A Taste Test To Predict COVID-19 Outcomes w/ Dr. Henry P. Barham

Episode Information

May 25, 2021

Dr. Henry P. Barham talks about his hallmark study published in JAMA that outlines a correlation between results of a simple at-home taste test and symptom severity and duration from COVID-19 and other viral illnesses.

Topics Include:

• The incredible research and data that has come out of the COVID-19 pandemic, including this breakthrough study
• The family of receptors that affect one’s innate immunity
• Innate vs. Adaptive immunity
• How they tested people’s expression of bitter taste receptors and followed them through COVID infection and duration to explore the correlation
• How he’s working with Phenomune to make the simple at-home taste test available to people who want to test their potential innate immunity
• How people are exploring whether or not you can stimulate the receptors to allow everyone to have higher expression and therefore more immunity
• How the receptors can wear down with age
• The potential byproduct of the study that countries can use the tests to strategically allocate vaccines when they are limited
• What happens when people lose their sense of taste and smell due to COVID
• How he appreciates Doctorpedia’s mission to deliver understandable information to people who need it

Highlights

• “It certainly has been a terrible year and disruption of our world and life, as we knew it with a new virus that has changed things, but certainly with the troubles that have happened there, there have been some really nice discoveries that have been made.”
• “Innate immunity is something that you’re born with. It’s genetic and that’s opposed to adaptive or humoral immunity, which is also called memory immunity. And that memory immunity is really what vaccinations and prior infections and things like that, how that’s helpful is by stimulating that type of immunity. Innate immunity is really your first line of defense.”
• “People who express these receptors at a high level appear to have essentially a higher form of innate immunity to it, as opposed to those who express it on a very low level and they did worse to the virus”
• “You hear these horror stories of young people who are otherwise healthy and everybody knows somebody who is otherwise healthy and exercises, but seems to do really poorly. And then some people who get it, but seem to do okay. Then you hear these reports that there are co-morbidities that weigh in – whether it’s age or diabetes or obesity – certainly seem to make things worse, but then you hear of some people who have those who seem to do okay. We basically wanted to see: did this carry any weight? If we tested people and then followed them to see how they did with COVID, was it predictive? And the results were pretty wild.”
• “I’ve actually been fortunate to work with a company called Phenomune who now is taking it and trying to help with it. Making the test available to where people can order it, do it at their house – it’s pretty easy to get it home and get your results of what your level of expression is, which is actually neat because the level of expression can change. Based on your diet, overall health status, age, things like that – your level of expression can go up or down. We’re studying ways to stimulate these receptors, because the idea would be that if you have some people that have high expression and seem to do very well, or often don’t even know they have the virus versus someone who has low expression and has a much tougher course with SARS-CoV-2.”
• “Their level of expression appears to decrease with age. Analogous to hair color. Obviously you inherit brown hair, say, and by the time you’re 70, it’s gray. That doesn’t mean that your genetic makeup has changed for gray hair. It’s just your phenotype or the outward expression of your genetic makeup has changed.”
• “The potential for other countries who have limited resources? What if it could be used in a way to help stratify the delivery of vaccinations in places that just don’t have the means to have the number of vaccinations available for their population? What if you could predict who’s going to get sick and stratify the order in which they deliver their vaccinations? That has incredible potential, so there are a lot of really cool parts to this that hopefully will be helpful.”
• “Most people who I see with the loss of smell several months later, they’ve regained their sense of smell or their ability to smell, but it’s altered and that’s even probably more frustrating is that things taste or smell different now.”

Relevant Links

• Doctorpedia Doctor Profile
• Interview with Dr. Sanjay Juneja
• JAMA Study
• Doctorpedia’s Landing Page Explaining The Study
• Phenomune

Episode Transcript

Daniel Lobell: (00:00)
This podcast or any written material derived from its transcripts represents the opinions of the medical professional being interviewed. The content here is for informational purposes only, and should not be taken as medical advice since every person is unique. Please consult your healthcare professional for any personal or specific needs.

Daniel Lobell: (00:17)
Hello, and welcome to the Doctorpedia podcast. I’m your host Daniel Lobell, and I’m honored to have on the line with me today, Dr. Henry Barham. How are you?

Dr. Henry P. Barham: (00:30)
I am great. Thanks so much for having me.

Daniel Lobell: (00:32)
Well, I’m excited to have you on and for me, this is personal because I, myself, am recovering from COVID and I understand that you have a very exciting study with some very interesting results to present to people regarding COVID and I, for one, am excited to have a front row seat to hear about

Dr. Henry P. Barham: (00:54)
Yeah. It certainly has been a terrible year and disruption of our world and life, as we knew it with a new virus that has changed things, but certainly with the troubles that have happened there, there have been some really nice discoveries that have been made. One of these studies that we’ve been following actually had some pretty incredible data that has been kind of a fascinating ride.

