Welcome to SciComm Radio

BPD is a chronic lung disease characterized by damage to the lungs and airways. This disease most commonly develops in premature newborns who cannot breathe well yet, and thus require oxygen therapy delivered via ventilators.

The guidelines followed by many neonatal intensive care units suggest setting ventilators to ensure that the volume of air moving in and out of the lungs in a single breath is between 4.5 and 6 milliliters per kilogram of body weight. However, studies have found that prolonged ventilation can increase the risk of lung injuries. This can contribute to the abnormal dilation of the trachea, increasing the resistance of airways and potentially leading to lung injury and scarring.

This lung injury, in premature infants, is called BPD, and when severe can require invasive procedures, such as tracheostomies. A tracheostomy involves cutting into a patient’s neck and creating an opening in the trachea, to facilitate the flow of oxygen into the lungs, through a tracheostomy tube. This tube is more stable than the endotracheal tubes used in the hospital and allows very long-term ventilation, for months to years, that can be provided in the home.

In infants, this procedure can lead to complications, further hospital admissions, and even death. Research investigating the care of premature infants is of utmost importance, as it could help to identify new therapeutic strategies to prevent or reduce ventilator-related lung damage, thus reducing the risk of severe BPD and the need for tracheostomies in premature infants.

Dr. Rebecca Rose, a Physician at Riley Hospital for Children and Associate Professor of Clinical Pediatrics at Indiana University is co-director of the interdisciplinary BPD inpatient team. This team meets regularly to discuss premature infants who still require ventilation through an endotracheal tube at 4 weeks of age to ensure consistency of care throughout their stay in the neonatal intensive care unit and improve long term outcomes. The team uses standardized assessments of real time data from the ventilator to tailor ventilator settings to the changing lung physiology as the baby ages. A recent paper examined the potential of carefully modulating the settings of ventilators to prevent air trapping, and decrease the severity of BPD and the need for tracheostomy.

The BPD team cares for patients in the neonatal intensive care unit at Riley Hospital for Children, which also includes a maternity center. Although doctors in this maternity center try to limit the use of invasive ventilators, many premature babies require them for several days, weeks, or months.

Dr. Rose and her colleagues collected data in their neonatal intensive care unit for a period of approximately four years, spanning from early 2017 to late 2021 as part of an ongoing effort to improve the quality of care and outcomes in premature infants. In late 2018, they introduced an interdisciplinary team of physicians, including pulmonologists, and neonatologists, who were trained on a protocol for assessing an infant’s need for bedside ventilation and adapting ventilator settings based on the patient’s lung mechanics.

This team, dubbed the “BPD Team”, implemented a strategy to assess lung mechanics and the interactions between an infant and the ventilator. These assessments could then guide changes in ventilator settings.

The team specifically focused their efforts on premature infants born before the end of the 29^th week of gestation, who were still on invasive mechanical ventilation (ventilator support through an endotracheal tube), which they categorized as being at high risk of developing severe BPD. These patients have already incurred injury to their lungs from the ventilator, and often require invasive ventilation for prolonged periods of time. Continued ventilation with “gentle ventilation”, the style of ventilator settings used to prevent BPD, in these patients can lead to ventilating only the less injured areas of the lung, creating areas of collapsed lung next to areas of overdistended lung.

For these high-risk infants, the team followed a set of recommendations designed to intervene early, to use larger breaths given less frequently to avoid air trapping and ensure that adequate positive pressure remains in the airways at the end of a breath cycle. These recommendations were designed to ensure that air from the ventilator inflates all areas of the lungs, and the patients exhale fully, decreasing air trapping in the lung and minimizing further damage in the lungs and airways.

Dr. Rose and her colleagues later analyzed the data and observations gathered in their neonatal intensive care unit to assess the effectiveness of the early interventions. This included the medical information and therapeutic outcomes of 207 infants, of which 75 were treated before the intervention and 132 afterwards.

The most premature infants participating in the study were born when they were at the 22^nd week of gestation, when their mothers were approaching the end of their 5^th month of pregnancy. The least premature were born at the 28^th week of gestation, when their mothers were in the 7^th month of pregnancy.

The team’s results were highly promising, as their intervention did appear to have beneficial results. By introducing their guidelines for adapting ventilation settings, they were able to significantly reduce the number of infants who required a tracheostomy after invasive ventilation.

While the difference in the patients’ average length of hospitalization before and after the intervention was not significant, the team did observe a trend indicating that the intervention helped some patients go home earlier. Specifically, the average length of stay in hospital before the intervention was 180 days, and this went down to 153 days after the intervention.

Overall, the recent study reported by Dr. Rose and her collaborators highlights the promise of early intervention strategies designed to adapt ventilation settings, to avoid unnecessarily exposing infants to highly intensive mechanical ventilation for prolonged periods of time. The intervention devised by the clinicians, which featured an inter-disciplinary team and ventilator assessment guidelines, was found to significantly reduce the need for tracheostomies.

These findings suggest that measuring changes in the lung mechanics of premature newborns and adapting ventilator settings accordingly could help to reduce ventilator-related injury to the lungs and airways, thus decreasing the severity of BPD. In the future, the work by Dr. Rose and her colleagues could inform the development of new protocols for neonatal intensive care units, which could help to improve the therapeutic outcomes for extremely premature newborns, limiting tracheostomy and home ventilation, and speeding up recovery.

Digital models that can incorporate pre-existing experimental data to accurately predict product quality and functionality are widely used in many manufacturing processes. However, despite the potential resource, time, and cost savings to be made, the pharmaceutical industry has remained largely steadfast in adhering to tried-and-tested methods, often citing the hesitation associated with introducing new technologies into established systems, alongside the risk of compromising final product quality. This is particularly pertinent since the production of medicines is tightly regulated, and attaining a precise product specification is crucial to optimise functionality and ensure patient safety.

Using computer-assisted modelling, new processes can be designed that require minimal additional preparatory experiments to determine the ideal manufacturing conditions. These operational processes can then be used to produce active pharmaceutical ingredients in a more timely, more sustainable and less expensive manner. This has the additional advantage of vastly increasing our understanding of the production process, ensuring that quality is embedded throughout every stage of production and mitigating the risk of a poorly functioning final product.   

Despite the considerable progress made in using digital modelling in manufacturing processes during recent years, a gap remains in the use of digital tools that encompass the entire production journey from the initial process design to the clinic-ready pharmaceutical product.

