1 00:00:03,840 --> 00:00:12,160 Speaker 1: Rube. I'm Holly Fry and this is season two of 2 00:00:12,280 --> 00:00:17,520 Speaker 1: Our Skin, a personal discovery podcast. Today we are honored 3 00:00:17,560 --> 00:00:21,840 Speaker 1: to welcome Victoria Vus to Our Skin. Victoria is a travel, 4 00:00:21,960 --> 00:00:26,200 Speaker 1: fashion and beauty influencer whose journey with siasis and the 5 00:00:26,280 --> 00:00:30,240 Speaker 1: multiple diagnoses that followed transformed not just her skin, but 6 00:00:30,320 --> 00:00:34,120 Speaker 1: her entire relationship to her body and health. It all 7 00:00:34,159 --> 00:00:38,600 Speaker 1: began in college, when a sudden flare revealed itself as soriasis. 8 00:00:39,479 --> 00:00:45,920 Speaker 1: Then came soriatic arthritis, then insulin resistance. The avalanche of 9 00:00:46,040 --> 00:00:50,680 Speaker 1: diagnoses could have been overwhelming, and often surely was, but 10 00:00:51,200 --> 00:00:55,520 Speaker 1: over time Victoria began to rebuild. She found a research 11 00:00:55,640 --> 00:01:00,800 Speaker 1: institute where a doctor listened, She found and starved online 12 00:01:00,840 --> 00:01:03,800 Speaker 1: communities that reminded her she was not alone, and she 13 00:01:03,920 --> 00:01:07,960 Speaker 1: began sharing her story one post at a time. Today, 14 00:01:08,120 --> 00:01:13,160 Speaker 1: she talks openly about stigma, flares, medical self advocacy, and 15 00:01:13,200 --> 00:01:15,399 Speaker 1: what it means to care for yourself in a body 16 00:01:15,440 --> 00:01:20,280 Speaker 1: that doesn't always cooperate. We are really grateful to anyone 17 00:01:20,319 --> 00:01:23,920 Speaker 1: who turns a challenge into an opportunity for advocacy, so 18 00:01:24,040 --> 00:01:28,679 Speaker 1: we are remarkably delighted to have Victoria here today. Welcome 19 00:01:28,720 --> 00:01:31,840 Speaker 1: to our skin. Thank you so much for having me. 20 00:01:31,959 --> 00:01:34,319 Speaker 1: I love that intro. Can you like intro me to 21 00:01:34,440 --> 00:01:38,920 Speaker 1: any room or party that I go? I loved that. Happily, 22 00:01:39,000 --> 00:01:41,080 Speaker 1: I'll just follow you around with a microphone. It will 23 00:01:41,160 --> 00:01:46,280 Speaker 1: be awkward at all. So, Victoria, it sounds like college, 24 00:01:46,959 --> 00:01:49,440 Speaker 1: which is such a tumultuous time for a lot of people, 25 00:01:50,120 --> 00:01:53,040 Speaker 1: was the starting point of this leg of your journey. 26 00:01:53,440 --> 00:01:56,000 Speaker 1: And you have said in interviews, and I love this 27 00:01:56,120 --> 00:02:01,640 Speaker 1: phrasing that that is when your psoriasis went fullage. Tell 28 00:02:01,680 --> 00:02:03,520 Speaker 1: me about that time in your life and how this 29 00:02:03,640 --> 00:02:05,160 Speaker 1: all unfolded for you. 30 00:02:05,880 --> 00:02:09,160 Speaker 2: Yeah, it's definitely evident looking back now that stress is 31 00:02:09,440 --> 00:02:11,919 Speaker 2: my trigger and that has proven time and time again, 32 00:02:12,240 --> 00:02:14,720 Speaker 2: which is awful, right because I'm already stressed out and 33 00:02:14,720 --> 00:02:17,200 Speaker 2: then my skin flares and now I'm even more stressed out. 34 00:02:17,680 --> 00:02:21,040 Speaker 2: But that has been my pattern, and so that was 35 00:02:21,280 --> 00:02:23,880 Speaker 2: I guess the first really stressful time in my life 36 00:02:23,919 --> 00:02:27,399 Speaker 2: that it presented in a way that was so terribly painful. 37 00:02:27,720 --> 00:02:30,359 Speaker 2: And actually what brought me into the doctor's office was 38 00:02:30,480 --> 00:02:32,320 Speaker 2: this little bump on the top of my foot that 39 00:02:32,480 --> 00:02:35,760 Speaker 2: was really painful to walk on, and I was told 40 00:02:35,800 --> 00:02:38,480 Speaker 2: it was soriatic arthritis, and it was like, okay, so 41 00:02:38,800 --> 00:02:41,280 Speaker 2: that's actually connected to what's going on with my skin. 42 00:02:41,600 --> 00:02:43,480 Speaker 2: It was coming down on my forehead a little bit, 43 00:02:43,480 --> 00:02:45,920 Speaker 2: so it was in my hairline and not too much 44 00:02:45,960 --> 00:02:47,919 Speaker 2: to worry about. But then it just kind of crept 45 00:02:47,919 --> 00:02:50,680 Speaker 2: down on my face. I will say, there's a stigma. 46 00:02:50,720 --> 00:02:54,320 Speaker 2: People would see something on your face and have negative 47 00:02:54,360 --> 00:02:58,000 Speaker 2: reactions to it, which is really hard. So not only 48 00:02:58,080 --> 00:03:00,160 Speaker 2: was it that internal pain I was dealing with, but 49 00:03:00,200 --> 00:03:02,000 Speaker 2: now it was literally on my face. 50 00:03:02,960 --> 00:03:05,359 Speaker 1: Nothing like being self conscious at a time in your 51 00:03:05,360 --> 00:03:07,640 Speaker 1: life when you're already trying to figure your stuff out. 52 00:03:07,880 --> 00:03:10,200 Speaker 1: It was a lot all at once. Oh my gosh. 53 00:03:10,400 --> 00:03:13,760 Speaker 1: I can't even imagine. Because you were diagnosed with psoriasis 54 00:03:13,800 --> 00:03:17,280 Speaker 1: and then your other diagnoses as I mentioned, soon followed, 55 00:03:17,320 --> 00:03:22,680 Speaker 1: so you got the soriotic arthritis, but then also insulin resistance. 56 00:03:23,560 --> 00:03:25,560 Speaker 1: This had to have felt like the universe was just 57 00:03:25,639 --> 00:03:28,760 Speaker 1: piling on you. How did you navigate all of this 58 00:03:29,360 --> 00:03:31,919 Speaker 1: and how quickly as this was happening to you did 59 00:03:31,919 --> 00:03:33,760 Speaker 1: you turn to online communities? 60 00:03:34,560 --> 00:03:37,160 Speaker 2: You know? It was tough because not only was it 61 00:03:37,200 --> 00:03:40,200 Speaker 2: those two things, it was also syss on my ovaries, 62 00:03:40,520 --> 00:03:44,240 Speaker 2: oh my lord. And then trying to treat the psoriasis, 63 00:03:44,280 --> 00:03:47,920 Speaker 2: I got peptic ulcers, and then also I guess I 64 00:03:48,000 --> 00:03:51,400 Speaker 2: was not drinking enough. I got kidney stones. So my 65 00:03:51,520 --> 00:03:55,480 Speaker 2: solution I dropped out of college. I mean, no one 66 00:03:55,560 --> 00:03:58,480 Speaker 2: can fault you. That's a lot to deal with. It 67 00:03:58,560 --> 00:04:00,640 Speaker 2: was a lot, and at that time I had gone 68 00:04:00,640 --> 00:04:03,240 Speaker 2: to university a little bit away from home, whereas the 69 00:04:03,280 --> 00:04:05,280 Speaker 2: first couple of years I was doing community college in 70 00:04:05,320 --> 00:04:07,840 Speaker 2: the same town with my dad. And so it was 71 00:04:07,880 --> 00:04:10,040 Speaker 2: all too much. All of that medical stuff and a 72 00:04:10,080 --> 00:04:12,280 Speaker 2: lot of non answers, a lot of doctors saying we 73 00:04:12,320 --> 00:04:14,800 Speaker 2: can't find anything wrong with you, which a lot of 74 00:04:14,840 --> 00:04:18,080 Speaker 2: us with insulin resistance pcos we hear that, and so 75 00:04:18,160 --> 00:04:20,760 Speaker 2: that was so frustrating. Plus on top of it, the 76 00:04:20,800 --> 00:04:24,560 Speaker 2: peptic ulcers and the inflammation. It was a lot. So yeah, 77 00:04:24,640 --> 00:04:27,800 Speaker 2: I started my life over again. I called my mom complained. 