In this insightful episode, Dr. Jill Carnahan sits down with Dr. Amy Proal as they delve into the emerging connections between Bartonella infections and Long Covid, revealing new research that may reshape our understanding of chronic illness. Discover how the MTOR pathway plays a pivotal role in pathogen survival and mitochondrial health, and how drugs like rapamycin could be game-changers in managing these infections. We also explore Mast Cell Activation Syndrome (MCAS) and its links to unresolved infections, offering hope for treatment beyond medication.

🌍 https://polybio.org/

Key Topics You'll Discover

① Bartonella and Long Covid:
👉 The episode highlights the connection between Bartonella infections and Long Covid. It is noted that individuals diagnosed with Long Covid often test positive for Bartonella, suggesting a potential link that is being actively researched.

② MTOR Pathway and Pathogens:
👉The MTOR pathway is discussed as a critical component in mitochondrial metabolism and its role in pathogen survival. Pathogens often hijack this pathway to sustain themselves, and inhibiting MTOR with drugs like rapamycin could stabilize mitochondria and impede pathogen replication.

③ Mast Cell Activation Syndrome (MCAS):
👉The conversation explores how mast cell activation can be linked to unresolved infections, suggesting that addressing these infections might reduce mast cell activity without relying heavily on medication.

④ Long Covid Research Consortium:
👉The formation of a consortium dedicated to Long Covid research is discussed. This group aims to share data and samples across sites to enhance understanding and accelerate research efforts.

⑤ Therapeutic Trials and Interventions:
👉Trials involving low-dose rapamycin and metformin are mentioned as promising approaches to manage infection-associated chronic issues. These drugs may help prevent the progression of acute infections to chronic conditions.

⑥ Environmental Factors and Health:
👉The importance of clean air and the impact of environmental factors like mold on health are discussed. The episode suggests practical solutions such as using HEPA filters and UVC lights to improve indoor air quality.

What You’ll Take Away

📌 Interconnected Systems: The human body's systems are highly interconnected, and understanding these connections is crucial for addressing chronic diseases.
📌 Research and Collaboration: Collaborative research efforts are vital for advancing our understanding of complex conditions like Long Covid.
📌 Innovative Treatments: Exploring new uses for existing medications, such as rapamycin and metformin, could offer new avenues for treatment.
📌 Environmental Awareness: Addressing environmental factors can play a significant role in managing health and preventing disease progression.

This episode provides valuable insights into the ongoing research and potential treatments for chronic diseases associated with infections, emphasizing the need for a holistic and collaborative approach.

Amy Proal, PhD

Amy Proal, PhD, is a microbiologist and chronic disease researcher with expertise in systems biology, the human microbiome, and the role of persistent infections in complex chronic conditions. She is the President of the Polybio Research Foundation, where she leads collaborative research projects focused on the molecular mechanisms driving conditions such as Long COVID, ME/CFS, and post-treatment Lyme disease. Dr. Proal earned her PhD in microbiology from Murdoch University and has published extensively on the intersection of infection, immunity, and neuroinflammation. Her work emphasizes the importance of precision medicine and open-science collaboration in tackling poorly understood diseases.

🌍 https://polybio.org/

Dr. Jill Carnahan, MD

Dr. Jill Carnahan is Your Functional Medicine Expert® dually board certified in Family Medicine for ten years and in Integrative Holistic Medicine since 2015. She is the Medical Director of Flatiron Functional Medicine, a widely sought-after practice with a broad range of clinical services including functional medical protocols, nutritional consultations, chiropractic therapy, naturopathic medicine, acupuncture, and massage therapy.

As a survivor of breast cancer, Crohn’s disease, and toxic mold illness she brings a unique perspective to treating patients in the midst of complex and chronic illness. Her clinic specializes in searching for the underlying triggers that contribute to illness through cutting-edge lab testing and tailoring the intervention to specific needs. 

A popular inspirational speaker and prolific writer, she shares her knowledge of hope, health, and healing live on stage and through newsletters, articles, books, and social media posts! People relate to Dr. Jill’s science-backed opinions delivered with authenticity, love and humor. She is known for inspiring her audience to thrive even in the midst of difficulties.

Featured in Shape Magazine, Parade, Forbes, MindBodyGreen, First for Women, Townsend Newsletter, and The Huffington Post as well as seen on NBC News and Health segments with Joan Lunden, Dr. Jill is a media must-have. Her YouTube channel and podcast features live interviews with the healthcare world’s most respected names. 

The Podcast

The Video

The Transcript – Overview

Overview

• Dr. Amy Proal's journey with chronic infections highlights a personal connection to her research, stemming from childhood illnesses that went undiagnosed despite severe symptoms.
• The PolyBio Research Foundation emphasizes persistent infections in complex chronic conditions like long COVID and ME/CFS, advocating for a systems biology approach in research.
• A CDC statistic reveals that 11% of Americans carry the latent Toxoplasma gondii parasite, which may influence neuropsychiatric symptoms.
• Chronic exposure to environmental factors like microplastics and mold contributes to immune dysfunction and worsens responses to
• infections.
• Traditional blood tests are inadequate for detecting pathogens that reside in tissues, necessitating alternative methods like tissue sampling for accurate diagnosis.
• Mast cell activation often signals underlying infections rather than isolated conditions, suggesting treatment should focus on root causes.
• Co-infections, such as Bartonella and Babesia, frequently complicate long COVID cases, and these pathogens can reactivate due to existing vascular infections.
• The microbiome's health is critical; disruptions can lead to conditions like leaky gut, causing microbial translocation and inflammatory responses.
• Air quality significantly impacts health; 80% of toxic load originates from breathable air, with HEPA filters proving effective against airborne pathogens.
• Collaborative research efforts, like the Long COVID Research Consortium, are essential in overcoming scientific silos and advancing understanding of pathogen persistence.

Notes

🎙️ Introduction and Background (01:22 – 05:12)
Dr. Jill hosts Resiliency Radio podcast focusing on integrative and functional medicine, with over 570,000 YouTube subscribers.
Dr. Amy Proal introduced as microbiologist and chronic disease researcher with PhD from Murdoch University, currently President of PolyBio Research Foundation.
Dr. Amy's personal illness journey began in childhood with multiple infections (pneumonia, scarlet fever, meningitis) between ages 3-5 in Mexico City, while twin sister remained healthy.
College symptoms included headaches, sleep trouble, light/sound sensitivity that worsened after senior year infection, leading to bedridden state.
Medical consultations consistently showed normal blood work despite severe symptoms, prompting self-research into chronic infections.

🔬 Research Foundation and Approach (02:33 – 28:03)
PolyBio Research Foundation studies role of persistent infections in complex chronic conditions including long COVID, ME/CFS, and post-treatment Lyme disease.
Foundation emphasizes systems biology approach and open science collaboration to tackle poorly understood diseases.
Research focuses on precision medicine approaches rather than one-size-fits-all treatments.
Foundation's unofficial slogan: ‘The issue is in tissue' – emphasizing need for tissue-based diagnostics over blood tests.

