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"disqusTitle": "Pregnant Women Face Big Questions With Cheaper DNA Sequencing",
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"content": "\u003cfigure id=\"attachment_41122\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/quest/2012/07/23/pregnant-women-face-big-questions-with-cheaper-dna-sequencing/9wkfetus/\" rel=\"attachment wp-att-41122\">\u003cimg class=\"size-full wp-image-41122\" title=\"9wkFetus\" src=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2012/07/9wkFetus.jpg\" alt=\"\" width=\"640\" height=\"367\" srcset=\"https://ww2.kqed.org/app/uploads/sites/39/2012/07/9wkFetus.jpg 640w, https://ww2.kqed.org/app/uploads/sites/39/2012/07/9wkFetus-400x229.jpg 400w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Cheap DNA sequncing has the potential to help more children overcome genetic disease.\u003c/figcaption>\u003c/figure>\n\u003cp>In the very near future, a pregnant woman will be able to learn a whole lot more than she currently can about the fetus she is carrying. And she can find out in a way that poses no risk to the fetus.\u003c/p>\n\u003cp>This is obviously a good thing for fetuses with previously hidden but treatable genetic diseases and for parents of special needs children so they can prepare themselves. But it will also open wider the Pandora’s Box of ethical dilemmas that prenatal testing already presents us with.\u003c/p>\n\u003cp>The most common ways to do prenatal testing right now -- amniocentesis and chorionic villus sampling (CVS) -- increases a woman's risk for miscarriage. Not a lot, but enough so that the testing shouldn't routinely be done. Basically the only time to do this kind of testing is when the risk for the fetus having a genetic problem is higher than the risk of miscarriage.\u003c/p>\n\u003cp>This is why, for example, only fetuses of older women are routinely tested for Down syndrome. Once a woman turns 35 or so, the risk for having a child with Down syndrome is higher than the risk for miscarriage.\u003c/p>\n\u003cp>New technologies are changing this calculation so that in the near future, prenatal testing may be available for any woman who can afford it. Like I said, this holds great promise for helping parents and their children. But it also raises troubling questions about what parents might do with this information.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The new technique is so much safer because unlike amniocentesis or CVS, it doesn’t mess with the fetus at all. All that is required is a blood draw from the mother. This is because a significant fraction of cell-free DNA in maternal blood comes from the fetus and because of how powerful and how cheap DNA sequencing has become.\u003c/p>\n\u003cp>Back \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/18838674\">in 2008\u003c/a>, DNA sequencing was powerful enough to use this technique to determine whether a fetus had extra or missing chromosomes. In other words, it could be used to figure out whether the fetus had Down syndrome (an extra chromosome 21), Turner syndrome (a single X with no Y), Edwards syndrome (an extra chromosome 18) and so on. These kinds of tests are being refined and will soon be widely available.\u003c/p>\n\u003cp>The test is actually a pretty simple one. Scientists do lots of DNA sequencing so they get a large number of different reads from each chromosome. They then compare the numbers and look for anything out of the ordinary.\u003c/p>\n\u003cp>This is easy to understand if you were just looking at the fetal DNA. In Down syndrome, you have three copies of chromosome 21 instead of the usual two. If you did this kind of sequencing, you’d find 1.5 times the usual amount of chromosome 21 DNA. So if all the other chromosomes gave 100 reads, a fetus with Down syndrome would give 150 for chromosome 21.\u003c/p>\n\u003cp>The cell-free DNA gives similar but much less pronounced results. Let’s say that the fetal DNA makes up about 19% of the total of cell-free DNA (this is a pretty typical number). When scientists compare all of the chromosomes, they will find an increased amount of chromosome 21 DNA but not as much as if they were looking just at fetal DNA. If I am doing my math right, they would get around 110 instead of 100 reads for chromosome 21. With enough DNA sequencing, this is enough to tell that the fetus has an extra chromosome 21.\u003c/p>\n\u003cfigure id=\"attachment_41127\" class=\"wp-caption aligncenter\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/quest/2012/07/23/pregnant-women-face-big-questions-with-cheaper-dna-sequencing/downresults/\" rel=\"attachment wp-att-41127\">\u003cimg class=\"size-full wp-image-41127\" title=\"DownResults\" src=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2012/07/DownResults.jpg\" alt=\"\" width=\"400\" height=\"126\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The extra chromosome 21 DNA found in the cell free DNA of the mother\u003c/figcaption>\u003c/figure>\n\u003cp>Now DNA sequencing has become so cheap and powerful that scientists can use the same technique to get much more information about the fetus. Instead of looking at big changes like extra or missing chromosomes, they can actually look for lots and lots of specific DNA differences that can lead to disease. And even more astonishingly, the scientists in \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/22763444\">this report\u003c/a> were able to read all of a fetus’ genes base by base. They can now get a complete genetic readout of the fetus.\u003c/p>\n\u003cp>Reading every letter of every gene won’t be ready for primetime in the near future but being able to look for lots of different genetic markers will. And remember, this is all without any risk to the fetus. At least not from the procedure…\u003c/p>\n\u003cp>This technique will allow doctors to diagnose and treat more genetic diseases earlier than ever before which will be of great benefit for some patients. For example, there are some genetic diseases whose symptoms can be completely headed off if the disease is treated early enough with dietary changes. This test will be able to help some of these people for the first time.\u003c/p>\n\u003cp>But this kind of information is a double-edged sword. I have to wonder how parents-to-be might use it. There are already girl shortages in parts of India and China because of the selective abortion of females. And we know that \u003ca href=\"http://blogs.discovermagazine.com/gnxp/2008/09/down-syndrome-and-abortion-rates/\">90% or so \u003c/a>of confirmed Down syndrome pregnancies end in abortion. This new test will certainly increase the number of Down syndrome abortions because so many more women will be able to find out if their fetus has an extra chromosome 21 or not.\u003c/p>\n\u003cp>It is obviously wrong to terminate a pregnancy because the fetus has two X chromosomes. And many people are troubled by terminating Down syndrome pregnancies as the condition is not fatal and many people with Down syndrome can lead happy and productive lives.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The question is, when parents-to-be can learn even more about their fetuses, what will be the result? What if the fetus is at increased risk for getting Alzheimer’s late in life? Or having high cholesterol? Or not having blue eyes?\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_41122\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/quest/2012/07/23/pregnant-women-face-big-questions-with-cheaper-dna-sequencing/9wkfetus/\" rel=\"attachment wp-att-41122\">\u003cimg class=\"size-full wp-image-41122\" title=\"9wkFetus\" src=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2012/07/9wkFetus.jpg\" alt=\"\" width=\"640\" height=\"367\" srcset=\"https://ww2.kqed.org/app/uploads/sites/39/2012/07/9wkFetus.jpg 640w, https://ww2.kqed.org/app/uploads/sites/39/2012/07/9wkFetus-400x229.jpg 400w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Cheap DNA sequncing has the potential to help more children overcome genetic disease.\u003c/figcaption>\u003c/figure>\n\u003cp>In the very near future, a pregnant woman will be able to learn a whole lot more than she currently can about the fetus she is carrying. And she can find out in a way that poses no risk to the fetus.\u003c/p>\n\u003cp>This is obviously a good thing for fetuses with previously hidden but treatable genetic diseases and for parents of special needs children so they can prepare themselves. But it will also open wider the Pandora’s Box of ethical dilemmas that prenatal testing already presents us with.\u003c/p>\n\u003cp>The most common ways to do prenatal testing right now -- amniocentesis and chorionic villus sampling (CVS) -- increases a woman's risk for miscarriage. Not a lot, but enough so that the testing shouldn't routinely be done. Basically the only time to do this kind of testing is when the risk for the fetus having a genetic problem is higher than the risk of miscarriage.\u003c/p>\n\u003cp>This is why, for example, only fetuses of older women are routinely tested for Down syndrome. Once a woman turns 35 or so, the risk for having a child with Down syndrome is higher than the risk for miscarriage.\u003c/p>\n\u003cp>New technologies are changing this calculation so that in the near future, prenatal testing may be available for any woman who can afford it. Like I said, this holds great promise for helping parents and their children. But it also raises troubling questions about what parents might do with this information.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The new technique is so much safer because unlike amniocentesis or CVS, it doesn’t mess with the fetus at all. All that is required is a blood draw from the mother. This is because a significant fraction of cell-free DNA in maternal blood comes from the fetus and because of how powerful and how cheap DNA sequencing has become.\u003c/p>\n\u003cp>Back \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/18838674\">in 2008\u003c/a>, DNA sequencing was powerful enough to use this technique to determine whether a fetus had extra or missing chromosomes. In other words, it could be used to figure out whether the fetus had Down syndrome (an extra chromosome 21), Turner syndrome (a single X with no Y), Edwards syndrome (an extra chromosome 18) and so on. These kinds of tests are being refined and will soon be widely available.\u003c/p>\n\u003cp>The test is actually a pretty simple one. Scientists do lots of DNA sequencing so they get a large number of different reads from each chromosome. They then compare the numbers and look for anything out of the ordinary.\u003c/p>\n\u003cp>This is easy to understand if you were just looking at the fetal DNA. In Down syndrome, you have three copies of chromosome 21 instead of the usual two. If you did this kind of sequencing, you’d find 1.5 times the usual amount of chromosome 21 DNA. So if all the other chromosomes gave 100 reads, a fetus with Down syndrome would give 150 for chromosome 21.\u003c/p>\n\u003cp>The cell-free DNA gives similar but much less pronounced results. Let’s say that the fetal DNA makes up about 19% of the total of cell-free DNA (this is a pretty typical number). When scientists compare all of the chromosomes, they will find an increased amount of chromosome 21 DNA but not as much as if they were looking just at fetal DNA. If I am doing my math right, they would get around 110 instead of 100 reads for chromosome 21. With enough DNA sequencing, this is enough to tell that the fetus has an extra chromosome 21.\u003c/p>\n\u003cfigure id=\"attachment_41127\" class=\"wp-caption aligncenter\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/quest/2012/07/23/pregnant-women-face-big-questions-with-cheaper-dna-sequencing/downresults/\" rel=\"attachment wp-att-41127\">\u003cimg class=\"size-full wp-image-41127\" title=\"DownResults\" src=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2012/07/DownResults.jpg\" alt=\"\" width=\"400\" height=\"126\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The extra chromosome 21 DNA found in the cell free DNA of the mother\u003c/figcaption>\u003c/figure>\n\u003cp>Now DNA sequencing has become so cheap and powerful that scientists can use the same technique to get much more information about the fetus. Instead of looking at big changes like extra or missing chromosomes, they can actually look for lots and lots of specific DNA differences that can lead to disease. And even more astonishingly, the scientists in \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/22763444\">this report\u003c/a> were able to read all of a fetus’ genes base by base. They can now get a complete genetic readout of the fetus.\u003c/p>\n\u003cp>Reading every letter of every gene won’t be ready for primetime in the near future but being able to look for lots of different genetic markers will. And remember, this is all without any risk to the fetus. At least not from the procedure…\u003c/p>\n\u003cp>This technique will allow doctors to diagnose and treat more genetic diseases earlier than ever before which will be of great benefit for some patients. For example, there are some genetic diseases whose symptoms can be completely headed off if the disease is treated early enough with dietary changes. This test will be able to help some of these people for the first time.\u003c/p>\n\u003cp>But this kind of information is a double-edged sword. I have to wonder how parents-to-be might use it. There are already girl shortages in parts of India and China because of the selective abortion of females. And we know that \u003ca href=\"http://blogs.discovermagazine.com/gnxp/2008/09/down-syndrome-and-abortion-rates/\">90% or so \u003c/a>of confirmed Down syndrome pregnancies end in abortion. This new test will certainly increase the number of Down syndrome abortions because so many more women will be able to find out if their fetus has an extra chromosome 21 or not.\u003c/p>\n\u003cp>It is obviously wrong to terminate a pregnancy because the fetus has two X chromosomes. And many people are troubled by terminating Down syndrome pregnancies as the condition is not fatal and many people with Down syndrome can lead happy and productive lives.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The question is, when parents-to-be can learn even more about their fetuses, what will be the result? What if the fetus is at increased risk for getting Alzheimer’s late in life? Or having high cholesterol? Or not having blue eyes?\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "A Unique HIV Case Inspires New Research",
"title": "A Unique HIV Case Inspires New Research",
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"content": "\u003cp>http://www.kqed.org/.stream/anon/radio/quest/2012/07/2012-07-23-quest.mp3\u003c/p>\n\u003cp>\u003cem>For the first time in more than 20 years, the International AIDS Conference is being held in the U.S. In 2010, President Obama lifted a more than two decade old travel ban on HIV positive people entering the country. The conference begins July 23\u003csup>rd\u003c/sup> in Washington D.C. One of the topics sure to be high on the agenda is: Where are we with a cure? More than 34 million people are living with HIV/AIDS worldwide, but only one person has apparently been cured of the virus.\u003c/em>\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"https://ww2.kqed.org/quest/author/amystanden/\">Amy Standen\u003c/a> spoke with the man known in some research circles as \u003cstrong>“the Berlin Patient.”\u003c/strong>\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>THE BERLIN PATIENT\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_41219\" class=\"wp-caption alignleft\" style=\"max-width: 160px\">\u003cimg class=\"size-full wp-image-41219 \" title=\"brown_160\" src=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2012/07/brown_160.jpg\" alt=\"\" width=\"160\" height=\"160\" srcset=\"https://ww2.kqed.org/app/uploads/sites/39/2012/07/brown_160.jpg 160w, https://ww2.kqed.org/app/uploads/sites/39/2012/07/brown_160-32x32.jpg 32w, https://ww2.kqed.org/app/uploads/sites/39/2012/07/brown_160-64x64.jpg 64w, https://ww2.kqed.org/app/uploads/sites/39/2012/07/brown_160-96x96.jpg 96w, https://ww2.kqed.org/app/uploads/sites/39/2012/07/brown_160-128x128.jpg 128w, https://ww2.kqed.org/app/uploads/sites/39/2012/07/brown_160-75x75.jpg 75w\" sizes=\"(max-width: 160px) 100vw, 160px\">\u003cfigcaption class=\"wp-caption-text\">Timothy Brown (photo: timothyrbrown.com)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>\u003ca href=\"http://timothyrbrown.com/\">Timothy Ray Brown\u003c/a>\u003c/strong> was diagnosed with HIV in 1995, when he was living in Berlin. Nine years later, still in Germany, he received another devastating diagnosis: leukemia.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>His doctor there had a novel idea. Maybe he could treat both diseases at once, by giving Brown a bone marrow transplant from a very specific type of donor, one who was CCR5 negative.\u003c/p>\n\u003cp>“It took 67 tries to find the right person,” says Brown.\u003c/p>\n\u003cp>The CCR5 mutation turns up in about one percent of Northern European descendants. It makes them naturally resistant to HIV infection.\u003c/p>\n\u003cp>Brown received two bone marrow transplants, one in 2007 and one in 2008, both from the same donor. The procedures were arduous, with lasting complications. But they also left Brown with a new immune system.\u003c/p>\n\u003cp>Brown, who is 46 and now lives in San Francisco, has apparently been free of the virus for about five years, and takes no HIV medications. Meanwhile, he’s watched friends die of the disease he no longer has.\u003c/p>\n\u003cp>“Being the only one in the world... I kind of have a slight guilt feeling about it,” he says.\u003c/p>\n\u003cp>Brown says he knows his treatment was risky and expensive, and that many researchers believe it's not a practical response to the worldwide AIDS epidemic. But he’s counting on science to change that.\u003c/p>\n\u003cp>Says Brown, “I’m hoping that when, and if, there is a cure it can be administered to the entire world. And I think that’s going to happen. I’m hoping for it.\"\u003c/p>\n\u003cp>\u003cstrong>THE TOOLS OF GENETIC ENGINEERING\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>\u003cem>California researchers are trying to replicate Timothy Brown’s treatment through a controversial gene therapy technique using stem cells. \u003ca href=\"http://ww2.kqed.org/quest/author/andrea-kissack/\">Andrea Kissack\u003c/a> spoke with one of those scientists, \u003cstrong>\u003ca href=\"http://pibbs.usc.edu/faculty/profile/?fid=186\">Paula Cannon\u003c/a>,\u003c/strong> a microbiologist at the University of Southern California.\u003c/em>\u003c/p>\n\u003cfigure id=\"attachment_41200\" class=\"wp-caption alignleft\" style=\"max-width: 160px\">\u003cimg class=\"size-full wp-image-41200\" title=\"Cannon_160\" src=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2012/07/Cannon_160.jpg\" alt=\"\" width=\"160\" height=\"160\" srcset=\"https://ww2.kqed.org/app/uploads/sites/39/2012/07/Cannon_160.jpg 160w, https://ww2.kqed.org/app/uploads/sites/39/2012/07/Cannon_160-32x32.jpg 32w, https://ww2.kqed.org/app/uploads/sites/39/2012/07/Cannon_160-64x64.jpg 64w, https://ww2.kqed.org/app/uploads/sites/39/2012/07/Cannon_160-96x96.jpg 96w, https://ww2.kqed.org/app/uploads/sites/39/2012/07/Cannon_160-128x128.jpg 128w, https://ww2.kqed.org/app/uploads/sites/39/2012/07/Cannon_160-75x75.jpg 75w\" sizes=\"(max-width: 160px) 100vw, 160px\">\u003cfigcaption class=\"wp-caption-text\">Paula Cannon, Keck School of Medicine, University of Southern California (photo: USC)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>You have been working with a technique that has proved successful in mice and will soon be expanding into human trials. How are you trying to replicate the apparent cure that has happened for Timothy Brown?\u003c/strong>\u003c/p>\n\u003cp>What we don’t want to have to do is do the same procedure that Timothy underwent. So let’s instead, how about the idea of taking some bone marrow stem cells from an AIDS patient, and engineering them so that we can make some of them also HIV resistant?