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"content": "\u003cp>The University of California will be receiving two CRISPR-related \u003ca href=\"http://patft.uspto.gov/netacgi/nph-Parser?Sect1=PTO1&Sect2=HITOFF&d=PALL&p=1&u=%2Fnetahtml%2FPTO%2Fsrchnum.htm&r=1&f=G&l=50&s1=9,994,831.PN.&OS=PN/9,994,831&RS=PN/9,994,831\" target=\"_blank\" rel=\"noopener\">patents\u003c/a>, marking another step forward in the university's long battle to assert its claims to the revolutionary technology.[contextly_sidebar id=\"HobWula6BihfuZ4zJKYzmOCLk2EeUohl\"]\u003c/p>\n\u003cp>UC Berkeley \u003ca href=\"https://nature1.berkeley.edu/breakthroughs/sp18/genes-to-global-solutions\" target=\"_blank\" rel=\"noopener\">pioneered the technology\u003c/a> in 2012, when a team led by biochemist \u003ca href=\"http://doudnalab.org/\" target=\"_blank\" rel=\"noopener\">Jennifer Doudna\u003c/a> reported that they had successfully developed a “programmable” genome-editing tool that makes highly targeted alterations to the genome of a plant or animal. A team at the \u003ca href=\"https://www.broadinstitute.org/\" target=\"_blank\" rel=\"noopener\">Broad Institute\u003c/a>, owned jointly by Harvard University and the Massachusetts Institute, was also researching the technology during the same period.\u003c/p>\n\u003cp>Commonly known as CRISPR—an acronym for Clustered Regularly Interspaced Short Palindromic Repeats, the groundbreaking technology offers a method to fix genes in living things. It could be used to develop everything from drought-resistant crops, to new treatments for genetic disorders and cancers.\u003c/p>\n\u003cp>UC Berkeley is in a \u003ca href=\"https://www.kqed.org/futureofyou/372137/uc-berkeley-renews-legal-fight-over-crispr-cas9-patent-rights\" target=\"_blank\" rel=\"noopener\">legal fight\u003c/a> with the Broad Institute over the patent rights to CRISPR. UC Berkeley filed its patent application before Broad did, but Broad fast-tracked its application.\u003c/p>\n\u003cp>The United States Patent and Trademark Office in February 2017 \u003ca href=\"https://www.kqed.org/futureofyou/338066/broad-institute-wins-decision-over-uc-berkeley-in-crispr-patent-battle\" target=\"_blank\" rel=\"noopener\">awarded a patent\u003c/a> to Broad for CRISPR's use in plant and animal cells, and a pending patent to UC Berkeley for CRISPR's use in bacterial cells. The UC appealed in April 2017, arguing its scientists were the first inventors of the technology.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[contextly_sidebar id=\"dldVTmrihr5ckptkstBunRusJqL7Q1kF\"]The patent granted to UC Berkeley on Tuesday focuses on using the tool to edit single-stranded RNA, according to \u003ca href=\"https://www.statnews.com/2018/06/13/university-of-california-granted-a-key-crispr-patent/\" target=\"_blank\" rel=\"noopener\">a \u003cem>STAT News \u003c/em>report\u003c/a>. The federal agency will reportedly award a second patent next week. That patent, reports STAT, will focus on using the tool to edit regions specifically 10 to 15 base pairs long.\u003c/p>\n\u003cp>Some experts are downplaying the patents' significance.\u003c/p>\n\u003cp>According to New York Law School associate professor Jacob Sherkow, who spoke with\u003ca href=\"https://www.statnews.com/2018/06/13/university-of-california-granted-a-key-crispr-patent/\" target=\"_blank\" rel=\"noopener\">\u003cem> STAT\u003c/em>\u003c/a>, the second patent will likely have “pretty minimal” commercial value.[contextly_sidebar id=\"r1GPWMK2Ali0LLhAqlMmjHyUin6pJWDz\"]\u003c/p>\n\u003cp>The USPTO has so far granted more than \u003ca href=\"https://www.broadinstitute.org/crispr/journalists-statement-and-background-crispr-patent-process\" target=\"_blank\" rel=\"noopener\">60 CRISPR-related patents\u003c/a> to inventors from 18 organizations, according to the Broad Institute.\u003c/p>\n\u003cp>Meanwhile, news of the university's patent awards come as two new \u003ca href=\"https://www.nature.com/articles/s41591-018-0050-6.epdf\" target=\"_blank\" rel=\"noopener\">studies\u003c/a> published on Monday caution that gene cells edited with CRISPR-Cas9 \u003ca href=\"https://www.kqed.org/futureofyou/442526/major-hurdle-for-crispr-edited-cells-might-cause-cancer-find-two-studies\" target=\"_blank\" rel=\"noopener\">may be linked\u003c/a> to cancer.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The University of California will be receiving two CRISPR-related \u003ca href=\"http://patft.uspto.gov/netacgi/nph-Parser?Sect1=PTO1&Sect2=HITOFF&d=PALL&p=1&u=%2Fnetahtml%2FPTO%2Fsrchnum.htm&r=1&f=G&l=50&s1=9,994,831.PN.&OS=PN/9,994,831&RS=PN/9,994,831\" target=\"_blank\" rel=\"noopener\">patents\u003c/a>, marking another step forward in the university's long battle to assert its claims to the revolutionary technology.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>UC Berkeley \u003ca href=\"https://nature1.berkeley.edu/breakthroughs/sp18/genes-to-global-solutions\" target=\"_blank\" rel=\"noopener\">pioneered the technology\u003c/a> in 2012, when a team led by biochemist \u003ca href=\"http://doudnalab.org/\" target=\"_blank\" rel=\"noopener\">Jennifer Doudna\u003c/a> reported that they had successfully developed a “programmable” genome-editing tool that makes highly targeted alterations to the genome of a plant or animal. A team at the \u003ca href=\"https://www.broadinstitute.org/\" target=\"_blank\" rel=\"noopener\">Broad Institute\u003c/a>, owned jointly by Harvard University and the Massachusetts Institute, was also researching the technology during the same period.\u003c/p>\n\u003cp>Commonly known as CRISPR—an acronym for Clustered Regularly Interspaced Short Palindromic Repeats, the groundbreaking technology offers a method to fix genes in living things. It could be used to develop everything from drought-resistant crops, to new treatments for genetic disorders and cancers.\u003c/p>\n\u003cp>UC Berkeley is in a \u003ca href=\"https://www.kqed.org/futureofyou/372137/uc-berkeley-renews-legal-fight-over-crispr-cas9-patent-rights\" target=\"_blank\" rel=\"noopener\">legal fight\u003c/a> with the Broad Institute over the patent rights to CRISPR. UC Berkeley filed its patent application before Broad did, but Broad fast-tracked its application.\u003c/p>\n\u003cp>The United States Patent and Trademark Office in February 2017 \u003ca href=\"https://www.kqed.org/futureofyou/338066/broad-institute-wins-decision-over-uc-berkeley-in-crispr-patent-battle\" target=\"_blank\" rel=\"noopener\">awarded a patent\u003c/a> to Broad for CRISPR's use in plant and animal cells, and a pending patent to UC Berkeley for CRISPR's use in bacterial cells. The UC appealed in April 2017, arguing its scientists were the first inventors of the technology.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>The patent granted to UC Berkeley on Tuesday focuses on using the tool to edit single-stranded RNA, according to \u003ca href=\"https://www.statnews.com/2018/06/13/university-of-california-granted-a-key-crispr-patent/\" target=\"_blank\" rel=\"noopener\">a \u003cem>STAT News \u003c/em>report\u003c/a>. The federal agency will reportedly award a second patent next week. That patent, reports STAT, will focus on using the tool to edit regions specifically 10 to 15 base pairs long.\u003c/p>\n\u003cp>Some experts are downplaying the patents' significance.\u003c/p>\n\u003cp>According to New York Law School associate professor Jacob Sherkow, who spoke with\u003ca href=\"https://www.statnews.com/2018/06/13/university-of-california-granted-a-key-crispr-patent/\" target=\"_blank\" rel=\"noopener\">\u003cem> STAT\u003c/em>\u003c/a>, the second patent will likely have “pretty minimal” commercial value.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The USPTO has so far granted more than \u003ca href=\"https://www.broadinstitute.org/crispr/journalists-statement-and-background-crispr-patent-process\" target=\"_blank\" rel=\"noopener\">60 CRISPR-related patents\u003c/a> to inventors from 18 organizations, according to the Broad Institute.\u003c/p>\n\u003cp>Meanwhile, news of the university's patent awards come as two new \u003ca href=\"https://www.nature.com/articles/s41591-018-0050-6.epdf\" target=\"_blank\" rel=\"noopener\">studies\u003c/a> published on Monday caution that gene cells edited with CRISPR-Cas9 \u003ca href=\"https://www.kqed.org/futureofyou/442526/major-hurdle-for-crispr-edited-cells-might-cause-cancer-find-two-studies\" target=\"_blank\" rel=\"noopener\">may be linked\u003c/a> to cancer.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Does Vitamin D Really Protect Against Colorectal Cancer?",
"title": "Does Vitamin D Really Protect Against Colorectal Cancer?",
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"content": "\u003cp>It's been clear for many years that vitamin D helps keep bones strong, but studies have been inconclusive and conflicting about the vitamin's value in protecting against certain cancers, including \u003ca href=\"https://www.cancer.gov/types/colorectal\" target=\"_blank\" rel=\"noopener\">colorectal cancer\u003c/a>.[contextly_sidebar id=\"9k4uFVtwqiLPQYTYxUgc0nIsJORbVOWp\"]\u003c/p>\n\u003cp>Now a large international \u003ca href=\"https://academic.oup.com/jnci/article-lookup/doi/10.1093/jnci/djy087\" target=\"_blank\" rel=\"noopener\">study\u003c/a> provides the strongest evidence yet that vitamin D may indeed be protective against colorectal cancer and that a deficiency may increase the risk of this cancer. The findings appear Thursday in the \u003cem>Journal of the National Cancer Institute\u003c/em>.\u003c/p>\n\u003cp>\"For both men and women, deficient levels of vitamin D were associated with a 30 percent increased risk of colorectal cancer,\" says \u003ca href=\"https://www.cancer.org/research/acs-researchers/marjorie-mccullough-bio.html\" target=\"_blank\" rel=\"noopener\">Marji McCullough\u003c/a>, a nutritional epidemiologist with the American Cancer Society and study co-author. People who had higher circulating blood levels of vitamin D\u003cstrong>, \u003c/strong>above the range deemed \"sufficient,\" had a 22 percent lower risk, she says.\u003c/p>\n\u003cp>The study pooled findings from 17 previous studies that included 12,813 adults in the U.S., Europe and Asia. Those studies collectively looked at 5,706 people with colorectal cancer and 7,107 people of a similar age and race who didn't have cancer. Women's menopausal status was also taken into account.\u003c/p>\n\u003cp>To determine what role vitamin D might be playing, researchers looked at participants' blood samples collected in the years before their cancer diagnosis. They also considered the established risk factors for colorectal cancer, including smoking, low physical activity and high body mass index.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"Our findings suggest what's optimal for bone health may not be optimal for colorectal risk reduction,\" McCullough says, which could mean higher doses are needed to prevent cancer. Current recommendations for vitamin D supplementation are based solely on studies showing conclusively that it does preserve bone health.\u003c/p>\n\u003cp>A particularly provocative finding of the study, McCullough says, is the relatively strong correlation between higher blood levels of vitamin D and lower risk of colorectal cancer in women.\u003c/p>\n\u003cp>\"We don't know why,\" she says. One hypothesis is that there is some interaction between vitamin D and female hormones. Or it's possible vitamin D prevents cancer by reducing the proliferation of tumor cells or by stopping their growth and \"actually killing those cells,\" she says.\u003c/p>\n\u003cp>Studies like this do not prove cause and effect but rather show only that there may be a connection between the levels of vitamin D circulating through the body and cancer. Still, the authors of the paper write that the results \"substantially strengthen the evidence, previously considered inconclusive, for a causal relationship\" between low vitamin D levels and colorectal cancer.[contextly_sidebar id=\"MAqLylPcwu1QCC3r4WiQXhzaSDOZfRPb\"]\u003c/p>\n\u003cp>Another interesting observation in the study, McCullough says, was that beyond a certain level, increasingly higher amounts of vitamin D in the blood had no additional benefit. At the highest levels above what is considered \"adequate,\" there was no further reduction in risk. In other words, she says, \"more is not necessarily better.\"\u003c/p>\n\u003cp>Her take-home message: Don't race out and buy high doses of vitamin D \"just in case.\" Overdoing it can be toxic. Taking too much vitamin D can cause kidney stones and, in very rare cases, death.\u003c/p>\n\u003cp>The issue of whether vitamin D supplements should be used at all to prevent colorectal cancer is still up in the air. \"The key question now is whether intervening with people who have low levels of vitamin D can make a difference,\" says \u003ca href=\"http://www.dana-farber.org/find-a-doctor/jeffrey-a-meyerhardt/\" target=\"_blank\" rel=\"noopener\">Dr. Jeffrey Meyerhardt\u003c/a>, director of the Gastrointestinal Cancer Center at Dana-Farber Cancer Institute in Boston, who was not involved in the study.\u003c/p>\n\u003cp>The study didn't evaluate whether adding vitamin D through food, sunlight or supplements made a difference in cancer risk. It was limited to looking at the level of vitamin D in people's blood.\u003c/p>\n\u003cp>Currently, a large \u003ca href=\"https://www.vitalstudy.org/\" target=\"_blank\" rel=\"noopener\">study\u003c/a> involving more than 25,000 patients is underway at Brigham and Women's Hospital in Boston to find out whether taking vitamin D supplements might reduce the risk of numerous cancers as well as heart disease and stroke. Meyerhardt says answers may be available in the coming year.\u003c/p>\n\u003cp>In the meantime, he suggests people talk with their health care provider about having a blood test to measure vitamin D levels. If you're starting in the deficient range, he says, some doctors might prescribe high doses, to be taken each week for a month or two, and then prescribe lower, maintenance levels.[contextly_sidebar id=\"x4oXchtt2cZV7lIWDVrGT7XXeJne7cWq\"]\u003c/p>\n\u003cp>The cancer society's McCullough says it is generally \u003ca href=\"https://www.bones.nih.gov/health-info/bone/bone-health/nutrition/calcium-and-vitamin-d-important-every-age\" target=\"_blank\" rel=\"noopener\">recommended\u003c/a> that adults have a daily intake of 600 international units of vitamin D up to age 70. Men and women over age 70 should increase their uptake to 800 IUs daily, she says.\u003c/p>\n\u003cp>People should talk with their doctor because different individuals have different needs, she says.\u003c/p>\n\u003cp>\"It depends on where you live and what race you are, because darker skin tends to absorb less vitamin D.\" Sun, age, genetics and weight also play a role in how the body processes vitamin D.\u003c/p>\n\u003cp>Vitamin D can be obtained from vitamin D-rich foods such as egg yolks, salmon, trout, swordfish, tuna and sardines. Numerous foods are fortified with vitamin D including cow's milk, almond milk, soy milk, some cereals and some orange juices.\u003c/p>\n\u003cp>\"If you have a serving of salmon, that's about 500 IUs, and a cup of milk would give you 100 IUs,\" McCullough says, which adds up to the daily recommended dose of 600 IUs.\u003c/p>\n\u003cp>But Meyerhardt says most people don't eat enough fatty fish to reach the recommended vitamin D intake.\u003c/p>\n\u003cp>\"Most vitamin D doesn't really come from your diet\" in most cases, he says. And he says multivitamins contain relatively low levels of vitamin D. \"So you really have to take a supplement\" to meet recommended doses.\u003c/p>\n\u003cp>Vitamin D is often called the \"sunshine\" vitamin, because exposure to sunlight can stimulate production of the vitamin. But exposure to sun is generally not recommended as a way to boost vitamin D, McCullough says, since at excessive levels it can raise the risk of melanoma and other skin cancers.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>More than 20 medical centers and organizations participated in the study, including Harvard, the American Cancer Society and the National Cancer Institute.\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=Does+Vitamin+D+Really+Protect+Against+Colorectal+Cancer%3F&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"excerpt": "The jury's been out on whether low blood levels of vitamin D increase the risk of colorectal cancer. Researchers say a new review involving more than 12,000 people strongly suggests the answer is yes.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>It's been clear for many years that vitamin D helps keep bones strong, but studies have been inconclusive and conflicting about the vitamin's value in protecting against certain cancers, including \u003ca href=\"https://www.cancer.gov/types/colorectal\" target=\"_blank\" rel=\"noopener\">colorectal cancer\u003c/a>.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Now a large international \u003ca href=\"https://academic.oup.com/jnci/article-lookup/doi/10.1093/jnci/djy087\" target=\"_blank\" rel=\"noopener\">study\u003c/a> provides the strongest evidence yet that vitamin D may indeed be protective against colorectal cancer and that a deficiency may increase the risk of this cancer. The findings appear Thursday in the \u003cem>Journal of the National Cancer Institute\u003c/em>.\u003c/p>\n\u003cp>\"For both men and women, deficient levels of vitamin D were associated with a 30 percent increased risk of colorectal cancer,\" says \u003ca href=\"https://www.cancer.org/research/acs-researchers/marjorie-mccullough-bio.html\" target=\"_blank\" rel=\"noopener\">Marji McCullough\u003c/a>, a nutritional epidemiologist with the American Cancer Society and study co-author. People who had higher circulating blood levels of vitamin D\u003cstrong>, \u003c/strong>above the range deemed \"sufficient,\" had a 22 percent lower risk, she says.\u003c/p>\n\u003cp>The study pooled findings from 17 previous studies that included 12,813 adults in the U.S., Europe and Asia. Those studies collectively looked at 5,706 people with colorectal cancer and 7,107 people of a similar age and race who didn't have cancer. Women's menopausal status was also taken into account.\u003c/p>\n\u003cp>To determine what role vitamin D might be playing, researchers looked at participants' blood samples collected in the years before their cancer diagnosis. They also considered the established risk factors for colorectal cancer, including smoking, low physical activity and high body mass index.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"Our findings suggest what's optimal for bone health may not be optimal for colorectal risk reduction,\" McCullough says, which could mean higher doses are needed to prevent cancer. Current recommendations for vitamin D supplementation are based solely on studies showing conclusively that it does preserve bone health.\u003c/p>\n\u003cp>A particularly provocative finding of the study, McCullough says, is the relatively strong correlation between higher blood levels of vitamin D and lower risk of colorectal cancer in women.\u003c/p>\n\u003cp>\"We don't know why,\" she says. One hypothesis is that there is some interaction between vitamin D and female hormones. Or it's possible vitamin D prevents cancer by reducing the proliferation of tumor cells or by stopping their growth and \"actually killing those cells,\" she says.\u003c/p>\n\u003cp>Studies like this do not prove cause and effect but rather show only that there may be a connection between the levels of vitamin D circulating through the body and cancer. Still, the authors of the paper write that the results \"substantially strengthen the evidence, previously considered inconclusive, for a causal relationship\" between low vitamin D levels and colorectal cancer.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Another interesting observation in the study, McCullough says, was that beyond a certain level, increasingly higher amounts of vitamin D in the blood had no additional benefit. At the highest levels above what is considered \"adequate,\" there was no further reduction in risk. In other words, she says, \"more is not necessarily better.\"\u003c/p>\n\u003cp>Her take-home message: Don't race out and buy high doses of vitamin D \"just in case.\" Overdoing it can be toxic. Taking too much vitamin D can cause kidney stones and, in very rare cases, death.\u003c/p>\n\u003cp>The issue of whether vitamin D supplements should be used at all to prevent colorectal cancer is still up in the air. \"The key question now is whether intervening with people who have low levels of vitamin D can make a difference,\" says \u003ca href=\"http://www.dana-farber.org/find-a-doctor/jeffrey-a-meyerhardt/\" target=\"_blank\" rel=\"noopener\">Dr. Jeffrey Meyerhardt\u003c/a>, director of the Gastrointestinal Cancer Center at Dana-Farber Cancer Institute in Boston, who was not involved in the study.\u003c/p>\n\u003cp>The study didn't evaluate whether adding vitamin D through food, sunlight or supplements made a difference in cancer risk. It was limited to looking at the level of vitamin D in people's blood.\u003c/p>\n\u003cp>Currently, a large \u003ca href=\"https://www.vitalstudy.org/\" target=\"_blank\" rel=\"noopener\">study\u003c/a> involving more than 25,000 patients is underway at Brigham and Women's Hospital in Boston to find out whether taking vitamin D supplements might reduce the risk of numerous cancers as well as heart disease and stroke. Meyerhardt says answers may be available in the coming year.\u003c/p>\n\u003cp>In the meantime, he suggests people talk with their health care provider about having a blood test to measure vitamin D levels. If you're starting in the deficient range, he says, some doctors might prescribe high doses, to be taken each week for a month or two, and then prescribe lower, maintenance levels.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The cancer society's McCullough says it is generally \u003ca href=\"https://www.bones.nih.gov/health-info/bone/bone-health/nutrition/calcium-and-vitamin-d-important-every-age\" target=\"_blank\" rel=\"noopener\">recommended\u003c/a> that adults have a daily intake of 600 international units of vitamin D up to age 70. Men and women over age 70 should increase their uptake to 800 IUs daily, she says.\u003c/p>\n\u003cp>People should talk with their doctor because different individuals have different needs, she says.\u003c/p>\n\u003cp>\"It depends on where you live and what race you are, because darker skin tends to absorb less vitamin D.\" Sun, age, genetics and weight also play a role in how the body processes vitamin D.\u003c/p>\n\u003cp>Vitamin D can be obtained from vitamin D-rich foods such as egg yolks, salmon, trout, swordfish, tuna and sardines. Numerous foods are fortified with vitamin D including cow's milk, almond milk, soy milk, some cereals and some orange juices.\u003c/p>\n\u003cp>\"If you have a serving of salmon, that's about 500 IUs, and a cup of milk would give you 100 IUs,\" McCullough says, which adds up to the daily recommended dose of 600 IUs.\u003c/p>\n\u003cp>But Meyerhardt says most people don't eat enough fatty fish to reach the recommended vitamin D intake.\u003c/p>\n\u003cp>\"Most vitamin D doesn't really come from your diet\" in most cases, he says. And he says multivitamins contain relatively low levels of vitamin D. \"So you really have to take a supplement\" to meet recommended doses.\u003c/p>\n\u003cp>Vitamin D is often called the \"sunshine\" vitamin, because exposure to sunlight can stimulate production of the vitamin. But exposure to sun is generally not recommended as a way to boost vitamin D, McCullough says, since at excessive levels it can raise the risk of melanoma and other skin cancers.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe src=\"https://www.npr.org/player/embed/618870881/618969757\" width=\"100%\" height=\"290\" frameborder=\"0\" scrolling=\"no\" title=\"NPR embedded audio player\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>As a science columnist for\u003cem> The New York Times, \u003c/em>Carl Zimmer had reported extensively about genetics and the role gene mutations play in various ailments. After a while, he got to wondering about what secrets his own genetic code holds.[contextly_sidebar id=\"AyWMyOjcCCjd9Wr45bM9omzK5fGeueow\"]\u003c/p>\n\u003cp>\"I wanted to know if there was anything I needed to worry about,\" Zimmer says. \"We all think back to our relatives who got sick and then wonder, 'Is that in me?'\"\u003c/p>\n\u003cp>So Zimmer worked with a genetics counselor to get his entire genome sequenced — an experience he describes as \"very nerve-wracking.\" He worried that he would discover a mutation that would put him on the path for a particular disease.