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Certolizumab, or rather addressed as its brand name Cimzia ®, is advertised to treat Crohn’s disease, rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, non-radiographic axial spondyloarthritis, and severe plaque psoriasis (a mouthful, I know). Cimzia ® is a monoclonal antibody. Put simply, a monoclonal antibody is an antibody that produces a single B clone through the process of injecting an animal with a specific antigen in which the singularity increases the specificity. Cimzia ® binds to tumor necrosis factor alpha (TNFa) which is a protein that produces inflammation in the body. The diseases that Cimzia ® is designed to treat all have problems associated with inflammation, therefore, when Cimzia ® binds to TNFa inflammation is reduced, slowed, or stopped by blocking its effects.

The official Cimzia ® website lists the following possible side effects:

• Heart failure
• Allergic reactions
  • Pain and itching at the site of injection
• Hepatitis B virus reactivation
• New or worsening nervous system problems
• Blood problems
• Immune reactions
• Upper respiratory infections
• Rash
• Cancer
• Urinary tract infections
• Diarrhea
• Abdominal pain
• Arthralgia

Notably, Cimzia ® has the possibility to worsen previous problems within those looking for treatment. Worsening heart failure, nervous system complications, and Hepatitis B reactivation are all possibilities for those taking the injection. There is also a possibility of immune reactions such as joint pain and rash which are already associated with the infections the drug aims to treat. Another thing to note is how cancer is listed. Seeing as those with Chron’s disease already have an increased risk for developing cancer this is a notable possibility.

The Cimzia ® website advises against taking the medication if you have diabetes, HIV-1, and/or are immunocompromised as you have a greater chance for infection. The website also heavily notes the possibility of developing tuberculosis and/or other infections. This is due to the drugs way of weakening the immune system making it more difficult for the body to fight infections. Cimzia ® impacts the immune system by inhibiting TNF which initiates the inflammatory response. This is helpful as it can block effects associated with the diseases it treats, however this can be dangerous as it can cause the susceptibility to other infections. Side effects, as mentioned before, also include immune reactions.

A blog post on IgM and IgG titers.

What are people most concerned with regarding the scary new virus? How do you know if you have it. While googling symptoms can help to indicate if you’re in danger, the only way to truly determine if you’re infected is a test. There are currently tests to indicate whether you’re positive for covid-19. Tests can also show if you were previously exposed and have since recovered based on antibody response.

Testing positive for certain titers can indicate infection. This works as specific antibodies are generated by the immune system in response to the presence of the virus. If exposed to the virus, an individual will have IgM antibodies and/or IgG antibodies present in the blood. IgM antibodies are associated with a current infection. IgG antibodies appear later in/after an infection.

Antibody detection can further indicate what stage an individual is in their infection. A higher IgM indicates the beginning of an infection (current infection) as the first antibody is being produced in response. Having primarily an IgG antibody titer can be interpreted as having been infected in the past/recently. Positive tests for both IgM and IgG indicate a current infection that can be interpreted as later stage as IgG is being produced. Overall, antibody detection can help to indicate exposure to the novel coronavirus.

A post on dendritic cell therapy.

Personalized care is a new and emerging form of treatment many physicians are prescribing their patients. So, what is personalized care?  The recipe for personalized care is a mixture of the highest quality, the most effective, and the most convenient care for all patients. But these seem to be the ingredients for all proper patient care, right? What separates personalized care is the tailored treatments for each patient that makes the recipe the highest quality, the most effective, and the most convenient care for them specifically.

What’s more personal than using your own body for treatment. Today, we’ll be talking about dendritic cell therapy for cancer as personalized care. Dendritic cells in the bloodstream work to identify threats to the body. These cells present threats to the immune system for the body to fight against. As personalized care, dendritic cell therapy uses a patient’s dendritic cells to train them to detect their cancerous cells. In lamest terms, the therapy should work by introducing your newly trained dendritic cells that can identify your cancer as a threat for your body to now work against.

In evaluating the value of new treatments, we gravitate towards weighing the cost and possible side effects. Research has determined dendritic cell vaccines to be generally safe with little severe side effects. Some report flu-like symptoms, including fevers and headaches, but these are actually considered a good sign of the vaccine effectively stimulating the immune system. In terms of cost, the therapy seems to cost around $20,000 per patient. I’ll let you weigh these things out and decide for yourself the value of personalized dendritic cell therapy.

An ENFJ’s perspective on social distancing

I don’t know how much you know about Myers Briggs personality types, but your girl over here is an authentic ENFJ. If you don’t know anything, all that you need to know is that the ‘E’ stands for ‘extrovert’. So basically, I thrive on social interaction. And what’s the opposite of social interaction? Social isolation, or better known as our shared current state of community due to COVID-19. So, if you still don’t understand, I’m currently not doing the best.

