温故而知新专栏 | 美国功能医学之父Jeffrey Bland谈从Covid-19大流行引发的思考

Deanna Minich: Looks like we are seeing a little dial. It's moving across, we're about to go live. So let's see what happens here. Okay? I think we're here. Think we landed jeff, we are on the metagenics institute page.

Jeffrey Bland:Thank you, doctor minich very much. This is quite a time that in my 74 years of living, I can say I've never experienced and I would think that probably no one else has either. This is a unique experience in human history, at least in recent history, but I would say no, in human history ever, because it's only recently that we have the ability to do the things we're doing right now electronically by sharing and and using the internet backbone to get Information and to get entertained and to be educated. And so all of these things we've certainly had pandemic before, but we've never had and infludemics simultaneously, which is what we're going through this combination right now which is both, I think a good news and bad news story. I last night we had its impulse with all of our kids and our grandkids. And this we shared PETS on the zoom. And we we have funny little anecdotes. And and then I this morning had one of my colleagues called me and he said, so Jeff, I'm just calling you first to check in. But and I find that I'm much more of a social person. I recognize, and I'm really lonely. And I just want to reach out to my friends and and have a moment of human connection, not just in digits. And so I think there's all sorts of things that are going on that we're learning as a consequence of this amazingly threatening pandemic and its threatening on many levels and not just biologically, but sociologically, politically, economically, culturally. And we do see how now the world is really one spaceship traveling through space that we're all interconnected as inhabitants. If there's ever a time where we need to recognize how interconnected we are, this is the time, I mean,with air travel and communications and the world growing smaller. And to think that somehow we're gonna isolate people out,those days are gone. So it's a new era with new challenges and new opportunities. And it's not the last pandemic we've had. It's certainly not the first, but we have to develop new tools to manage these processes.

Deanna Minich:Yeah. Said, in fact, this morning at the board meeting that you and I were both on, you had mentioned that the world will never be the same. Again, We are transitioning into more of a technological age, more of a connection age. And I think you've been vision in this for some time. So we have been catapulted into this present moment of really making that transition. Now, one of the things that you did which you sent out an EMAIL with an article that you've just written. And you've submitted it to a a journal. And we're always very curious to hear what your views are and what your take is. And the article was just, it was phenomenal in terms of looking at the past. And you specifically we're looking at HIV, you were looking at the 1980s and what was the mill You. so maybe you can set the stage for us talking, maybe unpack that article a little bit and verbalize for us historically. What have we seen with viruses? With pandemics or? Even just an epidemic?

Deanna Minich：是的，事实上，在今天早上咱们都参加的会议上，你也提到世界不会一直不变，我们也在过度到一个更加科技的时代，更加联结的时代。我觉得你也预料到了这点，因此，我们已经跃入了真正实现这一转变的当下。现在，你做了一件事，就是邮件里你刚刚写的交给期刊的文章，我们非常好奇想听听你的观点。这篇文章回顾了过去，很厉害。你也特别提到了HIV，提到1980s年代，或许你可以用这个平台跟我们讲讲，剖析一下你的文章，从历史的角度来谈谈，我们看到的病毒是什么样的？全球流行性的病毒，或者是普通流行病毒？

Jeffrey Bland:Thank you. I think all of us are reaching out to touch others and to support and to be part of this dialogue and to try to find solutions for sometimes the enigma of life, which we don't always understand. And we have to kind of deal with it in real time without full understanding. And so for me, I just have been spending a lot of time waking in and sleeping, Just having this process wash over me as to what we're going through and try  the best I can put my limbs on it to understand it. So this little article I wrote was what I am learning from covid-19 was a title. what I found is and I think as we grow older, we do this, we pull back our experiences and say, is there anything that we can use our previous lives experiences to use an analogy or as a as a grounding point for this new material? There were new experience that we're going through. So for me, I reflected on in 1981 through 83, I was on sabbatical at the linus pauling institute in palo alto, California, working with doctor pauling in his research group. In 82. We had a very remarkable, similar given to us because we invited similar presenters to come into the institute. And doctor Pauling could attract all sorts of very interesting people. This one was a very remarkable young man. He was an emergency room position at the university of California, Sanfrancisco medical system, and the Sanfrancisco hospital in which he just described the first example, at least in early California of a patient with HIV. This was 1982, As he described this particular situation. And he was then discussing how that particular situation was really manifest in the symptoms of the patient and its infectivity. It was very to me like I had a transition thinking about virus infections that i'd never had before. It became very real to me.

