15. What Causes Autoimmunity? A Deep Dive into Viruses, Inflammation, and Aging with Dr. Jessica Lasky Su

Hey friends, what if we stopped fighting over labels and actually started treating the mechanisms behind what's making people sick? That's the question driving today's conversation with Dr. Jessica Lasky-Su from Harvard Medical School and Brigham and Women's Hospital.

Here's the thing. Her team is working at the edge of some really fascinating science, genetics, epigenetics, proteomics, metabolomics, antibody profiling. And what we dig into is how long COVID research, viral exposures, and autoimmunity all connect. This isn't just academic, right? This shift in thinking could change how we approach everything from chronic fatigue to neurodegeneration.

We unpack the NIH's massive long COVID program. We're talking tens of thousands of participants, deep biospecimen collection, repeated measures over time, and patient advocates actually shaping what gets studied. The goal isn't some single tidy definition of long COVID. It's mapping out subtypes and mechanisms. Immune dysregulation, viral persistence, autonomic dysfunction, coagulation issues, mitochondrial strain. Once you define the mechanisms, drug repurposing becomes a real lever. You can match known compounds to pathways for faster trials and earlier relief for patients.

Then we zoom out a bit. Research grade antibody profiling can detect tens of thousands of potential autoantibodies, way beyond what routine panels show. Some of these signals correlate strongly with diseases like Parkinson's and Alzheimer's, hinting at early warning markers or maybe even direct roles in the disease process itself. Molecular mimicry explains how infections, especially persistent herpesviruses like HSV-1, EBV, CMV, and VZV, can trigger immune misfires that target our own tissues. It's good intentions gone wrong at the cellular level, and it's why mechanisms matter more than the names we slap on things.

We keep it practical too. Support immune balance with sleep, nutrition, movement, vitamin D optimization, stress regulation, gut health. If reactivation is suspected, talk to your clinician about antiviral strategies and stepped, mechanism aware care. This isn't hype. It's a grounded path from lab to life where functional medicine and rigorous research meet to shorten the distance between discovery and relief.

If this conversation resonates, subscribe, share it with someone who needs clarity, and leave a review to help others find the show. Your questions shape what we explore next.

That my friends, is the reality of medicine as I see it. Let's get real and get results.

Connect with us:

Root Seek Health: https://rootseekhealth.com/

📊 Got Lab Results But No Real Answers?

You're not alone. Many patients are stuck with test results but no clear path forward. I've created a free resource to help you understand what your labs might actually be telling you about your health.

Download your free guide "Lab Results Without Answers: Your Labs Are Only Half the Story"

Transcript

Setting The Stage

Dr. Mark Su 0:09

I'm Dr. Mark Su and welcome to the Functional Medicine Reality Podcast. Join me and our community weekly as we bring you unfiltered health from inflammation to longevity. Real stories, real people, real solutions. Experience real life health changes from both patients and practitioners. And learn how to turn cutting-edge information into real results in your own life so you can feel better, live longer, live healthier, and be confident and clear in your health care choices. Let's get real and get results. Hi everyone, welcome again to the Functional Medicine Reality Podcast. I'm Dr. Mark Su, and thanks for joining us. Today we have another in our series with uh practitioner and colleagues, professional guests as opposed to the patient guests. And today I have with us Dr. Jessica Lasky Sue. She is an associate professor at Harvard Medical School and Brigham Women's Hospital in Boston, Massachusetts. She's been a leader in applying genetics, speed genetics, opioomics, abalomics, and antibody profiling for those of you who are more technically minded or research-oriented in the healthcare research world. She's covered a wide range of topics in her research with chronic diseases across the entire lifespan, and including aging itself in more recent years. She has nearly 300 peer-reviewed publications. They span the whole diverse disease and aging-related outcomes spectrum of research. They include biologic age, cancer, respiratory illnesses, ocular illnesses, infectious conditions, metabolic conditions, neurodevelopmental and mental health concerns, as well as effects of environmental exposures such as air pollutants, forever chemicals, or PFAS, for those of you who know the term, nutrition and exercise that influence health, again, across the entire lifespan. So she's received numerous awards. She's both committed and passionate about her body of work, and we are husband and wife. So full disclosure, we have been married uh 26 years. We met at Cornell University, and uh this is not a Jessica is not brought to the table here as a guest because we are married, but because she has um uh a lot to bring to the table in terms of insights and information. But also the intent today is to talk a bit and share with others, share with you about the kinds of conversations and thoughts that we have in our in our home or in our private life, if you will, intersecting between the research that she does and the sort of patient care applications that my world where I where I live, the space that I exist in professionally. So again, all of this is wrapped into or under the umbrella of the focus uh being in our podcast of helping you live your best life by creating more clarity and truth-telling. And so today's just a little different in that we're gonna be talking more from a research angle, but it's gonna be a real insight into how that research sometimes is applied directly or a little indirectly into functional medicine, more so than conventional medicine, certainly. So with that, all that being said, Jessica, um, thanks for agreeing to do this together. It's obviously this is the first time we've done, I think the one of the maybe the first time we've ever done something like this, certainly obviously in the podcasting world, but uh you know, we've had very limited, rare times that we've collaborated in some kind of on a professional platform, if you will. Do you recall anything?

Dr. Jessica Lasky-Su 3:31

Oh, yeah. I it's actually funny. I was thinking this is, I think, the first time we've actually directly talked about this stuff in any type of setting outside of like our kitchen.

Dr. Mark Su 3:40

Yeah, we had some real limited professional, if you will, or work-related projects together, but it's really sparse and it was much more from an administrative and more business level, if you will, and definitely not on a sort of clinical and educational level, I think. Yeah.

Dr. Jessica Lasky-Su 3:53

So maybe we did a little during COVID. That's a one-play time.

Dr. Mark Su 3:56

Oh, yeah. Thank you. Thank you. So, yes, brief insight. So, Jessica, what headed the pandemic public health, I would dare say, the public health initiatives in our local communities and our towns through the school systems, being the researcher that you are at Harvard. And you know, so do you wanna do you wanna just flush anything else out about your background or do you want to make any quick comment about um, you know, as an add-on about the kind of research you're doing, like especially in that COVID-long COVID world, or do you want to just kind of jump in?

Dr. Jessica Lasky-Su 4:21

Yeah, we could we could jump in. Honestly, that was like pretty like extensive introduction to me. So that was great.

Research And Functional Medicine Converge

Dr. Mark Su 4:27

Okay. All right, well let's just yeah, let's just jump in. So let's set the stage. You know, as an example for with the kinds of conversations or the kind of scenarios we have, you know, when I go into conferences, and that happened just last week when I was at a conference again, you know, and I introduced who you are briefly to other people or comment on, you know, some of our intersects, it's it's very common, as you just alluded to, where people say to me, You guys must have really interesting dinner c dinner conversations. And to which I say, uh, we do when we have these conversations, but we're both always so busy that it's commonly it's it's tough to have those opportunities to have these conversations at all, actually. So it's not like it's a real regular thing. But that being said, the epitome story that I think about was I don't remember what year was, let's call it 2018, 2017. If it was earlier, I don't remember. I was heading off. You will remember this. We were in the kitchen, I was heading off to an Institute of Functional Medicine conference, their annual international conference, the AIC. And uh you're asking me as I'm heading out the door in the next 15 minutes, maybe. So where are you headed to? Right? If I recall right, I was headed to Hollywood, Florida. You said, so what kind of, I'm curious, like who are the presenters, what kind of topics? So I show you the agenda on my phone, right? I pull up the link, and you say, uh, I know the first two speakers. I have grants with them. I tell them I said hi, like on a personal note, right? And I'd never heard of either of these two speakers, all right. But one of them was Dr. Alessio Fasano. And so for people who know him, he I think of him as the founder of leaky gut syndrome. I say founder because that's his, you know, that's his, he put that on the map, if you will. I I say that to a lot of people as a you know, patients that, hey, uh, if you ever wonder if leaky gut is a legitimate, validated medical term, in medical terms we call it intestinal permeability, but Alessio Fasano, who's an MD and world-renowned researcher out of Boston, who my wife happens to know and has done research with, he's got all kinds of papers on this. And then you follow that up with, oh, the second presenter is Maureen Leonard, who I'd never heard of either. And you said, Oh, yeah, yeah, she's blah, blah, blah, blah, blah. Right. And so that was a really interesting and uh eye-opening experience for me, where not only did I not know them, but and you did, and I'm the one going to the conference, but you have these direct connections with like the guy who put Leaky Gut on the map, right? So I'm just curious, like what was let's start with that. What was your what was your experience thinking back to that moment with that intersect?

Dr. Jessica Lasky-Su 6:48

Yeah, actually, it's funny that you bring that up because that was was a really fun moment because I think it's sort of the quintessential example of how our worlds overlap and yet we we may not even know it. And one of the interesting things I think from a research perspective is while often research institutes, I think, are not thought of as functional medicine oriented, the irony is a lot of the research they do is completely functionally medicine oriented. I think that's a perfect example. Uh Alessio and I, I think we have certain areas of interest in the types of research that we do. And so I'd met him through, you know, um, this common interest, and it was really metabolomic profiling. But if you look at the content of his research, it's really is much more in the framework of what would be applied in a functional medicine setting. Yet he's at an academic research institute. So I think that was one of the places where I actually had this realization that from a practice uh the functional medicine often from a practicing point of view is implementing scientific findings earlier than what is often accepted in traditional medic medicine settings. And I think that's that's really, I think, one of the big advantages of functional medicine is they really are trying to incorporate things earlier to optimize care.

