The Blue Vanguard Vol.20

Yonsei Student Pharmacist

THE

BLUE

VANGUARD

MAIN ARTICLES Interviews

Eunjin Bae, Head of Market Access at Sanofi-Aventis Korea Co., Ltd.

Pharmaceuticals

Approval of Aduhelm for Alzheimer's Disease

National issues

COVID-19 Vaccination in the World and in South Korea

2021

DECEMBER

Vol.20

Editor's note YoonZoo Gee We have already reached the 20th Volume of The Blue Vanguard. These past two years have not been easy especially because of COVID-19. However, Blue Vanguardians have tried their best to write and design high quality articles to deliver important issues regarding pharmaceutics.

The main articles of this issue involve: an interview with the Head of Market Access at Sanofi Aventis Korea Co., Ltd, an article on approval of Aduhelm for Alzheimer's disease, an article on COVID-19 vaccination in the world and in South Korea. Make sure to read other articles as well because all of them are as equally intriguing and informative as the main articles.

Thank you all Blue Vanguardians for your hard work. It really must have not been easy writing and designing articles while keeping up with schoolwork. Unlike the past few semesters, I am grateful to have met a few of you ofline. We unfortunately only had one chance to meet each other in groups of fours, but I hope we can all get together as a group soon. Until then, make sure you all stay safe.

Other than that, I thank all our subscribers for reading and supporting our magazine. I would also like to say special thanks to Professor Jin-Hyun Jeong and Jong Hyeok Sung. We would not have been able to publish our articles without your support.

I hope you enjoy our 20th issue. Merry Christmas and a happy new year!

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CONTENTS 1) Interview

• Eunjin Bae, Head of Market Access at Sanofi-Aventis Korea Co., Ltd. : 4-5p

SANOFI

2) Pharmaceuticals

• Digital Therapeutics : Redefining Medicine : 6-7p • Approval of Aduhelm for Alzheimer's Disease : 8-9p • Prescription of SSRI Antidepressants : 10-11p

3) Column

• Plastics and Endocrine Disruptors : 12-13p • Pharmacist and Personal Branding : 14-15p

4) National Issues

• K-Bio Lab Hub : 16-17p • Doctornow, From All Angles : 18-19p • COVID-19 Vaccination in the World and in South Korea : 20-21p

5) International Issues

• Resilience of bumblebees to climate crisis : 22-23p • Pharmaceutical Pollution : 24-25p • COVID-19 and Vaccine Industry : 26-27p

6) Life issues

• Early to Bed, Early to Rise! Sleep Timing and Depression : 28-29p • SNS Body profile Boom - the side effects : 30-31p • Cultured Meat: Food of the Future : 32-33p 2021 VOL.20

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INTERVIEW

Interview With Eun Jin Bae, Head of Market Access at Sanofi-Aventis Korea Co., Ltd. YoonZoo Gee

I

yzgee@yonsei.ac.kr

n September of 2021, the Blue Vanguards of Yonsei Pharmacy had interviewed Eun Jin Bae, a pharmacist who works at Sanofi-Aventis Korea Co., Ltd. She is the Head of Market Access which strives for patient access by delivering the right treatment to the right patient at the right possible time and price.

Q: What Does a Career in Market Access Look Like?

New Launches Market Access team ensures that new treatments can be accessed to appropriate patients by the healthcare system through two steps: evidence generation and policy-shaping.

To generate evidence, we understand diseases, unmet needs, and product value to decide if a certain treatment satisfies social unmet needs. We also conduct public and relations feasibility assessments and scenarios assumptions to develop market access strategies and pricing scenarios. Then, we design a good payer value story that exhibits the growing demand and expectations of quality healthcare. Analyzing a cost-effectiveness model and budget impact is equally important as it helps us convince the payers to get reimbursement.

Besides generating evidence, we put a lot of effort into environmental shaping including policy. We do so by interacting with payers, medical societies and healthcare key stakeholders. We receive advice regarding unmet needs and strive to establish optimal reimbursement criteria. This allows previously non-eligible innovative drugs to become eligible for the reimbursement.

Both the evidence generation and policy shaping process are important as they can influence payers and policy makers into making favorable reimbursement decisions.

Life Cycle Management As for reimbursed drugs, our team prolongs the life cycle to compensate for policies that continue to reduce their price once they are reimbursed. First, we expand the reimbursed scope as they are often restricted to a limited range of reimbursement. We also anticipate price evolution and forecast for the price re-negotiation and optimization as well as risk management in price and access. Monitoring and shaping cost-containment policies can help extend their life cycle as well. Lastly, we take a strategic approach to handle objections and devise mitigation plans along with the cross-functional team in the company.

Q: What Is the Role of Market Access Within the Pharmaceutical Industry?

Traditionally, market access had been characterized as an art since its focus had been managing stakeholders’ relationships. Ever since the adoption of the positive listing system in 2007, however, the concept of pharmacoeconomics had newly been introduced. The transition towards Health Technology Assessment system had caused market access to focus on cost-effectiveness models that can demonstrate products’ value for money. Today, market access has evolved even further and has merged art and technique, both of which are essential in shaping and influencing various stakeholders. The direct impact on patients’ access to treatments is what makes market access so significant. It would thus be safe to say that market access is the key factor to a pharmaceutical firm’s success.

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INTERVIEW

Q: What Was Your Most Memorable Drug Reimbursement Case and Why?

I would say one of my most memorable reimbursement cases is Avastin which is my first experience for the success of the reimbursement. The seven-year journey from its reimbursement to its expansions has indeed been memorable because of the following reasons.

First, Avastin had been the first case to increase the Incremental Cost Effectiveness Ratio (ICER) threshold up to twice the Gross Domestic Product (GDP) in the oncology industry. South Korea has a low ICER threshold set at 1GDP in South Korea. It had previously been very difficult for anti-cancer drugs to be reimbursed since they have a high ICER threshold.

Second, Avastin had also been the first case to get reimbursement through the cost-effectiveness evaluation tract in South Korea without any Managed Entry Agreement (MEA). MEAs are arrangements made between manufacturers and payers to reduce payer uncertainty in the process of implementing innovative treatments.

After years of generating evidence and shaping policies, my team had been able to achieve Avastin’s reimbursement by doubling the original ICER threshold and executing a cost-effectiveness evaluation tract without MEA. Constantly being rejected for reimbursement had at times been demoralizing, but witnessing patients pass away without having the chance to access treatment is what kept me going. That is why I had felt so much pride when I had finally succeeded in reimbursing and expanding reimbursement scope of Avastin for all several indications.

Even to this day, Avastin reminds me the value of working at the frontline of patient access.

Q: What Aspects Make Dupixent Such an Innovative Biological Treatment for Atopic Dermatitis?

Dupixent is the only biologic drug that treats severe atopic dermatitis which does not improve with conventional treatments. Despite Dupixent’s effectiveness, patient access had been difficult as it had cost about 20 million won per year to use the drug. Negotiations had been made to increase patient access, but the process had not been easy.

My team and I had worked assiduously to generate evidence and shape policies.

All cross-functional teams had worked to enhance the disease’s awareness, influencing patients to voice their opinions. Thinking outside the box to create new evidence had also been very important in optimizing the cost-effectiveness model. In addition, a cross-functional effort with stakeholders’ engagement had caused a change in MEA policy for Dupixent in July 2019. It is the first case beyond oncology and rare disease in South Korea to achieve MEA. No one could expect such success within only a year and a half. There had been many challenges along the way but tortured atopic dermatitis patients had motivated me to do my best and think outside the box. I must say this would not have been possible if it were not for internal cross-functional team members and external stakeholders.

Q: What Are Important Competencies in Market Access?

I think having perseverance, positivity, and a never-giving-up spirit is very important. Market access articulates new hypotheses and tests nascent solutions to engage diverse stakeholders. Balancing various interests is difficult and may often lead to resistance. It is important to demonstrate these behaviors as the outcome will not always be controllable.

The interview allowed us to indirectly experience the work being done at the Market Acess team before being trained at a pharmaceutical company. Thank you so much for the amazing interview. B 2021 VOL.20

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PHARMACEUTICALS

Digital Therapeutics: redefining medicine

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Okyoon Kim

okyoonkim@gmail.com

e live in a rapidly changing world. Especially with the advances in artificial intelligence (AI) and the Internet of Things (loT), sometimes it’s even difficult to keep up with the changes. In the center of these changes, there is ‘digitalization.’ Whether you have noticed or not, everything around you is being digitalized. Paper books to e-books, supermarkets to online shopping, and schools to online education. With this transformation speeding up, there is one major field that is falling behind; medicine. Even though efforts have been made to digitalize the health care industry, it still has a long way to go compared to other industries.

However, due to continuous efforts, a new sector of medicine has emerged, called digital therapeutics (DTx).

Getting to Know DTx According to the Digital Therapeutics Alliance, digital therapeutics is defined as “evidence-based therapeutic interventions driven by high-quality software programs to prevent, manage, or treat a medical disorder or disease.”

These therapeutics share similarities with traditional drugs as they are prescribed by doctors and go through clinical trials and regulatory reviews. However, they differ in the way they are used. Since DTx is a software existing in forms of mobile applications or computer games, it is easily accessible on one’s devices. This makes DTx especially suitable for diseases or disorders that require engaging and personalized treatment.

Reaching the Unmet Needs Many health conditions require continuous interaction between patients and physicians. However, this need is not fully fulfilled in the present system due to various realistic reasons. DTx is the right fit to solve this issue.

Majority of DTx currently in the market target mental and behavioral disorders, including substance use disorder, sleep disorder, ADHD, etc. The first prescription digital therapeutics approved by the U.S. Food and Drug Administration (FDA) was Pear Therapeutics Inc.’s mobile application RE-SET, for substance abuse disorder patients, in 2017. As a pioneer of prescription DTx, Pear Therapeutics has also gained FDA approvals for opioid use disorder and chronic insomnia. According to their pipeline, DTx for alcohol use disorder, anxiety, bipolar disorder, schizophrenia, and depression are in development.

