A genuine thank you and farewell - this is the end of The Toxicologist Today

Since I was a child I have cultivated a few great passions in life, passions that overtime grew into professional objectives or intense hobbies. Some of these passions became a reality at adulthood, and some other ones simply didn't happen. No one is to blame, life is never linear and we, ourselves, are emotional roller-coasters who respond to time and experiences in different manners throughout our path. At some point when I was about eight years old I knew I wanted to be a medical doctor, a passion I had for taking care of people and shape their health to improved levels. By the age of 16 I really felt deeply connected with endocrinology and felt that I would be a great fit in said medical area. None of this became a reality because ... I simply don't know why, but I have my suspicions. Overall, it wasn't to happen. But the passion is still there; the motivation? Not so much!

I also, as a child, wished I was a writer published globally, not for the sake of money, I can assure you that regardless of how you might consider my ego, but for the sake of having so much to say about life, and at that time, so few people interested in what I thought. I wrote my first book, a novel about depression and misfortune at the age of 16 - "Gray Mosquitoes - Tragic fable of a suicidal" - was the name of that creation. The book did well in a national literature competition in Portugal and prompted me to keep writing. Writing for me was natural, writing for me was energetic, writing for me was deeply and utterly necessary to cleanse and integrate, accommodating all those feelings and observations into a structured analytical perspective. After that first novel several other followed, "Nayf" told the story of a fatherless adolescent with no emotional structure at all and who pushed back any external attempt of others to help him; and "As long as the world lasts" compiled numerous lyrics written for my personal music projects, like the band I had started back in 1995 named "Salem's Voice". 

Music is still one of my passions as it was in the past and as it as always been. I play bass and guitar but I am not a pro, I just like the way it makes me feel, it transports me to realities where the weight of the days simply isn't there anymore and for a few minutes I can evade from a deeply disturbed planet to a conceptualisation of whatever I want, based on what I am playing or listening to. Music does indeed heal, people know it, it is an accessible emotional 'psychotropic' with very few side effects. For me, from the moment I started playing some rubbish chords until the time I became the lead singer of my own band, music made perfect sense, but I always saw it as a positive therapeutic distraction from a convulsive meaningless world, and still today I hold the very same perspective on music-and-me.

My deep self wanted a better world for all, especially for those who experienced in life the same trajectory that I have had. I was born in an African country deeply devastated by civil war, moved to Europe, my family took a lot of time to base themselves in a region which made me experience 9 schools/nurseries (very much geographically distant) before joining university; and making friends became a hardship. And when you don't have the skills to make friends that easy, simply because you don't have the stability and they don't have the capacity to understand it and be an active part of your journey (empathy is a rarity in growing adolescents - believe me), you become isolated, misunderstood, atypical and mildly unwanted around the hordes of teenagers who are themselves trying to make sense of the world they were given to. This is when reading, one of my passions and that I recall having emerged in my life from the moment I started primary school, became ever so important. I have always been completely mad about compulsive reading, trying to intake all knowledge possible about so many different things. And this is one of the aspects that really characterises me, the capacity to show interest and discuss so many different topics - it has helped me connect with people I have very little in common with, and it has helped me adapt to the different urban tribes a lot better. 

I always read and read and read as much as possible. As a child I consumed the books of a library near my house, furiously, but at home the books I could find never triggered any interest as the topics were pretty much related to my parents' professional occupations, and those were never a passion of mine. I have always been a kid who was never compelled to follow his parents' professional routes; never liked it, never appealed to me. In that limitation (struggling to find something good to read) I turned to the community library, it was free, the range of books was much larger, but the topics were institutionalised and that was vastly boring. I have always been a person with enormous inner discomfort in relation to social injustice and inequity. I share it not to obtain any type of societal approval but to open up space for the external understanding that said attitude really shaped my years to come and the way I still operate to date. The need for information on more obscure realities, knowing the technicalities of the different things that were taking place around us and the different visions we could lay upon these systems drove me to many interesting books, films and documentaries (yes, cinema was also a passion of mine). 

Two books and three music albums marked strongly my adolescence, some even flagged that embryonic cut from when you become a real adolescent and integrally abandon childhood. This is exactly marked by the moment two very specific events occur in your life almost simultaneously, 1) you start loving someone (or at least at that stage it hurts as if it's love) and 2) you start worrying about the state of the planet and society you have around you. "Zoo Station: The Story of Christiane F." represents a moment in my life as a human being, as a person, where I understood for the first time that some battles had to be fought completely alone, by oneself... and character, resilience and integrity would be pivotal for one's victory. It also alerted me to the dark powers associated to drug consumption. I think parents around the world would help their children so much if this book, or any other pedagogic book of this crude nature became an adolescence gift to raise awareness on the reality of drugs, so much broadcasted these days as cool, entertaining and natural in opposition to their true nature of devastating, criminal and self-limiting substances. The other book was "The Perfume - The story of a Murderer" by Patrick Suskind, a book that actually became the topic for the song 'Scentless Apprentice' by my favourite band ever - Nirvana -, who created my favourite album ever "In Utero". These three icons are deeply embedded in my becoming a Person, the person I am today. The book offered me yet again that misanthropic living that will be life for so many of us throughout our existences, even though the fictional atmosphere is dark, criminal and psychotic, but if we read between the lines there is a person who was born under terrible conditions, never felt loved and spent his life seeking the notion of Love (and self-love) almost desperately with therapeutic objectives, if one can say it. The album offered that same vision but through the eyes of Kurt Cobain, someone I could understand and empathise with so much - my favourite artist ever.

