Hello and welcome to Sick Notes.
My name is Ed Hope, a junior doctor in the UK
and on this channel, we explain medical things in simple terms.
So, if that sounds good, why not come and join our community here on YouTube?
I've had many of you request this, including Corrupted Cyborg, just the other day.
He says "Hey, wondering if you can check out an animated show called 'Cells at Work'." So let's do it.
>> ♪ … kara sumi e Dakedo hirokute maigo maigo Tedasuke sareteru hataraku saibō ♪
>> Quite a funky intro it looks like these are the red blood cells carrying the oxygen around.
I'm hoping that it is subtitled, otherwise, it's going to be a really strange review.
>> ♪ Inochigake da zo (Inochigake da zo) Puraido motte Ken・Kou … ♪
Oh my word—falling zombies, in your body!
I think I'm gonna like this show. If this is how they're showing how viruses infect cells,
by showing them as zombies, that is a brilliant analogy.
Hopefully I can take some of that
and use it in my teaching because that is exactly how viruses work.
They can't replicate on their own. They need a host to do so, kind of like a zombie.
[He does know that zombies aren't real, right?!]
>> ♪ Hataraku? Hataraku! Hataraku! ♪
>> Just from all those cool imagery from the intro and the fact I'm a huge pathology nerd,
I can tell I'm really gonna enjoy this show.
>> Here's today's oxygen delivery!
[RED BLOOD CELL] [Her red color is due to the large amounts of hemoglobin.]
[She carries oxygen and carbon dioxide using blood circulation.]
>> Yes! So as I thought from the intro, it follows a red blood cell here.
I'm a big fan of the red blood cell,
so it's good to see them in action.
So, just to remind you guys,
the red blood cells are these main cells in the blood that give the blood its color.
And their job is to take oxygen from the lungs and take it to the tissue
and the way they do that is each cell is
packed full of this protein with an iron core called 'hemoglobin' which binds the oxygen to it.
>> (ground trembles) Huh?
What is this? >> Oh, no. Here they come! >> Run! (crowd screaming)
(eruption) >> Whoa! The vascular endothelial cells …
(knocked down) (gasping)
(stomp) (shriek)
>> Seems like a pretty damn comfortable place!
>> Right, so we have quite early on an
infection so looks like the endothelial cells—the cells that line the blood vessels—have been damaged.
So nice little touch there. Here are the nasties.
I think they're most likely bacteria because you see these tentacle things that are coming out from them.
They're most likely some of the structures that are on the bacteria. Let me show you quickly.
Let's draw a basic bacterium.
We have a cell membrane just like our cells do.
They have a nucleoid containing their DNA. So it's not quite as advanced as our nucleus.
They have some ribosomes which are kind of the factories that take the DNA and then
turn it into useful protein so they can maintain themselves.
And they have a cell wall, which our cells do not have,
because bacteria are single-cellular organisms.
So they need the cell wall to protect themselves from the environment, whereas our cells,
they tend to be specialized to certain jobs and therefore they don't need a cell wall because they rely on
all the other cells of the body to make a perfect environment for which they can function.
So the tentacle-like structures that we see in this bacterium are likely to be either
'pili' or 'fimbriae', these kind of hair-like projections.
Their job is a very crude kind of communication system, so there's another bacteria here
they can communicate via transferring of DNA and RNA via these kind of little hairs.
Or more likely, it may be what's called a 'flagella'
a kind of tail-like projection that's used for motility,
and as a kind of crude sensory organ by the bacteria.
>> (both screaming)
>> Huh?
(sliced) >> Die, germ!
(cut)
(serrated) >> Die!
(combat) >> Who are these guys?
(RBC gasping)
(knife sheathed) (radio channel crackles)
>> This is White Blood Cell Neutrophil Division, U-1146.
>> This is pretty darn accurate.
The neutrophils are the most common white blood cell
and they—as we can see here— their job is to be badass and to kill any kind of nasties in the body.
In this adaptation, they have knives. That's right!
Imagine how lethal our immune system would be with knives.
In reality, our white blood cells are even more badass.
They *eat* the bad guys. [NEUTROPHIL] [BACTERIUM]
We call this 'phagocytosis'. [Clip from: Mr Riddz Science]
Imagine your local police station dealing with criminals that way. That'd be pretty mad.
They also release enzymes and toxic chemicals that help break down the pathogens, too.
I'm talking about white blood cells now, not police officers.
>> ♪ (aftermath) (body dragging)
>> (grunting) Dammit!
I like all the little side posting to all the other areas of the body as well which hopefully will get explored
in other episodes, and little things like the valves appearing on the venous system.
As the blood's going back to the lungs, it actually moves under very low pressure. So you need valves
to stop it going back in the wrong direction.
>> RBC: Excuse me? There's something I'd like to ask you!
Um… excuse me…
(surprise)
(!!)
(?!!)
(door creaks)
(screaming) >> Don't act like nothing happened!
>> (incoherent screaming)
(collision)
>> The action sequences and the storytelling and the sound, is so well done.
