Chronic infections are composed of bacterial biofilms that can persist in and on our bodies for many years. But, biofilms are not constrained to chronic infections; they are present in several spaces in the healthy human body and basically everywhere in your surrounding.

Human Microbiome:

The human microbiome organized in the form of biofilms is known as Commensal Biofilms. The number of bacterial cells in the human body is ten times more than the total number of human cells. And if we talk about bacterial genes they constitute about 99% of total genes in the human body.

Commensal and natural biofilms are more diverse than chronic biofilms. These biofilms facilitate vital processes including the degradation of organic matter and facilitate plant growth.

ORAL BIOFILMS:

The oral cavity harbors hundreds of microbial species that are present either as planktonic cells or incorporated into biofilms. The majority of the oral microbes are commensal organisms. Those that are pathogenic microbes can result in oral infections, and at times can initiate systemic diseases.

There are two major types of oral biofilms:

1. Dental Biofilms/ Plaque
2. Carogenic Biofilms

Dental plaque is associated with caries and periodontal disease. But they also have some beneficial effects. Like:

1. Natural defense through the microbiome. The host microbiome act as a barrier to pathogens.
2. Protect teeth from erosion, which is de-mineralization of the teeth due to intake of fizzy acidic drinks.

Bacteria don't attach directly to the tooth cuz of the enamel surface is covered by a layer of salivary proteins called Pellicles. The first bacteria to adhere to is oral streptococci. Facultative Actinomyces acts as a receptor for other bacteria. Fusobacterium play a key role because it can aggregate with all bacteria in the biofilm. Biofilms develop from gram-positive to gram-negative rods and cocci.

Environmental factors affect biofilms. It is described by PHILLIP MARSH in a hypothesis called the ECOLOGICAL PLAQUE HYPOTHESIS, which states:

Change in ecological factors like access to growth factors, oxygen,pH and amount of gingival crevicular fluid determine the composition of the biofilm.

Carogenic biofilms:

Carogenic biofilms are described as microbial communities that create their own localized pH niche. These biofilms are dominated by 2 pathogens mainly:

1. Mutant Streptococci: It has a strong ability to adhere tooth due to sugar metabolism. It produces acid and can live at low pH.
2. Lactobacilli: It is found in already established lesions and is highly aciduric.

Caries:   Caries also known as cavities/demineralization is caused by biofilm production due to a drop in pH to 5.5. This drop in pH is due to acid production by fermentation. Caries allow bacteria to go to the pulp where nerves are located. Bacteria then induce inflammation and pain due to which pulp tissue becomes infected leading to necrosis. Due to necrosis nutrients convert from carbohydrates to proteins and the environment becomes more anaerobic.

An anaerobic environment favors the growth of proteolytic bacteria that spread from the root canal to the apical area of the tooth and jawbone. Biofilms in the pulp area are hard to identify.

Gingivitis:   Gum becomes swollen and red and may bleed. If not treated it can progress to periodontitis that lead to tooth loss.

Peridontitis:   Peridontitis is the loss of supporting tissue around teeth that result in the loosening of teeth.

Creator: Gunita Reine

Other Factors:

Other factors that can be a cause of oral biofilms are Dentures and Implants.

People who wear dentures usually have biofilms that contain Candida albicans, a pathogenic fungus that lives on the polymethyl acrylate used to make dentures (PMA). Denture wearers are at risk for denture stomatitis, an inflammation of the oral tissues that contribute to poor oral health, poor dental hygiene, and systemic diseases like diabetes.

Dental implants are man-made structures that replace lost teeth. They are constructed of plastic and titanium. Implant-related infections and inflammation can occur in patients who have them. The implant-related bacteria may gather and create a biofilm. The roughness of the implant's surface may alter bacterial adhesion to the implant and promote the development of biofilms. Peri-implantitis is an inflammatory condition that harms the oral tissue that supports the implant.

