Author: brookeni

The human immune system fights and protects our body from harmful antigens but sometimes it attacks parts of our body that are not harmful which is why drugs like Benlysta (belimumab) can help these mistakes in the immune response. When the foreign and potentially harmful antigen enters the human body, our immune systems react with B cells creating antibodies that can eliminate that antigen. However, the textbook describes that Georges Kohler and Cesar Milstein discovered a way to produce man-made antibodies in the laboratory. These antibodies are produced from a single B cell clone so all of the antibodies that are made from this clone are exactly the same, have the same characteristics, and only bind to one specific antigen. MedicineNet explains that these antibodies are called monoclonal antibodies because they only bind to one antigen and they are man-made from a B cell clone. Monoclonal antibodies can be created in the lab by injecting lab animals with an antigen, isolating the animal’s B cells, fusing those B cells with myeloma cells that can grow rapidly, and then isolate the antibodies created from the newly fused B and myeloma cell. 

An example of a monoclonal antibody is belimumab and the name given to this drug is Benlysta. This drug is used to treat Systemic Lupus Erythematosus (SLE). The Centers for Disease Control and Prevention (CDC) describes SLE as an autoimmune disease where B cells and other parts of the immune system attacks normal tissues in the body such as the joints, skin, brain, and lungs and causes inflammation. The side effects of this condition include sensitivity to the sun, pain, swelling, rashes, fevers, and more. MedicineNet describes that Benlysta blocks the B cell stimulatory protein and therefore reduces the B number of B cells that are creating the antibodies that are targeting normal tissues. This is targeted at the acquired immune response. This helps those with SLE because it is inhibiting factors that contribute to the attack on normal tissues. 

Benlysta is an intravenous drug that can help those with SLE but can also potentially cause serious side effects. GlaxoSmithKline (GSK) pharmaceutical company’s official website for belimumab, the FDA, and MedicineNet list the potential sides effects the drug: fever, chills, pain or burning with urination, cough, chest discomfort, chest pain, shortness of breath, cold sweats, itching, swelling of the face, anxiousness, fainting, low blood pressure, skin rash, suicidal thoughts, insomnia, nausea, diarrhea, stuffy nose, and depression. Benlysta makes a person more susceptible to other diseases because it is inhibiting the immune response that is also used to fight actually harmful invaders. GSK states that this drug can increase the risk of cancer because the immune system is inhibited and therefore can potentially allow for cancer to grow. Also, this drug can cause progressive multifocal leukoencephalopathy (PML) which is a serious brain infection. MedicineNet describes that live vaccines should not be administered while using this drug because it will be ineffective in creating B cells because this drug will inhibit those B cells. The acquired immune system is negatively affected because of actions of the B cells and their antibodies are inhibited. This blog post reminded me of the many commercials on TV that advertise these monoclonal antibodies and how much they can improve the lives of those who suffer from these diseases but…the majority of the commercials are often the lost list of side effects. This emphasizes that life with the drugs may not be that much better than without them.

The media surrounding Coronavirus is all over the place because, well, there is not much else to report on during this quarantine. It is so important to read valid information especially in uneasy times such as this one. Researchers and medical professionals are working so hard for all of us and I was able to learn about the things they are doing when testing people for COVID-19. An article in the Journal of Medical Virology was published at the end of February and explains the use of a rapid IgM-IgG antibody blood test. This test only takes 15 minutes and can easily be collected because it is a blood test. The other method of testing for COVID-19 is a virus nucleic acid Real-Time PCR that takes a lot longer and has higher rates of false negatives for the virus. 

The article explains that IgM is the antibody that is detected in the body as the initial line of defense in the immune system therefore indicating infection. The IgG antibody indicates a longer time since exposure because the body has been able to class switch to IgG antibodies. These researchers found that the combined IgM-IgG blood test has a sensitivity of 88.66% and an accuracy of 90.63%. This can be used to help properly diagnose those who have the virus and also diagnose people who may carry the virus in them but are asymptomatic. The Journal of Pharmaceutical Analysis also published an article this February that describes the immune pathogenesis of Coronavirus. This article further explains the role of IgM and IgG antibodies in the fight against COVID-19. It explains that the production of only IgM antibodies indicates a recent exposure to the virus, production of both IgM and IgG indicates that only some time has passed since exposure but the body is fighting it off, and only IgG indicates a long amount of time has passed since exposure. These antibody specific tests could be used to understand the immune stages of fighting the infection.

