(Photo via YouTube)
Don’t take the cinnamon challenge. That’s the advice from doctors in a new report about a dangerous prank depicted in popular YouTube videos that has led to hospitalizations and a surge in calls to U.S. poison centers.
Between fevers, congestion and diarrhea, there are numerous ways that microbes can make us feel sick. But just how do microorganisms cause these symptoms?
At any given time, the microbes inside of our bodies outnumber our own cells by at least 10 to 1. In general, these tiny organisms are harmless — and often beneficial — to us, but some bacteria, viruses, fungi and protozoan parasites cause nasty diseases. For example, Escherichia coli can cause diarrhea, rhinovirus is behind the common cold and the fungus Cryptococcus neoformans can bring about a severe form of meningitis.
As you’ve probably guessed, there is no singular way that microbes make us sick — different biological mechanisms underlie different disease symptoms. So let’s go over some of the ways that microbes cause different symptoms. (Note: This is a general guide and is in no way meant to be a comprehensive description of every symptom you could possibly get.)
Many disease symptoms that befall us are actually caused by the immune system’s response to invading pathogenic microbes, rather than something the microbes are doing, specifically. Take, for instance, the common cold.
When the rhinovirus gets into your upper respiratory tract and invades epithelial cells (those that line the cavities in the body), it triggers inflammatory and immune responses. Certain cells release histamines, which dilate your blood vessels and increase their permeability, allowing white blood cells and some proteins to get to the infected tissues.
You often experience nasal congestion because your inflamed blood vessels are now so large that they stuff you up. But histamines also affect the amount of mucus your body produces, as well as its viscosity — this altered mucus production, along with the increased fluid leakage from now-permeable capillaries, can cause a runny nose.
Similar immune system reactions take place when you develop pneumonia, which is most often caused by bacteria and viruses (especially the bacterium Streptococcus pneumonia). Your body has pretty decent defenses to keep microbes out of the lungs, including nose hairs that filter air and certain reflexes (coughing and sneezing) that shoot microorganisms that enter your body back out. But sometimes that’s just not enough.
If bacteria get inside the alveoli (tiny air sacs in the lungs), they can invade the spaces between cells and even travel to adjacent alveoli. Your immune system responds by once again inflaming your blood vessels and making them permeable, allowing white blood cells and proteins to come to the rescue. But this permeability allows fluids to seep into the alveoli, taking up space that’s needed for the oxygen-carbon dioxide exchange. You become somewhat oxygen deprived and exhibit the shortness of breath that’s a common symptom of pneumonia. Moreover, your respirations increase as you try to bring more oxygen in and blow more carbon dioxide out.
Pneumonia and the common cold are also marked by fever, something that also arises because of our immune system. When white blood cells called macrophages encounter bacteria or viruses in your system, they produce cell-signaling proteins called interleukin-1 (IL-1). These proteins do two things: They call in helper T-cells and they bind to certain hypothalamus receptors in your brain, causing a rise in your body temperature, which is thought to help kill some pathogenic microbes. Substances that induce fevers, such as IL-1, are called pyrogens; some bacteria can induce fevers with pyrogens, too.
Bacteria are divided into two major groups based on the structure of their cell wall: Gram-negative and Gram-positive bacteria. The outer membrane of Gram-negative bacteria, such as E. coli and Salmonella, contains large molecules called lipopolysaccharides, which are made up of lipids and polysaccharide (sugar) chains.
These molecules are also called endotoxins (pdf), and they can act as pyrogens. When certain cells called phagocytes engulf the bacteria, lipopolysaccharides get released, which in turn causes macrophages to release IL-1. These proteins, as you know, cause fever.
But endotoxins can do a lot more than cause fever. For instance, if the bacteria Neisseria meningitides reaches the brain from the bloodstream, it can cause bacterial meningitis (Meningococcal meningitis). Endotoxins stimulate the synthesis of pro-inflammatory molecules called cytokines. So when the bacteria reaches the blood-brain barrier, a sharp inflammatory response ensues, causing cerebral blood vessels to leak protein and fluid, and swelling to develop in the membrane between the brain and skull.
