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According to Medicinenet, the FDA has approved many monoclonal antibody drugs, and this week I will be discussing belimumab also known as Benlysta. What’s a monoclonal antibody drug you may ask? Well, our bodies produce antibodies upon infection of viruses, bacteria, parasites, or other harmful substances that evoke an immune response to fight off these pathogens. Mednet explains that scientists can also create antibodies that fight proteins that attack normal tissues in those who have autoimmune disorders. These antibodies are synthetically made to mimic those of the immune system to attack antigens which could be key for cancer treatments and for autoimmune diseases.

In the FDA’s approved list of monoclonal antibody drugs, belimumab caught my attention because this drug helps stop B cell activity involved in patients with systemic lupus erythematosus (SLE), an autoimmune disease. In SLE, the host’s B cells attack self-tissues and evoke an immune response. The goal of belimumab is to stop B cells by inhibiting BLys protein in B cells which are necessary for survival of the B cells, so patients experience less activity of SLE due to fewer antibodies produced by B cells that would attack self-tissues. Since this drug is negatively impacting the B cells of the acquired immune response, it is possible that this drug will cause other infections and even increase the risk of cancer. Also, patients taking belimumab should not be administered live vaccines since the acquired immune response is suppressed by belimumab. Below, I have listed all the possible side effects of belimumab. SLE effects a patient’s heart, skin, kidneys, lungs, and brain with symptoms including rash, fever, chest pain, hair loss, joint pain, fatigue and sensitivity to light. As you can see in the list of side effects, itching, rash, leg or arm pain, and insomnia are all possible effects of the drug. In SLE, patients can also have these symptoms, and this drug is supposed to treat these problems, but it may cause worsened symptoms.  

• nausea,
• diarrhea,
• vomiting,
• stomach pain,
• fever,
• stuffy or runny nose,
• cough (bronchitis),
• insomnia,
• leg or arm pain,
• migraine, and sore throat.
• allergic or infusion-related reactions such as itching; swelling of the face,
• lips,
• tongue, mouth, or throat as well as
• difficulty breathing,
• low blood pressure,
• dizziness,
• fainting,
• rash,
• redness, or
• swelling of the skin.

I think that the creation of monoclonal antibody drugs could be a great way to stop autoimmune diseases and cancer. However, when looking at the side effects of the drug and the symptoms of SLE, I am leaning on the side of caution because this drug seems to treat symptoms of LSE, but also bring about new side effects and problems for the patient. I think with further research, scientists could be able to limit these side effects and create more beneficial outcomes for patients. I think it is one step closer to finding a cure for cancer or autoimmune diseases in which patients self-tissues attack and cause immune response. This is my last blog post and I have had so much fun getting to share my thoughts and hopefully inform some readers about the world of microbiology. XOXO Carley

In my last post, I discussed what this epidemic has been like for me, but this week I want to investigate COVID-19 and share some information about antibody responses and potential vaccines that scientists are creating. This strain of coronavirus has been named SARS-CoV-2 and can be spread via respiratory droplets, close contact, and can even be spread asymptomatically. Doctors have used information about SARS and MERS to help discover and compare the antibody response in SARS-CoV-2. In a preliminary study by Asian Pacific Journal of Allergy and Immunology, one patient showed IgM antibodies 9 days after the onset of the illness and class switching to IgG by 14 days. This knowledge will help scientists neutralize the disease with a potential vaccine. Also, Journal has found that coronaviruses evade immune detection and immune response.

We have learned in class that antibodies are unique and different ones recognize specific structures on an antigen and when they attach, a specific immune response is mounted to ensure destruction of the pathogen. The initial response produces mainly IgM antibodies. Then, after the infection, IgG antibodies are created to remember the specific bacterium or viral particle in order to respond stronger the next time. So, what does this mean regarding COVID-19? Biospace.com recently reported that the FDA approved of antibody tests to see if patients have recovered from the illness, mounted appropriate immune response, and therefore, cannot get the illness again. The test detects IgM and IgG antibodies, so if IgM antibodies are detected, this means that the infection is in initial phases while the presence of both IgM and IgG antibodies indicate the infection is in active or recovery phase. If the patient’s blood detects only IgG antibodies, this could mean the patient had the infection previously and recovered.