To address this, CMAC collaborated with colleagues throughout the UK to develop digital process models for a series of routine pharmaceutical manufacturing steps, including crystallisation, filtration, washing, and drying. They used small-scale, material-sparing experiments to validate and refine their preliminary models to improve accuracy.

Their aim was to produce high-quality particles of the active ingredient in a widely used anti-inflammatory pain medication administered in tablet form. They also considered the low solubility of their active ingredient in the patient and using a physiologically relevant model of the human gastrointestinal tract, understood that a particle with a smaller surface area would maximise absorption by the human body after ingestion.

Furthermore, they intended to demonstrate that it was entirely possible to tailor these processes and produce target particles of differing sizes while maintaining the quality of the resulting tablets.

First, the team used available published data to identify the most appropriate solvents, processing methods, working temperatures, and analytical monitoring approaches to fulfil their requirements. Additionally, they prepared themselves to tackle known issues that may adversely impact outcomes, such as materials adhering to equipment, resulting in the unwanted accumulation of particulate matter, potential transfer line blockages, or disruption of heat transfer.

Increasingly, the use of potent organic molecules to produce medicines is becoming the norm, resulting in lower production volumes, more complex manufacturing processes and the risk that the material used during development outweighs production volumes.

Here, we are introduced to a streamlined method that incorporates digital design tools with the repurposing of material and data produced in earlier stages. This requires considerably lower volumes of active ingredient during the multi-step model development process compared to those reported in previous research.

Using existing experimental data and material meant that many of the experimental processes used in traditional development approaches were unnecessary and therefore eliminated, saving time, money and other resources.

One of the major objectives of CMAC’s research was to gain an increased understanding of the process itself, as opposed to retrospectively optimising the models using the final product. Indeed, controlling particle size has been identified as one of the most crucial targets in improving bio-availability.

Through innovative exploratory processes, the researchers achieved the impressive feat of designing a model that is transferrable to different particle size targets. This means that no additional experimentation is needed prior to implementing this production method to other particle sizes.

The capacity to identify blockages within equipment transfer lines in multi-stage processes would reduce the need for additional experimental screening and promote continuous processes, thus decreasing time, resource, and cost pressures even further. Refined models that address these issues are needed to ensure consistent quality standards. CMAC’s team has emphasised the importance of fully characterising the materials throughout the process, thus ensuring a high-calibre final product and reducing wastage.

There is an urgent need for more integrated, rapid process development that optimises pharmaceutical production outcomes. However, challenges persist. Notably, impurity impact during manufacturing remains unpredictable, and there are obstacles to overcome in designing processing models that consider and optimise several quality indicators simultaneously.

The pioneering work of CMAC and its collaborators has undoubtedly paved the way for the accelerated advancement of this groundbreaking technology. Faster, cheaper manufacturing protocols are within reach, and the desire to eliminate the need for additional validation processes may soon be a reality.

This will assist in the more cost-effective, more sustainable production of high-quality, optimally performing medicines for the treatment of various human diseases, and may prove invaluable when new pharmaceuticals are required swiftly.

Maintaining health into old age is a key priority for many, but time is not kind to the body. As we age, complex biochemical mechanisms in our body can begin to malfunction, leading to chronic health problems. For instance, in many people, tissues can become less sensitive to the action of insulin, the hormone that controls blood glucose levels. This can potentially pave the way for diabetes, and serious complications such as diabetic neuropathy, which involves painful lesions and ulcers that typically appear on the legs and feet. Insulin sensitivity deficits, inflammation and oxidative stress can also play a significant role in neurodegenerative diseases, such as Alzheimer’s disease. In fact, Alzheimer’s is sometimes described as diabetes type 3.

There are currently no effective treatments for either diabetic neuropathy or Alzheimer’s disease. However, Prof. Christian Bréchot and colleagues have accumulated a wealth of pre-clinical data for a new therapy for potential use in both conditions. This is ALF5755, a protein originally discovered in the liver, and which has demonstrated exciting efficacy in a range of disease states. The protein can directly bind and inactivate reactive oxygen molecules that cause cellular damage. It acts as a tissue repair molecule, which means it drives tissue regeneration and counterbalances tissue lesions and it also has significant anti-inflammatory effects and can help to reduce insulin sensitivity deficits.

Interestingly, ALF5755 tends to have the greatest effect on unhealthy and inflamed tissues. It binds to another protein called fibrin that forms long strands on the outside of cell membranes. Once bound to extracellular fibrin, ALF5755 has a local anti-oxidant effect by binding reactive oxygen molecules, and then this affects large protein bundles called receptors that are studded in the cell membrane. The receptors then transmit these changes inside the cell itself, helping to amplify the effectiveness of HIP treatment.

However, healthy cells tend to be covered with another protein called fibrinogen, and have less fibrin, meaning that HIP is less likely to affect them. This mechanism forms a serendipitous ALF5755 targeting effect for inflamed tissues, and may help to avoid off-target effects in healthier tissues.

One of the most painful and debilitating conditions for which ALF5755 has significant potential is diabetic neuropathy. Up to one third of patients with diabetes may experience foot ulcers, and up to 60% of such wounds become infected, with a significant associated risk that the affected limb will need to be amputated. In diabetes, high blood glucose levels lead to small vascular lesions which can become inflamed, leading to an increase in reactive oxygen molecules. These processes can damage and destroy nearby nerves, and the lesions can degenerate to form painful ulcers that are very difficult to treat. At present, no treatments exist that can slow or prevent diabetic neuropathy.

However, ALF5755 has shown exciting pre-clinical effectiveness in addressing the mechanisms underlying diabetic neuropathy. For instance, one study in mice showed that ALF5755 treatment could protect neurons in the brain from being killed through overstimulation, by exerting its anti-oxidant effects. In a second study in diabetic mice, ALF5755 treatment enhanced skin wound healing, in part by reducing levels of inflammatory proteins in the wound margin.

Impressively, in a sophisticated rat model of type 2 diabetes in which diabetic neuropathy arises as the rat grows older, ALF5755 treatment enhanced nerve sensitivity and associated muscle function.

The ALF5755 protein has also shown significant potential in pre-clinical models of Alzheimer’s disease. Alzheimer’s involves characteristic protein plaques and tangles within the brain, but it also involves inflammation and oxidative stress, providing an opportunity for HIP to provide therapeutic benefit.