The last two albums that brought up the first adult version of my own self were very different in nature. "The Cult - Pure Cult: for Rockers, Ravers, Lovers, and Sinners" showed me I was starting to feel different whilst reading the world around me, and that that was a genuine interest in girls (one specifically I should say, but that was never corresponded at any time, hence generating that emotional conflict where friendship becomes passion becomes attraction becomes sour!!!!). This album was an awaking moment in my personality for sure. And finally "Chaos AD" by Sepultura who basically x-rayed a world filled with disgust, social injustice and political/societal hypocrisy.

Finally, some people can say Football is also a passion of mine and I have always been naturally good at Sports, but impatient to tolerate what Sports have become as money-making industries. 

My passions were sown inside me in a way that made me a different kid amongst people who were acting really hard to come about Different (as in Cool). But no passion was in me as strong as my love for Science, especially Life Sciences. I am completely addicted to knowledge generated by consuming Science at all times, and that drove me to study so 'hard' in life, and when you do it out of love it's not hard anymore, it's a natural process, a dignifying one, a needed one, a must. I completed my university studies, my BSc, MRes, PhD, worked in research but that passion of mine (Research) was not fulfilled to the most because as a professional route it is deeply rotten and lacking principles and morals. I would not be able to stand for most of the technicalities that define one to be a 'modern slave' of a predefined scripted vicious thinking process, one that nowadays is ever more commercial than actually scientific.

So the way to combine my passion for science with my passion for knowledge and communicating said knowledge was to create a blog. This blog. The blog that shut doors today but that was ever so integral and important in allowing me to suck the juice of having someone interested in what I had to share. The scientific knowledge I was collecting for myself and decided to share with an audience for my questions would definitely be the questions of others. And I did if for quite some time with enormous pleasure and integrity, scientifically and personally, by approaching everything with the due referencing and never assuming absolutism. Everything can be questioned but all questions need a proper thought process. I pretty much enjoyed every single article I wrote hereby and I learned so much with this blog. The Toxicologist Today was, at some point, a flagship of scientific honor for me. The knowledge and debate generated helped solidify that idea that science needs conversational positioning, to attempt to prove or disprove theories.

But times evolve and where I still believe I have so much to give to an audience in terms of scientific communication, something that unfortunately I do not see entirely fulfilled with my professional career due to the limitations associated to the ins and outs of the nature of what I do, ..., I am sure I have so much to speak about, discuss, teach, learn from and debate on. But the platforms are changing, audiovisual channels became a reality of our days and I could see myself deriving to those platforms, but I don't want to. I really could do it naturally, but one thing is missing; that x-factor that really differentiates those who like from those who love, and those who love from those to act upon - The Passion. I don't have it anymore. It is time to seek pleasure in other things as I see myself reading more and learning more but purely for myself. Eventually sharing but not compulsively or needing to, but as a natural occurrence, if it has to be and without any kind of pressure, internal or external.

This is the end of The Toxicologist Today and I thank you deeply for nearly 11 years of my favourite blog on the Web.

Thanks to @Nate_Dumlao for making this photo available freely on @unsplash 🎁 https://unsplash.com/photos/k2GX9kNhXyQ?utm_source=twitter&utm_medium=referral&utm_content=creditShareLink 

From Sjogren's to Leaky Gut to Menière's to Labyrinthitis - a proposed theory

I have come across a few published articles that cover the high incidence of systemic autoimmune diseases in patient's with Menière's Disease, for example [1, 2], but I always wondered if the other way around could also be a possibility. I mean, one of the health disturbing aspects I have seen reported in Sjogren's patients has to do with events of labyrinthitis (inflammation of part of the inner ear) or pressure put in the inner ear by a very inflamed parotid gland that can trigger vestibular disturbance (i.e., related to the inner ear and sense of balance). However, since Sjogren's is so intrinsically related to metabolism and diet, I have also learned of the nefarious effects caused by certain foods and beverages in a patient's balance, vestibular 'equilibrium' and an impaired digestive tract.

It is easy to establish a chain of consequences that is potentially triggered at any point of the affected physiological system, one that in a healthy person can be counteracted and re-established to normality, but that in an autoimmune one will have to be compensated with potential biological actions that can, on their own, eventually initiate particular imbalances elsewhere in the system. 

However, autoimmunity (where Sjogren's sits as a syndrome) appears to be quite associated with Menière's disease (a pathophysiology marked by vertigo, tinnitus, high pressure felt at the inner ear, and in grave cases even resulting in hearing impairment) [1]. Menière's can play episodically through events usually marked by inflammation at an associated contiguous point, even resulting in potential bilateral vestibular hypofunction (in the worst scenarios). But just as Sjogren's syndrome, also Menière's disease is a chronic condition, hence persistent and recurrent, where the associated vertigo episodes can last from a only a few minutes to excruciating long hours. Now imagine the impact on the performing of regular activities such as driving, operating machinery, walking, etc.

