Michelle Monje: The Brain in Long Covid and Cancer
· 44 min
Episode Michelle Monje: The Brain in Long Covid and Cancer
Transcript with audio and relevant external links, recorded on 6 Feb 2024
Eric Topol (00:05):
Hello, this is Eric Topol with Ground Truths, and I have a remarkable guest with me today, Professor Michelle Monje, who is from Stanford, a physician-scientist there and is really a leader in neuro-oncology, the big field of cancer neuroscience, neuroinflammation, and she has just been rocking it recently with major papers on these fields, no less her work that's been on a particular cancer, brain cancer in kids that we'll talk about. I just want to give you a bit of background about Michelle. She is a National Academy of Medicine member, no less actually a National Academy of Medicine awardee with the French Academy for the Richard Lounsbery Award, which is incredibly prestigious. She received a Genius grant from the MacArthur Foundation and is a Howard Hughes Medical Institute (HHMI) scholar, so she is just an amazing person who I'm meeting for the first time. Michelle, welcome.
Michelle Monje (01:16):
Thank you. So nice to join you.
Long Covid and the Brain
Eric Topol (01:18):
Well, I just am blown away by the work that you and your colleagues have been doing and it transcends many different areas that are of utmost importance. Maybe we can start with Long Covid because that's obviously such a big area. Not only have you done work on that, but you published an amazing review with Akiko Iwasaki, a friend of mine, that really went through all the features of Long Covid. Can you summarize your thoughts about that?
Michelle Monje (01:49):
Yeah, and specifically we focused on the neurobiology of Long Covid focusing on the really common syndrome of cognitive impairment so-called brain fog after Covid even after relatively mild Covid. There has been this, I think really important and exciting, really explosion of work in the last few years internationally trying to understand this in ways that I am hopeful will be beneficial to many other diseases of cognition that occur in the context of other kinds of infections and other kinds of immune challenges. But what is emerging from our work and from others is that inflammation, even if it doesn't directly initially involve the nervous system, can very profoundly affect the nervous system and the mechanisms by which that can happen are diverse. One common mechanism appears to be immune challenge induced reactivity of an innate immune cell in the nervous system called microglia. These microglia, they populate the nervous system very early in embryonic development.
(02:58):
And their job is to protect the nervous system from infection, but also to respond to other kinds of toxic and infectious and immune challenges. They also play in healthy conditions, really important roles in neurodevelopment and in neuroplasticity and so they're multifaceted cells and this is some population of those cells, particularly in the white matter in the axon tracks that are exquisitely sensitive it seems to various kinds of immune challenges. So even if there's not a direct nervous system insult, they can react and when they react, they stop doing their normal helpful jobs and can dysregulate really important interactions between other kinds of cells in the brain like neurons and support cells for those neurons like oligodendrocytes and astrocytes. One common emerging principle is that microglial reactivity triggered by even relatively mild Covid occurring in the respiratory system, not directly infecting the brain or other kinds of immune challenges can trigger this reactivity of microglia and consequently dysregulate the normal interactions between cells and the brain.
(04:13):
So important for well-tuned and optimal nervous system function. The end product of that is dysfunction and cognition and kind of a brain fog impairment, attention, memory, ability to multitask, impaired speed of information processing, but there are other ways that Covid can influence the nervous system. Of course there can…
Links in the notes 12
- https://www.rev.com/transcript-editor/shared/Gu88NX5hvYcnEMLJz0cETFJQjqyhP_K7MaPhb1gDX-gLFHVujEk1npLbYeSejwhL4BBctTbbLWZJCA8OQQDu8Be_LPE?loadFrom=DocumentDeeplink&ts=5.97
- https://www.rev.com/transcript-editor/shared/dNfkuD9xQCSeBUOjkaySfHQYAVbRNjwcC185t8K10JC7GSMS_6CL-6Rdy9MUIJmMwkgxItiGMnHnQWKgH3M9SFroyV4?loadFrom=DocumentDeeplink&ts=76.26
- https://www.rev.com/transcript-editor/shared/lC5FBlzXTqczQ5K9jMg0OxoO94udFLgfwUmNrfETkgjJaCq9d67OfzRdJDrVIRk6UTz5WJNBhT_lzpTZX6OWu_X8q8k?loadFrom=DocumentDeeplink&ts=78.42
- https://www.cell.com/neuron/fulltext/S0896-6273(22)00910-2?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0896627322009102%3Fshowall%3Dtrue
- https://www.rev.com/transcript-editor/shared/3Go6gODtDSMXB4qjc1KCAcpsgRzqpzYDh1rUp52piOvSOo4_e9DHnaMZrJFwYUPkBd-QzN_68pj7v6WcZ9yF6VxjbQg?loadFrom=DocumentDeeplink&ts=109.59
- https://www.rev.com/transcript-editor/shared/o16wdjgISfGBx8T1JgAJUzp-bthp2wrkVXxHdDQPSaGDIrwphI40gFHM9EVERH5aLEfBtK8tOug8TF0NdgPCmWEFEWY?loadFrom=DocumentDeeplink&ts=178.71
- https://www.rev.com/transcript-editor/shared/JXYWc5_OSEy3IlmKmrPTkPBLVdMLlW8grVqEnf1kmHiGljUdHnxF_RJp5iKblEvWXFyLMHbwclWN6H8y9fgvuOv1j0I?loadFrom=DocumentDeeplink&ts=253.72
- https://www.rev.com/transcript-editor/shared/ygZMSwsxniQgqj5yUM_VQG8pdkW6t88s1wpLUBpxHCiiQY87igzMZJKonV0cEg0m_Sc7tyzpngR97MZIHfSwg4-lU4A?loadFrom=DocumentDeeplink&ts=321.94
- https://www.rev.com/transcript-editor/shared/tXmTX_gfoJL6DWzU0F5HdtLlHOdTh9Cx3ZLjbC6uetiiTPOQ2lJvEhBhogsjq5tPVKmLibEzQCoxyVgJxE1CBxN1hwA?loadFrom=DocumentDeeplink&ts=383.75
- https://www.rev.com/transcript-editor/shared/9_AOYe_yaLo8rPO63Bp22tDoHo0CFceMl2R5VH8ygQw1vL8C_56p3SNJY1ydQtWZNDi_DHl4s2aVfi2e30WW_tsHY1Q?loadFrom=DocumentDeeplink&ts=402.62
- https://www.rev.com/transcript-editor/shared/SB98ii_yNdMpYLOEPwm1pQ0pAXdJjvkYvWuJRx2uJ9TsW0iPyDt228rUP5xL7aEDHiLqcIcj7R60OOwZjrwyNL3OO0Q?loadFrom=DocumentDeeplink&ts=499.07
- https://erictopol.substack.com/subscribe?utm_medium=podcast&utm_campaign=CTA_4
Transcript
Shows are listed from Apple Podcasts' charts and directory, and Podcast Index where it is used. Every show and episode belongs to its publisher and plays from the publisher's own feed; this site hosts none of them. Explicit shows are for adult profiles only, and children’s profiles hear only children’s shows. More about this list.