78 00:04:27,880 --> 00:04:29,880 Speaker 2: She was in San Diego. She said, I'm gonna get 79 00:04:29,880 --> 00:04:31,479 Speaker 2: you a one way trip, come on out here, and 80 00:04:31,520 --> 00:04:33,919 Speaker 2: I said, let's do it. And like I've been in 81 00:04:33,920 --> 00:04:37,239 Speaker 2: San Diego since, it was the best decision. And that's 82 00:04:37,320 --> 00:04:40,360 Speaker 2: when I started not only seeking out an online community, 83 00:04:40,440 --> 00:04:43,279 Speaker 2: but also going to that clinical research place. 84 00:04:43,320 --> 00:04:46,000 Speaker 1: When you're seeking out an online community and you are 85 00:04:46,040 --> 00:04:49,839 Speaker 1: in a situation like yours, how do you even start, Like, 86 00:04:49,920 --> 00:04:55,480 Speaker 1: you can't just type into a search bar psoriasis, soriatic arthritis, pcos. 87 00:04:56,000 --> 00:04:58,440 Speaker 1: How do you find the right place for you? I 88 00:04:58,480 --> 00:05:01,400 Speaker 1: feel like I curated that, and I started with my interest, 89 00:05:01,480 --> 00:05:04,240 Speaker 1: which I guess was like fashion, something cute and fun. 90 00:05:04,320 --> 00:05:05,480 Speaker 1: And then I was like, you know what, I want 91 00:05:05,480 --> 00:05:07,400 Speaker 1: to get a little more real and talk about my skin. 92 00:05:07,520 --> 00:05:11,200 Speaker 1: And it's not like something I can totally hide anyway, 93 00:05:11,279 --> 00:05:13,440 Speaker 1: so let's just talk about it and I can complain 94 00:05:13,480 --> 00:05:15,400 Speaker 1: and other people can complain to me. And so then 95 00:05:15,400 --> 00:05:17,880 Speaker 1: it just became Oh, I actually really like being super 96 00:05:17,920 --> 00:05:21,760 Speaker 1: transparent and honest with my community. And it also leads 97 00:05:21,760 --> 00:05:24,640 Speaker 1: to a lot of people reaching out to me, enjoying 98 00:05:24,839 --> 00:05:26,680 Speaker 1: the fact that they have a place to you know, 99 00:05:26,920 --> 00:05:28,520 Speaker 1: bitch and moan if I'm allowed to swear. 100 00:05:28,880 --> 00:05:33,200 Speaker 2: So it's a comfortable place to express myself. An in turn, 101 00:05:33,320 --> 00:05:34,920 Speaker 2: I get to connect with other people who are going 102 00:05:34,960 --> 00:05:37,920 Speaker 2: through the same things, and I can share also things 103 00:05:37,920 --> 00:05:39,279 Speaker 2: that have worked for me. They can share things that 104 00:05:39,320 --> 00:05:41,120 Speaker 2: have worked for them, and we can figure it out together, 105 00:05:41,240 --> 00:05:44,240 Speaker 2: especially with doctors. Maybe not always listening to us. We 106 00:05:44,279 --> 00:05:46,920 Speaker 2: at least have other people who are in the trenches 107 00:05:47,000 --> 00:05:47,839 Speaker 2: and will listen. 108 00:05:48,320 --> 00:05:53,440 Speaker 1: Yeah, I'm glad you mentioned your doctors because I imagine finding 109 00:05:53,440 --> 00:05:56,480 Speaker 1: a treatment plan when you have all of these stacked 110 00:05:57,000 --> 00:06:00,599 Speaker 1: medical diagnoses going on is a little bit tricky. You 111 00:06:00,640 --> 00:06:03,039 Speaker 1: probably have a lot of different specialists in the mix, 112 00:06:03,600 --> 00:06:07,800 Speaker 1: hopefully communicating with one another, but I'm sure you also 113 00:06:07,880 --> 00:06:10,640 Speaker 1: have to self advocate a lot to make sure all 114 00:06:10,720 --> 00:06:13,160 Speaker 1: of those people are genuinely on the same page. 115 00:06:13,640 --> 00:06:17,960 Speaker 2: Yeah, especially because sometimes I'll get conflicting information. I went 116 00:06:18,000 --> 00:06:20,480 Speaker 2: to a rheumatologist who said nothing was wrong, and then 117 00:06:20,720 --> 00:06:22,719 Speaker 2: talking to a dermatologist They're like, no, you do have 118 00:06:22,800 --> 00:06:24,960 Speaker 2: soriatic arthritis. So I'm like, I don't know who to 119 00:06:24,960 --> 00:06:26,640 Speaker 2: listen to. I know there's pain, I don't know what 120 00:06:26,720 --> 00:06:29,440 Speaker 2: it is, but also I was on medication for the 121 00:06:29,480 --> 00:06:32,200 Speaker 2: pain and it gave me another problem, so please someone 122 00:06:32,320 --> 00:06:34,719 Speaker 2: help me out. And sometimes it looks like going to 123 00:06:34,800 --> 00:06:37,719 Speaker 2: other specialists if they say nothing's wrong, you know in 124 00:06:37,760 --> 00:06:40,919 Speaker 2: your body, And that's listening to yourself, advocating for yourself 125 00:06:41,040 --> 00:06:43,400 Speaker 2: and moving on to someone who will listen, which might 126 00:06:43,400 --> 00:06:46,680 Speaker 2: be hard but totally worth it. And you mentioned that 127 00:06:46,800 --> 00:06:50,240 Speaker 2: your mom had found this research institute that was working 128 00:06:50,400 --> 00:06:53,760 Speaker 2: on some psiriasis trials and that you got involved there. 129 00:06:54,720 --> 00:06:57,040 Speaker 2: One of the things that you have mentioned is that 130 00:06:57,640 --> 00:07:00,039 Speaker 2: you have a doctor there that is invested in you, 131 00:07:00,040 --> 00:07:03,680 Speaker 2: you and your health. I feel like when you say that, 132 00:07:03,760 --> 00:07:06,440 Speaker 2: so many people are gonna be like, what is that? Like? 133 00:07:07,080 --> 00:07:11,120 Speaker 1: What do you wish more doctors did that support their patients? 134 00:07:11,160 --> 00:07:13,480 Speaker 1: What are you getting from this person that you wish 135 00:07:13,560 --> 00:07:15,840 Speaker 1: every other medical professional would understand? 136 00:07:16,600 --> 00:07:21,680 Speaker 2: I think it's validating your feelings. You're not crazy for 137 00:07:22,480 --> 00:07:25,560 Speaker 2: feeling self conscious or the pain that you're feeling. Like 138 00:07:25,640 --> 00:07:28,040 Speaker 2: sometimes that is more than you can get at a 139 00:07:28,040 --> 00:07:30,120 Speaker 2: lot of doctors where you tell them you have a 140 00:07:30,160 --> 00:07:33,080 Speaker 2: pain and that they actually listen to you. So, you know, 141 00:07:33,200 --> 00:07:36,000 Speaker 2: you would think that that's basic stuff, but you know 142 00:07:36,200 --> 00:07:39,560 Speaker 2: that was new going to this clinical institute and their 143 00:07:39,640 --> 00:07:43,320 Speaker 2: whole point is to research and understand, and they want 144 00:07:43,320 --> 00:07:45,840 Speaker 2: you to be as comfortable as possible during that process. 145 00:07:46,200 --> 00:07:48,320 Speaker 2: You're also getting blood work done and all this stuff. 146 00:07:48,560 --> 00:07:50,640 Speaker 2: I think the biggest weight off my shoulders was I 147 00:07:50,720 --> 00:07:53,920 Speaker 2: wasn't trying super expensive treatments and paying a lot of 148 00:07:53,920 --> 00:07:57,320 Speaker 2: money and it not working. I was actually being paid 149 00:07:57,440 --> 00:08:01,080 Speaker 2: to try different things that were still saying with one 150 00:08:01,120 --> 00:08:05,920 Speaker 2: on one help from a dermatologist, and if they didn't work, well, 151 00:08:05,960 --> 00:08:08,840 Speaker 2: at least I tried something, and I can try another thing. 