Daniel Lobell: (01:26)
I got a chance to watch a little video presentation on this – a preview – but I don’t think there’s any chance I’m going to do it justice. Should I take a shot at it? [Laughs]

Dr. Henry P. Barham: (01:39)
I’d love to hear your take on it. That’s awesome.

Daniel Lobell: (01:41)
From my understanding, what you guys found – which is fascinating – is that basically based on the potency of people’s taste buds, you could tell whether or not they would be vastly or minimally affected by COVID. Is that correct?

Dr. Henry P. Barham: (01:57)
Yeah, that’s pretty close. Basically, as backstory, there are these family of receptors that have been studied to innate immunity or specifically sinonasal innate immunity. What that means is – innate immunity is something that you’re born with. It’s genetic and that’s opposed to adaptive or humoral immunity, which is also called memory immunity. And that memory immunity is really what vaccinations and prior infections and things like that, how that’s helpful is by stimulating that type of immunity. Innate immunity is really your first line of defense. It’s something you’re born with, it’s something that was there the whole time. We’ve studied these receptors as they affect your innate immunity, like in the nose and the sinus and the airway. They’re present on two types of cells, but basically what happens is when they’re stimulated, they produce a chemical that was found previously to prevent a replication of SARS-CoV-1 and then now SARS-CoV-2. Basically, people – as you said – people who express these receptors at a high level appear to have essentially a higher form of innate immunity to it, as opposed to those who express it on a very low level and they did worse to the virus. It’s an easy way to test for it. There’s actually what’s called essentially a taste test. What that does is you use a couple of chemicals to stimulate the receptors, and then one of the byproducts of the receptors is that you perceive, or you have a perception of a taste based on your level of expression of these chemicals.

Daniel Lobell: (03:46)
It’s a sour taste? I’m sorry to interrupt you.

Dr. Henry P. Barham: (03:50)
No, it’s actually, they’re called bitter taste receptors. When you have high expression of these and they are stimulated, you perceive it as like a really bitter response. Initially rodents and things like that would smell or taste things in their environment before they ate it to see if it was a potential pathogen. It stimulated – obviously they have a much higher expression of these than humans do – but it would act as a warning or a noxious or a painful response and get them to turn away from it so that they don’t ingest it or take it on. That’s the initial understanding of how these came about.

Daniel Lobell: (04:30)
That’s pretty, pretty fascinating stuff.

Dr. Henry P. Barham: (04:32)
Yeah. To answer your question, yes. We tested people’s expression of the receptor and based on the level of expression, it predicted how severe people did to COVID. It predicted the duration and severity of illness, should they get COVID. It was fascinating, obviously you have a virus that has taken on our entire world. The question has always been, “well, what if I get it? How well will I do? Will I get sick?” You hear these horror stories of young people who are otherwise healthy and everybody knows somebody who is otherwise healthy and exercises, but seems to do really poorly. And then some people who get it, but seem to do okay. Then you hear these reports that there are comorbidities that weigh in – whether it’s age or diabetes or obesity – certainly seem to make things worse, but then you hear of some people who have those who seem to do okay. We basically wanted to see: did this carry any weight? If we tested people and then followed them to see how they did with COVID, was it predictive? And the results were pretty wild, so it has certainly been a wild year.

Daniel Lobell: (05:49)
Yeah. Sounds like it. As somebody who is currently still on the mend and thankfully doing a lot better, it’s been over a month but I still don’t feel like myself yet. Is there hope with regards to this study bringing about maybe boosters? Is that a possibility – to boost your taste buds and in effect boost your immunity in that way?

Dr. Henry P. Barham: (06:19)
Yeah, it’s a great question. Obviously the term booster – people have read about this recently with booster vaccinations and things like that. The vaccine is certainly – and appropriately – taking off and is very helpful to stimulate one’s adaptive or memory immunity, should you get the virus. Basically what it does is it stimulates your body to then recognize it, to fight it off more quickly. This is a different angle in that it’s a different type of immunity, but to answer your question: yes. I’ve actually been fortunate to work with a company called Phenomune who now is taking it and trying to help with it. Making the test available to where people can order it, do it at their house – it’s pretty easy to get it home and get your results of what your level of expression is, which is actually neat because the level of expression can change. Based on your diet, overall health status, age, things like that – your level of expression can go up or down. We’re studying ways to stimulate these receptors, because the idea would be that if you have some people that have high expression and seem to do very well, or often don’t even know they have the virus versus someone who has low expression and has a much tougher course with SARS-CoV-2, then could you potentially stimulate the receptors in those people so that everybody has higher expression? Those are some of the things we’re working on now, which is kind of fascinating in its own way.

