Author: michellelee7

Coronavirus, also known as COVID-19, is an infectious disease that causes severe respiratory-related illness. The review article from the Asian Pacific Journal of Allergy and Immunology suggests that it’s caused by the strain SARS-CoV-2 and this strain is known to have evolved from zoonotic betacoronavirus that infected animals. This evolved strain became a new human coronavirus, COVID-19, and started spreading worldwide. Although there are no vaccines available to treat the virus, there are antibody responses that are produced. IgM is the first antibody response produced during the first contact to an antigen. This antibody protects the body from the bloodstream infections and it helps to trigger the classical pathway of complement system activation. Another type of antibody, IgG provides long term protection of the body with the half-life of 21 days. This means half the number of IgG molecules will be reduced after 21 days. IgG is the first class of antibody produced during the secondary response. Another important aspect of this antibody is its ability to pass from mother to fetus through vertical transmission. Mother passes down the IgG antibodies to the fetus before the birth and they continue to pass down through breast milk. 

Antibody titer is a laboratory test that depicts the presence and amount of antibodies in the blood. If the test is positive, the body has developed immunity. This means that antibodies were produced to fight off the antigens. The importance of having both IgM and IgG antibody is because IgM is released during primary response and IgG is released during secondary response. Having only the IgM means that it may fight of the antigen when it first encounters but if the same antigen is encountered later, there will be no antibodies released to fight off the antigen. Thus, it is crucial for presence of both IgM and IgG antibody. If we could determine an individual who was IgG positive with low or no IgM antibody, it will allow us to know that this individual may had infection sometime in the past. This also means that individual may carry the infection asymptomatically and infect others without knowing.  

Relating back to antibody response in COVID-19, according to the review article from the Norwegian Institute of Public Health, one study showed that infants delivered by coronavirus infected mothers had increased levels of IgG and IgM levels with more infants having the increased IgG levels. In addition, the study shows that there is sustained IgG levels one year after the infection of coronavirus and the level persisted up to 13 years after the infection. Along with that, two studies averaged out the seroconversion timing for both IgM and IgG antibodies and it showed that timing ranged from 10-12 days and 12-14 days respectively. The preliminary study in the review article from APJAI also supports that one patient showed peak of IgM at day 9 after the onset of COVID-19 and switched to IgG by the second week. Another type of coronavirus, SARS-CoV, shares a good amount of its genetic material with COVID-19 and this infection induces long lasting specific IgG and neutralizing antibody in the body for up to 2 years after the infection. However, even though COVID-19 may be similar to SARS-CoV, there are no supporting researches that COVID-19 will activate same immune response in the body. Through this, one can learn that IgM and IgG response play a crucial role in fighting off the antigens. Moreover, tracing back the steps of antibody production and response allow tests to be done in determining whether or not someone was infected and if that person showed symptoms. 

T cell immunotherapy is used as a type of cancer treatment that allows the body’s immune system to detect and destroy cancer cells. One of the ways that T cell therapy is used to treat patients is through CD19-targeted chimeric antigen receptor (CAR) modified T cell immunotherapy. According to a journal article from ScienceDirect, a website publishing peer-reviewed science journals, this therapy serves as a treatment that brings promising results in patients with relapsed/refractory lymphoid malignancies. Cluster of differentiation (CD) markers are cell surface molecules that allows scientists to distinguish between subsets of T cells and other white blood cells. Thus, CD19 indicates that it is B cell specific antigen that T cells are modified in the lab to find and destroy.

Before the process of how CAR T cell therapy is further explained, it is important to know the basic understandings of the relationship between antigen and immune receptors. Antigens are proteins that are attached on the surface of foreign substances. The immune system recognizes foreign substances in the body by finding those proteins. When the antigens are detected, T cells, a type of white blood cells, have their own proteins called receptors that attach to the antigens and destroy foreign substances by activating other parts of the immune system. Each foreign antigen has one immune receptor that binds to it. This being said, modifying the T cells is an essential step in the process of CAR modified T cell immunotherapy. As stated in the article on the American Cancer Society website, the white blood cells which includes T cells are removed from the patient’s blood first using the procedure called leukapheresis. After that, the T cells are separated and, in the lab, they are genetically modified by adding man-made chimeric antigen receptor (CAR). Each CAR is made for a specific cancer’s antigen. In the CD19-targeted chimeric antigen receptor modified T cell immunotherapy, CAR is made specifically to target CD19 antigen on the outside of the cancer cells. Therefore, this CAR does not work on cancer cells without CD19 antigens. Before CAR T cells are infused back to the patient, the patient may be given a weak chemotherapy. Chemotherapy helps to reduce the number of other immune cells so that CAR T cells has the chance to be activated. Moreover, it is given not very strong since CAR T cells work the best when there are some cancer cells to attack. 

