Tag Archives: bacteria

Autoimmune Disorders and Gluten Intolerance

Some medical conditions require a patient to eliminate gluten from their diet.

Celiac disease, which affects about 1% of the population of the United States (Mayo Clinic), is an autoimmune disorder based on an intolerance of gluten proteins. Autoimmune disorders occur when the immune system attacks particles that are normally not harmful to the body, either ingested food proteins or the body’s own cells.

Celiac disease occurs when the immune system attacks the body’s own cells after gluten is ingested. Specifically, the cells of the small intestine are targeted. Celiac disease-related attacks on the small intestine damage the cells that absorb nutrients during digestion (Celiac Disease Foundation).

Celiac disease is hereditary, meaning it runs in families. The pattern of inheritance is unknown (NIH). However, 95% of people with celiac disease have the same gene specific for celiac disease predisposition (Medscape, Genetics of Celiac Disease).

Rheumatoid arthritis is another autoimmune disorder relating to gluten intolerance. However, gluten is only one of many potential signals that can lead to an autoimmune attack. Rheumatoid arthritis causes inflammation of the joints – resulting in swelling, pain, and decreased movement ability (Arthritis Foundation).

Bailey Brislin, a UNC-Chapel Hill sophomore biology major preparing for medical school, was diagnosed with juvenile rheumatoid arthritis during her first year in high school. “My ankle had been swollen for months. We went to multiple doctors that couldn’t tell me what was wrong,” Brislin recalls of the time before her diagnosis. Finally, an ankle specialist ordered an MRI and referred Brislin to a rheumatologist after blood test results indicated Rheumatoid factor (RF) in her system. RF is an antibody characteristic of rheumatoid arthritis patients as well as people with other autoimmune disorders (Medscape, Rheumatoid Factor).

The next step to calculating Brislin’s proper treatment was a 5-week series of food sensitivity testing. Although the cause of rheumatoid arthritis is not fully known, potential factors triggering joint inflammation are food proteins, pathogens, female hormones, obesity, stress, and other environmental factors (Arthritis Foundation).

The results of Brislin’s sensitivity tests showed intolerance of gluten and dairy: typical occurrences among rheumatoid arthritis patients. After a while, Brislin realized that eliminating gluten from her diet had a much stronger impact on reducing  her joint inflammation than eliminating dairy.

“After a month off of gluten, I felt better. I was able to stop taking pain medication just by eliminating gluten alone,” Brislin says, “but I should be dairy-free too.” Many years later, Brislin still regularly takes immunosuppressant drugs to improve her condition.

After many years of maintaining a gluten-free diet to ensure her joint inflammation does not return, Brislin has also gathered an opinion on the growing trend of a gluten-free diet. Brislin compares people going gluten-free for no necessary reason to people trying a vegetarian diet just to see if they can do it. “There are people glorifying the gluten-free diet. It’s just bread,” Brislin says, in response to people going gluten-free for supposed “just to be healthy” reasons.

“So gluten-free becomes this very popular trend… and I get all of this criticism for being gluten-free. My rheumatologist always talks about how you don’t have to find the specific scientific data you want, just work with what has been proven in your own case,” Brislin says as she describes her encounters with gluten-free skeptics. Brislin experienced the growth of the gluten-free trend from a very unique perspective. She understands the necessity of eliminating gluten from the diet in certain circumstances but is also critical of the diet in other instances.

Her evaluation below perfectly sums up my goal in writing this series on the growing obsession with gluten:

“There are a lot of people who are very healthy who also eat gluten. I don’t think there’s anything inherently wrong with gluten – it’s not an evil food. Not eating a lot of bread is probably a good thing, but stopping eating bread and replacing it with gluten-free bread doesn’t make much sense… I’m not sure what dietary benefits people think that’s providing…”

Stay tuned for my third and last segment of my series on the gluten-free trend. This last post will contain further analysis on the development of the gluten-free trend, data from a poll of opinions about it, and an interview with Raleigh allergist Dr. Vaishali Mankad.

