1 00:00:09,240 --> 00:00:12,440 Speaker 1: I'm Holly Fry and this is season two of Our Skin, 2 00:00:12,640 --> 00:00:17,440 Speaker 1: a personal discovery podcast. Today we are honored to welcome 3 00:00:17,560 --> 00:00:21,720 Speaker 1: Jesstrand to our Skin. Jess is many things, a model, 4 00:00:21,760 --> 00:00:26,160 Speaker 1: an entrepreneur, and a passionate psoriasis advocate whose voice has 5 00:00:26,200 --> 00:00:29,400 Speaker 1: become a very powerful force in redefining what it means 6 00:00:29,440 --> 00:00:33,400 Speaker 1: to live and thrive with a visible chronic condition. Jess 7 00:00:33,440 --> 00:00:37,120 Speaker 1: develops psoriasis at twenty four, navigating flare ups and the 8 00:00:37,159 --> 00:00:40,800 Speaker 1: emotional toll of a skin condition while coming of age 9 00:00:40,960 --> 00:00:45,960 Speaker 1: in environments that often valued perfection over authenticity. But over time, 10 00:00:46,320 --> 00:00:50,720 Speaker 1: Jess started to reclaim her story. She challenges traditional beauty 11 00:00:50,720 --> 00:00:54,240 Speaker 1: standards by showing her skin exactly as it is, and 12 00:00:54,440 --> 00:00:58,440 Speaker 1: through entrepreneurship and online storytelling, she has built a platform 13 00:00:58,480 --> 00:01:04,560 Speaker 1: grounded in transparency, vulnerability, and cultural nuance. Today, Jess continues 14 00:01:04,560 --> 00:01:07,640 Speaker 1: to break barriers, helping others find beauty in their own 15 00:01:07,680 --> 00:01:11,319 Speaker 1: skin and pushing the wellness industry to be more inclusive. 16 00:01:11,920 --> 00:01:15,880 Speaker 1: Her advocacy centers on body neutrality, mental health, and creating 17 00:01:15,920 --> 00:01:21,560 Speaker 1: spaces where people with chronic illnesses truly feel seen. Jess, 18 00:01:21,640 --> 00:01:24,280 Speaker 1: Welcome to Our Skin. We are so thrilled to have 19 00:01:24,360 --> 00:01:25,120 Speaker 1: you with us. 20 00:01:25,360 --> 00:01:27,200 Speaker 2: Thank you for having me. I'm excited to be here. 21 00:01:27,600 --> 00:01:30,000 Speaker 1: I want to know your whole story. So starting off, 22 00:01:30,120 --> 00:01:35,200 Speaker 1: can you take us back to that first diagnosis of 23 00:01:35,240 --> 00:01:38,680 Speaker 1: psoriasis because you were only twenty four, and I'm sure 24 00:01:38,760 --> 00:01:42,440 Speaker 1: this was a very intense time, both emotionally and physically, 25 00:01:42,560 --> 00:01:44,559 Speaker 1: so talk us through it. Yeah. 26 00:01:44,600 --> 00:01:46,520 Speaker 2: So, when I was twenty four, I was on the 27 00:01:46,520 --> 00:01:49,600 Speaker 2: back of a job that was extremely toxic. So there 28 00:01:49,600 --> 00:01:52,240 Speaker 2: were a series of events that happened with some old 29 00:01:52,280 --> 00:01:54,680 Speaker 2: bosses of mine that were kind of doing a number 30 00:01:54,760 --> 00:01:58,560 Speaker 2: on my immune system and my mental health. So right 31 00:01:58,600 --> 00:02:00,440 Speaker 2: after one of these major events, so I think it 32 00:02:00,520 --> 00:02:03,960 Speaker 2: was actually a performance review, I broke out in this 33 00:02:04,240 --> 00:02:06,920 Speaker 2: rash across my chest, which I had never seen before. 34 00:02:07,200 --> 00:02:10,080 Speaker 2: It kind of spread all over my chest and my shoulders. 35 00:02:10,280 --> 00:02:13,079 Speaker 2: There were big, fread, angry welds. I'd never seen anything 36 00:02:13,240 --> 00:02:16,320 Speaker 2: like it, and they lasted for about a month. So 37 00:02:16,600 --> 00:02:20,160 Speaker 2: it kicked off this series of dermatology appointments with about 38 00:02:20,400 --> 00:02:23,320 Speaker 2: eight to ten different dermatologists. A lot of them couldn't 39 00:02:23,360 --> 00:02:25,840 Speaker 2: tell me what it was. I don't know really why 40 00:02:25,880 --> 00:02:28,320 Speaker 2: that was the case, but it went from everything from 41 00:02:28,840 --> 00:02:31,800 Speaker 2: we think it might be lupus to you might have 42 00:02:31,840 --> 00:02:34,200 Speaker 2: to go to a different specialist, And on the eighth 43 00:02:34,320 --> 00:02:39,040 Speaker 2: visit they finally diagnosed it assiasis and gut tapedsoriasis specifically. 44 00:02:39,639 --> 00:02:41,240 Speaker 2: So there was a long period of time where I 45 00:02:41,280 --> 00:02:43,520 Speaker 2: was doing allergy test and nothing was showing up. I 46 00:02:43,560 --> 00:02:48,519 Speaker 2: did a holistic course of treatment, which included like twenty 47 00:02:48,560 --> 00:02:50,640 Speaker 2: vials of my blood being taken and being tested for 48 00:02:50,680 --> 00:02:54,320 Speaker 2: everything under the sun. And to this day, outside of 49 00:02:54,320 --> 00:02:57,119 Speaker 2: having an official diagnosis, I don't think anyone's actually ever 50 00:02:57,160 --> 00:03:01,720 Speaker 2: been helpful in any sense in the traditional medical establishment 51 00:03:01,760 --> 00:03:03,720 Speaker 2: on how to treat it or how to contain it. 52 00:03:04,360 --> 00:03:07,680 Speaker 1: Your story makes me wonder about something because you talked 53 00:03:07,680 --> 00:03:10,520 Speaker 1: about this flare up happened after a stressful event, and 54 00:03:10,560 --> 00:03:12,239 Speaker 1: we know that stress can impact the body in a 55 00:03:12,320 --> 00:03:14,800 Speaker 1: lot of ways. But I hadn't really thought about it 56 00:03:14,880 --> 00:03:18,440 Speaker 1: until just now as you were talking having all of 57 00:03:18,480 --> 00:03:21,440 Speaker 1: these maybe diagnoses like it might be this, it might 58 00:03:21,480 --> 00:03:24,760 Speaker 1: be this is its own stress cycle. Do you think 59 00:03:24,840 --> 00:03:28,200 Speaker 1: that was a factor in how it was developing as 60 00:03:28,240 --> 00:03:29,480 Speaker 1: you were trying to figure it out. 61 00:03:30,160 --> 00:03:33,040 Speaker 2: Yeah, I think the idea that I didn't know what 62 00:03:33,120 --> 00:03:35,440 Speaker 2: it was and that there was something seriously wrong with 63 00:03:35,480 --> 00:03:38,680 Speaker 2: my body, and that traditional doctors could not tell me 64 00:03:38,760 --> 00:03:42,040 Speaker 2: what it was was incredibly destabilizing for me. The amount 65 00:03:42,080 --> 00:03:44,600 Speaker 2: of time it took to even diagnose it was a 66 00:03:44,640 --> 00:03:47,320 Speaker 2: really really stressful year of my life because it was 67 00:03:47,440 --> 00:03:51,880 Speaker 2: navigating by myself different avenues and different doctors and the 68 00:03:51,920 --> 00:03:56,119 Speaker 2: same type of doctor to give me different results and diagnoses, 69 00:03:56,120 --> 00:03:57,320 Speaker 2: which was really confusing for me. 70 00:03:58,080 --> 00:04:00,760 Speaker 1: You were training as a weight list at this point 71 00:04:00,760 --> 00:04:02,240 Speaker 1: in time, right, is that correct? 72 00:04:02,400 --> 00:04:03,360 Speaker 2: Yes? As a powerlifter. 73 00:04:03,920 --> 00:04:07,440 Speaker 1: The intensity of that surely was also hard on your body. Right. 