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05: The Microbes IN and ON us with Dr. Amy Proal
1.1k Plays4 months ago
In this episode, I talk with CEO of PolyBio Research Foundation, Dr. Amy Proal, who is a microbiologist passionate about advancing science in a way that we understand the roots and drivers of the chronic illnesses that impact millions of people every day. We talk about everything from persistent pathogens, to breaking down elitism in science, and so much more. I loved this episode! You’re going to learn so much!
PS: So sorry I’ve been away! I had a bit of a hiccup in my life due to this real estate transaction (just google my name and New York Times to learn about that)
So glad to resume here on the podcast. Thank you everyone for your support.
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Transcript
Microbial Evolution and Energy Disruption
00:00:00
Speaker
Many bacteria, many viruses have evolved ways by which they infect a cell, they get to the center of the cell, they pull the substrates out of our own mitochondria and they use them for their own energy or for their own replication, which alters our energy metabolism, usually never in a good way.
00:00:38
Speaker
First, thank you for coming on my podcast. I'd love to know all about you. I already know several things about you, but for everyone who's just perhaps meeting you for the first time, what's the elevator pitch on? All things Dr. Amy, pro al.
Dr. Amy's Nonprofit and Team Collaboration
00:00:55
Speaker
you Okay, so I'm a microbiologist, but I'm also the president of a nonprofit research organization that I founded with my partner, Mike Van Ellsiger, who's a neuroscientist at Harvard. And we run this nonprofit to study what we call either infection-associated chronic disease or post-acute infection syndromes. It depends what you want to call them. But basically, we're studying the chronic consequences of infection. And what we're looking at is every with every pathogen.
00:01:22
Speaker
with with anything you could get, bacterial infections, viral infections, a subset of people who get the infection don't recover. like They get sick and they get continual symptoms, and this can even last for a lifetime. With long COVID, ah many people have probably heard of being a prime example of that. You get COVID, and then for some reason, some people can't recover and they get really sick. So we're trying to study why that happens. right And to do that, What we figured out early on, and this was even before COVID, where we were already just studying these you know chronic consequences of infection, is we had to pull people into this this field from related fields. Because in cancer, in HIV, there are teams using actually some pretty advanced technologies to be able to understand what viruses or organisms are doing.
00:02:11
Speaker
and they just weren't in this sort of post-acute infection space. So that's a lot of what we do is we network, we find teams who are doing a really good job in related spaces and we pull them into this one to try to build collaborative projects. So that's what I spend a lot of my time on. And then as you know, I also and the scientific director for CORE, which is a clinic in Mount Sinai, and it is a clinic treating or working to treat patients with post-acute infection syndromes. And I really like my role there because what I want to do is make sure that I don't just sit
00:02:43
Speaker
with poly polybile with just all this academic knowledge falling on me you know that I know in my head, I want to make sure that we can apply it to the actual care of patients. So I actually want to know what's happening in that setting all the time so that we can figure out how to innovate it because it does need a lot of innovating, right? So those are the main things that I'm up to. Yes. I love it. The podcast is for general audiences in I have a few questions I want to ask you, but I first want to establish a foundation of knowledge for them so that they can have some context for the questions I have to ask you.
Human Microbiome and Chronic Disease
00:03:20
Speaker
Can you tell me if we imagine our bodies as a community, people cells versus microbial cells?
00:03:27
Speaker
What is the balance numerically between them? Is it one to one? Is it one to 10? I read things that said one to 10, and the more recent literature said one to one, but it's pretty substantial, right? Yeah. So this is what got me interested in studying organisms in the human body in the first place, is that when I was first coming into the field of microbiology, this is o over a decade ago, big didn't know, and we still don't know how many organisms inhabit the human body, but what we are learning, and which really matters, but like of course, in any human chronic disease, or and in just how humans function, is that humans are actually superorganisms.
00:04:15
Speaker
We are actually a mix of our human genes and then ah millions of genes of um our microbial inhabitants. And those microbial inhabitants that form microbiome communities in our bodies include bacteria, fungi, archaea, and then there's even a viral component to these ecosystems, the human virome, because all bacteria in the human body are actually themselves infected by viruses called bacteriophage that infect and modulate their activity. and The scope of this is is somewhat insane. There are millions of bacteria in the body. The estimate is is about one-to-one.
