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Speaker 1: Welcome to Creature future production of iHeartRadio. I'm your host

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Speaker 1: of Many Parasites, Katie Golden. I studied psychology and evolutionary biology,

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Speaker 1: and today on the show The Last of Us more

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Speaker 1: like the Best Fungus, We're talking about Ophiel cortescepts and

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Speaker 1: other fungi as we explore the possibilities of a fungal

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Speaker 1: infection taking control of the brain. Could there be a

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Speaker 1: fungal zombie apocalypse such as is depicted in the Last

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Speaker 1: of Us? Is Opiel Cortescepts real? And how does it

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Speaker 1: function in nature? How much do humans need to fear

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Speaker 1: the fungus? Discover this and more as we answer the

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Speaker 1: agele question, can ants contemplate the horrors of their existence?

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Speaker 1: Joining me to help answer these questions is Infectious Diseases

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Speaker 1: doctor and self described budding mycologist, Professor David Boulware. Welcome, Hey,

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Speaker 1: it's great to be here. Thank you for the invite.

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Speaker 1: I really like how you call yourself a budding my collogists,

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Speaker 1: don't think I miss that little fungus pun. Oh, it's

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Speaker 1: it is. I'm still budding. I think there's a lot

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Speaker 1: to learn. I think that's that's really what the pun

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Speaker 1: is about. There's a lot to learn about fungus, and

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Speaker 1: so I'm still learning along the way. I mean, absolutely,

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Speaker 1: I am also learning about fungus. I'm by no means

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Speaker 1: a fungal expert. I do know specifically about ophio Cortis

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Speaker 1: ups because of how famous it is in terms of

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Speaker 1: its effects on ants. But fungus is it is such

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Speaker 1: a I mean, first of all, it's an incredibly diverse

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Speaker 1: group of organisms. So a you have just by knowing

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Speaker 1: one type of fungus. It's not like you know the

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Speaker 1: entire fungal uh you know group. It's They're very diverse,

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Speaker 1: and they're all they all function in very weird and

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Speaker 1: different ways. I don't know how anyone can ever have

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Speaker 1: a total mastery over fungus. Yeah, I certainly talent. Unfortunately,

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Speaker 1: the majority of you know, fungus doesn't cause disease in humans.

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Speaker 1: There's you know, hundreds and millions of species of fungi

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Speaker 1: which are distinct from plants and distinct from animals in

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Speaker 1: their own kingdom, but only handful of them actually cause

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Speaker 1: pathologic disease in humans, right, Yeah, I think that is

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Speaker 1: really important to note. It's not as if they are

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Speaker 1: all out to get us. It's kind of like when

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Speaker 1: people think of bats as being all these blood sucking,

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Speaker 1: bloodthirsty little creatures, and it's like the majority most bat

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Speaker 1: species are either nectivorous, frugivorous, or insectivorous. There's only one

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Speaker 1: or two species that actually drink blood, and so they

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Speaker 1: get this like creepy bad rap. But most of them

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Speaker 1: are not what people think. And it's the same thing

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Speaker 1: with fungus. They most fungus is good, I mean or neutral.

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Speaker 1: It's not. It's not something we have to worry about.

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Speaker 1: So in the very popular TV so it actually came

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Speaker 1: from a video game called The Last of Us. It

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Speaker 1: depicts a pandemic zombie apocalypse. The fungus in the show

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Speaker 1: a species of Ophio corticeps contaminated food at a serial

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Speaker 1: factory I think in Jakarta and then spread globally when

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Speaker 1: people ate the contaminated food. This is all fictional. Don't

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Speaker 1: don't panic. People started showing signs of aggression, biting or

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Speaker 1: killing others. There's a mycologist in a show that determined

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Speaker 1: it was ophiocorticeps, which typically infects arthropods. So arthropods are

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Speaker 1: invertebrates like insects and spiders, and then it takes control

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Speaker 1: of their behavior of their bodies. But somehow, in this

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Speaker 1: fictional world, the ophio CORTESEPS jumps to humans, infects humans,

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Speaker 1: takes over their brains, and drives people to violently kill

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Speaker 1: or bite other people that's infecting them, you know, the

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Speaker 1: classic zombie trope and the infect kind of a twist

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Speaker 1: on that those that the infected humans slowly become subsumed

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Speaker 1: by this fungus, becoming coated and fungus. It's kind of

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Speaker 1: funny because when I look at the visuals of the show,

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Speaker 1: kind of looks like not just one species of fungus,

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Speaker 1: it looks like all sorts of different species covering. I mean,

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Speaker 1: for the visual impact, I think it is cool, if

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Speaker 1: not a little bit unrealistic. But yeah, it's just that

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Speaker 1: their whole bodies get covered in this fungus and then

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Speaker 1: they spread it through biting people or like I guess,

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Speaker 1: kind of mouth to mouth filament transmission, which is an

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Speaker 1: interesting twist on it. Have you seen the show at all, Doctors, Yeah,

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Speaker 1: I really, I have not seen the show. When it

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Speaker 1: came out, I was I was out of the country,

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Speaker 1: and I have not gone back to track of Town

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Speaker 1: and lash it. So, but I've heard a lot about it,

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Speaker 1: so it seems very entertaining. You know, maybe not factually accurate,

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Speaker 1: but you know that's it's entertainment value. Yeah, exactly. I

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Speaker 1: mean I could still enjoy it, even though throughout the

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Speaker 1: first episode I kept leaning over to my husband and

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Speaker 1: commenting like, now that doesn't make sense. Now that doesn't

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Speaker 1: make sense, But you know it's I still really like

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Speaker 1: that they incorporate some act, like some reference to an

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Speaker 1: actual fungus. That's that's neat. I think it makes people

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Speaker 1: curious about that kind of thing and then want to

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Speaker 1: find out more about it, which is what we are

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Speaker 1: going to try to do. So. Ophio corteseps. Is a

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Speaker 1: real genus of fungus and a fascinating one that we've

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Speaker 1: talked about on the show before, but it is not

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Speaker 1: quite as the HBO show depicts it. So the most

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Speaker 1: famous species of ophio corteseps is Ophiocortops unilateralists. It is

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Speaker 1: also called the zombie ant fungus, and it is indeed

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Speaker 1: exceedingly spooky. It is found in tropical forests all over

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Speaker 1: the world and infects ants of a specific species Camponotus leonardi.

