Sunday, April 22, 2012

Let's Talk

I want to thank Kate for her comment on my previous post, in which I asked how I could make my new mousie medications happier inside me. I want to make them squeak with pleasure as they rush through my veins eating up B lymphocytes with a satisfied smack of their lips.

Wait. Does a monoclonal antibody have lips?

And, of course, the process is not that simple. It actually goes like this:

     The rituximab antibody is a genetically engineered chimeric murine/human monoclonal antibody directed against the CD20 antigen found on the surface of normal and malignant B lymphocytes. The antibody is an IgG1-κ immunoglobulin containing murine light-chain and heavy-chain variable region sequences and human constant region sequences. Rituximab is composed of two heavy chains of 451 amino acids and two light chains of 213 amino acids (based on cDNA analysis) and has an approximate molecular weight of 145 kD. Rituximab has a binding affinity for the CD20 antigen of approximately 8.0 nM [1].
     Rituximab binds specifically to the antigen CD20 (human B lymphocyte restricted differentiation antigen, Bp35), a hydrophobic transmembrane protein with a molecular weight of approximately 35 kD located on pre- and mature-B lymphocytes. The antigen is also expressed on > 90 percent of B-cell non Hodgkin lymphomas (NHL), but is not found on hematopoietic stem cells, pro-B cells, normal plasma cells, or other normal tissues. CD20 regulates early steps in the activation process for cell-cycle initiation and differentiation, and possibly functions as a calcium ion channel. CD20 is not shed from the cell surface and does not internalize upon antibody binding. Free CD20 antigen is not found in the circulation [1].
     The Fab domain of Rituximab binds to the CD20 antigen on B lymphocytes, and the Fc domain recruits immune effector functions to mediate B-cell lysis in vitro. Possible mechanisms of cell lysis include complement-dependent cytotoxicity (CDC) and antibody-dependent cell-mediated cytotoxicity (ADCC). The antibody has been shown to induce apoptosis in the DHL-4 human B-cell lymphoma line. Rituximab binding has been observed on lymphoid cells in the thymus, the white pulp of the spleen, and a majority of B lymphocytes in peripheral blood and lymph nodes. Little or no binding was observed in the nonlymphoid tissues examined.

Um. I think I like the smacking-of-the-lips concept better. Definitely.

Kate's comment was: Thanks for telling the tale in detail. I may need to have IVIG infusions, and while the actual med is different, the protocols are similar. So I am learning what the roller coaster looks like - thank you!
     As for the mice - do what you do for all the other creatures in your life (doggies, crows, flamingos, etc. ) Talk to them. "Nice mousie. Go make me better, little mousie."

Kate. Brilliant. You're so right -- I need to communicate with these mice! It's what I do! I talk to my car! I talk to ....... everything!

So. How do I talk to millions of teensy mousie pieces doing the backstroke through my veins, hm? Do I try to speak their language? And what language DOES a mouse speak, anyway? I wouldn't want to get the dialect wrong or use improper grammar......

I think my problem in communication here is not the language since I speak to everyone and everything in English. I think the bigger issue is that there's zillions of them. It's so hard to address a very, very large group of mice, honestly; or a very, very large group of anything, come to think of it.

Pinky the flamingo? Singular. Ed 'n Al? Two. Two crows, each with their own personality. Goldie? One. The one and only.

Maybe I should address my new mousie friends in terms of the date they were infused. Like, "Who loves you, cycle day ONE mousies? Julia does, that's who! Yes she does! Yes she does! And because Julia loves you so much, she's provided a banquet of yummy B lymphocytes just for YOU! Because you're wonderful and special mousies! Mmmmmm....delish!"

And then.....on May first, when the next train car of mousies unloads in station Julia, I'll have to think of a way to introduce mousie group ONE to mousie group TWO. Maybe I should envision up a little mouse band playing Sousa marches as the train pulls into the Amtrak station. We'll need lots of balloons. And banners that say WELCOME MOUSIE GROUP TWO. I don't think I'll imagine an ice cream stand or popcorn cart in case those snacks would spoil their appetites. I want these girls to get started chomping on B cells right from the get-go.

I'm thinking they're all girls. I don't think I'd be comfortable with boy mousies running around in there.

I hope they all get along.

Adorable mousie found here.


Laura said...

Why, these mousies would have a B cell treat stand, right? :)

Gertrude said...

You speak to hundreds/thousands/millions?? via your blog. You need a blog for these mousies. I really answering your crazy train of thought? I am not even taking prednisone. You are a bad influence on my mind. Hope your mousies are doing their job and you are feeling better.

FFW said...

Maybe promise them grand cheese-tinis to wash down all the B cells?

Mice like peanut butter-maybe you should eat some. Or start spreading it on your pulse points?

Someone, someday, will read this, and we will ALL be given anti-psychotic drugs in heavy doses, and jackets that help us to hug ourselves.

Kate S. said...

I blush... and am quite proud that my comment took you in a fun direction.

One of the things I love about your blog is that despite everything that's happening, you are finding the fun that you can in your life.

And if that means Sousa marches and welcoming committees for the next round of mice, I'm all for it.

If I were to be all serious and sincere we could talk about the value of visualization of your body successfully healing because of the mice gobbling up B lymphocytes (ok... I have a problem visualizing lymphocytes, but for the sake of the visualization, let's say they are just like the dots in Pacman).

But whatever works, however we get through it! Hope you are feeling better soon.