Daniel Lobell: (08:05)
One thing that I thought was really interesting about your study – or at least from what I was privy to – was that you talked about how younger people naturally have these stronger taste buds and as you get older, they fade. Two things on that: one, I always remember my grandma telling me that chicken used to taste much better when she was younger and I always wondered, was it a matter of the steroids that we’ve pumped into chicken or have her taste buds faded over time?

Dr. Henry P. Barham: (08:38)
[Laughs] Yeah. Good question. I don’t know that I have the answer to that one.

Daniel Lobell: (08:40)
It’s a real chicken and the egg, because this doesn’t solve it anymore. [Laughs]

Dr. Henry P. Barham: (08:43)
Sadly. Maybe a combination of it..

Daniel Lobell: (08:48)
Yeah, it does definitely validate my posit, my theory that people’s taste buds do fade, which is interesting.

Dr. Henry P. Barham: (08:55)
Totally. At the baseline, it’s genetic. It’s inherited by Mendelian Genetics, or if you remember what a Punnett square it is – so that’s, if you remember like a XX and then Xx or xx, so you inherit it from mom and dad and basically about 25% of the population will inherit the two good genes or will have high expression of this. Around 50% will inherit one good gene, essentially, and so they’ll have some level of varying expression of it. And then about 25% of the population actually appears to not express it. They get two bad genes for it, so they don’t really express this family of receptors. Yes, to answer your question though – in the first two groups, especially the middle one, especially the one that expresses it, but on a medium level – theirs go down with age. Their level of expression appears to decrease with age. Analogous to hair color. Obviously you inherit brown hair, say, and by the time you’re 70, it’s gray. That doesn’t mean that your genetic makeup has changed for gray hair. It’s just your phenotype or the outward expression of your genetic makeup has changed. Just like that on these receptors, you can inherit what would look like genetically higher expression, but if you’re 70-75, the receptor can wear down and actually that’s how you’re going to behave to an infection, because it’s actually, how well the receptors are functioning at the time, as opposed to what your genes say they should be, if that makes sense. And that’s the whole idea behind phenotypic expression versus phenotype.

Daniel Lobell: (10:45)
Yeah, that does make sense. Good job explaining that to me. Thank you. The other thing of my two things that I was going to say is perhaps a by-product of your work is that chicken will taste better for my grandma and for everybody’s grandma.

Dr. Henry P. Barham: (10:59)
[Laughs] Listen, that may be my next goal is to get grandma’s chicken tasting better.

Daniel Lobell: (11:05)
If you can boost these taste buds and make them young again, I mean, I feel like, like the professor from Back to the Future, “Marty, you could make people young again!” [Laughs] What if it starts with the taste buds? [Laughs]

Dr. Henry P. Barham: (11:22)
[Laughs] No, you’re so right. When people ask about this research and stuff – I don’t think that you could find a nerdier topic. I work in the nose and the nose in and of itself – I get way too excited about research in general and the nose in general, probably more so – it’s not a great conversation starter.

Daniel Lobell: (11:44)
[Laughs] “Great Scott, Dr. Barham! You’ve discovered the fountain of youth!” [Laughs]

Dr. Henry P. Barham: (11:46)
The potential for this is incredible. Not only for immunity, and obviously we learned this through a novel virus or a pandemic, but the taste implications and the overall health and wellness implications of this are incredible. That’s what makes it fun.

Daniel Lobell: (12:08)
What if this whole thing happened just so you could make this discovery and reverse the aging process, at least in our mouths?

Dr. Henry P. Barham: (12:16)
Hey, listen, whatever discovery that pushes us along, that would be incredible.

Daniel Lobell: (12:21)
I have to think there’s a bright side to this somewhere that there’s a silver lining that with all the medical research that’s been done on this, hopefully some things have broken through that will help the public in a bigger way.

Dr. Henry P. Barham: (12:37)
I think you’re right and I think that’s one of the great parts of this study and the research in general is the potential here. Specific to your question – the altruistic standpoint of having a new test that is inexpensive, accurate, widely available, that people can do from the safety of their own home that helps predict potentially their severity should they get illness? Number one, from an information standpoint, that’s great. That’s been the question behind this whole virus and this whole pandemic is like, “who gets sick and who doesn’t? Well, if it answers that, it’s incredible. Okay. But then, push that forward. The potential for other countries who have limited resources? What if it could be used in a way to help stratify the delivery of vaccinations in places that just don’t have the means to have the number of vaccinations available for their population? What if you could predict who’s going to get sick and stratify the order in which they deliver their vaccinations? That has incredible potential, so there are a lot of really cool parts to this that hopefully will be helpful.

