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She has won several regional Emmy awards, a regional and a national Edward R. Murrow award. The Association for Health Journalists awarded Lesley best beat coverage. The Society of Professional Journalists has recognized her reporting several times. The Society of Environmental Journalists spotlighted her ongoing coverage of California's historic drought. \u003c/span>\u003cspan style=\"font-weight: 400;\">Before joining KQED in 2016, she covered food and sustainability for Capital Public Radio, the environment for Colorado Public Radio, and reported for both KUOW and KCTS9 in Seattle. \u003c/span>\u003cspan style=\"font-weight: 400;\">When not hunched over her laptop Lesley enjoys skiing with her toddler, surfing with her husband or scheming their next globetrotting adventure. Before motherhood she relished dancing tango till sunrise. When on deadline she fuels herself almost exclusively on chocolate chips.\u003c/span>\r\n\r\n\u003cspan style=\"font-weight: 400;\"> \u003c/span>","avatar":"https://secure.gravatar.com/avatar/3fb78e873af3312f34d0bc1d60a07c7f?s=600&d=blank&r=g","twitter":"lesleywmcclurg","facebook":null,"instagram":null,"linkedin":null,"sites":[{"site":"arts","roles":["author"]},{"site":"news","roles":["editor"]},{"site":"futureofyou","roles":["editor"]},{"site":"stateofhealth","roles":["author"]},{"site":"science","roles":["editor"]}],"headData":{"title":"Lesley McClurg | KQED","description":"KQED Health Correspondent","ogImgSrc":"https://secure.gravatar.com/avatar/3fb78e873af3312f34d0bc1d60a07c7f?s=600&d=blank&r=g","twImgSrc":"https://secure.gravatar.com/avatar/3fb78e873af3312f34d0bc1d60a07c7f?s=600&d=blank&r=g"},"isLoading":false,"link":"/author/lesleymcclurg"},"aahmed":{"type":"authors","id":"11428","meta":{"index":"authors_1591205172","id":"11428","found":true},"name":"Amel Ahmed","firstName":"Amel","lastName":"Ahmed","slug":"aahmed","email":"aahmed@kqed.org","display_author_email":false,"staff_mastheads":[],"title":null,"bio":"Amel Ahmed is a reporter for KQED. 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An Interview With CNBC's Christina Farr","publishDate":1545263282,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>We like to check in every once in awhile on the world of digital health, an area full of promise \u003ca href=\"https://www.kqed.org/futureofyou/438782/digital-medicine-may-have-just-hit-the-trough-of-disillusionment\" target=\"_blank\" rel=\"noopener\">but not, thus far, overbrimming with results\u003c/a>.\u003c/p>\n\u003cp>There are \u003ca href=\"https://www.kqed.org/futureofyou/437796/what-are-digital-healths-biggest-successes-and-disappointments-cnbcs-chrissy-farr-weighs-in\" target=\"_blank\" rel=\"noopener\">exceptions\u003c/a>, however, and as we did last year at this time, we're turning to San Francisco-based CNBC journalist\u003cstrong>\u003ca href=\"https://www.cnbc.com/christina-farr/\" target=\"_blank\" rel=\"noopener\"> Christina Farr, \u003c/a>\u003c/strong>who breaks a lot of health tech stories, to clue us in on her beat. This year we asked her what were the really big stories she covered in 2018.\u003c/p>\n\u003cp>\u003cstrong>Here are some highlights from our talk, in Christina's own words. The following has been edited for length and clarity.\u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>Big Digital Health: It's a Thing\u003c/strong>\u003c/p>\n\u003cp>It was a really big year in digital health, particularly where large tech companies are concerned: Apple, Amazon, Google, Microsoft, Samsung...\u003c/p>\n\u003caside class=\"pullquote alignright\">'As [big] tech companies attempt to become trillion-dollar or greater businesses, they need something more than just their core competencies. And you can't ignore health care; it's just too big.'\u003c/aside>\n\u003cp>John Doerr, the venture capitalist who is a big health investor, recounted at the Forbes Healthcare Summit how internet companies in the '90s aimed to disrupt the advertising space, which back then was based mostly on television advertising. Those companies thought they could do a better job because there was really no way at that time to measure and track the performance of ads in real time. So they took on this industry, which is now worth about $75 billion in the U.S.\u003c/p>\n\u003cp>By comparison the health care opportunity is $3.5 trillion in America alone. As these tech companies attempt to become trillion-dollar or greater businesses, they need something more than just their core competencies. And you can't ignore health care; it's just too big.\u003c/p>\n\u003cp>\u003cstrong>Here Comes Amazon ...\u003c/strong>\u003c/p>\n\u003cp>Amazon’s \u003ca href=\"https://www.cnbc.com/2018/06/28/amazon-to-acquire-online-pharmacy-pillpack.html\" target=\"_blank\" rel=\"noopener\">acquisition\u003c/a> of online pharmacy PillPack in June was a very big story. The announcement really marked them as a player, and the market response -- billions of dollars were knocked off some of these pharmacy stocks -- showed how much of a threat Amazon could be. It's also a very good deal for PillPack and probably showed the digital health community that those sorts of exits are possible.\u003c/p>\n\u003cfigure id=\"attachment_437838\" class=\"wp-caption alignright\" style=\"max-width: 589px\">\u003cimg class=\"size-full wp-image-437838\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/12/chrissyfarrphoto1.png\" alt=\"\" width=\"589\" height=\"428\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/12/chrissyfarrphoto1.png 589w, https://ww2.kqed.org/app/uploads/sites/13/2017/12/chrissyfarrphoto1-160x116.png 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/12/chrissyfarrphoto1-240x174.png 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/12/chrissyfarrphoto1-375x272.png 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/12/chrissyfarrphoto1-520x378.png 520w\" sizes=\"(max-width: 589px) 100vw, 589px\">\u003cfigcaption class=\"wp-caption-text\">CNBC's Chrissy Farr. \u003ccite>(CNBC)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Around the same time, Amazon also \u003ca href=\"https://www.cnbc.com/2018/12/14/amazon-explored-medical-diagnostics-was-in-talks-to-buy-confer-health.html\" target=\"_blank\" rel=\"noopener\">looked at Confer Health\u003c/a>, a company in the at-home medical diagnostic space. That's interesting, because it speaks to a strategy that goes deeper than just drug delivery.\u003c/p>\n\u003cp>Where Amazon could potentially go is this: Imagine you're experiencing symptoms for strep throat, and you \u003ca href=\"https://thenextweb.com/artificial-intelligence/2018/10/15/amazons-new-patent-will-allow-alexa-to-detect-your-illness/\" target=\"_blank\" rel=\"noopener\">talk to your Amazon Alexa device\u003c/a>, and there's an AI system, or a real physician, even, that speaks to you and recommends you get tested. A courier comes to your home with a portable device from which you run a sample and you get a result immediately. Or from there the same physician ships you a prescription. And that could all be done in a couple hours.\u003c/p>\n\u003cp>Or imagine an elderly person who potentially has the flu and might have to go to a physical clinic, and then from there bring a prescription to a Walgreens. That is an annoying user experience but also think about how many people they could infect with the flu on the way to the clinic and pharmacy. So I think there could be some basic things Amazon can do with diagnosing illness in the home. And if they can do that coupled with prescription drug delivery, that's a very \u003ca href=\"https://www.cnbc.com/2018/12/17/amazon-vision-future-health-care.html\" target=\"_blank\" rel=\"noopener\">different experience of health care\u003c/a> than we've seen.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cstrong>...and Apple\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>The whole Apple health care rollout was big, and I would probably pinpoint the electro-cardiogram\u003ca href=\"https://www.cnbc.com/video/2018/12/05/apple-watch-ecg-sensor-review.html\" target=\"_blank\" rel=\"noopener\"> being introduced on the Apple Watch\u003c/a> as the biggest story from what they've done this year. It got Apple into a more regulated medical device space; I don't know if they are now a medical device company, but they're certainly a consumer tech company that makes medical products.\u003c/p>\n\u003cp>It’s an important story because it sort of changed the game around proactive health monitoring. They were looking specifically for people who didn't even know they have a type of arrhythmia called atrial fibrillation.\u003c/p>\n\u003cp>That's controversial, as there are doctors who think this is bad news, because it's going to lead to a lot of anxious people thinking there's something wrong when there isn't. I've been hearing from physicians who already have patients with normal results reach out and ask, ‘Hey, does this look right?’ Doctors are already overloaded and don't want to be managing an influx of healthy people. So Apple's got to really make sure the false positive rate isn't too high, and they need to be transparent about what this ECG means.\u003c/p>\n\u003cp>But I think this is probably the beginning of what Apple's overall strategy is when it comes to bringing health monitoring to the watch.\u003c/p>\n\u003cp>\u003cstrong>... and, uh, Facebook? \u003c/strong>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">This year even Facebook was trying to get into digital health. At one point it hired some people in the medical community to \u003c/span>\u003ca href=\"https://www.cnbc.com/2018/04/05/facebook-building-8-explored-data-sharing-agreement-with-hospitals.html\">\u003cspan style=\"font-weight: 400\">approach top hospitals\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> about a patient data-sharing agreement. Facebook wanted to see if it could match up the health system's user data with its own data to see if patients might need special care\u003c/span>\u003cspan style=\"font-weight: 400\">. That seemed to be have fallen apart out of general fears of data privacy surrounding the company.\u003c/span>\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe src=\"https://player.cnbc.com/p/gZWlPC/cnbc_global?playertype=synd&byGuid=7000011603&size=530_298\" width=\"530\" height=\"298\" scrolling=\"yes\" class=\"iframe-class\" frameborder=\"0\">\u003c/iframe>\u003c/p>\n\u003cp>\u003cstrong>'Real Money' for Digital Health Startup \u003c/strong>\u003c/p>\n\u003cp>Pharmaceutical giant \u003ca href=\"https://www.cnbc.com/2018/02/15/roche-buying-flatiron-health-backed-by-alphabet.html\" target=\"_blank\" rel=\"noopener\">Roche bought Flatiron Health\u003c/a> in February for just over $2 billion. I think that was a big deal because it was a pharmaceutical company spending real money on a digital health startup. I think it shows that there can be real successes in the space. It's also a thumbs-up for precision medicine; Flatiron was basically creating a medical record system that was popular with oncologists, and then using data to figure out better treatments for those patients.\u003c/p>\n\u003cp>\u003cstrong>Watson Stumbles, or: \u003ca href=\"https://www.youtube.com/watch?v=P18EdAKuC1U\" target=\"_blank\" rel=\"noopener\">Health Care Ain't 'Jeopardy'\u003c/a>\u003c/strong>\u003c/p>\n\u003cp>In talking with folks familiar with the IBM Watson strategy, I think where they may have gone wrong is in building this AI system that was \u003ca href=\"https://www.statnews.com/2017/09/05/watson-ibm-cancer/\" target=\"_blank\" rel=\"noopener\">trained using top U.S. oncologists\u003c/a>, and then they tried to sell it to other big cancer centers. So if you're an oncologist at one of these other places, why wouldn't you just say, \"Well, I'm as good as these physicians at Memorial Sloan Kettering?\"\u003c/p>\n\u003cp>So I think they tried to sell into the wrong market because they thought they could get these really big contracts, and what they probably should have done is figured out a much cheaper system that they could have sold to smaller health systems; you can see why some of these local offices and physicians who don't have the same resources as Sloan Kettering would find it beneficial to get information on what Sloan Kettering would do in any given situation.\u003c/p>\n\u003cp>\u003cstrong>It's the Outcomes, Stupid\u003c/strong>\u003c/p>\n\u003cp>For a long time you didn't really see digital health companies invest in outcomes, because I think they wanted to be viewed more as technology companies. But there were a few -- Livongo, Omada Health, Propeller Health -- that were always sort of forward-leaning and did do that investment from the outset, and I think those companies are the ones that are doing better now.\u003c/p>\n\u003cp>Propeller Health was \u003ca href=\"https://www.jsonline.com/story/money/business/health-care/2018/12/03/propeller-health-madison-acquired-225-million/2192097002/\" target=\"_blank\" rel=\"noopener\">sold\u003c/a> this year to ResMed, for instance. I think it was because it had that focus on outcomes.\u003c/p>\n\u003cp>That model is especially important for the influx of companies trying to sell into the employer space, because in order to tell the difference between them, there has been a lot of questioning around: \"Is this actually making my population healthier? Is it really going to save me money?\"\u003c/p>\n\u003cp>In general I think the companies that are coming up this year have kind of learned from the mistakes of some of their predecessors and are positioning themselves with a bit more humility, and in many cases doing the right thing. They don't describe themselves, when pitching potential customers, as startups. They take themselves more seriously now, and they want to be viewed as new health care companies and businesses.\u003c/p>\n\u003cp>It just speaks to a general sort of growing-up.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n","blocks":[],"excerpt":"The tech journalist discusses where the digital health industry is headed after a year in which Big Tech made some Big investments.","status":"publish","parent":0,"modified":1545332340,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":33,"wordCount":1389},"headData":{"title":"What Were the Year's Biggest Digital Health Stories? An Interview With CNBC's Christina Farr | KQED","description":"The tech journalist discusses where the digital health industry is headed after a year in which Big Tech made some Big investments.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"445929 https://ww2.kqed.org/futureofyou/?p=445929","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/12/19/what-were-2018s-biggest-digital-health-stories-an-interview-with-cnbcs-christina-farr/","disqusTitle":"What Were the Year's Biggest Digital Health Stories? An Interview With CNBC's Christina Farr","source":"Digital Health","path":"/futureofyou/445929/what-were-2018s-biggest-digital-health-stories-an-interview-with-cnbcs-christina-farr","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>We like to check in every once in awhile on the world of digital health, an area full of promise \u003ca href=\"https://www.kqed.org/futureofyou/438782/digital-medicine-may-have-just-hit-the-trough-of-disillusionment\" target=\"_blank\" rel=\"noopener\">but not, thus far, overbrimming with results\u003c/a>.\u003c/p>\n\u003cp>There are \u003ca href=\"https://www.kqed.org/futureofyou/437796/what-are-digital-healths-biggest-successes-and-disappointments-cnbcs-chrissy-farr-weighs-in\" target=\"_blank\" rel=\"noopener\">exceptions\u003c/a>, however, and as we did last year at this time, we're turning to San Francisco-based CNBC journalist\u003cstrong>\u003ca href=\"https://www.cnbc.com/christina-farr/\" target=\"_blank\" rel=\"noopener\"> Christina Farr, \u003c/a>\u003c/strong>who breaks a lot of health tech stories, to clue us in on her beat. This year we asked her what were the really big stories she covered in 2018.\u003c/p>\n\u003cp>\u003cstrong>Here are some highlights from our talk, in Christina's own words. The following has been edited for length and clarity.\u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>Big Digital Health: It's a Thing\u003c/strong>\u003c/p>\n\u003cp>It was a really big year in digital health, particularly where large tech companies are concerned: Apple, Amazon, Google, Microsoft, Samsung...\u003c/p>\n\u003caside class=\"pullquote alignright\">'As [big] tech companies attempt to become trillion-dollar or greater businesses, they need something more than just their core competencies. And you can't ignore health care; it's just too big.'\u003c/aside>\n\u003cp>John Doerr, the venture capitalist who is a big health investor, recounted at the Forbes Healthcare Summit how internet companies in the '90s aimed to disrupt the advertising space, which back then was based mostly on television advertising. Those companies thought they could do a better job because there was really no way at that time to measure and track the performance of ads in real time. So they took on this industry, which is now worth about $75 billion in the U.S.\u003c/p>\n\u003cp>By comparison the health care opportunity is $3.5 trillion in America alone. As these tech companies attempt to become trillion-dollar or greater businesses, they need something more than just their core competencies. And you can't ignore health care; it's just too big.\u003c/p>\n\u003cp>\u003cstrong>Here Comes Amazon ...\u003c/strong>\u003c/p>\n\u003cp>Amazon’s \u003ca href=\"https://www.cnbc.com/2018/06/28/amazon-to-acquire-online-pharmacy-pillpack.html\" target=\"_blank\" rel=\"noopener\">acquisition\u003c/a> of online pharmacy PillPack in June was a very big story. The announcement really marked them as a player, and the market response -- billions of dollars were knocked off some of these pharmacy stocks -- showed how much of a threat Amazon could be. It's also a very good deal for PillPack and probably showed the digital health community that those sorts of exits are possible.\u003c/p>\n\u003cfigure id=\"attachment_437838\" class=\"wp-caption alignright\" style=\"max-width: 589px\">\u003cimg class=\"size-full wp-image-437838\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/12/chrissyfarrphoto1.png\" alt=\"\" width=\"589\" height=\"428\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/12/chrissyfarrphoto1.png 589w, https://ww2.kqed.org/app/uploads/sites/13/2017/12/chrissyfarrphoto1-160x116.png 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/12/chrissyfarrphoto1-240x174.png 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/12/chrissyfarrphoto1-375x272.png 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/12/chrissyfarrphoto1-520x378.png 520w\" sizes=\"(max-width: 589px) 100vw, 589px\">\u003cfigcaption class=\"wp-caption-text\">CNBC's Chrissy Farr. \u003ccite>(CNBC)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Around the same time, Amazon also \u003ca href=\"https://www.cnbc.com/2018/12/14/amazon-explored-medical-diagnostics-was-in-talks-to-buy-confer-health.html\" target=\"_blank\" rel=\"noopener\">looked at Confer Health\u003c/a>, a company in the at-home medical diagnostic space. That's interesting, because it speaks to a strategy that goes deeper than just drug delivery.