Posted on 07/06/2009 7:38:31 PM PDT by James Oscar
While researching the New Media, I became fascinated with the development of the Flu Blog. It seemed to represent not only the direction but the form and structure of the changing media in the Internet Age.
My original thesis was to write a series of articles detailing, as thoroughly as possible, the creation of the Flu Blog from inception to mainstream assimilation.
However, as often happens in war and creativity, events overtook the plan.
My derailment occurred in the following manor:
By December of 2006 I had researched, compiled and databased every conceivable factoid relating to the early years of flu blogging. I felt ready to publish my first article and on the second day of 2007 I started writing and soliciting feedback on a website called CurrentEvents.
I was very pleased with the finished product believing that both technically and factually I had established the main point of my thesis control of the media was being altered forever and that the evolution was being driven from the bottom up.
Here is that article:
--------------------------------------------
2007
2. Hong Kong Health Secretary calls for calm as SARS cases double, (83 up from 42 on Sunday)
3. LATEST SARS UPDATE - DETAILED MEDICAL INFORMATION
4. BREAKING BIG: POSSIBLE PATHOGEN DETECTED IN SARS CASE
5. Killer Virus (SARS) Identified
6. Seven victims of mystery pneumonia stayed on same floor of Hong Kong hotel
7. Guangdong doctor linked to SARS outbreak
8. President of the American Society of Microbiology on SARS - "Everything says it is airborne."
9. SARS REACHES HONG KONG SCHOOLS - 32 NEW CASES (IS THE BUG OUT OF THE BOX?)
10. CDC increases SARS cases to 22 in U.S.
11. CHINA CONFIRMS CASES AND DEATHS (SARS) - HONG KONG SITUATION DETERIORATING - 22 CASES IN US
12. Causative agent of SARS virus isolated from lung tissue - test is reliably identifying cases
13. SARS cases on the rise in Canada, may be spreading even further, 12 people showing symptoms
14. VIETNAM NEW SARS HOT ZONE, U.S. Warns Citizens in Vietnam To leave
15. SARS cases on the rise in Canada, may be spreading even further, 12 people showing symptoms
16. Singapore - 740 people quarantined, 14 new cases on Monday, Hospitals close, SARS spreads
17. 37 In United States May Have SARS
18. SARS epidemic spreads in Taiwan, three other CDC officials have become ill.
19. WHAT IS THE CAUSE OF SARS? ONE VIRUS, TWO VIRUSES WORKING IN CONCERT, OR A DETERMINANT UNKNOWN
20. Killer-flu a 'white terror': Expert, "It is the worst medical disaster I have ever seen.
21. Preliminary Clinical Description of Severe Acute Respiratory Syndrome
- and over the next eleven days guided both lay and professionals, transformed the web site, crushed the paradigm and changed the way we interface with breaking news forever.
Oh, and there is that strange aspect of her name.
Every literate person on the Web new and understood, not only what it meant, but the endless nuances that lay associated with that name, in this context.
She signed on as Mother Abigail.
The e-mails all asked the same questions and they were all about Mother Abigail. Did I know her? Who did she work for? Had I met her? Basically the same e-mail over and over again.
This pretty much let all the wind out of my sails for quite a while. Because the truth is that I knew nothing of her had exchange a couple of brief web-based e-mails and although I had read every word she had ever written on the subject, my knowledge of the person was ZIP.
The only consistent trait of my personality, as several of my ex-wives will tell you, is that I have no great fidelity to any concept. So I fell back and reviewed my goals.
After a season of Tanqueray and tonic I decided to change my focus.
2008
Via e-mail I asked MA if she would be willing to allow me to interview her and write an article about her. My operating paradigm at that time was that this lady was a seminal pioneer of the New Media and a scientist of serious reputation.
How naïve I was.
In the late summer of 2008 I was invited to visit her at her home on Lake Tahoe. It was a visit that would change my life.
DISCLAIMER
The following is a summary of conversations that occurred from August 2008 until June of 2009. All the words are mine and mine alone. When I asked MA if she would like to edit my work or review it for errors she declined. Prior to the final draft I asked MA for a quote and she declined but requested that I include her favorite poem While the Rain Is Easy which I did.
