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From
the Desk of Coordinator, Bioinformatics Centre |
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January 2008 Allergy – An Emerging Global Health Problem |
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During the orientation camp in 1964 for Fullbright scholars at Indianapolis, we were received by American families on the weekends. I was starved of spicy food though American Cafeterias are full with bland foods and desserts. When the hostess asked me, whether I like to cook, I jumped and offered to cook spicy Upma and asked for an onion. She immediately said that she is allergic to onion. It was a big surprise to me that food can be allergic and I became skeptic that these rich people are too delicate. Now a days use of ‘allergy’ word has become so common that we do hear that one saying that he or she is allergic to certain people. 35 million Americans suffer from hay fever formally known as “Seasonal allergic rhinitis”. Food allergies affect 3 million and potentially deadly. More than 50 million Americans suffer from allergies making them the sixth leading cause of chronic disease, costing $10 billion a year on allergy medicines, increasing to $ 18 billion after inclusion of hospital and doctor visits. The word allergy is derived from the Greek words “allos”, meaning different or changed and “ergos” meaning work or action. Thus allergy refers to misguided and harmful hypersensitivity reaction by our immune system to certain normally harmless foreign substances the so called allergens, such as pollens, ragweed, dust mite, molds, drugs and certain foods. Allergens in certain individuals cause production of specific type of antibody IgE in large amounts, which when reacted with the allergen, leads to release of histamine and other chemicals by the cells, causing inflammation and typical allergic symptoms such as itching, redness of the skin or a rash, coughing, sneezing, nasal congestion, wheezing, joint pain, abdominal distress or cramping etc. In non-allergic individuals, the allergens are removed by other classes of antibodies (IgA, IgM, IgG, and IgD). In adults most common foods causing allergic reactions include shrimp, crayfish, peanuts, daal (chick pea), while in children, eggs, milk and soyabean products, peanuts etc. In Japan rice allergy is more frequent. Increasing incidence of food allergy is due to processed foods containing food additives, synthetic flavors, preservatives & colours and number of known and unknown ingredients. Air pollution with organic carbon due to emissions from gasoline and diesel exhaust, nitrogen dioxide is another cause for increasing incidence of allergy. Thus allergy is likely to become a marker of fast life, environmental pollution, junk food consumption, commercialized hygiene chemical products and modernization distancing away from simple and natural living. Compromised natural resistance is the price we pay and depend on drugs and health aids for survival. The ‘immunocap’ specific IgE blood test using the appropriate regional respiratory allergy profile (Quest Diagnostics) provides a convenient method of confirming allergy and identifying the allergen so that one may be cautious in not exposing to or avoiding consumption of allergic substance. Though there is a dramatic decline in many previously-common childhood infections, considerable rise in prevalence of diseases like asthma is observed. Scientists call this the ”hygiene” hypothesis, with lack of exposure to viruses and other environmental factors to build up resistance. Most common colds and infections such as chickenpox provide a level of protection. The challenge is to find ways of reproducing the protective effects of childhood infections while reducing burden of getting these infectious diseases. Food companies have come up with probiotic dairy (fruit flavoured) drinks with helpful microorganisms (live Lactobacillus casei and other species) to strengthen body’s defense system. Alternate therapies such as NAET (www.naet.com) seem to help in successful management of Allergy. Yogic exercises like Yogamudra and Anuloma-viloma Pranayama are also found to be beneficial. Living in a clean dust-free environment, maintaining a healthy diet and leading a simple life with regular exercise are essential to make one allergy free.
