September 11, 2025 • 35 mins
Victoria Voos was in college when her psoriasis “went full rampage,” setting off a cascade of diagnoses—from psoriatic arthritis to insulin resistance—that could have been overwhelming. Instead, she built online communities, mastered the art of the clap back, and became a fierce advocate for herself and others. In this episode, she shares how clinical trials gave her both hope and hard data, the boundaries that keep her online space safe, and why humor is one of her best defenses. Plus, the surprising story of the science behind monoclonal antibodies—and how they’re changing treatment for psoriasis.
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Episode Transcript
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Speaker 1 (00:03):
Rube. I'm Holly Fry and this is season two of
Our Skin, a personal discovery podcast. Today we are honored
to welcome Victoria Vus to Our Skin. Victoria is a travel,
fashion and beauty influencer whose journey with siasis and the
(00:26):
multiple diagnoses that followed transformed not just her skin, but
her entire relationship to her body and health. It all
began in college, when a sudden flare revealed itself as soriasis.
Then came soriatic arthritis, then insulin resistance. The avalanche of
diagnoses could have been overwhelming, and often surely was, but
(00:51):
over time Victoria began to rebuild. She found a research
institute where a doctor listened, She found and starved online
communities that reminded her she was not alone, and she
began sharing her story one post at a time. Today,
she talks openly about stigma, flares, medical self advocacy, and
(01:13):
what it means to care for yourself in a body
that doesn't always cooperate. We are really grateful to anyone
who turns a challenge into an opportunity for advocacy, so
we are remarkably delighted to have Victoria here today. Welcome
to our skin. Thank you so much for having me.
I love that intro. Can you like intro me to
(01:34):
any room or party that I go? I loved that. Happily,
I'll just follow you around with a microphone. It will
be awkward at all. So, Victoria, it sounds like college,
which is such a tumultuous time for a lot of people,
was the starting point of this leg of your journey.
And you have said in interviews, and I love this
(01:56):
phrasing that that is when your psoriasis went fullage. Tell
me about that time in your life and how this
all unfolded for you.
Speaker 2 (02:05):
Yeah, it's definitely evident looking back now that stress is
my trigger and that has proven time and time again,
which is awful, right because I'm already stressed out and
then my skin flares and now I'm even more stressed out.
But that has been my pattern, and so that was
I guess the first really stressful time in my life
that it presented in a way that was so terribly painful.
(02:27):
And actually what brought me into the doctor's office was
this little bump on the top of my foot that
was really painful to walk on, and I was told
it was soriatic arthritis, and it was like, okay, so
that's actually connected to what's going on with my skin.
It was coming down on my forehead a little bit,
so it was in my hairline and not too much
to worry about. But then it just kind of crept
(02:47):
down on my face. I will say, there's a stigma.
People would see something on your face and have negative
reactions to it, which is really hard. So not only
was it that internal pain I was dealing with, but
now it was literally on my face.
Speaker 1 (03:02):
Nothing like being self conscious at a time in your
life when you're already trying to figure your stuff out.
It was a lot all at once. Oh my gosh.
I can't even imagine. Because you were diagnosed with psoriasis
and then your other diagnoses as I mentioned, soon followed,
so you got the soriotic arthritis, but then also insulin resistance.
(03:23):
This had to have felt like the universe was just
piling on you. How did you navigate all of this
and how quickly as this was happening to you did
you turn to online communities?
Speaker 2 (03:34):
You know? It was tough because not only was it
those two things, it was also syss on my ovaries,
oh my lord. And then trying to treat the psoriasis,
I got peptic ulcers, and then also I guess I
was not drinking enough. I got kidney stones. So my
solution I dropped out of college. I mean, no one
(03:55):
can fault you. That's a lot to deal with. It
was a lot, and at that time I had gone
to university a little bit away from home, whereas the
first couple of years I was doing community college in
the same town with my dad. And so it was
all too much. All of that medical stuff and a
lot of non answers, a lot of doctors saying we
can't find anything wrong with you, which a lot of
us with insulin resistance pcos we hear that, and so
(04:18):
that was so frustrating. Plus on top of it, the
peptic ulcers and the inflammation. It was a lot. So yeah,
I started my life over again. I called my mom complained.
She was in San Diego. She said, I'm gonna get
you a one way trip, come on out here, and
I said, let's do it. And like I've been in
San Diego since, it was the best decision. And that's
when I started not only seeking out an online community,
(04:40):
but also going to that clinical research place.
Speaker 1 (04:43):
When you're seeking out an online community and you are
in a situation like yours, how do you even start, Like,
you can't just type into a search bar psoriasis, soriatic arthritis, pcos.
How do you find the right place for you? I
feel like I curated that, and I started with my interest,
which I guess was like fashion, something cute and fun.
(05:04):
And then I was like, you know what, I want
to get a little more real and talk about my skin.
And it's not like something I can totally hide anyway,
so let's just talk about it and I can complain
and other people can complain to me. And so then
it just became Oh, I actually really like being super
transparent and honest with my community. And it also leads
to a lot of people reaching out to me, enjoying
(05:24):
the fact that they have a place to you know,
bitch and moan if I'm allowed to swear.
Speaker 2 (05:28):
So it's a comfortable place to express myself. An in turn,
I get to connect with other people who are going
through the same things, and I can share also things
that have worked for me. They can share things that
have worked for them, and we can figure it out together,
especially with doctors. Maybe not always listening to us. We
at least have other people who are in the trenches
and will listen.
Speaker 1 (05:48):
Yeah, I'm glad you mentioned your doctors because I imagine finding
a treatment plan when you have all of these stacked
medical diagnoses going on is a little bit tricky. You
probably have a lot of different specialists in the mix,
hopefully communicating with one another, but I'm sure you also
have to self advocate a lot to make sure all
(06:10):
of those people are genuinely on the same page.
Speaker 2 (06:13):
Yeah, especially because sometimes I'll get conflicting information. I went
to a rheumatologist who said nothing was wrong, and then
talking to a dermatologist They're like, no, you do have
soriatic arthritis. So I'm like, I don't know who to
listen to. I know there's pain, I don't know what
it is, but also I was on medication for the
pain and it gave me another problem, so please someone
help me out. And sometimes it looks like going to
(06:34):
other specialists if they say nothing's wrong, you know in
your body, And that's listening to yourself, advocating for yourself
and moving on to someone who will listen, which might
be hard but totally worth it. And you mentioned that
your mom had found this research institute that was working
on some psiriasis trials and that you got involved there.
One of the things that you have mentioned is that
(06:57):
you have a doctor there that is invested in you,
you and your health. I feel like when you say that,
so many people are gonna be like, what is that? Like?
Speaker 1 (07:07):
What do you wish more doctors did that support their patients?
What are you getting from this person that you wish
every other medical professional would understand?
Speaker 2 (07:16):
I think it's validating your feelings. You're not crazy for
feeling self conscious or the pain that you're feeling. Like
sometimes that is more than you can get at a
lot of doctors where you tell them you have a
pain and that they actually listen to you. So, you know,
you would think that that's basic stuff, but you know
that was new going to this clinical institute and their
(07:39):
whole point is to research and understand, and they want
you to be as comfortable as possible during that process.
You're also getting blood work done and all this stuff.
I think the biggest weight off my shoulders was I
wasn't trying super expensive treatments and paying a lot of
money and it not working. I was actually being paid
to try different things that were still saying with one
(08:01):
on one help from a dermatologist, and if they didn't work, well,
at least I tried something, and I can try another thing.