These changes lead to an increase in intracranial pressure, resulting in the common meningitis symptoms of headache, stiff neck and sensitivity to bright lights. The pressure on nerves and decreased blood flow starves the brain of oxygen, leading to permanent brain damage and sometimes death.
The bacteria are more deadly if they stick to the bloodstream, where they can cause a blood infection called sepsis. This ability is partly due to the fact that N. meningitides’s endotoxin concentration is up to a 1,000 times greater than that other Gram-negative bacteria. The toxins target the heart and reduce its ability to pump blood, while also causing blood vessels throughout the body to rupture (more specifically, white blood vessels cause the breaks with the chemicals they release in response to the endotoxin).
As the vessels throughout the body leak, blood pressure drops and blood flow slows, leading to the failure of some major body organs and systems, including the kidneys, liver and central nervous system. The disease can manifest a number of conspicuous symptoms, such as fever, light-headedness, rapid heartbeat and skin rash (from the blood leaking under the skin).
While only Gram-negative bacteria use endotoxins, both Gram-negative and Gram-positive bacteria can cause disease symptoms using exotoxins, a type of protein toxin. Exotoxins are grouped into categories based on their biologic effect on cells: Cytotoxins kill or damage cells, neurotoxins interfere with nerve impulses and enterotoxins affect the intestines.
Many well-known disease symptoms are traced back to exotoxins secreted by various bacteria. For example, the Gram-positive bacterium Streptococcus pyogenes releases three cytotoxins — one of its toxins damages blood capillaries, causing the infamous red rash of scarlet fever. Clostridium perfringens releases a toxin that disrupts normal cellular function and leads to the mass tissue necrosis commonly known as gangrene.
And when Corynebacterium diphtheriae is infected by a certain bacteriophage (bacteria-infecting virus), it can release the diphtheria toxin, which inhibits protein synthesis in cells and eventually causes their death. The cytotoxin can affect a wide range of tissues, and at high concentrations will produce diphtheria’s characteristic swollen neck, often called “bull neck.”
Bacterial neurotoxins are equally well known and scary. The uncontrollable spasms and convulsions of tetanus are all thanks to Clostridium tetani’s neurotoxin, which blocks the relaxation of skeletal muscles. Clostridium tetani’s relative, Clostridium botulinum, excretes a very potent neurotoxin that inhibits the release of the neurotransmitter acetylcholine — this inhibition prevents the transmission of nerve impulses to muscles, resulting in paralysis.
Now, let’s not forget about the wonderful enterotoxins that screw up our intestines. Vibrio cholerae’s cholera toxin (pdf) affects the ion transport and water balance in the intestines, causing epithelial cells to discharge large amounts of fluids and electrolytes. Some toxins produced by E. coli work in a similar way to the cholera toxin, while others are known to affect the intestinal blood vessels, causing bloody diarrhea.
Though we’ve covered quite a bit already, we’ve really only brushed the surface of how microbes bring about disease symptoms. Diarrhea, for example, can also come about when the single-celled parasite Giardia lamblia coats the intestines and prevents nutrient absorption. And the pain and frequent urination associated with urinary tract infections result from inflammation (pain from inflammation occurs only when the appropriate sensory nerve endings are in the inflamed area).
In addition, boils and other abscesses (such as those from a staph infection) can develop after bacteria populate a cut or break in the skin. Neutrophils, which are a type of white blood cells, rush to the infection, leading to inflammation. Eventually, pus forms from the mixture of old white blood cells, dead skin cells and bacteria.
And let’s not even get into viruses, which produce symptoms by triggering immune responses (like the rhinovirus), interfering with cells’ normal processes or destroying cells by exploding out of them.