Dr. Mark Su 8:06

Yeah, yeah, yeah. Absolutely. And you know, I don't even know if I ever told you, but I found out later that Alessandro Fasano was actually the chair, the chairman or the he spearheaded that whole conference. Which it to me is just so odd for me because I'm so used to this sort of dichotomy or compartmentalization, almost sometimes abrasive nature between conventional and functional medicine. And yet here's this guy who's extremely well decorated at Harvard, right, who put Leaky Gut on the map and he's heading the whole IFM yearly conference. It was it was just kind of mind-blowing for me.

Dr. Jessica Lasky-Su 8:38

Yeah, it and I will say, you know, one of the areas where I see that at most at play right now actually is in long COVID, in the larger long COVID consortium we have, because you're looking at that, and it's so many of the like symptoms and this and that are really classical symptoms, and maybe a lot of traditional medicine is criticized, you know, um, and and maybe uh they're harder to diagnose. And it really is this con, you know, the concept of like a lot of what people think of with things like Lyme disease, et cetera. But now it's in the setting of a pandemic, so it's way more prevalent, you know, across the board. You really you really see that this framework emerge. And it's actually really nice because in the same setting, you also have patients really advocating in those areas of research and really sort of pushing the envelope forward in a way that is really sort of pressing the functional medicine framework.

Dr. Mark Su 9:30

So flesh that out because most people don't know this. You and I know this. But um, so first of all, when it comes to just a backtrack just for a second, you know, uh to f to put more context behind that sort of uh research to or conventional medicine to functional medicine conversion or the evolution, sh many times doesn't ever happen, okay, in terms of concepts, principles, diagnoses, treatments, et cetera. But uh, you know, there are still I I would say it's less so now, and I don't know how familiar you are you are with this, but I'd say less so in the last maybe three to four years, maybe five years at the most, but easily pre-pandemic, just before the pandemic, so let's say five-ish years ago, leaky gut was still considered like a non-existent, silly, condescended upon topic by a lot of conventional medicine. But you know better than I, like uh the papers he was publishing on this were over 25 years ago. Right. Right. And then similarly, I'll just throw out there that, you know, staying on the gut health topic, that SIBO, which I don't know that you know I've ever talked about uh because I don't know how so I don't know how familiar you are with that, but that again is a topic that was it's been in research for a lot, a lot of years, and now there are conventional GIs, stroonerologists, who do tests for that. We have, you know, friends slash colleague in town, two of them, who test for SIBO, you know, recurrently, but that was so looked down upon and frowned upon and sort of tabooish for a lot of years in conventional medicine. So again, just summarizing your comment that, yeah, it's interesting that um so when people ask me, so Mark, what is functional medicine? And I'll just re- reference what you just said, uh part of a lot of it to me is the opportunity or the uh interest and initiative to try to apply findings in research or principles, studies, et cetera, more quickly now because people don't want to have to wait three, five, seven, ten or more years to get benefit just because it was validated in the in the conventional setting.

Dr. Jessica Lasky-Su 11:14

Yeah. Yeah.

Dr. Mark Su 11:15

So uh well, actually, I was just gonna you feel free to comment, or uh I was gonna ask you to now go back to the long COVID piece and just give people a little more context as to, you know, because that is another example of what I was what I'm referencing here, right? Leaky gut, SIBO, those are examples, but let's go to long COVID, because just like you said, what is long COVID? I ask people that all the time. So if you can just give a little more context as to what are you doing in the research world these days with long COVID and who are the players that you're collaborating with in long COVID, just to give it a little bit more sort of validation, if you were, credibility of the kind of research you're doing. Okay, these aren't people working out of the garage. And then you alluded to like patient advocates, you know, and then also you've told me before that some of those patient advocates are professionals, like even researcher prescribers, et cetera. And can you share some of those experiences that you've seen that kind of been eye-opening for you in that sort of intersect between this is what we think about research and holy crap, in the pandemic and this in front of our face, world-changing, life-changing once-in-a-generation or multiple generation experience, how that's opened your eyes with uh what happens in that sort of conventional versus functional medicine space?

Long COVID: Building The Largest Study

Dr. Jessica Lasky-Su 12:19

Yeah. And I actually think this, you know, this the long COVID is a great example. You know, the pandemic happened in the middle of the pandemic, you know, as, you know, we are starting to go get a hold on sort of COVID infection itself. All of a sudden we're seeing all these people with these long-term symptoms, you know, fatigue, loss of smell, this and that. And what happened at that time is these things started to emerge. The NIH, I have to have to give them a lot of credit, went really quickly to action to say, like, we know we're gonna have to study this in like incredibly credible timing, incredible speed. They basically got researchers throughout the entire US and said, Hey, we know we're gonna need to study this. We know we're gonna need to study the long-term effects. And I mean, it's like I think it was like 200 researchers across the United States from all different hospitals. And they they uh started, you know, enrolling people who were pregnant, they started enrolling ch children from the age of like three up. They started enrolling adults, they enrolled people who had never been infected with COVID, they enrolled people who had acute COVID infection, enrolled people who had post-acute COVID infection, and then they started following these individuals and collecting all sorts of information on symptoms, this and that, collecting blood samples, saliva, stool samples to fig sort of try to study this whole progression of the disease and who gets better, who who doesn't have symptoms, who ends up totally resolving the no symptoms, what are the symptoms? How do we define them? And then like as good.

Dr. Mark Su 13:45

And so actually just to just interject for you know listening for those listening, this is very much the insight on how research works on a population level, right? It's it's basically I I don't mean to be negative, but it if it comes across that way, but it's like it's data mining.

Dr. Jessica Lasky-Su 13:58

Yeah.

Dr. Mark Su 13:59

Right? I mean, it's population health, and it's okay, we're just gonna collect data and then sift through it over time and see what we see. Yeah. Is that fair?

Dr. Jessica Lasky-Su 14:06

Yeah. And you know, I think in the case of long COVID, people were so desperate because they are really they they're suffering, but like we didn't even have a grasp on like, well, what are the what are the major, major symptoms? Right. It's hard to assess that on a large level when you're just hearing individual stories. And like also, you know, it's clear that not necessarily all the symptoms are the same, right? So we just started from these fundamental questions like, what are the symptoms? What are the main symptoms? What's the range of symptoms? Are they the same in kids as they are in adults? Like, who is it request, you know? Some people, if it's resolving, how is that happening? Really, with this huge effort of like, can we figure out how to treat people better and how to prevent this?

Dr. Mark Su 14:48

And again, just as an observation, reflection, this is the research approach, is we want to keep a sort of open-minded and all-commerce mentality. We're not going in with biases. And I say that specifically because the previous uh you know professional interview here was with our good friend, very close family friend, best friends, George Pappanicolo. And we spent a lot of our session talking about biases that we have as practitioners. Right. So as researchers, the goal is to not have bias, right? Right. To be objective and as neutral as you can be for science. And so you guys have been collecting like this project has been collecting data for how long now?

Dr. Jessica Lasky-Su 15:20

Yeah, I think it started in 2021, right?

Dr. Mark Su 15:23

Okay.

Dr. Jessica Lasky-Su 15:24

It's collecting data and and the data's uh you know, we just got an extension to keep on following them, following patients.

Dr. Mark Su 15:30

And it's NIH funded.

Dr. Jessica Lasky-Su 15:31

NIH funded. It's one of their largest projects.

Dr. Mark Su 15:33

And you're like, it's over 200 researchers across the country.

Dr. Jessica Lasky-Su 15:35

Aaron Powell Yeah. You know, enormous. I mean, so you know, the the total number of people, like just let's say for adults, is like maybe 20,000, right?

Dr. Mark Su 15:43

Okay. And in in research world, how is that common? Is that small? Is that large?

Dr. Jessica Lasky-Su 15:47

Or what's the for something like long COVID, it's the largest in the world. Aaron Powell Okay.

Dr. Mark Su 15:51

Largest, largest long COVID study project in the world that you know of.

Dr. Jessica Lasky-Su 15:55

By far, by far. With this level of resolution. We also have sing like we also have a whole autopsy group that has all sorts of like, you know, um, specimens. So we're like we like and you know, I interact with these people all the time. Okay, this person died of long COVID. You know, let's look at like what their brain looked like, like what l like different parts of them look like so we can start understanding.

Dr. Mark Su 16:15

So in this you're interacting with these NIH folks how often on this project specifically?

Dr. Jessica Lasky-Su 16:20

Like on Monday, I had six hours of meetings.

Dr. Mark Su 16:23

On this topic alone?

Dr. Jessica Lasky-Su 16:24

On this topic alone. Yeah.

Dr. Mark Su 16:26

Okay.