Speaker 1 (08:09):
Right at that point, you may not be getting help
for your problem, but you are getting data about what
doesn't work, which is also important. One of the things
that we returned to a lot on the show, and
which you hinted at earlier, is that chronic illnesses that
are visible on your skin are this whole other level
of challenge because of the way other people react. If
(08:31):
I have my info correctly, you were once asked if
you had a chicken pox when you were actually having
a flare up. And I know that some people, particularly
in the psoriasis community that have really become advocates, they'll
view this as like a teachable moment for people that
are maybe being a little nosy Nancy. But others find
it a little bit harder to respond. And I'm curious
(08:53):
where you fall on that spectrum, like what your go
to behavior is for dealing with those moments.
Speaker 2 (09:00):
Well, I definitely love a clapback. I think that's my
go to for being online. Is a little bit spicy,
a little bit sassy, and I used humor with that woman.
My psoriasis is genetic, and so I was like, no,
it's psoriasis unless you and I are related, you're fine.
Like so I like qualmed her, like her issue with
maybe concern that she might get it. I'm like, no,
(09:21):
you're fine unless somehow you're in my family tree. This
isn't any of your concern. And I also remember I
was going to get my hair done and the lady
was washing my hair. She told me I had dan druff.
I'm like, no, it's zoriasis, and she's like, no, it's dandruff.
And I'm like, my dermatologist would disagree with you. So
it's like, I don't know why you're fighting me about
my own chronic illness. But okay, but yeah. My favorite
(09:45):
is the clapbacks online. I think it helps add some
comedic relief while also advocating at the same time, and
then not too mean about it.
Speaker 1 (09:53):
I promise I'm glad you mentioned online because you have
an online community that is really invested in your health
journey right along with you. You know, they are there
for you when medication doesn't pan out or when a
flare happens. What strength do you draw just on the
daily from them being on this path with you. That's
(10:15):
a good question.
Speaker 2 (10:16):
I think. I think I understand that it empowers other
people and it makes them feel good along with me,
And so I like that I can have that impact
and those clapbacks because we all Unfortunately, if you're in
the online space, it's like a plus sized person, you're
probably getting negative comments. It's unfortunate. That's just the way
(10:39):
the space works. Yeah, and no matter what it's about,
if it's my body, my skin, what have you. I
really find it empowering for me, and I think for
other people to kind of see other people put in
their place who are bullies and kind of level that
out a little bit. Even the scales there.
Speaker 1 (10:56):
Yeah, I imagine it also makes those people, even if
they did not intend to be a bully, realize though
that what they're doing is kind of inserting themselves in
other people's lives. I hope they learn something that would
be great. I'm curious because, especially since you talk about
loving a good clap back, what would you like people
(11:17):
to know when they happen upon your profile and they
click follow and it is obviously someone who is being
very transparent and sharing about their chronic illness. What are
the dos and don'ts for you of online behavior when
becoming a follower of someone like yourself.
Speaker 2 (11:33):
I definitely have boundaries, one being I don't share my weight,
but I'll share pretty much all the other stuff. Some
of that is for my own mental health, and also
as an audience member, I am not necessarily a fan
of that information. So I do try and keep a
safe space for myself and for my audience, and I
think they really appreciate it because they know there's certain
(11:57):
information they can avoid by coming to my little corner
of the internet. And I would say just respecting those boundaries,
and even if someone asked me, hey, what's your weight,
I would just tell them, oh, I'm not tracking that,
Like questions are fine, or they're like, hey, you usually
don't talk about your weight, but you just posted something,
you know xyz. And it also gives me an opportunity
to be like, well, you're right, I'm not talking about
my own weight, but I thought this was a great
(12:17):
resource for other people. And so then they're like, oh, okay,
thank you so much for letting me know. So I
think it's a really good exchange of information, So for
the most part, there's not much that'll get to me.
And if you're spicy, I'll be spicy back. I like
them how.
Speaker 1 (12:31):
You're also an educator in your heart. I think I
am curious to know how your relationship with your skin
has changed over time, because, of course there are probably
moments even when you are fully empowered, of being self conscious.
But it also sounds like there's an element to the
way you manage your life where you do not take
your skin or your health overall for granted, and that
(12:55):
is a very positive space to be in. So where
are you at with.
Speaker 2 (12:58):
All of that? My skin is pretty darn great right now.
It's not perfect, but it is much much better, and
I feel like, even though it's not perfect and I
definitely still have, you know, some self conscious things, I
am so much more grateful that I'm not in that
huge flare I was in. It was really tough and
really hard on my mental health. So grateful where I'm
(13:20):
at where my skin is now, even though it's not perfect.
But also presenting myself online, it's kind of like, how
could you hurt me if I just present myself as
real and even talk about how I feel about myself.
It's like you're saying all the things I've already said
to myself. There's really nothing you could do to hurt me.
So and at the end of the day, soriasis is
extra skin, so I guess you could say my skin's
(13:41):
just real thick.
Speaker 1 (13:43):
You know what I mean, speaking of putting yourself out there.
Speaker 2 (13:48):
One.
Speaker 1 (13:48):
You're a newlywed. Congratulations, thank you. And your wedding was
in the New York Times last year, which is incredibly cool.
You look so beautiful for our listeners that don't know,
Victoria has this spectacular head of just the most gorgeous
red hair you've ever seen, and you looked like a
Woodland fairy princess. It was so beautiful. But I'm really
curious what wedding planning was like, because that is a
(14:11):
time that also adds stress and self consciousness to people's lives.
Did you do anything differently to take care of yourself
and your skin and your mental health leading up to
that that maybe is not including the things that other
people have to consider.
Speaker 2 (14:25):
Yeah, So we actually split up our reception and the wedding,
so we had like a cute little wedding just by
the beach with some family, and then six months later
in the summer, when everyone could come to town, we had
our reception. That was definitely a little bit stressful. Thankfully,
I had my husband, my friends, and I actually hired
someone to kind of help me plan the event a
(14:46):
little bit. And I really recommend separating those things out
because I didn't have to worry about my dress, changing
locations and all that. By the time the event was happening,
I was like, this was the way to do it.
This was so much better. And then I was allo like,
we should do this again next year.
Speaker 1 (15:01):
Yeah, Oh so much fun. I imagine that feels more
like a party to you than when you have a
reception right after the wedding and you're still in the
logistics of, Okay, we have to do the pictures and
this person has to be included in this moment, and
that's pretty smart.
Speaker 2 (15:17):
Thank you. Yeah, we got the really nice, fancy photos
done the morning of the wedding, and that's checked off.
This is just a party for all the friends and family,
and so I actually put a lot of energy into
doing like raffles, games and stuff like that. It was Yeah,
we made sure the kids had fun and the adults
had fun, so I think.
Speaker 1 (15:32):
It was great. As our conversation today points out victoria,
Treating psoriasis, even if you were treating just psoriasis without
other factors, is a journey, and our medical community makes
breakthroughs every single day that will hopefully continue to bring
better treatments to people with psoriasis. And after the break
we're going to dive into a major breakthrough, and that
(15:54):
is monoclonal antibodies. I promise it's exciting woo science. In
nineteen seventy five, at the Medical Research Council Laboratory of
(16:15):
Molecular Biology in Cambridge, England, to scientists George Kueller and
Caesar Milstein were conducting what on the surface kind of
looked like a routine experiment. They were working with mouse
immune cells, aiming to understand how the body produces antibodies.
