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FM","link":"/"}},"futureofyou_444641":{"type":"posts","id":"futureofyou_444641","meta":{"index":"posts_1591205157","site":"futureofyou","id":"444641","score":null,"sort":[1538075041000]},"guestAuthors":[],"slug":"governments-decision-to-review-research-of-fetal-tissue-blasted-as-political-move","title":"Is the Federal Government Politicizing Research Involving Fetal Tissue?","publishDate":1538075041,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>\u003cstrong>Updated at 3:45 pm ET\u003c/strong>\u003c/p>\n\u003cp>The Department of Health and Human Services says it is reviewing all medical research involving human fetal tissue.\u003c/p>\n\u003cp>HHS \u003ca href=\"https://www.hhs.gov/about/news/2018/09/24/statement-from-the-department-of-health-and-human-services.html\" target=\"_blank\" rel=\"noopener\">said this week\u003c/a> that it will conduct an audit of \"all acquisitions involving human fetal tissue\" as well as \"all research involving fetal tissue to ensure consistency with statutes and regulations governing such research and to ensure the adequacy of procedures and oversight of this research in light of the serious regulatory, moral, and ethical considerations involved.\"[contextly_sidebar id=\"SsrZIxp3cgGelsMqmovjR5mXFrobSZOz\"]\u003c/p>\n\u003cp>In addition, HHS announced that it has canceled \u003ca href=\"https://www.fpds.gov/ezsearch/search.do?q=advanced+bioscience+resources+VENDOR_DUNS_NUMBER%3A%22786845982%22&s=FPDSNG.COM&templateName=1.4.4&indexName=awardfull&sortBy=SIGNED_DATE&desc=Y\" target=\"_blank\" rel=\"noopener\">a $15,000 contract\u003c/a> for a California-based company called Advanced Bioscience Resources to provide the Food and Drug Administration with human fetal tissue to develop testing protocols. The contract was terminated, HHS said, because the department \"was not sufficiently assured that the contract included the appropriate protections applicable to fetal tissue research or met all other procurement requirements.\"\u003c/p>\n\u003cp>Scientists use fetal tissue in medical research because it grows quickly and is highly versatile and long-lasting.\u003c/p>\n\u003cp>\"It allows us to answer specific questions that can't be answered by adult tissue, which is far more specialized,\"\u003c/p>\n\u003cp>NIH Associate Director for Science Policy Carrie Wolinetz \u003ca href=\"https://www.npr.org/sections/health-shots/2015/09/29/444214443/research-on-fetal-tissue-draws-renewed-political-scientific-scrutiny\" target=\"_blank\" rel=\"noopener\">told NPR's Rob Stein\u003c/a> in 2015. \"Fetal tissue can contain information — about structural features, or the architecture of organs — that cells in a dish alone can't provide. And this is sometimes very important to our understanding of disease.\"\u003c/p>\n\u003cp>Fetal tissue used in scientific research often comes from aborted fetuses. In an email to NPR, \u003ca href=\"https://law.wisc.edu/profiles/racharo\" target=\"_blank\" rel=\"noopener\">Alta Charo\u003c/a>, a professor of law and bioethics at the University of Wisconsin, explains why that is.[contextly_sidebar id=\"G1kyrCYVpzDmWCInUE7H0cF8gc9zn4Ce\"]\u003c/p>\n\u003cp>\"Miscarriages are not often an available source, as they do not take place in a controlled environment and may be due to genetic or other anomalies that would render the cadaveric tissues useless,\" she says. \"Therefore, the tissue usually comes from a fetus that has been aborted.\"\u003c/p>\n\u003cp>Despite the small size of the canceled FDA contract, some observers said the larger political symbolism is evident.\u003c/p>\n\u003cp>\"My instinct is that this is driven by politics, and is part of the overall effort to stigmatize and eventually criminalize abortion, as well as part of a larger campaign to roll-back the clock on sexual and reproductive rights,\" Charo says.\u003c/p>\n\u003cp>However, \u003ca href=\"https://lozierinstitute.org/team-member/david-prentice/\" target=\"_blank\" rel=\"noopener\">David Prentice\u003c/a>, vice president and research director for the Charlotte Lozier Institute, a conservative think tank opposed to abortion, says the HHS announcement doesn't go far enough.\u003c/p>\n\u003cp>\"Canceling a small FDA contract ... seems designed to mollify some Members of Congress and groups who were outraged by the continuing funding of fetal tissue research with taxpayer dollars,\" Prentice writes in an email to NPR. \"But what's needed is wholesale reform across the breadth of HHS. Use of fetal tissue is antiquated research, and [HHS Secretary Alex] Azar should redirect those funds to modern science and better alternatives, including adult stem cells.\"\u003c/p>\n\u003cp>\u003cem>Science\u003c/em> notes that on earlier this month, 45 groups opposed to abortion \u003ca href=\"https://www.sba-list.org/wp-content/uploads/2018/09/Group-Letter-to-Azar-FDA-and-fetal-tissue-FINAL-with-Signatures.pdf\" target=\"_blank\" rel=\"noopener\">sent a letter\u003c/a> to Azar calling the FDA contract for fetal tissue \"shocking\" and \"unacceptable.\" A few days later, 85 members of Congress \u003ca href=\"https://chrissmith.house.gov/uploadedfiles/2018-09-17_-chs-hartzler-walker_letter_on_fda_fetal_tissue_contract.pdf\" target=\"_blank\" rel=\"noopener\">sent a letter\u003c/a> to the FDA's commissioner, urging the agency to cancel the contract.\u003c/p>\n\u003cp>The National Institutes of Health, which also falls under HHS, spent $98 million last fiscal year on research that involved human fetal tissue. The NIH said it \"concurs that it is important that research involving human fetal tissue should be consistent with the statutes and regulation governing such research and that it is important to have adequate procedures for oversight.\"[contextly_sidebar id=\"xJs8IF14XoPynhHrniTrS5E5qgAhyVmm\"]\u003c/p>\n\u003cp>Use of fetal tissue in research has been controversial for some time, \u003cem>Science\u003c/em> magazine reported on Tuesday:\u003c/p>\n\u003cblockquote>\u003cp>\"In 2016, \u003ca href=\"https://energycommerce.house.gov/news/press-release/house-creates-select-panel-investigate-handling-infant-lives/\" target=\"_blank\" rel=\"noopener\">Republican members of the House of Representatives\u003c/a>, led by Representative Marsha Blackburn (TN), \u003ca href=\"https://www.sciencemag.org/news/2017/01/fact-checking-congress-s-fetal-tissue-report\">produced a report\u003c/a> that urged the federal government to transition to obtaining fetal tissue from miscarriages and stillbirths. But opponents of fetal tissue research have failed repeatedly to pass legislation that would end funding for research using tissue from electively aborted fetuses — most recently earlier this month, when language prohibiting such funding was stripped from a 2019 HHS spending bill.\"\u003c/p>\u003c/blockquote>\n\u003cp>\u003ca href=\"https://trentcenter.duke.edu/node/221\" target=\"_blank\" rel=\"noopener\">Ross McKinney\u003c/a>, chief scientific officer at the Association of American Medical Colleges, says fetal tissue was key in the development of major medical advances such as vaccines for polio, rubella, measles, chickenpox, adenovirus and rabies, as well as treatments for diseases such as rheumatoid arthritis, cystic fibrosis and hemophilia.\u003c/p>\n\u003cp>\"The unique characteristics of this tissue are essential to the study of fetal diseases, like those caused by Zika virus, and hold promise for advancing biomedical research in other areas as well, bringing hope to patients struggling with diseases such as Alzheimer's, Parkinson's, and multiple sclerosis,\" he writes in an email to NPR.\u003c/p>\n\u003cp>\"Fetal tissue continues to be an important resource for biomedical research, and the Association of American Medical Colleges fully supports its availability as one of the scientific methods that could save and improve lives.\"[contextly_sidebar id=\"GY9wMG5EY8EjMrFWoS2AArgcQmiE5UTu\"]\u003c/p>\n\u003cp>During \u003ca href=\"https://www.npr.org/2016/01/28/464594826/in-wake-of-videos-planned-parenthood-investigations-find-no-fetal-tissue-sales\" target=\"_blank\" rel=\"noopener\">a 2015 brouhaha\u003c/a>, the Obama-era HHS \u003ca href=\"https://www.plannedparenthood.org/files/3514/4709/3497/HHS_Letter_2015_08_14_-_FT_Research.pdf\" target=\"_blank\" rel=\"noopener\">sent a letter\u003c/a> to two Republican senators calling the use of fetal tissue in medical research \"an instrumental component of our attempts to understand, treat, and cure a number of conditions and diseases that affect millions of Americans,\" noting that scientists in the U.S. have been working with fetal tissue \u003ca href=\"https://fas.org/sgp/crs/misc/R44129.pdf\" target=\"_blank\" rel=\"noopener\">since the 1930s\u003c/a>.\u003c/p>\n\u003cp>\u003cem>NPR science correspondent Rob Stein contributed to this report.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Health+And+Human+Services+Says+It%27s+Reviewing+Use+Of+Fetal+Tissue+For+Research&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n","blocks":[],"excerpt":"The audit has been called a political gesture to placate anti-abortion groups that oppose use of the tissue. Fetal tissue has played a part in developing vaccines and medical treatments.","status":"publish","parent":0,"modified":1538075106,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":24,"wordCount":917},"headData":{"title":"Is the Federal Government Politicizing Research Involving Fetal Tissue? | KQED","description":"The audit has been called a political gesture to placate anti-abortion groups that oppose use of the tissue. Fetal tissue has played a part in developing vaccines and medical treatments.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Is the Federal Government Politicizing Research Involving Fetal Tissue?","datePublished":"2018-09-27T19:04:01.000Z","dateModified":"2018-09-27T19:05:06.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"444641 https://ww2.kqed.org/futureofyou/?p=444641","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/09/27/governments-decision-to-review-research-of-fetal-tissue-blasted-as-political-move/","disqusTitle":"Is the Federal Government Politicizing Research Involving Fetal Tissue?","source":"Health","nprImageCredit":"Chip Somodevilla","nprByline":"Laurel Wamsley, NPR","nprImageAgency":"Getty Images","nprStoryId":"651838889","nprApiLink":"http://api.npr.org/query?id=651838889&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"https://www.npr.org/2018/09/26/651838889/health-and-human-services-says-its-reviewing-use-of-fetal-tissue-for-research?ft=nprml&f=651838889","nprRetrievedStory":"1","nprPubDate":"Wed, 26 Sep 2018 16:17:00 -0400","nprStoryDate":"Wed, 26 Sep 2018 15:12:00 -0400","nprLastModifiedDate":"Wed, 26 Sep 2018 16:18:07 -0400","path":"/futureofyou/444641/governments-decision-to-review-research-of-fetal-tissue-blasted-as-political-move","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>Updated at 3:45 pm ET\u003c/strong>\u003c/p>\n\u003cp>The Department of Health and Human Services says it is reviewing all medical research involving human fetal tissue.\u003c/p>\n\u003cp>HHS \u003ca href=\"https://www.hhs.gov/about/news/2018/09/24/statement-from-the-department-of-health-and-human-services.html\" target=\"_blank\" rel=\"noopener\">said this week\u003c/a> that it will conduct an audit of \"all acquisitions involving human fetal tissue\" as well as \"all research involving fetal tissue to ensure consistency with statutes and regulations governing such research and to ensure the adequacy of procedures and oversight of this research in light of the serious regulatory, moral, and ethical considerations involved.\"\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>In addition, HHS announced that it has canceled \u003ca href=\"https://www.fpds.gov/ezsearch/search.do?q=advanced+bioscience+resources+VENDOR_DUNS_NUMBER%3A%22786845982%22&s=FPDSNG.COM&templateName=1.4.4&indexName=awardfull&sortBy=SIGNED_DATE&desc=Y\" target=\"_blank\" rel=\"noopener\">a $15,000 contract\u003c/a> for a California-based company called Advanced Bioscience Resources to provide the Food and Drug Administration with human fetal tissue to develop testing protocols. The contract was terminated, HHS said, because the department \"was not sufficiently assured that the contract included the appropriate protections applicable to fetal tissue research or met all other procurement requirements.\"\u003c/p>\n\u003cp>Scientists use fetal tissue in medical research because it grows quickly and is highly versatile and long-lasting.\u003c/p>\n\u003cp>\"It allows us to answer specific questions that can't be answered by adult tissue, which is far more specialized,\"\u003c/p>\n\u003cp>NIH Associate Director for Science Policy Carrie Wolinetz \u003ca href=\"https://www.npr.org/sections/health-shots/2015/09/29/444214443/research-on-fetal-tissue-draws-renewed-political-scientific-scrutiny\" target=\"_blank\" rel=\"noopener\">told NPR's Rob Stein\u003c/a> in 2015. \"Fetal tissue can contain information — about structural features, or the architecture of organs — that cells in a dish alone can't provide. And this is sometimes very important to our understanding of disease.\"\u003c/p>\n\u003cp>Fetal tissue used in scientific research often comes from aborted fetuses. In an email to NPR, \u003ca href=\"https://law.wisc.edu/profiles/racharo\" target=\"_blank\" rel=\"noopener\">Alta Charo\u003c/a>, a professor of law and bioethics at the University of Wisconsin, explains why that is.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"Miscarriages are not often an available source, as they do not take place in a controlled environment and may be due to genetic or other anomalies that would render the cadaveric tissues useless,\" she says. \"Therefore, the tissue usually comes from a fetus that has been aborted.\"\u003c/p>\n\u003cp>Despite the small size of the canceled FDA contract, some observers said the larger political symbolism is evident.\u003c/p>\n\u003cp>\"My instinct is that this is driven by politics, and is part of the overall effort to stigmatize and eventually criminalize abortion, as well as part of a larger campaign to roll-back the clock on sexual and reproductive rights,\" Charo says.\u003c/p>\n\u003cp>However, \u003ca href=\"https://lozierinstitute.org/team-member/david-prentice/\" target=\"_blank\" rel=\"noopener\">David Prentice\u003c/a>, vice president and research director for the Charlotte Lozier Institute, a conservative think tank opposed to abortion, says the HHS announcement doesn't go far enough.\u003c/p>\n\u003cp>\"Canceling a small FDA contract ... seems designed to mollify some Members of Congress and groups who were outraged by the continuing funding of fetal tissue research with taxpayer dollars,\" Prentice writes in an email to NPR. \"But what's needed is wholesale reform across the breadth of HHS. Use of fetal tissue is antiquated research, and [HHS Secretary Alex] Azar should redirect those funds to modern science and better alternatives, including adult stem cells.\"\u003c/p>\n\u003cp>\u003cem>Science\u003c/em> notes that on earlier this month, 45 groups opposed to abortion \u003ca href=\"https://www.sba-list.org/wp-content/uploads/2018/09/Group-Letter-to-Azar-FDA-and-fetal-tissue-FINAL-with-Signatures.pdf\" target=\"_blank\" rel=\"noopener\">sent a letter\u003c/a> to Azar calling the FDA contract for fetal tissue \"shocking\" and \"unacceptable.\" A few days later, 85 members of Congress \u003ca href=\"https://chrissmith.house.gov/uploadedfiles/2018-09-17_-chs-hartzler-walker_letter_on_fda_fetal_tissue_contract.pdf\" target=\"_blank\" rel=\"noopener\">sent a letter\u003c/a> to the FDA's commissioner, urging the agency to cancel the contract.\u003c/p>\n\u003cp>The National Institutes of Health, which also falls under HHS, spent $98 million last fiscal year on research that involved human fetal tissue. The NIH said it \"concurs that it is important that research involving human fetal tissue should be consistent with the statutes and regulation governing such research and that it is important to have adequate procedures for oversight.\"\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Use of fetal tissue in research has been controversial for some time, \u003cem>Science\u003c/em> magazine reported on Tuesday:\u003c/p>\n\u003cblockquote>\u003cp>\"In 2016, \u003ca href=\"https://energycommerce.house.gov/news/press-release/house-creates-select-panel-investigate-handling-infant-lives/\" target=\"_blank\" rel=\"noopener\">Republican members of the House of Representatives\u003c/a>, led by Representative Marsha Blackburn (TN), \u003ca href=\"https://www.sciencemag.org/news/2017/01/fact-checking-congress-s-fetal-tissue-report\">produced a report\u003c/a> that urged the federal government to transition to obtaining fetal tissue from miscarriages and stillbirths. But opponents of fetal tissue research have failed repeatedly to pass legislation that would end funding for research using tissue from electively aborted fetuses — most recently earlier this month, when language prohibiting such funding was stripped from a 2019 HHS spending bill.\"\u003c/p>\u003c/blockquote>\n\u003cp>\u003ca href=\"https://trentcenter.duke.edu/node/221\" target=\"_blank\" rel=\"noopener\">Ross McKinney\u003c/a>, chief scientific officer at the Association of American Medical Colleges, says fetal tissue was key in the development of major medical advances such as vaccines for polio, rubella, measles, chickenpox, adenovirus and rabies, as well as treatments for diseases such as rheumatoid arthritis, cystic fibrosis and hemophilia.\u003c/p>\n\u003cp>\"The unique characteristics of this tissue are essential to the study of fetal diseases, like those caused by Zika virus, and hold promise for advancing biomedical research in other areas as well, bringing hope to patients struggling with diseases such as Alzheimer's, Parkinson's, and multiple sclerosis,\" he writes in an email to NPR.\u003c/p>\n\u003cp>\"Fetal tissue continues to be an important resource for biomedical research, and the Association of American Medical Colleges fully supports its availability as one of the scientific methods that could save and improve lives.\"\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>During \u003ca href=\"https://www.npr.org/2016/01/28/464594826/in-wake-of-videos-planned-parenthood-investigations-find-no-fetal-tissue-sales\" target=\"_blank\" rel=\"noopener\">a 2015 brouhaha\u003c/a>, the Obama-era HHS \u003ca href=\"https://www.plannedparenthood.org/files/3514/4709/3497/HHS_Letter_2015_08_14_-_FT_Research.pdf\" target=\"_blank\" rel=\"noopener\">sent a letter\u003c/a> to two Republican senators calling the use of fetal tissue in medical research \"an instrumental component of our attempts to understand, treat, and cure a number of conditions and diseases that affect millions of Americans,\" noting that scientists in the U.S. have been working with fetal tissue \u003ca href=\"https://fas.org/sgp/crs/misc/R44129.pdf\" target=\"_blank\" rel=\"noopener\">since the 1930s\u003c/a>.\u003c/p>\n\u003cp>\u003cem>NPR science correspondent Rob Stein contributed to this report.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Health+And+Human+Services+Says+It%27s+Reviewing+Use+Of+Fetal+Tissue+For+Research&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/444641/governments-decision-to-review-research-of-fetal-tissue-blasted-as-political-move","authors":["byline_futureofyou_444641"],"categories":["futureofyou_1","futureofyou_73","futureofyou_1064"],"tags":["futureofyou_342","futureofyou_1176","futureofyou_1615","futureofyou_294"],"collections":["futureofyou_1094"],"featImg":"futureofyou_444642","label":"source_futureofyou_444641"},"futureofyou_444115":{"type":"posts","id":"futureofyou_444115","meta":{"index":"posts_1591205157","site":"futureofyou","id":"444115","score":null,"sort":[1535477558000]},"guestAuthors":[],"slug":"why-is-this-consumer-group-fighting-to-stop-a-nationwide-medical-study-of-sepsis","title":"Why is a Consumer Group Fighting to Stop a Nationwide Study Of Sepsis?","publishDate":1535477558,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>A consumer advocacy organization is asking federal health officials Tuesday to halt a large medical study being conducted at major universities nationwide.\u003c/p>\n\u003cp>Public Citizen says that the study, involving treatment for \u003ca href=\"https://www.cdc.gov/sepsis/\" target=\"_blank\" rel=\"noopener\">sepsis,\u003c/a> puts patients at risk and will at best produce confusing results.