\u003c/p>\n\u003cp>Where Amazon could potentially go is this: Imagine you're experiencing symptoms for strep throat, and you \u003ca href=\"https://thenextweb.com/artificial-intelligence/2018/10/15/amazons-new-patent-will-allow-alexa-to-detect-your-illness/\" target=\"_blank\" rel=\"noopener\">talk to your Amazon Alexa device\u003c/a>, and there's an AI system, or a real physician, even, that speaks to you and recommends you get tested. A courier comes to your home with a portable device from which you run a sample and you get a result immediately. Or from there the same physician ships you a prescription. And that could all be done in a couple hours.\u003c/p>\n\u003cp>Or imagine an elderly person who potentially has the flu and might have to go to a physical clinic, and then from there bring a prescription to a Walgreens. That is an annoying user experience but also think about how many people they could infect with the flu on the way to the clinic and pharmacy. So I think there could be some basic things Amazon can do with diagnosing illness in the home. And if they can do that coupled with prescription drug delivery, that's a very \u003ca href=\"https://www.cnbc.com/2018/12/17/amazon-vision-future-health-care.html\" target=\"_blank\" rel=\"noopener\">different experience of health care\u003c/a> than we've seen.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>...and Apple\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>The whole Apple health care rollout was big, and I would probably pinpoint the electro-cardiogram\u003ca href=\"https://www.cnbc.com/video/2018/12/05/apple-watch-ecg-sensor-review.html\" target=\"_blank\" rel=\"noopener\"> being introduced on the Apple Watch\u003c/a> as the biggest story from what they've done this year. It got Apple into a more regulated medical device space; I don't know if they are now a medical device company, but they're certainly a consumer tech company that makes medical products.\u003c/p>\n\u003cp>It’s an important story because it sort of changed the game around proactive health monitoring. They were looking specifically for people who didn't even know they have a type of arrhythmia called atrial fibrillation.\u003c/p>\n\u003cp>That's controversial, as there are doctors who think this is bad news, because it's going to lead to a lot of anxious people thinking there's something wrong when there isn't. I've been hearing from physicians who already have patients with normal results reach out and ask, ‘Hey, does this look right?’ Doctors are already overloaded and don't want to be managing an influx of healthy people. So Apple's got to really make sure the false positive rate isn't too high, and they need to be transparent about what this ECG means.\u003c/p>\n\u003cp>But I think this is probably the beginning of what Apple's overall strategy is when it comes to bringing health monitoring to the watch.\u003c/p>\n\u003cp>\u003cstrong>... and, uh, Facebook? \u003c/strong>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">This year even Facebook was trying to get into digital health. At one point it hired some people in the medical community to \u003c/span>\u003ca href=\"https://www.cnbc.com/2018/04/05/facebook-building-8-explored-data-sharing-agreement-with-hospitals.html\">\u003cspan style=\"font-weight: 400\">approach top hospitals\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> about a patient data-sharing agreement. Facebook wanted to see if it could match up the health system's user data with its own data to see if patients might need special care\u003c/span>\u003cspan style=\"font-weight: 400\">. That seemed to be have fallen apart out of general fears of data privacy surrounding the company.\u003c/span>\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe src=\"https://player.cnbc.com/p/gZWlPC/cnbc_global?playertype=synd&byGuid=7000011603&size=530_298\" width=\"530\" height=\"298\" scrolling=\"yes\" class=\"iframe-class\" frameborder=\"0\">\u003c/iframe>\u003c/p>\n\u003cp>\u003cstrong>'Real Money' for Digital Health Startup \u003c/strong>\u003c/p>\n\u003cp>Pharmaceutical giant \u003ca href=\"https://www.cnbc.com/2018/02/15/roche-buying-flatiron-health-backed-by-alphabet.html\" target=\"_blank\" rel=\"noopener\">Roche bought Flatiron Health\u003c/a> in February for just over $2 billion. I think that was a big deal because it was a pharmaceutical company spending real money on a digital health startup. I think it shows that there can be real successes in the space. It's also a thumbs-up for precision medicine; Flatiron was basically creating a medical record system that was popular with oncologists, and then using data to figure out better treatments for those patients.\u003c/p>\n\u003cp>\u003cstrong>Watson Stumbles, or: \u003ca href=\"https://www.youtube.com/watch?v=P18EdAKuC1U\" target=\"_blank\" rel=\"noopener\">Health Care Ain't 'Jeopardy'\u003c/a>\u003c/strong>\u003c/p>\n\u003cp>In talking with folks familiar with the IBM Watson strategy, I think where they may have gone wrong is in building this AI system that was \u003ca href=\"https://www.statnews.com/2017/09/05/watson-ibm-cancer/\" target=\"_blank\" rel=\"noopener\">trained using top U.S. oncologists\u003c/a>, and then they tried to sell it to other big cancer centers. So if you're an oncologist at one of these other places, why wouldn't you just say, \"Well, I'm as good as these physicians at Memorial Sloan Kettering?\"\u003c/p>\n\u003cp>So I think they tried to sell into the wrong market because they thought they could get these really big contracts, and what they probably should have done is figured out a much cheaper system that they could have sold to smaller health systems; you can see why some of these local offices and physicians who don't have the same resources as Sloan Kettering would find it beneficial to get information on what Sloan Kettering would do in any given situation.\u003c/p>\n\u003cp>\u003cstrong>It's the Outcomes, Stupid\u003c/strong>\u003c/p>\n\u003cp>For a long time you didn't really see digital health companies invest in outcomes, because I think they wanted to be viewed more as technology companies. But there were a few -- Livongo, Omada Health, Propeller Health -- that were always sort of forward-leaning and did do that investment from the outset, and I think those companies are the ones that are doing better now.\u003c/p>\n\u003cp>Propeller Health was \u003ca href=\"https://www.jsonline.com/story/money/business/health-care/2018/12/03/propeller-health-madison-acquired-225-million/2192097002/\" target=\"_blank\" rel=\"noopener\">sold\u003c/a> this year to ResMed, for instance. I think it was because it had that focus on outcomes.\u003c/p>\n\u003cp>That model is especially important for the influx of companies trying to sell into the employer space, because in order to tell the difference between them, there has been a lot of questioning around: \"Is this actually making my population healthier? Is it really going to save me money?\"\u003c/p>\n\u003cp>In general I think the companies that are coming up this year have kind of learned from the mistakes of some of their predecessors and are positioning themselves with a bit more humility, and in many cases doing the right thing. They don't describe themselves, when pitching potential customers, as startups. They take themselves more seriously now, and they want to be viewed as new health care companies and businesses.\u003c/p>\n\u003cp>It just speaks to a general sort of growing-up.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/445929/what-were-2018s-biggest-digital-health-stories-an-interview-with-cnbcs-christina-farr","authors":["80"],"categories":["futureofyou_1060","futureofyou_1062","futureofyou_1","futureofyou_73"],"tags":["futureofyou_26","futureofyou_80"],"featImg":"futureofyou_274615","label":"source_futureofyou_445929"},"futureofyou_445776":{"type":"posts","id":"futureofyou_445776","meta":{"index":"posts_1591205157","site":"futureofyou","id":"445776","score":null,"sort":[1544034704000]},"guestAuthors":[],"slug":"no-cash-no-organ-transplant-patients-must-prove-they-can-pay-enormous-bills","title":"No Cash, No Organ Transplant: Patients Must Prove They Can Pay Enormous Bills","publishDate":1544034704,"format":"aside","headTitle":"KQED Future of You | KQED Science","labelTerm":{"site":"futureofyou"},"content":"\u003cp>When Patrick Mannion heard about the Michigan woman denied a heart transplant because she couldn’t afford the anti-rejection drugs, he knew what she was up against.\u003c/p>\n\u003cfigure id=\"attachment_445781\" class=\"wp-caption alignright\" style=\"max-width: 270px\">\u003cimg class=\"wp-image-445781 size-full\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/12/transplant_costs1.jpg\" alt=\"\" width=\"270\" height=\"405\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/12/transplant_costs1.jpg 270w, https://ww2.kqed.org/app/uploads/sites/13/2018/12/transplant_costs1-160x240.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/12/transplant_costs1-240x360.jpg 240w\" sizes=\"(max-width: 270px) 100vw, 270px\">\u003cfigcaption class=\"wp-caption-text\">Patrick Mannion received a double-lung transplant in May 2017 after being diagnosed with idiopathic pulmonary fibrosis, a progressive, life-threatening lung disease. Through a transplant fundraising organization, HelpHopeLive, he has raised nearly $115,000, twice the original goal to help pay expenses that insurance didn’t cover, including copays for costly anti-rejection drugs. \u003ccite>(Courtesy of Patrick Mannion)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>On social media posts of a letter that \u003ca href=\"https://twitter.com/Ocasio2018/status/1066351594843844608\">went viral\u003c/a> last month, Hedda Martin, 60, of Grand Rapids, was informed that she was not a candidate for a heart transplant because of her finances. It recommended “a fundraising effort of $10,000.”\u003c/p>\n\u003cp>Patrick Mannion received a double-lung transplant in May 2017 after being diagnosed with idiopathic pulmonary fibrosis, a progressive, life-threatening lung disease. Through a transplant fundraising organization, HelpHopeLive, he has raised nearly $115,000, twice the original goal to help pay expenses that insurance didn’t cover, including copays for costly anti-rejection drugs.\u003c/p>\n\u003cp>Two years ago, Mannion, of Oxford, Conn., learned he needed a double-lung transplant after contracting idiopathic pulmonary fibrosis, a progressive, fatal disease. From the start, hospital officials told him to set aside $30,000 in a separate bank account to cover the costs.\u003c/p>\n\u003cp>Mannion, 59, who received his new lungs in May 2017, reflected: “Here you are, you need a heart — that’s a tough road for any person,” he said. “And then for that person to have to be a fundraiser?”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Martin’s case sparked outrage over a transplant system that links access to a lifesaving treatment to finances. But requiring proof of payment for organ transplants and post-operative care is common, transplant experts say.\u003c/p>\n\u003cp>“It happens every day,” said Arthur Caplan, a bioethicist at the New York University Langone Medical Center. “You get what I call a ‘wallet biopsy.’”\u003c/p>\n\u003cp>Virtually all of the nation’s more than 250 transplant centers, which refer patients to a \u003ca href=\"https://unos.org/\">single national registry\u003c/a>, require patients to verify how they will cover bills that \u003ca href=\"http://www.milliman.com/uploadedFiles/insight/2017/2017-Transplant-Report.pdf\">can total\u003c/a> $400,000 for a kidney transplant or $1.3 million for a heart, plus monthly costs that \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4520417/\">average $2,500\u003c/a> for anti-rejection drugs that must be taken for life, Caplan said. Coverage for the drugs is more scattershot than for the operation itself, even though transplanted organs will not last without the medicine.\u003c/p>\n\u003cp>For Martin, the social media attention helped. Within days, she had raised more than $30,000 through a GoFundMe account, and officials at Spectrum Health confirmed she was added to the transplant waiting list.\u003c/p>\n\u003cp>\u003ca href=\"https://newsroom.spectrumhealth.org/fyi/\">In a statement\u003c/a>, officials there defended their position, saying that financial resources, along with physical health and social well-being, are among crucial factors to consider.\u003c/p>\n\u003cp>“The ability to pay for post-transplant care and life-long immunosuppression medications is essential to increase the likelihood of a successful transplant and longevity of the transplant recipient,” officials wrote.\u003c/p>\n\u003cp>In the most pragmatic light, that makes sense. More than 114,000 people are waiting for organs in the U.S. and \u003ca href=\"https://optn.transplant.hrsa.gov/data/view-data-reports/national-data/\">fewer than 35,000\u003c/a> organs were transplanted last year, according to the United Network for Organ Sharing, or UNOS. Transplant centers want to make sure donated organs aren’t wasted.\u003c/p>\n\u003cp>“If you’re receiving a lifesaving organ, you have to be able to afford it,” said Kelly Green, executive director of HelpHopeLive, the Pennsylvania organization that has helped Mannion.\u003c/p>\n\u003cp>His friends and family have rallied, flocking to fundraisers that ranged from hair salon cut-a-thons to golf tournaments, raising nearly $115,000 so far for transplant-related care.\u003c/p>\n\u003cp>Allowing financial factors to determine who gets a spot on the waiting list strikes many as unfair, Caplan said.\u003c/p>\n\u003cp>“It may be a source of anger, because when we’re looking for organs, we don’t like to think that they go to the rich,” he said. “In reality, it’s largely true.”\u003c/p>\n\u003cp>Nearly half of the patients waiting for organs in the U.S. have private health insurance, UNOS data show. The rest are largely covered by the government, including Medicaid, the federal program for the disabled and poor, and Medicare.\u003c/p>\n\u003cp>Medicare also \u003ca href=\"https://www.medicareinteractive.org/get-answers/medicare-health-coverage-options/medicare-and-end-stage-renal-disease-esrd/esrd-medicare-basics\">covers\u003c/a> kidney transplants for all patients with end-stage renal disease. But, there’s a catch. While the cost of a kidney transplant is covered for people younger than 65, the program halts payment for anti-rejection drugs after 36 months. That leaves many patients facing sudden bills, said Tonya Saffer, vice president of health policy for the National Kidney Foundation.\u003c/p>\n\u003cp>Legislation that would extend Medicare coverage for those drugs has been stalled for years.\u003c/p>\n\u003cp>For Alex Reed, 28, of Pittsburgh, who received a kidney transplant three years ago, coverage for the dozen medications he takes ended Nov. 30. His mother, Bobbie Reed, 62, has been scrambling for a solution.\u003c/p>\n\u003cp>“We can’t pick up those costs,” said Reed, whose family runs an independent insurance firm. “It would be at least $3,000 or $4,000 a month.”\u003c/p>\n\u003cp>Prices for the drugs, which include powerful medications that prevent the body from rejecting the organs, have been falling in recent years as more generic versions have come to market, Saffer said.\u003c/p>\n\u003cp>But “the cost can still be hard on the budget,” she added.\u003c/p>\n\u003cp>It’s been a struggle for decades to get transplants and associated expenses covered by insurance, said Dr. Maryl Johnson, a heart failure and transplant cardiologist at the University of Wisconsin School of Medicine and Public Health.\u003c/p>\n\u003cp>“It’s unusual that there’s 100 percent coverage for everything,” said Johnson, a leader in the field for 30 years.\u003c/p>\n\u003cp>GoFundMe efforts have become a popular way for sick people to raise money. About a third of the campaigns on the site target medical needs, the company said.\u003c/p>\n\u003cp>But when patients need to raise money, they should use fundraising organizations specifically aimed at those costs, transplant experts say, including \u003ca href=\"https://helphopelive.org/\">HelpHopeLive\u003c/a>, the \u003ca href=\"https://transplants.org/\">National Foundation for Transplants\u003c/a> and the \u003ca href=\"https://www.americantransplantfoundation.org/programs/pap/\">American Transplant Foundation.\u003c/a>\u003c/p>\n\u003cp>There’s no guarantee funds generated through such general sites such as GoFundMe will be used for the intended purpose. In addition, the money likely will be regarded as taxable income that could jeopardize other resources, said Michelle Gilchrist, president and chief executive for the National Foundation for Transplants.\u003c/p>\n\u003cp>Her group, which helps about 4,000 patients a year, has raised $82 million for transplant costs since 1983, she said. Such efforts usually involve a huge public-relations push. Still, 20 percent of the patients who turn to NFT each year fail to raise the needed funds, Gilchrist said.\u003c/p>\n\u003cp>In those cases, the patients don’t get the organs they need. “My concern is that health care should be accessible for everyone,” she said, adding: “Ten thousand dollars is a lot to someone who doesn’t have it.”\u003c/p>\n\u003cp>Every transplant center in the U.S. has a team of social workers and financial coordinators who help patients negotiate the gaps in their care. Lara Tushla, a licensed clinical social worker with the Rush University transplant program in Chicago, monitors about 2,000 transplant patients. She urges potential patients to think realistically about the costs they’ll face.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“The pharmacy will not hand over a bag full of pills without a bag full of money,” she said. “They will not bill you. They want the copays before they give you the medication.”\u003c/p>\n\n","blocks":[],"excerpt":"It's called a 'wallet biopsy' -- requiring proof of payment for organ transplants and post-operative care. And it's common, transplant experts say.","status":"publish","parent":0,"modified":1544037026,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":34,"wordCount":1300},"headData":{"title":"No Cash, No Organ Transplant: Patients Must Prove They Can Pay Enormous Bills | KQED","description":"It's called a 'wallet biopsy' -- requiring proof of payment for organ transplants and post-operative care. And it's common, transplant experts say.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"445776 https://ww2.kqed.org/futureofyou/?p=445776","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/12/05/no-cash-no-organ-transplant-patients-must-prove-they-can-pay-enormous-bills/","disqusTitle":"No Cash, No Organ Transplant: Patients Must Prove They Can Pay Enormous Bills","nprByline":"JoNel Aleccia\u003cbr />Kaiser Health News","path":"/futureofyou/445776/no-cash-no-organ-transplant-patients-must-prove-they-can-pay-enormous-bills","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>When Patrick Mannion heard about the Michigan woman denied a heart transplant because she couldn’t afford the anti-rejection drugs, he knew what she was up against.\u003c/p>\n\u003cfigure id=\"attachment_445781\" class=\"wp-caption alignright\" style=\"max-width: 270px\">\u003cimg class=\"wp-image-445781 size-full\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/12/transplant_costs1.jpg\" alt=\"\" width=\"270\" height=\"405\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/12/transplant_costs1.jpg 270w, https://ww2.kqed.org/app/uploads/sites/13/2018/12/transplant_costs1-160x240.