Wishing all the readers ‘ALLERGY’ Free 2008
December 22, 2007 Prof. B. C. Harinath |
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April 2008 |
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July 2008 |
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Disease Elimination and Vaccine Business
Eliminating a disease from the World is not an easy task. Smallpox eradication has been a highly significant and remarkable success in the history of disease control in the universe. Similarly child immunization has been effective in protecting children from life threatening diseases. A recent study in USA on 13 Vaccine Preventable Diseases: whooping cough; tetanus; measles; mumps; rubella (German measles); invasive haemophilus influenza type b (Hib); acute hepatitis B; hepatitis A; chicken pox; strepto-coccus neumoniae; and small pox revealed that for immunization developed prior to 1980, there was a 92% reduction in vaccine preventable illnesses and a 99% or greater decline in deaths due to vaccine preventable diseases. For Vaccines (hepatitis, Hib and chicken pox) introduced after 1980, there was an 80% or greater decline in illnesses and deaths. (USA – Health Day News, Nov. 13, 2007). With the success, during the 1970’s and 80’s, the US Government established goals for achieving high vaccination rates (97%) offering federal grants to states. During this period, the number of mandated vaccines gradually increased (from 8 in 1980 to 22 in 2000) as vaccination became a requirement for a much younger population (the majority of all 30 childhood vaccines are administered before the age of 18 months). This resulted in alarming increase in reporting of autism (one in 150) in children compared to one in 10000 in 1970s, thus shaking the faith of public in safety of vaccine in promotion of health. Autism, an incapacitating developmental disability is a disease involving the brain, the immune system and the gastrointestinal tract, attributed to the chemical toxicity of mercury in thiomersal used as preservative a common vaccine ingredient in MMR, HIV, hepatitis B and DTP vaccines given in the first 18 months. (www.know-vaccines.org). Adjuvants are typically used to boost immune response. Adjuvants are sometimes called the dirty little secret of vaccines in the scientific community, as not much is known about how adjuvants work. At this juncture, it is of interest to consider the development of immunity, the defense system and how the survival instinct in humans resists infection in nature by innate and adaptive immune responses. The concept of immunity has intrigued mankind for thousands of years. With Louis Pasteur’s Germ theory of disease that the fledgling science of immunology began to explain how bacteria caused disease, and how, following infection, the human body gained the ability to resist further insults. Innate (nonspecific) immunity refers to the basic resistance to disease, the first line of defense against infection involving inflammation, complement system, mast cells, phagocytic cells namely macrophages, neutrophils and dendritic cells and granulocytes, natural killer cells etc. by various mechanisms. Adaptive immunity is often sub-divided into two major types depending on how the immunity was introduced. Natural immunity occurs through contact with a disease causing agent, when the contact was not deliberate, whereas acquired immunity develops through immunization. Adaptive immunity is further divided as (1) humoral immunity is the aspect of immunity that is mediated by secreted antibodies, whereas (2) Cell-mediated immunity is an immune response that involves the antigen-specific cytotoxic T-lymphocytes, and the release of various cytokines in response to an antigen. There is delicate balance between different immune components. Herd immunity (or community immunity) describes a type of immunity that occurs when the vaccination of a portion of the population (or herd) provides protection to unvaccinated individuals. Virologists have found that when a certain percentage of a population is vaccinated, the spread of the disease is effectively stopped. This critical percentage, called the herd immunity threshold, depends on the disease and the vaccine. Statistics from the government agencies of the U.S., the British Commonwealth and the UK show that between the 1800s and the time various vaccines were introduced, the incidence of the diseases for which vaccines were provided were reduced by 70% - 90%. For some, this prompts the question as to whether the reduction in the morbidity and mortality due to these diseases is owed to improved sewage systems, better nutrition, and improved home and work environments, all of which occurred during the same period. It will be of interest to compare Drugs Vs vaccines. Drugs, the specific killers or inhibitors of microorganisms are used once the infection is set in. However the vaccine is proposed to be used to boost specific immunity against anticipated entry of infective organism. In other words we are intravening with natural and subtle defense system, that too knowing that microorganisms may develop resistance due to inept handling. Similar to drug, vaccine may be used as therapeutic intervention alone or in combination in treatment of disease. It is important