Speaker 1: Welcome to Creature future production of iHeartRadio. I'm your host
Speaker 1: of Many Parasites, Katie Golden. I studied psychology and evolutionary biology,
Speaker 1: and today on the show The Last of Us more
Speaker 1: like the Best Fungus, We're talking about Ophiel cortescepts and
Speaker 1: other fungi as we explore the possibilities of a fungal
Speaker 1: infection taking control of the brain. Could there be a
Speaker 1: fungal zombie apocalypse such as is depicted in the Last
Speaker 1: of Us? Is Opiel Cortescepts real? And how does it
Speaker 1: function in nature? How much do humans need to fear
Speaker 1: the fungus? Discover this and more as we answer the
Speaker 1: agele question, can ants contemplate the horrors of their existence?
Speaker 1: Joining me to help answer these questions is Infectious Diseases
Speaker 1: doctor and self described budding mycologist, Professor David Boulware. Welcome, Hey,
Speaker 1: it's great to be here. Thank you for the invite.
Speaker 1: I really like how you call yourself a budding my collogists,
Speaker 1: don't think I miss that little fungus pun. Oh, it's
Speaker 1: it is. I'm still budding. I think there's a lot
Speaker 1: to learn. I think that's that's really what the pun
Speaker 1: is about. There's a lot to learn about fungus, and
Speaker 1: so I'm still learning along the way. I mean, absolutely,
Speaker 1: I am also learning about fungus. I'm by no means
Speaker 1: a fungal expert. I do know specifically about ophio Cortis
Speaker 1: ups because of how famous it is in terms of
Speaker 1: its effects on ants. But fungus is it is such
Speaker 1: a I mean, first of all, it's an incredibly diverse
Speaker 1: group of organisms. So a you have just by knowing
Speaker 1: one type of fungus. It's not like you know the
Speaker 1: entire fungal uh you know group. It's They're very diverse,
Speaker 1: and they're all they all function in very weird and
Speaker 1: different ways. I don't know how anyone can ever have
Speaker 1: a total mastery over fungus. Yeah, I certainly talent. Unfortunately,
Speaker 1: the majority of you know, fungus doesn't cause disease in humans.
Speaker 1: There's you know, hundreds and millions of species of fungi
Speaker 1: which are distinct from plants and distinct from animals in
Speaker 1: their own kingdom, but only handful of them actually cause
Speaker 1: pathologic disease in humans, right, Yeah, I think that is
Speaker 1: really important to note. It's not as if they are
Speaker 1: all out to get us. It's kind of like when
Speaker 1: people think of bats as being all these blood sucking,
Speaker 1: bloodthirsty little creatures, and it's like the majority most bat
Speaker 1: species are either nectivorous, frugivorous, or insectivorous. There's only one
Speaker 1: or two species that actually drink blood, and so they
Speaker 1: get this like creepy bad rap. But most of them
Speaker 1: are not what people think. And it's the same thing
Speaker 1: with fungus. They most fungus is good, I mean or neutral.
Speaker 1: It's not. It's not something we have to worry about.
Speaker 1: So in the very popular TV so it actually came
Speaker 1: from a video game called The Last of Us. It
Speaker 1: depicts a pandemic zombie apocalypse. The fungus in the show
Speaker 1: a species of Ophio corticeps contaminated food at a serial
Speaker 1: factory I think in Jakarta and then spread globally when
Speaker 1: people ate the contaminated food. This is all fictional. Don't
Speaker 1: don't panic. People started showing signs of aggression, biting or
Speaker 1: killing others. There's a mycologist in a show that determined
Speaker 1: it was ophiocorticeps, which typically infects arthropods. So arthropods are
Speaker 1: invertebrates like insects and spiders, and then it takes control
Speaker 1: of their behavior of their bodies. But somehow, in this
Speaker 1: fictional world, the ophio CORTESEPS jumps to humans, infects humans,
Speaker 1: takes over their brains, and drives people to violently kill
Speaker 1: or bite other people that's infecting them, you know, the
Speaker 1: classic zombie trope and the infect kind of a twist
Speaker 1: on that those that the infected humans slowly become subsumed
Speaker 1: by this fungus, becoming coated and fungus. It's kind of
Speaker 1: funny because when I look at the visuals of the show,
Speaker 1: kind of looks like not just one species of fungus,
Speaker 1: it looks like all sorts of different species covering. I mean,
Speaker 1: for the visual impact, I think it is cool, if
Speaker 1: not a little bit unrealistic. But yeah, it's just that
Speaker 1: their whole bodies get covered in this fungus and then
Speaker 1: they spread it through biting people or like I guess,
Speaker 1: kind of mouth to mouth filament transmission, which is an
Speaker 1: interesting twist on it. Have you seen the show at all, Doctors, Yeah,
Speaker 1: I really, I have not seen the show. When it
Speaker 1: came out, I was I was out of the country,
Speaker 1: and I have not gone back to track of Town
Speaker 1: and lash it. So, but I've heard a lot about it,
Speaker 1: so it seems very entertaining. You know, maybe not factually accurate,
Speaker 1: but you know that's it's entertainment value. Yeah, exactly. I
Speaker 1: mean I could still enjoy it, even though throughout the
Speaker 1: first episode I kept leaning over to my husband and
Speaker 1: commenting like, now that doesn't make sense. Now that doesn't
Speaker 1: make sense, But you know it's I still really like
Speaker 1: that they incorporate some act, like some reference to an
Speaker 1: actual fungus. That's that's neat. I think it makes people
Speaker 1: curious about that kind of thing and then want to
Speaker 1: find out more about it, which is what we are
Speaker 1: going to try to do. So. Ophio corteseps. Is a
Speaker 1: real genus of fungus and a fascinating one that we've
Speaker 1: talked about on the show before, but it is not
Speaker 1: quite as the HBO show depicts it. So the most
Speaker 1: famous species of ophio corteseps is Ophiocortops unilateralists. It is
Speaker 1: also called the zombie ant fungus, and it is indeed
Speaker 1: exceedingly spooky. It is found in tropical forests all over
Speaker 1: the world and infects ants of a specific species Camponotus leonardi.
