What Every Woman Should Know About Sex-Based Differences in Disease

Audio Description

Why do autoimmune diseases mostly affect women? How come eight of the last ten drugs recalled by the FDA posed greater health risks for women than men? Dr. Erica Ollmann Saphire, President/CEO of La Jolla Institute for Immunology, breaks down her cutting-edge research on sex-based differences in the immune system.


This transcript has been generated by an A.I. tool. Please excuse any typos.

Welcome to Women and Wealth. I'm Beata Kirr, Co-head of Investment Strategies at Bernstein, and this show aims to educate and inspire women to make the right choices for their wealth.

What may not be surprising that differences between men and women are large when it comes to health and medical. But what may be surprising to you is that as we learn more about these differences, is that hormones are not the only story.

In fact, our immune systems play a very big role. So today I'm really excited to be in a conversation with Dr.

Erica Ollmann Saphire. She's the president and CEO of La Jolla Institute for Immunology and you may recognize her name and face from the incredibly informative series of events we did with her back in the deep dark days of 2020 days that I still have PTSD thinking about.

But I do very much remember the conversations with Dr. Saphire as she explained to all of us the mechanics of covid, the vaccine, what was likely to happen next.

Incredible. But also with incredible clarity. Dr. Saphire also runs her own very successful research program, and she's here to talk with me today to talk about the latest research findings coming out of her group.

And we're gonna talk about the inevitable, about how things are different for women and how women's research is even different.

We're gonna talk about why women have unfortunately been understudied in the past. And what the implications are. So we've got a big agenda. Thank you for joining me today. 

Oh, it's so nice to be here. Thanks for having me. 

Yes. And by the way, we recognize we have matching plants. We did not plan that, but it turns out this way and it looks lovely and very symmetrical.

So those of you that are listening, hope you appreciate that. All right, well, let's get to it. In terms of our agenda today, as I mentioned, you're the president and CEO of the La Jolla Institute for Immunology.

And you're focused on studying the immune system, is that right? And only the immune system? Is that the scoping?

Yeah, so La Jolla Institute for Immunology, is a private nonprofit think tank. We have 25 of the world's best immunologists. So they're research professors, but they're completely dedicated just to research and just to discovery on the human immune system.

And the reason we focus on the human immune system is because it's

Singularly and critically linked to nearly every single human disease. You know, not just infectious disease, but also defense against cancer and heart disease and neurodegenerative disease and aging.

And it's so fundamental to who we are and how we can live and interact and be in society. That understanding its mechanisms and what makes it powerfully protective is transformative.

I believe you. I worry about my own immune system and its ability to transform me and protect me. So I'm looking forward to this conversation, but we're gonna start with this idea of why are we having this conversation as part of our Women in Wealth brand and our Women in Wealth series?

And the reason is obviously you've published some very interesting research focused on the sex differences in the immune system.

So I just wanna start with this big open-ended question. What's going on there? Why are they there to begin with and why are they so important? 

So this is fascinating. So this is all very new research, so if you haven't heard of it before, that's because it's brand new discoveries and brand new concepts.

So we used to think that blood was blood and, and immune cell was an immune cell. But actually we're finding out, it turns out that the immune systems of females are very different from the immune systems of.

So let me break that down for you. Now, every cell in your body, not just your reproductive cells, every cell in your body is either x X or x Y.

On that X chromosome, there are a lot of different immune genes. So females have two copies. So we've got twice the repertoire. We've got twice the palette to paint from males have one 

wait. Is this a good thing? 

Yes, it's good because females through our chromosomal makeup and also hormonal, And what turns these immune genes on and off tend to mount a much more powerful immune response.

When it comes to many aspects of immunity, what that means is that the fairer sex is also the stronger sex. So when you have two copies of those immune genes, what happens is that when you are developing and you are just a hundred cells big, you know, you're just barely outta egg or a. One of those two Xs becomes silent.

