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Human Milk Virome
Pia S. Pannaraj
Tuesday, Sept. 24, 2019 · 11:26 a.m. · 52m 06s
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everyone
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i'd like to think then f. we uh for having me and
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all the cheers uh for inviting me here to talk today um as
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doctor walker said my uh talk a little bit different we've been talking a lot about the
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bacteria and so today i'm going to talk
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about the viruses that by room um see the
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okay
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okay so and if uh that blank slide of what we don't
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know about the milk you know by room had even less data it
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yeah okay so viruses actually comprise
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um the highest numbers of a speech designer or five number
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of um different particle so tender that thirty one
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different viral particles exist on earth and then just one
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uh and mel of seawater you can find tend to the seventh viruses
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that's really that crazy number if you you know just think about that
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and so um so far is is of course because they're everywhere and hurt
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there we are going to find them also on the human body thirty day i'll talk a
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a bit about the environment human milk an infant cat with very few studies that exist out there
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um i talk about my room transmission with the focus on mother
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infant and then describe the role uh the uh the firemen infant how
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and so when we think about the intent that we got here we've been mostly concentrating on the bacteria
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but in addition to the bacteria we had these you could attic by earth that live
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there and then the battery of pages and
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it they play they all play very important roles
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and so most the time when you think about human viruses you think about a tree and the viral infections
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these are things like rhino virus kroner as caught the common cold uh there's lots of these viruses out there
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no no the persistent early in viruses these
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are the uh the herpes family uh for example
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um that can cause uphold stores that they persist in your body
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come back uh every time your immune system is a little bit depressed
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then there's and option is retroviruses in these actually make up about eight percent of the human d. n. a.
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and um and they they think they are incorporated into a human d. n. a. and then
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actually can even be incorporated the germ something get half from a generation to the next generation
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oh and then the the a bacterial stages these
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are viruses that infect bacteria and they comprise um
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uh uh they're they are about i'll tend to lead and backed back sure pages programs tool
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and then in addition to all of that the majority of the viruses that we identified in
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when we study the viral are actually novel and
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identified parses that we have no idea about yet
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so here are some picture of um pictures the battery of pages
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and these are back sure pages that uh are attached to a bacteria you could see that just
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so many of them here and again here in yellow attached to this bacteria style
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and and so why do we care about these spectral features they
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they um can attach the happy cycles so
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they uh are here attached to a fell and
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can undergo to a different lifestyle so one is the attach the fell insert their d. n. a.
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um and then the d. n. a. that and then this hijack be a bacterial replication system
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um produces more of these back sheriff ages
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and then eventually lies in you produce more pages
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and so in this manner though they also kill the bacteria the other important
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like cycle that they have is uh the like the gen x. cycles of here
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the i. d. n. a. is inserted into the bacteria that then that
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um inserts into the host uh gee the uh um d. n. a.
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and then that can actually induce changes in the holes to bacteria so that
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and it can actually be more uh
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more fit and actually perhaps replicate more or
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it could uh also induce antibiotic resistance genes so there's some
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uh advantages and potential just advantages of this happening
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and so this is why we hear a because the um
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they each can page and actual feature the same
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thing these pages can impact human half so uh
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um but uh she could talk thin colour talks in for example uh are from pages
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um that they can also uh determine virulent a pathogen is to be a
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can bring about in about resistance um that and actually change metabolic have to be
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it's like that this year to remind me the uh the german and um outbreak about um
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maybe close to ten years a fight between five to ten years ago
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um that that was in equal actually go producing um uh equal why
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uh she talks introducing equal like that word from does does
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that we from sprouts that effected out nearly four thousand people
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um that actually started with uh f. h. and then it was transferred
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actually from one equal like to another equally a job actually back sure transfer
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um that then was really increased it's a pathogen if the invariant
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and in addition there's even some um uh
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there's pages responsible for work when alone resistance to
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the same actually get talks introducing bacteria so just
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an example of how these pages impact or live
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so um before i go into a little bit more i just wanna show
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um how difficult it is to study the by
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wrong and these this is the the everything that's involved
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um when we've had either stool or breast milk um there's
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a lot of uh uh filtering and bob just filter out
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sells a cellular debris and to get rid if you mean a d. n. a. that's there
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um and so it's it before the sequencing so
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it's not quite as easy as uh studying the bacteria
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and that's partly why there are so few studies out there um
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because uh the difficulty and the challenges on also because of the cost
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so these are the study if um that have looked at the by rome
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um this is a it's actually not a complete list it seems like a lot
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some of these uh however had then uh using a p. c. r. uh studying uh
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using specific by rock climbers and picture and primus or back to your pages while others have
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um yeah but it's a good thing but you could see that it's really been let that
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at at many many many different sides are very similar to the bacterial sites that was just presented
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um so or all got a polite you're in c.