Speaker 1: While they can infect other species of ants, the fungus
Speaker 1: are most optimized for this one. So while foraging on
Speaker 1: the forest floor, and ant will pick up spores like
Speaker 1: little pieces of lint on its body, and the spore
Speaker 1: uses enzymes to break down the ants exoskeleton and it
Speaker 1: works its way into the ant's body, which is a
Speaker 1: kind of exfoliation that you definitely don't want in this situation.
Speaker 1: These spores will develop inside the ant's body into fungal
Speaker 1: growths and infect the ants soft tissues, but not necessarily
Speaker 1: its brain. That's something of a misconception. While it does
Speaker 1: seem to alter the ants central nervous system, it doesn't
Speaker 1: require the fungus to actually be growing inside of its brain.
Speaker 1: It's infiltrating all of the ants soft tissues. It can
Speaker 1: also it can grow like in its head, but it's
Speaker 1: not necessarily a physical presence in the brain that is
Speaker 1: causing the ant's behavior to be modified. It as these
Speaker 1: compounds that the fungus is releasing. So some of the
Speaker 1: behavioral modifications that will happen is that the ants will
Speaker 1: convulse and fall from the tree where usually their nest is,
Speaker 1: onto the forest floor. Then the ants will climb up
Speaker 1: a plant stem. They will grip onto the underside of
Speaker 1: the leaf. Usually there's like a vein on the underside
Speaker 1: of the leaf that they clamp down on with its mandibles,
Speaker 1: specifically on the north side of the plant, which is interesting.
Speaker 1: There's some speculation that it optimizes where it grips for
Speaker 1: moisture levels and temperature being ideal for the fungus. And
Speaker 1: it will stay there until the fungus overcomes the ant
Speaker 1: and kind of grows into this. You know, it looks
Speaker 1: very creepy, this sort of ant covered in fungus gripped
Speaker 1: onto this leaf. The Ophio cortu SEPs universe salus will
Speaker 1: grow its hypha into the ant and are these branching
Speaker 1: vein like structures of a fungus. They're also known as filaments,
Speaker 1: which allows the fungus to expand and transport nutrients, and
Speaker 1: a group of hype is called micellium. The ant becomes
Speaker 1: overwhelmed by the mycelium, which also roots the ant to
Speaker 1: the leaf, and then finally, after around four to ten days,
Speaker 1: a fruiting body or bodies will grow from the ant,
Speaker 1: which looks like a little stem with a bulb on
Speaker 1: top and then that will distribute the spores. So while
Speaker 1: this fungus is called the zombie ant fungus, once the
Speaker 1: ant is dead, it's just dead. It's not gonna reanimate this,
Speaker 1: this dead ant. So do we so, doctor Will, Where
Speaker 1: do we see any kind of fungus like this in
Speaker 1: humans that takes like takes over our brains and our
Speaker 1: bodies and controls us in this way? Oh exactly. I mean,
Speaker 1: there are certain types of fungus that can cause infections
Speaker 1: of the brain, and they can alter people's behavior certainly,
Speaker 1: but usually they just make people really really sick. Yeah, yeah, yeah,
Speaker 1: I it is. And one thing that's interesting to me
Speaker 1: is that this is definitely a scary thing that is real, right,
Speaker 1: this is a real fungus. But the only animals it
Speaker 1: seems like that it seems to have this kind of
Speaker 1: specific control over are arthropods insects. And so is it
Speaker 1: when we see something that impacts an arthropod or an
Speaker 1: insect or a spider, like, how how typical is it
Speaker 1: for diseases or something that is like zoonotic to originate
Speaker 1: from an insect versus something that is closer to us
Speaker 1: On the evolutionary tree. Yeah, so a lot of things,
Speaker 1: A lot of fungus can affect cold blooded animals and
Speaker 1: cold blooded you know, insects, etc. And Um. One of
Speaker 1: the theories behind why why are mammals warm blooded is
Speaker 1: that that the temperature difference protects us against bungal diseases.