00:04:57
Speaker
So for every human cell that you have, you have a bacterial cell, at least. For the viruses, the bacteria phage that infect the bacteria, the estimate is there are about 10 times more phage than bacteria. So that's an an incredible number of phage. In fact, Phage, these bacteria phage are sometimes referred to by people as dark matter because we've characterized so few phage and it's similar to outer space where we've named and found a couple of planets, but really we know there's this vast solar system. It's similar to phage in the human body. We've named some, but we have these trillions of phage that are trafficking along with bacteria through our tissue, our blood all the time. And so really,
00:05:46
Speaker
it does shift in understanding of what it means to be human, right? And then, so I recently posted something on Twitter and it was like this skit that this TikTok comedian put up and he was acting as a tapeworm. It was hilarious because it was a dialogue between the tapeworm and the human that it was inside. And the human took a probiotic gummy and the tapeworm was like, What was the intention behind that? Like, basically, like, dude, totally gaslighting him. In fact, in the skit, he said, you're gastric lighting me. But we have parasites living inside of us, too, that also influence our bodies, too. And like, I want to talk about the relationship because they brought it up in that skit. He was like, you're thinking up here, but you're not thinking down here. So can we talk about that? Is it called the gut brain axis?
00:06:42
Speaker
Well, yeah, so first, I mean, I think the important thing first is that we we all have, let's call it the human microbiome, viome these ecosystems of bacteria and viruses. And under conditions of health, balance, they you know where we live with them in a state of homeostasis. And so, they in fact, they metabolize a lot of our foods, their activity contributes to a lot of our signaling. Obviously, people who are healthy climbing mountains, whatever, have these organisms. But this is a thing, under conditions of inflammation or imbalance, some of these same organisms can shift their gene expression. They can shift what proteins they turn on off to start to act in their own interest instead of ours. And so a lot of chronic diseases are actually tied to what's called microbial dysbiosis or imbalance.
00:07:34
Speaker
where a lot of the organisms in the human bodies start to change their gene expression and the proteins they're making in a way that's not so great anymore it can drive inflammation or problems. And now you have issues. So that that the main thing there is that microbiome can actually start to cause problems for us and can be a really important thing that's understudy as a driver of a lot of human chronic disease processes. But within that, you also get your sort of single pathogens that themselves are, you know, definitely like a tapeworm. If they infect the human body, they are just purely acting in their own interests. They're hijacking us. I mean, literally pathogens will deal substrates from our mitochondria. In fact, ah I wrote a paper on this with my colleague, Mike Van Asker a few years ago.
00:08:24
Speaker
are mitochondria that make energy in every cell. Many bacteria, many viruses have evolved ways by which they infect a cell, they get to the center of the cell, they pull the substrates out of our own mitochondria, and they use them for their own energy or for their own replication, which alters our energy metabolism, usually never in a good way, and keeps them going, right? So in other words, they hijack us. Right? So that's what we study is we study not just how collective organisms are impacting humans, but also how select pathogens, which include everything from tapeworm type organisms to bacteria like the Lyme disease organism that people get from tick bites to the SARS-CoV-2 virus.
00:09:12
Speaker
can really start causing problems as single infectious agents. And the thing is, so many forms of chronic disease are becoming tied to the activity of these pathogens, including even Alzheimer's disease, including neurodegenerative disease. And part of that gets into what you mentioned before with like a gut-brain access. The thing is that Organisms in our bodies, for one thing, some of them can get into the brain directly. And from there, they can modulate even human cognition or neuroinflammatory or neuro signaling processes. Or they can, for example, change the way important nerves in our body signal. For example, the vagus nerve is this really important nerve.
00:09:54
Speaker
It innervates every trunk organ of the body, so it connects to the gut and the heart and the lungs, and then it also connects to the brain. And it it it it's conveying all these signals between the brain and the body all the time to regulate functions like ah even autonomic function, which is basically the ability to move from sitting to standing. You get, you're laying down, you get up, you everything adjusts. But if you have, so vagus nerve is part of like the signaling that allows that to happen. um But if you have problems and the organisms in your body are problematic or you get a pathogen, for example, into your gut that persist and causes problems, so it can throw off the signaling of that vagus nerve. And now you have that axis between the gut and the brain is dysregulated. So that is under study in the range of conditions, even can have a role in long COVID.
00:10:45
Speaker
where we think you know we see the SARS-CoV-2 virus potentially having detrimental effects on signaling of vagus nerve and other things like that.
Infections and Amyloid Plaque
00:10:52
Speaker
You mentioned Alzheimer's disease. Can you expand on that a little more? Definitely. so infection as a driver of Alzheimer's disease is just one of the most important and fascinating topics out there. it If you think about it, but rates of Alzheimer's disease are skyrocketing. They have been skyrocketing for a while now. It's really crazy. I think someone develops a new case of Alzheimer's every 30 seconds, something like that. So as we're talking, Raven, during this podcast, people are being diagnosed with new cases of Alzheimer's. It's just the rates are out of control.