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s. that that actually just came out earlier this month
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um multiple studies and the respiratory tract only few studies in mail
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a few studies in and the attic fluid one which show that there was not anything
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if there were no significant viruses in the uh in the attic fluid and and skin
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and these are all the different types of viruses uh that are there and so there are many
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but what will um soon get into little bit more is that a lot of either back to our features
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so um so we decided to look at the at the mail by
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room we wondered if it was different from other uh other side by side
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and so you could see here um this is the i don't know all in blue
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an infant feces in a in a red here and then
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it does these they separate out um from the adult you're in
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adele feces and i don't saliva so
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they are a different it's a different community
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in it the milk and in in think that compared to the other body site
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in addition it seems like the male and the infant got
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tend to cluster closer together compared to the other adult body sect
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when we look at uh in mother in inputs to well together or without another nail in in it's
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still a lot of then cluster together um that but there are a couple that cluster little it separately
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so we wandered it um and and say and then when we look at the
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what was there you could see here um the the the you carry out of viruses
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uh and then the battery of pages and over ninety five percent
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we're back to your features both in the milk and the stool
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uh and so we wondered if i'm up in either side either that
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either that top three there that me my over eighty eight
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doesn't like me yeah
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pushing it to okay them i already a cellphone ready am pored over eighty eight and
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they're really um difference but the differences are the uh the tail of the different of the features
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and then we look at diversity the viral diversity tends to
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um correlate with the bacterial diversity so i'm still well this is intends to only
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their intent that our uh less than one month of h. the very young infants
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still biodiversity here is actually still quite low or mail biodiversity it fire
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um and thing uh i think in this is this is the bacteria
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um again they'll get fired diversity than the in its tool
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and so this actually if similar to adult data where they've look this
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is that from my twins study and they looked at um uh and uh
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back sure diversity and there somewhere that twins were
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um had similar diversity uh and some whether discordant
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hi shown here and the viral but i'm here on the x. axis is the
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micro by on so the back yeah i'll for diversity and then here is the
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a viral i'll for diversity and what we see is that as
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you increase the micro microbial bad diversity you also increase the barrow adversity
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but interestingly this is only thirteen with the back sure
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of pages and not with that you korean writers is
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so the back to your pages which in fact the bacteria go up in diversity with the number of bacteria
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but the you created viruses are a pretty stable um
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the uh without dependent on the micro by on diversity
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so um we use so these graham the the say so these and pages remember i talked a
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little bit earlier about the three most common features that with ah um have different tales and that
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well determine how it attaches to the different bacteria and who it can attach to
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so for example um for example either the different attachment um the
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specific vector we sectors that are found in gram positive uh organisms
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and then here and the middle here um i found in a gram
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negative uh i'm sorry in both organisms and then down here gram negative
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and so depending on the type of hail and it can look for certain
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a risk factors in order to be able to insert it d. n. a.
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um and so this is important because um uh it
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that will determine what type of bacteria it can in fact
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sell 'em by ron transmission factor so there's a lot of
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different ways that by rooms can be transmitted and so there's um
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uh uh some that are modifier ball uh some that are fixed and
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then others that are moderate potentially modified also age sex genetics that's all fake
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but people have looked at different is um in adult
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got michael by on and uh and also in a polite