Speaker 1: And so that's sort of one of the hypotheses and
Speaker 1: theories of why sort of mammals sort of um escaped
Speaker 1: after sort of you know, sort of the great sort
Speaker 1: of the dinosaurs and sort of um, you know, the
Speaker 1: meteorites sort of striking your earth and sort of causing
Speaker 1: sort of dust clouds and all the plants dying off.
Speaker 1: And with that, then, uh, fungus is sort of a
Speaker 1: big part of decaying plant matter, and so breaking down
Speaker 1: plants and sort of that that process of decay is
Speaker 1: what funge i normally do in the environment. And so
Speaker 1: one of the theories of why then mammals sort of
Speaker 1: exploded and sort of took off after that is the
Speaker 1: temperature difference. Being warm blooded protects us from fungus because
Speaker 1: most fungus does not grow very well at ninety eight
Speaker 1: degrees and temperature. That's really interesting, I mean, it kind
Speaker 1: of makes sense too, then that when we see this
Speaker 1: specific ant controlling behavior or something like opio corti SEPs,
Speaker 1: it actually directs the ant to a very specific part
Speaker 1: of the forest floor. It's not content to just infect
Speaker 1: the ant wherever it is and the ant, you know,
Speaker 1: sprouts the fruiting body. It has evolved to kind of
Speaker 1: modulate the ant's behavior in such a way that the
Speaker 1: ant goes to like the underside of a leaf somewhere,
Speaker 1: whether there's the right amount of humidity, the right temperature,
Speaker 1: because really it wants kind of a ideal environment for itself.
Speaker 1: So to somehow be able to jump to a human
Speaker 1: and infect a human, it would require that it overcome
Speaker 1: this need for this very specific temperature range. And it
Speaker 1: seems that seems quite difficult to make such a leap.
Speaker 1: It does, and so most most fungus doesn't do that.
Speaker 1: But you know, one of the concerns with global warming
Speaker 1: is that the ambient temperature yeah in the environment humans
Speaker 1: and many places of the globe is coming closer and
Speaker 1: closer together. Such things that can live in the environment
Speaker 1: quite happily, there may be a selection pressure where they
Speaker 1: can jump to humans. And so at present, i'm in Minnesota,
Speaker 1: there's a big difference between ambi and temperature outside and
Speaker 1: the environment and what it is in the human body.
Speaker 1: But in other places around the world you've got high
Speaker 1: temperatures and so that that beer may be less. Yeah,
Speaker 1: that's interesting. I mean we have seen that in animals
Speaker 1: where the changing climate will change a situation that that
Speaker 1: animal has with something like a bacteria from being basically
Speaker 1: they can sort of coexist to it overwhelming the animal,
Speaker 1: like the pyga antelope, which was able to co exist
Speaker 1: with with a bacteria that would live in they are
Speaker 1: these so pyga antelope are these really interesting animals. They
Speaker 1: have these huge proboscuses. They it looks like the beginnings
Speaker 1: of an elephant, but then it just kind of stops.
Speaker 1: And you know these these proboscises are they breathe in
Speaker 1: a lot of air and they kind of like cool
Speaker 1: down the air or warm up the air, depending on
Speaker 1: like their needs. It's like a portable air conditioners slash
Speaker 1: heater unit. And so in their noses like they would
Speaker 1: there's often like bacteria bacteria well like moist warm areas,
Speaker 1: but they were their immune systems are able to fight
Speaker 1: off the bacteria in their nose when it's at a
Speaker 1: certain level, but when it's above a certain level, they
Speaker 1: can no longer fight it off. And the temperature changed.
Speaker 1: The temperature just being a little bit warmer made conditions
Speaker 1: a little bit better for this bacteria. And so you
Speaker 1: had whole herds of Siga antelope just dropping dead mysteriously.