The Journal of American Medical Association published an article that studied women who gave birth with the Coronavirus infection. The study was only on 6 mothers who tested positive for the virus which is important to understand because small sample sizes can influence application to larger populations. With that in mind, they found that five out of the six newborns tested positive for the IgG antibodies for COVID-19. This is exciting for the future because antibodies are being passed down to new babies so that they can better fight the infection. Microbiology has opened my interest for understanding COVID and many other diseases. I would have such a different outlook and more anxiety about the quarantine but reading this articles has help create hope for the future!

I am fascinated by this week’s blog topic because dendritic cells and T cells do amazing things in our bodies, and I never knew exactly what was happening in my body until taking this class. The first article I found was published in the journal, Oncology Reports, earlier this year and it discusses the combination of dendritic cells and cytotoxic T-cells as therapy treatments for patients with breast cancer. This study used dendritic cells and activated antigen specific T-cells that were isolated from the blood of breast cancer patients. The cells were treated with IL-12 and IL-18 and the researchers used a lysate of tumor tissue for the antigen. The study found that the use of these autologous dendritic cells helped anti-tumor responses, increased memory cells that reduced relapse and spread of new tumors, and that this type of therapy is not harmful to the participants. There were very minimal side effects associated with this therapy but there were some instances of flu-like symptoms such as fever and fatigue but they quickly went away and were not severe. 

The other article I found was published in January of this year and it took a different approach to using dendritic cells for breast cancer therapy. This study explores the influence of dendritic cells pulsed with breast cancer stem cell (CSCs) antigens to then activate effector lymphocytes to kill breast cancer cells. This was done using the RNA of the CSCs and the researchers targeted the CSCs because they play a role in the resistance to treatment in breast cancer cells. The study found that the dendritic cells pulsed with CSC RNA activated cytotoxic T cells, helper T cells, natural killer (NK) cells, and natural killer T (NKT) cells. These activated cells also killed more cancer cells that dendritic cells that were not treated with CSC RNA. This study also did not address any bad side effects and emphasized that this therapy has the potential to improve the lives of those with breast cancer.

The cost of the dendritic cell therapy is not directly addressed in these articles because these research projects are funded, but it can be expensive to receive any type of treatment over a long period of time. Until these types of therapy are more well known and accessible will people be able to afford them regularly. These articles are truly some good news in light of everything that is happening in the world with COVID-19. Reading about these new types of therapy is so interesting and it creates hope for the future. It also makes me think about how research has been stopped because of Coronavirus and it makes me wonder how it will influence researchers and their progress on life saving treatments such as these.

I am at a loss for words about everything that is happening right now. I am a senior here at UNC and I cannot even believe that our last semester has been cut so short. I know and understand how important it is to not have the rest of the semester or graduation right now but it is still very sad to reflect of the memories that I will not be able to make with my friends. I am also worried that I will catch the virus and that there is not much I can do about it except to quarantine myself and wash my hands very often. The meme I included above is testing positive for missing the homies and this is how I feel because I just want to be back on campus with my friends enjoying our last semester. This weekend was especially hard because I am in Alpha Phi and we were supposed to have our last formal on Saturday. I also realize that these are small inconveniences and that I have so much to be thankful for and I am very lucky to have a safe home.

My home is in Cary, North Carolina so luckily, I am not far from UNC at all which has made me feel like this is less drastic of a change. Both of my parents are also working from home so we are with each other all day every day. I don’t mind it except for when they ask me if I should be doing my homework or studying because I am so used to being independent at UNC. I personally am having a hard time adjusting to online school as well. I love walking around campus and going to class because I learn best by listening and participating through in person classes. I easily forget things so I am stressed I will accidentally miss an assignment that is due online. I have been enjoying zoom but it is way easier to get distracted at home during the zoom meetings than it is when in class. Hopefully, as the semester continues, my professors will accommodate for the changes that coronavirus has brought for us students and that my last semester at UNC will end on a good note.

I also work at the YMCA in Chapel Hill and I used to work 9 hours every week. I have been doing this for over 2 years so this is one of the other big changes that has happened to me. I now have way, way more free time and energy than I did before. This time has honestly allowed me to pull away from my everyday stresses and relax a lot. When we did have in person classes, I would have class from 9:30 until around 2 or 3 and then only have about an hour to relax before going to work from 5-8. I now have free time to run again (and the weather is so nice), to spend time with my family, and cook nice dinners that I never had time to do before! I used to basically only each soup and sandwiches but now I make all kinds of things. I also have time to do all of my homework and enjoy the readings of my joint English and Anthropology class. For class, we had to read Edgar Allen Poe’s The Masque of the Red Death and it is about a deadly disease that is spreading around in the story. I was able to take the time to read it, enjoy it, and not be rushed. Also, this story especially has had me reflect on the pandemic and how scary this virus is for everyone.