"While the Rain Is Easy" is from a collection of Tokuisei Verse called "My River". It is used with permission from the Author.
MA: Neu5Ac, however, has several important functions. Chief among these are the neutralization of toxins and monitoring of blood protein half life.
It is found in especially large concentrations in the saliva, urine, breast milk, cerebrospinal fluids, serum and other fluids in the human body. Considerable concentrations are also found in the kidneys, brain, heart and the adrenal glands.
Neu5Ac is found in abundance in whey protein isolate. In fact, this particular source has been found to be beneficial even in those who are normally lactose intolerant.
Eggs are also a very good source of Neu5Ac as well.
Q: How does the body use it?
MA: Neu5Ac is considered to be an immune moderator. It impacts the resistance of flow of mucus, and thus naturally defends the body against viral and bacterial infections.
It boosts cellular interaction, and has also been shown to have protective properties against influenza, pneumonia, hepatitis and other diseases.
Its negative charge is responsible for the slippery feel of saliva and mucins coating the bodys organs.
Neu5Ac is also becoming known as an agent necessary for mediating ganglioside distribution and structures in the brain.
Neu5Ac also acts as a receptor for influenza viruses.
MA: Whenever you see the word “glyco-” attached to something you should be thinking sugars (carbohydrates). Lots of the building blocks have sugars on them. Attaching a sugar is called glycosylation, and the thing that has the sugar attached is said to be glycosylated .
Chains of sugar building blocks (the block units are called monosaccharides) can be oligosaccharides (when there are only a few of them), polysaccharides (when there are many building blocks, often in the form of oligosaccharide units strung together) or, more generically, saccharides, sugar chains, or glycans.
Q: But what about Neu5Ac?
MA: I was getting around to that. We are discussing sialic acid and Neu5Ac -Neu5Ac has a slight modification; an acetyl group attached through a nitrogen at carbon 5 and so it is also called Neu5Ac, but is also called neuraminic acid.
Q: So Neu5Ac and “sialic acid” are the same?
MA: And it is call neuraminic acid. All the same.
The sialic acid is the thing the influenza virus is looking to grab onto via its hemagglutinin (HA) protein spike that protrudes from its surface.
The alternative name for sialic acid, neuraminic acid, might remind you of the name of the other protein spike on the flu virus, neuraminidase.
The neuriminidase protein on the virus is an enzyme, and any enzyme with the suffix -ase indicates it splits things off, in this case neuraminic or sialic acid (it is also sometimes called a sialidase).
Q: You got to be kidding.
MA: No child, terminology is not always our friend.
MA: Have you got a good handle on the Influenza thing? Do you understand glycosylation, neuraminic acid and neuriminidase?
A: I believe I can hold my own.
MA: Well, if that is the case then let’s use that knowledge to some good. I would like to back up to a wider view and using your understand of the influenza virus explore a few hypothetical scenarios.
A: OK
MA: What is the most efficient and economical way of fighting viral disease?
A: Vaccination?
MA: Yes of course. Vaccines are the most efficient means for preventing human and animal disease.
Smallpox and measles are excellent examples of successful vaccines, however some enveloped viruses still are without vaccines think HIV as the most prominent example.
MA: So here is my question for you. How can the measles virus vaccine still function after over 40 years, whereas the influenza virus vaccine needs to be replaced almost every year, and it has proven impossible to produce an HIV vaccine?
A: I don’t believe I can answer that.
MA: It is all about mutations child - all about mutations. The replicating enzymes of RNA viruses, such as measles, influenza, and HIV, make approximately one mistake per every 10,000 nucleotides.
But the answer to the differences in affectivity lie in the peculiar structure of the measles H glycoprotein, against which neutralizing antibodies are produced.
The influenza virus hemagglutinin glycoprotein, which binds to the viral receptor sialic acid, is richly covered with sugar chains. The receptor binding site at the top of the molecule is a shallow hollow.