So what? Oh, so I'm really looking back recognized that this was for me a transition in thinking about the power that these little nonliving organisms, because as we know, a virus is not alive until it really sits in an organism that can take on its machinery to do its work for it. And so this nonliving crystallizebal substance, an RNA virus could have those remarkable effects against all sorts of different potential biological processes. So I now recognize today that this HIV AIDS, which as a consequence of retro viral medications. We have now been able, fortunately to manage, still, today is a major world problem. We tend to forget about it, And that there are 770,000 individuals who die every year, at least in 2018, from this viral infection.So if we thought my word, we've got this horrible problem right now with covid-19, which is a problem. We compare it in the scope of these viral pandemic that have occurred over time. In fact, I've traced them since 1918 with the big so called Spanish flu, which really wasn't Spanish. It was just a consequence of world war one, labeled Spanish. But anyway, since that time, almost every 10 years we have had some kind of a global viral spread. Now it's become more well understood today and it has more chance for infection because of the travel we have today with jet travel.But these things come along with periodicity, just like the cicadas hatch Every seven years, these viral infections come to play. So this isn't the last time we're going to deal with this problem at all. The issue is how are we going to create a way of, A, mobilizing the appropriate medical force is necessary to manage it. and B reduce its infectivity and severity so that we are reserving those medical services just for the most sick, rather than having it have such a broad reach and frequency in our population.

When I asked that question, it let me to recognize that there are two constructs that regulate viral infections, one or what I you might call physical factors like social mobility, housing, medical services, stress those kind of things. And then there are these biological factors, which are those that influence the patency of our immune system. And what is happening in the field of immunology? Recently as if you follow what's going on in precision cancer therapy is we're finding these agents unblock the immune system or are able to unleash the immune system to do its job more effectively, like the PD1 inhibitors and certain forms of cancer therapy. What they really are is immunoadjuvants. So I ask myself the question, are there things that are modifiable that we can do as human beings that serve as immunoadjuvants to improve our immune vigilance against these particular things that occur frequently, these viral infections. The answer is and those immunoadjuvants, many of them are lifestyle related. How we eat, think, act, drink, breathe and then I went one step farther and I said, no, just a second. What do I know about the pharmaceutical industry in this recent decade? If you follow any advertisements for medications for drugs, either in print or in media and electronic media, what you see is ever increasing number of drugs that are being used that are immuno suppressant the fastest growing family of drugs in our culture now are immuno suppressant. And I went, I said, I wonder how many people are actually taking immuno suppressant drugs today. There is estimates that varies, but somewhere between 20 and 30 million Americans are routinely taking some form of immuno suppressant medication. Now when I thought of that, I thought my word, this is much different than those people are just on chemotherapy. That used to be what we thought of or have organ transplants around immuno suppressing.

But if you think of all of the kind of anti inflammatory drugs that are being produced there, immunosuppressant sees tnf Alpha blocking agents and so forth that we're seeing. So you've got all these variables that are mixing together. And then you lay on Top of it. These viruses that come periodically. Now you get the social consequences of the epidemic and overloading of the medical systems and so forth. So with all of that, then I thought the modifiable factors that we are in control of we can't really control the public health side very well. Because those are big institutional issues like housing and transportation. But we can control the individual immunoadjuvants that influence our body and the way we think act eat. And and so then that digs us deeply in what are those things? how do they influence then? The sub populations of immune cells that come out of our bone marrow stem cells are hemopoetic stem cells that then give rise the vigilance to allow us to be more able to defend against these inevitable exposures that we're gonna have, not just the flus that come along, but some of these more serious mutant viruses that they have higher infectivity. So that was the basis of my article. And in doing it, I actually felt a sense of more empowerment at the end, because I recognize that there are many things that we as a culture, if we empower individual self efficacy can do to be much more ready for the next virus that may come along that we have to, um generator on immune response to. So that was the nature of of what the articles about .