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and these were all affected by age sex in genetics
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um and these are that potentially modify well factors is so
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intentionally delivery method sometimes is modify while we're definitely seeing a lot more
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the syrian deliveries then uh and then we used to and so some of that
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may be a for you know some people may have an elective c. section just because it's easier
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um but that uh that also in addition to changing the micro
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the mike by um for the infant that also changes the bible
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um the interact with the environment a fax the viruses that you
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have on your body household contacts there's been a lot of that either
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people living uh adults living together um that they tend to
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share uh uh by with this for a period of time then
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it goes away and then somebody may bring in a new wires from the outside and then they shared again and it goes away
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um anybody use also facts the um the viral most
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likely because it effects the micro by on um and
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then there for the bacteria features might go down in
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number and diversity um and then joe yep i'm breath knock
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so very early in life um the the the first thing that happens is birth
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right so and we had that talked about so a little bit earlier in the um
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during pregnancy there they didn't didn't seem does find a lot of very significant numbers of viruses
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in the and the attic fluid um but so then the next thing that happens is birth
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and whether you're delivered by passion or see section
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um you could see the um peter diversity uh they
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uh uh be before the a. c. section compared
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to bash you know and they do cluster a distinctly
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and these are the different types of um bar all viruses that are there uh and again
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defer by c. section versus bad until every
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um uh so that uh uh an important factor
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then next is i'm breastfeeding so um uh uh this was actually shown earlier
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today but just like a we we looked at and bring breastfeeding with bacteria
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um we saw that in bacteria if you're exclusively breastfed during the first month of light
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um them on the baby's actually share about thirty five percent of
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the uh of the mike by on the bacteria microbiology and then
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that decreases over time which makes sense is the baby a third steffi
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from uh other means interaction of solid foods and also get get
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around in their environment crawling on the floor putting things in their mouth
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it changes the bacteria uh flora and so we wondered and
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the fame for um and so we think that a lot of
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that is non to baby but there's probably an component of
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baby them on it just sort of cycles between mom and baby
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and so we asked the same question for viruses so and
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do the viruses come from mom i'm from mom's milk or
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could it be the thing that other moms or just kind of random uh from the environment
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and we know that viruses can come from the out there were some hints earlier uh
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with the mount mail um the they can ease being more similar to the babies no
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we also know that there are viruses uh searches and c. m. v. or h. i. v.
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the action that transfer from milk from mount nailed to the baby and can infect the baby
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um well we didn't know much as much about are a bit
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bacterial features which comprise ninety five percent of that buyers that are there
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so this was the first any um that in in two thousand a that
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looked at 'em both pages and bacteria that transferred from a mail to baby
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and so they found that they were pages that infected uh that in fact laptop with l. s.
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laughter caucus structure caucus an enter caucus ceases that we're all a dominant and opened it in milk
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um but they do not actually find um uh the um the
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viral think with these uh of the page in the no itself
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um but they that they're they're using here
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was using a primers against the um the
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and some back chip pages of significance uh and not looking at all of the bible
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so and then this um this paper talking about
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two dozen seventeen looked at the maternal inheritance of um
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of the federal bacteria communities in different pages so they
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focused in as specifically on the buffalo bacteria and their pages
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and they actually show that there was um vertical transmission uh also the next
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sequence that bit aback sure in male and the deferral bacteria in the baby
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um they found that they were the same um that and