Dr. Jessica Lasky-Su 16:26

Yeah, six hours, six whole hours of meetings. So I'm I'm leading uh a huge part of this in terms of generating a huge amount of molecular data. So we're c we're generating genetics, epigenetics, proteomics, metabolomics, RNA sequencing, which is a gene expression, all this type of molecular data to sort of fundamentally answer these questions and sort of get to the point of can we treat people? Can we prevent this?

Dr. Mark Su 16:52

And so what happens down the road is when we hear news that, okay, we've firmly have decided, concluded that long COVID includes these kinds of symptoms commonly in 70% of people or these symptoms in 30% of people, or blah, blah, blah. Or we have this understanding of this mechanism or root cause, root mechanism, or this one, but not these, then a lot of that is derived out of studies and work like what you're talking about right now that you're involved with.

Dr. Jessica Lasky-Su 17:15

Exactly, exactly. And and sort of this component I'm adding on is, you know, an enormous huge effort that I think really is going to get at this. But I think also it's gonna get at the point that like what we all sort of know, long COVID isn't one disease, it's multiple subtypes of disease that likely need to have completely different treatments.

Dr. Mark Su 17:32

And that is curious that for me, I think about mechanisms versus disease, right? So because like in our, in our, I'll just briefly in our practitioner community in the functional medicine world for years now. I mean, I'm I'm saying at least since 2021, I don't think 2020, but practitioners have said in conferences, in personal conversations, oh yeah, the folks who my patients who have chronic Lyme, like they're all having reactivation of symptoms. And that's what other people are calling LOM COVID, but we're seeing it either in lab testing and/or symptoms. It's the exact same experience of what they've had when they've had reactivation of Lyme or mono or mold illness or whatever. So for me, a lot of other colleagues, we think of Long COVID as just another name for a collection of underlying root diseases, as you just said, but there can also just be root mechanisms like inflammation through this pathway, that pathway, or collections of pathways that don't necessarily fit within one disease per se.

Dr. Jessica Lasky-Su 18:24

Right. And actually, like the way you just said that is actually I love because, and again, we never talk about this because we're so busy, but like that, like literally, you know, the scope of what we're doing is defining distinct mechanisms of long COVID. Literally, that word mechanisms is what it's all about. And they also will say pathobiology or pathophysiology. And the point is if we can, if we can group people by common mechanisms, then treatments can be developed focused on those mechanisms. And that's really the goal.

Dr. Mark Su 18:53

And and from my perspective as a practitioner, if you identify this pathway as a 66%, you know, two-thirds percent contribution to people who have long COVID, that doesn't mean it's in conflict with, let's say, the patient, the patient in front of me says, Well, you know, I've had quote unquote chronic Lyme. And I say quote unquote, because, you know, if you're talking to conventional crowd, they don't believe that or whatever, but you know I've had chronic Lyme for like five years, and my symptoms of chronic Lyme are the exact same symptoms that I exacerbated that my other doctor is calling LOM COVID. Now you might say it's that mechanism pathway of X. But for me, that same mechanism could be what leads to the chronic Lyme symptoms as well as the long COVID symptoms. So it's not a contradiction.

Dr. Jessica Lasky-Su 19:32

No.

Patients As Partners In Research

Dr. Mark Su 19:33

Right? So you might find, you guys might find these are mechanisms in pathology that we identify, but that doesn't negate or contradict, say, chronic Lyme being reactivated. But in the mainstream messaging of what I would often hear in news is, or at least among practitioners, right, conventional practitioners might say, Well, that's hogwash, it's not Lyme, it's long COVID. Whereas in my mind, I'd say, I'm not, I don't need to pick a fight, but they're not mutually exclusive. They're they can be all kind of intersecting.

Dr. Jessica Lasky-Su 19:59

That's an example of where, like when I said often research is more aligned with functional medicine. So there's another group I'm involved with, and it's post-acute infections. And in that group, and it it's it's like, you know, I think it there's a lot of like what you're saying, reactivation, but like the a lot of the fundamental framework of them is that like a lot of these post-acute infections, and I was on Electra specifically, it was all about Lyme. You know, it was this chronic.

Dr. Mark Su 20:25

So background, is this a different project, a different research chart?

Dr. Jessica Lasky-Su 20:28

It's a different yeah, it's a different group.

Dr. Mark Su 20:29

Okay. Is it through NIH or not?

Dr. Jessica Lasky-Su 20:31

That one's not through NIH. It's uh but um it's you know, I'd say largely everyone in this sort of long COVID community has this framework of that these post-acute syndromes, right? Like there's likely very common physiology of a lot of them. And there's, you know, this idea of like viral persistence or whether you call it any type of sort of like, you know, if you have an infection and you have antibodies or something in the infection, that if you get another infection, what happens often, it sort of, you know, re instigates the prior infections as well. So your body goes even more crazy. And this idea of like cumulative viral load.

Dr. Mark Su 21:08

Multiple hit theory, we call it.

Dr. Jessica Lasky-Su 21:09

Yes, multiple hit theory. So that is that's one of the critical things.

Dr. Mark Su 21:12

Do you guys use that term in the research world or no?

Dr. Jessica Lasky-Su 21:14

Um the word that we use is um it might be viral load or um I'll have to look up the exact word, but it's the same concept, right? Okay. Like one of one of them with long COVID is um herpes simplex viruses. Aaron Powell Right.

Dr. Mark Su 21:28

So I do want to save the viral topic because I know that's hot on your mind. Yeah. But I want to save that because I do want you to touch point on what some of the um stories that you hear from the patient advocates that have impressed you with that long COVID topic that's you know, this humongous 20,000 people, you know, NIH funded project. And then we'll shift back to that viral topic because I know that's uh big on your mind.

Dr. Jessica Lasky-Su 21:47

Yeah, and so you know, I think this is one of the things I I actually loved about love about this project the most. And I think it's a new framework that the NIH is really trying to do, which is get patients who are really struggling or suffering and have them be. An active part of the research to provide guidance along the way. And for me, because I'm not a clinician, I'm a PhD. This is like tremendously valuable because I don't go to the office and see them. And so we'll have some sessions that are sessions, you know, that it's it's someone telling their story. Here you have someone like I remember there's a woman who's like a surgeon, a marathon runner, this and that. She gets long COVID. She can't, she can't even get out of bed. And I'm like, you know, some people may say, Oh, you can believe these things aren't real. And then you hear a story like that, and it's like, whoa, like that could be me. Right. And that that's really, really groundchanging.

Dr. Mark Su 22:39

I'm curious, does that do that? So it's a woman?

Dr. Jessica Lasky-Su 22:41

That was a woman, yeah.

Dr. Mark Su 22:42

Did she say that she'd been told this in your head or this isn't real or anything? Did she say anything like that?

Dr. Jessica Lasky-Su 22:47

So interestingly, I don't recall her saying that, but I've absolutely heard other people say that.

Dr. Mark Su 22:52

Who everyone's Yeah, that's what I'm curious about. How often have you heard those stories like I've just been marginalized, devaluated, discounted, like told I'd sit in my head or whatever?

Dr. Jessica Lasky-Su 23:01

Aaron Powell I think a lot of people have said that, but in this research setting where our whole goal is validating them and trying to get to the solution, in that setting, they hear anything but that because our whole goal is just to help them. So in that setting, I think they feel very firm. But like a lot of these people now are people who are heads of patient advocate groups that have had these types of like people saying, no, it's not real, et cetera. Um, but I'll just say, just from a practical point of view, you know, here I am charged with designing this huge study with generating all this molecular data. It's probably in total over anything. It's like $80 million worth of molecular data, this and that. I have to put it all together. And I have a group of a ton of different physicians and patient advocates, and we're trying to design this. And as we're talking about how we will do this, you know, one of the patient advocates like chimes in and um, we're talking about like, okay, how many times should we measure data? And the patient advocates, like, we need to measure so many times because, you know, if you're just looking at this at one point in time, you aren't seeing sort of how some people their symptoms get go get better and then they get worse. Or some people the symptoms continue to get worse. And she's really advocating about like that is a particular point. But then the the thing is as she's advocating about it, she's bringing in the stories of like, no, no, no, these people are desperate. We have to look at this. And it really just changes the way I'm, you know, the researcher sees it from being like a practical decision to an actual impact, right?

Dr. Mark Su 24:35

Yeah, and I and I I'll use the word emotional, right? I mean, it definitely brings an emotional layer in.

Dr. Jessica Lasky-Su 24:39

Right, exactly.

Drug Repurposing As Fast Relief

Dr. Mark Su 24:40

Right because when you when you the way I think about it, or the way I yeah, a lot of times I perceive not as a negative or value judgment or whatever, but you know, I th I put myself in your shoe because you talk a lot about, you know, statistics and power and you know the parameters of the research, how it was done, how it was designed, and all that kind of thing, which is all ultra important for the sake of objectivity and accuracy and integrity of the science. But it's a whole different story when you're dealing with an actual person and there's an emotional layer with that, right? Where the common conversation you and I have is, Mark, this is like this is going on, this is going on. And then I ask you, as you said, me, cool, like what's what's something I can do right now for a patient? And we may not have that answer, but the thing is I then I'm at I'm sort of teased because I want to talk about that with the patient in front of me like the next day, but I know they're gonna ask me, well, what do I do about it? And if I can't do anything about it, then I'm just creating like the it's it's like an unfair teaser for them, right? And that's where the functional medicine comes into play because when I hear you talk about these things, I'm asking myself, okay, do we understand a mechanism well enough that I can then dig on something else as an intervention that we know acts on that mechanism. We may not have data on it, we may not be able to say it's gonna address this topic, this condition or symptom, but it's something to try because the person's otherwise just suffering with no hope. Help is really what it's about.