The ways in which microbes produce disease symptoms are about as varied as the microbes themselves. Some microorganisms mess with our bodily functions, while others are satisfied with just destroying our cells. And, of course, there are all of those pathogens that turn our own immune system against us. Evil buggers.
The month of May is International Multiple Sclerosis Month
But what is Multiple Sclerosis? It’s easy to scroll over these things, but please take a minute to watch our newest video which breaks down the disease (which affects millions worldwide), and then help spread awareness by ‘sharing’ it with your friends and family, however you can.
Join the effort to erase MS!
Gynecologists Question Use Of Robotic Surgery For Hysterectomies
Bolstered by a recent study that found doctors performing hysterectomies performed using a pricey robot didn’t produce better results for patients than ordinary — and cheaper — procedures, the American Congress of Obstetricians and Gynecologists recently threw down a latex gauntlet against the use of robots.
“There is no good data proving that robotic hysterectomy is even as good as—let alone better—than existing, and far less costly, minimally invasive alternatives,” said a March statement by ACOG President James T. Breeden.
One in nine women will undergo a hysterectomy during her lifetime, making it one of the most common surgical procedures for women.
In recent years, more women have opted for a robot-assisted procedure, rather than surgery through a large abdominal incision or traditional laparoscopic surgery, in which a doctor manipulates surgical instruments through small incisions in the abdomen.
A study published in February in JAMA, the Journal Of The American Medical Association, and reports of problems have raised questions about robotic surgery. The Food and Drug Administration has been looking at the popular DaVinci robot system.
Health insurers generally pay for robotic surgery just as they would any other surgical procedure, and for patients, out-of-pocket costs are typically the same as they would be for other options.
Robot-assisted hysterectomy surgery is similar to the conventional laparascopic technique. But the procedure is performed by a surgeon sitting at a console some distance from the operating table who uses hand and foot controls to manipulate surgical tools that are attached to a robot’s arms.
Proponents of robot-assisted surgery say that it can be a good minimally invasive option when surgeries are complex and can result in less blood loss, pain and a quicker return to normal life than traditional open surgery.
But it’s also more costly. The JAMA study of more than 260,000 hysterectomy patients found that the median hospital cost for robot-assisted surgery was $8,868, compared with $6,679 for a laparoscopic hysterectomy.
It also found that although patients who got robotic hysterectomy were less likely than laparoscopic patients to be hospitalized for more than two days, there was no significant difference between the two groups on other measures such as complications and blood transfusion rates.
When hospitals have a robot, use of the $1 million-plus metal assistant tends to rise rapidly. The JAMA study found that between 2007 and 2010 robotically assisted hysterectomy grew from 0.5 percent to 9.5 percent overall.
But the growth was even faster when looking at numbers from just those hospitals with the robots. The researchers said robotic surgeries accounted for 22.4 percent of all hysterectomies at those hospitals three years after the robot arrived.
“As a tool, robotic surgery helps surgeons overcome the limitations of traditional [minimally invasive surgical] techniques to provide patients with a less invasive option and prevent the downstream costs and complications of an open procedure,” says Angela Wonson, a spokeswoman for Intuitive Surgical, the manufacturer of the da Vinci system.
Women who have already had multiple abdominal procedures or those with larger uteruses, “anything that might make the surgery technically difficult,” may be good candidates for robotic hysterectomies, says Jason Wright, an assistant professor of women’s health at Columbia University College of Physicians and Surgeons and the lead author of the study.
Wright uses a robot to perform some gynecologic procedures.
But the choice isn’t always obvious. “One of the things we struggle most with is to figure out which patient will benefit most with robotic surgery,” he says.
A man in Austria developed a cataract shaped like a star in his eye after he was punched, according to a report of his case.
The 55-year-old went to his doctor because his vision in that eye had progressively worsened over the previous six months, according to doctors who treated the man.
The patient said he’d been punched nine months earlier, the doctors wrote in their report.