This test is good news because scientists and doctors can assess when people can return to work or if quarantine should continue. These tests will be used to collect the plasma of recovered patients to treat ill patients, and can also be beneficial for healthcare providers because they can test to see who has antibodies and allow those people to treat ill patients. I think this is amazing news because it will help to identify those who amounted an immune response and can be used to help patients. I’m curious as to how quickly the vaccine will be made for this disease as it is affecting many lives and has changed the world as we know it. Either way, scientists are working tirelessly to help and save the lives of others, and it’s so encouraging. Thanks for reading and come back next week for more microbiology news!! Stay safe 🙂

Recently in the medical community, researchers, doctors, and scientists are trying to develop new treatments to help with cancer patients. Specifically, by investigating the nature of dendritic cells, scientists have been able to hopefully develop vaccines for cancer treatment. The US National Library of Medicine describes dendritic cell based anti-tumor vaccines have been deemed safe for patients. The researchers have found that a subset of dendritic cells has been effective at activating cytotoxic T cells and natural killer cells which promote anti-tumor immune response. The goal of this immunotherapy is to kill cancer cells by exposing them to boosted anti-tumor dendritic cells. The cells respond with adaptive immune responses by allowing immunity to foreign antigens or tolerance to self-molecules.

Scientific Reports describes a study of PD-1 inhibitors for treating advanced or metastatic cancer. The clinical trial showed to be most effective for patients under 65, male, current or former smokers, no CNS or liver metastasis, no EGFR mutation, and had high PD-L1 expression. The goal of this drug is to inhibit immune checkpoints of pathways to stabilize advanced or inoperable cancers. However, at this stage it is difficult to determine the factors of patients that would benefit most from immunotherapy. The study did show that immunotherapy showed to be tolerated better than chemotherapy. The anti-PD-1 inhibitor therapy resulted in a higher risk of arthralgia, diarrhea, dyspnea, pyrexia, rash, pneumonitis, and pruritus. Since the study was a clinical trial, it is hard to determine the price point of this immunotherapy administered to patients.

I read other articles about researchers trying to develop immunotherapy to help those whose cancers have grown too fast and progressed past the point of chemotherapy being successful. I think this therapy is a genius way to slow or even stop cancerous cells from multiplying and is definitely a step in the right direction to cure cancer. I personally have had a family member lose their life to pancreatic cancer recently, so when I read about all of these new therapies and treatments, I am hopeful for the future of medicine. I hope that one day scientists and doctors will find the cure for cancer so it won’t affect the ones we love anymore. Also, I hope to read and research more about the different therapies and clinical trials to gain a better understanding of not only the immune system, but also the future of medicine.

I was in Phoenix, Arizona enjoying the sun and time with family when I received the email from the University that informed us our spring break was extended and classes would be online. Looking back, I probably shouldn’t have been traveling, but Arizona was not in a State of Emergency at the time we left, so we made sure to wash our hands and not touch our face. At the end of my trip, I came back home to Greensboro, North Carolina and I’m here now writing this blog post. The Coronavirus has changed our world as we know it and I just want to share a little about how I am adjusting. I also want to offer some encouragement in this unprecedented and anxious time.

For starters, I completely underestimated how much work I was going to have during online class. Since students can’t go to class to take exams, my professors have given more assignments to compensate for this. I am thankful to every one of my professors for trying their very best to educate students in a time where we can’t even be on campus, but I’m definitely adjusting to ways I can manage my time better. I love the daily walks from my bed to my desk to get to class though :). In some ways, this time has been difficult, filled with anxiety, and sad because I don’t get to see my friends every day, but it has also taught me so much.

