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Dr. Steven Griffiths Monthly Column, published in the Times & Transcript
St Patrick's Day
Tuesday March 17, 2009
Long ago, in a kingdom far away, a dreadful pox stalked the peasantry. But Ole Doc Jenner knew that he could protect the youngsters who hadn’t caught it yet. He knew of a weaker smallpox that claimed one victim in every hundred rather than the fifty per cent typical of the high octane version. Like physicians from millennia before him, he scraped the pus from patients with the wimpier skin pox into the skin of healthy servants. Mind you, the nippers receiving “Ye Olde Variolous Material” invariably felt terrible: high fever, sweats, hallucinations of horseless carriages- all that stuff. In a few weeks though, they were generally up and running about again, cleaning chimneys and getting crushed by farm equipment.
Doc Jenner saw a possible alternative to this prophylactic misery. In the surrounding country side, another disease was the curse of dairy maids. Acquired from the less hygienic udders, cow pox generally didn’t cause much more than weeping blisters but was of cosmetic concern if being courted by Younge Master Boothroyd to provide scutage and heir. Of contemporaneous intrigue to Dr Jenner, smallpox in its various ghastly cloaks was uncommon amongst those intimately familiar with cows.
One day, Dr Jenner noticed that Sarah had caught cow pox from dear old Blossom. “Zounds!” He may have exclaimed.
“Tarry not! Fetch hither the Gardener’s boy forthwith!” he may have also bellowed (though probably not).
8 year old Jim Phipps was produced, scraped and anointed with Sarah’s pus.
Jim got a little poorly: Sarah’s cow pox had been transmitted successfully. But ‘twas a sniffle compared to ye variolous horrors some of his chums had experienced. Tiny Jim was up doing his nearly fatal chores within a week.
But we weren’t quite finished with the saintly lad yet.
Next Doc Jenner did inoculate Jim with the variolous material. Everyone waited for the suffering to begin (no Reality TV back then). But Jim didn’t flinch, not from the weaker strain of smallpox or indeed from any of the nastier varieties claiming pre-adolescent plebs in the following years. In the mean time, for her part, Blossom was nailed to the wall of a museum.
Jenner had acted upon anecdote and observation to identify a milder and more effective form of protection from smallpox. He called it vaccination (you wondered where the word came from: vacca means cow in latin) The virus in the cowpox pus was even wimpier than the virus in the weaker smallpox pus. Nevertheless it presented Jim’s immune cells with sufficient structural information to recognize and neutralise the nastier pox before it reached any momentum.
Let’s use a silly metaphor to milk and churn this concept into some cheesy confection.
Let’s say for example an unwashed tribe from a southern city are sending armour plated Yugos into Moncton to ram-raid local businesses. On the way into town, they generally look inconspicuous, camouflaging themselves with tarps advertising fiddleheads and barely legal clams.
Once inside the city limits, the tarps come off and chaos begins. In the orgies of pillaging that follow, it becomes apparent in the food court at Champlain Mall that the Yugos are not only armoured with old ship plating but they are also bristling with curling brooms and weedeaters, poking out from holes in the side. These keep the enraged shoppers off. The Yugos pile themselves high with hardware from SEARS and hoodies from West 49 and move on.
The more observant consumers notice that, occasionally, similar Yugos show up- but these are slower, merely covered with chip board and Nerf bats. Instead of wrecking the post office to grab commemorative coins, these Yugos are lucky if they can knock over a post box and generally trundle around Centennial Park frightening the ducks.
These ones are easy to catch. Some captured interlopers are carefully inspected. Notes are made regarding bumper stickers and mismatched hub caps; the places where implements poke out are identified as points where Maple syrup can be injected to immobilize the driver (the captured ones are remanded to the custody of Frenchy’s toupee shed for further rendition with Selection Lager). Information is power; coordination is power. Forewarned is forearmed. Neighbourhood watch groups of Moncton consumners set up shifts on the Salisbury bridge. Now they can easily spot the camo’ed Yugos, -sneakily spread out to further avoid suspicion-coming up the TCH2. Cell phone cameras are used to coordinate road blocks. Fortunately before getting too far onto Killam drive, the Yugos are diverted into the Coliseum parking lot, wherein the invaders are filled with syrup and allowed to harden. Some are retained to the toupee shed but most of them are sent packing to the south, via the Petticodiac, on The General Monkton (it’s in the future see, kinda like The Road Warrior. Hollywood: call me). Unfortunately some misery is actually experienced at the Princess Auto strip mall. No one thought to monitor the Mountain Road exit and some of the marauders scooted past Berry Mills on the TCH2. But even so there was sufficient time to mobilize the troops before chaos began at the Trinity plaza.