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/12/transplant_costs1-240x360.jpg 240w\" sizes=\"(max-width: 270px) 100vw, 270px\">\u003cfigcaption class=\"wp-caption-text\">Patrick Mannion received a double-lung transplant in May 2017 after being diagnosed with idiopathic pulmonary fibrosis, a progressive, life-threatening lung disease. Through a transplant fundraising organization, HelpHopeLive, he has raised nearly $115,000, twice the original goal to help pay expenses that insurance didn’t cover, including copays for costly anti-rejection drugs. \u003ccite>(Courtesy of Patrick Mannion)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>On social media posts of a letter that \u003ca href=\"https://twitter.com/Ocasio2018/status/1066351594843844608\">went viral\u003c/a> last month, Hedda Martin, 60, of Grand Rapids, was informed that she was not a candidate for a heart transplant because of her finances. It recommended “a fundraising effort of $10,000.”\u003c/p>\n\u003cp>Patrick Mannion received a double-lung transplant in May 2017 after being diagnosed with idiopathic pulmonary fibrosis, a progressive, life-threatening lung disease. Through a transplant fundraising organization, HelpHopeLive, he has raised nearly $115,000, twice the original goal to help pay expenses that insurance didn’t cover, including copays for costly anti-rejection drugs.\u003c/p>\n\u003cp>Two years ago, Mannion, of Oxford, Conn., learned he needed a double-lung transplant after contracting idiopathic pulmonary fibrosis, a progressive, fatal disease. From the start, hospital officials told him to set aside $30,000 in a separate bank account to cover the costs.\u003c/p>\n\u003cp>Mannion, 59, who received his new lungs in May 2017, reflected: “Here you are, you need a heart — that’s a tough road for any person,” he said. “And then for that person to have to be a fundraiser?”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Martin’s case sparked outrage over a transplant system that links access to a lifesaving treatment to finances. But requiring proof of payment for organ transplants and post-operative care is common, transplant experts say.\u003c/p>\n\u003cp>“It happens every day,” said Arthur Caplan, a bioethicist at the New York University Langone Medical Center. “You get what I call a ‘wallet biopsy.’”\u003c/p>\n\u003cp>Virtually all of the nation’s more than 250 transplant centers, which refer patients to a \u003ca href=\"https://unos.org/\">single national registry\u003c/a>, require patients to verify how they will cover bills that \u003ca href=\"http://www.milliman.com/uploadedFiles/insight/2017/2017-Transplant-Report.pdf\">can total\u003c/a> $400,000 for a kidney transplant or $1.3 million for a heart, plus monthly costs that \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4520417/\">average $2,500\u003c/a> for anti-rejection drugs that must be taken for life, Caplan said. Coverage for the drugs is more scattershot than for the operation itself, even though transplanted organs will not last without the medicine.\u003c/p>\n\u003cp>For Martin, the social media attention helped. Within days, she had raised more than $30,000 through a GoFundMe account, and officials at Spectrum Health confirmed she was added to the transplant waiting list.\u003c/p>\n\u003cp>\u003ca href=\"https://newsroom.spectrumhealth.org/fyi/\">In a statement\u003c/a>, officials there defended their position, saying that financial resources, along with physical health and social well-being, are among crucial factors to consider.\u003c/p>\n\u003cp>“The ability to pay for post-transplant care and life-long immunosuppression medications is essential to increase the likelihood of a successful transplant and longevity of the transplant recipient,” officials wrote.\u003c/p>\n\u003cp>In the most pragmatic light, that makes sense. More than 114,000 people are waiting for organs in the U.S. and \u003ca href=\"https://optn.transplant.hrsa.gov/data/view-data-reports/national-data/\">fewer than 35,000\u003c/a> organs were transplanted last year, according to the United Network for Organ Sharing, or UNOS. Transplant centers want to make sure donated organs aren’t wasted.\u003c/p>\n\u003cp>“If you’re receiving a lifesaving organ, you have to be able to afford it,” said Kelly Green, executive director of HelpHopeLive, the Pennsylvania organization that has helped Mannion.\u003c/p>\n\u003cp>His friends and family have rallied, flocking to fundraisers that ranged from hair salon cut-a-thons to golf tournaments, raising nearly $115,000 so far for transplant-related care.\u003c/p>\n\u003cp>Allowing financial factors to determine who gets a spot on the waiting list strikes many as unfair, Caplan said.\u003c/p>\n\u003cp>“It may be a source of anger, because when we’re looking for organs, we don’t like to think that they go to the rich,” he said. “In reality, it’s largely true.”\u003c/p>\n\u003cp>Nearly half of the patients waiting for organs in the U.S. have private health insurance, UNOS data show. The rest are largely covered by the government, including Medicaid, the federal program for the disabled and poor, and Medicare.\u003c/p>\n\u003cp>Medicare also \u003ca href=\"https://www.medicareinteractive.org/get-answers/medicare-health-coverage-options/medicare-and-end-stage-renal-disease-esrd/esrd-medicare-basics\">covers\u003c/a> kidney transplants for all patients with end-stage renal disease. But, there’s a catch. While the cost of a kidney transplant is covered for people younger than 65, the program halts payment for anti-rejection drugs after 36 months. That leaves many patients facing sudden bills, said Tonya Saffer, vice president of health policy for the National Kidney Foundation.\u003c/p>\n\u003cp>Legislation that would extend Medicare coverage for those drugs has been stalled for years.\u003c/p>\n\u003cp>For Alex Reed, 28, of Pittsburgh, who received a kidney transplant three years ago, coverage for the dozen medications he takes ended Nov. 30. His mother, Bobbie Reed, 62, has been scrambling for a solution.\u003c/p>\n\u003cp>“We can’t pick up those costs,” said Reed, whose family runs an independent insurance firm. “It would be at least $3,000 or $4,000 a month.”\u003c/p>\n\u003cp>Prices for the drugs, which include powerful medications that prevent the body from rejecting the organs, have been falling in recent years as more generic versions have come to market, Saffer said.\u003c/p>\n\u003cp>But “the cost can still be hard on the budget,” she added.\u003c/p>\n\u003cp>It’s been a struggle for decades to get transplants and associated expenses covered by insurance, said Dr. Maryl Johnson, a heart failure and transplant cardiologist at the University of Wisconsin School of Medicine and Public Health.\u003c/p>\n\u003cp>“It’s unusual that there’s 100 percent coverage for everything,” said Johnson, a leader in the field for 30 years.\u003c/p>\n\u003cp>GoFundMe efforts have become a popular way for sick people to raise money. About a third of the campaigns on the site target medical needs, the company said.\u003c/p>\n\u003cp>But when patients need to raise money, they should use fundraising organizations specifically aimed at those costs, transplant experts say, including \u003ca href=\"https://helphopelive.org/\">HelpHopeLive\u003c/a>, the \u003ca href=\"https://transplants.org/\">National Foundation for Transplants\u003c/a> and the \u003ca href=\"https://www.americantransplantfoundation.org/programs/pap/\">American Transplant Foundation.\u003c/a>\u003c/p>\n\u003cp>There’s no guarantee funds generated through such general sites such as GoFundMe will be used for the intended purpose. In addition, the money likely will be regarded as taxable income that could jeopardize other resources, said Michelle Gilchrist, president and chief executive for the National Foundation for Transplants.\u003c/p>\n\u003cp>Her group, which helps about 4,000 patients a year, has raised $82 million for transplant costs since 1983, she said. Such efforts usually involve a huge public-relations push. Still, 20 percent of the patients who turn to NFT each year fail to raise the needed funds, Gilchrist said.\u003c/p>\n\u003cp>In those cases, the patients don’t get the organs they need. “My concern is that health care should be accessible for everyone,” she said, adding: “Ten thousand dollars is a lot to someone who doesn’t have it.”\u003c/p>\n\u003cp>Every transplant center in the U.S. has a team of social workers and financial coordinators who help patients negotiate the gaps in their care. Lara Tushla, a licensed clinical social worker with the Rush University transplant program in Chicago, monitors about 2,000 transplant patients. She urges potential patients to think realistically about the costs they’ll face.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“The pharmacy will not hand over a bag full of pills without a bag full of money,” she said. “They will not bill you. They want the copays before they give you the medication.”\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/445776/no-cash-no-organ-transplant-patients-must-prove-they-can-pay-enormous-bills","authors":["byline_futureofyou_445776"],"categories":["futureofyou_452","futureofyou_1062","futureofyou_73"],"tags":["futureofyou_80"],"featImg":"futureofyou_445781","label":"futureofyou"},"futureofyou_445346":{"type":"posts","id":"futureofyou_445346","meta":{"index":"posts_1591205157","site":"futureofyou","id":"445346","score":null,"sort":[1541446325000]},"guestAuthors":[],"slug":"if-youre-anxious-play-tetris-says-study","title":"If You're Anxious, Play Tetris, Study Says","publishDate":1541446325,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{"site":"futureofyou"},"content":"\u003cp>If you've ever played Tetris — whether it was at an old-school Gameboy, or just on your iPhone — then you know: It's 8-bit enchantment.\u003c/p>\n\u003cp>\"Years of my life were lost disappearing into a game of Tetris on my Nintendo system,\" says \u003ca href=\"http://www.psychology.ucr.edu/faculty/sweeny/index.html\">Kate Sweeny\u003c/a>, a psychologist at the University of California, Riverside.\u003c/p>\n\u003cp>But maybe the hours she spent lining those little blocks (\"tetriminos\") into perfect rows of 10 weren't a total waste. Her latest research suggests that Tetris can ease us through periods of anxiety by getting us to a blissfully engrossed mental state that\u003ca href=\"https://www.npr.org/2015/04/17/399806632/what-makes-a-life-worth-living\"> psychologists call \"flow.\"\u003c/a>\u003c/p>\n\u003cp>\"The state of flow is one where you're completely absorbed or engaged in some kind of activity,\" Sweeny explains. \"You lose your self-awareness, and time is just flying by.\"\u003c/p>\n\u003cp>So say, you're waiting for a date to text you back, or for your LSAT scores, or — as much of the country will be doing on Tuesday — waiting for the election results. You may be tempted to think obsessively about the possibilities. Instead, Sweeny's research suggests, you may want to turn off Twitter alerts, and try distracting yourself with a brain game.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The \u003ca href=\"http://psycnet.apa.org/doiLanding?doi=10.1037%2Femo0000479\">study\u003c/a>, published recently in the journal \u003cem>Emotion\u003c/em>, focused on people who were waiting for uncertain, potentially life-altering news, and it found that a flow-inducing game of Tetris could help them cope.\u003c/p>\n\u003cp>Sweeny and her collaborators gathered a group of more than 300 college students and told them their peers would be evaluating how attractive they were. \"I know, it's kind of cruel, but we found it's a really effective way to get people stressed out,\" Sweeny says. While the participants awaited their attractiveness scores, the researchers had them play Tetris.\u003c/p>\n\u003cp>Some played a painfully slow, easy version of the game — which bored them. Some played an extremely challenging, fast version — which frustrated them. And everyone else played the classic version, which adapts to each player's individual skill level and gets them into that state of flow.\u003c/p>\n\u003cp>In the end, everyone experienced a degree of worry. But the third group reported slightly higher levels of positive emotions (on average, about a quarter of a point higher on a five-point scale) and slightly lower levels of negative emotions (half a point lower on a five-point scale).\u003c/p>\n\u003cp>\"It wasn't a huge difference, but we think it's noticeable,\" Sweeny says. \"And over time, it can add up.\"\u003c/p>\n\u003cp>The results line up with a growing body of research showing that regular doses of flow can boost our mood and help us manage stress. And although playing Tetris is a reliable way to achieve flow, other absorbing video games would work too. And if you'd rather put down your digital device, no worries. Games are by no means the only way.\u003c/p>\n\u003cp>\"Think of the activity that grabs your attention and doesn't let it go,\" says \u003ca href=\"https://dunn.psych.ubc.ca/\">Elizabeth Dunn\u003c/a>, a psychologist at the University of British Columbia who studies happiness. \"For me, it's mountain biking.\" For you, it could be chess or ballet.\u003c/p>\n\u003cp>\"I can't say I found this study particularly surprising at all,\" says Dunn, who wasn't involved in the research. \"Mostly because, based on previous research, it's hard to find a situation where the experience of flow isn't a good thing.\"\u003c/p>\n\u003cp>What the new research does suggest, she says, \"is that even in tough moments, we should push ourselves to do something challenging to get us out of the moment.\"\u003c/p>\n\u003cp>\"Go mountain biking, or rock climbing or have games night with your friends where you play really challenging games,\" she says.\u003c/p>\n\u003cp>And if all else fails, you can always try Tetris.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Maanvi Singh is a freelance writer and a regular contributor to NPR. You can find her on Twitter: \u003c/em>\u003ca href=\"https://twitter.com/maanvisings\">@maanvisings. \u003c/a>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Can%27t+Stop+Worrying%3F+Try+Tetris+To+Ease+Your+Mind&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n","blocks":[],"excerpt":"There could be an upside to your phone addiction. Games like Tetris can reduce anxiety, according to new research. So if you've got Election Day jitters, go ahead and launch that app.","status":"publish","parent":0,"modified":1541446990,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":19,"wordCount":656},"headData":{"title":"If You're Anxious, Play Tetris, Study Says | KQED","description":"There could be an upside to your phone addiction. Games like Tetris can reduce anxiety, according to new research. So if you've got Election Day jitters, go ahead and launch that app.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"445346 https://ww2.kqed.org/futureofyou/?p=445346","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/11/05/if-youre-anxious-play-tetris-says-study/","disqusTitle":"If You're Anxious, Play Tetris, Study Says","nprByline":"Maanvi Singh\u003cbr />NPR Shots","nprImageAgency":"Mary Mathis/NPR","nprStoryId":"662212524","nprApiLink":"http://api.npr.org/query?id=662212524&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"https://www.npr.org/sections/health-shots/2018/11/05/662212524/cant-stop-worrying-try-tetris-to-ease-your-mind?ft=nprml&f=662212524","nprRetrievedStory":"1","nprPubDate":"Mon, 05 Nov 2018 12:23:00 -0500","nprStoryDate":"Mon, 05 Nov 2018 05:00:00 -0500","nprLastModifiedDate":"Mon, 05 Nov 2018 12:23:18 -0500","nprAudio":"https://ondemand.npr.org/anon.npr-mp3/npr/me/2018/11/20181105_me_cant_stop_worrying_try_tetris_to_ease_your_mind.mp3?orgId=1&topicId=1128&d=153&p=3&story=662212524&ft=nprml&f=662212524","nprAudioM3u":"http://api.npr.org/m3u/1664280790-a2aa21.m3u?orgId=1&topicId=1128&d=153&p=3&story=662212524&ft=nprml&f=662212524","audioTrackLength":154,"path":"/futureofyou/445346/if-youre-anxious-play-tetris-says-study","audioUrl":"https://ondemand.npr.org/anon.npr-mp3/npr/me/2018/11/20181105_me_cant_stop_worrying_try_tetris_to_ease_your_mind.mp3?orgId=1&topicId=1128&d=153&p=3&story=662212524&ft=nprml&f=662212524","parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>If you've ever played Tetris — whether it was at an old-school Gameboy, or just on your iPhone — then you know: It's 8-bit enchantment.\u003c/p>\n\u003cp>\"Years of my life were lost disappearing into a game of Tetris on my Nintendo system,\" says \u003ca href=\"http://www.psychology.ucr.edu/faculty/sweeny/index.html\">Kate Sweeny\u003c/a>, a psychologist at the University of California, Riverside.\u003c/p>\n\u003cp>But maybe the hours she spent lining those little blocks (\"tetriminos\") into perfect rows of 10 weren't a total waste. Her latest research suggests that Tetris can ease us through periods of anxiety by getting us to a blissfully engrossed mental state that\u003ca href=\"https://www.npr.org/2015/04/17/399806632/what-makes-a-life-worth-living\"> psychologists call \"flow.\"\u003c/a>\u003c/p>\n\u003cp>\"The state of flow is one where you're completely absorbed or engaged in some kind of activity,\" Sweeny explains. \"You lose your self-awareness, and time is just flying by.\"\u003c/p>\n\u003cp>So say, you're waiting for a date to text you back, or for your LSAT scores, or — as much of the country will be doing on Tuesday — waiting for the election results. You may be tempted to think obsessively about the possibilities. Instead, Sweeny's research suggests, you may want to turn off Twitter alerts, and try distracting yourself with a brain game.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The \u003ca href=\"http://psycnet.apa.org/doiLanding?doi=10.1037%2Femo0000479\">study\u003c/a>, published recently in the journal \u003cem>Emotion\u003c/em>, focused on people who were waiting for uncertain, potentially life-altering news, and it found that a flow-inducing game of Tetris could help them cope.\u003c/p>\n\u003cp>Sweeny and her collaborators gathered a group of more than 300 college students and told them their peers would be evaluating how attractive they were. \"I know, it's kind of cruel, but we found it's a really effective way to get people stressed out,\" Sweeny says. While the participants awaited their attractiveness scores, the researchers had them play Tetris.\u003c/p>\n\u003cp>Some played a painfully slow, easy version of the game — which bored them. Some played an extremely challenging, fast version — which frustrated them. And everyone else played the classic version, which adapts to each player's individual skill level and gets them into that state of flow.\u003c/p>\n\u003cp>In the end, everyone experienced a degree of worry. But the third group reported slightly higher levels of positive emotions (on average, about a quarter of a point higher on a five-point scale) and slightly lower levels of negative emotions (half a point lower on a five-point scale).\u003c/p>\n\u003cp>\"It wasn't a huge difference, but we think it's noticeable,\" Sweeny says. \"And over time, it can add up.\"\u003c/p>\n\u003cp>The results line up with a growing body of research showing that regular doses of flow can boost our mood and help us manage stress. And although playing Tetris is a reliable way to achieve flow, other absorbing video games would work too. And if you'd rather put down your digital device, no worries. Games are by no means the only way.\u003c/p>\n\u003cp>\"Think of the activity that grabs your attention and doesn't let it go,\" says \u003ca href=\"https://dunn.psych.ubc.ca/\">Elizabeth Dunn\u003c/a>, a psychologist at the University of British Columbia who studies happiness. \"For me, it's mountain biking.\" For you, it could be chess or ballet.