\u003c/p>\n\u003cp>The \u003ca href=\"https://clinicaltrials.gov/ct2/show/NCT03434028?term=NCT03434028&rank=1\" target=\"_blank\" rel=\"noopener\">CLOVERS study\u003c/a> seeks to answer a key question about sepsis, which is a common and life-threatening response to infection. Sepsis kills more than 250,000 Americans a year, often by triggering the failure of multiple organs. As patients' blood vessels get leaky as a result of sepsis, it becomes difficult to maintain safe fluid balance and blood pressure.\u003c/p>\n\u003cp>Doctors use a combination of IV fluids and blood-pressure medicines called vasopressors, such as epinephrine and norepinephrine, to manage this life-threatening complication. But there is no consensus about the best strategy. Some doctors prefer to give lots of fluids and use drugs sparingly; others take the opposite approach.\u003c/p>\n\u003cp>\"So, trying to find the sweet spot — or the 'Goldilocks place' — is important,\" says \u003ca href=\"http://www.surgery.emory.edu/about-us/faculty_directory/faculty_profile_craig_coopersmith.html\" target=\"_blank\" rel=\"noopener\">Dr. Craig Coopersmith\u003c/a>, director of the surgical transplant intensive care unit at Emory University Hospital and an expert on sepsis.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The CLOVERS trial is an attempt to find that sweet spot. Patients who volunteer for the study are put into one of two groups: One gets plentiful fluids; the other gets limited fluids and more medication. Unlike most research, this study lacks a control group — people who receive the typically given amounts of IV fluids and drugs — as a comparison.\u003c/p>\n\u003cp>\"The problem is, both of those experimental ways for treating sepsis may do worse,\" says \u003ca href=\"https://www.citizen.org/about/michael-carome-md\" target=\"_blank\" rel=\"noopener\">Dr. Michael Carome,\u003c/a> head of the Public Citizen Health Research Group, which has lodged a complaint with federal health officials.\u003c/p>\n\u003cp>\"There may be higher mortality rates for both groups compared to usual care,\" Carome says, and without a comparison group there's no way to tell.\u003c/p>\n\u003cp>And if people on one of these experimental treatments do better than those on the other, that doesn't mean it would be better than usual care, he says. This study can't answer that question.\u003c/p>\n\u003cp>Carome is also alarmed that, in certain unusual circumstances, the protocol calls for holding off on treating dangerously low blood pressure for several hours.\u003c/p>\n\u003cp>\"No one caring for a sepsis patient would normally do that as part of usual care,\" he says.\u003c/p>\n\u003cp>The study, designed at Harvard and funded by the National Institutes of Health, went through multiple reviews by people who concluded that it didn't pose an undue risk to patients.\u003c/p>\n\u003cp>\"But the fact that it got through these layers of review with these serious design flaws signals that our system for protecting human subjects is broken,\" Carome says.\u003c/p>\n\u003cp>Coopersmith, who is not involved with the CLOVERS study, reviewed Public Citizen's complaint at NPR's request. He doesn't share Carome's sense of alarm.\u003c/p>\n\u003cp>Coopersmith agrees that including a comparison group that received the standard of care would be a better study design.\u003c/p>\n\u003cp>But, \"there's no clear standard of care for the first 24 hours,\" he says. Standard protocols for sepsis treatment dictate what doctors should do during the first six hours of treatment only, whereas the CLOVERS study is guiding treatment over a longer time period.\u003c/p>\n\u003cp>He says he agrees with Carome that the study won't clearly show that one of these experimental treatments is better than a more middle-of-the road approach to fluids and blood pressure medication; so sepsis doctors won't get clear guidance from the results. But the findings might help nudge doctors in one direction or another, he says, if it helps resolve the question of what's better — limited fluids or a lot?\u003c/p>\n\u003cp>As for the concerns about how to deal with a patient with very low blood pressure, Coopersmith says, \"in a very narrow patient population for a narrow period of time, there is a theoretical chance that someone could have what I would consider to be too low a blood pressure.\"\u003c/p>\n\u003cp>If he were a doctor involved in this trial and encountered that, he says, he would deviate from the protocol and treat that patient with standard care. He expects his colleagues would do that as well.\u003c/p>\n\u003cp>The study isn't designed the way he would have done it, Coopersmith says, but, he \"would be comfortable enrolling patients in this trial.\"\u003c/p>\n\u003cp>\u003ca href=\"http://cvbr.hms.harvard.edu/researchers/shapiro.html\" target=\"_blank\" rel=\"noopener\">Dr. Nathan Shapiro\u003c/a>, a professor of Emergency Medicine at Harvard's Beth Israel Deaconess Medical Center and one of the principal investigators for the CLOVERS study, stands by it. He declined a request for an interview, but sent a written response to NPR.\u003c/p>\n\u003cp>\"The study protocol was designed by expert clinicians in emergency and critical care medicine representing nearly 50 hospitals in the United States and follows a well-accepted design,\" he writes.\u003c/p>\n\u003cp>A spokesperson for the federal \u003ca href=\"https://www.hhs.gov/ohrp/\" target=\"_blank\" rel=\"noopener\">Office for Human Research Protections\u003c/a> says the office has not yet seen the Public Citizen complaint, but will review the allegations.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Richard Harris can be reached at \u003c/em>\u003ca href=\"mailto:rharris@npr.org\" target=\"_blank\" rel=\"noopener\">\u003cem>rharris@npr.org\u003c/em>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Critics+Trying+To+Stop+A+Big+Study+Of+Sepsis+Say+The+Research+Puts+Patients+At+Risk&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n","blocks":[],"excerpt":"The consumer advocacy group Public Citizen also says the multicenter study of life-threatening sepsis will at best produce confusing results. A Harvard doctor and designer of the research disagrees.","status":"publish","parent":0,"modified":1535479284,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":26,"wordCount":847},"headData":{"title":"Why is a Consumer Group Fighting to Stop a Nationwide Study Of Sepsis? | KQED","description":"The consumer advocacy group Public Citizen also says the multicenter study of life-threatening sepsis will at best produce confusing results. A Harvard doctor and designer of the research disagrees.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Why is a Consumer Group Fighting to Stop a Nationwide Study Of Sepsis?","datePublished":"2018-08-28T17:32:38.000Z","dateModified":"2018-08-28T18:01:24.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"444115 https://ww2.kqed.org/futureofyou/?p=444115","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/08/28/why-is-this-consumer-group-fighting-to-stop-a-nationwide-medical-study-of-sepsis/","disqusTitle":"Why is a Consumer Group Fighting to Stop a Nationwide Study Of Sepsis?","source":"Health","nprByline":"Richard Harris, NPR","nprImageAgency":"Portra Images/Getty Images","nprStoryId":"642315546","nprApiLink":"http://api.npr.org/query?id=642315546&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"https://www.npr.org/sections/health-shots/2018/08/28/642315546/critics-trying-to-stop-a-big-study-of-sepsis-say-the-research-puts-patients-at-r?ft=nprml&f=642315546","nprRetrievedStory":"1","nprPubDate":"Tue, 28 Aug 2018 10:21:00 -0400","nprStoryDate":"Tue, 28 Aug 2018 00:01:00 -0400","nprLastModifiedDate":"Tue, 28 Aug 2018 11:54:02 -0400","nprAudio":"https://ondemand.npr.org/anon.npr-mp3/npr/me/2018/08/20180828_me_questionable_sepsis_study.mp3?orgId=1&topicId=1128&d=207&p=3&story=642315546&ft=nprml&f=642315546","nprAudioM3u":"http://api.npr.org/m3u/1642525660-281cf2.m3u?orgId=1&topicId=1128&d=207&p=3&story=642315546&ft=nprml&f=642315546","audioTrackLength":207,"path":"/futureofyou/444115/why-is-this-consumer-group-fighting-to-stop-a-nationwide-medical-study-of-sepsis","audioUrl":"https://ondemand.npr.org/anon.npr-mp3/npr/me/2018/08/20180828_me_questionable_sepsis_study.mp3?orgId=1&topicId=1128&d=207&p=3&story=642315546&ft=nprml&f=642315546","parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>A consumer advocacy organization is asking federal health officials Tuesday to halt a large medical study being conducted at major universities nationwide.\u003c/p>\n\u003cp>Public Citizen says that the study, involving treatment for \u003ca href=\"https://www.cdc.gov/sepsis/\" target=\"_blank\" rel=\"noopener\">sepsis,\u003c/a> puts patients at risk and will at best produce confusing results.\u003c/p>\n\u003cp>The \u003ca href=\"https://clinicaltrials.gov/ct2/show/NCT03434028?term=NCT03434028&rank=1\" target=\"_blank\" rel=\"noopener\">CLOVERS study\u003c/a> seeks to answer a key question about sepsis, which is a common and life-threatening response to infection. Sepsis kills more than 250,000 Americans a year, often by triggering the failure of multiple organs. As patients' blood vessels get leaky as a result of sepsis, it becomes difficult to maintain safe fluid balance and blood pressure.\u003c/p>\n\u003cp>Doctors use a combination of IV fluids and blood-pressure medicines called vasopressors, such as epinephrine and norepinephrine, to manage this life-threatening complication. But there is no consensus about the best strategy. Some doctors prefer to give lots of fluids and use drugs sparingly; others take the opposite approach.\u003c/p>\n\u003cp>\"So, trying to find the sweet spot — or the 'Goldilocks place' — is important,\" says \u003ca href=\"http://www.surgery.emory.edu/about-us/faculty_directory/faculty_profile_craig_coopersmith.html\" target=\"_blank\" rel=\"noopener\">Dr. Craig Coopersmith\u003c/a>, director of the surgical transplant intensive care unit at Emory University Hospital and an expert on sepsis.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The CLOVERS trial is an attempt to find that sweet spot. Patients who volunteer for the study are put into one of two groups: One gets plentiful fluids; the other gets limited fluids and more medication. Unlike most research, this study lacks a control group — people who receive the typically given amounts of IV fluids and drugs — as a comparison.\u003c/p>\n\u003cp>\"The problem is, both of those experimental ways for treating sepsis may do worse,\" says \u003ca href=\"https://www.citizen.org/about/michael-carome-md\" target=\"_blank\" rel=\"noopener\">Dr. Michael Carome,\u003c/a> head of the Public Citizen Health Research Group, which has lodged a complaint with federal health officials.\u003c/p>\n\u003cp>\"There may be higher mortality rates for both groups compared to usual care,\" Carome says, and without a comparison group there's no way to tell.\u003c/p>\n\u003cp>And if people on one of these experimental treatments do better than those on the other, that doesn't mean it would be better than usual care, he says. This study can't answer that question.\u003c/p>\n\u003cp>Carome is also alarmed that, in certain unusual circumstances, the protocol calls for holding off on treating dangerously low blood pressure for several hours.\u003c/p>\n\u003cp>\"No one caring for a sepsis patient would normally do that as part of usual care,\" he says.\u003c/p>\n\u003cp>The study, designed at Harvard and funded by the National Institutes of Health, went through multiple reviews by people who concluded that it didn't pose an undue risk to patients.\u003c/p>\n\u003cp>\"But the fact that it got through these layers of review with these serious design flaws signals that our system for protecting human subjects is broken,\" Carome says.\u003c/p>\n\u003cp>Coopersmith, who is not involved with the CLOVERS study, reviewed Public Citizen's complaint at NPR's request. He doesn't share Carome's sense of alarm.\u003c/p>\n\u003cp>Coopersmith agrees that including a comparison group that received the standard of care would be a better study design.\u003c/p>\n\u003cp>But, \"there's no clear standard of care for the first 24 hours,\" he says. Standard protocols for sepsis treatment dictate what doctors should do during the first six hours of treatment only, whereas the CLOVERS study is guiding treatment over a longer time period.\u003c/p>\n\u003cp>He says he agrees with Carome that the study won't clearly show that one of these experimental treatments is better than a more middle-of-the road approach to fluids and blood pressure medication; so sepsis doctors won't get clear guidance from the results. But the findings might help nudge doctors in one direction or another, he says, if it helps resolve the question of what's better — limited fluids or a lot?\u003c/p>\n\u003cp>As for the concerns about how to deal with a patient with very low blood pressure, Coopersmith says, \"in a very narrow patient population for a narrow period of time, there is a theoretical chance that someone could have what I would consider to be too low a blood pressure.\"\u003c/p>\n\u003cp>If he were a doctor involved in this trial and encountered that, he says, he would deviate from the protocol and treat that patient with standard care. He expects his colleagues would do that as well.\u003c/p>\n\u003cp>The study isn't designed the way he would have done it, Coopersmith says, but, he \"would be comfortable enrolling patients in this trial.\"\u003c/p>\n\u003cp>\u003ca href=\"http://cvbr.hms.harvard.edu/researchers/shapiro.html\" target=\"_blank\" rel=\"noopener\">Dr. Nathan Shapiro\u003c/a>, a professor of Emergency Medicine at Harvard's Beth Israel Deaconess Medical Center and one of the principal investigators for the CLOVERS study, stands by it. He declined a request for an interview, but sent a written response to NPR.\u003c/p>\n\u003cp>\"The study protocol was designed by expert clinicians in emergency and critical care medicine representing nearly 50 hospitals in the United States and follows a well-accepted design,\" he writes.\u003c/p>\n\u003cp>A spokesperson for the federal \u003ca href=\"https://www.hhs.gov/ohrp/\" target=\"_blank\" rel=\"noopener\">Office for Human Research Protections\u003c/a> says the office has not yet seen the Public Citizen complaint, but will review the allegations.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Richard Harris can be reached at \u003c/em>\u003ca href=\"mailto:rharris@npr.org\" target=\"_blank\" rel=\"noopener\">\u003cem>rharris@npr.org\u003c/em>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Critics+Trying+To+Stop+A+Big+Study+Of+Sepsis+Say+The+Research+Puts+Patients+At+Risk&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/444115/why-is-this-consumer-group-fighting-to-stop-a-nationwide-medical-study-of-sepsis","authors":["byline_futureofyou_444115"],"categories":["futureofyou_1062","futureofyou_1","futureofyou_73"],"tags":["futureofyou_61","futureofyou_177","futureofyou_294","futureofyou_653"],"collections":["futureofyou_1093","futureofyou_1097"],"featImg":"futureofyou_444116","label":"source_futureofyou_444115"},"futureofyou_442945":{"type":"posts","id":"futureofyou_442945","meta":{"index":"posts_1591205157","site":"futureofyou","id":"442945","score":null,"sort":[1529614854000]},"guestAuthors":[],"slug":"anti-aging-researcher-faces-loss-of-his-inspiration-his-96-yr-old-dad","title":"Anti-Aging Researcher Faces Loss of His Inspiration: His 96-Year-Old Dad","publishDate":1529614854,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{"term":1094,"site":"futureofyou"},"content":"\u003cp>Leonid Peshkin calmly strokes his father’s thin, white hair. He gently exercises the old man’s arms to activate his muscles and get the blood flowing. He speaks, voice raised to reach him through the fog of age, poor hearing, and illness. “Papa,” he asks in their native Russian, “are you in pain?”\u003c/p>\n\u003cp>Almost imperceptibly, Miron Peshkin, age 96 and silenced by a minor heart attack, delirium, antibiotic-resistant infections, and six months of medical care, shifts his head to indicate “no.”\u003c/p>\n\u003cp>The younger Peshkin, 48, studies the biology of aging at Harvard Medical School in Boston. A broad-shouldered man with a twinkle always lurking in his brown eyes, Peshkin has been obsessed with aging since childhood because he worried that his father — then as old as other kids’ grandparents — would soon pass away.\u003c/p>\n\u003cp>“How funny it is,” Peshkin said, “that I had to be super worried he was going to die when I was 10. And here I am almost 50, and he’s still around.”\u003c/p>\n\u003cp>Now, as Miron lies virtually motionless in a nursing home, Peshkin fights his own battles with aging a few miles away, in a fifth-floor lab just off the Harvard Medical School quad.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The lab’s main attraction is a mammoth, glass-fronted incubator stocked with tiny crustaceans called water fleas. Peshkin is raising them to try to understand their natural lifespan. Once he knows how unusual it is for these bugs to survive past the 40 days they typically live at room temperature, he will begin dosing them with drugs to see if he can extend that trajectory.\u003c/p>\n\u003cfigure class=\"clear\">\n\u003cfigure class=\"wp-caption aligncenter\" style=\"max-width: 1024px\">\u003ca href=\"https://www.statnews.com/wp-content/uploads/2018/06/0613_STAT_LeonidPeshkin003.jpg\">\u003cimg class=\"extendsBeyondTextColumn\" src=\"https://www.statnews.com/wp-content/uploads/2018/06/0613_STAT_LeonidPeshkin003-1024x683.jpg\" alt=\"\" width=\"1024\" height=\"683\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Peshkin prepares to feed water fleas in his lab at Harvard Medical School. He studies their life cycle to better understand aging in humans. (Ruby Wallau/STAT)\u003c/figcaption>\u003c/figure>\n\u003c/figure>\n\u003cp>Peshkin and his parents also contribute to research in a less conventional way. All three have donated their genetic code and cells to science.\u003c/p>\n\u003cp>Those cells have been altered to reproduce indefinitely. Their usefulness to research will far outlast Miron’s life, and probably his mother’s and Peshkin’s too.\u003c/p>\n\u003cp>But that’s not what Peshkin’s aiming for, he said, quoting Woody Allen’s famous line about wanting to achieve immortality — not through his work — but by not dying.\u003c/p>\n\u003cp>That’s why Peshkin continues to fight for his father’s life, despite the increasing futility.\u003c/p>\n\u003cp>Yes, he understands that his father is old and unlikely to recover. But no, he isn’t ready to stop aggressive medical care, Peshkin has told the chaplain at the Catholic hospital that treated his father, and at the Jewish nursing home where Miron now lies in a world mostly his own.\u003c/p>\n\u003cp>Peshkin highlights the irony: Persecuted for decades in Russia for being Jewish, Miron has no real faith — except in science. And yet these people of faith want to decide his fate. Plus, Peshkin has come, over the six months of his father’s illness, to doubt the medical care that keeps him alive. Too many times doctors told him his father was gone; only to have him bounce back and become himself once again.\u003c/p>\n\u003cp>So every day Peshkin drives to the nursing home to stroke his father’s head, stretch his arms, talk to him, and check in with caregivers.\u003c/p>\n\u003cp>And Peshkin continues to struggle with the question that has haunted him since childhood: Why must his father die?\u003c/p>\n\u003cp>“It just didn’t make sense the whole idea that you have to get old, your parents, your loved ones have to get old and die,” Peshkin said. “It just made absolutely no sense to me and it still doesn’t.”\u003c/p>\n\u003cfigure class=\"clear\">\n\u003cfigure class=\"wp-caption aligncenter\" style=\"max-width: 993px\">\u003ca href=\"https://www.statnews.com/wp-content/uploads/2018/06/Leonid_Composite.jpg\">\u003cimg class=\"extendsBeyondTextColumn\" src=\"https://www.statnews.com/wp-content/uploads/2018/06/Leonid_Composite.jpg\" alt=\"Leon Peshkin 04\" width=\"993\" height=\"509\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">\u003cstrong>(Left) Aaron Peshkin with young Miron Peshkin in 1924. (Right) Miron Peshkin and Leonid Peshkin in 1973. Courtesy Leon Peshkin.