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it and the um found also that the features where the thing
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um and what they found though um was that the page was ways
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transmit it as a pro page so i'm in it in the in the bacteria
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it had um already integrated into the uh the hose jean transmitted is appropriate and
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then in the baby got actually a with
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able to replicate and um become more pages
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um i it got leading to lie still like this by having
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i'm much more pages to go around to all the other differ a bit low bacteria
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uh and then in our study we also um looked at
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uh i'm home along speed within payer so in mounds um on
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the b. b. pairs together how much of their sequences were the same
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compared to maybe with a random other pair and
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so you could see if we uh we didn't
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hear the numbers were always higher than if we
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pay that they be randomly with uh another bother
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and these were the um the um the viruses that we found in
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the the re within three pairs that had the most from allah g.
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and yeah and i really but that's out there just to show that there's a lot of analogy but
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also that the thing if you get a amount of be what we shared we're back to uh features
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so um so the question is then once these pages and other viruses get to the guy
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what happens to them how long are they there and i'm sorry there's
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not a lot of data about this in in pediatrics but an adult data
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um this is this was the study of ah one
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adult man um it's tool uh grabbing stewart multiple time points
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um and they looked at um the different how how different
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those communities were um the by the interval between time point
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um so this is a only one day ten days hundred is eight hundred fifty case
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you could see and so then the higher the number the last divergent
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and the lower the number the more they projects and here um with if it was only a few days in between samples
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um you didn't see a lot of change and then as you uh uh increased so that a
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large number days eight hundred fifty days to two and a half years then we see a more changes
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and the colours um actually which colour show up a for yale um
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but uh the temperate viruses in little um are the ones that are um
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a more often transmitted is pro pages or integrated into the into the back to eugene and you
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could see that there's a last change for them compared to the non not temperate uh buyers it's
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and i'm on the on your right hand side
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um that we look at the buyer of the uh um by of families
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and uh and the substitution rate so um as
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they are uh at the d. n. a. um
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replicate and itself then uh that uh uh occasionally they'll be substitutions
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i'm into that and that could lead to new jeans a new uh in about resistant
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et cetera and so i let my already a micro very a um
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had the highest amount as substitution uh that's up for a four percent in this particular study
00:22:06
and uh and that uh uh suggested that um as possible because that the a single stranded
00:22:12
i'm a d. n. a. a. f. age compared to the rest which are double stranded
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and so the single standing there's a lot more error prone compared to the double stranded um features
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and then i use a then can move between individuals now this steady um is a
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study of biko transplant says that are all the normal way that they just move between individuals
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um but i i think it's still interesting it's three at three
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p. d. actually patients who had a also it of clyde is
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and um and they were treated by still transplant actually between
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twenty two and thirty two times so they receive speaker microbial transplant
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i'm twenty to thirty times which seems like a lot
00:22:59
for me but uh anyway service single donor and so um
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so on this side uh on your uh laughed you have that patients
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um the uh their original by wrong and then your donor by room just below them
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and then uh uh the first column is pretty transplant
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then post um during the transplant and then post transplant
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and what you could see a in pink here a lot of
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the pink had the largest uh amount that stayed around post transplant
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i'm in all three of them and that was the thief oh really a um a which is interesting to me 'cause
00:23:37
that was also one of the highest um i'm out one
00:23:40
of the highest uh abundance for the ad pages in our studies
00:23:45
when we looked at maternal milk to uh going to in turn got
00:23:50
a civil ready was also one of the highest that was it that transferred in in step around uh for a little while
00:23:59
um so you're the only studies that actually looked at
