Author: helloalexa143

I have chosen to write about the monoclonal antibody drug adalimumab (Humira) this week. I chose this specific drug because it is used to treat Rheumatoid arthritis which my stepdad suffers from. According to Mednet, a monoclonal antibody is a manufactured antibody that is made in order to attack human antibodies that are not working properly. If someone has an autoimmune disorder, like Rheumatoid arthritis, their antibodies are mistaking self cells for pathogens and trying to destroy them. Scientists can take those antibodies that don’t work and place them in an animal reservoir like a mouse and then retrieve the antibodies the mouse produces against them. They now have monoclonal antibodies programmed to attack the antibodies that are attacking self cells. 

The purpose of Humira for someone with Rheumatoid arthritis is to “prevent further damage to your bones and joints and help your ability to perform daily activities”. The target of Humira is a protein called TNF-alpha. In a person with a normal functioning immune system, TNF-alpha is supposed to control the amount of inflammation in the body. In Rheumatoid arthritis, the body produces TNF-alpha in excess which leads to lots of joint inflammation and pain. Humira works to lessen this inflammation by binding to TNF-alpha and blocking it from causing further inflammation. The side effects of Humira are:

• Serious infections like Tuberculosis
• Hepatitis B in carriers
• Allergic reactions
• Nervous system problems
• Blood problems
• Heart failure
• Immune reactions such as chest pain and rashes
• Liver problems
• Psoriasis

I think that these side effects all sound very serious and are something that a person would have to consider when deciding if they want to take the medication. Personally, it would depend on how much pain I was in. If my pain was very severe I would probably risk these side effects in order to get relief. Another thing to consider would be if you have latent TB or Hep B. If you had these latent infections it would not be a good idea to take Humira because they have a higher chance of being reactivated. I looked at a paper from the American Society for Microbiology in order to understand the reason that Humira increases the risk of TB since I couldn’t find an exact explanation on the Humira website. The reason is that Humira is a TNF-alpha blocker, and one function of TNF-alpha is to control granulomas/tubercles. So in patients taking Humira, they would not be able to fight off new TB infections or latent TB infections as well.  This is an example of how the drug suppresses both innate and acquired immunity.

The Covid-19 virus has many mysteries associated with it, one of those being how to test people for the virus. Testing is very important because it helps researchers track the virus and how prevalent it is. It also is necessary in order to determine an accurate death rate for the virus. The World Health Organization published a report yesterday discussing some antibody response testing being done. One type of test uses antibodies bound to a paper strip that are supposed to detect Covid-19 antigen in the respiratory tract. The WHO warns that this is not a very accurate method due to the fact the antibodies may detect human coronavirus strains and give a false positive. Another issue is that this type of test would only be positive while the virus is still actively replicating; so this test would be good for diagnosing early infection but not good at detecting the virus in someone who may have had it longer. 

The World Health Organization also discussed another type of test that detects Covid-19 antibodies in the blood. According to the W.H.O. “Studies suggest that the majority of patients develop antibody response only in the second week after onset of symptoms”.This test is not applicable unless someone has had the virus for a decent amount of time and is already in the recovery phase. While this may seem like a waste of money to some since the patient would already be past the point where intermediate intervention would help, I think it is still important. Everyone that is assumed to have Covid should be verified that way researchers can get accurate numbers when they are creating death rates or talking about the number of confirmed cases. While this is a basic explanation of antibody testing the CDC has put out a recent article that goes more into depth. 

The CDC goes into detail about how the concentration of IgG antibodies can show how long someone has been infected. According to their research “IgG seroconversion can be reliably confirmed in the second week after disease onset”. This means that B cells have begun affinity maturation and class switching. IgG is much more capable of binding to an antigen than IgM, so as time goes on IgM is clipped out of the B cell DNA and only IgG is made. If someone had only IgM this would mean they were newly infected and the adaptive immune response was just barely started. If a tested patient had both IgG and IgM then that means class switching has started, which is probably in the second week of disease for Covid-19 as stated by the CDC above. If a person were to only have IgG antibodies then that would mean the person had the infection a while ago and had fought it off and developed immunity to that specific strain. That person would no longer be contagious because having only IgG antibodies indicates they were infected a long time ago. 