\u003c/p>\n\u003cp>As it turned out, the counselor told Zimmer he has a \"boring genome.\" Though Zimmer initially hoped for a more \"exciting and exotic\" assessment, the counselor reminded him \"A boring genome is a really good genome.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Zimmer writes about the broader implications of genetic research and testing in his new book, \u003cem>She Has Her Mother's Laugh: The Powers, Perversions and Potential of Heredity\u003c/em>.[contextly_sidebar id=\"YtqF4uhyPE2pCelB55bttG0XpqJfRSq3\"]\u003c/p>\n\u003chr>\n\u003cp>\u003cstrong>Interview Highlights\u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>On how the new genetic editing technology known as \u003ca href=\"https://www.npr.org/tags/419142387/crispr\" target=\"_blank\" rel=\"noopener\">CRISPR\u003c/a> works\u003c/strong>\u003c/p>\n\u003cp>What happens with CRISPR is that scientists will design a molecule — think of it as a probe — and it will search around in the DNA in a cell until if finds a very specific short sequence. And it will grab onto it, and it brings on with it basically molecular scissors, which will then cut the DNA at that spot — kind of like cutting tape. And you can cut out a segment of DNA. And if you just do that, DNA will heal itself. Basically the two loose ends will stitch themselves together, and now that piece is just missing. Or you can add in a little piece of different DNA, and you can actually get the cell to put in that new piece of DNA where you just cut out the old one.\u003c/p>\n\u003cp>\u003cstrong>On whether CRISPR technology could be used to treat diseases in humans\u003c/strong>\u003c/p>\n\u003cp>We're just on the verge of human trials. They will be starting, hopefully very soon, for diseases like sickle-cell anemia. There's actually a lot of research on muscular dystrophy as well. There are a few key diseases where scientists think these would be the best places to start. To basically inject CRISPR molecules into people's bodies; these CRISPR molecules would then go to certain kinds of cells and repair one particular spot in their DNA. And that treats the disease.\u003c/p>\n\u003cp>We shouldn't look at this as a panacea. ... There have been earlier kinds of treatments known as gene therapy, where you basically try to add an extra gene into someone's cells. And that [seemed] like it was just a slam dunk, but then it turned out to not work very well for years and years. ... So CRISPR could be even more exciting and truly revolutionary. We just have to wait and see what this first generation of human clinical trials show us.\u003c/p>\n\u003cp>\u003cstrong>On his visit to an insectarium where a scientist is breeding genetically modified mosquitoes that are resistant to malaria\u003c/strong>\u003c/p>\n\u003cp>First of all, you have to gown up before you go in there. ... And then you go through an air lock, and then you're in this room where there are mosquitoes living in all their different life cycles.\u003c/p>\n\u003cp>So there's a dark room where the female mosquitoes are laying their eggs, because they like to do it in the dark. And then the scientists pull the eggs out from these rooms and they inject DNA into them and then they put them in water, because that's where mosquito larvae like to develop.\u003c/p>\n\u003cp>And so you go into this other room where there are these tubs of water, and these snake-like things are slithering around in there and then they develop into adults. And the females need to drink blood; so [researchers] found that the containers for movie popcorn work really well. What they do is, they basically clamp a warm container of calves' blood on top of them, and then the mosquitoes are underneath — on the underside of the plastic lid — basically poking through and drinking the blood and fattening themselves up. ...\u003c/p>\n\u003cp>You can tell that they've been genetically altered because they have red eyes, which is kind of spooky. But you look at that and you say, well, that means that these could be the cure for malaria. It really could happen. And hundreds of thousands of people die every year of malaria. We've thrown everything we can at it and this parasite is still knocking us down worldwide. So, maybe this could be it – so, that's actually quite exciting.\u003c/p>\n\u003cp>\u003cstrong>On how genetic testing was used in the Golden State Killer case\u003c/strong>\u003c/p>\n\u003cp>For the \u003ca href=\"https://www.npr.org/sections/thetwo-way/2018/04/27/606624218/in-hunt-for-golden-state-killer-investigators-uploaded-his-dna-to-genealogy-site\" target=\"_blank\" rel=\"noopener\">Golden State Killer case\u003c/a>, what somebody decided to do was take the DNA that they had from these crime scenes, and upload it to one of these open-access sites — not a commercial site — and then see if they could find any close matches. And they found that there were some people that looked like they were distant cousins of this person. And they went and did the genealogical research to figure out \"Well, how would they be related?\" And then said \"OK, who are the possible relatives that this person could be, and where do they live?\" And that actually helped narrow down their search until they made an arrest.\u003c/p>\n\u003cp>\u003cstrong>On whether genetic testing companies will protect user privacy\u003c/strong>\u003c/p>\n\u003cp>You can choose different levels of privacy with a lot of these services. So, for example, some people will say \"I want you to look at my DNA. I want you to tell me about my ancestry.\" ... For 23 and Me they'll give you a few bits of information about your medical conditions, and that's it. But they will try to get you to opt in to sharing your data for their own basic research. At 23 and Me, for example, there's a whole team of researchers who are studying all sorts of ... diseases, sleep patterns and so on. And then they will also go into partnerships with drug development companies who will take their data, looking at, say, 50,000 people with lupus and 50,000 people who don't have lupus, and try to look for the genetic differences. Those could point the way toward possible drugs.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Phyllis Myers and Seth Kelley produced and edited the audio of this interview. Bridget Bentz and Seth Kelley adapted it for the Web.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 Fresh Air. To see more, visit \u003ca href=\"http://www.npr.org/programs/fresh-air/\">Fresh Air\u003c/a>.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=A+Science+Writer+Explores+The+%27Perversions+And+Potential%27+Of+Genetic+Tests&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"excerpt": "Carl Zimmer wondered what secrets lurked in his genetic code — so he decided to have his genome sequenced. He writes about the implications of the study of genetics in \u003cem>She Has Her Mother's Laugh.\u003c/em>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe src=\"https://www.npr.org/player/embed/618870881/618969757\" width=\"100%\" height=\"290\" frameborder=\"0\" scrolling=\"no\" title=\"NPR embedded audio player\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>As a science columnist for\u003cem> The New York Times, \u003c/em>Carl Zimmer had reported extensively about genetics and the role gene mutations play in various ailments. After a while, he got to wondering about what secrets his own genetic code holds.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"I wanted to know if there was anything I needed to worry about,\" Zimmer says. \"We all think back to our relatives who got sick and then wonder, 'Is that in me?'\"\u003c/p>\n\u003cp>So Zimmer worked with a genetics counselor to get his entire genome sequenced — an experience he describes as \"very nerve-wracking.\" He worried that he would discover a mutation that would put him on the path for a particular disease.\u003c/p>\n\u003cp>As it turned out, the counselor told Zimmer he has a \"boring genome.\" Though Zimmer initially hoped for a more \"exciting and exotic\" assessment, the counselor reminded him \"A boring genome is a really good genome.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Zimmer writes about the broader implications of genetic research and testing in his new book, \u003cem>She Has Her Mother's Laugh: The Powers, Perversions and Potential of Heredity\u003c/em>.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003chr>\n\u003cp>\u003cstrong>Interview Highlights\u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>On how the new genetic editing technology known as \u003ca href=\"https://www.npr.org/tags/419142387/crispr\" target=\"_blank\" rel=\"noopener\">CRISPR\u003c/a> works\u003c/strong>\u003c/p>\n\u003cp>What happens with CRISPR is that scientists will design a molecule — think of it as a probe — and it will search around in the DNA in a cell until if finds a very specific short sequence. And it will grab onto it, and it brings on with it basically molecular scissors, which will then cut the DNA at that spot — kind of like cutting tape. And you can cut out a segment of DNA. And if you just do that, DNA will heal itself. Basically the two loose ends will stitch themselves together, and now that piece is just missing. Or you can add in a little piece of different DNA, and you can actually get the cell to put in that new piece of DNA where you just cut out the old one.\u003c/p>\n\u003cp>\u003cstrong>On whether CRISPR technology could be used to treat diseases in humans\u003c/strong>\u003c/p>\n\u003cp>We're just on the verge of human trials. They will be starting, hopefully very soon, for diseases like sickle-cell anemia. There's actually a lot of research on muscular dystrophy as well. There are a few key diseases where scientists think these would be the best places to start. To basically inject CRISPR molecules into people's bodies; these CRISPR molecules would then go to certain kinds of cells and repair one particular spot in their DNA. And that treats the disease.\u003c/p>\n\u003cp>We shouldn't look at this as a panacea. ... There have been earlier kinds of treatments known as gene therapy, where you basically try to add an extra gene into someone's cells. And that [seemed] like it was just a slam dunk, but then it turned out to not work very well for years and years. ... So CRISPR could be even more exciting and truly revolutionary. We just have to wait and see what this first generation of human clinical trials show us.\u003c/p>\n\u003cp>\u003cstrong>On his visit to an insectarium where a scientist is breeding genetically modified mosquitoes that are resistant to malaria\u003c/strong>\u003c/p>\n\u003cp>First of all, you have to gown up before you go in there. ... And then you go through an air lock, and then you're in this room where there are mosquitoes living in all their different life cycles.\u003c/p>\n\u003cp>So there's a dark room where the female mosquitoes are laying their eggs, because they like to do it in the dark. And then the scientists pull the eggs out from these rooms and they inject DNA into them and then they put them in water, because that's where mosquito larvae like to develop.\u003c/p>\n\u003cp>And so you go into this other room where there are these tubs of water, and these snake-like things are slithering around in there and then they develop into adults. And the females need to drink blood; so [researchers] found that the containers for movie popcorn work really well. What they do is, they basically clamp a warm container of calves' blood on top of them, and then the mosquitoes are underneath — on the underside of the plastic lid — basically poking through and drinking the blood and fattening themselves up. ...\u003c/p>\n\u003cp>You can tell that they've been genetically altered because they have red eyes, which is kind of spooky. But you look at that and you say, well, that means that these could be the cure for malaria. It really could happen. And hundreds of thousands of people die every year of malaria. We've thrown everything we can at it and this parasite is still knocking us down worldwide. So, maybe this could be it – so, that's actually quite exciting.\u003c/p>\n\u003cp>\u003cstrong>On how genetic testing was used in the Golden State Killer case\u003c/strong>\u003c/p>\n\u003cp>For the \u003ca href=\"https://www.npr.org/sections/thetwo-way/2018/04/27/606624218/in-hunt-for-golden-state-killer-investigators-uploaded-his-dna-to-genealogy-site\" target=\"_blank\" rel=\"noopener\">Golden State Killer case\u003c/a>, what somebody decided to do was take the DNA that they had from these crime scenes, and upload it to one of these open-access sites — not a commercial site — and then see if they could find any close matches. And they found that there were some people that looked like they were distant cousins of this person. And they went and did the genealogical research to figure out \"Well, how would they be related?\" And then said \"OK, who are the possible relatives that this person could be, and where do they live?\" And that actually helped narrow down their search until they made an arrest.\u003c/p>\n\u003cp>\u003cstrong>On whether genetic testing companies will protect user privacy\u003c/strong>\u003c/p>\n\u003cp>You can choose different levels of privacy with a lot of these services. So, for example, some people will say \"I want you to look at my DNA. I want you to tell me about my ancestry.\" ... For 23 and Me they'll give you a few bits of information about your medical conditions, and that's it. But they will try to get you to opt in to sharing your data for their own basic research. At 23 and Me, for example, there's a whole team of researchers who are studying all sorts of ... diseases, sleep patterns and so on. And then they will also go into partnerships with drug development companies who will take their data, looking at, say, 50,000 people with lupus and 50,000 people who don't have lupus, and try to look for the genetic differences. Those could point the way toward possible drugs.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Phyllis Myers and Seth Kelley produced and edited the audio of this interview. Bridget Bentz and Seth Kelley adapted it for the Web.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 Fresh Air. To see more, visit \u003ca href=\"http://www.npr.org/programs/fresh-air/\">Fresh Air\u003c/a>.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=A+Science+Writer+Explores+The+%27Perversions+And+Potential%27+Of+Genetic+Tests&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "From Chaos To Calm: A Life Changed By Ketamine",
"title": "From Chaos To Calm: A Life Changed By Ketamine",
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"content": "\u003cp>For six years now, life has been really good for James. He has a great job as the creative director of an advertising firm in New York City. He enjoys spending time with his wife and kids.[contextly_sidebar id=\"s4NBmRFOwEaVfa4ea1pL5Kssair4SGBs\"]\u003c/p>\n\u003cp>And it has all been possible, he says, because for the past six years he has been taking a drug called\u003ca href=\"https://www.npr.org/sections/health-shots/2015/09/28/443203592/club-drug-ketamine-gains-traction-as-a-treatment-for-depression\" target=\"_blank\" rel=\"noopener\"> ketamine\u003c/a>.\u003c/p>\n\u003cp>Before ketamine, James was unable to work or focus his thoughts. His mind was filled with violent images. And his mood could go from ebullient to dark in a matter of minutes.\u003c/p>\n\u003cp>Ketamine \"helped me get my life back,\" says James, who asked that we not use his last name to protect his career.\u003c/p>\n\u003cp>Ketamine was developed as a human and animal anesthetic in the 1960s. And almost from the time it reached the market it has also been used as a mind-bending party drug.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But ketamine's story took a surprising turn in 2006, when researchers at the National Institutes of Health \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/16894061\">showed\u003c/a> that an intravenous dose could relieve severe depression in a matter of hours. Since then, doctors have prescribed ketamine \"off label\" to \u003ca href=\"https://www.npr.org/sections/health-shots/2017/03/20/520169959/ketamine-for-severe-depression-how-do-you-not-offer-this-drug-to-people\" target=\"_blank\" rel=\"noopener\">thousands of depressed patients\u003c/a> who don't respond to other drugs.\u003c/p>\n\u003cp>And pharmaceutical companies are \u003ca href=\"https://www.npr.org/sections/health-shots/2015/05/28/409800015/ketamine-depression-treatments-inspired-by-club-drug-move-ahead-in-tests\" target=\"_blank\" rel=\"noopener\">testing\u003c/a> several new ketamine-related drugs to treat depression. Johnson & Johnson expects to seek approval for its nasal spray \u003ca href=\"https://www.jnj.com/media-center/press-releases/new-phase-3-data-show-esketamine-nasal-spray-demonstrated-rapid-improvements-in-depressive-symptoms-in-patients-with-treatment-resistant-depression\" target=\"_blank\" rel=\"noopener\">esketamine\u003c/a> later this year, though the approval would be limited to use in a clinical setting.[contextly_sidebar id=\"WxNsPZS18b7j3a9u3SqMCjwKimnR3LX8\"]\u003c/p>\n\u003cp>Meanwhile, doctors have begun trying ketamine on patients with a wide range of psychiatric disorders other than depression. And there is now growing evidence it can help people with anxiety, bipolar disorder, post-traumatic stress disorder, and perhaps even obsessive-compulsive disorder.\u003c/p>\n\u003cp>\"I think it's actually one of the biggest advances in psychiatry in a very long time,\" says Dr. \u003ca href=\"https://www.mcleanhospital.org/biography/martin-teicher\" target=\"_blank\" rel=\"noopener\">Martin Teicher\u003c/a>, an associate professor of psychiatry at Harvard Medical School and director of the Developmental Biopsychiatry Research Program at McLean Hospital.\u003c/p>\n\u003cp>Ketamine may also offer new hope for people like James who have symptoms of several different psychiatric disorders.\u003c/p>\n\u003cp>James had a happy childhood, he says. But his thoughts were out of control. \"I always felt like I was crossing a freeway and my thoughts were just racing past me,\" he says.\u003c/p>\n\u003cp>He spent much of his childhood terrified of \"an unknown, an ambiguous force out there.\" The fear was \"overwhelming,\" he says. \"I literally slept with the cover over my head with just room to breathe through my mouth until I went to college.\"\u003c/p>\n\u003cp>And there was something else about James: his body temperature.\u003c/p>\n\u003cp>\"I overheated constantly,\" he says. \"I would wear shorts all year long. In my 20s in my apartment I would sleep with the windows open in the middle of the winter.\"\u003c/p>\n\u003cp>In his late 20s, James saw a doctor who told him he had attention deficit hyperactivity disorder. So he started taking stimulants.[contextly_sidebar id=\"IjfTHMEjzV27TicYbrGolDFdASO5y6qG\"]\u003c/p>\n\u003cp>At first, the pills helped him focus. Then they didn't, no matter how many he took.\u003c/p>\n\u003cp>He'd done well as an idea guy in the advertising industry. But now James was trying to work at home, and it wasn't going well.\u003c/p>\n\u003cp>\"ADHD pills will make you interested in anything,\" he says. \"So I was putting the desk together and taking the desk apart. I was putting a laptop stand together and taking it apart. I was going in a massive downward spiral.\"\u003c/p>\n\u003cp>James had always suffered from mood swings. But now they were rapid and extreme. And he couldn't stop thinking about gruesome scenarios, like a murderer coming for his family.\u003c/p>\n\u003cp>\"My wife took a summer off to be with me because she was scared of what was going to happen to me,\" he says. \"She would go to work for a few hours, then rush home. There would be times I'd call her just screaming, 'Please come home. I can't get through another minute.' \"\u003c/p>\n\u003cp>Eventually, James found his way to Dr. \u003ca href=\"http://bipolarchild.com/about/authors/\" target=\"_blank\" rel=\"noopener\">Demitri Papolos\u003c/a>, an associate professor of clinical psychiatry at Albert Einstein College of Medicine.\u003c/p>\n\u003cp>\"He was like a whirling dervish when he came into my office,\" Papolos says. \"He was extremely fearful and scanning the environment all the time and he overheated at the drop of a hat.\"\u003c/p>\n\u003cp>Papolos diagnosed James with a variant of bipolar disorder he calls the \"fear of harm phenotype.\" It typically appears in childhood and often doesn't respond to traditional psychiatric drugs.[contextly_sidebar id=\"ONPRitNVz88O9pFNNVQ7htlsCs7xWv0w\"]\u003c/p>\n\u003cp>But Papolos has found that the condition does respond to ketamine. \"It's been transformational,\" he says.\u003c/p>\n\u003cp>In January, Papolos published a \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/28866299\">study\u003c/a> of 45 children with the problem. They inhaled a nasal mist containing ketamine about twice a week. Nearly all got dramatically better.\u003c/p>\n\u003cp>Scientists still aren't sure why ketamine works, but there's \u003ca href=\"https://www.npr.org/sections/health-shots/2012/10/04/162299564/ketamine-relieves-depression-by-restoring-brain-connections\" target=\"_blank\" rel=\"noopener\">evidence\u003c/a> that it encourages the brain to rewire, to alter the connections between cells. That process has been linked to recovery from depression. And it may also explain why ketamine helps people who have symptoms associated with several different psychiatric disorders.\u003c/p>\n\u003cp>\"I think it's having multiple effects, and that means it's probably useful for multiple different disorders,\" Teicher says.\u003c/p>\n\u003cp>One of those effects involves a part of the brain involved in temperature regulation. And that could explain why patients like James usually stop overheating once they are taking ketamine.\u003c/p>\n\u003cp>James started taking a ketamine nasal spray every other day. He says his response was dramatic.\u003c/p>\n\u003cp>\"One day I turn to my wife and I'm like, 'I feel calm today. I don't know if it's the sun coming in, I don't know if it's just the way we're sitting here, but I feel like I could go and sit at the computer and work.' \"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The next day, James did sit down at his computer. A month later, he was back at work.\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=From+Chaos+To+Calm%3A+A+Life+Changed+By+Ketamine&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"excerpt": "The anesthetic ketamine first wowed the medical world with its ability to relieve severe depression in hours. Now it's showing promise for other psychiatric disorders, including bipolar and PTSD.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>For six years now, life has been really good for James. He has a great job as the creative director of an advertising firm in New York City. He enjoys spending time with his wife and kids.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>And it has all been possible, he says, because for the past six years he has been taking a drug called\u003ca href=\"https://www.npr.org/sections/health-shots/2015/09/28/443203592/club-drug-ketamine-gains-traction-as-a-treatment-for-depression\" target=\"_blank\" rel=\"noopener\"> ketamine\u003c/a>.\u003c/p>\n\u003cp>Before ketamine, James was unable to work or focus his thoughts. His mind was filled with violent images. And his mood could go from ebullient to dark in a matter of minutes.\u003c/p>\n\u003cp>Ketamine \"helped me get my life back,\" says James, who asked that we not use his last name to protect his career.\u003c/p>\n\u003cp>Ketamine was developed as a human and animal anesthetic in the 1960s. And almost from the time it reached the market it has also been used as a mind-bending party drug.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But ketamine's story took a surprising turn in 2006, when researchers at the National Institutes of Health \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/16894061\">showed\u003c/a> that an intravenous dose could relieve severe depression in a matter of hours. Since then, doctors have prescribed ketamine \"off label\" to \u003ca href=\"https://www.npr.org/sections/health-shots/2017/03/20/520169959/ketamine-for-severe-depression-how-do-you-not-offer-this-drug-to-people\" target=\"_blank\" rel=\"noopener\">thousands of depressed patients\u003c/a> who don't respond to other drugs.