The researchers used a mouse model of Alzheimer’s in which mice demonstrate characteristic protein plaques in their brains, along with memory and learning defects. They used genetic techniques to overexpress the ALF5755 protein in the mice, and successfully demonstrated that it could significantly reverse learning and memory defects over 6 months, and that it also increased levels of anti-oxidant enzymes in the brain. In a key aspect, the study demonstrated that ALF5755 could cross the blood-brain barrier, a specialized lining found in the blood vessels within the brain that often prevents therapies from entering.

In terms of the safety of ALF5755 therapy, so far, phase 1 and 2 studies in healthy men and patients with acute liver diseases who received intravenous administration of ALF5755, at a range of concentrations, showed no adverse effects, suggesting that this drug is safe for clinical use. At present, the therapy is designed to be delivered as a subcutaneous injection, but Bréchot and colleagues are working to develop a capsule formulation that patients could take orally.

Both diabetic neuropathy and Alzheimer’s are significant sources of suffering for many in old age, with no currently available treatment options to alleviate this. Finding new treatments that can help people to increase their health span and live happy lives into old age would be transformative. Therapies such as ALF5755 look to be a step in the right direction.

During his postdoctoral fellowship in the mid-2000s, Dr. Buck discovered that a common food additive called carrageenan can block the transmission of human papillomaviruses (which cause genital warts and cervical cancer). The idea of using food to fight viruses has sparked his imagination ever since. In January 2021, when a team of Taiwanese scientists led by Dr. Chi-Huey Wong showed that feeding hamsters mint tea helped them fight off Covid infections, Dr. Buck sat up and took notice. A subsequent publication from Dr. Mirko Trilling’s lab at the University of Duisburg-Essen found that a compound called caffeic acid, which is abundant in mint-family herbs, stimulates innate cellular defense pathways that suppress the replication of SARS-CoV-2, the virus behind Covid-19. More recently, several small clinical trials have found that people given extracts of mint family herbs show significantly milder Covid symptoms or even resist the infection entirely. After seeing these exciting results, Dr. Buck decided it was time to write an article for the peer-reviewed journal Medical Hypotheses, and to start a Substack blog to help get the word out.

The global spread of Covid in early 2020 required scientists to rapidly gather and share evidence to assist in preventing transmission and treating symptoms. Early rounds of official guidance were based upon preliminary lab experiments and small observational trials. Predictably, some of these early “best-guess” guidelines, such as hydroxychloroquine, ended in spectacular failure. Dr. Buck’s concern is that the idea of using mint tea to fight Covid might have been a precious baby that inadvertently got thrown out with the dirty hydroxychloroquine bathwater.

Although it may seem risky to try unproven medical interventions, it is far riskier to idly wait for conclusive evidence while a pandemic ravages the world. In a blog post, Dr. Buck refers to it as the “sit tight and assess” fallacy, after a scene in the satirical disaster movie Don’t Look Up. Our current regulatory infrastructure sometimes fails to appropriately weigh the risk of inaction in the face of an unfolding calamity.

It’s a well-known fact that eating certain types of foods can be beneficial to health. With this thought in mind, Dr. Buck proposes that routinely eating common culinary herbs of the mint family – for example, Simon and Garfunkel’s classic trio of sage, rosemary, and thyme – might decrease the severity of Covid symptoms or even help people resist becoming infected altogether. Since these herbs are widely available, easy to grow, and have been safely used by humans for millennia, it’s an experiment people can easily try in their own kitchens while waiting for larger randomized controlled trials to more conclusively address the hypothesis.

Dr. Buck’s review article recounts the story of another neglected herbal medicine known as wormwood. Teas made from various species of wormwood have been used to treat fevers for centuries. In 2015, Dr. Youyou Tu was awarded a Nobel prize for her discovery of the powerful antimalarial drug artemisinin in wormwood leaf extracts. Alongside artemisinin, the plant also produces a variety of additional anti-parasitic compounds. This is important because it’s a well-established fact that multi-drug cocktails can help fight the emergence of drug-resistant pathogens. These findings inspired a scientist named Pam Weathers to lead a series of clinical trials investigating whether pills made from compressed wormwood leaves could serve as an inexpensive alternative to pharmaceutical-grade artemisinin. Unfortunately, Dr. Weathers’ trial encountered technical obstacles and eventually became mired in controversy.

Dr. Buck proposes a simplified trial design in which people could be sent either active wormwood leaf preparations or a placebo herb preparation via regular mail service. Volunteers would then report back symptoms via a cellphone app. This decentralized approach might circumvent some of the challenges Dr. Weathers’ team encountered. In the simplest possible trial design, people could be sent wormwood seeds (or seeds for inactive control plants) that they could grow themselves and use as tea that might prevent or treat malaria.

Dr. Buck envisions similar trials to test the mint versus Covid hypothesis. In particular, he notes that different varieties of basil (another mint family herb) produce wildly different amounts of the proposed antiviral compound, caffeic acid. A decentralized design could theoretically enable a large trial at very low cost.

In related thoughts, Dr. Buck sings the praises of consuming mint and other herbal concoctions in daily life, whether drinking complex herb teas or indulging in delicious pesto pasta dishes. With a habit of upping his intake when necessary and encouraging his loved ones to adopt the same approach, he proudly proclaims that all those who have heeded his sage advice remain so-called “novids,” having never contracted the virus despite virtually guaranteed exposure. Indeed, as part of this vital research, Dr. Buck has rather gallantly tested several herb-based cocktails, resulting in a series of entertaining tasting sessions. This has prompted an impassioned plea for quality herbal cocktail ingredients. Purely for the purposes of robust scientific research, of course.

Während seines Postdoktorandenstipendiums Mitte der 2000er Jahre entdeckte Dr. Buck, dass ein häufiger Lebensmittelzusatzstoff namens Carrageen die Übertragung von humanen Papillomaviren (die Genitalwarzen und Gebärmutterhalskrebs verursachen) blockieren kann. Seitdem hat ihn die Idee, Lebensmittel zur Bekämpfung von Viren einzusetzen, fasziniert. Im Januar 2021 zeigte ein Team taiwanesischer Wissenschaftler unter der Leitung von Dr. Chi-Huey Wong, dass die Verabreichung von Minztee Hamstern dabei half, COVID-Infektionen zu bekämpfen. Dr. Buck wurde aufmerksam. Eine anschließende Veröffentlichung aus dem Labor von Dr. Mirko Trilling an der Universität Duisburg-Essen ergab, dass eine Verbindung namens Kaffeesäure, die in Minzgewächsen reichlich vorhanden ist, angeborene zelluläre Abwehrmechanismen stimuliert, die die Vermehrung von SARS-CoV-2, dem Virus hinter COVID-19, unterdrücken. Jüngst haben mehrere klinische Studien gezeigt, dass Menschen, die Extrakte aus Minzgewächsen erhielten, deutlich mildere COVID-Symptome aufwiesen oder sogar völlig unempfänglich für die Infektion waren. Nach diesen aufregenden Ergebnissen beschloss Dr. Buck, einen Artikel für die Fachzeitschrift Medical Hypotheses zu schreiben und einen Substack-Blog zu starten, um diese Botschaft zu verbreiten.