COVID-19 has taught me to get outside more, spend more time with family whether that be cooking meals or playing fun games outside, and it has also taught me that healthcare providers are absolute heroes. While I am so thankful to be in good health during this time, thousands of others are fighting this virus with the help of countless doctors and nurses. They risk their health daily to help the infected patients and it has shown me that bravery, compassion, and strength prevail during vastly terrifying times. While we all want life to get back to normal, I hope this pandemic will teach us all to rely on each other during trying times. We can’t control what other things may happen in this world, but we can control our perspective, attitude, and willingness to help others when hardships come.

Also I found this meme and it really speaks to me right now and I hope it can bring y’all a laugh or two.

A report from CNN states that sexually transmitted diseases have been on the rise for the past five years in the United States. CNN looked to discover why the disease rates have increased and in an interview with Elizabeth Torrone, a CDC epidemiologist, Torrone expressed that just last year, there were 2.4 million infections, the most cases ever recorded in the United States. So, what has led to the increase in STD rates? CNN reports it is due to an increase of people getting tested and a change in sexual behavior like the declining use of condoms. Also, CNN reported that the National Coalition of STD Directors said that inclines in STD rates are also due to the lack of federal, state, and local funding.

The rise in sexually transmitted diseases has also given rise to antibiotic-resistant organisms. In particular, drug-resistant gonorrhea seems to be the most alarming cases according to Dr. Mark Mulligan, chief of infectious diseases at NYU Langone Health. CNN interviewed Dr. Mulligan and he expressed that gonorrhea could potentially become untreatable due to its high resistance. The CDC reports that gonorrhea is not resistant to only one class of antibiotics and it spreads easily as the disease is often asymptomatic. If gonorrhea goes untreated, this can lead to serious repercussions like ectopic pregnancy, infertility, and cardiovascular or neurological problems. The CDC is working to combat and prevent antibiotic-resistant gonorrhea by increasing investigations of gonorrhea cases, searching for different ways to fund nucleic acid amplification tests, and inform local and state health departments to more rapidly respond to resistance.

In my opinion, I think this goes back to education. In my previous post I explained that I was never taught that vaccinations were vital for the immunocompromised until taking Microbiology and the same goes for STDs. I believe that educating more individuals about the risks of sexually transmitted diseases and teaching preventive actions like monogamy, abstinence, and the use of condoms is imperative to stop the cases from increasing. When I first learned about gonorrhea, I was shocked that it often goes undetected because individuals do not often show symptoms. I think this shows that regular screening is also important and offering regular screening to those who cannot afford it would also be helpful at preventing these diseases.

Just in 2019 alone, the CDC reports that 2.8 million antibiotic-resistant infections take place in the United States and take the lives of 35,000 people. The report the CDC published categorizes antibiotic-resistant bacteria as urgent, serious, and concerning based on the level of threat. When I looked at the urgent cases of antibiotic-resistant bacteria, I recognized several bacteria we have studied in Microbiology. One that I wanted to focus in on is Carbapenem-resistant Enterobacteriaceae. The CDC explains that these bacteria are a serious threat in healthcare facilities and some Enterobacteriaceae can resist almost all antibiotics. An example of bacteria from this family is Escherichia coli.

So, what makes bacteria resistant to certain antibiotics? For the family of Enterobacteriaceae, the CDC explains that they have continued to develop ways to undermine the effects of antibiotics used against them. The Reactgroup.org expresses that antibiotic-resistant bacteria have the ability to combat the effects of antibiotics that once were able to kill them. This causes infections to continue and therefore, explain the losses of many people. These resistant bacteria are a threat now and Science Daily describes a new species of antibiotic-resistant bacteria found in the Enterobacteriaceae family in Sweden. Its name is Scandinavium goeteborgense.

