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Natalizumab or Tysbari is a monoclonal antibody that treats multiple sclerosis and many of its courses such as clinically isolated syndrome, relapsing- remitted syndrome, and active secondary progressive disease. According to our textbook, monoclonal antibodies can be defined as “antibody molecules with a single specificity produced in vitro by lymphocytes that have been fused with a type of malignant myeloma cell. The product of fusing lymphocytes and myeloma cells is a hybridoma that receives the trait of proliferating and multiplying indefinitely from the myeloma cell and the specific antibody producing trait from the b cell. In the laboratory, scientists are able to isolate and harvest identical antibodies from the hybridomas that have the same constant and variable regions. Monoclonal antibodies provide a consistent base that facilitate the wide-spread and standardized use for tests that diagnose diseases and now antibiotics, such as natalizumab, that treat diseases.

Thee purpose of Tysbari is to limit the number of multiple sclerosis flares and to prevent the physical damage caused by MS from progressing quickly. Tysbari is administered intravenously ever 28 days, and the administering process takes two hours; one hour of infusion and an additional hour in the hospital to make sure you are not having a reaction to the infusion. According to this article, Tysbari works by preventing the white blood cells of the immune system from going into the brain and spinal chord. Tysbari prevents leukocytes from crossing the blood-brain barrier into the brain and spinal chord which leads to the detrimental nerve damaging effects of MS. According to this website, this monoclonal antibody is one of the recommended infused medications by the National Multiple Sclerosis Society.

According to the FDA, Tysbari is an immunosuppressant medication which can lead to some of its side effects. Some of the serious side effects of Tysbari include:

• Herpes Encephalitis or meningitis
• Liver damage which causes jaundice, nausea, vomiting, darkening of urine, feeling weak or tired
• Allergic reactions which cause hives, itching, trouble breathing, chest pain, dizziness, wheezing, chills, rash nausea, flushing of skin, and low blood pressure
• Infections due to weakened immune system

The most common side effects include:

• headache, feeling tired, urinary tract infection, joint pain, lung infection, nausea, depression, pain in your arms and legs, diarrhea, vaginitis, rash, nose and throat infection, and stomach-area pain

Tysbari can also cause PML or progressive multifocal leukoencephalopathy which can lead to death or severe disability. PML is especially dangerous because there is no known treatment for it. The risk of getting PML increases if you have been infected with JCV because it can cause PML if you have a weakened immune system which happens when taking an immunosuppresor such as Tysbari.

You cannot take Tisbari if you have an already weakened immune system because of conditions such as HIV, AIDS, leukemia, lymphoma, or had an organ transplant. Tysabari can also cause harm the baby’s of breast-feeding women.

PML and meningitis have severe effects in relation to MS because they both target the brain. PML causes progressive damage and inflammation of the white matter in the brain. Meningitis targets the membranes that cover the brain and the spinal chord. Both of these side effects can progress the nerve damage done by MS, and is a risk which should be considered when taking this medication. Additionally, a patient should not take this immunosuppressor medication if they have an already weakened immune system because they are more susceptible to infections that can progress the damage causes by MS and/or add additional health concerns to the patient.

The COVID-19 pandemic has affected our lives in unpredictable ways. Scientists around the globe are on a race against time to find better testing and treatment mechanisms in order to lower the number of cases worldwide. The current diagnostics tests monitor viral genetic material in respiratory secretions, however, this only detects whether or not the disease was present in the patient at the time of the test. Now, scientists are looking to learn about the antibody response of patients in order to find more about the disease in symptomatic and asymptomatic patients. Through more extensive tests we can learn more about the virus itself, the antibody response of patients. This could help us learn how to better treat patients and when we can return back to “normal life”.