152 00:08:09,400 --> 00:08:12,320 Speaker 1: Right at that point, you may not be getting help 153 00:08:12,480 --> 00:08:15,280 Speaker 1: for your problem, but you are getting data about what 154 00:08:15,360 --> 00:08:19,239 Speaker 1: doesn't work, which is also important. One of the things 155 00:08:19,280 --> 00:08:20,880 Speaker 1: that we returned to a lot on the show, and 156 00:08:20,920 --> 00:08:24,280 Speaker 1: which you hinted at earlier, is that chronic illnesses that 157 00:08:24,320 --> 00:08:27,720 Speaker 1: are visible on your skin are this whole other level 158 00:08:27,760 --> 00:08:31,240 Speaker 1: of challenge because of the way other people react. If 159 00:08:31,280 --> 00:08:33,959 Speaker 1: I have my info correctly, you were once asked if 160 00:08:34,000 --> 00:08:37,000 Speaker 1: you had a chicken pox when you were actually having 161 00:08:37,040 --> 00:08:40,640 Speaker 1: a flare up. And I know that some people, particularly 162 00:08:40,679 --> 00:08:44,640 Speaker 1: in the psoriasis community that have really become advocates, they'll 163 00:08:44,720 --> 00:08:47,360 Speaker 1: view this as like a teachable moment for people that 164 00:08:47,400 --> 00:08:50,720 Speaker 1: are maybe being a little nosy Nancy. But others find 165 00:08:50,760 --> 00:08:53,120 Speaker 1: it a little bit harder to respond. And I'm curious 166 00:08:53,160 --> 00:08:56,160 Speaker 1: where you fall on that spectrum, like what your go 167 00:08:56,240 --> 00:08:59,560 Speaker 1: to behavior is for dealing with those moments. 168 00:09:00,160 --> 00:09:02,840 Speaker 2: Well, I definitely love a clapback. I think that's my 169 00:09:02,920 --> 00:09:06,760 Speaker 2: go to for being online. Is a little bit spicy, 170 00:09:06,760 --> 00:09:10,040 Speaker 2: a little bit sassy, and I used humor with that woman. 171 00:09:10,360 --> 00:09:12,839 Speaker 2: My psoriasis is genetic, and so I was like, no, 172 00:09:12,960 --> 00:09:15,400 Speaker 2: it's psoriasis unless you and I are related, you're fine. 173 00:09:15,679 --> 00:09:19,080 Speaker 2: Like so I like qualmed her, like her issue with 174 00:09:19,160 --> 00:09:21,559 Speaker 2: maybe concern that she might get it. I'm like, no, 175 00:09:21,760 --> 00:09:25,840 Speaker 2: you're fine unless somehow you're in my family tree. This 176 00:09:25,920 --> 00:09:29,240 Speaker 2: isn't any of your concern. And I also remember I 177 00:09:29,280 --> 00:09:31,679 Speaker 2: was going to get my hair done and the lady 178 00:09:31,720 --> 00:09:33,559 Speaker 2: was washing my hair. She told me I had dan druff. 179 00:09:33,600 --> 00:09:36,000 Speaker 2: I'm like, no, it's zoriasis, and she's like, no, it's dandruff. 180 00:09:36,040 --> 00:09:38,480 Speaker 2: And I'm like, my dermatologist would disagree with you. So 181 00:09:38,960 --> 00:09:41,199 Speaker 2: it's like, I don't know why you're fighting me about 182 00:09:41,240 --> 00:09:45,320 Speaker 2: my own chronic illness. But okay, but yeah. My favorite 183 00:09:45,360 --> 00:09:49,160 Speaker 2: is the clapbacks online. I think it helps add some 184 00:09:49,160 --> 00:09:52,200 Speaker 2: comedic relief while also advocating at the same time, and 185 00:09:52,240 --> 00:09:53,680 Speaker 2: then not too mean about it. 186 00:09:53,720 --> 00:09:57,520 Speaker 1: I promise I'm glad you mentioned online because you have 187 00:09:57,600 --> 00:10:01,400 Speaker 1: an online community that is really invested in your health 188 00:10:01,480 --> 00:10:04,680 Speaker 1: journey right along with you. You know, they are there 189 00:10:04,800 --> 00:10:07,080 Speaker 1: for you when medication doesn't pan out or when a 190 00:10:07,080 --> 00:10:11,319 Speaker 1: flare happens. What strength do you draw just on the 191 00:10:11,400 --> 00:10:15,440 Speaker 1: daily from them being on this path with you. That's 192 00:10:15,440 --> 00:10:16,200 Speaker 1: a good question. 193 00:10:16,320 --> 00:10:20,880 Speaker 2: I think. I think I understand that it empowers other 194 00:10:20,920 --> 00:10:24,240 Speaker 2: people and it makes them feel good along with me, 195 00:10:24,880 --> 00:10:27,200 Speaker 2: And so I like that I can have that impact 196 00:10:28,240 --> 00:10:33,200 Speaker 2: and those clapbacks because we all Unfortunately, if you're in 197 00:10:33,200 --> 00:10:35,480 Speaker 2: the online space, it's like a plus sized person, you're 198 00:10:35,520 --> 00:10:39,280 Speaker 2: probably getting negative comments. It's unfortunate. That's just the way 199 00:10:39,320 --> 00:10:42,480 Speaker 2: the space works. Yeah, and no matter what it's about, 200 00:10:42,640 --> 00:10:45,280 Speaker 2: if it's my body, my skin, what have you. I 201 00:10:45,360 --> 00:10:47,880 Speaker 2: really find it empowering for me, and I think for 202 00:10:47,960 --> 00:10:50,840 Speaker 2: other people to kind of see other people put in 203 00:10:50,880 --> 00:10:53,880 Speaker 2: their place who are bullies and kind of level that 204 00:10:53,960 --> 00:10:56,040 Speaker 2: out a little bit. Even the scales there. 205 00:10:56,840 --> 00:11:00,000 Speaker 1: Yeah, I imagine it also makes those people, even if 206 00:11:00,080 --> 00:11:03,680 Speaker 1: they did not intend to be a bully, realize though 207 00:11:03,760 --> 00:11:06,120 Speaker 1: that what they're doing is kind of inserting themselves in 208 00:11:06,200 --> 00:11:09,840 Speaker 1: other people's lives. I hope they learn something that would 209 00:11:09,880 --> 00:11:14,640 Speaker 1: be great. I'm curious because, especially since you talk about 210 00:11:14,679 --> 00:11:17,520 Speaker 1: loving a good clap back, what would you like people 211 00:11:17,559 --> 00:11:20,199 Speaker 1: to know when they happen upon your profile and they 212 00:11:20,200 --> 00:11:23,719 Speaker 1: click follow and it is obviously someone who is being 213 00:11:23,840 --> 00:11:26,880 Speaker 1: very transparent and sharing about their chronic illness. What are 214 00:11:26,920 --> 00:11:29,920 Speaker 1: the dos and don'ts for you of online behavior when 215 00:11:30,600 --> 00:11:32,960 Speaker 1: becoming a follower of someone like yourself. 216 00:11:33,800 --> 00:11:37,400 Speaker 2: I definitely have boundaries, one being I don't share my weight, 217 00:11:37,679 --> 00:11:40,760 Speaker 2: but I'll share pretty much all the other stuff. Some 218 00:11:40,800 --> 00:11:43,000 Speaker 2: of that is for my own mental health, and also 219 00:11:43,480 --> 00:11:47,280 Speaker 2: as an audience member, I am not necessarily a fan 220 00:11:47,320 --> 00:11:50,120 Speaker 2: of that information. So I do try and keep a 221 00:11:50,160 --> 00:11:53,240 Speaker 2: safe space for myself and for my audience, and I 222 00:11:53,280 --> 00:11:57,200 Speaker 2: think they really appreciate it because they know there's certain 223 00:11:57,200 --> 00:12:00,000 Speaker 2: information they can avoid by coming to my little corner 224 00:12:00,160 --> 00:12:02,920 Speaker 2: of the internet. And I would say just respecting those boundaries, 225 00:12:02,920 --> 00:12:05,360 Speaker 2: and even if someone asked me, hey, what's your weight, 226 00:12:05,360 --> 00:12:06,920 Speaker 2: I would just tell them, oh, I'm not tracking that, 227 00:12:06,960 --> 00:12:09,360 Speaker 2: Like questions are fine, or they're like, hey, you usually 228 00:12:09,360 --> 00:12:11,400 Speaker 2: don't talk about your weight, but you just posted something, 229 00:12:11,480 --> 00:12:13,960 Speaker 2: you know xyz. And it also gives me an opportunity 230 00:12:13,960 --> 00:12:15,760 Speaker 2: to be like, well, you're right, I'm not talking about 231 00:12:15,760 --> 00:12:17,200 Speaker 2: my own weight, but I thought this was a great 232 00:12:17,240 --> 00:12:19,640 Speaker 2: resource for other people. And so then they're like, oh, okay, 233 00:12:19,640 --> 00:12:21,480 Speaker 2: thank you so much for letting me know. So I 234 00:12:21,520 --> 00:12:24,200 Speaker 2: think it's a really good exchange of information, So for 235 00:12:24,280 --> 00:12:26,599 Speaker 2: the most part, there's not much that'll get to me. 236 00:12:26,840 --> 00:12:30,640 Speaker 2: And if you're spicy, I'll be spicy back. I like 237 00:12:30,720 --> 00:12:31,200 Speaker 2: them how. 238 00:12:31,120 --> 00:12:34,240 Speaker 1: You're also an educator in your heart. I think I 239 00:12:34,280 --> 00:12:37,280 Speaker 1: am curious to know how your relationship with your skin 240 00:12:37,960 --> 00:12:41,000 Speaker 1: has changed over time, because, of course there are probably 241 00:12:41,040 --> 00:12:45,000 Speaker 1: moments even when you are fully empowered, of being self conscious. 