to consider whether indiscriminate use of variety of vaccines, aggressively marketed by multinationals will be beneficial in the long run in the prevention of the infections without causing new health problems. No wonder we are already facing the challenge of new and reemerging infectious diseases due to changes in life style, environmental pollution and climate change. Intravention with Nature’s defense system should be as minimum as possible, restricting to death causing microorganisms. With problems of drug resistance and inhibitory costs of development of new drugs, multinationals are moving towards 21 billion Global vaccine market expected in 2010 by creating fear of disease and other aggressive marketing techniques which is a danger signal affecting the intricate immune balance with dangerous consequences to human health such as a Autism. In the interest of disease management, research may be directed towards development of therapeutic vaccines. Number of infections have been identified as vaccine-preventable diseases for biomedical research and development of vaccines for intravention. As soon as new infection appears in the community, business interests create fear and push for a vaccine such as Bird flu, Chikungunya etc. as if it is simple solution, without concern of disturbing subtle mechanisms of defense system. The FDA says that 15% of the 1,23,000 adverse events reported since 1990 involved life threatening conditions, hospitalization, permanent disability, or death, which may or may not have been truly caused by an immunization. Hence for monitoring of vaccine safety, Vaccine Adverse Event Reporting System (VAERS) as a post-marketing safety surveillance programme in United States is collecting information about adverse events (possible side effects) that occur after administration of vaccines. There are also efforts to increase funding to push forward vaccination programmes in developing countries by borrowing money from international markets to provide under development aid and charging interest. Vaccine intervention should be more carefully implemented in developing countries in particular, due to the problems of storage and transport (cold chain), poor economic status and malnourished poor children. Large population and market potential should not be criteria for pushing vaccines by market forces without rigorous monitoring of the efficacy trials and significant beneficial effects. Let us realize that all is not well with vaccines. Discrimination on its essential requirement along with constant monitoring of the efficacy of the vaccine will be necessary in preventing new and complex health problems.
June, 2008 Prof. B. C. Harinath |
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October 2008 |
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Disease Elimination and Vaccine Business
Eliminating a disease from the World is not an easy task. Smallpox eradication has been a highly significant and remarkable success in the history of disease control in the universe. Similarly child immunization has been effective in protecting children from life threatening diseases. A recent study in USA on 13 Vaccine Preventable Diseases: whooping cough; tetanus; measles; mumps; rubella (German measles); invasive haemophilus influenza type b (Hib); acute hepatitis B; hepatitis A; chicken pox; strepto-coccus neumoniae; and small pox revealed that for immunization developed prior to 1980, there was a 92% reduction in vaccine preventable illnesses and a 99% or greater decline in deaths due to vaccine preventable diseases. For Vaccines (hepatitis, Hib and chicken pox) introduced after 1980, there was an 80% or greater decline in illnesses and deaths. (USA – Health Day News, Nov. 13, 2007). With the success, during the 1970’s and 80’s, the US Government established goals for achieving high vaccination rates (97%) offering federal grants to states. During this period, the number of mandated vaccines gradually increased (from 8 in 1980 to 22 in 2000) as vaccination became a requirement for a much younger population (the majority of all 30 childhood vaccines are administered before the age of 18 months). This resulted in alarming increase in reporting of autism (one in 150) in children compared to one in 10000 in 1970s, thus shaking the faith of public in safety of vaccine in promotion of health. Autism, an incapacitating developmental disability is a disease involving the brain, the immune system and the gastrointestinal tract, attributed to the chemical toxicity of mercury in thiomersal used as preservative a common vaccine ingredient in MMR, HIV, hepatitis B and DTP vaccines given in the first 18 months. (www.know-vaccines.org). Adjuvants are typically used to boost immune response. Adjuvants are sometimes called the dirty little secret of vaccines in the scientific community, as not much is known about how adjuvants work. At this juncture, it is of interest to consider the development of immunity, the defense system and how the survival instinct in humans resists infection in nature by innate and adaptive immune responses. The concept of immunity has intrigued mankind for thousands of years. With Louis Pasteur’s Germ theory of disease that the fledgling science of immunology began to explain how bacteria