🦠 Pathogen Persistence and Transmission (09:57 – 20:21)
11% of Americans harbor latent Toxoplasma gondii parasite in their brains according to CDC, potentially affecting neuropsychiatric symptoms.
Pathogens can be inherited from mother to child in utero, including herpes viruses and bacterial organisms.
Multiple infection sources identified: respiratory (RSV, enteroviruses, influenza, coronaviruses), vector-borne (Lyme, Bartonella, Babesia), mosquito-borne (West Nile), and parasites.
SARS-CoV-2 double-stranded RNA found in gut tissue over 2 years post-COVID infection, indicating viral persistence and replication.

🌍 Environmental Factors and Immune Dysfunction (17:30 – 20:21)
Microplastics now commonly found in human brains, representing new toxic burden.
Mold exposure creates immunosuppression through compounds like mycophenolic acid (used in organ transplant medications).
EMF structures can signal mold to produce more mycotoxins as defense mechanism.
Successive infections create downward spiral where each infection compromises immune response to subsequent pathogens.

🧪 Diagnostic Challenges and Solutions (26:33 – 28:03)
Traditional blood tests inadequate because pathogens hide in tissues, nerves, and organs to avoid immune detection.
Antibody testing problematic as compromised immune systems don't produce robust antibodies – those most severely infected often test negative.
Tissue sampling required through procedures like endoscopy, lymph node biopsy, bronchoscopy, and skin biopsy to detect persistent infections.
Foundation collecting tissue samples from multiple institutions to study pathogen persistence in long COVID and related conditions.

🛡️ Mast Cell Activation and Immune Response (29:30 – 36:27)
Mast cells are primary tissue responders to environmental factors and uncleared infections.
Persistent infections cause mast cell priming, leading to hyperactive responses to subsequent triggers.
Mast cell activation often indicates underlying infection rather than standalone condition – addressing root cause may reduce need for ongoing mast cell medications.
Connection between Pathogen-Induced Loss of Tolerance (PILT) and traditional Toxicant-Induced Loss of Tolerance (TILT) concepts.

🦠 Co-infections and COVID-19 (32:28 – 35:17)
SARS-CoV-2 primarily targets blood vessel endothelium, making those with existing vascular infections more vulnerable.
Bartonella commonly reactivated post-COVID due to shared vascular targeting – can be transmitted by ticks, spiders, cats, bees, and bedbugs.
Babesia (red blood cell parasite) also frequently found in long COVID patients alongside Bartonella.
High prevalence of tick-borne infections in non-endemic areas like Colorado, with vector diversity beyond traditional tick transmission.

🌱 Microbiome and Barrier Function (37:52 – 39:18)
Infections and toxins disrupt microbiome ecosystems similar to environmental destruction of rainforests.
Barrier breakdown (leaky gut, oral barriers) allows microbiome organisms to spill into circulation and reach tissues.
Microbiome restoration important component of mast cell stabilization and overall immune balance.

💨 Air Quality and Prevention (23:02 – 23:02)
80% of toxic load comes through air we breathe – clean air identified as lowest hanging fruit for prevention.
HEPA filters and UVC lights can effectively remove viral particles and other airborne pathogens from indoor spaces.
Air purification compared to water purification – should be standard practice in buildings and homes.

🤝 Research Collaboration and Integration (41:45 – 44:23)
Scientific specialization creates silos – labs working on complementary research often unaware of each other's work.
PolyBio creates Long COVID Research Consortium facilitating collaboration, data sharing, and sample sharing across institutions.
HIV research teams recruited to apply tissue viral detection methods to SARS-CoV-2 persistence studies.
Cross-site sample sharing maximizes research efficiency and accelerates discovery.

🧬 Mitochondrial Targeting Therapies (46:58 – 49:57)
All pathogens hijack mitochondria as obligate requirement for replication and survival.
mTOR pathway dysregulation common mechanism across pathogen infections.
Low-dose rapamycin (once weekly) shows promise for immune support versus high-dose immunosuppression.
Rapamycin trials in healthy older adults showed stronger vaccine responses, reduced T-cell exhaustion, and enhanced interferon production.
Metformin trial in acute COVID showed strongest signal for preventing long COVID development.

🔮 Treatment Philosophy and Future Directions (51:11 – 52:25)
Immune system typically acts correctly – activation indicates unaddressed factors rather than autoimmune malfunction.
Longevity medications (rapamycin, metformin) may have therapeutic applications in infection-associated chronic diseases.
Need for accessible diagnostic improvements to better identify persistent infections.
Foundation developing projects for enhanced pathogen diagnostics.

Transcript

00:01
Dr. Jill Carnahan
Hey everybody, thanks again for joining me for another episode of Resiliency Radio, your go to podcast for the most cutting edge insights integrative and functional medicine. I'm your host Dr. Jill and with each episode we dive into the heart of healing, personal transformation and really all things to do with optimal performance, longevity and things to make your life and your health better and improved. Today I am super excited to introduce a new researcher that I met through a conference recently talking about the microbiome and microbial insults to our system and actually doing the research out in the field to really give us as clinicians and you as a patient more information on how to combat chronic, long Covid or complex chronic illnesses. You are going to love the show. Stay tuned. I promise you're in for a treat with Dr. Amy. 

00:50
Dr. Jill Carnahan
Before we do, I just want to remind you hear me every week talk about drjillhealth.com where we have curated incredible products for you for things like your vascular mast cell activation, chronic complex infections, allergies, gut health. You can find them all at Dr. Jill Health and of course Dr. Jill Beauty. Some of my favorite products are there and you can peruse. My favorites is a really big seller with the Collagen Ha Collagen cream, the Biopeptide and the Vita CE Serum. But today I just want to remind you, one of our very best sellers that's back in stock is this Needle Free Serum. Yes, this, if you're not into Botox, is amazing for these little fine lines you can see I'm doing pretty well there around your face. This Needle Free Serum works amazing. 

01:38
Dr. Jill Carnahan
You only need a couple drops so the bottle lasts for quite a while and you can find that@doctor Jill health.com. Just check it out. Leave me some comments below and as you know, if you have not yet subscribed, you can hit subscribe. Many of you listen and don't subscribe and that is quite all right. This content is all for free, but you help me out. Help me to get great guests and to reach more people. If you are on YouTube, hit the subscrib and join the over 570,000 subscribers that we currently have and probably at the time of this posting, even more. Okay, without further ado, I want to introduce Dr. Amy Prowell, PhD. She's a microbiologist and chronic disease researcher with expertise in systems biology, the human microbiome and the role of persistent infections and complex chronic conditions. 

02:20
Dr. Jill Carnahan
She is the President of Poly Bio Research foundation where she leads collaborative research projects focused on the molecular mechanisms driving conditions such as long Covid ME, CFM best and post treatment Lyme disease. She earned her PhD in microbiology from Murdoch University and is published extensively on the intersection of infection, immunity and neuroinflammation. Her work emphasizes the importance of precision medicine and open science collaboration in tackling poorly understood disease. You are going to love this show. Welcome Dr. Amy. Dr. Amy, I am so excited to have you on Resiliency Radio. We have a lot in common, even though we've never officially met and I'm so excited to dive deep today. I always like to start I heard some of your personal story from some of the interviews you've done before and I think that's so relevant because it kind of drove. 