In class, Dr. Kramer told us that these organisms are becoming resistant because we are receiving antibiotics even when we aren’t sick through intake of animal products. Now, farmers are putting antibiotics in their feed in order to make the animals fatter for production. Also, Dr. Kramer expressed that many companies claim to sell products that are antibiotic free, but this term means that the animals cannot have antibiotics in their systems a few weeks prior to being sold. However, the animals may have been fed antibiotics since they were born and only stop ingesting them close to production time. This is a serious threat to our health because even when we think we are choosing the right meat that is antibiotic free, it actually may not be the case. If the market doesn’t change, there will be increased risk of infection from antibiotic-resistant bacteria. Also, it is imperative that healthcare providers take special care when diagnosing patients and treating with antibiotics because patients may not have that specific disease that the antibiotics target.

We reached a new decade this past January and while the year 2020 promises hope and new technologies, medical advances, surgeries, or maybe new cancer treatments. However, around the world we have seen diseases from decades ago reintroduced to civilizations. Why is that? Well for citizens of the United States, each child can and should be vaccinated to prevent a disease like Polio from making a comeback, but with the rise of anti-vaccine supporters, Polio and other diseases can and has resurfaced. For countries around the world however, they may not have access to these vaccines, so it is important for organizations and others to aid and provide resources for the health of these individuals. So, how can we make a difference globally and right here in the United States?

In order to globally make a difference and to eradicate Polio, UNICEF has prepared global stockpiles of Oral Polio Vaccine (OPV) for outbreaks and in December 2019, 160 million doses were delivered globally. The majority of the supply went to Nigeria which saw outbreaks and also Zambia, Angola, Ethiopia. In 2019, Pakistan saw an outbreak of polio. The Polio Eradication Organization says the cases increased by 132 in one year. However, The Polio Eradication Organization expresses that Polio is a disease that can be eradicated in as little as a few years with vaccinations.

The World Health Organization explains the Inactivated Polio Vaccine (IPV) is a wild-type virus that has been killed with formalin and injected in three doses with booster doses. This vaccine has eradicated Polio in Scandinavia and the Netherlands, but recently countries have used Oral Polio Vaccine. I think to ensure eradication in the United States of this disease, we need to educate individuals about vaccinations and express the danger without vaccinations. Personally, I was unaware of how important it is to vaccinate children and to keep adults updated with vaccines until I began studying microbiology. Educating students at an early age can help promote routine vaccinations.

Could your gut health predict how many years you have left on this earth? Scientists think that our microbiome can explain more about our health than our some of our genes can. Science Magazine explains that Braden Tierney, a computational biologist at Harvard Medical School, has investigated the microbiome in his study that could potentially identify markers in both the microbiome and genes of patients to diagnose diseases. One reason our microbiome is a good predictor of our health is because it’s changed by our environment, so it can help diagnose diseases like type II diabetes that is also impacted by one’s environment. However, there is much to be learned about our microbiome and it’s unclear to scientists why it can cause death or disease, but scientists are eager to discover what our microbes say about us.

Due to new technological advances, scientists are able to examine the DNA of organisms without having to keep them alive. Phys.org explains that the Integrative Human Biome Project in 2014 has allowed scientists to begin investigating the complexity of the microbiome. Phys.org expresses that different factors contribute to the makeup of each individual’s microbiome. For example, family members are likely to share similar microbiome and factors like type of delivery at birth effects which bacteria colonize the newborn gut. Also, whether one is active and their diet can affect the microbiota. What else effects our microbiota and how do we maintain a healthy microbiota?

Phys.org also says that scientists think that cutting down fats and increasing fiber in the diet which feeds microbes can be beneficial. I think scientists should keep investigating the microbiome because it could prolong the lives of individuals who maybe are genetically predisposed to certain diseases. Also, cardiovascular disease and obesity are two of the leading causes of death in the United States, so discovering ways in which we can improve the health of our microbiota may be a way to combat these diseases. Overall, our gut health is important for not only digesting foods, storing energy, breaking down fats and sugars, but now scientists are discovering that it could be linked to diseases that lead to death. Maintaining a proper diet and exercise is very important for the overall health of individuals, so I am curious to see what scientists discover regarding the microbiota and ways we can improve it.