But in the course of their work they created something
(16:35):
entirely new, a method for producing large quantities of identical
antibodies derived from a single immune cell. These monoclonal antibodies
would go on to revolutionized medicine, giving rise to some
of the most precise and powerful treatments in human history. Okay,
so why is this breakthrough. Why are monoclonal antibodies so incredible?
(16:58):
Have great news? The natural world, antibodies are the immune
systems elite reconnaissance and neutralization force. They're these y shaped
proteins that kind of patrol the bloodstream, each one custom
built to recognize and bind to a specific foreign invader
that can be a virus, a bacterium, or a toxin.
And when your body encounters a threat, specialized immune cells
(17:21):
called B cells respond by producing thousands of different antibodies,
each with its own unique molecular fingerprint, creating what scientists
call a polyclonal response victoria. You have been in a
lot of doctor's offices. Do you ever think about your
immune system this way? As kind of like soldiers and
spies in a massive conflict, never quite so granular.
Speaker 2 (17:44):
And if anything, I'm like, my body is the enemy,
so me and my body are at war.
Speaker 1 (17:52):
Polyclonal antibodies are really interesting. They come from many different
B cell clones. So even when all of these B
cells are responding to this same antigen like a virus,
each individual B cell clone produces antibodies that recognize slightly
different parts of that antigen. So you're going to get
a mixture of antibodies. Some might bind to one part
(18:13):
of the virus surface, others to different parts. Some might
bind tightly, others more loosely, et cetera. It's poly because
it comes from multiple clones of B cells. I kind
of love this because it's got a divide and conquer
situation going on, which is probably again similar to the
way that you've had to treat various things in your
(18:34):
own way if the parallels are real. The flip there
is that monoclonal antibodies come from a single B cell
or its clones, and since they all originate from one
parent cell, they're all identical and they all recognize the
exact same target in exactly the same way. It uses
the early stage mono because it comes from one source,
(18:55):
one B cell. Do you see where we're going with this.
We're getting targeted therapies. Yeah.
Speaker 2 (19:01):
Over the ride the autoimmune thing. Huh what she's so bright.
It wasn't just about wedding receptions split up. She's very insightful.
Cueller and Milstein's breakthrough changed everything by providing unlimited quantities
of these identical, predictable antibodies. This consistency opened the door
(19:21):
to reproducible experiments, standardized diagnostic tests, and most importantly, the
development of targeted therapies that could be manufactured at scale.
Although we're going to talk about that in a minute
and see that that part was really quite challenging and difficult.
Have you ever had to deal with the treatment that
I mean, you've mentioned that you would take things that
were hurting some things and helping others. I'm sure you
(19:44):
are well acquainted with the ideas of the negative things
you did not want out of a medication. Yeah. Using
n sets to help with the inflammation, it then caused
the peptic ulcers and that I had both left. I
had peptic ulcers and the inflammation. I'm like, this is fantastic,
Like thanks once again. Parallel to this. So, it actually
took a decade almost for the significance of this discovery
(20:05):
to be fully recognized. And that's because their focus was
in research understanding more about the immune system and how
it works. It's only when the therapeutic possibilities became clear
that Culer and Milstein had stumbled upon something really revolutionary.
So in nineteen eighty four, Culer and Milstein were awarded
the Nobel Prize in physiology or medicine along with an immunologist.
(20:29):
Neil's journ and their technique made it possible to produce
antibodies in the lab that could be tailored to recognize
a single specific target. So, in other words, it gave
scientists a way to build metaphorical molecular missiles. This is
all too pretty recent. It's in the last fifty years.
(20:49):
Did you realize that treatment for a lot of the
things that you're dealing with was happening so recently? LE mean, no,
but it makes sense, and like, yeah, I feel like
psoriasis isn't fully understood. There is a lot of questions
between dermatologists about like where's it from and what actually
triggers it, and so it definitely seems to be still
(21:11):
something that they're trying to wrap their minds around, which
is amazing considering it's not new, no ad it they
were busy doing other things, I guess.
Speaker 1 (21:21):
So. The original monoclonal antibodies produced through Culer and Milstein's
method were derived entirely from mouse proteins. These mouse derived
antibodies could effectively bind to specific human targets in lab settings,
but when they were injected into patients they were often rejected.
The human immune system saw them as foreign, and that
(21:43):
triggered immune reactions that ranged from like a mild allergic
response to complete neutralization of the treatment. And so this
problem actually became known as the HAMMER response, which stands
for human anti mouse antibodies. Patients immune says attacked the
therapeutic antibodies as though they were invaders and rendered them
(22:04):
ineffective and sometimes even dangerous. I feel like this is
a lab version of what you and other people with
chronic conditions deal with all the time. You have already
mentioned that your body is sometimes your enemy, that potential
frustration of your body working against the very treatments that
you are trying to help it with.
Speaker 2 (22:22):
Yeah, or treatments that only work for so long, like
your body just becomes immune to it over time.
Speaker 1 (22:28):
It's so frustrating. There were still so many more steps
ahead for this to actually become a workable and helpful thing,
because the next step in the evolution of monoclonal antibodies
came from another scientist that was working in that same
Cambridge lab, that was doctor Greg Winter. In the nineteen eighties,
Winter pioneered the technique of what's called humanization. That's when
(22:49):
parts of a mouse antibody responsible for recognizing a specific
target were grafted onto a framework that was made from
human antibody proteins, and then this hybrid molecule preserved the
mouse antibody specificity but dramatically reduced the risk of immune rejection.
Science is so cool. Winter's innovation really marked this turning
(23:11):
point because humanized monoclonal antibodies became viable tools for treating disease,
and researchers started exploring their use in everything from cancer
to autoimmune disorders. And although monoclonal antibodies are often associated
today with chronic diseases like psoriasis, rheumatoid arthritis, and various
(23:32):
forms of cancer, their impact actually reaches far beyond those fields.
One of their earliest and most enduring applications has actually
been in the fight against infectious disease. In the nineteen nineties,
monoclonal antibodies were developed to protect babies high risk infants
from respiratory sensicial virus that's RSV. That is, in case
(23:55):
you are not familiar, a common virus that can cause
severe respiratory illness, and by binding to and neutralizing RSV
before it could infect lung cells. Monoclonal antibody therapy helped
prevent hospitalization in vulnerable newborns and children with underlying health conditions,
and this idea of using antibodies to stop a virus
(24:18):
in its tracks was taken to new heights during a
fairly recent event that many of us will remember, the
twenty fourteen Abola outbreak in West Africa. As scientists race
to develop treatments against this frequently deadly virus, monoclonal antibodies
emerged as one of the most promising options. Researchers used
(24:40):
samples from a BULA survivors, and then they use those
to identify antibodies that had effectively neutralized the virus. Those
antibodies were then cloned and mass produced for therapeutic use.
When these monoclonal antibodies were administered early, they really significantly
improved survival rates and then, of course, much closer to
(25:02):
our recent past, the height of the COVID nineteen pandemic,
because monoclonal antibodies became frontline tools, researchers rapidly isolated antibodies
from people who had recovered from the virus and identified
those that could neutralize the SARS CoV two spike protein.
We have all seen pictures of those molecules that the
spike's coming off of them. Early in the pandemic, these
(25:25):
antibodies were shown to reduce hospitalizations and death in high
risk patients, especially if they were given soon after infection,
and they were also used as post exposure prophylaxis in
settings like nursing homes. However, as that virus evolved and
new variants emerged, a lot of those first generation antibodies
(25:46):
lost their effectiveness. We have all seen the news stories
about the newest mutation. This all revealed a key limitation.