00:11:27
Speaker
So the current thinking on Alzheimer's, there's probably something wrong. like we're Let's just say maybe then we need to think through what's causing Alzheimer's disease and to best understand, are we doing something wrong? right And the current thinking on like the mainstream sort of textbook still thinking on Alzheimer's disease is that there's this plaque in the brain, this amyloid plaque. I mean, we know it's there, that this amyloid plaque forms in the Alzheimer's brain. The current textbook thinking is that plaque is the driver of the disease. So many drugs have been created in the last years to remove that plaque from the Alzheimer's brain with the hope that that would get people better. And none of these drugs have worked. Just in a series, they just failed, they failed, they failed. Is it around the cells or is it aggregation inside of the cells? It is but sometimes between and in and sometimes even in the cells, but it's more like between aggregates in in the brain tissue. This is the thing though. there's
00:12:27
Speaker
a researcher who was actually a mentor of mine, his name is Rob Moyer, and he started to realize that this amyloid plaque, it's really conserved, like an evolutionary, it's been found in zebrafish, it's been found in in animals really early on and in in the human evolutionary scale, right? So if it's so damaging, like if it's so bad, Why isn't it being weeded out? like Why is amyloid being conserved as animals continue to to develop? And so he started to question why amyloid's there. And what he thought is, wait, maybe it's forming for a reason. In other words, maybe the plaque is forming in response to something.
00:13:12
Speaker
And so he started to look and see if he could find viruses in the brain. And indeed, what he started to realize in a really incredible series of experiments at Harvard Medical School is that if they took viruses like a herpes virus and put them in a neuron in a dish model, the amyloid plaque forms in response to the herpes virus. In other words, the plaque has a function, which is that when viruses or bacteria get into the brain, it forms as an antimicrobial peptide in order to capture them. And that's why the plaque is there, right? So we've been removing this plaque, but it's actually supposed to be trapping these organisms, right? And the root cause driver
00:13:53
Speaker
is infection, right? So the thing is we now need to switch in Alzheimer's to a new paradigm where we are trying to do research and treatment to look at the viruses that can be drivers of Alzheimer's. So for example, as part of our nonprofit right now, we have a team who studied the impact of the SARS-CoV-2 virus on Alzheimer's disease, you know, just showing that if SARS-CoV-2 gets into the brain, it can again seed the formation of these amyloid or tingles that are part of the Alzheimer's. So really, it's a paradigm shift in which
00:14:28
Speaker
you know And that gets down to it. like we've We've thought too long that humans are sterile and we keep blaming things like the plaque itself or the immune system alone for human chronic disease without considering that these organisms or pathogens that were infected with can themselves be
Scientific Progress and Research Gaps
00:14:49
Speaker
the drivers. And and what that opens up to us now is is a new world in which if we're able to to really document the activity of pathogens in these diseases, we can switch a lot of medicine to a more root cause type treatment where instead of just using palliative drugs that a lot of people get on, like immunosuppressive drugs like Humira or something that shut down the immune system but don't really cure you when people are on them for life,
00:15:18
Speaker
we can maybe get at the root causes of these diseases and actually treat them with antivirals or antibiotics. And that's, again, part of what I work on. That is incredibly fascinating. And I know that this is going to really shift a lot of people's perceptions of infection. I want to talk about this notion that scientists should have already known this because I feel like when people learn this information for the first time on this podcast, they're going to say, well, why haven't like, why don't we have these answers if they're so if these organisms are so prevalent in our bodies?
00:15:59
Speaker
Like, why is our knowledge further along? And of course, people are going to try to fill in the gaps with their own thoughts and feelings. And that kind of leads people down to this path of conspiracy theory of like, well, then something's being hidden from us. What do you have to say to those people? Just. really moved by the idea that we don't know so much about the body. So this is the thing. It's not conspiracy theory that we don't know. The the the thing is that science takes a lot of time to change. So I'll be honest, I forget who said it, but there's ah a saying, you know, science sometimes even advances one funeral at a time. I know that's a brutal way to say it, but the truth is that you have these old ideas
00:16:44
Speaker
And sometimes and those ideas get into the textbooks, right? And they're years of fresh studies, and it just takes time for them to be replaced. The thing is, a lot of the work that's tied infection to these chronic diseases like Alzheimer's, it's been done in recent years before some of our main textbooks were written. So people were trained in medical school 10 years ago. like It's just not in their book. look it so So we're in this period first where it's changing and it is. But second, the reason that there's a lot of, it's challenging to study infection and chronic disease because it this is the key thing. Like when we're studying persistent pathogens and a lot of these diseases, they're not found easily in your blood. So let's say, for example, that we are trying to study the impact of viruses on Alzheimer's disease.