74 00:04:08,000 --> 00:04:10,160 Speaker 2: What I ended up figuring out was that I had 75 00:04:10,240 --> 00:04:14,400 Speaker 2: been living at a level of intensity, like you say, physically, 76 00:04:14,760 --> 00:04:17,960 Speaker 2: with my career, emotionally, with the background that I come from, 77 00:04:18,440 --> 00:04:22,360 Speaker 2: that I think all coalesced into this condition. I think 78 00:04:22,680 --> 00:04:26,919 Speaker 2: my personality is geared towards pushing myself to the absolute limit, 79 00:04:27,400 --> 00:04:30,719 Speaker 2: and zoriasis was the result of that. It was genetic 80 00:04:30,760 --> 00:04:33,960 Speaker 2: as well, I'm sure, but living this way for such 81 00:04:33,960 --> 00:04:36,160 Speaker 2: a long time, it doesn't matter if it's seriasis or 82 00:04:36,200 --> 00:04:38,919 Speaker 2: another type of chronic condition, it's just the one that 83 00:04:39,000 --> 00:04:39,640 Speaker 2: was handed to me. 84 00:04:40,440 --> 00:04:44,240 Speaker 1: Was there a particular moment or a slow shift when 85 00:04:44,279 --> 00:04:48,599 Speaker 1: you really started to challenge that instinct of being embarrassed 86 00:04:48,680 --> 00:04:52,559 Speaker 1: or ashamed and start to realize that you could share 87 00:04:52,640 --> 00:04:54,560 Speaker 1: your skin and your story more openly. 88 00:04:55,360 --> 00:04:57,960 Speaker 2: So I've always been a really open person, like you 89 00:04:58,200 --> 00:04:59,400 Speaker 2: can say hi to me, and I'll tell you my 90 00:04:59,440 --> 00:05:02,280 Speaker 2: whole life star sorry. So I've never really been embarrassed 91 00:05:02,320 --> 00:05:04,480 Speaker 2: about the soriasis. I've been very open and candid about 92 00:05:04,480 --> 00:05:08,080 Speaker 2: the entire experience, from diagnosing it to treating it. I 93 00:05:08,120 --> 00:05:12,680 Speaker 2: think personally, within me there's been a process of accepting 94 00:05:12,800 --> 00:05:16,040 Speaker 2: what psyriasis is, which I think with everyone with chronic illness, 95 00:05:16,240 --> 00:05:19,400 Speaker 2: you go through a period where you deny that it's 96 00:05:19,440 --> 00:05:21,160 Speaker 2: happening to you. And it took me about a few 97 00:05:21,240 --> 00:05:23,920 Speaker 2: years to get over that mentality of this is not fair. 98 00:05:24,160 --> 00:05:27,200 Speaker 2: I'm a powerlifter, I eat while I take care of myself. 99 00:05:27,279 --> 00:05:29,360 Speaker 2: I'm excelling in all these parts of my life. Why 100 00:05:29,360 --> 00:05:31,679 Speaker 2: would this be happening to me to a place where 101 00:05:31,760 --> 00:05:34,880 Speaker 2: I do genuinely think that the psiasis is a gift 102 00:05:35,279 --> 00:05:37,400 Speaker 2: that was given by my body to understand and to 103 00:05:37,440 --> 00:05:40,800 Speaker 2: help regulate how I process and how I move through 104 00:05:40,800 --> 00:05:44,440 Speaker 2: the world, because without it, I'm very prone to running 105 00:05:44,440 --> 00:05:47,120 Speaker 2: at a million miles an hour, and with it, I 106 00:05:47,200 --> 00:05:49,480 Speaker 2: can't do that. I really have to listen to my body. 107 00:05:49,520 --> 00:05:53,039 Speaker 2: It's such a physical symptom of pushing yourself too hard. 108 00:05:53,320 --> 00:05:55,599 Speaker 2: So I would say that it came with just growing 109 00:05:55,680 --> 00:05:58,200 Speaker 2: up and becoming like a turning thirty, getting out of 110 00:05:58,200 --> 00:06:00,359 Speaker 2: my twenties. I think everybody goes through a period of 111 00:06:00,360 --> 00:06:03,640 Speaker 2: accepting themselves whatever, whether that's chronic illness or not, and 112 00:06:03,800 --> 00:06:06,400 Speaker 2: just a lot of years of therapy and thinking through 113 00:06:06,400 --> 00:06:09,200 Speaker 2: it and living with it, and then also committing to 114 00:06:09,240 --> 00:06:12,919 Speaker 2: different treatments and changing my lifestyle to accommodate it. It 115 00:06:13,000 --> 00:06:15,800 Speaker 2: just took a long time to adjust that that is 116 00:06:15,839 --> 00:06:17,560 Speaker 2: the way that I'm built, and there's no other way 117 00:06:17,560 --> 00:06:18,360 Speaker 2: that I can choose. 118 00:06:18,720 --> 00:06:20,599 Speaker 1: As I was looking at your social media and there 119 00:06:20,680 --> 00:06:23,400 Speaker 1: was a picture that you posted in twenty twenty, and 120 00:06:23,440 --> 00:06:25,560 Speaker 1: it's you, and you're in like a kind of goldish 121 00:06:25,600 --> 00:06:28,640 Speaker 1: pumpkinny colored bikini in it. Just as I have finally accepted, 122 00:06:28,680 --> 00:06:32,480 Speaker 1: I'm paraphrasing because I'm going from memory that psoriasis will 123 00:06:32,480 --> 00:06:34,839 Speaker 1: always be part of my body. And it was one 124 00:06:34,880 --> 00:06:38,560 Speaker 1: of those things where it's so obvious as a reader, 125 00:06:38,720 --> 00:06:42,480 Speaker 1: as someone perceiving that post, that's almost like the late 126 00:06:42,560 --> 00:06:46,880 Speaker 1: light bulb moment where like full acceptance happens. Yeah, how 127 00:06:47,200 --> 00:06:49,920 Speaker 1: do you get there? From the early part, a lot. 128 00:06:49,760 --> 00:06:55,119 Speaker 2: Of complaining, of a lot of why Me'm my ex 129 00:06:55,200 --> 00:06:58,159 Speaker 2: and current boyfriends are probably so sick of me talking 130 00:06:58,200 --> 00:07:00,719 Speaker 2: about it, and all my friends as well. But I 131 00:07:00,720 --> 00:07:03,799 Speaker 2: think that was just after maybe five cycles of flare 132 00:07:03,839 --> 00:07:05,279 Speaker 2: ups where I'd get rid of it and then it 133 00:07:05,279 --> 00:07:06,800 Speaker 2: would come back, and I'd get rid of it and 134 00:07:06,800 --> 00:07:09,159 Speaker 2: would come back, and then it just stopped feeling like 135 00:07:09,200 --> 00:07:13,200 Speaker 2: a temporary thing, and I started getting sick of going 136 00:07:13,240 --> 00:07:15,080 Speaker 2: through the same cycle, because if you have the same 137 00:07:15,120 --> 00:07:17,600 Speaker 2: mentality with something over and over and over again without 138 00:07:17,640 --> 00:07:21,080 Speaker 2: changing it, it starts to just grate on yourself and 139 00:07:21,120 --> 00:07:24,160 Speaker 2: everyone around you. So at some point, I think I 140 00:07:24,240 --> 00:07:28,240 Speaker 2: just realized that if I was going to fight against acceptance, 141 00:07:28,840 --> 00:07:31,400 Speaker 2: this was going to be a bigger deal than it was, 142 00:07:31,720 --> 00:07:33,520 Speaker 2: because fighting against it makes it worse. 143 00:07:33,880 --> 00:07:36,360 Speaker 1: It sounds like the shift is the difference between looking 144 00:07:36,400 --> 00:07:39,680 Speaker 1: at it as a problem to solve and the situation 145 00:07:39,800 --> 00:07:40,680 Speaker 1: to manage. 146 00:07:41,200 --> 00:07:43,360 Speaker 2: Yeah, And I think that like, as a daughter of 147 00:07:43,440 --> 00:07:47,520 Speaker 2: refugees and someone who's always strived to fix everything in 148 00:07:47,520 --> 00:07:51,240 Speaker 2: my life with hard work ethic, I cannot apply that 149 00:07:51,280 --> 00:07:54,600 Speaker 2: same logic to my chronic illness. My chronic illness requires 150 00:07:54,640 --> 00:07:57,239 Speaker 2: me to slow down, It requires me to emotionally regulate, 151 00:07:57,280 --> 00:08:00,480 Speaker 2: It requires me to eat well, to sleep well. Especially thirties, 152 00:08:00,480 --> 00:08:01,760 Speaker 2: I can't do the same things I was doing in 153 00:08:01,760 --> 00:08:04,520 Speaker 2: my twenties. It makes my sorices flow up even more now. 154 00:08:04,600 --> 00:08:08,280 Speaker 2: So it's an almost inverse response to how I was 155 00:08:08,320 --> 00:08:12,000 Speaker 2: conditioned to treat every problem in my life, which was 156 00:08:12,040 --> 00:08:14,440 Speaker 2: to apply myself one hundred percent to it. 157 00:08:15,200 --> 00:08:19,080 Speaker 1: You also model, which of course involves a lot of 158 00:08:19,160 --> 00:08:23,000 Speaker 1: varieties of visibility literal visibility, but also a degree of 159 00:08:23,040 --> 00:08:26,560 Speaker 1: emotional visibility, et cetera. Tell me about getting into modeling. 