Sexually transmitted diseases (STDs) are an extremely important topic to be discussed to adolescents and adults of all ages. Prevention is key to not only stop the spread of these diseases, but also to further prevent and protect people from irreversible complications that can occur when these diseases are left untreated. Also, as we have been discussing in class, the misuse or overuse of antibiotics can lead to antibiotic resistance and this can and is happening with bacterial sexually transmitted diseases. On January 6, 2020, Oxford Academic published an article under the Clinical Infectious Diseases journal that investigates the use of vaccines in protecting against gonorrhea. The article explains that there is evidence that two meningococcal vaccines have been observed to protect against  gonorrhea and that there is development of a gonococcal vaccine. These vaccines are very important because strains of gonorrhea are becoming antibiotic resistant so prevention is extremely essential. This article also assessed whether these vaccines would be able to fit the World Health Organization’s (WHO) goal of decreasing gonorrhea incidence by 90% from 2018 to 2030. Through their research this article found that even partially protective vaccines can decrease incidence rates of gonorrhea and help to combat antibiotic resistance through prevention. 

Antibiotic resistant gonorrhea is also being researched at Johns Hopkins School of Medicine. An article published in October of 2019 researches the use of ciprofloxacin as treatment for gonorrhea. This study was conducted in Baltimore, Maryland on 501 male participants. The study found that 32.4% of the participants strains of gonorrhea were resistant to ciprofloxacin and this antibiotic has not been used to treat gonorrhea due to this large amount of resistance. This article however, proposes that the reintroduction of ciprofloxacin as a treatment option could help decrease resistance to other antibiotics used to treat gonorrhea such as ceftriaxone and potentially increase effectiveness of this drug. There is risk that an emergence of more antibiotic resistance bacteria can occur through this type of research.

The Washington Post published an article in October of 2019 reporting that sexually transmitted infections such as chlamydia, syphilis, and gonorrhea are at the highest rates they have ever been in the United States. Another article, published in November of 2019 in the Sexually Transmitted Diseases journal, researched the influence of an enhanced partner notification strategy on the number of reported and controlled cases of gonorrhea in Nova Scotia, Canada. Gonorrhea can be seen to show no symptoms in women and may be one of the reasons why incidence increased after the enhanced partner notification so the spread of gonorrhea can be stopped and the partners can also be treated. They found a 2.9% increase in the number of cases from pre-intervention to post intervention. The findings from this article are so surprising because all around the world we see stigmas surrounding STDs and this stigma is so harmful to everyone because it only increases the spread of the diseases. It does this by causing people to not want to notify their partners that they have tested positive for a disease and that leaves the person to further spread the disease. Interventions, such as the one in this study in Canada, should be implemented everywhere to protect everyone and ensure better overall sexual health.

Antibiotic resistance is a major issue that is happening right now and many people do not know what exactly it is. Everyone is so focused on feeling better and worrying about the now instead of the future that bacteria is given many chances to develop resistance to the antibiotics we currently have. My own friends have shared only one dose of antibiotics because the full course of antibiotics was not finished after feeling better. I know that if this has happened a couple of times, even in my experience, it is probably happening more than we think as well. The importance of resistance should be available to everyone or else it will be too late and bacteria will be able to cause mass disease and we will have no weapons to fight those bacteria.

An article published earlier this year explains the evolution of Mycobacterium tuberculosis and its role in antibiotic resistance in Bamako, Mali. Multidrug resistant tuberculosis (MDR-TB) is becoming a major problem, especially in Mali, and this study observed the different lineages that the multidrug resistant strains were coming from and how they were evolving. The genotypes they observed had stemmed from Beijing, Cameroon, and Ghana and these are particularly virulent. They collected data from 76 patients with tuberculosis and found that 12% of the patients had multidrug resistant tuberculosis. This is a major problem because these resistant strains are then able to be spread to more people in the population and there are no drugs to help those who are sick. 

Another article conducted a study in Medellin, Colombia and observed 3 medical schools and their curriculum surrounding antibiotic resistance. The study found that about half of the students from all 3 medical schools did not feel that they had sufficient education in antibiotic resistance. This insufficient education was reflected in about half of the students when they were evaluated for their knowledge of treatment for urinary tract infections, upper respiratory infections, skin infections and soft tissue infections. This article is shocking to me because even medical students who are training to become doctors are not fully educated on antibacterial resistance so how is the general public supposed to know? Everyone knows that they should finish their entire course of antibiotics but many people do not because they do not think that this resistance will happen to them. Well, it is happening and it will not stop until it’s bacteria can survive!