It doesn’t help that other notable traits for ENFJ’s are being oversensitive and a characterized worrier. I’m sure you can see how this doesn’t pair well with trying to survive a pandemic. Along with general worries regarding COVID-19, I happen to have my wonderful great-grandparents as roommates, one of which actually celebrated his 83^rd birthday today (happy quarantine birthday paw paw). I’m sure they are tired of me reminding them to wash their hands every 5 seconds but I truly cannot help it knowing they are most susceptible. Also knowing that my long-distance boyfriend is finally 15 minutes down-the-road again instead of 11 hours away but I can’t see him completely sucks.

But, ENFJ’s are also known to be optimistic and lively. I’m trying my best to stay happy and cheer up the people around me. It is hard to be the best me possible when feeling a degree of loneliness I have truly never felt before. I do miss my friends and being in a cold classroom at 9:30am and my boyfriend and the movie theater and my roommate and the park. All we can do in this time is hope and according to my personality type, I’m pretty good at that.  

A post on a Gonorrhea epidemic

Let’s talk about sex baby – well sexually transmitted diseases to be more specific – and who better to begin with than little ole gonorrhea. Actually, she isn’t so little. As of October, the number of gonorrhea cases in the US hit a record high surpassing 580,000 reports marking the highest since 1991. Reported cases rose 5% from the previous year and 63% from 2014 indicating a massive prevalence of the infamous STD. With such outrageous numbers, I’m sure you’re curious on exactly how this epidemic arose.

The CDC suggests various reasons on why STD’s like gonorrhea are on the rise including drug use, poverty, stigma, and unstable housing, all of which can reduce access to STD prevention and care. The CDC also suggests that a substantial decrease in condom use, especially in vulnerable groups such as gay and bisexual men, have also led to the increase in cases. The CDC also makes sure to highlight budget cuts to STD programs which reduce screening and patient-follow up. It is also important to note however, that the US has done a significantly better job at STD screening, which could add a few cases to the incline, as a screening equals a reported case. However, despite being compared to previous under-reporting, there is still clearly an epidemic.

Accompanying the rise is cases is a decline in treatment options. The development of antibiotic resistant gonorrhea is not unfamiliar to microbiologists. Unfortunately, a single drug is most often used to treat gonorrhea, and as resistance increases, treatment options dwindle. The threat of antibiotic resistance is very real and gonorrhea is no stranger to this happening. The next step is to combat antibiotic resistance (in ways mentioned in the last blog post) and to work on developing a new drug to treat gonorrhea.

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A post on antibiotic resistance.

People are confused – like really confused, and we need to help them. For some reason the general public has started requesting antibiotics for any and every thing, misunderstanding the use of such drugs – i.e bacterial infections, NOT viruses. Not only are we taking antibiotics haphazardly, but when we do have a bacterial infection, we misuse and abuse the drug. Taking antibiotics for the wrong reason, the wrong way, or the wrong kind leads to disaster for us all. It’s gotten so bad that antibiotic resistance has been labeled a growing public health concern.

So how does antibiotic resistance affect more than just you? The CDC categorizes resistant bacteria as a “One Health problem” which means they can spread between people, animals, and the environment (so, everyone and everything). Most notably, resistant bacteria can appear in food, spreading from animals to people, which we’ve seen in salmonella bacteria. With heightened prevalence, no one is left insusceptible to antibiotic-resistant bacteria. According to the CDC, “at least 2.8 million people are infected with antibiotic-resistant bacteria or fungi, and more than 35,000 people die as a result.”

What happens if we lose the ability to use antibiotics? Overusing antibiotics has left us with drugs incapable of fulfilling their purpose in killing bacteria. And unfortunately, we can’t keep up. With more and more bacteria becoming resistant, it is becoming harder to develop new antibiotics to treat bacterial infections. And with this I’m left wondering, at what point do we fall too far behind?

A post on polio

Whether you’re a microbiologist or a high school student unaffiliated with immunology, you’ve heard of polio and our goal to rid the world of the deadly disease– permanently. To do this, there has been two types of vaccines created for the virus. IPV, or the Salk vaccine, was first instituted and decreased the prevalence of polio dramatically, but it came along with a disadvantage. In order to be effective, you needed multiple injections of the vaccine. With the needed series, to many, IPV just seemed too complicated and expensive.

Then came OPV, or the Sabin vaccine, IPV’s more reasonable sister. Because OPV is administered orally and doesn’t require a series, there is the advantage of it being cheaper. An even better advantage brought along with the vaccine is its ability to produce better herd immunity. In comparison to her high-maintenance sister, OPV’s caring attributes leave her being essential for polio eradication, as increasing herd immunity decreases disease. So how far have we come in completely erasing this virus from the face of our planet?

Pretty far I’d say. In October of 2019 on “World Polio Day”, the WHO declared WPV3, strain 3 of the virus, as globally eradicated. This is the second strain of the virus to be eradicated following WPV2 in 2015. WPV3 and WPV2 exist nowhere in any part of the world aside from secured specimens. While this is great progress, WPV1, the last strain, does still exist circulating in Pakistan and Afghanistan, and the goal was set for eradication by the year 2000. Seeing that we’re 20 over, we have some work to do.

A post on the microbiome.