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Another interesting DTx that gained FDA approval in 2018 is Akili Interactive’s EndeavorRx, a prescriptiononly game for pediatric patients with ADHD. Since EndeavorRx is a video game, it easily enhances compliance in young children, enabling improvement in ADHD symptoms effectively. The clinical trials showed that 68% of the children had meaningful clinical progress, proving its effects. Besides targeting mental and behavioral disorders, DTx can also be used for other diseases/disorders. For example, Kaia Health intends to improve patient’s ability to self-manage their musculoskeletal pain, Insulia aims to help patients with type 2 diabetes, and Propeller Health supports patients with asthma and COPD to increase medication adherence and reduce overall hospital visits. As of today, about 40 different DTx have been approved by the FDA, with efforts being made worldwide to raise the number.

Exploring the DTx Market Ranging from start-ups to global pharmaceutical companies taking part in this field, the DTx market is growing rapidly. The global DTx market size was valued at $2.88 billion in 2019 and is expected to be over $13.80 billion by 2027. This increase can be expected as smartphone and internet usage, the platform for DTx, is increasing worldwide.

In addition, the COVID-19 pandemic has also significantly impacted the DTx market. With the prolonged pandemic, the demand for DTx is constantly rising. Since people are required to stay at home, DTx has become the best choice for disorders requiring continuous treatment. As the pandemic has accelerated the adoption of digital therapeutics, it is expected to positively impact the expansion of the global DTx market.

Obstacles Do Exist Since DTx is a new field, there are various challenges to overcome. One major obstacle would be physician adoption. Because doctors have the right to prescribe, they should be able to trust the effectiveness of DTx in order to suggest them to their patients. The most definite way to solve this issue would be to prove its effectiveness via statistics. However, even though clinical trials are being done, they lack credibility. Since it is difficult to give placebo drugs in the form of DTx, many companies have chosen to compare patient outcomes with and without DTx. This cannot be a highly reliable result due to flaws like the placebo effect. To improve the accuracy of the clinical trials, many DTx companies are attempting new methods. For example, the clinical trials for Akili Interactive’s EndeavorRx were done using a sham app. A sham app is literally a ‘false’ app, which is designed similar to the actual app and can be used as the ‘placebo drug’ in clinical trials. This attempt was a success as it increased the validity of clinical trial results. Nonetheless, there are still issues regarding how fake the sham app should be since it cannot act exactly like a placebo drug.

Issues also exist in regulations. Because DTx is a new form of therapeutics, the regulations are yet to be fixed.

Many countries aside from the U.S. and several European countries do not have the administrative process for DTx approval. In order to allow DTx usage in these countries, they would need to set up a protocol first. However, the issue does not end just by having the approval regulations. Unlike traditional drugs, DTx is a software. This means that it has the potential to be updated after primary approvals. With the increasing interference of artificial intelligence as part of treatment, the software would evolve with the increasing number of users. Hence, administrations should prepare for regulations regarding these issues.

Future Directions Although many barriers still remain to the widespread adoption of DTx, it is still the most prospective field in digital healthcare. With its strengths of personalized treatment and high accessibility, it sure can be called the future of medicine. B 2021 VOL.20

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Approval of Aduhelm for Alzheimer’s Disease Jungeun Kim

dragon22@yonsei.ac.kr

What is Aduhelm (Aducanumab)?

A

duhelm, the brand name for the new treatment of Alzheimer’s disease, has been approved by the U.S Food and Drug Administration (FDA) as the first targeted therapy of the disease on June 7th, 2021. This is the first Alzheimer’s treatment approved by the FDA in 18 years (since 2003). Its maker, Biogen, had evaluated the efficacy of Aduhelm in two Phase 3 clinical trials, where they have confirmed the reduction of amyloid-beta plaques in patients with early stages of Alzheimer’s disease.

How does Aduhelm work?

The exact cause of Alzheimer’s disease is yet to be discovered. Currently, scientists are trying to understand the cause of Alzheimer’s disease on the role of two proteins: Amyloid-beta protein and Tau protein. The approval of Aduhelm supports the amyloid hypothesis, which states the accumulation of amyloid-beta protein as the main cause of Alzheimer’s disease. Amyloid precursor protein (APP) produces amyloid-beta protein fragments which clump together to form deposits (also known as plaques) in the brain. Deposits of insoluble amyloid-beta plaques in the brain trigger neurodegenerative processes associated with the loss of memory and cognitive ability. The amyloid hypothesis has never been universally accepted because of its unsuccessful drug trials supporting the hypothesis. In the meantime, Aduhelm had been approved by the FDA. Treatment of Aduhelm should be able to reduce the amyloid-beta plaques in Alzheimer’s patients with mild cognitive impairment or mild dementia. Aduhelm is an amyloid-beta-directed antibody that binds to amyloid-beta proteins. It targets an epitope that is normally inaccessible in the amyloid-beta monomer. This binding will reduce the number of amyloid- beta plaques present in the patients’ brains, potentially slowing down the neurodegeneration and disease progression.

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How is the approval of Aduhelm significant?

The approval of Aduhelm had not been an easily predictable outcome. In November 2020, FDA had rejected the approval of Aduhelm due to Biogen’s inconsistent clinical results. Also, there had been several flaws regarding safety issues in the clinical trials. Despite the FDA’s advisory committee voting against both full and accelerated approval of the drug, the Director of the Center for Drug Evaluation and Research had still decided to grant “accelerated approval” of the drug. The approval of Aduhelm is not only significant because it is the first FDA-approved Alzheimer’s treatment, but also because it proves that amyloid-beta protein is the main cause of the disease, thus supporting the “amyloid hypothesis”.

The approval naturally draws our attention to big pharmaceutical companies. It now remains to be seen whether big pharmaceutical companies decide to manufacture amyloid-beta targeted drugs, or whether these companies develop a new type of Alzheimer’s drug.

Controversies with the approval of Aduhelm There have been considerable controversies over the approval of the new Alzheimer’s drug, Aduhelm. Instead of granting “full approval” of the drug, the FDA has decided to grant “accelerated approval”, which means the drugs’ early clinical studies show that it could be effective for certain conditions. Early clinical studies have shown a significant reduction in amyloid-beta plaques in the brains of patients with mild Alzheimer’s condition. However, further extensive studies must be conducted for Biogen to obtain full approval of Aduhelm.

To prove that reduction of plaques leads to decreased symptoms and slowed disease progression, Biogen had conducted two main studies, which showed different outcomes. One study had shown that the progression of the disease is slower for people who had taken Aduhelm than for people who had taken a placebo treatment. In another study, people who had taken Aduhelm and people who had taken a placebo treatment showed similar Alzheimer progression rates. Despite these two contradictory outcomes, the FDA decided to approve the drug, expecting extensive studies to prove slowing down of the disease progression. Extensive studies will need to be conducted for the FDA to grant full approval of Aduhelm, and for widespread use of the new Alzheimer’s disease treatment.

Now what?

With accelerated approval of Aduhelm, Phase 4 confirmatory trials are required to verify the clinical benefit of the drug. If these trials fail to verify the clinical benefit, the drug cannot be commercialized. Currently, the administered dose allowed for Alzheimer’s patients is 10 mg/kg, given via intravenous infusion over one hour every four weeks. In addition, Aduhelm’s high cost is also causing a lot of concerns. Patients receiving Aduhelm will need to pay for the drug and MRI brain scans to monitor the side effects of the drug. Due to the high cost of Aduhelm, it is inaccessible to many Alzheimer’s patients. Some health clinics have even decided against prescribing the drug to patients. In order for more patients to receive this new treatment, Biogen should seek solutions to make the drug more accessible.

The main reason why Aduhelm is granted accelerated approval is that clinical trials have shown a reduction in plaques and a reduction in dementia cases. There has been a widespread debate on the effectiveness of the drug, but the FDA has concluded that the benefits of the drug outweigh the risks of the therapy. Despite the concerns and controversies of Aduhelm, the approval gives hope to Alzheimer’s patients and their families. Hopefully, Aduhelm will be the first drug to relieve the pain of Alzheimer’s patients in the near future. B

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Prescription of ssri antidepressants Jimin Seo

S

jmdemi@hanmail.net

What are SSRI Antidepressants?

elective serotonin reuptake inhibitors (SSRIs) are a class of drugs used to treat a wide range of psychological conditions, including but not limited to post-traumatic stress disorder, panic disorder, and anxiety disorder.

However, they are most commonly prescribed as antidepressants. As the name suggests, SSRIs work to increase the level of extracellular serotonin in the brain, a monoamine neurotransmitter that modulates human mood, emotions, appetite, and digestion. As a precursor to melatonin, it also regulates the circadian rhythm. Researchers postulate the lack of this hormone as a cause of depression. When serotonin is released into the synaptic gap, about 90% are recognized by receptors on the surface of the postsynaptic cell and absorbed via monoamine transporters in a process called reuptake. SSRIs inhibit this reuptake of serotonin and allow it to remain in the synaptic gap for longer than its normal duration. Unlike other classes of antidepressants such as tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs), SSRIs have fewer side effects as they do not affect adrenergic, cholinergic, and histaminergic receptors as much. For their safety, efficacy and tolerability, SSRIs are often the first line of pharmacotherapy for depression. Commonly prescribed SSRIs include Prozac, Zoloft, and Lexapro.