Dr. Jessica Lasky-Su 25:53

Right. Yeah, and I think that that's the point of the real push is to how can this help? And when you see people are desperate, getting to that as quickly as possible is really a critical point. And I think one of the aspects of that that has really been an impact in my research now is okay, well, let's think about the concept of drug repurposing, right? Okay, so and I'll tell you what I mean by that, right? So people are desperate. Like if we can really narrow things down to a pathway or a mechanism, as we've been saying, and and then then okay, we know that mechanism. Well, if we already have X drug that is FDA approved for that mechanism, like, you know, um the the steps to get that on the market or approved for another indication are way lower than to develop a new drug.

Dr. Mark Su 26:37

Absolutely.

Dr. Jessica Lasky-Su 26:39

So why don't we have a framework where we look at all of the drugs that are on the market and pull them all in and characterize them and do like broad level screenings of what could be potential treatments. So that's like one of the things my group's really working on now is like, well, if we have a if we have a large, huge dictionary of all this stuff and we show and we can indicate what the mechanisms are, we could connect them to potentially already approved drugs and get through the process.

Dr. Mark Su 27:04

So cool. It's it's a path of lesser resistance.

Dr. Jessica Lasky-Su 27:06

Yeah.

Dr. Mark Su 27:07

You know, it's funny because you've you've talked about this drug repurposing thing, and I hear it once in a blue moon in conferences or whatever, never in colleague conversations. But I never realized that until literally this moment that a lot of that benefit, number one, I just, you know, for me, I'm thinking, well, it's because the conventional mainstream world is familiar with, you know, regulated pharma. Right. Okay. And as you know, you know, on some level, in the functional medicine world, there tends to be a strong dogma of anti-pharma.

Dr. Jessica Lasky-Su 27:32

Right. Right.

Dr. Mark Su 27:32

An anti-establishment mentality on for various reasons we don't need to get into today. But yeah, holy crap. Like, yeah, is there ever going to be any data on supplements or herbals that might affect that mechanism? Like likely to almost impossibly not, right? For regulation purposes, because it's not a patentable or some people might jadedly say profitable intervention. But regardless of putting that aside, like you said, hey, we've already got these things regulated. We understand these things in a way that fits our um sort of conventional model and our framework and regulations. And it's a lot easier to slide over than have to reinvent the wheel, whether with a new pharma or with herbals or supplements and all the other hoops that you have to jump through with all that stuff. I never thought about that.

Dr. Jessica Lasky-Su 28:13

Yeah. It it actually, by the way, I could say there's a lot I could tell you about things that are not pharma that we can do a ton on that really to get at really, really easily.

Dr. Mark Su 28:22

Yeah.

Dr. Jessica Lasky-Su 28:23

So one of those things.

Dr. Mark Su 28:23

Are you hinting at another session another time?

Beyond Long COVID: Viral Triggers

Dr. Jessica Lasky-Su 28:25

Yeah, another session, another time. But yeah, one of my things right now is literally we are downloading what's called PubCem as every everything ever, like every chemical ever existed, every drug. And also I want to pull in like try, you know, medications have gotten to like, let's say, the end of like a phase three trial, but stop because maybe they aren't, maybe they didn't quite work well enough. Well, like, hey, if those are 90% of the way there, we can pull them up and we could sort of say this might be good for this subset rather than do something where you have to start from the beginning, pull one up there, you might be able to get it and identify it a lot faster. So I'm actually like creating that as like a natural part of the framework of how we're now doing stuff, which is really cool.

Dr. Mark Su 29:06

That is cool. So uh if I can, is it okay if I kind of slight pivot?

Dr. Jessica Lasky-Su 29:10

Yeah, yeah, sure.

Dr. Mark Su 29:10

So we've talked in the last few minutes here, we've been talking about long COVID. So it's you know, we could categorize that as a disease or a kind of like a chronic inflammatory condition, no doubt. Okay. You do research in both the um, you know, disease world as well as, as I've already mentioned in the intro, like longevity and health optimization, aging world. Okay, so staying on the former just for a second, and I'm giving you an opportunity here if you want to to jump into the viral thing, right? So the question is can you share with us uh uh whether it's the viral thing or not, what's something that's uh really hot on your mind is exciting to you in your research world that you're doing current day that pertains to chronic inflammation or illness conditions? Anything else besides long COVID?

Dr. Jessica Lasky-Su 29:52

Yeah, it yeah, I think that is the nice transition because there's this viral component.

Dr. Mark Su 29:57

You hinted at that earlier when you said the herpes simplex in the long COVID context.

Dr. Jessica Lasky-Su 30:02

And part of this really actually came exactly from that. Actually, going back to the conversation with Alessio Fasano and Maureen, you said, you know, from that conference, I was talking to Maureen one day and she was mentioned this whole idea of like, oh, well, I'm looking, I want to look at like sort of exposures to different viruses and how that might impact gut health.

Dr. Mark Su 30:21

That's what her research give me framework, how long ago was that?

Dr. Jessica Lasky-Su 30:24

This is like probably five years ago.

Dr. Mark Su 30:26

Okay.

Dr. Jessica Lasky-Su 30:26

I was like, wow, like you know, like it was during like maybe 2021, the beginning of the pandemic. So four four years ago.

Dr. Mark Su 30:32

Early half of pandemic, okay. Yeah.

Dr. Jessica Lasky-Su 30:34

Wow, like especially since COVID has just happened. I'm like, yeah, like that's really something we should be looking at more. And especially for other diseases like asthma, for example. We know like RSV is a cause of asthma. And like, like what viral exposures are causing what? So this put me on this whole framework of like, wow, we could look at there's new technology that can look at like all viral exposures. Like you can take a drop of blood and see like all viruses you've ever been exposed to, different strains of the flu, different strains of everything.

Dr. Mark Su 31:02

And like how does it be like not commercialized testing, just to be clear. Because people are gonna start digging on that, like, oh, how do I get that test? It's not commercial.

Dr. Jessica Lasky-Su 31:09

Yeah, it's not commercial at this point. But you know, the the the point there is really this question of like how your body reacts to different pathogens, viral exposures, it could be bacterial exposures, it could be fungus, it could be a lot of things. Like your body already has this way it reacts with an immune system to help it stay healthy, right? But like sometimes, most of the time, hopefully, that works well. But we also know that often when you have an infection, as in the case of something like long COVID or chronic, any post-acute chronic disease, like it doesn't always. Sometimes your immune system makes mistakes.

Dr. Mark Su 31:44

And often Yeah, so it doesn't sometimes the immune system doesn't rebalance or re-regulate.

Dr. Jessica Lasky-Su 31:48

It doesn't, yeah, it doesn't rebalance or re-regulate, or all of a sudden you start having these strange other symptoms.

Dr. Mark Su 31:54

That could be due to a variety a variety of mechanisms.

Dr. Jessica Lasky-Su 31:56

Variety of mechanisms.

Dr. Mark Su 31:58

Some one one hypothesis is that the infection, original infection is gone, and the problem is completely your immune system just not regulating. So that's maybe broadly in the autoimmune category. In other schools of thought, the infection never really is gone, even though conventional medicine might say it's gone.

Dr. Jessica Lasky-Su 32:13

Right. And then in in certain cases, we know it's not gone. Like and that that's something like the herpes virus, right? You get it once you've done it, it's it's always latent in your body, right? And whereas there are other viruses like, you know, let's say like a sinus infection, probably head cold. Head cold, it's gone, right? But like along the way, you know, in in that process, your body has created antibodies and this and that. So, you know, the whole thing is, and it may it may have changed sort of your immune response. It may have changed how you respond, you know, to other infections. It may sometimes it may make it where you become inflamed because your body's trying to protect you, but maybe not always in the right way, right? Yeah.

Dr. Mark Su 32:51

So good intention's gone bad.

Dr. Jessica Lasky-Su 32:53

Good intention's gone bad. And and this is like one of the this is sort of really the function.

Dr. Mark Su 32:58

I'm gonna write that down. That's gotta be a message with me with patient care. I just never thought about that. Good intention's gone bad. Autoimmunity.

Dr. Jessica Lasky-Su 33:03

Good intention's gone bad. And yeah, this whole concept of autoimmunity and your your body making these autoantibodies that are, you know, now accidentally fighting against yourself instead of against a disease. That very often happens when you have uh an infection.

Dr. Mark Su 33:19

And so one of the things that Do you really consider that as often from your research world?

Dr. Jessica Lasky-Su 33:23

I think it happens a lot more often than we realize, right?

Dr. Mark Su 33:26

I mean, because it's the statistics on autoimmunity have dramatically increased over the years.