Monoclonal antibodies are exquisitely specific, and even small mutations in
a viral target can render them completely obsolete. Still, though,
the rapid development and deployment of antibody therapies during COVID
(26:07):
demonstrated their value and their incredible versatility, and it actually
accelerated a lot of innovation across the field. I imagine
it is news to you that this one innovation from
the seventies has been such a boon to the treatment
of so many issues, both including the ones that you
live with and the others that you do not.
Speaker 2 (26:27):
Yeah, that's amazing, and I just got to say love
me some science, like, thank you for that.
Speaker 1 (26:32):
Right. So, while humanization actually did solve a lot of
problems associated with early antibodies, another challenge eventually emerged, and
that was how to address diseases that involve multiple molecular pathways.
And this is something that is specific in the psoriasis issue.
So in psoriasis and other inflammatory diseases, researchers started to
(26:54):
understand that different forms of the same inflammatory protein, such
as IL seventeen and IL seventeen F, actually worked together
to drive symptoms, so blocking just one was not always enough.
Actually talked about this earlier this season, how realizing it
had a partner in crime that was causing HAVOC was
(27:14):
a huge breakthrough. This realization then led to the development
of what are called bispecific antibodies. So these are engineered
molecules that are capable of recognizing and binding two different
targets simultaneously. Again, science, we love you. So instead of
building two separate monoclonal antibodies, researchers asked, could they build
(27:37):
a single molecule that worked like kind of a double
ended key, one that could basically unlock two different doors
at the same time. By specific obviously means the targets
two different disease pathways.
Speaker 2 (27:49):
It reminds me of when I would take some medications
and sometimes they would help my skin more than the inflammation,
like the arthritis, and then some would help the arthritis
more than the skin, and it's like, there's got to
be something that can do so.
Speaker 1 (28:01):
Unlike traditional drugs like aspirin or antibiotics, which are made
using chemical reactions, monoclonal antibodies are actually produced in living cells.
These cells, which are Chinese hamster ovary cells or cho cells,
have to be genetically engineered to produce the desired antibody protein,
and then they have to be kept alive and healthy
(28:23):
in controlled environments and fed with the right nutrients and
monitored constantly. So it is no small feat. In some
early formats, the antibodies that they had developed were prone
to falling apart or what's called misfolding themselves. Proteins are
made as long chains of amino acids that have to
fold into these very specific three D shapes to work properly.
(28:47):
For antibodies, The correct fold actually creates the precise binding
sites that allow them to grab onto their targets, and
so by the late nineteen eighties, cho cells had become
the gold standard for antibody production, and it seemed like
the first hurdle getting the antibodies to remain stable and
fold correctly was behind us.
Speaker 2 (29:08):
Sound so intimidating. They have to get it just right.
That's crazy, right. I want to like send a muffin
basket to every single scientist that works on these It's
such incredibly intricate work. Producing these bispecific antibodies adds another
layer of complexity because scientists have to ensure that both
binding sites are functional and stable, not just in the lab,
(29:30):
but in the very dynamic and unpredictable environment that is
a human body. Structural biologists have to fine tune every
part of the molecule, from its overall shape to the
electrostatic charges that influence how it folds and binds. As
we've been discussing, this entire manufacturing process is a feat
of precision engineering. A single batch of monoclonal antibody therapy
(29:54):
can take three to four months to produce, and it
involves hundreds of trained scientists and tech nicians. So we
might need to start a muffin basket fund. The facilities
that are required are also expensive. They cost hundreds of
millions of dollars. They have to operate under the strictest
possible quality standards, and in a world where we see
(30:15):
viruses mutate quickly, I mean that makes the news all
the time, it's easy to see why it can be
really hard to keep medications effective. As monoclonal antibodies have
grown more complex and more powerful, the bar for proving
their effectiveness has also risen for conditions like psoriasis in
vitro testing just in case anybody doesn't know, in vitro
(30:37):
just means in glass, So that's just saying researchers have
to test these antibodies in the lab before they are
used in humans like Victoria, who is sometimes the next step.
So in the lab, researchers simulate the inflammatory environment of
the skin, allowing them to test whether a given antibody
can neutralize its targets without disrupt other immune functions. In
(31:02):
a way, you are an important link in this whole chain,
because without people like you who are willing to be
part of those trials, we don't have that final piece
of the information. Yeah, and I have a very severe case,
so I think it's helpful for them to get that data.
That drug has to do some good stuff.
Speaker 1 (31:18):
To really for me. The payoff for all of this complexity,
as I'm sure you know, is quite substantial. So in
the realm of autoimmune disease, monoclonal antibodies have delivered results
that were once completely unthinkable. For people with moderate to
severe siriasis, antibody based therapies have achieved rates of skin
clearance far beyond what traditional treatments could ever offer, and
(31:41):
in some clinical trials, the majority of patients achieved complete
or near complete skin clearance. In infectious disease, monoclonal antibodies
have played life saving roles during public health crises. Their
ability to be developed rapidly, tailored precisely, and deployed flexibly
makes them invaluable tools in an era of emerging threats
(32:02):
and personalized medicine. In hindsight, the original insight of Keuler
and Milscene was simple but profound. Right, take the body's
most precise weapons that we naturally have anti bodies, and
then find a way to mass produce them outside the body.
And that one seemingly simple idea has grown into an
(32:22):
entire industry, one that sits at the intersection of immunology,
molecular biology, structural engineering, and industrial manufacturing. Today, monoclonal antibodies
are used to treat cancers, autoimmune diseases, allergic conditions, and
infectious diseases. They can be designed to deliver payloads, block signals,
(32:44):
or simply act as decoys. The frontier continues to expand,
and Victoria is part of that working in these trials.
So what began in this small lab in Cambridge has
grown into one of the most powerful and adaptable technologies
in modern science. That mouse sell that started at all
has become a global engine for human healing. Amazing, And
(33:06):
you're part of this big story, which I love. It
makes me love the whole thing even more. I really
like these science heavy episodes because I am a nerd
and you can really see how people build on one
another's discoveries and just how big the effort of medicinal
breakthroughs like this really are. You see it firsthand because
you are part of the process. And I do want
(33:27):
to end by coming back to you because I have
two more questions for you, and these are questions we
ask all of our guests at the end of each episode.
So the first is what suggestions do you have for
people who maybe don't have psoriasis themselves, but they love
someone who does, or they are in the life of
someone who does, and they want to be a help
and not make it more troubling.
Speaker 2 (33:49):
I think it'll come down to someone's individual needs. What
helps me the best with having friends and family when
I'm going through a flare is just supporting me and
and maybe even helping me put some lotion on my back.
Just that simple. And I'm someone who needs someone to say, yeah,
that does suck. You know what I mean?
Speaker 1 (34:08):
Yes, I see, I understand. Last, but not least, if
you could send one message to listeners who might be
grappling with their own diagnoses and might be early in
the journey, what would that be.
Speaker 2 (34:19):
I would say, even if it's just a small spot,
get it checked out, because it can start small and
then eventually creep down your face. You just don't know.
Speaker 1 (34:29):
Victoria, thank you so much for spending this time with me.
Speaker 2 (34:32):
Thank you for having me. It was a lot of fun.