Advertisements

How should you dry your hands?

One of my passions surrounding “biological awareness” so-to-speak is proper hand-washing behavior (see my BuzzFeed article – http://tinyurl.com/BacterialResistance). The perspective I want to take today, however, is actually the practice of drying hands after washing them. What is the best way to dry your hands post-cleansing? *My perspective of “best” = most sanitary*

Let’s look at some common options:

  1. Hand dryer
  2. Paper towels
  3. Cloth towel

Let’s go ahead and knock out that last option. Cloth towels are infamous for quickly becoming cesspools of germs like Coliform bacteria and Escherichia coli (1). E. coli is an infamous pathogen known for playing a role in cases of food-poisoning. Coliform bacteria are a group of bacteria commonly transferred by fecal contamination. These bacteria alone are not highly pathogenic, but their presence indicates a high incidence of other more dangerous germs that are similarly transmitted.

Poor hand-washing techniques exacerbate the colonization of these microorganisms. When microorganisms colonize, they are growing into communities of germs that are derived from a common ancestor and are increasingly resilient as they grow into larger numbers.  If one person does not adequately scrub their hands with soap and remove all dangerous infectious agents while washing, these leftover germs are transferred to the cloth towel. Also, since hand towels will realistically remain moist during the majority of their existence, essentially the perfect environment is created for many bacteria to grow and thrive until the next person comes along to dry their hands. Little does this person know, all progress made moments ago at the sink are erased (and potentially made worse) by re-infecting your hands with the germs harbored by the towel.

Our next option: utilizing hot air and friction (by rubbing your hands together) under an automatic hand dryer. This may seem like the best option because often you do not have to press a button or touch anything else after cleaning your hands. The preferred hand dryer is motion-activated and effectively dries your hands in 45 seconds. UNC Chapel Hill pharmacy student and science enthusiast Tim Angle is convinced that the warm air from these dryers is generated from a place swarming with bacteria. “Air dryers distribute bacteria due to their moist, warm environment that is prime for growing bacteria,” Angle explains. However, back in 2000, scientists showed that the air emitted from hand dryers is in fact just as sanitary as paper towels (2). In addition, in 2012, a group of researchers found that the air leaving a hand dryer actually had fewer microorganisms than the air entering it (3).

Nevertheless, Angle is still correct about the capability of warm air hand dryers to spread bacteria. This seemingly flawless method of using air to dry just-washed hands is still, in some ways, faulty. According to an article by three scientists comparing the hand-drying efficacy of various methods, warm air dryers and jet air dryers are more likely than drying hands with paper towels to spread potentially infectious droplets to the environment (4).

Dr. Christy Esmahan, a molecular biologist, brings up another flaw of warm air hand dryers. “It takes so long that people tend to leave with their hands still moist — a magnet for fresh germs.” Just like a wet cloth towel provides a fruitful breeding ground for germs, still-wet hands provide the same environment, especially when people leaving a restroom are highly likely to touch door handles and cell phones within seconds.

Considering my strictly sanitation focus, paper towels could very well be the best method for hand drying. One-time use greatly decreases risk of contamination in comparison to cloth towels. In addition, using paper towels includes the same benefit of frictional removal of bacteria as rubbing hands under a warm air dryer, while eliminating the high incidence of spreading potentially contaminated droplets to the environment.

hand drying preferences chart
Image 1: A Random Survey of Hand-Drying Preferences

Indeed, in a study of 47 random participants, a large majority preferred paper towels to warm air hand dryers (Image 1). However, the evidence for the sanitation of paper towels may not be enough to convince the large number of environmentally-concerned citizens to abandon warm air hand dryers and cloth towels. 63% of people preferring hand-drying methods other than paper towels mentioned reduction of waste as the main motivation for their choice. In addition, although the large majority of the surveyed participants did choose paper towels as their hand-drying method of choice, only 25% of those participants mentioned cleanliness and sanitation as their reasoning. 25% rationalized their choice with speed and efficiency.

