BioQuakes

AP Biology class blog for discussing current research in Biology

Tag: tuberculosis

The Future of Lung Health

In the 19th century, a tuberculosis outbreak killed every one in seven people worldwide. Scientists believed it to be a genetic disease that mainly children developed making it known as “the robber of youth”. It wasn’t until the year 1882 that Robert Koch’s discovery of tubercule bacillus revealed that tuberculosis was not a genetic disease but highly contagious. Although there was some hesitation in the medical community at first, Koch’s findings helped the U.S. launch massive public health campaigns to educate the public on tuberculosis prevention and treatment. Later in 1904, “William Osler and William Welch, together with Edward Livingston Trudeau, founded the forerunner of the American Thoracic Society, the National Association for the Study and Prevention of Tuberculosis”.  This sparked the beginning of pulmonary research – the conduction of clinically-oriented research into diseases and disorders affecting the lungs and respiratory tract (including molecular and cell-based investigations). With pulmonary research being around for more than 10o years, one would believe discovering something new at this point in history would be a long shot. But, recently researchers at the Perelman School of Medicine at the University of Pennsylvania found RASCs.

TB Culture

RASCs, also known as respiratory airway secretory cells, “line tiny airway branches, deep in the lungs, near the alveoli structures where oxygen is exchanged for carbon dioxide.” Scientists found that RASCs have stem-cell-like properties that allow them to regenerate other cells that are essential for normal functioning alveoli. They also discovered that smoking and the common smoking-related ailment called chronic obstructive pulmonary disease can disrupt the regenerative functions of RASCs. COPD is a chronic inflammatory lung disease that causes obstructed airflow from the lungs. Emphysema and chronic bronchitis are the two most common conditions that contribute to COPD (both bronchitis and emphysema affect the alveoli, the air sacks of the lungs).  The study’s first author Maria Basil, states “COPD is a devastating and common disease, yet we really don’t understand the cellular biology of why or how some patients develop it. Identifying new cell types, in particular new progenitor cells, that are injured in COPD could really accelerate the development of new treatments,”. COPD causes around 3 million deaths worldwide and current treatments can only slow the disease down rather than stop or reverse it. Mice being the common test subjects in lab procedures lack key features of the human lungs, which leads scientists to use healthy human donors to discover RASCs. Since RASCs are secretory cells it means that they produce proteins needed for the fluid lining of the airway. An organelle that we know produces secretory proteins is the ribosome. Ribosomes are tiny organelles that contain RNA and specific proteins within the cytoplasm. Ribosomes are directly involved in the manufacture of proteins by using RNA and amino acids. The discovery of RASCs will not only help advance future COPD treatments but can also lead to discover ways to treat other lung dieases.

Lungs open

Milking Scorpions yields $10,300/ml Antibiotic Venom

Why is it important?

Who would have thought that Scorpions could be providing useful antibiotics through their venom, something most would think of as a harmful substance. It was found that while testing the venom of a Mexican Diplocentrus melici scorpion, a previously studied venom, the venom could be split into two parts. The two types are called Escherichia coli and Mycobacterium tuberculosis bacteria” and when separated they both have specific uses. One of the parts was red and the other blue, it was found that one part was good at killing Staphylococcus, and the other was good at combatting Tuberculosis. Due to these findings, the scientists saw parts of the venom as potential antibodies.

(Scorpion Diagram) 

The Testing:

The two parts of the venom where both tested on rats. It was found that both parts respectively combatted the staph bacteria and the TB. The researchers, however, are skeptical as to whether the antibodies would work as well in humans, and how they would measure the correct amount to be administered to a human given that the substance is so difficult and/or expensive to obtain.

The High Pricetag:

“When electrical stimulation is used to “milk” the venom glands of scorpions, an average yield of anywhere from 0.006 mg to about 2.0 mg of venom can be obtained from a single scorpion.” Not a lot, right? But according to Scientific American, the “milk” from a single scorpion sells for about $10,300 per Milliliter, thats nearly $39 Million per gallon. The reason for its high price tag is its low quantity per scorpion and how inconvenient it is to extract the venom. Each scorpion also takes about two weeks to replenish its venom.

Conclusion:

While the thought of administering scorpion venom as a medical treatment, in my opinion, sounds awesome, it may not be the most realistic method. The testing proves that it does work for combating TB and Staph microorganisms, however, the tests were done on rats. Until the venom can be said for certain to be effective for humans, and there is a MUCH cheaper cost, I’m not sure how feasible it is to treat people with scorpion venom.

 

Can timing change everything?

