Author: morganodendahl

The monoclonal antibody drug that I have chosen to discuss is Stelara (ustekinumab). A monoclonal antibody is an antibody manufactured in a lab from a specific human antibody-producing cell. Stelara treats Crohn’s disease by targeting elevated levels of IL-12 and IL-23 that causes inflammation in the GI tract. The drug prevents these interleukins from binding to T-lymphocytes. Because we understand the causes of Crohn’s disease, it is amazing that it is possible to target on such a microscopic level the cause of disease. With more normal levels of these specific cytokines, it would surely be a relief for Crohn’s patients to experience reduced symptoms.

However, there are side effects associated with taking this drug. Some of these side effects include nasal congestion, sore throat, runny nose, upper respiratory tract infections, fever, headache, tiredness, itching, nausea and vomiting, redness at the injection site, vaginal yeast infections, urinary tract infections, sinus infection, bronchitis, diarrhea, stomach pain, and joint pain. I believe that there is still great benefit to taking the drug despite the risk, but of course one should always consult their doctor. Unfortunately, the drug has also been described as increasing the possibility of other infections like tuberculosis, cancers, or other bacterial, fungal, or viral infections due to its weakening of the immune system. Based on what we have learned in class, I can probably conclude that this is due to T-lymphocytes being inhibited from the drug.

Because this drug involves T-lymphocytes, the innate immune response is both being positively and negatively impacted. On one hand, the monoclonal antibody brings balance back to an immune system that was producing too much interleukins. On the other hand, the innate immune response must be inhibited in order to do so. In my opinion, a healthy individual should just be more wary of contracting illness when they take the medication. otherwise, this monoclonal antibody drug can help them lead a more normal life!

Well, here we are in April 2020, still dealing with the novel coronavirus, a.k.a COVID-19. While we have never faced anything like this before, the scientific community has done its best to develop new tests to determine how we can best fight this invisible enemy. One of the newest developments has been the use of antibody testing for those who have had the virus. Two of the antibodies that these tests look for are very familiar to those of us in Dr. Cramer’s Medical Microbiology: IgM and IgG. I’m so glad that we recently covered these antibodies in class so that we can understand just what the presence of these antibodies means.

We learned in class that when B cells are only partially activated (they have only received Signal 1), they can only make IgM antibodies, which are not very specific antibodies. According to a New York Times article, IgM levels sharply increase a few days after one has been infected with coronavirus, and IgG levels are at their highest around 28 days. As microbiology students, we can make the connection that if someone had only IgM antibody titers, they are early in the stage of infection. The body would then start to make more and more IgG after the B cells receive their second signal, and eventually IgM would stop being produced. This would be a gradual process.

But what would it mean if someone had a primarily IgG titer, or they were IgG positive? According to an article from Science News, after about 10 days of being infected with coronavirus, you are not likely to infect anyone else. This means that at 28 days when IgG levels are at their highest, they are in the late stage of infection, and probably won’t infect others. So, if we could determine who is IgG positive, it would be an absolute game changer. We could try to cure those fighting coronavirus using antibodies in the blood of those who have already become healthy again. My hope is that recovered individuals will volunteer to have their blood tested, and that antibodies are the answer to helping coronavirus patients!

How great would it be if we could find a new, efficient way to treat cancer? And how much GREATER would it be if we could treat it using cells found in the patients own blood? Scientists are now using something known as Chimeric antigen receptor (CAR) T cell therapy to treat hematologic cancers. According to a journal article from Oncology Reports, CAR T cell therapy involves taking T cells from a patient’s blood and engineering them so that they express the specific receptors for a tumor antigen. How crazy is it that we have the technology to do something like that?! It sure is great to live in the 21st century!

So how effective is CAR T cell therapy? The same study found that there was a 6-month survival rate of 89% (Rimjhim et al). This result is astounding! It is very encouraging that technology is enabling us to effectively treat diseases like this that we’ve never been able to before. However, there are some pretty big concerns surrounding CAR T cell therapy still. According to a similar journal article from The New England Journal of Medicine, there are some pretty serious side effects, including cytokine release syndrome and neurological events. Clearly, more research needs to be done about how we can use technology to treat cancer while avoiding such undesired effects.

