Jefferson Investigates: Small RNAs and Tuberculosis; How ALS Develops; Stigma of Hepatitis B

How Stigma Affects Asian Americans Living with Hepatitis B 

Asian Americans comprise just 6% of the U.S. population, but they represent over 60% of Americans with hepatitis B. Hepatitis B (HBV) is a virus that infects the liver, and while some people may recover from the infection, others can go on to develop liver failure or cancer. HBV is transmitted through blood, semen or other bodily fluids, but it can also be passed from mother to child during birth, which is how the majority of Asian Americans acquire the disease.

Up until 2010, laws in China allowed for discrimination against people with HBV, barring adults from employment and keeping children out of school. Though these policies are now outlawed, there remains a stigma against the disease in both China and the U.S.

Researcher Hee-Soon Juon, MSN, PhD at Thomas Jefferson University has been working with Asian-American communities to investigate and raise awareness of HBV since the early 2000’s. In a new study published in The Journal of Viral Hepatitis, she explores how stigma against HBV affects those with the condition.

The study surveyed 365 Korean-Americans with chronic hepatitis B (CHB) to see how stigma against HBV affected them. Participants responded to questions about their physical health, mental health and if they believed they had experienced racial discrimination.

Dr. Juon found that people who felt more stigmatized were more likely to report worse depression and physical health, and that greater knowledge of the disease didn’t necessarily translate to feeling less judged for their condition. Perceived racial discrimination was also tied to feelings of stigma and depression.

“We confirmed that stigma is very impactful for a CHB patient,” says Dr. Juon. “This can have consequences on their treatment journey.”

In fact, past research has shown that stigma against a disease may dissuade individuals from seeking care, cause mental distress or lead to explicit discrimination. Dr. Juon says the next steps in this research will be developing interventions that can help combat stigma for those with HBV.

By Marilyn Perkins

Small RNAs Boost Immune Response to Tuberculosis 

Tuberculosis kills about 1.3 million people each year, making it one of the most lethal infectious diseases in the world. Now, molecular biologist Yohei Kirino, PhD and his research team at Thomas Jefferson University has found that certain RNA molecules in people with tuberculosis are drastically different than those in healthy people. The findings, published in the journal Molecular Therapy Nucleic Acids, reveal a potential pathway to bolster the immune system against infection.

Small RNA molecules known as short noncoding RNAs show up in the body in response to an infection. Sequencing RNA from a blood sample is one way to find out what kind and how much of different RNA molecules are present. “However, our previous research showed that there are abundant amounts of short noncoding RNAs in infected cells that standard RNA sequencing is not catching,” says Dr. Kirino.

In a study spearheaded by PhD student Justin Gumas, the researchers modified the typical way to sequence RNA. Standard sequencing methods rely on two chemical features on the ends of RNA molecules that many short noncoding RNAs do not have. So, the researchers first treated the samples with an enzyme that equipped every RNA molecule with these features. They were then able to sequence all of the short noncoding RNAs in people with tuberculosis and compare them with those in healthy people.

The team found many short noncoding RNAs that had not been sequenced before and many that activate the immune system. The findings not only reveal how small noncoding RNAs drive the immune system to respond to infection like tuberculosis, but also provide a pool of potential therapeutic targets and biomarkers for estimating the severity of the immune response.

“During an infection, we think these small noncoding RNAs work as an immune booster,” says Dr. Kirino. “We believe there is an RNA pathway in the body that kick starts the immune response to tuberculosis infection.”

By Roni Dengler