Talk about seeing stars, sheesh.
Anonymous asked: Whow does ear wax develop?
What a wonderful inquiry! [Assuming you meant “how” as opposed to “whow”.] I hope you don’t mind if I expand from just “how is ear wax produced”, and also give you all some interesting information such as it’s purposes, and useful facts.
Earwax [also known as cerumen] is consistent of sebum, loose skin cells and oily secretion from within the ear, produced by the sebaceous gland, along with secretion from the ceruminous [apocrine] gland, both of which are located within the external [outer-third] canal. Earwax production increases when one experiences varied levels of anxiety, stress, and even fear or pain, along with the use certain drugs.
Like nose hair, earwax is a regularly over looked yet extraordinarily amazing defense system our bodies naturally produce to keep us healthy and happy. Earwax protects our inner ears from outside dangers such as dust, fungi, bacteria, and many other micro-organisms, including insects, that could irritate, and possibly even cause harm to and/or infect, our ears.
As gross as it may appear to some, you do more harm than good when cleaning out your ears with cotton swabs and other “earwax extracting” devices, especially when you poke around in your ear with your fingers. This could cause you to push your earwax farther into your ear, and produce problems with blockage, and even loss of hearing. Earwax not only keeps our ears lubricated, so they don’t dry out and cause discomfort [such as itchiness], whilst simultaneously being water-repellent, but also aids our ears so they’re automatic antibacterial self-cleaners. And besides keeping our ears safe and clean, earwax goes one step further in aiding our hearing by being a type of lubricant for sound waves so they can travel better through the canals.*
I’m sure some of you are now wondering then how am I supposed to clean my ear just in case they feel blocked up with excess earwax? In this case you have two options, visit a doctor so they can professionally help you clear it out, or do it knowledgeably and safely on your own, and here’s how via Canada Body & Health:
[Before attempting to go the latter route and perform ear-cleaning techniques described below by Canada Body & Health, or from this article, on yourself or a family member, talk to your physician to make sure you do it the proper way, and take all the necessary precautions. Health is important, but you should know as much accurate information as possible before doing any sort of self-treatment through extensive research and consulting your personal doctor.]
- First you will need to soften the wax. A couple of times a day for a few days, apply several drops of baby oil, mineral oil, glycerine, hydrogen peroxide, or commercially available products into your ear canal.
- Once softened, the wax can be washed out. To do this, tilt your head to the point where your ear canal is straight and use a rubber-bulb syringe to gently squirt water into the ear canal. Tip your head to let the water drain.
- Dry your ear with a towel or a hair dryer set on the cool setting.
“People with diabetes or weakened immune systems should consult their doctor before attempting this at home.
When to see a doctor: Make an appointment with your doctor if home treatments do not help or if your hearing has diminished. If you use hearing aids or are prone to blockage, you might choose to set up regular preventive ear-cleaning appointments with your doctor.”
Here is a graph [x] so you can visualize what I described above:
So I hope this answered your question, and gave you all a bit of a peek at the workings of your wonderful ears!
*Still looking further into how the wax specifically “helps” the sound-waves travel as I have not found the exact details as of yet.
A promising clinical study shows that the turkey tail mushroom (Trametes versicolor) improves the immune systems of breast cancer patients. The multiyear study, funded by the National Institutes of Health (NIH), tracked whether or not turkey tails could positively affect the immune system of patients rebound after they ended their radiation therapy.
Immunity — as measured by the number of lymphocyte cells and natural killer cell activity — usually declines dramatically after radiotherapy. Natural killer (NK) cells protect us from tumors and viruses. Researchers at the University of Minnesota Medical School and Bastyr University Research Institute hypothesized that breast cancer patients’ health can be improved after radiation treatment if NK cell counts increased quickly to attack remaining cancerous cells.