Deanna Minich:Excellent. Very well said. And so what I'm taking away from the article and what you just told us is that we have a locus of control. One of the things I've always liked, what you've said is that we don't have disease genes. We have genes of empowerment. What can we do to create a greater potential with our genes? So I look at this viral infection throughout the world. I look at it, its presence in China and Italy in certain European countries based on what you know about Americans and how we live the co morbidity that we might have ,What are we up against? Just as the background, the context? What have we been feeding our genes? What have we been doing with our genes? And how might we as a nation, respond differently to this virus than maybe other countries? Do you see disparity? Do see differences amongs the different places. Do you think that we're going to see an intensified effect relative to other countries? Do you think that we will have certain things that make us a bit more unique and personalized and how we might respond to the virus being that we have mixed genotypes? What's your overall take on genes, this overall nation and how we might respond versus how others have?

Jeffrey Bland:Yeah, that's a really excellent question. So let me make a statement. That's really kind of what I call a dust statement, because it's so self evident. Obvious. But sometimes those most obvious things we don't say. And so they just sit there silently. The most obvious thing I can say is that this disease theoretically is completely preventable. Think about that for a second. There is no such thing as a viral infection that is not theoretically totally preventable as contrasted to every other chronic disease that you can think of that is very complex and multifactorial. So its prevention is much more problematic. in the case of a viral infection. If you're never exposed, you don't get it. You can't say that about heart disease or diabetes or cancer or arthritis or whatever dementia. There's multiple factors. In this case. We start from the premise that if you're not exposed, you're not gonna get it. Then you say but, that's very abstract and kind of blue sky, because we can’t all live in a vacuum and have no exposure. So then you start think, what how much things do you want to layer on to exposure? That's why I think this the policy that's now engaged with copvid-19 is a very smart policy shelter at home because it is not only reducing the relative exposure to risk of a person who is carrying the virus, but it's also developing a pattern of behavior. When you're at home, you've got to start thinking about yourself and your family who's ever in that environment that you're sharing. Or maybe you're not sharing it with anybody. Maybe you're by yourself. It becomes very intense to be thinking about you and what you need to do in order to create your defense against a potential exposure. So you minimize your exposure, you maximize your resistance to the exposure becomes very personal.

And with that in mind, then you say, how do Americans differ from all other cultures? And I think there are many cultural differences and how we interact and behave and how we live. But there's also this interesting statistic that we don't know the origin of yet. And that is why do men seem to get more covid-19 infection than women? One might say, will it have something to do with hormones? Maybe maybe estrodial is a immune potentially hormone that gives women more protection. maybe it's also that women historically have been more interested about their bodies. And they're more proactive about health. And men are kind of like, I'll fix it when it's broken kind of an attitude. So maybe what we're looking at some of the socializations of organ reserve because organ reserve is built around putting something in the bank account that you draw on when you need it. So how do you put stuff in the bank account by finding the right things to do to maintain the reserve of organs, including your immune system, that will be giving you the reserve that you need the headspace to manage the uncertainty, like of infection. So that's never, that's a thought. Another thought is, well, maybe what we're really talking about here is some kind of a understanding of ourselves in which we are doing what personalized lifestyle intervention has been talking about for some time, and then eating right, exercising, right, thinking right, sleeping right? To meet our own biological needs based on our uniqueness. That's not the same for each person. So maybe we have a chance to reflect upon going from a public health model, which is community health to an individual health model, which is personal because infection with covid-19 is personal.