\u003c/strong>\u003c/figcaption>\u003c/figure>\n\u003c/figure>\n\u003cp>\u003cstrong>A Lifelong Interest in Longevity\u003c/strong>\u003c/p>\n\u003cp>Anti-aging research is one of today’s \u003ca href=\"https://www.statnews.com/2018/05/22/laura-deming-profile-longevity-fund/\" target=\"_blank\" rel=\"noopener\">hottest fields\u003c/a>. Billionaires donate fortunes to advance work aimed at slowing the hands of time.\u003c/p>\n\u003cp>But the genesis of Peshkin’s interest in longevity goes back 43 years, to the streets of Moscow.\u003c/p>\n\u003cp>Walking in the park with his babysitter, they crossed paths with a fancy funeral — big crowd, brass band, bright red open casket. Peshkin doesn’t remember who died, but he does remember the questions it left him with: What is death? Why do we have to die? Why put someone in a box who looks so alive?\u003c/p>\n\u003cp>His parents had always answered his questions before. But this time, their explanations were inadequate and awkward. Their inability to satisfy his curiosity made as big an impression on him as the funeral.\u003c/p>\n\u003cp>His father was a scientist, first in the aviation industry and then — when he was kicked out for being Jewish — in the oil and gas business, studying how liquified gas moves through sand. Working for the state, Miron didn’t earn much, so he translated technical documents from German and English into Russian for extra cash. Peshkin’s mother, Klavdia Logvinskaya, worked herself up from lab technician to engineer, researching additives that influence the properties of metal alloys.\u003c/p>\n\u003cp>They were always demanding of their son. They told Peshkin he had to be 10 times better than everyone else to overcome the discrimination he would face as a Jew.\u003c/p>\n\u003cp>Growing up, almost all the adults Peshkin knew were the Ph.D.-level scientists who were his parents’ friends. “It was clear that science is the only thing worth doing in life,” he said. As a young boy, a family friend showed him how to memorize a string of 50 facts after just a few minutes of study. “It gave me this idea of power over nature,” he said.\u003c/p>\n\u003cp>At age 10, after watching some television hospital dramas, Peshkin remembers taking a cord from an old desk lamp and having it at the ready to shock his father’s heart, in case he went into cardiac arrest. “It’s very good he never had a heart attack, because I would have finished him,” Peshkin said dryly.\u003c/p>\n\u003cp>Peshkin came to the United States in 1995 to attend Brown University, where he trained in statistical machine learning, a type of artificial intelligence, before switching to systems biology. His parents joined him in Boston a decade ago as political refugees, fleeing anti-Semitism.\u003c/p>\n\u003cp>His mother, sitting in his office recently after a nearby doctor’s appointment, reminds him in Russian that he also promised to build an engine to replace their failing hearts, so they would never die.\u003c/p>\n\u003cp>He still holds onto that dream of keeping them alive.\u003c/p>\n\u003cp>“I guess I’m not a very religious man. I don’t think there is some kind of rational design or purpose,” he said. “Even if there is, I’m not ready to accept [it].”\u003c/p>\n\u003cp>\u003cstrong>Searching for Clues to Reverse Aging\u003c/strong>\u003c/p>\n\u003cp>Some of the most exciting, perhaps fanciful, biomedical research involves slowing the aging process. Research in animals is especially tantalizing. Deprive a worm of calories and it will live longer. A number of drugs extend life in animals and are being studied to see if they can reduce the risk of age-related diseases in people.\u003c/p>\n\u003cp>Many anti-aging scientists themselves pop supplements or gratefully accept diagnoses of pre-diabetes so they can start taking drugs that have shown promise.\u003c/p>\n\u003cp>Peshkin’s own research focuses on the water flea, Latin name Daphnia, an insect barely visible to the naked eye. Known primarily as food for aquarium fish, these mostly transparent crustaceans eat algae and protozoa and survive for about 40 days when kept at room temperature. (They live longer in warmer environments.)\u003c/p>\n\u003cp>It’s that “on average” that troubles Peshkin. No one knows the full range of a Daphnia’s lifespan. So, if a Daphnia lives for 60 days while given a particular drug, is that a potential silver bullet or simply the water flea equivalent of human outlier, akin to his father living to 96? Or if they continue having offspring and resist turning opaque — the water flea version of going gray — does that mean that he’s extended their “healthspan,” which is the true goal of all anti-aging research?\u003c/p>\n\u003cp>Peshkin said water fleas make a good research species because of their relatively short lifespans, and because unlike flies or worms, they can be precisely dosed with medication. It’s hard to tell how much an individual fly is consuming; worms are very efficient at excreting nutrients they don’t need. Water fleas, on the other hand, have to absorb the medication Peshkin gives them, because they’re swimming in it, he said.\u003c/p>\n\u003cp>They can reproduce asexually, unless under stress, so all of his Daphnia are identical genetic clones.\u003c/p>\n\u003cp>He mentioned one cool trick with Daphnia that many middle school sciences classes try: Add caffeine to their water and you can watch their heartbeats speed up. (When Peshkin’s wife was pregnant seven yeas ago, he was worried about her addiction to coffee. He pumped tadpoles full of caffeine during their entire developmental process — and saw no issues in their offspring. His wife remains addicted.)\u003c/p>\n\u003cp>Last year, before Peshkin’s research funding didn’t come through and his water fleas died, he got encouraging early results from the fleas when he tried them on a drug called Wortmannin, shown to extend the life of fruit flies. He froze one Daphnia every day so he could later examine the genes that were turned on and off during development, and as the animal aged.\u003c/p>\n\u003cp>Now, he’s starting to build up his colony again in collaboration with Marc Kirschner, the founding director of Harvard’s systems biology department. “Our target is getting a steady supply of old animals. It’s trickier than it sounds,” he said.\u003c/p>\n\u003cp>He compares his scientific process to the child’s game Twenty Questions. “I use drugs as questions,” he said, interrogating them to see if they can extend the life of water fleas, and therefore, potentially, humans. “I want to find the minimal number of questions that allow you to get an answer.”\u003c/p>\n\u003cfigure class=\"clear\">\n\u003cfigure class=\"wp-caption aligncenter\" style=\"max-width: 1024px\">\u003ca href=\"https://www.statnews.com/wp-content/uploads/2018/06/0613_STAT_LeonidPeshkin001.jpg\">\u003cimg class=\"extendsBeyondTextColumn\" src=\"https://www.statnews.com/wp-content/uploads/2018/06/0613_STAT_LeonidPeshkin001-1024x683.jpg\" alt=\"Leon Peshkin 01\" width=\"1024\" height=\"683\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Peshkin in his office at Harvard Medical School. His genome will become the reference for labs all over the world. (Ruby Wallau/STAT)\u003c/figcaption>\u003c/figure>\n\u003c/figure>\n\u003cp>\u003cstrong>Henrietta Lacks 2.0\u003c/strong>\u003c/p>\n\u003cp>The human cells used most often in research labs around the world came originally from a Maryland woman named \u003ca href=\"http://www.lacksfamily.net/\" target=\"_blank\" rel=\"noopener\">Henrietta Lacks\u003c/a>, who died of cervical cancer in 1951. The doctors who treated her did not get her permission before shipping descendants of her cells all over the world. The ethics of that were questionable back then and are certainly unacceptable today.\u003c/p>\n\u003cp>So when Harvard geneticist George Church set out to amass human genome, health and trait data for research, he made informed consent a huge part of the process.\u003c/p>\n\u003cp>Miron was the 15th person to sign up for the Personal Genome Project, which now counts hundreds of participants; Peshkin and his mother soon followed. The three don’t share the privacy concerns some people have about making their genetic information public.\u003c/p>\n\u003cp>“I didn’t invent my genome,” Peshkin said. “This idea that it’s mine in the sense of property is sort of foreign to me.”\u003c/p>\n\u003cp>His mother said she can’t imagine ways that publishing her genome might hurt her. “This is for science and scientists,” Logvinskaya said in Russian, while Peshkin translated. “Those are not villains. Those are not random people.”\u003c/p>\n\u003cp>A few years after volunteering their information, Personal Genome Project organizers approached the family with a request: Would they participate in a federally funded effort to develop a standard for genetic sequencing?\u003c/p>\n\u003cp>Other fields set standards. A cylinder of platinum-iridium alloy, for instance, sits in a basement vault in the U.K., providing the \u003ca href=\"http://www.npl.co.uk/reference/faqs/where-and-how-is-the-uks-national-standard-kilogram-stored-(faq-mass-and-density)\" target=\"_blank\" rel=\"noopener\">reference weight\u003c/a> used around the world for a kilogram.\u003c/p>\n\u003cp>But when scientists sequence a genome, they have no way of knowing the accuracy of that sequence or whether it’s good enough, because they have no high-quality benchmark to compare it to. It’s that benchmark that the Genome in a Bottle project is working to create, said Justin Zook, a scientist at the National Institute of Standards and Technology and co-leader of the initiative. In addition to the Peshkin family, they’ve now sequenced one pilot genome and one man of Han Chinese descent. They plan to add that man’s parents soon, and eventually others that reflect more ethnic and racial diversity, Zook said.\u003c/p>\n\u003cdiv>\n\u003cdiv>\n\u003cdiv>\n\u003cp>Peshkin said he briefly contemplated one far-out concern with the project: If his was the reference genome, could his own body become valuable to a scientist who wanted to, say, test an Alzheimer’s drug on the real person it was designed to treat?\u003c/p>\n\u003c/div>\n\u003c/div>\n\u003c/div>\n\u003cp>“If my brain is the best brain for the experiment because they’ve been working with cells derived from me, maybe there’s suddenly a price on my head,” Peshkin said. “It’s more like a great plot for a movie, and I dismissed it because I thought it’s a very, very unlikely scenario to worry about.”\u003c/p>\n\u003cp>So he agreed.\u003c/p>\n\u003cp>Data associated with the Genome in a Bottle samples were downloaded to about 15,000 computers worldwide in 2017, Zook said, suggesting that there’s a strong appetite for the information.\u003c/p>\n\u003cp>Weirdly, Peshkin won’t be able to study his own samples; it wouldn’t be safe. Like Henrietta Lacks’ original cells, the ones he donated have been modified to reproduce indefinitely, which is essential for their scientific usefulness. But that makes them extremely dangerous to Peshkin himself — and only him. If he comes into contact with his own modified cells, his body won’t recognize them as foreign. “They will keep multiplying and growing on me and eventually will kill me,” he said matter-of-factly.\u003c/p>\n\u003cfigure class=\"clear\">\n\u003cfigure class=\"wp-caption aligncenter\" style=\"max-width: 1024px\">\u003ca href=\"https://www.statnews.com/wp-content/uploads/2018/06/0613_STAT_LeonidPeshkin010.jpg\">\u003cimg class=\"extendsBeyondTextColumn\" src=\"https://www.statnews.com/wp-content/uploads/2018/06/0613_STAT_LeonidPeshkin010-1024x683.jpg\" alt=\"Leon Peshkin 05\" width=\"1024\" height=\"683\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Peshkin exercises his father’s arm to activate his muscles and get the blood flowing. (Ruby Wallau/STAT)\u003c/figcaption>\u003c/figure>\n\u003c/figure>\n\u003cp>\u003cstrong>Privacy vs. Science\u003c/strong>\u003c/p>\n\u003cp>The Personal Genome Project is now considering what tissue to collect from Miron when his heart or another organ finally gives out, said Michael F. Chou, a lecturer in genetics and director of human subjects research for the project.\u003c/p>\n\u003cp>Miron’s gene sequence and tissue will be publicly available and connected with his health records; \u003ca href=\"https://www.broadinstitute.org/blog/gtex-useful-expression-cancer-research\" target=\"_blank\" rel=\"noopener\">other\u003c/a> gene expression data from tissue has been anonymized. Without that personal data, researchers can’t know if their pancreatic tissue sample came from a diabetic who died of a heart attack in his 50s, for instance, or from someone like Miron, who has lived nearly two decades longer than the average American male.\u003c/p>\n\u003cp>It may sound morbid to contemplate such ideas. But though Peshkin still sees death as pointless and illogical, it would be even more meaningless in his view to bury an intact body in the ground where it can do no good.\u003c/p>\n\u003cp>“I think the best we can do is leave our body to science, even though a lot of science is also a waste,” Peshkin said. “I think that science is the best thing we have.”\u003c/p>\n\u003cp>There isn’t much more time left to make these kinds of decisions.\u003c/p>\n\u003cp>Over the last two weeks Miron has slipped further away. Peshkin is sure his father, whose 97th birthday is July 9, can still hear him. But Miron is not as responsive as he was, his eyes are less alert, his stare more vacant. Peshkin would have given up already if his father hadn’t bounced back twice before, though he concedes that chances are now slim.\u003c/p>\n\u003cp>His father’s palliative care team has scheduled a meeting for Wednesday afternoon. Peshkin expects they will pressure him to dial back on Miron’s aggressive medical care, potentially hastening his demise.\u003c/p>\n\u003cp>He wonders aloud when he will be ready to accept what he still doesn’t think should be inevitable.\u003c/p>\n\u003cp>“I think I will try to fend it off for a little longer,” Peshkin said.\u003c/p>\n\u003cp>\u003cem>Correction: An earlier version of this story misclassified Daphnia on first reference and Peshkin’s field of research.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This story was originally published by \u003ca href=\"https://www.statnews.com/2018/06/20/anti-aging-researcher-father-death/\" target=\"_blank\" rel=\"noopener\">STAT\u003c/a>, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":null,"status":"publish","parent":0,"modified":1529722265,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":67,"wordCount":2819},"headData":{"title":"Anti-Aging Researcher Faces Loss of His Inspiration: His 96-Year-Old Dad | KQED","description":"Leonid Peshkin calmly strokes his father’s thin, white hair. He gently exercises the old man’s arms to activate his muscles and get the blood flowing. He speaks, voice raised to reach him through the fog of age, poor hearing, and illness. “Papa,” he asks in their native Russian, “are you in pain?” Almost imperceptibly, Miron","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Anti-Aging Researcher Faces Loss of His Inspiration: His 96-Year-Old Dad","datePublished":"2018-06-21T21:00:54.000Z","dateModified":"2018-06-23T02:51:05.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"442945 https://ww2.kqed.org/futureofyou/?p=442945","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/06/21/anti-aging-researcher-faces-loss-of-his-inspiration-his-96-yr-old-dad/","disqusTitle":"Anti-Aging Researcher Faces Loss of His Inspiration: His 96-Year-Old Dad","nprByline":"Karen Weintraub\u003cbr />STAT","path":"/futureofyou/442945/anti-aging-researcher-faces-loss-of-his-inspiration-his-96-yr-old-dad","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Leonid Peshkin calmly strokes his father’s thin, white hair. He gently exercises the old man’s arms to activate his muscles and get the blood flowing. He speaks, voice raised to reach him through the fog of age, poor hearing, and illness. “Papa,” he asks in their native Russian, “are you in pain?”\u003c/p>\n\u003cp>Almost imperceptibly, Miron Peshkin, age 96 and silenced by a minor heart attack, delirium, antibiotic-resistant infections, and six months of medical care, shifts his head to indicate “no.”\u003c/p>\n\u003cp>The younger Peshkin, 48, studies the biology of aging at Harvard Medical School in Boston. A broad-shouldered man with a twinkle always lurking in his brown eyes, Peshkin has been obsessed with aging since childhood because he worried that his father — then as old as other kids’ grandparents — would soon pass away.\u003c/p>\n\u003cp>“How funny it is,” Peshkin said, “that I had to be super worried he was going to die when I was 10. And here I am almost 50, and he’s still around.”\u003c/p>\n\u003cp>Now, as Miron lies virtually motionless in a nursing home, Peshkin fights his own battles with aging a few miles away, in a fifth-floor lab just off the Harvard Medical School quad.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The lab’s main attraction is a mammoth, glass-fronted incubator stocked with tiny crustaceans called water fleas. Peshkin is raising them to try to understand their natural lifespan. Once he knows how unusual it is for these bugs to survive past the 40 days they typically live at room temperature, he will begin dosing them with drugs to see if he can extend that trajectory.\u003c/p>\n\u003cfigure class=\"clear\">\n\u003cfigure class=\"wp-caption aligncenter\" style=\"max-width: 1024px\">\u003ca href=\"https://www.statnews.com/wp-content/uploads/2018/06/0613_STAT_LeonidPeshkin003.jpg\">\u003cimg class=\"extendsBeyondTextColumn\" src=\"https://www.statnews.com/wp-content/uploads/2018/06/0613_STAT_LeonidPeshkin003-1024x683.jpg\" alt=\"\" width=\"1024\" height=\"683\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Peshkin prepares to feed water fleas in his lab at Harvard Medical School. He studies their life cycle to better understand aging in humans. (Ruby Wallau/STAT)\u003c/figcaption>\u003c/figure>\n\u003c/figure>\n\u003cp>Peshkin and his parents also contribute to research in a less conventional way. All three have donated their genetic code and cells to science.\u003c/p>\n\u003cp>Those cells have been altered to reproduce indefinitely. Their usefulness to research will far outlast Miron’s life, and probably his mother’s and Peshkin’s too.\u003c/p>\n\u003cp>But that’s not what Peshkin’s aiming for, he said, quoting Woody Allen’s famous line about wanting to achieve immortality — not through his work — but by not dying.\u003c/p>\n\u003cp>That’s why Peshkin continues to fight for his father’s life, despite the increasing futility.\u003c/p>\n\u003cp>Yes, he understands that his father is old and unlikely to recover. But no, he isn’t ready to stop aggressive medical care, Peshkin has told the chaplain at the Catholic hospital that treated his father, and at the Jewish nursing home where Miron now lies in a world mostly his own.\u003c/p>\n\u003cp>Peshkin highlights the irony: Persecuted for decades in Russia for being Jewish, Miron has no real faith — except in science. And yet these people of faith want to decide his fate. Plus, Peshkin has come, over the six months of his father’s illness, to doubt the medical care that keeps him alive. Too many times doctors told him his father was gone; only to have him bounce back and become himself once again.\u003c/p>\n\u003cp>So every day Peshkin drives to the nursing home to stroke his father’s head, stretch his arms, talk to him, and check in with caregivers.\u003c/p>\n\u003cp>And Peshkin continues to struggle with the question that has haunted him since childhood: Why must his father die?\u003c/p>\n\u003cp>“It just didn’t make sense the whole idea that you have to get old, your parents, your loved ones have to get old and die,” Peshkin said. “It just made absolutely no sense to me and it still doesn’t.”\u003c/p>\n\u003cfigure class=\"clear\">\n\u003cfigure class=\"wp-caption aligncenter\" style=\"max-width: 993px\">\u003ca href=\"https://www.statnews.com/wp-content/uploads/2018/06/Leonid_Composite.jpg\">\u003cimg class=\"extendsBeyondTextColumn\" src=\"https://www.statnews.com/wp-content/uploads/2018/06/Leonid_Composite.jpg\" alt=\"Leon Peshkin 04\" width=\"993\" height=\"509\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">\u003cstrong>(Left) Aaron Peshkin with young Miron Peshkin in 1924. (Right) Miron Peshkin and Leonid Peshkin in 1973. Courtesy Leon Peshkin.\u003c/strong>\u003c/figcaption>\u003c/figure>\n\u003c/figure>\n\u003cp>\u003cstrong>A Lifelong Interest in Longevity\u003c/strong>\u003c/p>\n\u003cp>Anti-aging research is one of today’s \u003ca href=\"https://www.statnews.com/2018/05/22/laura-deming-profile-longevity-fund/\" target=\"_blank\" rel=\"noopener\">hottest fields\u003c/a>. Billionaires donate fortunes to advance work aimed at slowing the hands of time.