00:17:36
Speaker
We have to get people's brain tissue, and we have to do that in a very specific kind of study, and we have to set up the ways to get the tissue, and the tissue has to be well preserved, and then we have to use specific technologies to find the genetic materials. So you have to set up these actually big research projects to be able to find it, and someone meanwhile with Alzheimer's can come in, and you have no idea that there's a virus in their brain if you're just running standard tests. We've had to collect a lot more types of samples from people with chronic disease, so that's a lot of what polybioine nonprofit does is in patients with chronic symptoms after infection, we've set up and helped teams set up infrastructures where they can collect gut tissue, say via endoscopy or or lung tissue via bronchoscopy procedure or even lymph node tissue because those are the parts of the body where pathogens tend to hide out. They tend to get into our tissue or our nerves.
00:18:29
Speaker
And they're not in our blood like the blood the immune system is the most robust you're most likely to get targeted there so for pathogens there it's not usually there so this is the thing there's not a simple blood test for these pathogens and i think that's one of the the main reasons that that's also sort of harder to prove is we have to Find them in tissue samples and sometimes we have to use really advanced tools to be able to find small amounts of their genetic material or little amounts of their proteins and those tools are still in development. So the thing is what we kind of know in science by doing these studies.
00:19:04
Speaker
has yet to trickle into the clinic where doctors are just running the same panels on people and none of those panels yet contain any of this kind of testing or anything like that. What a lot of scientists know and are working on And this is one of the things we try to break down these barriers. There's this knowledge, but a couple people have it in these institutions and everything like that. And it hasn't trickled down yet for people to get. And it hasn't permeated medical school or the system yet where it's going to be actually taught to the doctors that are out there. Without that happening quite yet, people just don't know.
00:19:41
Speaker
And I also like when you mentioned that I think about clinical trials and I think about the kinds of people that tend to participate in them. It feels like it's kind of rare to see a clinical trial that has a really diverse representation of humanity. And I think what you just said really just lends itself to the importance of people participating because we need to learn these things. I don't know. It just, we, we've talked about so many things on this podcast, including like, I talked to a dolphin expert and I asked them about dolphin menstrual cycles and like, do dolphins have menstrual cycles? And they said, well, we actually don't do a lot of research on female dolphins.
00:20:22
Speaker
And I was like, what? You don't do a lot of research on female people. That's what I was told. And like she even told me that most of the lab rats that people use are male lab rats. I know, I know. No, I mean, that's in in humans as well. Diseases, women's conditions that affect women are way more underfunded, you know just under so like endometriosis or interstitial cystitis. So these diseases that are just so painful. like There's so few teams working on those conditions compared to what there could be. i mean And also just teams that are not, in a lot of cases, doing logical work. So one of the studies we're doing is where when people are undergoing surgery for endometriosis,
00:21:08
Speaker
when women are, we're getting their tissue. We're saying, like, don't throw it out. Like, this is one of the things of, like, a lot of our studies. We find surgeons who are working on it people with a certain condition, and we literally, like like, they would take this tissue otherwise, maybe preserve it or send some of it, you know, to be analyzed quickly and then get rid of it. We just say, no, like stabilize it and send it to our research teams. Now we can use all kinds of these extra tools to profile the whole immune, genetic, and infectious landscape of this tissue. Maybe like the third group in the world to just do this with endometriosis tissue. that's It's insane, right? So that does come from this history you know of of chronic disease with women, where you know women have totally been
00:21:53
Speaker
but considered hypo, hypo, you know what I'm saying? Like where? MS, not that long ago, I mean, was attributed to hysteria, yeah right? Like in other words, no way. for do This is the problem. Like there's a lot of conditions that includes even long COVID now, or and ME CFS, which is a condition related to long COVID where people become really sick after viral or bacterial infections often, they look fine. So they go to the doctor and the doctor runs,
00:22:26
Speaker
I don't know, like four blood tests that are pick up on like 0.1% of things that could be wrong in the human body. And when those don't come back with some signal, they just start, they're like, oh, you know, this must be in your head or something like that. And that that is it that's still an attitude in medicine that, you know, it's getting better, but it's it's there. There's this too much implanted idea that, oh, with women, like, Well, I mean, it could be some physical problem, like a virus in your brain or something, or it could just be, I don't know. Like it's literally in your head. Yeah, exactly. Yeah, no, that's the thing that's funny. You're exactly right, Robin. Like, I mean, Raven, like, you're dumbass.