Speaker 1 (34:33):
I learned a lot. Our skim is hosted by myself,
Holly Fry and executive produced and engineered by Ryan Martz.
Our executive producer and writer is Meredith Barnes. If you
enjoy the show, share it with your friends. You can
(34:54):
also listen and follow on the iHeartRadio app, Apple Podcasts,
or wherever you get your podcasts.
Rube. I'm Holly Fry and this is season two of
Our Skin, a personal discovery podcast. Today we are honored
to welcome Victoria Vus to Our Skin. Victoria is a travel,
fashion and beauty influencer whose journey with siasis and the
(00:26):
multiple diagnoses that followed transformed not just her skin, but
her entire relationship to her body and health. It all
began in college, when a sudden flare revealed itself as soriasis.
Then came soriatic arthritis, then insulin resistance. The avalanche of
diagnoses could have been overwhelming, and often surely was, but
(00:51):
over time Victoria began to rebuild. She found a research
institute where a doctor listened, She found and starved online
communities that reminded her she was not alone, and she
began sharing her story one post at a time. Today,
she talks openly about stigma, flares, medical self advocacy, and
(01:13):
what it means to care for yourself in a body
that doesn't always cooperate. We are really grateful to anyone
who turns a challenge into an opportunity for advocacy, so
we are remarkably delighted to have Victoria here today. Welcome
to our skin. Thank you so much for having me.
I love that intro. Can you like intro me to
(01:34):
any room or party that I go? I loved that. Happily,
I'll just follow you around with a microphone. It will
be awkward at all. So, Victoria, it sounds like college,
which is such a tumultuous time for a lot of people,
was the starting point of this leg of your journey.
And you have said in interviews, and I love this
(01:56):
phrasing that that is when your psoriasis went fullage. Tell
me about that time in your life and how this
all unfolded for you.
Speaker 2 (02:05):
Yeah, it's definitely evident looking back now that stress is
my trigger and that has proven time and time again,
which is awful, right because I'm already stressed out and
then my skin flares and now I'm even more stressed out.
But that has been my pattern, and so that was
I guess the first really stressful time in my life
that it presented in a way that was so terribly painful.
(02:27):
And actually what brought me into the doctor's office was
this little bump on the top of my foot that
was really painful to walk on, and I was told
it was soriatic arthritis, and it was like, okay, so
that's actually connected to what's going on with my skin.
It was coming down on my forehead a little bit,
so it was in my hairline and not too much
to worry about. But then it just kind of crept
(02:47):
down on my face. I will say, there's a stigma.
People would see something on your face and have negative
reactions to it, which is really hard. So not only
was it that internal pain I was dealing with, but
now it was literally on my face.
Speaker 1 (03:02):
Nothing like being self conscious at a time in your
life when you're already trying to figure your stuff out.
It was a lot all at once. Oh my gosh.
I can't even imagine. Because you were diagnosed with psoriasis
and then your other diagnoses as I mentioned, soon followed,
so you got the soriotic arthritis, but then also insulin resistance.
(03:23):
This had to have felt like the universe was just
piling on you. How did you navigate all of this
and how quickly as this was happening to you did
you turn to online communities?
Speaker 2 (03:34):
You know? It was tough because not only was it
those two things, it was also syss on my ovaries,
oh my lord. And then trying to treat the psoriasis,
I got peptic ulcers, and then also I guess I
was not drinking enough. I got kidney stones. So my
solution I dropped out of college. I mean, no one
(03:55):
can fault you. That's a lot to deal with. It
was a lot, and at that time I had gone
to university a little bit away from home, whereas the
first couple of years I was doing community college in
the same town with my dad. And so it was
all too much. All of that medical stuff and a
lot of non answers, a lot of doctors saying we
can't find anything wrong with you, which a lot of
us with insulin resistance pcos we hear that, and so
(04:18):
that was so frustrating. Plus on top of it, the
peptic ulcers and the inflammation. It was a lot. So yeah,
I started my life over again. I called my mom complained.
She was in San Diego. She said, I'm gonna get
you a one way trip, come on out here, and
I said, let's do it. And like I've been in
San Diego since, it was the best decision. And that's
when I started not only seeking out an online community,
(04:40):
but also going to that clinical research place.
Speaker 1 (04:43):
When you're seeking out an online community and you are
in a situation like yours, how do you even start, Like,
you can't just type into a search bar psoriasis, soriatic arthritis, pcos.
How do you find the right place for you? I
feel like I curated that, and I started with my interest,
which I guess was like fashion, something cute and fun.
(05:04):
And then I was like, you know what, I want
to get a little more real and talk about my skin.
And it's not like something I can totally hide anyway,
so let's just talk about it and I can complain
and other people can complain to me. And so then
it just became Oh, I actually really like being super
transparent and honest with my community. And it also leads
to a lot of people reaching out to me, enjoying
(05:24):
the fact that they have a place to you know,
bitch and moan if I'm allowed to swear.
Speaker 2 (05:28):
So it's a comfortable place to express myself. An in turn,
I get to connect with other people who are going
through the same things, and I can share also things
that have worked for me. They can share things that
have worked for them, and we can figure it out together,
especially with doctors. Maybe not always listening to us. We
at least have other people who are in the trenches
and will listen.
Speaker 1 (05:48):
Yeah, I'm glad you mentioned your doctors because I imagine finding
a treatment plan when you have all of these stacked
medical diagnoses going on is a little bit tricky. You
probably have a lot of different specialists in the mix,
hopefully communicating with one another, but I'm sure you also
have to self advocate a lot to make sure all
(06:10):
of those people are genuinely on the same page.
Speaker 2 (06:13):
Yeah, especially because sometimes I'll get conflicting information. I went
to a rheumatologist who said nothing was wrong, and then
talking to a dermatologist They're like, no, you do have
soriatic arthritis. So I'm like, I don't know who to
listen to. I know there's pain, I don't know what
it is, but also I was on medication for the
pain and it gave me another problem, so please someone
help me out. And sometimes it looks like going to
(06:34):
other specialists if they say nothing's wrong, you know in
your body, And that's listening to yourself, advocating for yourself
and moving on to someone who will listen, which might
be hard but totally worth it. And you mentioned that
your mom had found this research institute that was working
on some psiriasis trials and that you got involved there.
One of the things that you have mentioned is that
(06:57):
you have a doctor there that is invested in you,
you and your health. I feel like when you say that,
so many people are gonna be like, what is that? Like?
Speaker 1 (07:07):
What do you wish more doctors did that support their patients?
What are you getting from this person that you wish
every other medical professional would understand?
Speaker 2 (07:16):
I think it's validating your feelings. You're not crazy for
feeling self conscious or the pain that you're feeling. Like
sometimes that is more than you can get at a
lot of doctors where you tell them you have a
pain and that they actually listen to you. So, you know,
you would think that that's basic stuff, but you know
that was new going to this clinical institute and their
(07:39):
whole point is to research and understand, and they want
you to be as comfortable as possible during that process.
You're also getting blood work done and all this stuff.
I think the biggest weight off my shoulders was I
wasn't trying super expensive treatments and paying a lot of
money and it not working. I was actually being paid
to try different things that were still saying with one
(08:01):
on one help from a dermatologist, and if they didn't work, well,
at least I tried something, and I can try another thing.