Where some doctors might immediately resort to prescribing prochlorperazine maleate or any other typical phenothiazine indicated for severe nausea, from a personal perspective a patient must also learn how to identify the triggers that typically promote the onset of such vestibular disturbance. In different examples to me presented, I had the chance to read that this can be very closely associated to dietary options alongside the typical promoters, such as stress, anxiety, opportunistic viral infections that take advantage of structurally-compromised tissues, and the consumption of desiccants (such as alcohol, spicy foods, etc.).

Add to all this the still quite abstract concept of leaky gut, a disorder that has not yet been fully clinically accepted and medically characterised, but one that it is thought to involve cracks in the intestinal tissue that will allow the passage of unexpected macromolecules to the blood stream... molecules that due to their size, composition and complexity were not supposed to be allowed in the circulatory system, and that will, therefore, promote physiological disturbance. It is extremely difficult to find literature to support the idea of a leaky gut, but the same people who have been blaming gluten for several metabolic and physiological ailments have now turned (no personal judgement here at all!) to the idea of a leaky gut - as the portal to disarray. From within a list of supposed complications one can identify the multifactorial Menière's disease [3]. And considering what the authors also debate, i.e., "that patients often complain of aspecific gastrointestinal symptoms associated with autonomic dysregulation, frequently outweighed by the otological manifestations", a recurrent cycle of afflictions is theoretically hereby established.

In a way, and as suggested in the image that I have edited and enclosed in the post, the metabolic dietary stressors will trigger a reinforced imbalanced immune response, that is already appanage of an autoimmune disease patient. However, in association with a debilitated gastrointestinal mucosa, be it in the stomach (as it occurs typically with reflux or H. pylori infections, for example) or at the intestinal tissue, the molecules unexpectedly absorbed into the bloodstream will add to the inflammatory dynamics and  this will potentially increase the implications of ongoing inflammation at the vestibular domain. Ergo, making the vestibular tissues even more vulnerable to opportunistic viral infections, and affecting the profile of the naturally-occurring crystals in the inner ear's liquids (the endolymph and perilymph), consequently affecting the audiovestibular moiety, adding to the incidence and seriousness of the reported "dizziness, generalised, imbalance, ataxia, motion intolerance, positional vertigo, oscillopsia, and episodic vertigo" [2].

In that sense, it is my personal belief that dietary changes need to account for the supposed 'leakiness' of the gut, and might be able to help reduce (not cure!!!) the episodic occurrence of inflammation that affects equilibrium in an autoimmune patient. What do you have to say about it? Does it sound feasible?

[1] Gazquez, I., Soto-Varela, A., Aran, I. et al (2011). "High Prevalence of Systemic Autoimmune Diseases in Patients with Menière's Disease". PLoS One, 6(10): e26759.

[2] Girasoli, L., Cazzador, D., Padoan, R et al. (2018). "Autoimmunity and Otolaryngology Diseases - Update on Vertigo in Autoimmune Disorders, from Diagnosis to Treatment".  Journal of Immunology Research, pp. 1-16.

[3] Berardino, F., Zanetti, D., Ciusani, E. et al (2018). "Intestinal permeability and Ménière's disease". Am J Otolaryngol, 39(2), pp. 153-156.

Original post photo by Omid Armin on Unsplash

"Leadership is taking responsibility for the people around us" (Simon Sinek) - Part II

As expressed in my last post where I promised to publish one of the most, if not the most elevating motivational speech on management and leadership I ever witnessed; I hereby leave you with wise words from a very wise professional. Simon Sinek needs no introductions; his talks and seminars are profusely broadcasted on the web, and his teachings are pervasive for some, intrusive for others, but extremely relevant for all, i.e., organisations and the people they aggregate. So, in very thoughtful words, what does it mean for Simon Sinek, to be a leader?

"What does it mean to be healthy, what does it mean to be a great parent. I don't have five things to be a great parent, right?! It's a lifestyle and it comes number One, with the commitment that I am responsible for the life of another human being, the growth of another human being. The closest to leadership is parenting. You have to be an infinite student of parenting. You know, if you want to be a parent you ask your friends, you ask your own parents, you join groups, you read magazines, you watch talks, whatever it is you're constantly consuming how to deal with this constantly changing challenge of being a parent. And it's ups and downs and successes and failures, you know? And that's what it is Leadership. Leadership is the same. Great leaders are students of leadership, no matter how achieved they may be. They're still learning. And it's a lifestyle. It's the lifestyle of what I need to do to look after people which includes things like Listening, Learning how to Give and Receive Feedback, Learning how to have effective confrontations, how to discipline when necessary (in a way that's constructive); roam the halls, get to know people. Learning what it means to ask somebody questions. How do you ask questions? Some people are naturally good at being curious about other human beings and some people are uncomfortable because they're introverts or whatever, socially awkward, but we can learn. You know? How do you learn to remember people's names? 'Well, I'm bad at names' - No, you've just decided you're bad at names; we can learn to be good at names, so that when we walk down the hall and say - 'Hey Tom!' / 'Oh my God, he remembers my name?'. It's a nice feeling. It's a lifestyle. There are many many things we have to do and constantly work on to be a great leader, to create that environment.