Dr. Jessica Lasky-Su 33:31

Yeah, and and so they've dramatically increased. I think the biggest thing I can say is we don't know as much as we need to know. And I I I fundamentally think that, you know, autoimmunity is likely a big instigator of inflammation, which is broadly captured causing a lot of diseases or not necessarily causing, but predisposing us more to a broader range of diseases than what we might not understand at this point. You know, I think the I think the main thing is though, as as I started getting into the Syria, I'm like, can we measure like what, you know, viruses and stuff we've been exposed to? But more than that, like if there is this thing where a virus is causing some type of response, sometimes gone wrong in our body, and now we have these autoantibodies that could be attacking ourselves, could we measure those and sort of understand how those may end up impacting our predisposition to disease or measure what, the antibod- the autoimmunity antibodies?

Dr. Mark Su 34:28

Auto antibodies. Okay.

Dr. Jessica Lasky-Su 34:29

And how, you know, how does this affect the broad category of like how we age? And and this this framework is a fundamental belief.

Dr. Mark Su 34:37

So there you're extending, you're converting, you're inclusing, including, you're being inclusive of how much does the immune system, inflammation, which isn't all bad, right? Like you said, it's necessary to fight off stuff, but how much of that gone wrong might not only continue to extend symptoms and sort of illness, but might also impact aging itself. Aging. Independent of symptoms.

Dr. Jessica Lasky-Su 34:59

Correct. Independent of symptoms.

Dr. Mark Su 35:02

Okay.

Dr. Jessica Lasky-Su 35:03

And so this is really like an area that I thought, oh, this is really interesting. Um and if it fundamentally fits in with sort of bigger pictures of how we age, right? A lot of the concepts of things like words you may hear, buzzwords like senescence, right?

Dr. Mark Su 35:17

Zombie cells, as people call it.

Autoimmunity At Unseen Scale

Dr. Jessica Lasky-Su 35:18

A lot of these things are about like autoimmunity, you know, um gone wrong. So we started, you know, but the the interesting thing is like no one's ever looked in this on a broad scale, a really broad scale. So I was like, I really want to look at this. So I've been working, you know, in a way where we can actually measure these autoantibodies like with a drop of blood. What are all my autoantibodies? Right. And one of the things we found, like it absolutely blows me away.

Dr. Mark Su 35:43

No, just right, because a lot of people are gonna know, most people are gonna know that there are auto commercial tests for certain autoantibodies.

Dr. Jessica Lasky-Su 35:50

Right.

Dr. Mark Su 35:50

So uh yeah, antibody like autoimmune markers, right? So are you referencing the exact same ones by and large, as far as you know that we can do commercially? Are you referencing that there's a whole host and you know that it's like twofold more, fivefold more of these autoimmune markers that are not commercially available that you're looking at?

Dr. Jessica Lasky-Su 36:05

Yeah. So let me just put this in perspective. I was looking at the data this morning, um, and I was looking at the different autoantibodies that we have that we can look at.

Dr. Mark Su 36:14

It's in research.

Dr. Jessica Lasky-Su 36:16

In re- in research, right? Um and we actually the way the autoantibodies work, we can look at small peptides of the autoantibodies, or you can look at them in the level of the genes. Like on the level of the the the gene name or the protein that it's hitting, it's about twenty thousand.

Dr. Mark Su 36:31

Aaron Powell 20,000 different autoimmune markers?

Dr. Jessica Lasky-Su 36:34

Autoantibodies, yes.

Dr. Mark Su 36:35

So different autoantibodies, or you mean different like like you said, the genes of the antibodies, the the little portion of the antibodies, and so they all collect they could be one antibody and you're looking at three different facets of it, or 20,000 different autoimmune markers.

Dr. Jessica Lasky-Su 36:47

20,000 different autoantibodies.

Dr. Mark Su 36:49

Aaron Powell And then so you multiply that by like the parts, the gene of it, and this part of it, and then it could be like multiplied by another three or four fold.

Dr. Jessica Lasky-Su 36:55

Aaron Powell If you're looking at everything, all the little ones, it's about a hundred thousand.

Dr. Mark Su 36:58

Aaron Powell Wow. Okay. Yeah, because I mean I don't know if you know, but my guess as far as labs that we can look at commercially for autoimmunity is probably I don't know, I'm gonna guess not more than a hundred.

Dr. Jessica Lasky-Su 37:07

That's right. That's exactly right.

Dr. Mark Su 37:08

It's got to be, I'm I tend to underestimate. So I was gonna say like fifty, but let's say it's double. Let's say not more than a hundred, maybe.

Dr. Jessica Lasky-Su 37:13

That's right. So I'm saying like you're barely capturing anything. Like do you want to know the amount of low-hanging fruit here? So I'm like looking at the data, I'm like, oh, what do we see here? Right. And I'm seeing things like auto antibodies that are completely like driven by like the brain that are driven by like, you know, having an effect on neurology with these enormous impacts on things like Parkinson's disease, right? Like I'm talking about.

Dr. Mark Su 37:37

You're seeing antibodies that have a correlation on some level with Parkinson's, either by like correlation or causation.

Dr. Jessica Lasky-Su 37:45

So whenever you're doing this, and I know this has been a hot topic in a lot of areas recently, the first level of assessments that you do are what's called an association. Now, those are not causation. You have to do like randomized trials and this.

Dr. Mark Su 37:58

You gotta start, you gotta start small.

Dr. Jessica Lasky-Su 37:59

Start somewhere. But let me tell you one thing. Like if I look at something like Alzheimer's, right? Alzheimer's, we say, okay, what's the biggest risk factor for Alzheimer's? We would say genotyping yourself and see if you have the ApoE gene. That is the number one thing we can do to assess Apo E4 specifically. Yeah, Apo E4. To assess someone's risk for Alzheimer's. Okay, if you have two Apo E4 variants alleles, that puts your risk for Alzheimer's, it increases it about 12 fold. Okay. When I'm looking at these, I see one autoantibody increasing the risk of Parkinson's 50.

Dr. Mark Su 38:36

Okay. Yeah, so there's a lot of people out here listening who know about that ApoE4 with the men, it's it's mainstream, like you know, in podcasts, social media, whatever else, right? People know about that. And you're saying, okay, this may not be causation identified yet in validation and robust studies, volume, et cetera. But from what we see right now, this one marker, similar to the ApoE4 being one marker, looks to be fourfold more of a correlation with Parkinson's than ApoE is with dementia.

Dr. Jessica Lasky-Su 39:04

Yeah.

Dr. Mark Su 39:04

That is tremendous.

Dr. Jessica Lasky-Su 39:05

And now now Len even tell you this. So we see like five of these for Parkinson's.

Dr. Mark Su 39:10

Five different autoimmune markers?

Dr. Jessica Lasky-Su 39:12

Different ones.

Dr. Mark Su 39:13

That independently have such a high potency of correlation.

Dr. Jessica Lasky-Su 39:16

Yes. And when you look at them, one of them is targeting the gene that causes juvenile onset Parkinson's.

Dr. Mark Su 39:24

So if you have the I've never heard of that juvenile onset Parkinson's.

Dr. Jessica Lasky-Su 39:27

It's a juvenile, I mean, it's not like young, young, young, but it's it's a known gene that if you have it, you have the mutation, it stops working, you're gonna get Parkinson's. Right. And now I'm saying like these are people who don't have that gene variant, the it's it's a functioning gene, but all of a sudden they see the autoantibody and you see in this case it was a 20-fold risk of getting Parkinson's. So I'm sitting there like looking at this, I'm like, oh my gosh.

Dr. Mark Su 39:52

So to clarify that, my understanding, you're just saying if someone has that autoimmune marker, that autoimmune, uh that autoimmune antibody, then if they contract that, if that develops in their body perhaps at like 16 years of age, then it's a 20-fold risk that they're gonna develop Parkinson's at some point in their life.

Dr. Jessica Lasky-Su 40:11

Right.

Dr. Mark Su 40:12

By the math and model that you have right now. That's great.

Dr. Jessica Lasky-Su 40:14

And now this is now it's interesting because these are actually adults. When I said these, so my the premise is you get older, you get more and more autoantibodies, right? And all of them are pretty rare. That's a key thing. All of them are pretty rare. But if we're seeing like that level of increased risk for a target that you know causes a disease, when it comes to this question of causality, it's a way low, lower hanging fruit.

Dr. Mark Su 40:38

Right, right, right. So it's correlation, technically speaking, right now, because you haven't run like randomized, controlled, blah, blah, blah studies, kinds of level data. But when you put the connect the dots, you're putting that on top of a model that's already known. And so the expectation is extremely high that this will play out as you expect.

Dr. Jessica Lasky-Su 40:55

Right, exactly.

Dr. Mark Su 40:56

Even trying to be unbiased, you just you're connecting dots that are already in place.

Dr. Jessica Lasky-Su 41:00

Right.

Dr. Mark Su 41:00

So when I say that because that's how functional medicine, that's how we think as practitioners.

Dr. Jessica Lasky-Su 41:05

Right. Right.

Dr. Mark Su 41:05

It may not always work out. But if we already know this for this kind of situation and we I d we learned this, let's try connecting those dots. And there's more likely of a hope than just random shotgunning something and saying, well, uh, let's just try exercising more.

Parkinson’s, Alzheimer’s, And Risk Signals

Dr. Jessica Lasky-Su 41:18

Right. And and like it's as soon as you know that, if you can figure out that that's real, and you then all of a sudden queried a database and knew there's a drug to target that. Oh my gosh, let's use it. Like right now, there's no like no one knows how Parkinson's happens. No one knows any way to prevent it.