Speaker 1 (08:09):
Right at that point, you may not be getting help
for your problem, but you are getting data about what
doesn't work, which is also important. One of the things
that we returned to a lot on the show, and
which you hinted at earlier, is that chronic illnesses that
are visible on your skin are this whole other level
of challenge because of the way other people react. If
(08:31):
I have my info correctly, you were once asked if
you had a chicken pox when you were actually having
a flare up. And I know that some people, particularly
in the psoriasis community that have really become advocates, they'll
view this as like a teachable moment for people that
are maybe being a little nosy Nancy. But others find
it a little bit harder to respond. And I'm curious
(08:53):
where you fall on that spectrum, like what your go
to behavior is for dealing with those moments.
Speaker 2 (09:00):
Well, I definitely love a clapback. I think that's my
go to for being online. Is a little bit spicy,
a little bit sassy, and I used humor with that woman.
My psoriasis is genetic, and so I was like, no,
it's psoriasis unless you and I are related, you're fine.
Like so I like qualmed her, like her issue with
maybe concern that she might get it. I'm like, no,
(09:21):
you're fine unless somehow you're in my family tree. This
isn't any of your concern. And I also remember I
was going to get my hair done and the lady
was washing my hair. She told me I had dan druff.
I'm like, no, it's zoriasis, and she's like, no, it's dandruff.
And I'm like, my dermatologist would disagree with you. So
it's like, I don't know why you're fighting me about
my own chronic illness. But okay, but yeah. My favorite
(09:45):
is the clapbacks online. I think it helps add some
comedic relief while also advocating at the same time, and
then not too mean about it.
Speaker 1 (09:53):
I promise I'm glad you mentioned online because you have
an online community that is really invested in your health
journey right along with you. You know, they are there
for you when medication doesn't pan out or when a
flare happens. What strength do you draw just on the
daily from them being on this path with you. That's
(10:15):
a good question.
Speaker 2 (10:16):
I think. I think I understand that it empowers other
people and it makes them feel good along with me,
And so I like that I can have that impact
and those clapbacks because we all Unfortunately, if you're in
the online space, it's like a plus sized person, you're
probably getting negative comments. It's unfortunate. That's just the way
(10:39):
the space works. Yeah, and no matter what it's about,
if it's my body, my skin, what have you. I
really find it empowering for me, and I think for
other people to kind of see other people put in
their place who are bullies and kind of level that
out a little bit. Even the scales there.
Speaker 1 (10:56):
Yeah, I imagine it also makes those people, even if
they did not intend to be a bully, realize though
that what they're doing is kind of inserting themselves in
other people's lives. I hope they learn something that would
be great. I'm curious because, especially since you talk about
loving a good clap back, what would you like people
(11:17):
to know when they happen upon your profile and they
click follow and it is obviously someone who is being
very transparent and sharing about their chronic illness. What are
the dos and don'ts for you of online behavior when
becoming a follower of someone like yourself.
Speaker 2 (11:33):
I definitely have boundaries, one being I don't share my weight,
but I'll share pretty much all the other stuff. Some
of that is for my own mental health, and also
as an audience member, I am not necessarily a fan
of that information. So I do try and keep a
safe space for myself and for my audience, and I
think they really appreciate it because they know there's certain
(11:57):
information they can avoid by coming to my little corner
of the internet. And I would say just respecting those boundaries,
and even if someone asked me, hey, what's your weight,
I would just tell them, oh, I'm not tracking that,
Like questions are fine, or they're like, hey, you usually
don't talk about your weight, but you just posted something,
you know xyz. And it also gives me an opportunity
to be like, well, you're right, I'm not talking about
my own weight, but I thought this was a great
(12:17):
resource for other people. And so then they're like, oh, okay,
thank you so much for letting me know. So I
think it's a really good exchange of information, So for
the most part, there's not much that'll get to me.
And if you're spicy, I'll be spicy back. I like
them how.
Speaker 1 (12:31):
You're also an educator in your heart. I think I
am curious to know how your relationship with your skin
has changed over time, because, of course there are probably
moments even when you are fully empowered, of being self conscious.
But it also sounds like there's an element to the
way you manage your life where you do not take
your skin or your health overall for granted, and that
(12:55):
is a very positive space to be in. So where
are you at with.
Speaker 2 (12:58):
All of that? My skin is pretty darn great right now.
It's not perfect, but it is much much better, and
I feel like, even though it's not perfect and I
definitely still have, you know, some self conscious things, I
am so much more grateful that I'm not in that
huge flare I was in. It was really tough and
really hard on my mental health. So grateful where I'm
(13:20):
at where my skin is now, even though it's not perfect.
But also presenting myself online, it's kind of like, how
could you hurt me if I just present myself as
real and even talk about how I feel about myself.
It's like you're saying all the things I've already said
to myself. There's really nothing you could do to hurt me.
So and at the end of the day, soriasis is
extra skin, so I guess you could say my skin's
(13:41):
just real thick.
Speaker 1 (13:43):
You know what I mean, speaking of putting yourself out there.
Speaker 2 (13:48):
One.
Speaker 1 (13:48):
You're a newlywed. Congratulations, thank you. And your wedding was
in the New York Times last year, which is incredibly cool.
You look so beautiful for our listeners that don't know,
Victoria has this spectacular head of just the most gorgeous
red hair you've ever seen, and you looked like a
Woodland fairy princess. It was so beautiful. But I'm really
curious what wedding planning was like, because that is a
(14:11):
time that also adds stress and self consciousness to people's lives.
Did you do anything differently to take care of yourself
and your skin and your mental health leading up to
that that maybe is not including the things that other
people have to consider.
Speaker 2 (14:25):
Yeah, So we actually split up our reception and the wedding,
so we had like a cute little wedding just by
the beach with some family, and then six months later
in the summer, when everyone could come to town, we had
our reception. That was definitely a little bit stressful. Thankfully,
I had my husband, my friends, and I actually hired
someone to kind of help me plan the event a
(14:46):
little bit. And I really recommend separating those things out
because I didn't have to worry about my dress, changing
locations and all that. By the time the event was happening,
I was like, this was the way to do it.
This was so much better. And then I was allo like,
we should do this again next year.
Speaker 1 (15:01):
Yeah, Oh so much fun. I imagine that feels more
like a party to you than when you have a
reception right after the wedding and you're still in the
logistics of, Okay, we have to do the pictures and
this person has to be included in this moment, and
that's pretty smart.
Speaker 2 (15:17):
Thank you. Yeah, we got the really nice, fancy photos
done the morning of the wedding, and that's checked off.
This is just a party for all the friends and family,
and so I actually put a lot of energy into
doing like raffles, games and stuff like that. It was Yeah,
we made sure the kids had fun and the adults
had fun, so I think.
Speaker 1 (15:32):
It was great. As our conversation today points out victoria,
Treating psoriasis, even if you were treating just psoriasis without
other factors, is a journey, and our medical community makes
breakthroughs every single day that will hopefully continue to bring
better treatments to people with psoriasis. And after the break
we're going to dive into a major breakthrough, and that
(15:54):
is monoclonal antibodies. I promise it's exciting woo science. In
nineteen seventy five, at the Medical Research Council Laboratory of
(16:15):
Molecular Biology in Cambridge, England, to scientists George Kueller and
Caesar Milstein were conducting what on the surface kind of
looked like a routine experiment. They were working with mouse
immune cells, aiming to understand how the body produces antibodies.
But in the course of their work they created something
(16:35):
entirely new, a method for producing large quantities of identical
antibodies derived from a single immune cell. These monoclonal antibodies
would go on to revolutionized medicine, giving rise to some
of the most precise and powerful treatments in human history. Okay,
so why is this breakthrough. Why are monoclonal antibodies so incredible?