SSRI Prescription in Korea According to the Korean Ministry of Health and Welfare (MOHW), non-psychiatric doctors are not allowed to prescribe SSRI-based antidepressants for more than 60 days. While this regulation has been in place since March of 2002, the controversy has been reignited as the prolonged Covid-19 pandemic resulted in the rise of depressed patients. In January of 2021, the Korean Academy of Family Medicine (KAFM) released a statement requesting the lift of this 60-day ban. They find many serious problems with this restriction; for one, this just might be the biggest obstacle to reducing the rate of depression in Korea. While many doctors emphasize the importance of early treatment, only 10% of depressed patients in the country are shown to be receiving proper medical care. Psychiatrists make up only 4% of all practicing doctors, leaving many provincial areas in need of proper mental medical facilities. This makes it difficult for all patients diagnosed with depression to be transferred to a psychiatrist and receive effective and timely treatment. It seems that as negative sentiments about visiting psychiatrists still remain, many patients prefer to continue their treatment with local practitioners whom they have already built a strong doctor-patient relationship with. Furthermore, as depression often accompanies severe physical illnesses, allowing all family medicine doctors to diagnose and treat depression will enable parallel treatment.

It is already a well-known fact that depression is a major cause of suicide. Korea, a country that has continuously topped the suicide mortality rate among OECD nations, ironically seems to be the only nation that is limiting SSRI antidepressants as a first-line treatment in depression. Studies show that in European countries such as Finland, Sweden, and Norway, the use of safe SSRI antidepressants has significantly lowered suicidal rates in the past three decades. The ministry and the psychiatrists’ association have remained adamant that the current system be maintained

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in order to prevent over-prescription and misuse. However, it is worth noting that TCAs are free to be prescribed by all doctors despite the fact that they can cause fatal toxicity as they directly affect the cardiovascular system.

Since the January of 2017, the 60-day ban has been alleviated: non-psychiatric doctors are able to prescribe SSRI drugs but only to patients that suffer from one of the following four neurological disorders: Parkinson’s disease, epilepsy, dementia, and cerebrovascular disease. During the period from 2012 to 2016, TCAs were the primarily prescribed antidepressant. After the change in regulation, although TCAs are still dominantly prescribed, there was an increase in the prescription of SSRIs for all four diseases - especially in patients with dementia and Parkinson’s disease. The number of prescriptions for Lexapro and Zoloft in 2018 was 14% higher than the previous year, and the prescription of Newpram rose by 32%. Counting other generic drugs, the prescription of SSRIs has increased prominently after the alleviation. However, considering that the chances of being diagnosed with depression are significantly higher for patients suffering from such neurological disorders (20-25%), studies have shown that the prescription rate of antidepressants is still very low: 6.9% for cerebrovascular disease, 9.8% for epilepsy, 11.4% for Parkinson’s disease, and 10.0% for dementia. The results signify the possibility of under-diagnosis of depression in patients with neurological disorders and the need for more active treatment.

SSRI Prescription Outside of Korea Then what is the prescription practice of SSRIs like in other countries? In the United States, many primary care physicians including nurse practitioners (NPs) and general practitioners (GPs) are allowed to prescribe first-line antidepressants including SSRIs like Prozac and Zoloft in all 50 states. This is possible as the United States Drug Enforcement Administration (DEA) has declared antidepressants as non-controlled substances that do not hold the same potential for abuse or addiction as Schedule II-V controlled substances (morphine, adderall, ketamine, etc.). This applies to the UK as well. GPs in the UK can prescribe SSRIs to patients that show mild symptoms of depression, following a very detailed, structured guideline from the NHS that provides information on how to prescribe antidepressants. From the basic principles of antidepressant prescription to consideration of special populations (the elderly, patients with diabetes, renal and hepatic impairment, etc.), the guideline sets strict boundaries as to which specific SSRI antidepressants can be prescribed for patients of certain conditions. It even provides guidance on the procedures post-prescription such as monitoring suicide risks, referring to secondary care, collecting patient information needs, and informing patients on withdrawal symptoms. However, easy prescription of antidepressants cannot be seen as something purely positive. In the United States, antidepressants are the most commonly prescribed drugs. Many practitioners prescribe SSRIs as a safer alternative to benzodiazepines because they have less potential for abuse. Although SSRI antidepressants do not provide euphoric effects, patients might increase their doses when they feel like the drug is not working fast enough. Some might even take their medication with alcohol to amplify its effects. When patients fail to find relief, they can easily fall into overdosing and abusing their prescribed antidepressants. Like most other drugs, taking large doses of antidepressants will still prove to be dangerous and increase the chance of having seizures.

Conclusion While all prescriptions should be made under scrutiny and in consideration of individual patients’ conditions, it can be reasonably concluded that currently, SSRI antidepressants are the safest option available for early treatment of depression. It is important to note that despite their popularity in prescribing, there have been relatively few reported cases of abuse or misuse of SSRI drugs. SSRIs are thought to be relatively safe; rare cases in which the patient have died have been revealed to involve co-ingestion of alcohol or other class of antidepressants like TCAs. B

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COLUMN

Plastics and Endocrine Disruptors Donghyeon Kim kdhbbr@naver.com

Introduction

W

hat comes to your mind when you stir hot instant coffee with a plastic cover on top or when you see a hot pot with a plastic spatula? You may have heard of the word “environmental hormone”. People usually think that environmental hormones are secreted from heated plastic which is harmful for the body. These concepts are not totally wrong, but it would be nice to know accurately this time. First of all, environmental hormones are officially called endocrine disruptors. These hormones are secreted throughout our body to conduct various functions. However, environmental hormones are chemicals which enter from outside our body and act as hormones. These environmental hormones are released from various places. It may come from cosmetics, detergents, toys, medical devices, plastics, water bottles, perfumes, computers, and many more. Thus, we have been exposed to environmental hormones in our daily lives. It would be nice of course to monitor existence and amount of environmental hormones for items used in our everyday lives, but it is difficult in reality because this regulation cannot be done perfectly since new substances are continuously being made. Therefore, this article will introduce how to distinguish safe plastics so that we can keep ourselves safe from environmental hormones.

Plastics: What’s Dangerous and What’s Not There are many types of plastics around us. Depending on the use, function, and types, plastics are labled differently on the product. There are a total of six plastics that we must know in our daily lives; Polyethylene Terephthalate(PET) that is used in water bottles or films, polyethylene (PE) that is used in food containers or textiles, polycarbonate (PC) that is used in food containers or cell phone cases, polystyrene (PS) that is used in disposable items or toys, and polyvinyl chloride (PVC) that is used for building materials or toys. First, PET, PP, and PE are relatively safe because they do not contain environmental hormones such as bisphenol A (BPA) and phthalate. When PET is heated, it turns white or becomes crumpled. This phenomenon occurs not because some harmful substances are secreted, but because PET is made to be weak so that it becomes easily deformed by force. However, if PET is frozen then melted, environmental hormones can be secreted due to structural changes in plastic. Meanwhile, some studies have shown that in certain conditions bisphenol A (BPA) is detected in polycarbonate(PC) which is commonly used to make phone cases. So you should pay attention not to heat or smear oil on PC. A 1998 Japanese study found that heating up PS which is widely used in cup noodle containers up to 70-90 degree celsius resulted in deformation and detection of environmental hormones such as BPA and styrene dimer.

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This led to a significant decrease in cup noodle sales in Korea. Even though the Ministry of Food and Drug Safety announced that environmental hormones are undetected when PS is heated, scientific results show that environmental hormones are detected when PS materials are exposed to high temperatures. Therefore, it is not safe to expose PS materials to high temperatures. Second is PVC. PVC itself is harmless to human body, but phthalates that soften PVC act as harmful environmental hormones. Normally, phthalates present in PVC are slowly discharged. However, at high temperatures, discharge rate increases, causing phthalates to melt when exposed to oil components such as cooking oil.

Fortunately, safe eco-friendly material has replaced pthalates in some products, so it would be good to check for safety marks such as KC marks, which guarantee products do not contain harmful substances.

How to Identify Safe Plastics Then, which type of plastics should we be careful about? The types of plastics that you should be careful of are PS (polystyrene), PC (polycarbonate), and PVC (polyvinyl chloride). Conversely, PP (polypropylene), PE (polyethylene), and PET (pet) are relatively safe from environmental hormones, so you can use them to store food or beverages. In order to distinguish plastics easily, here are some easy-to-remember tips. The types that you should be careful while using are PS, PC, and PVC, so pay attention to plastics that contain the letters “s”, “c” and “v” that come after the letter “p”. On the other hand, safe plastics are PP, PE, and PET, so you can relax when you see the letters “P”, “E”, and “T” that come after the letter “P”. Remember that the safe types are “P”, “E”, and “T” and the unsafe types are S, C, and V after P. In addition to the six types of plastics mentioned previously, there are plastics marked as HDPE and LDPE, which stand for High Density PE and Low Density PE. Products may be marked with abbreviations or full names so it is important to be aware of them both.

Conclusion In modern society, plastics are used in many places. It is hard to find places where plastics are not used. Plastics are very useful in our lives, but environmental hormones can cause physiological problems in our bodies. Therefore, we should be able to distinguish safe plastics in order to avoid environmental hormones as much as possible. B

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Pharmacists and Personal Branding Kim Aran

dreamct717@naver.com

A

mong young pharmacists, the theme ”Personal branding” is emerging. Personal branding means selling your own products or services as a unique brand. Nowadays, young pharmacists are challenging to make their personal brands to promotes themselves. In this article, we will look at examples of pharmacists who are building their own unique brands; Pharmacist Choi Jinhye, KKamang Yaksa, Kkogi Yaksa, Jinshim Yaksa. They created their own brand from their long experience as pharmacists. They are building their own careers by walking a slightly different path compared to other pharmacists. After looking at the brands created by these pharmacists, we will talk about why current pharmacists should think about creating personal brands. As diversity and individuality become more important, a “brand” that allows pharmacists to be individual beings and not just “pharmacists, seems very important.