In conclusion, I have to add this random thought that I had. I think that I am extremely fortunate to be learning about how viruses and testing work at the exact same time that this global pandemic is occurring. It is so interesting to be able to learn while using the current event that is all over the news as an example. It also makes me feel more educated when I speak about the virus to my family and friends. If this crisis had happened last semester then I never would have understood how testing works in the way that I do now. 

T cell therapy is a new technique being used to try and treat patients with serious diseases, including cancer. The reason this new technique is so revolutionary is because it is customizable to each patient and their issues. I think that this is an incredible breakthrough and could be a major step on the path to curing cancer. So how does it work? According to the National Cancer Institute, the doctor will harvest T cells from a patient’s blood and reprogram the T cells to attack the cancer that is within the patient. Once the cells are reprogrammed, “Millions of the CAR T cells are grown in the laboratory and then given to the patient by infusion”. This treatment is really interesting to me it is not just some lab manufactured drug, it is the body’s own mechanisms and cells just being altered slightly. 

The Seattle Children’s Hospital also uses this technique and they provide a little more detail on how the new technology works, specifically in treating cancers like acute myeloid leukemia and acute lymphoblastic leukemia. The way that the T cell is modified is by adding recombinant DNA. This DNA creates a new receptor on T cells so that when they are put back in the body they can bind to cancer cells and flag them for destruction. This T cell therapy is specifically called “CAR T-cell therapy” because “the receptor that’s made on the new T cells that attack the cancer is called a Chimeric Antigen Receptor. The CAR T-cell treatment does not just end after the infusion. The newly inserted T cells are tagged so that they can be followed as they move throughout the body. This is really important because the doctors want to be able to follow the cells to see if they are working properly. If there does happen to be a problem then the doctors can use a drug called “cetuximab” which recognizes the tag and destroys the CAR T-cells. 

According to the website of The Seattle Children’s hospital they “treat more types of relapsed or refractory childhood cancers using T-cell therapies than any other facility”. They also do all of their CAR T-cell treatments in labs onsite so that they can quickly help patients. I hope that in the future they could potentially provide other hospitals with this technology in order to treat even more patients. I think this type of treatment could be the cancer treatment of the future due to how it is personalizable and doesn’t have the awful side effects that chemotherapy and radiation has. This treatment is costly, but so are most cancer treatments. It is something that will only decrease in cost if there are changes to our healthcare system. CAR T-cell therapy is not perfect but It one of the best options I have ever seen and I think it could help a lot of people who are not responding well to normal cancer treatment.

About two weeks ago it was announced that spring break would be extended and that classes at UNC would be moved to online. When I found out this news I was a little taken aback. I had been alone at my apartment for a couple of days already during spring break because I had clinicals going on for my CNA class in Durham. This means I was already getting kind of lonely and stir-crazy without my roommate and I was really upset when I found out this was just the beginning. When I went home for the weekend I was kind of panicking and asking my mom if I needed to stock up on anything. I was nervous because I wanted to stay home with my family but I couldn’t because I was required to attend my CNA class, which had not been canceled. 

When I went back to school last Monday I worked on staying busy cleaning, studying, and prepping for taking classes online. Staying motivated helped me from worrying too much and also made the days go faster. This doesn’t mean that I wasn’t checking the news and Facebook constantly for updates on Covid and closures, because I was doing that too. I went home again that weekend and stayed with my boyfriend. I observed that many of his friends weren’t taking social distancing as seriously as I would have hoped. I think young people still have the mindset that it is not a problem for them. One thing that has been stressing me out is the potential demise of the economy with so many people unable to work. I picked up takeout from a locally owned Mexican place near me and they seemed so grateful to get business. Luckily the people closest to me will be alright but I still worry for my community. 

Overall, I think the measures that UNC has taken are good and necessary. Now that they have changed the pass/fail guidelines I hope that students will be less stressed making the transition to online learning.  I have taken online classes before so I am familiar with the concept but if someone has never taken them it can be very challenging to self motivate and schedule times to get work done. At the same time, I think that people will be more likely to succeed during quarantine since they can’t really leave the house and be distracted. It is my prediction that by the end of April we will see case numbers dropping and things begin to become more normal in May. This is honestly the best-case scenario and requires everyone to do their part. Stay home!!!