Speaker 1: Like it was very, very creepy because you have this
Speaker 1: entire herd of antelope just dead on the ground and
Speaker 1: finding out that it's because well, the temperature is a
Speaker 1: little higher, so the bacteria was able to thrive a
Speaker 1: little better. It is creepy and it is a little
Speaker 1: bit spooky, this idea that fungus uh, you know, if
Speaker 1: it is driven a little bit towards being able to
Speaker 1: exist in a warmer environment than it would potentially be
Speaker 1: more of a risk to humans. I very mention indeed,
Speaker 1: so that that's a little bit of a concern. And
Speaker 1: so some of the you know, environmental sort of um
Speaker 1: kind of explosion with like a fungus called a Canada
Speaker 1: orus in particular is one of those that's more thermotolerant
Speaker 1: and um. And so one of the theories of why
Speaker 1: that's been selected out and is due to sort of
Speaker 1: the increase temperatures as well as sort of fun decide
Speaker 1: use a sort of in the environment and agriculture of
Speaker 1: anti fungal agents US used to protect crops. That's yeah,
Speaker 1: I mean, that's kind of reminds me of the we
Speaker 1: have a lot of concerns about the over use of
Speaker 1: antibacterials in antibiotics. But yeah, the overuse of anti fungals,
Speaker 1: I guess I that that concern I don't hear about
Speaker 1: too much. But how big of a concern do you
Speaker 1: think that is? Well, there's a lot of different So
Speaker 1: for plants, if you think about your tomato plant, like,
Speaker 1: you can get sort of various sort of diseases and
Speaker 1: a lot of those are mold and fungus is basically
Speaker 1: that they can affect the plants, and so in agriculture,
Speaker 1: molds are big deal. Molds are a type of fungus,
Speaker 1: and so there are a number of different you know,
Speaker 1: anti fungal properties. Um you know, compounds are used for agriculture,
Speaker 1: and so a lot of us are not used in humans,
Speaker 1: but but some of them actually are. They're in the
Speaker 1: same class that we use in humans. And so that
Speaker 1: that alarms me a little bit because we're starting to
Speaker 1: see more and more anti fungal resistance, and so with that,
Speaker 1: I would say, don't use compounds that are using humans
Speaker 1: in agriculture. But that's all right, I'll stop doing that. Well,
Speaker 1: uh so we're going to take a quick break, but
Speaker 1: when we get act we will be talking about some
Speaker 1: of the claims that the HBO show makes about fungus
Speaker 1: and using that kind of as a jumping off point
Speaker 1: to talk more about the impacts that fungi can have
Speaker 1: on human health. So we are back, and I am
Speaker 1: very lucky to be joined by Professor David Bulware, who
Speaker 1: is an infectious diseases doctor with an acute awareness of
Speaker 1: fungus and the risks of fungus. And I think that
Speaker 1: whenever people watch a show like The Last of Us,
Speaker 1: I mean, I think people know its fiction, people know
Speaker 1: it's science fiction, but it is it brings up these
Speaker 1: ideas of like of a fungal pandemic, and so sometimes
Speaker 1: the show will say things like in the beginning of
Speaker 1: the show, it talked about one of the dangers of
Speaker 1: this sort of outbreak of this fungus is that they
Speaker 1: have no treatments for fungal infections now before the break,
Speaker 1: we just talked about the potential overuse of antifungals, So
Speaker 1: already that's not quite accurate, right, Like, it's not that
Speaker 1: we don't have anything that treats fungus. You can pick
Speaker 1: it up off the shelf of pharmacy. You can get
Speaker 1: you know, cream for athletes foot, which is a type
Speaker 1: of anti fungal. Is that correct? Correct? There are a
Speaker 1: number of antifungal proper compounds and treatment summer creams, annointment
Speaker 1: that are topical, and there's a handful of them that
Speaker 1: they're used you know, orally or intravenously, but there's not
Speaker 1: that many real different therapies we have. And so there's
Speaker 1: maybe I don't know a douzend or so in total
Speaker 1: of different antifungal compounds that we use in humans, and
Speaker 1: it's pretty it's a pretty limited scope. So maybe the
Speaker 1: nuance that is sort of lost a in the you know,
Speaker 1: zombie Apocalypse show is that yes, we do have treatments
Speaker 1: for a fungus, but maybe they're not as specified or
Speaker 1: as numerous as the treatments we say have for viral
Speaker 1: infections or bacterial infections. Well, we don't have that many
Speaker 1: treatments for viral infections, right, But we do have a
Speaker 1: lot of antibiotics, and so with UM you know, anti
Speaker 1: fungal you know medicines. There's sort of three or four
Speaker 1: classes of antifungal medicines. Some of them are pretty toxic
Speaker 1: um you know, some of them are less toxic. But
Speaker 1: we do see resistance and we see some you know,
Speaker 1: some fungch eye that can be resistant to all three
Speaker 1: classes of antifungals. I see, And maybe we're not making
Speaker 1: that situation better if we overuse antifungals in agriculture. Well
Speaker 1: it's probably not super helpful, but I mean there are
Speaker 1: different antifungal things that are are not used in humans,
Speaker 1: it can certainly be used in an cultures. So I
Speaker 1: think the same in um, you know, in live stock,
Speaker 1: of using the same antibotics that we use in livestock.