160 00:08:26,600 --> 00:08:28,720 Speaker 1: How did you get your start there. 161 00:08:29,440 --> 00:08:32,640 Speaker 2: I was approached online by an agency who asked to 162 00:08:32,679 --> 00:08:34,800 Speaker 2: sign me, and I'm five foot one, which is something 163 00:08:34,800 --> 00:08:37,080 Speaker 2: you don't get to see on a podcast. So the 164 00:08:37,240 --> 00:08:40,960 Speaker 2: context of being five foot one Asian woman with tattoos, 165 00:08:41,520 --> 00:08:43,400 Speaker 2: with the way I grew up in Sydney, there was 166 00:08:43,440 --> 00:08:47,000 Speaker 2: no representation of Asian women modeling at that height. I 167 00:08:47,040 --> 00:08:48,680 Speaker 2: just assumed that would never be going to be something 168 00:08:48,720 --> 00:08:50,960 Speaker 2: that I could do, And when you add the skin 169 00:08:51,080 --> 00:08:53,720 Speaker 2: to it, it just didn't seem like that's what people 170 00:08:53,720 --> 00:08:55,800 Speaker 2: are looking for in the modeling industry. So I was 171 00:08:55,800 --> 00:08:58,439 Speaker 2: approached by an agency and I started doing a bunch 172 00:08:58,480 --> 00:09:02,200 Speaker 2: of commercial modeling work. And the ciasis has been an 173 00:09:02,240 --> 00:09:07,559 Speaker 2: interesting factor because in the modeling industry they distill you 174 00:09:07,640 --> 00:09:10,480 Speaker 2: into physical traits, Like they even talk about hands modeling 175 00:09:10,520 --> 00:09:13,439 Speaker 2: as parts modeling, right right. You get like defined by 176 00:09:13,480 --> 00:09:16,440 Speaker 2: these features of yours. So at times I've been casted 177 00:09:16,559 --> 00:09:20,679 Speaker 2: for mysoriasis, which is an interesting thing to be casted 178 00:09:20,679 --> 00:09:22,920 Speaker 2: for because I'm not in control of my flare ups. 179 00:09:23,000 --> 00:09:25,800 Speaker 2: So if a skin brand comes knocking and they're like, 180 00:09:25,880 --> 00:09:28,480 Speaker 2: we want people with psoriasis, I may not have a 181 00:09:28,520 --> 00:09:31,400 Speaker 2: flare up. So I functionally don't have czoriasis at that moment, 182 00:09:31,440 --> 00:09:34,160 Speaker 2: and I'm not helpful to them. And then they got 183 00:09:34,160 --> 00:09:36,520 Speaker 2: back to me and they said, Okay, that's great, but like, 184 00:09:36,559 --> 00:09:39,200 Speaker 2: do you have any on your face? And I kind 185 00:09:39,200 --> 00:09:41,760 Speaker 2: of was like, I can't really control if it goes 186 00:09:41,760 --> 00:09:45,120 Speaker 2: on my face. And then they said, well, we can't 187 00:09:45,160 --> 00:09:47,560 Speaker 2: find anyone with csoriasis on their face as a model, 188 00:09:48,000 --> 00:09:49,480 Speaker 2: And like, I don't think a lot of people get 189 00:09:49,480 --> 00:09:50,920 Speaker 2: crisis on their face. 190 00:09:51,360 --> 00:09:54,480 Speaker 1: I'm still a little bit gobsmacked at that. You have 191 00:09:54,840 --> 00:09:58,920 Speaker 1: described visibility as something of a double edged sword before 192 00:09:59,200 --> 00:10:03,000 Speaker 1: it's both empowered, worrying and exhausting. So I'm wondering, how 193 00:10:03,040 --> 00:10:06,320 Speaker 1: do you decide when you want to show up publicly 194 00:10:06,480 --> 00:10:09,040 Speaker 1: versus when you want to prioritize your own piece and 195 00:10:09,080 --> 00:10:10,360 Speaker 1: get a little bit of rejuvenation. 196 00:10:11,080 --> 00:10:13,360 Speaker 2: It just goes through cycles and whatever's going on with 197 00:10:13,400 --> 00:10:16,080 Speaker 2: the rest of my life and my mental landscape. But 198 00:10:16,880 --> 00:10:21,240 Speaker 2: during flare ups lately, they've been more severe. So when 199 00:10:21,240 --> 00:10:23,960 Speaker 2: they become more severe, it just takes over my life 200 00:10:24,000 --> 00:10:25,920 Speaker 2: a little bit more, and I'm more prone to speaking 201 00:10:25,920 --> 00:10:28,480 Speaker 2: about it because it's so present for me. But there 202 00:10:28,480 --> 00:10:31,360 Speaker 2: are times two where I'm thirty two now, so I've 203 00:10:31,360 --> 00:10:34,080 Speaker 2: been living in with it for eight years. It's just 204 00:10:34,200 --> 00:10:36,200 Speaker 2: such a part of my everyday life that I don't 205 00:10:36,559 --> 00:10:38,840 Speaker 2: think to share about it because it becomes a ritual 206 00:10:38,840 --> 00:10:41,480 Speaker 2: and a routine, the hair care thing with the Dandroff 207 00:10:41,480 --> 00:10:43,520 Speaker 2: on my head or whatever it is. But I think 208 00:10:43,520 --> 00:10:48,080 Speaker 2: in periods of particular insecurity, my response is to talk 209 00:10:48,120 --> 00:10:50,240 Speaker 2: to other people about it and to be public about it, 210 00:10:50,280 --> 00:10:53,320 Speaker 2: because I think the thing with being a creator online 211 00:10:53,360 --> 00:10:56,560 Speaker 2: too and having a visibility with the public online is 212 00:10:56,600 --> 00:10:59,360 Speaker 2: that you have a platform to share when things don't 213 00:10:59,440 --> 00:11:02,960 Speaker 2: feel amazing. There's always something going on in the background. 214 00:11:03,200 --> 00:11:05,360 Speaker 2: So in some way for me, if were a called 215 00:11:05,360 --> 00:11:09,439 Speaker 2: to share when I'm experiencing challenge, so when it's worse, 216 00:11:09,720 --> 00:11:11,440 Speaker 2: I'll share how to and be more public about it. 217 00:11:11,960 --> 00:11:14,319 Speaker 1: You have also talked about, you know, how you focus 218 00:11:14,400 --> 00:11:18,280 Speaker 1: on what soriasis doesn't like, like gluten stress, et cetera. 219 00:11:18,559 --> 00:11:22,920 Speaker 1: But you have also thought about what it does like. 220 00:11:23,080 --> 00:11:26,280 Speaker 1: So I want to know what does your soiasis like. 221 00:11:26,880 --> 00:11:29,199 Speaker 2: It likes when I'm living like a monk on a beach, 222 00:11:29,440 --> 00:11:33,640 Speaker 2: That's what it likes. It likes when I'm in Costa Rica, 223 00:11:33,760 --> 00:11:36,880 Speaker 2: not doing anything on vacation. It loves the ocean, It 224 00:11:36,960 --> 00:11:40,520 Speaker 2: loves sunshine. It loves eight hours of sleep and eating 225 00:11:40,600 --> 00:11:44,360 Speaker 2: only an only vegetable diet and not having any toxicity 226 00:11:44,400 --> 00:11:46,880 Speaker 2: in my life, which is unfortunately very far from the 227 00:11:46,880 --> 00:11:49,280 Speaker 2: reality of living in New York. So yeah, I would 228 00:11:49,280 --> 00:11:51,080 Speaker 2: say the main thing it loves is the ocean and 229 00:11:51,160 --> 00:11:51,720 Speaker 2: salt water. 230 00:11:52,440 --> 00:11:55,040 Speaker 1: What changes would you like to see in the way 231 00:11:55,400 --> 00:11:58,560 Speaker 1: that the wellness industry talks about healing and health. 