A team of scientists at Stanford Medicine have developed a test that can now detect antibodies in the plasma of the patient. According to this article, the test takes 2-3 day to receive results about the antibodies in the patient. This test monitors the IgM and IgG antibodies present during the viral infection of the patient. IgM antibodies are present towards the beginning of the infection and their quantity quickly decreases. IgG antibodies appear slowly after infection and stay longer than IgM antibodies. This test will allow for scientists to determine the number of mild infections present in the general public by detecting antibodies in asymptomatic patients. In the future, it will also help determine the amount of time that the antibody can provide protection to the patient from being reinfected. Some scientists in this article even suggest that convalescent plasma collected from these tests with antibodies from people recovering with COVID-19 could help treat acute COVID-19

The results of the test can be either negative or positive for both IgM or IgG. Results where IgM titers are present indicate that the infection is recent or still active because these antibodies are the first to be generated in response to an infection. Patients with both IgM and IgG titers indicate that a patient has been infected for a longer period of time and is reaching the end of the infection. The IgM antibodies are replaced by IgG as the infection progresses, so patients with only IgG antibodies indicate that they have been infected and could possibly be immune. According to this article, detecting levels of IgG in a patent could possibly determine if they could go back to work/school because they could have possible immunity. IgG positive tests could allow self-isolation measures to end because it indicates that patients are no longer in the state of infection where they can be contagious to others. However, according to this article, this test is not used to determine whether or not the patient is currently infected, it is used mainly to detect if the patient has been exposed to the coronavirus or not. Tests that measure antibody levels could help us better understand when we could go back to normal life without making the number of infections spike up.

According to this article, “T cell immunotherapy or CAR T-cell therapy is a type of cancer therapy that uses a patient’s own modified white blood cells to kill cancer cells.” Through Chimeric Antigen receptor T-cell therapy, T cells are modified in labs so that they can detect and destroy cancer kills. T cells are used because their receptors attach to foreign antigens of intruders, and this triggers the body’s immune system that kills foreign substances. In cancer, patients lack the right receptors that attach to the antigens of cancer in order to set off the body’s immune system that destroys the intruder. According to this article, CAR T-cell therapy is used to fix the lock, or immune receptor, that attaches to the key, or cancer antigens.

Through CAR-T Cell therapy, the t cells from the patient get changed by adding a man-made chimeric antigen receptor cell. This receptor allows them to be able to identify the specific cancer antigen associated with the cancerous disease. For example, the antigen for Leukemia is CD-19. This antigen is used to treat Leukemia only, and no other disease can be detected form this antigen. CAR T- cell therapy can take weeks and starts by the removal of t-cells from the patient through leukapheresis. The patient is required to stay still for 2-3 while the IV draws their blood. After collecting the blood, the t-cells are separated in the lab and CAR is added to them through genetic modification. The patient then receives large quantities of the CAR T-cells through CAR T-Cell infusion. Light chemotherapy is also required to lower the number immune cells already existing so that the CAR T-cells are forced to act on cancerous cells. Once they attack the cancerous cells, they grow in numbers and kill even more cells.

Cytokine release syndrome is a very common side effects of this treatment. Once the CAR t-cells start to replicate, they cause high amount of cytokines to be released in the blood. In effect, the patient develops high fevers and low blood pressure. According to this article, neurotoxicity is another side effect that can lead to brain swelling, confusion, seizures, and severe headaches. CAR T-Cell therapy is extremely expensive; one-time treatment can cost around 373,000!!! Although advances in science have led to us developing newer forms of treatment for patients with cancer, they continue to be very expensive and out of reach for many low income patients.

The emerging crisis has been very overwhelming for me as a first-generation student from a low income family. It has been scary to think about all of the people I love who are at higher risk for severe illness with covid-19. I wish I could spend more time with them because I am scared that this virus might take them away from me, but I continue to practice social distancing for their own safety. It is very hard to build up the focus to continue doing my school work. The other day I was working on my connect assignments for this class while the news played in the background that Italian soldiers were seen carrying large numbers of coffins to accommodate those who died from covid-19. In other news, the news channel that we watch at home, Univison, had an employee test positive for covid-19. They were forced to evacuate the building, yet they continued to film from the parking lot in order to deliver the news to the Spanish speaking public. This article has more information about it. This pandemic has created a new environment that people around the world are being forced to adjust to.

My family is fortunate enough that we don’t have any financial issues yet because my dad is considered an essential worker. However, there is always a possibility that they might lay off some workers at his job. I am very upset with the government’s aid plan because they ignore many groups of people; my parents are among one of the ignored groups. It opened up my eyes to a harsh reality I knew existed; they accept the labor of workers with an ITIN number, but they deny them of any resources even in a global pandemic. Undocumented immigrants are accepted only as workers and not as human beings who have needs.