caused disease, and how, following infection, the human body gained the ability to resist further insults. Innate (nonspecific) immunity refers to the basic resistance to disease, the first line of defense against infection involving inflammation, complement system, mast cells, phagocytic cells namely macrophages, neutrophils and dendritic cells and granulocytes, natural killer cells etc. by various mechanisms. Adaptive immunity is often sub-divided into two major types depending on how the immunity was introduced. Natural immunity occurs through contact with a disease causing agent, when the contact was not deliberate, whereas acquired immunity develops through immunization. Adaptive immunity is further divided as (1) humoral immunity is the aspect of immunity that is mediated by secreted antibodies, whereas (2) Cell-mediated immunity is an immune response that involves the antigen-specific cytotoxic T-lymphocytes, and the release of various cytokines in response to an antigen. There is delicate balance between different immune components. Herd immunity (or community immunity) describes a type of immunity that occurs when the vaccination of a portion of the population (or herd) provides protection to unvaccinated individuals. Virologists have found that when a certain percentage of a population is vaccinated, the spread of the disease is effectively stopped. This critical percentage, called the herd immunity threshold, depends on the disease and the vaccine. Statistics from the government agencies of the U.S., the British Commonwealth and the UK show that between the 1800s and the time various vaccines were introduced, the incidence of the diseases for which vaccines were provided were reduced by 70% - 90%. For some, this prompts the question as to whether the reduction in the morbidity and mortality due to these diseases is owed to improved sewage systems, better nutrition, and improved home and work environments, all of which occurred during the same period. It will be of interest to compare Drugs Vs vaccines. Drugs, the specific killers or inhibitors of microorganisms are used once the infection is set in. However the vaccine is proposed to be used to boost specific immunity against anticipated entry of infective organism. In other words we are intravening with natural and subtle defense system, that too knowing that microorganisms may develop resistance due to inept handling. Similar to drug, vaccine may be used as therapeutic intervention alone or in combination in treatment of disease. It is important to consider whether indiscriminate use of variety of vaccines, aggressively marketed by multinationals will be beneficial in the long run in the prevention of the infections without causing new health problems. No wonder we are already facing the challenge of new and reemerging infectious diseases due to changes in life style, environmental pollution and climate change. Intravention with Nature’s defense system should be as minimum as possible, restricting to death causing microorganisms. With problems of drug resistance and inhibitory costs of development of new drugs, multinationals are moving towards 21 billion Global vaccine market expected in 2010 by creating fear of disease and other aggressive marketing techniques which is a danger signal affecting the intricate immune balance with dangerous consequences to human health such as a Autism. In the interest of disease management, research may be directed towards development of therapeutic vaccines. Number of infections have been identified as vaccine-preventable diseases for biomedical research and development of vaccines for intravention. As soon as new infection appears in the community, business interests create fear and push for a vaccine such as Bird flu, Chikungunya etc. as if it is simple solution, without concern of disturbing subtle mechanisms of defense system. The FDA says that 15% of the 1,23,000 adverse events reported since 1990 involved life threatening conditions, hospitalization, permanent disability, or death, which may or may not have been truly caused by an immunization. Hence for monitoring of vaccine safety, Vaccine Adverse Event Reporting System (VAERS) as a post-marketing safety surveillance programme in United States is collecting information about adverse events (possible side effects) that occur after administration of vaccines. There are also efforts to increase funding to push forward vaccination programmes in developing countries by borrowing money from international markets to provide under development aid and charging interest. Vaccine intervention should be more carefully implemented in developing countries in particular, due to the problems of storage and transport (cold chain), poor economic status and malnourished poor children. Large population and market potential should not be criteria for pushing vaccines by market forces without rigorous monitoring of the efficacy trials and significant beneficial effects. Let us realize that all is not well with vaccines. Discrimination on its essential requirement along with constant monitoring of the efficacy of the vaccine will be necessary in preventing new and complex health problems.
September, 2008 Prof. B. C. Harinath |
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