Harshi Peiris, Ph.D.

New research just dropped on one of the strangest paradoxes in immunology: Epstein-Barr virus (EBV) — the virus behind mono that ~90% of adults are quietly carrying for life — May HELP protect against type 1 diabetes ... while DRIVING multiple sclerosis. Same virus. Opposite outcomes. 🧵

@mcuban Agree 100% on the middlemen, denial friction, and how conglomerates will fight AI agents every step of the way. But the real game-changer is precision medicine powered by biomarkers. We’ve spent decades treating most diseases as one-size-fits-all. They’re not. We can develop the same disease differently. Take Parkinson's ...It can be gut first or brain first. It could also be a Parkinsonism subtype. Biomarkers can now: 1. Predict disease risk years before symptoms appear 2. Identify the specific drivers (gut, inflammation, genetics, etc.) in each individual 3. Track progression in real time 4. Guide truly personalized diagnosis and treatment plans instead of generic protocols Most doctors simply can’t keep up with the explosion of new science. AI doctors/agents that integrate biomarkers + the latest research could finally make individualized care scalable and practical. Two quick examples of what this looks like today: Precision approaches in Parkinson’s (moving beyond dopamine replacement to root-cause, patient-specific plans): x.com/Neuroscope_mp/… AI and multi-omics model detecting ME/CFS (and implications for Long COVID) with high accuracy by mapping actual biology: x.com/Neuroscope_mp/… The tech is arriving. The system just needs to stop getting in the way.

It's not. Why ? Because 25 pct or more of a doctor's time is spent dealing with conglomerates that do all they can to make the doctor's care more difficult, and expensive, for both the doctor and patient. For every future agent we give AI doctors to deal with this friction, and to improve the quality of care, the conglomerates will have multiple adversarial agents doing all they can to delay and deny, to minimize their cost and maximize their float We see this already as the conglomerates use AI to find every possible way to manipulate contracts, and find ways to mislead, while hospitals hire companies for Revenue Cycle Management, who charge as much as 10 pct of revenue to have their agents try to do the reverse. It's the agentic version of Mad magazine Spy vs Spy I'll give you a further example. There isn't a single company, including yours, that knows the actual cost of the care they purchase for your employees and families. Not one. Cost is an important component of health care decision making. @a16z includes costs in defining its benefits. But you are blind to all but the total bill you pay. Your carrier, your ASO, your PBM, any company that touches the economics of care for your company is going to do everything they can to prevent you from using AI doctors or agents successfully If you want to see that change, stop working with the healthcare conglomerates. Write agents that define , optimize and contract directly with providers, to eliminate the uncessary middlemen. Feel free to use costpluswellness.com to train them. Until the conglomerates are disintermediated , HC in this country will continue to be fucked

Article 1 x.com/Neuroscope_mp/…

Why creatine matters way more for your brain than most people realize. First two articles in the new 8-part series are live for paid subscribers. Full details on: → How little actually crosses the blood-brain barrier → Who benefits most (especially as we age) → Practical protocols that work Full digital book version with more information coming free for Twitter and Substack subscribers at the end of the month. Article 2 x.com/Neuroscope_mp/…

Long COVID is not one disease or one symptom. Long COVID can manifest due to various reasons. 1. Some people experience neurological symptoms ... in this case, talk to a neurologist right away. Some of these symptoms can be reversed. Talk to a doctor soon. x.com/Neuroscope_mp/… 2. Inflammation - inflammation increases with infections. This is unavoidable and at the root of several diseases. Talk to a doctor and find other methods to reduce the inflammatory response. 3. There are current studies being conducted to detect long COVID and related symptoms. Some of these types can be treated once diagnosed properly. x.com/Neuroscope_mp/… 4. There are gut bacteria that decline with COVID. There are remedies for these as well. x.com/Neuroscope_mp/…

@medical_xpress I've got Long Covid and I do find myself feeling apathetic about treating my condition,which isn't my nature at all. Now I'm wondering if it's due to reduced dopamine. How can I treat this?

Brain scans found lower dopamine neuron markers across all major striatal regions in long COVID, the clearest evidence yet of brain dopamine-system injury that may help explain fatigue, slowed movement, and memory problems. medicalxpress.com/news/2026-07-e…

This is such an important inflection point. The groundbreaking work from Tony Wyss-Coray’s lab at Stanford shows that organs don’t age in sync. The brain often ages fastest and is the strongest predictor of mortality, followed closely by the immune system. Aging is deeply individual ... not one-size-fits-all. Specific cells and organ-derived signals in the blood can reveal how fast different parts of *your* body are aging. Organ-specific biomarkers give us a powerful new toolkit: they can predict underlying disease risk, track individual aging rates, catch problems early, and guide truly personalized preventative strategies before disease takes hold. This is precision aging medicine in action.

An inflection point in medicine. Medicine is moving from calendars to clocks — from counting the years you've lived to measuring how fast you're aging. —It's not linear. —It's asynchronous, as seen by organs and cells in our body A "translation" of our review paper this week in the new Ground Truths Simplified image made with ChatGPT

Thank you, @EricTopol, for sharing this excellent review. This is exactly where we need to go: Alzheimer’s not just treatable, but preventable. Precision medicine powered by biomarkers is the key. We can now track risk years before symptoms appear, predict who’s on the path to disease, and catch it early when intervention matters most. For those already progressing, biomarkers let us map the specific drivers in each person — amyloid, tau, inflammation, metabolic dysfunction — and guide truly individualized treatment plans that clear pathology while targeting root causes and slowing progression. This proactive, personalized approach changes everything. This is the purpose of @Neuroscope_mp

The EBV Paradox just dropped ... The same virus that ~90% of us carry quietly for life. It may help protect against type 1 diabetes… while driving multiple sclerosis. New mechanisms, real trial data, and a mind-bending split outcome. Full visual thread with sources 👇 #Immunology #ScienceTwitter

@BittBurger This study 😊

@Neuroscope_mp Didn't they just discover the two microbiome strains responsible for MS last week?

New research just dropped on one of the strangest paradoxes in immunology: Epstein-Barr virus (EBV) — the virus behind mono that ~90% of adults are quietly carrying for life — May HELP protect against type 1 diabetes ... while DRIVING multiple sclerosis. Same virus. Opposite outcomes. 🧵

@BittBurger For example here is a precision method to treat Parkinson’s

MS is not one disease. Neither Parkinson’s, alzhimers, cancer and even diabetes. That’s the key important factor. They have several root causes and routes to create diseases. So there are many subtypes. Each subtype of the disease has to be specifically diagnosed and the treated. This is why it’s best not to generalize each disease and find root causes when treating.

@KimbleKimble6 It’s usually latent and it takes time for multiple sclerosis to develop. For type 1 is protective.

@Neuroscope_mp Interesting, I’ve never researched long term affects from my mono with liver involvement at age 15.

#Immunology #ScienceTwitter

A wild example of how the same lifelong viral passenger can be either a saboteur or an accidental bodyguard, depending on the disease and the cells it interacts with. Immunology keeps proving stranger than fiction. Don’t discard established science and facts — this is still early, emerging research. Always talk to your doctor before making any health decisions. Follow for more clear breakdowns of new immunology + autoimmune disease research.