So some of your cells start making your dad's X for the rest of your life, and some of your cells start making your mom's X for the rest of your life. And so patches of your body develop with your dad's ex and patches of your body, develop with your mom's. Ex females are what we call Mosaic.

So if you look at a Calico cat and you know they've got patches of gray and patches of white and patches of orange, it's because in cats, the gene for coat color is on the x ch.

So Calico cats wear the orange X is present. They make that orange co color, or the gray X is present. They make that gray patch. It's like that for ourselves and our immune genes too.

So if you could actually see that we would look like calico cats where sometimes we're expressing this version of gene is sometimes respecting that version of immune gene.

So what that can mean is that we have twice the artillery, twice the the flavors of different immune recognition genes and patterns of things that we can launch in.

Now there's something else. It's not just what you encode and whether you have more colors to paint from, it's whether it's turned on. So a lot of those jeans are turned on and off under really precise control.

And sometimes it's not just on and off like a simple light switch. It's like a dimmer switch where it could be, you know, very dimly active or up to full flow brightness.

One of our professors ponder and vj, you call him V. He did a study where he looked at different blood samples that had the different white blood cells from a whole lot of different men and different women, and he found that the males and the females turned on entirely different patterns of genes.

So what happened in female immune cells in response to, you know, a, a danger or a pathogen was a different thing than what happened in the male immune cells.

And typically what happens is that the female cells immune. Is more powerful. They have more of that protective inflammatory activity, and that means that females are protected from a lot of things that males are not.

Females are more protective from lethal cancer. Females are more protected from heart disease. Females are much more protective from. Infectious disease, and you've seen this in your own household.

You know there's this concept of man flu, right? Oh yes. When the flu comes to your household, dad is down to the count and mom is still up and soldiering around and making soup for everybody.

It's because he's genuinely sicker. Sure. Males when infected was influenza, hepatitis B, covid, lots of other. Have more copies of virus per mil of blood. We call that the viral load.

They might have twice the amount of circulating virus, whereas the female has controlled it. So she's got a much more powerful immune response and powerful immune attack now, most of the time.

That is fantastic. Sometimes it's not. So females are also much more prone to autoimmune disease, and that's when an immune system starts attacking some of its own protein.

Some females are much more prone to that. So for some diseases, nine women, for every one man might get rheumatoid arthritis or something like that.

Wow, I'm, I'm still absorbing and reacting to the man flu thing because I'm processing, cuz that definitely is very, it feels very real to me. The comment, I'm hoping my husband's not gonna listen.

I don't mean to offend him, but it does seem like he is down for the count with just the most minor cold. 

Let's move on. So, so you've obviously made the case that the immune systems themselves are different with your fascinating illustration of the Calico Cat, that's really, um, helpful as an illustration for how the dynamics are different. I know a lot of this research that you've been putting out is recent and I think some of it was really reflective of what evolved during the pandemic.

So I'm curious. If you wanna zoom in on that a little bit. How did these differences play out during the pandemic and 

specifically around covid? You know, the pandemic was really interesting because it was the first time in history where that many millions of people all got the same virus at the same time for the first time.

And you could study what happened and that many millions of people got the same vaccine at the same time, and you could study what happened. And so what we saw is that, Are three times more likely to get severe disease after infection.

So, you know, there was this puzzle with Covid. Why? Why are some people in the hospital on a respirator and other people you know, have a little cold or they don't know they've been infected?

What are the differences in the immune response? What constitutes that individuality? That means that one person got sick and another didn't. You can tease that down to how their individual cells, meaning what genes they turned on and off, and what metabolites they launched and didn't launch. How those cells counteracted the virus.

So a female's more powerful immune attack cleared that virus earlier and kept at a lower level. So females were much less likely to get severe disease. In some studies. The greatest risk factor for severe disease hospitalization is just being male.

There's this other thing called long covid. You know, people that have these prolonged symptoms, um, and then sometimes there's like, um, effects in the gut or it's fogginess or just remain exhausted.