Speaker 1: You know, it's awesome major source of resistance. And in
Speaker 1: the US it's something about eighty percent of all antibotics
Speaker 1: or use in livestocking about twenty percent. This kind of
Speaker 1: ties into this idea of the evolution of fungus. So
Speaker 1: something like in the show Ophio Corta SEPs starts out
Speaker 1: in arthropods, I don't know of any mammals really that
Speaker 1: ophio Corta SEPs effects, And so it seems to make
Speaker 1: this jump from arthropods to humans. Do you think that
Speaker 1: it's realistic from an evolutionary point of view for a
Speaker 1: fungus to jump from an arthropod like an ant to
Speaker 1: a human without kind of any evolutionary steps in between,
Speaker 1: wellout a million years in between. Unlikely, But there are certainly,
Speaker 1: you know, fun fungi that do exist that can affect humans,
Speaker 1: And so I would be more concerned about sort of
Speaker 1: the current some of the current agents that we have,
Speaker 1: certain agents, but some of the current pathogens we have
Speaker 1: UM more so than some novel um fungus um coming out,
Speaker 1: although Candidaurus is somewhat of a novel fungus that has
Speaker 1: emerged and cause major problems and hospitals and healthcare centers
Speaker 1: in some cases with outbreaks. I see, So, how recent
Speaker 1: is this one? And you call it candida urus and
Speaker 1: of orus like your ear orus? Okay, um uh, it's um.
Speaker 1: It's over the kind of the last decade where it's
Speaker 1: sort of emerged and um, and it's sort of niche
Speaker 1: is that it's anti it's anti fungal resistant UH and
Speaker 1: so and it tends to there's been sort of sporadic
Speaker 1: cases that have happened, and CDCs has tracked numerous outbreaks
Speaker 1: and sort of behaves kind of weird, you know, unusual
Speaker 1: for for a fun guy. In what ways is it unusual? Well,
Speaker 1: that's more aggressive, and it's very hardy, where it's resistant
Speaker 1: not only to anti fungals but also to standard environmental
Speaker 1: cleaning and things like that. UM, some of the cleaning
Speaker 1: agents that it's it's pretty robust against. And UM. It's
Speaker 1: something that has caused certain problems and has sort of
Speaker 1: spread around the world from where when it was initially
Speaker 1: identified a little over a decade ago. And what kinds
Speaker 1: of problems does it cause for humans? Like in terms
Speaker 1: of illness, Well, well, normally UM, particularly you know fun
Speaker 1: bunch I are really good at UM picking up basically
Speaker 1: people who have weakened immune systems, so people who are
Speaker 1: you compromised U. And that can be due to a
Speaker 1: variety of reasons. It can be due to you know, cancer, chemotherapy,
Speaker 1: volumearic transplantation and things like that can also be to
Speaker 1: do hiv UM. But there's also a lot of new
Speaker 1: moncul antibodies that are used for rheumatology and other treatments
Speaker 1: U and so those supressed immune system in certain ways,
Speaker 1: and so that can predispose people to fungel infections. And
Speaker 1: so when you hear the TV commercials about it, if
Speaker 1: you've been exposed to tuberculosis or places where there may
Speaker 1: be fungel infections they're talking about, um, you know those
Speaker 1: issues where it predisposes you to risk of infection. You know,
Speaker 1: for the most part, most fungi kind of affect immuno
Speaker 1: compromise people for the most part. There are some exceptions, however,
Speaker 1: and a couple of those exceptions are things what we
Speaker 1: term as endemic mycoses. They're sort of endemic to certain
Speaker 1: regions around the world, and they live in sort of
Speaker 1: the environment, but they can form spores and you can
Speaker 1: inhale those in and you can get sick even if
Speaker 1: you're not immunocompromised. And so one of the more common
Speaker 1: ones is something called valley fever, which is a coucxidiorites mycosis.
Speaker 1: And so that's sense sort of the central Valley of
Speaker 1: California and in Arizona and kind of southwestern regions but
Speaker 1: also up as far north as Yakima in Washington, And
Speaker 1: so that's sort of inhaled spores that can cause a
Speaker 1: pneumonia and can cause serious disease in a subset of people.
Speaker 1: Similarly in the Midwest, or something called histoplasmosis, which also
Speaker 1: has inhaled spore that you can be exposed to and
Speaker 1: can cause illness, serious illness and you know, kind of
Speaker 1: regular people. That's interesting because so there is this computer
Speaker 1: game that predated this show, and it actually did feature
Speaker 1: inhaling spores as being in a root of infection, whereas
Speaker 1: now it seems like the show emphasizes like being bitten
Speaker 1: as a root of infection for fungus. Now, can you
Speaker 1: be like, can you get like a fungal infection through
Speaker 1: like an animal buy it or scratch or something. Is
Speaker 1: that like a typical root or is that more typically
Speaker 1: like a root for bacterial infection? Yeah, with with bites ut,
Speaker 1: it's a bacterial infection. You have a lot of bacteria
Speaker 1: that live in your mouth, and so that that's usually
Speaker 1: bacteral infection. But you can't have sort of um and
Speaker 1: you know, if you had a stick or something that
Speaker 1: that pokes your post to your skin sort of a local,
Speaker 1: localized inoculation where you kind of have have stuck something
Speaker 1: into your skin, splinters or wood or something like that.