Working from home has many distractions in addition to the fact that we are experiencing a global pandemic. I am trying to keep some form of consistency throughout my days to stay on track such as waking up and going to bed around the same time and using a planner. One of my main motivators is the fact that I cannot pass or fail MCRO 251 because I plan on applying to the nursing school next fall. It is extremely hard to maintain focus when there is so much going on in my life: I’m continuing my work-study job from home to help with any costs, I have a million assignments from all of my online classes, I am uncertain how long my dad will keep his job, I have to maintain a good GPA in order to apply to Nursing school, and I have many loved ones who are in the high risk of severe illness category. However, I continue to do my part to prevent the spread of covid-19. I am aware that my situation could be a lot worse, and I try to remain thankful for the things I have. I am very thankful for the health care workers who are risking their lives during these hard times.

Sexually transmitted diseases continue to exist and are transmitted at high rates in the US. According to the CDC’s STD surveillance report, in 2018 the levels of syphilis, gonorrhea, and chlamydia were at their highest rates recorded. There were 115,000 syphilis cases in the US during 2018 with a 14% increase in the infectious stage of syphilis cases from 2017-2018. Congenital syphilis also increased by 22% from 2017 to 2018. This increase in syphilis reports is a trend that has been observed since 1998 when it was at its lowest levels since the disease had been reported.

Syphillis is caused by Treponema pallidum and can enter the body through microscopic abrasions or mucous membranes present in the genitalia, mouth, or rectum. Chancres develop at the site of entry where the organism multiplies and proceeds to spread through the blood stream. The infection results in fever, rash, mucous membrane lesions, and can often lead to latent syphilis if not treated. The symptoms can then return as tertiary syphilis that can cause heart and blood vessel defects, eye abnormalities, and mental illnesses.

Syphillis is spread through sexual intercourse, however, it can also spread through different ways. Additionally, It can be spread by touching an ulcer from the primary syphilis infection or by kissing a person with secondary syphilis. Penicillin is the main antibiotic used for treatment of syphilis during the primary and secondary stage of the disease, and it is inserted intravenously for tertiary syphilis. Abstinence, monogamy, and correct use of condoms are the main methods of prevention from syphilis. These methods are extremely crucial not only to prevent the spread of syphilis to other adults, but also to prevent congenital syphilis which can lead to stillbirth and neonatal death. According to this article, congenital syphilis can also cause deafness, teeth deformities, and saddle nose in the infected newborns. It is crucial that we implement some or all of these methods of prevention in order to lower the rates of syphilis in the US for the safety of adults and newborns.

Superbugs are bacterial strains that have become resistant to antibiotics, making them harder to eliminate when treating an infection. Superbugs are causing problems with disease treatment because treatments that were once used to eliminate bacteria and reduce infections are now ineffective. Bacterial populations have always been able to change overtime to ensure survival under antibiotics, however, humans are speeding up the process like never before. Before antibiotics, people would die from infections that we now consider easily treatable. Because of patient misuse of antibiotics prescribed them, we are shaving off the amount of time that we can continue to use antibiotics successfully.

According to this article, some of the many factors contributing to the rapid spread of antibiotic resistant superbugs include misuse of antibiotics, poor infection control practices, living in unsanitary conditions, and mishandling food. The FDA has released several statements regarding the proper use of antibiotics. Some of their main recommendations include taking antibiotics as prescribed, not skipping doses, and not sharing antibiotics with others. Stopping treatment early can allow surviving bacteria to become resistant to the antibiotics that they were already exposed to. Sharing antibiotics with someone else may seem like a financially smart idea, but in the end, they can actually worsen a patient’s condition because they may not target the same bacteria. Not only are we training bacteria to become resistant through unnecessary exposure to our antibiotics, many countries are also feeding their cattle antibiotics for growing purposes. The antibiotics are oftentimes detected in the feces of the cattle, thus, proving bacterial exposure to our antibiotics.