Pharmacist Choi Jin-hye Who among the young pharmacists succeeded in personal branding? One might say Pharmacist Choi Jin-hye, the representative of the Neulpum Pharmacist Society. Choi Jin-hye, a leader of young pharmacists, is a pharmacist who constantly contemplates what is the project that is meaningful for young pharmacists. She produced “career design guidelines for young pharmacists” and published a book called “How to Use Pharmacy”. Recently, she worked as a planning director at the Korean Pharmaceutical Association and hosted external activities for students, providing them with an opportunity to learn what pharmacists do in practice. I am working on a project with pharmacist Choi Jin-hye at the Korean Pharmaceutical Association. What I felt while working close to her was that she was very passionate and had clear visions. She said that pharmacists should not hesitate to speak for pharmacists and to protect pharmacists’ rights. Individual pharmacists should be able to gather and argue why our rights are valid while constantly striving to become professionals.

KKamang Yaksa There is also a “KKamang Yaksa” that comes to mind when asked to choose a pharmacist with a personal brand.

The name “KKamang Yaksa” is a nickname created because of his dark skin. That is whay black is recognized as his brand color. He is working as a leader to expand his profession as a sports nutrition pharmacist which is unfamiliar in Korea. Recently, Atelier, a club of pharmacy students, conducted a project called “pharmaceutical student personal branding” with him.

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Kkogi Yaksa Kkogi Yaksa is a pharmacist and professional marketer. Recently, one pharmaceutical company scouted him as a marketing director. He is promoting himself through YouTube and Naver blogs, and created the brand under the nickname “Kkogi Yaksa.” He uses pharmacist licenses to deliver well-being knowledge to people. Because he has worked as a Product Manager for a pharmaceutical company, he knows how to promote medicines more efficiently and improve the brand image. He is building his own brand by promoting himself as an expert in medicine and marketing.

Jinshim Yaksa Jinshim Yaksa is a pharmacist who consults the branding of pharmacies. She advises that all pharmacies should approach patients with their own brand. In her book, she helps pharmacists to brand pharmacies from very basic contents such as how to communicate with patients. Recently, she has been expanding her scope of activities through blogs and YouTube.

Many people assure that to pharmacy students, will work for local pharmacies. However, there is a much broader spectrum of profession for pharmacy students to choose from. Many pharmacists are struggling to choose whther to work in pharmaceutical companies, hospitals, pharmacies or research institutes. This is where personal branding become important. I want to become my own “individual brand” by thinking about what I can do well as a pharmacist, what I want to do the most, and what my personality is.

Why do pharmacists need personal branding? In a modern society, where everyone is trying to survive competition, it is very important for us to become a “brand”. You always have to think about something only you can do. All pharmacists should not be considered a single mechanical component of a company or a preparatory robot working at a pharmacy. Finding what you can do and connecting it with the expertise of “pharmacology” to create your own brand will bring you new opportunities.

Currently, most pharmacy students choose to become pharmacy pharmacists after graduation. Perhaps this reflects practical reasons, and it is believed that they choose pharmacy pharmacists for time and financial leeway. Of course, pharmacists are essential to the community, and without them, there are no experts responsible for community health. However, it would not be very good for the majority of pharmacy students to become pharmacy. This is because pharmacy students have unique individual personalities and tendencies. Pharmacy students should thus take time to develop their own capabilities, and to think about what their specialty is in order to create their own personal brand. B

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K-Bio Lab Hub Namkyu Oh

dhskarb1997@gmail.com

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ecently chosen as the ‘K-Bio Lab Hub’, Songdo truly became the center of the Korean bio-industry. Looking back on the history of Songdo, which has dramatically changed from a wild reclaimed land to an international city leading the Korean bio-industry, we will now discuss how K-Bio emerged in Songdo.

Celltrion: The Beginning of the Korean Bio-indsutry When you talk about the Songdo bio cluster, two companies must come up in your mind; Celltrion and Samsung biologics. Both companies are located in Songdo and leading the Korean bio-industry. Celltrion is the first to become one of the world-class bio companies in South Korea, which was a barren land for bio-industry in the past. Celltrion was founded in 2002 by five co-workers who had lost their jobs from Daewoo. With the interesting in the bioindutry, they started a biotechnology business. When Jeongjin Seo (founder of Celltrion) was traveling around the world for his business, he succeeded in contacting VaxGen, an American vaccine company. VaxGen was looking for a company that could manufacture a large number of their vaccines at a low price. Even though Celltrion did not have a site for their factory yet, the founder won a contract with VaxGen by gaining confirmation for land to build their factory from the city of Incheon. Interestingly, it was the first step that turned Songdo into a bio hub.

Since then, Celltrion got more contracts on manufacturing and started to develop biosimilar medicines. After many complications, they succeeded in developing Remsima, the world’s first biosimilar drug. Remsima is a biosimilar drug of Remicade developed by Janssen, which is effective in treating autoimmune diseases. By getting approval from European Medicine Agency (EMA) and U.S. Food and Drug Administration (FDA), Remsima became the first mega-hit drug of Celltrion. Furthermore, by developing Herzuma (biosimilar of Herceptin: Breast cancer drug) and Truxima (biosimilar of Mabthera: CLL, RA drug), Celltrion truly solidified itself as a global bio company. In recent years, they challenged ‘bio better’ that has more efficacy or convenience than the original biomedicine and succeeded in receiving approval for RemsimaSC, a hypodermic formulation of Remsima, from EMA. Although there were several negative issues were surrounding the company, Celltrion is definitely a leader of K-Bio

Samsung Biologics: The Development of Songdo Bio Cluster If one said that the bio boom in South Korea started with the growth of Celltrion, we can say that the ‘Songdo bio cluster’ started with Samsung biologics settling down in Songdo. Due to emerging importance of the bio-industry in the future, Samsung established Samsung biologics (SBL) in 2011. It focused on CMO (Contract Manufacturing Organization) industry because it did not have the technology to develop new drug. Based on Samsung’s capital and foundry technology, it has grown rapidly. And now, Samsung biologics has 3 big factories that can manufacture biomedicines.

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In fact, SBL’s annual biomedicine production ranked second in the world. Its 3rd factory can produce 180,000L of biomedicine a year, which is the largest amount of output by a single factory. If the construction of its 4th factory is completed, SBL will become the largest CMO company ahead of Lonza, the world’s current No.1 CMO company in Switzerland. SBL is also developing biosimilar medicines with Samsung bioepis, a subsidiary of SBL. Expanding its business to CDMO (Contract Development & Manufacturing Organization) and CRO (Contract Research Organization), SBL is trying to provide services that expand over the entire process of making biomedicines. With the on-going investment on the Korean bio-industry from Samsung, the K-bio hub development is speeding up.

K-Bio Lab Hub Lately, Songdo was selected as ‘K-bio Lab Hub’ by the ministry of SMEs and Startups. K-bio Lab Hub benchmarks ‘Lab Central’, an organization supporting bio-startups in Boston (also famous for growing Moderna). This project aims to build infrastructures where all processes of bio-industry including foundation, research, development, and clinical trials can be intensively conducted. In addition to Celltrion and Samsung biologics, many bio startups are entering the Incheon Startup Park in Songdo. Other than startups, institutes such as the K-NIBRT (Korean National Institute for Bioprocessing Research and Training) center and Severance hospital are going to be built in Songdo.

These changes are expected to strengthen the Industry-Education Collaboration system in bio-industry. Also, as SK bioscience is preparing to transfer its headquarters and R&D center to Songdo, Songdo’s position as a hub of the bioindustry will be further assured.

COVID-19 and Pharmacists With the ongoing COVID-19 pandemic, people’s awareness of vaccines and medications are also increasing. In response to the global needs, many Korean bio companies are trying to develop medicines for COVID-19. Celltrion is developing a therapeutic antibody for COVID-19 named Regkirona (injection). Regkirona is the first COVID-19 medicine in South Korea to get a conditional approval from the Ministry of Food and Drug Safety (MFDS). Global phase 3 clinical trial of Regkirona is being conducted without a hitch. Meanwhile, Samsung biologics recently signed a contract with Moderna on manufacturing their mRNA vaccines for COVID-19. Being considered as the new solution for an insufficient supply of vaccines, this news attracted much public attention. Furthermore, SK bioscience is developing a vaccine candidate ‘GBP510’ which is in phase 3 clinical trial.

Because of COVID-19, expectation for Korean bio companies is higher than ever. At the same time, there is a need for professionals in bio-industry. As professionals in medicine, pharmacists can use their ability in many different positions throughout bio-industry like Regulatory Affair (RA), Quality Assurance (QA), Quality Control (QC), Pharmacovigilance (PV), Clinical Research Associate (CRA), MSL (medical science Liasion), Market Assessment (MA), etc. To meet the rapidly growing demand for manpower in bio-industry, many colleges of pharmacy are expanding their curriculum about pharmaceutical industry. Their enrollment quota is also increasing at the government level. Accordingly, the K-NIRBT project is being pushed forward in Songdo to cultivate people with expertise for the processes of bio-industry. I hope that pharmacists can turn their present crisis into opportunity as leaders of bio-industry in Songdo, which will become the international center of bio-industry. B

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DOCTORNOW, FROM ALL ANGLES Gayoung Lee

dlrkdud724@naver.com

Have you ever heard of the term ‘Telemedicine’? Telemedicine is broadly defined as the use of electronic communications and software by doctors to monitor and treat patients without the need of patients visiting hospital.

The novel coronavirus pandemic has brought a huge wave to the medical system around the globe. There is a potential risk of COVID-19 infection for the patients who go to see a doctor in person as there can be coronavirus carriers in the perimeter. This has led the South Korean government to seek other ways to keep treating patients while minimizing physical contact.

On March 2, 2020, Ministry of Health and Welfare (MOHW) of South Korea announced that patients are temporarily allowed to consult their doctors by phone and get prescriptions without visiting the clinic or hospital as long as the doctor thinks it is safe enough. Doctornow is a new platform based on this temporary allowance system provided by the company Doctorguide. Doctornow provides a telemedicine platform for phone call and medication delivery service. It also allows customers to complete entire medical treatment on their mobile devices through its App. Since its launch in November 2020, the number of service usage has exceeded to 300,000 and that of monthly users reached 100,000. It is now the 5th ranking application in google app store, and 3rd in apple app store in the medical division.