Gonorrhea is the second most common STI and also has very serious consequences, especially in women. According to the Nationwide Children’s Hosptial when Gonorrhea is left untreated in women, “it can lead to pelvic inflammatory disease (40% of infected women) that can result in severe long-term health implications such as infertility, adverse pregnancy outcomes and devastating neonatal complications”. I think that this should be very scary for females yet many sexually active people are probably oblivious to how serious Gonorrhea is. Another alarming statistic is that 80% of females who have Gonorrhea show no symptoms. This can lead to long periods of time with no treatment as well as increase the transmission of Gonorrhea every time an infected woman has a new sexual partner. Due to lack of education and the high rate of asymptomatic infections Gonorrhea is increasing in incidence throughout the United States and becoming more of a concern. 

One example where Gonorrhea incidence is increasing dramatically in “Texas counties with high shale drilling activity” according to researchers at the Yale School of Public Health. Shale drilling, also known as fracking, draws a large amount of qualified young men to a small rural area. Since these men are away from their homes for long periods of time they tend to explore sexually with new partners. This is why researchers believe that fracking sites have seen an increased incidence of Gonorrhea and other STI’s. I would imagine this same phenomenon occurs in areas like college campuses and military bases where there may be a large amount of single young men who are looking for “activities” to occupy their free time. I think that local, county-level governments need to recognize these risk factors for increased STI transmission and implement measures to make people are of how transmission works. I also think that frequent STI testing should be encouraged since many infections show no symptoms. 

On the bright side, recent studies done by the previously mentioned Nationwide Children’s Hosptial have discovered a new, targeted treatment for Gonorrhea. Treating Gonorrhea in the past has been difficult due to antibiotic resistance constantly making drugs ineffective after a short period of time. These new drugs carbamazepine and methyldopa already exist and have been used to treat other conditions; they are simply being repurposed to treat Gonorrhea. These types of drugs teach the host cell to recognize when gonorrhea bacteria bind and then kill the bacteria, they are also less prone to antibiotic resistance. I think this could be revolutionary in the treatment of gonorrhea and also help control transmission if people can be treated more effectively. Antibiotic resistance is a problem we have discussed extensively in class and this is a promising step towards avoiding that problem.

Since antibiotics were first discovered they have become commonly prescribed by doctors and taken for granted by patients. Most people have probably taken an antibiotic even if they had a virus, simply because they thought that it was a cure-all drug. While this seems harmless to an outsider, this is detrimental to microbiologists. The over-prescribing and improper use of antibiotics could mean that these miracle drugs could become ineffective sooner than you think. According to Dr. Alyssa Letourneau, director of the Massachusetts General Hospital Antimicrobial Stewardship Program “Bacteria are smart…so they can over time mutate to become resistant to the drug that fights them”. When antibiotics are continuously prescribed they quickly lose effectiveness and new antibiotics have to be developed. The bacteria can share their resistance with other bacteria which makes the resistance spread even faster. 

At some point, bacteria can become completely resistant to all known antibiotics and are referred to as superbugs. One example of a superbug that is listed as an urgent threat by the Centers for Disease Control (CDC) is Carbapenem-resistant Enterobacteriaceae (CRE). CRE is the largest threat in healthcare facilities since the patients are already immunocompromised. Since normal antibiotics don’t work doctors may be forced to use “more toxic or less effective treatment options” which could end up being just as harmful to the patient. Another example of a superbug is Clostridioides difficile, which we have already discussed in detail in class. C. diff causes large amounts of diarrhea and is actually caused by antibiotics killing off normal gut microbiota. One of the reasons the CDC is so concerned is because C. diff can cause severe dehydration that can be fatal. 