Poliomyelitis is a highly infectious virus that infects the intestines and then the nervous systems in those who are infected. This virus is transmitted through fecal contamination of food or water that is then consumed. The World Health Organization provides key details about polio such as there are three types of polio (type 1, type 2, and type 3) and information about the types of vaccines. The Oral Polio Vaccine (OPV) is administered as oral drops and there are two different types. The trivalent OPV protects against all three types of polio and the bivalent protects against only types 1 and 3 because type 2 was globally eradicated in 1999. The other main type of polio vaccine is the Inactivated Polio Vaccine (IPV) and is administered by injection. According to the Centers for Disease Control and Prevention, the IPV has been the only polio vaccine administered in the United States since 2000 but the OPV is more common in other countries because the oral drops do not have to be administered by a health professional. The CDC states that the IPV requires 4 doses at 2 months old, 4 months old, 6 – 18 months, and the final vaccine dose between 4 and 6 years old. The IPV vaccine protects 99 out of 100 children who receive the proper doses from the polio virus and is a required vaccine under state law for children entering school. 

The British Medical Journal (BMJ) published an article on October 24, 2019 that described the announcement of the eradication of the type 3 poliovirus by the World Health Organization. It has been over seven years since a type 3 poliovirus has been diagnosed and tests of fecal matter have also not found any evidence of the type 3 virus. The BMJ also describes that in Pakistan there has been violence and murder against polio vaccine workers because false videos were made that accused the polio vaccine of causing sickness and fainting. These videos were found to be made by three private schools who do not support vaccines but the impact of these videos is still influencing Pakistan. This has led to a sharp increase in children not receiving the polio vaccine. 

The World Health Organization announced in November of 2019 that global leaders have pledged $2.6 billion dollars to eradicate polio and the final type 1 poliovirus strain at the Reaching the Last Mile Forum in Abu Dhabi. Polio is still found in both Pakistan and Afghanistan and the main organization that manages polio vaccination is the Global Polio Eradication Initiative (GPEI). The GPEI is tasked with providing access to vaccination to over 450 million children each year with the added barriers of parents refusing to vaccinate their children. The pledges are from all over the world such as from the United States, Germany, New Zealand, Spain, and many other places. The polio workers also provide other vaccines as well such as for yellow fever and measles and help information mothers of the importance of vaccinations.

Before taking microbiology, I had never thought about my own microbiome but in fact I had! I use probiotics daily and the effectiveness of these probiotics is still being studied. The microbiome is fascinating because the early development of it is essential to one’s health throughout your entire life. Recent research is also finding that the microbiome can change throughout life and is not only influenced in the first years of life. A specific study, in the Journal of Clinical Medicine, researched renal transplant patients that had received their transplant at least a year before the study and they compared the microbiome of those patients to healthy individuals. It is often reported that those who have received a renal transplant then suffer from chronic diarrhea and abdominal pain and these researchers investigate the microbiome’s role in these issues. The researchers collected fecal samples to extract DNA and genes for the 16S rRNA of the participants. The study found that individuals who had received a renal transplant had lower diversity in their microbiota along with higher levels of Proteobacteria and lower levels of butyrate-producing bacteria.

            The butyrate-producing bacteria are very important to gut health and also influence the effectiveness of regulatory T-cells. This can increase inflammatory responses that can be linked to this dysbiosis in the gut microbiome. Immunosuppressive drugs and antibiotics play a large role in the disruption of this microbiota but the addition of butyrate can help to balance the low butyrate-producing bacteria concentration in renal transplant patients to help with or prevent chronic diarrhea. When the microbiome is not is dysbiosis however, it helps us in the digestion of every single thing we eat…even if that thing may have toxins. Another study I found in Current Pharmacology Reports, it explores the ways in which the microbiome can chemically change ingested arsenic in the gut.

            This report includes that the microbiome can influence the toxicity of arsenic in the body and this is important because arsenic is an ingredient in some medications. It is also found in the environment and can be inhaled, it can contaminate water, it is found in soils, and can contaminate food. Although it has been found that the microbiome can alter arsenic, arsenic can also alter the microbiome. This report includes that the microbiome can be influenced by arsenic in energy metabolism and immune signaling. These researchers also suggest that more research should be done to investigate whether arsenic plays a role in the spread of antibiotic resistance genes when exposed to harmful bacteria. These two articles have explored the microbiome in specific scenarios and it has my mind thinking that there are probably so many things that can influence our microbiome. The future holds a lot of knowledge about the power of the human microbiome.

