Interviewee, Dr.

Elsa Bou Ghanem

Research Associate, Tufts University
PhD, Microbiology & Immunology

Date of Interview: November 21, 2017

Start time of interview: 2:28
End time of interview: 2:50

Dr. BG : “I’ve wanted to talk to you about what you need from me and what you are working
on”

SW : “Ok, umm well, right now I’m narrowing down what I’m researching. I’ve narrowed it
down to the effect of aging on macrophages specifically, but I’m not really sure if I...yeah, that
what I have.”

Dr. BG : “Yeah, so just to let you know, I’m not a macrophage expert. I’m a neutrophil expert,
I’m not sure if that would make a difference to you. I study aging in neutrophils. So I would be
able to give you more input if that’s what you’re working on. I don’t know how attached you are
to your topic. Now, when you say researching, what exactly do you do. I hear you’re in high
school, where are you at in your education?”

SW : I’m in 11th grade, I’ve taken Biology AP as a course, so I have a basic understanding of
biology and the immune system.

Dr. BG : And you have an interest in research?

SW : Yeah, I want to be a scientist.

Dr. BG : Oh, that’s great, good to hear.

SW : I’m not particularly attached to the topic of macrophages, I do prefer the innate immune
response over the adaptive. I would be willing to look at the effect of aging on neutrophils.

Dr. BG : It’s just that I could give you more reviews and information...if it is alright with your
teacher.

SW : We’re pretty independent, we get to chose our own topics.

Dr. BG : Ok
SW : Can I ask you some questions?

Dr. BG : Sure

SW : Uh, well, I’m a bit confused about how aging affects cell functioning. A lot of articles that
I’ve read blame change in the microenvironment but I’m not sure what that means?

Dr. BG : Ok, so, basically you can imagine, imagine there is cells being produced in the tissue
for a function, but with age there are many dysfunctions, they are just not as young. I’ll give an
example, a neutrophil cannot kill bacteria as well in an aged host as well as in a young host. And
that can be true of different things, it could be that the cell has defects so the cell itself, for
example cannot swallow the bacteria and kill it or sometimes it does not have the wheels to
move, if you want, a machinery malfunction. Or it could be that’s where it’s at. So when people
talk about the microenvironment, basically they mean that the stuff surrounding the tissue. For
example imagine in an old environment they always talk about inclination, that means there are a
lot of cytokines being made and cytokines are proteins that can bind to cells and alter their
function. There are different cytokines in an old than a young environment. So the cells are going
to act very differently. Their seeing cytokines that tell the cells not to move, to stay in place. So
that’s what the mean when they talk about the microenvironment, in simplest expression. Or it
could just be the programming within the cell. They have just the wrong programming or
defective programs.

SW : So the cytokines act as signals and change gene expression? That’s what occurs?

Dr. BG : Yes, so cytokines don’t only change gene expression, it changes not only the proteins
synthesis, what it’s producing, and it can also be at the level of.

SW : Do we know why cytokines are produced as you age in the first place?

Dr. BG : Not really, there are theories. people think that as you chronically age you are exposed
to a lot of agents in the environments that causes damage, oxidation, and so your cells get
damaged. You always respond at a very low level and you experience inflammation. And the
theory is because you have chronic exposure to bacteria, toxins, things in the environment
throughout your lifetime. People are still trying to understand inflammation, what really drives it.
It is characterized by a lot of cytokines. Even though the individual or host is not affected.

SW : Does the thymus’ involution have an affect on the innate immune responses?
Dr. BG : I don’t think so, I’m not 100 percent sure. I think mostly it affects the production of T-
cells. I don't think people - not that I’m aware of - have looked into the effect on innate
immunity. I’m not familiar with that.

SW : Okay, yeah...

Dr. BG : But I think what people have really characterized is the design T-cell response with
aging. SO you don’t have as many new T-cells being produced, and that leads to what’s called T-
cell exhaustion. We do not have new ones being produced at least in the thymus the human has a
lot of specialized T-cells which accumulate throughout their life. Whenever they are exposed to a
new antigen they can create a newly specialized T-cell to find that pathogen exact. Although they
have the older ones, so they have trouble there, but they can’t mount proper adaptive immunity.
That’s one of the ideas there

SW : So, but um, lymphoid potential decreases and myeloid potential decreases, why is it that
there are more innate immune cells created due to aging

Dr BG : That’s in the blood marrow with age, because you get more hemopoietic, with age you
get an increased production of immune cells which is what happens with time. Keep in mind,
even though you are producing, for example in mice they produce more neutrophils, their
function is not the same. Though they produce them in larger numbers their functionality is
impair. It’s not only about numbers, it’s not quantity, the quality is very important.