\u003c/p>\n\u003cp>And the idea is we can do that, because now we have the genetic tools that allow us to go in and find the CCR5 gene in those stem cells and basically, like using a pair of scissors, we can cut it out. And then asking whether those cells that are now HIV resistant are gonna be powerful enough to actually sort of stop HIV in its tracks in patients.\u003c/p>\n\u003cp>\u003cstrong>So you are taking stem cells from patients and cutting out one protein and then putting the cells back, through a method like an IV?\u003c/strong>\u003c/p>\n\u003cp>Yes, we're trying to do the poor man’s version of what happened to Timothy Ray Brown. We’re going to use the tools of genetic engineering to snip out the CCR5 gene in a patient’s own cells, and in that way make some part of their immune system be resistant to HIV.\u003c/p>\n\u003cp>\u003cstrong>Last month there were some reports that Timothy Brown may not be virus free. What do you think about that? Is there a disagreement over detection levels or are there different kinds of cures?\u003c/strong>\u003c/p>\n\u003cp>By my definition of a cure which is for five years now he has had no replicating virus in his body, he is not able to infect anybody and he doesn’t have to take drugs. He is cured as far as I am concerned. If you want to get into semantics, one of the things that scientists are curious about is did we manage to remove every last trace of virus from his body or does he have some bits of dead virus floating around? I guess if you look long enough and hard enough – absolutely, we would find some traces of HIV. Importantly, if we are trying to develop ways to take lessons that happened to Timothy, and develop a treatment that can be given to people without needing a bone marrow transplant, to my mind the best possible outcome is that we find that Timothy still has these little remnants of HIV but despite that he is able to control it and he has cured himself through having this HIV resistant immune system.\u003c/p>\n\u003cp>\u003cstrong>You are using funds from the California Stem Cell Bond to help with this research?\u003c/strong>\u003c/p>\n\u003cp>That’s correct, and that’s been really, really important. When we first started this sort of work, we were doing it in collaboration with a biotech company in the Bay Area. And we were able to go to the California Institute of Regenerative Medicine, which is the agency that was set up after the stem cell initiative in 2004.\u003c/p>\n\u003cp>We were able to persuade them, I think, not just that in this way we could be using stem cells to really deliver a therapy to HIV-positive people, but also that the sort of techniques that we were developing in this way are going to have applications beyond HIV.\u003c/p>\n\u003cp>\u003cstrong>One of the challenges with stem cell therapy is the high cost of research and the distant payoff for the whole thing. So you are going to start the human trials in 2014 – what are you looking at in terms of seeing some signs if some of this gene therapy is working?\u003c/strong>\u003c/p>\n\u003cp>We have a series of benchmarks that we would look for. First of all, do we see any evidence that the CCR-5 negative cells are appearing in the patients after we give them the stem cells back? Are the levels of these cells increasing, which would suggest they have a selective advantage in the body?\u003c/p>\n\u003cp>We hope, of course, to end up with the situation, as happened with Timothy, whereby we can take the patients off the drugs, and they are themselves able to suppress and control the virus. I think for me, I’m very optimistic about it, because what we’re talking about are new types of medicine – gene therapies, cellular therapies – and we certainly don’t have the processes in place to make this cheap and easy yet. But I happen to believe that that’s just an engineering problem.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>If this works, if these sort of therapies can really allow people to live without taking drugs and to cure themselves of HIV, there’s gonna be such excitement about this, such a big effort into figuring out how to do it at scale, to do it cheaply. We’re just gonna invent whole different ways of doing medicine.\u003c/p>\n\n",
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"excerpt": "More than 34 million people live with HIV/AIDS worldwide but only one person may have been cured of the virus. We look at promising, genetic research that is aimed at replicating this apparent cure.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>http://www.kqed.org/.stream/anon/radio/quest/2012/07/2012-07-23-quest.mp3\u003c/p>\n\u003cp>\u003cem>For the first time in more than 20 years, the International AIDS Conference is being held in the U.S. In 2010, President Obama lifted a more than two decade old travel ban on HIV positive people entering the country. The conference begins July 23\u003csup>rd\u003c/sup> in Washington D.C. One of the topics sure to be high on the agenda is: Where are we with a cure? More than 34 million people are living with HIV/AIDS worldwide, but only one person has apparently been cured of the virus.\u003c/em>\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"https://ww2.kqed.org/quest/author/amystanden/\">Amy Standen\u003c/a> spoke with the man known in some research circles as \u003cstrong>“the Berlin Patient.”\u003c/strong>\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>THE BERLIN PATIENT\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_41219\" class=\"wp-caption alignleft\" style=\"max-width: 160px\">\u003cimg class=\"size-full wp-image-41219 \" title=\"brown_160\" src=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2012/07/brown_160.jpg\" alt=\"\" width=\"160\" height=\"160\" srcset=\"https://ww2.kqed.org/app/uploads/sites/39/2012/07/brown_160.jpg 160w, https://ww2.kqed.org/app/uploads/sites/39/2012/07/brown_160-32x32.jpg 32w, https://ww2.kqed.org/app/uploads/sites/39/2012/07/brown_160-64x64.jpg 64w, https://ww2.kqed.org/app/uploads/sites/39/2012/07/brown_160-96x96.jpg 96w, https://ww2.kqed.org/app/uploads/sites/39/2012/07/brown_160-128x128.jpg 128w, https://ww2.kqed.org/app/uploads/sites/39/2012/07/brown_160-75x75.jpg 75w\" sizes=\"(max-width: 160px) 100vw, 160px\">\u003cfigcaption class=\"wp-caption-text\">Timothy Brown (photo: timothyrbrown.com)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>\u003ca href=\"http://timothyrbrown.com/\">Timothy Ray Brown\u003c/a>\u003c/strong> was diagnosed with HIV in 1995, when he was living in Berlin. Nine years later, still in Germany, he received another devastating diagnosis: leukemia.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>His doctor there had a novel idea. Maybe he could treat both diseases at once, by giving Brown a bone marrow transplant from a very specific type of donor, one who was CCR5 negative.\u003c/p>\n\u003cp>“It took 67 tries to find the right person,” says Brown.\u003c/p>\n\u003cp>The CCR5 mutation turns up in about one percent of Northern European descendants. It makes them naturally resistant to HIV infection.\u003c/p>\n\u003cp>Brown received two bone marrow transplants, one in 2007 and one in 2008, both from the same donor. The procedures were arduous, with lasting complications. But they also left Brown with a new immune system.\u003c/p>\n\u003cp>Brown, who is 46 and now lives in San Francisco, has apparently been free of the virus for about five years, and takes no HIV medications. Meanwhile, he’s watched friends die of the disease he no longer has.\u003c/p>\n\u003cp>“Being the only one in the world... I kind of have a slight guilt feeling about it,” he says.\u003c/p>\n\u003cp>Brown says he knows his treatment was risky and expensive, and that many researchers believe it's not a practical response to the worldwide AIDS epidemic. But he’s counting on science to change that.\u003c/p>\n\u003cp>Says Brown, “I’m hoping that when, and if, there is a cure it can be administered to the entire world. And I think that’s going to happen. I’m hoping for it.\"\u003c/p>\n\u003cp>\u003cstrong>THE TOOLS OF GENETIC ENGINEERING\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>\u003cem>California researchers are trying to replicate Timothy Brown’s treatment through a controversial gene therapy technique using stem cells. \u003ca href=\"http://ww2.kqed.org/quest/author/andrea-kissack/\">Andrea Kissack\u003c/a> spoke with one of those scientists, \u003cstrong>\u003ca href=\"http://pibbs.usc.edu/faculty/profile/?fid=186\">Paula Cannon\u003c/a>,\u003c/strong> a microbiologist at the University of Southern California.\u003c/em>\u003c/p>\n\u003cfigure id=\"attachment_41200\" class=\"wp-caption alignleft\" style=\"max-width: 160px\">\u003cimg class=\"size-full wp-image-41200\" title=\"Cannon_160\" src=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2012/07/Cannon_160.jpg\" alt=\"\" width=\"160\" height=\"160\" srcset=\"https://ww2.kqed.org/app/uploads/sites/39/2012/07/Cannon_160.jpg 160w, https://ww2.kqed.org/app/uploads/sites/39/2012/07/Cannon_160-32x32.jpg 32w, https://ww2.kqed.org/app/uploads/sites/39/2012/07/Cannon_160-64x64.jpg 64w, https://ww2.kqed.org/app/uploads/sites/39/2012/07/Cannon_160-96x96.jpg 96w, https://ww2.kqed.org/app/uploads/sites/39/2012/07/Cannon_160-128x128.jpg 128w, https://ww2.kqed.org/app/uploads/sites/39/2012/07/Cannon_160-75x75.jpg 75w\" sizes=\"(max-width: 160px) 100vw, 160px\">\u003cfigcaption class=\"wp-caption-text\">Paula Cannon, Keck School of Medicine, University of Southern California (photo: USC)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>You have been working with a technique that has proved successful in mice and will soon be expanding into human trials. How are you trying to replicate the apparent cure that has happened for Timothy Brown?\u003c/strong>\u003c/p>\n\u003cp>What we don’t want to have to do is do the same procedure that Timothy underwent. So let’s instead, how about the idea of taking some bone marrow stem cells from an AIDS patient, and engineering them so that we can make some of them also HIV resistant?\u003c/p>\n\u003cp>And the idea is we can do that, because now we have the genetic tools that allow us to go in and find the CCR5 gene in those stem cells and basically, like using a pair of scissors, we can cut it out. And then asking whether those cells that are now HIV resistant are gonna be powerful enough to actually sort of stop HIV in its tracks in patients.\u003c/p>\n\u003cp>\u003cstrong>So you are taking stem cells from patients and cutting out one protein and then putting the cells back, through a method like an IV?\u003c/strong>\u003c/p>\n\u003cp>Yes, we're trying to do the poor man’s version of what happened to Timothy Ray Brown. We’re going to use the tools of genetic engineering to snip out the CCR5 gene in a patient’s own cells, and in that way make some part of their immune system be resistant to HIV.\u003c/p>\n\u003cp>\u003cstrong>Last month there were some reports that Timothy Brown may not be virus free. What do you think about that? Is there a disagreement over detection levels or are there different kinds of cures?\u003c/strong>\u003c/p>\n\u003cp>By my definition of a cure which is for five years now he has had no replicating virus in his body, he is not able to infect anybody and he doesn’t have to take drugs. He is cured as far as I am concerned. If you want to get into semantics, one of the things that scientists are curious about is did we manage to remove every last trace of virus from his body or does he have some bits of dead virus floating around? I guess if you look long enough and hard enough – absolutely, we would find some traces of HIV. Importantly, if we are trying to develop ways to take lessons that happened to Timothy, and develop a treatment that can be given to people without needing a bone marrow transplant, to my mind the best possible outcome is that we find that Timothy still has these little remnants of HIV but despite that he is able to control it and he has cured himself through having this HIV resistant immune system.\u003c/p>\n\u003cp>\u003cstrong>You are using funds from the California Stem Cell Bond to help with this research?\u003c/strong>\u003c/p>\n\u003cp>That’s correct, and that’s been really, really important. When we first started this sort of work, we were doing it in collaboration with a biotech company in the Bay Area. And we were able to go to the California Institute of Regenerative Medicine, which is the agency that was set up after the stem cell initiative in 2004.\u003c/p>\n\u003cp>We were able to persuade them, I think, not just that in this way we could be using stem cells to really deliver a therapy to HIV-positive people, but also that the sort of techniques that we were developing in this way are going to have applications beyond HIV.\u003c/p>\n\u003cp>\u003cstrong>One of the challenges with stem cell therapy is the high cost of research and the distant payoff for the whole thing. So you are going to start the human trials in 2014 – what are you looking at in terms of seeing some signs if some of this gene therapy is working?\u003c/strong>\u003c/p>\n\u003cp>We have a series of benchmarks that we would look for. First of all, do we see any evidence that the CCR-5 negative cells are appearing in the patients after we give them the stem cells back? 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"disqusTitle": "Hope for an Anti-Nicotine Vaccine",
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"content": "\u003cfigure id=\"attachment_40441\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2012/07/Cigarette_Ianier67_640x360.jpg\">\u003cimg class=\"size-full wp-image-40441\" title=\"Cigarette_Ianier67_640x360\" src=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2012/07/Cigarette_Ianier67_640x360.jpg\" alt=\"photograph of abandoned cigarette burning.\" width=\"640\" height=\"360\" srcset=\"https://ww2.kqed.org/app/uploads/sites/39/2012/07/Cigarette_Ianier67_640x360.jpg 640w, https://ww2.kqed.org/app/uploads/sites/39/2012/07/Cigarette_Ianier67_640x360-400x225.jpg 400w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Photograph courtesy of Ianier67 via Creative Commons.\u003c/figcaption>\u003c/figure>\n\u003cp>A friend once told me that it was 100 times harder for him to quit smoking cigarettes than to quit drinking alcohol. Clearly nicotine is highly addictive. About 45 million people in the U.S. smoke cigarettes, even though cigarette smoking leads to \u003ca title=\"CDC Smoking Facts Sheet\" href=\"http://www.cdc.gov/tobacco/data_statistics/fact_sheets/index.htm\">1 of every 5\u003c/a> deaths each year.\u003c/p>\n\u003cp>In a \u003ca title=\"CDC Analysis of National Health Interview Survey\" href=\"http://www.cdc.gov/tobacco/data_statistics/mmwrs/byyear/2011/mm6044a2/intro.htm\">National Health Interview Survey\u003c/a>, over half of the smokers reported trying to quit in the past year without success. In the future, these smokers may get a vaccine to help protect them from nicotine addiction.\u003c/p>\n\u003cp>Researchers from Weill Cornell Medical College and Scripps Research Institute have developed a new vaccine that may treat nicotine addiction by blocking the pleasurable sensations that nicotine creates in the brain. At the early stage of animal testing, Dr. Ronald Crystal and his colleagues have demonstrated that they can prevent nicotine from reaching the brain in mice using a single injection of vaccine, as described in the \u003ca title=\"Science Translational Medicine\" href=\"http://stm.sciencemag.org/\">latest issue\u003c/a> of \u003cem>Science Translational Medicine\u003c/em>.\u003c/p>\n\u003cp>Common active vaccines, like flu shots, work by introducing a small amount of virus so your immune system responds against the intruder. However, Crystal’s team created a different type – a genetic vaccine.\u003c/p>\n\u003cp>Their vaccine genetically modifies the liver to continuously produce high levels of an anti-nicotine antibody, in addition to normal liver production. These antibodies bind to nicotine in the blood, preventing it from reaching the brain. The trick is that you need anti-nicotine antibodies to be continuously present in the blood at sufficient levels.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Crystal’s team tested the effectiveness of their vaccine by injecting inoculated and control mice with nicotine at a level equal to smoking two cigarettes. When they measured the resulting nicotine levels, inoculated mice had seven times more nicotine in their blood than control mice and antibodies had captured nearly all (83%) of the nicotine. Inoculated mice also had 85% less nicotine in their brain than control mice.\u003c/p>\n\u003cp>This indicates that the vaccine produced sufficient levels of anti-nicotine antibodies, which bound to the nicotine in the blood and prevented it from entering the brain.\u003c/p>\n\u003cp>In addition, inoculated mice didn’t appear to experience any of the physical effects of nicotine. When given nicotine that reached the brain, control mice were less active and their blood pressure and heart rate reduced. In contrast, inoculated mice had no apparent reaction to the nicotine injection.\u003c/p>\n\u003cp>“Smoking affects a huge number of people worldwide, and there are many people who would like to quit, but need effective help,” Dr. Crystals said in a \u003ca title=\"Cornell Press Release\" href=\"http://weill.cornell.edu/news/releases/wcmc/wcmc_2012/06_27_12b.shtml\">press release\u003c/a>, “This novel vaccine may offer a much-needed solution.”\u003c/p>\n\u003cp>However, a vaccine for humans is at best years away. In the current study, the mice weren’t previously exposed to nicotine. Researchers now plan to study nicotine-addicted rats with free access to the drug, testing whether a reduction in the amount of nicotine in the brain alters nicotine-seeking behaviors. Ultimately they hope to test the vaccine in humans.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Even if the vaccine works perfectly with rodents, it may not translate into an effective vaccine for humans. The vaccine also doesn’t address the behavioral habits and psychological addiction to smoking. Finally, people may hesitate to genetically modify their bodies, even if it would help them quit smoking.\u003c/p>\n\n",