03:10
Dr. Jill Carnahan
So I don't know if you want to start there, but I would love to hear how did this adventure begin for you with complex chronic diseases and really bringing the research to the forefront? 

03:20
Amy Proal
Yes. No, I mean, and I don't tell my personal story as often these days, but I like to here and there. So yeah, I mean it's pretty straightforward and I think that this experience has actually happened to a good number of people. But first of all, I'm a fraternal twin. And when I was a child, I grew up outside the country. So I grew up in Mexico City, Mexico. And I don't know if this had to do with it or not, but I got a lot of infections between the ages of three and five, I got a crazy case of pneumonia, I got a terrible case of scarlet fever. I was hospitalized for a terrible case of meningitis. And my twin sister got none of these infections. Right. Then after that, after the age of five and through high school, I felt largely fine. 

04:03
Amy Proal
And I went on. I was, you know, I played sports, I was the captain of my tennis team. And then when I got to college, when I was in dc, I started to feel a little weird. I started to feel, I don't know, like I had more headaches, I had trouble sleeping. And of course, I mean, I think by sophomore year of college I would go to the student health center and be like, hey, I don't feel great. And they would of course say, you know, they'd run. I don't know, two things of my blood work fine. Yes, you're fine. You know, are you eating well? You know, are you exercising enough? That's the only thing that could be an issue here, right? And so, and I just leave. Right? 

04:44
Amy Proal
And so this went on for long enough and then at the end of senior year, I got Some infection, which I still don't know what it was, and got much worse and got very sick. So I was just really bad. I was pretty much bedridden. So I was there, couldn't tolerate light, couldn't even tolerate sound. Just very sick. So laying there in my bed, I thought, what can be wrong with me? I mean, first of all, I got much sicker after an infection. Also, when I was a child, I had all those infections. I mean, is there a chance that any of these infections, first of all, could just still be in my body? Even the ones that I had as a child? I mean, could that be. Because part of the symptoms I had was actually profound flu like symptoms. 

05:29
Amy Proal
So I had like a sore throat that would surge and the feeling of flu that would come and go. So it honestly felt a lot like I could still have some kind of ongoing infection. And of course, I brought this up to a good number of doctors and they were like, no, you don't. But then I began to be like, well, how do you know that? I mean, you can't. You're not testing me for any of these infections. Surely the infections could be, you know, in my brain or in my nerves or in parts of my body that you can't identify on your simple blood test. So, you know, I don't know how you're coming to that conclusion. 

06:02
Amy Proal
And so then finally I started to become really interested in all this literature on chronic infection is a driver of chronic disease, which basically took me back to even looking at textbooks written in the 1960s or in the 70s, when, honestly, there was a lot of energy on how different bacterial or viral or fungal or parasite organisms could drive a wide range of chronic diseases by persisting in a huge different number of human tissues. All of which really kind of came to some of a stop when theory of autoimmunity, which basically assumes the body is just sterile, kind of took hold and knocked that research down. But I became interested in this other work. 

06:44
Amy Proal
And so as I did that, I started a basic treatment that people were doing, which involved using low doses of pulsed antibiotics and a drug that basically, via some modeling, might support the immune system, which made sense to me. And over time, I sort of improved on this protocol and a number of other sort of antiviral and antimicrobial approaches that I was able to use to improve my health a lot. And once that happened, I thought, well, look, I want to study this more. Originally, I'd wanted to become a doctor. And I was like, I don't really want to be a doctor. I don't know that doctors right now have that many tools at their disposal to understand what's going on. I want to study these infections, and I want to understand what they do. 

07:23
Amy Proal
And that set me off to get a PhD in microbiology and then eventually to found PolyBio, the research nonprofit I lead that studies the role of infection and chronic disease and basically take me on that route. 

07:33
Dr. Jill Carnahan
I love it so much, Dr. Amy. Because here I am in functional medicine. I'm always saying it's toxic load plus infectious burden, creating inflammation, immune dysfunction. Right? And I'm in the clinic, I'm seeing the patterns, and I'm like. I'm like, seeing patients like you come in and say, my doc told me I'm fine. I've been to Stanford, I've been to ucla. I've been to all these major medical centers. They don't know what's wrong with me. And I'm like, well, we can dig deeper and find out. And what we find is. And I want to talk to you about this, but I want to frame it, because here I'm in the clinic, I'm not the researcher. And when I saw your research and I've dove into your website and then heard you speak on ici, it was such a profound, like, thank you. 

08:08
Dr. Jill Carnahan
Like, literally, I. You can see I'm glowing here because I'm so excited about the work that you guys are doing, because what you do is you bring legitimacy to what we're seeing in clinical practice, and then we're down in the roots trying to find those root causes and find the meds and the herbs and the things that actually change the terrain. So how did this groundbreaking. I mean, obviously this. Your. Your initial experience with being told there's nothing wrong and then realizing, oh, wait, there is something going on, there's so much to talk about. But let's just frame, like, well, how did you begin into this research and how did you really start to find? Because I saw your work on the tissues and how you know, check levels of different things. 

08:42
Dr. Jill Carnahan
Because I really believe in functional, integrative, root cause medicine, personalized, a precision, whatever you want to call it. These microbial infections and microbial effects on the tissues, in conjunction with our toxic load, are the root cause of most of our complex chronic conditions. 

08:58
Amy Proal
Right, I agree. And that is also what I've come to think is at least the leading hypothesis that we are looking at, which is exactly that, starting in the womb, really, where you can inherit from your mom, let's say, As a mother harbors a herpes virus or a different pathogen or bacterial organisms, many of those can actually be passed from mother to child in the womb. So you can inherit pathogens, even that set you up with that infection starting early in life. And then from that point on you're exposed to all kinds of different infections. I mean, there are first of all just a huge number of respiratory infections in and of themselves. Right. 

09:40
Amy Proal
So we have, you know, from RSV to the enteroviruses, which drive, let's say hand, foot and mouth disease, to all kinds of the different influenza strains to you now, the coronaviruses, there's a lot of those pathogens that we know we are getting on a regular basis. Then there's all kinds of other infections that we carry by ticks, let's say, or vector borne organisms. So that's your Borrelia, the Lyme pathogen. There's Bardinella, Babesia, Rickettsia, anaplasma. Then for example, there are the mosquito borne viruses. There are West Nile, there are all these other pathogens carried by mosquitoes. Then there are parasites. There's for example, just Toxoplasma gondii is a parasite. And this, you know, just always blows my mind. Approximately. 

10:29
Amy Proal
And this is the CDC, okay, approximately 11% or more of Americans are understood to harbor this latent plasma parasite in their brains in a apparently latent dormant state. Yeah, but I mean, come on, is it latent, Is it dormant? That's an assumption easily. This parasite in people's brains could be doing something. And in fact it is tied to be able to drive neuropsychiatric symptoms that can even change people's cognition, that can change the way that they function mentally. And when we look at all these conditions of apparent unknown cause, neuropsychiatric diseases, neurocognitive symptoms, obviously these parasites or bacteria, other pathogens that can literally modulate and drive neuroinflammatory symptoms have to be factored into the mix of factors that can be contributed in them. 