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Speaker 1: While they can infect other species of ants, the fungus

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Speaker 1: are most optimized for this one. So while foraging on

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Speaker 1: the forest floor, and ant will pick up spores like

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Speaker 1: little pieces of lint on its body, and the spore

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Speaker 1: uses enzymes to break down the ants exoskeleton and it

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Speaker 1: works its way into the ant's body, which is a

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Speaker 1: kind of exfoliation that you definitely don't want in this situation.

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Speaker 1: These spores will develop inside the ant's body into fungal

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Speaker 1: growths and infect the ants soft tissues, but not necessarily

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Speaker 1: its brain. That's something of a misconception. While it does

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Speaker 1: seem to alter the ants central nervous system, it doesn't

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Speaker 1: require the fungus to actually be growing inside of its brain.

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Speaker 1: It's infiltrating all of the ants soft tissues. It can

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Speaker 1: also it can grow like in its head, but it's

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Speaker 1: not necessarily a physical presence in the brain that is

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Speaker 1: causing the ant's behavior to be modified. It as these

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Speaker 1: compounds that the fungus is releasing. So some of the

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Speaker 1: behavioral modifications that will happen is that the ants will

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Speaker 1: convulse and fall from the tree where usually their nest is,

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Speaker 1: onto the forest floor. Then the ants will climb up

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Speaker 1: a plant stem. They will grip onto the underside of

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Speaker 1: the leaf. Usually there's like a vein on the underside

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Speaker 1: of the leaf that they clamp down on with its mandibles,

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Speaker 1: specifically on the north side of the plant, which is interesting.

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Speaker 1: There's some speculation that it optimizes where it grips for

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Speaker 1: moisture levels and temperature being ideal for the fungus. And

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Speaker 1: it will stay there until the fungus overcomes the ant

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Speaker 1: and kind of grows into this. You know, it looks

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Speaker 1: very creepy, this sort of ant covered in fungus gripped

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Speaker 1: onto this leaf. The Ophio cortu SEPs universe salus will

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Speaker 1: grow its hypha into the ant and are these branching

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Speaker 1: vein like structures of a fungus. They're also known as filaments,

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Speaker 1: which allows the fungus to expand and transport nutrients, and

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Speaker 1: a group of hype is called micellium. The ant becomes

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Speaker 1: overwhelmed by the mycelium, which also roots the ant to

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Speaker 1: the leaf, and then finally, after around four to ten days,

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Speaker 1: a fruiting body or bodies will grow from the ant,

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Speaker 1: which looks like a little stem with a bulb on

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Speaker 1: top and then that will distribute the spores. So while

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Speaker 1: this fungus is called the zombie ant fungus, once the

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Speaker 1: ant is dead, it's just dead. It's not gonna reanimate this,

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Speaker 1: this dead ant. So do we so, doctor Will, Where

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Speaker 1: do we see any kind of fungus like this in

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Speaker 1: humans that takes like takes over our brains and our

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Speaker 1: bodies and controls us in this way? Oh exactly. I mean,

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Speaker 1: there are certain types of fungus that can cause infections

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Speaker 1: of the brain, and they can alter people's behavior certainly,

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Speaker 1: but usually they just make people really really sick. Yeah, yeah, yeah,

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Speaker 1: I it is. And one thing that's interesting to me

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Speaker 1: is that this is definitely a scary thing that is real, right,

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Speaker 1: this is a real fungus. But the only animals it

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Speaker 1: seems like that it seems to have this kind of

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Speaker 1: specific control over are arthropods insects. And so is it

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Speaker 1: when we see something that impacts an arthropod or an

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Speaker 1: insect or a spider, like, how how typical is it

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Speaker 1: for diseases or something that is like zoonotic to originate

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Speaker 1: from an insect versus something that is closer to us

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Speaker 1: On the evolutionary tree. Yeah, so a lot of things,

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Speaker 1: A lot of fungus can affect cold blooded animals and

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Speaker 1: cold blooded you know, insects, etc. And Um. One of

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Speaker 1: the theories behind why why are mammals warm blooded is

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Speaker 1: that that the temperature difference protects us against bungal diseases.

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Speaker 1: And so that's sort of one of the hypotheses and

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Speaker 1: theories of why sort of mammals sort of um escaped

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Speaker 1: after sort of you know, sort of the great sort

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Speaker 1: of the dinosaurs and sort of um, you know, the

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Speaker 1: meteorites sort of striking your earth and sort of causing

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Speaker 1: sort of dust clouds and all the plants dying off.

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Speaker 1: And with that, then, uh, fungus is sort of a

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Speaker 1: big part of decaying plant matter, and so breaking down

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Speaker 1: plants and sort of that that process of decay is

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Speaker 1: what funge i normally do in the environment. And so

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Speaker 1: one of the theories of why then mammals sort of

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Speaker 1: exploded and sort of took off after that is the

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Speaker 1: temperature difference. Being warm blooded protects us from fungus because

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Speaker 1: most fungus does not grow very well at ninety eight

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Speaker 1: degrees and temperature. That's really interesting, I mean, it kind

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Speaker 1: of makes sense too, then that when we see this

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Speaker 1: specific ant controlling behavior or something like opio corti SEPs,

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Speaker 1: it actually directs the ant to a very specific part

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Speaker 1: of the forest floor. It's not content to just infect

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Speaker 1: the ant wherever it is and the ant, you know,

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Speaker 1: sprouts the fruiting body. It has evolved to kind of

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Speaker 1: modulate the ant's behavior in such a way that the

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Speaker 1: ant goes to like the underside of a leaf somewhere,

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Speaker 1: whether there's the right amount of humidity, the right temperature,

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Speaker 1: because really it wants kind of a ideal environment for itself.

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Speaker 1: So to somehow be able to jump to a human

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Speaker 1: and infect a human, it would require that it overcome

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Speaker 1: this need for this very specific temperature range. And it

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Speaker 1: seems that seems quite difficult to make such a leap.

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Speaker 1: It does, and so most most fungus doesn't do that.