\u003c/p>\n\u003cp>But the genesis of Peshkin’s interest in longevity goes back 43 years, to the streets of Moscow.\u003c/p>\n\u003cp>Walking in the park with his babysitter, they crossed paths with a fancy funeral — big crowd, brass band, bright red open casket. Peshkin doesn’t remember who died, but he does remember the questions it left him with: What is death? Why do we have to die? Why put someone in a box who looks so alive?\u003c/p>\n\u003cp>His parents had always answered his questions before. But this time, their explanations were inadequate and awkward. Their inability to satisfy his curiosity made as big an impression on him as the funeral.\u003c/p>\n\u003cp>His father was a scientist, first in the aviation industry and then — when he was kicked out for being Jewish — in the oil and gas business, studying how liquified gas moves through sand. Working for the state, Miron didn’t earn much, so he translated technical documents from German and English into Russian for extra cash. Peshkin’s mother, Klavdia Logvinskaya, worked herself up from lab technician to engineer, researching additives that influence the properties of metal alloys.\u003c/p>\n\u003cp>They were always demanding of their son. They told Peshkin he had to be 10 times better than everyone else to overcome the discrimination he would face as a Jew.\u003c/p>\n\u003cp>Growing up, almost all the adults Peshkin knew were the Ph.D.-level scientists who were his parents’ friends. “It was clear that science is the only thing worth doing in life,” he said. As a young boy, a family friend showed him how to memorize a string of 50 facts after just a few minutes of study. “It gave me this idea of power over nature,” he said.\u003c/p>\n\u003cp>At age 10, after watching some television hospital dramas, Peshkin remembers taking a cord from an old desk lamp and having it at the ready to shock his father’s heart, in case he went into cardiac arrest. “It’s very good he never had a heart attack, because I would have finished him,” Peshkin said dryly.\u003c/p>\n\u003cp>Peshkin came to the United States in 1995 to attend Brown University, where he trained in statistical machine learning, a type of artificial intelligence, before switching to systems biology. His parents joined him in Boston a decade ago as political refugees, fleeing anti-Semitism.\u003c/p>\n\u003cp>His mother, sitting in his office recently after a nearby doctor’s appointment, reminds him in Russian that he also promised to build an engine to replace their failing hearts, so they would never die.\u003c/p>\n\u003cp>He still holds onto that dream of keeping them alive.\u003c/p>\n\u003cp>“I guess I’m not a very religious man. I don’t think there is some kind of rational design or purpose,” he said. “Even if there is, I’m not ready to accept [it].”\u003c/p>\n\u003cp>\u003cstrong>Searching for Clues to Reverse Aging\u003c/strong>\u003c/p>\n\u003cp>Some of the most exciting, perhaps fanciful, biomedical research involves slowing the aging process. Research in animals is especially tantalizing. Deprive a worm of calories and it will live longer. A number of drugs extend life in animals and are being studied to see if they can reduce the risk of age-related diseases in people.\u003c/p>\n\u003cp>Many anti-aging scientists themselves pop supplements or gratefully accept diagnoses of pre-diabetes so they can start taking drugs that have shown promise.\u003c/p>\n\u003cp>Peshkin’s own research focuses on the water flea, Latin name Daphnia, an insect barely visible to the naked eye. Known primarily as food for aquarium fish, these mostly transparent crustaceans eat algae and protozoa and survive for about 40 days when kept at room temperature. (They live longer in warmer environments.)\u003c/p>\n\u003cp>It’s that “on average” that troubles Peshkin. No one knows the full range of a Daphnia’s lifespan. So, if a Daphnia lives for 60 days while given a particular drug, is that a potential silver bullet or simply the water flea equivalent of human outlier, akin to his father living to 96? Or if they continue having offspring and resist turning opaque — the water flea version of going gray — does that mean that he’s extended their “healthspan,” which is the true goal of all anti-aging research?\u003c/p>\n\u003cp>Peshkin said water fleas make a good research species because of their relatively short lifespans, and because unlike flies or worms, they can be precisely dosed with medication. It’s hard to tell how much an individual fly is consuming; worms are very efficient at excreting nutrients they don’t need. Water fleas, on the other hand, have to absorb the medication Peshkin gives them, because they’re swimming in it, he said.\u003c/p>\n\u003cp>They can reproduce asexually, unless under stress, so all of his Daphnia are identical genetic clones.\u003c/p>\n\u003cp>He mentioned one cool trick with Daphnia that many middle school sciences classes try: Add caffeine to their water and you can watch their heartbeats speed up. (When Peshkin’s wife was pregnant seven yeas ago, he was worried about her addiction to coffee. He pumped tadpoles full of caffeine during their entire developmental process — and saw no issues in their offspring. His wife remains addicted.)\u003c/p>\n\u003cp>Last year, before Peshkin’s research funding didn’t come through and his water fleas died, he got encouraging early results from the fleas when he tried them on a drug called Wortmannin, shown to extend the life of fruit flies. He froze one Daphnia every day so he could later examine the genes that were turned on and off during development, and as the animal aged.\u003c/p>\n\u003cp>Now, he’s starting to build up his colony again in collaboration with Marc Kirschner, the founding director of Harvard’s systems biology department. “Our target is getting a steady supply of old animals. It’s trickier than it sounds,” he said.\u003c/p>\n\u003cp>He compares his scientific process to the child’s game Twenty Questions. “I use drugs as questions,” he said, interrogating them to see if they can extend the life of water fleas, and therefore, potentially, humans. “I want to find the minimal number of questions that allow you to get an answer.”\u003c/p>\n\u003cfigure class=\"clear\">\n\u003cfigure class=\"wp-caption aligncenter\" style=\"max-width: 1024px\">\u003ca href=\"https://www.statnews.com/wp-content/uploads/2018/06/0613_STAT_LeonidPeshkin001.jpg\">\u003cimg class=\"extendsBeyondTextColumn\" src=\"https://www.statnews.com/wp-content/uploads/2018/06/0613_STAT_LeonidPeshkin001-1024x683.jpg\" alt=\"Leon Peshkin 01\" width=\"1024\" height=\"683\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Peshkin in his office at Harvard Medical School. His genome will become the reference for labs all over the world. (Ruby Wallau/STAT)\u003c/figcaption>\u003c/figure>\n\u003c/figure>\n\u003cp>\u003cstrong>Henrietta Lacks 2.0\u003c/strong>\u003c/p>\n\u003cp>The human cells used most often in research labs around the world came originally from a Maryland woman named \u003ca href=\"http://www.lacksfamily.net/\" target=\"_blank\" rel=\"noopener\">Henrietta Lacks\u003c/a>, who died of cervical cancer in 1951. The doctors who treated her did not get her permission before shipping descendants of her cells all over the world. The ethics of that were questionable back then and are certainly unacceptable today.\u003c/p>\n\u003cp>So when Harvard geneticist George Church set out to amass human genome, health and trait data for research, he made informed consent a huge part of the process.\u003c/p>\n\u003cp>Miron was the 15th person to sign up for the Personal Genome Project, which now counts hundreds of participants; Peshkin and his mother soon followed. The three don’t share the privacy concerns some people have about making their genetic information public.\u003c/p>\n\u003cp>“I didn’t invent my genome,” Peshkin said. “This idea that it’s mine in the sense of property is sort of foreign to me.”\u003c/p>\n\u003cp>His mother said she can’t imagine ways that publishing her genome might hurt her. “This is for science and scientists,” Logvinskaya said in Russian, while Peshkin translated. “Those are not villains. Those are not random people.”\u003c/p>\n\u003cp>A few years after volunteering their information, Personal Genome Project organizers approached the family with a request: Would they participate in a federally funded effort to develop a standard for genetic sequencing?\u003c/p>\n\u003cp>Other fields set standards. A cylinder of platinum-iridium alloy, for instance, sits in a basement vault in the U.K., providing the \u003ca href=\"http://www.npl.co.uk/reference/faqs/where-and-how-is-the-uks-national-standard-kilogram-stored-(faq-mass-and-density)\" target=\"_blank\" rel=\"noopener\">reference weight\u003c/a> used around the world for a kilogram.\u003c/p>\n\u003cp>But when scientists sequence a genome, they have no way of knowing the accuracy of that sequence or whether it’s good enough, because they have no high-quality benchmark to compare it to. It’s that benchmark that the Genome in a Bottle project is working to create, said Justin Zook, a scientist at the National Institute of Standards and Technology and co-leader of the initiative. In addition to the Peshkin family, they’ve now sequenced one pilot genome and one man of Han Chinese descent. They plan to add that man’s parents soon, and eventually others that reflect more ethnic and racial diversity, Zook said.\u003c/p>\n\u003cdiv>\n\u003cdiv>\n\u003cdiv>\n\u003cp>Peshkin said he briefly contemplated one far-out concern with the project: If his was the reference genome, could his own body become valuable to a scientist who wanted to, say, test an Alzheimer’s drug on the real person it was designed to treat?\u003c/p>\n\u003c/div>\n\u003c/div>\n\u003c/div>\n\u003cp>“If my brain is the best brain for the experiment because they’ve been working with cells derived from me, maybe there’s suddenly a price on my head,” Peshkin said. “It’s more like a great plot for a movie, and I dismissed it because I thought it’s a very, very unlikely scenario to worry about.”\u003c/p>\n\u003cp>So he agreed.\u003c/p>\n\u003cp>Data associated with the Genome in a Bottle samples were downloaded to about 15,000 computers worldwide in 2017, Zook said, suggesting that there’s a strong appetite for the information.\u003c/p>\n\u003cp>Weirdly, Peshkin won’t be able to study his own samples; it wouldn’t be safe. Like Henrietta Lacks’ original cells, the ones he donated have been modified to reproduce indefinitely, which is essential for their scientific usefulness. But that makes them extremely dangerous to Peshkin himself — and only him. If he comes into contact with his own modified cells, his body won’t recognize them as foreign. “They will keep multiplying and growing on me and eventually will kill me,” he said matter-of-factly.\u003c/p>\n\u003cfigure class=\"clear\">\n\u003cfigure class=\"wp-caption aligncenter\" style=\"max-width: 1024px\">\u003ca href=\"https://www.statnews.com/wp-content/uploads/2018/06/0613_STAT_LeonidPeshkin010.jpg\">\u003cimg class=\"extendsBeyondTextColumn\" src=\"https://www.statnews.com/wp-content/uploads/2018/06/0613_STAT_LeonidPeshkin010-1024x683.jpg\" alt=\"Leon Peshkin 05\" width=\"1024\" height=\"683\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Peshkin exercises his father’s arm to activate his muscles and get the blood flowing. (Ruby Wallau/STAT)\u003c/figcaption>\u003c/figure>\n\u003c/figure>\n\u003cp>\u003cstrong>Privacy vs. Science\u003c/strong>\u003c/p>\n\u003cp>The Personal Genome Project is now considering what tissue to collect from Miron when his heart or another organ finally gives out, said Michael F. Chou, a lecturer in genetics and director of human subjects research for the project.\u003c/p>\n\u003cp>Miron’s gene sequence and tissue will be publicly available and connected with his health records; \u003ca href=\"https://www.broadinstitute.org/blog/gtex-useful-expression-cancer-research\" target=\"_blank\" rel=\"noopener\">other\u003c/a> gene expression data from tissue has been anonymized. Without that personal data, researchers can’t know if their pancreatic tissue sample came from a diabetic who died of a heart attack in his 50s, for instance, or from someone like Miron, who has lived nearly two decades longer than the average American male.\u003c/p>\n\u003cp>It may sound morbid to contemplate such ideas. But though Peshkin still sees death as pointless and illogical, it would be even more meaningless in his view to bury an intact body in the ground where it can do no good.\u003c/p>\n\u003cp>“I think the best we can do is leave our body to science, even though a lot of science is also a waste,” Peshkin said. “I think that science is the best thing we have.”\u003c/p>\n\u003cp>There isn’t much more time left to make these kinds of decisions.\u003c/p>\n\u003cp>Over the last two weeks Miron has slipped further away. Peshkin is sure his father, whose 97th birthday is July 9, can still hear him. But Miron is not as responsive as he was, his eyes are less alert, his stare more vacant. Peshkin would have given up already if his father hadn’t bounced back twice before, though he concedes that chances are now slim.\u003c/p>\n\u003cp>His father’s palliative care team has scheduled a meeting for Wednesday afternoon. Peshkin expects they will pressure him to dial back on Miron’s aggressive medical care, potentially hastening his demise.\u003c/p>\n\u003cp>He wonders aloud when he will be ready to accept what he still doesn’t think should be inevitable.\u003c/p>\n\u003cp>“I think I will try to fend it off for a little longer,” Peshkin said.\u003c/p>\n\u003cp>\u003cem>Correction: An earlier version of this story misclassified Daphnia on first reference and Peshkin’s field of research.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>This story was originally published by \u003ca href=\"https://www.statnews.com/2018/06/20/anti-aging-researcher-father-death/\" target=\"_blank\" rel=\"noopener\">STAT\u003c/a>, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/442945/anti-aging-researcher-faces-loss-of-his-inspiration-his-96-yr-old-dad","authors":["byline_futureofyou_442945"],"categories":["futureofyou_1"],"tags":["futureofyou_1539","futureofyou_1549","futureofyou_1538","futureofyou_1548","futureofyou_1531","futureofyou_1545","futureofyou_1540","futureofyou_532","futureofyou_1530","futureofyou_1550","futureofyou_1537","futureofyou_1543","futureofyou_1542","futureofyou_1551","futureofyou_1541","futureofyou_141","futureofyou_952","futureofyou_61","futureofyou_1553","futureofyou_1532","futureofyou_1552","futureofyou_1547","futureofyou_1536","futureofyou_294","futureofyou_1544","futureofyou_1546","futureofyou_1533","futureofyou_198","futureofyou_1535","futureofyou_1534"],"collections":["futureofyou_1093","futureofyou_1097","futureofyou_1094"],"featImg":"futureofyou_442947","label":"futureofyou_1094"},"futureofyou_441745":{"type":"posts","id":"futureofyou_441745","meta":{"index":"posts_1591205157","site":"futureofyou","id":"441745","score":null,"sort":[1526929207000]},"guestAuthors":[],"slug":"new-snail-research-could-shake-up-our-understanding-of-memory","title":"New Snail Research Could Shake Up Our Understanding of Memory","publishDate":1526929207,"format":"standard","headTitle":"Future of You | KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>UCLA neuroscientists reported Monday that they have transferred a memory from one animal to another via injections of RNA, a startling result that challenges the widely held view of where and how memories are stored in the brain. [contextly_sidebar id=\"li8sZlyeZueTl33XPD1EtLOaLArCiTWy\"]\u003c/p>\n\u003cp>The finding from the lab of David Glanzman hints at the potential for new RNA-based treatments to one day restore lost memories and, if correct, could shake up the field of memory and learning.\u003c/p>\n\u003cp>“It’s pretty shocking,” said Dr. Todd Sacktor, a neurologist and memory researcher at SUNY Downstate Medical Center in Brooklyn, N.Y. “The big picture is we’re working out the basic alphabet of how memories are stored for the first time.” He was not involved in the research, which was \u003ca href=\"http://www.eneuro.org/content/early/2018/05/14/ENEURO.0038-18.2018\" target=\"_blank\" rel=\"noopener\">published in eNeuro\u003c/a>, the \u003ca href=\"http://www.eneuro.org/\" target=\"_blank\" rel=\"noopener\">online journal\u003c/a> of the Society for Neuroscience.\u003c/p>\n\u003cp>Many scientists are expected to view the research more cautiously. The work is in snails, animals that have proven a powerful model organism for neuroscience but whose simple brains work far differently than those of humans. The experiments will need to be replicated, including in animals with more complex brains. And the results fly in the face of a massive amount of evidence supporting the deeply entrenched idea that memories are stored through changes in the strength of connections, or synapses, between neurons.\u003c/p>\n\u003cp>“If he’s right, this would be absolutely earth-shattering,” said Tomás Ryan, an assistant professor at Trinity College Dublin, whose lab hunts for engrams, or the physical traces of memory. “But I don’t think it’s right.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Glanzman knows his unceremonial demotion of the synapse is not going to go over well in the field. “I expect a lot of astonishment and skepticism,” he said. “I don’t expect people are going to have a parade for me at the next Society for Neuroscience meeting.”\u003c/p>\n\u003cp>Even his own colleagues were dubious. “It took me a long time to convince the people in my lab to do the experiment,” he said. “They thought it was nuts.”\u003c/p>\n\u003cp>Glanzman’s experiments — funded by the National Institutes of Health and the National Science Foundation — involved giving mild electrical shocks to the marine snail Aplysia californica. Shocked snails learn to withdraw their delicate siphons and gills for nearly a minute as a defense when they subsequently receive a weak touch; snails that have not been shocked withdraw only briefly.[contextly_sidebar id=\"hBHp5EEY5u6iaZayEtFqvfhgpnNXWkKq\"]\u003c/p>\n\u003cp>The researchers extracted RNA from the nervous systems of snails that had been shocked and injected the material into unshocked snails. RNA’s primary role is to serve as a messenger inside cells, carrying protein-making instructions from its cousin DNA. But when this RNA was injected, these naive snails withdrew their siphons for extended periods of time after a soft touch. Control snails that received injections of RNA from snails that had not received shocks did not withdraw their siphons for as long.\u003c/p>\n\u003cp>“It’s as if we transferred a memory,” Glanzman said.\u003c/p>\n\u003cp>Glanzman’s group went further, showing that Aplysia sensory neurons in Petri dishes were more excitable, as they tend to be after being shocked, if they were exposed to RNA from shocked snails. Exposure to RNA from snails that had never been shocked did not cause the cells to become more excitable.\u003c/p>\n\u003cdiv>\n\u003cdiv>\n\u003cdiv>\n\u003cp>The results, said Glanzman, suggest that memories may be stored within the nucleus of neurons, where RNA is synthesized and can act on DNA to turn genes on and off. He said he thought memory storage involved these epigenetic changes — changes in the activity of genes and not in the DNA sequences that make up those genes — that are mediated by RNA.\u003c/p>\n\u003c/div>\n\u003c/div>\n\u003c/div>\n\u003cp>This view challenges the widely held notion that memories are stored by enhancing synaptic connections between neurons. Rather, Glanzman sees synaptic changes that occur during memory formation as flowing from the information that the RNA is carrying.\u003c/p>\n\u003cp>“This idea is radical and definitely challenges the field,” said Li-Huei Tsai, a neuroscientist who directs the Picower Institute for Learning and Memory at the Massachusetts Institute of Technology. Tsai, who recently co-authored a \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4874022/\" target=\"_blank\" rel=\"noopener\">major review on memory formation\u003c/a>, called Glanzman’s study “impressive and interesting” and said a number of studies support the notion that epigenetic mechanisms play some role in memory formation, which is likely a complex and multifaceted process. But she said she strongly disagreed with Glanzman’s notion that synaptic connections do not play a key role in memory storage.