Therefore, the concluding question seems to be not only “Which method is the most sanitary?” but also “How should the most appropriate method be communicated?” and, thinking holistically, “Should we be more concerned about sanitation or waste reduction?” Those who are biologically biased will likely continue to clash with the environmentally-minded. However, potential future projects that could bring the two fields together could revolve around biodegradable paper towels, for example. Ultimately, the question you should be asking yourself after reading this article is this:

What will it take to change YOUR daily hand-drying habits?

References

  1. Gerba, Charles P., Tamimi, Akrum H., Maxwell, Sherri, Sifuentes, Laura Y., Hoffman, Douglas R., Koenig, David W. 2014. Bacterial Occurrence in Kitchen Hand Towels. Food Protection Trends. 34(5): 312-317.
  2. Best, E.L., Parnell, P, Wilcox, M.H. December 2014. Microbiological comparison of hand-drying methods: the potential for contamination of the environment, user, and bystander. Journal of Hospital Infection. 88(4): 199-206.
  3. Huang, C., Ma, Wenjun, Stack, Susan. 2012. The Hygienic Efficacy of Different Hand-Drying Methods: A Review of the Evidence. Mayo Clinic Proceedings. 87(8): 791-798.
  4. Tayler, J.H., Brown, K.L., Toivenen, J, Holah J.T. December 2000. A microbiological evaluation of warm air hand driers with respect to hand hygiene and the washroom environment. Journal of Applied Microbiology. 89(6): 910-919.

Important Links

https://www.ChristyEsmahan.com

Agrobacterium: A Biological Syringe

Plants, just like humans, fall victim to bacterial infections. Dr. Ann Matthysse, a researcher in the Department of Biology at the University of North Carolina, has studied interactions between plants and pathogens since 1970, when she thought that Agrobacterium tumefaciens might lead to advances with cases of human cancer.

Matthysse initially thought that A. tumefaciens, a Gram-negative, rod-shaped bacterium found in upper layers of the soil, could be a model for cancer because it causes tumors in plants (Figure 1)

She found instead that the cancer-causing mechanism utilized by A. tumefaciens has virtually nothing to do with human cancer. However, continuing studies with the bacterium is still very beneficial due to its unique initial surface reactions with wounded plants as it binds them to begin infection.

Matthysse describes A. tumefaciens as “a biological syringe” because its virulence comes from a transfer of DNA upon infection of a plant wound, a process unique to this specific plant bacteria2. The transferred DNA integrates into the host cell chromosome and transforms the plant’s cells into tumor cells. These transformed cells then make metabolites that only A. tumefaciens is able to utilize as an energy source. The virus essentially taps into the host plant’s energy source in the same way a cell phone charger would pull energy from your car battery. This results in smaller fruit than normal being produced by the plant host, but it is usually not fatal to the plant unless the tumor blocks its main vascular tissue. Additionally, these initial surface interactions involved in DNA transfer will function the same even if non-natural, specifically-selected genes are inserted into the bacterium for transfer into a plant.

Now, Matthysse is interested in manipulating this mechanism to more efficiently develop genetically engineered crops. Some crops have been difficult to engineer, but these problems can be alleviated by identifying restrictions on the host range for agrobacterium. “Because if we knew what [these factors] were,” she proclaims, “it might be possible to counteract them.”2 If A. tumefaciens can be manipulated to bind to these plants like it does to other plant hosts, one could engineer some of these crops. For example, one could transfer genes that resist pathogenic fungi, and there is opportunity to improve nutrient levels in certain foods. “For example, rice that contains a lot of vitamin A, which would be good for people in India that don’t have a lot of vitamin A in their diet, has been made by putting the genes for vitamin A biosynthesis into rice.”