Here is a closer look into the Doctornow App. As you download the application Doctornow and log in, you are to select a doctor from 12 medical fields, including department of internal medicine, urology, family medicine, etc.

After that, you enter the symptoms you have on the questionnaire. A few minutes later, the assigned doctor will give you a call for a consultation and a prescription. Doctors are available via facetime, but most doctors use phone call for prescription. Moreover, you can get the medication delivered directly to your door with a delivery fee or you can pick it up at a pharmacy nearby. For now, it provides a free delivery service.

In South Korea, medicine delivery is strictly prohibited by the Pharmaceutical Affairs Law. According to the law, as written below, selling drugs is allowed only at pharmacies or in shops, which means any form of drug delivery system is not allowed.

Article 50, (1) “No pharmacy founder or drug distributor shall sell drugs at a place, other than his/her pharmacy or shop: Provided, That the same shall not apply where approval therefor is obtained from the head of a Si/Gun/Gu.

There is still an ongoing argument concerning the legality of Doctornow’s medicine delivery. Doctornow is an upgraded version of the app Baedal-yakgook which launched in July 2020. Baedal-yakgook had provided real time information of the clinics and pharmacies that implemented telemedicine and prescription delivery, as well as a quick medicine delivery. On September 2020, Ministry of Health and Welfare (MOHW) announced that it is illegal for Baedal-yakgook to advertise and provide medicine delivery service according to the article 50 of Pharmaceutical Affairs. In response to this announcement, Doctorguide rather upgraded the services by adding platform for telemedicine and relaunched it under a new application name, Doctornow. After a review by the MOHW, the application was finally approved for a limited time and range of service due to the temporary allowance system. Still, there exists controversy over whether it is legal or not to deliver medicine.

Then what are the advantages and challenges of using this app?

1) Advantages

Using the app Doctornow is not only easy but also timesaving for patients. More and more people do not want

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to leave their homes without good reason and prefer to order goods online. The medical industry is not an exception.

Now, they can get prescriptions and medication delivery on their phones when they do not have energy to get out of bed. They can also consult with doctors even when they do not have time to go to the clinic during opening hours. It also works when you are unwilling to tell the doctor your personal life face to face; the cases that involve Emergency Contraception or Viagra are just two of the many examples. Moreover, the patients who live far away from urban areas can get consultations from the doctor without spending more time in for transportation than in the clinic.

2) Challenges to overcome

There always exist challenges in every change. The convenience of using the app will certainly improve the access to healthcare, but it could also lead to potential drug misuse or abuse. Drug misuse happens when substances are taken for the right purpose, but lacking consistency with legal or medical guidelines. As the patients do not have face-to-face consultation with doctors or pharmacists, it is more likely to not follow notices or cautions. They may take incorrect dose or take the drug at wrong time. Drug abuse can also happen when patients misuse drugs to get high or inflict self-harm. For instance, according to articles on Doctornow, one could get a prescription of total 10 pills of Zolpidem from two clinics just in 10 minutes through the app. Someone may consume sleeping pills including Zolpidem to manage their moods or acquire a buzz. In worst-case scenarios, someone may consume them to commit suicide or a crime. Consequently, drug misuse and abuse aggravate health of individuals.

Increased access to healthcare can also affect healthcare finance of the nation. It is undoubtfully important to efficiently manage the budget. However, more and more people will use medical service more frequently through Doctornow App because of its convenience. It could lead to the waste of healthcare finance. The government always makes efforts to increase access to healthcare for underprivileged people as well as to reduce futile treatment expenditure. However, Doctorguide is now rather trying hard to increase the use of Doctornow in Gangnam, which is the biggest region of Seoul in Korea. Most people who live in Gangnam are not underprivileged. It is a wonder if this is the right direction of healthcare. Therefore, Doctornow should not only focus on the convenience of patients living in the big city, but also the disadvantaged patients.

There are several more challenges for Doctorguide to overcome. One of them is that there is no sufficient identification system for doctors and patients. Some patients may easily use other’s ID and passwords of the app to get inappropriate prescriptions. They do not need to enter any additional information to get a consultation. Furthermore, patients cannot be entirely sure if the voice beyond the phone is of a doctor or not. Therefore, a strict identification system is needed to avoid any kind of this problem. Another challenge is the possibility of the data leakage. Patient health information is a very sensitive data. If Doctornow grow to be used in all over the cities in Korea, Doctorguide will have to manage huge amount of health information. However, here is an article written in the privacy policy of Doctornow.

“However, the company is not responsible for damage to personal sensitive information caused by unexpected accidents despite technical security measures, caused by basic network risks such as hacking.”

It is questionable whether a small startup app can securely protect the information. Last but not least, there are problems caused by consultants on the phone. For now, most doctors on Doctornow provide phone call telemedicine and only few doctors are offering telemedicine on video calls. This means that most doctors make medical judgements by listening to the explanation of the symptoms by the patients instead of checking the symptoms with their own eyes.

This kind of examination brings along a high risk of diagnostic errors and decreases the chance to catch potential diseases early.

It is timely to carefully think about the right direction of healthcare system and remember the original purpose of healthcare. The purpose of healthcare is to achieve three major goals: more effective, less expensive, and more humane treatments. What are the solutions to improve quality as well as reduce costs? It’s time to think about the new direction of the Korean medical healthcare through this app, Doctornow. B

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COVID-19 Vaccination in the world and in South Korea Youngeun Choi

karenchoi@naver.com

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ince the pandemic emerged, scientists from all around the world, around 1750 experts from 124 countries gathered to create the first vaccine against SARS-CoV-2 which is also known as the COVID-19 virus. Thanks to everyone’s effort to end the pandemic, we were able to discover the genetic information of the virus. The virus is highly contagious; it has affected the whole world and changed everyone’s lifestyle. For this reason, FDA surprisingly approved an emergency use authorization for the first developed COVID-19 vaccine from Pfizer-BioNTech which was developed within a year. Since then, many other big pharmaceutical companies, including Moderna and AstraZeneca, also released their vaccines that are effective in eradicating the virus.

Vaccination Status around the World According to AFP, until April 24th, 2021, more than one billion doses of COVID-19 vaccine were administered.

Out of one billion doses, 58 percent of the doses were concentrated on United States, China, and India. These three countries administered 225.6 million, 216.1 million, and 138.4 million doses respectively. Moreover, the leading country with highest vaccinated population was Israel reaching up to about 60 percent. Following countries were United Arab Emirates with 51 percent, United Kingdom with 49 percent, and United States with 42 percent. As many concerned, the first vaccines went mostly to wealthy countries. Those who supported big pharmaceutical companies got priority and wealth for the new vaccines. Canada, United States, United Kingdom, Australia, and the European Union were the top five countries that pre-ordered the most COVID-19 vaccine doses. Wealthy countries account for only 16 percent of the globe’s population, but they took up around 47 percent of the whole vaccine doses. The COVAX programme, which is co-led by Gavi, WHO, and the Coalition for Epidemic Preparedness Innovation was established to accelerate fair and equitable vaccine access for every country in the world, especially including low-income countries. However, despite this COVAX programme, vaccination in low-income countries is still not fast enough to follow up that of wealthy countries.

Vaccination Status in South Korea On the other hand, South Korea, which is a member of OECD, is experiencing relatively slow vaccination compared to other OECD countries. According to ‘Our World in Data’, South Korea had only 24 percent of its population fully vaccinated by August 11th, 2021. This is third to last after Costa Rica and New Zealand amongst the 38 OECD countries.

While many western countries are considering booster shots (additional third dose) this October, majority of South Koreans are still getting their first or second dose. This slow vaccination of South Korea is because of a problem in COVID-19 vaccine pre-order. Whilst most wealthy countries started their vaccine pre-order in March 2020, South Korea hesitated to pre-order the vaccines. The government asserted safety issues of the new vaccines and the successful K-quarantine (South Korea’s COVID-19 strategy) as its reasons for hesitation. Experts in South Korea continuously refuted this assertion as safety issues can be considered after necessary amount of vaccine doses are fully retained.

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However, their claims were disregarded by the government. Eventually, vaccination status in South Korea proceeded just as experts have concerned. Ki-seok Jeong, professor of respiratory medicine at Hallym University Sacred Heart Hospital, mentioned that “The biggest reason for the spread of the virus is the government’s failure to prepare vaccines from the beginning.” He added, “As South Koreans’ awareness of quarantine is high, the COVID-19 situation would have subsided a lot by now if the vaccine had been secured quickly. There is a limit to what can be done until the vaccination rate increases. It is expected to take a long time until then.” As countries that suffered a lot during the beginning of the pandemic have started to appease their quarantine and COVID-19 guidelines, more criticisms are pouring out towards the Korean government for their late actions. The Korean government eventually admitted its misjudgment and rushed to attain many vaccines as fast as possible. South Korea, despite its late vaccination, fortunately carried up to 44 percent of the people fully vaccinated by August 24th, 2021.

• Supply Shortage of Tylenol: In addition to the slow vaccination problem, South Korea faced another problem this year regarding Tylenol shortage.

Tylenol is a famous brand name of the ingredient acetaminophen or paracetamol that relieves pain, fever, cold, cough, headache, and so on. Eun-kyeong Jeong, the head of the Korea Disease Control and Prevention Agency, mentioned the specific product name, Tylenol in March 2021, while saying, “it is fine to take fever reducers such as Tylenol if you have a fever after vaccination”. After her press briefing, fear of COVID-19 vaccine potential side effects and popularity of Tylenol made many pharmacies and convenience stores run out of it. This was ironic because supply of other acetaminophen drugs, which have the same drug effects as Tylenol, was sufficient. An executive at KPA’s Policy Division, Soo-yeon Jung said, “What they want is only Tylenol.” Aroused fear of the new vaccine made people desire only Tylenol and believe that only this drug is effective. To prevent this supply shortage, Tylenol was not mentioned and was replaced by its ingredient name, acetaminophen, in later press briefings. Public campaigns and posters were carried out by the Korean Pharmaceutical Association to tell people they can buy other acetaminophen drugs other than only Tylenol.