A Map of Cambodia: Cambodia Map from CIA World Factbook

Amongst individuals living with HIV, twenty to thirty percent die because of an additional tuberculosis infection. This co-infection is extremely common in Cambodia, a nation with 63,000 out of 13.2-million individuals living with just the HIV diagnosis, which eventually leads to AIDS. The HIV/Tuberculosis co-infection makes up 6.4% of Cambodia’s 5% HIV diagnosed population.

Dr. Anne Goldfeld, who has done studies on this trial as a Harvard Medical School employee and as President of the co- founder of the Cambodian Health Committee, says,


“Tuberculosis claims the lives of more than half a million people with HIV worldwide every year…”

 

She also says,


“This is a tragedy, because TB is completely curable when diagnosed and treated properly even in a patient with advanced HIV, especially if the patient also receives anti-retroviral therapy.”

 

In the past, the treatment for the co-infection has been very consistent. The treatment for Tuberculosis has been given to a patient immediately upon diagnosis. Two months later, anti-retroviral (ART) therapy for HIV would be given. However, recently, a trial entitled CAMELIA , >Cambodian Early versus Late Introduction of Antiretroviral Drugs, has helped give hope to HIV patients. The trial, which was created by Cambodian, French, and

 

American doctors, began in 2006 and lasted until 2010, encouraged five Cambodian hospitals to give HIV treatment to co-infected diagnosed patients only two short weeks following anti-tuberculosis treatment. The five hospitals are Calmette Hospital, Khmero-Soviet Friendship Hospital, and three provincial hospitals in the Siem Reap, Svay Rieng, and Takeo regions. This trial cut down the waiting time for HIV treatment by six weeks and overtime, the trial increased the survival rate of co-infected individuals by 33%.  Could six weeks really change the chance of survival for tuberculosis and HIV co-infected patients by such a great percentage? The answer is: absolutely! Did all medical physicians involved in this field of medicine agree with these techniques used to aid co-infected individuals? The answer is: definitely not.

 

Many of those who were opposed to the trial’s process said that the two treatments of Tuberculosis and the HIV  would wear the body down if done at similar times. Additional difficulties could be created for the body, which could already face toxicity with the required seven pills a day. The treatment was not risk-free either. It was possible that the immune system could become increasingly inflamed as it “rebound[ed] from HIV’s suppressive influence.” This trial was also available to patients who had an extremely strong immune system (given their diagnosis) at the time of treatment. Nevertheless, the benefits of the treatment have been much greater and more substantial than those doctors’ fears holding co-infected individuals from getting treated.

Doctors are still learning how the CAMELIA treatment can be improved and altered for the future. However, there has been enormous success with moving the treatments of co – infected Tuberculosis and HIV patients closer by six weeks. In just Cambodia, 661 patients participated in the CAMELIA trial, and less than one percent of the population participating, missed an appointment of the 8,955 scheduled for the population at the five separate hospitals. Many doctors, Cambodian citizens, and observers wanted this trial to work, and it was happening! The World Health Organization (WHO) should be encouraging this treatment more! Thirty three more percent of the initially co-infected patients of Cambodia are living! So where will the trial go next to help co – infected Tuberculosis and HIV patients? Ethiopia.

Killing Two Birds with One Stone

Credit: Fillmore Photography Flickr

Can you imagine having TWO life threatening diseases? Well, for some in Cambodia, that is the case. HIV and TB are two very common diseases that plague Cambodia, as well as other countries. Typically, a patient would go through TB treatment for two months and then begin HIV treatment. However, a new study done by Dr. Anne Goldfeld, the Program in Cellular and Molecule Medicine at Children’s Hospital Boston, and the CAMELIA (Cambodian Early versus Late Introduction of Antiretrovirals) shows that people with HIV and TB can benefit by being introduced HIV Treatment two weeks, instead of two months, after TB treatment was started. 

Doctors and researchers used to believe that the two medicines too much for the body to handle. Combining these two treatments would include taking seven, yes seven, pills a day. In addition, the pills would actually work against each other, the TB pills would work up the immune system to attack the TB and the HIV pills would suppress the immune system to stop the HIV from getting worse. This would put a massive strain on the body. However, this new study shows that the combination of the treatments can actually benefit the patient.

As of now there is no specific research or answers as to why the combination of the TB treatment and the HIV treatment is so effective. However, the study’s results are definitive. The patients that started the HIV treatment two weeks after starting the TB treatment had a better survival rate than those that started the HIV treatment later, 33% greater, to be exact.

Although the study did not give the exact reason behind this beneficial combination, it opened the door to a multitude of possibilities for HIV and TB sufferers around the world.

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