Die rapide weltweite Ausbreitung von COVID Anfang 2020 erforderte von Wissenschaftlern, schnell Forschungsergebnisse zu gewinnen und zu teilen, um die Übertragung des Virus einzudämmen und Symptome der Infektion zu behandeln. Früh in der Pandemie basierten Empfehlungen zur Vorbeugung und Behandlung auf vorläufigen Laborexperimenten und kleinen Beobachtungsstudien. Vorhersehbar endeten einige dieser frühen „Best-Guess“-Empfehlungen, wie die Gabe von Hydroxychloroquin, spektakulär im Scheitern. Dr. Bucks Sorge ist, dass die Idee, Minztee zur Bekämpfung von COVID einzusetzen, möglicherweise ein wertvolles Baby war, das versehentlich mit dem schmutzigen Hydroxychloroquin-Badewasser ausgeschüttet wurde. Obwohl es riskant erscheinen mag, unbewiesene medizinische Interventionen auszuprobieren, ist es viel riskanter, untätig auf schlüssige Beweise zu warten, während eine Pandemie die Welt verwüstet. In einem Blogbeitrag bezeichnet Dr. Buck dies als den „Sitz-und-Beobachtungs-Fehlschluss“, nach einer Szene in der satirischen Katastrophenkomödie ‘Don’t Look Up’. Unsere derzeitige Regulierungsinfrastruktur versagt manchmal darin, das Risiko der Untätigkeit angesichts einer sich entfaltenden Katastrophe angemessen abzuwägen.

Es ist allgemein bekannt, dass der Verzehr bestimmter Lebensmittel gesundheitsfördernd sein kann. Mit diesem Gedanken im Hinterkopf schlägt Dr. Buck vor, dass der regelmäßige Verzehr gängiger Küchenkräuter aus die Lippenblütler – zum Beispiel das klassische Trio von Simon und Garfunkel, Salbei, Rosmarin und Thymian – die Schwere der COVID-Symptome verringern oder sogar dazu beitragen könnte, dass Menschen überhaupt nicht infiziert werden. Da diese Kräuter weit verbreitet, leicht anzubauen und seit Jahrtausenden sicher von Menschen verwendet werden, ist es ein Experiment, das die Menschen leicht in ihren eigenen Küchen ausprobieren können, während sie auf größere randomisierte kontrollierte Studien warten, die die Hypothese schlüssiger überprüfen.

Dr. Bucks Übersichtsartikel erzählt die Geschichte eines weiteren vernachlässigten pflanzlichen Arzneimittels namens Wermutkraut. Tees aus verschiedenen Wermutarten werden seit Jahrhunderten zur Behandlung von Fieber verwendet. 2015 wurde Dr. Youyou Tu mit einem Nobelpreis für ihre Entdeckung des starken Antimalariamittels Artemisinin in Wermutblattextrakten ausgezeichnet. Neben Artemisinin produziert die Pflanze auch eine Vielzahl zusätzlicher antiparasitärer Verbindungen. Diese Beobachtung ist wichtig, da es eine wohlbekannte Tatsache ist, dass Kombinationstherapien mit mehreren Medikamenten gleichzeitig dazu beitragen können, die Entstehung arzneimittelresistenter Krankheitserreger zu bekämpfen. Diese Erkenntnisse inspirierten eine Wissenschaftlerin namens Pam Weathers dazu, eine Reihe von klinischen Studien durchzuführen zur Untersuchung, , ob Tabletten aus komprimierten Wermutblättern als kostengünstige Alternative zu pharmazeutisch hochwertigem Artemisinin dienen könnten. Leider stieß Dr. Weathers’ Studie auf technische Hindernisse und geriet schließlich in Kontroversen. Dr. Buck schlägt ein vereinfachtes Studiendesign vor, bei dem Menschen entweder aktive Wermutblattpräparate oder ein Placebo-Kräuterpräparat per Post erhalten könnten. Die Freiwilligen würden dann ihre Symptome über eine Handy-App zurückmelden. Dieser dezentrale Ansatz könnte einige der Herausforderungen umgehen, auf die das Team von Dr. Weathers stieß. Im einfachsten möglichen Studiendesign könnten den Menschen Wermutsamen (oder Samen für inaktive Kontrollpflanzen) geschickt werden, die sie selbst anbauen und danach als Tee einnehmen, der möglicherweise Malaria verhindern oder behandeln könnte. Dr. Buck stellt sich ähnliche Studien vor, um die Minze-gegen-Covid-Hypothese zu testen. Insbesondere merkt er an, dass verschiedene Basilikumarten (ein weiteres Kraut aus die Lippenblütler) sehr unterschiedliche Mengen der vorgeschlagenen antiviralen Verbindung Kaffeesäure produzieren. Ein dezentrales Design könnte theoretisch eine große Studie zu sehr geringen Kosten ermöglichen.

Unter all diesen Gesichtspunkten lobt Dr. Buck den Konsum von Minze und anderen Kräutermischungen im täglichen Leben, sei es durch den Genuss komplexer Kräutertees oder köstlicher Pesto-Pasta-Gerichte. Mit der Angewohnheit, seine tägliche Aufnahme dieser Naturprodukte bei Bedarf zu erhöhen, und der Ermutigung seiner Lieben, den gleichen Ansatz zu verfolgen, erklärt er stolz, dass alle, die seinem weisen Rat gefolgt sind, sogenannte „Novids“ geblieben sind und sich mit dem Virus trotz praktisch garantierter Exposition nie infiziert haben. Tatsächlich hat Dr. Buck im Rahmen dieser wichtigen Forschung mehrere auf Kräutern basierende Cocktails getestet, was zu einer Reihe amüsanter Verkostungssitzungen führte. Dies hat zu einem leidenschaftlichen Plädoyer für hochwertige Kräutercocktailzutaten geführt. Natürlich rein zu Forschungszwecken.