Females are much more likely to register long covid than males, so it's something about that more powerful immune response might be great for the initial clearance, but sometimes the continued activation can lead to disease. 

So some good and some bad in the outcomes long term, short term. But that is fascinating to see the magnitude of the differences play out.

And the thing about the good or bad, I mean, it's you're born how you're born and you can't change that. But what the opportunity for science is, is to understand what those differences are and use those as a source of information. So in science, all you can really ask for is a clear variable that you're gonna.

And a clear answer that's gonna result. And what's been amazing about the kind of studies we have coming out, and I, I never would've thought this would be true, is that if you separate the blood from men and the blood from women, you find differences.

And the differences point to why one group gets sick and one group.

So I'll give you another example. So we talked about whether how the chromosomes are different and how the chromosomes encode different genes and how the genes might be turned on or not turned on.

Depending on what you know, hormones that control the activity of those genes, like the dimmer switches, whether it's super varies or dim, there's something else.

It's how all the molecules in your cells. Metabolize the food. You eat molecules and the processes and they make little, um, molecules that have activities. These are called metabolites.

The metabolizer are things that come from the foods you eat or your cellular processes. One of our professors, Sonya Sharma, is doing very large studies in cohorts of people across Europe, United States, and she's looking at Alzheimer's disease and she's looking at heart.

And what Sonya found is she separates the blood samples into the ones from men and the ones from women, and those that are protected from the disease and those that are advancing in the disease only in the females and not in the males, and only in the females that are protected from disease, not in the ones that are advancing the disease.

She finds certain particular metabolites. So that's information that's a. Either that molecule itself is the reason that those women are protected, meaning fantastic.

That's an opportunity for the supplement to protect the men or that molecule points to a biochemical pathway that we need to understand, meaning disease erode somewhere along here.

If we study this pathway, we know why people are getting sick. We have an opportunity to better diagnose or treat or prevent the. 

So interesting. I'm processing and it's, it's really fascinating. So I'm gonna come back to a question on the research, but I wanna pivot for a moment to another thing. You mentioned, which is autoimmune disease, because that statistic that you threw out, I wanna just come back to and, and zoom in on a little bit.

I didn't realize this, but that autoimmune disease mostly affects women and the ratio really differs widely between specific diseases. But overall, The outcomes are that women are at much higher risk of developing it.

So lupus is one example where the ratio is 10 to one. So any more information on this correlation with the immune system and autoimmune that you wanna share?

Yeah, so this is really important and there's scientific things and there's sociological things. So, so lett, you start with the scientific. So autoimmunity is when your own immune system starts to attack a molecule that is you and not a.

And that can be triggered because it saw something in an infecting pathogen that looked similar, and so it's got a misguided attack.

It could be triggered by an environmental toxin. And it's really powerful. I mean, have you've seen how powerful your immune system is?

If you've ever touched something you're allergic to and you break out in hives and you see how immediate and how powerful it's, and someone who eats peanuts and has a peanut allergy and all of a sudden they can't breathe, the immune system is fast and it's strong.

So controlling what it attacks is essential. Not having, for example, an MS. Immune attack on neuro neurons is key to living a long and healthy life. So there've been all these studies and what inspired this autoimmunity? Your immune system is supposed to learn how to tell what is you from, what is not you.

How did that confusion there happen? And some of the earliest studies looked at twins. Because you have identical twins that have got exactly the same genes, and then you have fraternal twins, meaning non-identical genes.

They live in the same how, they have the same environment, but they're not the same gene.

And so you can look at these different groups to see is it genes or is it environment, is it nature or is it nurture? Now, historically, decades and decades ago, people saw the greatest link in autoimmune disease between identical twins, so there's some genetic predisposition.

Now, what's happened in the last 20.

The incidence of autoimmune disease is going up and up and up. Something's making it rise. And in the last 20 years, what doctors and scientists have seen is an increasing link now in the non-identical twins, people in the same house. So there's an environmental trigger as well. And the thoughts are, it could be a new infectious agent that's out in the world.

