1/
Why is vibrio vulnificus so bad for people with liver disease?
🤯The answer could blow your mind!🤯
Join me for a #tweetorial:
Act 1: Epi of v. vulnificus: What’s the deal with oysters?!
Act 2: Mechanism
#cirrhosis #livertwitter #idtwitter
Why is vibrio vulnificus so bad for people with liver disease?
🤯The answer could blow your mind!🤯
Join me for a #tweetorial:
Act 1: Epi of v. vulnificus: What’s the deal with oysters?!
Act 2: Mechanism
#cirrhosis #livertwitter #idtwitter
2/
First, a poll:
what is it about liver disease that makes vibrio vulnificus so bad for people with liver disease?
First, a poll:
what is it about liver disease that makes vibrio vulnificus so bad for people with liver disease?
3/
Who is Vibrio vulnificus?
1⃣Halophile=Needs salt 2 live. i.e. lives in sea
2⃣Makes a 'chitinase', embeds in mollusks
Infections caused:
3⃣Open wound in sea water: cellulitis
4⃣Raw oysters: deadly bacteremia
Epi:
5⃣Fortunately Rare. 0.8 infections/100000ppl
Who is Vibrio vulnificus?
1⃣Halophile=Needs salt 2 live. i.e. lives in sea
2⃣Makes a 'chitinase', embeds in mollusks
Infections caused:
3⃣Open wound in sea water: cellulitis
4⃣Raw oysters: deadly bacteremia
Epi:
5⃣Fortunately Rare. 0.8 infections/100000ppl
4/
Oysters?!
1⃣Vulnificus cases track with oyster production
2⃣Oysters from warm water are the riskiest
3⃣Cool job alert🚨: @CDCgov Epidemic intelligence service officers went 🚪-to-🚪investigating vulnificus cases. This is how the oyster connection was made.
Oysters?!
1⃣Vulnificus cases track with oyster production
2⃣Oysters from warm water are the riskiest
3⃣Cool job alert🚨: @CDCgov Epidemic intelligence service officers went 🚪-to-🚪investigating vulnificus cases. This is how the oyster connection was made.
5/
All studies show: the patients most likely to be affected have cirrhosis, alcohol use disorder and hemochromatosis.
What do these people have in common?
All studies show: the patients most likely to be affected have cirrhosis, alcohol use disorder and hemochromatosis.
What do these people have in common?
6/
Take-home point:
Alcohol-use disorder, #cirrhosis, and #hemochromatosis are each independently associated with iron-overload & high transferrin saturations...and low hepcidin levels
See below for the evidence in a throwback #tweetorial
Take-home point:
Alcohol-use disorder, #cirrhosis, and #hemochromatosis are each independently associated with iron-overload & high transferrin saturations...and low hepcidin levels
See below for the evidence in a throwback #tweetorial
7/
Vibrio & Iron
1⃣🦠 need our iron 2 live. 🦠 r smart & make 'siderophores' 2 grab our iron
2⃣We may have EVOLVED the anemia of chronic inflammation 2 defend us from 🦠 by⬆️hepcidin!
3⃣Vulnificus makes vulnibactin which liberates iron from saturated transferrin
Vibrio & Iron
1⃣🦠 need our iron 2 live. 🦠 r smart & make 'siderophores' 2 grab our iron
2⃣We may have EVOLVED the anemia of chronic inflammation 2 defend us from 🦠 by⬆️hepcidin!
3⃣Vulnificus makes vulnibactin which liberates iron from saturated transferrin
8/
Vulnificus is uniquely dangerous to people with iron-saturated transferrin
1⃣Normal plasma actually kills vulnificus
2⃣High hepcidin protects against vulnificus infection
And who has low hepcidin? hemochromatosis, alcohol use disorder, many w/#cirrhosis
Vulnificus is uniquely dangerous to people with iron-saturated transferrin
1⃣Normal plasma actually kills vulnificus
2⃣High hepcidin protects against vulnificus infection
And who has low hepcidin? hemochromatosis, alcohol use disorder, many w/#cirrhosis
9/
Poll again:
What is the connection between liver disease and the pathogenesis of vibrio vulnificus infection?
Poll again:
What is the connection between liver disease and the pathogenesis of vibrio vulnificus infection?
10/
To summarize:
Vibrio Vulnificus is a deadly infection:
🦠 Carried by 🦪🦪
🦠 Impacts people with liver disease
🦠 'cause they may have high Tsats
🦠 'cause the 🦠 gets iron from transferrin
So tell your patients with high Tsats: No 🦪!
To summarize:
Vibrio Vulnificus is a deadly infection:
🦠 Carried by 🦪🦪
🦠 Impacts people with liver disease
🦠 'cause they may have high Tsats
🦠 'cause the 🦠 gets iron from transferrin
So tell your patients with high Tsats: No 🦪!
11/11
This concludes a #tweetorial on how (and for whom) vibrio vulnificus impacts health. I learned a lot about the intersection of iron metabolism, evolution, and infections. And I hope you did too.
This concludes a #tweetorial on how (and for whom) vibrio vulnificus impacts health. I learned a lot about the intersection of iron metabolism, evolution, and infections. And I hope you did too.