\u003c/p>\n\u003cp>And pharmaceutical companies are \u003ca href=\"https://www.npr.org/sections/health-shots/2015/05/28/409800015/ketamine-depression-treatments-inspired-by-club-drug-move-ahead-in-tests\" target=\"_blank\" rel=\"noopener\">testing\u003c/a> several new ketamine-related drugs to treat depression. Johnson & Johnson expects to seek approval for its nasal spray \u003ca href=\"https://www.jnj.com/media-center/press-releases/new-phase-3-data-show-esketamine-nasal-spray-demonstrated-rapid-improvements-in-depressive-symptoms-in-patients-with-treatment-resistant-depression\" target=\"_blank\" rel=\"noopener\">esketamine\u003c/a> later this year, though the approval would be limited to use in a clinical setting.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Meanwhile, doctors have begun trying ketamine on patients with a wide range of psychiatric disorders other than depression. And there is now growing evidence it can help people with anxiety, bipolar disorder, post-traumatic stress disorder, and perhaps even obsessive-compulsive disorder.\u003c/p>\n\u003cp>\"I think it's actually one of the biggest advances in psychiatry in a very long time,\" says Dr. \u003ca href=\"https://www.mcleanhospital.org/biography/martin-teicher\" target=\"_blank\" rel=\"noopener\">Martin Teicher\u003c/a>, an associate professor of psychiatry at Harvard Medical School and director of the Developmental Biopsychiatry Research Program at McLean Hospital.\u003c/p>\n\u003cp>Ketamine may also offer new hope for people like James who have symptoms of several different psychiatric disorders.\u003c/p>\n\u003cp>James had a happy childhood, he says. But his thoughts were out of control. \"I always felt like I was crossing a freeway and my thoughts were just racing past me,\" he says.\u003c/p>\n\u003cp>He spent much of his childhood terrified of \"an unknown, an ambiguous force out there.\" The fear was \"overwhelming,\" he says. \"I literally slept with the cover over my head with just room to breathe through my mouth until I went to college.\"\u003c/p>\n\u003cp>And there was something else about James: his body temperature.\u003c/p>\n\u003cp>\"I overheated constantly,\" he says. \"I would wear shorts all year long. In my 20s in my apartment I would sleep with the windows open in the middle of the winter.\"\u003c/p>\n\u003cp>In his late 20s, James saw a doctor who told him he had attention deficit hyperactivity disorder. So he started taking stimulants.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>At first, the pills helped him focus. Then they didn't, no matter how many he took.\u003c/p>\n\u003cp>He'd done well as an idea guy in the advertising industry. But now James was trying to work at home, and it wasn't going well.\u003c/p>\n\u003cp>\"ADHD pills will make you interested in anything,\" he says. \"So I was putting the desk together and taking the desk apart. I was putting a laptop stand together and taking it apart. I was going in a massive downward spiral.\"\u003c/p>\n\u003cp>James had always suffered from mood swings. But now they were rapid and extreme. And he couldn't stop thinking about gruesome scenarios, like a murderer coming for his family.\u003c/p>\n\u003cp>\"My wife took a summer off to be with me because she was scared of what was going to happen to me,\" he says. \"She would go to work for a few hours, then rush home. There would be times I'd call her just screaming, 'Please come home. I can't get through another minute.' \"\u003c/p>\n\u003cp>Eventually, James found his way to Dr. \u003ca href=\"http://bipolarchild.com/about/authors/\" target=\"_blank\" rel=\"noopener\">Demitri Papolos\u003c/a>, an associate professor of clinical psychiatry at Albert Einstein College of Medicine.\u003c/p>\n\u003cp>\"He was like a whirling dervish when he came into my office,\" Papolos says. \"He was extremely fearful and scanning the environment all the time and he overheated at the drop of a hat.\"\u003c/p>\n\u003cp>Papolos diagnosed James with a variant of bipolar disorder he calls the \"fear of harm phenotype.\" It typically appears in childhood and often doesn't respond to traditional psychiatric drugs.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>But Papolos has found that the condition does respond to ketamine. \"It's been transformational,\" he says.\u003c/p>\n\u003cp>In January, Papolos published a \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/28866299\">study\u003c/a> of 45 children with the problem. They inhaled a nasal mist containing ketamine about twice a week. Nearly all got dramatically better.\u003c/p>\n\u003cp>Scientists still aren't sure why ketamine works, but there's \u003ca href=\"https://www.npr.org/sections/health-shots/2012/10/04/162299564/ketamine-relieves-depression-by-restoring-brain-connections\" target=\"_blank\" rel=\"noopener\">evidence\u003c/a> that it encourages the brain to rewire, to alter the connections between cells. That process has been linked to recovery from depression. And it may also explain why ketamine helps people who have symptoms associated with several different psychiatric disorders.\u003c/p>\n\u003cp>\"I think it's having multiple effects, and that means it's probably useful for multiple different disorders,\" Teicher says.\u003c/p>\n\u003cp>One of those effects involves a part of the brain involved in temperature regulation. And that could explain why patients like James usually stop overheating once they are taking ketamine.\u003c/p>\n\u003cp>James started taking a ketamine nasal spray every other day. He says his response was dramatic.\u003c/p>\n\u003cp>\"One day I turn to my wife and I'm like, 'I feel calm today. I don't know if it's the sun coming in, I don't know if it's just the way we're sitting here, but I feel like I could go and sit at the computer and work.' \"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The next day, James did sit down at his computer. A month later, he was back at work.\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=From+Chaos+To+Calm%3A+A+Life+Changed+By+Ketamine&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Clinic Claims Success In Making Babies With 3 Parents' DNA",
"title": "Clinic Claims Success In Making Babies With 3 Parents' DNA",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp>In a clinic on a side street in Kiev, the capital of Ukraine, doctors are doing something that, as far as is publicly known, is being done nowhere else in the world: using DNA from three different people to create babies for women who are infertile.[contextly_sidebar id=\"hJp3PK3nX6Xp23jBK7povAqNM584M314\"]\u003c/p>\n\u003cp>\"If you can help these families to achieve their own babies, why it must be forbidden?\" \u003ca href=\"http://nadiyaclinic.com/about-the-clinic/our-team/valery-zukin/\" target=\"_blank\" rel=\"noopener\">Valery Zukin\u003c/a>, director of the \u003ca href=\"http://nadiyaclinic.com/\" target=\"_blank\" rel=\"noopener\">Nadiya Clinic\u003c/a>, asks as he peers over his glasses. \"It is a dream to want to have a genetic connection with a baby.\"\u003c/p>\n\u003cp>I traveled to Ukraine because Zukin promised unusual access to his private fertility clinic, including the first demonstration for a U.S. journalist of how scientists create \"three-parent\" babies — a procedure prohibited by the U.S. Food and Drug Administration.\u003c/p>\n\u003cp>Zukin also arranged the first-ever interview with a mother of a 15-month-old boy who is one of the four children he says he has produced this way.\u003c/p>\n\u003cp>Three more of his patients are pregnant, Zukin says, including a woman from Sweden. Women from several other countries including Britain, Brazil and Israel are going through the process, he says.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Leading ethicists and genetics researchers criticize the clinic for rushing ahead to use this method for infertility. No one knows whether children produced this way will be healthy, they say. And some worry the procedure may open the door to \"designer babies.\"\u003c/p>\n\u003cp>\"This is pretty troubling,\" says \u003ca href=\"https://www.geneticsandsociety.org/user/25\" target=\"_blank\" rel=\"noopener\">Marcy Darnovsky\u003c/a>, who heads the Center for Genetics and Society, a U.S.-based watchdog group.\u003c/p>\n\u003cp>But Zukin dismisses those criticisms.\u003c/p>\n\u003cp>\"As a doctor I understand only one thing: We have parents who couldn't have children and now they have their own biological child. That's all,\" Zukin says.[contextly_sidebar id=\"e9qixdqsJYlqHyn9aCm0jBm9SiC8DfaI\"]\u003c/p>\n\u003cp>Zukin has helped form a \u003ca href=\"http://www.dl-nadiya.com/\" target=\"_blank\" rel=\"noopener\">company\u003c/a>, Darwin Life-Nadiya, with a \u003ca href=\"https://www.newhopefertility.com/\" target=\"_blank\" rel=\"noopener\">New York clinic\u003c/a> to market the service to U.S. women willing to travel to Ukraine. Ukrainian women pay about $8,000 for the procedure; for foreigners, it's about $15,000.\u003c/p>\n\u003cp>\u003cstrong>Transferring DNA From Egg to Egg\u003c/strong>\u003c/p>\n\u003cp>To show how the procedure works, Zukin sends me upstairs to the embryo lab. After putting on a sterile blue gown and booties, I meet Pavlo Mazur, a clinic embryo scientist.\u003c/p>\n\u003cp>\"We will begin,\" Mazur says, as he takes a clear plastic dish out of an incubator.\u003c/p>\n\u003cp>The dish contains a 1-day-old embryo. It was created by fertilizing the egg of a woman with sperm from her male partner.\u003c/p>\n\u003cp>The dish also holds a second embryo. This was made using the same man's sperm to fertilize an egg from another woman, who was paid to donate eggs.\u003c/p>\n\u003cp>After sliding the embryos under a large microscope, Mazur starts a timer. He has only 15 minutes to complete the delicate procedure without risking damage to the embryos.\u003c/p>\n\u003cp>A monitor nearby displays what Mazur sees through the microscope. A round structure comes into focus on the screen. It's one of the embryos.[contextly_sidebar id=\"lH4aHr8bWw920dNDT3zPx9BxxYAHoA23\"]\u003c/p>\n\u003cp>\"You see?\" Mazur says, pointing to two smaller round structures inside. They contain the DNA of the man and woman trying to have a baby.\u003c/p>\n\u003cp>\"One is from sperm. It's paternal,\" Mazur says. \"And the second one is maternal.\"\u003c/p>\n\u003cp>Mazur slowly inserts a tiny, hollow glass needle into the fertilized egg. Even though Mazur is under pressure to work fast, he can't move too quickly.\u003c/p>\n\u003cp>\"Very steady and slow,\" Mazur says. \"We don't want to damage it, right? We want it to survive.\"\u003c/p>\n\u003cp>He uses the needle to extract the would-be parents' DNA. Mazur does the same thing with the second fertilized egg, removing all the DNA — except for 37 genes known as \u003ca href=\"https://ghr.nlm.nih.gov/mitochondrial-dna\" target=\"_blank\" rel=\"noopener\">mitochondrial DNA\u003c/a>.\u003c/p>\n\u003cp>Mitochondria provide energy for eggs. A defect in the patient's mitochondrial DNA might be what's preventing her from getting pregnant. So using the donor's mitochondrial DNA may be what enables the patient to produce healthy embryos and babies.\u003c/p>\n\u003cp>\"It's like an universal currency for a cell,\" Mazur says. \"It helps for all processes within the cell.\"\u003c/p>\n\u003cp>The next step is to transfer the DNA of the woman and man trying to have a child into the donor's mostly gutted embryo — empty except for the other woman's mitochondrial DNA.\u003c/p>\n\u003cp>\"And now we will just try to put the genetic material of our patient inside,\" Mazur says as he gently inserts the needle holding the couple's DNA and injects the genes.\u003c/p>\n\u003cp>\"That's it,\" he says, glancing at his timer to see there are still two minutes left.\u003c/p>\n\u003cp>\"So, you see? It's inside,\" Mazur says, pointing to the couple's DNA. \"It will develop into embryo.\"\u003c/p>\n\u003cp>The Nadiya clinic is transferring embryos reconstructed this way into the wombs of women trying to become pregnant.\u003c/p>\n\u003cp>So far, the clinic has tried the procedure on 21 women. Fourteen attempts failed, probably because the women were older, the clinic staffers say.\u003c/p>\n\u003cp>But the other women either had babies or are pregnant. They were younger, but could never produce viable embryos on their own.\u003c/p>\n\u003cp>\"I adore that such technology exists. I adore that it can help some people,\" says Mazur.\u003c/p>\n\u003cp>These babies end up with DNA from three different people: the woman trying to have a baby; her male partner; and the egg donor who has provided 37 mitochondrial genes. That's why they're called three-parent babies.\u003c/p>\n\u003cp>But Mazur says that label is wrong.\u003c/p>\n\u003cp>\"These babies — they have DNA from mother and from father. So they are genetically related to their parents,\" Mazur says.[contextly_sidebar id=\"epZCsHoOtfaC0xfJUpdgovxcZOsKlTBF\"]\u003c/p>\n\u003cp>The overwhelming majority of the baby's DNA comes from the nucleus of the cell. And those are the genes responsible for the traits that most people consider their genetic inheritance, such as their eye and hair color, height, weight and personality.\u003c/p>\n\u003cp>The bit of mitochondrial DNA is \"incomparable,\" Mazur says. \"These children are more like their parents — not donor.\"\u003c/p>\n\u003cp>Mazur will present the clinic's latest results at the \u003ca href=\"https://www.eshre.eu/\" target=\"_blank\" rel=\"noopener\">European Society of Human Reproduction and Embryology\u003c/a>'s annual meeting in Barcelona in July.\u003c/p>\n\u003cp>\u003cstrong>Moving too fast?\u003c/strong>\u003c/p>\n\u003cp>Some scientists are welcoming this as a potentially exciting new option for some women.\u003c/p>\n\u003cp>\"It is pioneering work,\" says \u003ca href=\"http://cumc.p.cumcweb.org/mdphd/profile/degli\" target=\"_blank\" rel=\"noopener\">Dietrich Egli\u003c/a>, an assistant professor of developmental biology at Columbia University Medical Center in New York. The procedure is technically known as \"pronuclear transfer.\"\u003c/p>\n\u003cp>\"What we can learn from their work is that pronuclear transfer may be useful for some cases of infertility,\" says Egli.\u003c/p>\n\u003cp>But critics say it's far too soon to be attempting this procedure to create children.\u003c/p>\n\u003cp>\"This is really an irresponsible kind of human experimentation,\" Darnovsky of the Center for Genetics and Society says.\u003c/p>\n\u003cp>Not nearly enough laboratory and animal research has been done to know if the procedure is safe, Darnovsky and others say.\u003c/p>\n\u003cp>\"We just don't know what's going to happen to these children,\" Darnovsky says.\u003c/p>\n\u003cp>In the 1990s, a doctor in New Jersey injected fluid from healthy eggs into the eggs of infertile women, and some babies were born with mitochondrial DNA from three people. But that was discontinued after the FDA intervened.\u003c/p>\n\u003cp>Only one other baby is known to have been produced using a technique similar to the one being used by Zukin. \u003ca href=\"https://www.newhopefertility.com/about-us/fertility-doctor/john-zhang/\" target=\"_blank\" rel=\"noopener\">John Zhang\u003c/a> of the \u003ca href=\"https://www.newhopefertility.com/\" target=\"_blank\" rel=\"noopener\">New Hope Fertility Center\u003c/a> in New York performed a related procedure for a Jordanian couple to try to prevent their child from having \u003ca href=\"https://ghr.nlm.nih.gov/condition/leigh-syndrome\" target=\"_blank\" rel=\"noopener\">Leigh syndrome\u003c/a>, a disorder caused by defects in mitochondrial DNA.\u003c/p>\n\u003cp>That's why the procedure was developed — to help women carrying \u003ca href=\"https://medlineplus.gov/mitochondrialdiseases.html\" target=\"_blank\" rel=\"noopener\">mitochondrial disorders\u003c/a> have healthy children. In severe cases, these disorders can be fatal.\u003c/p>\n\u003cp>A U.S. National Academy of Sciences panel \u003ca href=\"https://www.npr.org/sections/health-shots/2016/02/03/465319186/babies-with-genes-from-three-people-could-be-ethical-panel-says\" target=\"_blank\" rel=\"noopener\">concluded\u003c/a> it could be ethical to attempt the procedure for this purpose. But because the FDA \u003ca href=\"https://www.fda.gov/BiologicsBloodVaccines/CellularGeneTherapyProducts/ucm570185.htm\">won't allow\u003c/a> it at all in the United States, the baby of the Jordanian couple whom \u003ca href=\"https://www.npr.org/sections/thetwo-way/2016/09/27/495668299/new-york-fertility-doctor-says-he-created-baby-with-3-genetic-parents\" target=\"_blank\" rel=\"noopener\">Zhang helped was born in Mexico in 2016.\u003c/a>\u003c/p>\n\u003cp>Doctors in the United Kingdom have started trying the technique to prevent mitochondrial disorders. But the British doctors are being \u003ca href=\"https://www.npr.org/2015/02/03/383578221/u-k-lawmakers-allow-scientists-to-attempt-dna-transplants\">allowed\u003c/a> to try to make only one baby at a time as part of a tightly regulated \u003ca href=\"https://www.npr.org/sections/health-shots/2014/11/10/360342623/combining-the-dna-of-three-people-raises-ethical-questions\" target=\"_blank\" rel=\"noopener\">research program\u003c/a>.[contextly_sidebar id=\"2QVJm0WQxeuB5lotTMLysQyqrPHpvncJ\"]\u003c/p>\n\u003cp>Zukin says he received approval for a five-year research program from the Ukrainian Postgraduate Medical Academy, which is under the auspices of the Ukrainian Ministry of Public Health. But Zukin concedes the procedure is far less regulated in his country. Nevertheless, he makes sure all the women understand they are undergoing an experimental procedure.\u003c/p>\n\u003cp>\"We explain everything to the families. And not all families give permission for providing this experimental procedure,\" he says.\u003c/p>\n\u003cp>Because mitochondrial DNA can be inherited, Darnovsky worries the procedure is crossing a line that long has been considered taboo: making changes in human DNA that can be passed down to future generations. One fear is that a mistake could create a new disease that could be inherited.\u003c/p>\n\u003cp>Mitochondrial DNA is inherited from the mother. Zukin already has used the procedure to produce one baby girl — a girl who could one day pass the mitochondrial DNA to her own children.\u003c/p>\n\u003cp>Darnovsky worries the procedure could also open the door to creating babies who are genetically modified for other reasons.\u003c/p>\n\u003cp>\"What we're seeing is a fast slide down a very slippery slope toward designer babies,\" Darnovsky says. \"We could see parents feeling eager to give their children traits like greater strength, needs less sleep. Some people are saying that, 'Yes, there are genes for IQ and we could have smarter babies.' \"\u003c/p>\n\u003cp>Zukin dismisses speculation about designer babies. He says he's interested only in helping women who are infertile have genetically related children or prevent mitochondrial diseases. And so far, all the babies he has created appear to be perfectly healthy, he says.\u003c/p>\n\u003cp>The only way to know whether the procedure works and is safe is to try it, he argues. He hopes to figure out how to make the procedure work for women suffering from age-related infertility as well, which would help far more women.\u003c/p>\n\u003cp>\"If you would like to swim,\" he says, \"then, first of all, you must jump in the water.\"\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>A second story on Wednesday afternoon features an exclusive interview with a mother and her three-parent son.\u003c/em>\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=Clinic+Claims+Success+In+Making+Babies+With+3+Parents%27+DNA+&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"excerpt": "A clinic in Kiev, Ukraine, stirs controversy by making babies with DNA from three different people to help women who are infertile bear children. It's the only clinic known to be doing this right now.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>In a clinic on a side street in Kiev, the capital of Ukraine, doctors are doing something that, as far as is publicly known, is being done nowhere else in the world: using DNA from three different people to create babies for women who are infertile.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"If you can help these families to achieve their own babies, why it must be forbidden?\" \u003ca href=\"http://nadiyaclinic.com/about-the-clinic/our-team/valery-zukin/\" target=\"_blank\" rel=\"noopener\">Valery Zukin\u003c/a>, director of the \u003ca href=\"http://nadiyaclinic.com/\" target=\"_blank\" rel=\"noopener\">Nadiya Clinic\u003c/a>, asks as he peers over his glasses. \"It is a dream to want to have a genetic connection with a baby.\"\u003c/p>\n\u003cp>I traveled to Ukraine because Zukin promised unusual access to his private fertility clinic, including the first demonstration for a U.S. journalist of how scientists create \"three-parent\" babies — a procedure prohibited by the U.S. Food and Drug Administration.\u003c/p>\n\u003cp>Zukin also arranged the first-ever interview with a mother of a 15-month-old boy who is one of the four children he says he has produced this way.\u003c/p>\n\u003cp>Three more of his patients are pregnant, Zukin says, including a woman from Sweden. Women from several other countries including Britain, Brazil and Israel are going through the process, he says.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Leading ethicists and genetics researchers criticize the clinic for rushing ahead to use this method for infertility. No one knows whether children produced this way will be healthy, they say. And some worry the procedure may open the door to \"designer babies.\"\u003c/p>\n\u003cp>\"This is pretty troubling,\" says \u003ca href=\"https://www.geneticsandsociety.org/user/25\" target=\"_blank\" rel=\"noopener\">Marcy Darnovsky\u003c/a>, who heads the Center for Genetics and Society, a U.S.-based watchdog group.\u003c/p>\n\u003cp>But Zukin dismisses those criticisms.\u003c/p>\n\u003cp>\"As a doctor I understand only one thing: We have parents who couldn't have children and now they have their own biological child. That's all,\" Zukin says.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Zukin has helped form a \u003ca href=\"http://www.dl-nadiya.com/\" target=\"_blank\" rel=\"noopener\">company\u003c/a>, Darwin Life-Nadiya, with a \u003ca href=\"https://www.newhopefertility.com/\" target=\"_blank\" rel=\"noopener\">New York clinic\u003c/a> to market the service to U.S. women willing to travel to Ukraine. Ukrainian women pay about $8,000 for the procedure; for foreigners, it's about $15,000.\u003c/p>\n\u003cp>\u003cstrong>Transferring DNA From Egg to Egg\u003c/strong>\u003c/p>\n\u003cp>To show how the procedure works, Zukin sends me upstairs to the embryo lab. After putting on a sterile blue gown and booties, I meet Pavlo Mazur, a clinic embryo scientist.\u003c/p>\n\u003cp>\"We will begin,\" Mazur says, as he takes a clear plastic dish out of an incubator.\u003c/p>\n\u003cp>The dish contains a 1-day-old embryo. It was created by fertilizing the egg of a woman with sperm from her male partner.\u003c/p>\n\u003cp>The dish also holds a second embryo. This was made using the same man's sperm to fertilize an egg from another woman, who was paid to donate eggs.\u003c/p>\n\u003cp>After sliding the embryos under a large microscope, Mazur starts a timer. He has only 15 minutes to complete the delicate procedure without risking damage to the embryos.\u003c/p>\n\u003cp>A monitor nearby displays what Mazur sees through the microscope. A round structure comes into focus on the screen. It's one of the embryos.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"You see?\" Mazur says, pointing to two smaller round structures inside. They contain the DNA of the man and woman trying to have a baby.\u003c/p>\n\u003cp>\"One is from sperm. It's paternal,\" Mazur says. \"And the second one is maternal.\"\u003c/p>\n\u003cp>Mazur slowly inserts a tiny, hollow glass needle into the fertilized egg. Even though Mazur is under pressure to work fast, he can't move too quickly.\u003c/p>\n\u003cp>\"Very steady and slow,\" Mazur says. \"We don't want to damage it, right? We want it to survive.\"\u003c/p>\n\u003cp>He uses the needle to extract the would-be parents' DNA. Mazur does the same thing with the second fertilized egg, removing all the DNA — except for 37 genes known as \u003ca href=\"https://ghr.nlm.nih.gov/mitochondrial-dna\" target=\"_blank\" rel=\"noopener\">mitochondrial DNA\u003c/a>.\u003c/p>\n\u003cp>Mitochondria provide energy for eggs. A defect in the patient's mitochondrial DNA might be what's preventing her from getting pregnant. So using the donor's mitochondrial DNA may be what enables the patient to produce healthy embryos and babies.\u003c/p>\n\u003cp>\"It's like an universal currency for a cell,\" Mazur says. \"It helps for all processes within the cell.\"\u003c/p>\n\u003cp>The next step is to transfer the DNA of the woman and man trying to have a child into the donor's mostly gutted embryo — empty except for the other woman's mitochondrial DNA.