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Speaker 1: But you know, one of the concerns with global warming

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Speaker 1: is that the ambient temperature yeah in the environment humans

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Speaker 1: and many places of the globe is coming closer and

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Speaker 1: closer together. Such things that can live in the environment

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Speaker 1: quite happily, there may be a selection pressure where they

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Speaker 1: can jump to humans. And so at present, i'm in Minnesota,

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Speaker 1: there's a big difference between ambi and temperature outside and

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Speaker 1: the environment and what it is in the human body.

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Speaker 1: But in other places around the world you've got high

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Speaker 1: temperatures and so that that beer may be less. Yeah,

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Speaker 1: that's interesting. I mean we have seen that in animals

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Speaker 1: where the changing climate will change a situation that that

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Speaker 1: animal has with something like a bacteria from being basically

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Speaker 1: they can sort of coexist to it overwhelming the animal,

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Speaker 1: like the pyga antelope, which was able to co exist

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Speaker 1: with with a bacteria that would live in they are

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Speaker 1: these so pyga antelope are these really interesting animals. They

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Speaker 1: have these huge proboscuses. They it looks like the beginnings

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Speaker 1: of an elephant, but then it just kind of stops.

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Speaker 1: And you know these these proboscises are they breathe in

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Speaker 1: a lot of air and they kind of like cool

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Speaker 1: down the air or warm up the air, depending on

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Speaker 1: like their needs. It's like a portable air conditioners slash

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Speaker 1: heater unit. And so in their noses like they would

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Speaker 1: there's often like bacteria bacteria well like moist warm areas,

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Speaker 1: but they were their immune systems are able to fight

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Speaker 1: off the bacteria in their nose when it's at a

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Speaker 1: certain level, but when it's above a certain level, they

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Speaker 1: can no longer fight it off. And the temperature changed.

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Speaker 1: The temperature just being a little bit warmer made conditions

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Speaker 1: a little bit better for this bacteria. And so you

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Speaker 1: had whole herds of Siga antelope just dropping dead mysteriously.

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Speaker 1: Like it was very, very creepy because you have this

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Speaker 1: entire herd of antelope just dead on the ground and

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Speaker 1: finding out that it's because well, the temperature is a

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Speaker 1: little higher, so the bacteria was able to thrive a

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Speaker 1: little better. It is creepy and it is a little

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Speaker 1: bit spooky, this idea that fungus uh, you know, if

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Speaker 1: it is driven a little bit towards being able to

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Speaker 1: exist in a warmer environment than it would potentially be

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Speaker 1: more of a risk to humans. I very mention indeed,

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Speaker 1: so that that's a little bit of a concern. And

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Speaker 1: so some of the you know, environmental sort of um

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Speaker 1: kind of explosion with like a fungus called a Canada

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Speaker 1: orus in particular is one of those that's more thermotolerant

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Speaker 1: and um. And so one of the theories of why

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Speaker 1: that's been selected out and is due to sort of

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Speaker 1: the increase temperatures as well as sort of fun decide

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Speaker 1: use a sort of in the environment and agriculture of

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Speaker 1: anti fungal agents US used to protect crops. That's yeah,

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Speaker 1: I mean, that's kind of reminds me of the we

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Speaker 1: have a lot of concerns about the over use of

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Speaker 1: antibacterials in antibiotics. But yeah, the overuse of anti fungals,

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Speaker 1: I guess I that that concern I don't hear about

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Speaker 1: too much. But how big of a concern do you

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Speaker 1: think that is? Well, there's a lot of different So

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Speaker 1: for plants, if you think about your tomato plant, like,

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Speaker 1: you can get sort of various sort of diseases and

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Speaker 1: a lot of those are mold and fungus is basically

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Speaker 1: that they can affect the plants, and so in agriculture,

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Speaker 1: molds are big deal. Molds are a type of fungus,

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Speaker 1: and so there are a number of different you know,

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Speaker 1: anti fungal properties. Um you know, compounds are used for agriculture,

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Speaker 1: and so a lot of us are not used in humans,

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Speaker 1: but but some of them actually are. They're in the

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Speaker 1: same class that we use in humans. And so that

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Speaker 1: that alarms me a little bit because we're starting to

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Speaker 1: see more and more anti fungal resistance, and so with that,

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Speaker 1: I would say, don't use compounds that are using humans

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Speaker 1: in agriculture. But that's all right, I'll stop doing that. Well,

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Speaker 1: uh so we're going to take a quick break, but

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Speaker 1: when we get act we will be talking about some

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Speaker 1: of the claims that the HBO show makes about fungus

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Speaker 1: and using that kind of as a jumping off point

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Speaker 1: to talk more about the impacts that fungi can have

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Speaker 1: on human health. So we are back, and I am

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Speaker 1: very lucky to be joined by Professor David Bulware, who

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Speaker 1: is an infectious diseases doctor with an acute awareness of

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Speaker 1: fungus and the risks of fungus. And I think that

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Speaker 1: whenever people watch a show like The Last of Us,

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Speaker 1: I mean, I think people know its fiction, people know

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Speaker 1: it's science fiction, but it is it brings up these

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Speaker 1: ideas of like of a fungal pandemic, and so sometimes

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Speaker 1: the show will say things like in the beginning of

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Speaker 1: the show, it talked about one of the dangers of

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Speaker 1: this sort of outbreak of this fungus is that they

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Speaker 1: have no treatments for fungal infections now before the break,

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Speaker 1: we just talked about the potential overuse of antifungals, So

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Speaker 1: already that's not quite accurate, right, Like, it's not that

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Speaker 1: we don't have anything that treats fungus. You can pick

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Speaker 1: it up off the shelf of pharmacy. You can get

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Speaker 1: you know, cream for athletes foot, which is a type

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Speaker 1: of anti fungal. Is that correct? Correct? There are a

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Speaker 1: number of antifungal proper compounds and treatment summer creams, annointment

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Speaker 1: that are topical, and there's a handful of them that

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Speaker 1: they're used you know, orally or intravenously, but there's not

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Speaker 1: that many real different therapies we have. And so there's

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Speaker 1: maybe I don't know a douzend or so in total

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Speaker 1: of different antifungal compounds that we use in humans, and

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Speaker 1: it's pretty it's a pretty limited scope. So maybe the