Most of the amino acids around this hollow and others on the surface of HA can mutate without significantly affecting receptor binding. However, HA has a rather rigid structure, and many mutations are not allowed because they would destabilize the molecule or lead to a nonfunctional molecule.
MA: You see why that could not be allowed?
A: Sure, you get some mutations in non-essential areas, but none in the binding site or in a “mission critical” area.
MA: Yes. The accumulation of mutations, selected and directed by the immune pressure in the host population, is such that the vaccine strains have to be frequently replaced - in order to be effective. H1N1 is such a strain. The vaccine needs to be adjusted to be effective.
However, the HIV surface glycoprotein, against which neutralizing antibodies should be made, is GP120.
This molecule is much more flexible than influenza virus HA. GP120 has a number of highly variable surface loops that do not seem to have a specific three-dimensional structure.
These structural changes are very large and are possible because the molecule is plastic. The combination of the sugar chains on the surface of GP120 together with its plastic structure and the variable loops that have no sequence constraint results in a molecule that is too flexible and variable for the production of neutralizing antibodies.
While the surface of the measles glycoprotein is also covered by sugar chains, but a large surface area is free from sugar chains and hosts a rather extensive binding site.
Once again mutations in this region are not allowed because they interfere with receptor binding. Therefore, the extreme sequence restriction of this site allows for very efficient production of neutralizing antibodies that by definition block binding of the virus to its receptor.
For this reason, the original vaccine strain developed in the 1960s is still effective.
September 24th, 2009
Just an update on this bit of conversation (spring of 2009) with MA.
An experimental HIV vaccine has for the first time cut the risk of infection, researchers say.
The vaccine - a combination of two earlier experimental vaccines - was given to 16,000 people in Thailand, in the largest ever such vaccine trial.
Researchers found that it reduced by nearly a third the risk of contracting HIV, the virus that leads to Aids.
It has been hailed as a significant, scientific breakthrough, but a global vaccine is still some way off.
The study was carried out by the US army and the Thai government over seven years on volunteers - all HIV-negative men and women aged between 18 and 30 - in parts of Thailand.
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Eric G. John, US Ambassador to Thailand: “(It has) brought us one step closer to an HIV vaccine”
The vaccine was a combination of two older vaccines that on their own had not cut infection rates.
Half of the volunteers were given the vaccine, while the other half were given a placebo - and all were given counselling on HIV/Aids prevention.
Participants were tested for HIV infection every six months for three years.
The results found that the chances of catching HIV were 31.2% less for those who had taken the vaccine - with 74 people who did not get the vaccine infected and 51 of the vaccinated group infected.
The vaccine is based on B and E strains of HIV that most commonly circulate in Thailand not the C strain which predominates in Africa.
‘Encouraging’
“This result is tantalisingly encouraging. The numbers are small and the difference may have been due to chance, but this finding is the first positive news in the Aids vaccine field for a decade,” said Dr Richard Horton, editor of the Lancet medical journal.
MA: What is the most efficient and economical way of fighting viral disease?
A: Vaccination?
MA: Yes of course. Vaccines are the most efficient means for preventing human and animal disease.
Smallpox and measles are excellent examples of successful vaccines, however some enveloped viruses still are without vaccines think HIV as the most prominent example.
MA: So here is my question for you. How can the measles virus vaccine still function after over 40 years, whereas the influenza virus vaccine needs to be replaced almost every year, and it has proven impossible to produce an HIV vaccine?
MA: The answer to the differences in affectivity lie in the peculiar structure of the measles H glycoprotein, against which neutralizing antibodies are produced.
MA: So we have seen that some viral infections are fought rather succesfully using vaccines and some are not.
Do you know of any other problems with vaccines?
A: I remember the dust-up about there being mercury in some vaccines.
MA: Yes some vaccines do contain Thimerasol, a mercury-containing preservative. However, there is no hard evidence that this product causes autism - and that is what has been claimed. But I do believe that children under 5 or 6 are often given Thimerasol free vaccines if possible, but my information might be a bit dated.
It is another aspect of vaccines that I would like to make you aware of and especially with the coming flu season.