Just like other treatments, there are side effects resulting from CAR T cell therapy. According to the article in the American Cancer Society website, as the CAR T cells multiply rapidly in the body to fight the cancer, it causes chemicals called cytokines to be released in massive amounts into the blood. This release causes the cytokine release syndrome and the patients may experience very high fevers and very low blood pressure. Along with that, CAR T cells can kill good B cells that help fight germs and patients may be at risk for infection. Other serious effect is neurotoxicity and this causes changes in the brain resulting in swelling, confusion, seizures, or severe headaches. The journal article from ScienceDirect includes patient-reported outcomes from receiving CD19-targeted chimeric antigen receptor (CAR) modified T cell immunotherapy. 37.5% of the patients reported cognitive difficulties after the CAR T cell therapy and the article states that there was a trend for a positive association between acute neurotoxicity and self-reported post-CAR T cognitive difficulties. No matter how advanced or minimal treatments may be, side effects and complications still follow as they do with more complicated treatments and they seem unavoidable. Therefore, I believe that taking care of your body and staying healthy are the best preventions and treatments that one can do for him/herself.

I’m sure this is many people’s first time dealing with the crisis like this but I feel like I’m being low- key homeschooled and this is definitely something very new to me. I usually love staying home all day but ever since I’m kind of “forced” to stay at home, I’ve been wanting to go outside almost every day. For example, I usually do fine staying at home to do my school work but for some reason, I can’t concentrate at home now and want to go to coffee shops to study and get things done. In psychology, there is a term called psychological reactance which is defined as a motivational arousal that occurs when people lose the freedom to control their behaviors. In other words, when a person feels that their choices are taken away or they are being limited by something or someone. I feel like I’m experiencing this arousal in a way or maybe there’s a sudden explosion of extrovertedness happening in me that’s causing this urge to go outside and hang out with people. 

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I’ve been relieving the thirst to go outside by helping out at my dad’s restaurant. I’ve been working at his restaurant as a waitress on the weekends for three years now. Since the restaurants are only allowed to take take-out orders now, I’ve been chilling at work because I don’t have to deal with serving food and cleaning up tables. Although I do enjoy going to work and seeing customers, simultaneously, I’m low-key paranoid about talking to people and being so close to them since coronavirus is so contagious and can be transmitted easily. In order to prevent transmission, I wash my hands every time after I touch people’s cards and before I touch my phone, chair, phone, etc. Along with that, I try to limit talking to the customers. With stimulus package, my family is hoping that it’ll help with my dad’s restaurant. 

I took a fall semester off this school year and came back this semester after deciding that I’m going to keep my psychology major and just apply for ABSN program after I graduate. I’m so shocked that this crisis is affecting so many systems from unemployment to alternating education systems. At first, when I heard that all of the classes were going to transition remotely, I was happy that I didn’t have to drive to UNC in the mornings anymore. Now, I’m starting to miss walking around in campus and seeing student activities happening around the pit. Along with that, I feel like there are more things to keep up for all of my classes now and since everything is online and I’m not good with technologies, it’s a little bit hard for me to adapt to this new transition. I’m so glad I’m taking this class now because it helps me to understand the material better with what’s happening in the world now. I’m hoping that everything will only get better from now on and trying to stay positive and being thankful for the people working hard to alleviate the current situation. 

Sexually transmitted infections, or STIs, are infections resulting from sexual contact that spread from person to person. Generally, they are spread through close sexual contact with body fluids that include but not limited to vaginal secretions, urethral discharge, and often through saliva. With this being said, the infections usually occur and are transmitted through unprotected sexual contact. Since many STIs are asymptomatic, it spreads unknowingly from infected person to others and may have different symptoms such as pain with urination, genital sores, rashes depending on the pathogen. There are curable antimicrobial medications for common bacterial STIs and with viral STIs, some antivirals may reduce the severity and duration of symptoms. 

One of common bacterial STIs is gonorrhea which is caused by Neisseria gonorrhoeae, a gram-negative diplococcus. According to a review article in the Clinics in Colon and Rectal Surgery, from the E-journal, transmission of gonorrhea occurs during asymptomatic period and the common symptoms include urethral discharge, dysuria, and vaginal discharge. With increasing cases of gonorrhea in the United States, CDC recommended treatment include dual therapy due to the potential for antimicrobial resistance and in the research article published on CDC, there are injectable medications available in the clinics that also helps to relieve drug resistance. 