I'm not a huge anime fan. Maybe I need to look at some more stuff. It's absolutely brilliant. Really compelling!
>> WBC: Target sighted! Found you, you bastard!
Die! You germ!
>> Heh. Sniffed me out already, you damn White Blood Cell?
No way am I gonna let you capture me!
(smoke, confused screaming)
So long!
>> O–Oh no! Is this a bacterial capsule? [CAPSULE]
>> So one bacteria survived the initial immune response,
and we see some of its defensive tactics,
in this case a capsule.
In reality, a capsule isn't something that's deployed like a cargo net.
It's really just part of the cell wall, sits outside of the bacteria, and it makes it harder to be phagocytosed.
So, it kind of like–
somebody ruining a meal, the neutrophils no longer wanting to eat that because it's covered
in something it doesn't like.
So here's our bacteria again. So we have the cell membrane, the cell wall
and now this one is gonna have a capsule
surrounding it, to make it harder for the neutrophils to phagocytose it.
>> This isn't looking good! He's a Pneumococcus!
If I don't kill him right away, he'll start dividing!
And if that happens, this world will… >> Pn–Pneumococcus?
>> The neutrophil recognizes this bacterium as 'pneumococcus' or to give its full name:
Streptococcus Pneumoniae
This kind of identification of bacteria is really kind of important and your body kind of does it in two ways.
It either has this 'innate immunity' and that's when it just knows something's bad; or it has this
'adaptive immunity', where your body learns which things are bad for you,
and so your immune system is more effective at attacking them later on.
In this example,
I think we're demonstrating innate immunity because this neutrophil just knows this guy is bad.
In reality, this happens because the bacteria have lots of proteins on its surface called 'receptors',
and the neutrophil will feel those proteins kind of like
somebody feeling a Christmas present. And then if it doesn't like what it's feeling it'll phagocytose.
It will eat the bad guy. Is that a good analogy? Who knows.
Whereas adaptive immunity mainly revolves around producing antibodies based on what we learned from
breaking down the bacterium during phagocytosis.
It takes a little bit longer to kick this process off and to produce the antibodies against it.
This is also why children are more likely to get infections because they don't have that adaptive immunity yet.
As the more and more bugs they see, the more and more their immune system recognizes it,
and can put antibodies in place to stop them having infections like that in the future.
>> Pneumonia's not the only disease that's caused by the Pneumococci.
There's something called "pneumococcal bacteremia."
>> And as they show here pneumococcus can cause some really nasty infections, most notably meningitis
and pneumonia—an infection of the air sacs of the lungs. This is where it gets its name from.
So "pneumo-" comes from the Greek meaning "to breathe" or "lungs",
and "coccus" is the rounded shape of the bacterium.
One way that we classify bacteria is kind of the shape they form.
'Cocci' would just be a single rounded bacteria,
a 'diplococci' is where the bacteria form colonies together,
a 'streptococcus' would be ones where they form a kind of chain-like structure,
and the 'staphylococcus' where they form a kind of grape-like structure.
Pneumococcus is actually a streptococcus because it forms these chain-like colonies
>> WBC: The Pneumococci attack each organ through the blood vessels,
seizing control of the meninges enveloping the brain, [PNEUMOCOCCUS BACTEREMIA]
ultimately destroying this world! [PNEUMOCOCCUS BACTEREMIA]
Those guys are super fast!
So when they talk about your "world ending" and "pneumococcal bacteremia," it's so well done.
What a brilliant way to show how infection can be so serious. Just to remind you guys,
"bacteremia": "bacter-" obviously comes from the bacteria, and "-emia" means "blood".
So bacteremia is where we get infection spreading through the bloodstream and this can lead
to something called 'sepsis': a kind of life-threatening condition where you get– your organs end up failing.
So this show has just tweaked a distant childhood memory. I remember watching a show in the 1980s
about the human body. I just googled it here. It's called "Once Upon a Time - Life".
Do you guys– do any of you remember that? I might have to check that out, too.
>> This is the Helper T Cell. [HELPER T COMMANDER NEWS] [HELPER T CELLS]
We've been informed [HELPER T COMMANDER NEWS] [HELPER T CELLS]
that a Pneumococcus is on the run within these very blood vessels! [HELPER T COMMANDER NEWS] [HELPER T CELLS]
We are mobilizing the Killer T Cells!
>> And here we have the helper T cells in their coordination role within the immune system,
which is exactly what they do, although
I can't remember loads about them, I'll be dusting off my immunology textbooks after I do this video.
But they're part of the adaptive immune response,
the one we talked about earlier where your body learns to be better at fighting infections the more it sees–
the more it sees them.
(marching)
>> In the name of the Killer T Cell Division, [KILLER T CELLS] [(CYTOTOXIC T CELLS]
finish the target within two seconds of sighting! [KILLER T CELLS] [(CYTOTOXIC T CELLS]
Any moron who lets them escape will be sent to the spleen! [KILLER T CELLS] [(CYTOTOXIC T CELLS]
>> Yes sir!