242 00:12:45,320 --> 00:12:47,720 Speaker 1: But it also sounds like there's an element to the 243 00:12:47,760 --> 00:12:50,680 Speaker 1: way you manage your life where you do not take 244 00:12:50,720 --> 00:12:55,240 Speaker 1: your skin or your health overall for granted, and that 245 00:12:55,679 --> 00:12:58,240 Speaker 1: is a very positive space to be in. So where 246 00:12:58,280 --> 00:12:58,960 Speaker 1: are you at with. 247 00:12:58,880 --> 00:13:02,480 Speaker 2: All of that? My skin is pretty darn great right now. 248 00:13:02,520 --> 00:13:06,200 Speaker 2: It's not perfect, but it is much much better, and 249 00:13:06,520 --> 00:13:09,560 Speaker 2: I feel like, even though it's not perfect and I 250 00:13:09,640 --> 00:13:13,280 Speaker 2: definitely still have, you know, some self conscious things, I 251 00:13:13,320 --> 00:13:15,640 Speaker 2: am so much more grateful that I'm not in that 252 00:13:15,800 --> 00:13:17,760 Speaker 2: huge flare I was in. It was really tough and 253 00:13:17,800 --> 00:13:20,360 Speaker 2: really hard on my mental health. So grateful where I'm 254 00:13:20,360 --> 00:13:22,440 Speaker 2: at where my skin is now, even though it's not perfect. 255 00:13:22,440 --> 00:13:25,839 Speaker 2: But also presenting myself online, it's kind of like, how 256 00:13:25,880 --> 00:13:28,679 Speaker 2: could you hurt me if I just present myself as 257 00:13:28,720 --> 00:13:31,840 Speaker 2: real and even talk about how I feel about myself. 258 00:13:31,840 --> 00:13:33,720 Speaker 2: It's like you're saying all the things I've already said 259 00:13:33,720 --> 00:13:36,160 Speaker 2: to myself. There's really nothing you could do to hurt me. 260 00:13:36,360 --> 00:13:39,200 Speaker 2: So and at the end of the day, soriasis is 261 00:13:39,240 --> 00:13:41,560 Speaker 2: extra skin, so I guess you could say my skin's 262 00:13:41,640 --> 00:13:42,480 Speaker 2: just real thick. 263 00:13:43,920 --> 00:13:47,600 Speaker 1: You know what I mean, speaking of putting yourself out there. 264 00:13:48,240 --> 00:13:48,440 Speaker 2: One. 265 00:13:48,520 --> 00:13:52,080 Speaker 1: You're a newlywed. Congratulations, thank you. And your wedding was 266 00:13:52,480 --> 00:13:55,280 Speaker 1: in the New York Times last year, which is incredibly cool. 267 00:13:55,760 --> 00:13:58,280 Speaker 1: You look so beautiful for our listeners that don't know, 268 00:13:58,800 --> 00:14:01,960 Speaker 1: Victoria has this spectacular head of just the most gorgeous 269 00:14:01,960 --> 00:14:04,440 Speaker 1: red hair you've ever seen, and you looked like a 270 00:14:04,600 --> 00:14:07,680 Speaker 1: Woodland fairy princess. It was so beautiful. But I'm really 271 00:14:07,720 --> 00:14:11,480 Speaker 1: curious what wedding planning was like, because that is a 272 00:14:11,520 --> 00:14:15,000 Speaker 1: time that also adds stress and self consciousness to people's lives. 273 00:14:15,400 --> 00:14:18,360 Speaker 1: Did you do anything differently to take care of yourself 274 00:14:18,440 --> 00:14:20,840 Speaker 1: and your skin and your mental health leading up to 275 00:14:20,880 --> 00:14:23,840 Speaker 1: that that maybe is not including the things that other 276 00:14:23,880 --> 00:14:24,920 Speaker 1: people have to consider. 277 00:14:25,440 --> 00:14:29,760 Speaker 2: Yeah, So we actually split up our reception and the wedding, 278 00:14:29,920 --> 00:14:32,520 Speaker 2: so we had like a cute little wedding just by 279 00:14:32,560 --> 00:14:35,280 Speaker 2: the beach with some family, and then six months later 280 00:14:35,280 --> 00:14:38,000 Speaker 2: in the summer, when everyone could come to town, we had 281 00:14:38,000 --> 00:14:42,080 Speaker 2: our reception. That was definitely a little bit stressful. Thankfully, 282 00:14:42,240 --> 00:14:44,880 Speaker 2: I had my husband, my friends, and I actually hired 283 00:14:44,880 --> 00:14:46,760 Speaker 2: someone to kind of help me plan the event a 284 00:14:46,760 --> 00:14:50,240 Speaker 2: little bit. And I really recommend separating those things out 285 00:14:50,280 --> 00:14:52,560 Speaker 2: because I didn't have to worry about my dress, changing 286 00:14:52,720 --> 00:14:56,000 Speaker 2: locations and all that. By the time the event was happening, 287 00:14:56,280 --> 00:14:58,360 Speaker 2: I was like, this was the way to do it. 288 00:14:58,400 --> 00:15:00,160 Speaker 2: This was so much better. And then I was allo like, 289 00:15:00,160 --> 00:15:01,400 Speaker 2: we should do this again next year. 290 00:15:01,800 --> 00:15:05,880 Speaker 1: Yeah, Oh so much fun. I imagine that feels more 291 00:15:05,960 --> 00:15:08,120 Speaker 1: like a party to you than when you have a 292 00:15:08,160 --> 00:15:11,040 Speaker 1: reception right after the wedding and you're still in the 293 00:15:11,040 --> 00:15:13,880 Speaker 1: logistics of, Okay, we have to do the pictures and 294 00:15:14,000 --> 00:15:16,120 Speaker 1: this person has to be included in this moment, and 295 00:15:16,360 --> 00:15:17,560 Speaker 1: that's pretty smart. 296 00:15:17,360 --> 00:15:19,720 Speaker 2: Thank you. Yeah, we got the really nice, fancy photos 297 00:15:19,720 --> 00:15:21,960 Speaker 2: done the morning of the wedding, and that's checked off. 298 00:15:22,080 --> 00:15:24,280 Speaker 2: This is just a party for all the friends and family, 299 00:15:24,520 --> 00:15:26,120 Speaker 2: and so I actually put a lot of energy into 300 00:15:26,160 --> 00:15:29,880 Speaker 2: doing like raffles, games and stuff like that. It was Yeah, 301 00:15:29,880 --> 00:15:32,040 Speaker 2: we made sure the kids had fun and the adults 302 00:15:32,040 --> 00:15:33,040 Speaker 2: had fun, so I think. 303 00:15:32,920 --> 00:15:37,040 Speaker 1: It was great. As our conversation today points out victoria, 304 00:15:37,120 --> 00:15:40,880 Speaker 1: Treating psoriasis, even if you were treating just psoriasis without 305 00:15:41,080 --> 00:15:44,600 Speaker 1: other factors, is a journey, and our medical community makes 306 00:15:44,640 --> 00:15:48,280 Speaker 1: breakthroughs every single day that will hopefully continue to bring 307 00:15:48,360 --> 00:15:51,640 Speaker 1: better treatments to people with psoriasis. And after the break 308 00:15:51,720 --> 00:15:54,520 Speaker 1: we're going to dive into a major breakthrough, and that 309 00:15:54,640 --> 00:16:11,400 Speaker 1: is monoclonal antibodies. I promise it's exciting woo science. In 310 00:16:11,480 --> 00:16:15,320 Speaker 1: nineteen seventy five, at the Medical Research Council Laboratory of 311 00:16:15,400 --> 00:16:20,480 Speaker 1: Molecular Biology in Cambridge, England, to scientists George Kueller and 312 00:16:20,640 --> 00:16:24,280 Speaker 1: Caesar Milstein were conducting what on the surface kind of 313 00:16:24,280 --> 00:16:27,960 Speaker 1: looked like a routine experiment. They were working with mouse 314 00:16:28,120 --> 00:16:32,600 Speaker 1: immune cells, aiming to understand how the body produces antibodies. 