232 00:11:59,440 --> 00:12:02,040 Speaker 2: I think this is a really big conversation that ties 233 00:12:02,080 --> 00:12:06,840 Speaker 2: into my opinions on the American healthcare system in general, 234 00:12:07,080 --> 00:12:09,800 Speaker 2: and it starts with food, and it starts with the 235 00:12:09,960 --> 00:12:12,720 Speaker 2: pollution in the air, in the water, in the way 236 00:12:12,720 --> 00:12:14,679 Speaker 2: that we grow our food. And I think there are 237 00:12:14,679 --> 00:12:17,199 Speaker 2: so many systems tied into it and what the wellness 238 00:12:17,240 --> 00:12:19,800 Speaker 2: industry is in America. So I would like for the 239 00:12:19,800 --> 00:12:23,360 Speaker 2: wellness industry to move away from you know, vitamins and 240 00:12:23,440 --> 00:12:27,760 Speaker 2: quick fixes and just all these like very broad solutions 241 00:12:27,800 --> 00:12:30,240 Speaker 2: that don't address what is at its root, which is 242 00:12:30,240 --> 00:12:33,240 Speaker 2: that the way that you take care of people here 243 00:12:33,679 --> 00:12:35,640 Speaker 2: through what we are fed and the way that we 244 00:12:35,760 --> 00:12:38,560 Speaker 2: go to the doctor needs to fundamentally change. 245 00:12:39,120 --> 00:12:44,000 Speaker 1: You have also built this very impressive, thoughtful, and really 246 00:12:44,080 --> 00:12:49,360 Speaker 1: welcoming online presence. I'm wondering how that relationship between you 247 00:12:49,440 --> 00:12:53,079 Speaker 1: and the chronic illness community has impacted your own journey 248 00:12:53,200 --> 00:12:54,960 Speaker 1: and what you've learned from other people. 249 00:12:55,800 --> 00:12:58,360 Speaker 2: For me, I don't have anyone in my life who 250 00:12:58,760 --> 00:13:02,960 Speaker 2: has a chronic skin condition that I know personally, so 251 00:13:03,040 --> 00:13:05,199 Speaker 2: I feel very alone in that sense in my day 252 00:13:05,240 --> 00:13:08,960 Speaker 2: to day life. So sharing online and being a member 253 00:13:09,000 --> 00:13:12,360 Speaker 2: of this larger online community it makes me feel a 254 00:13:12,400 --> 00:13:15,640 Speaker 2: little bit more stable. I think understanding that there are 255 00:13:15,679 --> 00:13:17,880 Speaker 2: other people who are like me who have the same 256 00:13:17,920 --> 00:13:20,280 Speaker 2: issues who struggle in the same ways, instead of what 257 00:13:20,320 --> 00:13:22,920 Speaker 2: I am physically reminded of every day in my normal life, 258 00:13:22,920 --> 00:13:24,720 Speaker 2: which is just gorgeous, gorgeous people. I love my friends, 259 00:13:24,720 --> 00:13:26,360 Speaker 2: They're beautiful, but they don't make me feel good about 260 00:13:26,360 --> 00:13:28,680 Speaker 2: my skin sometimes. And then on the other side, I 261 00:13:28,679 --> 00:13:33,040 Speaker 2: think there's an interesting aspect to this community, which is 262 00:13:33,080 --> 00:13:35,600 Speaker 2: that a lot of us might have siasis or exama 263 00:13:35,720 --> 00:13:38,319 Speaker 2: or whatever it is, but every condition is so specific 264 00:13:38,360 --> 00:13:41,719 Speaker 2: to the person. So when I post videos about my crisis, 265 00:13:41,760 --> 00:13:44,160 Speaker 2: I'll get a whole bunch of people offering that they 266 00:13:44,160 --> 00:13:46,319 Speaker 2: think I should do this. It must be a fungus, 267 00:13:46,440 --> 00:13:49,800 Speaker 2: I should do this, And whatever applies to you does 268 00:13:49,800 --> 00:13:52,360 Speaker 2: not necessarily apply to someone else. So this kind of 269 00:13:52,440 --> 00:13:55,480 Speaker 2: like spraying diagnoses to people online is something that I 270 00:13:55,480 --> 00:13:58,200 Speaker 2: think is problematic. When I try to talk about what's 271 00:13:58,240 --> 00:13:59,920 Speaker 2: worked for me, I try to have the caveat that 272 00:14:00,360 --> 00:14:03,440 Speaker 2: this has worked for me and that's specific to me 273 00:14:03,760 --> 00:14:06,319 Speaker 2: and like eight years of research and trial and error, 274 00:14:06,480 --> 00:14:09,080 Speaker 2: But it doesn't mean that this might work exactly for you. 275 00:14:09,520 --> 00:14:12,000 Speaker 2: But that's also the beauty of having psoriasis is that 276 00:14:12,040 --> 00:14:13,880 Speaker 2: it teaches you that you have to figure out your 277 00:14:13,880 --> 00:14:16,840 Speaker 2: own path and your own set of solutions and treatment 278 00:14:16,880 --> 00:14:19,680 Speaker 2: and management, and you can't really just rely on somebody 279 00:14:19,680 --> 00:14:21,800 Speaker 2: else's solution what they've learned from their condition. 280 00:14:22,520 --> 00:14:25,160 Speaker 1: You have already accomplished so much at thirty two, but 281 00:14:25,320 --> 00:14:28,640 Speaker 1: I am wondering what is next for you, whether that's 282 00:14:28,680 --> 00:14:31,360 Speaker 1: in your advocacy or your creative work or something that 283 00:14:31,400 --> 00:14:34,160 Speaker 1: we don't even know you have going on yet. What 284 00:14:34,240 --> 00:14:35,400 Speaker 1: do you have in your future? 285 00:14:35,920 --> 00:14:37,720 Speaker 2: So at the moment, I have about five jobs, so 286 00:14:37,760 --> 00:14:40,960 Speaker 2: I'm consulting for Planned Parenthood, which is my main client 287 00:14:41,040 --> 00:14:44,520 Speaker 2: with Vocal Media, so hopefully continuing with that work and 288 00:14:44,560 --> 00:14:48,280 Speaker 2: making sure they're not defunded. I'm also writing a fiction 289 00:14:48,360 --> 00:14:50,960 Speaker 2: book right now which I'm hoping will be released the 290 00:14:50,960 --> 00:14:53,680 Speaker 2: next year. And then finally I'm working on a photographic 291 00:14:53,760 --> 00:14:57,320 Speaker 2: series documenting the Vietnamese diaspora, which will be an exhibition 292 00:14:57,480 --> 00:14:59,720 Speaker 2: and an art book in a few years as well. 293 00:15:00,000 --> 00:15:02,000 Speaker 1: So when you said you were a high achiever, you 294 00:15:02,040 --> 00:15:05,640 Speaker 1: were not exaggerating a tiny amount. Jess, thank you so 295 00:15:05,720 --> 00:15:08,520 Speaker 1: much for telling us your story. As we hear often 296 00:15:08,560 --> 00:15:11,320 Speaker 1: in these interviews, treatment for psoriasis and for a lot 297 00:15:11,360 --> 00:15:15,440 Speaker 1: of chronic illnesses very rarely a straight line. Coming up 298 00:15:15,560 --> 00:15:18,040 Speaker 1: when we step back through a little bit of skin history, 299 00:15:18,360 --> 00:15:21,640 Speaker 1: we're going to learn how a few very groundbreaking scientists 300 00:15:21,680 --> 00:15:26,600 Speaker 1: solved a medical mystery. Why do perfectly effective medications sometimes 301 00:15:26,920 --> 00:15:30,320 Speaker 1: just stop working on psoriasis. We're going to come back 302 00:15:30,320 --> 00:15:46,960 Speaker 1: after this and talk all about it. In the early 303 00:15:47,040 --> 00:15:52,520 Speaker 1: two thousands, dermatology was experiencing a revolution. The arrival of 304 00:15:52,640 --> 00:15:57,120 Speaker 1: TNF alpha blockers had completely transformed the management of psoriasis 305 00:15:57,280 --> 00:16:03,440 Speaker 1: and other chronic inflammatory diseases. These new biologic medications, drugs 306 00:16:03,440 --> 00:16:07,600 Speaker 1: that targeted tumor necrosis factor alpha, were