(16:58):
Have great news? The natural world, antibodies are the immune
systems elite reconnaissance and neutralization force. They're these y shaped
proteins that kind of patrol the bloodstream, each one custom
built to recognize and bind to a specific foreign invader
that can be a virus, a bacterium, or a toxin.
And when your body encounters a threat, specialized immune cells
(17:21):
called B cells respond by producing thousands of different antibodies,
each with its own unique molecular fingerprint, creating what scientists
call a polyclonal response victoria. You have been in a
lot of doctor's offices. Do you ever think about your
immune system this way? As kind of like soldiers and
spies in a massive conflict, never quite so granular.
Speaker 2 (17:44):
And if anything, I'm like, my body is the enemy,
so me and my body are at war.
Speaker 1 (17:52):
Polyclonal antibodies are really interesting. They come from many different
B cell clones. So even when all of these B
cells are responding to this same antigen like a virus,
each individual B cell clone produces antibodies that recognize slightly
different parts of that antigen. So you're going to get
a mixture of antibodies. Some might bind to one part
(18:13):
of the virus surface, others to different parts. Some might
bind tightly, others more loosely, et cetera. It's poly because
it comes from multiple clones of B cells. I kind
of love this because it's got a divide and conquer
situation going on, which is probably again similar to the
way that you've had to treat various things in your
(18:34):
own way if the parallels are real. The flip there
is that monoclonal antibodies come from a single B cell
or its clones, and since they all originate from one
parent cell, they're all identical and they all recognize the
exact same target in exactly the same way. It uses
the early stage mono because it comes from one source,
(18:55):
one B cell. Do you see where we're going with this.
We're getting targeted therapies. Yeah.
Speaker 2 (19:01):
Over the ride the autoimmune thing. Huh what she's so bright.
It wasn't just about wedding receptions split up. She's very insightful.
Cueller and Milstein's breakthrough changed everything by providing unlimited quantities
of these identical, predictable antibodies. This consistency opened the door
(19:21):
to reproducible experiments, standardized diagnostic tests, and most importantly, the
development of targeted therapies that could be manufactured at scale.
Although we're going to talk about that in a minute
and see that that part was really quite challenging and difficult.
Have you ever had to deal with the treatment that
I mean, you've mentioned that you would take things that
were hurting some things and helping others. I'm sure you
(19:44):
are well acquainted with the ideas of the negative things
you did not want out of a medication. Yeah. Using
n sets to help with the inflammation, it then caused
the peptic ulcers and that I had both left. I
had peptic ulcers and the inflammation. I'm like, this is fantastic,
Like thanks once again. Parallel to this. So, it actually
took a decade almost for the significance of this discovery
(20:05):
to be fully recognized. And that's because their focus was
in research understanding more about the immune system and how
it works. It's only when the therapeutic possibilities became clear
that Culer and Milstein had stumbled upon something really revolutionary.
So in nineteen eighty four, Culer and Milstein were awarded
the Nobel Prize in physiology or medicine along with an immunologist.
(20:29):
Neil's journ and their technique made it possible to produce
antibodies in the lab that could be tailored to recognize
a single specific target. So, in other words, it gave
scientists a way to build metaphorical molecular missiles. This is
all too pretty recent. It's in the last fifty years.
(20:49):
Did you realize that treatment for a lot of the
things that you're dealing with was happening so recently? LE mean, no,
but it makes sense, and like, yeah, I feel like
psoriasis isn't fully understood. There is a lot of questions
between dermatologists about like where's it from and what actually
triggers it, and so it definitely seems to be still
(21:11):
something that they're trying to wrap their minds around, which
is amazing considering it's not new, no ad it they
were busy doing other things, I guess.
Speaker 1 (21:21):
So. The original monoclonal antibodies produced through Culer and Milstein's
method were derived entirely from mouse proteins. These mouse derived
antibodies could effectively bind to specific human targets in lab settings,
but when they were injected into patients they were often rejected.
The human immune system saw them as foreign, and that
(21:43):
triggered immune reactions that ranged from like a mild allergic
response to complete neutralization of the treatment. And so this
problem actually became known as the HAMMER response, which stands
for human anti mouse antibodies. Patients immune says attacked the
therapeutic antibodies as though they were invaders and rendered them
(22:04):
ineffective and sometimes even dangerous. I feel like this is
a lab version of what you and other people with
chronic conditions deal with all the time. You have already
mentioned that your body is sometimes your enemy, that potential
frustration of your body working against the very treatments that
you are trying to help it with.
Speaker 2 (22:22):
Yeah, or treatments that only work for so long, like
your body just becomes immune to it over time.
Speaker 1 (22:28):
It's so frustrating. There were still so many more steps
ahead for this to actually become a workable and helpful thing,
because the next step in the evolution of monoclonal antibodies
came from another scientist that was working in that same
Cambridge lab, that was doctor Greg Winter. In the nineteen eighties,
Winter pioneered the technique of what's called humanization. That's when
(22:49):
parts of a mouse antibody responsible for recognizing a specific
target were grafted onto a framework that was made from
human antibody proteins, and then this hybrid molecule preserved the
mouse antibody specificity but dramatically reduced the risk of immune rejection.
Science is so cool. Winter's innovation really marked this turning
(23:11):
point because humanized monoclonal antibodies became viable tools for treating disease,
and researchers started exploring their use in everything from cancer
to autoimmune disorders. And although monoclonal antibodies are often associated
today with chronic diseases like psoriasis, rheumatoid arthritis, and various
(23:32):
forms of cancer, their impact actually reaches far beyond those fields.
One of their earliest and most enduring applications has actually
been in the fight against infectious disease. In the nineteen nineties,
monoclonal antibodies were developed to protect babies high risk infants
from respiratory sensicial virus that's RSV. That is, in case
(23:55):
you are not familiar, a common virus that can cause
severe respiratory illness, and by binding to and neutralizing RSV
before it could infect lung cells. Monoclonal antibody therapy helped
prevent hospitalization in vulnerable newborns and children with underlying health conditions,
and this idea of using antibodies to stop a virus
(24:18):
in its tracks was taken to new heights during a
fairly recent event that many of us will remember, the
twenty fourteen Abola outbreak in West Africa. As scientists race
to develop treatments against this frequently deadly virus, monoclonal antibodies
emerged as one of the most promising options. Researchers used
(24:40):
samples from a BULA survivors, and then they use those
to identify antibodies that had effectively neutralized the virus. Those
antibodies were then cloned and mass produced for therapeutic use.
When these monoclonal antibodies were administered early, they really significantly
improved survival rates and then, of course, much closer to
(25:02):
our recent past, the height of the COVID nineteen pandemic,
because monoclonal antibodies became frontline tools, researchers rapidly isolated antibodies
from people who had recovered from the virus and identified
those that could neutralize the SARS CoV two spike protein.
We have all seen pictures of those molecules that the
spike's coming off of them. Early in the pandemic, these
(25:25):
antibodies were shown to reduce hospitalizations and death in high
risk patients, especially if they were given soon after infection,
and they were also used as post exposure prophylaxis in
settings like nursing homes. However, as that virus evolved and
new variants emerged, a lot of those first generation antibodies
(25:46):
lost their effectiveness. We have all seen the news stories
about the newest mutation. This all revealed a key limitation.