\u003c/p>\n\u003cp>Trinity College’s Ryan, like Glanzman, stands with a minority of neuroscientists — some call them rebels — who \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/28548457\" target=\"_blank\" rel=\"noopener\">question the idea\u003c/a> that memory is stored through synaptic strength. In 2015, Ryan was lead author of a Science paper with MIT Nobelist Susumu Tonegawa that showed \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/26023136\" target=\"_blank\" rel=\"noopener\">memories could be retrieved\u003c/a> even after synapse strengthening was blocked. Ryan said he is pursuing the idea that memories are stored through ensembles of neurons bound together by new synaptic connections, not by strengthening of existing connections.[contextly_sidebar id=\"U81WeRFYsnSgGUp9A3OIFy9mt8TlGFLL\"]\u003c/p>\n\u003cp>Ryan knows Glanzman and trusts his work. He said he believes the data in the new paper. But he doesn’t think the behavior of the snails, or the cells, proves that RNA is transferring memories. He said he doesn’t understand how RNA, which works on a time scale of minutes to hours, could be causing memory recall that is almost instantaneous, or how RNA could connect numerous parts of the brain, like the auditory and visual systems, that are involved in more complex memories.\u003c/p>\n\u003cp>But Glanzman said he is convinced RNA is playing a role that eclipses the synapse. In 2014, his lab showed that \u003ca href=\"https://elifesciences.org/articles/03896\" target=\"_blank\" rel=\"noopener\">memories of shocks that had been lost\u003c/a> in snails due to a series of experimental procedures could be recovered — but the synapse patterns that were lost with the memory reformed in random ways when the memories were recovered, suggesting memories were not stored there. Glanzman’s lab and others have also shown that long-term memory formation can be blocked by preventing epigenetic changes, even when synapse formation or strengthening is not altered.\u003c/p>\n\u003cp>“Synapses can come and go, but the memory can still be there,” he said, saying he sees synapses as merely the “reflection of knowledge held in the nucleus.”\u003c/p>\n\u003cp>Glanzman has studied memory for more than three decades. He did postdoctoral work with none other than Eric Kandel — the neuroscientist who shared the 2000 Nobel prize for research on Aplysia, probing the role of the synapse in memory — and he said he has spent most of his career believing that synaptic change was the key to memory storage.\u003c/p>\n\u003cp>But he said a series of findings from other labs and his own in recent years have led him to start questioning the synaptic dogma. He calls himself “a recovering synaptologist.”\u003c/p>\n\u003cp>The skepticism over Glanzman’s research may be in part because the work harkens back to an unnerving episode in science involving an unconventional psychologist, James V. McConnell, who spent years at the University of Michigan attempting to prove that something outside the brain — a factor he called “memory RNA” — could transfer memories. In the ’50s and ’60s, McConnell trained flatworms and then fed the bodies of trained worms to untrained worms. The untrained worms then appeared to exhibit the behavior of the trained worms they’d cannibalized, suggesting that memories were somehow transferred. He also showed that trained worms that were beheaded could remember their training after they grew new heads.[contextly_sidebar id=\"F5HcwGf5fX0A2ZqbT4U7VYdgDDaJshog\"]\u003c/p>\n\u003cp>Though the work was replicated by some other labs, McConnell’s work was largely ridiculed and is often described as a cautionary tale because so much time and money was spent by other labs trying, often unsuccessfully, to replicate the work. (McConnell died in 1990, five years after he’d been a target of the Unabomber Theodore Kaczynski.)\u003c/p>\n\u003cp>Recently, developmental biologist Michael Levin at Tufts has \u003ca href=\"https://www.theverge.com/2015/3/18/8225321/memory-research-flatworm-cannibalism-james-mcconnell-michael-levin\" target=\"_blank\" rel=\"noopener\">replicated McConnell’s experiments\u003c/a> on headless worms under more controlled settings and thinks McConnell may have indeed been correct.\u003c/p>\n\u003cp>Glanzman said one of McConnell’s students, Al Jacobson, demonstrated the transfer of memories between flatworms via RNA injections, coincidentally while an assistant professor at UCLA. The work was \u003ca href=\"http://www.nature.com/articles/209599a0\" target=\"_blank\" rel=\"noopener\">published in Nature in 1966\u003c/a> but Jacobsen never received tenure, perhaps because of doubts about his findings. The experiment was, however, \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC224185/\" target=\"_blank\" rel=\"noopener\">replicated in rats\u003c/a> shortly afterward.\u003c/p>\n\u003cp>Glanzman learned about McConnell’s work — and his satirical journal “Worm Runner’s Digest” — while he was a psychology undergraduate at Indiana University but never took the results seriously. Now, while he’s still not convinced McConnell was exactly right about being able to transfer memories, he does think both McConnell and Jacobson were onto something.\u003c/p>\n\u003cp>Working in the memory field can be tough for those who challenge the status quo. SUNY’s Sacktor, for example, has \u003ca href=\"https://www.statnews.com/2016/06/23/memory-research-neuroscience/\">spent more than 25 years\u003c/a> — despite the skepticism, rejection, and outright derision of fellow scientists — chasing down a single molecule, PKMzeta, that he believes is critical to the formation of long-term memories and may be connected to the RNA mechanisms that Glanzman has uncovered.\u003c/p>\n\u003cp>The stakes in the field are high because memory is so key to our sense of self and many scientists feel understanding the workings of memory is something that should have been figured out by now. “It’s the last of the great 20th-century questions in biology,” Sacktor said. “Some aspect has made it difficult for neuroscientists to figure out.”\u003c/p>\n\u003cp>The difficulty may be due in part to the overwhelming focus on synaptic strength. Some 12,000 papers have been published on synaptic strength without providing a good explanation for how memories are stored, Ryan noted, adding that he applauds Glanzman for opening up a new path, radical as it is, to explore.\u003c/p>\n\u003cp>“The reality is we know so little about memory,” Ryan said. “I’m excited about any new vistas and avenues.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This \u003ca href=\"https://www.statnews.com/2018/05/14/memory-transfer-between-snails-challenges-standard-theory/\" target=\"_blank\" rel=\"noopener\">story\u003c/a> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"The finding could shake up the field of memory and hints at the possibility for new RNA-based treatments to one day restore lost memories.","status":"publish","parent":0,"modified":1526926150,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":32,"wordCount":1748},"headData":{"title":"New Snail Research Could Shake Up Our Understanding of Memory | KQED","description":"The finding could shake up the field of memory and hints at the possibility for new RNA-based treatments to one day restore lost memories.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"New Snail Research Could Shake Up Our Understanding of Memory","datePublished":"2018-05-21T19:00:07.000Z","dateModified":"2018-05-21T18:09:10.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"441745 https://ww2.kqed.org/futureofyou/?p=441745","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/05/21/new-snail-research-could-shake-up-our-understanding-of-memory/","disqusTitle":"New Snail Research Could Shake Up Our Understanding of Memory","source":"Health","nprByline":"Usha Lee McFarling\u003cbr />STAT","path":"/futureofyou/441745/new-snail-research-could-shake-up-our-understanding-of-memory","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>UCLA neuroscientists reported Monday that they have transferred a memory from one animal to another via injections of RNA, a startling result that challenges the widely held view of where and how memories are stored in the brain. \u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The finding from the lab of David Glanzman hints at the potential for new RNA-based treatments to one day restore lost memories and, if correct, could shake up the field of memory and learning.\u003c/p>\n\u003cp>“It’s pretty shocking,” said Dr. Todd Sacktor, a neurologist and memory researcher at SUNY Downstate Medical Center in Brooklyn, N.Y. “The big picture is we’re working out the basic alphabet of how memories are stored for the first time.” He was not involved in the research, which was \u003ca href=\"http://www.eneuro.org/content/early/2018/05/14/ENEURO.0038-18.2018\" target=\"_blank\" rel=\"noopener\">published in eNeuro\u003c/a>, the \u003ca href=\"http://www.eneuro.org/\" target=\"_blank\" rel=\"noopener\">online journal\u003c/a> of the Society for Neuroscience.\u003c/p>\n\u003cp>Many scientists are expected to view the research more cautiously. The work is in snails, animals that have proven a powerful model organism for neuroscience but whose simple brains work far differently than those of humans. The experiments will need to be replicated, including in animals with more complex brains. And the results fly in the face of a massive amount of evidence supporting the deeply entrenched idea that memories are stored through changes in the strength of connections, or synapses, between neurons.\u003c/p>\n\u003cp>“If he’s right, this would be absolutely earth-shattering,” said Tomás Ryan, an assistant professor at Trinity College Dublin, whose lab hunts for engrams, or the physical traces of memory. “But I don’t think it’s right.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Glanzman knows his unceremonial demotion of the synapse is not going to go over well in the field. “I expect a lot of astonishment and skepticism,” he said. “I don’t expect people are going to have a parade for me at the next Society for Neuroscience meeting.”\u003c/p>\n\u003cp>Even his own colleagues were dubious. “It took me a long time to convince the people in my lab to do the experiment,” he said. “They thought it was nuts.”\u003c/p>\n\u003cp>Glanzman’s experiments — funded by the National Institutes of Health and the National Science Foundation — involved giving mild electrical shocks to the marine snail Aplysia californica. Shocked snails learn to withdraw their delicate siphons and gills for nearly a minute as a defense when they subsequently receive a weak touch; snails that have not been shocked withdraw only briefly.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The researchers extracted RNA from the nervous systems of snails that had been shocked and injected the material into unshocked snails. RNA’s primary role is to serve as a messenger inside cells, carrying protein-making instructions from its cousin DNA. But when this RNA was injected, these naive snails withdrew their siphons for extended periods of time after a soft touch. Control snails that received injections of RNA from snails that had not received shocks did not withdraw their siphons for as long.\u003c/p>\n\u003cp>“It’s as if we transferred a memory,” Glanzman said.\u003c/p>\n\u003cp>Glanzman’s group went further, showing that Aplysia sensory neurons in Petri dishes were more excitable, as they tend to be after being shocked, if they were exposed to RNA from shocked snails. Exposure to RNA from snails that had never been shocked did not cause the cells to become more excitable.\u003c/p>\n\u003cdiv>\n\u003cdiv>\n\u003cdiv>\n\u003cp>The results, said Glanzman, suggest that memories may be stored within the nucleus of neurons, where RNA is synthesized and can act on DNA to turn genes on and off. He said he thought memory storage involved these epigenetic changes — changes in the activity of genes and not in the DNA sequences that make up those genes — that are mediated by RNA.\u003c/p>\n\u003c/div>\n\u003c/div>\n\u003c/div>\n\u003cp>This view challenges the widely held notion that memories are stored by enhancing synaptic connections between neurons. Rather, Glanzman sees synaptic changes that occur during memory formation as flowing from the information that the RNA is carrying.\u003c/p>\n\u003cp>“This idea is radical and definitely challenges the field,” said Li-Huei Tsai, a neuroscientist who directs the Picower Institute for Learning and Memory at the Massachusetts Institute of Technology. Tsai, who recently co-authored a \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4874022/\" target=\"_blank\" rel=\"noopener\">major review on memory formation\u003c/a>, called Glanzman’s study “impressive and interesting” and said a number of studies support the notion that epigenetic mechanisms play some role in memory formation, which is likely a complex and multifaceted process. But she said she strongly disagreed with Glanzman’s notion that synaptic connections do not play a key role in memory storage.\u003c/p>\n\u003cp>Trinity College’s Ryan, like Glanzman, stands with a minority of neuroscientists — some call them rebels — who \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/28548457\" target=\"_blank\" rel=\"noopener\">question the idea\u003c/a> that memory is stored through synaptic strength. In 2015, Ryan was lead author of a Science paper with MIT Nobelist Susumu Tonegawa that showed \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/26023136\" target=\"_blank\" rel=\"noopener\">memories could be retrieved\u003c/a> even after synapse strengthening was blocked. Ryan said he is pursuing the idea that memories are stored through ensembles of neurons bound together by new synaptic connections, not by strengthening of existing connections.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Ryan knows Glanzman and trusts his work. He said he believes the data in the new paper. But he doesn’t think the behavior of the snails, or the cells, proves that RNA is transferring memories. He said he doesn’t understand how RNA, which works on a time scale of minutes to hours, could be causing memory recall that is almost instantaneous, or how RNA could connect numerous parts of the brain, like the auditory and visual systems, that are involved in more complex memories.\u003c/p>\n\u003cp>But Glanzman said he is convinced RNA is playing a role that eclipses the synapse. In 2014, his lab showed that \u003ca href=\"https://elifesciences.org/articles/03896\" target=\"_blank\" rel=\"noopener\">memories of shocks that had been lost\u003c/a> in snails due to a series of experimental procedures could be recovered — but the synapse patterns that were lost with the memory reformed in random ways when the memories were recovered, suggesting memories were not stored there. Glanzman’s lab and others have also shown that long-term memory formation can be blocked by preventing epigenetic changes, even when synapse formation or strengthening is not altered.\u003c/p>\n\u003cp>“Synapses can come and go, but the memory can still be there,” he said, saying he sees synapses as merely the “reflection of knowledge held in the nucleus.”\u003c/p>\n\u003cp>Glanzman has studied memory for more than three decades. He did postdoctoral work with none other than Eric Kandel — the neuroscientist who shared the 2000 Nobel prize for research on Aplysia, probing the role of the synapse in memory — and he said he has spent most of his career believing that synaptic change was the key to memory storage.\u003c/p>\n\u003cp>But he said a series of findings from other labs and his own in recent years have led him to start questioning the synaptic dogma. He calls himself “a recovering synaptologist.”\u003c/p>\n\u003cp>The skepticism over Glanzman’s research may be in part because the work harkens back to an unnerving episode in science involving an unconventional psychologist, James V. McConnell, who spent years at the University of Michigan attempting to prove that something outside the brain — a factor he called “memory RNA” — could transfer memories. In the ’50s and ’60s, McConnell trained flatworms and then fed the bodies of trained worms to untrained worms. The untrained worms then appeared to exhibit the behavior of the trained worms they’d cannibalized, suggesting that memories were somehow transferred. He also showed that trained worms that were beheaded could remember their training after they grew new heads.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Though the work was replicated by some other labs, McConnell’s work was largely ridiculed and is often described as a cautionary tale because so much time and money was spent by other labs trying, often unsuccessfully, to replicate the work. (McConnell died in 1990, five years after he’d been a target of the Unabomber Theodore Kaczynski.)\u003c/p>\n\u003cp>Recently, developmental biologist Michael Levin at Tufts has \u003ca href=\"https://www.theverge.com/2015/3/18/8225321/memory-research-flatworm-cannibalism-james-mcconnell-michael-levin\" target=\"_blank\" rel=\"noopener\">replicated McConnell’s experiments\u003c/a> on headless worms under more controlled settings and thinks McConnell may have indeed been correct.\u003c/p>\n\u003cp>Glanzman said one of McConnell’s students, Al Jacobson, demonstrated the transfer of memories between flatworms via RNA injections, coincidentally while an assistant professor at UCLA. The work was \u003ca href=\"http://www.nature.com/articles/209599a0\" target=\"_blank\" rel=\"noopener\">published in Nature in 1966\u003c/a> but Jacobsen never received tenure, perhaps because of doubts about his findings. The experiment was, however, \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC224185/\" target=\"_blank\" rel=\"noopener\">replicated in rats\u003c/a> shortly afterward.\u003c/p>\n\u003cp>Glanzman learned about McConnell’s work — and his satirical journal “Worm Runner’s Digest” — while he was a psychology undergraduate at Indiana University but never took the results seriously. Now, while he’s still not convinced McConnell was exactly right about being able to transfer memories, he does think both McConnell and Jacobson were onto something.\u003c/p>\n\u003cp>Working in the memory field can be tough for those who challenge the status quo. SUNY’s Sacktor, for example, has \u003ca href=\"https://www.statnews.com/2016/06/23/memory-research-neuroscience/\">spent more than 25 years\u003c/a> — despite the skepticism, rejection, and outright derision of fellow scientists — chasing down a single molecule, PKMzeta, that he believes is critical to the formation of long-term memories and may be connected to the RNA mechanisms that Glanzman has uncovered.\u003c/p>\n\u003cp>The stakes in the field are high because memory is so key to our sense of self and many scientists feel understanding the workings of memory is something that should have been figured out by now. “It’s the last of the great 20th-century questions in biology,” Sacktor said. “Some aspect has made it difficult for neuroscientists to figure out.”\u003c/p>\n\u003cp>The difficulty may be due in part to the overwhelming focus on synaptic strength. Some 12,000 papers have been published on synaptic strength without providing a good explanation for how memories are stored, Ryan noted, adding that he applauds Glanzman for opening up a new path, radical as it is, to explore.\u003c/p>\n\u003cp>“The reality is we know so little about memory,” Ryan said. “I’m excited about any new vistas and avenues.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>This \u003ca href=\"https://www.statnews.com/2018/05/14/memory-transfer-between-snails-challenges-standard-theory/\" target=\"_blank\" rel=\"noopener\">story\u003c/a> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/441745/new-snail-research-could-shake-up-our-understanding-of-memory","authors":["byline_futureofyou_441745"],"programs":["futureofyou_54"],"categories":["futureofyou_1","futureofyou_73"],"tags":["futureofyou_56","futureofyou_61","futureofyou_1047","futureofyou_294"],"featImg":"futureofyou_441749","label":"source_futureofyou_441745"},"futureofyou_441261":{"type":"posts","id":"futureofyou_441261","meta":{"index":"posts_1591205157","site":"futureofyou","id":"441261","score":null,"sort":[1525388451000]},"guestAuthors":[],"slug":"in-monkeys-researchers-find-possible-biological-marker-of-autism","title":"In Monkeys, Researchers Find Possible Biological Marker of Autism","publishDate":1525388451,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{"site":"futureofyou"},"content":"\u003cp class=\"big-cap-wrap danger-zone\">\u003cspan class=\"big-cap\">R\u003c/span>esearchers have been left empty-handed so far in their quest to uncover some measurable biological signal that could be used to \u003ca href=\"https://www.statnews.com/2017/02/15/brain-scan-autism-infant-diagnose/\">diagnose autism spectrum disorder\u003c/a>, leaving clinicians to identify the condition just based on a child’s behavior.