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Speaker 1: nuance that is sort of lost a in the you know,

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Speaker 1: zombie Apocalypse show is that yes, we do have treatments

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Speaker 1: for a fungus, but maybe they're not as specified or

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Speaker 1: as numerous as the treatments we say have for viral

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Speaker 1: infections or bacterial infections. Well, we don't have that many

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Speaker 1: treatments for viral infections, right, But we do have a

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Speaker 1: lot of antibiotics, and so with UM you know, anti

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Speaker 1: fungal you know medicines. There's sort of three or four

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Speaker 1: classes of antifungal medicines. Some of them are pretty toxic

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Speaker 1: um you know, some of them are less toxic. But

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Speaker 1: we do see resistance and we see some you know,

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Speaker 1: some fungch eye that can be resistant to all three

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Speaker 1: classes of antifungals. I see, And maybe we're not making

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Speaker 1: that situation better if we overuse antifungals in agriculture. Well

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Speaker 1: it's probably not super helpful, but I mean there are

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Speaker 1: different antifungal things that are are not used in humans,

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Speaker 1: it can certainly be used in an cultures. So I

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Speaker 1: think the same in um, you know, in live stock,

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Speaker 1: of using the same antibotics that we use in livestock.

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Speaker 1: You know, it's awesome major source of resistance. And in

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Speaker 1: the US it's something about eighty percent of all antibotics

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Speaker 1: or use in livestocking about twenty percent. This kind of

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Speaker 1: ties into this idea of the evolution of fungus. So

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Speaker 1: something like in the show Ophio Corta SEPs starts out

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Speaker 1: in arthropods, I don't know of any mammals really that

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Speaker 1: ophio Corta SEPs effects, And so it seems to make

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Speaker 1: this jump from arthropods to humans. Do you think that

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Speaker 1: it's realistic from an evolutionary point of view for a

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Speaker 1: fungus to jump from an arthropod like an ant to

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Speaker 1: a human without kind of any evolutionary steps in between,

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Speaker 1: wellout a million years in between. Unlikely, But there are certainly,

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Speaker 1: you know, fun fungi that do exist that can affect humans,

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Speaker 1: And so I would be more concerned about sort of

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Speaker 1: the current some of the current agents that we have,

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Speaker 1: certain agents, but some of the current pathogens we have

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Speaker 1: UM more so than some novel um fungus um coming out,

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Speaker 1: although Candidaurus is somewhat of a novel fungus that has

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Speaker 1: emerged and cause major problems and hospitals and healthcare centers

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Speaker 1: in some cases with outbreaks. I see, So, how recent

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Speaker 1: is this one? And you call it candida urus and

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Speaker 1: of orus like your ear orus? Okay, um uh, it's um.

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Speaker 1: It's over the kind of the last decade where it's

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Speaker 1: sort of emerged and um, and it's sort of niche

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Speaker 1: is that it's anti it's anti fungal resistant UH and

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Speaker 1: so and it tends to there's been sort of sporadic

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Speaker 1: cases that have happened, and CDCs has tracked numerous outbreaks

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Speaker 1: and sort of behaves kind of weird, you know, unusual

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Speaker 1: for for a fun guy. In what ways is it unusual? Well,

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Speaker 1: that's more aggressive, and it's very hardy, where it's resistant

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Speaker 1: not only to anti fungals but also to standard environmental

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Speaker 1: cleaning and things like that. UM, some of the cleaning

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Speaker 1: agents that it's it's pretty robust against. And UM. It's

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Speaker 1: something that has caused certain problems and has sort of

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Speaker 1: spread around the world from where when it was initially

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Speaker 1: identified a little over a decade ago. And what kinds

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Speaker 1: of problems does it cause for humans? Like in terms

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Speaker 1: of illness, Well, well, normally UM, particularly you know fun

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Speaker 1: bunch I are really good at UM picking up basically

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Speaker 1: people who have weakened immune systems, so people who are

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Speaker 1: you compromised U. And that can be due to a

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Speaker 1: variety of reasons. It can be due to you know, cancer, chemotherapy,

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Speaker 1: volumearic transplantation and things like that can also be to

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Speaker 1: do hiv UM. But there's also a lot of new

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Speaker 1: moncul antibodies that are used for rheumatology and other treatments

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Speaker 1: U and so those supressed immune system in certain ways,

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Speaker 1: and so that can predispose people to fungel infections. And

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Speaker 1: so when you hear the TV commercials about it, if

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Speaker 1: you've been exposed to tuberculosis or places where there may

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Speaker 1: be fungel infections they're talking about, um, you know those

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Speaker 1: issues where it predisposes you to risk of infection. You know,

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Speaker 1: for the most part, most fungi kind of affect immuno

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Speaker 1: compromise people for the most part. There are some exceptions, however,

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Speaker 1: and a couple of those exceptions are things what we

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Speaker 1: term as endemic mycoses. They're sort of endemic to certain

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Speaker 1: regions around the world, and they live in sort of

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Speaker 1: the environment, but they can form spores and you can

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Speaker 1: inhale those in and you can get sick even if

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Speaker 1: you're not immunocompromised. And so one of the more common

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Speaker 1: ones is something called valley fever, which is a coucxidiorites mycosis.

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Speaker 1: And so that's sense sort of the central Valley of

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Speaker 1: California and in Arizona and kind of southwestern regions but

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Speaker 1: also up as far north as Yakima in Washington, And

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Speaker 1: so that's sort of inhaled spores that can cause a

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Speaker 1: pneumonia and can cause serious disease in a subset of people.

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Speaker 1: Similarly in the Midwest, or something called histoplasmosis, which also

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Speaker 1: has inhaled spore that you can be exposed to and

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Speaker 1: can cause illness, serious illness and you know, kind of

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Speaker 1: regular people. That's interesting because so there is this computer

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Speaker 1: game that predated this show, and it actually did feature

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Speaker 1: inhaling spores as being in a root of infection, whereas

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Speaker 1: now it seems like the show emphasizes like being bitten

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Speaker 1: as a root of infection for fungus. Now, can you

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Speaker 1: be like, can you get like a fungal infection through

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Speaker 1: like an animal buy it or scratch or something. Is

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Speaker 1: that like a typical root or is that more typically

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Speaker 1: like a root for bacterial infection? Yeah, with with bites ut,

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Speaker 1: it's a bacterial infection. You have a lot of bacteria

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Speaker 1: that live in your mouth, and so that that's usually

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Speaker 1: bacteral infection. But you can't have sort of um and

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Speaker 1: you know, if you had a stick or something that

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Speaker 1: that pokes your post to your skin sort of a local,

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Speaker 1: localized inoculation where you kind of have have stuck something

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Speaker 1: into your skin, splinters or wood or something like that.

