Author: gracesigmon

The topic of this blog will not be the coronavirus (surprisingly), but rather, a monoclonal antibody drug called Reopro, or Abciximab. (Abciximab is way too hard to write over and over so I’m just going to call it Reopro). However, before I get into the specifics of this drug, what exactly is a monoclonal antibody? According to Medicinenet.com, monoclonal antibodies are synthetic antibodies, generally made in mice, that function like normal antibodies by protecting humans against one specific pathogen. Basically, the ‘mono’ stands for ‘one,’ the ‘clonal’ for the fact that they are clones, and antibody for, well, its pretty obvious.

Moving on to Reopro, what does this specific monoclonal antibody do? Well, you’re in luck, because I’m about to tell you. According to its manufacturer, Reopro is used to prevent complications when people have percutaneous coronary intervention, otherwise known as heart surgery. By “prevent complications” I mean it keeps the patient from developing blood clots. Reopro is essentially a blood thinner that works by binding to a receptor on platelets (called a glycoprotein IIb/IIIa receptor) and preventing them from clotting. Because this is a blood thinner, it does come along with possible bleeding-related side effects, including:

• internal bleeding
• GI/GU bleeding
• cerebrovascular accident
• bleeding diathesis
• thrombocytopenia
• Intracranial neoplasm
• arteriovenous malformation
• aneurysm
• hypertension
• allergic reaction

Essentially, this drug can make you bleed when you shouldn’t because it thins your blood. However, considering the side effects of ‘complications’ of percutaneous coronary intervention (including heart attack and death) it seems like it is worth the risk to take it. Additionally, none of the articles I read mentioned anything about this drug impacting the innate or acquired immune system. (Though its desired effect of lowering platelet clumping does interfere with the innate ability to prevent bleeding). I did not read anything about this drug increasing susceptibility to another pathogen either. On the whole, it seems like a desirable option for preventing blood clots.

Coronavirus is pretty much taking over the world right now, so it is safe to say that this blog is going to be a Covid-19-themed blog for the rest of its short existence. The topic for today is a new type of test that was just recently approved for Covid-19. Wait! Some of you (literally only my grader) may be thinking. I thought there were already tests developed for Covid-19? Why are we using our resources developing tests instead of on a vaccine or treatment? Well, my very interested reader, this type of test is different from the previous types and has its own unique advantages, much like the new queso blanco at Chipotle compared to their original queso, neither of which I can eat right now. (I also feel it is pertinent to note at this point how different my tone is in these later blogs compared to the first. I may be going slightly insane at this point in the quarantine… but hey, at least is will make for a little bit more interesting of a read for my grader.)

Anyway, returning to the point. According to Healthline.com, this new test from the company Cellex was approved on April 1st, and it is done through a finger prick instead of a throat swab. Essentially, this test looks for antibodies in the blood that would indicate you had been infected with coronavirus in the past, unlike other tests that determine if you are presently infected. According to a fact sheet by the FDA, this test specifically looks for the antibodies IgM and IgG. If only IgG is in the blood, then you know that you likely had coronavirus in the past, but probably don’t have it now, as IgG antibodies are formed later in the infection and are only unaccompanied by IgM at the very end of an infection or after an infection. However, if IgM antibodies are also in the blood, it is likely you are still carrying the disease as IgM tend to wan off near the end of the infection. Finally, if you only have IgM, this indicates that you are at the beginning of an infection and are likely still contagious. In summary, this test is most useful for figuring out if that ‘cold’ you had a few weeks ago was the coronavirus.

Why would this be helpful practically? If you are already over the sickness, why does it matter if it was covid or the flu? Well, determining if you had covid -19 can be helpful in identifying who you were in contact with during your sickness so that they can quarantine. It can also be helpful in adding to statistics on this disease, helping researchers learn more about how it spreads. Over all, this test seems like it has useful applications, and due to its fast return time of 15 minutes, it should be helpful in identifying and slowing this disease.

I love eating at Chipotle. One of the reasons I like this restaurant so much is that you can personalize your meal so you don’t have to have certain ingredients (I’m looking at you sour cream) in your food if you don’t want them there. You can build a rice bowl exactly how you want it. *I’m not a sponsor, but if you’re reading this, Chipotle, please contact me.* What if we could personalize medicine in the same way we personalize our Chipotle orders? It now seems as if this is possible through dendritic cell therapy.