00:23:06
Speaker
You are right that like people will tell women, you know, it's all in your head. And the truth is like, yeah, you're right. The infection is probably all in their head. Or you know what I'm saying? like like There's something in their head, but it's just not, it's an actual driver, physical driver of disease, like ah like a virus, not some kind of, you know, thoughts, right, or like inability to cope properly. So psychiatry, in other words, has kind of overtaken, it's overstepped, it's bounced. Psychiatry needs to just chill out. Yeah. Remove itself from, like, we're at a point now where psychiatry got involved in a lot of conditions because we didn't have data, you know, we didn't have imaging yet to get
00:23:49
Speaker
at the brain where we could show actual inflammation. And so psychiatry would come in and say, oh, maybe now for most conditions, we can show actual signs of dysfunction and now we need them to pull back and not be as quick to jump to these, you know, honestly kind of ridiculous psychosomatic
Vector-Borne Diseases and Diagnostics
00:24:07
Speaker
explanations for the disease. I talked to Dr. Shannon Delaney on a different podcast and she enlightened me to the facts around Lyme disease and specifically how it can manifest mood changes in young children. And then I was taught about how prevalent ticks are, right especially in the Northeast. And ticks are transmitters of
00:24:36
Speaker
the bacteria that causes Lyme disease. yeahp that So we talked about what are the chances that one of us has been bitten by a tick in our life. And she was like, well, it's actually quite high, and especially if you've been frolicking in grass or in nature. It doesn't take much. And she told me a story of one of her patients. It was literally her first time ever like being out in nature. And she went and had a picnic. and got bit by a tick and then experienced long-term effects of Lyme disease. I think about children who are
00:25:17
Speaker
I ran barefoot in the grass. I was like an outside girly loved playing in the dirt. I wonder how many kids are experiencing chronic diseases, but maybe don't find out until they're adults. And we haven't been taught to like be tested for that. If you don't have a tick attached to you, or if you don't have that Hallmark bullseye rash, we wouldn't know. And that doesn't always happen. And if you have darker skin, you might not even see it. So. What are your thoughts on this? No, it's a huge problem. And here's the thing is we have to take um all pathogens way more seriously. Like this is the truth. But when, whenever we get infected with things, and this even comes to the the viruses that infect, you know, children now in schools like RSV or hand, foot and mouth disease or strep, you know, it actually, though all those pathogens can, can cause
00:26:14
Speaker
serious problems and sometimes really bad long-term consequences. So it's it's not, I think we need a cultural change where, first of all, where and just getting in an infection is like, eh, you know, oh, I just got struck by it. It's like, no, I got struck and it matters. and i'm And I'm not saying that like all of us have to be ah paranoid, but I think that there's a lot of chronic diseases and a lot of people who feel sick out there and don't know what's wrong with them. And there's a lot of pathogens. And I think we need to merge that understanding a little bit closer that for people who have symptoms and they're not sure what's going on, especially children where you see changes in behavioral issues. that we have to consider ah that infections may play a role in their case, because strep is one pathogen that sometimes acts along with the Lyme pathogens that you mentioned to cause this syndrome called pans-pandas, where kids develop really bad OCD. So we have we know that, in other words,
00:27:13
Speaker
pathogens, these viruses and bacteria can sometimes be drivers of not just physical symptoms like flu-like symptoms, but actually neurological changes in thinking, anxiety, you know depression, OCD, right? And that's not even really understood either. So like, first of all, So first, we just need in general respect for for infection more. This is something i I truly think to be true. But when it comes to the tick-borne, vector-borne pathogen, it's like we we're doing the worst job. Like if you want to go to just the place where we are most ignoring infections that could matter, that's where it is.
00:27:50
Speaker
like The ticks do carry the Lyme pathogen, but here's the but interest. And sometimes this is the important part. They also even carry other bacteria that can cause a lot of chronic symptoms and problems. For example, Babesia, which is a parasite of Bartonella, an intracellular pathogen that can cause neuropathy, anxiety, a lot of of serious problems. So if you get by a tick, it's not even just Lyme, but you can get multiple problems that happen from this tick. Right? So I know that people are going to, as soon as they hear this, be like, okay, well, what can I do? Is Babesia on the Lyme test? Or is that a separate? Can you get tested for that? And is it separate? It's separate. So you'd have to ask your doctor to test you for Babesia. And this is the part that gets hard, that our current testing for these pathogens is not great. First of all, I just want to make the point that the Babesia and the Barnella, you don't even have to get a tick bite to get an infected. They're actually vector-borne pathogens, which means that they can be carried by fleas, by spiders, by just other organisms too. So for example, you could get a spider bite or you could interact with a cat that had, it's Bartonella. One of the types of Bartonella, one of the the strains of it is the driver of an illness called cat scratch fever.