The study titled “Phase I Clinical Trial of Trametes versicolor in Women with Breast Cancer,” recently published in the ISRN Oncology Journal, shows that turkey tail mushrooms can augment conventional therapies for treating breast cancer by increasing NK and CD8+T cell activity. This study suggests that turkey tail mushrooms are an effective adjunct to conventional chemotherapeutic medicines and radiation therapy. The authors concluded:
… research by our center continues to indicate that Trametes versicolor represents a novel immune therapy with significant applications in cancer treatment … The CD8+ T cell counts over the 9-week dose escalation study were enhanced in the 9 gm Tv dose cohort compared to both the 3 g or 6 g group. One-way ANOVA was used to analyze the overall difference between dosage groups over the treatment period (2-4-6 weeks). It showed the statistically significant increase in the CD8+ cytotoxic T cells for the 9 g group compared to both the 3 g and 6 g group (F(2, 6) = 42.04, P = 0.0003).
Due to its long history of therapeutic use, however, turkey tail prepared and packaged as an immune therapy drug is unlikely to be patentable, deterring big pharmas from conducting costly clinical studies. Typically, the longer the historical use of natural medicines for treating an ailment, the less likely derivatized drugs from these natural products will be patentable. To fill this research gap, the NIH established The National Center for Complementary and Alternative Medicine (www.nccam.nih.gov), which funded and oversaw this study. NIH’s interest is not surprising — more than 70 percent of new drugs are estimated to originate from natural sources.
Turkey tail mushrooms have been used to treat various maladies for hundreds of years in Asia, Europe, and by indigenous peoples in North America. Records of turkey tail brewed as medicinal tea date from the early 15th century, during the Ming Dynasty in China. Our ancestors certainly encountered them and most likely explored their uses long before written history. Since the late 1960s, researchers in Japan have focused on how turkey tail benefits human health and how extracts of turkey tail can boost the immune system.
What are turkey tail mushrooms?
This super-abundant colorful mushroom grows on dead trees, logs, branches, and stumps. Turkey tail mushrooms are called bracket fungi, meaning that they form thin, leather-like and leaf-like structures in concentric circles. Rather than gills underneath, as in shiitake mushrooms, their undersides have tiny pores, which emit spores, placing them in the polypore family. These mushrooms grow throughout the world, practically wherever trees can be found. In fact, turkey tails are some of most common mushrooms found on wood on the planet.
They are commonly called “turkey tail” because their various colors: brown, orange, maroon, blue and green — reminiscent of the plume of feathers in turkeys. In China, their common name is yun zhi. In Japan, this mushroom is known as kawaritake or “cloud mushrooms,” invoking an image of swirling clouds overhead. In many Asian cultures, turkey tails’ incurving cloud forms symbolize longevity and health, spiritual attunement and infinity.
What are the medicinal properties and how is it used?
Traditionally, our ancestors boiled mushrooms in water to make a soothing tea. Boiling served several purposes: killing contaminants, softening the flesh, and extracting the rich soluble polysaccharides. The mushrooms — called fruiting bodies by mycologists — are made of densely-compacted cobwebby cells called mycelium. With modern laboratory methods of cell tissue culture, the large-scale production of mycelium brought to light a whole new array of medicinal preparations. Nowadays, the commercial production of mycelium enables a cleaner and more digestible product than traditional mushroom preparations. Surprisingly, novel compounds are continually being discovered, which are not available using traditional preparations of the fruiting bodies, but are detectable within, and excreted from the rapidly growing mycelium.
The natural killer cells promoted by ingesting turkey tails also target virally-infected cells. Moreover, turkey tail mycelium excretes strong antiviral compounds, specifically active against Human papillomavirus (HPV), which causes cervical cancer, and hepatitis C virus (HEP-C), which causes liver cancer. Viruses that induce cancer are called “oncoviruses.” The virus-to-cancer connection is where medicinal mushrooms offer unique opportunities for medical research. The current thinking amongst many researchers is that turkey tails and other medicinal mushrooms lessen the odds of getting cancer by reducing causal co-factors such as oncoviruses.