\u003c/p>\n\u003cp>\"I can't say I found this study particularly surprising at all,\" says Dunn, who wasn't involved in the research. \"Mostly because, based on previous research, it's hard to find a situation where the experience of flow isn't a good thing.\"\u003c/p>\n\u003cp>What the new research does suggest, she says, \"is that even in tough moments, we should push ourselves to do something challenging to get us out of the moment.\"\u003c/p>\n\u003cp>\"Go mountain biking, or rock climbing or have games night with your friends where you play really challenging games,\" she says.\u003c/p>\n\u003cp>And if all else fails, you can always try Tetris.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Maanvi Singh is a freelance writer and a regular contributor to NPR. You can find her on Twitter: \u003c/em>\u003ca href=\"https://twitter.com/maanvisings\">@maanvisings. \u003c/a>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Can%27t+Stop+Worrying%3F+Try+Tetris+To+Ease+Your+Mind&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/445346/if-youre-anxious-play-tetris-says-study","authors":["byline_futureofyou_445346"],"categories":["futureofyou_1062","futureofyou_1","futureofyou_73"],"tags":["futureofyou_162"],"featImg":"futureofyou_445347","label":"futureofyou"},"futureofyou_445306":{"type":"posts","id":"futureofyou_445306","meta":{"index":"posts_1591205157","site":"futureofyou","id":"445306","score":null,"sort":[1540921365000]},"guestAuthors":[],"slug":"doctors-test-bacterial-smear-after-c-sections-to-bolster-babies-health","title":"Doctors Test Bacterial Smear After C-sections To Bolster Babies' Health","publishDate":1540921365,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>Danielle Vukadinovich is sitting up in a hospital bed at the Inova Women's Hospital in Falls Church, Va., waiting to give birth.\u003c/p>\n\u003cp>\"I feel good, I'm excited!\" says Vukadinovich, 35, of Annandale, Va., \"Nervous, but good!\"[contextly_sidebar id=\"FEjJfJVXw64VNWTIkBjmTrT87lKdBgJO\"]\u003c/p>\n\u003cp>Vukadinovich is getting a \u003ca href=\"https://medlineplus.gov/cesareansection.html\" target=\"_blank\" rel=\"noopener\">cesarean section\u003c/a> today. It's the second time for her — she underwent the surgical procedure 19 months ago when her twins were born.\u003c/p>\n\u003cp>This time Danielle wants to try something different, something that might sound strange. As soon as her daughter is born, a doctor will wipe bacteria fluid from Danielle's birth canal all over her baby's body.\u003c/p>\n\u003cp>\"I haven't told many people about this yet,\" Vukadinovich says, laughing. \"I understand why people would be like, 'Oh my gosh. That's so weird.' But I don't think it's yucky. It's normal. It's natural really.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The procedure, known as \"\u003ca href=\"https://www.mayoclinic.org/healthy-lifestyle/infant-and-toddler-health/expert-answers/vaginal-seeding/faq-20380881\" target=\"_blank\" rel=\"noopener\">vaginal seeding\u003c/a>,\" is designed to help babies develop healthy microbiomes — the collection of friendly bacteria that inhabit every person's body. Some people call it a \"bacterial baptism.\"\u003c/p>\n\u003cp>\"It's a little bit like that baby's first dunk,\" says \u003ca href=\"https://www.inova.org/indirectory/clinicaltrials.aspx?design=true&dirId=1&LoadCategory=ITMI&LoadSubCategory=Microbiome&memberID=280\" target=\"_blank\" rel=\"noopener\">Shira Levy\u003c/a>, the microbiome research manager at the Inova hospital. \"That's their first religious experience. You know, they get the water and that changes their spirituality.\u003c/p>\n\u003cp>\"In this case, they get the bacteria and that changes their microbiome,\" Levy says. \"This is their first microbiome experience.\"\u003c/p>\n\u003cp>The procedure was developed in response to the sharp rise in C-section births in recent years. That increase has been accompanied by \u003ca href=\"https://www.npr.org/sections/health-shots/2015/09/30/444746094/missing-microbes-provide-clues-about-asthma-risk\" target=\"_blank\" rel=\"noopener\">more cases of asthma\u003c/a>, allergies, eczema, obesity, and other diseases.\u003c/p>\n\u003cp>The theory is that the rise in these diseases might be happening, in part, because babies aren't getting exposed to their mother's microbes the way they would if they were passing naturally through the birth canal.[contextly_sidebar id=\"0AllfLEduBOKAavkhBROexZnBFbtKljt\"]\u003c/p>\n\u003cp>\"We think that one of the reasons that babies born by C-section are at increased risk for these diseases is because they don't receive that first beneficial exposure to their mother's vaginal microbiome,\" says \u003ca href=\"https://www.inova.org/Physician_Directory/Suchitra-K-Hourigan-MD/824530\" target=\"_blank\" rel=\"noopener\">Suchitra Hourigan\u003c/a>, a pediatric gastroenterologist at Inova.\u003c/p>\n\u003cp>One very small study \u003ca href=\"https://www.npr.org/sections/health-shots/2016/02/01/464905786/researchers-test-microbe-wipe-to-promote-babies-health-after-c-sections\" target=\"_blank\" rel=\"noopener\">indicated \u003c/a>that swabbing C-section babies with their mother's microbes immediately after birth could make their microbiomes develop more like those of babies born vaginally.\u003c/p>\n\u003cp>But the appeal of vaginal seeding has outpaced evidence that it is safe and effective.\u003c/p>\n\u003cp>Some couples have started trying vaginal seeding on their own. Vukadinovich jokes that she considered doing it herself. After all, she says, she's a nurse and her husband is a high school biology teacher.\u003c/p>\n\u003cp>\"I even told my mom: 'Nobody has to know. My husband would help me out,' \" she says, laughing. \"But I try not to take unnecessary risks.\"\u003c/p>\n\u003cp>Vukadinovich knows the procedure could be risky. Babies could be inadvertently exposed to disease-causing microbes, such as herpes virus or streptococcus bacteria.\u003c/p>\n\u003cp>In fact, medical groups such as the American College of Obstetrics and Gynecology \u003ca href=\"https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Vaginal-Seeding\" target=\"_blank\" rel=\"noopener\">warn\u003c/a> women against doing this. \"While there are data to suggest that there may be some scientific plausibility to the concept, it is not without significant risks,\" says \u003ca href=\"http://newsroom.ucla.edu/experts/preview/578561302cfac209100154a4/\" target=\"_blank\" rel=\"noopener\">Neil Silverman\u003c/a>, a clinical professor of obstetrics and gynecology at the UCLA School of Medicine, who represents ACOG. The group notes that mothers also transfer microbes to their newborns through skin-to-skin contact and breastfeeding.\u003c/p>\n\u003cp>So Vukadinovich was thrilled when she found out she could be part of the first \u003ca href=\"https://clinicaltrials.gov/ct2/show/NCT03298334?term=vaginal+seeding&rank=1\" target=\"_blank\" rel=\"noopener\">study\u003c/a> the Food and Drug Administration is allowing to rigorously test whether the procedure is safe and helps improve babies' health.[contextly_sidebar id=\"kMHzgUs0dutTuVHV7G0EJpefrLt2hB8h\"]\u003c/p>\n\u003cp>\"Who knows what's going to happen with the results? But if it does show something positive, I just think that would be great for kids and parents,\" she says.\u003c/p>\n\u003cp>Hourigan, who's helping lead the study, agrees. \"Just to be able to reduce one risk factor for obesity, especially when there are such high [C-section rates] in the U.S., would be huge,\" she says.\u003c/p>\n\u003cp>In the study, half of the babies will get swabbed with their mother's microbes; half will get swabbed with a sterile solution. All of the mothers will be carefully screened for dangerous infections.\u003c/p>\n\u003cp>All of the babies will then be followed for three years to see if they become obese or develop other health problems. A \u003ca href=\"https://clinicaltrials.gov/ct2/show/NCT03567707?term=vaginal+seeding&rank=2\" target=\"_blank\" rel=\"noopener\">similar study\u003c/a> is starting at the Icahn School of Medicine at Mount Sinai in New York City.\u003c/p>\n\u003cp>Vukadinovich agreed to let an NPR reporter and photographer observe her baby's birth and the swabbing. It's the first time journalists have been allowed to watch a baby go through the study.\u003c/p>\n\u003cp>\u003cstrong>Evelyn Marie is Born\u003c/strong>\u003c/p>\n\u003cp>As the nurses wheel Vukadinovich into the operating room, Hourigan, Levy and Dr. Varsha Deopujari follow. Deopujari, the study's clinical manager, will do the actual swabbing.\u003c/p>\n\u003cp>Inside the OR, everyone quickly takes their places. As the surgeon starts, Hourigan explains what's happening. It goes very fast.\u003c/p>\n\u003cp>\"An incision is being made into mom, and they are getting ready to take out the baby,\" Hourigan says. \"They can see the head. And the head is now coming out of the C-section incision. Baby's head is out.\"\u003c/p>\n\u003cp>In less than a minute after the surgery starts, the baby girl is completely out. A nurse rushes the newborn to a nearby table to clear her breathing. After the baby is breathing smoothly, Deopujari starts swabbing with a gauze pad.\u003c/p>\n\u003cp>First, she swabs the baby's mouth, cheeks and face. After turning the gauze over to expose more bacteria, Deopujari wipes the baby's hands and arms. Next, she wipes down her chest, goes over her abdomen, up the other arm and then over her back.[contextly_sidebar id=\"umm131VoK2OKqBWygztDrKkMjOgsaGeH\"]\u003c/p>\n\u003cp>\"And the swabbing is now over,\" Hourigan says.\u003c/p>\n\u003cp>Deopujari hands the baby back to a nurse. Hourigan and her team quickly head out of the OR.\u003c/p>\n\u003cp>\"That went perfectly,\" she says. \"Baby came out and was crying. We waited until baby was stable, and the swabbing went just as planned.\"\u003c/p>\n\u003cp>Hourigan and her colleagues will swab 50 babies to make sure their procedure is safe. If it is, they plan to expand the study to 800 babies, who would randomly receive either the bacterial swab or a placebo, throughout the Inova hospital system.\u003c/p>\n\u003cp>The results could prove important. \"We need more data and we need better data,\" says Silverman, of ACOG. \"If it shows that there is a clear benefit, then this process can be re-evaluated.\"\u003c/p>\n\u003cp>The next morning, Vukadinovich, her husband, Nick, 41, and their new daughter are together in a hospital room.\u003c/p>\n\u003cp>\"I'm good — feeling good today,\" she says, cradling her baby.\u003c/p>\n\u003cp>The couple doesn't know if their new daughter, who they would later name Evelyn Marie, was exposed to her mother's microbes or a sterile placebo solution. But they have their fingers crossed she was swabbed with bacteria.\u003c/p>\n\u003cp>\"I really hope that she was,\" Vukadinovich says. \"If there's a decreased chance of her having any health issues, that would be awesome.\"\u003c/p>\n\u003cp>Her husband, Nick, agrees.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\"We're not terribly religious so we won't baptize with water — holy water,\" Nick says. \"But since we're scientists, we like the idea of a bacterial baptism instead of a holy baptism — because now she's been initiated with bacteria, friendly bacteria, that should protect her down the road.\"\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Doctors+Test+Bacterial+Smear+After+Cesarean+Sections+To+Bolster+Babies%27+Microbiomes&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n","blocks":[],"excerpt":"After a C-section, does swabbing a baby with the mother's microbes reduce the risk of obesity and other health problems later in life? An ambitious study to help answer the question is underway.","status":"publish","parent":0,"modified":1540921365,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":42,"wordCount":1252},"headData":{"title":"Doctors Test Bacterial Smear After C-sections To Bolster Babies' Health | KQED","description":"After a C-section, does swabbing a baby with the mother's microbes reduce the risk of obesity and other health problems later in life? An ambitious study to help answer the question is underway.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"445306 https://ww2.kqed.org/futureofyou/?p=445306","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/10/30/doctors-test-bacterial-smear-after-c-sections-to-bolster-babies-health/","disqusTitle":"Doctors Test Bacterial Smear After C-sections To Bolster Babies' Health","source":"DIY Health","nprByline":"Rob Stein, NPR","nprImageAgency":"Mary Mathis/NPR","nprStoryId":"658254175","nprApiLink":"http://api.npr.org/query?id=658254175&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"https://www.npr.org/sections/health-shots/2018/10/30/658254175/doctors-test-bacterial-smear-after-cesarean-sections-to-bolster-babies-microbiom?ft=nprml&f=658254175","nprRetrievedStory":"1","nprPubDate":"Tue, 30 Oct 2018 09:58:00 -0400","nprStoryDate":"Tue, 30 Oct 2018 05:03:00 -0400","nprLastModifiedDate":"Tue, 30 Oct 2018 12:45:06 -0400","nprAudio":"https://ondemand.npr.org/anon.npr-mp3/npr/me/2018/10/20181030_me_doctors_test_bacterial_smear_after_cesarean_sections_to_bolster_babies_microbiomes.mp3?orgId=1&topicId=1128&d=421&p=3&story=658254175&ft=nprml&f=658254175","nprAudioM3u":"http://api.npr.org/m3u/1662009687-72e5e0.m3u?orgId=1&topicId=1128&d=421&p=3&story=658254175&ft=nprml&f=658254175","audioTrackLength":422,"path":"/futureofyou/445306/doctors-test-bacterial-smear-after-c-sections-to-bolster-babies-health","audioUrl":"https://ondemand.npr.org/anon.npr-mp3/npr/me/2018/10/20181030_me_doctors_test_bacterial_smear_after_cesarean_sections_to_bolster_babies_microbiomes.mp3?orgId=1&topicId=1128&d=421&p=3&story=658254175&ft=nprml&f=658254175","parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Danielle Vukadinovich is sitting up in a hospital bed at the Inova Women's Hospital in Falls Church, Va., waiting to give birth.\u003c/p>\n\u003cp>\"I feel good, I'm excited!\" says Vukadinovich, 35, of Annandale, Va., \"Nervous, but good!\"\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Vukadinovich is getting a \u003ca href=\"https://medlineplus.gov/cesareansection.html\" target=\"_blank\" rel=\"noopener\">cesarean section\u003c/a> today. It's the second time for her — she underwent the surgical procedure 19 months ago when her twins were born.\u003c/p>\n\u003cp>This time Danielle wants to try something different, something that might sound strange. As soon as her daughter is born, a doctor will wipe bacteria fluid from Danielle's birth canal all over her baby's body.\u003c/p>\n\u003cp>\"I haven't told many people about this yet,\" Vukadinovich says, laughing. \"I understand why people would be like, 'Oh my gosh. That's so weird.' But I don't think it's yucky. It's normal. It's natural really.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The procedure, known as \"\u003ca href=\"https://www.mayoclinic.org/healthy-lifestyle/infant-and-toddler-health/expert-answers/vaginal-seeding/faq-20380881\" target=\"_blank\" rel=\"noopener\">vaginal seeding\u003c/a>,\" is designed to help babies develop healthy microbiomes — the collection of friendly bacteria that inhabit every person's body. Some people call it a \"bacterial baptism.\"\u003c/p>\n\u003cp>\"It's a little bit like that baby's first dunk,\" says \u003ca href=\"https://www.inova.org/indirectory/clinicaltrials.aspx?design=true&dirId=1&LoadCategory=ITMI&LoadSubCategory=Microbiome&memberID=280\" target=\"_blank\" rel=\"noopener\">Shira Levy\u003c/a>, the microbiome research manager at the Inova hospital. \"That's their first religious experience. You know, they get the water and that changes their spirituality.\u003c/p>\n\u003cp>\"In this case, they get the bacteria and that changes their microbiome,\" Levy says. \"This is their first microbiome experience.\"\u003c/p>\n\u003cp>The procedure was developed in response to the sharp rise in C-section births in recent years. That increase has been accompanied by \u003ca href=\"https://www.npr.org/sections/health-shots/2015/09/30/444746094/missing-microbes-provide-clues-about-asthma-risk\" target=\"_blank\" rel=\"noopener\">more cases of asthma\u003c/a>, allergies, eczema, obesity, and other diseases.\u003c/p>\n\u003cp>The theory is that the rise in these diseases might be happening, in part, because babies aren't getting exposed to their mother's microbes the way they would if they were passing naturally through the birth canal.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"We think that one of the reasons that babies born by C-section are at increased risk for these diseases is because they don't receive that first beneficial exposure to their mother's vaginal microbiome,\" says \u003ca href=\"https://www.inova.org/Physician_Directory/Suchitra-K-Hourigan-MD/824530\" target=\"_blank\" rel=\"noopener\">Suchitra Hourigan\u003c/a>, a pediatric gastroenterologist at Inova.\u003c/p>\n\u003cp>One very small study \u003ca href=\"https://www.npr.org/sections/health-shots/2016/02/01/464905786/researchers-test-microbe-wipe-to-promote-babies-health-after-c-sections\" target=\"_blank\" rel=\"noopener\">indicated \u003c/a>that swabbing C-section babies with their mother's microbes immediately after birth could make their microbiomes develop more like those of babies born vaginally.\u003c/p>\n\u003cp>But the appeal of vaginal seeding has outpaced evidence that it is safe and effective.\u003c/p>\n\u003cp>Some couples have started trying vaginal seeding on their own. Vukadinovich jokes that she considered doing it herself. After all, she says, she's a nurse and her husband is a high school biology teacher.\u003c/p>\n\u003cp>\"I even told my mom: 'Nobody has to know. My husband would help me out,' \" she says, laughing. \"But I try not to take unnecessary risks.\"\u003c/p>\n\u003cp>Vukadinovich knows the procedure could be risky. Babies could be inadvertently exposed to disease-causing microbes, such as herpes virus or streptococcus bacteria.\u003c/p>\n\u003cp>In fact, medical groups such as the American College of Obstetrics and Gynecology \u003ca href=\"https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Vaginal-Seeding\" target=\"_blank\" rel=\"noopener\">warn\u003c/a> women against doing this. \"While there are data to suggest that there may be some scientific plausibility to the concept, it is not without significant risks,\" says \u003ca href=\"http://newsroom.ucla.edu/experts/preview/578561302cfac209100154a4/\" target=\"_blank\" rel=\"noopener\">Neil Silverman\u003c/a>, a clinical professor of obstetrics and gynecology at the UCLA School of Medicine, who represents ACOG. The group notes that mothers also transfer microbes to their newborns through skin-to-skin contact and breastfeeding.\u003c/p>\n\u003cp>So Vukadinovich was thrilled when she found out she could be part of the first \u003ca href=\"https://clinicaltrials.gov/ct2/show/NCT03298334?term=vaginal+seeding&rank=1\" target=\"_blank\" rel=\"noopener\">study\u003c/a> the Food and Drug Administration is allowing to rigorously test whether the procedure is safe and helps improve babies' health.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"Who knows what's going to happen with the results? But if it does show something positive, I just think that would be great for kids and parents,\" she says.\u003c/p>\n\u003cp>Hourigan, who's helping lead the study, agrees. \"Just to be able to reduce one risk factor for obesity, especially when there are such high [C-section rates] in the U.S., would be huge,\" she says.\u003c/p>\n\u003cp>In the study, half of the babies will get swabbed with their mother's microbes; half will get swabbed with a sterile solution. All of the mothers will be carefully screened for dangerous infections.