…

Diese Audioaufnahme ist eine Zusammenfassung des Artikels „The mint versus Covid hypothesis“ in Medical Hypotheses, https://doi.org/10.1016/j.mehy.2023.111047

Cocktailrezepte sind auf Dr. Bucks Substack-Blog „Viruses Must Die“ verfügbar https://cbuck.substack.com

大约在 2005 年，当时巴克还是一名博士后研究员，他发现，卡拉胶作为一种常见的食品添加剂，可以抵抗人类乳头瘤病毒（能导致生殖器疣和宫颈癌）的感染。从那以后，巴克就萌生起了“用食物抵抗病毒感染”的想法。2021 年 1 月，翁启惠领导的一支台湾科学家团队指出，给仓鼠喂薄荷茶可以帮助它们抵抗新冠肺炎的感染。在听到这个消息之后，巴克便对开始这一类信息保持着密切的关注。 随后，杜伊斯堡-埃森大学的米尔科·特里林实验室发表了一篇论文，这篇论文指出，在薄荷科草本植物中，有一种含量非常丰富的化合物，叫咖啡酸，它可以刺激先天的细胞防御机制，抑制SARS-CoV-2病毒（可以引起新冠肺炎）的复制。最近，有几项小型临床试验还发现，服用薄荷科草本植物提取物的人只表现出轻微的新冠肺炎症状，有的人甚至还完全抵抗了新冠病毒的感染。在了解到这些发现之后，巴克决定给《医学假说》杂志写一篇文章，同时还开设了一个Substack 博客来宣传这些研究发现。

2020年初，新冠病毒席卷全球，科学家们迫切需要收集有关新冠病毒的各种信息，用于开发出新冠病毒的预防治疗方案。由于对新冠病毒的了解有限，加上早期的官方指导策略需要依赖大量的实验与试验，因此，在初始的探索过程中，一些被认为是“最佳治疗药物”，如羟氯喹，最终以试验失败告终了。 巴克担心薄荷茶会被拿来与羟氯喹这些“失败药物”一起讨论，最后没有得到应有的重视。

尽管尝试未经证实的医疗干预措施会面临着危险，但如果只静静等待着治疗方案的出现，不采取任何行动，那么所面临的病毒风险将会更大。在一篇博客文章中，巴克将这种行为称为“坐视不管”，这个说法源自讽刺性灾难电影《不要抬头》中的一个场景 。我们目前的监管基础设施有时无法衡量出灾难来临时“坐以待毙”的风险。

众所周知，食用某些特定类型的食物会对健康有益。根据这一点，巴克提出，食用一些烹饪过的薄荷科草本植物可能会减轻新冠肺炎疾病的症状，甚至可以完全抵抗新冠病毒的感染。常见的薄荷科草本植物有鼠尾草、迷迭香和百里香。人类种植这些草本植物已经有上千年的历史，而且它们也非常容易获得，种植起来也非常简单。因此，人们完全可以在家中进行测试，同时等待着随机对照试验对这一假说进行验证。

巴克的文献综述还讲述了另一个容易被人忽视的“艾草故事”。数百年来，人们经常使用各种艾草来制备茶叶，然后再用这些茶叶来治疗发烧疾病。2015年，屠呦呦因在艾草叶提取物中发现抗疟药物青蒿素而获得诺贝尔奖。除了青蒿素之外，艾草里还含有其他抗寄生虫化合物，这一点非常重要，因为多种药物的联合使用可以有效防止耐药性病原体的出现。这些发现引起了一位名叫帕姆·韦瑟斯的科学家的兴趣，随后他做了一些临床性试验，将艾草叶制作成药片，他想知道这种方法是否具备同样的治疗效果，并且相较于药用青蒿素，这种方法的价格是否更为低廉。不幸的是，他的试验遇到了技术方面的困难，最终还引起了人们的争议。

巴克提出了一种简化型的试验设计，在这种设计中，人们可以通过常规邮件服务收到活性的艾草叶药剂或者安慰剂草本植物药剂。然后，志愿者可以通过手机应用程序报告相关症状的情况。这种去中心化的方法或许可以规避韦瑟斯遇到的一些难题。在最简单的试验设计中，人们可以收到艾草种子（或者无活性对照植物的种子），然后种植一些用于预防或治疗疟疾的茶叶。

巴克设想了一些类似的试验来验证薄荷与新冠病毒的假说。他特别指出，不同品种的罗勒（另一种薄荷科草本植物）产生的咖啡酸的含量差异显著。从理论上讲，去中心化设计可以让我们以非常低的成本进行大规模的试验。

除此之外，巴克还倡导在日常生活中食用薄荷和其他草本植物混合食品。他还有一个习惯，那就是他会在需要的时候增加草本植物的摄入量，并且他还鼓励他的亲人也采取同样的做法。他还骄傲地宣称，那些听从了他的建议的人都成为了“零感染者”，永远都不会受到新冠病毒的感染。事实上，在这项重要研究中，巴克自己亲自测试了由几种草本植物制作成的混合物，甚至还将测试过程当成了一个“品茶会”。之后他还开始追求起了高质量的草本植物。当然，实际上他这么做是为了可以进行更加严谨的科学研究。

本音频是对《医学假说》杂志中的论文《薄荷与新冠病毒的假说》的概述。

https://doi.org/10.1016/j.mehy.2023.111047

草本植物混合物的配方可在巴克的 Substack博客《病毒必须消失》中找到。

https://cbuck.substack.com

Developing a successful business model and then resting on your laurels forevermore sure sounds tempting. Unfortunately, the world usually doesn’t work that way. In a book called “Only the Paranoid Survive: How to Exploit the Crisis Points That Challenge Every Company and Career,” author Andy Grove states the following: “Business success contains the seeds of its own destruction. The more successful you are, the more people want a chunk of your business, and then another chunk, and then another, until there is nothing left.”

The historical success of anesthesiology in delivering excellent patient safety in the perioperative space has potentially allowed it to become overlooked in terms of its value. Advances in patient safety have also opened the field up to other perioperative practitioners seeking to advance their own cause, taking little chunks at a time. This has sparked controversy within anesthesiology, which has further distracted the field from thinking about its future direction.  

These issues have prompted Dr. Matthew Sherrer from the University of Alabama Birmingham and colleagues to author a Commentary paper entitled “The Icarus Paradox and the Future of Anesthesiology”, which details this strategic malaise and proposes ways that the field can survive and thrive in the future.