\u003c/p>\n\u003cp>\"And now we will just try to put the genetic material of our patient inside,\" Mazur says as he gently inserts the needle holding the couple's DNA and injects the genes.\u003c/p>\n\u003cp>\"That's it,\" he says, glancing at his timer to see there are still two minutes left.\u003c/p>\n\u003cp>\"So, you see? It's inside,\" Mazur says, pointing to the couple's DNA. \"It will develop into embryo.\"\u003c/p>\n\u003cp>The Nadiya clinic is transferring embryos reconstructed this way into the wombs of women trying to become pregnant.\u003c/p>\n\u003cp>So far, the clinic has tried the procedure on 21 women. Fourteen attempts failed, probably because the women were older, the clinic staffers say.\u003c/p>\n\u003cp>But the other women either had babies or are pregnant. They were younger, but could never produce viable embryos on their own.\u003c/p>\n\u003cp>\"I adore that such technology exists. I adore that it can help some people,\" says Mazur.\u003c/p>\n\u003cp>These babies end up with DNA from three different people: the woman trying to have a baby; her male partner; and the egg donor who has provided 37 mitochondrial genes. That's why they're called three-parent babies.\u003c/p>\n\u003cp>But Mazur says that label is wrong.\u003c/p>\n\u003cp>\"These babies — they have DNA from mother and from father. So they are genetically related to their parents,\" Mazur says.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The overwhelming majority of the baby's DNA comes from the nucleus of the cell. And those are the genes responsible for the traits that most people consider their genetic inheritance, such as their eye and hair color, height, weight and personality.\u003c/p>\n\u003cp>The bit of mitochondrial DNA is \"incomparable,\" Mazur says. \"These children are more like their parents — not donor.\"\u003c/p>\n\u003cp>Mazur will present the clinic's latest results at the \u003ca href=\"https://www.eshre.eu/\" target=\"_blank\" rel=\"noopener\">European Society of Human Reproduction and Embryology\u003c/a>'s annual meeting in Barcelona in July.\u003c/p>\n\u003cp>\u003cstrong>Moving too fast?\u003c/strong>\u003c/p>\n\u003cp>Some scientists are welcoming this as a potentially exciting new option for some women.\u003c/p>\n\u003cp>\"It is pioneering work,\" says \u003ca href=\"http://cumc.p.cumcweb.org/mdphd/profile/degli\" target=\"_blank\" rel=\"noopener\">Dietrich Egli\u003c/a>, an assistant professor of developmental biology at Columbia University Medical Center in New York. The procedure is technically known as \"pronuclear transfer.\"\u003c/p>\n\u003cp>\"What we can learn from their work is that pronuclear transfer may be useful for some cases of infertility,\" says Egli.\u003c/p>\n\u003cp>But critics say it's far too soon to be attempting this procedure to create children.\u003c/p>\n\u003cp>\"This is really an irresponsible kind of human experimentation,\" Darnovsky of the Center for Genetics and Society says.\u003c/p>\n\u003cp>Not nearly enough laboratory and animal research has been done to know if the procedure is safe, Darnovsky and others say.\u003c/p>\n\u003cp>\"We just don't know what's going to happen to these children,\" Darnovsky says.\u003c/p>\n\u003cp>In the 1990s, a doctor in New Jersey injected fluid from healthy eggs into the eggs of infertile women, and some babies were born with mitochondrial DNA from three people. But that was discontinued after the FDA intervened.\u003c/p>\n\u003cp>Only one other baby is known to have been produced using a technique similar to the one being used by Zukin. \u003ca href=\"https://www.newhopefertility.com/about-us/fertility-doctor/john-zhang/\" target=\"_blank\" rel=\"noopener\">John Zhang\u003c/a> of the \u003ca href=\"https://www.newhopefertility.com/\" target=\"_blank\" rel=\"noopener\">New Hope Fertility Center\u003c/a> in New York performed a related procedure for a Jordanian couple to try to prevent their child from having \u003ca href=\"https://ghr.nlm.nih.gov/condition/leigh-syndrome\" target=\"_blank\" rel=\"noopener\">Leigh syndrome\u003c/a>, a disorder caused by defects in mitochondrial DNA.\u003c/p>\n\u003cp>That's why the procedure was developed — to help women carrying \u003ca href=\"https://medlineplus.gov/mitochondrialdiseases.html\" target=\"_blank\" rel=\"noopener\">mitochondrial disorders\u003c/a> have healthy children. In severe cases, these disorders can be fatal.\u003c/p>\n\u003cp>A U.S. National Academy of Sciences panel \u003ca href=\"https://www.npr.org/sections/health-shots/2016/02/03/465319186/babies-with-genes-from-three-people-could-be-ethical-panel-says\" target=\"_blank\" rel=\"noopener\">concluded\u003c/a> it could be ethical to attempt the procedure for this purpose. But because the FDA \u003ca href=\"https://www.fda.gov/BiologicsBloodVaccines/CellularGeneTherapyProducts/ucm570185.htm\">won't allow\u003c/a> it at all in the United States, the baby of the Jordanian couple whom \u003ca href=\"https://www.npr.org/sections/thetwo-way/2016/09/27/495668299/new-york-fertility-doctor-says-he-created-baby-with-3-genetic-parents\" target=\"_blank\" rel=\"noopener\">Zhang helped was born in Mexico in 2016.\u003c/a>\u003c/p>\n\u003cp>Doctors in the United Kingdom have started trying the technique to prevent mitochondrial disorders. But the British doctors are being \u003ca href=\"https://www.npr.org/2015/02/03/383578221/u-k-lawmakers-allow-scientists-to-attempt-dna-transplants\">allowed\u003c/a> to try to make only one baby at a time as part of a tightly regulated \u003ca href=\"https://www.npr.org/sections/health-shots/2014/11/10/360342623/combining-the-dna-of-three-people-raises-ethical-questions\" target=\"_blank\" rel=\"noopener\">research program\u003c/a>.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Zukin says he received approval for a five-year research program from the Ukrainian Postgraduate Medical Academy, which is under the auspices of the Ukrainian Ministry of Public Health. But Zukin concedes the procedure is far less regulated in his country. Nevertheless, he makes sure all the women understand they are undergoing an experimental procedure.\u003c/p>\n\u003cp>\"We explain everything to the families. And not all families give permission for providing this experimental procedure,\" he says.\u003c/p>\n\u003cp>Because mitochondrial DNA can be inherited, Darnovsky worries the procedure is crossing a line that long has been considered taboo: making changes in human DNA that can be passed down to future generations. One fear is that a mistake could create a new disease that could be inherited.\u003c/p>\n\u003cp>Mitochondrial DNA is inherited from the mother. Zukin already has used the procedure to produce one baby girl — a girl who could one day pass the mitochondrial DNA to her own children.\u003c/p>\n\u003cp>Darnovsky worries the procedure could also open the door to creating babies who are genetically modified for other reasons.\u003c/p>\n\u003cp>\"What we're seeing is a fast slide down a very slippery slope toward designer babies,\" Darnovsky says. \"We could see parents feeling eager to give their children traits like greater strength, needs less sleep. Some people are saying that, 'Yes, there are genes for IQ and we could have smarter babies.' \"\u003c/p>\n\u003cp>Zukin dismisses speculation about designer babies. He says he's interested only in helping women who are infertile have genetically related children or prevent mitochondrial diseases. And so far, all the babies he has created appear to be perfectly healthy, he says.\u003c/p>\n\u003cp>The only way to know whether the procedure works and is safe is to try it, he argues. He hopes to figure out how to make the procedure work for women suffering from age-related infertility as well, which would help far more women.\u003c/p>\n\u003cp>\"If you would like to swim,\" he says, \"then, first of all, you must jump in the water.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>A second story on Wednesday afternoon features an exclusive interview with a mother and her three-parent son.\u003c/em>\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=Clinic+Claims+Success+In+Making+Babies+With+3+Parents%27+DNA+&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Most women with the most common form of early-stage breast cancer can safely skip chemotherapy without hurting their chances of beating the disease, doctors are reporting from a landmark study that used genetic testing to gauge each patient’s risk.[contextly_sidebar id=\"BFMet48xKrp1h6NyWt3K8Xsz7gIOPSeq\"]\u003c/p>\n\u003cp>The study is the largest ever done of breast cancer treatment, and the results are expected to spare up to 70,000 patients a year in the United States and many more elsewhere the ordeal and expense of these drugs.\u003c/p>\n\u003cp>“The impact is tremendous,” said the study leader, Dr. Joseph Sparano of Montefiore Medical Center in New York. Most women in this situation don’t need treatment beyond surgery and hormone therapy, he said.\u003c/p>\n\u003cp>The study was funded by the National Cancer Institute, some foundations and proceeds from the U.S. breast cancer postage stamp. Results were discussed Sunday at an American Society of Clinical Oncology conference in Chicago and published by the New England Journal of Medicine. Some study leaders consult for breast cancer drugmakers or for the company that makes the gene test.\u003c/p>\n\u003cp>\u003cstrong>Moving Away From Chemo\u003c/strong>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Cancer care has been evolving away from chemotherapy — older drugs with harsh side effects — in favor of gene-targeting therapies, hormone blockers and immune system treatments. When chemo is used now, it’s sometimes for shorter periods or lower doses than it once was.\u003c/p>\n\u003cp>For example, another study at the conference found that Merck’s immunotherapy drug Keytruda worked better than chemo as initial treatment for most people with the most common type of lung cancer, and with far fewer side effects.[contextly_sidebar id=\"sLig6uVQeZQDplnvMdLRkmGUnVlPvI7v\"]\u003c/p>\n\u003cp>The breast cancer study focused on cases where chemo’s value increasingly is in doubt: women with early-stage disease that has not spread to lymph nodes, is hormone-positive (meaning its growth is fueled by estrogen or progesterone) and is not the type that the drug Herceptin targets.\u003c/p>\n\u003cp>The usual treatment is surgery followed by years of a hormone-blocking drug. But many women also are urged to have chemo to help kill any stray cancer cells. Doctors know that most don’t need it, but evidence is thin on who can forgo it.\u003c/p>\n\u003cp>The study gave 10,273 patients a test called Oncotype DX, which uses a biopsy sample to measure the activity of genes involved in cell growth and response to hormone therapy, to estimate the risk that a cancer will recur.\u003c/p>\n\u003cp>\u003cstrong>What the Study Found\u003c/strong>\u003c/p>\n\u003cp>About 17 percent of women had high-risk scores and were advised to have chemo. The 16 percent with low-risk scores now know they can skip chemo, based on earlier results from this study.\u003c/p>\n\u003cp>The new results are on the 67 percent of women at intermediate risk. All had surgery and hormone therapy, and half also got chemo.[contextly_sidebar id=\"TPjTNdjmhxB5MX6ZoUQCtfkvBdzmJm43\"]\u003c/p>\n\u003cp>After nine years, 94 percent of both groups were still alive, and about 84 percent were alive without signs of cancer, so adding chemo made no difference.\u003c/p>\n\u003cp>Certain women 50 or younger did benefit from chemo; slightly fewer cases of cancer spreading far beyond the breast occurred among some of them given chemo, depending on their risk scores on the gene test.\u003c/p>\n\u003cp>\u003cstrong>Will People Trust the Results?\u003c/strong>\u003c/p>\n\u003cp>All women like those in the study should get gene testing to guide their care, said Dr. Richard Schilsky, chief medical officer of the oncology society. Oncotype DX costs around $4,000, which Medicare and many insurers cover. Similar tests including one called MammaPrint also are widely used.\u003c/p>\n\u003cp>Testing solved a big problem of figuring out who needs chemo, said Dr. Harold Burstein of the Dana-Farber Cancer Institute in Boston. Many women think “if I don’t get chemotherapy I’m going to die, and if I get chemo I’m going to be cured,” but the results show there’s a sliding scale of benefit and sometimes none, he said.\u003c/p>\n\u003cp>Dr. Lisa Carey, a breast specialist at the University of North Carolina’s Lineberger Comprehensive Cancer Center, said she would be very comfortable advising patients to skip chemo if they were like those in the study who did not benefit from it.[contextly_sidebar id=\"2pkXhBlSu04mLyMby8g8IUTSIxIwtjpB\"]\u003c/p>\n\u003cp>Dr. Jennifer Litton at MD Anderson Cancer Center in Houston, agreed, but said: “Risk to one person is not the same thing as risk to another. There are some people who say, ’I don’t care what you say, I’m never going to do chemo,’” and won’t even have the gene test, she said. Others want chemo for even the smallest chance of benefit.\u003c/p>\n\u003cp>Adine Usher, 78, who lives in Hartsdale, New York, joined the study 10 years ago at Montefiore and was randomly assigned to the group given chemo.\u003c/p>\n\u003cp>“I was a little relieved. I sort of viewed chemo as extra insurance,” she said. The treatments “weren’t pleasant,” she concedes. Her hair fell out, she developed an infection and was hospitalized for a low white blood count, “but it was over fairly quickly and I’m really glad I had it.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>If doctors had recommended she skip chemo based on the gene test, “I would have accepted that,” she said. “I’m a firm believer in medical research.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Most women with the most common form of early-stage breast cancer can safely skip chemotherapy without hurting their chances of beating the disease, doctors are reporting from a landmark study that used genetic testing to gauge each patient’s risk.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The study is the largest ever done of breast cancer treatment, and the results are expected to spare up to 70,000 patients a year in the United States and many more elsewhere the ordeal and expense of these drugs.\u003c/p>\n\u003cp>“The impact is tremendous,” said the study leader, Dr. Joseph Sparano of Montefiore Medical Center in New York. Most women in this situation don’t need treatment beyond surgery and hormone therapy, he said.\u003c/p>\n\u003cp>The study was funded by the National Cancer Institute, some foundations and proceeds from the U.S. breast cancer postage stamp. Results were discussed Sunday at an American Society of Clinical Oncology conference in Chicago and published by the New England Journal of Medicine. Some study leaders consult for breast cancer drugmakers or for the company that makes the gene test.\u003c/p>\n\u003cp>\u003cstrong>Moving Away From Chemo\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Cancer care has been evolving away from chemotherapy — older drugs with harsh side effects — in favor of gene-targeting therapies, hormone blockers and immune system treatments. When chemo is used now, it’s sometimes for shorter periods or lower doses than it once was.\u003c/p>\n\u003cp>For example, another study at the conference found that Merck’s immunotherapy drug Keytruda worked better than chemo as initial treatment for most people with the most common type of lung cancer, and with far fewer side effects.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The breast cancer study focused on cases where chemo’s value increasingly is in doubt: women with early-stage disease that has not spread to lymph nodes, is hormone-positive (meaning its growth is fueled by estrogen or progesterone) and is not the type that the drug Herceptin targets.\u003c/p>\n\u003cp>The usual treatment is surgery followed by years of a hormone-blocking drug. But many women also are urged to have chemo to help kill any stray cancer cells. Doctors know that most don’t need it, but evidence is thin on who can forgo it.\u003c/p>\n\u003cp>The study gave 10,273 patients a test called Oncotype DX, which uses a biopsy sample to measure the activity of genes involved in cell growth and response to hormone therapy, to estimate the risk that a cancer will recur.\u003c/p>\n\u003cp>\u003cstrong>What the Study Found\u003c/strong>\u003c/p>\n\u003cp>About 17 percent of women had high-risk scores and were advised to have chemo. The 16 percent with low-risk scores now know they can skip chemo, based on earlier results from this study.\u003c/p>\n\u003cp>The new results are on the 67 percent of women at intermediate risk. All had surgery and hormone therapy, and half also got chemo.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>After nine years, 94 percent of both groups were still alive, and about 84 percent were alive without signs of cancer, so adding chemo made no difference.\u003c/p>\n\u003cp>Certain women 50 or younger did benefit from chemo; slightly fewer cases of cancer spreading far beyond the breast occurred among some of them given chemo, depending on their risk scores on the gene test.\u003c/p>\n\u003cp>\u003cstrong>Will People Trust the Results?\u003c/strong>\u003c/p>\n\u003cp>All women like those in the study should get gene testing to guide their care, said Dr. Richard Schilsky, chief medical officer of the oncology society. Oncotype DX costs around $4,000, which Medicare and many insurers cover. Similar tests including one called MammaPrint also are widely used.\u003c/p>\n\u003cp>Testing solved a big problem of figuring out who needs chemo, said Dr. Harold Burstein of the Dana-Farber Cancer Institute in Boston. Many women think “if I don’t get chemotherapy I’m going to die, and if I get chemo I’m going to be cured,” but the results show there’s a sliding scale of benefit and sometimes none, he said.\u003c/p>\n\u003cp>Dr. Lisa Carey, a breast specialist at the University of North Carolina’s Lineberger Comprehensive Cancer Center, said she would be very comfortable advising patients to skip chemo if they were like those in the study who did not benefit from it.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Dr. Jennifer Litton at MD Anderson Cancer Center in Houston, agreed, but said: “Risk to one person is not the same thing as risk to another. There are some people who say, ’I don’t care what you say, I’m never going to do chemo,’” and won’t even have the gene test, she said. Others want chemo for even the smallest chance of benefit.\u003c/p>\n\u003cp>Adine Usher, 78, who lives in Hartsdale, New York, joined the study 10 years ago at Montefiore and was randomly assigned to the group given chemo.\u003c/p>\n\u003cp>“I was a little relieved. I sort of viewed chemo as extra insurance,” she said. The treatments “weren’t pleasant,” she concedes. Her hair fell out, she developed an infection and was hospitalized for a low white blood count, “but it was over fairly quickly and I’m really glad I had it.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>If doctors had recommended she skip chemo based on the gene test, “I would have accepted that,” she said. “I’m a firm believer in medical research.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "New Cancer Care Dilemma: Patients Want Immunotherapy Even When Evidence Is Lacking",
"title": "New Cancer Care Dilemma: Patients Want Immunotherapy Even When Evidence Is Lacking",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp class=\"danger-zone\">Immunotherapy is a source of great hope in cancer care. It has \u003ca href=\"https://www.statnews.com/2017/09/12/cancer-immunotherapy-improvement/\">rescued\u003c/a>some patients from the brink, while giving others a reason to believe that they, too, could beat the long odds.[contextly_sidebar id=\"0iktmFOQroWtY1hQ3e3h8lY9q5AbDMyB\"]\u003c/p>\n\u003cp class=\"danger-zone\">But these therapies are also creating a vexing dilemma for doctors: Their patients, citing \u003ca href=\"https://www.ispot.tv/ad/w_y8/keytruda-its-tru-donnas-story-living-longer-is-possible\" target=\"_blank\" rel=\"noopener\">television ads\u003c/a> and media accounts of miraculous recoveries, are pushing hard to try them, even when there is little to no evidence the drugs will work for their particular cancer.\u003c/p>\n\u003cp class=\"danger-zone\">Doctors want to give their patients every shot at survival, but can they justify prescribing a drug when it hasn’t been tested for that patient’s type of cancer? Many of these treatments bring risks of painful — even life-threatening— side effects and carry total price tags pushing $1 million. In some cases, insurers won’t pay.\u003c/p>\n\u003cp class=\"\">“Whether it works or not, the burden both financially and emotionally on families and patients is massive,” said Dr. Vicki Jackson, chief of Massachusetts General Hospital’s palliative care unit, which helps patients with their decision-making process. “If you try it and it doesn’t work, then you’ve used up all your life savings.”\u003c/p>\n\u003cp class=\"\">There are few objective guideposts to determine which patients should get which treatments, or even undergo genetic testing to determine whether they are among the minority of patients who might benefit substantially from immuno-oncology medicines. The dividing line is often drawn by variations in age, tumor stage, and underlying health status — and the weight given to those measures still relies on physician discretion.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“Is it ethically and morally appropriate to not offer these potentially curative options on the basis of a very slight difference in kidney or liver function?” asked Dr. Ephraim Hochberg, a Mass. General oncologist who specializes in lymphoma.\u003c/p>\n\u003cp>Precision medicine, and the use of genetic markers to predict the success of treatments, promises to help answer these questions. Scientists at Stanford, for example, \u003ca href=\"https://www.statnews.com/2018/05/14/cancer-immunotherapy-pet-predictor/\">engineered\u003c/a> a radioactive molecule, detectable by PET imaging, to track whether a patient’s T cells are activated and thus capable of fighting cancer if the patient is given immunotherapy.[contextly_sidebar id=\"FOtikbkxZiNfNj2OB2DLb5zd76Z6QV0k\"]\u003c/p>\n\u003cp>The technique worked in lab mice but has not yet been tried in human patients, and other such approaches are further off. Meanwhile, patients and doctors are left to make life and death treatment decisions on uncertain terrain.\u003c/p>\n\u003cp>This struggle plays out on a near-daily basis at Mass. General, a Harvard-affiliated academic medical center with a deep well of resources and expertise. STAT interviews with specialists at the hospital reveal both the complexity of the variables at play, and the difficulty of establishing clear treatment protocols when data on real-world outcomes is still lacking.\u003c/p>\n\u003cp>The extent of these difficulties is only magnified for oncologists working with fewer resources in smaller community hospitals, where the vast majority of the nation’s cancer patients receive their care.\u003c/p>\n\u003cp>The uncertainty over treatment eligibility primarily pertains to a new class of treatments that harness the power of a patient’s immune system to attack cancer cells. These drugs have reached the market fairly recently, and have been tested in patients with a limited number of cancer types. And even in those types, the \u003ca href=\"https://www.statnews.com/2017/03/08/immunotherapy-cancer-breakthrough/\">drugs work only some of the time\u003c/a>.\u003c/p>\n\u003cp>These treatments include the checkpoint inhibitors Keytruda and Opdivo, CAR-T drugs such as Yescarta and \u003ca href=\"https://www.statnews.com/2017/08/30/novartis-car-t-cancer-approved/\">Kymriah\u003c/a>, and neo-antigen vaccines.\u003c/p>\n\u003cp>Hochberg often deals with patients who want to try \u003ca href=\"https://www.statnews.com/2017/10/27/car-t-kite-cell-journey/\">CAR-T therapy\u003c/a>, which re-engineers a patient’s T cells to recognize molecules on cancer cells and attack them. CAR-T drugs cost between $375,000 and $475,000, and the administration of treatment and follow-up care adds hundreds of thousands of thousands of dollars to the total bill.\u003c/p>\n\u003cp>In theory, CAR-T therapies can be tried on older patients whose bodies cannot withstand chemotherapy and radiation, but the National Comprehensive Cancer Network, which publishes treatment guidelines, has not established detailed eligibility criteria.\u003c/p>\n\u003cp>A similar struggle is playing out over the use of checkpoint inhibitors. It is not always clear which patients should get tested for a rare genetic condition, known as mismatch repair syndrome, that indicates receptivity to these drugs. While the testing is routinely conducted in treatment for patients with uterine and colon cancers, it is not always done for patients with other types of cancer.