11:24
Amy Proal
With all of these infections that we can sustain and many of which we don't fully clear, and I think this is the biggest part of what we study is there's a huge assumption that when people get an infection, it just clears after their symptoms go away. Which, you know, if you're a pathogen, isn't really what you want to do. Honestly, once you've found a host, you kind of want to stick around. I mean, why not keep persisting in this person, at least in a low level Right. 

11:51
Amy Proal
In a level, in what we call often now a reservoir, where, yeah, you don't have the pathogen maybe through every single cell and tissue of your body, but little amounts of the pathogen are persisting in parts of your tissue, in parts of your nerves where they can still drive inflammation, where they can directly hijack the functioning of your mitochondria, which is a huge thing that almost all pathogens do, where they can drive all kinds of changes, even to the way our human genes end up signaling. They can change the way that our cells control our signaling pathways by creating proteins or metabolites that distort those pathways. 

12:29
Amy Proal
So there are so many pathogens, there are so many mechanisms by which they can drive chronic symptoms, that once you start to realize that, yes, it really isn't even implausible that they can be contributing to a wide range of chronic diseases. And then, like you said, mixed in the other environmental factors. Right? Yeah. All the other parts of the exposome and the mold exposures, the chemicals, the other factors that either hold down the immune system or, you know, drive their own dysregulation, they mix and match in with the infections. Right. Where one of, as you would know, the most common presentations of chronic disease is someone who's been or being exposed to mold, for example, which is holding down the immune system and dysregulating the body's ability to detoxify correctly. 

13:13
Amy Proal
And an infection that now they have more trouble clearing, that can now probably persist better in their system. Right. So all of these things are feeding into each other to be able to drive symptoms. And I do think that if we're able to understand that, diagnose them better, address them better, we stand to really reverse the epidemic of chronic disease that we're finally these days able to talk about more openly. 

13:35
Dr. Jill Carnahan
I could not agree more. And that's why, like, I love the legitimacy of the polybio, the foundation that you've created and the work that you're doing that brings to what we. Like I said, because I'm just in the clinical practice, I'm not doing master research. I just see these patterns. Right. And then I hear someone like you talking and sharing your research. I'm like, yes, it's so helpful. And if anyone, you know, is finding this hard to believe, just think about chickenpox. You get it when you're five or not nowadays you get vaccine vaccinated, but years ago, when I was at age, I got chickenpox. And then, you know, you're 70, you have a surgical for your hip, and you get reactivation as shingles, like duh. In medical, even in medical training, we know these old viruses from literally decades can reactivate. 

14:14
Dr. Jill Carnahan
That's not a question. And so I don't know why it's so hard to think about cmb, Epstein Barr, any herpetic virus families, or these tick borne infections. What do you make of. In my perspective, I think that compared to say 50 years ago, where there was maybe a little bit more nutrient dense soil and less air quality issues and less mold and all this, were better able to dampen down, like have our immune system actually keep these things in check because it's not that we, that they're always active. Right. What would you talk about as far as the interplay between the strength of our immune system, the increasing toxicity of our environment and why, like we're seeing more of these reactivations and things popping up now than say several decades ago? 

14:54
Amy Proal
Yeah, no, you're right. Because that is one of the things that somewhat stymied the field of tying chronic infection to chronic disease is that people, a lot of people, for example, harbor Epstein Barr virus, right. It's one of these main herpes viruses. You can get it, you know, you get it from mono, you know, the kissing disease. Right. Which you know, to me is interesting. Like people will get mono and they're like, you know, and it's like, oh man, you know, look, Epstein Barr virus is no joke. 

15:22
Dr. Jill Carnahan
It's no joke. And the autoimmune connection, right? I mean, there's lots of literature connecting it to Ms. And to neurodevelopmental diseases, mechanistically to Ms. 

15:32
Amy Proal
I mean, where this team at Stanford did a really good study which shows that this protein created by the Epstein Barr virus is really similar in size and shape to a human neuron protein in the brain that the immune system attacks in Ms. But what really happens is that the immune system in the brain attacks the viral protein to try to target the virus. And then it cross reacts with that neuron protein because it's so similar in size and shape. It's kind of like if you wear an army and you're firing on your enemy and they're wearing red, right? And then there's like civilians wearing red. It's like that's what's happening. The immune system's trying to get the virus protein and it hits the human neurons, but it's really actually going after the virus first and foremost. 

16:13
Amy Proal
What's on going places that infection kind of. Yes, at the heart of multiple sclerosis, right? So, okay, so these, you know, overall, those viruses, you know, a part of about 90% of people maybe, or even more have Epstein Barr virus. So. And not everyone's getting ms, so obviously exactly. A lot comes down to how well your immune system can control that virus and say, like, no, no, no. Like, you stay down, right? You're going to try to come up, be more active, create more of those proteins, but we're not going to let you. We're going to keep you in check. Right? And that's where, if the immune system is in bad shape, you have more and more of an ability for the pathogens to activate and become more problematic and so to speak to those factors. 

16:59
Amy Proal
I mean, I definitely think that toxic burden, it seems like it, look, it seems like it would have increased. For example, microplastics alone sort of blow my mind. I don't know. There are factors where we've so artificially added to what people are being exposed to on a regular basis where, you know, just straight up science papers suggest at this point that people harbor a good amount of microplastics, often in the brain. I mean, that just cannot be good. So I think, like, factors like that, where people are obviously exposed to vastly more plastics, to vastly more artificial materials, are probably not helping out at all. I also do think that mold is so overlooked that it's almost painful. I mean, at this point, I don't really know, I'm not an expert on mold to know enough of which buildings had mold before versus now. 

17:56
Amy Proal
But what I know is that there are enough buildings, people, when you start to actually test rooms for mold, where it's so common and it's so ignored by the vast majority of people, that the number of people that are just living in older housing now, there's a lot of water, there's a lot of. I mean, there's a huge propensity for there to be mold and other factors that are simply unaddressed. Right? So, I mean, those are just some of the factors, although, you know, I'm not sure. Like, the other thing too is that we really are, I think, seeing probably more repeated infections than we've ever seen in history. And that's where as much as the COVID pandemic, I understand why people are pretty over it and are tired of that was a pretty bungled pandemic. 

18:45
Amy Proal
But at the same time, the introduction of SARS COV2 into the population is not great. It's just those two things can be true at the same time, unfortunately. And we do study a lot of people with long Covid who get sicker after a COVID infection. And yes, some people do get sicker after the vaccine, but a lot of people really do get sick after infection with the virus too. Right. And so unfortunately we even found that in a lot of our studies where we're able to get tissue samples from patients with long Covid, that virus isn't even fully clearing from people's tissues. This is one of the bigger things in long Covid, for example, in the tissue of the gut, which actually has a lot of the ACE2 receptors that the SARS CoV2 virus uses for entry, we will get. 