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Speaker 1: Sometimes UM you can see local local actions. But the

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Speaker 1: majority if of fundel infections are inhaled and so where

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Speaker 1: you're inhaling the scores and so that's the majority of

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Speaker 1: infections that occur in humans. UM with funnel infections, that's

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Speaker 1: usually the route of jury for most most fungus. So

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Speaker 1: so far we don't have to worry too much about

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Speaker 1: a biting zombie apocalypse. More like a floating cloud that

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Speaker 1: we should avoid. Oh yeah, a windy day that that's good.

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Speaker 1: But you know your your immune system and you know

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Speaker 1: we've If you're exposed to to fungus and spores in

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Speaker 1: the environment every day when you're outside on a windy day,

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Speaker 1: and so it's usually it's not a big deal. Your

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Speaker 1: body's immune system takes care of it. You don't even

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Speaker 1: know that you've been exposed. The exceptions would be if

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Speaker 1: you're exposed to a lot all at once, or you're

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Speaker 1: you're exposed to um to something to end your immune

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Speaker 1: system as weekend. For some reason, well, that kind of

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Speaker 1: reminds me of like the when house mold can actually

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Speaker 1: cause problems for people. So mold is a type of fungus. Uh,

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Speaker 1: and so like something that may not be so much

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Speaker 1: of a problem and say a wide open field or

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Speaker 1: a bog where you're not you know, kind of you're

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Speaker 1: in the open space, Like if it's in a home

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Speaker 1: with not great ventilation, is that where you see maybe

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Speaker 1: more problems with like inhalation of spores. Yeah, some people

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Speaker 1: will particularly they can develop sort of an allergic response.

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Speaker 1: And so it's this hyper you know, kind of hyper

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Speaker 1: response to certain molds and an as an allergy and

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Speaker 1: so um with that that can trigger asthma, trigger others

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Speaker 1: or respirae diseases. Um, that can serve as a trigger

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Speaker 1: for that. And so certainly that that can be a

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Speaker 1: case and is common um likely with with the trigger

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Speaker 1: for a lot of people's asthma. Well, we are going

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Speaker 1: to take another quick break, but when we return, we

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Speaker 1: are going to talk about the likelihood of a brain

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Speaker 1: infection by a fungus. So your back right before the break.

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Speaker 1: We're talking about like allergic reactions and that kind of

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Speaker 1: reminds me of the one of the most the bane

428
00:26:08,600 --> 00:26:13,280
Speaker 1: of my existence, at least is the fungus that causes

429
00:26:14,040 --> 00:26:19,399
Speaker 1: dandruff because not everyone, like every the way I heard it,

430
00:26:19,440 --> 00:26:21,520
Speaker 1: explain to me and correct me if I'm wrong about this,

431
00:26:21,640 --> 00:26:26,040
Speaker 1: is that there are some very common fungi that are

432
00:26:26,160 --> 00:26:30,520
Speaker 1: often found on humans, on people, and they often don't

433
00:26:30,520 --> 00:26:35,280
Speaker 1: cause problems. But some people have more of a reaction

434
00:26:35,359 --> 00:26:38,919
Speaker 1: to that, and that can cause anything from like dandruff

435
00:26:39,080 --> 00:26:43,919
Speaker 1: to other adverse skin reactions like exema, and I have

436
00:26:44,040 --> 00:26:47,479
Speaker 1: had a lot of skin reactions or um, you know,

437
00:26:47,600 --> 00:26:51,320
Speaker 1: sort of a scalp itchiness that I think I am

438
00:26:51,400 --> 00:26:56,480
Speaker 1: particularly affected by this fungus. But um, so like it

439
00:26:56,560 --> 00:27:00,600
Speaker 1: is that do people's reactions to fungus kind of very

440
00:27:00,720 --> 00:27:03,520
Speaker 1: depending on you know, your immune system or just your

441
00:27:03,800 --> 00:27:10,080
Speaker 1: your your physiology. Yeah, dandrift can be caused by a

442
00:27:10,119 --> 00:27:13,120
Speaker 1: fungus called Malsesia, which is a common thing that lives

443
00:27:13,119 --> 00:27:16,000
Speaker 1: on people's skin. Yeah, some people that lives there and

444
00:27:16,040 --> 00:27:18,640
Speaker 1: it's happy and it's just sort of present and not

445
00:27:18,640 --> 00:27:20,840
Speaker 1: not a big deal. Some people will develop more of this,

446
00:27:20,960 --> 00:27:24,160
Speaker 1: you know, more inflammatory hyper response to it and get

447
00:27:24,240 --> 00:27:28,080
Speaker 1: dandrift and get suberic dermatitis and sort of other conditions

448
00:27:28,080 --> 00:27:30,520
Speaker 1: that are a response to that. And so it's sort

449
00:27:30,520 --> 00:27:34,600
Speaker 1: of the immune system's response to that fungi that can

450
00:27:34,640 --> 00:27:39,679
Speaker 1: cause inflammation. Yeah, so I I'm just unlucky that I

451
00:27:39,720 --> 00:27:42,679
Speaker 1: can't be friends with this fungus that lives on my

452
00:27:42,720 --> 00:27:46,560
Speaker 1: scalp and I have to kill it with the again

453
00:27:47,000 --> 00:27:51,119
Speaker 1: a shampoo that has an antifungal in it. Which, so

454
00:27:51,160 --> 00:27:54,240
Speaker 1: I do feel a little bit protected in a fungal

455
00:27:54,280 --> 00:27:59,320
Speaker 1: apocalypse situation because I would just use my anti fungal

456
00:28:00,080 --> 00:28:02,760
Speaker 1: mpoo on these. I'm not sure if that's kind of

457
00:28:02,760 --> 00:28:06,879
Speaker 1: really work too well for you. Probably probably okay with

458
00:28:07,119 --> 00:28:11,800
Speaker 1: preventing your zombie apocalypse as long as it is a

459
00:28:11,880 --> 00:28:17,320
Speaker 1: zombie apocalypse caused by really itchy zombies with seboric dermatitis.