00:29:12
Speaker
where you just get it from, unfortunately, interacting with a cat that has fleas. so Think about how many kids or people sometimes have interactions where you don't even need a tick bite. You just need interactions. but so so that's it's just There's no understanding of that out there at all. like not even for that The stereotype is like, oh, you have to have gone camping. You can get bit, first of all, with a tick and in a urban area playground. yeah There's been studies that have found ticks in LA playgrounds, like you don't even have to go deep into the woods. And second, you don't even need that got a tick bite to get something. You can just, you know, have a spider issue or bite or something. So there's definitely way more ways to get them. But this is that is the the crux of the problem is that the testing for them is not great, because especially for Lyme, because Lyme, it's like
00:30:03
Speaker
A little bit like SARS-CoV-2 that we study in long COVID now, it's a really tissue-based pathogen. and What Lyme loves to do is infect connective tissue. It infects that the tissue, that it infects the joints, it infects the nerves, right? When it gets into someone's body, they're causing like pain, connective tissue issues, joint problems. But again, it's not in your blood. This is the problem. you We don't have a test to find it. And then some doctors order antibody testing. So basically like seeing if the immune system created a response to Lyme. But that doesn't tell you really if you had it or if you have it because antibodies, here's the worst part is Borrelia
00:30:44
Speaker
The Lyme pathogen debilitates the immune response over time as it persists in you in a way that can actually make you make less antibodies. So the worst part is the sickest person who might have the you know deepest case of Lyme in their connective tissue and their nerve is even making the antibodies that are part of the test. right So like one of the biggest things, again, that our nonprofit works on is innovating the testing diagnostics for Lyme and tick-borne disease. It's just it's like one more place where we need to build better tests. Those tests either need to be able to find smaller amounts of the pathogen's genetic material or we have to even be able to potentially get a tissue sample from patients and just look like sometimes we can do ah a punch biopsy. We have a study where you can get a little piece of thigh punch biopsy that contains a little bit of tissue and peripheral nerves from a patient
00:31:37
Speaker
And we're seeing if if we can find Bartonella in those samples. And so, so for example, and and people say like, OK, well, then you'd have to do a ah tissue biopsy for diagnosis. Well, fine. I mean, whenever we think there's, you know, in cancer, we're more than happy to do a biopsy if we think there's an like issue with the tumor. so we we shouldn't you know In my opinion, we should be using that same paradigm on patients who could have these kinds of illnesses. If needed, we could do a biopsy or something something like that. so That's part of what we're looking at. I think one of the things is you actually can go off symptoms sometimes to consider if you might have a Lyme or or Babesia or Bartonella infection. There's a questionnaire created by a Lyme doctor named Richard Horowitz. it's probably I bet you can Google it.
00:32:20
Speaker
And you can fill it out. And it starts to just give you an idea, at least if your symptoms fall into the types of symptoms experienced by people with Lyme or Babesia or Bartonella. And at least that gives you like a, all right, maybe I should head down this road, try to get some testing done. you know there There are some companies you have to pay out of pocket that have testing. The problem is they're not covered by insurance. And that's a whole other you know crazy issue is that that's one of the things at Sinai that we're trying to work on when we're creating a clinic for patients with issues after infection is we're doing clinical trials and a lot of research studies because that helps for the tools or the drugs that we're trying to get covered by insurance because we can publish a paper
00:33:12
Speaker
that gets attention that shows signal in patients. Otherwise, a lot of what's being developed for things like Lyme or other conditions are by a biotech company that might come into the space and develop a test that's a little bit better, and it costs $3,000. And that's the problem, is then it becomes only able to be accessed by a few. And that's good. and it's ah at At least the test exists. and yet I want to build a medical system that everyone can access. and so That's the challenge, too, is developing diagnostics, but making sure that they don't end up in just the hands of companies that charge huge amounts that only a few people can get. like We have to make diagnostics that are open source, that are affordable, that everyone can get. so That's part of the whole challenge in the space.
00:34:01
Speaker
This is really important and it ties into what I was reading about the history of how we understand this field because from what I learned, we've known that there has been some sort of connection between our overall human health and pathogens or like organisms, infections. Once we figured out, hey, antibiotics can knock out certain pathogens and that works, then the attention sort of went away from infectious diseases toward non-infectious diseases like cancer.
Funding Challenges and Scientific Collaboration
00:34:39
Speaker
And so then we've seen like
00:34:42
Speaker
I mean, I guess it's kind of feels like that's how that's when the the modern biotech industry was born. But you're drawing, you're kind of circling back and drawing this important funding and attention toward, hey, we're actually like the story is not done. We need to continue furthering our knowledge here because it's It's simply not done. How do you feel about the current climate and the contrast between what work gets funded and what work doesn't get funded in this space?