>> Cytotoxic T-cells are ones that have matured to kill your own cells.
You might think "Why on earth would you ever want part of your immune system to kill your own cells?"
Well, your cells can be infected by things like
bacteria– intracellular bacteria, or viruses,
and also have its DNA modified by things like cancers.
In all those examples you'd want to kill the cell to stop it replicating and to stop it causing more damage.
I wouldn't expect it to be useful in a kind of pneumococcus response,
because pneumococcus is an extracellular bacteria, so it doesn't live within our cells.
Therefore I think a cytotoxic T-cell response wouldn't really be effective in this scenario.
>> (pushing cart) (exasperation) [CAPILLARY 052]
Th– There are so many capillaries!
>> I can totally empathize with the red blood cells getting lost around the human body.
That's pretty much how you spend half of medical school around the wards.
>> I just hope I don't run into him. (curious grunt)
(box shakes)
(blade slicing)
♪ (suspense)
(tendrils emerge) (RBC gasping)
>> Hey!
Thanks. For transporting me all this way!
>> (scream)
Okay, so the pneumococcus was hiding with the red blood cell. So we talked about it mainly being
extracellular, so it doesn't actually go into cells, but this isn't really kind of a hard and fast rule.
Bacteria can have part of their life cycles in and out of the cell. They just cause all sorts of trouble.
I don't know specifically in the case of pneumococcal–
I think it's totally plausible that it would find some
temporary safety along with the red blood cell.
>> (Pneumococcus cackles)
>> (S–Somebody!)
(ceiling vent drops)
>> WBC: I can see you haven't done your homework.
♪ (conflict) We, White Blood Cells, are transmigrating cells.
Meaning we can slip through blood vessel walls to reach our enemies! [MIGRATION]
>> White Blood Cell!
>> And here he is! I love that sort of scientific basis as well
that he says he's a migrating cell. He's absolutely right.
Neutrophils can just go anywhere really, wherever their affection's needed. Pretty cool.
>> (weapons impact)
(clash)
(sizzle)
>> White Blood Cell!
>> Stay back!
A capsule, huh?
Yeah, so we talked earlier about the capsule not being some kind of cargo net that the bacteria deploys,
but more actually a protective layer around here that stops it getting phagocytosed.
And now we see the white blood cell unable to attack it.
>> (clang) It's all over!
White Blood Cell, forget about idiots like me and run! (blocking)
>> Maybe I'll go for that.
>> (gasp) (combat)
>> Ed: The action sequences are so cool.
>> (wall bursts) ♪ (dire orchestra and choir)
>> Scurrying around like that…
What's wrong, White Blood Cell?
… that you share the same fate! Die! >> (no!)
(buzzer and alarm)
>> ??
(alarm stops) (mechanism actuates)
(steam) (arms extend) (warning buzzer)
(shield created) (panicked gasping)
>> Public address: We have succeeded in capturing the bacterium.
>> OK, got it! Very good! So this is the 'mucus'– This represents the mucus being produced.
Obviously, our bodies need oxygen from the environment.
Part of the price we pay for getting oxygen from the environment is we need to expose our cells
to the environment. So viruses and bacteria can get into our respiratory tract, and they very often do.
We don't just rely on the immune system later on to deal with infections.
There are lots of defenses before we even get to the immune system.
One of them is we produce mucus in our respiratory tract. Now mucus provides a physical barrier between
any kind of bacteria and our tissues, and they kind of get stuck in this mucus.
And we then have these hairs called cilia.
Together the mucus and the cilia make up the 'mucociliary escalator'.
This mucus then gets moved up out the respiratory tract, and then so it's–
The mucus sticks and then the cilia eradicate, and then it comes out of the respiratory tract.
I'm guessing at this point we're about to see a big old cough to eject this pneumococcus out of the body.
Let's find out.
>> ♪ (lively orchestra)
[SNEEZE] [SNEEZE ONE]
>> S–Stop it!
>> PA: Starting the countdown
Three, two…
One!
>> (missile launch) Stooop!
(fuselage separates)
(multiple independent launch)
♪ (triumphant crescendo)
>> Okay, not so much a big cough rather than a sneeze missile.
>> Achoo! (explosions)
>> Brilliant ending!
Brilliant show!
That was freaking awesome!
Not just because I'm a physiology and pathology nerd, but the story, the animation, and the stuff they did with it.
Absolutely knocked it out the park.
Definitely going to be covering more of these episodes on the channel. [@DrHopeSickNotes]
They are right up my street and I'd recommend you guys checking them out beforehand. [@DrHopeSickNotes]
So look at the description down below and you can see where you can view all the episodes,
and then subscribe to my channel, obviously, so you'll be notified when I take a look at them and we can–
You can hear my thoughts about it.
And keep your recommendations coming in, because I would never have found this show without you guys.
Thank you so much, and just thank you for all that continued support on the channel.
So until next time, I'll see you soon.
♪ (outro theme)