00:24:04
um that milk and in pain got samples over time
00:24:08
uh and what they found was that the um this is that
00:24:12
back to your pages and then is that uh you korean viruses
00:24:16
so the thing is actually start out quite high and then decrease over time
00:24:22
and then the um you could gothic biases actually start low and increase over time and that makes
00:24:28
sense to um to as as pediatricians because and
00:24:32
the kids one counter different viruses in their young life
00:24:35
and then some of those persist in the body over time
00:24:38
in so that have the uh slow gradual increase over time
00:24:42
and that is that you could just go down and this study compared um back sure fade is
00:24:48
uh in orange here and uh and that bacteria uh in below and you so you
00:24:54
could see that that bacteria as the as that active age goes up the bacteria calmed down
00:25:01
and anything here um that basically the the there's this
00:25:05
predator prey relationship between the back sure page in the bacteria
00:25:09
and uh some people collect kill the winner and it's the predator prey
00:25:14
suggest that there's some cycling up and down uh the uh the different um
00:25:20
uh that page in the bacteria so here is um depicted here we have f. h. here are
00:25:27
kind of going down that fly killing a little bad where the uh bacteria go up in number
00:25:32
and then into will uh down here are that you periodic um uh viruses and
00:25:38
this all tends to stable lies over time similar the bacteria around three years of age
00:25:44
but this whole middle section that the dotted lines are really
00:25:47
a question mark because we don't have studies um that uh
00:25:52
we don't have enough longitudinal studies with enough numbers to really uh
00:25:57
you know if this is true this is all hypothesise based on the
00:26:01
two studies that you start earlier um on what happens with the fade in the bacteria
00:26:09
and so one wonders oh uh with this um change over time
00:26:14
and with the number of bacteria going up and down if any of those kind of
00:26:18
crop these windows of opportunity where there's some critical time period dinner time point in early life
00:26:24
um where the microbes typically the bacteria influence
00:26:29
in new development and not of metabolic development
00:26:32
and so if the pages are there then perhaps they're
00:26:35
also helping to control the bacteria so that there's not a
00:26:39
too big of a proliferation of the uh pathogenic bacteria are the ones that don't
00:26:45
induce in intolerance correctly um and uh and it's almost
00:26:50
it's interesting to me that mother nature's sort of introduce
00:26:53
all these different factors perhaps to control the bacteria uh
00:26:57
that potential for i. g. a. n. i. and about email
00:27:01
to bind a certain factory a potentially pathogenic bacteria
00:27:05
um so that they're not a misbehaving in infant got
00:27:09
there's the potential for uh august back right um
00:27:12
to act is pretty bad x. to feed certain bacteria
00:27:15
uh the favour certain bacteria over others um and then there's the potential um now
00:27:21
for viruses are also to um to
00:27:25
either in fact until ah bacteria or two
00:27:28
uh introduce the the good genes in them to make them more uh fit in their environment
00:27:37
um and so this is not one study that i'm just came out recently that showed
00:27:41
a whole be calm energy gnomes environments where they looked at um
00:27:46
the potential for uh about bacteria
00:27:49
and viruses um uh to actually different
00:27:53
cellular functions there are possible and so you could see up there um
00:27:58
and some of the different prophecies a lot to say we're passes the um
00:28:03
um have metabolism uh and then here
00:28:07
specific um k. halfway that are involved in
00:28:11
in there you see a lot of metabolism um in a
00:28:14
infectious diseases which also implied in a in a logic diseases
00:28:19
um or in a logic a teaching um and uh and many
00:28:24
other prophecies either and this is an adult but um but still
00:28:30
classically transferable to pediatrics it's something that needs to be steady
00:28:36
so i'm not really that just the very the very few studies that have been done in pediatrics
00:28:42
so this is a a a that the um
00:28:46
there is one group that looked at uh inputs with
00:28:49
diarrhoea and they classified them by the type of
00:28:53
stools so i'm from palate so that's i guess it
00:28:57
well maybe to drive or maybe a good stool um all
00:29:01
the way to a watery um with several classifications in between
00:29:06
and so um the u. k. they looked specifically at they you carry out of my room and saw that they were changes
00:29:13
um with associated with the type of stool consistency
00:29:18
but i didn't know it was this the cost the the effect just in this as in maybe neither just in association
00:29:24
um but either so far and you could see this was just published about
00:29:28
the nineteen either so far the only types of studies that are better out there
00:29:34
and another study a little bit about another study i'm not looked at auto immune diseases
00:29:42
and um that's a specifically type one diabetes and found that the and have no by rome
00:29:48
um it changes a preceding auto immunity in
00:29:51
type one diabetes in uh in susceptible children
00:29:55
um and so again hard you know i'm caught in a fact
00:30:00
really just i'm just starting with an association a type of study
00:30:05
um and then um that jeff gordon script looked at uh malnutrition so they um
00:30:11
uh with the viral patterns in help the
00:30:14
in a set in happy and malnourished when paris
00:30:18
i'm from malawi and they found that um by wrong patterns were
00:30:23
concord it and help the twin pairs that you have to copy paris
00:30:26
um the vi rooms are very similar but then if you had
00:30:30
a um one twin uh became
00:30:32
malnourished then um you also thought some
00:30:37
some similarities actually both of that ball by round speaking altered
00:30:42
uh and there with the late got lycra by and development associated with it
00:30:48
you are probably remember he had and that their group as published
00:30:52
um extensively on the got micro by on and show that there are uh there's the late got
00:30:58
i'm michael by um development uh or maturity in it um children that are malnourished
00:31:05
um and so what we see what we saw there is that um
00:31:10
when you look for when they look at the viruses that what they found within increased prevalence of
00:31:15
this virus a family and mellow over eighty a and circle verde families
00:31:21
in page populations that could distinguish them now nourished wayne from the help between
00:31:26
and these two um uh families have also been associated with
00:31:31
uh increase i'm a die real on this is uh and also um
00:31:37
with a a looking at each adults h. i. v. infected versus not
00:31:42
um all day the shady infected also had a increase
00:31:45
problems uh this uh no low uh ready a family
00:31:51
ah and then another uh a group in china um i've
00:31:55
followed around forty five hundred children uh over respiratory it's even
00:32:00
yeah ever sever respiratory seasons and um and looked at
00:32:05
uh how many times they developed acute respiratory tract infections and
00:32:11
so uh what they found that they they looked at all of the
00:32:14
viral that they focus then on this property on a battery f. h.