Dr. Mark Su 41:33

So back to the drug repurposing.

Dr. Jessica Lasky-Su 41:34

Yeah, that goes to the drug repurposing, exactly. So I'm seeing this, and I'm seeing this for Parkinson's, Alzheimer's, multiple sclerosis, every type of like cancer you can think of. I'm seeing it for autoimmune diseases. I'm seeing it for like this and this this range of things where I'm looking at these, and in like almost all cases, I'm looking at these, and they're like functionally very relevant. That's what's amazing. Like, you know, cancer for breast cancer, we see BRCA2, autoantibody to BRCA2.

Dr. Mark Su 42:04

BRCA2. Wait, wait, an antibody to the BRCA gene? Yes. It's an antibody to the gene?

Dr. Jessica Lasky-Su 42:09

Yeah, so it's an antibody to the protein that the gene makes. That gene makes.

Dr. Mark Su 42:14

Okay. So someone has a BRCA2 gene, they make some proteins from that gene, and then you're saying, if I understand this, this is all lifetime, this is raw, unscripted, right? So you're telling me if someone then develops an antibody to that protein, they might have that gene. That gene might give them an increased risk of breast cancer via that BRACA 2 gene. But if they develop an antibody to it, then even if that gene or that protein doesn't explode and really manifest itself, the pro antibody itself can then sort of take off in a different direction and effectually cause a similar problem through a different pathway.

Dr. Jessica Lasky-Su 42:46

Well, so this is this is like these are great questions. And oh, I love this because this is like a reverse, right? So now Mark is asking, acting like the researcher here. So like your questions are exactly the types of things I'm thinking. The question is, okay, how could we use it? Can we use it? Is it useful? You know, that could be answered many ways. And some of that gets at the question of it's not causation, it's association. And in some cases it may be mechanistic, but in other cases, it may be a very early biomarker, way prior to disease. Now, in these in these cases, these are autoantibodies we've seen before disease develops.

Dr. Mark Su 43:22

Okay, so you're basically if I hear you're right, you're saying, right now, Mark, back off. We're not down that road, let's not get ahead of ourselves. We're just saying we see the correlation between an antibody with BRCA2 and breast cancer.

Dr. Jessica Lasky-Su 43:33

Right.

Dr. Mark Su 43:34

Whether that means how that exactly plays out that someone develops breast cancer, is it that the antibodies are just part of the story that naturally developed, or is it something that can develop a second pathway or whatever? We don't know that part yet. But the fact of the matter is you're kind of on a high level just saying autoimmunity is a if I hear you right, you're saying autoimmunity is a way bigger deal. As much as people talk about this all the time in the functional medicine world, I mean all the time, you're saying you don't. That's right. You guys have a hundred markers and we have 20,000 markers in the back end in research, and the data accumulation that's happening live time right now is mind-blowing. And this is a way bigger deal than you even think.

Dr. Jessica Lasky-Su 44:13

That's right. That's exactly what I'm saying. And it's so mind-blowing. I've been in research now for like 25 years. You know, 25 years ago, we thought this is how genetics would be. Not at all. Um, you know, we've gone forward, we see things like um like other types of data, like epigenetics is really good at tracking aging, right? Um you know, in some cases it could be causal, and others not. But I've never seen in my career where I'm seeing things that are this big of an effect.

Dr. Mark Su 44:42

So you are you are a Harvard researcher. Um well, world renowned, I'll say world-renowned. I you can beg to differ, but I understand I'm biased, but I I perceive you from your data. And I you know me, I tend to almost, if you're a family member or a close friend, like you almost have to prove yourself even more, okay, because I don't want to come across bias. I perceive you as like a top five researcher in the world in some select areas, areas. You've you've you've been the president of the metabolomic society across uh I think society, right, across the whole world, okay. And you're telling me in 25 years in your own career, the kind of data you're seeing now with autoimmunity, with these antibodies and the correlation with more to come across the spectrum of all kinds of illnesses and cancers is some of the most impressive and strongest data you've ever seen in 25 years.

Dr. Jessica Lasky-Su 45:27

Yeah, absolutely. It's it's like mind-blowing. So, you know, like so as a researcher, right, what it makes me think is like going back to the question of like the patient, right? Like, oh my gosh, like it's you really feel compelled to be like, oh my gosh, if this is real, like we've got to do something. Like, how can we get this out? Right. Like, how could we actually follow this up? Because I I really do think, like, I have this perception now of let's say something like Parkinson's or multiple sclerosis, you know, and a lot of these things have been so like we haven't been able to really get at root causes in a lot of cases. If there's a way that we could actually take this and be like, like I actually think with some of these, what we're gonna find is there there's a few autoantibodies that are either either causal or really demarcating exactly the path that's causing that person to get get Parkinson's or whatever. If there's a way to use this to prevent or treat or delay getting a disease, we need to do it ASAP, right? Yeah. Those are a lot of the conversations I'm having now that let's say, like in the case of something like Parkinson's, if we know that this is a this that the loss of function of this gene causes Parkinson's, you know, and it it it is if it's an auto antibody that's the like doing this, right? I've already had conversations with like, oh, well, you can put things in the place to maybe prevent that autoantibody from from engaging to create loss of function. Like there's things like that that you could potentially do that could be a really low-hanging fruit way to like you know get rid of disease. And so like those are now like where I'm really like, oh my gosh, I've gotta Yeah.

Dr. Mark Su 47:02

So sorry, go ahead.

Dr. Jessica Lasky-Su 47:03

Yeah, yeah, yeah. No, it's just it's it's a it really sort of like compels me to action.

Molecular Mimicry And Herpes Viruses

Dr. Mark Su 47:07

Yeah. So where where my mind goes then is I'm sure there's many people listening to this thinking, okay, so what are the causes of that autoimmunity? Right. And so you're not speaking to that. That's research is okay, one step at a time, and we gotta right. So and it's multivariable as to which antibodies we're talking about, which kind of symptoms and conditions that might correlate, et cetera, right? But you started talking about the viral piece. So is is am I are there connections there to be drawn, or are you did you shift from the virus topic to autoimmunity more broadly, just that there's a bunch of antibodies that create autoimmunity and we just that's that that to be determined what the other connections are.

Dr. Jessica Lasky-Su 47:39

Yeah, I know that's so right that you made that, you asked that question because that is fundamentally the link. The very first thing I did, and when we literally just submitted this paper, is to look at and characterize the relationship between viral infections and autoantibodies. And for this first paper, we just looked at five herpes simplex viruses. So herpes simplex one and two, which are the mouth one and sexually transmitted, then Epstein Barr, which is mono, CMV, which is another adverse one, chicken pox, CM.

Dr. Mark Su 48:10

Yeah, so for in case some people don't know, I say this to patients all the time, but I think you can tell me if you know differently. I think we have known what is it 30, low 30s number of herpes viruses?

Dr. Jessica Lasky-Su 48:19

Yeah, and it depends how you define them in the running rings. But yeah, yeah.

Dr. Mark Su 48:22

Yeah, so sometimes you can mix, let's call it 30 plus. Okay, but I and I think commercially we have testing available for nine, one through nine, but we all have these, and some people don't know this, and you've already said this once or twice, so I'm just gonna spell it out more clearly. These herpes viruses don't leave the body well, and maybe arguably maybe they don't. Maybe you can edit that for me. But herpes one, as you said, typically mouth sores, like who doesn't have that? All right. I mean, we data that I know about from residency training 20 plus years ago, 25 years ago, with 60 plus percent of America who's never had a cold sore actually has antibodies to cold sores. They could start having cold sores anytime in their life. Type two is traditionally stereotypically the genital sores. Type three is chicken. Chicken pox is herpes virus number three. And then mono is herpes virus number four. You mentioned CMV, cytomegalavirus is herpes number five, herpes number six is um slap cheek syndrome that we all get, most every kid gets in their lifetime as it's like it's almost never that an adult doesn't have antibodies to hyper herpes number six. And then there's a cancer called kapaces sarcoma that is associated with herpes number either, I think it might be eight. I can't remember. But anyway, so I don't mean to digress, apologize, just a little background for our listeners. So keep going.

Dr. Jessica Lasky-Su 49:28

Yeah. And so, and so actually in the list that you just said, sort of the ones that we put at were a primary group of like, I think eight or nine herpes viruses. And so our whole goal was just to say how are these related to all these autoantibodies, right?

Dr. Mark Su 49:40

Because Did you already have a suspicion or are you that's like random look at the drawing?

Dr. Jessica Lasky-Su 49:44

I don't want to have a suspicion.

Dr. Mark Su 49:45

Okay.