How are the varied types of southern marauders similar to being infected with a virus and protecting ourselves with a weaker version?
Like our imaginary Yugos, viruses sneak into our cells using normal transport routes and traffic signals. Initially the viruses seem indistinguishable from normal cell traffic consisting of membranous bubbles called microvesicles or exosomes. The viruses are covered with stolen proteins as camouflage. Also, like the Yugos, once inside the cell, the tarps come off and the viruses start to hijack the resources of the cellular mall to make new copies. Some viruses accomplish this with greater speed and brutality than others: compare the small pox strain with cow pox for example. Generally speaking though, clobbering the host doesn’t make much sense to natural selection or spectral omniscience. Because of the inexorable logic of Darwin, there are many more milder budget versions of human disease that, figuratively speaking, just want to chase the ducks.
The milder pox and other weaker cousins of disease used in vaccines are processed by our immune cells; molecular notes are made regarding the places where sticky proteins called antibodies can be applied; other immune defenders identify points in the infected cells into which they can pour enzymes to prevent the viruses from doing any more damage. All of this information is stored in readiness for the actual invasion. If it does happen, the immune system is much better prepared to deal with the actual threat. The immune cells don’t use camera phones obviously but release signals called cytokines that bring in other cells with different coordinating and neutralization skills. In summary then, the weaker strains of infectious agents and cancer proteins we put in vaccines are rather like training exercises for our immune system
It is difficult to imagine that the observations made many centuries ago by Dr Edward Jenner remain the most sophisticated intuitive concept of disease control beyond indoor plumbing. Smallpox is now extinct except in science fiction doomsday scenarios.
Beyond the immodest brilliance of Doc Jenner and his contemporaries, the sophistication lies in manipulating the immune system, the most amazing surveillance machinery you can imagine.
Our immune system will never be bettered, ever (unless we have a 4.5 billion year time line). It has the capacity to distinguish between our own tiny cogs and gears -proteins, fats and carbs- and those of microscopic pirates that want to get in. It can also identify when some of its own cogs and gears spin out of control and act out of context, the process that causes cancer. If we continue with the Yugo analogy, cancer might be like having some of our own shoppers decide they were going to start the sort of pillaging behaviour they had previously frowned upon. Such homegrown miscreants will be much harder to find and catch of course. But trust me, it will be possible.
The other 4.5 billion year old machine that will never be bettered is human intelligence. Its better qualities are analysis, observation, experimentation, reason and constructive passion. Evolutionarily we’re separated by a fraction of a hiccup from Dr Jenner and we still have these two ancient magnificent systems side by side. We can continue to recognise the connections. Cooler still, we now have big shiny toys that can tell us the differences between weak bugs and nasty bugs, the decent citizens from the pirates; we can identify what molecular road exits they aim for and whether they’re likely to make a run at the cellular equivalent of Pier One or Circuit City.
Our task now is to use our intelligence, reason and conscience to prepare long term goals; pimp out the molecular gift of the immune system of our species with our ever increasing wisdom and analytical capability- leave behind the magic bullet solutions that can be rebranded along with their side effects.
There is no more perfect cost effective measure than vaccination for health management. The dopey thing is we could make the world a really better place and keep lots of global consumers in a sustained quality of life and productivity. But vaccines are not very cost effective. If successful, there are no return customers; no taxable industries, no short term profit. That is not to say that there is a remarkable list of preventable diseases that take millions of souls form us each year. Unfortunately there is no real incentive or infrastructure to provide vaccines to the developing world even in the absence of internal strife. This attitude may change with lessons now being learned in other fields of human endeavor. Godspeed.
Stay Frosty and Keep a Grip
Read more about Dr Edward Jenner here http://en.wikipedia.org/wiki/Edward_Jenner
As edited for Times and Transcript http://timestranscript.canadaeast.com/news/article/605544
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