It's in the individual. It's not just in the community. Yes, the communities built up of individuals, but it's really related to individuals and how they're living, where they're living in all the variables that influence that. So I think this is a deep period of reflection. And then people say, okay, do I need to start taking gobs of nutrients? And do I need to start doing all sorts of in new pharmaceuticals that are still kind of speculative, like hydroxychloroquine or something of that nature. What where should I go? And I think before a person does any of that, my belief is they need to ground themselves and remind themselves who is in charge. They're not unbend a knees seeking rescue from the known person whose ambition. they are going inside themselves to find out what do they know about themselves, their health, their locus of control, their sphere of influence, and how they're going to regain Maybe. the ultimately most important thing we have is the mastery of our Genes translate into our phenotype. And maybe this is one of those moments in history where a resetting of that relationship we have individually with our genetic potential，really becomes very real. Because in the end, we are all susceptible to viruses in differing degrees based upon our immunological vigilance. And that is in part related to our choices in life.

Deanna Minich:Yeah, absolutely. It is so personal. It's so individualized. And that leads me to think about even people's responses and how they've been on the continuum from panic, high level panic into this anxiety, then maybe a low level anxiety. And then maybe a I would say being cautious but not overly panicked. And then there's the other side of not caring at all and feeling like I'm already doing these things. So I should be okay. Doctor David perlmutter talk today about mental hijacking and how we can be on this continuum. And so I think what you're saying about this being a personalized issue, and what do we have to learn about ourselves? Much of what we can see about ourselves also comes through the response that we have to this pandemic. Right? We can learn so much just about our response to life. Are we reactive and inflammatory and impulsive? There's a place for that as well. But how do we manage and how do we transform this? So I'm sure you have some wisdom along the lines of stress and how we take a personalized mental health approach to this as well.

Jeffrey Bland:Yeah, i'd like to talk, thank you about just briefly about my view of stress. Because I think I may have a little bit of a contrarian view about stress than the average view. Um, I think stress is agnostic. I don't think it's a value related term. I don't think it's a negative term. I think it is the process by which the body responds to a change in the environment. And that is can be called resilience.And so stress and its response is a natural process of our accommodation for change. And that change can exceed our coping mechanism and our resilience. And now it becomes what we call distress. They for me, this concept of the stress it comes along with this infection is the recognition that for those individuals who by their choice in life or their circumstances are on the front lines of managing.the extraordinarily high demand in people who are seriously ill from this infection are frontline individuals.

The stress that I have should be channeled into doing something productive to assist these people that don't have those choices there by the nature of their, um, professions or they're where they are in life. They're out there. Some people have analogize this to doing warren, their war Warriors. I always hate to use that kind of militaristic metaphor. But these are courageous people doing courageous things. And what i'd like to think is whatever stress I feel, not being in the emergency room and not being on the front line of providing care. These individuals that stress should be put into a way to positively support for these individuals who are really doing the miraculous work with great courage. And um, I think each one of us ask ourselves the question. If we're not primary caregivers are in the front lines of the increase responders, as do we have the right stuff to do that if called upon? And each person probably has to explore that in themselves, not saying everybody is necessarily psychologically suited for that. But every person can give some of their intention, their stress into being a positive for us. For others who are doing that,for our culture. And I think my feeling is fresh should be channeled in the positive activity right now, not into running about like a tiger around the tree and melting in the butter. So that's kind of how I see this response to stress. It should be part of our mobilization of our positive energy to create goodness for others in need.

Deanna Minich:I remember that you had a quote like that in your office, something about being used up in this process of life in order to give and to serve, to dedicate our energy in that direction, to really swart it, rather than put it into a different path that doesn't give a return. Right? So it's like currency. It's like, how do we shuffle that energy? Right? We only have so much energy. How do we make the most of it? I'm curious is a personal question for you. And then I have a high level question, but a personal question for you. And I I I know you a bit. So I could probably give some idea as to how you might answer this. But in this time of all things covid, how have you adjusted your life? So when I think about you and maybe stress you're right, hans sel has the definition that you gave. Right? That was coined in what? 1936. And so it's taken on a more negative term. But I I you're very active person, you're a musician, you're a thinker, you're a visionary, you dive into the literature, you see these times as an opportunity. So I'm kind of curious just to bridge into you as a person, because we're all so intrigued with your life too, and how you stay in that zone. So are there some other things that you find yourself doing during this time that you probably did before, but now you're shifting a little bit or you're doing more of it. And we just like to know a little bit more personally about how you're taking this.

