DrAngry. The Angry Mask

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DrAngry is the inventive type and with his pom-pom fanclub has come up with a new line for ProfG and the Guys and Gals at BartsHealth, to help ensure they have protective gear. As you can see the Mickey Mouse is offset by the natty protective eyewear. If you are going to go down to this virus, DrA says you may as well be stylish. It no doubt carefully hides the panty liner, Do-It-Yourself HEPA (Anti-bug) filter.

DrA has no doubt been scrubbed of Prof Coles Christmas card list as he has found another chink in the alemtuzumab armour. Baker et al. Frontiers Immunol 2020; 11:24. He has currently got a pair of wire cutters to expose that chink and has designed and made a way to see if you are more likely to respond to alemtuzumab. Or put another way..a method so see if you won’t respond to alemtuzumab. If you have been reading the story this technology is based on system using glow-in-the-dark shrimp vomit…Well sort of.

So you are about to have another course of alemtuzumab would you be like to know you are likely to respond and would you want to wait 5 hours for the result or would you want to wait a few minutes?

We need to invent a device to read the level of shrimp vomit. DrA has found a friend….DrAlexsan (and as with some Eastern Europes they put their surname first:-), who said “Simples” and turned the kitchen table sized device-sized into a miniture tool. You can read his book

Maybe you can help the DrAs with their prototype. Was it DrAlexsan who said “I did not do all zat for cheap car insurance.. I mean a pregnancy test?”.

Indeed a test is coming your way to see if you have had the virus and this is based on a pregnacy test. A drop of blood and if you have human chorionic gonadotropin , you get a line .. A coVID 19 test is based on a similar principle

pregnancy test

Now DrA could have knocked this COVID test up in a week or two and it was designed before our labs were shut down. However, we would be still trying to do all the validation tests now and where would we have got positive blood from. However the SARS-Cov-2 kit only gives you a “yes”…has been infected. A “no” may mean no infection of the assay isn’t sensitive enough. Depending on the test it could mean you have been infected with a another virus. However, the DocA approach tells you how much SARS-Cov2 would be present.

Now the levels of SARS Cov2 infection aren’t important so it is oK to get a yes/no answer, but as we will show, the levels of the anti-alemtuzumab response are important to guess whether you will respond or not.

I wonder if this would have a use of COVID19? or perhaps maybe some other use. Indeed I can think of one already (See below)

Drug reaction with eosinophilia and systemic symptoms after ocrelizumab therapy. Nylund M, Vuorinen T, Airas L.Mult Scler Relat Disord. 2020 Mar 14;42:102058. We report here on a young woman with multiple sclerosis, who developed a condition with eosinophilia and swelling of limbs seven weeks after initiation of ocrelizumab treatment. We consider her drug reaction to be compatible with a drug reaction with eosinophilia and systemic symptoms (DRESS), also called drug-induced hypersensitivity syndrome. She was treated with antihistamine and corticosteroid treatments, and recovered fully within three months of symptom onset. Ocrelizumab was not re-initiated. We are not aware of other DRESS-like cases related to ocrelizumab treatment.

So it looks like this person has an allergy to ocrelizumab. This needs testing.

Seven weeks after ocrelizumab there would be plenty of ocrelizumab still floating around is this was causes the DRESS. Eosinophils are cells associated with allergy. Many years ago someone came to the lab to say that an immunosuppressive drug was associated with enhanced numbers of eosinophils…My boss said are the animals infected with worms, because when you see high levels of eosinophils you should think allergies or parasitic worms. Sure enough they had Pinworms. The Eosinophils were made in response to the worm infection and the immunosuppressive took the brakes off the eosinophil numbers…Did this person have an ictchy bum? (Pin worms live in the intestines eggs exit via the bum hole. The eggs itch, you scatch, fingers in mouth, you touch something and other people put their hands on their mouth and re-infestation occurs)

However, wear the AngryMask and that isn’t going to happen.

You see the AngryMask has lots of functions:-)

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MouseDoctor

4 comments

Leave a Reply to Tom H Cancel reply

  • Dr. Angry, you are correct, that while rare, DRESS is possible with OCREVUS. As noted on this blog, I have been discussing my infusion related reactions stemming from my last round in January 2020. (I have had 3-4 cycles total) Unfortunately, my efforts to get an anti-drug antibody test were unsuccessful……even tried your research colleague in the U.S. and was told no such test exists.

    Now after reading your post today, I am 99% sure I am allergic to the drug. I am 7-8 weeks post OCREVUS infusion, and recently I began having sporadic allergic reactions. My neurologists have said I can longer take the drug, but that is as far as they are willing to go. So unfortunately, I cannot provide your team with more documented evidence of DRESS in an OCREVUS treated pwms, but anecdotally, rest assured that there are more OCREVUS treated pwms that have DRESS and serum sickness.

    I would like to read the research paper you referenced above about this topic; however, the full text is not free and the site does not allow one to purchase the paper………Thank you for continuing to provide us pwms with information during these challenging times. HEALTHCARE HEROS!

    • It is simply not true that the is “no such test” Roche had to develop such a test as part of the regulatory requirements and if you get your neuro to read the Hauser et al. 2017 paper there is a clear comment on immunogenicity and I am sure if your neuro pushed I am sure Roche could do. If you could have your sera collected and stored this could be used in assay development as we have the technology. Ofatumumab reacts to a differnt bit of the CD20. Are your CD20 B cells depleting. If they are then there is no neurtralising response, if they are not depleting then you are neutralizing.

    • they will be shooting off the shelves as you write,but I have also seen another video warning you about the glass fibres that will go in your lungs

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