Speaker 1: Sometimes UM you can see local local actions. But the
Speaker 1: majority if of fundel infections are inhaled and so where
Speaker 1: you're inhaling the scores and so that's the majority of
Speaker 1: infections that occur in humans. UM with funnel infections, that's
Speaker 1: usually the route of jury for most most fungus. So
Speaker 1: so far we don't have to worry too much about
Speaker 1: a biting zombie apocalypse. More like a floating cloud that
Speaker 1: we should avoid. Oh yeah, a windy day that that's good.
Speaker 1: But you know your your immune system and you know
Speaker 1: we've If you're exposed to to fungus and spores in
Speaker 1: the environment every day when you're outside on a windy day,
Speaker 1: and so it's usually it's not a big deal. Your
Speaker 1: body's immune system takes care of it. You don't even
Speaker 1: know that you've been exposed. The exceptions would be if
Speaker 1: you're exposed to a lot all at once, or you're
Speaker 1: you're exposed to um to something to end your immune
Speaker 1: system as weekend. For some reason, well, that kind of
Speaker 1: reminds me of like the when house mold can actually
Speaker 1: cause problems for people. So mold is a type of fungus. Uh,
Speaker 1: and so like something that may not be so much
Speaker 1: of a problem and say a wide open field or
Speaker 1: a bog where you're not you know, kind of you're
Speaker 1: in the open space, Like if it's in a home
Speaker 1: with not great ventilation, is that where you see maybe
Speaker 1: more problems with like inhalation of spores. Yeah, some people
Speaker 1: will particularly they can develop sort of an allergic response.
Speaker 1: And so it's this hyper you know, kind of hyper
Speaker 1: response to certain molds and an as an allergy and
Speaker 1: so um with that that can trigger asthma, trigger others
Speaker 1: or respirae diseases. Um, that can serve as a trigger
Speaker 1: for that. And so certainly that that can be a
Speaker 1: case and is common um likely with with the trigger
Speaker 1: for a lot of people's asthma. Well, we are going
Speaker 1: to take another quick break, but when we return, we
Speaker 1: are going to talk about the likelihood of a brain
Speaker 1: infection by a fungus. So your back right before the break.
Speaker 1: We're talking about like allergic reactions and that kind of
Speaker 1: reminds me of the one of the most the bane
Speaker 1: of my existence, at least is the fungus that causes
Speaker 1: dandruff because not everyone, like every the way I heard it,
Speaker 1: explain to me and correct me if I'm wrong about this,
Speaker 1: is that there are some very common fungi that are
Speaker 1: often found on humans, on people, and they often don't
Speaker 1: cause problems. But some people have more of a reaction
Speaker 1: to that, and that can cause anything from like dandruff
Speaker 1: to other adverse skin reactions like exema, and I have
Speaker 1: had a lot of skin reactions or um, you know,
Speaker 1: sort of a scalp itchiness that I think I am
Speaker 1: particularly affected by this fungus. But um, so like it
Speaker 1: is that do people's reactions to fungus kind of very
Speaker 1: depending on you know, your immune system or just your
Speaker 1: your your physiology. Yeah, dandrift can be caused by a
Speaker 1: fungus called Malsesia, which is a common thing that lives
Speaker 1: on people's skin. Yeah, some people that lives there and
Speaker 1: it's happy and it's just sort of present and not
Speaker 1: not a big deal. Some people will develop more of this,
Speaker 1: you know, more inflammatory hyper response to it and get
Speaker 1: dandrift and get suberic dermatitis and sort of other conditions
Speaker 1: that are a response to that. And so it's sort
Speaker 1: of the immune system's response to that fungi that can
Speaker 1: cause inflammation. Yeah, so I I'm just unlucky that I
Speaker 1: can't be friends with this fungus that lives on my
Speaker 1: scalp and I have to kill it with the again
Speaker 1: a shampoo that has an antifungal in it. Which, so
Speaker 1: I do feel a little bit protected in a fungal
Speaker 1: apocalypse situation because I would just use my anti fungal
Speaker 1: mpoo on these. I'm not sure if that's kind of
Speaker 1: really work too well for you. Probably probably okay with
Speaker 1: preventing your zombie apocalypse as long as it is a
Speaker 1: zombie apocalypse caused by really itchy zombies with seboric dermatitis.