Dendritic cell therapy is a relatively new form of therapy that is used to treat cancer. According to one article, DC therapy consists in vaccines that work to improve the body’s immune system by “presenting and activating specific antigens at the tumor site.” By so doing, DC vaccines activate T cells to start an immune response while also avoiding the uncomfortable side effects of traditional cancer treatments, such as chemotherapy. Because of this, there has been a lot of research put into this form of therapy recently, meaning that there are many different version of DC vaccines available or currently being tested. One such vaccine being researched is a DC nano-vaccine that is meant to target Ovarian cancer, the most lethal type of reproductive cancer in women (according to the CDC). This vaccine is dubbed a “mini vaccine,” and has been shown by a recent study to be more effective than traditional DC vaccines. Another recent study proposed that a preliminary injection of OC-DC (DC vaccine containing autologous oxidized tumor lysate) would helpe ‘prime’ T cells to better receive another DC vaccine called PEP-DC when treating ovarian cancer.

Over all, DC vaccines seem pretty great. Unfortunately, unlike Chipotle, they are not affordable. In fact, Provenge (the first DC vaccine to be approved) costs $93,000 for the three infusions (according to FierceBiotech). I don’t have that kind of money, and neither do most other people. It seems (like most things in life) that this form of treatment would be much improved by making it cheaper.

Today is World TB Day. Honestly, I did not know that World TB Day was a thing until yesterday. However, it seems appropriate that this little-known holiday falls today considering TB is one of the diseases I am currently studying. I also recently had to go into an urgent care (which was quite a risky feat in the quarantined world we live in now) to get a TB test done for a summer job. Basically, TB (like another disease right now) is making itself fairly difficult to ignore.

Indeed, when I did a quick google search of TB, a news article came up that reported a TB case in early February at a high school in Durham. This (literally) hits close to home as I live somewhat near Durham. It is also pretty shocking to read about a case so near where I live considering that TB is actually a fairly rare disease. According to the CDC, TB only had a reported rate of 2.7 cases per 100,000 persons in the US in 2019. Following the identification of a case of this rare disease in Durham, those who could have come into contact with the infected person were screened to prevent transmission.

Early identification and treatment, like the the type exemplified by the school officials in Durham, is an effective method for reducing spread of this disease. However, many organizations are working not just to reduce transmission, but to implement broad-based plans and strategies to completely remove TB from the face of the earth. One such organization is the World Health Organization (WHO). In their published strategy to end TB, they mention 3 key pillars to ending TB: integrated patient care and prevention, bold policies and supportive systems, and intensified research and innovation. Relying on these pillars and the actions they entail, WHO hopes to effectively end TB by 2035. This sounds very hopeful, but only time will tell if their strategies are successful.

So far this blog has focused on the scientific aspect of microbiology. Today, I’m going to focus on how a specific microorganism has drastically affected my life. Over the past several weeks, a strain of the coronavirus called Covid-19 has spread greatly in the United States leading to school, restaurant, library, park, etc, closures. Because of this virus I got an extra week of Spring break but I am also now quarantined at home for the foreseeable future. Right now it kind of feels like I am living in the movie Contagion, but instead of raiding stores for any viable form of nutrients, people seem to primarily want TP.

Because we can no longer return to campus, almost all classes have moved to an online format using Zoom. I had my first 3 Zoom classes today, all of which went remarkably better than my practice Zoom call of last Friday. However, that was not a very difficult feat: I ended my practice call on the verge of punching something (Andy Bernard-style). Actually, that’s not completely true. I never actually made it onto the practice call because I never got it to work. Yay me!

However, there have been some nice aspects of being quarantined at home. I have gotten to spend a lot of time with my family watching movies, doing puzzles, playing board games, going for walks, and baking. (Basically I’m living the dream life of a 75-year-old.) It is also comforting to know that I am doing all I can to keep not only myself safe, but all the immunocompromised people around me, such as my grandparents. Sometimes we have to be willing to be uncomfortable and deprived to help those around us. I think this mentality is something our country drastically needs, and hopefully this awful virus will at least have the good effect of returning a bit of this unselfishness to the US.

The Coronavirus has been taking over the news for some time now. However, for me personally it has been somewhat easy to forget about it due to a busy school schedule. Thus, it was fairly shocking to hear that so many of my friends who are traveling to Florida for spring break are expected to self-quarantine for two weeks when they return due to Covid-19. This led me to become quite alarmed over the severity of this disease. Additionally, it led me to research just how much this epidemic, or really, pandemic, has spread. Should these students really self-quarantine, or is the whole situation being overblown?

The CDC has currently issued level 3 travel warnings for China, Iran, Italy, and South Korea. However, it appears we no longer should just be afraid of contracting Covid-19 through international travel. According to an update by the CDC, there are currently 20 cases of covid-19 in the US that are due to person-to-person spread alone! There are additionally 30 travel-related cases and 49 pending cases, for a total of 99. Though these numbers are not terribly large, this virus has clearly infiltrated our country and is quite capable of spreading despite the measures people are putting in place to stop it.