\u003c/p>\n\u003cp>“The fundamental problem is that it’s a costly test, so people are reluctant to make it automatic,” said Dr. David Ryan, clinical director of Mass. General’s Cancer Center. “Right now we’re relying on the oncologist to pick up those patients where there’s a reasonable chance of having mismatch repair deficiency, and ordering that test from pathology. Everybody’s having a hard time figuring out how to do this.”[contextly_sidebar id=\"blUI6ansejyqkxbdlWCDpHI5OeCoOQ3E\"]\u003c/p>\n\u003cp>Insurers play a key role in making sure that sky-high spending for these drugs is based on evidence of efficacy. But their involvement cuts both ways. In some cases, they deny coverage for treatments even when they are recommended by oncologists who believe there is a strong scientific basis to back up their decisions.\u003c/p>\n\u003cp>That scenario arose recently for Dr. Zosia Piotrowska, a medical oncologist at Mass. General who specializes in treating lung cancer. She recommended a combination of targeted therapies for a 50-year-old mother of four who has struggled with metastatic lung cancer for five years.\u003c/p>\n\u003cp>The patient’s cancer is exceedingly rare and marked by a gene mutation that indicates greater receptivity to targeted therapies. Piotrowska said various combinations of treatments had allowed the patient to live a normal life for several years, but her insurer recently denied coverage for the new round of treatment, which comes with a price of $16,000 a month.\u003c/p>\n\u003cp>Piotrowska appealed the decision, but the insurer still denied coverage, citing a lack of support for the treatment option in National Comprehensive Cancer Network guidelines. Though such guidelines set forth detailed protocols, they do not address the myriad nuances of each type of cancer and rapid changes in treatment options.\u003c/p>\n\u003cp>“The guidelines can’t keep up with the pace of research,” Piotrowska said. “As we learn more and more and develop better treatments, certain patients fall into these loopholes where we understand the biology of what’s going on, we have a treatment, but you can’t explain it to the insurer.”\u003c/p>\n\u003cp>That denial of coverage means the patient must decide whether to pay out of pocket and drain family savings for an uncertain benefit. Piotrowska said this patient has enough resources to continue with treatment, but for the vast majority of patients, the price would mean certain financial ruin.\u003c/p>\n\u003cp>The advent of immune-based therapies is only making the decisions harder. For a \u003ca href=\"https://www.statnews.com/2017/03/08/immunotherapy-cancer-breakthrough/\">small percentage\u003c/a> of patients, the treatments can be a savior, but without comprehensive insurance coverage, they are guaranteed to lead to financial distress. And because there is not yet much data on how the patients who initially benefit are faring in the long run, it is nearly impossible for new patients and their families to assess costs and benefits.\u003c/p>\n\u003cp>Doctors said the confusion over who should get immune-based treatments is bound to be exacerbated by the passage last month of the controversial \u003ca href=\"https://www.statnews.com/2018/05/30/trump-signs-right-to-try/\">“right-to-try” legislation\u003c/a>, which aims to give patients with terminal illness a different pathway to try experimental medicines that haven’t yet been approved by the Food and Drug Administration. It will not be clear how the law will affect patients until regulations are clarified in the coming months.[contextly_sidebar id=\"uFgg9fWxQTxW5cFzzQ7kroOuopy28usR\"]\u003c/p>\n\u003caside class=\"read-more standard\">\n\u003cdiv class=\"read-more-text\">\u003c/div>\n\u003c/aside>\n\u003cp>In some ways, the pressures and uncertainties posed by new cancer treatments are good problems to have. Julie Guillot said she wishes she’d had the luxury of such challenges when her son was sick.\u003c/p>\n\u003cp>Zach was diagnosed with acute myeloid leukemia when he was 5. For a boy of that age, concerns about unclear clinical benefits of treatments and sky high costs do not apply in the same way they might for an older patient. All the calculations point to the same answer: Try everything you can.\u003c/p>\n\u003cp>Zach received heavy doses of chemotherapy and three bone marrow transplants during years of expensive treatment that left him suffering from uncontrollable fevers, nausea, and infections. He died in 2014.\u003c/p>\n\u003cp>Guillot now works as an \u003ca href=\"https://www.statnews.com/2017/02/20/car-t-therapy-critics-just-dont-get/\">advocate\u003c/a> to help other patients get access to the best treatments and to ensure that experimentation in cancer care can continue to proceed on its inevitably hard and messy course toward cures.\u003c/p>\n\u003cp>“If we are avoidant of new therapies because of the risk, the lack of data, or the cost, breakthrough therapies like CAR-T and bone marrow transplant would never be developed,” she said. “When you are faced with this, people are willing to take risks for a chance to live.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This story was originally published by \u003ca href=\"https://www.statnews.com/2018/06/04/cancer-care-dilemma-immunotherapy/\" target=\"_blank\" rel=\"noopener\">STAT\u003c/a>, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp class=\"danger-zone\">Immunotherapy is a source of great hope in cancer care. It has \u003ca href=\"https://www.statnews.com/2017/09/12/cancer-immunotherapy-improvement/\">rescued\u003c/a>some patients from the brink, while giving others a reason to believe that they, too, could beat the long odds.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp class=\"danger-zone\">But these therapies are also creating a vexing dilemma for doctors: Their patients, citing \u003ca href=\"https://www.ispot.tv/ad/w_y8/keytruda-its-tru-donnas-story-living-longer-is-possible\" target=\"_blank\" rel=\"noopener\">television ads\u003c/a> and media accounts of miraculous recoveries, are pushing hard to try them, even when there is little to no evidence the drugs will work for their particular cancer.\u003c/p>\n\u003cp class=\"danger-zone\">Doctors want to give their patients every shot at survival, but can they justify prescribing a drug when it hasn’t been tested for that patient’s type of cancer? Many of these treatments bring risks of painful — even life-threatening— side effects and carry total price tags pushing $1 million. In some cases, insurers won’t pay.\u003c/p>\n\u003cp class=\"\">“Whether it works or not, the burden both financially and emotionally on families and patients is massive,” said Dr. Vicki Jackson, chief of Massachusetts General Hospital’s palliative care unit, which helps patients with their decision-making process. “If you try it and it doesn’t work, then you’ve used up all your life savings.”\u003c/p>\n\u003cp class=\"\">There are few objective guideposts to determine which patients should get which treatments, or even undergo genetic testing to determine whether they are among the minority of patients who might benefit substantially from immuno-oncology medicines. The dividing line is often drawn by variations in age, tumor stage, and underlying health status — and the weight given to those measures still relies on physician discretion.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“Is it ethically and morally appropriate to not offer these potentially curative options on the basis of a very slight difference in kidney or liver function?” asked Dr. Ephraim Hochberg, a Mass. General oncologist who specializes in lymphoma.\u003c/p>\n\u003cp>Precision medicine, and the use of genetic markers to predict the success of treatments, promises to help answer these questions. Scientists at Stanford, for example, \u003ca href=\"https://www.statnews.com/2018/05/14/cancer-immunotherapy-pet-predictor/\">engineered\u003c/a> a radioactive molecule, detectable by PET imaging, to track whether a patient’s T cells are activated and thus capable of fighting cancer if the patient is given immunotherapy.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The technique worked in lab mice but has not yet been tried in human patients, and other such approaches are further off. Meanwhile, patients and doctors are left to make life and death treatment decisions on uncertain terrain.\u003c/p>\n\u003cp>This struggle plays out on a near-daily basis at Mass. General, a Harvard-affiliated academic medical center with a deep well of resources and expertise. STAT interviews with specialists at the hospital reveal both the complexity of the variables at play, and the difficulty of establishing clear treatment protocols when data on real-world outcomes is still lacking.\u003c/p>\n\u003cp>The extent of these difficulties is only magnified for oncologists working with fewer resources in smaller community hospitals, where the vast majority of the nation’s cancer patients receive their care.\u003c/p>\n\u003cp>The uncertainty over treatment eligibility primarily pertains to a new class of treatments that harness the power of a patient’s immune system to attack cancer cells. These drugs have reached the market fairly recently, and have been tested in patients with a limited number of cancer types. And even in those types, the \u003ca href=\"https://www.statnews.com/2017/03/08/immunotherapy-cancer-breakthrough/\">drugs work only some of the time\u003c/a>.\u003c/p>\n\u003cp>These treatments include the checkpoint inhibitors Keytruda and Opdivo, CAR-T drugs such as Yescarta and \u003ca href=\"https://www.statnews.com/2017/08/30/novartis-car-t-cancer-approved/\">Kymriah\u003c/a>, and neo-antigen vaccines.\u003c/p>\n\u003cp>Hochberg often deals with patients who want to try \u003ca href=\"https://www.statnews.com/2017/10/27/car-t-kite-cell-journey/\">CAR-T therapy\u003c/a>, which re-engineers a patient’s T cells to recognize molecules on cancer cells and attack them. CAR-T drugs cost between $375,000 and $475,000, and the administration of treatment and follow-up care adds hundreds of thousands of thousands of dollars to the total bill.\u003c/p>\n\u003cp>In theory, CAR-T therapies can be tried on older patients whose bodies cannot withstand chemotherapy and radiation, but the National Comprehensive Cancer Network, which publishes treatment guidelines, has not established detailed eligibility criteria.\u003c/p>\n\u003cp>A similar struggle is playing out over the use of checkpoint inhibitors. It is not always clear which patients should get tested for a rare genetic condition, known as mismatch repair syndrome, that indicates receptivity to these drugs. While the testing is routinely conducted in treatment for patients with uterine and colon cancers, it is not always done for patients with other types of cancer.\u003c/p>\n\u003cp>“The fundamental problem is that it’s a costly test, so people are reluctant to make it automatic,” said Dr. David Ryan, clinical director of Mass. General’s Cancer Center. “Right now we’re relying on the oncologist to pick up those patients where there’s a reasonable chance of having mismatch repair deficiency, and ordering that test from pathology. Everybody’s having a hard time figuring out how to do this.”\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Insurers play a key role in making sure that sky-high spending for these drugs is based on evidence of efficacy. But their involvement cuts both ways. In some cases, they deny coverage for treatments even when they are recommended by oncologists who believe there is a strong scientific basis to back up their decisions.\u003c/p>\n\u003cp>That scenario arose recently for Dr. Zosia Piotrowska, a medical oncologist at Mass. General who specializes in treating lung cancer. She recommended a combination of targeted therapies for a 50-year-old mother of four who has struggled with metastatic lung cancer for five years.\u003c/p>\n\u003cp>The patient’s cancer is exceedingly rare and marked by a gene mutation that indicates greater receptivity to targeted therapies. Piotrowska said various combinations of treatments had allowed the patient to live a normal life for several years, but her insurer recently denied coverage for the new round of treatment, which comes with a price of $16,000 a month.\u003c/p>\n\u003cp>Piotrowska appealed the decision, but the insurer still denied coverage, citing a lack of support for the treatment option in National Comprehensive Cancer Network guidelines. Though such guidelines set forth detailed protocols, they do not address the myriad nuances of each type of cancer and rapid changes in treatment options.\u003c/p>\n\u003cp>“The guidelines can’t keep up with the pace of research,” Piotrowska said. “As we learn more and more and develop better treatments, certain patients fall into these loopholes where we understand the biology of what’s going on, we have a treatment, but you can’t explain it to the insurer.”\u003c/p>\n\u003cp>That denial of coverage means the patient must decide whether to pay out of pocket and drain family savings for an uncertain benefit. Piotrowska said this patient has enough resources to continue with treatment, but for the vast majority of patients, the price would mean certain financial ruin.\u003c/p>\n\u003cp>The advent of immune-based therapies is only making the decisions harder. For a \u003ca href=\"https://www.statnews.com/2017/03/08/immunotherapy-cancer-breakthrough/\">small percentage\u003c/a> of patients, the treatments can be a savior, but without comprehensive insurance coverage, they are guaranteed to lead to financial distress. And because there is not yet much data on how the patients who initially benefit are faring in the long run, it is nearly impossible for new patients and their families to assess costs and benefits.\u003c/p>\n\u003cp>Doctors said the confusion over who should get immune-based treatments is bound to be exacerbated by the passage last month of the controversial \u003ca href=\"https://www.statnews.com/2018/05/30/trump-signs-right-to-try/\">“right-to-try” legislation\u003c/a>, which aims to give patients with terminal illness a different pathway to try experimental medicines that haven’t yet been approved by the Food and Drug Administration. It will not be clear how the law will affect patients until regulations are clarified in the coming months.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003caside class=\"read-more standard\">\n\u003cdiv class=\"read-more-text\">\u003c/div>\n\u003c/aside>\n\u003cp>In some ways, the pressures and uncertainties posed by new cancer treatments are good problems to have. Julie Guillot said she wishes she’d had the luxury of such challenges when her son was sick.\u003c/p>\n\u003cp>Zach was diagnosed with acute myeloid leukemia when he was 5. For a boy of that age, concerns about unclear clinical benefits of treatments and sky high costs do not apply in the same way they might for an older patient. All the calculations point to the same answer: Try everything you can.\u003c/p>\n\u003cp>Zach received heavy doses of chemotherapy and three bone marrow transplants during years of expensive treatment that left him suffering from uncontrollable fevers, nausea, and infections. He died in 2014.\u003c/p>\n\u003cp>Guillot now works as an \u003ca href=\"https://www.statnews.com/2017/02/20/car-t-therapy-critics-just-dont-get/\">advocate\u003c/a> to help other patients get access to the best treatments and to ensure that experimentation in cancer care can continue to proceed on its inevitably hard and messy course toward cures.\u003c/p>\n\u003cp>“If we are avoidant of new therapies because of the risk, the lack of data, or the cost, breakthrough therapies like CAR-T and bone marrow transplant would never be developed,” she said. “When you are faced with this, people are willing to take risks for a chance to live.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>This story was originally published by \u003ca href=\"https://www.statnews.com/2018/06/04/cancer-care-dilemma-immunotherapy/\" target=\"_blank\" rel=\"noopener\">STAT\u003c/a>, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "This Digital Pill Wants To Make Following Your Prescription Easier",
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"content": "\u003cp>Doctors \u003ca href=\"http://annals.org/aim/fullarticle/1357338/interventions-improve-adherence-self-administered-medications-chronic-diseases-united-states\" target=\"_blank\" rel=\"noopener\">estimate\u003c/a> about half of all medications for chronic conditions are not taken as prescribed, resulting in $100 billion to $289 billion in preventable health care costs and more than 100,000 deaths every year in the U.S. \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/22510235\" target=\"_blank\" rel=\"noopener\">A majority of adults\u003c/a> say they struggle with remembering to take their prescriptions.[contextly_sidebar id=\"2CHr3EdFO0IpmlPpjqlB7AVQ3gwHnKDA\"]\u003c/p>\n\u003cp>Now, as with many other seemingly intractable challenges, technology has been enlisted to help. A new clinical study is underway at 16 health centers around the country to see if a pill with an ingestible sensor can improve medication adherence rates for \u003ca href=\"https://www.cdc.gov/hepatitis/hcv/cfaq.htm\" target=\"_blank\" rel=\"noopener\">Hepatitis C\u003c/a> drugs.\u003c/p>\n\u003cp>\u003ca href=\"https://www.proteus.com/\" target=\"_blank\" rel=\"noopener\">Proteus Digital Health\u003c/a>, the inventor of this so-called digital pill, is part of an emerging field of medicine and one of a handful of companies designing these high-tech pills.\u003c/p>\n\u003cp>While medication adherence is an issue for everyone, it can be especially difficult for patients with mental health and substance abuse conditions to rigorously follow their prescriptions.\u003c/p>\n\u003cp>And the latter is a significant factor in the spread of Hepatitis C. Intravenous drug use, particularly opioids, has fueled a \u003ca href=\"https://www.cdc.gov/nchhstp/newsroom/2017/Hepatitis-Surveillance-Press-Release.html\">spike in\u003c/a> Hepatitis C infections in recent years.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>On Wednesday’s PBS NewsHour, I explore how a new wave of Hepatitis C drugs, known as direct-acting antivirals, can cure the disease 95 percent of time when used as prescribed. But insurance providers have limited their payouts and the access for direct-acting antivirals, due to the drugs’ expensive price tag.\u003c/p>\n\u003cp>[youtube https://www.youtube.com/watch?v=3DN2gI87R3Q?feature=oembed]\u003c/p>\n\u003cp>David Wyles, head of infectious diseases at \u003ca href=\"https://www.denverhealth.org/\" target=\"_blank\" rel=\"noopener\">Denver Health\u003c/a> where the digital pill is being trialed, said the information gathered from the study may help \u003ca href=\"https://www.chlpi.org/chlpi-nvhr-launch-interactive-report-card-project-grading-52-medicaid-programs-discriminatory-hepatitis-c-treatment-restrictions/\" target=\"_blank\" rel=\"noopener\">convince insurers to expand access \u003c/a>to the new but more expensive Hepatitis C drugs. \u003ca href=\"https://www.denverhealth.org/\" target=\"_blank\" rel=\"noopener\">Denver Health\u003c/a> has 18 voluntary patients enrolled in the trial and is one of the largest study sites. The Colorado Department of Health estimates about \u003ca href=\"https://drive.google.com/file/d/0B0tmPQ67k3NVQjJXSFRGajdWUEE/view\" target=\"_blank\" rel=\"noopener\">70,000\u003c/a> people in the state carry Hepatitis C, and Denver Health cares for many of them.\u003c/p>\n\u003cp>“Insurance payers have imposed restrictions, not necessarily based on medical or scientific facts,” Wyles said. “This is a population that some will look at and say, ‘They won’t take their medications, why would we want to treat them?’ Potentially this study is something to refute that if we can show adherence rates are good.”[contextly_sidebar id=\"64LqO8WUg7X2FUJe9uqsRXqMVyuUE8BQ\"]\u003c/p>\n\u003cp>Proteus’ digital pill consists of the prescription medication with a tiny, FDA-approved ingestible sensor, packed inside a gel capsule. Once swallowed, minerals in the sensor react when they hit the acids in the stomach and create a tiny electronic signal. A band-aid-like patch, worn on the skin of the torso, captures this signal and relays it to an app on a smartphone or tablet.\u003c/p>\n\u003cp>Patients share the data with their doctors but also control who else has access. Their doctors can then monitor when and how many pills have been taken.\u003c/p>\n\u003cp>“If the patient misses a dose or a couple of doses, you can set up an alert in the program to send you an email. You can contact them and hopefully intervene right away,” David Wyles said. “Without the technology, you may not know anything until your next visit, which could be a month later, and then it’s too late to do anything.”\u003c/p>\n\u003cp>Yet the new technology raises questions about patient privacy. \u003ca href=\"https://psychnews.psychiatryonline.org/doi/full/10.1176/appi.pn.2017.pp12a2\" target=\"_blank\" rel=\"noopener\">Some doctors in the mental health community\u003c/a> expressed concerns last year about patient trust and misuse of data when the \u003ca href=\"https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm584933.htm\" target=\"_blank\" rel=\"noopener\">FDA approved\u003c/a> Proteus Digital Health’s sensors to be embedded in the antipsychotic drug \u003ca href=\"https://www.proteus.com/press-releases/otsuka-and-proteus-announce-the-first-us-fda-approval-of-a-digital-medicine-system-abilify-mycite/\" target=\"_blank\" rel=\"noopener\">Abilify.[contextly_sidebar id=\"BuXdE0rwLJ9KNHT80EszuM4r2ocN7n84\"]\u003c/a>\u003c/p>\n\u003cp>“In an era in which even the National Security Agency gets hacked, there are obvious concerns about patient privacy with a technology that communicates personal medical information,” Paul Appelbaum, director of the division of Law, Ethics, and Psychiatry at Columbia University, \u003ca href=\"https://psychnews.psychiatryonline.org/doi/full/10.1176/appi.pn.2017.pp12a2\" target=\"_blank\" rel=\"noopener\">told Psychiatric News\u003c/a>. “The potential for this technology to be misused by judges and probation officers who may require offenders to use pills with sensors, and then respond punitively to the most trivial failure to adhere to the treatment regimen, is real.”\u003c/p>\n\u003cp>Dr. George Savage, chief medical officer for Proteus Digital Health, said his company is adamant about patients controlling their own data: “The patient owns their own data and decides who to share it with beyond their medical team. We don’t sell data and never will.”\u003c/p>\n\u003cp>Nine health systems across the U.S. have used the technology so far for conditions like diabetes, heart failure, and hypertension. Proteus Digital Health is also testing the digital pills with oncology and HIV drugs, and on patients using opioids for pain relief. Dr. Savage said adherence rates with the digital pills have been shown to be high.\u003c/p>\n\u003cp>‘When we provide feedback to the patient, adherence is about 87 percent,” Savage said. “When we add in someone following up with a patient, like a doctor, adherence is 96 percent. Near perfection.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Editor’s note: This post has been updated to clarify that the signal is only sent once when the pill reaches the stomach acid and that the related patch is worn on the torso.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Doctors \u003ca href=\"http://annals.org/aim/fullarticle/1357338/interventions-improve-adherence-self-administered-medications-chronic-diseases-united-states\" target=\"_blank\" rel=\"noopener\">estimate\u003c/a> about half of all medications for chronic conditions are not taken as prescribed, resulting in $100 billion to $289 billion in preventable health care costs and more than 100,000 deaths every year in the U.S. \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/22510235\" target=\"_blank\" rel=\"noopener\">A majority of adults\u003c/a> say they struggle with remembering to take their prescriptions.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Now, as with many other seemingly intractable challenges, technology has been enlisted to help. A new clinical study is underway at 16 health centers around the country to see if a pill with an ingestible sensor can improve medication adherence rates for \u003ca href=\"https://www.cdc.gov/hepatitis/hcv/cfaq.htm\" target=\"_blank\" rel=\"noopener\">Hepatitis C\u003c/a> drugs.\u003c/p>\n\u003cp>\u003ca href=\"https://www.proteus.com/\" target=\"_blank\" rel=\"noopener\">Proteus Digital Health\u003c/a>, the inventor of this so-called digital pill, is part of an emerging field of medicine and one of a handful of companies designing these high-tech pills.