00:32:18
and they found that hit that develop multiple uh q. respiratory tract infections
00:32:23
had higher amounts of the stage significantly higher amount of uh that probably on a
00:32:28
battery of age compared to those that only had a single uh acute respiratory infection
00:32:34
and and here you could see this uh a goes
00:32:37
up with the actual number respiratory infection first second third
00:32:41
and what they've done with this program a bacteria actually had the
00:32:44
ability to induce a certain uh increase know about the site kinds
00:32:49
um in the respiratory track uh perhaps leading to more uh symptoms
00:32:55
uh more information uh in yeah in those children with multiple respiratory infection
00:33:04
oh and then uh this study i'm also just came out earlier this year uh
00:33:08
in um in being led actually looked at children who were vaccinated with a polio vaccine
00:33:15
and then uh and look to see a look that
00:33:18
immune response so in the lighter a colour here sir
00:33:22
negative the darker colours are positive meaning uh that they
00:33:26
converted um uh and develop an increase in a bunny
00:33:31
um and they looked at the uh amount of
00:33:34
um the prevalence of all their intro parses so
00:33:38
and the question was could either enter viruses interfere with vaccine
00:33:43
response to whole yours and and what they thought was yes
00:33:48
so you could see in the um in the zero negative group uh again
00:33:53
and a lighter colour they all had higher amount of each of these enter viruses
00:33:58
ah in there got a right to at the time of vaccination
00:34:02
um and they do not respond uh and so they do not respond as well to the vaccine
00:34:08
and so it's an interesting concept that is
00:34:10
viruses can also interfere with yeah with anybody response
00:34:16
and in fact the uh immune system
00:34:20
so um so those are obvious that either an insurance again not very many um
00:34:26
but uh but one can kind of think about you know
00:34:29
potential uh next absent potential uses for um for viruses yes
00:34:35
uh we were finance to be helpful so here i'm not
00:34:39
a kind and i think that a documented in a figure um
00:34:43
potential you page inspired um approaches so you could uh i give page there
00:34:50
p. where it uh you know the most the attack the pathogen pathogenic bacteria
00:34:55
and so then they all die often you are left with some uh good bacteria
00:35:01
um so uh you could have um a a page
00:35:06
enzymes i'm kind of them really doing the thing thing
00:35:09
um bile from the spurs all by the same
00:35:12
method um a drug sentences it sent to vacation
00:35:17
um so you can kind introduce pages to either um
00:35:22
uh i can promote the the bacteria better prevent or um or
00:35:27
kill off the pathogenic bacteria that you don't want to be there
00:35:30
but there's still a ways to go um there's a lot of limitations of the current studies and um
00:35:38
um most of the studies that we know so far are
00:35:41
a cross section of data um with a small number of subjects
00:35:46
and even in a in a few that were um
00:35:48
longitudinal again a very small number of subjects where we have
00:35:52
uh a date over time uh especially in early life
00:35:56
where there's so many changes uh um to the baby
00:36:01
um and there is a a lot of studies where they only looked at the baby
00:36:06
um but does it the uh it doesn't include mothering infant at the pair so
00:36:10
we can actually study them nope microbes uh and viruses and the baby's microcode arses
00:36:18
and yeah and the technology is still a expensive um it
00:36:23
this is a lot of lean viruses integrated viruses double stranded
00:36:27
uh i. d. n. a. viruses and then large you could you could attic buyers this so there's still a lot of um
00:36:34
unknown is actually uh in in several studies can be up to us
00:36:39
seven b. e. d. v. ninety percent of uh the viral particles that are there so we we really
00:36:45
r. g. s. knocking at the very tip of the iceberg and when even be
00:36:50
uh like the ice per picture you showed earlier really just be like a pack type iceberg um
00:36:56
and uh and there's a lack of standardised protocols um an incomplete borrow databases so
00:37:02
um so that's the other part of the problem is that you know we we
00:37:06
use the borrowed databases that are out there but because all that many of these
00:37:09
viruses are novel an unknown you know we it's hard to tell exactly what they are
00:37:17
uh so kindly view all of the of the flight of what we um hypothesise
00:37:23
ah happens um a kind of a summary of ever done the things that i talked about um that there are
00:37:30
all of these different factors that influence the viruses the by
00:37:34
robot then mother mother's milk and in the in think that
00:37:39
uh and that there is this trajectory over time that's still unclear
00:37:43
uh where we need more data but uh but i think it's a nice um
00:37:48
a potential field of study um and then uh and then just like with the bacteria we need
00:37:54
more um mechanistic uh data of what actually happens
00:37:59
to try to movie on the uh association the yeah
00:38:05
so um with that i'd like to thank and these are a lot
00:38:09
of uh students that work with me um uh my a former mentor um
00:38:15
and some collaborators where extending our studies still
00:38:19
i am actually uh p. attic infectious disease
00:38:22
um doctor and and uh i training more uh back to
00:38:26