Dr. Jessica Lasky-Su 49:45

And and so in that, you know, and then and then how are those related to disease as a broad thing? Now, I will say there's a way that we sort of limited this a little bit, but the there's a few general things they'll say. Number one, the association of these herpes viruses to a lot of autoantibodies is very, very clear. And it's it's not like really the number that we sort of attribute is like such an underestimate to what is actually there. And the the mechanism of how this happens is sort of like what I said. I think, you know, and and there's this is all emerging, and we will know more as we go along. But, you know, your body's trying to create an antibody to the herpes virus, and accidentally it creates an antibody to yourself, something yourself that has a very similar structure. And that's one of the ways we can sort of tell is that the structure is similar. So we found like, okay, here's an autoantibody, and it's like really strongly associated with herpes simplex one, let's say. And then when we look at the structure, we see oh, the structure is actually really similar. It makes sense that your body would accidentally make an antibody to this rather than herpes viruses. And that concept is called molecular mimicry, how that happens. And so, like, we we actually it's shown like the amount of times this happens is way more than what we've realized. And um, so many of the autoantibodies aren't even characterized, right, in terms of then how they affect disease. So that's sort of the critical link here of how you can go from one.

Dr. Mark Su 51:09

If I hear you're right. So just backing up here, you're saying you started by saying, okay, so we've got all these autoimmune markers that we're looking at, and the data is um beyond mind-blowing. And then backing up further, it appears that a meaningful, some meaningful number of these auto antibodies. Again, there's you're looking at you said 20,000 to 100%.

Dr. Jessica Lasky-Su 51:27

Yeah, yeah. 20,000, yeah, distinctly.

Dr. Mark Su 51:30

There's some number, whatever that number is. It could be only 50, but whatever. I mean, that could be very meaningful that you've got that they seem to be a sequelae of sick consequences of, or maybe not even that strongly, just they they are strongly associated with, correlated with viral infections.

Dr. Jessica Lasky-Su 51:46

Right.

Dr. Mark Su 51:46

As a root cause of that, those autoimmune markers.

Dr. Jessica Lasky-Su 51:49

Right. Exactly. Yeah. And so, you know, and I again I'll say there's a lot more to learn here and understand and to really prove. But, you know, I said viral infections, but what I would actually expand it to in terms of my interest and what really needs to be looked at is the scope of pathogens. And I'm just gonna leave it that broadly because, you know, viral infections, bad bacterial infections, which you could even have in your gut, right? Uh to, you know, so many other things that are infections that your body would have some type of response to is is sort of part of this. And I mean, I can even get onto the broader question of environmental exposures. Like I don't know how that would work, and that's like a different, a completely different area, but it does beg the question, right, about a lot of these things.

What Can We Do Now

Dr. Mark Su 52:34

And yeah, so you're in totality, because you've done work in this arena, especially in the aging stuff I've seen, where you're talking about the exposome, right? Our our general exposures in life, which, you know, in blue zone by definition, or a observation correlation, there's lesser exposures than living in you know, far LA County where there's been forest fires around you and then you're all over pollution, smog, explosion, blah, blah, blah, blah. But we're all, it's unescapable that we have more and more environmental exposures as human species live longer and makes more artificial things, right? And so you're saying, okay, you got the bug world, which viruses, fungus, bacteria, parasites, and they all got subclasses and all this other stuff, and maybe amoebas and other stuff, right? All those bugs could cause, possibly could cause immune reactivity, autoimmunity specifically. And then you're saying, hey, that that very well may be the case with a bunch of toxins too. We just don't know right now.

Dr. Jessica Lasky-Su 53:23

Right. I think is what you're saying. Yeah, that's exactly right. And and I will say, like, yeah, exposome is good, could be uh another entire podcast because that's another super interesting area with I think a ton of things to learn and to research in that world. A ton, a ton, ton, ton. Right. Um, and um, you know, but it, you know, when you, you know, you're seeing all these things and um, you know, the interconnections I think are are really important in terms of getting that, you know, prevention or delay or like how, you know, are there ways you can measure like your exposures, like, you know, and can you do anything about it? I think those are really important questions, you know, that we all face and want to know the answer to. And research is getting there, but there's, you know, um, it's it that that's probably the most fun part. Like you and I always talk about this. What we do, we both love so much. I think one of the fun things is like when there are questions you really want to answer, and maybe it's even for yourself, because you're like, I just want to know if this is affecting this, that it's fun to actually be in the research and be able to do that and answer questions. And then then when it turns out like, oh my gosh, this could actually be like a huge thing, it's even more exciting.

Dr. Mark Su 54:29

Yeah. So if I were to, um, you know, and I think we'll probably just land on this and maybe one last more personal question, because, you know, just uh this has kind of carried us through just time-wise here. Um, but you know, I'm thinking, okay, if I'm a, you know, if I'm a just a public, late public listener to this this conversation right now, or especially if I have a little more awareness of sort of functional medicine practices, concepts, et cetera, or I'm a practitioner who, okay, what is an action point I can take right now, right? So we may not know. You may uh you've already alluded to we we may not, we don't know yet the number of root cause initiations, provocators of that autoimmunity. Okay. So you're looking at like some kind of mechanism that's part of that sequence of events. I know that in in the functional medicine world as practitioners and patients, where everyone starts thinking about is gut health, number one. All right. I mean, maybe if it's not number one, it's near number one in everybody's mind. And then the next thing we're thinking about is um just things that we can do on our own in terms of cleaner eating, sure, exercise, sleep, et cetera. But a lot of it we're thinking about like food reactivity, because we've in the functional medicine world, we have a lot of awareness either in um you know data and or uh anecdotally and the combinations, that a lot of that uh uh reactivity, that sort of molecular mimicry, et cetera, occurs with food, especially sort of GMO foods, et cetera, et cetera. So in terms of action points now, because then if we think about the viruses, I already just said, like, who doesn't have HHV6 as a kid? Who doesn't get who doesn't have HSV1, right? So that gets a little um fatalistic, thinking, well, this is literally completely unavoidable. And if those viruses never leave my body, then I'm doomed, right? And so this is where you and I had a brief conversation before where for me as a practitioner, I'm thinking, okay, look, I've become more convicted now about uh giving people antiviral therapy. I don't know if that's necessarily going to do the job, but that's one avenue. So I don't care if it's pharma, non-pharma. And then another option is how do we keep improving your immune system, specifically in the T helper cell one category, no other details here, to improve your immune system so that you can keep fighting off and sort of compartmentalizing and keeping in check those viruses. Okay. And so because we're not going to avoid every parent kisses their kid. Well, it should be likely. So if every parent's got T you know HSV1, then how is it their kid's not going to? I don't know if that's a stoppable cycle. So not to get failistic on the viruses, again, going to the cigar, what is an action point for us now? And again, that can be another thing for exposums and all that stuff, uh, you know, just a general whole. But um, we don't know that data right now, but it certainly could be a call to action to say, hey, the things that we can control or influence with lifestyle factors and then other pieces as guided by a practitioner. That's how I think about things through the viral world, those are things we can we can do what we can do. Is that a fair statement? Or do you have other thoughts right now for the lay listener, the any practitioner or patient?

Dr. Jessica Lasky-Su 57:13

That's a good question because I'd say, you know, it's interesting because this is a question you always ask me. And there's so many areas of what I'm doing research in where my answer to this question, because you've always asked me, is like, oh, I know the next step because you've asked me, and now is that this is what we want to do. The interesting thing about this is because it's just sort of emerging. I'm just sort of like, you know, looking at this for the first time, the questions I'm really focused on answering is are there broad major ways we can prevent this from like a novel disc drug discovery? So because of that, I have looked less on the level of like, okay, you have this, what can you do? But I I will say that I think there are a few things. And I mean, I the the clear one is anything that is going to be optimizing the immune system, certainly like making sure you have high levels of things like vitamin D, you know, or things that are gonna be pro-immune are I think the logical low-hanging fruit things that I would be I would be doing. You know, I mean, I can say healthcare, wellness, this and that, mind what you're putting in your body, that all these things are gonna help, right?

Dr. Mark Su 58:13

Do you ever come across research on vitamin C or no?

Dr. Jessica Lasky-Su 58:16

You know what? I haven't done as much, to be honest.

Purpose, Impact, And Legacy

Dr. Mark Su 58:18

Sure. But I get that question a lot, you know. And so anyway, curious.

Dr. Jessica Lasky-Su 58:22

Yeah, and uh in a lot of the other research I doing, we we definitely see a lot of different vitamins come into, you know, that we we see pop up for sure in how we're measuring things and like some of the other research I'm doing with blood.

Dr. Mark Su 58:34

But impact on immune system specifically?

Dr. Jessica Lasky-Su 58:36

But I mean I would say for this, it's optimizing the immune system. The challenge here though is everything is interrelated, right?

Dr. Mark Su 58:42

Yeah, yeah.

Dr. Jessica Lasky-Su 58:43

You want to hit, like when you're seeing this, right? Okay, this may be the disease you're trying to prevent, and there's all sorts of things going together. You want to like target the big hub that's the biggest thing leading to that disease. That's what I think.

Dr. Mark Su 58:55

The one's making the biggest impact and contributing to the problem.

Dr. Jessica Lasky-Su 58:58

Right. And what I what I think is like even with some of the auto antibody thing, one of some of the biggest hubs may be these auto antibodies that we've never been targeting. We've been trying to target all the offshoots. Well, if you're not targeting the main thing, you're not gonna do as much. So, but in the same note, in the absence of knowing how to target that main thing, what are ways we can disentangle it to make it so this is m weaker? And that's how I think of it, right? Let's remove all the little connections. And that is all through care of yourself, self-care, doing all those things to optimize immunity. So that's where I am right now with that.