Speaker 1: So U but that these are like a lot of
Speaker 1: the fungal infections that are most commonly known like um athletes,
Speaker 1: foot candida, you know, like seboric dermatitises are all. There
Speaker 1: are more topical infections. We did talk a little bit
Speaker 1: about inhaled spores that can cause um, you know, respiratory issues,
Speaker 1: but uh, it seems like it's pretty rare for something
Speaker 1: like a fungal infection too. I mean, for most types
Speaker 1: of infection to reach the brain is quite rare because
Speaker 1: we have the blood brain barrier, the brain is quite
Speaker 1: well protected. But sometimes things do actually reach the brain.
Speaker 1: And there is I only know of one actually through
Speaker 1: your twitter, which is cryptococcal meningitis. So can you talk
Speaker 1: a little bit about this form of infection. Yeah, so cryptococcus.
Speaker 1: It's another yeast, So Cryptcoccus neoformans is. It's a common thing.
Speaker 1: Once again, it's in the environments. Everyone is sort of
Speaker 1: exposed to it and you live your life happily ever
Speaker 1: after and you never know you've been exposed to it.
Speaker 1: If you become immunocompromise or once again, if you're exposed
Speaker 1: to a lot all at once, some people can get
Speaker 1: pretty sick, and so some people will throughout pneumonia, But
Speaker 1: the most sort of fear complication is meningitis, where the
Speaker 1: fungus basically disseminates from the lungs through your blood stream
Speaker 1: throughout the whole body, but also into your brain and
Speaker 1: can sort of lodge into the blood vessels of your brain.
Speaker 1: And there's a couple different theories of how it crosses
Speaker 1: the blood brain barrier, but it gets into the brain
Speaker 1: and surrounds the brain and when it surrounds the brain,
Speaker 1: it kind of plugs up the absorption of how your
Speaker 1: your spinal fluid is absorbed, and so it kind of
Speaker 1: it's like a clug sync where this sort of backs up,
Speaker 1: and so it creates a high pressure around your brain
Speaker 1: which sort of slowly crushes your brain. Which sounds terrible,
Speaker 1: and it very much is terrible. And so it's a
Speaker 1: slow growing infection, unlike a lot of bacterial meningitis, and
Speaker 1: so it's something that develops over days to weeks, two months,
Speaker 1: and so people will eventually show up to healthcare just
Speaker 1: complain of this unrelenting headache, that this is terrible, and
Speaker 1: so it's it's a pretty unpleasant disease. I would say, yeah,
Speaker 1: So I mean, is this something that it can be fatal?
Speaker 1: It certainly can be fatal. It's probably one of the
Speaker 1: more fatal fungal infections. It's also highly treatable. And so
Speaker 1: you know, among our patients and our sort of clinical
Speaker 1: trials and things like that, about ninety percent of people
Speaker 1: can can survive and do well a long term. But
Speaker 1: you know, without that sort of with expert care and
Speaker 1: then sort of a fair number of resources and more
Speaker 1: routine care fatality rates can be you know, forty percent
Speaker 1: or higher. Yeah, I mean, that's I think it is.
Speaker 1: It's interesting that we actually do have like the I guess,
Speaker 1: quite frightening diseases like a brain infection caused by fungus,
Speaker 1: but then we have treatments for it, hopefully treatments that
Speaker 1: people can have access to. I know that that can
Speaker 1: be a problem, of course, getting people access to these treatments.
Speaker 1: I think that is something that I find interesting in
Speaker 1: terms of these more apocalyptic movies, the idea that when
Speaker 1: we're faced with something we haven't seen before, that we
Speaker 1: have no tools at our disposal, whereas well, I mean
Speaker 1: what we've seen with like the coronavirus pandemic. Yes, we
Speaker 1: didn't have a treatment at the beginning, but we developed
Speaker 1: the treatment. And the idea that somehow society would break
Speaker 1: down before we even could begin to start any kind
Speaker 1: of intervention, to me is not super likely. I mean,
Speaker 1: what do you think, Yeah, fortunately decided to not break down.