Monoclonal antibodies are exquisitely specific, and even small mutations in
a viral target can render them completely obsolete. Still, though,
the rapid development and deployment of antibody therapies during COVID
(26:07):
demonstrated their value and their incredible versatility, and it actually
accelerated a lot of innovation across the field. I imagine
it is news to you that this one innovation from
the seventies has been such a boon to the treatment
of so many issues, both including the ones that you
live with and the others that you do not.
Speaker 2 (26:27):
Yeah, that's amazing, and I just got to say love
me some science, like, thank you for that.
Speaker 1 (26:32):
Right. So, while humanization actually did solve a lot of
problems associated with early antibodies, another challenge eventually emerged, and
that was how to address diseases that involve multiple molecular pathways.
And this is something that is specific in the psoriasis issue.
So in psoriasis and other inflammatory diseases, researchers started to
(26:54):
understand that different forms of the same inflammatory protein, such
as IL seventeen and IL seventeen F, actually worked together
to drive symptoms, so blocking just one was not always enough.
Actually talked about this earlier this season, how realizing it
had a partner in crime that was causing HAVOC was
(27:14):
a huge breakthrough. This realization then led to the development
of what are called bispecific antibodies. So these are engineered
molecules that are capable of recognizing and binding two different
targets simultaneously. Again, science, we love you. So instead of
building two separate monoclonal antibodies, researchers asked, could they build
(27:37):
a single molecule that worked like kind of a double
ended key, one that could basically unlock two different doors
at the same time. By specific obviously means the targets
two different disease pathways.
Speaker 2 (27:49):
It reminds me of when I would take some medications
and sometimes they would help my skin more than the inflammation,
like the arthritis, and then some would help the arthritis
more than the skin, and it's like, there's got to
be something that can do so.
Speaker 1 (28:01):
Unlike traditional drugs like aspirin or antibiotics, which are made
using chemical reactions, monoclonal antibodies are actually produced in living cells.
These cells, which are Chinese hamster ovary cells or cho cells,
have to be genetically engineered to produce the desired antibody protein,
and then they have to be kept alive and healthy
(28:23):
in controlled environments and fed with the right nutrients and
monitored constantly. So it is no small feat. In some
early formats, the antibodies that they had developed were prone
to falling apart or what's called misfolding themselves. Proteins are
made as long chains of amino acids that have to
fold into these very specific three D shapes to work properly.
(28:47):
For antibodies, The correct fold actually creates the precise binding
sites that allow them to grab onto their targets, and
so by the late nineteen eighties, cho cells had become
the gold standard for antibody production, and it seemed like
the first hurdle getting the antibodies to remain stable and
fold correctly was behind us.
Speaker 2 (29:08):
Sound so intimidating. They have to get it just right.
That's crazy, right. I want to like send a muffin
basket to every single scientist that works on these It's
such incredibly intricate work. Producing these bispecific antibodies adds another
layer of complexity because scientists have to ensure that both
binding sites are functional and stable, not just in the lab,
(29:30):
but in the very dynamic and unpredictable environment that is
a human body. Structural biologists have to fine tune every
part of the molecule, from its overall shape to the
electrostatic charges that influence how it folds and binds. As
we've been discussing, this entire manufacturing process is a feat
of precision engineering. A single batch of monoclonal antibody therapy
(29:54):
can take three to four months to produce, and it
involves hundreds of trained scientists and tech nicians. So we
might need to start a muffin basket fund. The facilities
that are required are also expensive. They cost hundreds of
millions of dollars. They have to operate under the strictest
possible quality standards, and in a world where we see
(30:15):
viruses mutate quickly, I mean that makes the news all
the time, it's easy to see why it can be
really hard to keep medications effective. As monoclonal antibodies have
grown more complex and more powerful, the bar for proving
their effectiveness has also risen for conditions like psoriasis in
vitro testing just in case anybody doesn't know, in vitro
(30:37):
just means in glass, So that's just saying researchers have
to test these antibodies in the lab before they are
used in humans like Victoria, who is sometimes the next step.
So in the lab, researchers simulate the inflammatory environment of
the skin, allowing them to test whether a given antibody
can neutralize its targets without disrupt other immune functions. In
(31:02):
a way, you are an important link in this whole chain,
because without people like you who are willing to be
part of those trials, we don't have that final piece
of the information. Yeah, and I have a very severe case,
so I think it's helpful for them to get that data.
That drug has to do some good stuff.
Speaker 1 (31:18):
To really for me. The payoff for all of this complexity,
as I'm sure you know, is quite substantial. So in
the realm of autoimmune disease, monoclonal antibodies have delivered results
that were once completely unthinkable. For people with moderate to
severe siriasis, antibody based therapies have achieved rates of skin
clearance far beyond what traditional treatments could ever offer, and
(31:41):
in some clinical trials, the majority of patients achieved complete
or near complete skin clearance. In infectious disease, monoclonal antibodies
have played life saving roles during public health crises. Their
ability to be developed rapidly, tailored precisely, and deployed flexibly
makes them invaluable tools in an era of emerging threats
(32:02):
and personalized medicine. In hindsight, the original insight of Keuler
and Milscene was simple but profound. Right, take the body's
most precise weapons that we naturally have anti bodies, and
then find a way to mass produce them outside the body.
And that one seemingly simple idea has grown into an
(32:22):
entire industry, one that sits at the intersection of immunology,
molecular biology, structural engineering, and industrial manufacturing. Today, monoclonal antibodies
are used to treat cancers, autoimmune diseases, allergic conditions, and
infectious diseases. They can be designed to deliver payloads, block signals,
(32:44):
or simply act as decoys. The frontier continues to expand,
and Victoria is part of that working in these trials.
So what began in this small lab in Cambridge has
grown into one of the most powerful and adaptable technologies
in modern science. That mouse sell that started at all
has become a global engine for human healing. Amazing, And
(33:06):
you're part of this big story, which I love. It
makes me love the whole thing even more. I really
like these science heavy episodes because I am a nerd
and you can really see how people build on one
another's discoveries and just how big the effort of medicinal
breakthroughs like this really are. You see it firsthand because
you are part of the process. And I do want
(33:27):
to end by coming back to you because I have
two more questions for you, and these are questions we
ask all of our guests at the end of each episode.
So the first is what suggestions do you have for
people who maybe don't have psoriasis themselves, but they love
someone who does, or they are in the life of
someone who does, and they want to be a help
and not make it more troubling.
Speaker 2 (33:49):
I think it'll come down to someone's individual needs. What
helps me the best with having friends and family when
I'm going through a flare is just supporting me and
and maybe even helping me put some lotion on my back.
Just that simple. And I'm someone who needs someone to say, yeah,
that does suck. You know what I mean?
Speaker 1 (34:08):
Yes, I see, I understand. Last, but not least, if
you could send one message to listeners who might be
grappling with their own diagnoses and might be early in
the journey, what would that be.
Speaker 2 (34:19):
I would say, even if it's just a small spot,
get it checked out, because it can start small and
then eventually creep down your face. You just don't know.
Speaker 1 (34:29):
Victoria, thank you so much for spending this time with me.
Speaker 2 (34:32):
Thank you for having me. It was a lot of fun.
Speaker 1 (34:33):
I learned a lot. Our skim is hosted by myself,
Holly Fry and executive produced and engineered by Ryan Martz.
Our executive producer and writer is Meredith Barnes. If you
enjoy the show, share it with your friends. You can
(34:54):
also listen and follow on the iHeartRadio app, Apple Podcasts,
or wherever you get your podcasts.
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