Conclusion In overall, the whole world is struggling to fight against and eventually conquer COVID-19 virus. Much improvement can still be done about the difference in vaccine supply among different countries. However, despite emerging difficulties regarding vaccine supply and various mutants, everyone’s effort toward the massive pandemic including those from scientists and even ordinary citizens will hopefully help us gain back our normal lives with full freedom in near future. B 2021 VOL.20

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Resilience of Bumblebees to Climate Crisis Kyubin Kim

kkb5252@naver.com

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umblebees are known as the major pollinators in most boreal and temperate ecosystems. Despite their strong viability, bumblebees are threatened by current climate change, especially by changes in seasons, rising average temperatures, and extreme weather events. These events have induced responses such as selection in key traits and contraction of species. Here are some ways in which bumblebees have overcome the threats from climate change and emerging pathogens. Understanding their adaption towards different climates and viruses helps us improve bumblebees’ climate response models and face nature’s vulnerability to climate change.

Bumblebees, what are they?

Bumblebees are eusocial bees that are found worldwide across a wide range of climates, including subtropical, tropical, and subarctic regions. Bumblebees have been highly beneficial as they increase crop yield and quality and contribute more than 16 trillion won per year. Similar to many other insects, the population of bumblebees is decreasing due to a variety of factors that are mostly anthropogenic. Anthropogenic factors include exposure to pesticides and pathogens, habitat loss, and climate change. Climate change is considered to be the most conspicuous factor for their decline in species. Rise of the global temperature, increase of the CO2 concentration, abrupt changes in precipitation patterns, and increased frequency of extreme and severe weather events are some aspects of current climate crisis.

Thermal resistance There have been many studies about the responses of heat-stressed bees. Bumblebees endure extreme weather by thermoregulation. Unlike other insects, bumblebees are capable of controlling their body temperature. Nevertheless, the current extreme cold events pose a threat to the bees. When the temperature is low, bumblebees generate heat by shivering their flight muscles. This process involves fructose diphosphatase and phosphofructokinase. This process has allowed bumblebees to survive in extreme climates such as the tundra. However, when bees face even colder weather, their ability to thermoregulate would be under pressure. Bumblebees living in severe, harsh cold temperature have upregulated their myosin chain genes which are highly essential for muscle function and troponin genes, which involves Ca2+. Hot weather is another problem for bumblebees. Their resistance to high temperatures is known to be mainly related to heat shock protein (hsp). Bumblebees activate their transcriptional heat shock response and change expression levels of their hsp genes. This allows them to adapt to severe heat stress.

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Pathogen spillover due to climate change is harming bees It is known for sure that the climate crisis challenges the management of diseases and pests on Earth. Extension of warm weather enhances systematic and cell-to-cell propagation of viruses within hosts. This increases the possibility of disease outbreak and new viral diseases, threatening wild animals such as bumblebees. Here is an explanation as to why an increase in temperature allows viruses to find new hosts. Temperature is a major parameter that affects biochemical reactions and molecular structure of DNAs and proteins. Warmer temperature causes an increase in the fluidity of membrane and cytoskeletal dynamics. For example, studies have shown that replication of TMV(Tobacco mosaic virus) increases their multiplication and replication when the temperature is higher. Similarly, an increase in temperature resulted in the spillover of viruses that harms bumblebees. Bumblebees have become competent host of viruses such as BQCV, DWV-A/B. Moreover, the spillover of Deformed Wing Virus from honeybees to bumblebees decreased the abundance and distribution of bumblebees. Spillover of pathogens due to climate change may even attack humans. Just like the coronavirus, which had a shocking impact worldwide, spillover of pathogens can equally have a huge impact.

Climate crisis, now and foreseen ‘Climate Change 2021’, a sixth assessment report about climate change recently published by IPCC(Intergovernmental Panel on Climate Change) reminds us of the severity of the ongoing climate crisis. It is unambiguous that humans have contributed to global warming. Changes in the atmosphere, land, and ocean are faster than what we think. Global temperature of the Earth’s surface is 0.99 degrees Celsius higher in 2001-2020 than that of 1850-1900. Atmospheric CO2 concentrations are higher in 2019 than at any time in at least two million years. In 2011-2020, the average temperature in the Arctic had been the lowest for the past 150 years. Scientists warn that the Earth’s average temperature will continue to increase. The global temperature will rise by 1.5 or 2 degrees Celsius during the 21st century unless reductions in CO2 occur.

To conclude Climate crisis is a significant factor that influences our earth. As we can see, climate change has a negative impact on bumblebees. Despite their ability to endure harsh conditions, bumblebee populations are already declining rapidly all over the world. Also, bumblebees’ distribution, phenology, and physiological traits are also affected by extreme climates.

Moreover, climate change has also increased the chances of pathogen spillover which further threatens bumblebees. We need to be aware of the reality of human-induced environmental and climatic changes and set appropriate conservation strategies for our future Earth. B

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Pharmaceutical Pollution Ji Won Son

E

sonjw119@naver.com

verybody is aware of the considerable threats posed on the environment by carbon dioxide emission, burning of fossil fuels, and plastic wastes. However, only few are aware of pharmaceutical pollution, and how they ail our planet Earth. Pharmaceuticals in the environment have been detected in over 70 countries, covering all 5 UN regional groups, and this number and detected drug concentration are constantly increasing. This pharmaceutical pollution is not simple nor trivial; it is a serious issue that the whole world should pay attention to and put their heads together. Why is it such a great deal? What are the long-term consequences? And how can we tackle the current issue? Let’s find out.

Pharmaceuticals in the Environment: Why does it matter?

Pharmaceuticals devastate the environment as they flow into water bodies and soil, and bring adverse effects on living organisms. Although pharmaceuticals are being detected in the environment in low concentrations that some might consider negligible, chronic exposure to drugs can lead to gene mutation, disruption of the endocrine system causing alteration of fundamental physiological functions, formation of antibiotic-resistant bacterium, growth inhibition, and so on. One of the representative cases is the feminization phenomenon of male fish. Intersex fishes are found in different parts of the world, due to hormonal drugs like ethinyl estradiol and steroids. It was reported that in Dore River, France, 60% of the downstream fish were feminized due to steroidal drugs disposed from the nearby factory.

This is far from being an isolated case. Since biological target systems in animals and humans are different in some extent, a drug that is intended to have a certain effect on human might have an alternative effect on wild animals. For example, diclofenac, a non-steroid anti-inflammatory drug (NSAID), causes severe kidney failure on Gyps vultures, resulting in the accumulation and crystallization of urine in their blood. This has ultimately led to the dramatic decline of Gyps vulture species.

Furthermore, pharmaceuticals that are introduced into the soil can be absorbed into the plants through roots and accumulate in various plant parts. This raises concerns about the potential uptake of pharmaceuticals into crops.

Pharmaceutical contamination matters not only because it brings harm to the environment, but also because we humans are the ultimate victims that would suffer from the repercussions, slowly, without ever noticing. Since humans are at the top of the food chain, drugs taken up by animals and plants will end up on our plates.

There’s more. Most of the sewage treatment plants that are in use today are not designed to filter drugs, which means that tap water that we use every day to wash might contain drug residues. Also, pharmaceuticals absorbed in the soil are introduced into groundwater, and the polluted groundwater eventually enters drinking water source. Long-term consequences on our bodies are yet to be identified, but I can guarantee that they are not going to be friendly.

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Causes Pharmaceuticals enter the environment through various pathways. The dominant source of the pharmaceuticals is from patients’ excretion, in which they pass through their bodies and flow into waterways. The rest of the pharmaceuticals detected in the environment are attributed to improper disposal of leftover drugs from households and pharmaceutical wastes from manufacturing factories. However, we cannot simply blame individuals and the manufacturing companies for the contamination nor lay responsibility upon them because there are other various factors that worsen the situation.

The limitation of wastewater treatment system is one of them. According to a UNESCO study, out of 118 assessed pharmaceuticals, only 9 were removed from wastewater treatment processes with an efficiency of 95%, and half of the compounds were removed partially with an efficiency of only about 50%.

Currently, Advanced Environmental Risk Assessment (AERA), a system for assessing pharmaceutical impact on the environment in advance, is mandatory according to the international guidelines. The problem is that while Canada, U.S.A., and EU conduct Advance Environmental Risk Assessment (AERA) for all pharmaceuticals, both human and veterinary drugs, many other countries, including South Korea, apply AERA only on veterinary drugs and the application scope is narrower. This seriously calls for the introduction of stricter and unified international regulatory guidelines.

Other than these factors, the absence of adequate regulatory standards regarding drug disposals, defective wastewater treatment plants, and over-prescribing behavior of health professionals have been making contributions to this whole situation.

What should be done?

Pharmaceutical contamination is inevitable, but there are ways to reduce the amount of disposed pharmaceutical wastes.

First of all, proper disposal of pharmaceuticals should be carried out by individuals. Expired medicines should not be flushed or thrown away in household trash. The best way of disposing pharmaceuticals is by dropping off the medicines in “drug take-back” sites. The disposing system varies in different countries, but many countries have a “Drug take-back” program where certain sites in each community are designated to collect unused or leftover drugs. In South Korea, local pharmacies and public health centers are the designated drug-collecting sites.

The government should be cognizant of the pharmaceutical pollution issue and take substantive actions. Regulations regarding drug disposal should be intensified, and stricter management and supervision are necessary. Also, all countries should conduct AERA for both human and veterinary drugs. This way, pharmaceutical companies can scientifically predict and evaluate the risks of drugs to the environment in advance and seek ways to reduce them.

But the most important thing is to raise awareness among people and bring international attention to this problem.