Conclusion: 

• Gingivitis is mediated by the amount of bacteria in biofilm while caries & peridontitis are mediated by changes in the environment that favor the growth of pathogenic species. 
• Caries develop due to a decrease in pH while periodontitis develops due to an increase in pH.

 LIVING WITH HOPE IN MULTIPLE SCLEROSIS!!

INTRODUCTION:

          Multiple sclerosis (MS) is a central nervous system illness that affects the flow of information inside the brain and between the brain and the rest of the body. It's a brain and spinal cord condition that can be devastating. The protective sheath (myelin) that surrounds nerve fibres is attacked by the immune system in MS, causing communication issues between the brain and the rest of the body. The condition might eventually cause permanent nerve injury or degeneration.

CAUSES:

        Multiple sclerosis has no recognized aetiology. It's classified as an autoimmune illness because the immune system attacks the body's own tissues. This immune system dysfunction in MS causes the fatty substance that coats and protects nerve fibers in the brain and spinal cord to be destroyed (myelin). Myelin is similar to the insulation that protects electrical cables. The messages that go along that nerve fibre may be slowed or inhibited if the protecting myelin is broken and the nerve fibre is exposed..

           It isn't clear why MS develops in some people and not others. A combination of genetics and environmental factors appears to be responsible.

SYMPTOMS:

        Depending on where the damaged nerve fibres are located, the signs and symptoms of multiple sclerosis can vary widely from person to person and during the course of the disease. Movement is typically hampered by symptoms such as:

1. Numbness or weakness in one or more limbs, usually on one side of the body at a time, or in the legs and trunk
2. Certain neck movements, particularly bending the neck forward, cause electric shock feelings (Lhermitte sign)
3. Tremor, a shaky gait, or a lack of coordination

Vision issues are also frequent, and include:

• Partially or completely lost vision, usually in one eye at a time, and often accompanied by pain while moving the eyes.

Multiple sclerosis symptoms may also include:

•          Slurred speech
•          Fatigue
•          Dizziness
•          Tingling or pain in parts of your body
•          Problems with sexual, bowel and bladder function

TREATMENT:

           There is no known cure for multiple sclerosis; treatments can substantially improve the symptoms.

Medication:

         Corticosteroids are drugs that are used to treat inflammation and inhibit the immune system.

         Interferon beta blockers: The progression of the disease can be delayed.

Therapy:

1. Plasmapheresis is a procedure in which a patient's blood is drawn, the plasma separated, and new plasma is put back into the patient to remove antibodies that target the nerves.
2. Physical therapy aids in the maintenance of mobility and physical activities.
3. Occupational therapy: This is used to avoid disease-related impairment.
4. Speech and physical therapy are two types of therapy that might help you enhance your speaking skills.
5. Immunotherapy: This type of treatment focuses on immune cells or processes that are thought to be relevant in the progression of the disease.

Nutrition

            Multiple Sclerosis does not require a special diet. Certain meals may be beneficial to people with Multiple Sclerosis. This is supposed to be unique to each individual.

RISK FACTORS:

            These factors may increase your risk of developing multiple sclerosis:

1. Age. MS can strike at any age, however it commonly strikes between the ages of 20 and 40. Younger and older persons, however, may be affected.
2. Sex. Relapsing-remitting MS affects more than two to three times as many women as it does males.
3. History of the family. You have an increased risk of acquiring MS if one of your parents or siblings has had the disease.
4. Several infections. MS has been associated to a number of viruses, including Epstein-Barr, the virus that causes infectious mononucleosis.
5. Race. White people, particularly those of Northern European ancestry, are the most vulnerable to MS. Asian, African, and Native American peoples have
 the lowest risk.
6.  Climate. MS is far more prevalent in temperate settings, such as Canada, the northern United States, New Zealand, southeastern Australia, and Europe.
7. Vitamin D is a fat-soluble vitamin. Low vitamin D levels and limited sunshine exposure are linked to an increased risk of MS.
8. A number of autoimmune illnesses. If you have other autoimmune conditions including thyroid disease, pernicious anaemia, psoriasis, type 1 diabetes, or inflammatory bowel disease, you're at a slightly increased risk of having MS.
9. Smoking. Smokers are more likely than nonsmokers to acquire a second event that confirms relapsing-remitting MS after experiencing an initial event of symptoms that may signify MS.