Here we are, back to school after summer and then after Christmas break and rather than enjoying ourselves and our classes we must worry about…the flu. The flu spreads every single year and causes death and yet people still do not get their vaccine and this in turn jeopardizes those who are unable to get it. The Centers for Disease Control and Prevention (CDC) provides weekly updates of the 2019-2020 flu season and we are currently in week 5 of data collection. The CDC estimates that at least 22 million people have been infected from the flu in the 2019-2020 season and 12,000 people have died from it. There are 4 types of the influenza virus and they are called A, B, C, or D. A and B are the viruses found in humans while C and D only cause mild flu symptoms or are observed in other animals such as cattle. However, there are hundreds of subtypes, clades, and sub-clades of the flu and this virus is able to change each year with antigenic shift. This causes the flu vaccine to be helpful but not necessarily prevent the flu because it does not exactly match the exact flu each year.

A policy statement from the American Academy of Pediatrics released recommendations for the 2019-2020 flu season in October of 2019. The 2 types of flu vaccine include the inactivated influenza vaccine (IIV) and the live attenuated influenza vaccine (LAIV) and everyone over the age of 6 months is recommended to receive a flu vaccine. This statement provides information on the vaccines that are most safe for each age group and targets hesitations to receiving the vaccine such and with immunocompromised individuals or those with egg allergies. Is recommended that those who are in close contact with immunocompromised individuals to either receive the IIV vaccine or wait at least 7 days after receiving the LAIV before coming into contact with those individuals. It also states that those will an egg allergy can safely receive either vaccine so this should be not a barrier.

The CDC also reports of the effectiveness of the flu vaccines each year. For this year, the overall effectiveness is 38%. The vaccines are predicted to be 62% effective against the A[H1N1]pdm09 virus, 22% effective against the A[H3N2] virus, and 50% effective against the flu B viruses. The 2019-2020 vaccine contains hemagglutinin (HA) from an A/Brisbane/02/2018(H1N1)pdm09-like virus, an A/Kansas/14/2017(H3N2)-like virus, and a B/Colorado/06/2017-like virus. The CDC also recommends receiving the vaccine before the rates of infection are high because then the body has less time to recognize the vaccine before the body is exposed to the virus. Those who are at increased risk of complications from the flu virus should take special precaution to receive their flu vaccine so that if they are exposed to the vaccine they have taken measures to prevent these types of complications. The flu can range from 2 awful weeks of body aches, stuffy nose, cough or it can lead to death which is why the vaccination and awareness of the flu should be taken very seriously.

            On February 6, it was announced that the CDC has created a portable flu testing kit that cuts for on-site detection of the flu. This kit is called Mobile Influenza Analysis and it amazing because it cuts the time necessary to identify flu viruses in half. Hopefully more advances will be made in the future to help diminish the mortality rate of influenza and help those who are susceptible to complications be protected from it.

The Novel Coronavirus is happening and spreading rapidly throughout the world right now. According the World Health Organization’s (WHO) website, there are many different types of coronaviruses that cause respiratory infections. These infections range from colds to Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV). The novel coronavirus (nCoV-2019) was first reported in December of 2019 in Wuhan, China and has now spread all over the world including reported cases in the United States, Sweden, Thailand, Spain, and many more according to the Centers for Disease Control and Prevention (CDC). This spread has been reported to be from traveling from Wuhan, China. Coronaviruses are zoonotic viruses and this means that they are transmitted between animals and humans according to the WHO. The novel corona virus has been found to stem from bats and the full genome of the virus has been mapped.

The novel coronavirus has been found to be a betacoronavirus, similar to SARS and MERS, as described by the CDC. A research study published in The Lancet on January 24, 2020 confirmed the transmission of the novel coronavirus from person to person and not only from animal to person. These researchers were able to study a family that had traveled to Wuhan and then came into contact with another family member that had not be to Wuhan and that family member also became infected with the novel coronavirus. Person to person transmission is defined by the CDC as through respiratory droplets of an infected person leave their body in coughs or sneezes. The CDC reports that the symptoms of nCoV-2019 include fever, cough, and shortness of breath and it has an incubation period of 2-14 days.

The CDC has last updated information on the novel coronavirus on January 31, 2020 and has confirmed cases in the United States in Arizona, California, Illinois, and Washington. This outbreak is extremely important to stay up to date on because prevention is fundamental to stop the spread of this virus that we do not have a vaccination for at this time. The CDC has provided precautions for the general public and for health care providers but I think it should be discussed more in schools and colleges. I knew how diseases spread but I did not truly understand until my first or second microbiology class and this information needs to be available to everyone, not just those who are able to take microbiology. In a crisis such as an outbreak it is extremely important to protect yourself and others from potential spread of disease and to contain the disease for further study.