Study identifies how Epstein-Barr virus triggers multiple sclerosis

A new study from Stanford Medicine found that part of the Epstein-Barr virus mimics an adhesion protein made in the brain and spinal cord, leading the immune system to mistakenly attack the body’s nerve cells. 

The adhesion protein is GlialCAM, found in the insulating sheath on nerves.  Epstein-Barr virus, a common type of herpes virus, triggers multiple sclerosis by priming the immune system to attack our own neuron system. The study found that approximately 20% to 25% of patients with multiple sclerosis have antibodies in their blood that bind tightly to both a protein from the Epstein-Barr virus, called EBNA1, and the adhesion protein made in the brain and spinal cord GlialCAM. To search for this elusive mechanistic link, the researchers started by examining the antibodies produced by immune cells in the blood and spinal fluid of nine MS patients. Unlike in healthy individuals, the immune cells of MS patients traffic to the brain and spinal cord -- highly neurotrophic, where they produce large amounts of a few types of antibodies. Patterns of these antibody proteins, called oligoclonal bands, are found during analysis of the spinal fluid and are part of the diagnostic criteria for MS. No one knows exactly what those antibodies bind to or where they’re from previously. 

This finding is really important and interesting in that it illustrates how autoimmune disease ever generated, not only by what mechanism but also where it came from. 

---Wenqi Song

Malawi Declares Polio Potential Outbreak

Health authorities in Malawi have declared an outbreak of wild poliovirus type 1 after a case was confirmed in a 3-year-old girl in the capital, Lilongwe. The 3-year-old girl experienced paralysis in November, and stool specimens were collected. Virus DNA has been identifies in the stool sample and the strain identified  is linked to one circulating in Sindh Province in Pakistan. Polio remains endemic only in Afghanistan and Pakistan. Whether the girl had traveled to Pakistan or was infected in Malawi is very significant detail that would indicate whether or not transmission was actively occurring in Malawi.

As long as wild polio exists still, anywhere in the world all countries remain at risk of importation of the virus. Increasing immunization rate would largely help with preventing the outbreak. 

--Wenqi

Vitamin D Deficiency Linked to Severe COVID

A newly published paper "Pre-infection 25-hydroxyvitamin D3 levels and association with severity of COVID-19 illness" on PLOS ONE suggests the correlation between low vitamin D status and both an increased risk of infection with SARS-CoV-2 and poorer clinical outcomes. The study searched patients with positive polymerase chain reaction (PCR) tests for SARS-CoV-2 (COVID-19) for historical 25(OH)D levels measured 14 to 730 days prior to the positive PCR test. Results show that a lower vitamin D status was more common in patients with the severe or critical disease than in individuals with mild or moderate disease. Patients with vitamin D deficiency (<20 ng/mL) were 14 times more likely to have severe or critical disease than patients with 25(OH)D ≥40 ng/mL. 

The differences still applied after researchers controlled for the patients' age, gender, and history of chronic diseases.

Knowing this correlation, health officials in several countries have recommended vitamin D supplements during the pandemic. 

--Wenqi

Childhood Trauma May Influence Vaccine Hesitancy

 COVID-19 vaccine hesitancy may be associated with traumatic events in childhood that undermine trust, including domestic violence, abuse in the home, or neglect. Findings by Prof. Mark A. Bellis, College of Human Sciences, Bangor University, United Kingdom, and colleagues, were published online in BMJ Open. Studies found that hesitancy or refusal to get the vaccine increased with the number of traumas reported.

Researchers used responses to a nationally representative telephone survey of adults in Wales taken between December 2020 and March 2021, when COVID restrictions were in force. The survey asked about nine types of adverse childhood experiences (ACEs) before the age of 18, including: parental separation; physical, verbal, and sexual abuse; exposure to domestic violence; and living with a household member who has mental illness, misuses alcohol and/or drugs, or who was incarcerated. About half of the respondents said they hadn't experienced any childhood trauma. Of those who did, one in five said they had experienced one type, 17% reported two to three types, and 10% reported four or more. Survey results showed that people with more ACEs were more likely to have low trust in National Health Service COVID-19 information.

Researchers suggest the effect of childhood adversity needs to be considered at all levels in health systems

---Wenqi Song 

The Unfortunate Link Between Health Misinformation and Moneymaking

I recently read a blog post on MedPage (https://www.medpagetoday.com/opinion/revolutionandrevelation/96978) that discussed the monetization of health information and misinformation. It was written by a physician named Milton Packard who described a conversation that he had with a colleague during the pandemic. Packard has been a columnist for MedPage since 2018 and states that he does not make any money or have any sponsorships for any of the posts that he writes. They are purely written from his perspective, with his personal opinions based on his experience in the medical field. A colleague had recently asked him how much money he made per MedPage article, and the colleague was surprised to find that Packard was writing the articles for free. “You are kidding me! You are giving your work away for free?” The colleague said. “But you are writing whole essays that are very well written and researched. Your opinions are valued, and thousands of people want to read what you write.” The colleague went on to discuss how other physicians like Eric Topol have curated massive twitter followings during the pandemic and who have also joined Substack as a “writer-in-residence” where they share their opinions for a price. But the colleague also discussed the dark side of substack, saying that some people use Substack to profit off spreading health/COVID/vaccine misinformation. “They are making millions of dollars a year by selling their thoughts to subscribers on Substack,” the colleague said. “Being a physician who spreads disinformation about COVID-19 is very profitable.” 

I found the discussion between Packard and his colleague very interesting and eye-opening. In an era where virtually anyone has a platform to speak their mind, due to social media outlets like twitter, information is not as regulated as it used to be. In this regard, it has been hard to control misinformation because anyone can post and anyone can read what they want. However, I think it's an entirely different battle when money comes into the picture. It makes me feel frustrated that people can make millions of dollars each year by promoting misinformation, and I can unfortunately see exactly how that model would work. Someone whose words are provocative, controversial, and extreme may get more views and be in higher demand than someone who speaks with more facts and caution (and who understands the complexity of science), so the person who is spewing misinformation could get paid more. I think it’s very sad to see that money could potentially drive a scientist or doctor to deliberately spread misinformation, and I wonder what the role of hospitals and universities is in regulating this type of speech from their doctors/scientists. 

-Sophia

Pfizer Vaccine for Children

In class today, we had a guest lecturer named Sally Susman, and she is the Executive Vice President and Chief Corporate Affairs Officer at Pfizer. She was telling us that Pfizer's goal is to reduce suffering worldwide and to get medicine to those who need it or who might not have it available. Sally Susman has a team of 400 people around the globe who work together to interact with people around the world. The COVID pandemic changed quite a lot of the company. Their goal at the beginning of the pandemic was to create a vaccine within a year, when this usually takes over a decade to do. And through very long hours and meetings every single day, they were successful.

Currently, Pfizer is trying to get the vaccine available to as many people as possible. Sally Susman told us that the Pfizer vaccine has just been approved in for children older than 6 months old. This has huge implications for the stop of the spread of COVID-19 because it will get rid of a large portion of the unvaccinated population and increase the safety in elementary schools. A big problem before this got approved was unvaccinated children getting and spreading COVID to their families at home. Furthermore, the children were more at risk for a serious or possibly fatal case of COVID because they were unvaccinated. This will greatly decrease the spread of the virus and hopefully reduce some anxiety parents have about their children going to public schools.

-Lauren Burch