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"excerpt": "Recent research shows that a new vaccine led to consistently high anti-nicotine antibody levels that prevented nicotine from reaching the brain. If these findings are confirmed in people, this vaccine could be an effective therapy to help prevent nicotine addiction.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_40441\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2012/07/Cigarette_Ianier67_640x360.jpg\">\u003cimg class=\"size-full wp-image-40441\" title=\"Cigarette_Ianier67_640x360\" src=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2012/07/Cigarette_Ianier67_640x360.jpg\" alt=\"photograph of abandoned cigarette burning.\" width=\"640\" height=\"360\" srcset=\"https://ww2.kqed.org/app/uploads/sites/39/2012/07/Cigarette_Ianier67_640x360.jpg 640w, https://ww2.kqed.org/app/uploads/sites/39/2012/07/Cigarette_Ianier67_640x360-400x225.jpg 400w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Photograph courtesy of Ianier67 via Creative Commons.\u003c/figcaption>\u003c/figure>\n\u003cp>A friend once told me that it was 100 times harder for him to quit smoking cigarettes than to quit drinking alcohol. Clearly nicotine is highly addictive. About 45 million people in the U.S. smoke cigarettes, even though cigarette smoking leads to \u003ca title=\"CDC Smoking Facts Sheet\" href=\"http://www.cdc.gov/tobacco/data_statistics/fact_sheets/index.htm\">1 of every 5\u003c/a> deaths each year.\u003c/p>\n\u003cp>In a \u003ca title=\"CDC Analysis of National Health Interview Survey\" href=\"http://www.cdc.gov/tobacco/data_statistics/mmwrs/byyear/2011/mm6044a2/intro.htm\">National Health Interview Survey\u003c/a>, over half of the smokers reported trying to quit in the past year without success. In the future, these smokers may get a vaccine to help protect them from nicotine addiction.\u003c/p>\n\u003cp>Researchers from Weill Cornell Medical College and Scripps Research Institute have developed a new vaccine that may treat nicotine addiction by blocking the pleasurable sensations that nicotine creates in the brain. At the early stage of animal testing, Dr. Ronald Crystal and his colleagues have demonstrated that they can prevent nicotine from reaching the brain in mice using a single injection of vaccine, as described in the \u003ca title=\"Science Translational Medicine\" href=\"http://stm.sciencemag.org/\">latest issue\u003c/a> of \u003cem>Science Translational Medicine\u003c/em>.\u003c/p>\n\u003cp>Common active vaccines, like flu shots, work by introducing a small amount of virus so your immune system responds against the intruder. However, Crystal’s team created a different type – a genetic vaccine.\u003c/p>\n\u003cp>Their vaccine genetically modifies the liver to continuously produce high levels of an anti-nicotine antibody, in addition to normal liver production. These antibodies bind to nicotine in the blood, preventing it from reaching the brain. The trick is that you need anti-nicotine antibodies to be continuously present in the blood at sufficient levels.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Crystal’s team tested the effectiveness of their vaccine by injecting inoculated and control mice with nicotine at a level equal to smoking two cigarettes. When they measured the resulting nicotine levels, inoculated mice had seven times more nicotine in their blood than control mice and antibodies had captured nearly all (83%) of the nicotine. Inoculated mice also had 85% less nicotine in their brain than control mice.\u003c/p>\n\u003cp>This indicates that the vaccine produced sufficient levels of anti-nicotine antibodies, which bound to the nicotine in the blood and prevented it from entering the brain.\u003c/p>\n\u003cp>In addition, inoculated mice didn’t appear to experience any of the physical effects of nicotine. When given nicotine that reached the brain, control mice were less active and their blood pressure and heart rate reduced. In contrast, inoculated mice had no apparent reaction to the nicotine injection.\u003c/p>\n\u003cp>“Smoking affects a huge number of people worldwide, and there are many people who would like to quit, but need effective help,” Dr. Crystals said in a \u003ca title=\"Cornell Press Release\" href=\"http://weill.cornell.edu/news/releases/wcmc/wcmc_2012/06_27_12b.shtml\">press release\u003c/a>, “This novel vaccine may offer a much-needed solution.”\u003c/p>\n\u003cp>However, a vaccine for humans is at best years away. In the current study, the mice weren’t previously exposed to nicotine. Researchers now plan to study nicotine-addicted rats with free access to the drug, testing whether a reduction in the amount of nicotine in the brain alters nicotine-seeking behaviors. Ultimately they hope to test the vaccine in humans.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Even if the vaccine works perfectly with rodents, it may not translate into an effective vaccine for humans. The vaccine also doesn’t address the behavioral habits and psychological addiction to smoking. Finally, people may hesitate to genetically modify their bodies, even if it would help them quit smoking.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>\u003cem>\"Reflect that I may be an acquired taste. You probably did not like olives the first time you tasted them. Now you probably do. Give me the same chance you would an olive.\"\u003cbr>\n--P.G. Wodehouse,\u003c/em> Leave it to Psmith\u003c/p>\n\u003cp>I've always hated olives. I'd pick them off pizzas and out of salads. And as for eating one whole? Forget it! But in the last few weeks, I've actually started eating them on purpose. It could be because I'm pregnant, a condition which has me \u003ca href=\"http://www.ajcn.org/content/43/3/414.short\" title=\"Taste Changes During Pregnancy\">craving salt\u003c/a>--and few foods are saltier than a nice olive.\u003c/p>\n\u003cfigure id=\"attachment_39713\" class=\"wp-caption alignright\" style=\"max-width: 231px\">\u003ca href=\"http://ww2.kqed.org/quest/2012/06/19/how-i-learned-to-love-olives-and-hate-their-pests/olive_diversity/\" rel=\"attachment wp-att-39713\">\u003cimg src=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2012/06/olive_diversity-231x169.jpg\" alt=\"Diversity of Olives\" title=\"olive_diversity\" width=\"231\" height=\"169\" class=\"size-thumbnail wp-image-39713\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Diversity of olives. Photo by {link url=http://www.flickr.com/photos/jurvetson/}Steve Jurvetson{/link}.\u003c/figcaption>\u003c/figure>\n\u003cp>Olives, of course, don't come off the tree salty. But they also don't come off the tree edible. Lye can leach out the raw olive's bitterness in just a few days, but it's not exactly flavorful, so the cured olives must be washed and transferred to brine. If you're willing to wait for weeks, you can also bypass the lye and just cure the olives in straight brine. Plain water and plain salt are \u003ca href=\"http://www.wikihow.com/Cure-Olives\" title=\"How to Cure Olives\">other alternatives\u003c/a> for patient olive-curers.\u003c/p>\n\u003cp>Curing, as I've learned, is only one of many factors that determine the nature of the final product. Do they pick the fruit unripe or ripe? It's not as obvious as you might think--some olives are ripe when green, and some unripe olives are made black by processing. Do they treat the olives with vinegar as well as brine? That's how to make kalamatas--which I still haven't warmed up to, despite my newfound affection for this 7000-year-old crop. No, I'm loyal. I love my California olives.\u003c/p>\n\u003cfigure id=\"attachment_39715\" class=\"wp-caption alignleft\" style=\"max-width: 168px\">\u003ca href=\"http://ww2.kqed.org/quest/2012/06/19/how-i-learned-to-love-olives-and-hate-their-pests/olives/\" rel=\"attachment wp-att-39715\">\u003cimg src=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2012/06/olives_glass-168x253.jpg\" alt=\"Olives in a glass\" title=\"Olives\" width=\"168\" height=\"253\" class=\"size-medium wp-image-39715\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Martini olives. Photo by {link url=http://www.flickr.com/photos/evpeters/}Edward Peters{/link}.\u003c/figcaption>\u003c/figure>\n\u003cp>Olive trees were brought to California by Fransciscan missionaries in 1769; the Mediterranean climate must have reminded them of home, for they flourished. In fact, depending on \u003ca href=\"http://www.martinimuse.com/how_the_martini_got_its_name.shtml\" title=\"How the Martini Got Its Name\">which story you believe\u003c/a>, California olives may have debuted in the original martini, named after the city of Martinez. I only mention this because yesterday was National Martini Day, if you're into that kind of thing. (For obvious reasons, I'm not.)\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Olive trees in California managed to live free of their native pest, the \u003ca href=\"http://figueroafarms.com/orchardservices/olive-fly/OliveFruitFly.pdf\" title=\"Olive Fruit Fly\">olive fruit fly\u003c/a>, for over 200 years. But the persistent parasite finally arrived in the New World in 1998, and within a few years spread across the state's olive groves. It lays its eggs in olive fruits, ruining them for both oil and eating, and it can perform this trick every 30 days when summer temperatures are ideal. Best for the little maggots is a range of 68 to 86 degrees Fahrenheit, which means California can fight back with hot summers.\u003c/p>\n\u003cp>Unfortunately, the fruit flies won the 2011 round. Not only was last summer relatively mild, but the table olive crop was light. When the crop is light, sometimes it's not worth picking an orchard, so farmers also don't bother to spray for fruit flies. The triple play of cool summers, fruit left on the trees, and no spray gave olive fruit flies a field day.\u003c/p>\n\u003cp>Starting with the recent \u003ca href=\"http://www.mercurynews.com/health/ci_20875211/bay-area-copes-surprisingly-sweltering-weather\" title=\"Mercury News - Hot Weather\">heat wave\u003c/a> across the Bay Area, I'm wondering if this summer might deliver a fruit fly smackdown. That's something pleasant to think about as we sit around sweltering and sucking on ice cubes.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>In fact, I'm going to get some olives right now.\u003c/p>\n\u003cfigure id=\"attachment_39712\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/quest/2012/06/19/how-i-learned-to-love-olives-and-hate-their-pests/franciscan_olives/\" rel=\"attachment wp-att-39712\">\u003cimg src=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2012/06/Franciscan_olives.jpg\" alt=\"Olives left on the tree\" title=\"Franciscan_olives\" width=\"640\" height=\"360\" class=\"size-full wp-image-39712\" srcset=\"https://ww2.kqed.org/app/uploads/sites/39/2012/06/Franciscan_olives.jpg 640w, https://ww2.kqed.org/app/uploads/sites/39/2012/06/Franciscan_olives-400x225.jpg 400w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Olives left on the tree, Franciscan Winery, Napa. Photo by {link url=http://www.flickr.com/photos/nagarjun/}Nagarjun Kandukuru{/link}.\u003c/figcaption>\u003c/figure>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>\"Reflect that I may be an acquired taste. You probably did not like olives the first time you tasted them. Now you probably do. Give me the same chance you would an olive.\"\u003cbr>\n--P.G. Wodehouse,\u003c/em> Leave it to Psmith\u003c/p>\n\u003cp>I've always hated olives. I'd pick them off pizzas and out of salads. And as for eating one whole? Forget it! But in the last few weeks, I've actually started eating them on purpose. It could be because I'm pregnant, a condition which has me \u003ca href=\"http://www.ajcn.org/content/43/3/414.short\" title=\"Taste Changes During Pregnancy\">craving salt\u003c/a>--and few foods are saltier than a nice olive.\u003c/p>\n\u003cfigure id=\"attachment_39713\" class=\"wp-caption alignright\" style=\"max-width: 231px\">\u003ca href=\"http://ww2.kqed.org/quest/2012/06/19/how-i-learned-to-love-olives-and-hate-their-pests/olive_diversity/\" rel=\"attachment wp-att-39713\">\u003cimg src=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2012/06/olive_diversity-231x169.jpg\" alt=\"Diversity of Olives\" title=\"olive_diversity\" width=\"231\" height=\"169\" class=\"size-thumbnail wp-image-39713\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Diversity of olives. Photo by {link url=http://www.flickr.com/photos/jurvetson/}Steve Jurvetson{/link}.\u003c/figcaption>\u003c/figure>\n\u003cp>Olives, of course, don't come off the tree salty. But they also don't come off the tree edible. Lye can leach out the raw olive's bitterness in just a few days, but it's not exactly flavorful, so the cured olives must be washed and transferred to brine. If you're willing to wait for weeks, you can also bypass the lye and just cure the olives in straight brine. Plain water and plain salt are \u003ca href=\"http://www.wikihow.com/Cure-Olives\" title=\"How to Cure Olives\">other alternatives\u003c/a> for patient olive-curers.\u003c/p>\n\u003cp>Curing, as I've learned, is only one of many factors that determine the nature of the final product. Do they pick the fruit unripe or ripe? It's not as obvious as you might think--some olives are ripe when green, and some unripe olives are made black by processing. Do they treat the olives with vinegar as well as brine? That's how to make kalamatas--which I still haven't warmed up to, despite my newfound affection for this 7000-year-old crop. No, I'm loyal. I love my California olives.\u003c/p>\n\u003cfigure id=\"attachment_39715\" class=\"wp-caption alignleft\" style=\"max-width: 168px\">\u003ca href=\"http://ww2.kqed.org/quest/2012/06/19/how-i-learned-to-love-olives-and-hate-their-pests/olives/\" rel=\"attachment wp-att-39715\">\u003cimg src=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2012/06/olives_glass-168x253.jpg\" alt=\"Olives in a glass\" title=\"Olives\" width=\"168\" height=\"253\" class=\"size-medium wp-image-39715\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Martini olives. Photo by {link url=http://www.flickr.com/photos/evpeters/}Edward Peters{/link}.\u003c/figcaption>\u003c/figure>\n\u003cp>Olive trees were brought to California by Fransciscan missionaries in 1769; the Mediterranean climate must have reminded them of home, for they flourished. In fact, depending on \u003ca href=\"http://www.martinimuse.com/how_the_martini_got_its_name.shtml\" title=\"How the Martini Got Its Name\">which story you believe\u003c/a>, California olives may have debuted in the original martini, named after the city of Martinez. I only mention this because yesterday was National Martini Day, if you're into that kind of thing. (For obvious reasons, I'm not.)\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Olive trees in California managed to live free of their native pest, the \u003ca href=\"http://figueroafarms.com/orchardservices/olive-fly/OliveFruitFly.pdf\" title=\"Olive Fruit Fly\">olive fruit fly\u003c/a>, for over 200 years. But the persistent parasite finally arrived in the New World in 1998, and within a few years spread across the state's olive groves. It lays its eggs in olive fruits, ruining them for both oil and eating, and it can perform this trick every 30 days when summer temperatures are ideal. Best for the little maggots is a range of 68 to 86 degrees Fahrenheit, which means California can fight back with hot summers.\u003c/p>\n\u003cp>Unfortunately, the fruit flies won the 2011 round. Not only was last summer relatively mild, but the table olive crop was light. When the crop is light, sometimes it's not worth picking an orchard, so farmers also don't bother to spray for fruit flies. The triple play of cool summers, fruit left on the trees, and no spray gave olive fruit flies a field day.\u003c/p>\n\u003cp>Starting with the recent \u003ca href=\"http://www.mercurynews.com/health/ci_20875211/bay-area-copes-surprisingly-sweltering-weather\" title=\"Mercury News - Hot Weather\">heat wave\u003c/a> across the Bay Area, I'm wondering if this summer might deliver a fruit fly smackdown. That's something pleasant to think about as we sit around sweltering and sucking on ice cubes.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>In fact, I'm going to get some olives right now.\u003c/p>\n\u003cfigure id=\"attachment_39712\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/quest/2012/06/19/how-i-learned-to-love-olives-and-hate-their-pests/franciscan_olives/\" rel=\"attachment wp-att-39712\">\u003cimg src=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2012/06/Franciscan_olives.jpg\" alt=\"Olives left on the tree\" title=\"Franciscan_olives\" width=\"640\" height=\"360\" class=\"size-full wp-image-39712\" srcset=\"https://ww2.kqed.org/app/uploads/sites/39/2012/06/Franciscan_olives.jpg 640w, https://ww2.kqed.org/app/uploads/sites/39/2012/06/Franciscan_olives-400x225.jpg 400w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Olives left on the tree, Franciscan Winery, Napa. Photo by {link url=http://www.flickr.com/photos/nagarjun/}Nagarjun Kandukuru{/link}.\u003c/figcaption>\u003c/figure>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Farmworkers Pay a Heavy Price for California's Bounty ",
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"content": "\u003cfigure id=\"attachment_39377\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/quest/2012/06/13/farmworkers-pay-a-heavy-price-for-californias-bounty/chandler_strawberries_carousel/\" rel=\"attachment wp-att-39377\">\u003cimg class=\"size-thumbnail wp-image-39377\" title=\"Chandler strawberries \" src=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2012/06/Chandler_strawberries_carousel-300x169.jpg\" alt=\"strawberries\" width=\"300\" height=\"169\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Next time you enjoy a bowl of fresh juicy strawberries, consider this: chances are, the farmworker who picked them for about $7.50 an hour comes home to toxic tap water tainted with chemicals used to grow them.\u003c/figcaption>\u003c/figure>\n\u003cp>When I first came to California many years ago, it took me a long time to get used to the idea that I could buy fresh strawberries in the middle of winter. For this Pennsylvania girl, fresh strawberries meant late spring, time to hit the local farm stands with my mom, looking for the plumpest specimens for her light-as-air shortcake.\u003c/p>\n\u003cp>Well into adulthood, in fact, the taste of strawberries has--until recently--evoked that exhilarating moment when school let out, freedom beckoned, life seemed filled with possibilities.\u003c/p>\n\u003cp>Of course, California has distinct growing seasons, too, but the mostly mild climate of the state’s agricultural regions allows farmers to harvest strawberries and corn in December; some crops, like oranges, broccoli, and avocados are grown year-round.\u003c/p>\n\u003cp>California's ability to raise fruits and vegetables all year helps feed the nation, and the state's nearly $40 billion agricultural industry has dominated America’s agricultural production for decades. To maintain this productivity, farmers use nitrogen fertilizers and waste manure from cows. Plants need nitrogen to grow, but \u003ca href=\"http://www.swhydro.arizona.edu/archive/V8_N4/feature2.pdf\">crops typically take up less than half\u003c/a> of all the nitrogen applied. The rest is released into the air, runs off into streams, or slowly percolates through the soil into the groundwater.\u003c/p>\n\u003cp>Once in groundwater, nitrogen turns into compounds called nitrates. Studies link nitrates to thyroid dysfunction, various cancers, and miscarriage, though the evidence is inconclusive. But there’s little disagreement that nitrates pose a serious risk to infants, who can develop a potentially deadly disorder called “blue baby syndrome,” which starves tissues of oxygen.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Nitrates turn toxic when bacteria in the gut and saliva turn them into nitrites. And because babies have a \u003ca href=\"http://www.plosbiology.org/article/info%3Adoi%2F10.1371%2Fjournal.pbio.0050177\">different community of microbes\u003c/a> in their guts than adults, including more nitrite-producing bacteria, they are far more vulnerable to nitrate exposures.\u003c/p>\n\u003cp>California officials have long known that nitrates are one of the most widespread contaminants in the state’s groundwater. About 16 million people in California get their drinking water from groundwater sources. That’s why, in 2008, the Legislature required the state Water Resources Control Board to report on the causes of contamination and identify potential solutions. The water board contracted experts at UC Davis, who released their \u003ca href=\"http://www.californiareport.org/archive/R201203130850/a\">widely covered report\u003c/a> in March.\u003c/p>\n\u003cp>The \u003ca href=\"http://groundwaternitrate.ucdavis.edu/\">UC Davis researchers\u003c/a> looked at nitrate contamination in two of the prime agricultural regions in California, the Tulare Lake Basin and the Salinas Valley, where about 2.6 million people rely on groundwater. They found that agriculture accounts for 96% of nitrate-contaminated groundwater. More than a quarter of a million people in these regions may have nitrates in their drinking water.\u003c/p>\n\u003cfigure id=\"attachment_39392\" class=\"wp-caption alignleft\" style=\"max-width: 240px\">\u003ca href=\"http://ww2.kqed.org/quest/2012/06/13/farmworkers-pay-a-heavy-price-for-californias-bounty/faucet/\" rel=\"attachment wp-att-39392\">\u003cimg class=\"size-large wp-image-39392\" title=\"Faucet\" src=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2012/06/Faucet-240x360.jpg\" alt=\"Faucet\" width=\"240\" height=\"360\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">More than 250,000 people living in the Tulare Lake Basin and Salinas Valley can't drink their tap water because it's contaminated with nitrates. Most are low-income and Latino. (Photo: Benutzer:Alex Anlicker/Wikimedia Commons)\u003c/figcaption>\u003c/figure>\n\u003cp>Some of the poorest people in the state live in these agricultural areas. And many of those coping with tainted drinking water work in the fields that leach the nitrates, picking our produce, our strawberries, oranges and lemons.\u003c/p>\n\u003cp>In April, I went to Tulare County for a \u003ca href=\"http://www.environmentalhealthnews.org/ehs/news/2012/pollution-poverty-people-of-color-series-summary\">story for Environmental Health News\u003c/a> to speak with residents who've been struggling with nitrate contamination for years. Their taps dispense toxic water they can’t drink but they still have to pay for their monthly water bill. And then they have to buy bottled water from the grocery store or fill up five-gallon jugs from a water vending machine—something I’d wager most San Franciscans have never seen.\u003c/p>\n\u003cp>\u003ca href=\"http://www.environmentalhealthnews.org/ehs/news/2012/pollution-poverty-and-people-of-color-nitrate-day-4\">One woman I spoke to\u003c/a>, a single mother of four named Bertha Dias, makes $7.50 an hour picking fruit. She pays nearly five times as much to have safe drinking water in her house than the average San Franciscan pays to drink water so pristine \u003ca href=\"http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2003/03/26/MN279761.DTL\">Willie Brown famously bottled it\u003c/a> as Hetch Hetchy Mountain Water.\u003c/p>\n\u003cp>The nitrate contamination problem has been covered before, including an \u003ca href=\"http://californiawatch.org/nitrate-contamination-spreading-california-communities\">in-depth investigation by California Watch\u003c/a> in 2010. Yet the problem hasn't gone away.\u003c/p>\n\u003cp>Low-income people seeking safe drinking water throughout Tulare County are working with the Visalia-based \u003ca href=\"http://www.communitywatercenter.org/\">Community Water Center\u003c/a> to find their own solutions. Potential solutions run from digging a new well to hooking up to a larger water system to installing filtration systems under the sink. But many measures are temporary fixes, until the state figures out how to deal with the problem over the long term--which the UC Davis study concluded would cost about $36 million a year.\u003c/p>\n\u003cp>In 2009, strawberries brought in more than three-quarters of a billion dollars for Salinas Valley farmers, resulting from a 10-year increase in consumer demand, Carolyn O'Donnell, communications director for the California Strawberry Commission, told a reporter for \u003ca href=\"http://www.thecalifornian.com/article/20100623/BUSINESS/6230307/Strawberries-top-lettuce-Monterey-County-s-No-1-crop\">TheCalifornian.com\u003c/a>. She attributed the increased demand to better-tasting varieties that hold up better under shipping.\u003c/p>\n\u003cp>Now Bay Area consumers can see Salinas Valley strawberries at their local grocery stores nearly anytime except winter, when shipments from Southern California pick up the slack.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>But now when I think of strawberries, the romance is gone. I can't help but think of Bertha Dias and the other farmworkers like her, who spend long, hot days picking our fruit and vegetables out in the fields, only to come home to water they can't drink. They deserve better.\u003c/p>\n\n",