00:35:19
Speaker
you yeah that's a ah big issue. You know, going back to the history of connecting infection to chronic disease, one of the the hardest periods for that was when the theory of autoimmunity gained hold. I mean, it's easy and to call something autoimmune because you measure in immune response and people are inflamed and you blame the immune system and then that's sort of an easier paradigm for the pharmaceutical industry to come on. They can come make blockbuster drugs that knock down the immune response without asking why is the immune response dysregulated in the first place. So the problem is that infections connections to chronic disease got sort of pushed to the side while
00:36:03
Speaker
autoimmunity was to be honestly over assumed in a lot of conditions. And I think that now that's changing. In fact, when it comes to cancers, you know, a good number of cancers are driven by viruses. So I think at least 10% of cancers like Epstein-Barr virus is a cancer on congenic driving virus. They transformed that the cancer itself. So this is the thing about viruses is they can pack the cells that they infect and and transform their metabolism. There's got to be drivers of why things are happening, and viruses are are beautiful drivers. Whenever you see things changing, transforming, viruses, because they're able to push our own cells to to be moving in this more detrimental direction,
00:36:48
Speaker
But I think that when it comes to grants and funding for this, it's been really difficult. I think that a famous story does come down to Alzheimer's disease and infection. So the National Institute of Health, or and NIH, funds most research on science. And they had a um panel. You decide you come up with an idea for a study, what you want to do. You write it up, and you submit it to the and NIH to be reviewed for consideration for funding. and There's a panel of people there that review the grants and make the decisions on whether they get funded or not. It turns out that for years, for Alzheimer's, there was kind of this click, and basically, one journalist called it a cabal, honestly, of people who just were not into the idea of and infection i mean infection in Alzheimer's. so it it Partly because their own work didn't show it, this is the biggest problem. like You have people often on these grant committees where
00:37:43
Speaker
their research is something new actually goes through and they're the experts, then their work could be like be less relevant. This is a big problem in science. So the people on the committees are often very unlikely to let the new ideas or the breakthroughs go through because they kind of want to keep that sort of old guard stuff part of it. Sometimes it's just human nature like that. The grant committees and Alzheimer's knocked down grants on infection for years. You just couldn't get one. This was just well known. so And then finally, due to patient advocacy, due to all kinds of issues, they finally started to just change it recently, where they now let a few grants through on this topic that, quite frankly, is the most important topic, right? So that's the thing is government funding can be
00:38:32
Speaker
Extremely conservative and also you know it it's difficult sometimes to break into sort of like the circles that you need to do to get government funding. We at Polybio, we get funding from private donors because I really i realized when I started Polybio that We were just not going to be able to move research on infection and these conditions forward fast enough with just government grants. And so what we do is we build projects to make slide deck showing like the team, the project, what we're going to do, the tools we're going to use. and
00:39:10
Speaker
we get it out there and we actually see if people who have ah private funding want to make it happen. And that's an okay model and it's been working for us, but we need more support from government. So what government needs to do then is know create a better, more like sort of fast track grant mechanism because a current government grant can take over two years to get funded. This is what people don't realize either. Like you submit It takes so long to get reviewed. Then it comes back with feedback. Then you have to answer. I mean, often this happens and you answer the feedback that takes another eight months. I mean, it it really is, can be well over a year.
00:39:51
Speaker
before a person gets a decision on a grant. I mean, that's that timeline is just not feasible. It's just not okay. I mean, especially, for example, let's say with long COVID that we've been studying now. We have this pandemic, new novel virus just rips through the world and people start developing chronic symptoms. And we're supposed to put grants into a... You know, this slow, step-wise mechanism, I mean, that's that's madness. So they they need to create a government system for that that turns grants around more quickly and actually just favors new novel ideas. There's one government agency called ARPRAH that does that, but the levels we're not sure if they're accepting grants along the infection side. We just turned one in. <unk> We'll find out.
00:40:42
Speaker
We'll see. I know. I know. But the ARPA-H model, this the sort of like faster turnaround time, you know we are actually looking for truly new things. It has to become like the whole government model. like like It really should be it shouldn't be this one group but that does that. It should be the whole NIH that does that. Is it weird for me to say that white supremacy is slowing down scientific research and just like the notion of elitism and ego like egocentric
00:41:20
Speaker
um you know, our way or the highway, you know, we want to dominate the space type energy. I feel like if we were just, if the culture is more collaborative and accepting of diverse opinions, we wouldn't necessarily be here. Exactly right. I mean, look, I just, I don't know, white supremacy, but like, that One of the things that that we do at Polybio that I've done is is just network with team people. like I do not care if someone has a fancy title. I don't care if they're like the head of seven departments. I don't care i really actually only care if they have a good idea, if they are are doing good work. right and i don't This kind of just comes from my own life where
00:42:12
Speaker
You know, I've read papers and I've kind of partially, even before I got a PhD, I taught myself a lot of the science by just reading in this. I started to learn about what works in science based off the just the ideas, not what other people were telling me was right. And so that's what we do. We just. we we We have cool conversations with everyone out there and we figure out who's doing what and then we get people together and we we say like, look, like your lab is right next to this lab. You guys could share tools, you could share samples. And and when people start engaging like that, it's it's so much better. First of all, we we we are learning way more
00:42:54
Speaker
we're We're definitely like the new ideas are are going more fast, more quickly. and And yeah, when things don't work, it's kind of more acknowledged and we're able to adapt more quickly. And and that kind of culture can absolutely move things forward. So so what we what we definitely need in science is just is less of this, like, yeah, you can only succeed if top people and, you know, government accept your grant and it has to be... that like this We need, like, panels of of diverse people, exactly, with different from the community, from different backgrounds, from different walks of life.