Since this is not a simple issue that can be solved by an individual or a single country, everyone from all around the world should come together and find ways to weather the storm. B

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COVID-19 AND VACCINE INDUSTRY Cho YouYoung

I

youyoung0129@gmail.com

t has already been two years since COVID-19 appeared, and vaccinations are actively taking place in November 2021. Globally, as of 4 November 2021, a total of 7,027,377,238 vaccine doses have been administered. Korea, as of October 2021, recorded the first inoculation rate of 78.7 and the final inoculation rate of 64.6%. 8.62 million vaccines were introduced in the first half of 2021, and 56.3 million vaccines were introduced in the third quarter.

Among 38 OECD countries, Portugal, Chile, Iceland, and Spain ranked first to fourth in the first vaccination rate. South Korea (78.44%) was ranked fifth. Japan (75.05%) was ranked 13th and the United States (64.91%) was ranked 25th.

Vaccine Development Status Several vaccines that are currently in use. There are four types of vaccines: whole virus, protein subunit, viral vector, and nucleic acid (RNA and DNA). All vaccines protect people but do so by inducing immunity in a slightly different way.

The first mass vaccination program started in early December 2020. The Pfizer/BioNtech Comirnaty vaccine was listed for WHO Emergency Use Listing (EUL) on 31 December 2020. The SII/Covishield and AstraZeneca/AZD1222 vaccines were given EUL on 16 February 2020. The Janssen/Ad26.COV 2.S developed by Johnson & Johnson, was listed for EUL on 12 March 2021. The Moderna COVID-19 vaccine was listed for EUL on 30 April 2021 and the Sinopharm COVID-19 vaccine was listed for EUL on 7 May 2021. The Sinopharm vaccine is produced by Beijing Bio-Institute of Biological Products Co Ltd, subsidiary of China National Biotec Group (CNBG). The Sinovac-CoronaVac was listed for EUL on 1 June 2021.

Vaccine Approval Process in Korea The domestic introduction procedure of a vaccine follows that of the approval process for medicines. However, it has one more step called ‘national shipping approval’ that comes after. So, its steps are registration, preliminary evaluation, advisory, survey, and approval. The final step is a procedure to ensure the safety and effectiveness of the vaccine. Distribution and sale of the vaccine are available if all these steps are satisfied. The drug licensing process begins when the manufacturer and importer apply for the item’s permission for the item. They must prove the safety of the drug by submitting data on nonclinical trials, clinical trials, and quality assurance to the Ministry of Food and Drug Safety. Currently, the Ministry of Food and Drug Safety has formed a “COVID-19 vaccine and treatment approval review team.” In general, the drug approval process takes more than 180 days, but the Ministry of Food and Drug Safety has shortened the COVID-19 vaccine to within 40 days.

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INTERNATIONAL ISSUES

Global Vaccine Purchase Status The first purchases were made in May 2020 by the US and the UK for the Oxford-AstraZeneca vaccine. The first purchases for low-income countries began in January 2021, through the African Union’s pooled procurement approach. Many countries in Latin America, Africa, and Asia still have not yet been able to purchase enough vaccine to cover their populations. It is important to note that purchase of vaccine is not the same as delivery of vaccine.

For instance, despite Canada’s early deals, it has only received a fraction of its order. Demand has outstripped supply for COVID-19 vaccines around the world since the first vaccine’s emerge. COVAX and other alliances are thus critical to ensure equitable allocation of vaccines for low- and middle-income countries (LMICs). A partnership between GAVI, the World Health Organization, and the Coalition for Epidemic Preparedness Innovations (CEPI), COVAX promotes equitable distribution of vaccines, so that the pandemic finally comes to an end.

Why is Pfizer So Successful?

Pfizer is the world’s largest pharmaceutical company with the largest privately financed research organization. The company has shown even greater growth, with stock prices rising ever since the approval of Pfizer COVID-19 Vaccine by the FDA in August 2021. This might be because Pfizer has developed the first non-emergency, but official COVID-19 vaccine approved by FDA. But how did Pfizer become the global force it is today before this incident? Pfizer was founded by two German immigrants as Charles Pfizer & Company in Brooklyn, New York in 1849. It was financed with a $2,500 loan from one of their fathers. Pfizer was a chemist, and his cousin Charles Erhart was a confectioner.

The cousins’ first product, a form of santonin used to treat intestinal worms. Years later, in the 1940s, Pfizer became the first company to discover a way to mass-produce penicillin. In 1988, Pfizer launched an anti-erectile dysfunction drug Viagra. Hailed as a “miracle drug”, Viagra has been a reliable source of income for 15 years, with sales reaching $2bn in the US alone in 2012. In the 21st Century, Pfizer acquired many other pharmaceutical companies, including Warner-Lambert in 2000 Pharmacia in 2003, and Wyeth in 2009. In 2004, Pfizer was added to the Dow Jones stock index, which tracks the 30 biggest publicly listed companies in the US. Throughout this long history, Pfizer has been able to become a major pharmaceutical company today based on solid knowledge, technology, and huge amount of capital.

The Process of Setting the Price of Vaccines The price of a new vaccine is a complex process that can have a significant long-term impact on science, healthcare, and public health. In addition, pricing of new vaccines can have a significant impact on vaccine adoption. The pricing of vaccines basically follows the following 11 general components of a pricing strategy. Plus, it has one more additional component. Discounts are a major part of the new vaccine price structure. Bulk vaccine buyers often try to negotiate effective prices lower than the regular price of the new vaccine, especially in low-income countries when a new vaccine meets urgent needs. Discounts may vary depending on specific geographic regions, populations, buyers, and time of year or other circumstances. Purchase volume is not the only motivation for discount.

The vaccine industry is essential for mankind to survive the war against microorganisms. Therefore, unlike other industries, it must be considered in more many ways (equal, safety, effectiveness, and persistence), and the resulting complex steps exist additionally. As long as mankind exists in the future, infectious diseases will continue to emerge, and the vaccine industry is a huge future-oriented industry that targets people around the world. The current epidemic will not end with COVID-19. Therefore, emerging powerhouses must continue to emerge in this field, and infrastructure for vaccine development must always be established. B

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LIFE ISSUES

Early to Bed, Early to Rise! Sleep Timing and Depression Kim Dah Eun

kcherry@yonsei.ac.kr

W

hether for the prolonged stay-at-home days from COVID19 or for some other reasons, the average bedtime for people in their twenties, especially university students, is around 2 to 3 AM. Also known as ‘night owls’, students easily pull off all-nighters for upcoming exam weeks or project deadlines. The famous idiom “The early bird catches the worm” is now considered old fashioned. Rather, the sleep controversy between morning larks and night owls is the rising new.

As a night owl myself, I have always tried to rationalize my irregular sleep pattern by insisting that each people have their own typical chronotype: the natural inclination of their body to sleep at a certain time. Repetition of drowsiness during daytime and unpleasantness during nighttime pushed me to reconsider my sleep cycle. So, I decided to investigate the pros and cons of nocturnal and diurnal sleep patterns. My new sleep cycle must be set based on scientific facts and must be contributing to both my physical and mental well-being. Eventually I jumped through new facts, articles, and studies about the correlation between sleep timing and depression which was intriguing in every sense.

The Correlation of Sleep Timing and Depression According to the research published on JAMA Psychiatry (Journal of American Medical Association), psychiatrist Daghlas, Lane, Saxena, and Vetter studied the positive influence of moving bedtime up to earlier hours.

The researchers started by evaluating the genetic data of 850,000 people and sleep pattern data collected from wearable trackers worn for seven days. Participants also had to answer a questionnaire related to sleep timing preference. These were done to figure out the sleep patterns of the subjects and their genetic information regarding major depressive disorders.

Study results showed that one third of the participants were diurnal, 9% were nocturnal, and the rest were intermediate. In addition, the overall average sleep midpoint-median between bedtime and wake up time-was found to be 3 AM. Researchers then made the participants go to sleep an hour earlier than their usual sleep time for a week.

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LIFE ISSUES

The length of sleep was fixed to about 6 to 7 hours. Only the sleep time was set as a variable. Researchers also secured anonymous medical and prescriptive records related to the diagnosis of major depression. Then, a new statistical technique was introduced to examine whether sleeping early lowered the risks of depression for people who are genetically vulnerable to depression. As a result, the risk of major depression decreased by 23% when the participants’ sleep midpoint was pulled an hour early. In other words, if an individual with the same length of sleep hours went to bed at 12 PM instead of 1AM, he or she would be less vulnerable to major depression disorders. More surprisingly, when the participants’ sleep midpoint was pulled even earlier, the risk was lowered up to 40%.

It is, however, not clear in this study whether people who are already diurnal can benefit from moving their bedtime earlier. Still, this study has great significance in that it provides strong evidence for the correlation between sleep timing and the risk of major depression disorders. There have been studies showing the relationship between mood with the exposure to sunlight during daytime, and the secretion of specific hormones in early risers which is responsible for shutting the depressive mood off. Also, studies on biological clocks and circadian rhythm have been widespread, but the accurate quantitative data on how an individual would reach a transition of mental health was limited. In fact, this study is said to be one of the first to quantify the degree of change in sleep timing required to pose an impact on mental health.

Tuning up Your Rhythm with Daylight Remote classes and working from home due to COVID-19 are causing delayed sleep patterns in many people’s lives. We live in a society created for morning larks so night owls can often feel as if they are constantly out of synchronization with social clocks. Since we have looked at the experimental evidence about how earlier sleep timing improves our daily mood, let me introduce a few tips from Rafael Pelayo, MD, clinical professor at Standford, to make life cycle modifications.

First, adjust in small increments. Many of us may be aware that it is much harder to pull up our sleep timing than to push it further. Hence, to tune up your sleep timing, you should make small changes, just about 15 minutes each day. Second, do not take naps. Napping can be a disturbance for a good night’s sleep. If you feel like napping, try doing some active work or exercising to help overcome your sleepiness. Third, do not hit snooze. Consistency is most important in fixing a habit. Maintaining your sleep schedule is no exception. Do not hit the snooze button, change your mindset, and try to think of reasons to start the day early. Also, avoid late night snacks and exercising near bedtime. Active digestion and exercise cause a disturbance in getting a good night’s sleep. Finally, relax. Make sure your room atmosphere is comfortable, including the temperature, and the air. Clear your mind about the events that happened in the daytime. This will make you look forward to sleeping and waking up the next day.