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"excerpt": "California farmworkers work long days for about $7.50 an hour to pick fruit in orchards doused with nitrogen fertilizers. A UC Davis study released in March found that nitrates from fertilizers and dairy waste have contaminated groundwater supplies. Because farmworkers live near the fields they work in, they're at high risk for nitrate-contaminated drinking water.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_39377\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/quest/2012/06/13/farmworkers-pay-a-heavy-price-for-californias-bounty/chandler_strawberries_carousel/\" rel=\"attachment wp-att-39377\">\u003cimg class=\"size-thumbnail wp-image-39377\" title=\"Chandler strawberries \" src=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2012/06/Chandler_strawberries_carousel-300x169.jpg\" alt=\"strawberries\" width=\"300\" height=\"169\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Next time you enjoy a bowl of fresh juicy strawberries, consider this: chances are, the farmworker who picked them for about $7.50 an hour comes home to toxic tap water tainted with chemicals used to grow them.\u003c/figcaption>\u003c/figure>\n\u003cp>When I first came to California many years ago, it took me a long time to get used to the idea that I could buy fresh strawberries in the middle of winter. For this Pennsylvania girl, fresh strawberries meant late spring, time to hit the local farm stands with my mom, looking for the plumpest specimens for her light-as-air shortcake.\u003c/p>\n\u003cp>Well into adulthood, in fact, the taste of strawberries has--until recently--evoked that exhilarating moment when school let out, freedom beckoned, life seemed filled with possibilities.\u003c/p>\n\u003cp>Of course, California has distinct growing seasons, too, but the mostly mild climate of the state’s agricultural regions allows farmers to harvest strawberries and corn in December; some crops, like oranges, broccoli, and avocados are grown year-round.\u003c/p>\n\u003cp>California's ability to raise fruits and vegetables all year helps feed the nation, and the state's nearly $40 billion agricultural industry has dominated America’s agricultural production for decades. To maintain this productivity, farmers use nitrogen fertilizers and waste manure from cows. Plants need nitrogen to grow, but \u003ca href=\"http://www.swhydro.arizona.edu/archive/V8_N4/feature2.pdf\">crops typically take up less than half\u003c/a> of all the nitrogen applied. The rest is released into the air, runs off into streams, or slowly percolates through the soil into the groundwater.\u003c/p>\n\u003cp>Once in groundwater, nitrogen turns into compounds called nitrates. Studies link nitrates to thyroid dysfunction, various cancers, and miscarriage, though the evidence is inconclusive. But there’s little disagreement that nitrates pose a serious risk to infants, who can develop a potentially deadly disorder called “blue baby syndrome,” which starves tissues of oxygen.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Nitrates turn toxic when bacteria in the gut and saliva turn them into nitrites. And because babies have a \u003ca href=\"http://www.plosbiology.org/article/info%3Adoi%2F10.1371%2Fjournal.pbio.0050177\">different community of microbes\u003c/a> in their guts than adults, including more nitrite-producing bacteria, they are far more vulnerable to nitrate exposures.\u003c/p>\n\u003cp>California officials have long known that nitrates are one of the most widespread contaminants in the state’s groundwater. About 16 million people in California get their drinking water from groundwater sources. That’s why, in 2008, the Legislature required the state Water Resources Control Board to report on the causes of contamination and identify potential solutions. The water board contracted experts at UC Davis, who released their \u003ca href=\"http://www.californiareport.org/archive/R201203130850/a\">widely covered report\u003c/a> in March.\u003c/p>\n\u003cp>The \u003ca href=\"http://groundwaternitrate.ucdavis.edu/\">UC Davis researchers\u003c/a> looked at nitrate contamination in two of the prime agricultural regions in California, the Tulare Lake Basin and the Salinas Valley, where about 2.6 million people rely on groundwater. They found that agriculture accounts for 96% of nitrate-contaminated groundwater. More than a quarter of a million people in these regions may have nitrates in their drinking water.\u003c/p>\n\u003cfigure id=\"attachment_39392\" class=\"wp-caption alignleft\" style=\"max-width: 240px\">\u003ca href=\"http://ww2.kqed.org/quest/2012/06/13/farmworkers-pay-a-heavy-price-for-californias-bounty/faucet/\" rel=\"attachment wp-att-39392\">\u003cimg class=\"size-large wp-image-39392\" title=\"Faucet\" src=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2012/06/Faucet-240x360.jpg\" alt=\"Faucet\" width=\"240\" height=\"360\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">More than 250,000 people living in the Tulare Lake Basin and Salinas Valley can't drink their tap water because it's contaminated with nitrates. Most are low-income and Latino. (Photo: Benutzer:Alex Anlicker/Wikimedia Commons)\u003c/figcaption>\u003c/figure>\n\u003cp>Some of the poorest people in the state live in these agricultural areas. And many of those coping with tainted drinking water work in the fields that leach the nitrates, picking our produce, our strawberries, oranges and lemons.\u003c/p>\n\u003cp>In April, I went to Tulare County for a \u003ca href=\"http://www.environmentalhealthnews.org/ehs/news/2012/pollution-poverty-people-of-color-series-summary\">story for Environmental Health News\u003c/a> to speak with residents who've been struggling with nitrate contamination for years. Their taps dispense toxic water they can’t drink but they still have to pay for their monthly water bill. And then they have to buy bottled water from the grocery store or fill up five-gallon jugs from a water vending machine—something I’d wager most San Franciscans have never seen.\u003c/p>\n\u003cp>\u003ca href=\"http://www.environmentalhealthnews.org/ehs/news/2012/pollution-poverty-and-people-of-color-nitrate-day-4\">One woman I spoke to\u003c/a>, a single mother of four named Bertha Dias, makes $7.50 an hour picking fruit. She pays nearly five times as much to have safe drinking water in her house than the average San Franciscan pays to drink water so pristine \u003ca href=\"http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2003/03/26/MN279761.DTL\">Willie Brown famously bottled it\u003c/a> as Hetch Hetchy Mountain Water.\u003c/p>\n\u003cp>The nitrate contamination problem has been covered before, including an \u003ca href=\"http://californiawatch.org/nitrate-contamination-spreading-california-communities\">in-depth investigation by California Watch\u003c/a> in 2010. Yet the problem hasn't gone away.\u003c/p>\n\u003cp>Low-income people seeking safe drinking water throughout Tulare County are working with the Visalia-based \u003ca href=\"http://www.communitywatercenter.org/\">Community Water Center\u003c/a> to find their own solutions. Potential solutions run from digging a new well to hooking up to a larger water system to installing filtration systems under the sink. But many measures are temporary fixes, until the state figures out how to deal with the problem over the long term--which the UC Davis study concluded would cost about $36 million a year.\u003c/p>\n\u003cp>In 2009, strawberries brought in more than three-quarters of a billion dollars for Salinas Valley farmers, resulting from a 10-year increase in consumer demand, Carolyn O'Donnell, communications director for the California Strawberry Commission, told a reporter for \u003ca href=\"http://www.thecalifornian.com/article/20100623/BUSINESS/6230307/Strawberries-top-lettuce-Monterey-County-s-No-1-crop\">TheCalifornian.com\u003c/a>. She attributed the increased demand to better-tasting varieties that hold up better under shipping.\u003c/p>\n\u003cp>Now Bay Area consumers can see Salinas Valley strawberries at their local grocery stores nearly anytime except winter, when shipments from Southern California pick up the slack.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>But now when I think of strawberries, the romance is gone. I can't help but think of Bertha Dias and the other farmworkers like her, who spend long, hot days picking our fruit and vegetables out in the fields, only to come home to water they can't drink. They deserve better.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Tackling the Cause of Cystic Fibrosis One Mutation at a Time",
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"content": "\u003cfigure id=\"attachment_39185\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/quest/2012/06/11/tackling-the-cause-of-cystic-fibrosis-one-mutation-at-a-time/ivacaftor/\" rel=\"attachment wp-att-39185\">\u003cimg src=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2012/06/Ivacaftor.jpg\" alt=\"\" title=\"Ivacaftor\" width=\"640\" height=\"365\" class=\"size-full wp-image-39185\" srcset=\"https://ww2.kqed.org/app/uploads/sites/39/2012/06/Ivacaftor.jpg 640w, https://ww2.kqed.org/app/uploads/sites/39/2012/06/Ivacaftor-400x228.jpg 400w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">This little molecule is changing how some cystic fibrosis patients are treated. And how new drugs may be made in the future.\u003c/figcaption>\u003c/figure>\n\u003cp>There was big news in the cystic fibrosis (CF) field recently: a new CF drug called ivacaftor (or VX-770 or Kalydeco) has been approved that does more than target the symptoms of CF. It actually works to get the broken gene working again. \u003c/p>\n\u003cp>The good news is that this is the first treatment that has the potential to cure this genetic disease (as long as the patients keep taking their medicine). The bad news is that it is only approved for around 4-5% of people with CF. This last bit of news may get a lot better in the near future but ivacaftor will never help every CF sufferer.\u003c/p>\n\u003cp>The reason for this has to do with the fact that there is more than one way to break the main gene involved in CF -- the CFTR gene -- and that there is more than one class of CFTR break.\u003c/p>\n\u003cp>The CFTR gene has the instructions for making the CFTR protein. This protein needs to get made and sent to the membrane so it can do its job of shuttling chloride ions back and forth. If you have a slight difference* in the gene that disrupts any step, then you can end up with CF. (Although not every slight difference leads to CF -- not by a long shot!)\u003c/p>\n\u003cfigure id=\"attachment_39190\" class=\"wp-caption alignright\" style=\"max-width: 250px\">\u003ca href=\"http://ww2.kqed.org/quest/2012/06/11/tackling-the-cause-of-cystic-fibrosis-one-mutation-at-a-time/cftr/\" rel=\"attachment wp-att-39190\">\u003cimg src=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2012/06/CFTR.jpg\" alt=\"\" title=\"CFTR\" width=\"250\" height=\"230\" class=\"size-full wp-image-39190\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">There are many ways to keep this protein from working. Each way may need a different medicine.\u003c/figcaption>\u003c/figure>\n\u003cp>So some CF-causing differences in the CFTR gene will keep the protein from being made while others will keep it from making it to the membrane. Still others will keep the channel from opening wide enough to let the chloride ions pass through. Ivacaftor helps people in this last category.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>These folks have a mutation in their gene called G551D. As you might recall, genes are written in a simple language that just has four letters—A, G, C, and T. These letters are all grouped together in a gene to form three letter words. \u003c/p>\n\u003cp>With the exception of three words that act like a period at the end of a sentence, each of these words corresponds to one of twenty different amino acids. So a gene is really just the instructions for stringing together certain amino acids in a certain order.\u003c/p>\n\u003cp>The CFTR protein is made up of 1470 of these three letter words. The people helped by ivacaftor have a letter change that causes the cell to read the 551st word as a D instead of a G. This is enough to cause the protein to have trouble letting the chloride ions through.\u003c/p>\n\u003cp>Ivacaftor enhances CFTR’s ability to open up. So it makes sense that it would help people with the G551D variation. But it also makes sense why it won’t help for other CF patients.\u003c/p>\n\u003cp>For example, around 10% of people with CF have what is called a nonsense mutation in their CFTR gene. What happens in these cases is that a word that normally corresponds to an amino acid is mutated so that it now codes for a period. The cell stops reading the gene too soon and so you end up with only a part of the protein. Usually these “truncated” proteins can’t do much of anything. \u003c/p>\n\u003cp>Giving one of these patients a drug that helps the full length protein open wider isn’t going to be of much help. No, you need a drug that will ignore the period and make at least some functional CFTR. And there is a drug in the pipeline called PTC-124 that just might be able to pull this off. Of course PTC-124 will be of little use for people with the G551D variant!\u003c/p>\n\u003cp>Now having said this, ivacaftor may be more than a one trick pony. In fact, it may be able to help the majority of people with CF in the near future. \u003c/p>\n\u003cfigure id=\"attachment_39195\" class=\"wp-caption alignright\" style=\"max-width: 150px\">\u003ca href=\"http://ww2.kqed.org/quest/2012/06/11/tackling-the-cause-of-cystic-fibrosis-one-mutation-at-a-time/atcgpeople/\" rel=\"attachment wp-att-39195\">\u003cimg src=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2012/06/atcgPeople.jpg\" alt=\"\" title=\"atcgPeople\" width=\"150\" height=\"184\" class=\"size-full wp-image-39195\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Our genetic uniqueness will make finding cures more difficult.\u003c/figcaption>\u003c/figure>\n\u003cp>Most people with CF have a certain mutation called delta508. Basically the 508th word has gone missing in their CFTR gene.\u003c/p>\n\u003cp>What happens in these cases is that most of the CFTR protein gets lost on its way to the membrane. But a tiny bit does make it to the right place and ivacaftor might be able to boost that little bit enough to help these patients. \u003c/p>\n\u003cp>Ivacaftor is currently in Phase 2 clinical trials to see if it can help patients with the delta508 variant. The results are promising so far.\u003c/p>\n\u003cp>These treatments for CF are showing how we may have to deal with genetic diseases in the future. As I talked about in my last \u003ca href=\"http://ww2.kqed.org/quest/2012/05/28/why-your-newfound-uniqueness-a-nightmare-for-your-doctor/\">blog\u003c/a>, we are all unique genetically. This means that even simple genetic diseases are going to be like CF and come in many different classes that will all have to be treated differently. It also means that new drugs may only help a relatively small number of patients.\u003c/p>\n\u003cp>This last point will require a paradigm shift in how drugs are developed too. Most big pharma companies won’t touch drugs that treat so few people. Ivacaftor is showing us the way here too.\u003c/p>\n\u003cp>The Cystic Fibrosis Foundation provided big pharma with a sizeable chunk of change to get this drug through clinical trials and to the market. The new paradigm may be that interested patient groups collaborate with big pharma to get these “boutique” drugs to market. \u003c/p>\n\u003cp>It’ll be interesting to see if this is a viable business model. But at least for now a minority of CF patients can have real hope.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>*These DNA differences go by lots of different names: variant, SNP, mutation, mistake, etc.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_39185\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/quest/2012/06/11/tackling-the-cause-of-cystic-fibrosis-one-mutation-at-a-time/ivacaftor/\" rel=\"attachment wp-att-39185\">\u003cimg src=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2012/06/Ivacaftor.jpg\" alt=\"\" title=\"Ivacaftor\" width=\"640\" height=\"365\" class=\"size-full wp-image-39185\" srcset=\"https://ww2.kqed.org/app/uploads/sites/39/2012/06/Ivacaftor.jpg 640w, https://ww2.kqed.org/app/uploads/sites/39/2012/06/Ivacaftor-400x228.jpg 400w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">This little molecule is changing how some cystic fibrosis patients are treated. And how new drugs may be made in the future.\u003c/figcaption>\u003c/figure>\n\u003cp>There was big news in the cystic fibrosis (CF) field recently: a new CF drug called ivacaftor (or VX-770 or Kalydeco) has been approved that does more than target the symptoms of CF. It actually works to get the broken gene working again. \u003c/p>\n\u003cp>The good news is that this is the first treatment that has the potential to cure this genetic disease (as long as the patients keep taking their medicine). The bad news is that it is only approved for around 4-5% of people with CF. This last bit of news may get a lot better in the near future but ivacaftor will never help every CF sufferer.\u003c/p>\n\u003cp>The reason for this has to do with the fact that there is more than one way to break the main gene involved in CF -- the CFTR gene -- and that there is more than one class of CFTR break.