00:43:36
Speaker
they're in government looking over proposals that come in and, and, and, and ranking them off, off logic, you know, off just practical, like, just practical, like, like, but not don't leave you like for too like like, yeah, exactly. Like, yeah, you're exactly right to take all the snobbery out the whole thing. Like, just, just take it down and, and, and, and let everyone talk and, and make it, and make it cool. Yeah. I know that people are going to be so comforted knowing that someone like you with these values and notions of how science should be done is behind such an important organization, the Polybio Research Foundation.
Public Engagement and Support for Polybio
00:44:19
Speaker
Yes, this that's a research foundation. i I think it's just so important that you are leading this effort because I know you're going to have the impact that you've already had the impact that you're looking to make and it's going to be successful because you're doing exactly what needs to be done um to move our knowledge of the roots of these diseases and then the treatments of these diseases forward. So I'm i'm excited. I'm really happy to be you know tangentially even a part of what you're doing. um And it's really cool to to get more of your perspective on the bigger picture because it is fascinating. And so how can people support you? I think, like, what how can we support what you're doing?
00:45:08
Speaker
I mean, funding, you know, donations are helpful, but I think beyond that, the main thing is is to share what we're doing and and get out to the extent that's possible. Even this, just doing interviews um or sharing other interviews or other papers that we've written more widely is helpful because we want to you know like in In terms of changing paradigms and getting people more accustomed to the and you know ties to infection and the stuff that we're doing, the more that we can just get ah word out, the more that that helps us you know get a seat at the table where are we where we wanted and where we can be able to talk further right so i think that that that at the very least just like go to our website read through our projects there's interviews on there there's there's lots of stuff and just check out our materials and start to start to learn this was just what i think is is cool especially for for patients
00:46:13
Speaker
you know, or for people who themselves might be affected by a condition tied to infection, there it's just just it's empowering to learn about it, right? Don't think that, you know, that you can't get it, that some expert has to get it. You know, there's, that's absolutely untrue. Like some of the most basic parts of of what goes wrong when people, you know, get sick, like, like we study, for example, a lot pathogen persistence, right? Like we study now in long COVID how a lot of people who are infected with the SARS-CoV-2 virus might not even fully clear it. And that might be part of why some people develop symptoms after long COVID.
00:46:51
Speaker
that That's really straightforward, right? Like the idea that you get an infection and then part of why you develop chronic symptoms is because you still have the... I mean, it like it doesn't take a genius to get this, right? it's Their concepts are actually really straightforward, right? And that's one of the things that I also dislike about academic medicine. ah It tries to make it seem like, a oh, it's so... No, it's not. Like the main trends I really, you can get them, you can understand them. And if you start to read about it, and if you start to to read especially about infection in the microbiome, those ecosystems of the human body, it's totally fascinating. I mean, it it it just gives you a new, you know, understanding of so many, you know, as you're going through life, like, like, don't you want to know?
00:47:41
Speaker
You know, like that all these organisms are in and on you, like don't you even want to be thinking? yeah it So my my thing to people is just start reading and listening and learning. And in that you'll find so many clues already to be able to sort of better navigate through a lot of you know what's going on in this space and to be able then to be one of the voices that helps move it forward. Amy, this is so exciting. And your website is polybio dot.org. Can people follow you and Polybio online if they are interested in catching up and keeping up with all that's going on?
00:48:22
Speaker
Yes, my Twitter is microbe-minded too, which I know is really cheesy, but it's true. I always have microbes. If you know me, if you, like my husband, i'm I never to stop talking about infection. It's ah it's a joke, but it's true. um So microbe-minded too. is my Twitter, and then Polybio's Twitter is PolybioRF. So yeah, follow me or us. Oh, yeah. Oh, they're going to love all of them. Yes. Well, thank you, Amy. I learned so much, and i'm I've got a million more questions, of course, but that's exactly what science is. like you yeah You get answers, and then those answers don't solve everything. You just and exactly are you left with 100 additional questions.
00:49:06
Speaker
right yeah But that's why we do what we do because it's just this never-ending journey and it's very rewarding when the questions that we answer help us answer also questions about life and help us to get solutions for other people that might be suffering. So thank you for the work that you do um and thank you for your time. I know everyone's going to love this. So if you have any questions for Dr. Amy Pearl, yeah um Leave them. You can leave them to me and I'll give them to her and maybe I can get you some answers. Yeah.