\u003c/p>\n\u003cp>While medication adherence is an issue for everyone, it can be especially difficult for patients with mental health and substance abuse conditions to rigorously follow their prescriptions.\u003c/p>\n\u003cp>And the latter is a significant factor in the spread of Hepatitis C. Intravenous drug use, particularly opioids, has fueled a \u003ca href=\"https://www.cdc.gov/nchhstp/newsroom/2017/Hepatitis-Surveillance-Press-Release.html\">spike in\u003c/a> Hepatitis C infections in recent years.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>On Wednesday’s PBS NewsHour, I explore how a new wave of Hepatitis C drugs, known as direct-acting antivirals, can cure the disease 95 percent of time when used as prescribed. But insurance providers have limited their payouts and the access for direct-acting antivirals, due to the drugs’ expensive price tag.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutube'>\n \u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutubeInside'>\n \u003ciframe\n loading='lazy'\n class='utils-parseShortcode-shortcodes-__youtubeShortcode__youtubePlayer'\n type='text/html'\n src='//www.youtube.com/embed/3DN2gI87R3Q?feature=oembed'\n title='//www.youtube.com/embed/3DN2gI87R3Q?feature=oembed'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003c/p>\n\u003cp>David Wyles, head of infectious diseases at \u003ca href=\"https://www.denverhealth.org/\" target=\"_blank\" rel=\"noopener\">Denver Health\u003c/a> where the digital pill is being trialed, said the information gathered from the study may help \u003ca href=\"https://www.chlpi.org/chlpi-nvhr-launch-interactive-report-card-project-grading-52-medicaid-programs-discriminatory-hepatitis-c-treatment-restrictions/\" target=\"_blank\" rel=\"noopener\">convince insurers to expand access \u003c/a>to the new but more expensive Hepatitis C drugs. \u003ca href=\"https://www.denverhealth.org/\" target=\"_blank\" rel=\"noopener\">Denver Health\u003c/a> has 18 voluntary patients enrolled in the trial and is one of the largest study sites. The Colorado Department of Health estimates about \u003ca href=\"https://drive.google.com/file/d/0B0tmPQ67k3NVQjJXSFRGajdWUEE/view\" target=\"_blank\" rel=\"noopener\">70,000\u003c/a> people in the state carry Hepatitis C, and Denver Health cares for many of them.\u003c/p>\n\u003cp>“Insurance payers have imposed restrictions, not necessarily based on medical or scientific facts,” Wyles said. “This is a population that some will look at and say, ‘They won’t take their medications, why would we want to treat them?’ Potentially this study is something to refute that if we can show adherence rates are good.”\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Proteus’ digital pill consists of the prescription medication with a tiny, FDA-approved ingestible sensor, packed inside a gel capsule. Once swallowed, minerals in the sensor react when they hit the acids in the stomach and create a tiny electronic signal. A band-aid-like patch, worn on the skin of the torso, captures this signal and relays it to an app on a smartphone or tablet.\u003c/p>\n\u003cp>Patients share the data with their doctors but also control who else has access. Their doctors can then monitor when and how many pills have been taken.\u003c/p>\n\u003cp>“If the patient misses a dose or a couple of doses, you can set up an alert in the program to send you an email. You can contact them and hopefully intervene right away,” David Wyles said. “Without the technology, you may not know anything until your next visit, which could be a month later, and then it’s too late to do anything.”\u003c/p>\n\u003cp>Yet the new technology raises questions about patient privacy. \u003ca href=\"https://psychnews.psychiatryonline.org/doi/full/10.1176/appi.pn.2017.pp12a2\" target=\"_blank\" rel=\"noopener\">Some doctors in the mental health community\u003c/a> expressed concerns last year about patient trust and misuse of data when the \u003ca href=\"https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm584933.htm\" target=\"_blank\" rel=\"noopener\">FDA approved\u003c/a> Proteus Digital Health’s sensors to be embedded in the antipsychotic drug \u003ca href=\"https://www.proteus.com/press-releases/otsuka-and-proteus-announce-the-first-us-fda-approval-of-a-digital-medicine-system-abilify-mycite/\" target=\"_blank\" rel=\"noopener\">Abilify.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/a>\u003c/p>\n\u003cp>“In an era in which even the National Security Agency gets hacked, there are obvious concerns about patient privacy with a technology that communicates personal medical information,” Paul Appelbaum, director of the division of Law, Ethics, and Psychiatry at Columbia University, \u003ca href=\"https://psychnews.psychiatryonline.org/doi/full/10.1176/appi.pn.2017.pp12a2\" target=\"_blank\" rel=\"noopener\">told Psychiatric News\u003c/a>. “The potential for this technology to be misused by judges and probation officers who may require offenders to use pills with sensors, and then respond punitively to the most trivial failure to adhere to the treatment regimen, is real.”\u003c/p>\n\u003cp>Dr. George Savage, chief medical officer for Proteus Digital Health, said his company is adamant about patients controlling their own data: “The patient owns their own data and decides who to share it with beyond their medical team. We don’t sell data and never will.”\u003c/p>\n\u003cp>Nine health systems across the U.S. have used the technology so far for conditions like diabetes, heart failure, and hypertension. Proteus Digital Health is also testing the digital pills with oncology and HIV drugs, and on patients using opioids for pain relief. Dr. Savage said adherence rates with the digital pills have been shown to be high.\u003c/p>\n\u003cp>‘When we provide feedback to the patient, adherence is about 87 percent,” Savage said. “When we add in someone following up with a patient, like a doctor, adherence is 96 percent. Near perfection.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Editor’s note: This post has been updated to clarify that the signal is only sent once when the pill reaches the stomach acid and that the related patch is worn on the torso.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Chasing A New Way To Prevent HIV: Passive Immunization",
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"content": "\u003cp>After decades of intense effort, an effective vaccine against HIV is not on the horizon — and, some say, may never be possible. So some AIDS researchers are going passive.\u003c/p>\n\u003cp>As in passive immunization.[contextly_sidebar id=\"Xmf3XI2gbMPO20A46mYbeYfSv5R7TcOk\"]\u003c/p>\n\u003cp>Active immunization is what an effective vaccine does. It stimulates the recipient to make antibodies that protect against a disease. Passive immunization involves the direct injection of antibodies extracted from survivors of a particular infection.\u003c/p>\n\u003cp>It's an \u003ca href=\"https://academic.oup.com/cid/article/51/2/239/303856\" target=\"_blank\" rel=\"noopener\">old method\u003c/a> of preventing infection when a vaccine isn't available — once used, for instance, to protect at-risk people from hepatitis before vaccines were developed. Instead of the lifelong protection from a really good vaccine, passive immunization is a temporary bulwark against infection.\u003c/p>\n\u003cp>A \u003ca href=\"https://www.nature.com/articles/s41591-018-0001-2\" target=\"_blank\" rel=\"noopener\">new report\u003c/a> in \u003cem>Nature Medicine \u003c/em>gives reason to believe it can work against HIV — at least, so far, in monkeys.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[contextly_sidebar id=\"7iTJpxzoihSEFdeAGr40HVv2JFxPnQpZ\"]A single injection of two anti-HIV antibodies protected five of six macaque monkeys from infection for six to nine months as they got weekly inoculations of a potent human-simian hybrid of the virus called SHIV.\u003c/p>\n\u003cp>\"We think this approach might be an important way to prevent transmission in humans, particularly in regions of the world where HIV is endemic,\" says \u003ca href=\"https://irp.nih.gov/pi/malcolm-martin\" target=\"_blank\" rel=\"noopener\">Malcolm Martin\u003c/a>, chief of the viral pathogenesis and viral section of the National Institute of Allergies and Infectious Diseases and a senior author of the paper. \"This is not a vaccine but a way to prevention.\"\u003c/p>\n\u003cp>\u003ca href=\"https://www.gatesfoundation.org/Who-We-Are/General-Information/Leadership/Global-Health/Emilio-Emini\" target=\"_blank\" rel=\"noopener\">Emilio Emini\u003c/a>, director of the Gates Foundation's HIV program, a funder of the new research, agrees the approach is worth pushing. \"The potential is there for the development of a neutralizing antibody cocktail that could be injected to provide many months of protection against HIV infection,\" Emini says. (The Gates Foundation is also a funder of NPR and this blog.)\u003c/p>\n\u003cp>Over the last few years, scientists have identified something like 100 of these anti-HIV antibodies, giving them plenty of opportunities to mix and match for maximum effectiveness.\u003c/p>\n\u003cp>The hope is that an injection of these antibodies every six to 12 months could protect large numbers of people from HIV in parts of the world where most infections are occurring. Currently 1.8 million people are newly infected with HIV every year. And other means of prevention, such as a daily pill containing anti-HIV drugs, have proved too cumbersome. \"Taking a pill every day can be just about impossible to do in a population of young people, even under the best of circumstances,\" Emini says.\u003c/p>\n\u003cp>And protecting that young population is key. \"In southern Africa, in particular, over the past 10 or 15 years there's been an explosion of young people,\" Emini says. \"In many of these countries the average age is in the 20s. Having the means to protect these young people is something that will be absolutely critical to controlling the epidemic.\"[contextly_sidebar id=\"jyiWKAHmWck20bKRGd11NV0NQ6LVdv2F\"]\u003c/p>\n\u003cp>The \u003cem>Nature Medicine \u003c/em>paper is just the latest report from a burgeoning new branch of HIV research that's gathering momentum.\u003c/p>\n\u003cp>\"This is not just about doing cool science — and this is cool science,\" says Mitchell Warren, executive director of \u003ca href=\"https://www.avac.org/\">AVAC\u003c/a>, a global HIV prevention advocacy group. \"People are excited about this antibody research as a whole new prevention approach. The long-term goal is still a vaccine. But in HIV prevention we will take what we can get.\"\u003c/p>\n\u003cp>But if you've been following AIDS, you might be wondering how antibodies from HIV-infected people could possibly protect against infection. After all, the hallmark of HIV infection is that immune defenses don't work.\u003c/p>\n\u003cp>The answer is that researchers are using antibodies derived from a tiny fraction of HIV-infected people — about 1 percent — called \"elite controllers\" or (the term Martin prefers) \"elite neutralizers.\" As his term indicates, these \"elite\" patients make antibodies that can neutralize, or kill, HIV. The patients typically have low levels of the virus and can live longer without virus-suppressing drugs before they get symptoms of immune system collapse, or AIDS.\u003c/p>\n\u003cp>Ultimately, most elite neutralizers do progress to AIDS if they don't take antiviral drugs. The reason, Martin says, is that during the initial stages of their HIV infection, their immune system \"takes a major hit from which it never recovers.\" That allows HIV to establish hideaways, or reservoirs, in the body. By the time their immune systems start generating antibodies to neutralize HIV, Martin says, \"it's too late\" to keep the infection under control forever. The horse is out of the barn.\u003c/p>\n\u003cp>[contextly_sidebar id=\"w4gEpTxAayvKFMwRczIPppV0noiBfi2u\"]In the new work and \u003ca href=\"https://www.npr.org/sections/health-shots/2013/10/31/242093426/aids-scientists-encouraged-by-antibodies-that-hit-monkey-virus)\">previous experiments\u003c/a>, Martin and colleagues have identified the particular antibodies from these rare patients that can prevent HIV infection in the test tube. They then harvest these antibodies from patients and test them in monkeys to see if they prevent HIV infection from getting established in the first place. They've also learned to tweak the antibodies, introducing mutations that extend their lifetime in the bloodstream. And they've found that passive immunization works best when they combine two types of antibodies in one injection.\u003c/p>\n\u003cp>Two other findings improve the prospects that passive immunization may work in the real world:\u003c/p>\n\u003cul>\n\u003cli>It can be given by subcutaneous injections — a simple jab just under the skin — a much simpler and cheaper maneuver than the intravenous infusions used in earlier studies.\u003c/li>\n\u003cli>Small doses — three times lower than earlier IV doses — were enough to give many months of protection. That will bring the cost down too.\u003c/li>\n\u003c/ul>\n\u003cp>These elements \"make this report very important,\" Emini says. \"Everything is moving in the right direction.\"\u003c/p>\n\u003cp>Martin says another promising factor is the likelihood that the injected antibodies will stick around longer in humans' bloodstream than they do in monkeys' – thus offering more durable protection.\u003c/p>\n\u003cp>That's because a monkey's immune system recognizes the human-derived antibodies as foreign and so generate antibodies against the antibodies, clearing them from the blood. In studies when humans have been injected with these antibodies, Martin says, \"so far, there has been no report of humans ever developing anti-antibodies. So it's very likely, though we don't have proof of this, that these antibodies will last longer when we give them to humans.\"\u003c/p>\n\u003cp>The antibody cocktail researchers envision would contain neutralizing antibodies directed at multiple parts of the HIV outer coat. That would work against various strains of HIV circulating around the world and reduce the risk the virus would develop resistance.\u003c/p>\n\u003cp>Still, genetically engineered antibodies \"are actually quite expensive to produce,\" Emini acknowledges. \"So we need to develop ways to produce them at cost levels that are realistic for countries where most of the infection still occurs.\" The Gates Foundation's target price is no more than $150 per person per year — an amount comparable to the cost of HIV drug treatments now \u003ca href=\"https://www.npr.org/sections/health-shots/2013/10/31/242093426/aids-scientists-encouraged-by-antibodies-that-hit-monkey-virus)\">reaching 21 million people a year\u003c/a>.\u003c/p>\n\u003cp>Momentum behind the passive immunization against HIV is [contextly_sidebar id=\"qBSUXVbfErfptQT2yYDrSIGwPatdWI2n\"]growing. \u003ca href=\"https://www.avac.org/trial-search?field_prevention_option_tid%5B%5D=1&keys=&title=&field_status_value=Ongoing&field_phase_value=All\">Eight human studies are underway\u003c/a> using the approach.\u003c/p>\n\u003cp>Two of them are enrolling a total of 5,000 people at risk of HIV infection — men who have sex with men in the United States, Latin America and South Africa, and women in seven African countries.\u003c/p>\n\u003cp>Those trials are using one of the first of the 100 anti-HIV antibodies to be discovered, called VRC01. But it has to be delivered every two months in 45-minute intravenous infusions. So even if that's shown to be effective in preventing HIV infections, it's not going to be practical as a real-world prevention strategy.\u003c/p>\n\u003cp>The two-antibody combination in the new report might be. It's being injected into humans in a small study that began last August. It's designed to see if any adverse effects arise, but it can also yield useful data on how long the antibody persists in humans and whether humans mount an immune defense against them.\u003c/p>\n\u003cp>Even though the monkey studies and human trials are preliminary, there's a sense of urgency behind the passive-immunization approach. Despite surprising success in getting anti-HIV treatment to infected people in most-affected nations, nobody thinks the world can treat its way out of the HIV pandemic.\u003c/p>\n\u003cp>\"The concern is that if we don't control the pandemic, 15 or 20 years from now we'll have more people with HIV in southern Africa than we had 15 years ago,\" Emini says. \"So the urgency remains very strong, and getting stronger.\"\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Richard Knox is a New Hampshire-based health and science reporter, former NPR science correspondent and currently senior correspondent for WBUR in Boston. He's been reporting on HIV/AIDS since the beginning of the epidemic. Contact him @DickKnox\u003c/em>\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=Chasing+A+New+Way+To+Prevent+HIV%3A+Passive+Immunization&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>After decades of intense effort, an effective vaccine against HIV is not on the horizon — and, some say, may never be possible. So some AIDS researchers are going passive.\u003c/p>\n\u003cp>As in passive immunization.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Active immunization is what an effective vaccine does. It stimulates the recipient to make antibodies that protect against a disease. Passive immunization involves the direct injection of antibodies extracted from survivors of a particular infection.\u003c/p>\n\u003cp>It's an \u003ca href=\"https://academic.oup.com/cid/article/51/2/239/303856\" target=\"_blank\" rel=\"noopener\">old method\u003c/a> of preventing infection when a vaccine isn't available — once used, for instance, to protect at-risk people from hepatitis before vaccines were developed. Instead of the lifelong protection from a really good vaccine, passive immunization is a temporary bulwark against infection.\u003c/p>\n\u003cp>A \u003ca href=\"https://www.nature.com/articles/s41591-018-0001-2\" target=\"_blank\" rel=\"noopener\">new report\u003c/a> in \u003cem>Nature Medicine \u003c/em>gives reason to believe it can work against HIV — at least, so far, in monkeys.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>A single injection of two anti-HIV antibodies protected five of six macaque monkeys from infection for six to nine months as they got weekly inoculations of a potent human-simian hybrid of the virus called SHIV.\u003c/p>\n\u003cp>\"We think this approach might be an important way to prevent transmission in humans, particularly in regions of the world where HIV is endemic,\" says \u003ca href=\"https://irp.nih.gov/pi/malcolm-martin\" target=\"_blank\" rel=\"noopener\">Malcolm Martin\u003c/a>, chief of the viral pathogenesis and viral section of the National Institute of Allergies and Infectious Diseases and a senior author of the paper. \"This is not a vaccine but a way to prevention.\"\u003c/p>\n\u003cp>\u003ca href=\"https://www.gatesfoundation.org/Who-We-Are/General-Information/Leadership/Global-Health/Emilio-Emini\" target=\"_blank\" rel=\"noopener\">Emilio Emini\u003c/a>, director of the Gates Foundation's HIV program, a funder of the new research, agrees the approach is worth pushing. \"The potential is there for the development of a neutralizing antibody cocktail that could be injected to provide many months of protection against HIV infection,\" Emini says. (The Gates Foundation is also a funder of NPR and this blog.)\u003c/p>\n\u003cp>Over the last few years, scientists have identified something like 100 of these anti-HIV antibodies, giving them plenty of opportunities to mix and match for maximum effectiveness.\u003c/p>\n\u003cp>The hope is that an injection of these antibodies every six to 12 months could protect large numbers of people from HIV in parts of the world where most infections are occurring. Currently 1.8 million people are newly infected with HIV every year. And other means of prevention, such as a daily pill containing anti-HIV drugs, have proved too cumbersome. \"Taking a pill every day can be just about impossible to do in a population of young people, even under the best of circumstances,\" Emini says.\u003c/p>\n\u003cp>And protecting that young population is key. \"In southern Africa, in particular, over the past 10 or 15 years there's been an explosion of young people,\" Emini says. \"In many of these countries the average age is in the 20s. Having the means to protect these young people is something that will be absolutely critical to controlling the epidemic.\"\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The \u003cem>Nature Medicine \u003c/em>paper is just the latest report from a burgeoning new branch of HIV research that's gathering momentum.\u003c/p>\n\u003cp>\"This is not just about doing cool science — and this is cool science,\" says Mitchell Warren, executive director of \u003ca href=\"https://www.avac.org/\">AVAC\u003c/a>, a global HIV prevention advocacy group. \"People are excited about this antibody research as a whole new prevention approach. The long-term goal is still a vaccine. But in HIV prevention we will take what we can get.\"\u003c/p>\n\u003cp>But if you've been following AIDS, you might be wondering how antibodies from HIV-infected people could possibly protect against infection. After all, the hallmark of HIV infection is that immune defenses don't work.\u003c/p>\n\u003cp>The answer is that researchers are using antibodies derived from a tiny fraction of HIV-infected people — about 1 percent — called \"elite controllers\" or (the term Martin prefers) \"elite neutralizers.\" As his term indicates, these \"elite\" patients make antibodies that can neutralize, or kill, HIV. The patients typically have low levels of the virus and can live longer without virus-suppressing drugs before they get symptoms of immune system collapse, or AIDS.\u003c/p>\n\u003cp>Ultimately, most elite neutralizers do progress to AIDS if they don't take antiviral drugs. The reason, Martin says, is that during the initial stages of their HIV infection, their immune system \"takes a major hit from which it never recovers.\" That allows HIV to establish hideaways, or reservoirs, in the body. By the time their immune systems start generating antibodies to neutralize HIV, Martin says, \"it's too late\" to keep the infection under control forever. The horse is out of the barn.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>In the new work and \u003ca href=\"https://www.npr.org/sections/health-shots/2013/10/31/242093426/aids-scientists-encouraged-by-antibodies-that-hit-monkey-virus)\">previous experiments\u003c/a>, Martin and colleagues have identified the particular antibodies from these rare patients that can prevent HIV infection in the test tube. They then harvest these antibodies from patients and test them in monkeys to see if they prevent HIV infection from getting established in the first place. They've also learned to tweak the antibodies, introducing mutations that extend their lifetime in the bloodstream. And they've found that passive immunization works best when they combine two types of antibodies in one injection.\u003c/p>\n\u003cp>Two other findings improve the prospects that passive immunization may work in the real world:\u003c/p>\n\u003cul>\n\u003cli>It can be given by subcutaneous injections — a simple jab just under the skin — a much simpler and cheaper maneuver than the intravenous infusions used in earlier studies.\u003c/li>\n\u003cli>Small doses — three times lower than earlier IV doses — were enough to give many months of protection. That will bring the cost down too.\u003c/li>\n\u003c/ul>\n\u003cp>These elements \"make this report very important,\" Emini says. \"Everything is moving in the right direction.\"\u003c/p>\n\u003cp>Martin says another promising factor is the likelihood that the injected antibodies will stick around longer in humans' bloodstream than they do in monkeys' – thus offering more durable protection.\u003c/p>\n\u003cp>That's because a monkey's immune system recognizes the human-derived antibodies as foreign and so generate antibodies against the antibodies, clearing them from the blood. In studies when humans have been injected with these antibodies, Martin says, \"so far, there has been no report of humans ever developing anti-antibodies. So it's very likely, though we don't have proof of this, that these antibodies will last longer when we give them to humans.\"\u003c/p>\n\u003cp>The antibody cocktail researchers envision would contain neutralizing antibodies directed at multiple parts of the HIV outer coat. That would work against various strains of HIV circulating around the world and reduce the risk the virus would develop resistance.