The overexposure of antibiotics to bacteria is allowing the rapid spread of antibiotic-resistant bacteria, and it is ultimately dooming future generations from using antibiotics. In this article, the CDC explains that there are more than 35,000 deaths resulting from antibiotic resistant infections. Not only are antibiotic-resistant infections hard to treat, they are also hard to contain and can be easily spread, thus increasing resistance within the species. In the CDC’s 2019 AR Threats Report, Carbapenem-resistant Enterobacteriaceae was considered an urgent threat. The bacteria that are part of this group are often called the Nightmare bacteria because some of them are resistant to almost all antibiotics. This large family of deadly bacteria can cause pneumonia, infections in the blood stream, urinary tract infections, and even meningitis. As a growing number of superbugs appear, it is important to keep in mind the recommendations of the FDA and CDC. By doing this, not only can we slow down the process of becoming antibiotic resistant, we can also slow down the spread of infections caused by antibiotic-resistant bacteria. We need to speak out about the use of antimicrobials in farm animal production, and we need to encourage proper use of antibiotics by patients.

Poliomyelitis is caused by the poliovirus and can be considered a paralytic disease because it attacks the spinal cord. However, according to the CDC, the majority of the people infected with poliovirus do not even show noticeable symptoms, which contributes to its spread. Paralysis, meningitis, and paresthesia are severe symptoms that can be caused by this virus, primarily in children under the age of 5. Polio is very close to being eradicated due to vaccinations, however, it is still endemic in two countries, Afghanistan and Pakistan. According to this article, if local governments can ensure that all children in these two countries can be vaccinated, it is very possible that polio could be completely eradicated from the globe.

The inactivated polio vaccine (IPV), which consists of inactivated virus particles of three serotypes, can be administered in the arms or leg of a patient. As of 2000, it is the only vaccine used in the United States. The OPV has not been used in the Unites States because it has an increased risk of the vaccine derived poliovirus and because of the minimal risk of a wild poliovirus entering the country. The prevention plan for this method includes a series of four injections spanning from the age of 2 months old to 4-6 years old. According to the CDC, the IPV is extremely effective, ensuring 90% immunity to all three types of the poliovirus after 2 doses, and at least 99% immunity after 3 doses. It is extremely critical to provide our children with the proper vaccine doses in order to protect them from this debilitating virus.

The Oral Polio Vaccine (OPV) is used in the remaining countries of the world because of its cheaper oral administration. The OPV is made up of attenuated strains of the poliovirus. Because the OPV allows the attenuated strain to replicate in the cells lining the throat and intestinal tract, it can lead to better mucosal immunity than the IPV. With the OPV, the antibiodies in the body attack the virus before it infects the cells. Although, OPV can also lead to vaccine-related poliomyelitis, it needs to be used to completely eradicate Polio world-wide because it prevents the spread of the wild poliovirus. The governments of countries where polio is still endemic should prioritize the health of their citizens by providing the OPV or IPV. Not only are they protecting the health of the children in their country, they are also preventing the world-wide spread of it through traveling.

The human microbiome can be defined as the ecological communities of commensal, symbiotic, and pathogenic microorganisms, and it is oftentimes referred to as the metagenome. This is because of its ability to predict “complex” human diseases alongside human genomes. According to this article, microbiota is even seen as a better predictor of certain diseases than the human genome because of its vulnerability to the host’s environment. Its sensibility to the environment allows it to change and better predict phenotypic changes in a host that characterize an illness. The microbiota has become a topic of high interest in treating and diagnosing illnesses.

Since the microbiome is being studied more than ever before, new findings reported by this article say that they have observed associations between the microbiome and cardiovascular, neurologic, respiratory, metabolic, gastrointestinal, and hepatic diseases. Specifically, the gut’s microbiome has been the subject of talk and study due to its association with many diseases such as parasitic diseases. Oftentimes these parasitic illnesses are seen only in context within the host and outside factors that effect the microbiome, such as diet, are oftentimes ignored. This article analyzes the relationship between diet, the microbiome, and parasitises. It concludes that it is possible to change a host’s resistance to parasitic infections by altering diet, and in effect, altering the microbiome, however, even more studies are needed to solidify these observations.