460
00:28:17,400 --> 00:28:20,600
Speaker 1: So U but that these are like a lot of

461
00:28:20,640 --> 00:28:25,879
Speaker 1: the fungal infections that are most commonly known like um athletes,

462
00:28:26,000 --> 00:28:31,520
Speaker 1: foot candida, you know, like seboric dermatitises are all. There

463
00:28:31,520 --> 00:28:34,920
Speaker 1: are more topical infections. We did talk a little bit

464
00:28:34,960 --> 00:28:41,200
Speaker 1: about inhaled spores that can cause um, you know, respiratory issues,

465
00:28:42,280 --> 00:28:46,040
Speaker 1: but uh, it seems like it's pretty rare for something

466
00:28:46,120 --> 00:28:49,960
Speaker 1: like a fungal infection too. I mean, for most types

467
00:28:50,000 --> 00:28:52,960
Speaker 1: of infection to reach the brain is quite rare because

468
00:28:52,960 --> 00:28:56,520
Speaker 1: we have the blood brain barrier, the brain is quite

469
00:28:56,520 --> 00:28:59,920
Speaker 1: well protected. But sometimes things do actually reach the brain.

470
00:29:01,120 --> 00:29:07,320
Speaker 1: And there is I only know of one actually through

471
00:29:07,400 --> 00:29:12,680
Speaker 1: your twitter, which is cryptococcal meningitis. So can you talk

472
00:29:12,720 --> 00:29:18,000
Speaker 1: a little bit about this form of infection. Yeah, so cryptococcus.

473
00:29:18,160 --> 00:29:22,920
Speaker 1: It's another yeast, So Cryptcoccus neoformans is. It's a common thing.

474
00:29:22,960 --> 00:29:25,200
Speaker 1: Once again, it's in the environments. Everyone is sort of

475
00:29:25,320 --> 00:29:27,720
Speaker 1: exposed to it and you live your life happily ever

476
00:29:27,760 --> 00:29:29,600
Speaker 1: after and you never know you've been exposed to it.

477
00:29:30,320 --> 00:29:33,720
Speaker 1: If you become immunocompromise or once again, if you're exposed

478
00:29:33,760 --> 00:29:36,160
Speaker 1: to a lot all at once, some people can get

479
00:29:36,160 --> 00:29:39,480
Speaker 1: pretty sick, and so some people will throughout pneumonia, But

480
00:29:39,560 --> 00:29:42,720
Speaker 1: the most sort of fear complication is meningitis, where the

481
00:29:43,080 --> 00:29:47,040
Speaker 1: fungus basically disseminates from the lungs through your blood stream

482
00:29:47,080 --> 00:29:49,960
Speaker 1: throughout the whole body, but also into your brain and

483
00:29:50,000 --> 00:29:52,640
Speaker 1: can sort of lodge into the blood vessels of your brain.

484
00:29:52,640 --> 00:29:54,320
Speaker 1: And there's a couple different theories of how it crosses

485
00:29:54,360 --> 00:29:56,040
Speaker 1: the blood brain barrier, but it gets into the brain

486
00:29:56,120 --> 00:29:59,720
Speaker 1: and surrounds the brain and when it surrounds the brain,

487
00:30:00,160 --> 00:30:03,680
Speaker 1: it kind of plugs up the absorption of how your

488
00:30:03,840 --> 00:30:06,880
Speaker 1: your spinal fluid is absorbed, and so it kind of

489
00:30:06,920 --> 00:30:09,239
Speaker 1: it's like a clug sync where this sort of backs up,

490
00:30:09,280 --> 00:30:11,920
Speaker 1: and so it creates a high pressure around your brain

491
00:30:11,960 --> 00:30:15,600
Speaker 1: which sort of slowly crushes your brain. Which sounds terrible,

492
00:30:15,640 --> 00:30:19,280
Speaker 1: and it very much is terrible. And so it's a

493
00:30:19,360 --> 00:30:22,960
Speaker 1: slow growing infection, unlike a lot of bacterial meningitis, and

494
00:30:23,000 --> 00:30:26,080
Speaker 1: so it's something that develops over days to weeks, two months,

495
00:30:26,840 --> 00:30:30,360
Speaker 1: and so people will eventually show up to healthcare just

496
00:30:30,440 --> 00:30:34,080
Speaker 1: complain of this unrelenting headache, that this is terrible, and

497
00:30:34,120 --> 00:30:38,840
Speaker 1: so it's it's a pretty unpleasant disease. I would say, yeah,

498
00:30:38,880 --> 00:30:42,760
Speaker 1: So I mean, is this something that it can be fatal?

499
00:30:44,000 --> 00:30:45,440
Speaker 1: It certainly can be fatal. It's probably one of the

500
00:30:45,480 --> 00:30:49,040
Speaker 1: more fatal fungal infections. It's also highly treatable. And so

501
00:30:50,000 --> 00:30:52,560
Speaker 1: you know, among our patients and our sort of clinical

502
00:30:52,560 --> 00:30:55,560
Speaker 1: trials and things like that, about ninety percent of people

503
00:30:55,640 --> 00:30:59,360
Speaker 1: can can survive and do well a long term. But

504
00:30:59,480 --> 00:31:01,960
Speaker 1: you know, without that sort of with expert care and

505
00:31:02,000 --> 00:31:04,520
Speaker 1: then sort of a fair number of resources and more

506
00:31:04,600 --> 00:31:08,600
Speaker 1: routine care fatality rates can be you know, forty percent

507
00:31:08,720 --> 00:31:11,920
Speaker 1: or higher. Yeah, I mean, that's I think it is.