Everything that we are talking about in the infinite game is really really really hard. it is so much easier to build a company based on short-term ambitions than it is an infinite cause. It just is, right? It's also fun until it's not. Less inspiring but sometimes hitting a goal feels good. It's much easier to just hire and fire people frequently. Hire fast Fire fast, as to hiring slowly and firing slowly because we try and take care of our people as best as we can. It's hard to build teams. All that stuff we talked about Leadership, like what am I supposed to do to build a trusting team? Well, I wish I could give you a list of five things. It's really really hard to be a parent. It's much easier to be an uncle or an ant, or not have kids. It's hard!!! So why do it? It's fun and exciting to be. To try and beat our competitors, but to have to face our own weaknesses every day, that's exhausting. Existential flexibility, I'd rather not. I'd just would rather not. So the reason this takes courage to completely change our mindset about the game that we're actually players in and how we want to approach these things, and do we want to shift our mindset and our organizations to prepare for the infinite game to be organized for the infinite game. It takes courage because we're going to be swimming upstream in a world that is very finite driven. You know the pressures on us are overwhelming from wall street, or our own egos, or from internal incentive structures bosses, whatever it is the pressures are overwhelming for us to play the finite game. And so how do you stand up to massive external pressure? Courage, and courage is something that comes from relationships, it's external. A world famous trapeze artist would never attempt a brand new death defying act for the first time without a net! They would never do it, so why do we think that we could do something difficult without external support too? I've had the opportunity to meet real heroes, people who've risked their lives to save the lives of others with the belief that they were gonna die... and they didn't. And when asked why did you do it they all say something similar which is they would have done it for me. It's external and so we have to take the time to foster and take care of people around us, to nurture our relationships because when we're going to be doing something difficult, when we're going to be swimming upstream, when we're going to be innovating and doing something different, there are days we're going to doubt ourselves, there are days we're going to get knocked in our ass, there are days that storms are going to rise, and we have to have people who say - 'I got your back'. You need to do this, world needs this - 'Keep going, I believe in you'.  

Courage comes from not only our willingness to do that for others, but then their willingness to do it for us, and if we commit ourselves to a just cause and we're willing to do those things, then you know the great thing is we take a lot of people with us, and change the world for the better and... isn't that sort of the point of an infinite life? To leave this world in better shape than we found it? To leave the companies that we work for in better shape than when we started? To leave our families stronger and better capable than what they can do without us? Isn't that what it means to live an infinite life that we can literally live on beyond our own lives.

[...] An infinite mindset means that, it is something I can't do but I can influence and take care of the people to the left of me and to the right of me. I can take care of the people who work for me, I can even take care of the person I work for. Sometimes we have a toxic boss not because they're bad but because we don't understand the pressure they're under. Sometimes to simply exhibit empathy to our boss - 'Hey boss you were really harsh on us today, is everything all right? What's going on, I'm worried about you!'. We can succeed together, - 'I'm here to help you'. No matter where we are inside our organisation, leadership is not about rank or authority, leadership is taking responsibility for the people around us. And so anybody, on any team at any rank at any level can be a leader. The first choice is that we have to want to be. A  dear friend of mine, lieutenant general George Flynn from the marine corps said that the first criterion to being a leader is you have to want to be one, so any of us can volunteer to be a leader and that's what you do, you commit yourself to seeing that the people with whom we work on a daily basis love coming to work, they feel that someone's got their back, they feel supported, they feel that they have top cover, they feel someone cares about them as a human being listens to them, knows their story, allows them to be themselves. We can be that leader and what you start to see is those teams become really high performing, those teams become super tight and you start to hear rumours across the company because everybody wants into that team because apparently it's a great team to work with, to work on, and before you know it, one of those people goes and moves to another team and they take everything that they learned because leadership is learned and they do it for another team, and if we take that infinite mindset then eventually the tail will wag the dog and it doesn't matter if it's this CEO or another CEO because we will outlast whoever is in charge right now and that's the goal we're doing this for, the good of the organization, we're doing this for the good of the cause, and the tail can wag the dog.

[...] Be the leader you wish you had, become a student of leadership, study it, read about it, watch things about it, practice it every day, be a parent, join the movement means -'I'm going to take care of my team. 'Sometimes I'm in a leadership position, and sometimes I'm not, and it doesn't matter. I'm going to practice leadership'. If I'm a salesperson, if I work at the check-in counter of an airline, I'm going to take care of the people I work with and take care of the customers as if as if they're my family. Practice leadership, learn about it, study it, because I do these things because I recognize I'm just a piece of a jigsaw puzzle, because when we do a jigsaw puzzle the first thing you do is lean the picture of the the box against the wall and then you start putting the pieces together to build that picture. My job in this movement, I'm the guy who points at the box, I'm the one who's pointing at the picture, pointing at the picture maybe pointing out a couple of the pieces and where they go, but I need lots of people to join me, we need lots of people to join us who say I have a piece of the puzzle, I'm willing to lead this way, I'm willing to abandon Milton Friedman ideals and and do something bigger, something more, follow that. Live with an infinite mindset, lead with an infinite mindset and put their piece down and say how can I help build that vision? We need the army and so, how people can engage in the movement is actually practicing all the stuff more than anything else, that's what we need'.