Dr. Mark Su 59:31

But back to the epigenetics and and uh what happens beyond your genetics.

Dr. Jessica Lasky-Su 59:36

Exactly. But um, you know, I'm hoping in a year I'll have different questions, different answers to that question.

Dr. Mark Su 59:41

No, and I and I I didn't hear you say, and I we won't go into it for for the sake of for multiple reasons. But you know, interestingly, I think right now, and I'll land here and finish with this, that I'm talking about, I'm asking the question essentially how do we sort of prevent initiation of or progression, early stage progression of autoimmunity, right? Like if you can't avoid the viruses effectively and look, we live in a toxic world progressively, yeah. Like, what are you gonna do about that? Okay, hey, we can control other factors that in the big mess of um entanglement, as you just said, I love that word, um, can all cumulatively in principle lead to progression of autoimmunity, ging, inflammation. It doesn't matter if you have symptoms or you don't, it's all the same, whether it's chronic illness and inflammation or chronic inflammation leading to inflammation and aging. But on the flip side, the way I think the way pharma works, because I've said you know, dad, my dad was was a researcher in the drug world, right? And so the way they think and the way you know a lot of research works is okay, we may not if we're trying to, if we identified a hundred causes, root causes and provoke provocations of this one condition, how are we gonna standardize that? How are we gonna take action to intervene with a hundred different root causes? And even if you narrowed it down to, okay, these 10 are the bigger causes out of the hundred, the other 90 are smaller, you know, efforts, we're gonna focus on those 10. But holy crap, like working on 10 root causes is not easy. But if you find an intervention that says, hey, all a hundred of those, or 80 out of those hundred, including nine out of those 10 big lifters, end up funneling through this end common denominator process. And we can affect that end process by this drug repurposed or this way or that way, new, repurposed, whatever. That's the big winner on a standardized population level.

Dr. Jessica Lasky-Su 1:01:21

That's right.

Dr. Mark Su 1:01:22

That's the way that we're gonna affect change faster because good luck hurting cats to affect all those 10 or 90 some topics. Let's just get the common denominator. And that's where, previewing briefly, like you're doing some research on that with the autoimmunity work where there's some meaningful hope. So my point is just to bring hope, that there's some meaningful hope you guys are working on to say we think we have something that we can work on that's a common denominator with autoimmunity as a whole that could impact a lot of these biomarkers, symptoms, conditions, et cetera, that arise from all these different various root causes. But until then, what we can do to take care of ourselves, mentally, emotionally, spiritually, our lifestyle factors, cleaner eating, society, blah, blah, blah. Those are all things we can still advocate for for sure.

Dr. Jessica Lasky-Su 1:02:01

Right. Exactly.

Dr. Mark Su 1:02:02

Fair to say?

Dr. Jessica Lasky-Su 1:02:02

Fair to say, fair to say.

Dr. Mark Su 1:02:04

Okay. So uh really strong pivot, but last question, and you can make it as brief as you'd like. Uh so you know, I wanted to, you know, I threw out this question to you, and you liked the question, so let's let's go with it. With everything you just described, right? And I mean, that's uh this has been really fulfilling for me. Um quite, yeah. We we we have some fun little passing conversations here and there, but uh yeah, this is this is a different experience, and um, I've just really enjoyed that. So thanks on multiple levels. But with everything you just described that is really hopeful and inspiring and uh fueling for you personally, what do you and I haven't asked, you've never I've never asked you this outright, you haven't responded, so this is all raw. What kind of legacy, you know, I'm we're I'm 51, you're 50, right? Mid life. What kind of legacy do you want to leave in this world in your life when it comes to your professional body of work?

Dr. Jessica Lasky-Su 1:02:51

Yeah. And I it's it's interesting that you mentioned asked that because I think if you asked me this even like three or four years ago, right, I don't think I would have had this as concretely uh I wouldn't have been able to answer this as concretely. But I think also something about turning 50 right gives you a different perspective. And it really has put me in a different framework of like, okay, there's a lot of stuff I'm doing. There's a lot of things we're finding out. But like ultimately for me, at the end of the day, I want to have an impact on people's lives. And how can I do that the most? And it really has given me great motivation and impetus to take like things we're doing and really push them toward helping people and preventing disease in a way that I hadn't before. And a lot of that is engagement with okay, like, is this a treatment? Could this be a treatment? Let's push it forward forward. Let's really be much more proactive about taking things we're finding and following up to see if there's a treatment or a way that we could actually impact people's lives and prevent things. And so my engagement with people at different levels of being able to have that happen is just really skyrocketed in the last like six months, even because I feel like I don't want to, you know, if my research is just about me publishing papers, like what am I doing? Right. Like that is no, that is no real impact. That's not like, you know, ultimately, well, I like to say, oh, I'm super altruistic all the all the time. That's totally not true. But when it comes to this, I realize a big motivation is like really wanting to impact people and prevent diseases. And wow, wouldn't that be amazing? And so I think that's really where my focus has been is pushing things to like really see if we can develop new treatments or preventions and this and that.

Dr. Mark Su 1:04:40

Yeah. No, that's beautiful. Um that's beautiful because I think you we would agree, uh, you would know better than I, but in the research world, it's you know, you gotta publish to keep your job, right? You you have to have papers, you have to you have to write grants, you have to have funding. So this sort of nut that this world's chasing there is largely grant money, and that stems from publications and producing, right? But um, when you have the opportunity to have more space and be advanced enough in your career, et cetera, and have the opportunities that you're encountering now to anticipate or uh have hope for or see the more conversion impact directly into lives, people on an emotional level, it's uh I would imagine that's a game changer on how you operate and certainly at least in your mindset in your sort of missional calling and how you operate just internally within yourself on a week to week basis.

Dr. Jessica Lasky-Su 1:05:29

For sure. For sure.

Dr. Mark Su 1:05:30

That's a great um full circle. Yes, I think we'll not to be overly abrupt here, but I think um I think we'll call it a day here.

Dr. Jessica Lasky-Su 1:05:36

Sounds good.

Dr. Mark Su 1:05:36

We've got a lot more fodder if we can ever uh if we can uh when we it'll take some effort as usual, but we'll perhaps we'll carve some time and uh revisit some other questions that we already alluded to in this one and you know we've thought out as other possible topics for for future episodes. But thanks again. Again, you know, I I really appreciate you, not just professionally with all the stuff we talked about here. I've said it before, but I'll say it again here. As the kids like to say, I I glaze on you. Like all the time with patience, this the street cred and the um the kudos and honor that um you you you kid you know I I tell people this all the time. I say it again right now to you, I tell people all the time, you are busier than I am. Legitimately, you are busier than I am. And I will say here like you pulled a freaking all-nighter for work on the eve of your 50th birthday a few months ago.

Dr. Jessica Lasky-Su 1:06:21

Yeah, that's crazy.

Dr. Mark Su 1:06:22

Right? You pulled an all-nighter for a grant in the context of all the kind of chaos that's been going on recently with all the research world and all that stuff. You pulled an all-nighter on your the eve of your 50th birthday. I mean, and the number when we did that Zoom celebration with all your like past colleagues and friends and all these all these folks, the message was very clear. Everybody, all these people, especially in your workplace, were just like, you take care so much care of us, you look out for us. We just so appreciate you. It's all heartfelt. We, you know, we just want you to take care of yourself. We we've I heard it over and over, like you, you are a equally a a human and person, a relatable person, not just a boss or a person who's providing the support, financial support structure and work projects and bringing in the uh you know the projects for us to work on. Like it's it's so it's just a uh encouragement right now because um you you I know you you spin a hundred miles a minute and you you do bring a lot to the world. I I do hope and pray for you individually that you see the fruits of your labor, whatever that looks like, doesn't have to be prejudged or whatever you might visit that to be. I just hope and trust that you will experience beyond personal fulfillment um some fruits of your labor in this lifetime. I know you will. I hope it I hope you appreciate it.

Dr. Jessica Lasky-Su 1:07:33

Yeah, I do. And thank you. I that beats that beats a lot. You know it does.

Dr. Mark Su 1:07:37

I really, I really so um yeah, for those listening, um again, this is um we'll have others, uh we'll do some others with um Dr. Jessica and other practitioners as well, uh colleagues, sometimes in the practitioner world, sometimes not. But again, um we're here. Uh this is an insight into the research world, how functional medicine practitioners think about applying some of that research in in certain ways, at least in this conversation. Hopefully we provided some not just some insights for curiosity's sake, but some um some take-home messages as well as hope. And uh again, for those of you who, if you if you've never ventured into the functional medicine world and you're dealing with problems that you feel you're not getting help with, you're not feeling heard, you're not feeling listened to, you're not making progress with, if it's if the shoe fits and we can be of service to you, it is our honor and privilege. You can find us at rootseekhealth.com as a uh virtual practice across the country. And if you are working with somebody and we don't ever want to create conflicts, certainly we encourage you to make progress with who you work with. But if you're needing a second opinion or even just as a one off, or you uh just have curiosities, you can reach us through that same website at rootseekhealth.com. Until next time, um thanks Jessica, and um we'll talk to the rest of you on the next podcast.