\u003c/p>\n\u003cp>All of the babies will then be followed for three years to see if they become obese or develop other health problems. A \u003ca href=\"https://clinicaltrials.gov/ct2/show/NCT03567707?term=vaginal+seeding&rank=2\" target=\"_blank\" rel=\"noopener\">similar study\u003c/a> is starting at the Icahn School of Medicine at Mount Sinai in New York City.\u003c/p>\n\u003cp>Vukadinovich agreed to let an NPR reporter and photographer observe her baby's birth and the swabbing. It's the first time journalists have been allowed to watch a baby go through the study.\u003c/p>\n\u003cp>\u003cstrong>Evelyn Marie is Born\u003c/strong>\u003c/p>\n\u003cp>As the nurses wheel Vukadinovich into the operating room, Hourigan, Levy and Dr. Varsha Deopujari follow. Deopujari, the study's clinical manager, will do the actual swabbing.\u003c/p>\n\u003cp>Inside the OR, everyone quickly takes their places. As the surgeon starts, Hourigan explains what's happening. It goes very fast.\u003c/p>\n\u003cp>\"An incision is being made into mom, and they are getting ready to take out the baby,\" Hourigan says. \"They can see the head. And the head is now coming out of the C-section incision. Baby's head is out.\"\u003c/p>\n\u003cp>In less than a minute after the surgery starts, the baby girl is completely out. A nurse rushes the newborn to a nearby table to clear her breathing. After the baby is breathing smoothly, Deopujari starts swabbing with a gauze pad.\u003c/p>\n\u003cp>First, she swabs the baby's mouth, cheeks and face. After turning the gauze over to expose more bacteria, Deopujari wipes the baby's hands and arms. Next, she wipes down her chest, goes over her abdomen, up the other arm and then over her back.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"And the swabbing is now over,\" Hourigan says.\u003c/p>\n\u003cp>Deopujari hands the baby back to a nurse. Hourigan and her team quickly head out of the OR.\u003c/p>\n\u003cp>\"That went perfectly,\" she says. \"Baby came out and was crying. We waited until baby was stable, and the swabbing went just as planned.\"\u003c/p>\n\u003cp>Hourigan and her colleagues will swab 50 babies to make sure their procedure is safe. If it is, they plan to expand the study to 800 babies, who would randomly receive either the bacterial swab or a placebo, throughout the Inova hospital system.\u003c/p>\n\u003cp>The results could prove important. \"We need more data and we need better data,\" says Silverman, of ACOG. \"If it shows that there is a clear benefit, then this process can be re-evaluated.\"\u003c/p>\n\u003cp>The next morning, Vukadinovich, her husband, Nick, 41, and their new daughter are together in a hospital room.\u003c/p>\n\u003cp>\"I'm good — feeling good today,\" she says, cradling her baby.\u003c/p>\n\u003cp>The couple doesn't know if their new daughter, who they would later name Evelyn Marie, was exposed to her mother's microbes or a sterile placebo solution. But they have their fingers crossed she was swabbed with bacteria.\u003c/p>\n\u003cp>\"I really hope that she was,\" Vukadinovich says. \"If there's a decreased chance of her having any health issues, that would be awesome.\"\u003c/p>\n\u003cp>Her husband, Nick, agrees.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"We're not terribly religious so we won't baptize with water — holy water,\" Nick says. \"But since we're scientists, we like the idea of a bacterial baptism instead of a holy baptism — because now she's been initiated with bacteria, friendly bacteria, that should protect her down the road.\"\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Doctors+Test+Bacterial+Smear+After+Cesarean+Sections+To+Bolster+Babies%27+Microbiomes&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/445306/doctors-test-bacterial-smear-after-c-sections-to-bolster-babies-health","authors":["byline_futureofyou_445306"],"categories":["futureofyou_1060","futureofyou_1062","futureofyou_1","futureofyou_73"],"tags":["futureofyou_631","futureofyou_1635","futureofyou_61","futureofyou_68","futureofyou_520"],"collections":["futureofyou_1093","futureofyou_1097"],"featImg":"futureofyou_445307","label":"source_futureofyou_445306"},"futureofyou_444527":{"type":"posts","id":"futureofyou_444527","meta":{"index":"posts_1591205157","site":"futureofyou","id":"444527","score":null,"sort":[1540882861000]},"guestAuthors":[],"slug":"advanced-skin-cancer-was-once-a-death-sentence-immunotherapy-is-changing-that","title":"Advanced Skin Cancer Was Once a Death Sentence. Immunotherapy Is Changing That","publishDate":1540882861,"format":"audio","headTitle":"KQED Future of You | KQED Science","labelTerm":{"site":"futureofyou"},"content":"\u003cp>Most cancer patients are haunted by the same two questions:\u003c/p>\n\u003cp>\"Why me?\"\u003c/p>\n\u003caside class=\"pullquote alignright\">'If I had been diagnosed five years prior, who knows if I would be here.'\u003c/aside>\n\u003cp>\"Why now?\"\u003c/p>\n\u003cp>Not Ashley Walton.\u003c/p>\n\u003cp>Walton, 34, actually feels lucky advanced melanoma struck when it did.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“If I had been diagnosed five years prior, who knows if I would be here,\" she says.\u003c/p>\n\u003cp>Stage 4 melanoma used to be a death sentence. The disease doesn’t respond to radiation or chemotherapy, and patients survived, on average, less than a year.\u003c/p>\n\u003cp>But over the last decade, doctors are successfully using a new approach, one significantly different than the treatment options available for the last 150 years.\u003c/p>\n\u003cp>Instead of burning or poisoning cancer cells, new medicines unleash the body's natural defenses to fight them.\u003c/p>\n\u003cp>This treatment is called immunotherapy.\u003c/p>\n\u003cfigure id=\"attachment_444546\" class=\"wp-caption aligncenter\" style=\"max-width: 1857px\">\u003cimg class=\"size-full wp-image-444546\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/09/IMG_6200-e1537470859372.jpg\" alt=\"\" width=\"1857\" height=\"1209\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6200-e1537470859372.jpg 1857w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6200-e1537470859372-160x104.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6200-e1537470859372-800x521.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6200-e1537470859372-768x500.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6200-e1537470859372-1020x664.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6200-e1537470859372-1200x781.jpg 1200w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6200-e1537470859372-1180x768.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6200-e1537470859372-960x625.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6200-e1537470859372-240x156.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6200-e1537470859372-375x244.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6200-e1537470859372-520x339.jpg 520w\" sizes=\"(max-width: 1857px) 100vw, 1857px\">\u003cfigcaption class=\"wp-caption-text\">Ashley Walton drinks fluid to prepare for magnetic resonance imaging (MRI) scan to check on the progress of her melanoma. \u003ccite>(Lesley McClurg/ KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Beating the Odds\u003c/strong>\u003c/p>\n\u003cp>When Walton was 26, she found a mole on the back of her hip.\u003c/p>\n\u003cp>\"It started morphing into this ugly, dark, bleeding thing,\" she says, grimacing. \"I just knew something was wrong.\"\u003c/p>\n\u003cp>Doctors surgically removed her tumor. But a couple of years later, she discovered a tiny lump in her abdomen. It felt like a popcorn kernel, and within a few weeks grew to the size of a walnut.\u003c/p>\n\u003cp>A biopsy revealed she had stage 4 melanoma.\u003c/p>\n\u003cp>Walton searched online for information about the disease. She recalls the moment she discovered the average survival rate: six to nine months.\u003c/p>\n\u003cp>\"I remember sort of losing my hearing, almost losing my vision to where I felt like I was in a tunnel,\" she says.\u003c/p>\n\u003cp>But when she consulted with her oncologist, Dr. Adil Daud of UC San Francisco, he had consoling news.\u003c/p>\n\u003cp>“He told me if there's any time to have a melanoma -- right now is a pretty good time to have it -- because there's a lot of stuff opening up to you,\" she says.\u003c/p>\n\u003cp>Dr. Daud was referring to immune checkpoint inhibitors, which he says are increasing survival rates by at least threefold. These cancer drugs help the immune system do what it’s supposed to -- fight pathogens.\u003c/p>\n\u003cp>Normally the immune system recognizes disease-causing organisms. But cancer cells are unusual because they go undetected as harmful. Immune checkpoint inhibitors make them visible for attack.\u003c/p>\n\u003cfigure id=\"attachment_444547\" class=\"wp-caption aligncenter\" style=\"max-width: 1728px\">\u003cimg class=\"size-full wp-image-444547\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/09/IMG_6291-e1537471184446.jpg\" alt=\"\" width=\"1728\" height=\"1166\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6291-e1537471184446.jpg 1728w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6291-e1537471184446-160x108.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6291-e1537471184446-800x540.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6291-e1537471184446-768x518.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6291-e1537471184446-1020x688.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6291-e1537471184446-1200x810.jpg 1200w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6291-e1537471184446-1180x796.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6291-e1537471184446-960x648.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6291-e1537471184446-240x162.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6291-e1537471184446-375x253.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6291-e1537471184446-520x351.jpg 520w\" sizes=\"(max-width: 1728px) 100vw, 1728px\">\u003cfigcaption class=\"wp-caption-text\">Ashley Walton and her mother in a quarterly doctor appointment at UCSF Medical Center. \u003ccite>(Lesley McClurg/ KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cb>Treatment Earns Nobel Prize\u003c/b>\u003c/p>\n\u003cp>The Food and Drug Administration’s approval of the first immune checkpoint inhibitor in 2011 marked a breakthrough in the field.\u003c/p>\n\u003cp>The technology behind Ipilimumab, which is branded as Yervoy, was developed in a UC Berkeley lab in the 1990s, by a student named Matthew Krummel, now an immunotherapy researcher at \u003ca href=\"http://krummellab.com/\" target=\"_blank\" rel=\"noopener\">UCSF\u003c/a>.\u003c/p>\n\u003cp>“I was a very frustrated graduate student for a few years, trying to develop an antibody that would do something,\" Krummel says.\u003c/p>\n\u003cp>He wanted to influence how cells behave. After many long nights, Krummel noticed one antibody successfully manipulating the movement of immune cells.\u003c/p>\n\u003cp>“You can drive them like a car; you can accelerate them; or you can brake them,\" Krummel says. \"And then it was really like playtime.”\u003c/p>\n\u003cp>He injected the antibodies into mice with cancer. In the very first set of experiments, their tumors shrunk.\u003c/p>\n\u003cp>Earlier this month, Krummel’s thesis advisor, James Allison, won the Nobel Prize for Medicine for their lab's work on immune checkpoint inhibitors.\u003c/p>\n\u003cp>\u003cstrong>Years of Harrowing Treatments\u003c/strong>\u003c/p>\n\u003caside class=\"pullquote alignright\">'Across different tumor types, only about 20 percent of patients with cancer respond to today's immunotherapy.'\u003ccite>Dr. Adil Daud, UCSF\u003c/cite>\u003c/aside>\n\u003cp>When Walton started immunotherapy treatment, including Ipilimumab, the 90-minute drips were followed by side effects like fever, diarrhea, rash, vomiting and gastritis. This is not uncommon in immunotherapy, as the drugs can put a patient’s immune system into overdrive provoking an attack on healthy cells, tissues and organs.\u003c/p>\n\u003cp>Walton’s tumors initially shrunk, but within six months, new tumors cropped up, in her abdomen. Her oncologist then ran through the list of available drugs, moving on as each one, sometimes tried in combination, in turn failed to deliver the knockout blow.\u003c/p>\n\u003cp>“It's absolutely exhausting emotionally and physically to know that there's no option for you,” says Walton. “Those were the days when I felt like I will probably die from this, and I’ll die young.”\u003c/p>\n\u003cp>Finally, eight years later, she heard the magic word: remission. Dr. Daud isn't sure if it was the buildup of multiple immunotherapy drugs or some new combination that did the trick.\u003c/p>\n\u003cp>“There are so many advancements being made in the field of immunotherapy that even if [one] doesn't cure you, it gets you to the next big thing,” says Walton.\u003c/p>\n\u003cp>Now that she has been off immunotherapy for 10 months, Walton tentatively asked Dr. Daud something that had been her mind for a long time.\u003c/p>\n\u003cp>\"So, what do you think about pregnancy or trying to start a family?\" asked Walton.\u003c/p>\n\u003cp>\"I think this is a good time to get pregnant, actually,\" responded Dr. Daud.\u003c/p>\n\u003cp>Both doctor and patient could barely contain their glee, punctuating the question-and-answer session with happy giggles. Walton \u003cspan style=\"font-weight: 400\">crosses her fingers and smiles. \u003c/span>Throughout her treatment, doctors warned that getting pregnant would be too dangerous. But Daud now trusts her body's ability to support a child.\u003c/p>\n\u003cp>\u003cstrong>A Hopeful Future\u003c/strong>\u003c/p>\n\u003cp>Stories like Walton's are sparking a lot of excitement among oncologists.\u003c/p>\n\u003cp>\"So imagine when we’ve gone from a time when we had nothing to offer, to today, and they are talking about a cure for some patients with advanced melanoma,\" says Dr. Leonard Lichtenfeld, deputy chief medical officer for the American Cancer Society.\u003c/p>\n\u003cp>Scientists and major pharmaceutical companies are waging huge bets on immunotherapy. There are currently about 1,000 active trials to develop the next miracle drug. Lichtenfeld is optimistic, but he is also cautious about adding to the hype.\u003c/p>\n\u003cp>“We don’t know in how many cancers they are going to be effective,” he says. “And we still don’t know how to harness the maximum benefit from these drugs by, say, using them in combination with other drugs.”\u003c/p>\n\u003cp>Currently, 40 percent of advanced melanoma patients still do not respond to immunotherapy. The statistics are even worse for other cancers.\u003c/p>\n\u003cp>“It is still very common to not have immune treatment work at all,” says Dr. Daud. “Across different tumor types, only about 20 percent of patients with cancer respond to today's immunotherapy, so the numbers are much more sobering.\"\u003c/p>\n\u003cp>He hypothesizes that age, gender, concurring autoimmune diseases, or even gut bacteria may influence patient responsiveness, but he says we know very little about these factors.\u003c/p>\n\u003cp>“I think there's a lot of fundamental questions about the immune system that we just simply don't know the answer to,” says Daud.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“And yet I do foresee a day when we use other types of treatment infrequently to treat cancer, and most cancers will be treated with immunotherapy. But we still have a long ways to go.”\u003c/p>\n\n","blocks":[],"excerpt":"'If I had been diagnosed five years prior, who knows if I would be here,' says Ashley Walton, who after eight draining years of treatment has finally heard the magic word: remission.","status":"publish","parent":0,"modified":1540998273,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":51,"wordCount":1224},"headData":{"title":"Advanced Skin Cancer Was Once a Death Sentence. Immunotherapy Is Changing That | KQED","description":"'If I had been diagnosed five years prior, who knows if I would be here,' says Ashley Walton, who after eight draining years of treatment has finally heard the magic word: remission.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"444527 https://ww2.kqed.org/futureofyou/?p=444527","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/10/30/advanced-skin-cancer-was-once-a-death-sentence-immunotherapy-is-changing-that/","disqusTitle":"Advanced Skin Cancer Was Once a Death Sentence. Immunotherapy Is Changing That","audioUrl":"https://www.kqed.org/.stream/anon/radio/science/2018/10/McClurgImmuneTherapy.mp3","audioTrackLength":383,"path":"/futureofyou/444527/advanced-skin-cancer-was-once-a-death-sentence-immunotherapy-is-changing-that","parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Most cancer patients are haunted by the same two questions:\u003c/p>\n\u003cp>\"Why me?\"\u003c/p>\n\u003caside class=\"pullquote alignright\">'If I had been diagnosed five years prior, who knows if I would be here.'\u003c/aside>\n\u003cp>\"Why now?\"\u003c/p>\n\u003cp>Not Ashley Walton.\u003c/p>\n\u003cp>Walton, 34, actually feels lucky advanced melanoma struck when it did.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“If I had been diagnosed five years prior, who knows if I would be here,\" she says.\u003c/p>\n\u003cp>Stage 4 melanoma used to be a death sentence. The disease doesn’t respond to radiation or chemotherapy, and patients survived, on average, less than a year.\u003c/p>\n\u003cp>But over the last decade, doctors are successfully using a new approach, one significantly different than the treatment options available for the last 150 years.\u003c/p>\n\u003cp>Instead of burning or poisoning cancer cells, new medicines unleash the body's natural defenses to fight them.\u003c/p>\n\u003cp>This treatment is called immunotherapy.\u003c/p>\n\u003cfigure id=\"attachment_444546\" class=\"wp-caption aligncenter\" style=\"max-width: 1857px\">\u003cimg class=\"size-full wp-image-444546\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/09/IMG_6200-e1537470859372.jpg\" alt=\"\" width=\"1857\" height=\"1209\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6200-e1537470859372.jpg 1857w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6200-e1537470859372-160x104.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6200-e1537470859372-800x521.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6200-e1537470859372-768x500.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6200-e1537470859372-1020x664.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6200-e1537470859372-1200x781.jpg 1200w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6200-e1537470859372-1180x768.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6200-e1537470859372-960x625.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6200-e1537470859372-240x156.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6200-e1537470859372-375x244.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6200-e1537470859372-520x339.jpg 520w\" sizes=\"(max-width: 1857px) 100vw, 1857px\">\u003cfigcaption class=\"wp-caption-text\">Ashley Walton drinks fluid to prepare for magnetic resonance imaging (MRI) scan to check on the progress of her melanoma. \u003ccite>(Lesley McClurg/ KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Beating the Odds\u003c/strong>\u003c/p>\n\u003cp>When Walton was 26, she found a mole on the back of her hip.\u003c/p>\n\u003cp>\"It started morphing into this ugly, dark, bleeding thing,\" she says, grimacing. \"I just knew something was wrong.