INTRODUCTION:

           Prion illnesses are a group of uncommon neurodegenerative conditions that afflict humans and animals. Long incubation periods, spongiform alterations linked with neuronal death, and a failure to elicit an inflammatory response characterise them. Prions are thought to be the cause of TSEs (transmissible spongiform encephalopathies).

          The functions of these normal prion proteins are still being researched. The aberrant folding of prion proteins causes brain damage and the disease's typical signs and symptoms. Prion illnesses are usually deadly and advance quickly.

WHAT ARE PRIONS?

       Proteinaceous infectious particles are referred to as Prion. Prions are infectious organisms that cause a variety of neurological disorders in mammals, including Creutzfeldt-Jakob disease. Prions cause improper folding of normal proteins in the brain, specifically the misfolding of prion proteins (PrP). Prion affects both humans and animals, and infected meat products can sometimes spread the disease to humans..

Structure of Prions

HOW CAN YOU GET PRION DISEASES?

          You can get prion diseases in three ways:

·          ACQUIRED:

           Exposure to abnormal PrP from an outside source may occur through contaminated food or medical equipment.

·         INHERITED:

           Mutations present in the gene that codes for PrP leads to the production of misfolded PrP.

·         NATURALLY:

          Misfolded PrP may develop without any known cause.

Prion infection transmission

TPYES OF PRION DISEASES:

           Prion diseases can occur in both humans and animals. Both have disease characterized in different types. Some of them are listed below:

Human prion diseases are:

1.          Fatal Familial insomnia (FFI)
2.         Gerstmann-Straussler-Scheinker syndrome (GSS)
3.          Kuru
4.          Variant Creutzfeldt-Jakob disease (vCJD)
5.          Creutzfeldt-Jakob disease (CJD)

Animal prion diseases are:

1.          Bovine spongiform encephalopathy (BSE)
2.          Chronic wasting disease (CWD)
3.          Scrapie
4.          Feline spongiform encephalopathy (FSE)
5.         Transmissible mink encephalopathy (TME)
6.          Ungulate spongiform encephalopathy

SYMPTOMS:

        The following are some of the symptoms of prion diseases:

• Dementia that progresses quickly
• Walking difficulties and changes in gait
• Hallucinations
• Muscle tenseness
• Personality morphs (Confusion, Difficulty speaking, Depression, Disorientation)
• Fatigue

DIAGNOSIS:

       Prions have symptoms that are similar to those of other neurological illnesses, making them difficult to identify. The only way to diagnose it is by a post-mortem brain biopsy. A medical specialist, on the other hand, can diagnose it using symptoms, your medical history, and many tests. These tests include the following:

• Magnetic resonance imaging (MRI) is a type of imaging that (MRI) A magnetic resonance imaging (MRI) scan can produce a precise image of your brain. This can aid healthcare workers in visualising prion disease-related alterations in brain structure.
• CSF (cerebrospinal fluid) testing CSF can be collected and analysed for neurodegeneration-related indicators. A test for detecting signs of human prion disease was developed in 2015.
• Electroencephalography (EEG) is a type of brain imaging (EEG) This test records your brain's electrical activity

TREATMENT:

        There is presently no treatment for prion illnesses, however medication can help keep the disease at bay. Scientists are still trying to develop a treatment for prion illnesses. Anti-prion antibodies and "anti-prions (Trusted Source)" that prevent the reproduction of aberrant PrP are among the potential therapeutics being studied.

CAN PRIONS BE PREVENTED?