\u003c/p>\n\u003cp>Still, genetically engineered antibodies \"are actually quite expensive to produce,\" Emini acknowledges. \"So we need to develop ways to produce them at cost levels that are realistic for countries where most of the infection still occurs.\" The Gates Foundation's target price is no more than $150 per person per year — an amount comparable to the cost of HIV drug treatments now \u003ca href=\"https://www.npr.org/sections/health-shots/2013/10/31/242093426/aids-scientists-encouraged-by-antibodies-that-hit-monkey-virus)\">reaching 21 million people a year\u003c/a>.\u003c/p>\n\u003cp>Momentum behind the passive immunization against HIV is \u003c/p>\u003cp>\u003c/p>\u003cp>growing. \u003ca href=\"https://www.avac.org/trial-search?field_prevention_option_tid%5B%5D=1&keys=&title=&field_status_value=Ongoing&field_phase_value=All\">Eight human studies are underway\u003c/a> using the approach.\u003c/p>\n\u003cp>Two of them are enrolling a total of 5,000 people at risk of HIV infection — men who have sex with men in the United States, Latin America and South Africa, and women in seven African countries.\u003c/p>\n\u003cp>Those trials are using one of the first of the 100 anti-HIV antibodies to be discovered, called VRC01. But it has to be delivered every two months in 45-minute intravenous infusions. So even if that's shown to be effective in preventing HIV infections, it's not going to be practical as a real-world prevention strategy.\u003c/p>\n\u003cp>The two-antibody combination in the new report might be. It's being injected into humans in a small study that began last August. It's designed to see if any adverse effects arise, but it can also yield useful data on how long the antibody persists in humans and whether humans mount an immune defense against them.\u003c/p>\n\u003cp>Even though the monkey studies and human trials are preliminary, there's a sense of urgency behind the passive-immunization approach. Despite surprising success in getting anti-HIV treatment to infected people in most-affected nations, nobody thinks the world can treat its way out of the HIV pandemic.\u003c/p>\n\u003cp>\"The concern is that if we don't control the pandemic, 15 or 20 years from now we'll have more people with HIV in southern Africa than we had 15 years ago,\" Emini says. \"So the urgency remains very strong, and getting stronger.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Richard Knox is a New Hampshire-based health and science reporter, former NPR science correspondent and currently senior correspondent for WBUR in Boston. He's been reporting on HIV/AIDS since the beginning of the epidemic. Contact him @DickKnox\u003c/em>\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=Chasing+A+New+Way+To+Prevent+HIV%3A+Passive+Immunization&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp class=\"p1\">A cutting-edge immune system treatment cured certain cancers in 97 percent of mice, and it didn’t require chemotherapy. The treatment is now headed for a human trial at the \u003ca href=\"http://med.stanford.edu/\" target=\"_blank\" rel=\"noopener\">Stanford University School of Medicine.\u003c/a>\u003c/p>\n\u003cp>[contextly_sidebar id=\"kQL3J5XDxpDn2B9MPaqB9jKa15YAzuFt\"]Stanford researchers looked at four types of tumors— breast cancer, colon cancer, lymphoma, and melanoma. The clinical trial will, however, be limited to individuals with low-grade lymphoma.\u003c/p>\n\u003cp>The \u003ca href=\"http://stm.sciencemag.org/content/10/426/eaan4488\" target=\"_blank\" rel=\"noopener\">study\u003c/a>, published in journal \u003ca href=\"http://stm.sciencemag.org/\" target=\"_blank\" rel=\"noopener\">Science Translational Medicine, \u003c/a>is part of a new wave of innovative cancer research focusing on the body's immune system. Recent developments in the field mark a watershed moment in cancer research, says Ronald Levy, a Stanford oncology professor and the study's senior author.\u003c/p>\n\u003cp>[contextly_sidebar id=\"bc7NJIwxkt2B4Cp42gfRjdCM1aSALuS5\"]The \u003ca href=\"http://med.stanford.edu/news/all-news/2018/01/cancer-vaccine-eliminates-tumors-in-mice.html\" target=\"_blank\" rel=\"noopener\">treatment\u003c/a> injects two immune stimulants directly into a tumor. The combination of stimulants activates the immune system's T-cells, the white blood cells responsible for fighting signs of infection in the body. In the successfully treated mice, the activated cells eliminated the entire tumor from the bodies of the mice.\u003c/p>\n\u003cp>\"It's really a very exciting time,\" says Levy. \"These successful therapies have come after decades of work in trying to make the immune system fight the cancer. And now that we know that it's possible, it has brought an enormous amount of interest and investment into the field.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The side affects of the treatment are typically what you would expect from any injection — possible fever and soreness at the injection site.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>While the clinical trial has not yet started, Stanford Medical School researchers are currently accepting applications for volunteers and \u003ca href=\"http://med.stanford.edu/cancer/trials/vaccine.html\" target=\"_blank\" rel=\"noopener\">providing information\u003c/a> about the study.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp class=\"p1\">A cutting-edge immune system treatment cured certain cancers in 97 percent of mice, and it didn’t require chemotherapy. The treatment is now headed for a human trial at the \u003ca href=\"http://med.stanford.edu/\" target=\"_blank\" rel=\"noopener\">Stanford University School of Medicine.\u003c/a>\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>Stanford researchers looked at four types of tumors— breast cancer, colon cancer, lymphoma, and melanoma. The clinical trial will, however, be limited to individuals with low-grade lymphoma.\u003c/p>\n\u003cp>The \u003ca href=\"http://stm.sciencemag.org/content/10/426/eaan4488\" target=\"_blank\" rel=\"noopener\">study\u003c/a>, published in journal \u003ca href=\"http://stm.sciencemag.org/\" target=\"_blank\" rel=\"noopener\">Science Translational Medicine, \u003c/a>is part of a new wave of innovative cancer research focusing on the body's immune system. Recent developments in the field mark a watershed moment in cancer research, says Ronald Levy, a Stanford oncology professor and the study's senior author.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>The \u003ca href=\"http://med.stanford.edu/news/all-news/2018/01/cancer-vaccine-eliminates-tumors-in-mice.html\" target=\"_blank\" rel=\"noopener\">treatment\u003c/a> injects two immune stimulants directly into a tumor. The combination of stimulants activates the immune system's T-cells, the white blood cells responsible for fighting signs of infection in the body. In the successfully treated mice, the activated cells eliminated the entire tumor from the bodies of the mice.\u003c/p>\n\u003cp>\"It's really a very exciting time,\" says Levy. \"These successful therapies have come after decades of work in trying to make the immune system fight the cancer. And now that we know that it's possible, it has brought an enormous amount of interest and investment into the field.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "A Dietary Supplement Makes Old Mice Youthful. Will It Work in People?",
"title": "A Dietary Supplement Makes Old Mice Youthful. Will It Work in People?",
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"content": "\u003cp>Transfusing \u003ca href=\"https://www.statnews.com/2018/03/02/young-blood-anti-aging-study/\" target=\"_blank\" rel=\"noopener\">young blood\u003c/a> and freezing heads may get most of the anti-aging and life-extension buzz, but don’t count out the molecule hunters: After setbacks and stumbles and what critics called \u003ca href=\"http://blogs.sciencemag.org/pipeline/archives/2010/01/12/the_sirtris_compounds_worthless_really\" target=\"_blank\" rel=\"noopener\">debacles\u003c/a>, these scientists are figuring out which biochemicals might potentially, possibly be fountains of youth in pill form.[contextly_sidebar id=\"YaFBEqHshnjDvp4XR5pAEiDxJjAI7Fx4\"]\u003c/p>\n\u003cp>In the latest advance, biologists \u003ca href=\"http://www.cell.com/cell/fulltext/S0092-8674(18)30152-1\" target=\"_blank\" rel=\"noopener\">reported\u003c/a> on Thursday that a molecule already sold by supplement makers (even as scientists scramble to understand it) restored youthfulness to blood vessels in 20-month-old mice, an age comparable to 70 years in people. The research supports the idea that boosting certain genes and molecules that fade with age could keep people functional, resilient, and even spry well into their 80s, even without living longer.\u003c/p>\n\u003cp>“I think it’s quite an important paper,” said Dr. Eric Verdin, of the California-based Buck Institute for Research on Aging, who was not involved in the\u003ca href=\"https://www.kqed.org/futureofyou/439750/superagers-maintain-memory-into-80s-and-90s\" target=\"_blank\" rel=\"noopener\"> new research\u003c/a>. “It’s probably not the magic pill everyone is looking for, but it’s one more brick in our efforts to understand aging and healthspan,” or how long people can stay biologically young(ish) even as their birthday candles proliferate.[contextly_sidebar id=\"Vl0Meh1Zh9UAHnk3RIGR5S5B5rBQ0sSW\"]\u003c/p>\n\u003cp>Others were more skeptical, calling the advance at best “incremental” (and asking to remain anonymous so as not to antagonize colleagues). And science is littered with examples of compounds that worked in mice but not people. “It’s hard to tell how significant any contribution is until it has been replicated and extended” by other labs, said David Harrison of the Jackson Lab, an expert on the molecular \u003ca href=\"https://www.kqed.org/futureofyou/440080/hearts-get-younger-even-at-middle-age-with-exercise\" target=\"_blank\" rel=\"noopener\">mechanisms of aging.\u003c/a>\u003c/p>\n\u003caside>\u003c/aside>\n\u003cp>The new study, in Cell, found that boosting mice’s levels of the naturally occurring molecule NMN, which humans also have, increased levels of another called NAD+. That, in turn, raised levels of a famous anti-aging enzyme called SIRT1, which has been the focus of nearly 30 years of research.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>After two months of NMN, more blood vessels sprouted in the old mice’s muscles. The density of the smallest vessels — capillaries — became comparable to that of young mice. Blood flow increased, and the animals’ endurance, measured by how long they could run on a treadmill before becoming exhausted, was 56 percent to 80 percent greater than that of untreated old mice: 1,400 feet compared to 780 feet.[contextly_sidebar id=\"8Tmsn0Ufo1g8AeUi0b3OJ5Td2G7sq49c\"]\u003c/p>\n\u003cp>The treated mice also benefitted from exercise like mice half their age. In young animals, exercise spurs the creation of new blood vessels and boosts muscle mass, but that effect weakens with age in both people and mice. NMN restored the blood-vessel- and muscle-boosting effects of a good treadmill run, basically “reversing vascular aging in the mice,” said study co-leader David Sinclair of Harvard Medical School.\u003c/p>\n\u003cp>\u003cimg class=\"aligncenter wp-image-440373 size-medium\" title=\"iStock\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/03/iStock-639071970-800x588.jpg\" alt=\"\" width=\"800\" height=\"588\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-639071970-800x588.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-639071970-160x118.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-639071970-768x564.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-639071970-1020x749.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-639071970-1920x1411.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-639071970-1180x867.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-639071970-960x705.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-639071970-240x176.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-639071970-375x275.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-639071970-520x382.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/p>\n\u003cp>Opinions differed on how important that is. One expert on the biology of aging said, “So David’s found another molecule that prevents aging?” (Sinclair was a prominent exponent of resveratrol, a compound that slowed aging in mice but proved disappointing in people.) The Jax’s Harrison questioned whether the inbred mice used in the study were representative of humans, who are genetically diverse.\u003c/p>\n\u003cp>New blood vessels could also be a mixed blessing. They support the growth of tumors, which is why anti-angiogenesis molecules have become cancer drugs. The scientists found no excess cancers in the mice given NMR, but “more study is warranted,” they wrote.[contextly_sidebar id=\"EmvIbKqj3sGiXrLYKODcw1UEPJNlCkZr\"]\u003c/p>\n\u003cp>The blood-vessel benefits of NMN didn’t happen if the mice lacked the SIRT1 gene, probably the brightest star in the anti-aging firmament. In the 1990s, it and the six other genes belonging to the family called sirtuins took aging research by storm, as biologists showed that increasing the genes’ activity extended lifespan in yeast, roundworms, and fruit flies by up to 30 percent. When Massachusetts Institute of Technology’s Leonard Guarente, whose lab was sirtuin central, found that the lifespan-extending effect of drastic caloric restriction works by turning up sirtuin genes, it seemed to point the way to slowing aging: Activate sirtuins with a molecule.\u003c/p>\n\u003cp>That proved easier said than done. Some studies, especially in higher animals, contradicted the simple notion that overexpression of sirtuins translated into longer life. The biggest setback involved resveratrol, a compound found in grapes and wine, which activates the SIRT1 gene. After years of hyperbolic headlines and soaring sales, the resveratrol bubble burst. GlaxoSmithKline bought Cambridge, Mass.-based Sirtris Pharmaceuticals, which Sinclair co-founded in 2004 to develop sirtuin-boosting compounds, for $720 million, but within five years essentially shut it down.[contextly_sidebar id=\"FSd7BTxFEMjJhm2kkUJ0cTaJQITZc3CT\"]\u003c/p>\n\u003cp>“Resveratrol is very, very good [at activating SIRT1 and extending lifespan] if you’re a mouse,” said Guarente, who cheerfully acknowledges buying a 10-year supply of micronized resveratrol. Most of it is still in his basement. “But the human trials were all over the place, which was unsettling,” he said.\u003c/p>\n\u003cp>Those failures led scientists to search for other sirtuin-boosting molecules. In 2014, Guarente co-founded Elysium Health, which, for $40 to $60 per month, sells a dietary supplement that boosts NAD+ levels and activates SIRT1. Since levels of NAD+ fall as people age, the hope is that providing the raw material for it will raise those levels, slowing aging. The pills seem to be safe, Guarente and colleagues \u003ca href=\"https://www.nature.com/articles/s41514-017-0016-9\" target=\"_blank\" rel=\"noopener\">reported\u003c/a> last year, and additional human studies are underway to test whether they benefit health.\u003c/p>\n\u003cp>Thanks to \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3188402/\" target=\"_blank\" rel=\"noopener\">negative studies\u003c/a>, the jury is still out on whether anything related to sirtuins will extend lifespan, but the Cell study offers some hope for extending healthspan. If boosting NAD+ promotes blood vessel formation via SIRT1, it might “rescue muscle mass” that otherwise decreases as blood vessels atrophy, Guarente said. That could prevent the bone loss, frailty, and falls that can be fatal in old age.\u003c/p>\n\u003cp>“Anything that contributes to muscle health through vascular health is likely to be quite important,” said the Buck Institute’s Verdin, who takes a daily NAD+ precursor.\u003c/p>\n\u003caside>\u003c/aside>\n\u003cp>Sinclair and his team are now studying whether raising NAD+ might also spur the creation of blood vessels in the brain. There and in other organs, said Sinclair, “the lack of oxygen and buildup of waste products” that results from loss of small blood vessels “sets off a downward spiral of disease and disability.” In the brain, that would include vascular dementia.\u003c/p>\n\u003cp>Sinclair takes NMN to boost NAD+ levels. “In someone my age [49], it’s probably harder to see immediate benefits,” he said, though he said he feels sharper and younger on it. After his 78-year-old father began taking NMN “he started climbing mountains and going whitewater rafting and looking forward to the next five years,” Sinclair said. “It might be psychological, but it isn’t hurting.”\u003c/p>\n\u003cp>Only rigorous human research can determine that. Metro International Biotech, a Michigan-based startup for which Sinclair consults, just finished a clinical trial of the safety of a proprietary version of NMN and hopes to start a trial of the molecule’s efficacy this year, Sinclair said.\u003c/p>\n\u003cp>One concern is that boosting sirtuins could backfire. An excess of the molecules, Verdin said, can promote autoimmunity, which causes diseases such as Crohn’s and rheumatoid arthritis.\u003c/p>\n\u003cp>“That should give us pause about broad claims of what they can do,” he cautioned. “I worry sometimes that [with NAD+-boosting pills already on the market] the field is getting ahead of itself.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This story was originally published by\u003ca href=\"https://www.statnews.com/\" target=\"_blank\" rel=\"noopener\"> STAT\u003c/a>, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Transfusing \u003ca href=\"https://www.statnews.com/2018/03/02/young-blood-anti-aging-study/\" target=\"_blank\" rel=\"noopener\">young blood\u003c/a> and freezing heads may get most of the anti-aging and life-extension buzz, but don’t count out the molecule hunters: After setbacks and stumbles and what critics called \u003ca href=\"http://blogs.sciencemag.org/pipeline/archives/2010/01/12/the_sirtris_compounds_worthless_really\" target=\"_blank\" rel=\"noopener\">debacles\u003c/a>, these scientists are figuring out which biochemicals might potentially, possibly be fountains of youth in pill form.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>In the latest advance, biologists \u003ca href=\"http://www.cell.com/cell/fulltext/S0092-8674(18)30152-1\" target=\"_blank\" rel=\"noopener\">reported\u003c/a> on Thursday that a molecule already sold by supplement makers (even as scientists scramble to understand it) restored youthfulness to blood vessels in 20-month-old mice, an age comparable to 70 years in people. The research supports the idea that boosting certain genes and molecules that fade with age could keep people functional, resilient, and even spry well into their 80s, even without living longer.\u003c/p>\n\u003cp>“I think it’s quite an important paper,” said Dr. Eric Verdin, of the California-based Buck Institute for Research on Aging, who was not involved in the\u003ca href=\"https://www.kqed.org/futureofyou/439750/superagers-maintain-memory-into-80s-and-90s\" target=\"_blank\" rel=\"noopener\"> new research\u003c/a>. “It’s probably not the magic pill everyone is looking for, but it’s one more brick in our efforts to understand aging and healthspan,” or how long people can stay biologically young(ish) even as their birthday candles proliferate.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Others were more skeptical, calling the advance at best “incremental” (and asking to remain anonymous so as not to antagonize colleagues). And science is littered with examples of compounds that worked in mice but not people. “It’s hard to tell how significant any contribution is until it has been replicated and extended” by other labs, said David Harrison of the Jackson Lab, an expert on the molecular \u003ca href=\"https://www.kqed.org/futureofyou/440080/hearts-get-younger-even-at-middle-age-with-exercise\" target=\"_blank\" rel=\"noopener\">mechanisms of aging.\u003c/a>\u003c/p>\n\u003caside>\u003c/aside>\n\u003cp>The new study, in Cell, found that boosting mice’s levels of the naturally occurring molecule NMN, which humans also have, increased levels of another called NAD+. That, in turn, raised levels of a famous anti-aging enzyme called SIRT1, which has been the focus of nearly 30 years of research.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>After two months of NMN, more blood vessels sprouted in the old mice’s muscles. The density of the smallest vessels — capillaries — became comparable to that of young mice. Blood flow increased, and the animals’ endurance, measured by how long they could run on a treadmill before becoming exhausted, was 56 percent to 80 percent greater than that of untreated old mice: 1,400 feet compared to 780 feet.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The treated mice also benefitted from exercise like mice half their age. In young animals, exercise spurs the creation of new blood vessels and boosts muscle mass, but that effect weakens with age in both people and mice. NMN restored the blood-vessel- and muscle-boosting effects of a good treadmill run, basically “reversing vascular aging in the mice,” said study co-leader David Sinclair of Harvard Medical School.\u003c/p>\n\u003cp>\u003cimg class=\"aligncenter wp-image-440373 size-medium\" title=\"iStock\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/03/iStock-639071970-800x588.jpg\" alt=\"\" width=\"800\" height=\"588\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-639071970-800x588.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-639071970-160x118.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-639071970-768x564.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-639071970-1020x749.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-639071970-1920x1411.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-639071970-1180x867.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-639071970-960x705.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-639071970-240x176.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-639071970-375x275.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-639071970-520x382.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/p>\n\u003cp>Opinions differed on how important that is. One expert on the biology of aging said, “So David’s found another molecule that prevents aging?” (Sinclair was a prominent exponent of resveratrol, a compound that slowed aging in mice but proved disappointing in people.) The Jax’s Harrison questioned whether the inbred mice used in the study were representative of humans, who are genetically diverse.\u003c/p>\n\u003cp>New blood vessels could also be a mixed blessing. They support the growth of tumors, which is why anti-angiogenesis molecules have become cancer drugs. The scientists found no excess cancers in the mice given NMR, but “more study is warranted,” they wrote.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The blood-vessel benefits of NMN didn’t happen if the mice lacked the SIRT1 gene, probably the brightest star in the anti-aging firmament. In the 1990s, it and the six other genes belonging to the family called sirtuins took aging research by storm, as biologists showed that increasing the genes’ activity extended lifespan in yeast, roundworms, and fruit flies by up to 30 percent. When Massachusetts Institute of Technology’s Leonard Guarente, whose lab was sirtuin central, found that the lifespan-extending effect of drastic caloric restriction works by turning up sirtuin genes, it seemed to point the way to slowing aging: Activate sirtuins with a molecule.\u003c/p>\n\u003cp>That proved easier said than done. Some studies, especially in higher animals, contradicted the simple notion that overexpression of sirtuins translated into longer life. The biggest setback involved resveratrol, a compound found in grapes and wine, which activates the SIRT1 gene. After years of hyperbolic headlines and soaring sales, the resveratrol bubble burst. GlaxoSmithKline bought Cambridge, Mass.-based Sirtris Pharmaceuticals, which Sinclair co-founded in 2004 to develop sirtuin-boosting compounds, for $720 million, but within five years essentially shut it down.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>“Resveratrol is very, very good [at activating SIRT1 and extending lifespan] if you’re a mouse,” said Guarente, who cheerfully acknowledges buying a 10-year supply of micronized resveratrol. Most of it is still in his basement. “But the human trials were all over the place, which was unsettling,” he said.