SW: That makes sense. Is it that...so do the cytokines affect neutrophils and innate immune cells
more than they would affect B-cells and T-cells.

Dr. BG : They have affect on both types of cells, both the innate and adaptive. Cytokines can
affect the cell as long as the cells have the receptor for that cytokine

SW : Hmm

Dr. BG: Yeah, and so, yeah, it’s the none that cytokines can affect most t and b cells and affect
the innate immune response, and affect neutrophils and macrophages which are more apart of the
innate. Do you have other problems with innate immunity? You know mounting the specialized
immune response they can have a host of other problems that are very well characterized in the
literature.

SW: Do you have any recommendations on what I should learn specifically on neutrophils when
I am researching them later?
Dr. BG: Yeah I can send you some reviews that I think would be helpful for you.

SW: Thank you, yeah, that would be very helpful

Dr. BG: And there's a very good review on aging in general that I really liked, McKetta, for you
to read.

SW: Ok, that sounds interesting, thank you. Do you have any more questions about my topic or
the project?

Dr. BG: Yeah, yeah, I wanted to discuss what you do, what’s expected of you. You read papers
and you write a summary of that you learned? Or how do you do it? Are there things you have to
turn in at a specific time? Talk to me a little more about that.

SW: Yes we do, we do read a lot of articles. We turn in annotations and critical reads. We turn
those in weekly, we’re working on writing a paper that will be turned in in January. I’ll be
working on this the entire year. I’ll be trying to get a paper published at the end of the year, or by
the end of the year.

Dr. BG: Ok, and published, what do you mean?

SW: I’m not sure, I have to figure out what I want my final product to be. I just have to figure
out what I want to do with my research. And I’m figuring that out now.

Dr BG: Ok, yeah, so umm, I should let you know I study neutrophils in the context of an
infection. I work on a bacterial pneumonia, a strain called streptococcus pneumoniae. And this
bacteria is very serious, it causes serious infection in the elderly. It’s the leading cause of
pneumonia in the elderly. So that's why it’s relevant to aging because the aging population is
very susceptible to this infection. And there’s two vaccines that people can take to fight the
infection, but the vaccine does not seem to work that great in older adults. Is your topic related?
Would you be interesting in learning about my topic? I would be able to help you better then.

SW: I might be interested, yeah. How does the bacteria in the infection affect the immune other
than how their aging bodies do? And is that…

Dr. BG: Yeah, so basically when you get an infection with any bacteria or any viruses you have
your innate immune response, your first line of defense. They get to site where the bacteria are
and basically they try to kill the bacteria and keep it in check, giving time for the body to mount
an adaptive immune response. An adaptive immune response is specialized, you produce-cells
and T-cells that can recognize your bacteria. They’ve become very good soldiers to kill the
bacteria, and, um, a lot of bacteria are involved a lot of different ways to escape from the
immune system, for example, the bacteria I work with, do you take any microbiology?

SW : No I haven't

Dr BG: Ok, no you haven’t, so basically it’s a special type of cell wall, surrounded by a sugar
capsule. And this makes neutrophils unable to fight bacteria, partially because of age-related
issues that build up.

Reflection

The interview went well, I was able to ask questions, get answers, and secure a better

understanding of my topic thanks to my advisor’s help and understandable explanations. I

stuttered a bit, attempting to respond to the information that was thrown at me. This was partially

because we were discussing a topic I was more unfamiliar with, neutrophils, and I did not know

the technical terminology she did. I also was able to figure out a more specific topic to study, and

what line of thought and logic I would be following and testing. Dr. Bou Ghanem explained her

own research, and what she would be able to help me understand, which is what helped me

narrow my topic and be more specific in my interests. She specified that she was studying the

immune system in reaction to an infection, and neutrophils specifically. This makes sense given

the immune response to infection is truly what is important in any scenario, including

senescence. In the next interview, I want to focus on this with a better knowledge of the subject

specifically so that we are able to have more in-depth discussion. I would like to stutter and

fumble for words less, and have a more specific goal in mind for the information I would like to

learn from her (as opposed to the more introductory and basic knowledge so to gauge each

other’s knowledge). It was difficult to find that comfortable level ground of discussion and

understand what we could do and explain for each other. It was also difficult to come up with

questions completely on the fly (though the ones I came up based on what I already knew I
wanted to know were easy to come up with). It was surprisingly easy to figure out what my new

topic would be and what I would need to do to understand that topic.