There’s a new magic solution floating among health fixated social media who’s only concern is your microbiome, but there’s no way this can be a cure-all, right? Well, first things first – there’s actually truth behind this phenomenon. Yes, most of us have heard that a healthy microbiome is the key to avoiding obesity and can, at base-level, understand how this is possible. What’s interesting is that the benefits of a healthy microbiome are being shown as going beyond the digestive system. Recent studies have linked the microbiome to mental and cardiovascular health.

Benefiting from your microbiome means keeping it healthy and healthy gut microbiota means diverse gut microbiota. So how do you diversify the little guys in your tummy? Most suggestions include consuming probiotics, prebiotics, and fermented foods. What seems to be the most important tip is to avoid being predictable. Switching up what you eat everyday can lead you to a diverse, and therefore, healthy microbiome.

Reading these tips, I was reminded of a dear old trend that left the nation in a frenzy running frantically towards the nearest Whole Foods – kombucha. Kombucha is a fermented beverage, which means a “yes, drink me” on the checklist for a diverse microbiome provided by aforementioned research. While we aren’t sure if kombucha positively effects human health, we have seen some correlation in positive effects of consuming things that have been fermented. The most interesting is a correlation between fermented products producing lower cortisol levels (which works to indicate stress) which would seemingly help to convey the microbiome as helping with mental health. With this being said, greater research is needed to understand and validate these effects, but for now I say keep drinking your kombucha if you’d like.

A post on the 2019-2020 flu season

It’s that time of year again – it’s flu season baby – and as of now, we’re in peak activity time. Around this time last year, the WHO was meeting for this year’s vaccine selection which we now know is a recommendation of either the IIV, RIV4, or the LAIV4 vaccine for anyone over the age of 6 months this flu season. Seeing as to where we are in the season, those who wish for a flu shot probably already received one by now. With flu vaccines offered literally almost anywhere, getting vaccinated is easier than ever. Avoiding the dreaded flu is as simple as stopping by to your local target (which you were going to do anyway let’s face it) and asking for a FREE vaccine. So why don’t more people do it?

Most people question the effectiveness of the vaccine. But listen, tracking effectiveness isn’t the easiest thing to do – considering we are in the midst of the season – so the CDC hasn’t estimated the effectiveness for this year’s vaccine as of yet. This is because effectiveness is measured in comparing the rate of illness in those who were vaccinated and those who weren’t at the end of the season. What confuses me is how people seemingly don’t make a simple cost-benefit analysis in regards to the vaccine. Even if this year’s vaccine didn’t have the greatest effectiveness, the vaccine still offers the benefits of producing antibodies guys! But also, given that the vaccine consists of 4 viruses, the odds that the vaccine protects against some, if not all, of the flu viruses of the season is in our favor.

If the effectiveness still worries you, FluView offers insight into what is happening with the current flu and is updated weekly. After checking it out for this week, the CDC has estimated around 22 million flu illnesses and 12,000 deaths in the 2019-2020 flu season. With this being said, the report states that the mortality rate has remained low and hospitalization rate constant in comparison to previous seasons. The CDC should have effectiveness estimates later in February according to FluView. Overall, flu activity is stated to be high at this time so be careful out there.

Wakefield’s infamous study, released in 1998, produced a public uproar as Wakefield seemingly proposed that he had uncovered a linkage between the MMR vaccine and autism. Now, as the public began to digest Wakefield’s findings, it became important to truly analyze his methods. Wakefield’s study focused on children, in which he selected 12 participants. Yes, you heard me right; Wakefield’s study was based on a sample size in the double digits. Along with the controversy surrounding the extremely minute participant pool, the way in which Wakefield gathered these 12 children remained under scrutiny as he was outed for hand-selecting his 12 participants rather than following a legit sampling method.

What followed was a straight beeline towards uncovering Wakefield’s true motives for the study. According to “The MMR vaccine and autism: Sensation, refutation, retraction, and fraud”, Wakefield was involved with parents with active lawsuits against the manufacturers of the vaccine leading many to associate financial gain as Wakefield’s main motive. It was also uncovered that Wakefield violated a degree of ethical standards when conducting his study on the children. Later, 10 of the 12 co-authors of the study refuted the proposed link between the MMR vaccine and autism along with the formal retraction of the study. What followed was a release of various epidemiological studies signifying the falsified connection made by Wakefield.

While in my personal opinion, the small sample size and ethical problems of Wakefield’s study make it easily dismissible, a great deal of the public began to doubt the MMR vaccine. As shown in the UK, where Wakefield originally released his study, the use of the MMR vaccine has declined since his publication. The current (as of this 2006 publication) uptake rate was 11% below the average for producing herd immunity creating a serious threat for an outbreak. According to the study, 38% of a cross-sectional study sample received their primary information on MMR from TV networks. Gathering lifesaving information from the TV is particularly alarming. I hope we can begin to create a flow of the correct information of the MMR vaccine and lock away the dangerous implications of the Wakefield study. It’s time to end the Wakefield myth.