The interplay between an infection during pregnancy and stress in puberty plays a key role in the development of schizophrenia, as behaviourists from ETH Zurich demonstrate in a mouse model. However, there is no need to panic.
Around one per cent of the population suffers from schizophrenia, a serious mental disorder that usually does not develop until adulthood and is incurable. Psychiatrists and neuroscientists have long suspected that adverse enviromental factors may play an important role in the development of schizophrenia. Prenatal infections such as toxoplasmosis or influenza, psychological, stress or family history have all come into question as risk factors. Nevertheless, until now researchers were unable to identify the interplay of the individual factors linked to this serious mental disease.
However, a research group headed by Urs Meyer, a senior scientist at the Laboratory of Physiology & Behaviour at ETH Zurich, has now made a breakthrough: for the first time, they were able to find clear evidence that the combination of two environmental factors contributes significantly to the development of schizophrenia-relevant brain changes and at which stages in a person’s life they need to come into play for the disorder to break out. The researchers developed a special mouse model, with which they were able to simulate the processes in humans virtually in fast forward. The study has just been published in the journal Science.
Mom’s love good for child’s brain
School-age children whose mothers nurtured them early in life have brains with a larger hippocampus, a key structure important to learning, memory and response to stress.
The new research, by child psychiatrists and neuroscientists at Washington University School of Medicine in St. Louis, is the first to show that changes in this critical region of children’s brain anatomy are linked to a mother’s nurturing.
Their research is published online in theProceedings of the National Academy of SciencesEarly Edition.
“This study validates something that seems to be intuitive, which is just how important nurturing parents are to creating adaptive human beings,” says lead author Joan L. Luby, MD, professor of child psychiatry. “I think the public health implications suggest that we should pay more attention to parents’ nurturing, and we should do what we can as a society to foster these skills because clearly nurturing has a very, very big impact on later development.”
The brain-imaging study involved children ages 7 to 10 who had participated in an earlier study of preschool depression that Luby and her colleagues began about a decade ago. That study involved children, ages 3 to 6, who had symptoms of depression, other psychiatric disorders or were mentally healthy with no known psychiatric problems.
As part of the initial study, the children were closely observed and videotaped interacting with a parent, almost always a mother, as the parent was completing a required task, and the child was asked to wait to open an attractive gift. How much or how little the parent was able to support and nurture the child in this stressful circumstance — which was designed to approximate the stresses of daily parenting — was evaluated by raters who knew nothing about the child’s health or the parent’s temperament.
“It’s very objective,” Luby says. “Whether a parent was considered a nurturer was not based on that parent’s own self-assessment. Rather, it was based on their behavior and the extent to which they nurtured their child under these challenging conditions.”
The study didn’t observe parents and children in their homes or repeat stressful exercises, but other studies of child development have used similar methods as valid measurements of whether parents tend to be nurturers when they interact with their children.
For the current study, the researchers conducted brain scans on 92 of the children who had had symptoms of depression or were mentally healthy when they were studied as preschoolers. The imaging revealed that children without depression who had been nurtured had a hippocampus almost 10 percent larger than children whose mothers were not as nurturing.
“For years studies have underscored the importance of an early, nurturing environment for good, healthy outcomes for children,” Luby says. “But most of those studies have looked at psychosocial factors or school performance. This study, to my knowledge, is the first that actually shows an anatomical change in the brain, which really provides validation for the very large body of early childhood development literature that had been highlighting the importance of early parenting and nurturing. Having a hippocampus that’s almost 10 percent larger just provides concrete evidence of nurturing’s powerful effect.”
Luby says the smaller volumes in depressed children might be expected because studies in adults have shown the same results. What did surprise her was that nurturing made such a big difference in mentally healthy children.
“We found a very strong relationship between maternal nurturing and the size of the hippocampus in the healthy children,” she says.