Another common bacterial STI is syphilis. This disease occurs more commonly in male than females and humans are the only reservoir. The review article from the E-journal website states that there are three progressive stages of manifestations if left untreated. Moreover, the trademark symptom of this infection is genital ulcer or chancre on the site of inoculation and although the chancre may heal without treatment, there is a subsequent latent infection that follows. The recommended first-line treatment for syphilis is an injectable antimicrobial drug of penicillin G benzathine which alleviates the drug resistance to the pathogen according to the CDC research article. 

I think the most important takeaway from this blog post is the emphasis on the importance of having a monogamous relationship with an uninfected person and the necessity of having protected sex. Although the condom use does not ultimately protect one from contracting STIs, I still believe that it’s one of the effective measures that a person should use in order to reduce the risk of obtaining STIs. The pleasure of having an unprotected sex may be great at that moment of time but the consequences that might follow is definitely not worth the pleasure that one may had. Moreover, it is scary to know that many STIs are asymptomatic with some of them having a long incubation period, which loops back around to the seriousness of protecting one’s body. 

Superbug is classified as antibiotic resistant microbes that are emerging in the world. The emergence of superbugs is due to imprudent and redundant use of antibiotics on illnesses such as the flu, cold, etc. According to the research article published on ACM Digital Library, a research platform, the World Health Organization delineated 12 antibiotic-resistant bacteria as superbugs. There are many problems associated with the emergence of superbugs with one of them being increasing morbidity and mortality rates. This is due to bacteria’s ability to evolve every time with exposure to antibiotic treatment. Along with that, in the research article, it mentions that there is extremely little information antibiotic resistance so it is difficult to develop a solution to the problem. 

As mentioned in the paragraph above, the emergence of antibiotic resistant bacteria is due to misusage of the antibiotics in humans and inability to create antibiotics that bacteria can’t evolve from. The article on superbugs from Indian Journal of Practical Pediatrics describes superbugs as the microbes that evolved through “survival of the fittest”. Moreover, some superbugs are multidrug resistant which makes it even more challenging. Losing the ability to use antibiotics is another deadly threat posed to the human population. This means there are no longer effective treatments available for certain conditions and people who are vulnerable to illnesses are at a greater risk. 

Before I took this class, I have never heard about superbug and through doing this blog, I realize how threatening superbug actually is. The fact that there is very little information about the mechanism of antibiotic resistance is alarming to me and also makes me wonder what the medical researchers are doing about the problem. Some bacteria are building resistance to some of the very powerful antibiotics and I wonder what steps the medical researchers will take next in order to stop this from rising into something worse. It is even more cautionary for people who are susceptible to diseases and the regions around the world that are not aware of the importance of infection control. In this situation, I think the best way to delay the emergence of more superbugs is to practice efficient antibiotic management and infection control.

Poliomyelitis, or commonly known as Polio, is a type of viral disease of the central nervous system. The causative agent is a non-enveloped, single-stranded RNA enterovirus and is a member of the Picornaviridae family. The main characteristic of this disease is the destruction of motor neurons which results in large muscle paralysis such as arms and legs. According to the review article published by Bangladesh Journal of Medicine, there are three serotypes of poliovirus and protection against one type does not provide protection to the two other types. The only reservoir are humans with a main mode of transmission being fecal/oral route. There are two types of polio vaccines available that are commonly used throughout the world, which are IPV and OPV. 

IPV, or inactivated polio vaccine, is a type of polio vaccine administered through an injection using the sterile syringe. OPV, or oral polio vaccine, is a type of polio vaccine consisting of an attenuated poliovirus. This can be administered orally, as drops on the tongue. Compared to the IPV, OPV is a more popular and convenient option because the cost of production is low, does not require syringes, and stimulates durable immunity, according to the research article posted on PLOS, a nonprofit journal publishing website. Moreover, the review article on the Bangladesh Journal of Medicine affirms that intestine is the primary site of the poliovirus entry and the strains in OPV produce effective immunity in the intestine as well as immunity to all three serotypes of the poliovirus. 

In the last six months, there hasn’t been a case of polio in the world. The PLOS research article states that number of incidences of polio cases has been reduced by more than 99.9% globally with wild polio virus occurrence only in three countries, Afghanistan, Nigeria, and Pakistan, since 2018. The use of polio vaccines since 1988 helped to significantly drop the number of cases in the world, which shows that vaccines have been effective. Although there are pros and cons to each type of vaccine, I believe that it has been efficacious in the effort to eradicate poliovirus because research shows that out of the three serotypes, type 2 and 3 has been eradicated. Even though type 1 virus is still prevailing in the three countries, some protection is better than no protection and I’m very impressed to know about the precipitous drop in the global cases as well as the effect of two polio vaccines. 

