering antigen presenting cells associated with the Spike protein produced by COVID-19 vaccine or the Spike protein of viral particles. This may be enhanced by fragment crystallizable (Fc ) mediated uptake via fragment crystallizable (Fc ) Receptors once an antibody response to the spike has occurred, and may set up conditions for extreme presentation of Angiotensin-converting enzyme 2 ( ACE2) epitopes to B and T cells, aided by strong T cells help from epitopes derived from Spike protein attachment or other viral expressed proteins. .Therefore, we use existing and emerging evidence to propose a testable hypothesis that spike protein based Vaccines which will lead to high expression of spike protein by different human cells expected to initiate Autoantibodies and T cells to ACE2 after a period of repeated vaccination . These autoantibodies may generated by forced presentation of the ACE2 protein in a complex with vaccine Spike protein in Fc Receptor positive Antigen Presenting Cells in the lung. The development of autoantibodies to ACE2 expected to make damage to the host epithelial cells and hamper their ACE2 dependent function in lungs, and the other different organs like intestine, testes which express ACE2. This pattern of lung injury also occurs in Pulmonary Hypertension secondary to Scleroderma with elevated levels of anti ACE2 antibodies.. These autoimmune process may also explain why myocarditis and other forms of inflammatory responses show up weeks or months after a patient has ostensibly recovered from COVID-19 infection. , In numerous animal models vaccine donation with full length spike protein predisposed to the inflammatory pulmonary disease complication. . In addition, we hypothesis that spike protein-based vaccines could potentiate platelet activation and aggregation leading to thrombosis and blood clots by initiating autoantibodies against ACE2 of human platelets or triggering platelets aggregation through the strong interaction with their surface ACE2. As a study found that SARS-CoV-2 Spike protein directly potentiates platelet activation , enhanced platelet aggregation. After incubation with Spike protein, platelets also displayed markedly clot retraction. . As a result, we conclude that the developer of the covid-19 vaccines should use an effective ACE2 modulator like Isotretinoin which consider potent ACE2 blocker to mitigate this potential risk by assisting in the development of antibodies targeting spike protein not antibodies targeting ACE2 and spike protein complex that could increase the risk of auto antibodies to cellular ACE2. Furthermore, the efficacy and safety of the COVID-19 vaccine can be influenced by several variables, especially the Antibody Dependent Enhancement process (ADE).ADE is a phenomenon in which antiviral antibodies facilitate viral infection of target immune cells and, in some cases, make a second infection worse, such as dengue fever , Here, we submitted this clinical trial depending on a clinical study submited by egyptian scientists (ClinicalTrials.gov Identifier: NCT04353180) which is the first study indicated that 13 cis Retinoic Acid will provide complete protection against COVID-19 owing to its ability to induce mucosal IgA antibodies that are less prone to ADE phenomenon and responsible for passive mucosal immunity in the respiratory tract. Retinoic acid strengthens mucosal immunity via inducing IgA antibodies and considered potent IgA isotype Moreover, its impact on ACE2 receptors, Memory T cells, CD4+/CD8+ ratio, Neutrophil Chetnotaxis, Interferon Type1, Thrombin, Transmembrane serine protease 2 (TMPRSS2), toll-like receptor 3 (TLR3), mitochondrial antiviral-signaling protein (MAVS), papain-like protease (PLpro), and Interleukin 6 ( Il-6).
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