Speaker 1: It wasn't wasn't quite obvious there for a while, but no, um, yeah, no,
Speaker 1: I think I think that you can see that with
Speaker 1: ingenuity and resources, and I mean there's a lot of
Speaker 1: smart people around the world that can work towards solving
Speaker 1: a problem. UM. And so oftentimes it's an issue of priority,
Speaker 1: prioritization UM. And in some cases it's about you know,
Speaker 1: in our system, it's about the commercial market UM. And
Speaker 1: so can you make you know, can a pharmaceutical you
Speaker 1: know company make money off of a treatment? And so
Speaker 1: for a lot of you know, antibiotics and anti fungals UM,
Speaker 1: there's not a huge insensive UM for UM. You know,
Speaker 1: you can't make a huge amount of money off of
Speaker 1: an antibiotic you take for two weeks, UM. Universes a
Speaker 1: medicine you take for the rest of your life, you know,
Speaker 1: you can make you a ton of money off of
Speaker 1: or a cancer therapy where you're on it for several
Speaker 1: weeks or months. UM. And so there has been sort
Speaker 1: of a disincentive and sort of sort of disinvestments I'm
Speaker 1: not sure if that's a word, but under we'll say
Speaker 1: an underinvestment and new sort of antimicrobial agents, both for
Speaker 1: bacteria as well as for fungi and so UM so
Speaker 1: cryptococcus for instances considered sort of a neglected the neglected
Speaker 1: disease by the FDA. UM. And so there's some incentives
Speaker 1: and things that people can um and try to um
Speaker 1: you know, bring a new drug to market, and they
Speaker 1: have sort of incentives to do so. UM. But's still
Speaker 1: it's a big it's a big reach. And so for um,
Speaker 1: you know, some diseases, well we have treatments for them,
Speaker 1: you know, like valley fever that's in California. UM with
Speaker 1: coxy UM. There are you know, cajet better treatments. And
Speaker 1: so I think we still need better treatments for a
Speaker 1: lot of the fungi just because the treatments are pretty
Speaker 1: toxic that we have sometimes. So what you're saying is
Speaker 1: that medical care should be based on science and human
Speaker 1: health rather than profits, which I think is strange and interesting.
Speaker 1: Well it's it's you know, I think sometimes can you
Speaker 1: can you how do you allow the question is really
Speaker 1: you know, we live in a a capitalist society, and so
Speaker 1: how can you align profit motive to us as for innovation?
Speaker 1: And so you know, we can have a new headache drug,
Speaker 1: or we have a new erectile dysfunction drug, but that's
Speaker 1: really not like probably the most really impactful thing for
Speaker 1: all of human health and existence, even though you can
Speaker 1: make a lot of money off of it. Yea and
Speaker 1: so um. And so the question is how, yeah, how
Speaker 1: do you kind of stimulate a for profit you know,
Speaker 1: pharma system to also consider other things which are in
Speaker 1: the public good. I mean, maybe make them watch The
Speaker 1: Last of Us and scare them and tell them, yes,
Speaker 1: this could definitely happen if we don't start developing new
Speaker 1: anti fungals. I'll try that suggestion. I'm not sure that
Speaker 1: will work, but that there are some things in the
Speaker 1: pipeline then, and there are a lot of this goes
Speaker 1: back to basic science and stuff of like people working
Speaker 1: in time tubes and sort of you know, in mouse
Speaker 1: models and sort of all the sort of basic science
Speaker 1: stuff to identify a new targets and so those targets
Speaker 1: can be moved forward and looked at what if you
Speaker 1: block that target? And so it is kind of a
Speaker 1: long road of taking you know, a concept to them
Speaker 1: like into a drug trial, and in humans is a
Speaker 1: long long road that can take you know, decades or
Speaker 1: more sometimes. Yeah, so we yeah, it is. It is
Speaker 1: something that we really have to incentive. I hate the
Speaker 1: word incentivize, but yes, incentivized, push push towards doing um. Well,
Speaker 1: before we go, is there anything that you want would
Speaker 1: like people to know about fungus or the relationship between
Speaker 1: fungus or and human health, or or why you're interested
Speaker 1: in mycology. Well, I think you know funch I are diverse,
Speaker 1: you know organisms and so um. One of the more
Speaker 1: common ones that that people might be familiar with is
Speaker 1: U sacrimicy serve, which is brewers y east, which is
Speaker 1: used and you don't have to make wine to make
Speaker 1: you know, flour and baking and so there are good
Speaker 1: things and there's good properties that have been developed with
Speaker 1: with some yeast. Most of these living environment and don't
Speaker 1: cause any human disease and they're part of through of
Speaker 1: the natural process of decaying um, you know, dead and
Speaker 1: dyeing plant matter and and I guess animal matter as well. Um.
Speaker 1: But there are a handful that certainly can cause serious
Speaker 1: disease and they can be highly fatal, and we certainly
Speaker 1: do need more better therapies. But yeah, people are working
Speaker 1: on those, but it's kind of a slow, slow slog
Speaker 1: often and so you know, I'm I don't know, I
Speaker 1: guess halfway through my career, but I still consider myself
Speaker 1: a budding mycologists and still learning along the way of
Speaker 1: all the interesting things that these organisms can do um
Speaker 1: and how best we can help people with these affections.
Speaker 1: So don't judge a fungus by its cap is sort
Speaker 1: of the lesson here. Or should we sometimes? I don't know.
Speaker 1: I've never picked a wild mushroom and tried to eat
Speaker 1: it because I cannot judge emotion by its cap responsibly
Speaker 1: without maybe poisoning a help I think that's probably a
Speaker 1: good analogy. Some can be wonderful and some will feel
Speaker 1: you well, thank you so much for joining me today,
Speaker 1: Professor David Bolware, and for answering my questions. That's that's
Speaker 1: pleasure to be here. Thank you for the vict