It could be some toxins, it could be. Or it could be reduced exposure to things that we know are immuno protective, like sunlight. If we're not outside as much as our ancestors, we're not getting that sunlight. We have protective.

So we're trying to look at those causes, but we also see what the differences are in mechanism.

So every autoimmune disease is different. One explanation they have in common is that if the female immune response, a woman is, the immune response is in general stronger and more powerful, and it's amped.

It's also gonna be amped up in the wrong ways as well as the right ways. Mm-hmm. Now there are other specific differences that have to do with our genetic makeup.

So remember when we're talking about how every single cell in your body is either X, X or x Y Yeah. There are a lot of genes on your X chromosome that control things like how your different pieces of DNA operate. Only some of your DNA actually encodes molecules for you. A lot of it is. Kind of silent, and that's silent.

It's called heterochromatin. Pieces of heterochromatin can jump and move around, and that can cause disease. You have evolved molecules that keep that in check and keep that controlled, and those are on the X chromosome.

Now, if you have a mutation in those molecules, if you have a mutation that X chromosome, it can lead to all kinds of health problems and cancers and disease and autoimmunity.

Imagine first, if you are a male and you only have one ex chromosome versus you're a female and you have two. If that male who only has one ex he can rely on, has a mutation in that X, he might die as a child, or he might not ever develop from a fertilized egg. It could be what we call embryonic lethal, right?

It's a disaster. The male can't move on. That male won't be born. The female's got one good and one bad. She's gonna live, she's gonna. But then somewhere later in life, in adulthood, she's got that problem going on where not everything is right in all of the sections of her body, like in all the Calico cat patches.

And that's why the same mutation can result in someone who lives to adulthood in a female but has an autoimmune disease versus, you know, maybe that being, might not make it if they were male.

So there's a lot of different differences that control why an autoimmune disease might develop and might develop in a female versus in a.

And it's interesting, it's been understudied, and this is the sociological thing. Autoimmune diseases are kind of difficult to understand and diagnose, and they can affect a lot of different organ systems. So, you know, there are a lot of autoimmune patients that have been frustrated for years going from one doctor to another.

Well, is this a digestive problem? Is it a neural problem? Is, is it this, is it that? And because it mostly affected women, you know, a. Doctors looked at this and said, you know, it's all in your head, or You're depressed or you're exhausted and didn't recognize that, no, she's sick.

In the absence of clear mechanisms of disease or clear markers of disease or clear tests of disease, a lot of doctors would just look at these patients who are mostly women and say, yeah, we don't really know what's wrong with you.

You know, and chalk it up. Stress or depression or something when there really was something very wrong with the immune attack. And so that's why this kind of research is so important.

There are millions of girls and women living with autoimmune disease. The incidence is rising. It can be life-threatening and certainly debilitating to your life and your livelihood.

It's something that we need to understand. It's an under-researched, understudied. And because females are 50, 51% of the population, and not only are we in the workforce, we're also the primary caretakers for generations. Young and old diseases of women are devastating for our economy. There's some really interesting numbers here.

There's a group called wham, women's Health Access Matters, and they commissioned the Rand Corporation to do research on this and said, okay, these diseases that are understudied in women like rheumatoid arthritis, Look different and have insufficiently appreciated in women like heart disease.

What if we increased federal investment or private investment in research in these diseases?

Just a little bit. What would be the end result on the economy in terms of the workforce and health and people's lives and livelihoods? And it's astounding.

You know, in one of their studies, they, um, they said, okay, if we increase the investment of research in this area by 300 million, they calculated a 14 billion boost to the.

So it's a tremendous return on investment to just look at this difference between males and females and figure out how we can deliver better health 

for everybody. That is not only a great explanation of the differences in autoimmune disease by gender, but also the real impetus for why we should continue to research it.