Interestingly, there is currently a shortage of anesthesiologists in the US, leading to an excess of work and a financial windfall for the specialty. While some anesthesiologists may see this as a sign of health for the sector, Dr. Sherrer and his colleagues caution against complacency and suggest that the US healthcare system itself may be failing, leading to a trend towards cost-saving with negative results for anesthesiology. Instead, the team suggests that these conditions could provide some breathing space for experimentation, forward planning, and a strategic pivot.

Their Commentary paper uses the examples of Blockbuster, the now defunct video rental service, and Intel, a massive corporation that sells microprocessors, to illustrate the pitfalls and advantages of different mindsets and their effect on the long-term prospects of a company. Blockbuster failed to anticipate the rise of streaming and turned down an offer to partner with Netflix, to instead maintain its traditional DVD rental service. This did not end well.

Intel, on the other hand, redefined its value proposition by correctly anticipating that competing with Japanese manufacturers in creating memory chips would be pointless. The company instead pivoted to creating microprocessors, ultimately becoming one of the largest corporations in the world. The lessons in these examples could hold true for anesthesiology, which may need to chart its own disruptive models rather than having them chosen by others.

It may seem simplistic to urge anesthesiologists to make decisions that will ensure the longevity of their specialty without a clear view of what the future holds. While it is true that hindsight clarifies all, but usually too late, the team’s paper suggests a series of practical forward-thinking steps that could assist with this future reorientation.

One piece of advice cited in the paper involves leaders within the field engaging in self-reflection and intentionally auditing their blind spots. Regularly engaging in this type of activity could assist in identifying potential inflection points. Inflection points are also known as time zero events, and they signal a disruptive event that can drastically change the context in which a business or profession operates, such as the streaming revolution that left Blockbuster in the shade.

In her 2019 book, “Seeing Around Corners: How to Spot Inflection Points in Business Before They Happen”, author Rita McGrath suggests that anticipating and responding to inflection points is better performed as early as possible. Using the analogy of an obstacle on the road facing a driver, only a small turn of the wheel is required to avoid the obstacle when it is still far away, but drastic action is required to avoid an obstacle that suddenly appears directly in front of the car.

Put simply, a failure of imagination and vision will likely lead to unpleasant surprises. Envisioning various inflection points and then anticipating what would lead to such an event in the years prior could help leaders in anesthesiology to begin planning ahead. However, merely anticipating disastrous developments in the field is not enough. Embracing the same innovation that permitted excellent patient safety is important in creating new opportunities in the future.

This would involve encouraging and empowering those who wish to experiment with new approaches and technologies to proceed, while also maximizing the use of existing technologies to enhance patient care further. For instance, developing wearable devices that can monitor a patient’s vital signs unobtrusively could extend this impressive patient safety record to the post-operative space, where many patients experience serious complications, and enhance the value proposition of anesthesiology to hospital administrators. Such initiatives could create a tangible return on investment and cement the idea that anesthesiology is an investment rather than a cost for the healthcare system.

Another tactic that could assist the field in moving forward is the idea of placing “little bets”. This involves trying various new initiatives on a small scale and then assessing what worked and what did not – a strategy that McGrath refers to as “discovery driven planning.” The risk involved is minimal, but the potential rewards could enable a powerful strategic shift to future-proof the specialty. Another key aspect to developing the specialty is ending the turf wars between nurse anesthetists and physician anesthesiologists, which is counterproductive to good patient care, and instead focusing on productive collaboration.

Moreover, Dr. Sherrer and his colleagues do not believe that good work performed in the past should be discarded, but rather the field should proceed using what has worked and discard that which has yet to bear fruit.

For instance, in 2011 the perioperative surgical home initiative, a comprehensive care delivery model, was launched. The scheme was ambitious and welcome, but untested, and various components have failed to bear fruit. However, some aspects of the initiative, such as preoperative optimization and “enhanced recovery after surgery” pathways have gained traction and demonstrated value. Dr. Sherrer and colleagues are keen to emphasize respect for those who proposed the perioperative surgical home initiative, and advise that anesthesiology should build on its most successful aspects.

Anesthesiology is at a crossroads, and currently has space to conceive and implement strategic pivots. By embracing a little discomfort and placing discovery-driven planning at the heart of the specialty, anesthesiology can evolve and thrive into the future.

With a Master of Science in Chemistry from IIT Bombay and a Doctor of Philosophy in Organic Chemistry from Oregon State University, Dr. Raghavan is a highly trained chemist. More than fifteen years ago, he began formulating Metadichol and has been studying its potential benefits ever since.

Metadichol is based on the research of a Dutch doctor named Christiaan Eijkman, who traveled to the East Indies to study the spread of Beriberi – a condition associated with vitamin B1 deficiency. According to Eijkman’s research, the likelihood that chickens would have this sickness varied depending on the kind of rice they were fed. In particular, the hens became ill from eating polished rice, but eating unpolished rice seemed to help them recover. Policosanol, a molecule found in the majority of plant and vegetable foods, is the active ingredient in unpolished rice and has been shown to have positive health effects.

Policosanol is a key component of Metadichol. This active ingredient has been shown to have several positive health effects.

In the first studies conducted on rats, Dr. Raghavan discovered that a 5-milligram dose of Metadichol simultaneously affected a wide range of biological indicators. After that, he began working with other scientists and research centers to conduct clinical studies on humans to assess how the supplement would perform.

Thirteen patients with metabolic syndrome and an average of 25 to 30 years of diabetes participated in the supplement’s 2010 clinical trial. According to Dr. Raghavan, the supplement stabilized blood pressure and lipid indicators, including HDL and Triglycerides. These results were later corroborated in investigations involving different patients, demonstrating its possible usefulness in lowering the risk of cardiovascular events such as heart disease and stroke.

Dr. Raghavan explains that metadichol boosts antioxidant activity while simultaneously reducing inflammation and oxidation. Even in individuals who did not get vitamin C during the trial, he and his colleagues found that those who took the supplement had significantly higher levels of the vitamin.

According to Dr. Raghavan, metadichol increases the GLU2 and GLUt4 genes, which in turn allow vitamin C to enter the body and be recycled. The Gulo enzyme, which allows the body to naturally manufacture vitamin C, has long been known to be dormant in humans and other primates.