Post image by Matteo Vistocco on Unsplash.

Misconceptions of Management and Leadership - Part I

I've held the opinion I am hereby sharing for quite a long time, due to not believing that it is indeed genuinely respected that almost universally-proclaimed freedom of speech. Everything in our lives comes at a cost, and every single action, professional and personal must be balanced very tightly and responsibly, especially in this day and age where whatever shows up in the web will forever claim its eternal footprint. However, there is a greater energy inside me that has always driven me to be as courageous and determined as my conscience demands; such does not have to come up with disruption to anyone's well-being, and I am sure that our entitlement to think and feel makes us ever more human and generates a proactive synergetic world... for the better.

I have been quite shocked about the displacement of realities between what several stakeholders claim about management skills, leadership skills, and the actual day-to-day reality of what is seen and felt by all of us in our professional experiences, in our professional involvement. It is incredible how social networks have become a public speaking platform for so many colorful diagrams and schematic presentations on the qualities of leadership and management. Don't take me wrong, it is important to have it discussed, it is relevant to have it uniformised and it is crucial to have it debated. What I suspect is not healthy is still the enormous present misconception that a manager and leader have achieved such level because of their professional qualities associated to their solid people skills. That is not true, and most of us who have put any thought into the rationalisation of this simple, yet extremely important problematics, have understood that management and leadership are still positions and properties that happen as consequence of professional progression, not a natural assumption by the system, of qualities that are integral for the role.

Some time back I experienced working with a manager in a certain project that was probably the least qualified human being, in human interaction, that I have seen in decades. The attitude of this person was almost like going back in time where arrogance, lack of sympathy and presumptuousness were obligatory in manager/leader and had to irrevocably be accompanied by a face that never smiled and a stern attitude of eternal discontentment. I am completely sure that said person was undeniably solid in their performance as a pillar, not because of the quality of their results but just because of the parallel built between what was delivered by their style of management and leadership and the dying ever classic idea of bossing around. No space for debating ideas emerged from the arrogance that their position is a clear reflection of an intellectual superiority.

Well, that old, very old-age incorporation of distance and unattainability, be it intellectual and even communicational (due to the lack of presence and availability said person assumed as part of their theatre of management and leadership), had to obviously claim their victims. The project was in shambles, there was a clear gigantic gap between the actioners and the thinkers, no adequate positioning towards the future with present brainstorming for success and harmony, and eventually people found dismay. Actually, here sits yet a very important concept that is still nowadays misinterpreted by many stakeholders, especially those that occupy positions of decision and leadership; i.e., that harmony somewhat resembles laziness, and that an entropic reactional work system delivers precepts of effectiveness based on anxiety. This incredible idiotic misconception can be called - Glorification of Stress -, and has claimed the professional vitality of many projects throughout the world because it is generated by people who do not understand the first thing about people and still understand the world as a system of owners and effectors, one that will operate ever more efficiently if the 'lower rank' agents are constantly under threat, limited in their access to information concerning the vitality of the projects and their own professional progressions.

This manager I am referring to had embodied the idea that scaring the others and maintaining a distance, using of proverbial arrogance and short messaging of direct orders was so effective that they needed to maintain that status quo, and swarm this approach towards other departments and other personnel. I eventually left the project due to the fact that I saw way too much disorganisation and lack of integrity, but in the back of my mind remained this bitterness that professionally we are so limited in our capacity to speak freely and engage in practical/useful conversation that can promote the betterment of our team spirit and the glory of our team achievements. And here lies yet another misconception, the last one I'd like to stress for the sake of time - the measuring of success is based on numerical goals, very few projects ever assess how happy were the professionals during the process of reaching said goals, and the effects such processes had in their mental/emotional and even professional health. This is ever more evident when corporations are managing employees that are not directly contracted to the organisation or are linked contractually for a temporary/short span of time. It generates detachment, it generates a human disconnection that basically uses people's greed or insecurity as a generator of intra-competitiveness rather that inter-cooperativity. This is even more a reality if management and leaders proclaim or use that typical insidious trick of announcing out loud the project is going poorly, not all will have their contracts renewed and people are under intense scrutiny. Once again the worst aspects of human nature surface and what should be gaining from team spirit will be exploiting professional survivalism. Do not be fooled. All loose! Only the corporation that makes use of such trickery will temporarily gain from it until the different people find dismay, understand they have been played and assume a posture of personal dignity by leaving at all costs, personal and professional. Big corporations then go about recycling the methodology promising other new inexperienced staff the same volatile and empty 'dreams', and the never ending circus of disrespect will keep claiming professional lives and producing stories of unfortune.

Management, Leadership, these active agencies of any team can only produce real holistic positive results if they act as immediate generators of Team Spirit. If they row towards their objectives as one and make sure that no one is left behind at all cost. It is in this ultimate defiance of hardship that any employee will strive to be the best version of themselves.

For Part II I will bring you what is perhaps the most iconic (and don't forget you are reading this from a known Iconoclast) speech I ever heard about reaching goals and the necessary elements of happiness and justice for all.

Thank you all for reading 'til this point. I hope I have enticed you enough to come and visit the 2nd part.