\"\u003c/p>\n\u003cp>Doctors surgically removed her tumor. But a couple of years later, she discovered a tiny lump in her abdomen. It felt like a popcorn kernel, and within a few weeks grew to the size of a walnut.\u003c/p>\n\u003cp>A biopsy revealed she had stage 4 melanoma.\u003c/p>\n\u003cp>Walton searched online for information about the disease. She recalls the moment she discovered the average survival rate: six to nine months.\u003c/p>\n\u003cp>\"I remember sort of losing my hearing, almost losing my vision to where I felt like I was in a tunnel,\" she says.\u003c/p>\n\u003cp>But when she consulted with her oncologist, Dr. Adil Daud of UC San Francisco, he had consoling news.\u003c/p>\n\u003cp>“He told me if there's any time to have a melanoma -- right now is a pretty good time to have it -- because there's a lot of stuff opening up to you,\" she says.\u003c/p>\n\u003cp>Dr. Daud was referring to immune checkpoint inhibitors, which he says are increasing survival rates by at least threefold. These cancer drugs help the immune system do what it’s supposed to -- fight pathogens.\u003c/p>\n\u003cp>Normally the immune system recognizes disease-causing organisms. But cancer cells are unusual because they go undetected as harmful. Immune checkpoint inhibitors make them visible for attack.\u003c/p>\n\u003cfigure id=\"attachment_444547\" class=\"wp-caption aligncenter\" style=\"max-width: 1728px\">\u003cimg class=\"size-full wp-image-444547\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/09/IMG_6291-e1537471184446.jpg\" alt=\"\" width=\"1728\" height=\"1166\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6291-e1537471184446.jpg 1728w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6291-e1537471184446-160x108.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6291-e1537471184446-800x540.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6291-e1537471184446-768x518.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6291-e1537471184446-1020x688.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6291-e1537471184446-1200x810.jpg 1200w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6291-e1537471184446-1180x796.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6291-e1537471184446-960x648.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6291-e1537471184446-240x162.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6291-e1537471184446-375x253.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6291-e1537471184446-520x351.jpg 520w\" sizes=\"(max-width: 1728px) 100vw, 1728px\">\u003cfigcaption class=\"wp-caption-text\">Ashley Walton and her mother in a quarterly doctor appointment at UCSF Medical Center. \u003ccite>(Lesley McClurg/ KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cb>Treatment Earns Nobel Prize\u003c/b>\u003c/p>\n\u003cp>The Food and Drug Administration’s approval of the first immune checkpoint inhibitor in 2011 marked a breakthrough in the field.\u003c/p>\n\u003cp>The technology behind Ipilimumab, which is branded as Yervoy, was developed in a UC Berkeley lab in the 1990s, by a student named Matthew Krummel, now an immunotherapy researcher at \u003ca href=\"http://krummellab.com/\" target=\"_blank\" rel=\"noopener\">UCSF\u003c/a>.\u003c/p>\n\u003cp>“I was a very frustrated graduate student for a few years, trying to develop an antibody that would do something,\" Krummel says.\u003c/p>\n\u003cp>He wanted to influence how cells behave. After many long nights, Krummel noticed one antibody successfully manipulating the movement of immune cells.\u003c/p>\n\u003cp>“You can drive them like a car; you can accelerate them; or you can brake them,\" Krummel says. \"And then it was really like playtime.”\u003c/p>\n\u003cp>He injected the antibodies into mice with cancer. In the very first set of experiments, their tumors shrunk.\u003c/p>\n\u003cp>Earlier this month, Krummel’s thesis advisor, James Allison, won the Nobel Prize for Medicine for their lab's work on immune checkpoint inhibitors.\u003c/p>\n\u003cp>\u003cstrong>Years of Harrowing Treatments\u003c/strong>\u003c/p>\n\u003caside class=\"pullquote alignright\">'Across different tumor types, only about 20 percent of patients with cancer respond to today's immunotherapy.'\u003ccite>Dr. Adil Daud, UCSF\u003c/cite>\u003c/aside>\n\u003cp>When Walton started immunotherapy treatment, including Ipilimumab, the 90-minute drips were followed by side effects like fever, diarrhea, rash, vomiting and gastritis. This is not uncommon in immunotherapy, as the drugs can put a patient’s immune system into overdrive provoking an attack on healthy cells, tissues and organs.\u003c/p>\n\u003cp>Walton’s tumors initially shrunk, but within six months, new tumors cropped up, in her abdomen. Her oncologist then ran through the list of available drugs, moving on as each one, sometimes tried in combination, in turn failed to deliver the knockout blow.\u003c/p>\n\u003cp>“It's absolutely exhausting emotionally and physically to know that there's no option for you,” says Walton. “Those were the days when I felt like I will probably die from this, and I’ll die young.”\u003c/p>\n\u003cp>Finally, eight years later, she heard the magic word: remission. Dr. Daud isn't sure if it was the buildup of multiple immunotherapy drugs or some new combination that did the trick.\u003c/p>\n\u003cp>“There are so many advancements being made in the field of immunotherapy that even if [one] doesn't cure you, it gets you to the next big thing,” says Walton.\u003c/p>\n\u003cp>Now that she has been off immunotherapy for 10 months, Walton tentatively asked Dr. Daud something that had been her mind for a long time.\u003c/p>\n\u003cp>\"So, what do you think about pregnancy or trying to start a family?\" asked Walton.\u003c/p>\n\u003cp>\"I think this is a good time to get pregnant, actually,\" responded Dr. Daud.\u003c/p>\n\u003cp>Both doctor and patient could barely contain their glee, punctuating the question-and-answer session with happy giggles. Walton \u003cspan style=\"font-weight: 400\">crosses her fingers and smiles. \u003c/span>Throughout her treatment, doctors warned that getting pregnant would be too dangerous. But Daud now trusts her body's ability to support a child.\u003c/p>\n\u003cp>\u003cstrong>A Hopeful Future\u003c/strong>\u003c/p>\n\u003cp>Stories like Walton's are sparking a lot of excitement among oncologists.\u003c/p>\n\u003cp>\"So imagine when we’ve gone from a time when we had nothing to offer, to today, and they are talking about a cure for some patients with advanced melanoma,\" says Dr. Leonard Lichtenfeld, deputy chief medical officer for the American Cancer Society.\u003c/p>\n\u003cp>Scientists and major pharmaceutical companies are waging huge bets on immunotherapy. There are currently about 1,000 active trials to develop the next miracle drug. Lichtenfeld is optimistic, but he is also cautious about adding to the hype.\u003c/p>\n\u003cp>“We don’t know in how many cancers they are going to be effective,” he says. “And we still don’t know how to harness the maximum benefit from these drugs by, say, using them in combination with other drugs.”\u003c/p>\n\u003cp>Currently, 40 percent of advanced melanoma patients still do not respond to immunotherapy. The statistics are even worse for other cancers.\u003c/p>\n\u003cp>“It is still very common to not have immune treatment work at all,” says Dr. Daud. “Across different tumor types, only about 20 percent of patients with cancer respond to today's immunotherapy, so the numbers are much more sobering.\"\u003c/p>\n\u003cp>He hypothesizes that age, gender, concurring autoimmune diseases, or even gut bacteria may influence patient responsiveness, but he says we know very little about these factors.\u003c/p>\n\u003cp>“I think there's a lot of fundamental questions about the immune system that we just simply don't know the answer to,” says Daud.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“And yet I do foresee a day when we use other types of treatment infrequently to treat cancer, and most cancers will be treated with immunotherapy. But we still have a long ways to go.”\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/444527/advanced-skin-cancer-was-once-a-death-sentence-immunotherapy-is-changing-that","authors":["11229"],"categories":["futureofyou_1062","futureofyou_1","futureofyou_73"],"tags":["futureofyou_103","futureofyou_686","futureofyou_80"],"featImg":"futureofyou_444544","label":"futureofyou"},"futureofyou_445028":{"type":"posts","id":"futureofyou_445028","meta":{"index":"posts_1591205157","site":"futureofyou","id":"445028","score":null,"sort":[1539370848000]},"guestAuthors":[],"slug":"human-retinas-grown-in-a-dish-reveal-origin-of-color-vision","title":"Human Retinas Grown In a Dish Reveal Origin Of Color Vision","publishDate":1539370848,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>In order to see the red of a sunset or the green of spring leaves, developing human eyes need to get the right hormone at the right time.\u003c/p>\n\u003cp>That's the finding of a team of scientists who studied how color vision develops using hundreds of human retinas grown in the lab.\u003c/p>\n\u003cp>The discovery, \u003ca href=\"http://science.sciencemag.org/cgi/doi/10.1126/science.aau6348\" target=\"_blank\" rel=\"noopener\">published\u003c/a> Thursday in the journal \u003cem>Science\u003c/em>, could help accelerate current efforts to cure colorblindness. It could also lead to new treatments for diseases including macular degeneration, the leading cause of vision loss.\u003c/p>\n\u003cp>\"It's important that we understand how nature controls the development of the retina so we can understand better why things go wrong in disease and how we can treat them,\" says \u003ca href=\"https://www.linkedin.com/in/smbeck2000/\" target=\"_blank\" rel=\"noopener\">Steven Becker\u003c/a>, a scientist at the National Eye Institute. The newly published findings are a step in that direction, says Becker, who has no connection to the research.\u003c/p>\n\u003cp>The development of color vision in people has been difficult to study because it usually occurs in the womb — and out of sight. But two scientists at Johns Hopkins University thought they might find some answers using retinas grown in the lab.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>These \"\u003ca href=\"https://www.youtube.com/watch?v=4CHvLNjg6nI\" target=\"_blank\" rel=\"noopener\">retinal organoids\u003c/a>\" have been around for a few years but are difficult and tedious to grow, says \u003ca href=\"https://www.linkedin.com/in/kiara-eldred-984b1513/\" target=\"_blank\" rel=\"noopener\">Kiara Eldred\u003c/a>, a graduate student at Hopkins who is the paper's first author.\u003c/p>\n\u003cp>It takes up to a year to turn a batch of immature retinal cells into a functioning organoid.\u003c/p>\n\u003cp>\"For the first week of their life, I take care of them every day,\" Eldred says. After a couple of weeks, she says, the cells become \"a little bit more independent.\"\u003c/p>\n\u003cp>And with luck, these clusters of immature cells develop into a 3D structure that \"looks and acts like a developing retina that you would see in a baby,\" says \u003ca href=\"http://sites.krieger.jhu.edu/johnstonlab/people/\" target=\"_blank\" rel=\"noopener\">Bob Johnston\u003c/a>, Eldred's boss and an assistant professor in the biology department.\u003c/p>\n\u003cp>Johnston's lab had been studying vision in flies. But he and Eldred saw a chance to try something much more ambitious.\u003c/p>\n\u003cp>\"We discussed this crazy idea of: Could we use these human retinal organoids to study how we get the different color-sensing cells in our eyes?\" Johnston says.\u003c/p>\n\u003cp>Using human cells was key because you can't study how humans see color in a fly, or even a mouse.\u003c/p>\n\u003cp>\"Mice don't sense red,\" Johnston says. \"They don't have these red-detecting cells. So we really have to study this in human tissue to get any insight into how it works.\"\u003c/p>\n\u003cp>Johnston and Eldred knew that in a human fetus, cells that detect blue light appear first. Then come cells that respond to red and green light.\u003c/p>\n\u003cp>And research on animals suggested that the thyroid hormone was involved in the development of these color-sensing cells, called cones. So Johnston had Eldred conduct an experiment with immature retinal cells.\u003c/p>\n\u003cp>\"I added thyroid hormone to the dish during their development, and we got more red-green cones developing in those organoids,\" she says. \"We got really excited because we were on to something.\"\u003c/p>\n\u003cp>It would take years and many more experiments to confirm that the thyroid hormone was actually triggering the emergence of color vision. And the team still hasn't figured out what causes some cones to go on to become even more specialized by detecting only red or only green.\u003c/p>\n\u003cp>But Johnston says his lab is now preparing to take on two new goals.\u003c/p>\n\u003cp>\"One is to restore color vision to people that are colorblind,\" he says. What his lab is learning, he says, could help speed an \u003ca href=\"https://www.npr.org/sections/health-shots/2015/03/25/395303785/university-and-biotech-firm-team-up-on-colorblindness-therapy\" target=\"_blank\" rel=\"noopener\">existing effort\u003c/a> to use gene therapy to cure colorblindness.\u003c/p>\n\u003cp>The lab's second goal is to use retinal organoids to better understand diseases including glaucoma and \u003ca href=\"https://medlineplus.gov/maculardegeneration.html\" target=\"_blank\" rel=\"noopener\">macular degeneration\u003c/a>, a leading cause of vision loss.\u003c/p>\n\u003cp>Macular degeneration affects the macula, an area of the retina that provides high-resolution vision. The condition has been hard to study, though, because mice don't have a macula.\u003c/p>\n\u003cp>So Johnston hopes to learn more by having his lab create macular organoids.\u003c/p>\n\u003cp>There's growing optimism among scientists that new treatments for retinal diseases will emerge from such efforts, Becker says. Initially, he says, researchers had doubts about whether a retina grown in a dish could mimic the real thing.\u003c/p>\n\u003cp>But studies like this one on color vision, he says, \"show that the similarity is quite high.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>To encourage scientists to develop more retinal organoids, the National Eye Institute is sponsoring a \u003ca href=\"https://nei.nih.gov/content/nih-solicits-next-generation-retina-organoids-prize-competition\" target=\"_blank\" rel=\"noopener\">scientific competition\u003c/a> with $1 million in prizes.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Human+Retinas+Grown+In+A+Dish+Reveal+Origin+Of+Color+Vision&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n","blocks":[],"excerpt":"Our ability to see colors develops in the womb. Now scientists have replicated that process, which could help accelerate efforts to cure colorblindness and lead to new treatments for diseases.","status":"publish","parent":0,"modified":1539631049,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":27,"wordCount":761},"headData":{"title":"Human Retinas Grown In a Dish Reveal Origin Of Color Vision | KQED","description":"Our ability to see colors develops in the womb. Now scientists have replicated that process, which could help accelerate efforts to cure colorblindness and lead to new treatments for diseases.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"445028 https://ww2.kqed.org/futureofyou/?p=445028","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/10/12/human-retinas-grown-in-a-dish-reveal-origin-of-color-vision/","disqusTitle":"Human Retinas Grown In a Dish Reveal Origin Of Color Vision","source":"Health","nprByline":"Jon Hamilton, NPR","nprImageAgency":"Johns Hopkins University","nprStoryId":"656560767","nprApiLink":"http://api.npr.org/query?id=656560767&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"https://www.npr.org/sections/health-shots/2018/10/11/656560767/human-retinas-grown-in-a-dish-reveal-origin-of-color-vision?ft=nprml&f=656560767","nprRetrievedStory":"1","nprPubDate":"Thu, 11 Oct 2018 18:53:00 -0400","nprStoryDate":"Thu, 11 Oct 2018 14:01:00 -0400","nprLastModifiedDate":"Thu, 11 Oct 2018 17:56:46 -0400","nprAudio":"https://ondemand.npr.org/anon.npr-mp3/npr/atc/2018/10/20181011_atc_human_retinas_grown_in_a_dish_reveal_origin_of_color_vision.mp3?orgId=1&topicId=1128&d=223&p=2&story=656560767&ft=nprml&f=656560767","nprAudioM3u":"http://api.npr.org/m3u/1656682256-4e09f0.m3u?orgId=1&topicId=1128&d=223&p=2&story=656560767&ft=nprml&f=656560767","audioTrackLength":224,"path":"/futureofyou/445028/human-retinas-grown-in-a-dish-reveal-origin-of-color-vision","audioUrl":"https://ondemand.npr.org/anon.npr-mp3/npr/atc/2018/10/20181011_atc_human_retinas_grown_in_a_dish_reveal_origin_of_color_vision.mp3?orgId=1&topicId=1128&d=223&p=2&story=656560767&ft=nprml&f=656560767","parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>In order to see the red of a sunset or the green of spring leaves, developing human eyes need to get the right hormone at the right time.\u003c/p>\n\u003cp>That's the finding of a team of scientists who studied how color vision develops using hundreds of human retinas grown in the lab.\u003c/p>\n\u003cp>The discovery, \u003ca href=\"http://science.sciencemag.org/cgi/doi/10.1126/science.aau6348\" target=\"_blank\" rel=\"noopener\">published\u003c/a> Thursday in the journal \u003cem>Science\u003c/em>, could help accelerate current efforts to cure colorblindness. It could also lead to new treatments for diseases including macular degeneration, the leading cause of vision loss.\u003c/p>\n\u003cp>\"It's important that we understand how nature controls the development of the retina so we can understand better why things go wrong in disease and how we can treat them,\" says \u003ca href=\"https://www.linkedin.com/in/smbeck2000/\" target=\"_blank\" rel=\"noopener\">Steven Becker\u003c/a>, a scientist at the National Eye Institute. The newly published findings are a step in that direction, says Becker, who has no connection to the research.\u003c/p>\n\u003cp>The development of color vision in people has been difficult to study because it usually occurs in the womb — and out of sight. But two scientists at Johns Hopkins University thought they might find some answers using retinas grown in the lab.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>These \"\u003ca href=\"https://www.youtube.com/watch?v=4CHvLNjg6nI\" target=\"_blank\" rel=\"noopener\">retinal organoids\u003c/a>\" have been around for a few years but are difficult and tedious to grow, says \u003ca href=\"https://www.linkedin.com/in/kiara-eldred-984b1513/\" target=\"_blank\" rel=\"noopener\">Kiara Eldred\u003c/a>, a graduate student at Hopkins who is the paper's first author.\u003c/p>\n\u003cp>It takes up to a year to turn a batch of immature retinal cells into a functioning organoid.\u003c/p>\n\u003cp>\"For the first week of their life, I take care of them every day,\" Eldred says. After a couple of weeks, she says, the cells become \"a little bit more independent.\"\u003c/p>\n\u003cp>And with luck, these clusters of immature cells develop into a 3D structure that \"looks and acts like a developing retina that you would see in a baby,\" says \u003ca href=\"http://sites.krieger.jhu.edu/johnstonlab/people/\" target=\"_blank\" rel=\"noopener\">Bob Johnston\u003c/a>, Eldred's boss and an assistant professor in the biology department.\u003c/p>\n\u003cp>Johnston's lab had been studying vision in flies. But he and Eldred saw a chance to try something much more ambitious.