19:32
Amy Proal
There's a couple teams that have gotten tissue from the gut via procedure from patients with long Covid and found double stranded rna, which is a type of the RNA the virus only produces when it's replicating. Wow. In that gut tissue over two years after the person had Covid. Right. So the SARS CoV2 virus is even capable of long term persistence. Right. So unfortunately we even added this new player into the mix of other infections that people are already getting. So the fact that people get Covid and then strep and then RSV and then influenza and then pick up some kind of vector borne infection and then have some other. I mean, every single friend I know who has kids tells me these days that there are rare periods when someone isn't sick. 

20:21
Amy Proal
I mean, it's like a constant thing to be like, okay, someone's sick this week, someone brought this back from school. Here's another thing. And that's not great because what happens is overall, when you're dealing with one infection, the immune system gets caught up with that. Right? Like whatever it is, your T cells start to form to try to address that infection. The infection. The pathogen is trying to down regulate the immune system so that it can better persist or stick around. All of that isn't great. You get the next infection, your system is less equipped to deal with that one. Now that one probably has a better likelihood of persisting and maybe not clearing. So you start to add into what sometimes I call successive infection, or each infection is starting to kind of compromise the immune system. 

21:06
Amy Proal
Compromise the system so that it makes it easier for the person to have a problem with the next infection, which then they can. And now of course, they're going to be even more susceptible to mold, to other factors, to all these other things because their system is going to have trouble dealing with those. And then you go down this kind of downward spiral. Right. So the Fact that we just added one more pathogen, SARS CoV2, into this regular mix. That doesn't help either. It doesn't. And one of the things there that I think we could do to address this. I'll just go ahead and pitch this now. Is to clean indoor air. I just. There is the lowest hanging fruit that I think a lot of people can get behind for even different reasons. Right. 

21:50
Dr. Jill Carnahan
Yeah. 

21:51
Amy Proal
We work with groups that can create, you know, excellent HEPA filters that truly filter a good number of virus viral particles out of the air. Or have germicidal UVC lights which actually use a UV light that's safe. I don't know. It seems to be in studies, at least in, like, a very crowded space. You know, you could put this UVC light in. It literally kills viruses in the air. So you can layer a room with HEPA filters with uvc, you can pretty much remove the viruses from the air and at the same time purify from mold better. Purify from all kinds, from wildfire, smoke from all kinds of other factors that are also in the air that we don't want. And I think that to a point, I don't understand why we're not doing that more. 

22:41
Amy Proal
Because, for example, if you look at water, right, we made this decision back not long ago to purify our water where we obviously have water purification tanks. Even the government's behind this. We clean our water, and then even when our water's supposedly pure and arrives at our faucet, we get an extra Brita, we get an extra system. We're filtering it. We should do that with our air. We should filter our air too. If we did that, I really think we would lower the number of infections people get. And it's at least a good start. So there's things like that I think are things that we could. 

23:17
Dr. Jill Carnahan
Hey, guys, just a quick pause to remind you. If you haven't yet subscribed, please click the subscribe button below. If you're on YouTube, hit the bell to be notified of future episodes. We know a ton of you listen and don't subscribe, and everything I produce here is free. So I'm just encouraging you to help us reach more people, attract amazing guests. You and hit that subscribe button and join those people who've already subscribed here. If you are on itunes or Spotify or any other platforms where you're listening to podcast, would you stop by and leave us a review that also helps us out? Okay, back to the show. Thanks so much. Low hanging Sort of brute. I love your. Again, you're speaking my language. I always say clean air, clean water, clean food and air. That's. 

23:59
Dr. Jill Carnahan
The statistics show 80% of the toxic load is through the air that we breathe. And this mold issue really is because of poorly constructed, fast, you know, constructed buildings because of all the hurricanes and floods and things. Because of. As weird as it sounds, mold is a living organism. And if it's in your walls or your house, you have massive EMF structures. That actual signal will signal the mold that there's a danger because it senses it like a living organism, and it will actually produce more mycotoxins. That's been proven. So there's all these weird things that sound crazy but actually have scientific validity behind them in the fact of why mold is becoming a bigger issue. And then, as you well know, some of the mycotoxins that mold produces, like mycophenolic acid, are like a known. 

24:39
Dr. Jill Carnahan
They use it for a drug for organ transplants. So it's like a known massive immunosuppressive. So I could not agree more. Interestingly, during the pandemic, we had like five filters in our office, the HEPA, but like you said, the VOC, which is like 2.5 microns and below, which can actually help filter the viruses. We didn't have the UV lights, but that would be a great step. I love just reinforcing that for people listening because it can be pretty simple to get a standalone filter, at least in your bedroom or a UV light in your furnace. And these things you can have installed. Now, I could not agree more. 

25:09
Dr. Jill Carnahan
Now, one thing I heard you talk about ici, that I thought was so fascinating and in my experience is so true clinically, again, is often after people would get Covid or multiple times, they would be very ill or have long Covid symptoms. And for me, it was differentiating. Is this like a mast cell issue where the immune is dysfunctional and creating histamine prostaglandins? Is it more of a reactivation of some other infection? And I'm going to the study you quoted about Bartonella being reactivated after and again. Or is it just a long Covid causing inflammation and the spike protein retained? Do you want to talk a little about what you've seen in the research? Because like I said, when I heard you talk, I was like, yes, yes. 

25:45
Dr. Jill Carnahan
Because it so validates what we see in clinical practice and also the conundrum of, as a clinician saying, is it reactivation of Epstein Barr? Is it reactivation of LYME or bartonella or is it just long Covid and inflammation from that? As a researcher, how do you view that kind of issue? 

26:01
Amy Proal
Yeah, those are all the questions we're trying to study. Exactly. So I think the hardest part when you're trying to understand if the person still has the infection is that you can often not do it via simple blood tests at all, or even a lot of blood tests, because the pathogen, and let's say it's SARS COV2, let's just say you don't even clear SARS COV2 it doesn't persist in the blood where it's going to get targeted. I mean, if you're any pathogen and you're just free floating around in the blood, the immune system will recognize you and kill you. So what all pathogens do is hide, especially over time, in tissue where they get into your tissue, they burrow deeper into your tissue, sometimes infect a nerve, which is great for them. 

26:44
Amy Proal
They can hang out in that nerve and then that's where they're at. And this is the problem is the person on their blood work and even via antibody testing that for pathogens can seem negative when the organism is in tissue with the antibody testing being problematic. Because when we said before, when I told you before, that the pathogens often knock down the immune system, what happens then is people who often have the most severe persistent infections have a compromised immune system and they don't form antibodies robustly which indicate the presence of the pathogen. In other words, the immune system has to be strong to form good antibodies. So ironically, the people who could have the infection most aren't doing that right. 

27:28
Amy Proal
So a huge amount of what we've done at Polybio when we're studying, let's say SARS cov2 persistence in long Covid is help research teams at different institutions collect tissue samples from people with long Covid or related chronic conditions tied to infection. So we actually have to go and do a lot more work to be able to get the permissions, let's say, for example, to do an endoscopy procedure where we're able to get the tissue from the gut of people with long Covid or a related condition, or to do a lymph node biopsy that gets a little piece of tissue from the lymph nodes where the pathogen would actually again be expected to be. Right. We even have some groups getting skin biopsy samples from people that have peripheral nerves in them or were able to look for infections there. 