Jeffrey Bland:I kind of view the latter of a person's life. And I think I can say with some degree of assuring that at 74, statistically, that would be the case for me. You start asking, ok, what are the things that one can do at this age, to Make a contribution. I think the answer to that comes from the wisdom of experience, right? In life. It comes from what have you learned from your opportunity to live seven plus decades and observe all sorts of interesting things and interesting people going sometimes extraordinary things. How can you bring that back? two others that you'd like them to accelerate their learning or to have access to that Information, to hopefully give them some new tools that would allow them to make their brilliance even more polished in brilliant. So for me, it's this whole covid thing is kind of got me wound up because it is a motivator for payback. because I've been very, very fortunate and blessed for my years of living, of having extraordinary things and people in my lives that were really they didn't seek them out, but I've been just very fortunate to know them starting with my own parents and going on through the rest of my living. So I just feel that right now. This is a time I'm gonna use the term to be wound up, but wound up in the right way so that you are being present for service in ways that without forcing it down people's throats. But if asked, you're prepared to provide service.  I think that that wisdom which resides in our older age members of our population, often which is discounted or marginalized, in these times, can be very, very helpful. Cause they give some perspective. They give some groundedness, they give some sense of, we've been here before to some extent. And I can tell you it wasn't easy then. And we'll find a way through this. So that is kind of the model that I'm having. It was reminded again to me in that AIDS experience back in 1982. I that was such a tumultuous time in the eighties that many people thought the world was coming to the end. I it was horrendous And it was horrendous. I don't want to discount. That was many unfortunate deaths occurred during that time.we did find a way through. And I think that's the model that I'm feeling right now that it's being fully present fully bring anything I have to bear to contribute in whatever I can to to getting through this next Challenge.

Deanna Minich:Beautiful. My final question for you has to do with planetary health. So if we're zoomed into the individual, you talked about an individual's genes, the relationship with their genes. How do we now see this pandemic as maybe a call to action for what's going on the planet? Would you like to speak to personalize health? And how does that translate into planetary health at this stage of where we're at now?

Yeah, thank you. But my metaphor that I'm using right now to discuss that, which may be a too esoteric, so I will beg a apology, if it is, is the metaphor of the immune system. So we think of the immune system being in the human as being that which is capable of resisting offenders that might take charge of us and causes injury. But the immune system exists in every organized structure. The immune system exists in plants. The immune system obviously exists in all other animals immune system  is present in societies and it's present in global planetary cycles, You can find if you define the immune system as being that process at resist injury. There is an immune system in every organized structure. In the absence of an immune system, what happens is that organized structure takes the natural tendency universe to go to hell in a hand baskets, that’s called entropy, entropy district disturbs and distributes things by a natural choice. You don't have to work at it. Things will fall apart naturally. The immune system keeps things organized by resisting entropy. Therefore, if we talk about a covid-19 effect on trying to randomize us to the universe by taking the molecules apart upon which were made and make them dust into the universe. Our immune system is fighting back against that. Then by the same token, we have societal structures that are trying to fight back against. That's immune system of our society. We might think of it as the first respond as our hospital and medical system. We might think of it as the government that has this responsibility to maintain organized structure against covid.

We might think of it in terms of nitrogen, carbon, hydrogen, oxygen cycles in the biosphere, and the regulation of planetary temperatures and sustenance of stability of the planet. this construct of immune health which is now very focused on the immediacy of the virus Infection really is a metaphor to everything that we need, and they're all interconnected. Everything I just mentioned is interconnected from global planetary, organized structures that we call resistance to injury. to political systems, to economic systems, to social structures, to our individual bodies in the interaction with all other plants and animals. So if we don't think as a hologram and we don't see this interconnected and we try to piece it apart as just an individual, another episode in human history than we lost a big learning opportunity to really create a new society with a new vision connected together with the principle of survival, which I think is the operative take away from this Challenge.