\u003c/p>\n\u003cp>Those failures led scientists to search for other sirtuin-boosting molecules. In 2014, Guarente co-founded Elysium Health, which, for $40 to $60 per month, sells a dietary supplement that boosts NAD+ levels and activates SIRT1. Since levels of NAD+ fall as people age, the hope is that providing the raw material for it will raise those levels, slowing aging. The pills seem to be safe, Guarente and colleagues \u003ca href=\"https://www.nature.com/articles/s41514-017-0016-9\" target=\"_blank\" rel=\"noopener\">reported\u003c/a> last year, and additional human studies are underway to test whether they benefit health.\u003c/p>\n\u003cp>Thanks to \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3188402/\" target=\"_blank\" rel=\"noopener\">negative studies\u003c/a>, the jury is still out on whether anything related to sirtuins will extend lifespan, but the Cell study offers some hope for extending healthspan. If boosting NAD+ promotes blood vessel formation via SIRT1, it might “rescue muscle mass” that otherwise decreases as blood vessels atrophy, Guarente said. That could prevent the bone loss, frailty, and falls that can be fatal in old age.\u003c/p>\n\u003cp>“Anything that contributes to muscle health through vascular health is likely to be quite important,” said the Buck Institute’s Verdin, who takes a daily NAD+ precursor.\u003c/p>\n\u003caside>\u003c/aside>\n\u003cp>Sinclair and his team are now studying whether raising NAD+ might also spur the creation of blood vessels in the brain. There and in other organs, said Sinclair, “the lack of oxygen and buildup of waste products” that results from loss of small blood vessels “sets off a downward spiral of disease and disability.” In the brain, that would include vascular dementia.\u003c/p>\n\u003cp>Sinclair takes NMN to boost NAD+ levels. “In someone my age [49], it’s probably harder to see immediate benefits,” he said, though he said he feels sharper and younger on it. After his 78-year-old father began taking NMN “he started climbing mountains and going whitewater rafting and looking forward to the next five years,” Sinclair said. “It might be psychological, but it isn’t hurting.”\u003c/p>\n\u003cp>Only rigorous human research can determine that. Metro International Biotech, a Michigan-based startup for which Sinclair consults, just finished a clinical trial of the safety of a proprietary version of NMN and hopes to start a trial of the molecule’s efficacy this year, Sinclair said.\u003c/p>\n\u003cp>One concern is that boosting sirtuins could backfire. An excess of the molecules, Verdin said, can promote autoimmunity, which causes diseases such as Crohn’s and rheumatoid arthritis.\u003c/p>\n\u003cp>“That should give us pause about broad claims of what they can do,” he cautioned. “I worry sometimes that [with NAD+-boosting pills already on the market] the field is getting ahead of itself.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>This story was originally published by\u003ca href=\"https://www.statnews.com/\" target=\"_blank\" rel=\"noopener\"> STAT\u003c/a>, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>When Shaun Banagan hops up on the exam table in a doctor's office at UCSF Benioff Children’s Hospital his small frame barely crumples the wax paper. The shy 13-year-old has very thin arms and slight wrists.\u003c/p>\n\u003caside class=\"pullquote alignright\">'If this had been a year or two ago we wouldn’t have had this treatment to offer him.'\u003ccite>Dr. Jennifer Willert, UCSF\u003c/cite>\u003c/aside>\n\u003cp>It's October, 2017, and Shaun and his family are waiting anxiously for his oncologist, Dr. Jennifer Willert, to read his latest lab results.\u003c/p>\n\u003cp>“He’s in full remission right now without any detectable disease,\" Willert says. \"So, he’s as negative as you can possibly get!\"\u003c/p>\n\u003cp>The small teen pulls aside his surgical face mask and smiles.\u003c/p>\n\u003cp>\u003cstrong>A Grueling Battle \u003c/strong>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Shaun is one of at least 50\u003cstrong> \u003c/strong>children who are in remission because of a breakthrough treatment that engineers the body's own immune system to fight cancer. Last August, the U.S. Food and Drug Administration (FDA) \u003ca href=\"https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm574058.htm\" target=\"_blank\" rel=\"noopener\">approved\u003c/a> the treatment -- the first accepted gene therapy in the nation -- based on the success of clinical trials like Shaun's.\u003c/p>\n\u003cp>But Shaun's family didn’t know if this day would ever come. Six years ago, he was diagnosed with a form of leukemia called Acute Lymphoblastic Leukemia (ALL), which is the most common cancer in children. The National Cancer Institute estimates that about 3,100 patients under age 20 are diagnosed with ALL each year in America.\u003c/p>\n\u003cfigure id=\"attachment_439703\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-439703\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/02/IMG_4083-e1519260166462-800x511.jpg\" alt=\"\" width=\"800\" height=\"511\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/02/IMG_4083-e1519260166462-800x511.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/02/IMG_4083-e1519260166462-160x102.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/02/IMG_4083-e1519260166462-768x491.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/02/IMG_4083-e1519260166462-1020x652.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2018/02/IMG_4083-e1519260166462-1180x754.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2018/02/IMG_4083-e1519260166462-960x613.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2018/02/IMG_4083-e1519260166462-240x153.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/02/IMG_4083-e1519260166462-375x240.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/02/IMG_4083-e1519260166462-520x332.jpg 520w, https://ww2.kqed.org/app/uploads/sites/13/2018/02/IMG_4083-e1519260166462.jpg 1809w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Shaun Banagan with his mom, Sheila, and his dad, Clifford, at a doctor appointment in San Francisco. \u003ccite>(Lesley McClurg/ KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Shaun started chemotherapy for the blood cancer a few weeks after his diagnosis. It was his eighth birthday.\u003c/p>\n\u003cp>Suddenly, playing outside was off limits. Shaun's condition made him prone to bleeding. Shaun's mom, Sheila Banagan, started home schooling him -- that is, when he didn’t have fever or nausea. He spent hours day after day at the hospital, and before long he lost his hair.\u003c/p>\n\u003cp>\u003cstrong>A Flicker of Hope \u003c/strong>\u003c/p>\n\u003cp>Then, after three-and-a-half years, Shaun’s blood tests were normal. His nurses filled the clinic with banners and balloons. They were just about to cut the cake when a doctor interrupted the party.\u003c/p>\n\u003cp>The cancer had returned.\u003c/p>\n\u003cp>“It just crushes your world,\" Sheila Banagan says. \"The littlest tiniest bit of hope was taken away from me.\"\u003c/p>\n\u003cp>Shaun endured a second round of intensified chemotherapy to prepare his system for a bone marrow transplant. The procedure went well, but six months later he relapsed.\u003c/p>\n\u003cdiv class=\"sharedaddy show-for-medium-up\">\u003ca href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/02/CART_DESKTOP_V04_180223.jpg\">\u003cimg class=\"aligncenter size-full wp-image-439753\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/02/CART_DESKTOP_V04_180223.jpg\" alt=\"\" width=\"975\" height=\"802\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/02/CART_DESKTOP_V04_180223.jpg 975w, https://ww2.kqed.org/app/uploads/sites/13/2018/02/CART_DESKTOP_V04_180223-160x132.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/02/CART_DESKTOP_V04_180223-800x658.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/02/CART_DESKTOP_V04_180223-768x632.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/02/CART_DESKTOP_V04_180223-960x790.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2018/02/CART_DESKTOP_V04_180223-240x197.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/02/CART_DESKTOP_V04_180223-375x308.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/02/CART_DESKTOP_V04_180223-520x428.jpg 520w\" sizes=\"(max-width: 975px) 100vw, 975px\">\u003c/a>\u003c/div>\n\u003cdiv class=\"show-for-small-only\">\u003c/div>\n\u003cp> \u003c/p>\n\u003caside class=\"pullquote alignright\">'The science is exciting. The results have been spectacular for some people.'\u003ccite>Dr. Len Lichtenfeld,\u003cbr>\nAmerican Cancer Society\u003c/cite>\u003c/aside>\n\u003cp>\u003cstrong>Last-Ditch Option\u003c/strong>\u003c/p>\n\u003cp>Dr. Willert knew there was only one possibility left. UCSF was just about to launch its first clinical trial using a breakthrough therapy.\u003c/p>\n\u003cp>“If this had been a year or two ago we wouldn’t have had this treatment to offer him,\" says Willert.\u003c/p>\n\u003cp>The therapy is called \u003ca href=\"https://www.cancer.org/treatment/treatments-and-side-effects/treatment-types/immunotherapy/car-t-cell1.html\" target=\"_blank\" rel=\"noopener\">CAR-T\u003c/a>-- which stands for chimeric antigen receptor (CAR) T-cell therapy -- and it's intended to super-boost the immune system. Doctors try CAR-T when everything else fails.\u003c/p>\n\u003cp>Shaun’s medical team shipped a sample of his blood to a lab. There, scientists genetically engineered his immune cells to detect his cancer cells and destroy them. In other words, they hacked the cells. Technicians multiplied massive numbers of new cells and then sent the reprogrammed blood back to San Francisco where Shaun received an infusion. His blood was now full of virulent cancer killers.\u003c/p>\n\u003cp>\u003cb>'Severe' Side Effects\u003c/b>\u003c/p>\n\u003cp>The key to CAR-T therapy is that it solves a central problem with cancer. Usually the body's immune system doesn't recognize cancer cells as foreign, and that's why they can proliferate without the body's usual defenses. CAR-T therapy is like giving the immune system glasses.\u003c/p>\n\u003cp>\"CAR-T can wake the immune system up so it recognizes cancer cells as abnormal,\" says Dr. Len Lichtenfeld, Deputy Chief Medical Officer for the American Cancer Society. \"Then it goes after the cancer in a very real way, but that attack can sometimes be very vicious. It can cause very severe side effects.\"\u003c/p>\n\u003cp>Shaun fought off high fevers and flu-like symptoms in the Intensive Care Unit for a few weeks.\u003c/p>\n\u003cp>Lennie Sender, an oncologist at Children’s Hospital of Orange County, has dubbed the reprogrammed cells 'Frankenstein molecules' because they don't just go after cancer cells; CAR-T cells kill good immune cells too -- white blood cells called B-cells that destroy viruses and infections in the body.\u003c/p>\n\u003cp>\"You lose your B-cells,\" says Sender. \"So, now you have to give patients monthly transfusions of replacement, and it could be for life.\"\u003c/p>\n\u003cp>\u003cstrong>Thumbs Up from the Federal Government\u003c/strong>\u003c/p>\n\u003cp>But the FDA is convinced the risks are worth it for some patients. A little over a month after the FDA approved CAR-t to treat Shaun's condition, the agency \u003ca href=\"https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm581216.htm\" target=\"_blank\" rel=\"noopener\">approved\u003c/a> the therapy for large B-cell lymphoma. This type of lymphoma is one of several types of \u003ca href=\"https://www.cancer.org/cancer/non-hodgkin-lymphoma.html\">non-Hodgkin's lymphoma\u003c/a>.\u003c/p>\n\u003cp>[contextly_sidebar id=\"JGmX60chbAt46mWyiOqoudvsmxPMm9J5\"]The procedure runs about a half million dollars per patient because each treatment has to be individually engineered, but scientists hope technological advancements can change that. Some experts say CAR-T marks a watershed moment in learning how to harness the immune system to fight cancer. Thousands of clinical trials are going on right now to push the science of immunotherapy forward.\u003c/p>\n\u003cp>\u003cstrong>A New Frontier\u003c/strong>\u003c/p>\n\u003cp>\"The science is exciting. The results have been spectacular for some people,\" says Lichtenfeld. \"There's no question.\"\u003c/p>\n\u003cp>He cautions, though, the science is still in early stages. \"Unfortunately, for some people it has not worked. We can never forget that.\"\u003c/p>\n\u003cp>A year after his CAR-T treatment, Shaun’s mom, Sheila, is grateful he's still in remission.\u003c/p>\n\u003cp>“This is really the greatest gift that our family received,\" Sheila says, tears pooling in her eyes. \"It’s a miracle.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Shaun’s life isn’t quite back to normal yet; his immune system is still too fragile for him to play outside with his brother and sister, or attend school. Shaun hopes he'll be back in class next fall.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Shaun is one of at least 50\u003cstrong> \u003c/strong>children who are in remission because of a breakthrough treatment that engineers the body's own immune system to fight cancer. Last August, the U.S. Food and Drug Administration (FDA) \u003ca href=\"https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm574058.htm\" target=\"_blank\" rel=\"noopener\">approved\u003c/a> the treatment -- the first accepted gene therapy in the nation -- based on the success of clinical trials like Shaun's.\u003c/p>\n\u003cp>But Shaun's family didn’t know if this day would ever come. Six years ago, he was diagnosed with a form of leukemia called Acute Lymphoblastic Leukemia (ALL), which is the most common cancer in children. The National Cancer Institute estimates that about 3,100 patients under age 20 are diagnosed with ALL each year in America.\u003c/p>\n\u003cfigure id=\"attachment_439703\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-439703\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/02/IMG_4083-e1519260166462-800x511.jpg\" alt=\"\" width=\"800\" height=\"511\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/02/IMG_4083-e1519260166462-800x511.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/02/IMG_4083-e1519260166462-160x102.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/02/IMG_4083-e1519260166462-768x491.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/02/IMG_4083-e1519260166462-1020x652.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2018/02/IMG_4083-e1519260166462-1180x754.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2018/02/IMG_4083-e1519260166462-960x613.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2018/02/IMG_4083-e1519260166462-240x153.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/02/IMG_4083-e1519260166462-375x240.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/02/IMG_4083-e1519260166462-520x332.jpg 520w, https://ww2.kqed.org/app/uploads/sites/13/2018/02/IMG_4083-e1519260166462.jpg 1809w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Shaun Banagan with his mom, Sheila, and his dad, Clifford, at a doctor appointment in San Francisco. \u003ccite>(Lesley McClurg/ KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Shaun started chemotherapy for the blood cancer a few weeks after his diagnosis. It was his eighth birthday.\u003c/p>\n\u003cp>Suddenly, playing outside was off limits. Shaun's condition made him prone to bleeding. Shaun's mom, Sheila Banagan, started home schooling him -- that is, when he didn’t have fever or nausea. He spent hours day after day at the hospital, and before long he lost his hair.\u003c/p>\n\u003cp>\u003cstrong>A Flicker of Hope \u003c/strong>\u003c/p>\n\u003cp>Then, after three-and-a-half years, Shaun’s blood tests were normal. His nurses filled the clinic with banners and balloons. They were just about to cut the cake when a doctor interrupted the party.\u003c/p>\n\u003cp>The cancer had returned.\u003c/p>\n\u003cp>“It just crushes your world,\" Sheila Banagan says. \"The littlest tiniest bit of hope was taken away from me.\"\u003c/p>\n\u003cp>Shaun endured a second round of intensified chemotherapy to prepare his system for a bone marrow transplant. The procedure went well, but six months later he relapsed.\u003c/p>\n\u003cdiv class=\"sharedaddy show-for-medium-up\">\u003ca href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/02/CART_DESKTOP_V04_180223.jpg\">\u003cimg class=\"aligncenter size-full wp-image-439753\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/02/CART_DESKTOP_V04_180223.jpg\" alt=\"\" width=\"975\" height=\"802\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/02/CART_DESKTOP_V04_180223.jpg 975w, https://ww2.kqed.org/app/uploads/sites/13/2018/02/CART_DESKTOP_V04_180223-160x132.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/02/CART_DESKTOP_V04_180223-800x658.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/02/CART_DESKTOP_V04_180223-768x632.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/02/CART_DESKTOP_V04_180223-960x790.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2018/02/CART_DESKTOP_V04_180223-240x197.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/02/CART_DESKTOP_V04_180223-375x308.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/02/CART_DESKTOP_V04_180223-520x428.jpg 520w\" sizes=\"(max-width: 975px) 100vw, 975px\">\u003c/a>\u003c/div>\n\u003cdiv class=\"show-for-small-only\">\u003c/div>\n\u003cp> \u003c/p>\n\u003caside class=\"pullquote alignright\">'The science is exciting. The results have been spectacular for some people.'\u003ccite>Dr. Len Lichtenfeld,\u003cbr>\nAmerican Cancer Society\u003c/cite>\u003c/aside>\n\u003cp>\u003cstrong>Last-Ditch Option\u003c/strong>\u003c/p>\n\u003cp>Dr. Willert knew there was only one possibility left. UCSF was just about to launch its first clinical trial using a breakthrough therapy.\u003c/p>\n\u003cp>“If this had been a year or two ago we wouldn’t have had this treatment to offer him,\" says Willert.\u003c/p>\n\u003cp>The therapy is called \u003ca href=\"https://www.cancer.org/treatment/treatments-and-side-effects/treatment-types/immunotherapy/car-t-cell1.html\" target=\"_blank\" rel=\"noopener\">CAR-T\u003c/a>-- which stands for chimeric antigen receptor (CAR) T-cell therapy -- and it's intended to super-boost the immune system. Doctors try CAR-T when everything else fails.\u003c/p>\n\u003cp>Shaun’s medical team shipped a sample of his blood to a lab. There, scientists genetically engineered his immune cells to detect his cancer cells and destroy them. In other words, they hacked the cells. Technicians multiplied massive numbers of new cells and then sent the reprogrammed blood back to San Francisco where Shaun received an infusion. His blood was now full of virulent cancer killers.\u003c/p>\n\u003cp>\u003cb>'Severe' Side Effects\u003c/b>\u003c/p>\n\u003cp>The key to CAR-T therapy is that it solves a central problem with cancer. Usually the body's immune system doesn't recognize cancer cells as foreign, and that's why they can proliferate without the body's usual defenses. CAR-T therapy is like giving the immune system glasses.\u003c/p>\n\u003cp>\"CAR-T can wake the immune system up so it recognizes cancer cells as abnormal,\" says Dr. Len Lichtenfeld, Deputy Chief Medical Officer for the American Cancer Society. \"Then it goes after the cancer in a very real way, but that attack can sometimes be very vicious. It can cause very severe side effects.\"\u003c/p>\n\u003cp>Shaun fought off high fevers and flu-like symptoms in the Intensive Care Unit for a few weeks.\u003c/p>\n\u003cp>Lennie Sender, an oncologist at Children’s Hospital of Orange County, has dubbed the reprogrammed cells 'Frankenstein molecules' because they don't just go after cancer cells; CAR-T cells kill good immune cells too -- white blood cells called B-cells that destroy viruses and infections in the body.\u003c/p>\n\u003cp>\"You lose your B-cells,\" says Sender. \"So, now you have to give patients monthly transfusions of replacement, and it could be for life.\"\u003c/p>\n\u003cp>\u003cstrong>Thumbs Up from the Federal Government\u003c/strong>\u003c/p>\n\u003cp>But the FDA is convinced the risks are worth it for some patients. A little over a month after the FDA approved CAR-t to treat Shaun's condition, the agency \u003ca href=\"https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm581216.htm\" target=\"_blank\" rel=\"noopener\">approved\u003c/a> the therapy for large B-cell lymphoma. This type of lymphoma is one of several types of \u003ca href=\"https://www.cancer.org/cancer/non-hodgkin-lymphoma.html\">non-Hodgkin's lymphoma\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>The procedure runs about a half million dollars per patient because each treatment has to be individually engineered, but scientists hope technological advancements can change that. Some experts say CAR-T marks a watershed moment in learning how to harness the immune system to fight cancer. Thousands of clinical trials are going on right now to push the science of immunotherapy forward.\u003c/p>\n\u003cp>\u003cstrong>A New Frontier\u003c/strong>\u003c/p>\n\u003cp>\"The science is exciting. The results have been spectacular for some people,\" says Lichtenfeld. \"There's no question.\"\u003c/p>\n\u003cp>He cautions, though, the science is still in early stages. \"Unfortunately, for some people it has not worked. We can never forget that.\"\u003c/p>\n\u003cp>A year after his CAR-T treatment, Shaun’s mom, Sheila, is grateful he's still in remission.\u003c/p>\n\u003cp>“This is really the greatest gift that our family received,\" Sheila says, tears pooling in her eyes. \"It’s a miracle.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Shaun’s life isn’t quite back to normal yet; his immune system is still too fragile for him to play outside with his brother and sister, or attend school. Shaun hopes he'll be back in class next fall.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
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"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
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"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
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"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
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"tagline": "Politics from a personal perspective",
"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
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"possible": {
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"title": "Possible",
"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
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"pri-the-world": {
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"title": "PRI's The World: Latest Edition",
"info": "Each weekday, host Marco Werman and his team of producers bring you the world's most interesting stories in an hour of radio that reminds us just how small our planet really is.",
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"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-World-Podcast-Tile-360x360-1.jpg",
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},
"radiolab": {
"id": "radiolab",
"title": "Radiolab",
"info": "A two-time Peabody Award-winner, Radiolab is an investigation told through sounds and stories, and centered around one big idea. In the Radiolab world, information sounds like music and science and culture collide. Hosted by Jad Abumrad and Robert Krulwich, the show is designed for listeners who demand skepticism, but appreciate wonder. WNYC Studios is the producer of other leading podcasts including Freakonomics Radio, Death, Sex & Money, On the Media and many more.",
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},
"reveal": {
"id": "reveal",
"title": "Reveal",
"info": "Created by The Center for Investigative Reporting and PRX, Reveal is public radios first one-hour weekly radio show and podcast dedicated to investigative reporting. Credible, fact based and without a partisan agenda, Reveal combines the power and artistry of driveway moment storytelling with data-rich reporting on critically important issues. The result is stories that inform and inspire, arming our listeners with information to right injustices, hold the powerful accountable and improve lives.Reveal is hosted by Al Letson and showcases the award-winning work of CIR and newsrooms large and small across the nation. In a radio and podcast market crowded with choices, Reveal focuses on important and often surprising stories that illuminate the world for our listeners.",
"airtime": "SAT 4pm-5pm",
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"officialWebsiteLink": "https://www.revealnews.org/episodes/",
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},
"rightnowish": {
"id": "rightnowish",
"title": "Rightnowish",
"tagline": "Art is where you find it",
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