In order to stop the spread of these superbugs and prevent antibiotics from becoming completely useless, changes need to be made sooner rather than later. In my opinion, the changes need to start with medical professionals. Antibiotics are prescribed way too often and many times are not even necessary. Patients get a lot of hate for not taking them properly but I think doctors should be just as responsible since they are medical professionals. The average American doesn’t know how an antibiotic works or what type of illnesses require antimicrobial treatment. On the other hand, a doctor goes through years of school, training, and certifications in order to have the authority to prescribe these drugs. 

The prescribing of antibiotics needs to be dialed back majorly and they should only be used as a last resort under close supervision. If this doesn’t happen then superbugs are only going to get more powerful and claim more lives. Time is limited and it is time to treat these little bacteria as a big problem. 

In the midst of the flu season and the Covid-19 outbreak, polio is not at the forefront of most people’s minds. This is especially apparent in the United States where there have been no polio cases for the past 40 years, according to an article from Vax Before Travel. This is an example of one of the many privileges that come with living in the United States. Polio, which can cause paralysis and death, has not been an issue in the United States for so many years because we have access to vaccines which results in herd immunity. This is especially important because children are most at risk. Not every country is so fortunate to have eradicated the disease. Vax Before Travel writes that the CDC is warning people that “various countries primarily located in central and eastern Africa” are experiencing polio outbreaks. 

These countries experiencing the outbreaks are now rushing to get as many people vaccinated as possible. Ghana is one of the countries that has seen recent polio cases and they are taking action to fight it. According to Business Ghana, “The Ghana Health Service (GHS) is to begin a Nationwide Inactive Polio Vaccine (IPV) immunization campaign to immunize children under five years against polio virus type two”. The Inactive Polio Vaccine has only been available in Ghana since 2018, due to “global shortages”. The other type of polio vaccine is referred to as OPV which stands for the Oral Polio Vaccine. IPV is considered the best version of the vaccine and is most successful against fighting Polio Virus Type 2 which is the cause of the recent outbreaks. 

The privilege of the west and other developed countries is highlighted by the disparities of countries like Ghana. Developing nations are struggling to eradicate a disease that we haven’t seen in 40 years. I think it is unfortunate that major advancements in the public health field, such as IPV, are unequally enjoyed by wealthy nations. While many nations like Ghana were facing IPV shortages up until 2018 and could only administer OPV, the United States clearly wasn’t being affected. Vax Before Travel wrote that “The IPV has been the only polio vaccine offered in the USA since 2000”. This is alarming to me and should be alarming to others, but many people don’t even see the problem because Western media doesn’t acknowledge that there is a polio outbreak. I could tell you details about the Kardasians and the Oscars but I didn’t even know that Polio was still an issue until I started this blog post. I encourage everyone to stay educated on current world events and spread awareness about what countries need help so that we don’t get lost in our cloud of privilege while other humans suffer. 

If you told someone who wasn’t a microbiologist that their body was full of bacteria they might be scared, but what they don’t know is that bacteria is an essential component of human health. The microbiome is constantly being researched and recently there have been many exciting discoveries that could change the way we look at the gut.  According to an article written by Andy Corbley from the Good News Network, “A new paper awaiting peer-review from Harvard Medical School has found evidence that the human microbiome has a greater power of detecting disease and predicting mortality than the current applications derived from genetic mapping”. The researchers at Harvard looked into 47 studies that connected the microbiome to human disease. They then compared those findings to 24 studies that connected genetics to human disease. The researchers concluded that according to the studies they analyzed, the microbiome was a better predictor of disease than the human genome. 

The article highlights the microbiome’s potential with diseases like Type 2 Diabetes and colorectal cancer but also warns that there is more research to be done. While these diseases have a somewhat obvious link to the gut, other diseases such as Major Depressive Disorder have also been linked to the microbiome. This was surprising to me as I was researching because I have always thought of depression as a disease of the mind and not a disease of the body. The Drug Target Review discussed multiple studies that have attempted to link the microbiome to MDD. I was shocked to read that “the gut contains the largest number of neurons in the body, outside of the brain”. This changed the perception I have of depression and my understanding of the human body as a whole.