\u003c/p>\n\u003cp class=\"danger-zone\">But on Wednesday, \u003ca href=\"http://stm.sciencemag.org/lookup/doi/10.1126/scitranslmed.aam9100\" target=\"_blank\" rel=\"noopener\">scientists reported\u003c/a> in the journal Science Translational Medicine that a hormone that regulates blood pressure could be one of those signposts.\u003c/p>\n\u003cp class=\"danger-zone\">They found that low concentrations of the molecule — called arginine vasopressin, or AVP — in the cerebrospinal fluid corresponded to autism-like social behavior in male monkeys, while a high AVP concentration signaled the most social animals. And they discovered similar results when looking at AVP concentrations in the cerebrospinal fluid, or CSF, of a small group of boys.\u003c/p>\n\u003cp class=\"\">“It’s really exciting work,” said Dr. Mollie Meffert, a molecular neuroscientist at Johns Hopkins, who was not involved in the study. “One of the most interesting things is the finding that the vasopressin in the CSF correlates with sociality in the macaques and in autism with children.”\u003c/p>\n\u003cp class=\"\">Meffert said if vasopressin concentrations are confirmed to correspond to \u003ca href=\"https://www.statnews.com/2016/03/31/autism-rate/\">autism\u003c/a>, they could perhaps be used to diagnose the condition and as a gauge to measure the effect of treatment candidates. And Karen Parker, the lead author of the study and associate professor of psychiatry and behavioral sciences at Stanford, said that the hormone could become a drug target if future studies show boosting its levels can assuage the social impairments of autism spectrum disorder.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Autism is diagnosed based on social and communication deficits and repetitive behaviors like hand-flapping or obsessions.\u003c/p>\n\u003cp>A biological diagnostic test for autism is so important, researchers say, because the earlier children start therapeutic interventions, the better the results. Without a medical test, children are typically diagnosed \u003ca href=\"https://www.cdc.gov/mmwr/volumes/67/ss/ss6706a1.htm?s_cid=ss6706a1_w\" target=\"_blank\" rel=\"noopener\">around age 4 1/2\u003c/a>, based on their behavior or a lag in their development.\u003c/p>\n\u003cp>Parker emphasized that the study’s findings are preliminary, and that the discovery of low AVP concentrations in boys with autism was based on so few samples that it needs to be replicated in a larger study. Future studies will also explore whether that association holds in adults and if levels of AVP or other hormones are associated with autism in girls and female animals.\u003c/p>\n\u003cp>Parker added that parents should not try to treat their children with vasopressin, which is used to regulate blood pressure and to treat a condition called diabetes insipidus, given that it has not been tested in autism, it’s not clear what the appropriate dose would be, and it can have \u003ca href=\"https://www.emedicinehealth.com/drug-vasopressin/article_em.htm#sideeffects\" target=\"_blank\" rel=\"noopener\">significant side effects.\u003c/a>\u003c/p>\n\u003cp>One challenge in studying the underlying biology of autism spectrum disorder is the lack of reliable rodent models of the condition. But Parker and colleagues have \u003ca href=\"http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0165401\" target=\"_blank\" rel=\"noopener\">in past studies\u003c/a> established that the natural\u003cstrong> \u003c/strong>variation of social functioning in monkeys can serve as a solid stand-in for people.\u003c/p>\n\u003cp>“They have the complex social cognition that we would care about for the control individuals, and if we can identify animals that have a deficit that’s spontaneously occurring — like humans do — that’s the value of the model,” said Parker, who is also an affiliate scientist at the California National Primate Research Center.\u003c/p>\n\u003cp>For the new study, the researchers identified 15 male rhesus macaques that exhibited low sociality, meaning they weren’t interested in playing with or grooming their fellow macaques, along with 15 highly social monkeys. They then ran tests looking for any significant differences in nine biological markers that \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/24462936\" target=\"_blank\" rel=\"noopener\">had been implicated\u003c/a> \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/26483618\" target=\"_blank\" rel=\"noopener\">in past studies\u003c/a> as possibly linked to autism, including the expression of certain genes, the products of certain signaling pathways, and the concentrations of the hormones AVP and oxytocin.\u003c/p>\n\u003cp>Only one stood out as a marker for the differences in social behavior: the concentration of AVP in the monkey’s cerebrospinal fluid, a colorless material that coats the brain and spinal cord. Notably, the levels of AVP in the blood showed no significant divergence in the two groups of monkeys.\u003c/p>\n\u003cp>To confirm their results, the researchers looked at a second group of male monkeys and again homed in on AVP concentration in the cerebrospinal fluid as being correlated to the sociality of the monkey — the lower the AVP, the less they interacted with their fellow macaques.\u003c/p>\n\u003cp>Then it was time to look at people.\u003c/p>\n\u003cp>Because obtaining cerebrospinal fluid is invasive — it requires a lumbar tap — the researchers relied on samples that had been previously collected from boys for other medical reasons, often as part of a chemotherapy treatment. They found that boys with autism spectrum disorder had lower AVP concentrations in their CSF, though with only 14 samples total — seven from control boys and seven from boys with autism spectrum disorder — the researchers could not draw firm conclusions.\u003c/p>\n\u003cp>Parker said that it’s not clear if low AVP concentrations in the cerebrospinal fluid might contribute to the social problems of autism or just be another consequence of the condition. She also added that it would likely just be one biological marker of autism, which has complicated, multifaceted causes.\u003c/p>\n\u003cp>But she said researchers have for several decades viewed vasopressin as an key influencer of social function, particularly in male animals. If AVP does indeed have some role to play in autism spectrum disorder, then its importance in males could help explain in part why \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/28545751\" target=\"_blank\" rel=\"noopener\">three to four times\u003c/a> more males are diagnosed with the condition than \u003ca href=\"https://www.statnews.com/2016/10/25/autism-girls-reveal-secrets/\">females\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“When people talk about autism, one of the things that feels a bit neglected is that the prevalence is very male-biased,” Parker said. “So if you’re thinking about disease mechanisms, it would be really interesting to think about the biology that’s informative to either male or female functioning.”\u003c/p>\n\n","blocks":[],"excerpt":null,"status":"publish","parent":0,"modified":1525373470,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":16,"wordCount":994},"headData":{"title":"In Monkeys, Researchers Find Possible Biological Marker of Autism | KQED","description":"Researchers have been left empty-handed so far in their quest to uncover some measurable biological signal that could be used to diagnose autism spectrum disorder, leaving clinicians to identify the condition just based on a child’s behavior. But on Wednesday, scientists reported in the journal Science Translational Medicine that a hormone that regulates blood pressure could be one","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"In Monkeys, Researchers Find Possible Biological Marker of Autism","datePublished":"2018-05-03T23:00:51.000Z","dateModified":"2018-05-03T18:51:10.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"441261 https://ww2.kqed.org/futureofyou/?p=441261","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/05/03/in-monkeys-researchers-find-possible-biological-marker-of-autism/","disqusTitle":"In Monkeys, Researchers Find Possible Biological Marker of Autism","path":"/futureofyou/441261/in-monkeys-researchers-find-possible-biological-marker-of-autism","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp class=\"big-cap-wrap danger-zone\">\u003cspan class=\"big-cap\">R\u003c/span>esearchers have been left empty-handed so far in their quest to uncover some measurable biological signal that could be used to \u003ca href=\"https://www.statnews.com/2017/02/15/brain-scan-autism-infant-diagnose/\">diagnose autism spectrum disorder\u003c/a>, leaving clinicians to identify the condition just based on a child’s behavior.\u003c/p>\n\u003cp class=\"danger-zone\">But on Wednesday, \u003ca href=\"http://stm.sciencemag.org/lookup/doi/10.1126/scitranslmed.aam9100\" target=\"_blank\" rel=\"noopener\">scientists reported\u003c/a> in the journal Science Translational Medicine that a hormone that regulates blood pressure could be one of those signposts.\u003c/p>\n\u003cp class=\"danger-zone\">They found that low concentrations of the molecule — called arginine vasopressin, or AVP — in the cerebrospinal fluid corresponded to autism-like social behavior in male monkeys, while a high AVP concentration signaled the most social animals. And they discovered similar results when looking at AVP concentrations in the cerebrospinal fluid, or CSF, of a small group of boys.\u003c/p>\n\u003cp class=\"\">“It’s really exciting work,” said Dr. Mollie Meffert, a molecular neuroscientist at Johns Hopkins, who was not involved in the study. “One of the most interesting things is the finding that the vasopressin in the CSF correlates with sociality in the macaques and in autism with children.”\u003c/p>\n\u003cp class=\"\">Meffert said if vasopressin concentrations are confirmed to correspond to \u003ca href=\"https://www.statnews.com/2016/03/31/autism-rate/\">autism\u003c/a>, they could perhaps be used to diagnose the condition and as a gauge to measure the effect of treatment candidates. And Karen Parker, the lead author of the study and associate professor of psychiatry and behavioral sciences at Stanford, said that the hormone could become a drug target if future studies show boosting its levels can assuage the social impairments of autism spectrum disorder.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Autism is diagnosed based on social and communication deficits and repetitive behaviors like hand-flapping or obsessions.\u003c/p>\n\u003cp>A biological diagnostic test for autism is so important, researchers say, because the earlier children start therapeutic interventions, the better the results. Without a medical test, children are typically diagnosed \u003ca href=\"https://www.cdc.gov/mmwr/volumes/67/ss/ss6706a1.htm?s_cid=ss6706a1_w\" target=\"_blank\" rel=\"noopener\">around age 4 1/2\u003c/a>, based on their behavior or a lag in their development.\u003c/p>\n\u003cp>Parker emphasized that the study’s findings are preliminary, and that the discovery of low AVP concentrations in boys with autism was based on so few samples that it needs to be replicated in a larger study. Future studies will also explore whether that association holds in adults and if levels of AVP or other hormones are associated with autism in girls and female animals.\u003c/p>\n\u003cp>Parker added that parents should not try to treat their children with vasopressin, which is used to regulate blood pressure and to treat a condition called diabetes insipidus, given that it has not been tested in autism, it’s not clear what the appropriate dose would be, and it can have \u003ca href=\"https://www.emedicinehealth.com/drug-vasopressin/article_em.htm#sideeffects\" target=\"_blank\" rel=\"noopener\">significant side effects.\u003c/a>\u003c/p>\n\u003cp>One challenge in studying the underlying biology of autism spectrum disorder is the lack of reliable rodent models of the condition. But Parker and colleagues have \u003ca href=\"http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0165401\" target=\"_blank\" rel=\"noopener\">in past studies\u003c/a> established that the natural\u003cstrong> \u003c/strong>variation of social functioning in monkeys can serve as a solid stand-in for people.\u003c/p>\n\u003cp>“They have the complex social cognition that we would care about for the control individuals, and if we can identify animals that have a deficit that’s spontaneously occurring — like humans do — that’s the value of the model,” said Parker, who is also an affiliate scientist at the California National Primate Research Center.\u003c/p>\n\u003cp>For the new study, the researchers identified 15 male rhesus macaques that exhibited low sociality, meaning they weren’t interested in playing with or grooming their fellow macaques, along with 15 highly social monkeys. They then ran tests looking for any significant differences in nine biological markers that \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/24462936\" target=\"_blank\" rel=\"noopener\">had been implicated\u003c/a> \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/26483618\" target=\"_blank\" rel=\"noopener\">in past studies\u003c/a> as possibly linked to autism, including the expression of certain genes, the products of certain signaling pathways, and the concentrations of the hormones AVP and oxytocin.\u003c/p>\n\u003cp>Only one stood out as a marker for the differences in social behavior: the concentration of AVP in the monkey’s cerebrospinal fluid, a colorless material that coats the brain and spinal cord. Notably, the levels of AVP in the blood showed no significant divergence in the two groups of monkeys.\u003c/p>\n\u003cp>To confirm their results, the researchers looked at a second group of male monkeys and again homed in on AVP concentration in the cerebrospinal fluid as being correlated to the sociality of the monkey — the lower the AVP, the less they interacted with their fellow macaques.\u003c/p>\n\u003cp>Then it was time to look at people.\u003c/p>\n\u003cp>Because obtaining cerebrospinal fluid is invasive — it requires a lumbar tap — the researchers relied on samples that had been previously collected from boys for other medical reasons, often as part of a chemotherapy treatment. They found that boys with autism spectrum disorder had lower AVP concentrations in their CSF, though with only 14 samples total — seven from control boys and seven from boys with autism spectrum disorder — the researchers could not draw firm conclusions.\u003c/p>\n\u003cp>Parker said that it’s not clear if low AVP concentrations in the cerebrospinal fluid might contribute to the social problems of autism or just be another consequence of the condition. She also added that it would likely just be one biological marker of autism, which has complicated, multifaceted causes.\u003c/p>\n\u003cp>But she said researchers have for several decades viewed vasopressin as an key influencer of social function, particularly in male animals. If AVP does indeed have some role to play in autism spectrum disorder, then its importance in males could help explain in part why \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/28545751\" target=\"_blank\" rel=\"noopener\">three to four times\u003c/a> more males are diagnosed with the condition than \u003ca href=\"https://www.statnews.com/2016/10/25/autism-girls-reveal-secrets/\">females\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“When people talk about autism, one of the things that feels a bit neglected is that the prevalence is very male-biased,” Parker said. “So if you’re thinking about disease mechanisms, it would be really interesting to think about the biology that’s informative to either male or female functioning.”\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/441261/in-monkeys-researchers-find-possible-biological-marker-of-autism","authors":["11428"],"categories":["futureofyou_1"],"tags":["futureofyou_555","futureofyou_56","futureofyou_61","futureofyou_294"],"featImg":"futureofyou_441264","label":"futureofyou"},"futureofyou_441174":{"type":"posts","id":"futureofyou_441174","meta":{"index":"posts_1591205157","site":"futureofyou","id":"441174","score":null,"sort":[1525201206000]},"guestAuthors":[],"slug":"drug-sanctuaries-offer-hope-for-a-post-antibiotic-world","title":"‘Drug Sanctuaries’ Offer Hope for a Post-Antibiotic World","publishDate":1525201206,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>We are at risk of entering a post-antibiotic era.\u003c/p>\n\u003cp>Each year since 2013, a major global institution — including the \u003ca href=\"http://reports.weforum.org/global-risks-2013/risk-case-1/the-dangers-of-hubris-on-human-health/\" target=\"_blank\" rel=\"noopener\">World Economic Forum\u003c/a>, the \u003ca href=\"http://www.who.int/antimicrobial-resistance/global-action-plan/en/\" target=\"_blank\" rel=\"noopener\">World Health Organization\u003c/a> and the \u003ca href=\"http://www.un.org/ga/search/view_doc.asp?symbol=A/71/L.2&referer=/english/&Lang=E\" target=\"_blank\" rel=\"noopener\">United Nations General Assembly\u003c/a> — has issued this grave warning to the world.[contextly_sidebar id=\"XV9iH3usDUjTEoRS7VEResmysvKM5CrO\"]\u003c/p>\n\u003cp>A \u003ca href=\"https://theconversation.com/canada-could-lead-the-fight-for-life-in-a-post-antibiotic-world-80864\" target=\"_blank\" rel=\"noopener\">post-antibiotic future is daunting\u003c/a>. When the drugs don’t work, we get sicker more often. We stay sicker longer. This hurts the economy because sick people don’t work.\u003c/p>\n\u003cp>In response, we really only have two options.\u003c/p>\n\u003cp>One is to gather more arrows in our quiver — by discovering new antibiotics to which microbes like bacteria are not currently resistant.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The second is to manage our current arsenal of drugs better so that they remain effective for as long as possible. The key to doing this is to reduce the global burden of antibiotic resistance by decreasing the quantity of drugs we use.\u003c/p>\n\u003cp>\u003cstrong>Delivering drugs differently\u003cbr>\n\u003c/strong>The first strategy of response to antibiotic resistance is not as easy as it sounds. While there are many potential new therapies that could be effective, there are few incentives for industry to invest in their development.\u003c/p>\n\u003cp>If an antibiotic works well, it is used for a short time — a few days to a couple of weeks at the most. The \u003ca href=\"https://www.pharmaceutical-journal.com/news-and-analysis/features/why-are-there-so-few-antibiotics-in-the-research-and-development-pipeline/11130209.article\" target=\"_blank\" rel=\"noopener\">commercial return on a drug designed to treat longer lasting non-communicable illnesses, like cancer, for instance, can be much higher\u003c/a> because the drugs are used for longer.\u003c/p>\n\u003cp>The logic of the second strategy is straightforward. The widespread use of antibiotics in medicine and agriculture means that a drug-resistant variant of a bacterium will enjoy a strong selective advantage and can quickly spread. So by reducing the use of drugs, we reduce the selection pressure on resistance and slow the rate at which resistance evolves and spreads. Simple.[contextly_sidebar id=\"VbydMq0RqS7R9WIF0Ye7B1EZAyZoMl2y\"]\u003c/p>\n\u003cp>Except it’s not. How, precisely, should we reduce the volume of drugs we use?\u003c/p>\n\u003cp>We can’t just introduce a blanket ban on prescriptions and stop using drugs altogether. If my loved one is sick and there is a drug that can make them better, I want that drug.\u003c/p>\n\u003cp>But maybe we could deliver our drugs in ways that would make it harder for resistance to evolve and spread? And so prolong the amount of time a drug remains effective?