28:12
Amy Proal
People getting through a bronchoscopy procedure Lung tissue from people with long Covid. So via those studies of tissue, we're able to actually show in honestly papers that get noticed that the pathogen is still there. And if no one did that work, it would simply be assumed that they were not there. Right. So the key part of our, one of the central parts of our polybio research program is this collection and study of tissue samples via procedures or even during surgery. Right. And to the point where, you know, our slogan, unofficial slogan is the issue is in tissue. 

28:49
Dr. Jill Carnahan
Oh, I love it. 

28:50
Amy Proal
We really do want to focus on that. Right. But the thing is that mast cells, which you mentioned before, which we know, right, There are patients with, whether it's long Covid or chronic Lyme disease or infection associated chronic disease, where we know at least that when they take medications that control mast cell activity so different antihistamines that their symptoms sometimes improve, which strongly suggests that mast cell activation is happening in them. But the thing to understand is that mast cells are the primary cell in tissue that's responding to any sort of environmental or unaddressed factors. So if the person hasn't cleared an infection and there is a little reservoir there, the first cell really that's going to come in and say, hold on, this infection is still here, is a mast cell. Right? 

29:41
Amy Proal
And what happens is if you don't clear the infection, the mast cell keeps basically saying, like, hey, it's here. And it becomes pretty primed, which can happen where now it takes on this sort of state where it's almost hyperactive. And the next thing that also the mast cell response to it responds in like a overactive way because it's already been primed by the first sort of unaddressed factor. And I think that's what happens in a lot of cases is that someone doesn't clear an infection or something, the mast cells become primed. Now when they eat something, when they're exposed to another factor or whatever, now the mast cells become activated and primed and open. And so you get this cascading activation of mast cells that could become a big problem. 

30:25
Amy Proal
But the key there is that the mast cell activation doesn't have to be separate from the infections. I think there's a lot of people who will say, oh, this person has MCAs, right? And they think of just the mast cells doing this in and of themselves, which I suppose is possible. But I think that key to think about is that an uncleared infection would be one of the most logical reasons to have mast cells that keep activating. And so I think that the mast cell field needs to keep thinking about that connection because very likely, if you address the infection or some of the other issues that are activating the mast cells, maybe you can then lower their activity without having to continually use the mast cell meds. Right. 

31:08
Amy Proal
So I think that intersection is important and I think that the other factors that we look at, for example, the co infections like Bartonella. Yes. So a key thing in long Covid cases is that you have people who get Covid and get sick. All of a sudden they have chronic symptoms. But if you think about what the SARS CoV2 virus does, one of the targets, especially of the spike protein, is that it has very detrimental impacts on the blood vessels. So SARS CoV2 is a blood vessel? 

31:45
Dr. Jill Carnahan
Yes, endothelial. It's an endothelial. 

31:48
Amy Proal
Endothelial targeting virus. I mean, it infects most tissue types, but it truly just inflames damages the blood vessels. So if you already have an underlying problem in your blood vessels, you're more likely probably to have a vascular like Bartonella. 

32:08
Dr. Jill Carnahan
Right? Yeah, exactly. 

32:09
Amy Proal
So if you think through the pathogens that infect the vasculature, one is Bartonella, which is a pretty underappreciated pathogen that, you know, this is one of the things with Bartonella is it's a tick borne pathogen, so it can be carried by ticks, so you can get a tick bite. And in addition to getting Lyme disease or other infections, you can get Bartonella. But most people don't realize that you don't have to get a tick bite to get Bartonella. It can be carried by spiders, cats. 

32:40
Dr. Jill Carnahan
And bees, and even bedbugs. 

32:42
Amy Proal
Right, exactly. Just so many other vectors that are very common. So I think many people, and this is even in the standard research community, are starting to agree that Bartonella is underappreciated as an organism that a good number of people pick up. Now, it does seem that some people can carry Bartonella and remain fairly asymptomatic. A little like Epstein Barr virus. You know, not everyone who has that has the severe disease. But if something again allows that Bartonella to activate and emerge more, especially in the blood vessels, you're probably going to deal with a lot more symptoms driven by Bartonella. And that confluence of SARS CoV2 and the spike protein, whether it's from the virus or maybe the vaccine, targeting the blood vessels. And having asymptomatic Bartonella infection in the blood vessels is a brutal combination. 

33:40
Amy Proal
So we see increasingly when we test people for Bartonella who have A long Covid diagnosis that they are positive. We're doing some work on that hopefully we'll even publish formally soon where we'll show that people who have a long Covid diagnosis have a high likelihood of having Bartonella. And not just Bartonella, actually, even Babesia, which is a parasite, another not very appreciated parasite which can also again which is primarily carried by ticks. Although these days I think we could probably study more vectors on all of these bacteria. And Babesia infects the red blood cells, so does Bartonella, but Babesia infects red blood cells directly. So really it's another pathogen that can become disrupted when you have another virus like SARS CoV2 that gets involved with blood vessel or blood cell function. 

34:39
Amy Proal
So Babesia is another one that I think we need to increasingly consider in cases where people are chronically ill. 

34:46
Dr. Jill Carnahan
I could again, I could not agree more because in clinical practice just Lyme alone, which is the classical Borrelia bergter fairy for those of you which is carried in the east coast and Wisconsin and California, there's so infections and even in my state of Colorado it's not considered Lyme endemic, but we have a lot of tick borne relapsing fevers, Babesias, Bartonellas and so that awareness round. In fact CBS did a little segment about two months ago and asked me to talk about because there's lots of ticks in our area at that time, like does Lyme exist in Colorado? And I kept saying it's about Lyme and the co infectious side. If we just talk about Lyme, yeah, it is more likely Connecticut, the classical Borrelia burgdorferi. But there's so many more tick borne of these vector borne infections that people are not thinking about. 

35:28
Dr. Jill Carnahan
And yes, we have them in Colorado and Wisconsin and Wyoming and Texas and places that aren't typically endemic. So I loved that you talked about the mast cells as these because I always say they're doing their job right, like they just got irritable. It's like poking a sleeping bear trying to protect us. And then it kind of goes awry because whatever the nidus that was there to trigger them is not, is still there in the tissues. And whether it's toxins or infections or both, there's a new couple of papers out about toxicant and loosening loss of tolerance T I L T and it's this new term for kind of the old multiple chemical sensitivity. And what it's saying is a lot of those things where people are super sensitive to chemicals and smells and everything in the world is really driven by mast cells. 

36:09
Dr. Jill Carnahan
Well, I could make a case for, and I'd love your opinion as a researcher, that not only toxicant induced, but pathogen induced loss of tolerance. Right, Same kind of thing. Do you want to talk a little bit about how those, you know, and how that mast cell and infection really play out and then become this perfect storm that's hard to stop? 