Researchers have discovered that amphibians, reptiles, fish, and rodents – animals capable of producing vitamin C – do not experience heart attacks or blood clots. Consequently, lowering the probability of getting cardiovascular disease and other cardiovascular problems may be possible by enhancing the human body’s ability to produce this vitamin.

Additionally, Dr. Raghavan and colleagues discovered that Metadichol aided weight loss by accelerating this process in individuals with a higher body mass index. The supplement also helped the body make more globulin, an important immune system regulator. These findings suggest that Metadichol may have a wide range of health benefits, offering hope for those seeking to improve their overall health.

According to the study, the supplement also increases energy levels. It decreases insulin resistance, defined as the body’s inadequate response to insulin. Given the extensive list of diseases and disorders associated with insulin resistance – including lung disease, heart disease, pancreatitis, cataracts, strokes, and even some cancers – this property could be extremely helpful. The potential of Metadichol in reducing insulin resistance is believed to be due to its ability to regulate blood sugar levels and improve the body’s sensitivity to insulin.

In diabetes, the hormone insulin is not working as it should, leading to uncontrolled blood sugar levels. In clinical trials, Dr. Raghavan’s group found that Metadichol increased insulin-producing cell activity by 63%. This increase in insulin production is believed to be due to the supplement’s ability to activate specific genes, such as IRS1, IRS2, GLU2 and GLUT4, which play a crucial role in insulin production and regulation.

They suggest that the supplement had a beneficial effect on patient health by targeting biological markers linked to diabetes. It is more common to use a combination of pharmaceutical medications rather than just one product to target these markers.

Another set of scientific trials looked at the ability of Metadichol to reduce wrinkles and improve skin health. In these trials, Dr. Raghavan’s team recommended the daily application of Metadichol gel, spray, or cream to areas of damaged skin, rashes, patches, or apparent symptoms of aging. According to the doctors’ observations, multiple patients’ conditions were alleviated, including acne, psoriasis, wrinkles, eczema, burns, herpes, and scars.

In another study, Dr. Raghavan found that 1 picogram of Metadichol increased telomerase in stem cells by a factor of sixteen. Telomerase is the enzyme responsible for maintaining the length of telomeres in cells. Maintaining telomere length is key to reversing the signs of aging and other age-related conditions.

Furthermore, Klotho is a gene that exhibits anti-aging properties and anti-cancer activity. The expression of this gene has been shown to decline with age, and is also very low in cancer cells. Dr. Raghavan and his colleagues have shown that cells exposed to Metadichol show increased expression of Klotho, further highlighting the promise of this supplement in anti-aging therapies, while also suggesting its potential to be used in combination with cancer treatments to enhance treatment efficacy.

According to Dr. Raghavan’s research, Metadichol also induces the expression of Yamanaka factor genes, which have also shown promise in cancer therapies. In addition to these Yamanaka factor genes and Klotho, Metadichol also appears to facilitate the expression of a large family of intracellular transcription factors that play crucial roles in regulating development, metabolism, and homeostasis.

According to the results from additional trials, Metadichol may also promote healthy kidney and liver function. Metadichol’s potential to improve kidney and liver function is believed to be due to its antioxidant and anti-inflammatory properties, which can help reduce the risk of organ damage and improve overall health.

Dr. Raghavan explains that Metadichol may also aid in the healing process after bacterial infections. He believes that the supplement’s healing benefits are due to its ability to enhance the body’s immune response and promote the regeneration of damaged tissues. Clinical research demonstrated that patients who took Metadichol recovered faster from superbug infections that are resistant to standard antibiotics, indicating the supplement’s potential as a complementary treatment for such infections.

Dr. Raghavan and colleagues also administered the supplement to COVID-19 patients, and noticed that its use was associated with a reduction in respiratory symptoms.

According to the data collected by Dr. Raghavan’s team, Metadichol has the potential to complement treatments for many different medical issues. If future clinical trials with bigger patient populations confirm these results, more doctors and dietitians may be persuaded to prescribe the supplement.

Humans are tribal creatures. Given the right conditions, such as a perceived scarcity of resources, many of us will rapidly adopt an “us vs. them” mindset. This tendency towards conflict and competition is firmly rooted in our evolution, where survival of the fittest is a major driving mechanism. However, these thought patterns can be deeply problematic when they erupt in a professional capacity, and prevent colleagues from effectively working together.

This is the situation in which anesthesiologists and certified registered nurse anesthetists find themselves in many US hospitals. A perceived scrabble for professional rights and responsibilities can develop into a toxic work culture, with micro-aggressions and conflict common in the surgical theatre. The consequences of this strife are serious, with burnout and anxiety affecting staff along with a potential reduction in the quality of patient care.

Recognizing the untenable nature of this situation, Dr. Sherrer, an anesthesiologist, began to think about different ways to interact with his colleagues. He realized that healthcare is a team sport, and if healthcare is to be evidence-based, then it would make sense to use the evidence for effective team-work.

Dr. Sherrer realized that the participants in this conflict could be described as having a “finite game” mindset. A finite game is played with the purpose of winning and relegating your opponent to a losing position. However, while reading the 2019 book, The Infinite Game by Simon Sinek, Dr. Sherrer discovered that an infinite game mindset could provide a blueprint for reduced conflict and enhanced cooperation in anesthesia.

An infinite game is not played to win, but rather ‘winning’ is interpreted as staying in the game as long as possible. This could be described as a mindset that prioritizes strategies to enhance the longevity of participation in the game. One could describe marriage as an infinite game, for example, where “winning” is the stable continuation of a happy marriage, rather than somehow defeating your spouse.

In a recent Commentary paper, Dr. Sherrer and his colleagues expand on five practices originally proposed by Simon Sinek as essential when adopting an infinite game mindset, and discusses how they can be applied to address the current discord in anesthesia. These are advancing a just cause, building trusting teams, studying your worthy rivals, preparing for existential flexibility and demonstrating the courage to lead. The authors of the paper envisage these principles as forming the basis for Infinite Anesthesia, a platform that hosts these concepts as they apply to anesthesia, with a view to share this philosophy as widely as possible to enable change.

In the context of anesthesia, advancing a just cause takes the form of aspiring to create a supportive workplace where anesthesiologists and nurse anesthetists work together in a respectful way to focus on their mutual top priority – patient care. This acknowledges that the patient loses in the finite game that is currently playing out in anesthesia. Patient and healthcare staff satisfaction represent valid metrics to measure whether this just cause has been fulfilled.