helping patients achieve 307 00:16:07,680 --> 00:16:11,600 Speaker 1: clearer skin than many had seen in decades. For patients 308 00:16:11,600 --> 00:16:15,480 Speaker 1: with severe psoriasis, that change was dramatic. Prior to these 309 00:16:15,520 --> 00:16:20,200 Speaker 1: breaks through treatments, options were limited topical treatments requiring meticulous 310 00:16:20,280 --> 00:16:24,880 Speaker 1: daily application, oral medications with serious side effects, or light 311 00:16:24,960 --> 00:16:29,920 Speaker 1: therapy demanding frequent clinic visits. The most effective systemic treatments, 312 00:16:29,960 --> 00:16:33,880 Speaker 1: like methotrex eight, required careful monitoring for liver damage and 313 00:16:33,960 --> 00:16:38,600 Speaker 1: other complications. I'm curious just the side effect thing is 314 00:16:38,680 --> 00:16:41,720 Speaker 1: always in any medication. I'm going to take the first 315 00:16:41,720 --> 00:16:44,000 Speaker 1: thing I'm looking at. How much have you been thinking 316 00:16:44,000 --> 00:16:46,520 Speaker 1: about that? As you've been presented with options. 317 00:16:46,840 --> 00:16:48,600 Speaker 2: It's the only thing I think about. I think about 318 00:16:48,600 --> 00:16:50,320 Speaker 2: what's the long term side effects? With the short term 319 00:16:50,320 --> 00:16:53,240 Speaker 2: side effects are not telling me what it is forah person. 320 00:16:53,680 --> 00:16:57,280 Speaker 1: So when patients started on these TNF alpha inhibitors, the 321 00:16:57,360 --> 00:17:02,080 Speaker 1: results often seemed really miraculous. Within months, severe plaques would 322 00:17:02,120 --> 00:17:06,919 Speaker 1: fade dramatically. Many people achieved about seventy five percent improvement 323 00:17:06,960 --> 00:17:10,439 Speaker 1: in their symptoms. That was a life changing transformation. It 324 00:17:10,520 --> 00:17:14,000 Speaker 1: allowed them to feel comfortable wearing short sleeves and to 325 00:17:14,000 --> 00:17:17,560 Speaker 1: feel confident in social situations. Often for the first time 326 00:17:17,640 --> 00:17:21,159 Speaker 1: in years. You've mentioned that you're very transparent. Did you 327 00:17:21,200 --> 00:17:23,000 Speaker 1: ever have that sort of like I don't want to 328 00:17:23,000 --> 00:17:25,359 Speaker 1: go out My skin is misbehaving right now. 329 00:17:25,560 --> 00:17:28,639 Speaker 2: Every day I'm someone who has thong bikinis to the beach, 330 00:17:28,800 --> 00:17:31,480 Speaker 2: and it affects my ability to wear my thong bikinis, 331 00:17:31,520 --> 00:17:32,640 Speaker 2: which is not fun. 332 00:17:32,760 --> 00:17:36,320 Speaker 1: Right, But the thing is, even as dermatology celebrated these 333 00:17:36,480 --> 00:17:40,520 Speaker 1: revolutionary treatments, there was this nagging question lingering in the 334 00:17:40,560 --> 00:17:44,640 Speaker 1: minds of scientists, which was why didn't these treatments work 335 00:17:44,680 --> 00:17:48,639 Speaker 1: for everyone? And why did some patients who initially responded 336 00:17:48,680 --> 00:17:53,280 Speaker 1: beautifully suddenly stop improving. Have you had one of these 337 00:17:53,359 --> 00:17:55,800 Speaker 1: drop off situations where something is working for you and 338 00:17:55,840 --> 00:17:56,840 Speaker 1: then it's not anymore. 339 00:17:57,119 --> 00:17:59,359 Speaker 2: Yeah, steroid cream specifically. 340 00:17:59,359 --> 00:18:01,199 Speaker 1: That's got to be heartening when you think you have 341 00:18:01,280 --> 00:18:03,720 Speaker 1: found the solution and then well you. 342 00:18:03,640 --> 00:18:05,960 Speaker 2: Start to enter the territory were you're mixing six different 343 00:18:05,960 --> 00:18:08,480 Speaker 2: staroid creams to see if there's any result, which is 344 00:18:08,520 --> 00:18:09,160 Speaker 2: not fun. 345 00:18:09,240 --> 00:18:12,399 Speaker 1: And also hard to have like a control in terms 346 00:18:12,400 --> 00:18:14,679 Speaker 1: of like how it's all going wow, can't Yeah. And 347 00:18:14,720 --> 00:18:19,440 Speaker 1: here's the thing. The logic behind TNF blockers seemed completely sound. 348 00:18:20,000 --> 00:18:23,760 Speaker 1: TNF alpha, a protein that signals inflammation throughout the body, 349 00:18:23,960 --> 00:18:28,800 Speaker 1: was clearly elevated in sooriatic skin, so block TNF alpha 350 00:18:29,040 --> 00:18:33,439 Speaker 1: reduce inflammation cleared the skin. That all makes perfect sense, 351 00:18:33,840 --> 00:18:38,400 Speaker 1: and it did work, sometimes spectacularly. But as these medications 352 00:18:38,400 --> 00:18:42,080 Speaker 1: moved into widespread use, there were patterns emerging that puzzled 353 00:18:42,119 --> 00:18:46,960 Speaker 1: researchers because while TNF alpha blockers were undeniably effective, they 354 00:18:47,040 --> 00:18:52,600 Speaker 1: had limitations that suggested that psoriasis inflammation was more complex 355 00:18:52,680 --> 00:18:57,600 Speaker 1: than previously understood. So some patients would show partial improvement 356 00:18:57,680 --> 00:19:01,600 Speaker 1: and then kind of plateau. Other had a better response 357 00:19:01,600 --> 00:19:05,840 Speaker 1: but lost responsiveness over time. And then a small but 358 00:19:06,080 --> 00:19:12,080 Speaker 1: significant number experienced paradoxical psoriasis. So that's an unexpected onset 359 00:19:12,119 --> 00:19:16,040 Speaker 1: of psoriasis following the use of TNF inhibitors to treat 360 00:19:16,080 --> 00:19:21,080 Speaker 1: inflammation related to another condition. So sometimes a person would 361 00:19:21,080 --> 00:19:22,879 Speaker 1: have a flare up that had not had it before. 362 00:19:23,480 --> 00:19:27,560 Speaker 1: Oh wow. Listen. Bodies are a fascinating mechanism, and the 363 00:19:27,600 --> 00:19:30,800 Speaker 1: way the bodies solve problems isn't always how they should 364 00:19:30,800 --> 00:19:32,840 Speaker 1: go on paper. Have you ever had any of those 365 00:19:32,880 --> 00:19:34,480 Speaker 1: like this did not go how I expected? 366 00:19:35,400 --> 00:19:37,600 Speaker 2: I mean every time I think that's when I was like, 367 00:19:37,640 --> 00:19:40,000 Speaker 2: I should stop eating dairy and it did nothing, So 368 00:19:40,000 --> 00:19:41,800 Speaker 2: I was, I guess I can keep eating ice cream. 