That statistic is very powerful, but it's not just an autoimmune disease that it is understudied this notion of gender differences. I think it's interesting to point out that it wasn't until 1993, I think that's right, until the N I H mandated that women even be include.

In clinical studies, and even today, I don't have the stats on what percentage it is today, but I do know that through some of our investment portfolios, we actually currently are investing in a company whose job it is to get diversity into clinical studies because now there's a broader mandate as well, but it's hard to do.

Their pushback as to why there's a whole company focused on this is because they have to really go out, educate the population. Explain the importance of diversity in clinical studies. So it seems like the hurdle to success here is high. It's not just on the side of the researchers that have to direct more dollars in focus to gender-based differences, but you also need the population to recognize the differences.

But just thought you might wanna comment on that. And what's your perspective 

on where we are? Great points. There's history here and it's not, you know, sinister, exclusion. It's either just that people didn't know or they were doing the best they could. So for example, a lot of vaccines were mostly tested in military recruits because, you know, they didn't really have a whole lot of choice in the matter.

Uh, and military recruits are mostly, you know, 18 to 25 year old males. And so a lot of our historical understanding of how vaccines work has come from young men in animal studies.

They might have tested things on males to keep the females back for. So they thought they're doing the right thing with their research dollars, but it meant that they were setting the effects in males, not these effects in females.

There's another complication. Hormones dramatically control those dimmer switches. Whether your genes are on or off or what's going on, hormones have a tremendous effect.

And what happens when? So your immune responses are different in different times of the month. True for. It's true for humans, and a lot of researchers looked at this and they said, this is just too complicated, right?

This is just so hard to figure out in the female mice. We're just gonna use the male mice so that the data is cleaner, right? It's important to understand how to treat women all month long, right? This is information we need. It's not that it's too complicated and therefore we're not gonna study it. We might need to do a better job to get that kind of information if things change with different shifts in the hormonal cycle.

That's information we. Females have also not volunteered as much for clinical trials.

They've been reluctant to recruit women, particularly of childbearing age because they wanna make sure that they don't introduce some drug that's gonna be damaging for a developing fetus. In a way they dunno, you know, like, um, thalidomide for example, wasn't detected as a threat in the early studies.

Only when it was given to pregnant women was. No, the birth defect noted. So they've been reluctant to test things on women of childbearing age anyway, so because the data was more complicated, because hormonal shifts made things act differently and cause they didn't have as many women in clinical trials, that's all been a black box.

We haven't sufficiently understood how things operate in females and that's really. Because I think eight of 10 of the drugs that have been most recently pulled off the market for adverse effects had those adverse effects in females. Didn't know that. Yeah, that's right. That's a very concerning statistic.

It is. So ambient, for example, is metabolized much more slowly in females than males. So a given dose is gonna last longer in that female brain, and that was noted because women who still had ambience from the previous night's insomnia, you know, might get into car accidents more often. So it's critically important to understand how things are metabolized and used by and launched by both sexes.

The trouble is that a lot of our drugs are one size fits all right? Everybody gets a hundred mg pink tablet no matter who you are. And you know, the market's already figured out to sell us different blue genes, right? Men by different genes from women. Maybe we should think about different tailored vaccines and different tailored therapeutics, knowing they're gonna operate with different immune responses at the end.


you're, you're one step ahead of me, cuz that's where I was gonna jump in and ask you this question because it's the inevitable next step, right? So we're lamenting the fact that first you had to figure out that there were these differences. Obviously your organization and others have figured it out, but then you have to make.

Everybody aware and then change the research, change the population, and it, it ultimately, obviously it's this question of personalized treatment and there's been a lot of progress here.

I mean, this is one thing that gives me some hope is I'm thinking back to a conversation we had with the Breast Cancer Research Foundation, uh, president and c e o, because we're talking about just how much progress had been made in breast cancer, in particular in terms of personalized treatment.