\u003c/p>\n\u003cp>\"We discussed this crazy idea of: Could we use these human retinal organoids to study how we get the different color-sensing cells in our eyes?\" Johnston says.\u003c/p>\n\u003cp>Using human cells was key because you can't study how humans see color in a fly, or even a mouse.\u003c/p>\n\u003cp>\"Mice don't sense red,\" Johnston says. \"They don't have these red-detecting cells. So we really have to study this in human tissue to get any insight into how it works.\"\u003c/p>\n\u003cp>Johnston and Eldred knew that in a human fetus, cells that detect blue light appear first. Then come cells that respond to red and green light.\u003c/p>\n\u003cp>And research on animals suggested that the thyroid hormone was involved in the development of these color-sensing cells, called cones. So Johnston had Eldred conduct an experiment with immature retinal cells.\u003c/p>\n\u003cp>\"I added thyroid hormone to the dish during their development, and we got more red-green cones developing in those organoids,\" she says. \"We got really excited because we were on to something.\"\u003c/p>\n\u003cp>It would take years and many more experiments to confirm that the thyroid hormone was actually triggering the emergence of color vision. And the team still hasn't figured out what causes some cones to go on to become even more specialized by detecting only red or only green.\u003c/p>\n\u003cp>But Johnston says his lab is now preparing to take on two new goals.\u003c/p>\n\u003cp>\"One is to restore color vision to people that are colorblind,\" he says. What his lab is learning, he says, could help speed an \u003ca href=\"https://www.npr.org/sections/health-shots/2015/03/25/395303785/university-and-biotech-firm-team-up-on-colorblindness-therapy\" target=\"_blank\" rel=\"noopener\">existing effort\u003c/a> to use gene therapy to cure colorblindness.\u003c/p>\n\u003cp>The lab's second goal is to use retinal organoids to better understand diseases including glaucoma and \u003ca href=\"https://medlineplus.gov/maculardegeneration.html\" target=\"_blank\" rel=\"noopener\">macular degeneration\u003c/a>, a leading cause of vision loss.\u003c/p>\n\u003cp>Macular degeneration affects the macula, an area of the retina that provides high-resolution vision. The condition has been hard to study, though, because mice don't have a macula.\u003c/p>\n\u003cp>So Johnston hopes to learn more by having his lab create macular organoids.\u003c/p>\n\u003cp>There's growing optimism among scientists that new treatments for retinal diseases will emerge from such efforts, Becker says. Initially, he says, researchers had doubts about whether a retina grown in a dish could mimic the real thing.\u003c/p>\n\u003cp>But studies like this one on color vision, he says, \"show that the similarity is quite high.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>To encourage scientists to develop more retinal organoids, the National Eye Institute is sponsoring a \u003ca href=\"https://nei.nih.gov/content/nih-solicits-next-generation-retina-organoids-prize-competition\" target=\"_blank\" rel=\"noopener\">scientific competition\u003c/a> with $1 million in prizes.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Human+Retinas+Grown+In+A+Dish+Reveal+Origin+Of+Color+Vision&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/445028/human-retinas-grown-in-a-dish-reveal-origin-of-color-vision","authors":["byline_futureofyou_445028"],"categories":["futureofyou_1060","futureofyou_1062","futureofyou_1","futureofyou_73"],"tags":["futureofyou_141","futureofyou_1625","futureofyou_1626","futureofyou_565"],"collections":["futureofyou_1093"],"featImg":"futureofyou_445029","label":"source_futureofyou_445028"},"futureofyou_444953":{"type":"posts","id":"futureofyou_444953","meta":{"index":"posts_1591205157","site":"futureofyou","id":"444953","score":null,"sort":[1539187421000]},"guestAuthors":[],"slug":"big-data-gives-a-boost-to-immunology-research-and-potentially-treatments","title":"Big Data Gives a Boost to Immunology Research and Potentially, Treatments","publishDate":1539187421,"format":"standard","headTitle":"Women’s Health | KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>Researchers at UC San Francisco have unveiled the largest \u003ca href=\"http://10kimmunomes.org/\" target=\"_blank\" rel=\"noopener\">searchable database\u003c/a> of immunology data, gathered from 10,000 people of various ages, ethnicity, and backgrounds. It could lead to more effective treatments for a wide range of immune disorders.[contextly_sidebar id=\"lms9rSPdk5pG72xqgRdVMiGv0hv7IpdH\"]\u003c/p>\n\u003cp>The new data pool represents the \u003ca href=\"https://www.cell.com/cell-reports/fulltext/S2211-1247(18)31451-7\" target=\"_blank\" rel=\"noopener\">largest control group\u003c/a> ever compiled on the human immune system, according to the study published on Tuesday in the journal, \u003cem>Cell Reports\u003c/em>.\u003c/p>\n\u003cp>Called the \u003ca href=\"http://10kimmunomes.org/\" target=\"_blank\" rel=\"noopener\">10,000 Immunomes Project\u003c/a> (10KIP), it's the culmination of four years of work and provides an instant comparison group for researchers studying the immune system and immune dysfunction.\u003c/p>\n\u003cp>UCSF researchers created the tool using immunology data from 83 studies representing 10,000 healthy subjects, according to senior author Atul Butte, director of the \u003ca href=\"http://bakarinstitute.ucsf.edu/\" target=\"_blank\" rel=\"noopener\">Bakar Computational Health Sciences Institute\u003c/a> at UCSF.\u003c/p>\n\u003caside class=\"pullquote alignright\">‘If the field of genetics is able to compile large collections consisting of millions of people, why does immunology lag behind?’\u003ccite>Atul Butte, UCSF\u003c/cite>\u003c/aside>\n\u003cp>The data comes from studies on organ transplants, autoimmune disease trials, vaccine studies and other research funded by the National Institute of Allergy and Infectious Diseases (NIAID).\u003c/p>\n\u003cdiv>\n\u003cp>\"We have sub-populations in the U.S. that don't really participate in studies so why not just gather all this massive data on the immune system in one central place,\" says Butte. \"We can turn to this data to see what is going on in a healthy immune system spanning different populations in the U.S.\"\u003c/p>\n\u003cp>Butte says the ability to manipulate immune system activity will benefit a wide range of patients, including transplant recipients, cancer and AIDS patients, and those suffering from some form of immune dysfunction.\u003c/p>\n\u003cp>Autoimmune Disease (AD) in particular, an historically underfunded field, could benefit greatly from the availability of a large and diverse control group, according to Butte.\u003c/p>\n\u003cp>\u003cstrong>Rise of Autoimmine Disease\u003c/strong>\u003c/p>\n\u003cp>AD is one of the fastest growing illnesses in the U.S., with 20 percent of the population or one in five people, suffering from the disorder.[contextly_sidebar id=\"KPqEb6LD9ky4mDsIDJAEnoEvgzkEna45\"]\u003c/p>\n\u003cp>Despite AD being \u003ca href=\"https://www.aarda.org/who-we-are/our-mission/\" target=\"_blank\" rel=\"noopener\">one of the top 10 leading causes\u003c/a> of death in females up to 64 years of age, research has continued to lag behind, according to Butte.\u003c/p>\n\u003cp>The National Institutes of Health\u003ca href=\"https://ww2.kqed.org/science/2018/10/09/voting-on-daylight-saving-time-animal-confinement-and-water-propositions-3-7-and-12-explained/\" target=\"_blank\" rel=\"noopener\"> has spent\u003c/a> $591 million dollars on AD research compared to the $6.1 billion spent on cancer. Current treatments consist of risky immunosuppressants that can lead to devastating long-term side effects.[contextly_sidebar id=\"ZbtYikLAiggPmeNWkxr4kKECzkkjZf4Z\"]\u003c/p>\n\u003cp>UCSF researchers developed the new searchable database in part to boost AD research. Typically, studies done on immune systems are smaller and it's rare to get 10,000 participants, according to Butte.\u003c/p>\n\u003cp>Plus, the human immune system is a moving target.\u003c/p>\n\u003cp>\"It's a difficult field to study because unlike DNA for example, your immune system changes from morning to night. So which aspect of the immune system scientists focus on, and \u003cem>when\u003c/em> they study it, these are all problems we are getting better at. We just need more studies.\"\u003c/p>\n\u003cp>To test their new tool, researchers created a custom control group comprised of women between 18 and 40 years of age and compared it to 56 pregnant women who participated in a prior study tracking immune changes during pregnancy.\u003c/p>\n\u003cp>Using this control group, researchers were able to detect how various immune cells and cell signaling proteins, called cytokines, changed from pre-pregnancy levels— measurements that the original study failed to pick up.\u003c/p>\n\u003cp>Researchers also used the new tool to compare immunity in people from different racial and ethnic backgrounds. The findings showed both known differences as well as new information that could only be seen by combining data from dozens of different studies.\u003c/p>\n\u003cp>For instance, researchers found that regulatory T cells, which suppress the immune response, are present at higher levels in African Americans, compared to all other groups.\u003c/p>\n\u003cp>\u003cstrong>Shareable Science\u003c/strong>\u003c/p>\n\u003cp>Butte sees the searchable database as part of a broader trend in science, promoting open access where more scientists are willing to share their raw data with others.\u003c/p>\n\u003cp>\"It's really hundreds of people who have essentially contributed to this work,\" he notes.\u003c/p>\n\u003cp>Butte says he hopes his work will bring immunology to the forefront and inspire others to rethink their approach to the field.\u003c/p>\n\u003cp>\"If the field of genetics is able to compile large collections consisting of millions of people,\" he wonders, \"why does immunology lag behind? I want to get people in the field thinking about larger collections of samples that cut across race, age and gender.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003c/div>\n\u003cp>\u003c/p>\n","blocks":[],"excerpt":"UCSF scientists have created the largest searchable database consisting of immunology data gathered from 10,000 people spanning different ages, ethnicity, and backgrounds. ","status":"publish","parent":0,"modified":1539129653,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":26,"wordCount":755},"headData":{"title":"Big Data Gives a Boost to Immunology Research and Potentially, Treatments | KQED","description":"UCSF scientists have created the largest searchable database consisting of immunology data gathered from 10,000 people spanning different ages, ethnicity, and backgrounds. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"444953 https://ww2.kqed.org/futureofyou/?p=444953","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/10/10/big-data-gives-a-boost-to-immunology-research-and-potentially-treatments/","disqusTitle":"Big Data Gives a Boost to Immunology Research and Potentially, Treatments","source":"Health","path":"/futureofyou/444953/big-data-gives-a-boost-to-immunology-research-and-potentially-treatments","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Researchers at UC San Francisco have unveiled the largest \u003ca href=\"http://10kimmunomes.org/\" target=\"_blank\" rel=\"noopener\">searchable database\u003c/a> of immunology data, gathered from 10,000 people of various ages, ethnicity, and backgrounds. It could lead to more effective treatments for a wide range of immune disorders.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The new data pool represents the \u003ca href=\"https://www.cell.com/cell-reports/fulltext/S2211-1247(18)31451-7\" target=\"_blank\" rel=\"noopener\">largest control group\u003c/a> ever compiled on the human immune system, according to the study published on Tuesday in the journal, \u003cem>Cell Reports\u003c/em>.\u003c/p>\n\u003cp>Called the \u003ca href=\"http://10kimmunomes.org/\" target=\"_blank\" rel=\"noopener\">10,000 Immunomes Project\u003c/a> (10KIP), it's the culmination of four years of work and provides an instant comparison group for researchers studying the immune system and immune dysfunction.\u003c/p>\n\u003cp>UCSF researchers created the tool using immunology data from 83 studies representing 10,000 healthy subjects, according to senior author Atul Butte, director of the \u003ca href=\"http://bakarinstitute.ucsf.edu/\" target=\"_blank\" rel=\"noopener\">Bakar Computational Health Sciences Institute\u003c/a> at UCSF.\u003c/p>\n\u003caside class=\"pullquote alignright\">‘If the field of genetics is able to compile large collections consisting of millions of people, why does immunology lag behind?’\u003ccite>Atul Butte, UCSF\u003c/cite>\u003c/aside>\n\u003cp>The data comes from studies on organ transplants, autoimmune disease trials, vaccine studies and other research funded by the National Institute of Allergy and Infectious Diseases (NIAID).\u003c/p>\n\u003cdiv>\n\u003cp>\"We have sub-populations in the U.S. that don't really participate in studies so why not just gather all this massive data on the immune system in one central place,\" says Butte. \"We can turn to this data to see what is going on in a healthy immune system spanning different populations in the U.S.\"\u003c/p>\n\u003cp>Butte says the ability to manipulate immune system activity will benefit a wide range of patients, including transplant recipients, cancer and AIDS patients, and those suffering from some form of immune dysfunction.\u003c/p>\n\u003cp>Autoimmune Disease (AD) in particular, an historically underfunded field, could benefit greatly from the availability of a large and diverse control group, according to Butte.\u003c/p>\n\u003cp>\u003cstrong>Rise of Autoimmine Disease\u003c/strong>\u003c/p>\n\u003cp>AD is one of the fastest growing illnesses in the U.S., with 20 percent of the population or one in five people, suffering from the disorder.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Despite AD being \u003ca href=\"https://www.aarda.org/who-we-are/our-mission/\" target=\"_blank\" rel=\"noopener\">one of the top 10 leading causes\u003c/a> of death in females up to 64 years of age, research has continued to lag behind, according to Butte.\u003c/p>\n\u003cp>The National Institutes of Health\u003ca href=\"https://ww2.kqed.org/science/2018/10/09/voting-on-daylight-saving-time-animal-confinement-and-water-propositions-3-7-and-12-explained/\" target=\"_blank\" rel=\"noopener\"> has spent\u003c/a> $591 million dollars on AD research compared to the $6.1 billion spent on cancer. Current treatments consist of risky immunosuppressants that can lead to devastating long-term side effects.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>UCSF researchers developed the new searchable database in part to boost AD research. Typically, studies done on immune systems are smaller and it's rare to get 10,000 participants, according to Butte.\u003c/p>\n\u003cp>Plus, the human immune system is a moving target.\u003c/p>\n\u003cp>\"It's a difficult field to study because unlike DNA for example, your immune system changes from morning to night. So which aspect of the immune system scientists focus on, and \u003cem>when\u003c/em> they study it, these are all problems we are getting better at. We just need more studies.\"\u003c/p>\n\u003cp>To test their new tool, researchers created a custom control group comprised of women between 18 and 40 years of age and compared it to 56 pregnant women who participated in a prior study tracking immune changes during pregnancy.\u003c/p>\n\u003cp>Using this control group, researchers were able to detect how various immune cells and cell signaling proteins, called cytokines, changed from pre-pregnancy levels— measurements that the original study failed to pick up.\u003c/p>\n\u003cp>Researchers also used the new tool to compare immunity in people from different racial and ethnic backgrounds. The findings showed both known differences as well as new information that could only be seen by combining data from dozens of different studies.\u003c/p>\n\u003cp>For instance, researchers found that regulatory T cells, which suppress the immune response, are present at higher levels in African Americans, compared to all other groups.\u003c/p>\n\u003cp>\u003cstrong>Shareable Science\u003c/strong>\u003c/p>\n\u003cp>Butte sees the searchable database as part of a broader trend in science, promoting open access where more scientists are willing to share their raw data with others.\u003c/p>\n\u003cp>\"It's really hundreds of people who have essentially contributed to this work,\" he notes.\u003c/p>\n\u003cp>Butte says he hopes his work will bring immunology to the forefront and inspire others to rethink their approach to the field.\u003c/p>\n\u003cp>\"If the field of genetics is able to compile large collections consisting of millions of people,\" he wonders, \"why does immunology lag behind? I want to get people in the field thinking about larger collections of samples that cut across race, age and gender.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003c/div>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/444953/big-data-gives-a-boost-to-immunology-research-and-potentially-treatments","authors":["11428"],"series":["futureofyou_219"],"categories":["futureofyou_1060","futureofyou_1062","futureofyou_1","futureofyou_73"],"tags":["futureofyou_1198","futureofyou_1594","futureofyou_1623","futureofyou_327","futureofyou_271"],"collections":["futureofyou_1093","futureofyou_1097"],"featImg":"futureofyou_444955","label":"source_futureofyou_444953"},"futureofyou_444942":{"type":"posts","id":"futureofyou_444942","meta":{"index":"posts_1591205157","site":"futureofyou","id":"444942","score":null,"sort":[1539118849000]},"guestAuthors":[],"slug":"crispr-cures-inherited-disorder-in-mice-paving-way-for-genetic-therapy-before-birth","title":"CRISPR Cures Inherited Disorder in Mice, Paving Way for Genetic Therapy Before Birth","publishDate":1539118849,"format":"standard","headTitle":"Future of You | KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp class=\"danger-zone\">Nearly 40 years after surgeons first \u003ca href=\"https://www.ucsf.edu/news/2011/02/9366/ucsf-surgeon-reflects-performing-worlds-first-fetal-surgery-30-years-ago\" target=\"_blank\" rel=\"noopener\">operated on fetuses\u003c/a> to cure devastating abnormalities, researchers have taken the first step toward curing genetic disease before birth via genome editing: scientists reported on Monday that they used the genome editing technique CRISPR to alter the DNA of laboratory mice in the womb, eliminating an often-fatal liver disease before the animals had even been born.[contextly_sidebar id=\"kLt87B75fzdQ6XiJiVHbmy8S3RDMp2KF\"]\u003c/p>\n\u003cp class=\"danger-zone\">The research, by a team at the University of Pennsylvania and the Children’s Hospital of Philadelphia (CHOP), is a very early proof of concept. But while CRISPRing human fetuses is years away, at best, the success in mice bolsters what Dr. William Peranteau, who co-led the study, calls his dream of curing genetic diseases before birth.\u003c/p>\n\u003cp class=\"danger-zone\">“A lot more animal work needs to be done before we can even think about applying this [fetal genome editing] clinically,” said Peranteau, a pediatric and fetal surgeon at CHOP. “But I think fetal genome editing may be where fetal surgery [which is now routine] once was, and that one day we’ll use it to treat diseases that cause significant morbidity and mortality.”