A big thank you to Mary Agopian for submitting her MIMM 214 assignment to post on The Turret. This guest post will help you understand the impacts of stress on your health.

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Dear University Students, Chronic Stress Affects your Immune System

By: Mary Agopian

Fatigue, headaches, irritability, digestive problems, heart palpitations, insomnia, dry mouth, and many more [5]; these are all symptoms we have experienced at one moment or another during periods of high stress, such as during midterm and exam season. Stress linked conditions are on the rise [5], the leading demographic being young adults ages 17-24.[1] As university students, our stress levels might spike and then gradually decrease as we finish each exam, but as these stress episodes become more and more common in our daily lives, the episodic stress turns into chronic stress. Chronic stress can be described as when the symptoms stated above start presenting themselves together, many times in a row, over a long period of time.[6]  Chronic stress can influence many different facets of our lives, it can introduce a strain in our academic careers, our personal relationships, and our physical health. But, chronic stress can also have a major influence on our immune system.[7] How exactly can it do that?

Four and a half decades ago, Robert Ader and Nicholas Cohen [8] coined the term “psychoneuroimmunology”. This term describes the complex interaction between the nervous system and the immune system. Both of these systems are constantly communicating and influencing one another through biological messengers called cytokines.[9]  Cytokines are a broad class of proteins that signal to other molecules in the immune and nervous system to start or maintain functions that are essential for everyday life. Imagine cytokines as town criers, the town’s people rely on cytokines for news about their town and news about the next town over,  since the next town’s activities will also impact their daily lives. Expanding this analogy into psychoneuroimmunology, cytokines deliver important messages, also known as signals, concerning both the immunological system and the neurological system, since both systems are intertwined with one another- like two towns situated next to each other. Proinflammatory cytokines are a subset of cytokines that make up a large part of our defense against disease.[9] Continuing with our town crier analogy, these proinflammatory cytokines would be a subset of town criers that relay news solely relating to attacks, also known as infections. In an episodic stress response, the proinflammatory cytokines are increased allowing for more signalling that an attack is underway. While in a chronic stress response, inflammatory cytokines are decreased leaving there to be an open door for infections. But, how is it possible that chronic stress can have that drastic of an effect on proinflammatory cytokines?

The study A Possible Change Process of Inflammatory Cytokines in the Prolonged Chronic Stress and Its Ultimate Implications for Health [10] published by Tian Rui et al. explains this very phenomenon. It states that the presence of chronic stress can change the expression of certain parts of our brain, like the hypothalamic pituitary adrenal (HPA) axis. The HPA axis controls our stress response by upregulating or downregulating the secretion of certain hormones.[11] In the case of chronic stress, there is a downregulation of the HPA axis’s activity which has the effect of increasing the presence of the hormone- cortisol.[11] Cortisol has many complex and dynamic functions in the body, but for the sake of simplicity, we will only consider its stress related function.[12] High levels of cortisol block the activity of proinflammatory cytokines, explaining why chronic stress leaves us more vulnerable to infections. [13]

As we enter the summer season and take summer courses or find ways to spend our time, I would advise that we take care of our stress levels and find healthy coping habits; talking to one another virtually or seeing a professional if and when possible, taking long walks, meditating, dancing, watching an episode (or a few episodes) of our favorite trashy TV show.  These might seem like huge wastes of time, but in the long run they help decrease stress levels and keep us healthy by not putting our immune system at risk.