As we approached the new decade at the beginning of January, we also approached the peak of the daunting flu season. While it wasn’t the start necessarily, more people began to get that nasty headache, sinus congestion, fever, and chills we all know as the flu. This year, the CDC has estimated 8,000 deaths from the flu in the United States. The NPR Organization warns individuals in the United States that we should be more concerned about getting the flu than the coronavirus. Allison Aubrey from the organization suggests that the best way to fight against the flu is to get the flu shot and to wash your hands as frequently as possible.

The CDC explains that the 2019-2020 flu vaccine is comprised of H1N1 pdm09-like virus, H3N2-like virus, and Victoria lineage virus. The vaccine changes each year because the flu never stays the same from year to year, but normally lessens the risk of individuals getting it by 40-60%. If you or a loved one comes down with the flu, the CDC encourages that you get help from professionals who can supply flu antiviral drugs within 48 hours of when symptoms begin. Whenever I tell my friends and family to get the flu shot, they always respond with “well, I got the flu shot last year and still got the flu”. Yes, it’s true you may still get the flu if you obtain the vaccine, but this is because you could’ve already been exposed before vaccination, you have been exposed to a virus that wasn’t in this year’s vaccine, or your immune system still couldn’t protect against it. The CDC explains however, that getting the flu vaccine can reduce the symptoms and length of the disease if you acquire it! While protection isn’t guaranteed, wouldn’t you want your symptoms to not last as long?

The flu is a serious disease that unfortunately takes the lives of many individuals in the United States and across the world yearly, but we can protect ourselves and loved ones from fatal outcomes. It is also imperative that we get the flu vaccine so we can protect others who may be immunocompromised from ourselves. Also, making sure to wash your hands and surfaces regularly can prevent this disease. If we get the flu and spread the disease to a young child whose immune system cannot protect him/her as well, then we are only hurting that child because we made the decision to not become vaccinated. My goal here is to not guilt trip everyone into getting the flu vaccine, but this flu season, think about the children.

In response to Andrew Wakefield’s claim that the MMR vaccine leads to autism in children, the CMAJ-JAMC commented on its later retraction of the paper published in the Lancet. This claim that MMR vaccine leads to autism was retracted due to various aspects of the study including the small sample of 12 children in the Royal Free Hospital and School of Medicine. These patients had chronic enterocolitis and regressive developmental disorder. It was later discovered that the study was funded by lawyers who represented anti-vaccine parents. However, the council who reviewed the study found it to be unethical towards the patients involved in intense testing. Other parties against the study include pediatricians like Dr. Suzanne Lewis, who understands the risks involved with children not vaccinated. A reason for publishing the paper could be because the parents involved were so eager to find answers as to why their children developed autism and because it was popular in the media at the time to find causes of autism.

            Although the Lancet paper was retracted, the repercussions of such a study informing parents that vaccinating their children with the MMR vaccine causes autism could very well contribute to a decrease in children being vaccinated, and therefore, more outbreaks of the measles. Today, the CDC collected data from the World Health Organization that showed from January 1-July 31 of 2019, 182 countries reported 235,569 more cases of the measles than in 2018. The African Region, Western Pacific Region, and European Region were among the largest increases of cases. This disease is life-threatening and in 2017, caused 110,000 deaths according to the CDC. However, this disease is preventable if the individual is vaccinated. The CDC reports more than 21 million lives have been saved since 2000 because of the MMR vaccine. To allow awareness and prevention, the CDC is striving to deliver the vaccine across the world, supporting investigations of any outbreaks, and supporting immunization campaigns.

            So, what is contributing to the increased outbreak? The UNICEF Organization merely states that decreased vaccination rates leads to increased measles outbreaks. The measles is a highly contagious disease, so 95% of the population must be vaccinated to prevent the spread of the disease. UNICEF explains that decreased rates of immunization are due to poor health services, civil strife in countries, misinformation, and reducing awareness. However, the best way to prevent this disease is to vaccinate individuals and in countries like the United Kingdom, Ukraine, and the Philippines, there have been significant increases in disease outbreaks when the people were misinformed about vaccines.