\u003c/p>\n\u003cp>The CFTR gene has the instructions for making the CFTR protein. This protein needs to get made and sent to the membrane so it can do its job of shuttling chloride ions back and forth. If you have a slight difference* in the gene that disrupts any step, then you can end up with CF. (Although not every slight difference leads to CF -- not by a long shot!)\u003c/p>\n\u003cfigure id=\"attachment_39190\" class=\"wp-caption alignright\" style=\"max-width: 250px\">\u003ca href=\"http://ww2.kqed.org/quest/2012/06/11/tackling-the-cause-of-cystic-fibrosis-one-mutation-at-a-time/cftr/\" rel=\"attachment wp-att-39190\">\u003cimg src=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2012/06/CFTR.jpg\" alt=\"\" title=\"CFTR\" width=\"250\" height=\"230\" class=\"size-full wp-image-39190\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">There are many ways to keep this protein from working. Each way may need a different medicine.\u003c/figcaption>\u003c/figure>\n\u003cp>So some CF-causing differences in the CFTR gene will keep the protein from being made while others will keep it from making it to the membrane. Still others will keep the channel from opening wide enough to let the chloride ions pass through. Ivacaftor helps people in this last category.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>These folks have a mutation in their gene called G551D. As you might recall, genes are written in a simple language that just has four letters—A, G, C, and T. These letters are all grouped together in a gene to form three letter words. \u003c/p>\n\u003cp>With the exception of three words that act like a period at the end of a sentence, each of these words corresponds to one of twenty different amino acids. So a gene is really just the instructions for stringing together certain amino acids in a certain order.\u003c/p>\n\u003cp>The CFTR protein is made up of 1470 of these three letter words. The people helped by ivacaftor have a letter change that causes the cell to read the 551st word as a D instead of a G. This is enough to cause the protein to have trouble letting the chloride ions through.\u003c/p>\n\u003cp>Ivacaftor enhances CFTR’s ability to open up. So it makes sense that it would help people with the G551D variation. But it also makes sense why it won’t help for other CF patients.\u003c/p>\n\u003cp>For example, around 10% of people with CF have what is called a nonsense mutation in their CFTR gene. What happens in these cases is that a word that normally corresponds to an amino acid is mutated so that it now codes for a period. The cell stops reading the gene too soon and so you end up with only a part of the protein. Usually these “truncated” proteins can’t do much of anything. \u003c/p>\n\u003cp>Giving one of these patients a drug that helps the full length protein open wider isn’t going to be of much help. No, you need a drug that will ignore the period and make at least some functional CFTR. And there is a drug in the pipeline called PTC-124 that just might be able to pull this off. Of course PTC-124 will be of little use for people with the G551D variant!\u003c/p>\n\u003cp>Now having said this, ivacaftor may be more than a one trick pony. In fact, it may be able to help the majority of people with CF in the near future. \u003c/p>\n\u003cfigure id=\"attachment_39195\" class=\"wp-caption alignright\" style=\"max-width: 150px\">\u003ca href=\"http://ww2.kqed.org/quest/2012/06/11/tackling-the-cause-of-cystic-fibrosis-one-mutation-at-a-time/atcgpeople/\" rel=\"attachment wp-att-39195\">\u003cimg src=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2012/06/atcgPeople.jpg\" alt=\"\" title=\"atcgPeople\" width=\"150\" height=\"184\" class=\"size-full wp-image-39195\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Our genetic uniqueness will make finding cures more difficult.\u003c/figcaption>\u003c/figure>\n\u003cp>Most people with CF have a certain mutation called delta508. Basically the 508th word has gone missing in their CFTR gene.\u003c/p>\n\u003cp>What happens in these cases is that most of the CFTR protein gets lost on its way to the membrane. But a tiny bit does make it to the right place and ivacaftor might be able to boost that little bit enough to help these patients. \u003c/p>\n\u003cp>Ivacaftor is currently in Phase 2 clinical trials to see if it can help patients with the delta508 variant. The results are promising so far.\u003c/p>\n\u003cp>These treatments for CF are showing how we may have to deal with genetic diseases in the future. As I talked about in my last \u003ca href=\"http://ww2.kqed.org/quest/2012/05/28/why-your-newfound-uniqueness-a-nightmare-for-your-doctor/\">blog\u003c/a>, we are all unique genetically. This means that even simple genetic diseases are going to be like CF and come in many different classes that will all have to be treated differently. It also means that new drugs may only help a relatively small number of patients.\u003c/p>\n\u003cp>This last point will require a paradigm shift in how drugs are developed too. Most big pharma companies won’t touch drugs that treat so few people. Ivacaftor is showing us the way here too.\u003c/p>\n\u003cp>The Cystic Fibrosis Foundation provided big pharma with a sizeable chunk of change to get this drug through clinical trials and to the market. The new paradigm may be that interested patient groups collaborate with big pharma to get these “boutique” drugs to market. \u003c/p>\n\u003cp>It’ll be interesting to see if this is a viable business model. But at least for now a minority of CF patients can have real hope.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>*These DNA differences go by lots of different names: variant, SNP, mutation, mistake, etc.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Screening Sunscreens: Environmental Working Group's 2012 Report",
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"content": "\u003cfigure id=\"attachment_39221\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2012/06/Sunscreens_JoeShlabotnik_feature.jpg\">\u003cimg class=\"size-full wp-image-39221\" title=\"Sunscreens_JoeShlabotnik_feature\" src=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2012/06/Sunscreens_JoeShlabotnik_feature.jpg\" alt=\"colorful bottles of different brands of sunscreen\" width=\"640\" height=\"360\" srcset=\"https://ww2.kqed.org/app/uploads/sites/39/2012/06/Sunscreens_JoeShlabotnik_feature.jpg 640w, https://ww2.kqed.org/app/uploads/sites/39/2012/06/Sunscreens_JoeShlabotnik_feature-400x225.jpg 400w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Photograph courtesy of Joe Shlabotnik via Creative Commons\u003c/figcaption>\u003c/figure>\n\u003cp>I’m one of those grocery shoppers who flips a package around to check the ingredients on a label before buying it for the first time. Checking food packages is easy, because I expect to see only recognizable simple ingredients. What about sunscreen? How can you tell if it’s safe?\u003c/p>\n\u003cp>The \u003ca title=\"Environmental Working Group\" href=\"http://www.ewg.org/\">Environmental Working Group\u003c/a> (EWG) has done extensive research to evaluate the effectiveness and safety of over 1800 sunscreens on the market so you don’t have to. Their Sixth Annual \u003ca title=\"EWG 2012 Sunscreen Guide\" href=\"http://breakingnews.ewg.org/2012sunscreen/sunscreens-exposed/executive-summary/\">2012 Sunscreen Guide\u003c/a> lists the best and worst sunscreens. It’s worth a look to make sure your sunscreen isn’t in their “Hall of Shame.” The EWG also provides detailed information about potentially harmful sunscreen ingredients.\u003c/p>\n\u003cp>There is general concern over the large number of sunscreens with exaggerated SPF claims. The SPF (Sun Protection Factor) indicates the level of protection that a sunscreen offers against UVB -- the ultraviolet rays that cause sunburn. For instance, SPF 15 sunscreen protects against 93% of the sun’s UVB rays and SPF 50 protects against 98%. Users of high-SPF sunscreens often increase their risk of sun damage by staying out in the sun longer with a single application.\u003c/p>\n\u003cp>Many of these high-SPF sunscreens provide little protection from UVA rays, which are more deeply penetrating and 30-50 times more prevalent than UVB rays. Research shows that UVA radiation causes skin damage and increases the \u003ca title=\"research article on DNA damage from UVA exposure\" href=\"http://www.ncbi.nlm.nih.gov/pubmed/15140232\">risk of cancer\u003c/a>. It is important to use a sunscreen with zinc oxide, titanium oxide or 3% avobenzone so it protects against both UVA and UVB.\u003c/p>\n\u003cp>People also don’t use enough sunscreen to get the benefit of the SPF rating promised on the bottle. According to the EWG, people \u003ca title=\"article on typical SPF effectiveness\" href=\"http://breakingnews.ewg.org/2012sunscreen/sunscreens-exposed/whats-wrong-with-high-spf/\">typically use\u003c/a> 25% of the recommended amount so SPF 100 to 15 sunscreens actually perform like SPF 3.2 to 2.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The EWG is concerned about retinyl palmitate, a form of vitamin A found in one-fourth of sunscreens. It’s an anti-aging ingredient used as a stabilizer. Although research is not definitive, there is \u003ca title=\"research article on retinyl palmitate\" href=\"http://www.ewg.org/report/what-scientists-say-about-vitamin-sunscreen\">evidence\u003c/a> that retinyl palmitate may promote cancer when used on sun-exposed skin. The EWG recommends that you avoid sunscreens with vitamin A (any form of retinyl or retinol).\u003c/p>\n\u003cp>You also need to be careful of products with oxybenzone, found in more than half of beach and sport sunscreens. It penetrates the skin and has been linked to allergies, hormone disruption and cell damage. The U.S. Centers for Disease Control and Prevention found that \u003ca title=\"research article on benzophenone-3 exposure\" href=\"http://ehp03.niehs.nih.gov/article/info:doi/10.1289/ehp.11269\">97 percent of Americans tested had oxybenzone\u003c/a> in their bodies and additional research is underway to understand how this affects our health. The EWG advises against using sunscreens with oxybenzone, although the \u003ca title=\"Personal Care Products Council, a trade association\" href=\"http://www.ctfa.org/\">Personal Care Products Council\u003c/a> disputes these safety allegations.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Discouraged? All these troubling facts may tempt you to give up on sunscreen altogether. However, public health agencies still recommend using sunscreen, just not as your first line of defense. Hats, clothing and shade provide the most reliable sun protection. When that isn’t enough, use the Environmental Working Group’s Sunscreen Guide to help you select a relatively safe sunscreen.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_39221\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2012/06/Sunscreens_JoeShlabotnik_feature.jpg\">\u003cimg class=\"size-full wp-image-39221\" title=\"Sunscreens_JoeShlabotnik_feature\" src=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2012/06/Sunscreens_JoeShlabotnik_feature.jpg\" alt=\"colorful bottles of different brands of sunscreen\" width=\"640\" height=\"360\" srcset=\"https://ww2.kqed.org/app/uploads/sites/39/2012/06/Sunscreens_JoeShlabotnik_feature.jpg 640w, https://ww2.kqed.org/app/uploads/sites/39/2012/06/Sunscreens_JoeShlabotnik_feature-400x225.jpg 400w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Photograph courtesy of Joe Shlabotnik via Creative Commons\u003c/figcaption>\u003c/figure>\n\u003cp>I’m one of those grocery shoppers who flips a package around to check the ingredients on a label before buying it for the first time. Checking food packages is easy, because I expect to see only recognizable simple ingredients. What about sunscreen? How can you tell if it’s safe?\u003c/p>\n\u003cp>The \u003ca title=\"Environmental Working Group\" href=\"http://www.ewg.org/\">Environmental Working Group\u003c/a> (EWG) has done extensive research to evaluate the effectiveness and safety of over 1800 sunscreens on the market so you don’t have to. Their Sixth Annual \u003ca title=\"EWG 2012 Sunscreen Guide\" href=\"http://breakingnews.ewg.org/2012sunscreen/sunscreens-exposed/executive-summary/\">2012 Sunscreen Guide\u003c/a> lists the best and worst sunscreens. It’s worth a look to make sure your sunscreen isn’t in their “Hall of Shame.” The EWG also provides detailed information about potentially harmful sunscreen ingredients.\u003c/p>\n\u003cp>There is general concern over the large number of sunscreens with exaggerated SPF claims. The SPF (Sun Protection Factor) indicates the level of protection that a sunscreen offers against UVB -- the ultraviolet rays that cause sunburn. For instance, SPF 15 sunscreen protects against 93% of the sun’s UVB rays and SPF 50 protects against 98%. Users of high-SPF sunscreens often increase their risk of sun damage by staying out in the sun longer with a single application.\u003c/p>\n\u003cp>Many of these high-SPF sunscreens provide little protection from UVA rays, which are more deeply penetrating and 30-50 times more prevalent than UVB rays. Research shows that UVA radiation causes skin damage and increases the \u003ca title=\"research article on DNA damage from UVA exposure\" href=\"http://www.ncbi.nlm.nih.gov/pubmed/15140232\">risk of cancer\u003c/a>. It is important to use a sunscreen with zinc oxide, titanium oxide or 3% avobenzone so it protects against both UVA and UVB.\u003c/p>\n\u003cp>People also don’t use enough sunscreen to get the benefit of the SPF rating promised on the bottle. According to the EWG, people \u003ca title=\"article on typical SPF effectiveness\" href=\"http://breakingnews.ewg.org/2012sunscreen/sunscreens-exposed/whats-wrong-with-high-spf/\">typically use\u003c/a> 25% of the recommended amount so SPF 100 to 15 sunscreens actually perform like SPF 3.2 to 2.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The EWG is concerned about retinyl palmitate, a form of vitamin A found in one-fourth of sunscreens. It’s an anti-aging ingredient used as a stabilizer. Although research is not definitive, there is \u003ca title=\"research article on retinyl palmitate\" href=\"http://www.ewg.org/report/what-scientists-say-about-vitamin-sunscreen\">evidence\u003c/a> that retinyl palmitate may promote cancer when used on sun-exposed skin. The EWG recommends that you avoid sunscreens with vitamin A (any form of retinyl or retinol).\u003c/p>\n\u003cp>You also need to be careful of products with oxybenzone, found in more than half of beach and sport sunscreens. It penetrates the skin and has been linked to allergies, hormone disruption and cell damage. The U.S. Centers for Disease Control and Prevention found that \u003ca title=\"research article on benzophenone-3 exposure\" href=\"http://ehp03.niehs.nih.gov/article/info:doi/10.1289/ehp.11269\">97 percent of Americans tested had oxybenzone\u003c/a> in their bodies and additional research is underway to understand how this affects our health. The EWG advises against using sunscreens with oxybenzone, although the \u003ca title=\"Personal Care Products Council, a trade association\" href=\"http://www.ctfa.org/\">Personal Care Products Council\u003c/a> disputes these safety allegations.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Discouraged? All these troubling facts may tempt you to give up on sunscreen altogether. However, public health agencies still recommend using sunscreen, just not as your first line of defense. Hats, clothing and shade provide the most reliable sun protection. When that isn’t enough, use the Environmental Working Group’s Sunscreen Guide to help you select a relatively safe sunscreen.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_38754\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/quest/2012/05/28/why-your-newfound-uniqueness-a-nightmare-for-your-doctor/humdivinasia/\" rel=\"attachment wp-att-38754\">\u003cimg src=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2012/05/HumDivInAsia.jpg\" alt=\"\" title=\"HumDivInAsia\" width=\"640\" height=\"356\" class=\"size-full wp-image-38754\" srcset=\"https://ww2.kqed.org/app/uploads/sites/39/2012/05/HumDivInAsia.jpg 640w, https://ww2.kqed.org/app/uploads/sites/39/2012/05/HumDivInAsia-400x223.jpg 400w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Our surprising genetic diversity will give scientists fits for years.\u003c/figcaption>\u003c/figure>\n\u003cp>A couple of new studies confirm what many of us have feared: each of us is surprisingly unique genetically. This is to be feared because of the impact it will have on the future of personalized medicine. Our individual uniqueness will make predicting our risk for disease much trickier than we thought. And it will make finding treatments that much harder too.\u003c/p>\n\u003cp>You’ve probably read that all humans share somewhere between 99.5% and 99.9% of their DNA. Usually this is translated into saying that we have a difference in our DNA every 1000 bases or so. (By bases I mean the A’s, G’s, C’s, and T’s that make up our DNA.)\u003c/p>\n\u003cp>These differences were supposed to be shared by many people. So a lot of people would have a G at a certain position and the rest of us would have a T. The first \u003ca href=\"http://www.sciencemag.org/content/early/2012/05/16/science.1217876\">study \u003c/a>shows that this is not the case.\u003c/p>\n\u003cp>Instead, we all have many rare DNA differences scattered throughout our DNA. When the researchers looked at 202 different genes from 14,002 people, they found a rare variant every 17 bases or so. This is way higher than many people thought.\u003c/p>\n\u003cp>What’s worse is that these differences aren’t all benign. The other \u003ca href=\"http://www.sciencemag.org/content/early/2012/05/21/science.1219240\">study published in \u003cem>Science\u003c/em>\u003c/a> showed that a surprisingly high percentage, around 2.3%, is predicted to significantly impact a gene. In other words, we are all burdened with many gene-altering and so potentially harmful DNA differences. \u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>So the world of genetics is getting turned on its head yet again. Not so long ago, the idea was that diseases shared a common set of DNA differences. So everyone with sickle cell anemia had a certain DNA difference (or at least a certain few). Same thing with cystic fibrosis and all the other genetic diseases.\u003c/p>\n\u003cfigure id=\"attachment_38759\" class=\"wp-caption alignright\" style=\"max-width: 150px\">\u003ca href=\"http://ww2.kqed.org/quest/2012/05/28/why-your-newfound-uniqueness-a-nightmare-for-your-doctor/manypaths/\" rel=\"attachment wp-att-38759\">\u003cimg src=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2012/05/ManyPaths.jpg\" alt=\"\" title=\"ManyPaths\" width=\"150\" height=\"343\" class=\"size-full wp-image-38759\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">There are many paths to the same illness.\u003c/figcaption>\u003c/figure>\n\u003cp>Now it looks like there are many individual paths to a disease. For example, while most cases of cystic fibrosis do involve glitches in the CFTR gene, there are lots of glitches that can cause the disease. And that makes figuring out your chances for getting or passing cystic fibrosis to your children even harder.\u003c/p>\n\u003cp>Many (perhaps even most) of us will have DNA differences in our CFTR genes that haven’t been seen before. We don’t yet know which differences can lead to cystic fibrosis.\u003c/p>\n\u003cp>Believe it or not, cystic fibrosis is the easy case; at least it usually involves just one gene. More complex genetic diseases like Type 2 diabetes or \u003ca href=\"http://ww2.kqed.org/quest/video/alzheimers-is-the-cure-in-the-genes/\">Alzheimer’s \u003c/a>are going to be complicated by the fact that many different genes can be involved and we are all littered with unique differences in these genes. \u003c/p>\n\u003cp>For example, there will be a huge set of genes involved in Type 2 diabetes. Each of us will have numerous unique DNA differences strewn throughout these genes. Some of these changes will increase your risk for getting Type 2 diabetes and some will lower your risk.\u003c/p>\n\u003cp>Unfortunately the way scientists can tell if a difference is involved in a disease is by comparing two large groups of people with and without the disease. If a certain DNA difference turns up more often in the disease group, then it may be involved in causing the disease.