36:27
Amy Proal
Right, exactly. You know, I think that, Yes, I think whenever you see an activated immune cell, what I always do is say, why? Because their immune cells, our immune systems, are on our side usually. And I think this is one of the things that we need to start thinking about more. You know, autoimmunity. And theory of autoimmunity has led to a lot of thinking in the world of medicine that, I don't know, the immune system screws up or the immune system dismiss fires or something, which is increasingly less shown to be true. Whereas the immune system actually exactly has a lot of smart ways of coming in and protecting it. So if you see mast cell activation, there's probably some factor. It makes less sense to me that the mast cell just goes crazy and activates. 

37:14
Amy Proal
It makes a lot more sense that there is an unaddressed toxin and unaddressed infection that the mast cell is actually correctly coming in to recognize. It's just that if you don't get rid of the tox and you don't get rid of the infection, the mast cell doesn't know what to do after a while and gets overly activated. Right. So I think that is key to understanding the mast cell issues. I think though too, you know, one of the factors in terms of just organisms in the human body and mast cell activity is that in addition to the single infections we can get, like the herpes virus infections and the bartonella infections, we all have these huge ecosystems of organisms, the human microbiome. Right. We have trillions of interacting organisms in our gut. 

37:56
Amy Proal
But increasingly, these organisms are understood to persist in the nose, in the lungs, in other body sites. Right. Where we have these ecosystems of organisms. Again, under conditions of immune function, they're usually in a commensal or in a state where they're balanced. It's a little like a forest or something. Right. Or a rainforest. If all the animals, yeah, they're eating each other and there's all kinds of relationships, but if the ecosystem is imbalanced, there's, you know, all of these relationships are playing out normally. Whereas if some factor throws off the rainforest, now all of a sudden everything Gets skewed. That happens a lot where what can happen too is an infection, let's say even Covid again, or another tick borne infection. By dropping the immune function now, all these collective organisms in the human body can become imbalanced. 

38:47
Amy Proal
And when that happens, you have all these other organisms in the gut or other body sites that can themselves become problematic in the barriers of the gut. When people are talking about, for example, leaky gut or whatever. Yes, I mean, if the ecosystem in the gut starts to skew to become, in and of itself, like now, pro inflammatory or start to create metabolites that are actually not helpful for our human signaling, the inflammation from that can wear down the barrier of the gut or sometimes this can even happen in the mouth. And now those organisms can spill through those barriers into the blood where even they can get probably transferred into tissue. 

39:27
Amy Proal
So a lot of what can be happening too that activates mast cells is that microbiome ecosystems and the wear down of our barriers and the gut barrier, the oral barrier, allow organisms to leak into the circulation and increasingly even get into tissue in a collective sense. That might also be perpetuating mast cells more often in a way that can add to this picture of them being activated in ways that are. So in that sense, sometimes approaches that help restore gut microbiome health, I think can also be useful in cases where people have activated mast cells. Because it's one area where you can intervene somewhat to get that microbiome back in shape. And it's sort of like one factor you can stabilize as you sort of address the different hits, if you will, that can keep the mast cells perpetually active. 

40:15
Dr. Jill Carnahan
Well, I love that because I think with the muscles, just as you hit on, it's not just whack a mole and hitting down the muscles, because we use H1 blockers, H2 blockers, muscle stabilizers, all these things, and it works. And most people need multi layers. But if you don't ever address that thing that's triggering them, you're just going to be on, you know, seven meds for the rest of your life, which isn't really sustainable. I love that you brought in the microbiome. I was going to ask about that and I do think that's a great target. So I want to talk just a little about tissues because that's been your research. And so before we kind of wrap up, two things. 

40:44
Dr. Jill Carnahan
First of all, one thing that I noticed in researching your research was I really love that you have been able to find all these various people that are doing their own research and don't each other and kind of start to bring like you really have a great systems biology thinking that a lot of researchers don't. What's been the most surprising as far as finding out who else is out there doing some research and how have you kind of put it together with the Polybio Research Foundation? 

41:08
Amy Proal
Yeah, exactly. That's what I love to do, actually. It is my passion because science does lack big picture thinkers. I'll just say this because no one in science training is encouraged to do that. So what happens is if you go into training as a scientist, early on you're advised to specialize. So people will study, for example, like the characteristics of a single T cell and what it does, and they'll spend their careers understanding that one immune cell and all of the facets of what it can do. But maybe not the larger picture in which this T cell is doing things with other factors that are also happening in the human body. So what happened to me is that when I was doing my PhD in microbiology, I was still a little bit sick. I had some symptoms. 

41:55
Amy Proal
So I was allowed to do part of the PhD as a literature based PhD and also where it was the early days where were starting to use computers to identify organisms in the human body. And it was cool that I did part of this training at the J. Craig Banner Institute, which is a group that we still work with researchers there. And basically what you can do is you can get a sample from someone, you can pull the genetic material out of the sample, you put it into a computer and then you read the sequences. Like the computer maps them to the backbones of different pathogens. And this was starting to happen right when I was getting my PhD and I was like, that's cool. So I was able to do part of my PhD that way. 

42:41
Amy Proal
And as I was kind of integrating then into the PhD a couple different topics which I was allowed to do as part of this, I realized how labs that are even next to each other don't even know what the other lab is doing. Like there would be one lab working on a topic who didn't realize that the people next door had the machine or the samples that they needed to answer the rest of the question they were working on. There was just such segmentation between groups that it's maddening. So what I did decide to do was by creating Polybao as a foundation to stay in a big picture role and to basically be the person that, along with some of our core team, looks at the whole space and Figures out who's doing. 

43:30
Amy Proal
Doing cool research on different parts of the picture we're talking about, because we talked about all these different hits and all these different players in people's cases. So to really understand the full picture of chronic disease, you have to have groups working on those different factors, and they obviously have to be talking to each other. So that's what we do is we look at the literature and we say, like, who published that study? That was really good. We just reach out to them and say, hey, for example, a lot of the teams that we brought into the Long Covid space actually came from hiv, because when were looking at the fact that SARS COV2 doesn't fully clear from some people's tissues, the people who most understand how to find viruses in tissue are actually the HIV world. 

44:12
Amy Proal
So we would go and approach those groups and say, look, the method you're using where you can use this cool probe to find HIV in this tissue sample, can you do that with SARS COV2? And they're like, yeah, I think we could. And we help guide them and to basically begin to work on new topics. And then we basically make sure that the team's working on the projects we support talk. And so we've hold meetings where, for example, one team will present what they're working on and other people give feedback and thoughts. And we created a consortium, at least for Long Covid, called the Long Covid Research Consortium, where we really are a group of scientists working together, sharing our ideas, sharing our data, which is great. 

44:56
Amy Proal
And part of that too, comes down to the fact that we also share samples across sites, because some groups can collect certain samples more easily, Some groups have better methods for certain types of tissue. So by integrating all these networks across sites, I think, number one, we understand a lot more, and we also save a lot of time and we save a lot of effort. So I think that's key to science is that because the human body and all of our systems are so interconnected, and because there are so many parts of what causes human chronic disease that interact with each other, the teams that study chronic disease also must interact with each other. So that's a lot of what we work on. 