But if the side effects alone aren’t enough to convince you that T cell therapy needs to be improved, take a look at the costs. The study in Oncology Reports found that when you consider all of the hospitalization and drugs related to the treatment are considered, a single cancer patient can face $1,500,000 in bills (Rimjhim et al). That’s for ONE person! I’m starting to think it may not be worth it when considering how harsh the side effects are! One thing is clear: before CAR T cell therapy goes into widespread use, side effects must be diminished and costs must go down. It is impressive technology, but I’m confident that over time, we can make it even better!

These last few weeks have felt like the longest of my life. Just 3 weeks ago when Dr. Cramer said in class that she “might end up having to give lectures online,” I thought she was crazy. Yet less than 3 weeks later, here I am, doing all of my coursework from the old table in my family’s bonus room. I haven’t left my house in 4 days. I’ve completely moved out of my dorm. It’s so weird to have this period of such uncertainty, and so far I don’t really know how to feel.

I haven’t gone stir-crazy quite yet, but I have no doubt that I will experience those feelings if we have to social-distance ourselves for weeks and weeks and weeks. I’m pretty introverted and tend to stay home a lot anyways, but even I have a breaking point. I keep thinking of more and more things that we’re missing out on because of all of this — but I’m trying not to focus on it. I feel bad for businesses that are being hurt by being forced to close, and I really hope that there will be no long-lasting effects on the economy. I’ve been looking at the Dow Jones almost every day. I’ve also been trying to keep up with the latest the news about COVID-19. The Daily Tar Heel has a really helpful interactive map that tracks the number of cases in North Carolina and it is updated every day.

So what else have I been doing all this time? For the first couple weeks (during our extended “spring break”), I did a whole lot of nothing. A little bit of homework, but not much. After I found out that I’d have to stay home indefinitely, I’ve been doing a little more. I’ve been pretty diligent with my online classes and assignments. I’m still a little overwhelmed with all of the changes to my courses, but I’m attempting to stay as organized as I can to keep track of everything. I try to find some time to relax with a TV show here and there. Every Wednesday I look forward to the newest episode of Survivor on CBS. I cleaned out my closet, and I’m still in the process of organizing everything I brought home from my dorm. Finally, I try to have at least one phone call a day with a friend. It’s nice to hear someone else’s voice that isn’t a member of your family. It all just feels like a game of wait-and-see-what-happens. Until we know, I’m just chillin’.

STDs are something we’ve all heard about and been warned about before. We all seem to know how to prevent them, and yet they still exist. Recent numbers are even more alarming, specifically regarding syphilis. According to a 2019 press release from the CDC, cases of syphilis increased 14 percent from 2017 to 2018, and congenital syphilis increased a whopping 40 percent. SYPHILIS?! Why, in the 21st century, is there an uptick in this disease which is considered by many to be so ancient?

According to the same CDC report, the reason for this outbreak is due to many reasons, including inadequate use of condoms, cuts to STD programs, as well as reduced access to STD prevention and care due to drug use, poverty/inadequate housing, and just plain stigma. Now I will admit, when I first read this report, I was quick to assume that people were being just stupid and carelessly having unsafe sex. But after reading more, it seems to me like we as a country have neglected our emphasis on ensuring people have the means to practice safe sex. If we can’t provide people with proper sex education or the proper protection, no wonder the number of cases is exploding! The government should work on more programs to fix this problem.

The most heartbreaking information to me comes from the discussion about the cases of congenital syphilis. This is syphilis passed from a pregnant woman to her baby. According to a CBS News article, newborn DEATHS from congenital syphilis increased 22 percent within this same time period. This is heartbreaking. Apparently health officials are pushing for pregnant women to be tested before giving birth. While I agree this is important, I think the MOST important focus of resources should be on prevention of the disease in the first place. One thing that I think is pretty important is good Sex Ed programs in schools. People should not have to die from this disease, especially not innocent newborns who have no control over whether they contract this disease or not!

When I was about 8, I had a tonsillitis-like bacterial infection. I had a fever of about 102 and felt like crap, but I went to the doctor, was prescribed an antibiotic, and felt better in a matter of days. But recently, it’s been looking more and more like there will come a day when this can no longer happen. This is because of antibiotic resistant bacteria commonly known as “superbugs.” According to an NPR broadcast from Richard Harris, one superbug, called pseudomonas, resides in the host permanently as most antibiotics are ineffective to it. The broadcast also reported that gonorrhea, along with other very common bacteria, are now even more antibiotic-resistant. This is the scariest part to me. What will happen if we can’t even treat some of the most common bacterial infections that affect people every day? It will be as if we were back in the days when we did not have antibiotics at all.