knowledge just i'm very interested in an immune responses the vaccine
00:38:30
um so uh we are looking uh and so there are some back think that
00:38:35
have significantly different um we to respond
00:38:38
in the developed countries compared to developing countries
00:38:42
and uh oh so we're trying to understand why i'm kind of focused on
00:38:46
in a logic aspects and then i'm trying to understand how be uh uh the
00:38:52
viruses and the micro by on a play a role
00:38:55
in that and so these are uh collaborators there um
00:38:59
uh and then uh uh u. c. f. t. david pride who
00:39:03
i worked with and on our our by room study if um
00:39:07
the big push me in a university of pennsylvania when i bear when i first started on
00:39:12
the micro by um i um went over there and spent um some
00:39:16
just a couple days in his lap talking with a white lab people
00:39:19
on the buyer informatics people to to learn um all all of this
00:39:24
so uh thank you very much if she small pimple construction huh oh okay
00:39:37
oh thank you very much for rumours presentation i have your permission row starting
00:39:44
from one rubbish f. o. referring grow reduce if you off for new world
00:39:51
so we know oh oh my remote chef room freeze off remarkable started actually oh
00:39:59
okay but i'm sure most of you put by what version
00:40:05
so oh why why low there should be more response
00:40:12
or or spears who've worked you know with the white of were warriors
00:40:17
um pair of books you're going to buy both flushes also there should be more
00:40:24
and what we should be more move users i'm i'm i'm
00:40:28
contribute to him off for me
00:40:37
mission to pursue stimulated our viruses so for those five six
00:40:44
we'll be human operable specially score groove you or are you do so
00:40:49
so should the views of your uh_huh to six months to two years of lose
00:40:54
we have a high profile who's been for review of movie life is i'm the
00:40:59
rashes reviewers from pillar should be become foreign who've worked for or i mean how
00:41:06
uh_huh to prosecute him of how presumably to remote
00:41:11
look you hyper simply virus from one try to do
00:41:14
uh_huh yeah hi remember are somewhat more reviews i'm gonna produce a very simple to
00:41:19
ruin your email program of the remote flu shot grocer shingle slip from right but how
00:41:26
shoots are wherever somebody from what you've your your system
00:41:34
oh my remote disapproval stripes remember probably use few probably
00:41:43
okay so that it's a question so when i'm not at the
00:41:47
first question on the um the virus setting and the vaccine response
00:41:51
this study focused mostly on the ukrainian of viruses and be
00:41:55
a antisocial enter martha specifically so now on the back through pages
00:42:01
um and so it wasn't looking at pages that would in fact that bacteria
00:42:06
and then life i'm taking that too diverse improved every program you very very loose
00:42:11
yeah i mean it in you differences between you created viruses and bacteria pages
00:42:17
yes it is the bacteria pages that will affect the different uh bacteria
00:42:22
that that he there because in a better fit yes for life is
00:42:27
uh and so i think that's what your uh thinking about
00:42:30
that potentially there's life is perhaps there'd be bigger mean respond
00:42:34
um but in here it with that the that
00:42:37
uh there were enter viruses there perhaps that may well
00:42:42
somewhat similar the polio virus and so therefore their backs
00:42:45
in in with polio virus and the means system then
00:42:49
uh i think that already knows you know how to
00:42:51
respond to that particular virus into doesn't mountain immune response
00:42:56
so and then your second question about uh h. e. g. six um the i you
00:43:01
know so most the time for for us it doesn't cause a lot of problems um
00:43:07
uh later in life uh when we see it is if you have somebody with who's in you know the path later in life
00:43:13
then uh the h. h. v. six will come uh so when it does with h. i. v. that's we're in
00:43:18
a compromise from a chemotherapy or uh uh uh i mean
00:43:23
the bone marrow transplant uh so those types of patient yeah
00:43:30
ah that's a good question i don't know the answer to that you know of any audience members no
00:43:39
i know
00:43:48
a job you mention briefly remote remote compared but of course fig but pro program
00:43:55
others will probably reach forward commons for mobile what the job people knew bruce
00:44:02
because you probably with the job is much more wooden bar improve the real basics
00:44:09
i'm a big ups from our boy who says
00:44:15
how bush true blue imperfect go
00:44:20
would be more your overall for for the fact
00:44:24
my six for simple vocal about include comes for you
00:44:32
most of your of work to be more people go go for other was
00:44:37
i've been trying or friction six years ago result remembers
00:44:42
the bathroom or who are for with regard reports from africa
00:44:47
but usually mobile for just one growth reduce problem oh him of recall
00:44:55
you prefer it but could thought for sure remember or from the moment we go blue
00:45:01
person from the first moment immune response forthcoming but people
00:45:07
infected with the book world i have four pushes more calls
00:45:13
maybe you can say something goes the ball prefer to mingle avoid going
00:45:17
to remember we're components which will be for people for whom you'll remember consequence
00:45:23