Microbiome is a collection of the microbes that are established in human body and they are combinations of bacteria, parasites, fungi, and viruses. Just like how everyone has their own unique DNA, everyone has their own unique combination of microbes that is regulated by the DNA. According to an article published by Harvard T.H. Chan, School of Public Health, the person’s first exposure to microbiome is during delivery either through the birth canal or through caesarean section. The type of microorganisms that infants are exposed to depends on the method of delivery and the type of species that the mother carries. Breast milk also presents the infant to specific microorganisms that are found in the milk. This allows each person to compose of their own unique microbiome. 

The microorganisms found in the body are symbiotic, or beneficial and some are pathogenic, or harmful. In a healthy individual, the coexistence of both the symbiotic and pathogenic microbes are possible as long as there is no interruption in the body such as illnesses that impedes the balance of those microbes. With the harmonious balance in the body, there are many health benefits resulting from the microbiome. For example, the healthy immune system is maintained by the microbiome of the gastrointestinal tract, ensuring the breakdown of the toxic food chemicals, based on the research article published on PLOS, a nonprofit publisher organization. Moreover, as mentioned in the article by Harvard, the families of bacteria found in the gut and the colon protects the gut by preventing the growth of harmful bacteria, leading to healthy immune system.  

There are many health benefits associated with microbiota but as mentioned in the previous paragraph, if dysbiosis occurs, our body may become more vulnerable to diseases. Balanced microbiome fights off the pathogens that are acquired through contaminated water or food but if there is a disturbance between the microbes, these microbes may not be able to provide any protection and will not be able to function normally. Along with that, according to ‘hygiene hypothesis’ stated in the PLOS research article, the intestinal dysbiosis can be associated with the increased incidence of the immune-related disorders.

Before doing my research on microbiome, I did not know that it had many different roles in our body, contributing to organization of many systems. That being said, microbiome plays a critical role in keeping the body systems in check and being the first line of defense if any pathogenic organisms enter the body and try to cause disruptions. I also realized that it is crucial to not stimulate it and keep it disturbance-free because although it would normally provide us with beneficial prevention and protection, it could also make our body more susceptible to diseases. Thus, maintaining a disturbance-free microbiome should be our first priority in order to stay healthy.

Influenza, commonly known as the flu, is a respiratory illness resulting from the influenza viruses, especially from the viruses A and B. It is contagious and the severity ranges from mild to severe and may cause death in some cases. Annually, the flu season starts late fall and lasts till late winter. When it comes to flu vaccination, according to the article published by CDC, flu viruses changes constantly. Thus, the flu vaccinations compose of different attenuated strains every year.

The effectiveness of the flu vaccination is always in question by many people as flu season rolls around each year. Based on the report published on CDC, there are various factors that determines the effectiveness of the vaccines such as age and health conditions of the person as well as the similarity between the strains in the vaccine and the circulating flu viruses. Along with that, the timing of vaccination plays some role in effectiveness of the vaccines. The onset of the flu is unpredictable so there is no exact time to when the vaccination should be given. However, it is recommended that vaccines should be available by end of October according to the report published on CDC. Even though it is not guaranteed that vaccines will prevent vaccinated person from getting the flu, it does provide crucial protection from the illness and the complications that may follow.

As Dr. Cramer always says, “Protection is better than no protection at all!”, I definitely agree with that saying and I’m strongly in favor of the flu vaccination. As stated on the paragraph above, although vaccines cannot provide 100% protection from the flu, it still serves as a method of prevention for older adults, people with health complications and pregnant women according to the article published in NPR. The article also states that based on the recommendations from the WHO infectious disease experts, the 2019-20 vaccine contains four live, attenuated strains: two influenza A strains that are changed from last year’s strains to match the circulating viruses and two influenza B strains that stayed the same. I believe this year’s vaccine is effective because the disease experts continue to find strains that are most similar to that of the circulating viruses and it’ll still be used as preventative measure for the complications that follows the flu.

Hi! My name is Michelle Lee and this post is an introduction about myself.

I’m originally from Busan, South Korea but I moved to the States when I was 11 years old. I lived in Duluth, Georgia for a year and moved to Cary, North Carolina and lived there since then.

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I’m a psychology major with a neuroscience minor and I’m supposed to be a graduating senior this year but I took a fall semester off last year because I did not want to graduate without knowing what I wanted to do after graduating. I’m back this spring semester after taking a 3-month CNA program while I was taking the semester off and now I want to get into ABSN program at either UNC or Duke after I graduate.

I’m taking this class because I believe that it’ll serve as an important foundation to my future learning in the nursing program!