The second principle, building trusting teams, is one that Dr. Sherrer has already tackled in his own institution, which suffered from discord among anesthesia staff. Rather than let a toxic work culture fester under the surface, the hospital elected to bring in professional facilitators who chaired meetings between the warring parties where open dialogue was encouraged. Dr. Sherrer and his colleagues describe these meetings as very challenging but incredibly worthwhile, and they have paved the way for respectful and trusting working conditions with more open communication.

The third principle involves studying your worthy rivals. In the context of anesthesia, this would involve anesthesiologists and nurse anesthetists changing their mindset towards each other. In the current finite game mentality, anesthesiologists and nurse anesthetists see each other as serious rivals or even enemies. Changing to an infinite game mindset would involve seeing each other as fellow players in the game, where the real enemy is counterproductive adversarial behavior.

The fourth principle is preparing for existential flexibility, which means the ability to drastically change course to advance a just cause. In a finite game, drastically changing course is typically reactive and defensive, whereas in an infinite game, this should be possible in a responsive way that accounts for the needs of all stakeholders.

In the context of anesthesia, this involves acknowledging the great strides that have been made in terms of patient safety, which has directly facilitated the rise of nurse anesthetists as semi-independent practitioners of anesthesia. An infinite mindset celebrates this, and seeks to build on it. This could take the form of encouraging people within the anesthesia community to explore new avenues of patient care, such as wearable devices that can extend this impressive patient safety to the post-operative space, while continuing to use existing technologies to further enhance patient safety.

The final principle is demonstrating the courage to lead. Dr. Sherrer and his colleagues’ paper detailing the application of an infinite mindset has already generated controversy within the anesthesia community, with some keen to maintain the status quo. However, an infinite mindset seeks to use opposing views to provide balance and inform strategic decision-making. Forward-looking thinking and grounded, pragmatic thinking can complement each other, with one providing a potential future direction and the other providing helpful detail that can assist in stress-testing, avoiding errors and making sure that ideas stack up in ‘real world’ scenarios.      

Excitingly, an infinite mindset and the principles underlying it are not just applicable to anesthesia. There are many workplaces with toxic rivalries, in medicine and beyond. By promoting these principles and demonstrating that they can work in anesthesia, Dr. Sherrer and his colleagues hope that others may adopt and use an infinite mindset to enhance collaboration and productivity in a wide variety of fields.

TB is major global health scourge, leading to 1.7 million deaths annually. It has been estimated that up to one-third of the world’s population may be infected with TB. In most cases, these infections are latent and symptomless, but they can become active in approximately 10% of cases. Active TB is contagious and can be lethal, particularly if left untreated, and typically involves chronic cough, blood-containing mucus, fever and weight loss.

Diagnosing TB is notoriously challenging. Distinguishing between latent and active disease can be tricky, as well as distinguishing between TB and other inflammatory diseases, such as Sarcoidosis. Sarcoidosis typically involves the formation of lumps of white blood cells called granulomas. When sarcoidosis presents in the lungs, it can create similar symptoms to TB, such as coughing and weight loss.

While Sarcoidosis and TB can present very similarly, their causes and required treatments differ significantly. Therefore, developing new diagnostic tools that can rapidly and accurately distinguish between active TB, latent TB and Sarcoidosis would be very valuable in enabling clinicians to prescribe the most appropriate course of treatment as soon as possible.

Both Sarcoidosis and TB involve significant inflammation, and there is evidence for the role of the immune system in both diseases. Moreover, identifying proteins that are characteristically present in each disease state could be useful in diagnosing them. One way to do this is to identify antibodies in patient blood samples that will bind to these proteins.

Antibodies are typically Y-shaped protein structures that are created and released into the blood by cells of the immune system. They can bind to other proteins, such as those present on bacterial pathogens, with a high degree of specificity. Therefore, they can be very useful tools for researchers measuring specific proteins in the body or for doctors who wish to identify a protein that is associated with a specific disease. Despite the promise of antibody-based diagnostic assays, those created for TB diagnosis have lacked accuracy.

Professor Lobelia Samavati and her colleagues at the Wanye State University School of Medicine in Michigan are working to change this. Their work in this area began to emerge in 2015, when they published a paper in the journal EBioMedicine. In this paper, they describe a technique to identify the relationships between proteins and antibodies in Sarcoidosis that could pave the way for antibody-based diagnostic tools.

This involved isolating DNA from white blood cells and airway cells obtained from Sarcoidosis patients. The researchers then inserted this isolated DNA into a phage display. Phages are tiny viruses that infect bacteria, but they will dutifully display the proteins encoded by the inserted DNA on their surfaces – creating a so-called ‘peptide array’.

Next, Professor Samavati and her team exposed the peptide array to serum samples from Sarcoidosis patients and healthy controls. Human serum contains huge numbers of antibodies, and some of these bound strongly to specific peptides on the array.

By analyzing the binding pattern, the researchers identified a set of antibody-bound peptides that were hallmarks of Sarcoidosis. This allowed them to discriminate between the serum of healthy controls and that of Sarcoidosis patients. Interestingly, when the researchers exposed the array to serum from TB patients, it also revealed characteristic binding that allowed them to discriminate between serum samples from TB, Sarcoidosis and healthy controls.  

In a follow-on study in the journal Microbiology Spectrum published in 2023, Professor Samavati’s team performed a similar task. This time, however, they focused on one of the most promising diagnostic targets discovered during their previous study. This is the protein Transketolase, which is essential for the growth of the bacteria that cause TB.

The researchers created peptides that represented slightly different parts of the Transketolase protein, and then incorporated them into a rapid assay that may be suited for diagnostic purposes, known as an ELISA.

Using their new assay, the team tested serum samples from patients with TB, latent TB, Sarcoidosis and from healthy controls. They found that the approach could sensitively and specifically discriminate between TB, latent TB, Sarcoidosis and healthy samples. Interestingly, the technology may also be amenable to incorporation into a lateral flow test, such as the ubiquitous COVID-19 tests or common pregnancy tests, which could make it well suited for point-of-care use. Other applications may include using the Transketolase peptides as components in a TB vaccine.  

Professor Samavati hopes that her team’s findings will pave the way for easy-to-use, rapid diagnostic tests that can be deployed by community healthcare workers or in local clinics in the fight against TB and Sarcoidosis. Administering the correct treatment as soon as possible is crucial in achieving optimal treatment outcomes. Such diagnostic breakthroughs may help to make this possible in the case of TB and Sarcoidosis.