Exploring chronic disease
11 Jun 2009
Two weeks ago, I boarded a 747 to travel to Beijing, China in order to speak at the 2009 International Congress of Antibodies. Within minutes of hitting the runway, we were greeted by a crew of officials wearing surgical masks and wielding thermometers. The fever analysis was performed as part of an effort on behalf of the Chinese government to ensure that neither I nor my fellow travelers had the swine flu. Luckily I was cleared and proceeded to my hotel which was also the site of the Conference. Before checking into my room, I had to get my temperature checked yet a second time by the hotel staff. I wasn’t opposed to the routine screenings since, at the time, if anyone on my hotel floor had the swine flu the entire floor would be quarantined.
The door of our hotel was guarded by two cement lions and delicate Chinese flowers in a vase were built into the hotel revolving door. The first night, I was exhausted and fell into a deep sleep due to the jet lag. I woke up to greet my colleague, Dr. Trevor Marshall, whose flight had arrived during the night. He was surprisingly chipper and we set off to explore our surroundings. The hotel was located close to the stadium from the 2008 Summer Olympics, also known as the “Bird’s Nest.” Dr. Marshall was lucky enough to have a view of the stadium from his hotel room window. I had to settle for a view of the boring side of the street. Down the street we discovered a Chinese cafeteria that served the locals and had better food than the hotel, at least in my opinion. It was the first of my many trips there to get a stir-fry or other delicious dishes. We also cheated by discovering a supermarket with American food products that we stocked up on for snacks. Then we went to a fourteen-story building occupying a whole city block. It was full of innumerable electronic devices for sale at low prices. Given his earlier work as a microchip designer, surely this was Dr. Marshall’s mothership.
The first thing I’ll say about the Conference is that its name – International Congress of Antibodies – is something of a misnomer. The reality is that the Conference was not for antibodies but people.
Conference registration was the next day. Finding the registration took some time. It was in a completely different part of the hotel and most of the hotel staff didn’t speak any English at all. In fact, it was the first time in my life where I truly felt “lost in translation.” Even my elaborate hand gestures often couldn’t help the hotel staff understand what I needed, particularly when it came to setting up my Internet connection, trying to use their business center, or communicating with the housekeeping staff about when I would and would not be in my room.
It quickly became apparent that essentially all guests that stay at the Beijing International Continental Hotel are Chinese and that few tourists stay at the hotel. This meant it was easy to pick out other researchers arriving for the Conference. It was as simple as noting that someone spoke a foreign language, had european or hispanic features, or was gesticulating at the front desk.
The Conference officially began on Thursday morning. The opening talks consisted largely of the Conference sponsors touting their products or companies. Eventually I became even more accustomed to such talks since at least half of the researchers presenting were also associated with biotech companies or other businesses that not only conduct research but also sell tools for antibody detection and creation. Their talks were generally of less interest to me than those that discussed purely scientific work.
The researchers hailed from around the world, several from Europe and the USA, even some from Latin America. Unfortunately, most of the researchers from Japan were not able to attend the Conference because of an increasing number of swine flu cases in their country that had made the Chinese authorities nervous. Perhaps this worked in my favor. Originally I had been scheduled to speak at a session on Saturday afternoon about antibodies and diagnostic tools. However, there is actually very little about diagnostics in my speech. So I asked one of the Conference organizers if I could switch to speak in a session specifically about autoimmune disease the next morning, which had an empty slot because of a Japanese speaker’s absence. She said yes.
Before Sunday rolled around I perused the halls, introducing myself and getting to know my fellow conference attendees. Most people were very open and eager to talk about their work or China in general. Every lunch and dinner we would all walk in a pack back to the main hotel where a buffet-style meal was served. The food was Chinese and sometimes intriguing – intriguing as in I really didn’t know what I was eating! There was plenty of meat in sauce and green leafy vegetables, and of course, plenty and plenty of rice.
Lunch and dinner served as perfect times to make friends. I met a woman from the UK with a wonderful sense of sarcasm and humor. Two German men who managed biotech companies were also very outgoing and full of interesting stories about Germany and their other travels abroad. I really enjoyed the enthusiasm of a Chinese-born researcher who now works at the University of Toronto. His interest piqued when I told him about the MP. Later, after hearing my talk, he became even more enthusiastic and kindly told me that my speech had exceeded his expectations. In fact, I don’t think I’ve ever been at a Conference where Dr. Marshall’s work was so well-received. Nearly everyone wanted to learn about the Pathogenesis. Many weren’t even familiar with latest estimates released by the Human Microbiome Project which state that at least 90% of cells in the human body are bacterial in origin. Everyone seemed to agree that such a plethora of bacteria could very likely cause a wide variety of autoimmune and inflammatory diagnoses. By Sunday morning I had whetted the scientific appetities of as many people as I could so that they would come listen to my speech.
