Bugs N' Drugs

I'm back in school already. (Feels like I never left) I'm starting out the year with microbiology, which covers all of the nasty little viruses, bacteria, parasites which can cause us a lot of misery. I have been a little nervous about this part of my studies because I have to learn dozens of names like Erysipelothrix rhysiopathiae, and Nocardia cyriacigeorgia, how they are transmitted, how they make us sick, and how to kill the little buggers. I'm starting to compile a list of bug caused diseases that I never want to get. Here goes...

Bacillus anthracis - commonly called known as anthrax. This critter lives in the soil and can be found hanging out on sheep or other livestock but is infamous for the spores which have been created biological weapons. Once inhaled the spores can reside in the lungs for up to two months without causing disease. The body has cells called macrophages which ingest the spores and transport them to lymph nodes so our immune system can destroy them but when they get there these critters begin to grow and divide. They secrete toxins which travel throughout the blood stream which causes fluid and blood to leak out of the vessels. The patient starts to bleed out of their bodily orifices and can die within 72 hours after inhalation if treatment isn't administered. Luckily, common antibiotics can treat this infection if caught early enough. This was the stuff that was sent through the mail a couple of years ago.

Ebola Virus - Ever seen the movie 'Outbreak'?

H5N1 - this is the serotype for Avian influenza (Bird flu). It can't go from human to human yet but has a very high mortality rate in people infected from chickens. This is the one that has gotten so much attention in asian fowl over the last few years. The crappy thing about this virus is that it is more dangerous to younger people that to other population groups. It causes a hyperactive response of the immune system and therefore younger people with a strong immune system are a lot worse off with this disease. Many experts agree that it is not a matter of if it becomes transmissable from human to human but when. A small minority believe that if it was going to happen it would have already.

HPV - Human Papilloma Virus. This critter is pretty common. Certain types cause cervical cancer and are the target of the new HPV vaccine Gardasil. Some types can cause common warts. No big deal right? Not if you have a very rare defect with your immune system. Just do a goolge image search for Tree Man of Java.

The last on my short list is: Streptococcus pyogenes (Group A strep). This one may sound familiar. It is responsible for strep throat, scarlet fever and rheumatic fever. While those range from serious annoyance to debilitating, the thing that I fear the most from this bug is, drum roll please, necrotizing fasciitis. For some reason, introduction of this critter through the skin can cause an infection capable of reducing skin, muscle, fat and connective tissue into goo within hours. One of my favorite books, 'Complications' by Atul Gawande, cites a case where a young woman got it in her leg from dancing on a lawn at a wedding. It result from penetrating wounds or surgery. The only cure is "surgical debrigdgement" of damaged tissue. (ie remove it surgically) The bacteria also secrete toxins into the blood stream and the patient can die within days of receiving the infection. Many of the survivors are left with horrible scars. WARNING! Only google image search this one if you have a strong stomach. (yes, I dare you!)

I am also learning about the drugs to take out these nasties. Unfortunately, overuse of antibiotics is making many diseases hard to treat. Bacteria can mutate and become resistant to antibiotics if they are not used carfully. So I'll stand up on my soap box and encourage everyone to finish every last pill of their antibiotics prescriptions when prescribed and dont ask for a prescription if the doctor says you dont need it. (ie. you have a virus instead of a bacterial infection)

My summer research

Just thought that I would take a minute to update y'all on what I have been doing this summer. I have been working in the Center for Gene Therapy at Nationwide Children's Hospital in Columbus. I received a scholarship from the medical school to help with living expenses. The research we are doing is really interesting. The short of it is that we are working on a treatment that would help rebuild muscle in patients who have muscle wasting diseases like Duchenne Muscular Dystrophy. There is a protein called follistatin which has been shown to increase muscle fiber size and function. Follistatin inhibits another protein called myostatin which limits muscle size. There are some interesting things that happen when you take out myostatin. The pictures below are of animals which have a defect in the myostatin gene. The dog is a whippet greyhound... yeah the fast really skinny tpe. This is called double muscling and recenlty this myostatin defect (if you could call it that) has recenlty been identified in a four year old boy. In our lab, We use a virus to deliver DNA to muscle cells. The DNA codes for follistatin which causes the muscle cells to produce extra follistatin and inhibit myostatin. We have gotten some pretty ripped mice and monkeys with this therapy and everything is looking really good so far. They want to start clinical trials on humans in about a year and I am helping my lab look at the immune response to gene delivery in monkeys.