315 00:16:32,840 --> 00:16:35,240 Speaker 1: But in the course of their work they created something 316 00:16:35,520 --> 00:16:40,479 Speaker 1: entirely new, a method for producing large quantities of identical 317 00:16:40,520 --> 00:16:46,120 Speaker 1: antibodies derived from a single immune cell. These monoclonal antibodies 318 00:16:46,160 --> 00:16:49,440 Speaker 1: would go on to revolutionized medicine, giving rise to some 319 00:16:49,480 --> 00:16:53,720 Speaker 1: of the most precise and powerful treatments in human history. Okay, 320 00:16:53,800 --> 00:16:57,680 Speaker 1: so why is this breakthrough. Why are monoclonal antibodies so incredible? 321 00:16:58,280 --> 00:17:02,160 Speaker 1: Have great news? The natural world, antibodies are the immune 322 00:17:02,160 --> 00:17:06,880 Speaker 1: systems elite reconnaissance and neutralization force. They're these y shaped 323 00:17:06,920 --> 00:17:10,560 Speaker 1: proteins that kind of patrol the bloodstream, each one custom 324 00:17:10,600 --> 00:17:14,160 Speaker 1: built to recognize and bind to a specific foreign invader 325 00:17:14,440 --> 00:17:17,240 Speaker 1: that can be a virus, a bacterium, or a toxin. 326 00:17:17,720 --> 00:17:21,280 Speaker 1: And when your body encounters a threat, specialized immune cells 327 00:17:21,280 --> 00:17:25,920 Speaker 1: called B cells respond by producing thousands of different antibodies, 328 00:17:26,000 --> 00:17:30,240 Speaker 1: each with its own unique molecular fingerprint, creating what scientists 329 00:17:30,320 --> 00:17:34,520 Speaker 1: call a polyclonal response victoria. You have been in a 330 00:17:34,520 --> 00:17:37,200 Speaker 1: lot of doctor's offices. Do you ever think about your 331 00:17:37,200 --> 00:17:39,919 Speaker 1: immune system this way? As kind of like soldiers and 332 00:17:40,000 --> 00:17:44,480 Speaker 1: spies in a massive conflict, never quite so granular. 333 00:17:44,600 --> 00:17:47,240 Speaker 2: And if anything, I'm like, my body is the enemy, 334 00:17:48,040 --> 00:17:49,600 Speaker 2: so me and my body are at war. 335 00:17:52,000 --> 00:17:55,399 Speaker 1: Polyclonal antibodies are really interesting. They come from many different 336 00:17:55,440 --> 00:17:58,359 Speaker 1: B cell clones. So even when all of these B 337 00:17:58,480 --> 00:18:02,080 Speaker 1: cells are responding to this same antigen like a virus, 338 00:18:02,440 --> 00:18:07,600 Speaker 1: each individual B cell clone produces antibodies that recognize slightly 339 00:18:07,640 --> 00:18:09,719 Speaker 1: different parts of that antigen. So you're going to get 340 00:18:09,720 --> 00:18:13,600 Speaker 1: a mixture of antibodies. Some might bind to one part 341 00:18:13,640 --> 00:18:16,720 Speaker 1: of the virus surface, others to different parts. Some might 342 00:18:16,760 --> 00:18:20,760 Speaker 1: bind tightly, others more loosely, et cetera. It's poly because 343 00:18:20,760 --> 00:18:23,920 Speaker 1: it comes from multiple clones of B cells. I kind 344 00:18:23,920 --> 00:18:25,760 Speaker 1: of love this because it's got a divide and conquer 345 00:18:25,880 --> 00:18:31,879 Speaker 1: situation going on, which is probably again similar to the 346 00:18:31,920 --> 00:18:34,200 Speaker 1: way that you've had to treat various things in your 347 00:18:34,200 --> 00:18:37,520 Speaker 1: own way if the parallels are real. The flip there 348 00:18:37,600 --> 00:18:41,080 Speaker 1: is that monoclonal antibodies come from a single B cell 349 00:18:41,280 --> 00:18:44,320 Speaker 1: or its clones, and since they all originate from one 350 00:18:44,440 --> 00:18:47,800 Speaker 1: parent cell, they're all identical and they all recognize the 351 00:18:47,880 --> 00:18:52,040 Speaker 1: exact same target in exactly the same way. It uses 352 00:18:52,119 --> 00:18:55,800 Speaker 1: the early stage mono because it comes from one source, 353 00:18:55,920 --> 00:18:58,719 Speaker 1: one B cell. Do you see where we're going with this. 354 00:18:59,000 --> 00:19:01,640 Speaker 1: We're getting targeted therapies. Yeah. 355 00:19:01,760 --> 00:19:07,119 Speaker 2: Over the ride the autoimmune thing. Huh what she's so bright. 356 00:19:07,520 --> 00:19:10,760 Speaker 2: It wasn't just about wedding receptions split up. She's very insightful. 357 00:19:11,320 --> 00:19:16,639 Speaker 2: Cueller and Milstein's breakthrough changed everything by providing unlimited quantities 358 00:19:16,680 --> 00:19:21,840 Speaker 2: of these identical, predictable antibodies. This consistency opened the door 359 00:19:21,880 --> 00:19:27,720 Speaker 2: to reproducible experiments, standardized diagnostic tests, and most importantly, the 360 00:19:27,800 --> 00:19:31,840 Speaker 2: development of targeted therapies that could be manufactured at scale. 361 00:19:31,880 --> 00:19:33,840 Speaker 2: Although we're going to talk about that in a minute 362 00:19:33,840 --> 00:19:36,840 Speaker 2: and see that that part was really quite challenging and difficult. 363 00:19:37,320 --> 00:19:39,000 Speaker 2: Have you ever had to deal with the treatment that 364 00:19:39,160 --> 00:19:41,040 Speaker 2: I mean, you've mentioned that you would take things that 365 00:19:41,080 --> 00:19:44,439 Speaker 2: were hurting some things and helping others. I'm sure you 366 00:19:44,480 --> 00:19:47,120 Speaker 2: are well acquainted with the ideas of the negative things 367 00:19:47,160 --> 00:19:49,800 Speaker 2: you did not want out of a medication. Yeah. Using 368 00:19:49,960 --> 00:19:53,359 Speaker 2: n sets to help with the inflammation, it then caused 369 00:19:53,400 --> 00:19:55,720 Speaker 2: the peptic ulcers and that I had both left. I 370 00:19:55,720 --> 00:19:58,600 Speaker 2: had peptic ulcers and the inflammation. I'm like, this is fantastic, 371 00:19:58,800 --> 00:20:01,960 Speaker 2: Like thanks once again. Parallel to this. So, it actually 372 00:20:02,040 --> 00:20:05,840 Speaker 2: took a decade almost for the significance of this discovery 373 00:20:05,840 --> 00:20:08,800 Speaker 2: to be fully recognized. And that's because their focus was 374 00:20:08,800 --> 00:20:12,880 Speaker 2: in research understanding more about the immune system and how 375 00:20:12,920 --> 00:20:16,840 Speaker 2: it works. It's only when the therapeutic possibilities became clear 376 00:20:17,000 --> 00:20:21,000 Speaker 2: that Culer and Milstein had stumbled upon something really revolutionary. 377 00:20:21,400 --> 00:20:24,520 Speaker 2: So in nineteen eighty four, Culer and Milstein were awarded 378 00:20:24,560 --> 00:20:29,040 Speaker 2: the Nobel Prize in physiology or medicine along with an immunologist. 379 00:20:29,240 --> 00:20:33,240 Speaker 2: Neil's journ and their technique made it possible to produce 380 00:20:33,320 --> 00:20:37,280 Speaker 2: antibodies in the lab that could be tailored to recognize 381 00:20:37,320 --> 00:20:40,600 Speaker 2: a single specific target. So, in other words, it gave 382 00:20:40,680 --> 00:20:45,280 Speaker 2: scientists a way to build metaphorical molecular missiles. This is 383 00:20:45,320 --> 00:20:48,840 Speaker 2: all too pretty recent. It's in the last fifty years. 384 00:20:49,320 --> 00:20:51,560 Speaker 2: Did you realize that treatment for a lot of the 385 00:20:51,560 --> 00:20:55,840 Speaker 2: things that you're dealing with was happening so recently? LE mean, no, 386 00:20:56,119 --> 00:21:00,160 Speaker 2: but it makes sense, and like, yeah, I feel like 387 00:21:00,200 --> 00:21:04,400 Speaker 2: psoriasis isn't fully understood. There is a lot of questions 388 00:21:04,400 --> 00:21:07,880 Speaker 2: between dermatologists about like where's it from and what actually 389 00:21:07,920 --> 00:21:11,240 Speaker 2: triggers it, and so it definitely seems to be still 390 00:21:11,280 --> 00:21:14,320 Speaker 2: something that they're trying to wrap their minds around, which 391 00:21:14,359 --> 00:21:18,880 Speaker 2: is amazing considering it's not new, no ad it they 392 00:21:18,880 --> 00:21:20,520 Speaker 2: were busy doing other things, I guess. 