References

1. Bethune S. Teen stress rivals that of adults [Internet]. American Psychological Association (APA). 2014 [cited 24 January 2020]. Available from: https://www.apa.org/monitor/2014/04/teen-stress
2. Reinberg S. More College Students Seeking Mental Health Care [Internet]. Consumer HealthDay. 2018 [cited 22 January 2020]. Available from: https://consumer.healthday.com/mental-health-information-25/anxiety-news-33/more-college-students-seeking-mental-health-care-738933.html
3. Stress, Mental Health, and Generation Z [Internet]. Western Governors University. 2019 [cited 22 January 2020]. Available from: https://www.wgu.edu/blog/stress-mental-health-generation-z1906.html
4. Levine R. U of T expert on the rise of students seeking help for mental health [Internet]. University of Toronto News. 2019 [cited 23 January 2020]. Available from: https://www.utoronto.ca/news/u-t-expert-rise-students-seeking-help-mental-health
5. Kandola A. What are the health effects of chronic stress? [Internet]. Medical News Today. 2018 [cited 25 January 2020]. Available from: https://www.medicalnewstoday.com/articles/323324.php#signs-and-symptoms
6. Sachs B. Coping with stress. Stress Medicine [Internet]. 1991 [cited 25 January 2020];7(1):61-63. Available from: https://onlinelibrary.wiley.com/doi/abs/10.1002/smi.2460070111
7. Goldman B. Study explains how stress can boost immune system [Internet]. Stanford Medicine News Center. 2012 [cited 22 January 2020]. Available from: https://med.stanford.edu/news/all-news/2012/06/study-explains-how-stress-can-boost-immune-system.html
8. Robert Ader, Founder of Psychoneuroimmunology, Dies [Internet]. University of Rochester Medical Center Rochester. 2011 [cited 22 January 2020]. Available from: https://www.urmc.rochester.edu/news/story/3370/robert-ader-founder-of-psychoneuroimmunology-dies.aspx
9. Hou R, Baldwin D. A neuroimmunological perspective on anxiety disorders. Human Psychopharmacology: Clinical and Experimental [Internet]. 2011 [cited 24 January 2020];27(1):6-14. Available from: https://doi.org/10.1002/hup.1259
10. Tian R, Hou G, Li D, Yuan T. A Possible Change Process of Inflammatory Cytokines in the Prolonged Chronic Stress and Its Ultimate Implications for Health. The Scientific World Journal [Internet]. 2014 [cited 22 January 2020];2014:1-8. Available from: https://www.hindawi.com/journals/tswj/2014/780616/
11. Alschuler L. The HPA Axis [Internet]. Integrative Therapeutics. 2016 [cited 1 March 2020]. Available from: https://www.integrativepro.com/Resources/Integrative-Blog/2016/The-HPA-Axis
12. What is Cortisol? [Internet]. Hormone Health Network. 2018 [cited 1 March 2020]. Available from: https://www.hormone.org/your-health-and-hormones/glands-and-hormones-a-to-z/hormones/cortisol
13. Fernandes E, Estanislau C, Venancio E. Moderate Intensity Physical Exercise: Psychoneuroimmunological Aspects [Internet]. ResearchGate. 2020 [cited 25 January 2020]. Available from: https://www.researchgate.net/publication/328564056_Moderate_intensity_physical_exercise_Psychoneuroimmunological_aspects

A big thank you to Reese Ladak for submitting their MIMM 214 assignment to post on The Turret. This guest post may give you new hope about the future of cancer treatments!

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CAR T-Cell Therapy: A New Era in Cancer Treatments

Reese Ladak

“I’m sorry, the test came back positive. You have cancer.” – are words that no patient ever wishes to hear. Characterized by rapid and uncontrollable proliferation of cells, cancer research has the most funding–and with good reason, given how cancer death rates have decreased only 32% in males and 17% in females in 30 years (Close, 2015). Although conventional treatments like chemotherapy and radiation are effective, more than 35% of cancer patients in the US alone died in 2018 (Siegel, et al., 2018). Oncology treatments thus far have been not as effective as they are mentally, physically, and financially taxing on a person. This, however, will not be the case for much longer. Due to extensive research by scientists and biomedical engineers, a new branch of cancer treatment, CAR T-cell therapy, is on the rise (Maus, et al., 2014). In the near future, patients sitting in a doctor’s office will no longer skip a heartbeat when they hear the word “cancer.”

What is it?

As the name suggests, CAR T-cell therapy involves T cells, which are soldiers of the body that protect it from harm. Each T cell has a specific pathogen (or “enemy”) of the body that it targets and subsequently destroys. In CAR T-cell therapy, the pathogens are solely cancer cells, courtesy of the chimeric antigen receptor (CAR) (Pagel, 2017). The science behind CAR is simple: only cancerous cells carry the specific molecule which CAR has strong affinity for, and hence all the T cells carrying CAR will be targeted towards just cancerous cells (Guthrie, 2019). With that said, CAR inducing a higher degree of selectivity in T cells is the reason behind CAR T-cell therapy’s increased effectiveness compared to chemotherapy. The more conventional treatments, such as chemotherapy, are untargeted forms of treatment, meaning both cancerous and healthy cells are victims. Hence, the undesirable side effects of conventional cancer treatments, including hair loss, are no longer a concern for patients. Not only is it safer than chemotherapy, CAR T-cell therapy is much more convenient. With chemotherapy, patients must receive daily treatments. Contrastingly, patients undergoing CAR T-cell therapy require only one treatment, since CAR T cells autonomously fight the cancer to eradication (Tripathy, 2017).

Is it effective?

Based on a study done in 2016, where multiple CAR T-cell therapies were administered, it is! This study was trying to find the best way for CAR T-cell therapy to target cancerous cells, by evaluating different target molecules on cancerous cells that CAR may have high affinity towards. The study indicated that CAR T-cell therapy shows great potential. Based on the data based on more than 8,000 patients, it was apparent that blood cancers are much more treatable than solid tumours through CAR T-cell therapy. Furthermore, it was found that CD19 was the target molecule that was the most effective; a remarkable 80% of patients were completely cured of their cancer. The study also addressed a few flaws of CAR T-cell therapy, but, fortunately, they are quite manageable, and their severity is insignificant compared to that of cancer (Almåsbak, Aarvak, & Vemuri, 2016).

Should I care?