A: And what is that?
MA: It is a phenomena called antibody-dependent enhancement.
As we discussed this winter the majority of viral infections of animals and man are not fatal, but are followed by recovery and the development of a state of relative or absolute resistance against re-infection with the same virus.
Much of this resistance can be attributed to specific antiviral antibodies, although cellular immune mechanisms also contribute to the protection of the host.
However not all antiviral antibodies are necessarily virus neutralizing antibodies - in addition to these virus neutralizing antibodies or non-neutralizing antibodies a further group of antibodies exist: antibodies which enhance the infectivity of the virus.
This phenomenon is known as antibody-dependent-enhancement (ADE) of viral infectivity and has been observed with various macrophage-infecting viruses.
The common features of viruses exhibiting ADE are:
A. preferential replication in macrophages,
B. ability to establish persistence
C. and antigenic diversity
A: That’s odd. How does it work?
MA: ADE occurs when the host is more efficiently infected by a combination of virus plus antibody than by the virus alone.
Can you see that?
A: Yea, I guess. But it seems strange that an antibody would aid the virus in infection.
MA: Child, nothing in the world of Virology is strange. Let’s go back to our favorite subject the HIV virus for a moment.
A vaccine trial for HIV was stopped prematurely in September 2007 due to evidence that vaccinees may have been more susceptible to HIV infection than placebo control individuals.
MA: This is very important - do you understand what I just said?
A: Yes, they were trying to find a vaccine for AIDS and when the tried the experimental vaccine they had to stop the trials because the vaccinated subjects were acquiring AIDS faster than the control group.
MA: In humans the complement system is a key component of innate immunity and provides a first line of defense against invading pathogens that can bridge the innate and adaptive arms of the immune system.
It is not only a mechanism for direct protection against invading pathogens but also interacts with the adaptive immune system to optimize the pathogen-specific humoral and cellular defense cascade in the body, especially for viral pathogens.
Please read this article I saved for you.
Interaction of HIV with the complement system
HIV infection leads to the immediate activation of the complement system, even in the absence of HIV-specific antibodies. However, after seroconversion, the presence of HIV-specific antibodies triggers further activation of the classical complement pathway.
Antibodies that may enhance HIV infection in vitro were described shortly after HIV had first been isolated found that sera from HIV-infected individuals enhance in vitro HIV infection of the complement receptor type 2 (CR2; CD21)-bearing T lymphoblastoid cell line, MT2.
This enhancement was dependent on antibodies and mediated by complement and coined the term complement-mediated antibody-dependent enhancement (C-ADE).
The mechanism of C-ADE has been investigated by several studies during the past two decades.
Binding of antibody to gp41 initiates the complement cascade and leads to the deposition of the C3dg complement component on the virion. Opsonized viruses subsequently bind to CR2 distributed on mature B cells and follicular dendritic cells (FDC).
Ultimately, the engagement of CR2 and CD4 receptors by opsonized virions leads to an increased rate of HIV spread through the tissue culture with a ten-fold increase in viral reverse transcriptase released into the culture medium and an increase in HIV genomic RNA. In addition, evidence from in vitro and in vivo studies indicated that C-ADE occurs early in infection during the acute, high viremia phase.
A: That not only seems Greek to me but a bit out of the way, as related to our discussion of the novel H1N1 virus.
MA: But it is central to our conversation. You are going to witness the advent this fall of a new strain of flu, you are going to have mass infections, you are going to have mass inoculations with a hastily developed vaccine, you are going to witness the dispensing of millions and millions of doses of Tamiflu. It is this confluence of events that bothers me.
MA: It is altogether proper that we look at the pitfalls that might appear in the very near future.
A: OK, it’s just that I dont really get the problem yet. I understand that there is an inherent danger in giving new vaccines to large numbers of people. As you point out - sometimes these things can backfire. But do you really anticipate a problem with the flu vaccine - whatever that may be?
MA: No I don’t, but as we started this conversation last summer - it is often the results that you do not plan for that are the most damaging.
A: I don’t understand?
MA: I did not expect you to - yet.
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