\u003c/p>\n\u003cp>But now everyone has lots of unique DNA differences, many of which can contribute to disease. The people in the disease group won’t share a lot of the same differences that lead to disease. This means it is going to be hard to figure out which differences matter.\u003c/p>\n\u003cp>Our best bet may be to figure out as much DNA from as many people as possible so we can at least start to get a handle on which genes are involved in a particular disease. Then we can start to explore which DNA differences matter and which ones don’t. One thing is for sure, this is going to take awhile to sort out.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"http://www.sciencecodex.com/knowing_genetic_makeup_may_not_significantly_improve_disease_risk_prediction-92164\">\u003cem>This\u003c/em> \u003c/a>\u003cem>came out after I wrote the blog. More evidence that knowing our DNA may not help us out as much as we had hoped.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_38754\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/quest/2012/05/28/why-your-newfound-uniqueness-a-nightmare-for-your-doctor/humdivinasia/\" rel=\"attachment wp-att-38754\">\u003cimg src=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2012/05/HumDivInAsia.jpg\" alt=\"\" title=\"HumDivInAsia\" width=\"640\" height=\"356\" class=\"size-full wp-image-38754\" srcset=\"https://ww2.kqed.org/app/uploads/sites/39/2012/05/HumDivInAsia.jpg 640w, https://ww2.kqed.org/app/uploads/sites/39/2012/05/HumDivInAsia-400x223.jpg 400w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Our surprising genetic diversity will give scientists fits for years.\u003c/figcaption>\u003c/figure>\n\u003cp>A couple of new studies confirm what many of us have feared: each of us is surprisingly unique genetically. This is to be feared because of the impact it will have on the future of personalized medicine. Our individual uniqueness will make predicting our risk for disease much trickier than we thought. And it will make finding treatments that much harder too.\u003c/p>\n\u003cp>You’ve probably read that all humans share somewhere between 99.5% and 99.9% of their DNA. Usually this is translated into saying that we have a difference in our DNA every 1000 bases or so. (By bases I mean the A’s, G’s, C’s, and T’s that make up our DNA.)\u003c/p>\n\u003cp>These differences were supposed to be shared by many people. So a lot of people would have a G at a certain position and the rest of us would have a T. The first \u003ca href=\"http://www.sciencemag.org/content/early/2012/05/16/science.1217876\">study \u003c/a>shows that this is not the case.\u003c/p>\n\u003cp>Instead, we all have many rare DNA differences scattered throughout our DNA. When the researchers looked at 202 different genes from 14,002 people, they found a rare variant every 17 bases or so. This is way higher than many people thought.\u003c/p>\n\u003cp>What’s worse is that these differences aren’t all benign. The other \u003ca href=\"http://www.sciencemag.org/content/early/2012/05/21/science.1219240\">study published in \u003cem>Science\u003c/em>\u003c/a> showed that a surprisingly high percentage, around 2.3%, is predicted to significantly impact a gene. In other words, we are all burdened with many gene-altering and so potentially harmful DNA differences. \u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>So the world of genetics is getting turned on its head yet again. Not so long ago, the idea was that diseases shared a common set of DNA differences. So everyone with sickle cell anemia had a certain DNA difference (or at least a certain few). Same thing with cystic fibrosis and all the other genetic diseases.\u003c/p>\n\u003cfigure id=\"attachment_38759\" class=\"wp-caption alignright\" style=\"max-width: 150px\">\u003ca href=\"http://ww2.kqed.org/quest/2012/05/28/why-your-newfound-uniqueness-a-nightmare-for-your-doctor/manypaths/\" rel=\"attachment wp-att-38759\">\u003cimg src=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2012/05/ManyPaths.jpg\" alt=\"\" title=\"ManyPaths\" width=\"150\" height=\"343\" class=\"size-full wp-image-38759\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">There are many paths to the same illness.\u003c/figcaption>\u003c/figure>\n\u003cp>Now it looks like there are many individual paths to a disease. For example, while most cases of cystic fibrosis do involve glitches in the CFTR gene, there are lots of glitches that can cause the disease. And that makes figuring out your chances for getting or passing cystic fibrosis to your children even harder.\u003c/p>\n\u003cp>Many (perhaps even most) of us will have DNA differences in our CFTR genes that haven’t been seen before. We don’t yet know which differences can lead to cystic fibrosis.\u003c/p>\n\u003cp>Believe it or not, cystic fibrosis is the easy case; at least it usually involves just one gene. More complex genetic diseases like Type 2 diabetes or \u003ca href=\"http://ww2.kqed.org/quest/video/alzheimers-is-the-cure-in-the-genes/\">Alzheimer’s \u003c/a>are going to be complicated by the fact that many different genes can be involved and we are all littered with unique differences in these genes. \u003c/p>\n\u003cp>For example, there will be a huge set of genes involved in Type 2 diabetes. Each of us will have numerous unique DNA differences strewn throughout these genes. Some of these changes will increase your risk for getting Type 2 diabetes and some will lower your risk.\u003c/p>\n\u003cp>Unfortunately the way scientists can tell if a difference is involved in a disease is by comparing two large groups of people with and without the disease. If a certain DNA difference turns up more often in the disease group, then it may be involved in causing the disease.\u003c/p>\n\u003cp>But now everyone has lots of unique DNA differences, many of which can contribute to disease. The people in the disease group won’t share a lot of the same differences that lead to disease. This means it is going to be hard to figure out which differences matter.\u003c/p>\n\u003cp>Our best bet may be to figure out as much DNA from as many people as possible so we can at least start to get a handle on which genes are involved in a particular disease. Then we can start to explore which DNA differences matter and which ones don’t. One thing is for sure, this is going to take awhile to sort out.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"http://www.sciencecodex.com/knowing_genetic_makeup_may_not_significantly_improve_disease_risk_prediction-92164\">\u003cem>This\u003c/em> \u003c/a>\u003cem>came out after I wrote the blog. More evidence that knowing our DNA may not help us out as much as we had hoped.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Making Women Partners in Breast Cancer Research",
"title": "Making Women Partners in Breast Cancer Research",
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"content": "\u003cfigure id=\"attachment_38099\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/quest/2012/05/16/making-women-partners-in-breast-cancer-research/cancercellsi640/\" rel=\"attachment wp-att-38099\">\u003cimg src=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2012/05/CancerCellsI640-300x169.jpg\" alt=\"breast cancer cells\" title=\"breast cancer cells\" width=\"300\" height=\"169\" class=\"size-thumbnail wp-image-38099\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Cancer cells under a microscope. Colored stains mark different compartments in the cell. The nucleus is red and lysosomes (which break down waste) are purple. (Image: Carolin Zehetmeier, Morphosys AG, Germany)\u003c/figcaption>\u003c/figure>\n\u003cp>Dr. Susan Love thinks breast cancer researchers need to get over their addiction to rodents. \u003c/p>\n\u003cp>America’s most famous breast cancer surgeon started treating women some 30 years ago. “And we’re still doing the same thing we did when I started,” she told a crowd in San Francisco last month at the \u003ca href=\"http://sagecongress.org/\">Sage Bionetworks conference\u003c/a>, aimed at transforming biomedical research.\u003c/p>\n\u003cp>“Surgery radiation, chemotherapy, hormones, and now we’ve added a little bit of targeted therapies,” said Love, a clinical professor of surgery at UCLA. “We never subtract anything, mind you, we only add things on top. And our results are about the same.” \u003c/p>\n\u003cp>Although \u003ca href=\"http://www.cdc.gov/cancer/breast/statistics/trends.htm\">breast cancer incidence and mortality\u003c/a> have decreased since 1998, by 1.3% and 2% respectively, more than 200,000 women will be diagnosed with breast cancer this year and more than 40,000 will die from it. Nearly 110 women die from breast cancer every day.\u003c/p>\n\u003cp>Experts think earlier detection and better treatments account for the decline in deaths, but screening carries risks. With mass screening comes overdiagnosis—that is, diagnosing a condition that would not prove symptomatic or fatal—and \u003ca href=\"http://www.youtube.com/watch?feature=player_embedded&v=bRKc7YqFNps\">with overdiagnosis comes overtreatment\u003c/a> and other potential harms (see video below). Screening technology can’t distinguish between aggressive and harmless tumors, which can shrink or even disappear on their own. Overdiagnosis will likely just increase as imaging technology finds smaller and smaller tumors.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Medical experts acknowledged in an editorial in the \u003ca href=\"http://www.annals.org/content/156/7/536.full\">Annals of Internal Medicine\u003c/a> last month that it’s time to recognize overdiagnosis as a serious problem. Most patient-education materials don’t even mention overdiagnosis and most women aren’t aware of the possibility, the authors said. As they pointed out, and any woman knows, “the impact of a cancer diagnosis lasts a lifetime.”\u003c/p>\n\u003cp>It’s hard to think of a physician who’s done more to acknowledge the trauma of breast cancer than the author of the best-selling “Dr. Susan Love’s Breast Book,” now in its fifth edition. \u003c/p>\n\u003cp>That book, along with Love's early refusal to accept the oxymoronic (emphasis on moronic) “early detection is your best prevention” mantra of mainstream cancer and advocacy organizations, won her a place of honor among frustrated breast cancer activists, who know all too well that if you can diagnose cancer, you haven't prevented it. Detecting it, by definition, means it's there.\u003c/p>\n\u003cfigure id=\"attachment_38139\" class=\"wp-caption alignleft\" style=\"max-width: 245px\">\u003ca href=\"http://ww2.kqed.org/quest/2012/05/16/making-women-partners-in-breast-cancer-research/louis-jacques_goussier_enzyklopadie_diderot_pl_xxix-3/\" rel=\"attachment wp-att-38139\">\u003cimg src=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2012/05/Louis-Jacques_Goussier_Enzyklop%C3%A4die_Diderot_Pl_XXIX2-245x360.jpg\" alt=\"breast cancer surgery tools\" title=\"breast cancer surgery tools\" width=\"245\" height=\"360\" class=\"size-large wp-image-38139\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The surgical tools used on breast cancer patients in the 18th century look gruesome, but aren't really so far removed from the \"slash, burn and poison\" approach to breast cancer today. (Illustration: Louis-Jacques Goussier)\u003c/figcaption>\u003c/figure>\n\u003cp>Activists have long \u003ca href=\"http://bcaction.org/2007/02/21/from-the-executive-director-of-pills-prevention-and-politics/\">pushed researchers to shift their focus\u003c/a> from treatments and cures to true prevention. \u003c/p>\n\u003cp>Despite $4 billion spent on breast cancer research, researchers still don’t know what causes it or how to prevent it. Yet Love believes that the tools exist to “eradicate breast cancer within our lifetime” if we ask the right questions.\u003c/p>\n\u003cp>And for decades, Love has helped shine the spotlight on causes, not cures, to spare women from that dreaded diagnosis. But that goal will remain elusive, she believes, as long as researchers keep studying the disease in rodents. That’s because mice and rats don’t get breast cancer. Researchers have to give it to them.\u003c/p>\n\u003cp>So she’s been trying to wean researchers off rodents. “I can say this is a good study, you could do that in women, and they say, ‘Let me tell you about my rats.’ ” \u003c/p>\n\u003cp>Yet researchers can learn valuable insights into the origins of disease by comparing people with an illness to matched cohorts of healthy people, as the legendary \u003ca href=\"http://www.channing.harvard.edu/nhs/\">Nurses’ Health Study\u003c/a> has demonstrated for heart disease, diabetes and other conditions. \u003c/p>\n\u003cp>Finding the causes and, ultimately, how to prevent breast cancer requires a radical shift in thinking, Love said. And that means that at least some researchers have to give up their rats and mice and start working with the people who get the disease. \u003c/p>\n\u003cp>Researchers used to tell Love that even if they did want to study women, they didn’t know how to find them. But she knew that was the easy part. So for more than three years, the Dr. Susan Love Research Foundation has been recruiting an online \"army of women\" with a target of enrolling “one million women and a few good men.” \u003c/p>\n\u003cfigure id=\"attachment_38216\" class=\"wp-caption alignright\" style=\"max-width: 270px\">\u003ca href=\"http://ww2.kqed.org/quest/2012/05/16/making-women-partners-in-breast-cancer-research/susan-love-unplugged/\" rel=\"attachment wp-att-38216\">\u003cimg src=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2012/05/Susan-Love-Unplugged-270x360.jpg\" alt=\"susan love at sage bionetworks\" title=\"Susan Love at Sage Bionetworks\" width=\"270\" height=\"360\" class=\"size-large wp-image-38216\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Dr. Susan Love spoke at the Sage Bionetworks conference in San Francisco last month. The Seattle-based nonprofit is dedicated to “moving beyond the current medical information system and its rewards.” \u003c/figcaption>\u003c/figure>\n\u003cp>“Scientists come to us with studies that need people, and we e-blast them out to everybody in the army,” Love said.\u003c/p>\n\u003cp>So far, they’ve recruited 365,000 women for about 60 studies. Seven in 10 of the women don’t have breast cancer, but are \"altruistic,” Love said. They’re willing to undergo unpleasant procedures to help researchers figure out root causes. In one study, women in the control group had to endure a sigmoidoscopy and a biopsy. And Love got more enrollees than researchers could use.\u003c/p>\n\u003cp>By the end of this summer, the foundation will be launching its own \u003ca href=\"http://www.armyofwomen.org/how_splash/pdf/HOW_2012.pdf\">Health of Women Study.\u003c/a> The large online breast cancer cohort study will follow women with and without a diagnosis to identify new risk factors. It will also follow breast cancer survivors to identify factors that predict long-term survival and consequences of different therapies. \u003c/p>\n\u003cp>Any woman over 18 \u003ca href=\"https://www.armyofwomen.org/getinvolved\">can register online\u003c/a> or with a mobile phone. (Men are welcome, too.) \u003c/p>\n\u003cp>Love’s study will let participants suggest questions they’d like to see tested, because she thinks you don’t need a PhD to come up with a good idea.\u003c/p>\n\u003cp>She told her San Francisco audience that early theories about the cause of \u003ca href=\"http://www.cdc.gov/hpv/\">human papillomavirus\u003c/a> (HPV) came from observations of people who knew a man whose wife died of cervical cancer, and who then married a second woman who died of the same cancer. “They said, well maybe it’s the guy.”\u003c/p>\n\u003cp>“And then we figured out it was sexually transmitted, then we figured out it was a virus and now we have a vaccine.”\u003c/p>\n\u003cp>Potentially, Love reminds us, “Everybody is a patient.” She thinks eliminating disease is something we should all do together.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“[youtube=http://www.youtube.com/watch?v=bRKc7YqFNps]”\u003c/p>\n\n",
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"excerpt": "Dr. Susan Love, breast cancer surgeon and women's health advocate, has long railed against cancer researchers' fixation on treatments and cures. After spending more than $4 billion on breast cancer research, we still don't know what causes the disease or how to prevent it. It's time to focus on looking for causes, she says. And she wants your help.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_38099\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/quest/2012/05/16/making-women-partners-in-breast-cancer-research/cancercellsi640/\" rel=\"attachment wp-att-38099\">\u003cimg src=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2012/05/CancerCellsI640-300x169.jpg\" alt=\"breast cancer cells\" title=\"breast cancer cells\" width=\"300\" height=\"169\" class=\"size-thumbnail wp-image-38099\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Cancer cells under a microscope. Colored stains mark different compartments in the cell. The nucleus is red and lysosomes (which break down waste) are purple. (Image: Carolin Zehetmeier, Morphosys AG, Germany)\u003c/figcaption>\u003c/figure>\n\u003cp>Dr. Susan Love thinks breast cancer researchers need to get over their addiction to rodents. \u003c/p>\n\u003cp>America’s most famous breast cancer surgeon started treating women some 30 years ago. “And we’re still doing the same thing we did when I started,” she told a crowd in San Francisco last month at the \u003ca href=\"http://sagecongress.org/\">Sage Bionetworks conference\u003c/a>, aimed at transforming biomedical research.\u003c/p>\n\u003cp>“Surgery radiation, chemotherapy, hormones, and now we’ve added a little bit of targeted therapies,” said Love, a clinical professor of surgery at UCLA. “We never subtract anything, mind you, we only add things on top. And our results are about the same.” \u003c/p>\n\u003cp>Although \u003ca href=\"http://www.cdc.gov/cancer/breast/statistics/trends.htm\">breast cancer incidence and mortality\u003c/a> have decreased since 1998, by 1.3% and 2% respectively, more than 200,000 women will be diagnosed with breast cancer this year and more than 40,000 will die from it. Nearly 110 women die from breast cancer every day.\u003c/p>\n\u003cp>Experts think earlier detection and better treatments account for the decline in deaths, but screening carries risks. With mass screening comes overdiagnosis—that is, diagnosing a condition that would not prove symptomatic or fatal—and \u003ca href=\"http://www.youtube.com/watch?feature=player_embedded&v=bRKc7YqFNps\">with overdiagnosis comes overtreatment\u003c/a> and other potential harms (see video below). Screening technology can’t distinguish between aggressive and harmless tumors, which can shrink or even disappear on their own. Overdiagnosis will likely just increase as imaging technology finds smaller and smaller tumors.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Medical experts acknowledged in an editorial in the \u003ca href=\"http://www.annals.org/content/156/7/536.full\">Annals of Internal Medicine\u003c/a> last month that it’s time to recognize overdiagnosis as a serious problem. Most patient-education materials don’t even mention overdiagnosis and most women aren’t aware of the possibility, the authors said. As they pointed out, and any woman knows, “the impact of a cancer diagnosis lasts a lifetime.”\u003c/p>\n\u003cp>It’s hard to think of a physician who’s done more to acknowledge the trauma of breast cancer than the author of the best-selling “Dr. Susan Love’s Breast Book,” now in its fifth edition. \u003c/p>\n\u003cp>That book, along with Love's early refusal to accept the oxymoronic (emphasis on moronic) “early detection is your best prevention” mantra of mainstream cancer and advocacy organizations, won her a place of honor among frustrated breast cancer activists, who know all too well that if you can diagnose cancer, you haven't prevented it. Detecting it, by definition, means it's there.