The CDC reports that most of these cases are in Washington State and California, so I would definitely say that people who travel there should self-quarantine. However, Florida, where my friends are visiting, is a little bit more on the line. The CDC labeled Florida as having between 1-5 cases on a map tracking Covid-19. The Florida Department of Health (as of March 5), has reported nine positive cases, with 69 tests pending and 248 people being monitored. All this information leads me to think that the severity of the virus in Florida is in the air at this point. It will be interesting to see how many of the pending tests come back positive. However, in light of the uncertainty, it does seem like a good idea to self-quarantine. This is especially true in light of how flexible professors are being with school work at this point. You could prevent transmission of such a scary disease and get a two-week break at the same time!

I have never liked going to the doctor’s office. When I was little, every well-check appointment would be accompanied with at least some tears. I am sure these appointments were stressful for my mom as well, trying to wrangle four young children into a small dimly-lit office (where they were all determined not to go). This isn’t even considering shots. I can remember being three years old and hiding behind a chair to avoid an immunization. Honestly, it doesn’t surprise me that so many people don’t vaccinate their children. Moral concerns aside, it is extremely difficult to get a screaming toddler or surly preteen to a check-up.

However, there are very serious consequences of not vaccinating your children. One specific disease that both has a vaccine and continues to kill many people is HPV, or human papillomavirus. According to a study on HPV vaccines, this virus is the most common sexually transmitted disease and is linked with cervical cancer. Specifically, there are two HPV genotypes (16 and 18) that are “associated with approximately 70% of all invasive cervical cancers.” The CDC also notes that HPV can cause throat, tongue, tonsil, vagina, and other cancers. In light of the serious consequences of this disease, it seems pretty important to do all that you can to prevent it. One way to prevent contracting this disease is by vaccinating with the HPV vaccine. According to a vaccine information statement from the CDC, the HPV vaccine is generally given to kids around 11-12 years old in two doses. If the child is above 15 years old, the vaccine is given in three separate doses. Referring back to the first paragraph, it can be difficult (even for pro-vaxers) to get their preteen/young teenager into a clinic 2-3 separate times. After all, by this age kids have very busy schedules and generally do not like going to the doctor’s. Fortunately, a new study indicates that even one does of the HPV vaccine can be effective at reducing risk of cervical disease in females. In short, the HPV vaccine is a great method for prevention, even if you can only drag your kid into one appointment.

So far, this discussion has focused on prevention of HPV using vaccines. However, it is important to understand how this disease is transmitted in order to employ other methods to prevent contraction. This may seem pretty obvious, but the CDC tells us that HPV (as an STD) is transmitted through sex. Two ways the CDC recommends to prevent contraction and stop transmission is by using condoms and being part of a monogamous relationship. However, in light of the fact that you can still get HPV from only ever having sex with one person, cervical screening for women between 21-65 years is still recommended. In summary, there are many ways to prevent contraction of HPV, but you’re probably still going to have to go to the doctor’s at some point.

I was recently talking to a friend about how great it is to live in a world with modern medicine. Gone are the days when many ‘simple’ infections ended in death. For this, we have antibiotics to thank. But what if we had to return to those times when there simply wasn’t a medicine for bacterial infections? It is actually very possible that those time are not only in the past, but also in the near future, due to the emergence of antibiotic-resistant superbugs.

When you think of the word superbug, it might bring to mind an image of a brooding little bacterium in a cape. It probably actually didn’t for you, but it did for me. Interestingly enough, a superbug is in many ways the bacterial version of a supervillain. According to the Merriam-Webster dictionary, a superbug is “a pathogenic microorganism and especially a bacterium that has developed resistance to the medications normally used against it.” But how do bacteria develop this resistance? According to a Medical News Today article, superbugs form because, in the presence of an antibiotic, only the bacteria strong enough to survive that medication procreate and pass on their traits. This naturally selective process forms new populations of bacteria that are stronger and more resistant to that antibiotic.

One such superbug is Carbapenem-resistant Enterobacteriaceae (CRE). The CDC says that this type of bacteria generally causes infections in healthcare settings and is resistant to Carbapenem antibiotics, and, occasionally, all available antibiotics. They label it as “a threat to public health.” Indeed, in a 2019 AR threats report, the CDC reports that CRE was responsible for 13,100 hospitalizations and 1,100 deaths in 2017. This scary bacteria has even been nicknamed the “Nightmare bacteria.” (I think that’s a pretty good supervillain name for a bacterium, don’t you?)