One of the studies that stood out the most to me was about the impact of prebiotics and probiotics. There is a type of medication called psychobiotics that helps with depression by giving patients specific probiotics. The support done for this medication comes from both animal and human trials that measured cortisol levels, which is the stress hormone, along with some other indicators. The trials found that when appropriate pre- and probiotics were administered there were lower cortisol levels in the urine. This evidence supports the claim that altering the microbiota can also alter mental health. I think that this is really interesting and could be a really exciting step to help those who suffer from MDD. I hope that more research into the microbiota’s link to both physical and mental disease will result in new treatment options for many conditions.  

Every year as fall comes around there are some traditions that we can always count on: the leaves changing, a new school year, and flu season. In my opinion, this has seemed like one of the worst flu seasons we have had in a long time. There are also statistics that support my theory that this is an especially rough flu season. According to Rachael Rettner, a senior writer at Live Science, the CDC reported that “In the U.S. alone, the flu has already caused an estimated 19 million illnesses, 180,000 hospitalizations and 10,000 deaths this season”. Rettner points out that although these are high numbers, there is a predictability about Influenza that provides a sliver of relief. For example, in the case Novel Coronavirus nobody knows what to expect or how long it will last. 

Influenza occurs every year and number of those infected always drops after the first couple months of the year. By that time, a new vaccine for the upcoming flu season is in the works. When creating the flu vaccine researchers include both A stains and B strains. According to the Washington Post, normally “the A strain of influenza dominates during the early months, and the B strain shows up toward the end”. This year there has been a prominent B strain that is accounting for many more influenza cases than B strains typically do. This B strain is most harmful to children and has resulted in over 30 pediatric deaths.

 Many uneducated anti-vaxxers may claim that this is evidence of the flu vaccine not working, but they would be mistaken (as they usually are). The B strain that is going around is not the exact one that was included in the vaccine, but it still provides protection because they are somewhat similar. As the wise Dr. Cramer said in microbiology class: “SOME PROTECTION IS BETTER THAN NO PROTECTION”. The Washington Post discussed a study done by the CDC and they found that out of almost 200 pediatric patients with Influenza B, none had been vaccinated. Hopefully the tragedies this year can serve as a warning and come next flu season more people will choose to be vaccinated. Until then remember to wash your hands, because even if you got your flu shot you may still get Coronavirus…good luck :). 

The Novel Coronavirus which originated in Wuhan, China could be considered one of the biggest news stories of the decade so far. While the virus began as an issue only isolated to China, the CDC (Centers for Disease Control) has now confirmed cases in 19 different countries. The virus spreads from person to person “via respiratory droplets produced when an infected person coughs or sneezes”. The most common symptoms of Novel Coronavirus are fever, coughing, and breathing difficulties. Since symptoms can appear two days to two weeks after exposure the disease continues to spread before the host even knows that they are sick. 

According to the New York Times, there are now more than 6,000 reported cases of Novel Coronavirus surpassing the previous SARS epidemic which hit China in the early 2000s. This has resulted in 132 deaths, none of those being outside of China. Airport screenings have begun in an attempt to keep the disease from spreading and the United States has evacuated 200 citizens from China. Other nations that plan to follow suit include: “France, South Korea, Japan, Morocco, Germany, Kazakhstan, Britain, Canada, Russia, the Netherlands, Myanmar and Australia”. One roadblock in tracking the disease has been a scarcity of test kits, which unfortunately means that the number of Novel Coronavirus cases and deaths is likely even higher than what is being reported. Another issue reported by The New York Times was a markup on face masks being sold in Beijing. Customers who were trying to protect themselves by covering their nose and mouth were being charged over $100 for a simple mask. 

As Novel Coronavirus continues to spread the CDC has come out with a list of preventative measures that could help decrease the risk of contracting the virus. One of the simplest things to do is to wash your hands frequently and refrain from touching your mouth, eyes, and nose with dirty hands. If you begin to feel sick it is important to stay at home and monitor your symptoms so that other people you may come into contact with while out do not get infected. Even if you think that you have been infected with Novel Coronavirus you should not go to the doctor and risk exposing others. The CDC instructs people to “call ahead and tell them about your recent travel and your symptoms”. Although the US has not declared Coronavirus a major threat at the moment this could change if the virus continues to spread. Reported cases are increasing every day and it is important to stay vigilant no matter how safe you may feel.