And obviously that is, Mostly, uh, a women's disease, not exclusively of course, but mostly. And so that was encouraging. That was really hopeful. We had that discussion around breast cancer awareness month last year, I believe. And generally speaking, we have seen in cancer treatment in particular much more personalized d n A based treatment.

And we've done a lot of research on that internally as well, in terms of the companies we're investing in, that once D n A sequencing became much cheaper, that that really opened the. To personalized treatment. Okay. That's the good news. But I'm still coming back to the pill issue. How is it that we've made so much progress in something like DNA sequencing and personalized treatment as a result of that, but then a sleeping pill, we can't figure out the differences by body weight.

You know, give me some hope on treatment. Like how do you think we make progress here on the more commonly taken pill forms then? 

Someone has to think to ask the question about how this works in different groups. And I think we all grew up thinking blood was blood and a brain was a brain, and it's very new information that there are different cells and different things happening.

You know, female brains are also different from male brains. We may have also grown up just trying to get a seat at the table and join the workplace as equals.

And so female scientist and doctors weren't quite so interested in pointing out the differences so much as just trying to remain employed. But now we're uncovering this and you know, it's not just led by the female scientist doctors.

There's a lot of our leading research. You mean I how the 1900 genes that are expressed differently in males and females came from, you know, a man's lab. You have to know.

That there's something to look for and do the research to find it. Someone has to think that there's something to discover. Someone has to start digging to find that vein of gold.

But now that we've found that vein of gold and more people have realized, oh, This is important. This is fundamental. More people are starting to mine. So it's like that goal, that wellspring of innovation has now been discovered and scientists are now realizing this is a fantastic source of information.

Not only is it just the right thing to do to improve medicine, this is gonna explain, you know, the mysteries of why did one person get sick and another one different. It's not a mystery. There's a molecular reason and we now have the tools to start to tang. 

Well, that's helpful.

So I mean, I would think if eight out of 10 drugs have been pulled up the market recently and it's clear that there were different side effects with women versus men, where do you think we are on a scale of one to 10 with the drug research industry really acknowledging this and moving forward with the idea that you might have gender specific medication, you know, off the shelf, whatever you can grab.

Is that a possibility in the next five years, 10 

years? It's definitely a possibility, and I think we're getting. And I think it's gonna be good for the drug companies because you have to invest so much money in getting all of the candidate molecules through each phase of the, you know, phase one, phase two, phase three, all the testing, all the formulation.

They don't wanna fail at the end. They want that information early so that if that molecule is gonna fail, they wanna fail before they've invested in another billion dollars.

So the availability now of these better tools, these better transcriptome analysis like we're doing at lgi, and the fact that we know there's different kinds of immune cells acclimated in different ways, that's early information they can use earlier in their pipeline to help steer their investment about how is this gonna operate in different kinds of people, in different strata of patients.

So that's gonna save them money. And then if you think about, you know, they've made a tremendous investment to get a molecule into a drug to help people for a. It's got a timer on that patent. If they can improve it in some way, they've got a new drug. Yep. So it's a benefit for them.

They suddenly realize, oh gosh, you know, a different formulation is gonna work better in males, or this other formulation is gonna work better in females, or it's gonna prevent this side effect.

They've got a new drug. So there's an incentive there. But I think what's really important is that the research has to show the way that there is something to find here. Found that VE goal. Now we need to understand and explain exactly what the differences are. And that comes down to, I think, basic researchers.

And those basic researchers are scientists at think tanks and universities that are uncovering this information and they put it in the public domain for different companies developing drugs and medicines and vaccines to use. And so I think what's been really exciting over the last couple years are advocacy groups like.

That are turning attention on this. So members of Congress are now starting to speak on this subject and there's new language in the Defense Appropriations bill that this information is essential to keep our war fighters healthy. This is information that we need also for our whole population.

And researchers like our whole institute, Lahoya Institute for Immunology is pivoting this way because whether the cells are male or female and what's responding to when and what this information is, this is fundamental and essential to every single laboratory in the building.

