Very happy to share this cover art created by Audra Geras for the JCI!
Audra was commissioned by Dr. Tim Vartanian at Cornell to create this image showing how two epsilon toxin, ETX, producing strains of Clostridium perfringens, strains B and D, when found in the gut microbiome, appear to be implicated in demyelination damage of neurons in areas of the brain associated with multiple sclerosis. This important scientific research by Dr. Vartanian and his colleagues is impressive, exceptionally elegant work with the potential to lead to much-needed novel therapies for MS.
The lower left portion of the image shows both an ETX-producing strain (blue bacteria) in the mucus layer of the small intestine, as well as a non-toxin-producing strain (green bacteria). The ETX-producing bacteria are shown secreting ETX molecules that then enter the blood vessels in the intestinal villi. ETX is a pore-forming molecule. The formation of ETX pores in the endothelial cells of capillaries in the blood brain barrier (BBB) seen in the top right of the cover, damages the integrity of the barrier allowing the infiltration of myelin autoreactive CD4+ T lymphocytes into the brain parenchyma. These lymphocytes release inflammatory cytokines and cytokines that provide secondary signals to other cells in the immune cascade. This pathologic immune response leads ultimately to the destruction of the myelin insulation on neurons.
The challenges in creating this piece were both a crazy-short timeline, as well as the difficulty of depicting a story that takes place in multiple environments – the gut microbiome, the blood-brain-barrier and the brain parenchyma – all while staying aware of the title and copy placement on the cover.
Both Audra and Dr. Vartanian were very excited that this image was the final selection for use on the May, 2023 cover!
