Saturday, November 17, 2012

Oh those Bartonella!

Bartonella Quintana (from here)

My friend across the pond put me onto a post describing Trench Fever that was a scourge of Allied troops in World War I. This is a topic that certainly has six degrees of interest surrounding it like the expanding ripples in a pond. (it is also something that would take forever to research without the Internet.)

As my friend and the article point out, there are three different lice (louse) infestations of man. There is head lice (the scourge of elementary school), with their little egg shells called nits (as in "nit picking"), pubic lice, ye olde crabs, and body lice which are the vector of Trench Fever. Apparently it wasn't appreciated until after WWI that the louse was the vector. There may have been a million cases of Trench Fever during the War which didn't lead to fatalities but did lead to incapacitation and, eventually, depression.

So, Ripple 1. Depression after combat. Two books that deal with the mental state of soldiers: first is actually a series, The Ghost Road, by Pat Barker. The focus is on shell shock but with the incidence of Trench Fever so high (it is rarely fatal) one wonders how many of the soldiers experiencing shell shock had comorbid depression sequelae to this infection. As a Rickettsia infection it is similar to Rocky Mountain spotted fever and, see below, Cat Scratch Fever. RMSF can have major CNS effects, but its main pathological effect is on blood vessels leading to necrosis of fingers and toes. Presumably this is due to invasion of the blood vessel wall by the organism. The second book that comes to mind is Birdsong by Sebastian Faulks. (I only now find out that it is also a part of a triolgy including The Girl at the Lion d'Or and Charlotte Gray; the first I have read but not the second). Neither Ghost Road or Birdsong explicitly mentions Trench Fever, to my knowledge though there is a sequence in Ghost Road where the soldiers get to take showers and laundry their clothes.

Ripple 2: Bartonella Quintana, transmitted by the louse and the causative organism of Trench Fever, has very interesting biology. How the biology relates to the symptoms it is hard to tell. For one thing the organism inhibits apoptosis of infected cells. Apoptosis, or programmed cell death, is a Holy Grail of cancer research. That is, most cells in the human that can be transformed into cancer cells are cells that reproduce. Bone marrow and the linings of the intestine and the lung are constantly turning over. Cells, maybe stem cells, are also constantly dividing to produce new bone marrow and epithelial cells. In turn, the old, senescent cells must commit hari kari, or apoptosis. This may have something to do with telomeres, repetitive nucleotide sequences that protects the ends of chromosomes. In any case, a cancer cell has apoptosis blocked in a similar manner to a cell infected with Bartonella Quintana. In the latter case, all that happens is that the disease persists and the patient can experience multiple relapses of Trench Fever. Not a very nice prospect but not as serious as cancer.

Ripple 3: Bartonella Hensalae and Quintana again. Bartonella Hensalae is a not uncommon infection best known as Cat Scratch Fever. Cats carry this bacteria but do not become infected. Actually, it is usually kittens less than six months and they are prone to scratch! (I can't really tell you from personal experience because I am not very friendly with cats.) After the scratch, which sometimes becomes locally infected, the bacteria goes to a regional lymph node and can cause gross and painful enlargement. This scares the living devil out of everyone since mimics lymphoma. There is also a meningitis caused by Bartonella Hensalae but is is uncommon.

One further biologic property of B.Hensalae is that it induces angioneogenesis, that is, the growth of new blood vessals. This also occurs with B. Quintana. Ironically, this is also a property of cancer cells. Without angioneogenesis, there would be no growth of tumors since they would run out of their blood supply. Much research is going into this field, led in the past by Judah Folkman (very interesting man, he.) In the case of these two bacteria, it is termed Bacillary Angiomatosis.

I think one could follow the ripples out pretty far. Interestingly, scratching around the Internet looking up these links raises a lot more questions than it answers. While similar in many respects, infections with the three organisms B. Quintana, B. Hensalae and Rickettsia rickettsii are vastly different, even though they each have similar biology (untreated R. rickettsii can easily be fatal). On the other hand, why is it that the simple little head louse while causing infinite consternation in the classroom is basically harmless?

Chinese Cowboy

I was impressed by the diversity of costumes at the Chinese Congress. My word, they even had a Cowboy! Of course the Native Americans have close genetic ties to Asians, particularly the Navajo. So, I guess they should have Cowboys too.

Wednesday, November 14, 2012

What can one say?

Seaside Heights Before Sandy (1980)

After Sandy


There are those of use that are very pleased with the result of last week's election in the United States. Obama meeting with his campaign staff sort of summed up our feelings. But we have so much work to do, it is a little daunting. I think that the very top of the list is climate change. The reality is that we are doing little or nothing to cut down the planet's carbon emissions. Even worse, the next big thing appears to be using methane as a fuel. Methane produces CO2 just as any hydrocarbon. In addition, methane as a greenhouse gas is much more potent than CO2 and much could be released in the extraction.

The next task is to control the spread of nuclear weapons and to actually, for all intents and purposes, eliminate them. The Comprehensive Test Ban Treaty is sitting in our Senate, awaiting ratification. It is unclear how long it will be before it can muster the 66 votes necessary to pass it. It is truly amazing that something as important as this can be blocked by the political whims of 13 men.

Hopefully the economy will continue to meander upwards. I still think a major push in rebuilding infrastructure would be the equivalent of WWII in stimulating things. But our culture weighs against it. I have a suspicion that I am ignoring the true situation in that up until 2009, America was totally addicted to accumulating trash, not vitalizing our country. Every Christmas I would watch as families went on buying sprees having to purchase the latest gizmo for their children. One year it is "Tickle Me Elmo" and another it is Hannah Montana. The lifetime of most of this ephemera can be measured in milliseconds. It piles up, and piles up. It is hard to throw things away. All it does is inculcate a sense of entitlement and a sense of greed in our children. These children are soon teenagers and then adults. Such an ethos branded on their souls can't be good.

But, I am as guilty as they. There is something intrinsically pleasing about consuming. Given that the product always looks better in the magazine advertisement or on the web site that it does in reality. There is still that frisson of pleasure when one opens the package and takes out the new toy. And, I know, all this is necessary to create jobs so we can make more and more trash. The trouble is, the jobs will be in Walmart.

Finally, the most important thing for America is to somehow heal the rift that has been created between the two political groups. I can never remember a time in previous elections when the losing party harbored such hate for those who won. As I tried to point out in a post on violence in the Super Bowel, Americans have been brainwashed into thinking that there is only one outcome: winning. Of course not everybody can be a winner, and there is many a High School athlete who learns this the hard way. But to experience the rancor that is out there this past week toward Obama and others is a new experience. It does not bode well for the spirit of cooperation that will be needed to get the country rebuilding infrastructure, removing the peril of nuclear weapons, and literally changing the ethos of the polity.