369 00:19:41,880 --> 00:19:42,600 Speaker 2: At least that's a win. 370 00:19:43,240 --> 00:19:46,760 Speaker 1: The thing that was finally realized is that solving these 371 00:19:46,800 --> 00:19:51,760 Speaker 1: mysteries of why these variant responses would happen would come 372 00:19:51,960 --> 00:19:55,679 Speaker 1: not from studying the success stories, but from examining the 373 00:19:55,680 --> 00:19:59,920 Speaker 1: cases where the medications fell short. What researchers discovered would 374 00:20:00,080 --> 00:20:04,199 Speaker 1: fundamentally change how we understand seriasis and lead to an 375 00:20:04,400 --> 00:20:09,040 Speaker 1: entirely new generation of therapies. As scientists started dissecting the 376 00:20:09,040 --> 00:20:13,400 Speaker 1: immune pathways involved in psoriasis more carefully, a protein called 377 00:20:13,440 --> 00:20:18,040 Speaker 1: INTERLUCN seventeen or IL seventeen, kept appearing in places where 378 00:20:18,040 --> 00:20:21,760 Speaker 1: it could not be ignored. Ile seventeen had actually been 379 00:20:21,760 --> 00:20:24,760 Speaker 1: discovered in the nineteen nineties, but its role in human 380 00:20:24,760 --> 00:20:29,080 Speaker 1: disease remained unclear until a new class of immune cells 381 00:20:29,160 --> 00:20:33,879 Speaker 1: was identified. Interluken is a type of protein secreted by 382 00:20:33,920 --> 00:20:36,600 Speaker 1: a lot of different types of cells, and these assists 383 00:20:36,600 --> 00:20:40,360 Speaker 1: the cells in our body in communicating with one another. Specifically, 384 00:20:40,880 --> 00:20:44,159 Speaker 1: interlukens stimulate immune response, so you can see why they 385 00:20:44,160 --> 00:20:47,840 Speaker 1: would be tied to psoriasis. So in a healthy immune system, 386 00:20:48,080 --> 00:20:50,639 Speaker 1: your inter lukens act like traffic controllers. So when a 387 00:20:50,680 --> 00:20:53,240 Speaker 1: pathogen shows up, like if you have a fungus on 388 00:20:53,280 --> 00:20:57,880 Speaker 1: your skin, certain immune cells called THH seventeen cells release 389 00:20:58,080 --> 00:21:02,439 Speaker 1: IL seventeen A and IL seventeen F that rallies the 390 00:21:02,440 --> 00:21:06,159 Speaker 1: immune system. The area gets inflamed, and that inflammation is 391 00:21:06,200 --> 00:21:09,160 Speaker 1: what kills the invader. But then once the thread is gone, 392 00:21:09,480 --> 00:21:14,720 Speaker 1: anti inflammatory signals turn off the response. Ideally, to give 393 00:21:14,760 --> 00:21:18,160 Speaker 1: a little more context to the IL seventeen family, because 394 00:21:18,160 --> 00:21:21,560 Speaker 1: we're putting these letters on the end, the IL seventeen 395 00:21:21,640 --> 00:21:27,000 Speaker 1: family actually has six members. IL seventeen ABC, ET, cetera 396 00:21:27,200 --> 00:21:30,399 Speaker 1: all the way to F. A is the most active 397 00:21:30,400 --> 00:21:33,439 Speaker 1: in the body. It is also the most studied. It 398 00:21:33,480 --> 00:21:37,679 Speaker 1: triggers inflammation. It's the most influential gas pedal of the group. 399 00:21:38,160 --> 00:21:41,199 Speaker 1: IL seventeen F is very similar to A in its 400 00:21:41,200 --> 00:21:44,240 Speaker 1: structure and function, and they can even pair up to 401 00:21:44,400 --> 00:21:48,240 Speaker 1: form a hybrid molecule. And their similarity is why these 402 00:21:48,359 --> 00:21:52,320 Speaker 1: two cytokines targeted together can be such a useful treatment 403 00:21:52,640 --> 00:21:56,840 Speaker 1: for people with psoriasis and other autoimmunity. So just so 404 00:21:57,160 --> 00:22:00,119 Speaker 1: we get the other letters out of the way. D 405 00:22:00,400 --> 00:22:03,480 Speaker 1: is a little less well understood. It's primarily active in 406 00:22:03,520 --> 00:22:07,520 Speaker 1: the gut and nervous system. C is produced by epithelial cells, 407 00:22:07,520 --> 00:22:09,520 Speaker 1: which make up a lot of the outer layer of 408 00:22:09,560 --> 00:22:14,280 Speaker 1: our skin, but also the gut, so they're implicated in storiasis, 409 00:22:14,320 --> 00:22:18,560 Speaker 1: but also in conditions like inflammatory bowel disease. D is 410 00:22:18,600 --> 00:22:22,119 Speaker 1: actually the most mysterious of this group. It may have 411 00:22:22,200 --> 00:22:25,640 Speaker 1: a role in our bodies natural monitoring for cancer, but 412 00:22:25,720 --> 00:22:28,240 Speaker 1: we need more research in that area. And then E 413 00:22:28,400 --> 00:22:30,560 Speaker 1: is kind of a player. It also goes by the 414 00:22:30,600 --> 00:22:33,040 Speaker 1: name IL twenty five, so it steps out on the 415 00:22:33,080 --> 00:22:36,560 Speaker 1: rest of the group. It's got multiple identities it actually 416 00:22:36,600 --> 00:22:40,960 Speaker 1: inhibits IL seventeen a, a natural break to ALE seventeen A 417 00:22:41,160 --> 00:22:43,639 Speaker 1: and f's gas pedal function that we talked about. I 418 00:22:43,680 --> 00:22:46,240 Speaker 1: know this is a ton of science, but this idea 419 00:22:46,280 --> 00:22:50,000 Speaker 1: that we have these things in our bodies that are 420 00:22:50,000 --> 00:22:53,280 Speaker 1: telling it what to do, and that if those communications 421 00:22:53,280 --> 00:22:56,119 Speaker 1: get disrupted, the whole system kind of falls apart is 422 00:22:56,680 --> 00:22:59,439 Speaker 1: very fascinating to me. Have you ever heard about it 423 00:22:59,480 --> 00:23:01,800 Speaker 1: talked about that way or talk to your any medical 424 00:23:01,800 --> 00:23:04,760 Speaker 1: professionals that explained it that way. No, absolutely not. It's 425 00:23:04,800 --> 00:23:09,920 Speaker 1: really interesting. So in psoriasis, these danger signals like ILE 426 00:23:10,000 --> 00:23:13,639 Speaker 1: seventeen A and ILE seventeen F get turned on, but 427 00:23:13,720 --> 00:23:17,080 Speaker 1: the problem is that they never fully turn off. They 428 00:23:17,160 --> 00:23:19,600 Speaker 1: act like there's a fire alarm going off in your 429 00:23:19,600 --> 00:23:22,800 Speaker 1: body when there is no fire, and that is what 430 00:23:22,880 --> 00:23:27,080 Speaker 1: causes things like overproduction of skin cells, so thickened areas 431 00:23:27,080 --> 00:23:30,760 Speaker 1: of skin that you would call a plaque redness which 432 00:23:30,800 --> 00:23:35,760 Speaker 1: is just blood vessel dilation, scaling, which indicates rapid skin turnover, 433 00:23:36,240 --> 00:23:39,760 Speaker 1: and chronic inflammation which is caused by those immune cells 434 00:23:39,760 --> 00:23:43,640 Speaker 1: staying active and ready all the time. So this whole 435 00:23:43,640 --> 00:23:47,159 Speaker 1: mechanism was discovered and presented in a landmark article in 436 00:23:47,200 --> 00:23:50,679 Speaker 1: the journal Nature in two thousand and six, working together 437 00:23:50,760 --> 00:23:54,240 Speaker 1: out of Harvard Medical School and Brigham Women's Hospital in Boston. 438 00:23:54,320 --> 00:23:57,560 Speaker 1: Two researchers on this paper, doctor V. J. Cushru and 439 00:23:57,640 --> 00:24:01,040 Speaker 1: doctor Estelle Batelli, along with their team, played a completely 440 00:24:01,160 --> 00:24:03,919 Speaker 1: key role in describing THH seventeen and how it works, 441 00:24:04,240 --> 00:24:07,159 Speaker 1: because before this paper came out and you may have 442 00:24:07,200 --> 00:24:09,639 Speaker 1: gotten this version, the immune system was thought to have 443 00:24:09,680 --> 00:24:13,840 Speaker 1: a basic binary going on. THH one cells are pro inflammatory, 444 00:24:13,880 --> 00:24:16,719 Speaker 1: they ramp up the immune system. THH two cells are 445 00:24:16,760 --> 00:24:19,560 Speaker 1: anti inflammatory, and they calm the immune system down and 446 00:24:19,600 --> 00:24:23,160 Speaker 1: turn off those alarm bells. But that's not accurate. It's 447 00:24:23,200 --> 00:24:28,439 Speaker 1: more complicated, just like life and treatment. So Kutru and 448 00:24:28,480 --> 00:24:34,200 Speaker 1: Beatelli introduced a third axis. THCH seventeen is uniquely pathogenic, 449 00:24:34,520 --> 00:24:38,840 Speaker 1: produces IL seventeen and is distinct from those other two 450 00:24:38,920 --> 00:24:41,239 Speaker 1: TH one and THH two, So there was like a 451 00:24:41,280 --> 00:24:45,719 Speaker 1: third whole situation going on. They essentially in this paper 452 