Yes, you definitely should – even if cancer is not a relevant part of your life. Cancer has been tormenting us for too long with requiring expensive, time-consuming and less than ideal treatments. Although current CAR T-cell treatments are far from perfect, such as being expensive and not 100% targeted towards cancerous cells, it is a major improvement from existing treatments–and it is only going to get better in the future. Current studies are trying to improve the selectivity of CAR T-cell therapy on blood cancers, as well as to introduce a way for the therapy to target solid tumours effectively (Sendra, 2018). Hence, a future where patients no longer have to worry about cancer is imminent.

References

• Almåsbak, H., Aarvak, T., & Vemuri, M. C. (2016). CAR T Cell Therapy: A Game Changer in Cancer Treatment. Journal of Immunology Research,2016, 1-10. doi:10.1155/2016/5474602
• Close, K. (2015, August 03). JAMA Paper Breaks Down Medical Research Funding in the US. Retrieved from https://diatribe.org/jama-paper-breaks-down-medical-research-funding-us
• Guthrie, G. (2019, January 24). CAR T-Cell Immunotherapy: The 2018 Advance of the Year. Retrieved from https://www.cancer.net/blog/2018-01/car-t-cell-immunotherapy-2018-advance-year
• Maus, M. V., Grupp, S. A., Porter, D. L., & June, C. H. (2014). Antibody-modified T cells: CARs take the front seat for hematologic malignancies. Blood,123(17), 2625-2635. doi:10.1182/blood-2013-11-492231
• Pagel, J. M. (2017, November 01). Chimeric Antigen Receptor (CAR) T-Cell Therapy. Retrieved from https://jamanetwork.com/journals/jamaoncology/fullarticle/2652907
• Sendra, J. W. (2018, May 23). What You Need to Know About CAR T-Cell Therapy for Cancer. Retrieved from https://healthblog.uofmhealth.org/cancer-care/what-you-need-to-know-about-car-t-cell-therapy-for-cancer
• Siegel, R. L., Miller, K. D., & Jemal, A. (2018). Cancer statistics, 2018. CA: A Cancer Journal for Clinicians,68(1), 7-30. doi:10.3322/caac.21442
• Tripathy, D. (2017, March 19). Weighing the Benefits and Risks of CAR T-Cell Therapy: The Stakes Are High. Retrieved from https://www.curetoday.com/publications/cure/2017/hematology-1-2017/weighing-the-benefits-and-risks-of-car-tcell-therapy-the-stakes-are-high

On May 15th, 2019 the Schulich Library closed for major renovation work. Schulich staff and collections have been relocated to the McLennan-Redpath Library Complex. Additional study spaces are being created in the McLennan-Redpath Complex including seating on the 2nd floor of Redpath and the 2nd floor of McLennan, as well as a number of new bookable group study rooms.

• The Schulich Collection: 160,000 volumes have been moved to the basement of the Redpath Library Building and will be open to users in August 2019. Users can now request Schulich items for pickup at any branch location via the catalogue. Items not available for retrieval or pick up can be access through the InterLibrary Loan (ILL) Service.
• Course Reserves: The Schulich reserve collection has moved to the main floor of McLennan Library Building in the HSSL Self-Serve Reserves Room for quick retrieval. The Self-Serve Reserves Room next to the Information Desk on the main floor of McLennan is open during regular borrowing service hours (i.e. when the service desk is open) and can be accessed by anyone during that time. Students, faculty, and staff wanting to access the room outside of regular borrowing service hours can be granted special access to the room. For more information, click here.
• The Reference Collection and Standards: Schulich’s Reference Collection and Standards will be available in the reference area on the main floor of the McLennan Library Building.
• Librarians: The Schulich Librarians are now based out of the 6th floor of the McLennan Library Building. We are still available to help you! You can get in touch by either emailing schulich.library@mcgill.ca or calling 514-398-4734. Library users are also welcome to visit in person.

When the construction work is completed in 2021, the Schulich Library will feature: more study and workspaces, improved accessibility, restored exterior masonry, a new HVAC system, and an expanded number of washrooms.

More information, including the timeline, scope and impact on users, is available here.

For all health sciences users and/or those who use Point of Care tools, we are delighted to announce that we have new access to Dynamed Plus.

Access it using this link!

Information on how to install the application on your mobile device can be found here!

A little bit about Dynamed Plus:

It’s a point of care, evidence-based, decision making tool. It is updated daily on a range of drugs, medical conditions, and calculators of many kinds.

The search functionality is improved over the old Dynamed, both in the general search bar, and within the monograph. It’s easy to read and find answers to clinical questions at a rapid pace.

Each article is edited by a team, using only current, high-quality evidence. To allow for maximum transparency, you can follow the step-by-step methodology that editors use here: http://www.dynamed.com/home/content/evidence-based-content/7-step-editorial-process

We recommend that all students, faculty, and staff, try out this awesome new tool!