The onocobiome has also become a topic of interest recently due to the observed link between the microbiome and the changes it can cause in the immune system that can lead to cancer. According to this article, the microbiome has the power to change the way the body responds to anticancer drugs through its systemic effects on hosts. It also explains that there have been certain microbial species identified throughout the progression of cancer in a host. In class we discusses about the reappearance of Helicobacter pylori in many cases of gastric cancers. The microbiome should definitely continue to be studied because of its sensitivity to the environment that makes it a better predictor for some diseases than DNA. The continued study of the microbiome is also important because we could find new ways of preventing or treating illnesses due to the microbiome’s reactibility to the environment. Lastly, it is important to continue looking into the patterns of microbial species within certain illnesses because it could lead us to finding better ways to treat said illnesses.

Influenza is a viral disease that can cause mild or severe symptoms. Some symptoms include fever, cough, sore throat, body aching, and runny nose. The influenza is caused by a single-stranded, segmented RNA virus. Because it is a segmented virus, it is capable of changing with every replication through antigenic drift. Mutations of the virus’s genes can lead to changes in the NA and HA surface proteins of the virus. These continuous mutations over time lead to antigenic drift of the virus, and the body can not recognize the proteins of the new virus. For this reason, a new vaccine is created and adjusted every year in order to grant immunity towards the evolved version of the influenza virus based on the changes that occurred during the previous season.

According to this article, the 2019-2020 influenza season is expected to be the worst since 2017-2018, the deadliest influenza season in the decade. The December graph uploaded by the CDC shows that the influenza death rate in 2019 is similar to that of the 2017 influenza season. The severity of this season can be seen in this article which reported that the Influenza Like Illness activity was reportedly high in 45 states out of the 50 states in the United States during the first week of February. The majority of the influenza-involved hospitalizations were in connection with the influenza A virus, at 62.2% of hospitalizations. More recent reports show that the cumulative hospitalization rate this season is similar to that of other seasons, the rates of children and young adults are higher than usual.

Vaccine effectiveness normally ranges between 40% to 60%, but is is currently too early in the season to make an estimation about the effectiveness of this year’s vaccine. There are several options for vaccines this year, however, all regular-dose flu shots will be quadrivalent. In addition, the CDC and ACIP are now telling people that vaccinating before July and August can reduce the effectiveness of vaccines during the flu season, and they are suggesting to get vaccinated in late-October. Vaccination is important for everyone, but it is even more crucial for susceptible suspects such as those under 2 years old and those older than 65 years old. No matter the effectiveness of this year’s vaccine, it is important to get vaccinated because some protection can still be provided from the antibodies created by the body when vaccinated; some protection is better than no protection. Although some argue that they still get infected with influenza despite receiving the vaccine, the vaccine can be the difference between mild and severe symptoms or severe symptoms and death.

Andrew Wakefield was the gastroenterologist who claimed that there was a connection between the MMR vaccine and autism. This Time’s article states that Wakefield did his observations in Royal Free Hospital in London. He only observed a dozen autistic patients with viruses from the vaccines in their gut. However, autism-like symptoms were observed in 8 of the 12 patients days after receiving the vaccine. When other scientists were unable to link autism to the MMR vaccine, the credibility of his work was questioned, and this led to the retraction of his paper by the journal who published it.

After the retraction of his paper, news came out about Wakefield’s connection with attorneys representing parents who believed their children had been harmed by the use of vaccines. This was incredibly important information because it represented external motives for the publication of his paper. The U.K used this as the ethical justification to revoke his medical license. There were other issues with his data collection that made his findings invalid, such as recruitment methods for his patients and the misrepresentation of his patient’s symptoms.

The publication of Wakefield’s study had an immediate effect on parent’s worldwide. This article states that many parents stopped vaccinating their children out of fear of the said connection between the MMR vaccine and autism. However, the decrease in number of children being vaccinated not only exposed them to the effects of Measles, Mumps, and Rubella, but it also exposed immunocompromised individuals to the diseases. The Measles outbreaks in places like the UK, Canada, and the USA can be attributed to unvaccinated children. All vaccines come with side effects and do not 100% guarantee immunity, however, they have been proven to decrease the number of cases of these diseases, according to this article. As someone who wishes to become a mother in the future, I would much rather take the risk of rare side effects and vaccinate my children instead of not vaccinating and exposing them to the long-term effects of these diseases. In addition, herd immunity only protects the immunocompromised if those who can use vaccines become vaccinated.