Although 95 percent of the parents whose nurturing skills were evaluated during the earlier study were biological mothers, the researchers say that the effects of nurturing on the brain are likely to be the same for any primary caregiver — whether they are fathers, grandparents or adoptive parents.
The fact that the researchers found a larger hippocampus in the healthy children who were nurtured is striking, Luby says, because the hippocampus is such an important brain structure.
When the body faces stresses, the brain activates the autonomic nervous system, an involuntary system of nerves that controls the release of stress hormones. Those hormones help us cope with stress by increasing the heart rate and helping the body adapt. The hippocampus is the main brain structure involved in that response. It’s also key in learning and memory, and larger volumes would suggest a link to improved performance in school, among other things.
Past animal studies have indicated that a nurturing mother can influence brain development, and many studies in human children have identified improvements in school performance and healthier development in children raised in a nurturing environment. But until now, there has not been solid evidence linking a nurturing parent to changes in brain anatomy in children.
“Studies in rats have shown that maternal nurturance, specifically in the form of licking, produces changes in genes that then produce changes in receptors that increase the size of the hippocampus,” Luby says. “That phenomenon has been replicated in primates, but it hasn’t really been clear whether the same thing happens in humans. Our study suggests a clear link between nurturing and the size of the hippocampus.”
She says educators who work with families who have young children may improve school performance and child development by not only teaching parents to work on particular tasks with their children but by showing parents how to work with their children.
“Parents should be taught how to nurture and support their children,” Luby says. “Those are very important elements in healthy development.”
(Image: The hippocampus (highlighted in fuchsia) is a key brain structure important to learning, memory and stress response. New research shows that children who were nurtured by their mothers early in life have a larger hippocampus than children who were not nurtured as much. Credit: Washington University Medical School from press release)
Gonorrhea is caused by the bacteria Neisseria gonorrhoeae. The bacteria grow in warm, moist areas of the body, including the tube that carries urine out of the body (urethra). In women, the bacteria may be found in the reproductive tract (which includes the fallopian tubes, uterus, and cervix). The bacteria can even grow in the eyes.A gonorrhea infection that has not spread to the bloodstream or other areas almost always can be cured with antibiotics. Gonorrhea that has spread is a more serious infection but almost always gets better with treatment.
A third of the world’s population is infected with Toxoplasma gondii and scientists find that the parasite can modify the brain.
Doctors announced on Sunday that a baby had been cured of an H.I.V. infection for the first time, a startling development that could change how infected newborns are treated and sharply reduce the number of children living with the virus that causes AIDS.
The baby, born in rural Mississippi, was treated aggressively with antiretroviral drugs starting around 30 hours after birth, something that is not usually done. If further study shows this works in other babies, it will almost certainly change the way newborns of infected mothers are treated all over the world. The United Nations estimates that 330,000 babies were newly infected in 2011, the most recent year for which there is data, and that more than 3 million children globally are living with H.I.V.
If the report is confirmed, the child born in Mississippi would be only the second well-documented case of a cure in the world, giving a boost to research aimed at a cure, something that only a few years ago was thought to be virtually impossible.
The first person cured was Timothy Brown, known as the “Berlin patient,’’ a middle-aged man with leukemia who received a bone-marrow transplant from a donor genetically resistant to H.I.V. infection.
“For pediatrics, this is our Timothy Brown,’’ said Dr. Deborah Persaud, associate professor at the Johns Hopkins Children’s Center and lead author of the report on the baby. “It’s proof of principle that we can cure H.I.V. infection if we can replicate this case.’’
Dr. Persaud and other researchers spoke in advance of a presentation of the findings on Monday at the Conference on Retroviruses and Opportunistic Infections in Atlanta.
Some outside experts, who have not yet heard all the details, said they needed convincing that the baby had truly been infected. If not, this would be a case of prevention, something already done for babies born to infected mothers.