393 00:21:21,200 --> 00:21:25,720 Speaker 1: So. The original monoclonal antibodies produced through Culer and Milstein's 394 00:21:25,720 --> 00:21:30,560 Speaker 1: method were derived entirely from mouse proteins. These mouse derived 395 00:21:30,560 --> 00:21:35,240 Speaker 1: antibodies could effectively bind to specific human targets in lab settings, 396 00:21:35,880 --> 00:21:39,440 Speaker 1: but when they were injected into patients they were often rejected. 397 00:21:40,119 --> 00:21:43,159 Speaker 1: The human immune system saw them as foreign, and that 398 00:21:43,240 --> 00:21:46,480 Speaker 1: triggered immune reactions that ranged from like a mild allergic 399 00:21:46,560 --> 00:21:51,080 Speaker 1: response to complete neutralization of the treatment. And so this 400 00:21:51,160 --> 00:21:55,520 Speaker 1: problem actually became known as the HAMMER response, which stands 401 00:21:55,560 --> 00:22:01,040 Speaker 1: for human anti mouse antibodies. Patients immune says attacked the 402 00:22:01,040 --> 00:22:04,720 Speaker 1: therapeutic antibodies as though they were invaders and rendered them 403 00:22:04,720 --> 00:22:08,480 Speaker 1: ineffective and sometimes even dangerous. I feel like this is 404 00:22:08,520 --> 00:22:11,560 Speaker 1: a lab version of what you and other people with 405 00:22:11,640 --> 00:22:14,760 Speaker 1: chronic conditions deal with all the time. You have already 406 00:22:14,760 --> 00:22:17,760 Speaker 1: mentioned that your body is sometimes your enemy, that potential 407 00:22:17,800 --> 00:22:21,479 Speaker 1: frustration of your body working against the very treatments that 408 00:22:21,520 --> 00:22:22,800 Speaker 1: you are trying to help it with. 409 00:22:22,840 --> 00:22:26,199 Speaker 2: Yeah, or treatments that only work for so long, like 410 00:22:26,200 --> 00:22:28,400 Speaker 2: your body just becomes immune to it over time. 411 00:22:28,480 --> 00:22:31,359 Speaker 1: It's so frustrating. There were still so many more steps 412 00:22:31,400 --> 00:22:35,040 Speaker 1: ahead for this to actually become a workable and helpful thing, 413 00:22:35,320 --> 00:22:38,520 Speaker 1: because the next step in the evolution of monoclonal antibodies 414 00:22:38,560 --> 00:22:42,080 Speaker 1: came from another scientist that was working in that same 415 00:22:42,119 --> 00:22:45,680 Speaker 1: Cambridge lab, that was doctor Greg Winter. In the nineteen eighties, 416 00:22:45,920 --> 00:22:49,720 Speaker 1: Winter pioneered the technique of what's called humanization. That's when 417 00:22:49,880 --> 00:22:53,880 Speaker 1: parts of a mouse antibody responsible for recognizing a specific 418 00:22:53,960 --> 00:22:57,040 Speaker 1: target were grafted onto a framework that was made from 419 00:22:57,119 --> 00:23:02,359 Speaker 1: human antibody proteins, and then this hybrid molecule preserved the 420 00:23:02,400 --> 00:23:06,840 Speaker 1: mouse antibody specificity but dramatically reduced the risk of immune rejection. 421 00:23:08,000 --> 00:23:11,760 Speaker 1: Science is so cool. Winter's innovation really marked this turning 422 00:23:11,800 --> 00:23:17,280 Speaker 1: point because humanized monoclonal antibodies became viable tools for treating disease, 423 00:23:17,440 --> 00:23:21,960 Speaker 1: and researchers started exploring their use in everything from cancer 424 00:23:22,000 --> 00:23:27,040 Speaker 1: to autoimmune disorders. And although monoclonal antibodies are often associated 425 00:23:27,080 --> 00:23:32,399 Speaker 1: today with chronic diseases like psoriasis, rheumatoid arthritis, and various 426 00:23:32,400 --> 00:23:36,800 Speaker 1: forms of cancer, their impact actually reaches far beyond those fields. 427 00:23:37,200 --> 00:23:41,080 Speaker 1: One of their earliest and most enduring applications has actually 428 00:23:41,119 --> 00:23:45,440 Speaker 1: been in the fight against infectious disease. In the nineteen nineties, 429 00:23:45,600 --> 00:23:50,600 Speaker 1: monoclonal antibodies were developed to protect babies high risk infants 430 00:23:50,600 --> 00:23:55,240 Speaker 1: from respiratory sensicial virus that's RSV. That is, in case 431 00:23:55,280 --> 00:23:57,919 Speaker 1: you are not familiar, a common virus that can cause 432 00:23:57,920 --> 00:24:03,160 Speaker 1: severe respiratory illness, and by binding to and neutralizing RSV 433 00:24:03,320 --> 00:24:07,879 Speaker 1: before it could infect lung cells. Monoclonal antibody therapy helped 434 00:24:07,880 --> 00:24:13,920 Speaker 1: prevent hospitalization in vulnerable newborns and children with underlying health conditions, 435 00:24:14,880 --> 00:24:18,520 Speaker 1: and this idea of using antibodies to stop a virus 436 00:24:18,560 --> 00:24:21,919 Speaker 1: in its tracks was taken to new heights during a 437 00:24:21,920 --> 00:24:25,399 Speaker 1: fairly recent event that many of us will remember, the 438 00:24:25,520 --> 00:24:30,240 Speaker 1: twenty fourteen Abola outbreak in West Africa. As scientists race 439 00:24:30,320 --> 00:24:35,360 Speaker 1: to develop treatments against this frequently deadly virus, monoclonal antibodies 440 00:24:35,400 --> 00:24:40,040 Speaker 1: emerged as one of the most promising options. Researchers used 441 00:24:40,040 --> 00:24:42,880 Speaker 1: samples from a BULA survivors, and then they use those 442 00:24:42,920 --> 00:24:48,800 Speaker 1: to identify antibodies that had effectively neutralized the virus. Those 443 00:24:48,840 --> 00:24:52,480 Speaker 1: antibodies were then cloned and mass produced for therapeutic use. 444 00:24:53,200 --> 00:24:58,000 Speaker 1: When these monoclonal antibodies were administered early, they really significantly 445 00:24:58,000 --> 00:25:02,320 Speaker 1: improved survival rates and then, of course, much closer to 446 00:25:02,520 --> 00:25:06,119 Speaker 1: our recent past, the height of the COVID nineteen pandemic, 447 00:25:06,280 --> 00:25:11,840 Speaker 1: because monoclonal antibodies became frontline tools, researchers rapidly isolated antibodies 448 00:25:11,880 --> 00:25:15,240 Speaker 1: from people who had recovered from the virus and identified 449 00:25:15,240 --> 00:25:18,960 Speaker 1: those that could neutralize the SARS CoV two spike protein. 450 00:25:19,480 --> 00:25:21,800 Speaker 1: We have all seen pictures of those molecules that the 451 00:25:21,840 --> 00:25:25,280 Speaker 1: spike's coming off of them. Early in the pandemic, these 452 00:25:25,280 --> 00:25:29,240 Speaker 1: antibodies were shown to reduce hospitalizations and death in high 453 00:25:29,320 --> 00:25:33,520 Speaker 1: risk patients, especially if they were given soon after infection, 454 00:25:33,960 --> 00:25:37,320 Speaker 1: and they were also used as post exposure prophylaxis in 455 00:25:37,400 --> 00:25:42,439 Speaker 1: settings like nursing homes. However, as that virus evolved and 456 00:25:42,520 --> 00:25:46,320 Speaker 1: new variants emerged, a lot of those first generation antibodies 457 00:25:46,520 --> 00:25:49,400 Speaker 1: lost their effectiveness. We have all seen the news stories 458 00:25:49,440 --> 00:25:53,560 Speaker 1: about the newest mutation. This all revealed a key limitation. 