\u003c/p>\n\u003cfigure id=\"attachment_38139\" class=\"wp-caption alignleft\" style=\"max-width: 245px\">\u003ca href=\"http://ww2.kqed.org/quest/2012/05/16/making-women-partners-in-breast-cancer-research/louis-jacques_goussier_enzyklopadie_diderot_pl_xxix-3/\" rel=\"attachment wp-att-38139\">\u003cimg src=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2012/05/Louis-Jacques_Goussier_Enzyklop%C3%A4die_Diderot_Pl_XXIX2-245x360.jpg\" alt=\"breast cancer surgery tools\" title=\"breast cancer surgery tools\" width=\"245\" height=\"360\" class=\"size-large wp-image-38139\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The surgical tools used on breast cancer patients in the 18th century look gruesome, but aren't really so far removed from the \"slash, burn and poison\" approach to breast cancer today. (Illustration: Louis-Jacques Goussier)\u003c/figcaption>\u003c/figure>\n\u003cp>Activists have long \u003ca href=\"http://bcaction.org/2007/02/21/from-the-executive-director-of-pills-prevention-and-politics/\">pushed researchers to shift their focus\u003c/a> from treatments and cures to true prevention. \u003c/p>\n\u003cp>Despite $4 billion spent on breast cancer research, researchers still don’t know what causes it or how to prevent it. Yet Love believes that the tools exist to “eradicate breast cancer within our lifetime” if we ask the right questions.\u003c/p>\n\u003cp>And for decades, Love has helped shine the spotlight on causes, not cures, to spare women from that dreaded diagnosis. But that goal will remain elusive, she believes, as long as researchers keep studying the disease in rodents. That’s because mice and rats don’t get breast cancer. Researchers have to give it to them.\u003c/p>\n\u003cp>So she’s been trying to wean researchers off rodents. “I can say this is a good study, you could do that in women, and they say, ‘Let me tell you about my rats.’ ” \u003c/p>\n\u003cp>Yet researchers can learn valuable insights into the origins of disease by comparing people with an illness to matched cohorts of healthy people, as the legendary \u003ca href=\"http://www.channing.harvard.edu/nhs/\">Nurses’ Health Study\u003c/a> has demonstrated for heart disease, diabetes and other conditions. \u003c/p>\n\u003cp>Finding the causes and, ultimately, how to prevent breast cancer requires a radical shift in thinking, Love said. And that means that at least some researchers have to give up their rats and mice and start working with the people who get the disease. \u003c/p>\n\u003cp>Researchers used to tell Love that even if they did want to study women, they didn’t know how to find them. But she knew that was the easy part. So for more than three years, the Dr. Susan Love Research Foundation has been recruiting an online \"army of women\" with a target of enrolling “one million women and a few good men.” \u003c/p>\n\u003cfigure id=\"attachment_38216\" class=\"wp-caption alignright\" style=\"max-width: 270px\">\u003ca href=\"http://ww2.kqed.org/quest/2012/05/16/making-women-partners-in-breast-cancer-research/susan-love-unplugged/\" rel=\"attachment wp-att-38216\">\u003cimg src=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2012/05/Susan-Love-Unplugged-270x360.jpg\" alt=\"susan love at sage bionetworks\" title=\"Susan Love at Sage Bionetworks\" width=\"270\" height=\"360\" class=\"size-large wp-image-38216\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Dr. Susan Love spoke at the Sage Bionetworks conference in San Francisco last month. The Seattle-based nonprofit is dedicated to “moving beyond the current medical information system and its rewards.” \u003c/figcaption>\u003c/figure>\n\u003cp>“Scientists come to us with studies that need people, and we e-blast them out to everybody in the army,” Love said.\u003c/p>\n\u003cp>So far, they’ve recruited 365,000 women for about 60 studies. Seven in 10 of the women don’t have breast cancer, but are \"altruistic,” Love said. They’re willing to undergo unpleasant procedures to help researchers figure out root causes. In one study, women in the control group had to endure a sigmoidoscopy and a biopsy. And Love got more enrollees than researchers could use.\u003c/p>\n\u003cp>By the end of this summer, the foundation will be launching its own \u003ca href=\"http://www.armyofwomen.org/how_splash/pdf/HOW_2012.pdf\">Health of Women Study.\u003c/a> The large online breast cancer cohort study will follow women with and without a diagnosis to identify new risk factors. It will also follow breast cancer survivors to identify factors that predict long-term survival and consequences of different therapies. \u003c/p>\n\u003cp>Any woman over 18 \u003ca href=\"https://www.armyofwomen.org/getinvolved\">can register online\u003c/a> or with a mobile phone. (Men are welcome, too.) \u003c/p>\n\u003cp>Love’s study will let participants suggest questions they’d like to see tested, because she thinks you don’t need a PhD to come up with a good idea.\u003c/p>\n\u003cp>She told her San Francisco audience that early theories about the cause of \u003ca href=\"http://www.cdc.gov/hpv/\">human papillomavirus\u003c/a> (HPV) came from observations of people who knew a man whose wife died of cervical cancer, and who then married a second woman who died of the same cancer. “They said, well maybe it’s the guy.”\u003c/p>\n\u003cp>“And then we figured out it was sexually transmitted, then we figured out it was a virus and now we have a vaccine.”\u003c/p>\n\u003cp>Potentially, Love reminds us, “Everybody is a patient.” She thinks eliminating disease is something we should all do together.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cfigure id=\"attachment_37481\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/quest/2012/05/14/personalized-medicine/pills/\" rel=\"attachment wp-att-37481\">\u003cimg src=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2012/05/Pills.jpg\" alt=\"\" title=\"Pills\" width=\"640\" height=\"361\" class=\"size-full wp-image-37481\" srcset=\"https://ww2.kqed.org/app/uploads/sites/39/2012/05/Pills.jpg 640w, https://ww2.kqed.org/app/uploads/sites/39/2012/05/Pills-400x226.jpg 400w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">We've taken another baby step away from the current one size fits all health care system.\u003c/figcaption>\u003c/figure>\n\u003cp>We may finally be at the threshold of the age of personalized medicine. In a recent \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/22424236\">study\u003c/a>, scientists were able to predict that a man was at a higher risk for developing Type 2 diabetes and over a two-year period tracked his health as he developed the disease. And even better, because they caught it so early, they were able to stave off the diabetes with lifestyle changes. This man’s glucose levels have returned to normal.\u003c/p>\n\u003cp>Wow. This story highlights the promise of at least one aspect of personalized medicine. By looking at someone’s DNA, you can predict what might go wrong with someone and so keep an eye out for early symptoms. Or maybe even start out with the right lifestyle changes that will keep the disease from developing in the first place.\u003c/p>\n\u003cp>This study also showed that intensely studying a single person can yield potential benefits for lots of other people. The researchers saw that just before the test subject’s glucose levels spiked, he had a viral infection. No one was really looking for viruses that trigger Type 2 diabetes in people. Now they will. (Keep in mind we don’t yet know if the two are connected or if it was just a coincidence.)\u003c/p>\n\u003cp>The study also points to the obstacles we still need to overcome to realize the full potential of personalized medicine. The top ones I could think of off the top of my head are our own ignorance, the inconvenience, the expense, and our lack of willpower.\u003c/p>\n\u003cp>The researchers were able to predict an increased risk for diabetes as well as an increased risk for high triglycerides but very little else. There is certainly more information lurking in his DNA…we just don’t understand our DNA well enough to tease it out yet.\u003c/p>\n\u003cfigure id=\"attachment_37488\" class=\"wp-caption alignright\" style=\"max-width: 250px\">\u003ca href=\"http://ww2.kqed.org/quest/2012/05/14/personalized-medicine/personalpill/\" rel=\"attachment wp-att-37488\">\u003cimg src=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2012/05/PersonalPill.jpg\" alt=\"\" title=\"PersonalPill\" width=\"250\" height=\"302\" class=\"size-full wp-image-37488\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Soon your treatments will be tailored for you based on at least partly on what's in your DNA.\u003c/figcaption>\u003c/figure>\n\u003cp>Another related issue is whether we actually do know enough to make good predictions or if we just got lucky here. In other words, was his developing Type 2 diabetes a coincidence or was he really at a higher risk for getting it? He didn’t have any classic risk factors but given that so many people in the U.S. have the disease, it could have been chance. Doing many more studies on lots of different people should give us some idea about how predictive our DNA really is right now.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Besides our still sketchy knowledge, we also have to deal with the expense and inconvenience of this form of personalized medicine. The test subject had over twenty blood draws over a two year period that each looked at tens of thousands of different things. Not many people would put up with so many blood draws. And the expense of looking at all those different molecules is prohibitively expensive.\u003c/p>\n\u003cp>A better knowledge of our risks can help with the second point. Once we understand our DNA better and so know what are most likely risks are, we’ll be able to test for fewer molecules which should make the whole thing more affordable. This may also solve the first problem too.\u003c/p>\n\u003cp>Maybe in the future we’ll look at few enough molecules or the tests will be sensitive enough to get the information we need from a simple finger prick. Then we’d all be like folks with diabetes, self testing our blood on a regular basis. And hopefully in the more distant future, we’ll have some sort of implant that reads the information for us automatically without the need for a blood draw.\u003c/p>\n\u003cp>All of these are technical hurdles that will almost certainly be overcome at some point. The last obstacle, though, is much more difficult. It deals with human nature.\u003c/p>\n\u003cp>One reason this is such a powerful story is that the test subject was able to get his glucose under control without the use of medicines. This is not only good for him but it suggests that this form of personalized medicine may prove to be cost effective sooner rather than later. Keeping his Type 2 diabetes at bay will probably save tons of money over his life time. Perhaps even enough to justify the cost of his testing.\u003c/p>\n\u003cp>But to control his glucose levels, he had to make radical changes to his diet and exercise regime. He had to eat a whole lot less sugar and fat and exercise a lot more. Sound familiar?\u003c/p>\n\u003cp>Everyone should be doing this stuff anyway but most of us don’t. Will we have the willpower to realize the full potential of personalized medicine? Or will things pretty much stay the same except with more frequent scolding from our doctors? \u003c/p>\n\u003cp>Of course, catching a disease early and getting patients their medications early when it could do the most good is obviously wonderful too. Just not as cost effective.\u003c/p>\n\u003cp>[youtube=http://www.youtube.com/watch?v=xbjqHj_J0is]\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>What a visit to the doctor in the near future might look like.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_37481\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/quest/2012/05/14/personalized-medicine/pills/\" rel=\"attachment wp-att-37481\">\u003cimg src=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2012/05/Pills.jpg\" alt=\"\" title=\"Pills\" width=\"640\" height=\"361\" class=\"size-full wp-image-37481\" srcset=\"https://ww2.kqed.org/app/uploads/sites/39/2012/05/Pills.jpg 640w, https://ww2.kqed.org/app/uploads/sites/39/2012/05/Pills-400x226.jpg 400w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">We've taken another baby step away from the current one size fits all health care system.\u003c/figcaption>\u003c/figure>\n\u003cp>We may finally be at the threshold of the age of personalized medicine. In a recent \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/22424236\">study\u003c/a>, scientists were able to predict that a man was at a higher risk for developing Type 2 diabetes and over a two-year period tracked his health as he developed the disease. And even better, because they caught it so early, they were able to stave off the diabetes with lifestyle changes. This man’s glucose levels have returned to normal.\u003c/p>\n\u003cp>Wow. This story highlights the promise of at least one aspect of personalized medicine. By looking at someone’s DNA, you can predict what might go wrong with someone and so keep an eye out for early symptoms. Or maybe even start out with the right lifestyle changes that will keep the disease from developing in the first place.\u003c/p>\n\u003cp>This study also showed that intensely studying a single person can yield potential benefits for lots of other people. The researchers saw that just before the test subject’s glucose levels spiked, he had a viral infection. No one was really looking for viruses that trigger Type 2 diabetes in people. Now they will. (Keep in mind we don’t yet know if the two are connected or if it was just a coincidence.)\u003c/p>\n\u003cp>The study also points to the obstacles we still need to overcome to realize the full potential of personalized medicine. The top ones I could think of off the top of my head are our own ignorance, the inconvenience, the expense, and our lack of willpower.\u003c/p>\n\u003cp>The researchers were able to predict an increased risk for diabetes as well as an increased risk for high triglycerides but very little else. There is certainly more information lurking in his DNA…we just don’t understand our DNA well enough to tease it out yet.\u003c/p>\n\u003cfigure id=\"attachment_37488\" class=\"wp-caption alignright\" style=\"max-width: 250px\">\u003ca href=\"http://ww2.kqed.org/quest/2012/05/14/personalized-medicine/personalpill/\" rel=\"attachment wp-att-37488\">\u003cimg src=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2012/05/PersonalPill.jpg\" alt=\"\" title=\"PersonalPill\" width=\"250\" height=\"302\" class=\"size-full wp-image-37488\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Soon your treatments will be tailored for you based on at least partly on what's in your DNA.\u003c/figcaption>\u003c/figure>\n\u003cp>Another related issue is whether we actually do know enough to make good predictions or if we just got lucky here. In other words, was his developing Type 2 diabetes a coincidence or was he really at a higher risk for getting it? He didn’t have any classic risk factors but given that so many people in the U.S. have the disease, it could have been chance. Doing many more studies on lots of different people should give us some idea about how predictive our DNA really is right now.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Besides our still sketchy knowledge, we also have to deal with the expense and inconvenience of this form of personalized medicine. The test subject had over twenty blood draws over a two year period that each looked at tens of thousands of different things. Not many people would put up with so many blood draws. And the expense of looking at all those different molecules is prohibitively expensive.\u003c/p>\n\u003cp>A better knowledge of our risks can help with the second point. Once we understand our DNA better and so know what are most likely risks are, we’ll be able to test for fewer molecules which should make the whole thing more affordable. This may also solve the first problem too.\u003c/p>\n\u003cp>Maybe in the future we’ll look at few enough molecules or the tests will be sensitive enough to get the information we need from a simple finger prick. Then we’d all be like folks with diabetes, self testing our blood on a regular basis. And hopefully in the more distant future, we’ll have some sort of implant that reads the information for us automatically without the need for a blood draw.\u003c/p>\n\u003cp>All of these are technical hurdles that will almost certainly be overcome at some point. The last obstacle, though, is much more difficult. It deals with human nature.\u003c/p>\n\u003cp>One reason this is such a powerful story is that the test subject was able to get his glucose under control without the use of medicines. This is not only good for him but it suggests that this form of personalized medicine may prove to be cost effective sooner rather than later. Keeping his Type 2 diabetes at bay will probably save tons of money over his life time. Perhaps even enough to justify the cost of his testing.\u003c/p>\n\u003cp>But to control his glucose levels, he had to make radical changes to his diet and exercise regime. He had to eat a whole lot less sugar and fat and exercise a lot more. Sound familiar?\u003c/p>\n\u003cp>Everyone should be doing this stuff anyway but most of us don’t. Will we have the willpower to realize the full potential of personalized medicine? Or will things pretty much stay the same except with more frequent scolding from our doctors? \u003c/p>\n\u003cp>Of course, catching a disease early and getting patients their medications early when it could do the most good is obviously wonderful too. Just not as cost effective.\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/xbjqHj_J0is'\n title='//www.youtube.com/embed/xbjqHj_J0is'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>What a visit to the doctor in the near future might look like.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "New Research Hopes to Conquer Food Allergies",