Post photo by Markus Spiske on Unsplash

The buzz around vaccine adjuvants

There has been a huge buzz recently in my line of work, coming from many preoccupied members of the public who have expressed their concern around adjuvants used in the Covid-19 vaccines. The concern is acceptable however most of what is suggested by the public is not immediately correct. A lot of people have assumed their panic because some of the adjuvants might be based on aluminium (a known heavy metal with relevant toxicity), and other adjuvants assumed by the public as more organic and for that matter supposed immediately safer to use. In order to clarify the public of the ins and outs of the dangers associated to any of the aforementioned aspects, it is important to also be aware of the science behind the use of adjuvants, as only a composed knowledge can be fully integral.

What are vaccine adjuvants and why are these used?

Adjuvants are merely substances that, generally speaking, are introduced in a system to help it perform its functions better. In that sense, vaccine adjuvants are ingredients that when put in a vaccine will enhance the immune response, especially on those vaccines that use weakened viral compounds and particles, and where the immune response might not be sufficient to have a fully effective vaccine [1]. It's a 'helping hand' to make the vaccine's effect more pronounced and accurate. In completely random terms but with the sole purpose of producing a visual aid, imagine that someone (a virus) is entering your house (vaccine injection) and you want the guards (immune system) to be fully prepared to repel the robbers (immune response) and be prepared to avoid them breaking into the house again in the near future by training sentinels (memory cells) that specifically recognise them robbers and contain them before they can cause any further damage (antibodies). The adjuvant would be the alarm ring that would buzz noisily as the robbers enter the premises, to make the immune system fully aware that unwanted people have invaded private property, hence helping prepare a much faster and robust response to contain them.

Which are the most typical vaccine adjuvants?

Vaccine adjuvants have been used in clinical virology for decades with very positive results, however recently some researchers have re-evaluated the role of aluminium-based adjuvants and consider them to have had their efficacy overrated through the years, and possibly inadequately assesed for their neurotoxicity and potential adverse effects [2,3]. Some people ask why are new adjuvants being studied if the scientific community sees aluminium-adjuvants to be completely safe? My personal take is that three very specific reasons support it, the first being the fact that better/more accurate/more potent adjuvants are known to generate more pronounced immune responses in terms of vaccine efficacy, where the toughest challenge is to develop vaccines that can induce a stronger "T cell immunity with purified or recombinant vaccine antigens" [5]; the second is the need for more organic solutions that will not react or interfere concomitantly with other medication and/or metal-sensitive procedures, such as the lipid rafts in the cell membrane that can cause "cell damage and necrosis with release of uric acid, ATP, and DNA" [6]; and the third is that the jury is still out there in what concerns the absolute safety of aluminium-based adjuvants.

Some people have recently asked me for examples of adjuvants and their nature, but because this is not immediately my field I had to browse a little to know that what I am talking about is correct. And I found a few, namely:

- CpG1018 - "Cytosine phosphoguanine (CpG), a synthetic form of DNA that mimics bacterial and viral genetic material", 

- MF59 that is an "oil in water emulsion composed of squalene (an organic compound originally obtained from shark liver oil and that is used in flu vaccines, to the best of my knowledge. This substance is not vulnerable to lipid peroxidation and that is a relevant property for any adjuvant inserted in the human body.

- Aluminium, the available research as shown that this metal that is ubiquitously found, and for that matter people are naturally exposed to it through water, soil and even food; is not harmful if kept below known toxicity levels. One of its great advantages is that it is readily absorbed by the human body. The internal aluminum concentration is identified from urine and also blood, and it has been shown that maintaining these levels below the tolerance values helps in avoiding the development of subclinical signs of aluminium toxicity (i.e., confusion, muscle weakness, speech problems, seizures, bone pain an deformity, paediatric arrested development) [4].

There are also other adjuvants available but not so frequently used in immunisation protocols (due to low commercial demand), such as Monophosphoryl Lipid A (isolated from the surface of bacteria).

As to the organic adjuvants, the same principle of concentration and cause-effects is applied, for organic does not immediately read safe. All biological substances can be toxicants if applied with a nefarious concentration or when triggering detrimental biochemical processes. Think about snake's venom, the right concentration has been used to improve spasticity, cancer-related issues, you name it. The wrong concentration can kill!!

Before any populist sporadic decision by the consumer, it is very important to understand that the safety of all vaccines is closely monitored by many professional health regulators. Even though it is important to keep researching to identify more optimised and effective adjuvants, presently their safety is genuinely established to the toxicity levels of all ingredients known to have a cause-effect in the human body, particularly with vulnerable patients. The vaccination process has safeguarded entire populations from pathobiological devastation and its science must be respected and reported for its proven grounds and robustness. However, bringing the topic to the discussion table is also relevant for the democratisation of science, so people don't fundament their decision based on unsupported non-scientific principles shared via social networks, rather than the consubstantiated science that is available for all at reach of an article... just like this one. 

I hope I have helped with my share. The ultimate education is responsibility of the person who questions the principle behind any solution.

[1] Squalene, National Library of Medicine, [https://pubchem.ncbi.nlm.nih.gov/compound/Squalene], last update unknown, last access on the 13th of September 2021.

[2] Tomljenovic, L., Shaw, C. A. (2011). "Aluminum vaccine adjuvants: are they safe?". Curr Med Chem, 18(17), pp. 2630-7.