459 00:25:54,280 --> 00:25:59,600 Speaker 1: Monoclonal antibodies are exquisitely specific, and even small mutations in 460 00:25:59,640 --> 00:26:03,840 Speaker 1: a viral target can render them completely obsolete. Still, though, 461 00:26:03,920 --> 00:26:07,640 Speaker 1: the rapid development and deployment of antibody therapies during COVID 462 00:26:07,680 --> 00:26:12,240 Speaker 1: demonstrated their value and their incredible versatility, and it actually 463 00:26:12,280 --> 00:26:15,720 Speaker 1: accelerated a lot of innovation across the field. I imagine 464 00:26:15,720 --> 00:26:18,720 Speaker 1: it is news to you that this one innovation from 465 00:26:18,720 --> 00:26:21,800 Speaker 1: the seventies has been such a boon to the treatment 466 00:26:21,840 --> 00:26:24,800 Speaker 1: of so many issues, both including the ones that you 467 00:26:24,880 --> 00:26:26,639 Speaker 1: live with and the others that you do not. 468 00:26:27,240 --> 00:26:30,200 Speaker 2: Yeah, that's amazing, and I just got to say love 469 00:26:30,280 --> 00:26:32,280 Speaker 2: me some science, like, thank you for that. 470 00:26:32,600 --> 00:26:35,919 Speaker 1: Right. So, while humanization actually did solve a lot of 471 00:26:35,960 --> 00:26:41,320 Speaker 1: problems associated with early antibodies, another challenge eventually emerged, and 472 00:26:41,359 --> 00:26:46,160 Speaker 1: that was how to address diseases that involve multiple molecular pathways. 473 00:26:46,240 --> 00:26:49,840 Speaker 1: And this is something that is specific in the psoriasis issue. 474 00:26:50,200 --> 00:26:54,399 Speaker 1: So in psoriasis and other inflammatory diseases, researchers started to 475 00:26:54,480 --> 00:26:59,040 Speaker 1: understand that different forms of the same inflammatory protein, such 476 00:26:59,040 --> 00:27:04,520 Speaker 1: as IL seventeen and IL seventeen F, actually worked together 477 00:27:04,680 --> 00:27:08,440 Speaker 1: to drive symptoms, so blocking just one was not always enough. 478 00:27:08,840 --> 00:27:11,919 Speaker 1: Actually talked about this earlier this season, how realizing it 479 00:27:11,960 --> 00:27:14,480 Speaker 1: had a partner in crime that was causing HAVOC was 480 00:27:14,520 --> 00:27:19,040 Speaker 1: a huge breakthrough. This realization then led to the development 481 00:27:19,119 --> 00:27:23,040 Speaker 1: of what are called bispecific antibodies. So these are engineered 482 00:27:23,040 --> 00:27:27,280 Speaker 1: molecules that are capable of recognizing and binding two different 483 00:27:27,320 --> 00:27:31,800 Speaker 1: targets simultaneously. Again, science, we love you. So instead of 484 00:27:31,800 --> 00:27:36,960 Speaker 1: building two separate monoclonal antibodies, researchers asked, could they build 485 00:27:37,000 --> 00:27:40,119 Speaker 1: a single molecule that worked like kind of a double 486 00:27:40,200 --> 00:27:43,760 Speaker 1: ended key, one that could basically unlock two different doors 487 00:27:43,800 --> 00:27:47,640 Speaker 1: at the same time. By specific obviously means the targets 488 00:27:47,680 --> 00:27:49,200 Speaker 1: two different disease pathways. 489 00:27:49,320 --> 00:27:51,520 Speaker 2: It reminds me of when I would take some medications 490 00:27:51,520 --> 00:27:54,359 Speaker 2: and sometimes they would help my skin more than the inflammation, 491 00:27:54,760 --> 00:27:57,280 Speaker 2: like the arthritis, and then some would help the arthritis 492 00:27:57,280 --> 00:27:58,840 Speaker 2: more than the skin, and it's like, there's got to 493 00:27:58,880 --> 00:28:00,879 Speaker 2: be something that can do so. 494 00:28:01,160 --> 00:28:05,320 Speaker 1: Unlike traditional drugs like aspirin or antibiotics, which are made 495 00:28:05,440 --> 00:28:11,119 Speaker 1: using chemical reactions, monoclonal antibodies are actually produced in living cells. 496 00:28:11,440 --> 00:28:15,679 Speaker 1: These cells, which are Chinese hamster ovary cells or cho cells, 497 00:28:16,240 --> 00:28:20,360 Speaker 1: have to be genetically engineered to produce the desired antibody protein, 498 00:28:20,920 --> 00:28:23,520 Speaker 1: and then they have to be kept alive and healthy 499 00:28:23,560 --> 00:28:26,959 Speaker 1: in controlled environments and fed with the right nutrients and 500 00:28:27,080 --> 00:28:31,239 Speaker 1: monitored constantly. So it is no small feat. In some 501 00:28:31,400 --> 00:28:34,879 Speaker 1: early formats, the antibodies that they had developed were prone 502 00:28:34,960 --> 00:28:40,080 Speaker 1: to falling apart or what's called misfolding themselves. Proteins are 503 00:28:40,080 --> 00:28:42,800 Speaker 1: made as long chains of amino acids that have to 504 00:28:42,800 --> 00:28:46,720 Speaker 1: fold into these very specific three D shapes to work properly. 505 00:28:47,280 --> 00:28:51,520 Speaker 1: For antibodies, The correct fold actually creates the precise binding 506 00:28:51,640 --> 00:28:54,920 Speaker 1: sites that allow them to grab onto their targets, and 507 00:28:55,040 --> 00:28:58,320 Speaker 1: so by the late nineteen eighties, cho cells had become 508 00:28:58,720 --> 00:29:02,080 Speaker 1: the gold standard for antibody production, and it seemed like 509 00:29:02,080 --> 00:29:05,480 Speaker 1: the first hurdle getting the antibodies to remain stable and 510 00:29:05,520 --> 00:29:07,840 Speaker 1: fold correctly was behind us. 511 00:29:08,120 --> 00:29:10,360 Speaker 2: Sound so intimidating. They have to get it just right. 512 00:29:10,480 --> 00:29:13,480 Speaker 2: That's crazy, right. I want to like send a muffin 513 00:29:13,560 --> 00:29:16,680 Speaker 2: basket to every single scientist that works on these It's 514 00:29:16,760 --> 00:29:22,640 Speaker 2: such incredibly intricate work. Producing these bispecific antibodies adds another 515 00:29:22,840 --> 00:29:26,560 Speaker 2: layer of complexity because scientists have to ensure that both 516 00:29:26,640 --> 00:29:30,400 Speaker 2: binding sites are functional and stable, not just in the lab, 517 00:29:30,480 --> 00:29:33,680 Speaker 2: but in the very dynamic and unpredictable environment that is 518 00:29:33,760 --> 00:29:37,960 Speaker 2: a human body. Structural biologists have to fine tune every 519 00:29:38,040 --> 00:29:41,000 Speaker 2: part of the molecule, from its overall shape to the 520 00:29:41,040 --> 00:29:45,240 Speaker 2: electrostatic charges that influence how it folds and binds. As 521 00:29:45,360 --> 00:29:49,480 Speaker 2: we've been discussing, this entire manufacturing process is a feat 522 00:29:49,640 --> 00:29:54,800 Speaker 2: of precision engineering. A single batch of monoclonal antibody therapy 523 00:29:54,840 --> 00:29:57,600 Speaker 2: can take three to four months to produce, and it 524 00:29:57,680 --> 00:30:01,160 Speaker 2: involves hundreds of trained scientists and tech nicians. So we 525 00:30:01,240 --> 00:30:04,720 Speaker 2: might need to start a muffin basket fund. The facilities 526 00:30:04,720 --> 00:30:08,680 Speaker 2: that are required are also expensive. They cost hundreds of 527 00:30:08,680 --> 00:30:11,720 Speaker 2: millions of dollars. They have to operate under the strictest 528 00:30:11,760 --> 00:30:15,520 Speaker 2: possible quality standards, and in a world where we see 529 00:30:15,640 --> 00:30:18,160 Speaker 2: viruses mutate quickly, I mean that makes the news all 530 00:30:18,200 --> 00:30:20,479 Speaker 2: the time, it's easy to see why it can be 531 00:30:20,520 --> 00:30:25,520 Speaker 2: really hard to keep medications effective. As monoclonal antibodies have 532 00:30:25,600 --> 00:30:29,840 Speaker 2: grown more complex and more powerful, the bar for proving 533 00:30:29,840 --> 00:30:34,320 Speaker 2: their effectiveness has