So is there a plan to stop the fast progression of antibiotic resistance? Scientists are currently coming up with experimental ideas of how to fight back against antibiotic resistance. Some of these ideas include prescribing smaller doses, using multidrug combinations, or switching the kind of drug used every 12 to 24 hours so the drug does not have time to become resistant (Harris). I think these tactics are worth exploring, especially since things will just continue to get worse if we keep abusing antibiotics the way that we are. Antibiotics are just another thing that we take for granted in this day and age. We’re too spoiled!

Another big reason for growing antibiotic resistance is due to the farming industry. According to an article from CNN Health, farms often give their livestock antibiotics in order to make them fatter and produce more meat to sell, and fifteen of America’s fast food chains were given “F” ratings for their use of food products with antibiotics. I’m sure many people don’t even think about the fact that they are consuming antibiotics and contributing to a huge problem when they chow down on a Big Mac. It’s pretty gross and underhanded that the farming industry is allowed to do this, and there should be some sort of crackdown on the heavy use of antibiotics like this. Save us from the Antibiotic Resistance Apocalypse!

When I think of polio, the first thing I think of is Franklin Delano Roosevelt. I think it says something that the first case of polio that comes to mind for me is one from so long ago. But for many developing countries around the world, polio is not quite something that is a thing of the distant past. According to a CNN article, countries like the Philippines, Pakistan, and Afghanistan are experiencing cases of vaccine-derived strains of polio as of recently, and organizations like the WHO and UNICEF are pushing for participation in synchronized polio vaccination. But what does this mean? Some might think that receiving the polio vaccine is GIVING people polio. It’s a LOT more complicated than that. Let me explain.

There are two types of polio vaccinations. The first type is known as the inactivated polio vaccine (IPV). According to a systematic review from Cochrane Systematic Reviews, the IPV is the slightly less affordable option for polio vaccination, which is why it is not used as much in developing countries. The other type of vaccine is the oral polio vaccine (OPV). OPV is the attenuated vaccine, and is more effective at eradicating wild polio virus than IPV, but it is more likely to mutate and cause paralysis since it is a piece of the weakened virus (Cochrane Systematic Reviews). This is exactly what’s going on in the Philippines, Pakistan, and Afghanistan. To me, it seems that BOTH the IPV and OPV are essential in eradicating polio, and we should be using the synchronized polio vaccination (with both OPV and IPV) that the WHO suggests. If it were me deciding on world health issues, it would give me a lot more peace of mind knowing that both were being used in conjunction with one another to minimize risk.

Knowing what we know about the OPV and IPV, as well as trends in polio cases recently, first world countries should step up to help in the fight to fully eradicate polio and vaccine-derived polio elsewhere. We should prioritize fundraising for organizations who aim to provide the synchronized polio vaccine to countries in need. We do not want to live in a world in which these previously-eradicated diseases begin to crop up again and threaten lives. This is a preventable disease, people! We also need to make sure that people are vaccinated here at home as well, and raise awareness about how this disease can affect people. Don’t send the world back into the 1940s!

Right now, inside your gut, there’s thousands upon thousands of microorganisms. Pretty creepy, huh? But don’t worry. It’s a good thing. As more and more technology becomes available, we’ve been able to learn so much more about how our microbiome affects our health. Let’s start with how the microbiome helps us. According to a journal in the Journal of Nutrition, consuming a diet of high fiber aids Prevotella bacteria growth in your gut, which in turn aids in weight loss. That’s right, if you feed your gut bacteria healthy food, they’ll help you lose weight and maintain a healthy metabolism!

So stock up on all those high-fiber fruits and veggies, because it’s obvious that having healthy gut bacteria means a healthier you. But what would happen if instead of feeding these healthy gut microbiota, you eliminated them? Premature newborns are usually given antibiotics after birth, but according to a study from the Washington School of Medicine in St. Louis, good gut bacteria are eliminated when this happens, allowing more disease-carrying and antibiotic resistant bacteria to proliferate. Basically, this means you need that good bacteria in your gut, or else the bad stuff will take over and put you at risk later down the road. This is a good reason why we should be careful to not over-prescribe antibiotics, because we don’t want to be overtaken by mutant antibiotic-resistant gut bacteria. Totally messes with the whole healthy microbiome thing.