[3] Klotz, K., Weistenhöfer, W., Neff, F. et al (2017). "The Health Effects of Aluminum Exposure". Dtsch Arztebl Int. 114(39), pp. 653–659.

[4] Igbokwe, I. O., Igwenagu, E., Igbokwe, N. A. (2019). "Aluminium toxicosis: a review of toxic actions and effects". Interdiscip Toxicol. 12(2), pp. 45–70.

[5] Coffman, R. L., Sher, A., Seder, R. A. (2010). "Vaccine Adjuvants: Putting Innate Immunity to Work". Immunity. 33(4), pp. 492–503.

[6] HogenEsch, H. (2012). "Mechanism of Immunopotentiation and Safety of Aluminum Adjuvants". Front Immunol., 3(406), pp. 1-13.

Post Photo by Mufid Majnun on Unsplash

Some say Lion's Mane mushroom is the Jungle's King in fighting neurodegenerative diseases

Very recently, an incredible docuseries debuted on Netflix. It covers the highly interesting world of Fungi, their emergence as kings of the ecosystems, debunking the public generalised idea of an apparent vulnerability. We couldn't be 'more wrong'!!!! If there is a resilient species, clever for their societal dynamics, incredibly adapted to making their presence noticed with the sporulation of millions of very light microspores that get carried away by the weakest breeze, FUNGI are the deal. I wouldn't be able to reduce their tenacity and biological cleverness in a small book, let alone a paragraph in a blog post. 

Please watch the series 'Fantastic Fungi' (hopefully the link will be available for the years to come for everyone to savor the educational quality of its content).

***

Fungi are very adaptable and in the game of survival that all species play for their own sake, they went from absurdly evolved underground networks to making other species do exactly what they want; a process as bizarre as the morbid zombie-like approach I have written about in a previous post entitled 'Survival of the Poisonous: "Ophiocordyceps vs. Ant'.

Nevertheless, a particular species of mushrooms that immediately caught my attention was the one known as Lion's Mane (Hericium erinaceus). This mushroom has been identified as having very interesting properties that can help solve, once and for all, the most challenging aspects of the neurological decadence in humans, especially those related to Alzheimer's. In a time where researchers try their very best in gathering the most clinically relevant information concerning this disease, and where predictors of incidence in humans are now starting to emerge from these research projects (like the one from the Lund University [1] that might help tackle the price and diagnosis' limitations that see around 20 to 30% of patients with Alzheimer’s disease ending up wrongly diagnosed even within specialised healthcare [1]. The project lead by Professor Oskar Hansson generated a prototype online algorithm that makes use of the combination of a simplified blood test ('measuring a variant of the tau protein [phosphylated tau] and a risk gene for Alzheimer’s') associated to a short (~10 minutes) triplet of cognitive tests. Alongside the simplicity of the process, especially when considering how challenging these patients can be when facing complex tasks, is the fact that the diagnosis predicts correctly with over 90% certainty exactly which patients would be in risk of developing dementia due to Alzheimer’s disease within a period of four years. 

This tool will not only increase the quality of care of patients in a predictive and planning fashion, but also concentrate and focus the targeting of the different developed drugs in more accurate indicators and variables, treatment-wise.

It is here, when it comes to treatment, that some researchers have been interested in the incredible potential that Lion's Mane Mushroom is reporting from the different investigational projects around the globe. For example, some investigators have observed this mushroom to have therapeutic properties that promote recovery of nerve and brain health [2] due to its erinacine production in the mycelia of its organism. The same authors even propose an optimised process for an advantageous fermentation process, so the content in erinacine A (the only erinacine substance that has been confirmed as having pharmacological activity in the central nervous system in rats) is increased [2]. Their rat models have helped identify protective properties in Ischemic Stroke (showing capacity to reduce neuronal apoptosis and stroke cavity size in the studied rat brains), Parkinson's Disease (a disease with a profile of gradual loss of dopaminergic cells in the substantia nigra pars compacta region of the brain, and that ultimately ends up resulting in motor problems such as 'resting tremor, rigidity, bradykinesia, and postural instability') - however, with Lion's Mane erinacine A, the dopaminergic injuries and accumulated oxidative stress in the stratum and substantia nigra were significantly improved. And even with transgenic rat-models of Alzheimer's disease where the occurrence of amyloid-β plaques that participate also in the increasing of secondary brain comorbidities such as 'inflammation, excitotoxicity, and apoptosis', and add on to the negative effects associated to the deposition of hyperphosphorylated tau proteins - in this study the observed transgenic mice treated with H. erinaceus mycelia were able to 'recover behavioral deficits after 81 days of administration'.

***

The range of protective/recovering activities observed in the brain of different transgenic mice mimicking the different aforementioned neurodegenerative complications, reveal a promising way forward, as some studies have recently established:

Li, I-C. et al 2020 with the 'Prevention of Early Alzheimer’s Disease by Erinacine A-Enriched Hericium erinaceus Mycelia Pilot Double-Blind Placebo-Controlled Study' studied the effects of capsules containing two contrasting concentrations (350 mg/g and 5 mg/g) of erinacine A per day in treating mild Alzheimer's patients and observed that the highest concentration is well-tolerated and beneficial to their neurocognition.