also risen for conditions like psoriasis in 534 00:30:34,440 --> 00:30:37,800 Speaker 2: vitro testing just in case anybody doesn't know, in vitro 535 00:30:37,960 --> 00:30:41,920 Speaker 2: just means in glass, So that's just saying researchers have 536 00:30:42,040 --> 00:30:44,959 Speaker 2: to test these antibodies in the lab before they are 537 00:30:45,040 --> 00:30:49,840 Speaker 2: used in humans like Victoria, who is sometimes the next step. 538 00:30:50,320 --> 00:30:54,000 Speaker 2: So in the lab, researchers simulate the inflammatory environment of 539 00:30:54,000 --> 00:30:57,360 Speaker 2: the skin, allowing them to test whether a given antibody 540 00:30:57,720 --> 00:31:02,640 Speaker 2: can neutralize its targets without disrupt other immune functions. In 541 00:31:02,680 --> 00:31:05,440 Speaker 2: a way, you are an important link in this whole chain, 542 00:31:05,520 --> 00:31:08,400 Speaker 2: because without people like you who are willing to be 543 00:31:08,440 --> 00:31:11,280 Speaker 2: part of those trials, we don't have that final piece 544 00:31:11,320 --> 00:31:14,560 Speaker 2: of the information. Yeah, and I have a very severe case, 545 00:31:14,600 --> 00:31:16,800 Speaker 2: so I think it's helpful for them to get that data. 546 00:31:16,880 --> 00:31:19,160 Speaker 2: That drug has to do some good stuff. 547 00:31:18,840 --> 00:31:23,080 Speaker 1: To really for me. The payoff for all of this complexity, 548 00:31:23,080 --> 00:31:25,800 Speaker 1: as I'm sure you know, is quite substantial. So in 549 00:31:25,840 --> 00:31:29,880 Speaker 1: the realm of autoimmune disease, monoclonal antibodies have delivered results 550 00:31:29,880 --> 00:31:33,960 Speaker 1: that were once completely unthinkable. For people with moderate to 551 00:31:34,040 --> 00:31:38,040 Speaker 1: severe siriasis, antibody based therapies have achieved rates of skin 552 00:31:38,120 --> 00:31:41,600 Speaker 1: clearance far beyond what traditional treatments could ever offer, and 553 00:31:41,640 --> 00:31:45,360 Speaker 1: in some clinical trials, the majority of patients achieved complete 554 00:31:45,440 --> 00:31:50,680 Speaker 1: or near complete skin clearance. In infectious disease, monoclonal antibodies 555 00:31:50,680 --> 00:31:54,720 Speaker 1: have played life saving roles during public health crises. Their 556 00:31:54,760 --> 00:31:59,280 Speaker 1: ability to be developed rapidly, tailored precisely, and deployed flexibly 557 00:31:59,600 --> 00:32:02,880 Speaker 1: makes them invaluable tools in an era of emerging threats 558 00:32:02,880 --> 00:32:07,680 Speaker 1: and personalized medicine. In hindsight, the original insight of Keuler 559 00:32:07,720 --> 00:32:11,240 Speaker 1: and Milscene was simple but profound. Right, take the body's 560 00:32:11,320 --> 00:32:15,080 Speaker 1: most precise weapons that we naturally have anti bodies, and 561 00:32:15,160 --> 00:32:18,600 Speaker 1: then find a way to mass produce them outside the body. 562 00:32:19,040 --> 00:32:22,800 Speaker 1: And that one seemingly simple idea has grown into an 563 00:32:22,960 --> 00:32:26,920 Speaker 1: entire industry, one that sits at the intersection of immunology, 564 00:32:27,080 --> 00:32:34,480 Speaker 1: molecular biology, structural engineering, and industrial manufacturing. Today, monoclonal antibodies 565 00:32:34,480 --> 00:32:39,160 Speaker 1: are used to treat cancers, autoimmune diseases, allergic conditions, and 566 00:32:39,400 --> 00:32:44,320 Speaker 1: infectious diseases. They can be designed to deliver payloads, block signals, 567 00:32:44,440 --> 00:32:48,880 Speaker 1: or simply act as decoys. The frontier continues to expand, 568 00:32:48,920 --> 00:32:51,600 Speaker 1: and Victoria is part of that working in these trials. 569 00:32:51,640 --> 00:32:54,840 Speaker 1: So what began in this small lab in Cambridge has 570 00:32:54,880 --> 00:32:58,200 Speaker 1: grown into one of the most powerful and adaptable technologies 571 00:32:58,240 --> 00:33:01,680 Speaker 1: in modern science. That mouse sell that started at all 572 00:33:01,840 --> 00:33:06,520 Speaker 1: has become a global engine for human healing. Amazing, And 573 00:33:06,560 --> 00:33:08,400 Speaker 1: you're part of this big story, which I love. It 574 00:33:08,440 --> 00:33:11,160 Speaker 1: makes me love the whole thing even more. I really 575 00:33:11,240 --> 00:33:14,080 Speaker 1: like these science heavy episodes because I am a nerd 576 00:33:14,280 --> 00:33:17,400 Speaker 1: and you can really see how people build on one 577 00:33:17,440 --> 00:33:21,240 Speaker 1: another's discoveries and just how big the effort of medicinal 578 00:33:21,280 --> 00:33:24,960 Speaker 1: breakthroughs like this really are. You see it firsthand because 579 00:33:25,000 --> 00:33:27,760 Speaker 1: you are part of the process. And I do want 580 00:33:27,760 --> 00:33:29,960 Speaker 1: to end by coming back to you because I have 581 00:33:30,200 --> 00:33:33,239 Speaker 1: two more questions for you, and these are questions we 582 00:33:33,280 --> 00:33:35,520 Speaker 1: ask all of our guests at the end of each episode. 583 00:33:35,640 --> 00:33:39,000 Speaker 1: So the first is what suggestions do you have for 584 00:33:39,080 --> 00:33:42,920 Speaker 1: people who maybe don't have psoriasis themselves, but they love 585 00:33:42,960 --> 00:33:44,800 Speaker 1: someone who does, or they are in the life of 586 00:33:44,800 --> 00:33:46,520 Speaker 1: someone who does, and they want to be a help 587 00:33:46,560 --> 00:33:49,040 Speaker 1: and not make it more troubling. 588 00:33:49,720 --> 00:33:52,960 Speaker 2: I think it'll come down to someone's individual needs. What 589 00:33:53,080 --> 00:33:56,600 Speaker 2: helps me the best with having friends and family when 590 00:33:56,600 --> 00:33:59,840 Speaker 2: I'm going through a flare is just supporting me and 591 00:34:00,000 --> 00:34:02,880 Speaker 2: and maybe even helping me put some lotion on my back. 592 00:34:03,040 --> 00:34:06,880 Speaker 2: Just that simple. And I'm someone who needs someone to say, yeah, 593 00:34:06,880 --> 00:34:08,279 Speaker 2: that does suck. You know what I mean? 594 00:34:08,600 --> 00:34:11,719 Speaker 1: Yes, I see, I understand. Last, but not least, if 595 00:34:11,760 --> 00:34:14,879 Speaker 1: you could send one message to listeners who might be 596 00:34:15,000 --> 00:34:17,759 Speaker 1: grappling with their own diagnoses and might be early in 597 00:34:17,800 --> 00:34:18,960 Speaker 1: the journey, what would that be. 598 00:34:19,680 --> 00:34:22,160 Speaker 2: I would say, even if it's just a small spot, 599 00:34:22,360 --> 00:34:25,920 Speaker 2: get it checked out, because it can start small and 600 00:34:25,960 --> 00:34:28,600 Speaker 2: then eventually creep down your face. You just don't know. 601 00:34:29,360 --> 00:34:31,840 Speaker 1: Victoria, thank you so much for spending this time with me. 602 00:34:32,320 --> 00:34:33,960 Speaker 2: Thank you for having me. It was a lot of fun. 603 00:34:33,960 --> 00:34:43,640 Speaker 1: I learned a lot. Our skim is hosted by myself, 604 00:34:43,680 --> 00:34:47,560 Speaker 1: Holly Fry and executive produced and engineered by Ryan Martz. 605 00:34:48,000 --> 00:34:51,560 Speaker 1: Our executive producer and writer is Meredith Barnes. If you 606 00:34:51,680 --> 00:34:54,319 Speaker 1: enjoy the show, share it with your friends. You can 607 00:34:54,360 --> 00:34:58,160 Speaker 1: also listen and follow on the iHeartRadio app, Apple Podcasts, 608 00:34:58,239 --> 00:35:04,799 Speaker 1: or wherever you get your podcasts.