Where does this bacteria come from, though? Some of it you have acquired as soon as you are born. However, according to a CNN report, babies delivered via C-section miss out on some of the good microbiota that they would encounter had they passed through the vagina. More research needs to be done about how we can make up for this if a C-section delivery is medically necessary. It just goes to show how important our microbiome is! Do everything you can to promote your healthy guy bacteria today! Eat your fiber, and don’t take too many drugs (antibiotics).

Coughing. Fever. Aching. Generally feeling like crap. For many, these are the classic signs and symptoms of the dreaded influenza that is so common this time of year. The last time I had the flu, I experienced all of these symptoms. It was December 2012. One week prior, I had just received the flu shot. But when I arrived at urgent care, I tested positive for Influenza A. It turns out that this year, general trends reflect my own former situation. NBC News has reported that this year, there has been an uptick in diagnoses of influenza A, and in this flu season alone, 68 children died of the flu while 180,000 people have been hospitalized. The report also indicates that one of the best ways to protect yourself from falling victim to the flu is washing your hands.

But what happens if, like me, you get vaccinated, and you find yourself sick anyways? According to a CNN article by Elizabeth Cohen, scientists have not been able to develop a flu vaccine that adequately fights this season’s strain, as it is only 58% effective. However, the report goes on to add that even though the protection from this year’s shot is limited, you should still get vaccinated since some protection is better than no protection. Personally, I’d willingly find one of the many places that offers FREE flu shots and get vaccinated if it meant that my case of the flu was even a little bit alleviated. Especially since we won’t know for sure EXACTLY how effective this year’s vaccine was until after flu season is already over (Cohen).

Just get vaccinated. It’s worth it. There’s a reason why I’ll have to receive the flu vaccine every year if I become a health professional. Because even a little protection is better than no protection. When you’re laying in bed, having to call off work or miss an important class, you’ll always be wondering what that flu vaccine could have done for you. If nothing else, do it for those who may be immunocompromised and can’y afford to catch the flu from someone like you. We can’t cure the flu, but we can sure as heck try to make it suck just a little bit less.

So I’m sure by now most people have heard the jokes about vaccinations and autism all over social media. Maybe you’ve heard of the “anti-vax” parents who refuse to vaccinate their children out of fear that they’ll become autistic. But where did talk like this originate? Back in 1998, Dr. Andrew Wakefield published a study in which he claimed to have found an association between the MMR vaccine and the development of autism in children. According to an article from the Canadian Medical Association Journal written by Laura Eggertson, Wakefield included 12 children (11 boys and 1 girl) as the participants of his study, all of which had been referred to the Royal Free Hospital for chronic enterocolitis and regressive developmental disorder. They were each carefully selected for this particular study. Immediately, the design of this study raises red flags to anyone who’s taken any basic science course and learned anything about experimental design. Twelve participants? Even if the rest of Wakefield’s study was purely honest, transparent, and flawless, it’s pretty clear that 12 patients are not nearly enough to represent an entire population. Facts about the study like these tell me one thing: members of the Anti-Vaccination movement have not truly read this study and critically evaluated it.

Another alarming revelation about the study are the apparent motivations behind it. Lawyers on behalf of parents suing vaccine manufacturers paid Wakefield to conduct the research (Eggertson). This revelation blows my mind. The fact that parents and doctors (both of whom are supposed to care for children) would exploit children like this is absolutely horrifying. As someone who may have my own children someday, I would want to ensure my doctors were telling me accurate information in the best interest of my child. According to another article from the Indian Journal of Psychiatry, other scientists immediately began publishing their own epidemiological studies which refuted Wakefield’s claim that there was a link between the MMR vaccine and the development of autism, and The Lancet retracted the entire article back in 2010. At the VERY least, Wakefield’s study is obviously questionable. The Lancet has truly tarnished their reputation for publishing an article in which was clearly not reviewed properly. Wakefield’s study has far too many weaknesses.

Despite the gross illegitimacy of Wakefield’s report, it has had a huge impact on parents’ decisions on whether or not to vaccinate their children. According to a CDC report, in 2019, there were more worldwide cases of the measles from January to July than in any year since 2006. To combat this, the CDC participates in the Measles and Rubella Initiative in order to promote immunization and prevent outbreaks. When I think about how common these outbreaks are becoming, I think about people who lived in a time before vaccines like MMRV were available. If you could go back in time and tell a person living in the 1800s that all they had to do to protect their child from dying from chicken pox was a simple shot, I think any one of them would take it. These diseases are preventable, and there is absolutely no reason why people should have to die.