           Properly cleaning and sterilizing medical equipment may prevent the spread of the disease. If you have or may have CJD, do not donate organs or tissue, including corneal tissue. Newer regulations that govern the handling and feeding of cows may help prevent the spread of prion diseases. There’s currently no way to prevent inherited or sporadic forms of prion disease. If someone in your family has had an inherited prion disease, you may consider consulting with a genetic counselor to discuss your risk of developing the disease.

PAINKILLER:

        Painkillers are medications that are used to alleviate discomfort. They are available under several brand names. They can be used to:

• Tablets, liquids, and capsules are taken by mouth.
• Injections are used.
• Through a back passage (rectum).
• Creams, ointments, and patches are available.

TYPES OF PAINKILLERS:

          Despite the fact that painkillers come in a variety of forms, they are primarily categorized into three categories:

1. Non-steroidal anti-inflammatory medicines (NSAIDs) are commonly used in low-risk situations to avoid blood clotting, particularly in persons who have previously had a heart attack. Aspirin, naproxen, and other similar drugs are examples.
2. PARACETAMOL
3. OPIOIDS : Also known as opiates. Weak opioids is how they're commonly referred as. They're mostly used to treat severe pains, but they can lead to addiction and have other negative consequences, so they shouldn't be taken lightly. Morphine, tramadol, and other narcotics are examples. People who are addicted to heavy opioids are usually admitted to hospitals.

HOW DO PAINKILLERS WORK?

         Many substances are produced and released at the site of pain, such as a sore throat, a burnt finger, or a broken limb. These chemicals cause you to experience pain and cause your body to send more blood to the hurting spot. This is why the sore area is frequently swollen and red.

         Painkillers function by attaching to opiate receptors in the brain and suppressing the sense of pain. This disrupts the transmission of messages from the central nervous system to the brain.

          NSAIDs function by inhibiting the activity of cyclo-oxygenase (COX) enzymes, which are chemical enzymes. COX enzymes aid in the production of prostaglandins, which are a type of molecule. At locations of injury or damage, several prostaglandins are implicated in the creation of pain and inflammation. NSAIDs are not all created equal, and some work in somewhat different ways than others.

          No one is quite certain how paracetamol works. However, it is believed to function by inhibiting COX enzymes in the brain and spinal cord. Paracetamol is a pain reliever and a fever reducer. It does not, however, aid with inflammation.

          Opioids work through interacting with receptors in the central nervous system, the gut, and other regions of the body. This reduces the way you sense pain and your reaction to it, while also increasing your pain tolerance. 

SIDE EFFECTS OF PAINKILLERS:

             Even if people take painkillers as recommended, they might have a harmful impact on your body. Here are some of the ways that painkiller use might damage your physical health, according to the Cleveland Clinic:

1. IMMUNE SYSTEM COMPROMISE: When you take a painkiller, your body's ability to fight infection is weakened. The greatest strategy to increase immunity is to quit taking medicines right away.
2. STOMACH: It is generally known that painkillers can cause severe constipation. This can happen as soon as a day or two after you start using it, causing abdominal distention and bloating, as well as more serious side effects like haemorrhoids and intestinal obstruction.
3. INCREASED Suffering: Painkillers can make some people's pain worse. People with such problems are switched to different medications.
4. HORMONES: Painkiller use frequently results in low testosterone or oestrogen levels, which can lead to erectile dysfunction, decreased libido, exhaustion, hot flashes, menstruation irregularities, weight gain, and depression. Hormonal imbalance can also lead to more serious issues including infertility and osteoporosis.

          Painkillers, whether prescribed by a doctor or purchased on the street, can induce significant alterations in the user's brain and body. Although short-term drug use can cause some damage, long-term use and misuse of opioids causes the most dramatic or dangerous effects to the brain and body. Long-term drug usage also raises the risk of addiction and physical dependence on the drugs. After a while, users just use these medicines to avoid bodily withdrawal symptoms and to feel physically normal.

            To avoid such harmful effects, avoid using painkillers with drastic effects especially those having long term cycles.