In 2006, the Centers for Disease Control and Prevention (CDC) reported that an Escherichia coli outbreak occurred from the bacteria infecting salad vegetables and causing disease in those eating the vegetables raw (Figure 2). In the numerous studies that were based on the results reported, Salmonella was also identified as a cause of disease through a similar route. E. coli was traditionally used in the lab as a control for the A. tumefaciens experiments because it did not bind to the plant host, so E. coli studies quickly began. Matthysse found that salad leaves and sprouts encountered bacteria in multiple situations:  contamination of irrigation water or equipment, improperly prepared manure fertilizer, and in post-harvest situations. Once the bacteria are bound, they cannot be removed simply by washing; infected sprouts and fruits that are not cooked prior to eating pose the greatest risk for transferring the disease to humans.

It turns out that the signals produced by the plant cell stimulate bacterial binding for A. tumefaciens, E. coli, and Salmonella. There are multiple ways that A. tumefaciens,  E. coli, and Salmonella appear to be binding to alfalfa sprouts and other salad vegetables. However, studies show that there might be a single sensory pathway that could be blocked so the bacteria are unaware of the presence of a plant in their vicinity. Thus, although the bacteria are ultimately unable to be removed once bound to the plant tissue, the sensory pathway approach could bypass this problem and prevent the bacteria from ever binding in the first place (Figure 3). Currently, Matthysse is looking at multiple methods of blocking/changing signals from plants and/or altering signal receptors on pathogenic bacteria. It might be possible to manipulate the environment so that sensory genes are turned on too soon or too late, and thus attachment and infection are not as effective.

The future of these studies remains promising, and Matthysse acknowledges the difficulty and importance of designing the most effective experiments:  identifying which factors matter the most, pinpointing the best incubation time, appropriating growth temperatures, and other conditions are a serious time investment. Practicality also has to be considered in this situation; increasing costs to customers is not a helpful option when considering long-term reduction in E. coli and Salmonella infections in raw salad vegetables. Eating leafy greens has always seemed very healthy and beneficial to the human diet, but these foods are just as prone to contamination as others. It is probably not common to consider the conditions of our salad, given that it is purchased from a seemingly safe grocery store. “We have all gotten so far away from where our food actually comes from,” Matthysse says.

Ultimately, Matthysse’s studies could lead to revolutionary improvements in genetically modified foods, and the possibilities for utilizing the A. tumefaciens gene transfer mechanism are endless. Her experiments to prevent the binding of pathogens like E. coli and Salmonella to salad vegetables could significantly reduce the number of outbreaks of these pathogens. Understanding these complicated interactions will continue to provide a strong foundation for future studies of plant pathogens.

Escherichia coli, a Gram-negative bacterium widely studied in the lab as a model organism and also found in cases of food poisoning
Figure 2: Escherichia coli, a Gram-negative bacterium widely studied in the lab as a model organism and also found in cases of food poisoning
Attachment of Agrobacterium tumefaciens to tomato root hairs. The decrease in binding visible from (A) to (B) is a comparison of wildtype A. tumefaciens (A) to A. tumefaciens without the attachment mediating gene, UPP(B).
Figure 3: Attachment of Agrobacterium tumefaciens to tomato root hairs. The decrease in binding visible from (A) to (B) is a comparison of wildtype A. tumefaciens (A) to A. tumefaciens without the attachment mediating gene, UPP(B).
Dr. Ann Matthysse, Professor of Biology, University of North Carolina at Chapel Hill.
Dr. Ann Matthysse, Professor of Biology, University of North Carolina at Chapel Hill.

References:

  1. Ann G. Matthysse; Frontiers in Plant Science 2014, 5, 1-8.
  2. Interview with Ann G. Matthysse, Ph.D. 9/18/2014.
  3. Update on Multi-State Outbreak of E. coli O157:H7 Infections From Fresh Spinach, October 6, 2006. http://www.cdc.gov/ecoli/2006/september/updates/100606.htm. (accessed September 22, 2014).

Image Sources:

  1. A. tumefaciens and E. coli: Public Domain
  2. Figure 3: Ann Matthysse

This article was previously published in Carolina Scientific Magazine, Fall 2014.