After every flood comes an even more damaging blight: mould

In a week that has seen extensive flooding in the UK and Ireland it is timely to look at the damage caused by moulds growing on all the damp materials left when the floodwaters recede. Many materials including building materials such as plasterboard will absorb and hold on to water long enough to allow the growth of moulds. They are difficult to dry out and it only takes 48 hours of damp to result in large amounts of fungal growth particularly in places where little sunlight shines.

So what next?
Clearing up is largely a case of throwing out all materials that are mouldy and cannot be cleaned e.g.soft furnishings, carpets, clothing, units and furniture made out of chipboard, wallpaper. Drying out homes as quickly as possible is a high priority as moulds can grow in hidden cavities and prefers to keep out of the light.
There are extensive instructions on how to clean up here - on the right hand side under the heading 'Emergencies: Floods and Hurricanes'.

Health Effects
There are many potential health effects of living in a damp mould affected house and the discussions on this subject are plentiful. There are two recent review publications that go into this subject in some detail, both published this year (2009), the first one being written by a prominent fungal researcher who herself  lives in New Orleans and whose home was flooded:

• Health effects of Aspergillus in food and air (2009)
• Fungal spores: A critical review of the toxicological and epidemiological evidence as a basis for occupational exposure limit setting (2009)

Here in the UK we have the National Aspergillosis Centre which specialises in the treatment of all aspergillus infections and is closely affiliated with the Regional Mycology Laboratory in Manchester which has a large amount of expertise in the investigation of indoor mould. RML is run by Professor Malcolm Richardson who advised the World Health Organisation on indoor health effects of  fungi amongst others and is a Professor of Medical Mycology at Manchester University.

The US have a (voluntary) certification scheme for mold remediating companies, many run by the Indoor Air Quality Association. The Environmental Protection Agency have a listing of the associations involved here.

Aspergillus provides a solution to grapefruit juice interacting with medications

Grapefruit juice has been shown to interfere with absorbtion and/or metabolism of several prescription drugs with potentially hazardous consequences in some cases. The effect can be either to increase or lower the amount of the drug circulating in the blood of the patient, so if a drug such as one meant to lower blood pressure was taken with grapefruit juice the effect could be to reduce blood pressure too much (see here for more examples).

The aim of drug management is to find a dosage level which causes blood levels to stay within a useful range for each patient. It is not hard to imagine a patient unaware of the interaction between grapefruit juice and their medication might take a glass of grapefruit juice with their drug causing drug blood levels to increase. When the juice carton is empty they might use a different drink causing levels to drop again resulting in much confusion on the part of their doctor over what the right dose for them is!

There is clearly some benefit to understanding what component of grapefruit juice is important for this interaction and in removing it from grapefuit juice offered for comsumption. It is already known that one factor is furanocomarins (FC) which inhibit the enzymatic activity in the liver of patients that activates some drugs, so one aim is to remove FC's from grapefruit juice.
The United States Department of Agriculture (USDA) have made some progress in this regard. They have identified fungi that can remove or inactivate FC's from grapefruit juice and are in the process of finding out how the fungus does that.

It is ironic to note that the fungus used at the USDA is Aspergillus niger. Aspergillus (more usually fumigatus) causes a serious infection known as aspergillosis. The infections are treated with antifungal drugs in an attempt to eradicate the fungus. Once such antifungal is itraconazole and itraconazole is one of those drugs that interact with grapefruit juice, enhancing the effective dose.One species of Aspergillus is helping counteract the pathogenicity of another!

Identification of new fungal protein "TmpL" which shields A.fumigatus and assists with the infection process.

Researchers at the Virginia Bioinformatics Institute (VBI) at Virginia Tech and Montana State University have discovered a fungal protein that plays a key role in causing disease in plants and animals and which also shields the fungal pathogen from oxidative stress. The protein was identified in both Alternaria brassicicola (which causes much crop damage) and Aspergillus fumigatus a human pathogen, which can cause death in immune compromised people.

Reactive oxygen molecules are known to be important in fungal development and virulence.

The researchers have found that a fungal protein called "TmpL" is critical for the infective process of host tissue and helps the fungal pathogen regulate oxidative stress responses-inflicted upon as a result of the host immune response to infection.
The current study shows that TmpL is essential for both types of fungi to cause disease in their host cells. Dr. Kwang-Hyung Kim at VBI, the lead scientist working on the project, remarked, "TmpL appears to be located in the membrane of the Woronin body, a specialized peroxisomal organelle found specifically in the cells of hyphae in filamentous fungi. When the function of TmpL is impaired or its gene inactivated, both A. brassicicola and A. fumigatus show drastic decreases in their ability to cause disease in the experimental host systems of cabbage, Arabidopsis, and the mouse. Deletion of the TmpL gene also makes the fungi extremely sensitive to oxidative stress in the lab."

Dr Lawrence at VBI said: "In this study, we provide the first evidence that a certain type of disease-related protein from both a plant and animal fungal pathogen is critical for protecting the pathogen and for causing infection of healthy host tissue. As such, this protein represents a good starting point as a potential target for the development of efficient and novel therapeutics for both plant and animal fungal diseases."
more information

Merck merge with Schering Plough for $41 billion

Merck (manufacturer of the antifungal drug Caspofungin) and Schering-Plough (manufacturer of the antifungal drug Posaconazole) have merged their companies to form a single company that will operate under the name Merck. The merger has cost Merck over $41 billion.
The merger was initially announced in March 2009 and has taken 8 months to complete.

The new company will have a combined revenue of $40 billion with savings of $3.5billion a year due after duplicated jobs are removed. It will have 15 candidate drugs being developed for market in the near future and will be employing people in 140 countries. Over half of its revenues will be earned outside the US.

How will this help the consumer?
Drug development is a hugely expensive business with billions of dollars at stake in every drug in late stage development. Billions of dollars have to be invested in the development of every drug and every drug can still fail vital tests after years of expensive development, losing vast amounts of money.
Some drugs are more likely to fail than others so smaller companies are more likely to concentrate on the 'sure thing' in order to avoid catastrophic finacial losses.

As a larger company the new Merck will now be able to do more 'risky' drug development as it will be able to absorb more financial risk. It will be able to investigate treatments for markets in which there are less well defined targets in the hope of the higher financial returns that they could bring.

Some illnesses effect smaller numbers of people but still require huge investment with which to develop new drugs to treat those illnesses. The consequent return is smaller as it can only be sold to fewer people. These drugs are less likely to be made by smaller companies as the potential return is lower. People needing treatment for rarer illnesses such as aspergillosis should be encouraged that they are more likely to be given new treatments in the future as a result of this merger.