508
00:31:12,600 --> 00:31:17,640
Speaker 1: It's interesting that we actually do have like the I guess,

509
00:31:17,960 --> 00:31:23,160
Speaker 1: quite frightening diseases like a brain infection caused by fungus,

510
00:31:23,160 --> 00:31:28,080
Speaker 1: but then we have treatments for it, hopefully treatments that

511
00:31:28,120 --> 00:31:30,720
Speaker 1: people can have access to. I know that that can

512
00:31:30,840 --> 00:31:34,520
Speaker 1: be a problem, of course, getting people access to these treatments.

513
00:31:35,240 --> 00:31:38,440
Speaker 1: I think that is something that I find interesting in

514
00:31:38,560 --> 00:31:43,520
Speaker 1: terms of these more apocalyptic movies, the idea that when

515
00:31:43,520 --> 00:31:46,360
Speaker 1: we're faced with something we haven't seen before, that we

516
00:31:46,600 --> 00:31:49,840
Speaker 1: have no tools at our disposal, whereas well, I mean

517
00:31:49,880 --> 00:31:54,239
Speaker 1: what we've seen with like the coronavirus pandemic. Yes, we

518
00:31:54,280 --> 00:31:57,280
Speaker 1: didn't have a treatment at the beginning, but we developed

519
00:31:57,400 --> 00:32:00,680
Speaker 1: the treatment. And the idea that somehow society would break

520
00:32:00,720 --> 00:32:04,200
Speaker 1: down before we even could begin to start any kind

521
00:32:04,240 --> 00:32:07,360
Speaker 1: of intervention, to me is not super likely. I mean,

522
00:32:07,400 --> 00:32:10,400
Speaker 1: what do you think, Yeah, fortunately decided to not break down.

523
00:32:10,400 --> 00:32:14,120
Speaker 1: It wasn't wasn't quite obvious there for a while, but no, um, yeah, no,

524
00:32:14,160 --> 00:32:16,160
Speaker 1: I think I think that you can see that with

525
00:32:16,320 --> 00:32:19,400
Speaker 1: ingenuity and resources, and I mean there's a lot of

526
00:32:19,440 --> 00:32:21,840
Speaker 1: smart people around the world that can work towards solving

527
00:32:21,840 --> 00:32:26,040
Speaker 1: a problem. UM. And so oftentimes it's an issue of priority,

528
00:32:26,280 --> 00:32:30,400
Speaker 1: prioritization UM. And in some cases it's about you know,

529
00:32:30,480 --> 00:32:34,040
Speaker 1: in our system, it's about the commercial market UM. And

530
00:32:34,080 --> 00:32:36,360
Speaker 1: so can you make you know, can a pharmaceutical you

531
00:32:36,400 --> 00:32:39,160
Speaker 1: know company make money off of a treatment? And so

532
00:32:39,200 --> 00:32:42,600
Speaker 1: for a lot of you know, antibiotics and anti fungals UM,

533
00:32:42,640 --> 00:32:46,960
Speaker 1: there's not a huge insensive UM for UM. You know,

534
00:32:47,000 --> 00:32:48,600
Speaker 1: you can't make a huge amount of money off of

535
00:32:48,600 --> 00:32:51,880
Speaker 1: an antibiotic you take for two weeks, UM. Universes a

536
00:32:51,960 --> 00:32:54,320
Speaker 1: medicine you take for the rest of your life, you know,

537
00:32:54,360 --> 00:32:56,200
Speaker 1: you can make you a ton of money off of

538
00:32:56,320 --> 00:32:58,120
Speaker 1: or a cancer therapy where you're on it for several

539
00:32:58,840 --> 00:33:01,720
Speaker 1: weeks or months. UM. And so there has been sort

540
00:33:01,720 --> 00:33:05,239
Speaker 1: of a disincentive and sort of sort of disinvestments I'm

541
00:33:05,280 --> 00:33:07,160
Speaker 1: not sure if that's a word, but under we'll say

542
00:33:07,160 --> 00:33:11,640
Speaker 1: an underinvestment and new sort of antimicrobial agents, both for

543
00:33:11,720 --> 00:33:15,200
Speaker 1: bacteria as well as for fungi and so UM so

544
00:33:15,240 --> 00:33:19,280
Speaker 1: cryptococcus for instances considered sort of a neglected the neglected

545
00:33:19,280 --> 00:33:23,040
Speaker 1: disease by the FDA. UM. And so there's some incentives

546
00:33:23,040 --> 00:33:26,800
Speaker 1: and things that people can um and try to um

547
00:33:26,880 --> 00:33:28,320
Speaker 1: you know, bring a new drug to market, and they

548
00:33:28,320 --> 00:33:30,640
Speaker 1: have sort of incentives to do so. UM. But's still

549
00:33:30,800 --> 00:33:33,560
Speaker 1: it's a big it's a big reach. And so for um,

550
00:33:33,600 --> 00:33:36,640
Speaker 1: you know, some diseases, well we have treatments for them,

551
00:33:36,680 --> 00:33:39,680
Speaker 1: you know, like valley fever that's in California. UM with

552
00:33:39,880 --> 00:33:43,480
Speaker 1: coxy UM. There are you know, cajet better treatments. And

553
00:33:43,560 --> 00:33:45,360
Speaker 1: so I think we still need better treatments for a

554
00:33:45,360 --> 00:33:48,560
Speaker 1: lot of the fungi just because the treatments are pretty

555
00:33:48,600 --> 00:33:51,680
Speaker 1: toxic that we have sometimes. So what you're saying is

556
00:33:51,720 --> 00:33:57,040
Speaker 1: that medical care should be based on science and human

557
00:33:57,080 --> 00:34:01,400
Speaker 1: health rather than profits, which I think is strange and interesting.

558
00:34:02,520 --> 00:34:04,959
Speaker 1: Well it's it's you know, I think sometimes can you

559
00:34:05,000 --> 00:34:06,920
Speaker 1: can you how do you allow the question is really

560
00:34:06,960 --> 00:34:08,960
Speaker 1: you know, we live in a a capitalist society, and so

561
00:34:09,000 --> 00:34:12,440
Speaker 1: how can you align profit motive to us as for innovation?