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"content": "\u003cfigure id=\"attachment_36560\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/quest/2012/05/07/new-research-to-conquer-food-allergies/peanuts_byeuromagic_640x360/\" rel=\"attachment wp-att-36560\">\u003cimg src=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2012/04/peanuts_byEuroMagic_640x360.jpg\" alt=\"peanuts\" title=\"peanuts_byEuroMagic_640x360\" width=\"640\" height=\"360\" class=\"size-full wp-image-36560\" srcset=\"https://ww2.kqed.org/app/uploads/sites/39/2012/04/peanuts_byEuroMagic_640x360.jpg 640w, https://ww2.kqed.org/app/uploads/sites/39/2012/04/peanuts_byEuroMagic_640x360-400x225.jpg 400w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Photograph courtesy of EuroMagic via Creative Commons\u003c/figcaption>\u003c/figure>\n\u003cp>My nephew is one of the 6 million children in the United States with food allergies. He has a severe nut allergy, requiring an epinephrine (adrenaline) injection and immediate trip to the emergency room after contact with someone whose touched or eaten nuts. His rapid onset of life-threatening symptoms includes swelling of the throat, difficulty breathing, and hives. He isn’t alone. The number of children with peanut allergies has \u003ca href=\"http://www.webmd.com/allergies/news/20100514/peanut-allergies-in-kids-on-the-rise\">tripled in the last decade\u003c/a>. Every three minutes a food allergy reaction sends someone to the emergency room and every 6 minutes the reaction is one of life-threatening anaphylaxis.\u003c/p>\n\u003cp>Although children often out-grow their allergies to milk, egg, wheat and soy, this is occurring more slowly than in previous decades. Allergies to peanuts, tree nuts, fish or shellfish are generally lifelong allergies.\u003c/p>\n\u003cp>A food allergy reaction is a learned response, meaning that our bodies learn to overreact to particular food proteins. In this process, the IgE antibody, that is suppose to fight off infections, instead recognizes certain food proteins as abnormal invaders. The IgE antibody tells the body to release histamines and other chemicals that can cause a progressive and sometimes life-threatening reaction (see \u003ca href=\"http://www.foodallergy.org/page/animation-of-how-a-reaction-occurs\" title=\"FAAN Animation of How A Reaction Occurs\">animated explanation\u003c/a>).\u003c/p>\n\u003cp>Unfortunately there is no cure for food allergies. Unlike other allergies, there aren’t any proven treatments for food allergies either. The only solution has been to avoid the allergy-triggering food. In the case of accidental exposure, antihistamines are taken for mild reactions or epinephrine shots and a trip to the hospital are critical for more severe reactions.\u003c/p>\n\u003cp>However, promising food allergy therapies are now under study – recently moving from laboratory and animal testing into human clinical trials. The goal is to persuade patients’ immune systems that food allergens aren’t serious threats. \u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Early clinical trial results have shown promise for three experimental treatments:\u003c/p>\n\u003cp>•\t\u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/19063824\" title=\"Oral Immunotherapy for Food Allergy\">\u003cstrong>Oral Immunotherapy\u003c/strong>\u003c/a>: Under close medical supervision, patients swallow tiny but increasingly larger amounts of the allergy-triggering food in order to build up immunity. It is being tested for peanut, egg and milk allergies.\u003c/p>\n\u003cp>•\t\u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/21281959\" title=\"Sublingual Immunotherapy for Peanut Allergy\">\u003cstrong>Sublingual Immunotherapy\u003c/strong>\u003c/a>: Liquid containing allergy-triggering food proteins is placed under the tongue, where it is quickly absorbed into the bloodstream. It is being tested for a variety of food allergies. \u003c/p>\n\u003cp>•\t\u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/22475999\" title=\"Nonallergen-specific Treatments for Food Allergy\">\u003cstrong>Food Allergy Herbal Formula-2\u003c/strong>\u003c/a> (FAHF-2): Patients take pills comprised of a nine-herb formula that is based on traditional Chinese medicine. This therapy alters the global immune response, rather than that of a single allergen, so it could treat patients allergic to multiple foods. It is being tested for peanut, tree nut, fish and shellfish allergies.\u003c/p>\n\u003cp>In addition, scientists are trying to understand how food allergies develop in order to help prevent them. For instance, \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/22464642\" title=\"Update on risk factors for food allergy\">recent studies\u003c/a> indicate that early skin exposure to a food protein leads to allergic sensitization, but early oral exposure to a food allergen induces tolerance.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>These new studies should give hope to the 15 million people in the United States with food allergies. In order to help educate people about food allergies, the fourteenth annual \u003ca href=\"http://www.foodallergy.org/section/food-allergy-awareness-week11\" title=\"Food Allergy Awareness Week\">Food Allergy Awareness Week\u003c/a> is May 13-19.\u003c/p>\n\n",
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"excerpt": "A food allergy reaction sends someone to the emergency room every three minutes. However, the 15 million people with food allergies now have hope. New clinical trials show promise for three experimental treatments: oral immunotherapy, sublingual immunotherapy and food allergy herbal formula-2. Scientists are also trying to understand how food allergies develop to help prevent them.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_36560\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/quest/2012/05/07/new-research-to-conquer-food-allergies/peanuts_byeuromagic_640x360/\" rel=\"attachment wp-att-36560\">\u003cimg src=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2012/04/peanuts_byEuroMagic_640x360.jpg\" alt=\"peanuts\" title=\"peanuts_byEuroMagic_640x360\" width=\"640\" height=\"360\" class=\"size-full wp-image-36560\" srcset=\"https://ww2.kqed.org/app/uploads/sites/39/2012/04/peanuts_byEuroMagic_640x360.jpg 640w, https://ww2.kqed.org/app/uploads/sites/39/2012/04/peanuts_byEuroMagic_640x360-400x225.jpg 400w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Photograph courtesy of EuroMagic via Creative Commons\u003c/figcaption>\u003c/figure>\n\u003cp>My nephew is one of the 6 million children in the United States with food allergies. He has a severe nut allergy, requiring an epinephrine (adrenaline) injection and immediate trip to the emergency room after contact with someone whose touched or eaten nuts. His rapid onset of life-threatening symptoms includes swelling of the throat, difficulty breathing, and hives. He isn’t alone. The number of children with peanut allergies has \u003ca href=\"http://www.webmd.com/allergies/news/20100514/peanut-allergies-in-kids-on-the-rise\">tripled in the last decade\u003c/a>. Every three minutes a food allergy reaction sends someone to the emergency room and every 6 minutes the reaction is one of life-threatening anaphylaxis.\u003c/p>\n\u003cp>Although children often out-grow their allergies to milk, egg, wheat and soy, this is occurring more slowly than in previous decades. Allergies to peanuts, tree nuts, fish or shellfish are generally lifelong allergies.\u003c/p>\n\u003cp>A food allergy reaction is a learned response, meaning that our bodies learn to overreact to particular food proteins. In this process, the IgE antibody, that is suppose to fight off infections, instead recognizes certain food proteins as abnormal invaders. The IgE antibody tells the body to release histamines and other chemicals that can cause a progressive and sometimes life-threatening reaction (see \u003ca href=\"http://www.foodallergy.org/page/animation-of-how-a-reaction-occurs\" title=\"FAAN Animation of How A Reaction Occurs\">animated explanation\u003c/a>).\u003c/p>\n\u003cp>Unfortunately there is no cure for food allergies. Unlike other allergies, there aren’t any proven treatments for food allergies either. The only solution has been to avoid the allergy-triggering food. In the case of accidental exposure, antihistamines are taken for mild reactions or epinephrine shots and a trip to the hospital are critical for more severe reactions.\u003c/p>\n\u003cp>However, promising food allergy therapies are now under study – recently moving from laboratory and animal testing into human clinical trials. The goal is to persuade patients’ immune systems that food allergens aren’t serious threats. \u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"amazon": "https://music.amazon.com/podcasts/26099305-72af-4542-9dde-ac1807fe36d5/kqed-s-the-california-report",
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},
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"id": "californiareportmagazine",
"title": "The California Report Magazine",
"tagline": "Your state, your stories",
"info": "Every week, The California Report Magazine takes you on a road trip for the ears: to visit the places and meet the people who make California unique. The in-depth storytelling podcast from the California Report.",
"airtime": "FRI 4:30pm-5pm, 6:30pm-7pm, 11pm-11:30pm",
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"officialWebsiteLink": "/californiareportmagazine",
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"order": 10
},
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM3NjkwNjk1OTAz",
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},
"city-arts": {
"id": "city-arts",
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"info": "A one-hour radio program to hear celebrated writers, artists and thinkers address contemporary ideas and values, often discussing the creative process. Please note: tapes or transcripts are not available",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/05/cityartsandlecture-300x300.jpg",
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"airtime": "SUN 1pm-2pm, TUE 10pm, WED 1am",
"meta": {
"site": "news",
"source": "City Arts & Lectures"
},
"link": "https://www.cityarts.net",
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"rss": "https://www.cityarts.net/feed/"
}
},
"closealltabs": {
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"info": "Close All Tabs breaks down how digital culture shapes our world through thoughtful insights and irreverent humor.",
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"officialWebsiteLink": "/podcasts/closealltabs",
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"order": 1
},
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"title": "Code Switch / Life Kit",
"info": "\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />",
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"id": "commonwealth-club",
"title": "Commonwealth Club of California Podcast",
"info": "The Commonwealth Club of California is the nation's oldest and largest public affairs forum. As a non-partisan forum, The Club brings to the public airwaves diverse viewpoints on important topics. The Club's weekly radio broadcast - the oldest in the U.S., dating back to 1924 - is carried across the nation on public radio stations and is now podcasting. Our website archive features audio of our recent programs, as well as selected speeches from our long and distinguished history. This podcast feed is usually updated twice a week and is always un-edited.",
"airtime": "THU 10pm, FRI 1am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Commonwealth-Club-Podcast-Tile-360x360-1.jpg",
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"meta": {
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"source": "Commonwealth Club of California"
},
"link": "/radio/program/commonwealth-club",
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"google": "https://podcasts.google.com/feed/aHR0cDovL3d3dy5jb21tb253ZWFsdGhjbHViLm9yZy9hdWRpby9wb2RjYXN0L3dlZWtseS54bWw",
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},
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"id": "forum",
"title": "Forum",
"tagline": "The conversation starts here",
"info": "KQED’s live call-in program discussing local, state, national and international issues, as well as in-depth interviews.",
"airtime": "MON-FRI 9am-11am, 10pm-11pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Forum-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED Forum with Mina Kim and Alexis Madrigal",
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"source": "kqed",
"order": 9
},
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM5NTU3MzgxNjMz",
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"id": "freakonomics-radio",
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"info": "Freakonomics Radio is a one-hour award-winning podcast and public-radio project hosted by Stephen Dubner, with co-author Steve Levitt as a regular guest. It is produced in partnership with WNYC.",
"imageSrc": "https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/05/freakonomicsRadio.png",
"officialWebsiteLink": "http://freakonomics.com/",
"airtime": "SUN 1am-2am, SAT 3pm-4pm",
"meta": {
"site": "radio",
"source": "WNYC"
},
"link": "/radio/program/freakonomics-radio",
"subscribe": {
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"apple": "https://itunes.apple.com/us/podcast/freakonomics-radio/id354668519",
"tuneIn": "https://tunein.com/podcasts/WNYC-Podcasts/Freakonomics-Radio-p272293/",
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},
"fresh-air": {
"id": "fresh-air",
"title": "Fresh Air",
"info": "Hosted by Terry Gross, \u003cem>Fresh Air from WHYY\u003c/em> is the Peabody Award-winning weekday magazine of contemporary arts and issues. One of public radio's most popular programs, Fresh Air features intimate conversations with today's biggest luminaries.",
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"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=214089682&at=11l79Y&ct=nprdirectory",
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"here-and-now": {
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"info": "A live production of NPR and WBUR Boston, in collaboration with stations across the country, Here & Now reflects the fluid world of news as it's happening in the middle of the day, with timely, in-depth news, interviews and conversation. Hosted by Robin Young, Jeremy Hobson and Tonya Mosley.",
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"rss": "https://feeds.npr.org/510051/podcast.xml"
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},
"hidden-brain": {
"id": "hidden-brain",
"title": "Hidden Brain",
"info": "Shankar Vedantam uses science and storytelling to reveal the unconscious patterns that drive human behavior, shape our choices and direct our relationships.",
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"airtime": "SUN 7pm-8pm",
"meta": {
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"source": "NPR"
},
"link": "/radio/program/hidden-brain",
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},
"how-i-built-this": {
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"title": "How I Built This with Guy Raz",
"info": "Guy Raz dives into the stories behind some of the world's best known companies. How I Built This weaves a narrative journey about innovators, entrepreneurs and idealists—and the movements they built.",
"imageSrc": "https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/05/howIBuiltThis.png",
"officialWebsiteLink": "https://www.npr.org/podcasts/510313/how-i-built-this",
"airtime": "SUN 7:30pm-8pm",
"meta": {
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"source": "npr"
},
"link": "/radio/program/how-i-built-this",
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"npr": "https://rpb3r.app.goo.gl/3zxy",
"apple": "https://itunes.apple.com/us/podcast/how-i-built-this-with-guy-raz/id1150510297?mt=2",
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},
"hyphenacion": {
"id": "hyphenacion",
"title": "Hyphenación",
"tagline": "Where conversation and cultura meet",
"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. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2025/03/Hyphenacion_FinalAssets_PodcastTile.png",
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"officialWebsiteLink": "/podcasts/hyphenacion",
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"order": 15
},
"link": "/podcasts/hyphenacion",
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"spotify": "https://open.spotify.com/show/2p3Fifq96nw9BPcmFdIq0o?si=39209f7b25774f38",
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},
"jerrybrown": {
"id": "jerrybrown",
"title": "The Political Mind of Jerry Brown",
"tagline": "Lessons from a lifetime in politics",
"info": "The Political Mind of Jerry Brown brings listeners the wisdom of the former Governor, Mayor, and presidential candidate. Scott Shafer interviewed Brown for more than 40 hours, covering the former governor's life and half-century in the political game – and Brown has some lessons he'd like to share. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-Political-Mind-of-Jerry-Brown-Podcast-Tile-703x703-1.jpg",
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"officialWebsiteLink": "/podcasts/jerrybrown",
"meta": {
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"source": "kqed",
"order": 18
},
"link": "/podcasts/jerrybrown",
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"apple": "https://itunes.apple.com/us/podcast/id1492194549",
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}
},
"latino-usa": {
"id": "latino-usa",
"title": "Latino USA",
"airtime": "MON 1am-2am, SUN 6pm-7pm",
"info": "Latino USA, the radio journal of news and culture, is the only national, English-language radio program produced from a Latino perspective.",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/latinoUsa.jpg",
"officialWebsiteLink": "http://latinousa.org/",
"meta": {
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"source": "npr"
},
"link": "/radio/program/latino-usa",
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"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=79681317&at=11l79Y&ct=nprdirectory",
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"rss": "https://feeds.npr.org/510016/podcast.xml"
}
},
"marketplace": {
"id": "marketplace",
"title": "Marketplace",
"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.",
"airtime": "MON-FRI 4pm-4:30pm, MON-WED 6:30pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Marketplace-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.marketplace.org/",
"meta": {
"site": "news",
"source": "American Public Media"
},
"link": "/radio/program/marketplace",
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"rss": "https://feeds.publicradio.org/public_feeds/marketplace-pm/rss/rss"
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},
"masters-of-scale": {
"id": "masters-of-scale",
"title": "Masters of Scale",
"info": "Masters of Scale is an original podcast in which LinkedIn co-founder and Greylock Partner Reid Hoffman sets out to describe and prove theories that explain how great entrepreneurs take their companies from zero to a gazillion in ingenious fashion.",
"airtime": "Every other Wednesday June 12 through October 16 at 8pm (repeats Thursdays at 2am)",
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"officialWebsiteLink": "https://mastersofscale.com/",
"meta": {
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"source": "WaitWhat"
},
"link": "/radio/program/masters-of-scale",
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"apple": "http://mastersofscale.app.link/",
"rss": "https://rss.art19.com/masters-of-scale"
}
},
"mindshift": {
"id": "mindshift",
"title": "MindShift",
"tagline": "A podcast about the future of learning and how we raise our kids",
"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>",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Mindshift-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED MindShift: How We Will Learn",
"officialWebsiteLink": "/mindshift/",
"meta": {
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"source": "kqed",
"order": 12
},
"link": "/podcasts/mindshift",
"subscribe": {
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5",
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"stitcher": "https://www.stitcher.com/podcast/kqed/stories-teachers-share",
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}
},
"morning-edition": {
"id": "morning-edition",
"title": "Morning Edition",
"info": "\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. Hosts Steve Inskeep, David Greene and Rachel Martin bring you the latest breaking news and features to prepare you for the day.",
"airtime": "MON-FRI 3am-9am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Morning-Edition-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.npr.org/programs/morning-edition/",
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"link": "/radio/program/morning-edition"
},
"onourwatch": {
"id": "onourwatch",
"title": "On Our Watch",
"tagline": "Deeply-reported investigative journalism",
"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?",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/On-Our-Watch-Podcast-Tile-703x703-1.jpg",
"imageAlt": "On Our Watch from NPR and KQED",
"officialWebsiteLink": "/podcasts/onourwatch",
"meta": {
"site": "news",
"source": "kqed",
"order": 11
},
"link": "/podcasts/onourwatch",
"subscribe": {
"apple": "https://podcasts.apple.com/podcast/id1567098962",
"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5ucHIub3JnLzUxMDM2MC9wb2RjYXN0LnhtbD9zYz1nb29nbGVwb2RjYXN0cw",
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}
},
"on-the-media": {
"id": "on-the-media",
"title": "On The Media",
"info": "Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us",
"airtime": "SUN 2pm-3pm, MON 12am-1am",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/onTheMedia.png",
"officialWebsiteLink": "https://www.wnycstudios.org/shows/otm",
"meta": {
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"source": "wnyc"
},
"link": "/radio/program/on-the-media",
"subscribe": {
"apple": "https://itunes.apple.com/us/podcast/on-the-media/id73330715?mt=2",
"tuneIn": "https://tunein.com/radio/On-the-Media-p69/",
"rss": "http://feeds.wnyc.org/onthemedia"
}
},
"pbs-newshour": {
"id": "pbs-newshour",
"title": "PBS NewsHour",
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"imageURL": "https://cdn.kqed.org/wp-content/uploads/2026/10/Nav-News-Nov2026ElectionCoverage@2x-7bd4aad4.png",
"description": "Get informed in minutes with our Voter Guide for California’s November 3 election."
},
"podcasts-radio": {},
"video-tv": {},
"events": {},
"support": {}
}
}
}