It unites all of us as an essential area where the information had been overlooked. Now we see how valuable it's, it's really important that we now do.

Fundamental research that usually like NIH funded or philanthropically funded research to get that information out there to make drugs better for men and women, and information available about, well, how did this cancer evolve if we separate the cells and figure out which ones got sick and why?

We can explain disease. Disease won't just be something that happens to us and we dunno why, but we're able to understand exactly what went wrong so we can prevent it in somebody else and we can treat it in that 

person. I mean, this is inspiring. It's very inspiring. It's very hopeful. So I hope all of our viewers and listeners will remember, like you heard it first here.

I mean, I have not heard a prior conversation about gender-based differences in research and treatment, and it's exciting to be on the cutting edge of what's hopeful and innovation for the future. So thank you for all the research and all the perspective. I wanna move to a lightning round. Two questions with quick answers.

Right. Just to kind of wrap up and change the direction a little bit under the lens of Women and Wealth, this conversation I lead really for, uh, many different perspectives. But one of the perspectives that we often talk about with why we have a conversation about women and wealth is an undeniable truth.

Just like the chromosomes are undeniable, the undeniable. Is that women outlive men, and we talk about how that means 95% of women will be their primary financial decision maker at some point in their life, whether they want to or not, right?

Whether it's through their choice or not. And it's really a wake up call, but lightning round question, quick response.

Any comments on that statistic about longevity? Does it come back to the immune system and our more powerful ch. 

That family immune system is why we live longer. 

All right, well that's the response. So it all comes back to that's it, that's why you're doing all the research there. It protects our brains.

It protects our hearts. It, uh, controls cancer. It's, it's everything. 

That's awesome and I'm glad you're focused exclusively on research around it. So that answers that. And then the last question in the lightning round is a question that we ask all of our guests on the Women and Wealth Podcast, which is this idea around investing with intention.

Obviously this has not been a conversation about investing today, it's a conversation about your super important research. But just to pivot it away from that, as a an executive leader who is a woman, you know, I'm really interested in understanding. How you think about investing with intention and how you spend your time, talent, treasure, however you'd wanna 

answer that.

We gotta spend your time, talent, your treasure in the direction where you wanna leave a legacy. What's important to you?

If your health is the reason that you can work or can't work, or the health of a loved one is the reason you can work or can't work, or you can't go and visit. Grandkids because there's a pandemic on, or you've lost your sister to cancer.

You know, health is the most important thing. When we have our own money and we earn our own money, we can put it in the places that are meaningful to us, where we can make the change that we think there should be in the world, and we can demand with our investments, that we can make information and equality a.

Whether that's investing in companies that are doing the right kind of research, or whether that's investing with your philanthropy in a research program that's gonna make a finding available, that's gonna enable something else. And you know that's a lasting legacy for you and your family and your generations, is to make this information available and possible.

Something you can put your name on is something that you've really and truly achieved for. I'm so 

inspired. I'm really grateful for our time today and and your research. And I know there's so much to cover, right? The volumes of output that comes out of the institute we've been pouring through and 30, 40 minutes doesn't give us nearly enough.

So I feel like it, it would only be fair if I asked you, do you have anything else that's really pressing that you wanted our listeners to hear some kind of takeaway stat that you want us all the walk away with? 

You know, I think that the exciting thing is that this is a front. You haven't heard about this before.

This is just coming out. This is brand new information and it's something that your friends need to know about and there's more coming out every day. They're in Southern California. I love them to come and visit us and tour the labs and meet the scientists and, and see what's going on for themselves. I love it.

I love it. I'm, I'm flying out there soon, so we'll, we'll reunite shortly. But thank you so much, Erica, for the time today, for all the information and really, most importantly, for your research and focus. You've made it clear today that the immune system is what matters most. Uh, we've got some great benefits in our gender and there's some ramifications of it that aren't so great.

So you've left me feeling hopeful for the future in terms of research and treatment evolution. So thanks. 

Thanks for your time. 

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