562
00:34:12,719 --> 00:34:16,400
Speaker 1: And so you know, we can have a new headache drug,

563
00:34:16,480 --> 00:34:19,239
Speaker 1: or we have a new erectile dysfunction drug, but that's

564
00:34:19,320 --> 00:34:22,440
Speaker 1: really not like probably the most really impactful thing for

565
00:34:22,480 --> 00:34:24,640
Speaker 1: all of human health and existence, even though you can

566
00:34:24,640 --> 00:34:26,160
Speaker 1: make a lot of money off of it. Yea and

567
00:34:26,200 --> 00:34:30,799
Speaker 1: so um. And so the question is how, yeah, how

568
00:34:30,800 --> 00:34:33,719
Speaker 1: do you kind of stimulate a for profit you know,

569
00:34:34,080 --> 00:34:37,759
Speaker 1: pharma system to also consider other things which are in

570
00:34:37,800 --> 00:34:40,719
Speaker 1: the public good. I mean, maybe make them watch The

571
00:34:40,800 --> 00:34:43,200
Speaker 1: Last of Us and scare them and tell them, yes,

572
00:34:43,280 --> 00:34:46,919
Speaker 1: this could definitely happen if we don't start developing new

573
00:34:46,920 --> 00:34:51,320
Speaker 1: anti fungals. I'll try that suggestion. I'm not sure that

574
00:34:51,360 --> 00:34:53,880
Speaker 1: will work, but that there are some things in the

575
00:34:53,920 --> 00:34:56,160
Speaker 1: pipeline then, and there are a lot of this goes

576
00:34:56,160 --> 00:34:59,680
Speaker 1: back to basic science and stuff of like people working

577
00:34:59,719 --> 00:35:02,120
Speaker 1: in time tubes and sort of you know, in mouse

578
00:35:02,200 --> 00:35:03,919
Speaker 1: models and sort of all the sort of basic science

579
00:35:03,920 --> 00:35:06,280
Speaker 1: stuff to identify a new targets and so those targets

580
00:35:06,320 --> 00:35:08,320
Speaker 1: can be moved forward and looked at what if you

581
00:35:08,400 --> 00:35:10,000
Speaker 1: block that target? And so it is kind of a

582
00:35:10,040 --> 00:35:13,399
Speaker 1: long road of taking you know, a concept to them

583
00:35:13,840 --> 00:35:16,560
Speaker 1: like into a drug trial, and in humans is a

584
00:35:16,600 --> 00:35:19,520
Speaker 1: long long road that can take you know, decades or

585
00:35:19,560 --> 00:35:22,560
Speaker 1: more sometimes. Yeah, so we yeah, it is. It is

586
00:35:22,600 --> 00:35:26,080
Speaker 1: something that we really have to incentive. I hate the

587
00:35:26,120 --> 00:35:31,680
Speaker 1: word incentivize, but yes, incentivized, push push towards doing um. Well,

588
00:35:31,760 --> 00:35:35,239
Speaker 1: before we go, is there anything that you want would

589
00:35:35,320 --> 00:35:40,320
Speaker 1: like people to know about fungus or the relationship between

590
00:35:40,360 --> 00:35:43,480
Speaker 1: fungus or and human health, or or why you're interested

591
00:35:43,520 --> 00:35:46,200
Speaker 1: in mycology. Well, I think you know funch I are diverse,

592
00:35:46,640 --> 00:35:50,799
Speaker 1: you know organisms and so um. One of the more

593
00:35:50,840 --> 00:35:53,520
Speaker 1: common ones that that people might be familiar with is

594
00:35:53,680 --> 00:35:58,239
Speaker 1: U sacrimicy serve, which is brewers y east, which is

595
00:35:58,400 --> 00:36:00,399
Speaker 1: used and you don't have to make wine to make

596
00:36:00,480 --> 00:36:04,279
Speaker 1: you know, flour and baking and so there are good

597
00:36:04,320 --> 00:36:06,680
Speaker 1: things and there's good properties that have been developed with

598
00:36:06,680 --> 00:36:10,560
Speaker 1: with some yeast. Most of these living environment and don't

599
00:36:10,560 --> 00:36:12,360
Speaker 1: cause any human disease and they're part of through of

600
00:36:12,400 --> 00:36:16,440
Speaker 1: the natural process of decaying um, you know, dead and

601
00:36:16,520 --> 00:36:20,920
Speaker 1: dyeing plant matter and and I guess animal matter as well. Um.

602
00:36:20,960 --> 00:36:23,040
Speaker 1: But there are a handful that certainly can cause serious

603
00:36:23,040 --> 00:36:27,640
Speaker 1: disease and they can be highly fatal, and we certainly

604
00:36:27,680 --> 00:36:30,439
Speaker 1: do need more better therapies. But yeah, people are working

605
00:36:30,440 --> 00:36:32,640
Speaker 1: on those, but it's kind of a slow, slow slog

606
00:36:33,480 --> 00:36:35,960
Speaker 1: often and so you know, I'm I don't know, I

607
00:36:36,000 --> 00:36:38,000
Speaker 1: guess halfway through my career, but I still consider myself

608
00:36:38,040 --> 00:36:41,640
Speaker 1: a budding mycologists and still learning along the way of

609
00:36:41,680 --> 00:36:45,239
Speaker 1: all the interesting things that these organisms can do um

610
00:36:45,320 --> 00:36:48,160
Speaker 1: and how best we can help people with these affections.

611
00:36:48,880 --> 00:36:52,640
Speaker 1: So don't judge a fungus by its cap is sort

612
00:36:52,640 --> 00:36:56,160
Speaker 1: of the lesson here. Or should we sometimes? I don't know.

613
00:36:56,239 --> 00:36:59,399
Speaker 1: I've never picked a wild mushroom and tried to eat

614
00:36:59,440 --> 00:37:03,600
Speaker 1: it because I cannot judge emotion by its cap responsibly

615
00:37:03,680 --> 00:37:07,279
Speaker 1: without maybe poisoning a help I think that's probably a

616
00:37:07,280 --> 00:37:11,399
Speaker 1: good analogy. Some can be wonderful and some will feel

617
00:37:11,400 --> 00:37:15,280
Speaker 1: you well, thank you so much for joining me today,

618
00:37:16,160 --> 00:37:19,640
Speaker 1: Professor David Bolware, and for answering my questions. That's that's

619
00:37:19,680 --> 00:37:21,839
Speaker 1: pleasure to be here. Thank you for the vict