Every session at the Conference was monitored by two chairmen, and in my case, both were very open-minded and intelligent scientists. My speech was the last in the session, but finally I made my way to the podium. As I spoke, I could sense that the colorful backgrounds and strong images on my slides (designed by my colleague Paul Albert) were helping people to capture the important aspects of the speech. Several camera flashes illuminated the room when I put up a slide covered by a prolific number of names of different bacterial species recently determined to persist in saliva.
The main point of my speech was to re-examine the concept of the “autoantibody.” Currently, autoimmune disease is thought to result when the immune system attacks itself. In such a model, antibodies, which are molecules used by the immune system to neutralize foreign objects, are thought to be created in response to our own human DNA.
What I pointed out was that, since the human body is composed of more microbial than human cells, this is not necessarily the case. The antibodies detected in what is now considered to be “autoimmune” disease may actually be created in response to bacteria. Specifically, when the innate immune system is activated by continually trying to kill chronic bacteria it activates the adaptive immune system. The adaptive immune system, which is the branch of the immune system that creates antibodies, then likely proceeds to create such antibodies in response to fragments of bacterial DNA generated by the death of the infected cells.
At the conclusion of the speech, those members of the crowd that hadn’t left in disgust began to lob vegetables towards the stage. Fortunately, some of the produce was fresh, and I had enough for a salad….
The truth is more boring: the speech seemed to go over quite well. The audience applauded enthusiastically, and a number of hands shot up for questions. So many people had questions that a number of people missed lunch to listen to my follow-up remarks. One of the session’s chairmen, Dr. Audrey Tchorbanov of the Bulgarian Academy of Sciences, seemed impressed with the speech and we posed for photos together. A few other people did the same. A pediatrician from Denmark who had given a very interesting speech himself about sepsis in infants commented numerous times on the groundbreaking nature of Dr. Marshall’s work. I think, as has been the case with every conference I’ve spoken at so far, the audience was pleasantly surprised to hear a speech that discussed how scientific observations and more theoretical work can be applied to clinical care.
To celebrate a successful presentation, Dr. Marshall treated me to a meal that has been a favorite of Chinese emperors since the time of the early Ming dynasty. I forget the Mandarin term for it, but I believe in English it is calledgrilled cheese sandwich and french fries with ketchup.
Later that day, I returned to a few sessions and then retired to my room to decompress. The wry woman from the UK arranged for a group of us to go out that night in honor of the end of the Conference. There were about eight of us including the biotech guys from Germany and the pediatrician from Denmark. We were also joined by a scientist from Ireland whose thick brogue and lively banter kept us laughing all night. One of the members of our group, a Chinese woman, took us to a lake surrounded by rows of outside bars with comfy couches and chairs. The temperature was perfect – warm and breezy. We celebrated until four or five in the morning when we finally headed back to the hotel. It was encouraging to see that, like me, most of my fellow scientists are able to combine work with play.
If it were even possible to sum up China and her people in a single word, that word would be “ambitious.” You can see ambition in the medal counts from the 2008 Beijing Olympics and in the Beijing skyline, being built ever upwards at a furious pace. But I can also see the urge to succeed in Chinese researchers’ apparent receptiveness to the MP and the science which supports it.
I feel that China may eventually prove to be fertile ground for the MP to flourish. There is no vitamin D added to the food chain. Supplementation with D is not promoted or generally used as a therapy in chronic disease. Because pale white skin is considered beautiful in China, staying out of the sun is common practice for the Chinese. Chinese women in particular walk around with sun umbrellas and wear sunglasses and often long-sleeved shirts. Whereas American magazines advertise tanning salons and creams, Chinese magazines advertise hats and skin-whitening cream.
Perhaps I should not have been surprised then that the Chinese people seemed much healthier than the Americans I’m used to seeing. For one thing, almost no one in China is obese or even fat, and it’s not like these people don’t know how to eat! Also, I was impressed at the lack of acne in the Chinese population. It seemed that every Chinese woman – whether at the airport, the hotel, or at the Conference itself – had perfectly blemish-free skin.
All in all, it was a great trip. I certainly plan to keep in touch with some of the people I met, and I definitely hope to return.
Amy Proal graduated from Georgetown University in 2005 with a degree in biology. While at Georgetown, she wrote her senior thesis on Chronic Fatigue Syndrome and the Marshall Protocol.