In light of the destructive forces of CRE alone, not even mentioning the many other superbugs, it seems to be in the world’s best interest to prevent the formation of new superbugs. But how can this be done? Well, the Medical News Today article mentioned earlier gives some simple advice on this front. Basically, we should only take antibiotics when we really, really, need to. This means not taking them longer than prescribed and not taking them for viral infections. So, next time you drag your achy, tired body to the doctor and they tell you that you have a cold, DO NOT insist on an antibiotic. It will literally do nothing, and you will then become a major figure in the origin story of the next superbug.

One of the most disturbing diseases I am aware of is pertussis, better known as whooping cough. According to an informational page on pertussis by the CDC, whooping cough begins with cold-like symptoms. It then moves on to cause high pitched “whoops” as a baby or young child frantically tries to breath in between fits of extreme coughing and vomiting. About half of babies who come down with whooping cough have to be hospitalized. Considering its distinct and painful symptoms, it is strange that the extent of my knowledge of this gruesome disease, until a few weeks ago, was due solely to it being referenced in historical fiction books. Unfortunately, whooping cough doesn’t only live in the pages of historical fiction. According to a surveillance report by the CDC, there were 15,662 cases of whooping cough in 2019.

It seems strange that such a disturbing disease would still be so prevalent in the US today in light of modern healthcare advancements. However, it is not for lack of trying by the healthcare community. In fact, there is a vaccine for this sickness, called DTaP (there is also an adult version called Tdap). In an article about this vaccine by the CDC, I learned that DTaP is given in a series of five injections, and is effective for 8/10 to 9/10 children for the first year after their last immunization. It is only effective for 7/10 children 5 years after getting their final shot. These statistics alone seem to indicate how this disease could continue to spread. After all, even if everybody were to vaccinate their children, which they won’t, whooping cough could still infect 3/10 children 5 years after their last shot.

This may lead some to question why we don’t come up with a more effective vaccine. Well, this CDC article would be able to inform them that a more ‘effective’ vaccine did, indeed, exist. It was called DTP, and was a whole cell vaccine that helped build up immunity to the disease by introducing a weakened version of the actual bacteria into the body. However this vaccine’s side effects were too severe, so it was replaced with the slightly less effective, but safer, acellular DTaP vaccine used today. Basically, in healthcare we always have to do a cost-benefit analysis and decide which of the options we have is the best for the general public. As in this case, there is sometimes not a perfect option. To end on a lighter note, the 15,662 cases present in 2019 is MUCH lower than the 200,000 cases present in the 1940s. Clearly, even an imperfect solution is capable of saving thousands of lives.

Contracting polio has never been a big fear in my life. Honestly, I didn’t really know anything about this disease until a character in a tv show I watch (set in the 50s in London) became deathly ill with polio. The reason for my ignorance can be traced to the fact that polio has been eradicated from the United States, according to the CDC. But how did the US eradicate this disease in the first place? Also, what are we doing to eradicate it in other countries?

According to our textbook, polio was primarily eliminated in the US due to the use of oral polio vaccine, or OPV. This vaccine is an attenuated vaccine that prevents the disease from being spread, and thus provides herd immunity, by creating a strong mucosal immunity. According to the CDC, this vaccine is administered in oral drops to children. “But wait,” some of you may be thinking, “I don’t remember ever taking little drops of a vaccine!” Well, that is probably because you didn’t. Essentially, we used the herd immunity provided by the OPV to get rid of Polio in the US years ago, but then switched to a different vaccine that is less capable of harmful mutations than the OPV. This new vaccine is called an inactivated poliovaccine, or IPV. According to the CDC, we began using it in the US in 1987, and started using it exclusively in 2000. The main reason we hadn’t used this vaccine before is that it doesn’t provide as good of herd immunity as the OPV, but in a country where polio has been eradicated, that is not a problem.

Unfortunately, polio has not been eradicated from other countries, and thus, they must continue to administer OPV to try to get rid of the virus. According to the World Health Organization, Pakistan, along with Afghanistan, is one of the two remaining countries with cases of polio. Indeed, Pakistan had 144 cases of polio last year, which was a huge increase from the 12 cases in 2018. I believe that this is a huge problem that our government and the world in general ought to be doing something about. We have the tools to get rid of this disease, and we ought to make it a priority to do so.

It seems like there are a lot of people who agree with me in this. From a UN news article, I was informed that UN Secretary-General António Guterres recently traveled to Pakistan to show his support for a Pakistani government initiative to eliminate polio in their country forever. According to the news article, this initiative will try to impact around 39 million kids through methods such as door-to-door campaigns and vaccinations at transit points. I honestly think that this is a great picture of people around the world from different cultures and backgrounds working together to save lives. There are so many other problems out there that could be solved or reduced if we maintained this commitment to working together.