\u003c/p>\n\u003cp>\u003cstrong>Creating drug sanctuaries\u003cbr>\n\u003c/strong>One suggestion that\u003ca href=\"http://kassenlab.weebly.com/\" target=\"_blank\" rel=\"noopener\"> my research group\u003c/a> has been exploring is to make use of \u003ca href=\"https://onlinelibrary.wiley.com/doi/abs/10.1002/evl3.43\" target=\"_blank\" rel=\"noopener\">drug sanctuaries, or drug-free environments\u003c/a> — to effectively reduce the strength of selection for resistance.\u003c/p>\n\u003cp>If drug-sensitive variants of microbes have a growth advantage over resistant ones when no drug is around, then sensitive variants would predominate in drug-free refuges and help keep resistant ones from taking over the population.\u003c/p>\n\u003cp>Drug sanctuaries could be used in hospitals. For example, different wards could restrict the use of certain drugs (generating a form of spatial sanctuary) or could alternate the use of a drug on the same ward over time (a form of temporal sanctuary).\u003c/p>\n\u003cp>Evolutionary models can help guide us here. Variation in time is like paying taxes: You can’t avoid it. A variant that evolves in a temporally varying environment is the one that does best across all conditions experienced.\u003c/p>\n\u003cp>Variation in space, on the other hand, provides more options because the different locations can act as refuges for the specialized variants of bacteria. Because those locations are always available, then specialists can coexist indefinitely. At least in theory.\u003c/p>\n\u003cp>\u003cstrong>Buying us time\u003cbr>\n\u003c/strong>This seems to be what happened when we did an experiment to test the theory.\u003c/p>\n\u003cp>Resistance to the commonly used antibiotic ciprofloxacin took longer to spread in laboratory populations of the opportunistic pathogen Pseudomonas aeruginosa — a bacterium that causes acute infections in hospitals, especially intensive- care units, and chronic infections in the lungs of cystic fibrosis patients — when drug sanctuaries were experienced in space rather than time.\u003c/p>\n\u003cp>Resistant and sensitive genetic variants actually coexisted in spatial sanctuaries because of a trade-off between resistance and growth rate.\u003c/p>\n\u003cp>Resistant variants could withstand the drug, but grew far more slowly than sensitive ones in the sanctuary. The result was that neither could be eliminated by natural selection.[contextly_sidebar id=\"MjDUXQparIcTA4fgoyev9hL5QsR382iY\"]\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>What surprised us, though, was that over time, this trade-off broke down.\u003c/p>\n\u003cdiv class=\"post__col \">\n\u003cdiv class=\"post__col-right\">\n\u003carticle>\n\u003cdiv class=\"body-text\">\n\u003cp>The resistant strains actually gained mutations that improved their ability to grow in the absence of the drug. By the end of the experiment, most populations in the spatial sanctuary were dominated by antibiotic-resistant strains.\u003c/p>\n\u003cp>Evidently drug sanctuaries in space could allow us to keep using drugs for longer, but not indefinitely. Eventually we will need new arrows in our quiver.\u003c/p>\n\u003cp>\u003cstrong>A challenge for evolutionary biology\u003cbr>\n\u003c/strong>Our experiments are highly contrived and restricted to one strain of one pathogen evolving in response to one drug in the defined and controlled conditions of a laboratory.\u003c/p>\n\u003cp>Whether our conclusions hold for other bugs and other drugs, or more complicated networks of transmission characteristic of hospitals and the communities they are embedded in, remains to be seen.\u003c/p>\n\u003cp>What our work allows us to do is get directly at the ecological and genetic mechanisms responsible for the emergence, coexistence and eventual demise of diversity.\u003c/p>\n\u003cp>Using these evolutionary principles in more complex, real-world situations to manage our arsenal of drugs for as long as possible will be a major challenge for evolutionary biology in the years to come.\u003c/p>\n\u003c/div>\n\u003c/article>\n\u003c/div>\n\u003c/div>\n\n","blocks":[],"excerpt":"One key to reducing the global burden of antibiotic resistance is by decreasing the quantity of drugs we use. But we can’t just introduce a blanket ban on prescriptions and stop using drugs altogether. ","status":"publish","parent":0,"modified":1525173275,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":30,"wordCount":919},"headData":{"title":"‘Drug Sanctuaries’ Offer Hope for a Post-Antibiotic World | KQED","description":"One key to reducing the global burden of antibiotic resistance is by decreasing the quantity of drugs we use. But we can’t just introduce a blanket ban on prescriptions and stop using drugs altogether. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"‘Drug Sanctuaries’ Offer Hope for a Post-Antibiotic World","datePublished":"2018-05-01T19:00:06.000Z","dateModified":"2018-05-01T11:14:35.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"441174 https://ww2.kqed.org/futureofyou/?p=441174","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/05/01/drug-sanctuaries-offer-hope-for-a-post-antibiotic-world/","disqusTitle":"‘Drug Sanctuaries’ Offer Hope for a Post-Antibiotic World","source":"Health","nprByline":"Rees Kassen\u003cbr />The Conversation","path":"/futureofyou/441174/drug-sanctuaries-offer-hope-for-a-post-antibiotic-world","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>We are at risk of entering a post-antibiotic era.\u003c/p>\n\u003cp>Each year since 2013, a major global institution — including the \u003ca href=\"http://reports.weforum.org/global-risks-2013/risk-case-1/the-dangers-of-hubris-on-human-health/\" target=\"_blank\" rel=\"noopener\">World Economic Forum\u003c/a>, the \u003ca href=\"http://www.who.int/antimicrobial-resistance/global-action-plan/en/\" target=\"_blank\" rel=\"noopener\">World Health Organization\u003c/a> and the \u003ca href=\"http://www.un.org/ga/search/view_doc.asp?symbol=A/71/L.2&referer=/english/&Lang=E\" target=\"_blank\" rel=\"noopener\">United Nations General Assembly\u003c/a> — has issued this grave warning to the world.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>A \u003ca href=\"https://theconversation.com/canada-could-lead-the-fight-for-life-in-a-post-antibiotic-world-80864\" target=\"_blank\" rel=\"noopener\">post-antibiotic future is daunting\u003c/a>. When the drugs don’t work, we get sicker more often. We stay sicker longer. This hurts the economy because sick people don’t work.\u003c/p>\n\u003cp>In response, we really only have two options.\u003c/p>\n\u003cp>One is to gather more arrows in our quiver — by discovering new antibiotics to which microbes like bacteria are not currently resistant.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The second is to manage our current arsenal of drugs better so that they remain effective for as long as possible. The key to doing this is to reduce the global burden of antibiotic resistance by decreasing the quantity of drugs we use.\u003c/p>\n\u003cp>\u003cstrong>Delivering drugs differently\u003cbr>\n\u003c/strong>The first strategy of response to antibiotic resistance is not as easy as it sounds. While there are many potential new therapies that could be effective, there are few incentives for industry to invest in their development.\u003c/p>\n\u003cp>If an antibiotic works well, it is used for a short time — a few days to a couple of weeks at the most. The \u003ca href=\"https://www.pharmaceutical-journal.com/news-and-analysis/features/why-are-there-so-few-antibiotics-in-the-research-and-development-pipeline/11130209.article\" target=\"_blank\" rel=\"noopener\">commercial return on a drug designed to treat longer lasting non-communicable illnesses, like cancer, for instance, can be much higher\u003c/a> because the drugs are used for longer.\u003c/p>\n\u003cp>The logic of the second strategy is straightforward. The widespread use of antibiotics in medicine and agriculture means that a drug-resistant variant of a bacterium will enjoy a strong selective advantage and can quickly spread. So by reducing the use of drugs, we reduce the selection pressure on resistance and slow the rate at which resistance evolves and spreads. Simple.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Except it’s not. How, precisely, should we reduce the volume of drugs we use?\u003c/p>\n\u003cp>We can’t just introduce a blanket ban on prescriptions and stop using drugs altogether. If my loved one is sick and there is a drug that can make them better, I want that drug.\u003c/p>\n\u003cp>But maybe we could deliver our drugs in ways that would make it harder for resistance to evolve and spread? And so prolong the amount of time a drug remains effective?\u003c/p>\n\u003cp>\u003cstrong>Creating drug sanctuaries\u003cbr>\n\u003c/strong>One suggestion that\u003ca href=\"http://kassenlab.weebly.com/\" target=\"_blank\" rel=\"noopener\"> my research group\u003c/a> has been exploring is to make use of \u003ca href=\"https://onlinelibrary.wiley.com/doi/abs/10.1002/evl3.43\" target=\"_blank\" rel=\"noopener\">drug sanctuaries, or drug-free environments\u003c/a> — to effectively reduce the strength of selection for resistance.\u003c/p>\n\u003cp>If drug-sensitive variants of microbes have a growth advantage over resistant ones when no drug is around, then sensitive variants would predominate in drug-free refuges and help keep resistant ones from taking over the population.\u003c/p>\n\u003cp>Drug sanctuaries could be used in hospitals. For example, different wards could restrict the use of certain drugs (generating a form of spatial sanctuary) or could alternate the use of a drug on the same ward over time (a form of temporal sanctuary).\u003c/p>\n\u003cp>Evolutionary models can help guide us here. Variation in time is like paying taxes: You can’t avoid it. A variant that evolves in a temporally varying environment is the one that does best across all conditions experienced.\u003c/p>\n\u003cp>Variation in space, on the other hand, provides more options because the different locations can act as refuges for the specialized variants of bacteria. Because those locations are always available, then specialists can coexist indefinitely. At least in theory.\u003c/p>\n\u003cp>\u003cstrong>Buying us time\u003cbr>\n\u003c/strong>This seems to be what happened when we did an experiment to test the theory.\u003c/p>\n\u003cp>Resistance to the commonly used antibiotic ciprofloxacin took longer to spread in laboratory populations of the opportunistic pathogen Pseudomonas aeruginosa — a bacterium that causes acute infections in hospitals, especially intensive- care units, and chronic infections in the lungs of cystic fibrosis patients — when drug sanctuaries were experienced in space rather than time.\u003c/p>\n\u003cp>Resistant and sensitive genetic variants actually coexisted in spatial sanctuaries because of a trade-off between resistance and growth rate.\u003c/p>\n\u003cp>Resistant variants could withstand the drug, but grew far more slowly than sensitive ones in the sanctuary. The result was that neither could be eliminated by natural selection.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>What surprised us, though, was that over time, this trade-off broke down.\u003c/p>\n\u003cdiv class=\"post__col \">\n\u003cdiv class=\"post__col-right\">\n\u003carticle>\n\u003cdiv class=\"body-text\">\n\u003cp>The resistant strains actually gained mutations that improved their ability to grow in the absence of the drug. By the end of the experiment, most populations in the spatial sanctuary were dominated by antibiotic-resistant strains.\u003c/p>\n\u003cp>Evidently drug sanctuaries in space could allow us to keep using drugs for longer, but not indefinitely. Eventually we will need new arrows in our quiver.\u003c/p>\n\u003cp>\u003cstrong>A challenge for evolutionary biology\u003cbr>\n\u003c/strong>Our experiments are highly contrived and restricted to one strain of one pathogen evolving in response to one drug in the defined and controlled conditions of a laboratory.\u003c/p>\n\u003cp>Whether our conclusions hold for other bugs and other drugs, or more complicated networks of transmission characteristic of hospitals and the communities they are embedded in, remains to be seen.\u003c/p>\n\u003cp>What our work allows us to do is get directly at the ecological and genetic mechanisms responsible for the emergence, coexistence and eventual demise of diversity.\u003c/p>\n\u003cp>Using these evolutionary principles in more complex, real-world situations to manage our arsenal of drugs for as long as possible will be a major challenge for evolutionary biology in the years to come.\u003c/p>\n\u003c/div>\n\u003c/article>\n\u003c/div>\n\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/441174/drug-sanctuaries-offer-hope-for-a-post-antibiotic-world","authors":["byline_futureofyou_441174"],"categories":["futureofyou_1","futureofyou_73"],"tags":["futureofyou_1184","futureofyou_697","futureofyou_952","futureofyou_1056","futureofyou_294"],"featImg":"futureofyou_441195","label":"source_futureofyou_441174"},"futureofyou_440367":{"type":"posts","id":"futureofyou_440367","meta":{"index":"posts_1591205157","site":"futureofyou","id":"440367","score":null,"sort":[1521748381000]},"guestAuthors":[],"slug":"a-dietary-supplement-makes-old-mice-youthful-will-it-work-in-people","title":"A Dietary Supplement Makes Old Mice Youthful. Will It Work in People?","publishDate":1521748381,"format":"standard","headTitle":"Future of You | KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>Transfusing \u003ca href=\"https://www.statnews.com/2018/03/02/young-blood-anti-aging-study/\" target=\"_blank\" rel=\"noopener\">young blood\u003c/a> and freezing heads may get most of the anti-aging and life-extension buzz, but don’t count out the molecule hunters: After setbacks and stumbles and what critics called \u003ca href=\"http://blogs.sciencemag.org/pipeline/archives/2010/01/12/the_sirtris_compounds_worthless_really\" target=\"_blank\" rel=\"noopener\">debacles\u003c/a>, these scientists are figuring out which biochemicals might potentially, possibly be fountains of youth in pill form.[contextly_sidebar id=\"YaFBEqHshnjDvp4XR5pAEiDxJjAI7Fx4\"]\u003c/p>\n\u003cp>In the latest advance, biologists \u003ca href=\"http://www.cell.com/cell/fulltext/S0092-8674(18)30152-1\" target=\"_blank\" rel=\"noopener\">reported\u003c/a> on Thursday that a molecule already sold by supplement makers (even as scientists scramble to understand it) restored youthfulness to blood vessels in 20-month-old mice, an age comparable to 70 years in people. The research supports the idea that boosting certain genes and molecules that fade with age could keep people functional, resilient, and even spry well into their 80s, even without living longer.\u003c/p>\n\u003cp>“I think it’s quite an important paper,” said Dr. Eric Verdin, of the California-based Buck Institute for Research on Aging, who was not involved in the\u003ca href=\"https://www.kqed.org/futureofyou/439750/superagers-maintain-memory-into-80s-and-90s\" target=\"_blank\" rel=\"noopener\"> new research\u003c/a>. “It’s probably not the magic pill everyone is looking for, but it’s one more brick in our efforts to understand aging and healthspan,” or how long people can stay biologically young(ish) even as their birthday candles proliferate.[contextly_sidebar id=\"Vl0Meh1Zh9UAHnk3RIGR5S5B5rBQ0sSW\"]\u003c/p>\n\u003cp>Others were more skeptical, calling the advance at best “incremental” (and asking to remain anonymous so as not to antagonize colleagues). And science is littered with examples of compounds that worked in mice but not people. “It’s hard to tell how significant any contribution is until it has been replicated and extended” by other labs, said David Harrison of the Jackson Lab, an expert on the molecular \u003ca href=\"https://www.kqed.org/futureofyou/440080/hearts-get-younger-even-at-middle-age-with-exercise\" target=\"_blank\" rel=\"noopener\">mechanisms of aging.\u003c/a>\u003c/p>\n\u003caside>\u003c/aside>\n\u003cp>The new study, in Cell, found that boosting mice’s levels of the naturally occurring molecule NMN, which humans also have, increased levels of another called NAD+. That, in turn, raised levels of a famous anti-aging enzyme called SIRT1, which has been the focus of nearly 30 years of research.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>After two months of NMN, more blood vessels sprouted in the old mice’s muscles. The density of the smallest vessels — capillaries — became comparable to that of young mice. Blood flow increased, and the animals’ endurance, measured by how long they could run on a treadmill before becoming exhausted, was 56 percent to 80 percent greater than that of untreated old mice: 1,400 feet compared to 780 feet.[contextly_sidebar id=\"8Tmsn0Ufo1g8AeUi0b3OJ5Td2G7sq49c\"]\u003c/p>\n\u003cp>The treated mice also benefitted from exercise like mice half their age. In young animals, exercise spurs the creation of new blood vessels and boosts muscle mass, but that effect weakens with age in both people and mice. NMN restored the blood-vessel- and muscle-boosting effects of a good treadmill run, basically “reversing vascular aging in the mice,” said study co-leader David Sinclair of Harvard Medical School.\u003c/p>\n\u003cp>\u003cimg class=\"aligncenter wp-image-440373 size-medium\" title=\"iStock\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/03/iStock-639071970-800x588.jpg\" alt=\"\" width=\"800\" height=\"588\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-639071970-800x588.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-639071970-160x118.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-639071970-768x564.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-639071970-1020x749.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-639071970-1920x1411.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-639071970-1180x867.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-639071970-960x705.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-639071970-240x176.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-639071970-375x275.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-639071970-520x382.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/p>\n\u003cp>Opinions differed on how important that is. One expert on the biology of aging said, “So David’s found another molecule that prevents aging?” (Sinclair was a prominent exponent of resveratrol, a compound that slowed aging in mice but proved disappointing in people.) The Jax’s Harrison questioned whether the inbred mice used in the study were representative of humans, who are genetically diverse.\u003c/p>\n\u003cp>New blood vessels could also be a mixed blessing. They support the growth of tumors, which is why anti-angiogenesis molecules have become cancer drugs. The scientists found no excess cancers in the mice given NMR, but “more study is warranted,” they wrote.[contextly_sidebar id=\"EmvIbKqj3sGiXrLYKODcw1UEPJNlCkZr\"]\u003c/p>\n\u003cp>The blood-vessel benefits of NMN didn’t happen if the mice lacked the SIRT1 gene, probably the brightest star in the anti-aging firmament. In the 1990s, it and the six other genes belonging to the family called sirtuins took aging research by storm, as biologists showed that increasing the genes’ activity extended lifespan in yeast, roundworms, and fruit flies by up to 30 percent. When Massachusetts Institute of Technology’s Leonard Guarente, whose lab was sirtuin central, found that the lifespan-extending effect of drastic caloric restriction works by turning up sirtuin genes, it seemed to point the way to slowing aging: Activate sirtuins with a molecule.\u003c/p>\n\u003cp>That proved easier said than done. Some studies, especially in higher animals, contradicted the simple notion that overexpression of sirtuins translated into longer life. The biggest setback involved resveratrol, a compound found in grapes and wine, which activates the SIRT1 gene. After years of hyperbolic headlines and soaring sales, the resveratrol bubble burst. GlaxoSmithKline bought Cambridge, Mass.-based Sirtris Pharmaceuticals, which Sinclair co-founded in 2004 to develop sirtuin-boosting compounds, for $720 million, but within five years essentially shut it down.[contextly_sidebar id=\"FSd7BTxFEMjJhm2kkUJ0cTaJQITZc3CT\"]\u003c/p>\n\u003cp>“Resveratrol is very, very good [at activating SIRT1 and extending lifespan] if you’re a mouse,” said Guarente, who cheerfully acknowledges buying a 10-year supply of micronized resveratrol. Most of it is still in his basement. “But the human trials were all over the place, which was unsettling,” he said.