00:24:45,840 --> 00:24:51,359 Speaker 1: identified the immune cell type responsible for chronic IL seventeen signaling, which, 453 00:24:51,440 --> 00:24:55,240 Speaker 1: in the years following their paper was finally directly linked 454 00:24:55,600 --> 00:25:00,840 Speaker 1: to psoriasis, soriatic arthritis, and other autoimmune diseases, and then 455 00:25:00,960 --> 00:25:05,320 Speaker 1: later other researchers applied these findings to skin and joint diseases, 456 00:25:05,520 --> 00:25:09,240 Speaker 1: and all of this work ultimately reinforced the findings of 457 00:25:09,240 --> 00:25:12,400 Speaker 1: that two thousand and six paper. Around the same time 458 00:25:12,440 --> 00:25:15,800 Speaker 1: that IL seventeen A was taking center stage, there was 459 00:25:15,960 --> 00:25:20,240 Speaker 1: another closely related cytokine that's ILE seventeen F, and it 460 00:25:20,359 --> 00:25:24,280 Speaker 1: was quietly being characterized by another leading researcher. That was 461 00:25:24,320 --> 00:25:26,520 Speaker 1: doctor J. Coles, who at the time was at the 462 00:25:26,600 --> 00:25:30,840 Speaker 1: University of Pittsburgh, and Coles had been studying IL seventeen 463 00:25:30,880 --> 00:25:35,080 Speaker 1: family cytokines in the early two thousands, focusing specifically on 464 00:25:35,119 --> 00:25:38,960 Speaker 1: their roles in mucosal immunity and inflammation, so kind of 465 00:25:39,000 --> 00:25:42,160 Speaker 1: working in tandem and separately. In two thousand and one, 466 00:25:42,400 --> 00:25:45,760 Speaker 1: Coles and his team published one of the first detailed 467 00:25:45,760 --> 00:25:49,680 Speaker 1: papers on IL seventeen F, identifying it as a distinct 468 00:25:49,720 --> 00:25:54,520 Speaker 1: cytokine co expressed with IL seventeen A by THH seventeen cells, 469 00:25:54,560 --> 00:25:57,520 Speaker 1: so just meaning that it gets put into the system 470 00:25:57,560 --> 00:26:00,560 Speaker 1: at the same time as ILE seventeen A by the 471 00:26:00,600 --> 00:26:04,280 Speaker 1: TCH seventeen cells. So his lab was able to demonstrate 472 00:26:04,280 --> 00:26:08,800 Speaker 1: that ASLE seventeen F could independently induce inflammation and was 473 00:26:08,840 --> 00:26:13,240 Speaker 1: prettylarly active in lung and epithelial tissues, which make up 474 00:26:13,560 --> 00:26:16,080 Speaker 1: ninety five percent of the outer layer of our skin, 475 00:26:16,720 --> 00:26:20,680 Speaker 1: So that of course had special relevance to psoriasis research. 476 00:26:21,320 --> 00:26:24,320 Speaker 1: So Cole's work opened the door to a deeper understanding 477 00:26:24,480 --> 00:26:28,239 Speaker 1: of how dual signaling pathways could operate in tandem and 478 00:26:28,320 --> 00:26:32,400 Speaker 1: compound inflammation in chronic diseases like psoriasis. So even if 479 00:26:32,400 --> 00:26:35,200 Speaker 1: you're addressing one, its buddy can come to the party 480 00:26:35,240 --> 00:26:37,480 Speaker 1: and still make a mess. So we're going to step 481 00:26:37,520 --> 00:26:40,159 Speaker 1: back to the beginning of this story. We started with 482 00:26:40,280 --> 00:26:45,560 Speaker 1: TNF blockers. TNF alpha is a general purpose inflammatory amplifier. 483 00:26:46,119 --> 00:26:48,679 Speaker 1: Like a police siren. You don't know what the issue is, 484 00:26:48,720 --> 00:26:51,439 Speaker 1: You just know that you hear the alarm somewhere. With 485 00:26:51,560 --> 00:26:54,960 Speaker 1: the discovery of th seventeen cells and how they work, 486 00:26:55,080 --> 00:26:59,480 Speaker 1: researchers were able to single out immune responses that specifically 487 00:26:59,520 --> 00:27:02,640 Speaker 1: affected the skin as well as other things. It's kind 488 00:27:02,640 --> 00:27:04,679 Speaker 1: of like getting an alert on your phone with a 489 00:27:04,720 --> 00:27:08,920 Speaker 1: weather warning. You hear the alarm and you get information 490 00:27:08,960 --> 00:27:11,399 Speaker 1: about the problem rather than it just being a general 491 00:27:11,440 --> 00:27:13,720 Speaker 1: alarm and you going, hey, I wonder what's up, So 492 00:27:14,119 --> 00:27:17,399 Speaker 1: they were able to develop treatments that had more specific 493 00:27:17,520 --> 00:27:21,600 Speaker 1: and precise applications. And as that picture clarified, so did 494 00:27:21,600 --> 00:27:25,440 Speaker 1: the clinical ones. Because patients who had plateaued on TNF 495 00:27:25,520 --> 00:27:29,760 Speaker 1: inhibitors or even medications that had blocked ILE seventeen A 496 00:27:30,359 --> 00:27:35,320 Speaker 1: often still had lingering symptoms, and dermatologists and rheumatologists started 497 00:27:35,359 --> 00:27:40,359 Speaker 1: to suspect that blocking ile seventeen F Ile seventeen a's 498 00:27:40,359 --> 00:27:44,000 Speaker 1: messy friend was actually the missing link, that there was 499 00:27:44,040 --> 00:27:46,360 Speaker 1: an aspect to it that had not been addressed at 500 00:27:46,359 --> 00:27:49,840 Speaker 1: that point. So with treatments that block both IL seventeen 501 00:27:49,880 --> 00:27:53,840 Speaker 1: A and ile seventeen F, studies showed not only faster 502 00:27:53,960 --> 00:27:58,840 Speaker 1: improvement of psoriasis symptoms, but also far more complete skin clearance. 503 00:27:58,880 --> 00:28:01,840 Speaker 1: So patients that were previously kind of plateaued or stuck 504 00:28:02,240 --> 00:28:05,040 Speaker 1: at a seventy five percent improvement rate, we're now reaching 505 00:28:05,600 --> 00:28:08,480 Speaker 1: ninety percent clearance and even in some cases one hundred 506 00:28:08,480 --> 00:28:12,560 Speaker 1: percent clearance. One of the biggest risks when treatment involves 507 00:28:12,560 --> 00:28:14,840 Speaker 1: our immune system, and if you are looking at side 508 00:28:14,880 --> 00:28:18,400 Speaker 1: effects as I know you are, is infection. So one 509 00:28:18,480 --> 00:28:22,400 Speaker 1: way these discoveries make patient lives better is that their 510 00:28:22,440 --> 00:28:26,959 Speaker 1: suppression of the immune system is highly targeted, so you 511 00:28:27,000 --> 00:28:30,520 Speaker 1: can treat the mechanisms that cause psoriasis flare ups, but 512 00:28:30,600 --> 00:28:33,560 Speaker 1: leave the rest of the immune system free to proceed 513 00:28:33,560 --> 00:28:37,240 Speaker 1: accordingly handling any other pathogens or issues that require an 514 00:28:37,280 --> 00:28:40,400 Speaker 1: immune response, Like if you get the flu, your body 515 00:28:40,440 --> 00:28:43,960 Speaker 1: is still ready. Yeah, this is so incredibly cool and important. 