The most important part of medical examination

The most important part of a medical examination of a patient is to check the room what kind of room you are.

This is because medical examination is about changing your statistical estimation of health state of the patient, and the most important estimator is the location you are. Are you in the emergency room, are you in the street, are you at the wards or the clinic. If the patient complains of chest pain and you are in the emergency room, the likelihood of myocardial infarction is much different then when you are at the orthopedic clinic etcetera

Viral remnants in our genome a possible cause of auto-immunity?

So our genome is our building blocks. Its a big book of information that tells how to make you. The weird thing is that only 1-1.5% codes for the actual proteins used.

Retroviruses like HIV insert their own DNA into the genome of a cell. So they add themselves into the genome. Thus this cell becomes part human part virus.

When they completely sequenced the human genome, they found that around 1-1.5% genes actually code for proteins and around 8% code for virusses! They are the fossil remnants of ancient retroviruses like HIV, that now are inactivated. They are called human endogenous retroviruses or HERVs. They even resurected a virus from this part in the lab, appropriately called phoenix virus.

Sometimes part of the virus DNA actually gets used for the good. For example one very important reason why we are intelligent is the way we develop in the womb and how efficient the mother can transfer oxygen and nutrients to the child. For that the placenta is used, which is a fascinating and enormous complex organ, especially immunogically. To make it function properly a certain lining of cells have to fuse together to create a membrane of syncytiotrophoblasts.

We utilize a protein called syncitin to do this. We got this protein from viruses. An ancient retrovirus. That is absolutely amazing.

Now what are the positive and negative effects of this viral genome remnants in general? Maybe it plays an important role of autoimmunity, because the immune system must be smelling something weird about these proteins we adopted from viruses. Maybe an important rule in cancer risk.

By the way I think an important thing to note here is that this will probably an extremely rare occurence of humans actually using DNA of retroviruses.

References:

  1. https://fivethirtyeight.com/features/what-percent-virus-are-you/
  2. https://www.nature.com/news/2006/061030/full/news061030-4.html
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4198168/
  4. https://en.wikipedia.org/wiki/Syncytin-1

Polio vaccine

Excerpt from Virus: a Short introduction

Albert Sabin (1906–93), manufactured a live attenuated polio vaccine that became available in the early 1960s. He grew the virus in the laboratory until a weakened strain emerged that induced immunity without causing disease. This vaccine was cheaper and easier to produce than the inactivated product and could be taken orally, a great advantage, particularly for use in the developing world. Furthermore, oral administration uses the natural route of wild polio virus infection, and so the vaccine strain replicates in the gut and is excreted in faeces. It can then spread in the community, effectively vaccinating those who have not officially received a dose of vaccine. However, because the virus grows in the body, there is a chance that it will mutate into a pathogenic strain. Although rare, this does occur, with live attenuated polio vaccine causing paralytic polio in about one in a million vaccinees.

The WHO Polio World Eradication Campaign begun in 1988 aimed to achieve over 80%; coverage with oral vaccine. This was highly successful in eradicating wild virus, and the global incidence had declined by 99%; by 2005, with just a few pockets of infection remaining in Afghanistan, India, Pakistan, and Nigeria. Paradoxically, as the incidence of wild polio infection declined, the relative risk of vaccine-related polio caused by mutant vaccine virus rose, so that now most cases of paralytic polio are caused by the vaccine strain. Also, with the vaccine strain of polio virus circulating in the community, it is not possible to completely eradicate the virus. For these reasons, several Western countries have reverted to using the inactivated vaccine, and this will probably have to happen worldwide before complete eradication can be achieved.