45:38
Dr. Jill Carnahan
That was one of the most impressive things that I read, and of course, I heard you speak about that, because so many researchers aren't. It's kind of the same medicine. We have rheumatologists, gastroenterologists, neurologists, immunologists, and no one's talking. We're like, wait, this is all Connected, Right. It's like it all works together. And we need your specialty in mind and everybody else. So lastly, before we ask, you know, let people know where they can find you, how they can support your research, do you want to talk about any sort of, whether it's microbiome targeted therapies, immune modulation, or what from your research? But if you were to talk to clinicians out there, which I have a lot of you who listen, what would you tell us to be thinking about or are watching for as far as how do we actually treat these patients? 

46:17
Amy Proal
Yeah. One of many interests and one of the things that we're studying is how medications that impact mitochondrial activity might actually help to control infection. And part of that comes from the fact that, and I think this is key to understand is that every pathogen, especially viruses, so viruses are actually called obligate intracellular parasites, which means that they cannot replicate, they cannot create a new version of themselves at all without infecting your human cell and pulling the substrates that they need to create a new version of themselves out of your human mitochondria. And thus, when they do that, they skew the activity of mitochondria. I mean, as they pull substrates out, the way that the mitochondria can signal after that is messed up, it's high hijacked. 

47:10
Amy Proal
So inevitably, and it's not just viruses, bacteria, as part of the way they replicate, as part of the way they stay alive at all, they have to gain again their nutrition substrates from your mitochondria. So all of these pathogens are continually hijacking your mitochondria and changing your mitochondrial output as part of what they're doing. Now, one of the main pathways that they dysregulate as they hijack your mitochondria is the MTOR pathway. So MTOR is this kind of key pathway that does a lot of things, but is connected to mitochondrial metabolism and mitochondrial function. And pathogens not as a whole. 

47:50
Amy Proal
A lot of them upregulate MTOR signaling as part of this mitochondrial hijacking, which means that MTOR inhibitors, for example, rapamycin, might actually stabilize mitochondria in a way that makes it much harder for pathogens to do that hijacking and gain those substrates gets in the way of it. Again, we need more research on this, but we're running a trial of low dose rapamycin. This is key, low dose, because in a high dose rapamycin, it's immunosuppressive. In a low dose, there's fascinating work that shows that Rapamycin taken once a week in a low dose, or rapalogs, which are compounds similar to rapamycin, might actually support the immune response. So for example, there's one team who in healthy older adults, they gave adults, the adults rapamycin or low dose rapamycin or in some cases these rapalogs. 

48:44
Amy Proal
And in two trials, at the end of taking the rapamycin or the rapalox, a couple things happened. The people had a stronger, they gave them the influenza vaccine. Sorry, but they had a stronger antibody response to the influenza vaccine than the people who had not been given the low dose rapamycin. Another thing is they measured T cell exhaustion and T cells when they're exhausted, which is often because again, they're trying to address an unrecognized infection, express these markers of exhaustion that you can measure. And they found that people who had taken the rapamycin or rapalogs had less T cell exhaustion, which was very interesting. And last, one study found that interferons, which are parts of the immune system that are key in controlling and keeping infections in check, were upregulated. There was a stronger interferon response. 

49:32
Amy Proal
And part of that, this is our thinking, but part of what we're trying to study is maybe by stabilizing MTOR signaling and getting in the way of how pathogens can maybe hijack that mitochondria, you get in the way of the pathogen to survive and replicate, which basically gives the immune system a break, allowing it to come back up to better create interference, to be less exhausted on the side of T cell signals. So that's what we're looking at. Which means that drugs, not just like low dose rapamycin, could beneficial for people with infection associated chronic issues. Metformin, for example, is another one that's interesting. 

50:10
Amy Proal
So for example, in long Covid, one trial actually showed, because obviously key to preventing a lot of infection associated diseases, if you treat when the person gets the infection, which we don't do enough of, you could prevent progression to chronic issues. There's a trial in acute Covid where people were given metformin. And that is the trial that has one of the most signals of preventing people developing long Covid. And really then you start to wonder, well, metformin must also have antiviral properties. Again, it's possible that metformin gets in the way of the ability of pathogens to modulate mitochondrial metabolism to survive or replicate. So one of the bigger trends that I think is going to be using some of these, you know, medications that impact mitochondrial Metabolism that are even used by the longevity space to promote health span or lifespan. 

51:02
Amy Proal
But in patients with infection related issues to probably be able to help, possibly support the immune system on those patients. 

51:09
Dr. Jill Carnahan
Wow, that's just mind blowing. And my mind goes so many places because I think a lot of times we think of like as functional medicine, anti aging, longevity clinicians. How do we upregulate mtor? Obviously we need autophagy as well, but we might support the mitochondria where it's actually potentially the opposite because of the hijacking. So that's totally exciting. And then the T cell exhaustion is something we see in clinical practice a lot as well where these just get obliterated or the persistence of the spike protein in the macrophages, whatever. Well, I have so enjoyed this. We're going to have you back but for now if people are interested in learning about your research, donating to the foundation or finding anything about you, can you go give us your website and maybe any upcoming opportunities or how people can support you? 

51:52
Amy Proal
Sure. I mean our website is polybio.org and you know, I mean there's a donate button right there you can donate which is really truly helpful for us. But also. Yeah, I mean that would be the main thing. We have a couple of projects. Our focus now of many, but one that we're really excited about is we're trying to help teams create accessible diagnostics to better diagnose infection. And I think this is key is we are tired of the test that you as a clinician even has access to being so bad. We want to improve the diagnostics. This is possible, it's just not. It's a matter of how much we care. 

52:32
Amy Proal
So part of your interested in better pathogen diagnostics, we have some specific projects that we're doing to do that and so if you contact us through our website where we have an info button, we can give you more information on those which would be huge. 

52:44
Dr. Jill Carnahan
Cool, I love that. I'll do everything I can to get the word out because I think it looks like a big game changer, your research and then what we're seeing. So thank you again for your journey and just for seeing that, having the insight to see this importance of big picture, the importance of pathogens and the importance of actually doing the research so that we out here in the field of clinical practice can use that to help patients. It's just been amazing. Hey everybody, thanks so much again for joining me for this episode of resiliency radio with Dr. Amy Prowell with Polybio research. What a phenomenal amount of information. I know if you're a patient out there, you can resonate. If you're a clinician, hopefully. This is a big aha and a wow moment for you to really put this all together. 

53:26
Dr. Jill Carnahan
I know I mentioned a few times the things I see in clinical practice and it was so exciting to first hear Dr. Amy talk about their research because what they're doing is actually validating the complex chronic illness that I see in clinical practice and where the things come together with toxic load and infectious burden. And I love that she's even thinking about mold, as you well know, one of my favorite topics, and these infections that can pop up and cause illness. So I hope you'll reach out to her and just support her in any way that you can. If you are watching on any platform or on YouTube, you can find the links in the show notes below. And if you haven't yet, hit subscribe. It helps us get amazing people like Dr. Amy on the show. 

54:05
Dr. Jill Carnahan
Please hit subscribe or leave a review wherever you listen to podcast and we will see you again next week for another episode of Resiliency Radio. Thanks so much.