\u003c/p>\n\u003cp>Simon Waddington of University College London, a leader in research to develop fetal gene therapy who was not involved in the new study, called the CRISPR approach “an elegant refinement of the brute-force technology” that’s been the focus of \u003ca href=\"https://www.nature.com/articles/s41591-018-0106-7\" target=\"_blank\" rel=\"noopener\">animal studies\u003c/a> of fetal genetic therapy.\u003c/p>\n\u003cp>The success in mouse fetuses raises the possibility that, even before \u003ca href=\"https://www.statnews.com/2018/07/25/can-gene-therapy-halt-diseases-in-babies-before-theyre-even-born/\">traditional gene therapy\u003c/a> is ready to treat inherited disorders in utero, genome editing might emerge as a safer, more effective approach. In traditional gene therapy, an entire healthy gene is ferried, typically by a virus, into cells containing a disease-causing gene. With CRISPR, only the mutated bit of a defective gene is changed. It’s the difference between retyping a whole 5,000 word document and using Word’s “find and replace” to correct a typo.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“We think this represents a safer and more precise way to make changes in the genome,” said Dr. Kiran Musunuru of Penn and a co-leader of the study. “It’s is the better way forward if you want to take CRISPR into the clinic.”[contextly_sidebar id=\"WspKwnRfkmuJ8Ui6Pu5mBgKtCSqZqfJ5\"]\u003c/p>\n\u003cp>The rationale for fetal genetic therapy is simple: it could halt a disease before it causes irreversible and even fatal damage. In people, the inherited liver disease that the scientists targeted in mice, called hereditary tyrosinemia type 1, starts damaging the liver months before birth. Another rationale: because a fetus’s immune system is immature, it is less likely than even a newborn’s to attack the alien CRISPR molecules.\u003c/p>\n\u003cp>For their study, \u003ca href=\"https://www.nature.com/articles/s41591-018-0184-6\" target=\"_blank\" rel=\"noopener\">published in Nature Medicine\u003c/a>, Musunuru and his colleagues gently opened the uterus of a pregnant mouse, removed the fetus from the amniotic sac, and injected CRISPR into the vitelline vein, which is near the surface of the sac and connects to the liver. “We wanted to make sure we got the genome editor into the liver rather than everywhere else,” Musunuru said. The fetus was then replaced in the uterus and was born normally.\u003c/p>\n\u003cp>Instead of using the original form of CRISPR, which cuts DNA where a gene is mutated and inserts a replacement string of A’s, T’s, C’s, and G’s, the scientists used the form of CRISPR called base editing. \u003ca href=\"https://www.statnews.com/2016/04/20/clever-crispr-advance-unveiled/%5D\">Invented\u003c/a> just two years ago, base editing changes an incorrect DNA letter, or base, to the correct one, such as a C to a T or a G to an A. Its advantage is that it doesn’t need to cut DNA to do this, as CRISPR 1.0 does; those cuts can wreak \u003ca href=\"https://www.statnews.com/2018/07/16/crispr-potential-dna-damage-underestimated/\">genetic havoc\u003c/a>, with unknown consequences for CRISPR’d cells.\u003c/p>\n\u003cp>For a dry run, the scientists first made a CRISPR base editor that changes a \u003ca href=\"https://ghr.nlm.nih.gov/gene/PCSK9\" target=\"_blank\" rel=\"noopener\">gene called PCSK9\u003c/a>, which makes a protein that helps regulate the amount of cholesterol in the bloodstream, into a super-cholesterol-lowering form. When injected into mouse fetuses, the base editor changed liver cells as intended and left other organs alone. Crucially, the mouse mother showed no effects of the CRISPR treatment. After birth, the baby mice had ultra-low cholesterol levels, showing that the CRISPR base editor had worked. Only about 15 percent of the liver cells of the baby mice had been edited, but that fraction remained stable through the animals’ adulthood.[contextly_sidebar id=\"7RKromVt2cYnSDdz2L7SJg04iooF89dn\"]\u003c/p>\n\u003cp>The amount of genetic havoc from the base editing was low: about 2 percent, compared to 40 percent for many uses of traditional CRISPR. And none of the likely spots for “off target” effects — DNA sites that resemble the target and so might be inadvertently edited — showed any sign of being altered.\u003c/p>\n\u003cp>The Philadelphia scientists then tried their technique on hereditary tyrosinemia type 1. HT1, which strikes 1 in 100,000 newborns worldwide, is \u003ca href=\"https://rarediseases.info.nih.gov/diseases/2658/tyrosinemia-type-1\" target=\"_blank\" rel=\"noopener\">caused by\u003c/a> any of several mutations in a \u003ca href=\"https://ghr.nlm.nih.gov/gene/FAH\" target=\"_blank\" rel=\"noopener\">gene called FAH\u003c/a>. All the mutations cause the build-up of toxic breakdown products of the amino acid tyrosine, a component of protein, and ultimately destroy the liver. Treatment with the drug nitisinone and a strict tyrosine-free diet is not always effective, with the result that children sometimes develop fatal liver failure or liver cancer.\u003c/p>\n\u003cp>The scientists used their base editor on a gene related to the disease-causing one. If this gene, \u003ca href=\"https://ghr.nlm.nih.gov/gene/HPD\" target=\"_blank\" rel=\"noopener\">called HPD\u003c/a>, is disabled, then no toxic metabolites of tyrosine ever get to where FAH is unable to handle them.\u003c/p>\n\u003cp>Changing a C to a T in the HPD gene disabled it. No toxic molecules built up in the livers of the fetal mice. No other organs showed signs of editing, no off-target effects were detected, and having only 15 percent of their liver cells edited was enough to cure the mice and keep them cured into adulthood. “We weren’t expecting it, but the genome-edited mice did much better” than mice treated with nitisinone, Musunuru said. “They survived longer and gained more weight.”\u003c/p>\n\u003cp>The scientists hope to study fetal base editing for other severe congenital diseases. It remains to be seen whether this technique or conventional gene therapy, which provides an entire replacement gene, will work better.\u003c/p>\n\u003cp>“I’d consider that CRISPR isn’t a replacement” for the latter, Waddington said, “but will be an additional tool” for curing genetic diseases in the womb.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003ci>\u003cspan style=\"font-weight: 400\">This \u003c/span>\u003c/i>\u003ca href=\"https://www.statnews.com/2018/10/08/crispr-cures-inherited-disorder-in-mice-paving-way-for-genetic-therapy-before-birth/\" target=\"_blank\" rel=\"noopener\">\u003ci>\u003cspan style=\"font-weight: 400\">story\u003c/span>\u003c/i>\u003c/a>\u003ci>\u003cspan style=\"font-weight: 400\"> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/span>\u003c/i>\u003cspan style=\"font-weight: 400\">\u003cbr>\n\u003c/span>\u003c/p>\n\n","blocks":[],"excerpt":"In mice with a fatal genetic disease, toxic proteins begin accumulating in the liver before birth. CRISPR performed in utero reversed the condition.","status":"publish","parent":0,"modified":1539042769,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":16,"wordCount":1141},"headData":{"title":"CRISPR Cures Inherited Disorder in Mice, Paving Way for Genetic Therapy Before Birth | KQED","description":"In mice with a fatal genetic disease, toxic proteins begin accumulating in the liver before birth. CRISPR performed in utero reversed the condition.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"444942 https://ww2.kqed.org/futureofyou/?p=444942","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/10/09/crispr-cures-inherited-disorder-in-mice-paving-way-for-genetic-therapy-before-birth/","disqusTitle":"CRISPR Cures Inherited Disorder in Mice, Paving Way for Genetic Therapy Before Birth","source":"Hope/Hype","nprByline":"Sharon Begley\u003cbr />STAT","path":"/futureofyou/444942/crispr-cures-inherited-disorder-in-mice-paving-way-for-genetic-therapy-before-birth","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp class=\"danger-zone\">Nearly 40 years after surgeons first \u003ca href=\"https://www.ucsf.edu/news/2011/02/9366/ucsf-surgeon-reflects-performing-worlds-first-fetal-surgery-30-years-ago\" target=\"_blank\" rel=\"noopener\">operated on fetuses\u003c/a> to cure devastating abnormalities, researchers have taken the first step toward curing genetic disease before birth via genome editing: scientists reported on Monday that they used the genome editing technique CRISPR to alter the DNA of laboratory mice in the womb, eliminating an often-fatal liver disease before the animals had even been born.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp class=\"danger-zone\">The research, by a team at the University of Pennsylvania and the Children’s Hospital of Philadelphia (CHOP), is a very early proof of concept. But while CRISPRing human fetuses is years away, at best, the success in mice bolsters what Dr. William Peranteau, who co-led the study, calls his dream of curing genetic diseases before birth.\u003c/p>\n\u003cp class=\"danger-zone\">“A lot more animal work needs to be done before we can even think about applying this [fetal genome editing] clinically,” said Peranteau, a pediatric and fetal surgeon at CHOP. “But I think fetal genome editing may be where fetal surgery [which is now routine] once was, and that one day we’ll use it to treat diseases that cause significant morbidity and mortality.”\u003c/p>\n\u003cp>Simon Waddington of University College London, a leader in research to develop fetal gene therapy who was not involved in the new study, called the CRISPR approach “an elegant refinement of the brute-force technology” that’s been the focus of \u003ca href=\"https://www.nature.com/articles/s41591-018-0106-7\" target=\"_blank\" rel=\"noopener\">animal studies\u003c/a> of fetal genetic therapy.\u003c/p>\n\u003cp>The success in mouse fetuses raises the possibility that, even before \u003ca href=\"https://www.statnews.com/2018/07/25/can-gene-therapy-halt-diseases-in-babies-before-theyre-even-born/\">traditional gene therapy\u003c/a> is ready to treat inherited disorders in utero, genome editing might emerge as a safer, more effective approach. In traditional gene therapy, an entire healthy gene is ferried, typically by a virus, into cells containing a disease-causing gene. With CRISPR, only the mutated bit of a defective gene is changed. It’s the difference between retyping a whole 5,000 word document and using Word’s “find and replace” to correct a typo.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“We think this represents a safer and more precise way to make changes in the genome,” said Dr. Kiran Musunuru of Penn and a co-leader of the study. “It’s is the better way forward if you want to take CRISPR into the clinic.”\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The rationale for fetal genetic therapy is simple: it could halt a disease before it causes irreversible and even fatal damage. In people, the inherited liver disease that the scientists targeted in mice, called hereditary tyrosinemia type 1, starts damaging the liver months before birth. Another rationale: because a fetus’s immune system is immature, it is less likely than even a newborn’s to attack the alien CRISPR molecules.\u003c/p>\n\u003cp>For their study, \u003ca href=\"https://www.nature.com/articles/s41591-018-0184-6\" target=\"_blank\" rel=\"noopener\">published in Nature Medicine\u003c/a>, Musunuru and his colleagues gently opened the uterus of a pregnant mouse, removed the fetus from the amniotic sac, and injected CRISPR into the vitelline vein, which is near the surface of the sac and connects to the liver. “We wanted to make sure we got the genome editor into the liver rather than everywhere else,” Musunuru said. The fetus was then replaced in the uterus and was born normally.\u003c/p>\n\u003cp>Instead of using the original form of CRISPR, which cuts DNA where a gene is mutated and inserts a replacement string of A’s, T’s, C’s, and G’s, the scientists used the form of CRISPR called base editing. \u003ca href=\"https://www.statnews.com/2016/04/20/clever-crispr-advance-unveiled/%5D\">Invented\u003c/a> just two years ago, base editing changes an incorrect DNA letter, or base, to the correct one, such as a C to a T or a G to an A. Its advantage is that it doesn’t need to cut DNA to do this, as CRISPR 1.0 does; those cuts can wreak \u003ca href=\"https://www.statnews.com/2018/07/16/crispr-potential-dna-damage-underestimated/\">genetic havoc\u003c/a>, with unknown consequences for CRISPR’d cells.\u003c/p>\n\u003cp>For a dry run, the scientists first made a CRISPR base editor that changes a \u003ca href=\"https://ghr.nlm.nih.gov/gene/PCSK9\" target=\"_blank\" rel=\"noopener\">gene called PCSK9\u003c/a>, which makes a protein that helps regulate the amount of cholesterol in the bloodstream, into a super-cholesterol-lowering form. When injected into mouse fetuses, the base editor changed liver cells as intended and left other organs alone. Crucially, the mouse mother showed no effects of the CRISPR treatment. After birth, the baby mice had ultra-low cholesterol levels, showing that the CRISPR base editor had worked. Only about 15 percent of the liver cells of the baby mice had been edited, but that fraction remained stable through the animals’ adulthood.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The amount of genetic havoc from the base editing was low: about 2 percent, compared to 40 percent for many uses of traditional CRISPR. And none of the likely spots for “off target” effects — DNA sites that resemble the target and so might be inadvertently edited — showed any sign of being altered.\u003c/p>\n\u003cp>The Philadelphia scientists then tried their technique on hereditary tyrosinemia type 1. HT1, which strikes 1 in 100,000 newborns worldwide, is \u003ca href=\"https://rarediseases.info.nih.gov/diseases/2658/tyrosinemia-type-1\" target=\"_blank\" rel=\"noopener\">caused by\u003c/a> any of several mutations in a \u003ca href=\"https://ghr.nlm.nih.gov/gene/FAH\" target=\"_blank\" rel=\"noopener\">gene called FAH\u003c/a>. All the mutations cause the build-up of toxic breakdown products of the amino acid tyrosine, a component of protein, and ultimately destroy the liver. Treatment with the drug nitisinone and a strict tyrosine-free diet is not always effective, with the result that children sometimes develop fatal liver failure or liver cancer.\u003c/p>\n\u003cp>The scientists used their base editor on a gene related to the disease-causing one. If this gene, \u003ca href=\"https://ghr.nlm.nih.gov/gene/HPD\" target=\"_blank\" rel=\"noopener\">called HPD\u003c/a>, is disabled, then no toxic metabolites of tyrosine ever get to where FAH is unable to handle them.\u003c/p>\n\u003cp>Changing a C to a T in the HPD gene disabled it. No toxic molecules built up in the livers of the fetal mice. No other organs showed signs of editing, no off-target effects were detected, and having only 15 percent of their liver cells edited was enough to cure the mice and keep them cured into adulthood. “We weren’t expecting it, but the genome-edited mice did much better” than mice treated with nitisinone, Musunuru said. “They survived longer and gained more weight.”\u003c/p>\n\u003cp>The scientists hope to study fetal base editing for other severe congenital diseases. It remains to be seen whether this technique or conventional gene therapy, which provides an entire replacement gene, will work better.\u003c/p>\n\u003cp>“I’d consider that CRISPR isn’t a replacement” for the latter, Waddington said, “but will be an additional tool” for curing genetic diseases in the womb.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003ci>\u003cspan style=\"font-weight: 400\">This \u003c/span>\u003c/i>\u003ca href=\"https://www.statnews.com/2018/10/08/crispr-cures-inherited-disorder-in-mice-paving-way-for-genetic-therapy-before-birth/\" target=\"_blank\" rel=\"noopener\">\u003ci>\u003cspan style=\"font-weight: 400\">story\u003c/span>\u003c/i>\u003c/a>\u003ci>\u003cspan style=\"font-weight: 400\"> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/span>\u003c/i>\u003cspan style=\"font-weight: 400\">\u003cbr>\n\u003c/span>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/444942/crispr-cures-inherited-disorder-in-mice-paving-way-for-genetic-therapy-before-birth","authors":["byline_futureofyou_444942"],"programs":["futureofyou_54"],"categories":["futureofyou_1062","futureofyou_1","futureofyou_73"],"tags":["futureofyou_94","futureofyou_927","futureofyou_324"],"collections":["futureofyou_1097","futureofyou_1094"],"featImg":"futureofyou_1194","label":"source_futureofyou_444942"},"futureofyou_444933":{"type":"posts","id":"futureofyou_444933","meta":{"index":"posts_1591205157","site":"futureofyou","id":"444933","score":null,"sort":[1539111653000]},"guestAuthors":[],"slug":"how-does-your-brain-construct-your-conscious-reality","title":"How Does Your Brain Construct Your Conscious Reality?","publishDate":1539111653,"format":"aside","headTitle":"KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>https://www.youtube.com/watch?v=lyu7v7nWzfo\u003c/p>\n\u003cp>\u003cem>Part 4 of the \u003c/em>TED Radio Hour \u003cem>episode \u003c/em>\u003ca href=\"http://www.npr.org/programs/ted-radio-hour/485704159/what-makes-us-us\" target=\"_blank\" rel=\"noopener\">What Makes Us ... Us\u003c/a>\u003c/p>\n\u003cp>\u003cstrong>About Anil Seth's TED Talk\u003c/strong>\u003c/p>\n\u003cp>When we look around, it feels like we're seeing an objective reality. But neuroscientist Anil Seth says everything we perceive, from objects to emotions, is an act of informed guesswork by the brain.\u003c/p>\n\u003cp>\u003cstrong>About Anil Seth\u003c/strong>\u003c/p>\n\u003cp>\u003ca href=\"http://www.anilseth.com/\">Anil Seth\u003c/a> is a professor of cognitive and computational neuroscience at the University of Sussex, where he studies consciousness and its role in health and disease.\u003c/p>\n\u003cp>He co-directs the \u003ca href=\"http://www.sussex.ac.uk/sackler/\" target=\"_blank\" rel=\"noopener\">Sackler Centre for Consciousness Science\u003c/a> and is the Editor-in-Chief of the academic journal \u003cem>Neuroscience of Consciousness\u003c/em>. Seth was also the 2017 President of the British Science Association (Psychology Section). He is the co-author of \u003ca href=\"http://www.anilseth.com/books\" target=\"_blank\" rel=\"noopener\">\u003cem>30-Second Brain\u003c/em>,\u003c/a> a best-seller that explores how the brain works.\u003c/p>\n\u003cp>Seth is a regular contributor to the \u003cem>New Scientist, The Guardian\u003c/em>, and the BBC.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Anil+Seth%3A+How+Does+Your+Brain+Construct+Your+Conscious+Reality%3F&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n","blocks":[],"excerpt":"When we look around, it feels like we're seeing an objective reality. 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To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Anil+Seth%3A+How+Does+Your+Brain+Construct+Your+Conscious+Reality%3F&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/444933/how-does-your-brain-construct-your-conscious-reality","authors":["byline_futureofyou_444933"],"categories":["futureofyou_1060","futureofyou_1062","futureofyou_1"],"tags":["futureofyou_56","futureofyou_1576","futureofyou_59","futureofyou_1224"],"collections":["futureofyou_1097"],"featImg":"futureofyou_444934","label":"source_futureofyou_444933"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. 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