Daniel Lobell: (14:02)
Yeah. I didn’t even think about the way you could expedite or allocate the resources you have in a limited situation to the exact right people. Wow. That’s amazing.

Dr. Henry P. Barham: (14:11)
Yeah.

Daniel Lobell: (14:12)
Wow, doctor, this is really very fascinating stuff and what an incredible discovery that you’ve come upon here.

Dr. Henry P. Barham: (14:20)
It’s been great.

Daniel Lobell: (14:21)
Now, let me make it about me. [Laughs]

Dr. Henry P. Barham: (14:25)
I want to hear it.

Daniel Lobell: (14:26)
When is my smell going to come back? When am I going to fully get my taste back? Is there anything you know about that? Can I boost it somehow? Is there a way to speed it up?

Dr. Henry P. Barham: (14:35)
Yeah. A lot of the findings or recommendations are really extrapolated on previous viruses and loss of sense of smell and taste as related to those. Things actually like olfactory retraining, which kind of seems a little hocus-pocus, like there’s no way this is actually gonna work – but the idea there is that you’re going to hyper stimulate the nerve, which has lost function through infection or injury from this virus. You start it firing again so that it’s not altered. Most people who I see with the loss of smell several months later, they’ve regained their sense of smell or their ability to smell, but it’s altered and that’s even probably more frustrating is that things taste or smell different now. There are certain things that they will totally avoid that they used to like before. Trying to get it back functioning has certainly been a new thing that we’re studying, as the appropriate ways to do that, but there are options. I do think that we’ll work to get through yours back. Maybe off this podcast, but I’m happy to help.

Daniel Lobell: (15:52)
Oh, thank you. I’d appreciate it. The other question is how does this relate to boosting the lung function? Is there a possibility that this research will also help in that way? Or is it strictly help in terms of the taste?

Dr. Henry P. Barham: (16:12)
It’s interesting. Simply hearing that we use a taste test to direct your understanding and everything towards loss of smell and taste, but it’s actually not. What we’re actually studying is a group or family of receptors that is part of your immunities, as we talked about earlier. Like potential prevention of either infection or prevention of severe infection – and that’s systemic. Acting as your initial barrier of defense to prevent a systemic or a widespread infection, which would involve your lungs also, which is interesting that you asked that because these receptors are also in the lungs. They’re throughout your entire airway track, in addition to your GI tract and all that. Now they do contribute to taste or activation of them does contribute to part of taste or the bitterness, but that’s not really their primary role, especially like extra-orally, meaning outside of the mouth, but throughout the airway. It’s really part of immunity more than it is a factor in loss of smell and taste.

Daniel Lobell: (17:25)
Wow. Well, doctor, I think this is – to put it in the corniest terms possible, a very tasty discovery that you’ve made here. [Laughs]

Dr. Henry P. Barham: (17:34)
[Laughs] I love it. It passes the sniff test is another corny line.

Daniel Lobell: (17:43)
[Laughs] It’s a good comeback. It’s very exciting. You should be excited. I’m excited. I’m hopeful that this is going to be the beginning to a massive change in how we treat this and look at this in the future.

Dr. Henry P. Barham: (17:59)
I certainly appreciate that. Look, it’s an honor to be on here and do this. Doctorpedia – I’ve been really impressed. You all do a great job of delivery of information direct to patients, which I think is really helpful, especially in this day and age coming on the back end of a pandemic where it changed healthcare as we know it. Hats off to y’all for doing forums like this and delivery of information to patients who need it. So thanks for that.

Daniel Lobell: (18:30)
Thank you so much. I hope to have you back on the podcast at some point where we could do a full interview and really dive into all the cool things that you do and who you are. I hope that’s something we can get in the works.

Dr. Henry P. Barham: (18:42)
I’d love that.

Daniel Lobell: (18:44)
All right. Have a wonderful day and I appreciate your time. Thank you.

Dr. Henry P. Barham: (18:48)
You, too. Thanks so much.

Daniel Lobell: (18:55)
This podcast or any written material derived from its transcripts represents the opinions of the medical professional being interviewed. The content here is for informational purposes only, and should not be taken as medical advice since every person is unique. Please consult your healthcare professional for any personal or specific needs.