Many evening people and even some morning people sometimes experience melancholy whenever staying awake past midnight. Early to bed and early to rise can be a solution. B

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LIFE ISSUES

SNS BODY PROFILE BOOM - THE SIDE EFFECTS Seo Yeong Kim

katherina623@naver.com

Taking body profile photos- a new trend in The MZ generation

T

hese days, various health-related YouTube videos are released and many people are interested in getting in shape. Since the advent of COVID-19, attention has been focused on exercise, especially at home working.

Young people have been interested in sports, but interest in health care overall has increased due to the prolonged pandemic situation.

Taking body profile has become popular along with exercise. A body profile is to take a picture of one’s body built from exercise. Social distancing has limited people from outdoor activities, making it natural for people to record and share personal lives online. Taking body profiles, and recording youth have become a new trend in The MZ generation. On 2021 August 13, there had been more than 2.2 million posts hashtag with “Body Profiles” on Instagram. The figure is surprising compared to about 500,000 hashtags for “Miracle Morning,” which has also become very popular after the advent of COVID-19.

Why is it so popular?

There are many reasons why people are so fascinated by body profiles. They usually take body profiles to remember the wonderful solid bodies that they have achieved. Moreover, as people get older, their elasticity gradually decreases, so they take body profile photos to record their youth. Likewise, face profile photos are in vogue because people want to remember their young appearance. Some people book body profiles to motivate themselves to exercise. Recently, many stars have recorded their challenges with body profiles. These celebrities’ body profile challenges have had a great influence on the public.

According to Kwak So-kyung’s study on the effect of media on women’s diet, the body image on media has caused a gap from reality. Women go on a diet as they internalize the skinny bodies on media as a standard of beauty.

Studies have shown that media also affects women’s satisfaction with their bodies.

Yoo Hyun-jae, a professor of knowledge convergence media at Sogang University said, “As celebrities have a great presence in Korea, their influence cannot be ignored. The reality of indirect advertising by celebrities with diet companies is also serious.” He thinks this phenomenon is what triggers the body profile trend.

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LIFE ISSUES

The side effects?

As this body profile obsession arises, more and more people complain about side effects of body profile, because they mostly rapidly cram for body profile. This not only harms their physical health, but also mental health.

Ordinary people do not feel much difficulty in the beginning, but if a beginner maintains a healthy diet for more than three months, there is a high probability of developing stress in the long term. In addition, intaking carbohydrates are excessively restricted during the preparation, so the desire for carbohydrates becomes bigger.

Hormones are the key reason why people suffer from yo-yo diet after the body profile. If people do not have enough fat in their body, ghrelin hormone, which tells us to eat, is secreted. If people have a lot of fat, leptin hormone is secreted, and signal us to stop eating. When taking a body profile, only a minimum amount of body fat is left.

Ghrelin will be secreted and people will be stressed to ignore the signals to eat. If people live at a low body fat rate, they cannot produce cell membranes, sex hormones, and cortisol hormones. Vitamin D will not be synthesized well, causing bone weakening and poor bile secretion. Some studies show that each time fat intake is reduced by half, the level of estrogen, a female hormone, decreases by about 20%.

Some people lose hair when they go on excessive diets. Protein-oriented meals cause nutrient imbalance weakening hair growth. Typically, a lack of iron that promotes follicle cell division causes hair loss. On top of that, extreme stress on weight loss can also accelerate the rate of hair loss.

People usually go on excessive exercise and diet because they think it is cool to be thinner than maintaining a healthy body. Extreme exercise and diet control lead to loss of healthy eating habits, ultimately lowering self-esteem.

Moreover, physical stress leads to mental insecurity.

To minimize the side effects…

The purpose of body profile should be clarified to prevent mental and physical damage. Rather than trying to win it in a short period of time, people should prepare it nice and slowly to minimize the side effects of body profile.

During the preparation, it is important to properly control the speed of weight loss. It is recommended to lose weight at around 5% of your weight a month. In general, losing two to three kg in a month is appropriate. In addition, drinking as much water as 3 liters a day is important. The kidney may be damaged from intense muscle exercise, so people should drink enough water before and after exercising.

People should set an appropriate goal for body fat and take body profile photos when they achieve so. They should not be too greedy to lower body fat. People should love themselves for who they are. Self-esteem is important. They should take pride in themselves and have a positive mindset throughout the procedure. B

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LIFE ISSUES

CULTURED MEAT:

FOOD OF THE FUTURE SeungYeon Noh

roh99hh@gmail.com

T

he world’s population is expected to surge past 9.7 billion by 2050. This will lead to increased demand for food, especially greater demands for meat as the worldwide preference for meat over grains is increasing.

However, it seems like traditional meat production by animal agriculture will not be sustainable until then.

Traditional livestock farming requires water, land, fodder, and agricultural expansion to produce forage. These processes not only require huge amounts of resources, but also discharge methane, carbon dioxide, and wastewater which raise environmental costs. Therefore, to meet the demands of the future, a meat analog, the ‘cultured meat’ is in the limelight.

About Cultured meat is edible meat derived from cell engineering. It is also named as in vitro meat, lab grown meat, cell-based meat, bio-artificial meat or clean meat. The manufacturing process begins with harvesting cells from live animals. They are then cultured in bioreactors with high densities to produce animal protein. To be specific, tissues are first isolated from domestic animals like cattle, pigs and chickens. Then, stem cells are extracted from the tissues and are differentiated into mature myofibers. Finally, fat, juice, and food additives are added to produce cultured meat.

Safety issues Here are some arguments regarding the safety of cultured meat. Advocates claim that it is much safer than conventional meat as its confined culture system is fully controlled by researchers which can reduce the likelihood of contagion outbreak. Unlike cultured meat, conventional meat faces exterior interchanges which generate potential contamination via slaughtering and intestinal pathogens. However, opponents assert that researchers cannot fully control every cultivation process which can incur unexpected consequences regarding public health. For instance, during cell multiplications, some regulatory disorders may occur which will then cause fatal effects on human health when consumed.

Comparison with conventional meat Emission of greenhouse gases Production cost Animal ethics and welfare problems Possibility of mass production Consumers’ acceptability Sustainability Production time Threat from enterobacteria

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Conventional meat high low high high high low long high

Cultured meat low high but potentially low low low but potentially high low high short low

LIFE ISSUES

For the mercantile success of cultured meat – in terms of technology 1. Cells

Cells widely used for cultured meat are those capable of self-renewing. Particularly, we isolate undeveloped satellite cells for incubation. These satellite cells play a part in revitalizing muscle injuries. Under normal conditions, they remain dormant due to cell cycles controlled by negative regulators, growth factor regulation, and expression of tumor suppressors such as retinoblastoma protein (Rb). Although it is hard to make them proliferate, they easily differentiate into myofibril by intrinsic or extrinsic stimulus. Regeneration ability of skeletal muscles is due to satellite cells that reside within the muscular tissues. Additionally, other cells including embryonic stem cells, induced pluripotent stem cells (iPSCs), and adipogenic stem cells also have enough differentiation potency. Among these, induced pluripotent stem cells are the most promising as they are non-embryo based alternatives and are easy to differentiate. However, no case has been reported about successful cytogenesis using these cells.

2. Culture media

Culture media decide the essential nutrients, growth factors, hormones, oxygen, pH, and osmotic pressure needed for cells. For immature cells to differentiate into skeletal muscle, fat, and connective tissues, transmuting the medium composition is indispensable. However, regulating the composition only comes natural in conventional meat. To show an example, adjusting fat composites by controlling the ratio between saturated fatty acids and polyunsaturated fatty acids is easily done in current livestock but not in cultured meat. Likewise, for cells to positively uptake micronutrients, organization of growth media should be well understood since required nutritional components differ from their maturational stage. Above all, fetal bovine serum (FBS) takes up the most crucial portion in the latest study about cell nurturing. Serum serves as a carrier of lipids, enzymes, micronutrients and microelements through permeability. However, there follow some serious ethical issues since the serum is gained from slaughtering calves.

It is contradictory as cultured meat aims slaughter-free. Also, the high price of FBS results in high production costs.

This is why finding cost-effective alternatives for FBS is of prime importance.

3. Mass production

High volume manufacturing of cell culture is required for stable supply and lower price of cultured meat. The most significant point in this technology is cultivating large amounts of cells in a confined place. As cells grow by attaching to their flasks in all directions, incubating them in three-dimensional (3D) spaces can largely enhance the yield than that in two-dimensional spaces. Even so, 3D culture systems confronted the difficulties regarding the ways to create a uniform environment inside the bioreactors. If cells gather, temperature, pH, and concentration of nutrients become uneven for the cells to nurture. Therefore, adjusting the number of cells, days to culture, and the amount of culture medium will be crucial to untie these challenges.

Future directions Cultured meat has superiority over existing livestock products in terms of environmental concerns and usage of resources. However, on account of technology and production cost, cultured meat needs to do more to substitute original meat. For the commercialization of cultured meat, overcoming safety issues by finding out various cells with differentiation potential, culture medium without animality, and effectual mass cell culture methods should be carried out. B

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Members Editor in chief

VICE Editor in chief COPY MANAGER

YoonZoo Gee

okyoon kim

Youngeun CHOI

Journalist

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gayoung lee

kyubin kim

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seoyeong kim

THE BLUE VANGUARD

jungeun kim

seung yeon noh

jimin seo

ji won son

namkyu oh

youyoung cho

daehyun kim

heedo yang

jiwon kim

jiwon yang

Designer

desigN MANAGER jihyun kim

seokyung kim

2021 VOL.19

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Reference