probably viruses which really should be worse remotely reports mew because that's the we'll go through it
00:45:32
thank you yeah thank you for bringing up is very important points
00:45:36
um i didn't choose to concentrate on those various is because it
00:45:40
there's actually a lot more known about them but i think i just want to reiterate your uh important point about h. i. v. that
00:45:46
it is chance it can be transferred through nobody is rare
00:45:49
and so the recommendation is to continue breastfeeding exclusively for six months
00:45:54
uh and to hear if possible and then to have a slow me
00:45:58
uh because that they found that if you mean rapidly uh you actually have
00:46:02
a higher a risk of transmitting h. i. v. uh from other to infringe
00:46:08
and then c. m. b. uh a lot uh they i know they're seventy eight holidays here in the audience and so
00:46:14
uh as you well know there's a lot lots of consequences
00:46:17
uh potentially a theme be a particular age transferred in euro but
00:46:22
possibly also transferred uh uh it to a premature right
00:46:26
infant um so yes thank you for bringing on it
00:46:34
i thank you for the wonderful talk but as a customer from u. c. davis
00:46:37
so i wonder if you could comment on bacteria fish their p. this is known
00:46:41
to be successfully um eliminating bacterial infections what are your thoughts on utilise invective fish there
00:46:48
and manipulating the microphone off uh_huh perhaps it just out of state
00:46:54
the question if i think i'm i think that eventually that would be a nice uh
00:47:00
therapeutic method i think right now we just i feel like we don't know enough yet
00:47:05
um because there are uh so many different back jeff ages there
00:47:10
and and we know that there are certain ones that are
00:47:13
um predisposed in fact certain bacteria but it's hard to know
00:47:17
if they uh also can potentially affect other bacteria and
00:47:21
so that perhaps you'd be doing a disservice if your
00:47:24
killing off the bacteria egg picking up both good actor and bad bacteria um
00:47:29
but i do see it as a potentially promising a therapeutic in the future
00:47:37
yes
00:47:40
i think you remote only need to reopen we continue with the time thank you very much
00:47:44
for your own wonderful talk oh you mentioned about breast milk and we all know that much notoriety
00:47:52
oh perfect responded to him to bring is new and oh oh including people
00:47:59
between can can you if it appropriate peaks fall back to using oh i
00:48:04
you'd think that how what about the um the fact of maternal great on this meal
00:48:11
the u. o. whereas c.
00:48:15
i think that's a great question um but there's no answer that's known at this time there just
00:48:21
isn't a a lot of data or there isn't any data that i know of ah at this time
00:48:26
so look at maternal diet and uh which viruses are in jail
00:48:31
and how that affects the infant got but uh i imagine that that data will come out soon uh as
00:48:37
there is a you know more as they are more
00:48:41
people looking at the by rome um and uh and and
00:48:46
learning from the past now grabbing a pretty melodic data as well i hope we will know seen all rushed laurel
00:48:57
oh really oh true portions what
00:49:01
happens one room or room to cushion
00:49:07
sure i'll parlours was shown spectrum
00:49:12
that's a great question um how you don't think there's any data out there for us to know for sure
00:49:20
now there are um several anti virus that are out there that they don't
00:49:25
when they don't work very well and see there's very few so i it's like we're works very well for
00:49:31
a a just to be but not actually so well for maybe the rest of the herpes a virus family
00:49:37
um and uh and that's well for other viruses and thing with the other entire that exist
00:49:43
um and in most the time they're not a prescriber routine bear on this is
00:49:48
i'm the only one that are prescribed for routine on this is would be effective year for herpes virus or also time of year for
00:49:54
the flu virus um so i think we don't know oh yes
00:49:58
uh what effect that might have on the other viruses but um but
00:50:04
i think maybe not as much as we might think unlike
00:50:08
antibiotics just because the um our entire barrels are not uh
00:50:14
not that affected in general homo true true one shortage
00:50:20
really though oh well no mileage will but true push
00:50:29
it to one more of just same thing happen portions
00:50:34
yeah i'm so in this study they looked at uh i developed
00:50:39
in overtime so it looks like the viruses also were delayed um but
00:50:44
but it looks like that the delay was mostly because the bacteria were delayed them yes
00:50:52
really push for a possible mentioned of oh we're what we're going to lose your server meiosis
00:51:07
uh_huh sure from those more
00:51:15
well a lot of the viruses in the seawater are uh you know i don't really need your
00:51:23
uh_huh yeah there are a lot of fate is that a lot of uh uh
00:51:28
really a lot of all of the different types of viruses but the majority are pages
00:51:33
um and um but you know he means a swim
00:51:36
in the ocean all the time and so uh i think
00:51:40
the risk of being infected there would be just like the risk of being in the environment and probably the the
00:51:46
viruses that infect us both we get from other humans
00:51:50
so contact with other humans um will give us those letters
00:51:58
strange
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