516 00:28:44,640 --> 00:28:47,440 Speaker 1: Looking back, it's of course clear that the major breakthroughs 517 00:28:47,440 --> 00:28:50,800 Speaker 1: that led to dual targeting of AISLE seventeen A ANDISLE 518 00:28:50,840 --> 00:28:53,680 Speaker 1: seventeen F did not come from a single lab or 519 00:28:53,720 --> 00:28:58,320 Speaker 1: a Eureka moment. They emerged from two decades of methodical research, 520 00:28:58,480 --> 00:29:01,720 Speaker 1: which was often driven by a desig to understand just 521 00:29:01,800 --> 00:29:04,840 Speaker 1: why some patients didn't improve when they were supposed to. 522 00:29:05,840 --> 00:29:08,360 Speaker 1: When I was initially reading this information and looking at 523 00:29:08,400 --> 00:29:11,280 Speaker 1: your story, this to me seemed like an odd but 524 00:29:11,360 --> 00:29:14,840 Speaker 1: interesting parallel to the way a lot of people come 525 00:29:14,920 --> 00:29:18,680 Speaker 1: to a point of acceptance in their psoriasis, which is 526 00:29:18,720 --> 00:29:21,240 Speaker 1: also very gradual. Right. It's not as though you just 527 00:29:21,320 --> 00:29:23,600 Speaker 1: decide one day I'm going to accept it. There's a 528 00:29:23,600 --> 00:29:26,040 Speaker 1: lot of other work that you put in mentally and emotionally, 529 00:29:26,600 --> 00:29:29,560 Speaker 1: just the way this was a very slow progression of 530 00:29:29,600 --> 00:29:31,360 Speaker 1: people going. I think we have part of it. No, 531 00:29:31,480 --> 00:29:32,040 Speaker 1: we have another. 532 00:29:32,160 --> 00:29:34,040 Speaker 2: YEA, let's speed it up, let's keep it crying. 533 00:29:36,400 --> 00:29:40,280 Speaker 1: Doctor J. Coles helped identify the biological relevance of Aisle 534 00:29:40,360 --> 00:29:44,600 Speaker 1: seventeen F, showing that it mattered independently, and doctors VJ. 535 00:29:44,760 --> 00:29:48,040 Speaker 1: Kushru and Estelle Batelli helped define the origin of these 536 00:29:48,080 --> 00:29:51,760 Speaker 1: cytokines the th seventeen cells that produce them in a 537 00:29:51,840 --> 00:29:56,400 Speaker 1: regulated cascade. So without these insights together, the rationale for 538 00:29:56,480 --> 00:30:00,320 Speaker 1: dual targeting would never have reached the clinic. So the 539 00:30:00,400 --> 00:30:03,880 Speaker 1: lesson in complex diseases is that you often need more 540 00:30:03,920 --> 00:30:07,080 Speaker 1: than one key to unlock the door, and there's still 541 00:30:07,080 --> 00:30:08,840 Speaker 1: a range. I want to be clear, like, it's not 542 00:30:08,960 --> 00:30:12,160 Speaker 1: as though this works for everybody. You, yourself, and all 543 00:30:12,200 --> 00:30:15,040 Speaker 1: of our guests have talked about every path is different 544 00:30:15,040 --> 00:30:17,200 Speaker 1: and what helps you is not necessarily going to be 545 00:30:17,240 --> 00:30:18,440 Speaker 1: the solution for someone else. 546 00:30:18,680 --> 00:30:23,479 Speaker 2: Has this been reflected in prescribe medication today or are 547 00:30:23,520 --> 00:30:24,720 Speaker 2: they still trialing and testing? 548 00:30:24,920 --> 00:30:27,680 Speaker 1: This is reflected in the medications that we're using today. 549 00:30:27,800 --> 00:30:31,360 Speaker 1: So if someone had been receiving medication in like two 550 00:30:31,440 --> 00:30:33,880 Speaker 1: thousand and two, it would be potentially very different from 551 00:30:33,920 --> 00:30:36,360 Speaker 1: what they would be prescribed today. So thanks to the 552 00:30:36,480 --> 00:30:41,600 Speaker 1: vision and perseverance of researchers across multiple institutions and disciplines, 553 00:30:41,760 --> 00:30:45,680 Speaker 1: patients now have access to treatments that offer not just improvement, 554 00:30:45,800 --> 00:30:48,840 Speaker 1: but the possibility of complete skin clearance and with it 555 00:30:49,480 --> 00:30:51,360 Speaker 1: a new kind of freedom. Cool. 556 00:30:51,720 --> 00:30:52,360 Speaker 2: That's so great. 557 00:30:52,440 --> 00:30:55,600 Speaker 1: Support our scientists and researchers people, we need them. This 558 00:30:55,680 --> 00:30:57,840 Speaker 1: is all so incredible to me, and we see this 559 00:30:57,960 --> 00:31:00,760 Speaker 1: all the time on the show, how science build upon 560 00:31:00,800 --> 00:31:05,120 Speaker 1: each other's work and it's that combination of insights that 561 00:31:05,320 --> 00:31:08,920 Speaker 1: brings us these amazing breakthroughs, And it feels so hopeful 562 00:31:08,960 --> 00:31:11,400 Speaker 1: to me, and I suspect you as well. 563 00:31:11,800 --> 00:31:13,360 Speaker 2: Yeah, I mean, I definitely want to learn more about 564 00:31:13,400 --> 00:31:13,680 Speaker 2: it now. 565 00:31:14,160 --> 00:31:17,840 Speaker 1: I do want to ask you two quick questions Jess, 566 00:31:17,880 --> 00:31:22,400 Speaker 1: before we let you go. First, I want suggestions from 567 00:31:22,400 --> 00:31:25,040 Speaker 1: you that you may have for people that perhaps don't 568 00:31:25,080 --> 00:31:29,080 Speaker 1: have psoriasis themselves, but they love someone who does. They 569 00:31:29,080 --> 00:31:30,880 Speaker 1: have someone in their lives that they want to support. 570 00:31:30,920 --> 00:31:32,120 Speaker 1: What is the advice you give. 571 00:31:32,000 --> 00:31:35,040 Speaker 2: Them compliment them on every other thing that's going on 572 00:31:35,040 --> 00:31:38,080 Speaker 2: if they're going through a particularly insecure period, like something 573 00:31:38,080 --> 00:31:40,080 Speaker 2: that my friends tell me a lot, which actually does 574 00:31:40,160 --> 00:31:42,520 Speaker 2: help when I'm down about it is one of my friends, 575 00:31:42,560 --> 00:31:46,080 Speaker 2: Jeremy says, if you didn't have psoriasis, you would be 576 00:31:46,200 --> 00:31:50,320 Speaker 2: too perfect, and nobody thinks perfect is interesting and I 577 00:31:50,400 --> 00:31:52,840 Speaker 2: actually that really helps me every time I'm like, I 578 00:31:52,880 --> 00:31:55,040 Speaker 2: can't be too perfect, because then it would be unfair 579 00:31:55,080 --> 00:31:56,000 Speaker 2: to everybody else. 580 00:31:56,440 --> 00:31:59,640 Speaker 1: Jeremy with the Life Insight, if j just didn't have 581 00:31:59,680 --> 00:32:04,640 Speaker 1: says we couldn't handle it. And last, but not least, 582 00:32:04,880 --> 00:32:06,600 Speaker 1: I know you have a platform that you do this, 583 00:32:06,680 --> 00:32:10,000 Speaker 1: but for our listeners, if you could send one message 584 00:32:10,040 --> 00:32:12,920 Speaker 1: to anyone who may be grappling with their own diagnoses, 585 00:32:13,200 --> 00:32:13,880 Speaker 1: what would that be. 586 00:32:14,440 --> 00:32:17,360 Speaker 2: I think I would say that everything is given to 587 00:32:17,400 --> 00:32:19,680 Speaker 2: you for a reason, and you're never given something that 588 00:32:19,720 --> 00:32:22,320 Speaker 2: you're not able to handle. So I think searching for 589 00:32:22,400 --> 00:32:25,280 Speaker 2: what it's meant to teach you, rather than resisting it 590 00:32:25,320 --> 00:32:26,480 Speaker 2: is always going to be helpful. 591 00:32:26,920 --> 00:32:30,080 Speaker 1: AH, beautiful approach, Jess. Thank you so much for spending 592 00:32:30,120 --> 00:32:32,640 Speaker 1: this time with us today. Thank you for having me. 593 00:32:32,680 --> 00:32:34,920 Speaker 1: This was so fun, just a delight for us. We 594 00:32:35,000 --> 00:32:38,000 Speaker 1: are so grateful and cannot wait to see what you 595 00:32:38,080 --> 00:32:46,120 Speaker 1: do next. Our Skin is hosted by myself, Holly Frye 596 00:32:46,280 --> 00:32:50,480 Speaker 1: and executive produced and engineered by Ryan Martz. Our executive 597 00:32:50,520 --> 00:32:54,160 Speaker 1: producer and writer is Meredith Barnes. If you enjoy the show, 598 00:32:54,400 --> 00:32:56,880 Speaker 1: share it with your friends. You can also listen and 599 00:32:56,920 --> 00:33:00,640 Speaker 1: follow on the iHeartRadio app, Apple Podcasts, or wherever you 600 00:33:00,680 --> 00:33:01,800 Speaker 1: get your podcasts.