我们会从生物圈中的氮、碳、氢、氧循环来考虑，以及星球温度的调节和星球稳定性的维持。现在关注病毒感染的即时性的这种免疫健康构造确实是我们需要的一种比喻，它们是相互关联的。从抵御伤害的全球的、星球的、有组织的结构，到政府系统、生态系统、社会结构，到与其他所有动植物互动的个体。

因此，如果我们不认为这是整体，并且看不到这种相互联系，试图将其作为个体分开，这就是人类历史上另一个事件，我们就失去了大量学习机会，无法将新视野和生存原则联系在一起，创建一个新社会，我认为这是这次挑战的关键所在。

Deanna Minich:Mhm. We have so much to learn from this virus as a messenger.

Thank you for leaving us on that positive note. It really does allow us to zoom in and zoom out and see what we can glean from all of this. Right? I it's um, we've never had some you mentioned HIV and what we've been through in the past. But this is so unique. We're at a different time in history. We're at a different time with technology. So back to your quote that we opened up with the world will be a different place. The world will surely be different for your grandchildren and the matrices of all these families and how they're into relating. And so thank you for your words to about the planet. I really like your analogy of the immune system. The first line of defense,

Jeffrey Bland:if I could say one other quick thing in close. Um, I took the dog, I'm very fortunate. Now we live right next to what it called what's called the grand forest, which has a 20 miles of trails in the woods.

So I've been taking the dog out like a lot of other people are been for walks. It's sort of I never saw so many people on the trails. It's interesting. I happen to run into my neighbors who are really remarkable younger people than I and they have young children, a daughter, that's seven, and a son. That's three. And so I we stopped and we were maintaining our distance, but we were talking to one another. And I said, how's it going for you? They said the husband who is a designer of zoos around the world. So he does a huge amounts of traveling and designing these new architecture of zoos and open spaces for animals and stuff. Very, very interesting. And his wife is a landscape architect from Berkeley who is very much about ecological landscaping. And he said immediately says, I've never been home this much in my professional life because I travel all the time to the zoos all over the world. The time my companies employed to work with. His wife said yes, it's been very interesting. Now for the four of us as a family to be together all the time. And I wasn't said with anything other than this is incredible. This is really redefining us as a family. I want to away from that with my dog. Nothing. I said to I said, this is the good news. All sorts of families now better in their homes, seven days a week now that are learning new social structures of appreciating how they are as human beings that will forever hopefully positively imprint their lives. And that is to me a very positive part of getting more resilience and healing our immune system.

Deanna Minich:coming back to the home base, coming back for our own inner immune system through our family. Jeff, thank you so much. Thank you for sharing your wisdom, your bright vision, and most of all, I would say, the hope that your words carry, I think that's so important at a time like this. And you've always been positive and really looking at everything as an opportunity. Thank you so much for sharing your thoughts. And for all of the technical difficulties that we had today. I know that everybody will enjoy listening and really taking in this conversation. Thank you so much.

Jeffrey Bland:I wanna turn it around and say the same to you. I've had the privilege of, as I mentioned, meeting many and working with many remarkable people over my years. And you're on my short list of remarkable people that the day that we were fortunate enough to be able to start our professional relationship over 10 years ago was was really a high point for me as I look back in the people that I've had the privilege of working with. So thank you so much.

Deanna Minich:Thank you. I think it all started with their mothers, right?

Jeffrey Bland:The whiter,we both went to school with our brown bags of our chop vegetables. And that everyone thought we were weird.

Deanna Minich:I know. And here we are in a conversation. Our moms really had an impact. And I think that's what's happening now is just like you said, we're mothers are, it's just interesting how this is being experienced in the home. Again, thank you so much. Really a pleasure night.

Jeffrey Bland:Everybody stay safe. Thank you.

视频来源：metagenicsinstitute.com

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