“The one uncertainty is really definitive evidence that the child was indeed infected,” said Dr. Daniel R. Kuritzkes, chief of infectious diseases at Brigham and Women’s Hospital.
Dr. Persaud and some other outside scientists said they were certain the baby – whose name and gender were not disclosed – had been infected. There were five positive tests in the baby’s first month of life – four for viral RNA and one for DNA. And once the treatment started, the virus levels in the baby’s blood declined in the pattern characteristic of infected patients.
Dr. Persaud said there was also little doubt that the child experienced what she called a “functional cure.” Now 2½ , the child has been off drugs for a year with no sign of functioning virus.
The cochlea, pictured super-magnified, is a spiralling tunnel that leads deep inside our ear. It acts as a funnel, feeding sound from the outside world through a ‘lawn’ of sensory hair cells which line the organ of corti, highlighted here in red. As noise floods in, the sensory hairs wave around, opening up electrical channels that take speedy messages to the brain. Our auditory hair cells are intricate and fragile, making them prone to damage by diseases and infections. The World Health Organization (WHO), promoting today as International Day for Ear and Hearing, supports immunization schemes worldwide in efforts to prevent hearing loss. They also advise on safety for people with noisy jobs – after all, constant exposure to loud noises can rip out our sensitive ear hair cells. Such damage is irreparable; we are born with just 30,000 of these precious hairs and once they’re gone, they’re gone for good.
Written by John Ankers
A ‘functional HIV cure’ — In a monumental first for medicine, doctors announced today that a baby has been cured of an HIV infection. Dr. Deborah Persaud, who presented the child’s case today at the 20th annual Conference on Retroviruses and Opportunistic Infection, called it “definitely a game-changer.”
Persaud, of Johns Hopkins University Medical School, is the lead author of a report recounting the child’s treatment. The identity of the little girl, who was born to an HIV-positive woman in rural Mississippi, has yet to be released. What we do know is that she is only the second person in the world — and the first child — to be cured of HIV in its devastating 32-year history. If the case is confirmed, it is truly unprecedented.
The abstract for Persaud’s presentation (which can be found in its entirety here) provides details of the child’s treatment, which involved very early administration of antiretroviral therapy (ART), initiating treatment when the child was just 30 hours old (emphasis added):
Methods: Infant exposure to HIV was confirmed through review of maternal HIV antibody and plasma viral load tests, including HIV drug resistance testing. Infant infection was documented using standard HIV DNA polymerase chain reaction (PCR) and plasma viral load. ART administration was confirmed with medical and pharmacy records and maternal report of medication adherence. Persistence of HIV infection following treatment discontinuation was assessed using standard clinical assays that included plasma viral load, proviral DNA, and HIV antibody testing. Ultrasensitive HIV DNA (droplet digital PCR), plasma viral load (single copy) assays, and quantitative co-culture assays were done at age 24 and 26 months to further assess HIV persistence. HLA typing was done to confirm matching of the mother–infant pair.
Results: Maternal infection with wild type subtype B HIV was verified. The mother and infant shared HLA haplotypes. Infant infection was confirmed by positive HIV DNA and RNA testing on 2 separate blood samples obtained on the 2nd day of life. 3 additional plasma viral load tests (days of life 7, 12, and 20) were positive before reaching undetectable levels at age 29 days.
The child, who is now 2 and a half years old, has reportedly been off drugs for a year. Still, her blood tests continue to show no signs of a functioning virus.
The authors’ conclusions say it all: “This is the first well-documented case of functional cure in an [HIV-positive] child and suggests that very early [antiretroviral therapies] may prevent establishment of a latent reservoir and achieve cure in children.
We’ll keep you posted as more info comes to light. In the meantime, read the researchers’ account of the girl’s case at CROI: “Functional HIV Cure after Very Early ART of an Infected Infant.” See also: these general overviews by NPR and the NYT.
I have no words for how awesome this is, here’s hoping a fully functioning cure is now in the near future.