Their cytotoxicity has already been established a long time back as low by other studies, I hereby mention solely two as an example to avoid a longer text [3] [4]; but this study by Li et al (2020) [5] where a 70-fold higher concentration has been used without observed clinical cytotoxicity is ever so promising for the future paths this realm of investigation may take.

Post picture kindly taken from https://www.healthline.com/nutrition/lions-mane-mushroom.

[1] Simple Diagnostic Tool Predicts Individual Risk of Alzheimer’s, Neuroscience News, [https://neurosciencenews.com/individulaized-alzhiemers-risk-tool-18484/], last visited on the 3rd of August 2021, last update on the 24th of May 2021

[2] Li, I-C., Lee, L-Y., Tzeng, T-T., Chen, W-P., Chen, Y-P., Shiao, Y-J., Chen, C-C. (2018). "Neurohealth Properties of Hericium erinaceus Mycelia Enriched with Erinacines". Behav Neurol. 2018.

[3] Mori, K., Inatomi, S., Ouchi, K. et al. (2009). "Improving effects of the mushroom Yamabushitake (Hericium erinaceus) on mild cognitive impairment: a double-blind placebo-controlled clinical trial". Phytother Res.; 23: pp. 367–72.

[4] Nagano, M., Shimizu, K., Kondo, R. et al. (2010). "Reduction of depression and anxiety by 4 weeks Hericium erinaceus intake". Biomed Res.; 31, pp. 231–7.

[5] Li, I-C., Chang, H-H., Lin, C-H et al (2020). "Prevention of Early Alzheimer’s Disease by Erinacine A-Enriched Hericium erinaceus Mycelia Pilot Double-Blind Placebo-Controlled Study". Front. Aging Neurosci.; 12 (155), pp. 1-13.

On Japanese Encephalitis

As part of my ongoing professional training I have recently come across a range of pharmaceutical products indicated for ailments that were partly unknown to me, but that due to their profile I consider obligatory to write about as these have potential to impact on the health of unaware tourists (typically immunologically naïve) travelling to areas where the incidence of such issues is very relevant. Especially now that gradually and slowly the world is opening doors and borders, once again, to tourists. 

Japanese Encephalitis - this is a very relevant public issue in Asia, a seasonal endemic disease in 24 countries across the continent and that is transmitted by a mosquito bite with grave consequences (high morbidity and mortality numbers) and presently lacking an effective treatment [1], hence prophylactic vaccination is the best way to go, especially when considering that there are no laboratory virology tests designed for its recognition [2]. This disease is the number one reason for viral encephalitis and neurological disability in the Asian continent [1, 2].

Scientists and clinical staff consider that most of the cases remain unknown because they are never reported to health authorities and health support bodies. With 68000 symptomatic cases, almost 3 thirds of infected are children [1,2]. The reasoning behind under-reported cases might be associated to the symptoms resembling different common health issues, non-specific symptomatology and the lack of knowledge the infected and healthcare workers hold on this problem. The idea that diagnosis requires liquid to be collected from the cerebrospinal fluid, in order to analyse the content on antibodies, might as well put most of the infected and a financially-limited healthcare system off.

Since the word epidemic is now known to the main public due to the covid-19 pandemic-after-epidemic, Japanese Encephalitis has already caused deadly ones, for example in Indonesia Papua New Guinea, and even in an area of Northern Queensland (Australia). Transmission occurs initially within a restricted animal population (usually pigs and birds drinking from infected water sources). However, due to low viremia (presence of virus in the blood) in humans we represent a stoppage (i.e., dead-end host) in the infectivity process, but every 1/1000 infected person will develop the disease whereas a third of the symptomatic patients eventually perish [3]. When patients are fortunate enough to recover from the disease, so much neurological damage is left behind that a sort of 'Long-Japanese Encephalitis' might take weeks, if not months to be corrected (some patients might need help for the rest of their lives). [1]

The virus has an initial incubation phase that could go from 4 to 14 days. The very first symptoms emerging would be the 'typical' acute headache, vomiting, pyrexia. These will later on progress to behavioral and mental changes and acute weakness that emerge of the initial stages of following, more severe, symptom, i.e., acute encephalitis.

Only a sustained consistent vaccination program developed in the endemic areas was capable of controlling the spread of the disease, but not able to eradicate it. [4]

[1] Mackenzie, J. S., Gubler , D. J., Petersen, L. R. (2004). "Emerging flaviviruses: the spread and resurgence of Japanese encephalitis, West Nile and dengue viruses". Review Nat Med, 10(12 Suppl):S98-109.

[2] Campbell, G. L., Hills, S. L., Fischer, M. (2011). "Estimated global incidence of Japanese encephalitis: a systematic review". Bull World Health Organ. 89(10): 766–774E.

[3] Diagana, M., Preux, P-M., Dumas, M. (2007). "Japanese encephalitis revisited". Review J Neurol Sci, 15;262(1-2):165-70. 

[4] Burchard, G. D., Caumes, E., Connor, B. A., et al (2009). "Expert opinion on vaccination of travelers against Japanese encephalitis". Review J Travel Med, 16(3):204-16. 

Photo by Olga Kononenko on Unsplash