\u003c/p>\n\u003cp>Those failures led scientists to search for other sirtuin-boosting molecules. In 2014, Guarente co-founded Elysium Health, which, for $40 to $60 per month, sells a dietary supplement that boosts NAD+ levels and activates SIRT1. Since levels of NAD+ fall as people age, the hope is that providing the raw material for it will raise those levels, slowing aging. The pills seem to be safe, Guarente and colleagues \u003ca href=\"https://www.nature.com/articles/s41514-017-0016-9\" target=\"_blank\" rel=\"noopener\">reported\u003c/a> last year, and additional human studies are underway to test whether they benefit health.\u003c/p>\n\u003cp>Thanks to \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3188402/\" target=\"_blank\" rel=\"noopener\">negative studies\u003c/a>, the jury is still out on whether anything related to sirtuins will extend lifespan, but the Cell study offers some hope for extending healthspan. If boosting NAD+ promotes blood vessel formation via SIRT1, it might “rescue muscle mass” that otherwise decreases as blood vessels atrophy, Guarente said. That could prevent the bone loss, frailty, and falls that can be fatal in old age.\u003c/p>\n\u003cp>“Anything that contributes to muscle health through vascular health is likely to be quite important,” said the Buck Institute’s Verdin, who takes a daily NAD+ precursor.\u003c/p>\n\u003caside>\u003c/aside>\n\u003cp>Sinclair and his team are now studying whether raising NAD+ might also spur the creation of blood vessels in the brain. There and in other organs, said Sinclair, “the lack of oxygen and buildup of waste products” that results from loss of small blood vessels “sets off a downward spiral of disease and disability.” In the brain, that would include vascular dementia.\u003c/p>\n\u003cp>Sinclair takes NMN to boost NAD+ levels. “In someone my age [49], it’s probably harder to see immediate benefits,” he said, though he said he feels sharper and younger on it. After his 78-year-old father began taking NMN “he started climbing mountains and going whitewater rafting and looking forward to the next five years,” Sinclair said. “It might be psychological, but it isn’t hurting.”\u003c/p>\n\u003cp>Only rigorous human research can determine that. Metro International Biotech, a Michigan-based startup for which Sinclair consults, just finished a clinical trial of the safety of a proprietary version of NMN and hopes to start a trial of the molecule’s efficacy this year, Sinclair said.\u003c/p>\n\u003cp>One concern is that boosting sirtuins could backfire. An excess of the molecules, Verdin said, can promote autoimmunity, which causes diseases such as Crohn’s and rheumatoid arthritis.\u003c/p>\n\u003cp>“That should give us pause about broad claims of what they can do,” he cautioned. “I worry sometimes that [with NAD+-boosting pills already on the market] the field is getting ahead of itself.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This story was originally published by\u003ca href=\"https://www.statnews.com/\" target=\"_blank\" rel=\"noopener\"> STAT\u003c/a>, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"Biologists found that a supplement already sold in stores restored youthfulness to blood vessels in mice.","status":"publish","parent":0,"modified":1521748407,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":24,"wordCount":1324},"headData":{"title":"A Dietary Supplement Makes Old Mice Youthful. Will It Work in People? | KQED","description":"Biologists found that a supplement already sold in stores restored youthfulness to blood vessels in mice.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"A Dietary Supplement Makes Old Mice Youthful. Will It Work in People?","datePublished":"2018-03-22T19:53:01.000Z","dateModified":"2018-03-22T19:53:27.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"440367 https://ww2.kqed.org/futureofyou/?p=440367","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/03/22/a-dietary-supplement-makes-old-mice-youthful-will-it-work-in-people/","disqusTitle":"A Dietary Supplement Makes Old Mice Youthful. Will It Work in People?","source":"Hope/Hype","nprByline":"Sharon Begley\u003c/BR>\u003cstrong>STAT\u003c/strong>","path":"/futureofyou/440367/a-dietary-supplement-makes-old-mice-youthful-will-it-work-in-people","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Transfusing \u003ca href=\"https://www.statnews.com/2018/03/02/young-blood-anti-aging-study/\" target=\"_blank\" rel=\"noopener\">young blood\u003c/a> and freezing heads may get most of the anti-aging and life-extension buzz, but don’t count out the molecule hunters: After setbacks and stumbles and what critics called \u003ca href=\"http://blogs.sciencemag.org/pipeline/archives/2010/01/12/the_sirtris_compounds_worthless_really\" target=\"_blank\" rel=\"noopener\">debacles\u003c/a>, these scientists are figuring out which biochemicals might potentially, possibly be fountains of youth in pill form.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>In the latest advance, biologists \u003ca href=\"http://www.cell.com/cell/fulltext/S0092-8674(18)30152-1\" target=\"_blank\" rel=\"noopener\">reported\u003c/a> on Thursday that a molecule already sold by supplement makers (even as scientists scramble to understand it) restored youthfulness to blood vessels in 20-month-old mice, an age comparable to 70 years in people. The research supports the idea that boosting certain genes and molecules that fade with age could keep people functional, resilient, and even spry well into their 80s, even without living longer.\u003c/p>\n\u003cp>“I think it’s quite an important paper,” said Dr. Eric Verdin, of the California-based Buck Institute for Research on Aging, who was not involved in the\u003ca href=\"https://www.kqed.org/futureofyou/439750/superagers-maintain-memory-into-80s-and-90s\" target=\"_blank\" rel=\"noopener\"> new research\u003c/a>. “It’s probably not the magic pill everyone is looking for, but it’s one more brick in our efforts to understand aging and healthspan,” or how long people can stay biologically young(ish) even as their birthday candles proliferate.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Others were more skeptical, calling the advance at best “incremental” (and asking to remain anonymous so as not to antagonize colleagues). And science is littered with examples of compounds that worked in mice but not people. “It’s hard to tell how significant any contribution is until it has been replicated and extended” by other labs, said David Harrison of the Jackson Lab, an expert on the molecular \u003ca href=\"https://www.kqed.org/futureofyou/440080/hearts-get-younger-even-at-middle-age-with-exercise\" target=\"_blank\" rel=\"noopener\">mechanisms of aging.\u003c/a>\u003c/p>\n\u003caside>\u003c/aside>\n\u003cp>The new study, in Cell, found that boosting mice’s levels of the naturally occurring molecule NMN, which humans also have, increased levels of another called NAD+. That, in turn, raised levels of a famous anti-aging enzyme called SIRT1, which has been the focus of nearly 30 years of research.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>After two months of NMN, more blood vessels sprouted in the old mice’s muscles. The density of the smallest vessels — capillaries — became comparable to that of young mice. Blood flow increased, and the animals’ endurance, measured by how long they could run on a treadmill before becoming exhausted, was 56 percent to 80 percent greater than that of untreated old mice: 1,400 feet compared to 780 feet.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The treated mice also benefitted from exercise like mice half their age. In young animals, exercise spurs the creation of new blood vessels and boosts muscle mass, but that effect weakens with age in both people and mice. NMN restored the blood-vessel- and muscle-boosting effects of a good treadmill run, basically “reversing vascular aging in the mice,” said study co-leader David Sinclair of Harvard Medical School.\u003c/p>\n\u003cp>\u003cimg class=\"aligncenter wp-image-440373 size-medium\" title=\"iStock\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/03/iStock-639071970-800x588.jpg\" alt=\"\" width=\"800\" height=\"588\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-639071970-800x588.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-639071970-160x118.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-639071970-768x564.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-639071970-1020x749.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-639071970-1920x1411.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-639071970-1180x867.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-639071970-960x705.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-639071970-240x176.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-639071970-375x275.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-639071970-520x382.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/p>\n\u003cp>Opinions differed on how important that is. One expert on the biology of aging said, “So David’s found another molecule that prevents aging?” (Sinclair was a prominent exponent of resveratrol, a compound that slowed aging in mice but proved disappointing in people.) The Jax’s Harrison questioned whether the inbred mice used in the study were representative of humans, who are genetically diverse.\u003c/p>\n\u003cp>New blood vessels could also be a mixed blessing. They support the growth of tumors, which is why anti-angiogenesis molecules have become cancer drugs. The scientists found no excess cancers in the mice given NMR, but “more study is warranted,” they wrote.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The blood-vessel benefits of NMN didn’t happen if the mice lacked the SIRT1 gene, probably the brightest star in the anti-aging firmament. In the 1990s, it and the six other genes belonging to the family called sirtuins took aging research by storm, as biologists showed that increasing the genes’ activity extended lifespan in yeast, roundworms, and fruit flies by up to 30 percent. When Massachusetts Institute of Technology’s Leonard Guarente, whose lab was sirtuin central, found that the lifespan-extending effect of drastic caloric restriction works by turning up sirtuin genes, it seemed to point the way to slowing aging: Activate sirtuins with a molecule.\u003c/p>\n\u003cp>That proved easier said than done. Some studies, especially in higher animals, contradicted the simple notion that overexpression of sirtuins translated into longer life. The biggest setback involved resveratrol, a compound found in grapes and wine, which activates the SIRT1 gene. After years of hyperbolic headlines and soaring sales, the resveratrol bubble burst. GlaxoSmithKline bought Cambridge, Mass.-based Sirtris Pharmaceuticals, which Sinclair co-founded in 2004 to develop sirtuin-boosting compounds, for $720 million, but within five years essentially shut it down.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>“Resveratrol is very, very good [at activating SIRT1 and extending lifespan] if you’re a mouse,” said Guarente, who cheerfully acknowledges buying a 10-year supply of micronized resveratrol. Most of it is still in his basement. “But the human trials were all over the place, which was unsettling,” he said.\u003c/p>\n\u003cp>Those failures led scientists to search for other sirtuin-boosting molecules. In 2014, Guarente co-founded Elysium Health, which, for $40 to $60 per month, sells a dietary supplement that boosts NAD+ levels and activates SIRT1. Since levels of NAD+ fall as people age, the hope is that providing the raw material for it will raise those levels, slowing aging. The pills seem to be safe, Guarente and colleagues \u003ca href=\"https://www.nature.com/articles/s41514-017-0016-9\" target=\"_blank\" rel=\"noopener\">reported\u003c/a> last year, and additional human studies are underway to test whether they benefit health.\u003c/p>\n\u003cp>Thanks to \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3188402/\" target=\"_blank\" rel=\"noopener\">negative studies\u003c/a>, the jury is still out on whether anything related to sirtuins will extend lifespan, but the Cell study offers some hope for extending healthspan. If boosting NAD+ promotes blood vessel formation via SIRT1, it might “rescue muscle mass” that otherwise decreases as blood vessels atrophy, Guarente said. That could prevent the bone loss, frailty, and falls that can be fatal in old age.\u003c/p>\n\u003cp>“Anything that contributes to muscle health through vascular health is likely to be quite important,” said the Buck Institute’s Verdin, who takes a daily NAD+ precursor.\u003c/p>\n\u003caside>\u003c/aside>\n\u003cp>Sinclair and his team are now studying whether raising NAD+ might also spur the creation of blood vessels in the brain. There and in other organs, said Sinclair, “the lack of oxygen and buildup of waste products” that results from loss of small blood vessels “sets off a downward spiral of disease and disability.” In the brain, that would include vascular dementia.\u003c/p>\n\u003cp>Sinclair takes NMN to boost NAD+ levels. “In someone my age [49], it’s probably harder to see immediate benefits,” he said, though he said he feels sharper and younger on it. After his 78-year-old father began taking NMN “he started climbing mountains and going whitewater rafting and looking forward to the next five years,” Sinclair said. “It might be psychological, but it isn’t hurting.”\u003c/p>\n\u003cp>Only rigorous human research can determine that. Metro International Biotech, a Michigan-based startup for which Sinclair consults, just finished a clinical trial of the safety of a proprietary version of NMN and hopes to start a trial of the molecule’s efficacy this year, Sinclair said.\u003c/p>\n\u003cp>One concern is that boosting sirtuins could backfire. An excess of the molecules, Verdin said, can promote autoimmunity, which causes diseases such as Crohn’s and rheumatoid arthritis.\u003c/p>\n\u003cp>“That should give us pause about broad claims of what they can do,” he cautioned. “I worry sometimes that [with NAD+-boosting pills already on the market] the field is getting ahead of itself.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>This story was originally published by\u003ca href=\"https://www.statnews.com/\" target=\"_blank\" rel=\"noopener\"> STAT\u003c/a>, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/440367/a-dietary-supplement-makes-old-mice-youthful-will-it-work-in-people","authors":["byline_futureofyou_440367"],"programs":["futureofyou_54"],"categories":["futureofyou_1060","futureofyou_1062","futureofyou_1","futureofyou_73"],"tags":["futureofyou_61","futureofyou_1144","futureofyou_978","futureofyou_294","futureofyou_1434"],"collections":["futureofyou_1093","futureofyou_1097"],"featImg":"futureofyou_440369","label":"source_futureofyou_440367"},"futureofyou_440341":{"type":"posts","id":"futureofyou_440341","meta":{"index":"posts_1591205157","site":"futureofyou","id":"440341","score":null,"sort":[1521570643000]},"guestAuthors":[],"slug":"as-towns-lose-their-newspapers-disease-detectives-left-flying-blind","title":"As Towns Lose Their Newspapers, Disease Detectives Left Flying Blind","publishDate":1521570643,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{"term":1093,"site":"futureofyou"},"content":"\u003cp>Maia Majumder was on Twitter earlier this month when she saw a map that terrified her.\u003c/p>\n\u003cp>The map recorded the number of local newspapers in each county across the United States. Large swaths were shaded light pink, denoting a county that had no local newspaper at all. As a record of the decline of the American newspaper industry, it was disconcerting.\u003c/p>\n\u003cp>But Majumder, a scientist who specializes in mathematical modeling, saw something different in the splotches of light pink: a disaster for infectious disease surveillance.\u003c/p>\n\u003cp>Epidemiologists rely on all kinds of data to detect the spread of disease, including reports from local and state agencies and social media. But local newspapers are critical to identifying outbreaks and forecasting their trajectories.\u003c/p>\n\u003caside class=\"pullquote alignright\">'“Local media is the bedrock of internet surveillance.’ \u003ccite>John Brownstein, Healthmap\u003c/cite>\u003c/aside>\n\u003cp>On the map, Majumder saw every county without a local newspaper as a community where health officials and disease researchers could be flying blind.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“We rely very heavily on local news. And I think what this will probably mean is that there are going to be pockets of the U.S. where we’re just not going to have a particularly good signal anymore,” said Majumder, a Ph.D. candidate at the Massachusetts Institute of Technology.\u003c/p>\n\u003cp>Majumder is a computational epidemiology research fellow at HealthMap, a 12-year-old disease detection project run by researchers from Boston Children’s Hospital. The website uses nontraditional data sources — reports from local news outlets and social media platforms among them— to track global infectious disease activity in real time.\u003c/p>\n\u003cp>\u003cimg class=\"size-medium wp-image-295309 aligncenter\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2050/12/newspapers-800x533.gif\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2050/12/newspapers-800x533.gif 800w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/newspapers-160x107.gif 160w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/newspapers-768x512.gif 768w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/newspapers-1020x680.gif 1020w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/newspapers-1920x1280.gif 1920w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/newspapers-1180x787.gif 1180w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/newspapers-960x640.gif 960w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/newspapers-240x160.gif 240w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/newspapers-375x250.gif 375w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/newspapers-520x347.gif 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">The information HealthMap gathers is used not only by public health authorities, but by researchers around the world who are studying things like the changing geographic distribution of diseases — think Zika — and the impact of climate change on disease patterns, said John Brownstein, one of the co-founders of the site.\u003c/p>\n\u003cp>“Local media is the bedrock of internet surveillance — the kind of work that we do in terms of scouring the web looking for early signs of something taking place in a community,” explained Brownstein, chief innovation officer at Boston Children’s and a pioneer in the field of using sources other than public health data to do this type of work.\u003c/p>\n\u003cp>He pointed to the 2009 H1N1 influenza pandemic as an example of a case in which local reporting helped to bring an emerging disease threat to global attention.\u003c/p>\n\u003cp>\u003cstrong>Tracking an Outbreak\u003c/strong>\u003cbr>\nThe Centers for Disease Control and Prevention was the first agency to detect that two young children in California had been infected with a flu strain circulated in pigs. As officials were trying to figure out if the cases were blips or part of something bigger, however, disease detectives began crawling through recent media reports to determine whether unusual numbers of people with flu-like illness in Mexico had also been sickened by the new virus. It turned out they had been. The new virus was spreading.[contextly_sidebar id=\"eRWHDjM3IMP7OEH2GlfugYXA5fly6vp3\"]\u003c/p>\n\u003cp>“It makes sense that if we see a reduction in local reporting, you’re not going to have that early signaling of something in a community,” Brownstein said.\u003c/p>\n\u003cp>Without local reporting, it’s also harder to follow an outbreak and assess its progress. Majumder used the example of the massive 2016-2017 mumps outbreak in northwestern Arkansas to illustrate the point.\u003c/p>\n\u003cp>She and colleagues were trying to figure out why the outbreak was so large — nearly 3,000 cases all told. Had the virus simply found its way into an area with lots of unvaccinated children? Or was something else driving transmission?\u003c/p>\n\u003cp>That’s the kind of information that is hugely helpful to public health authorities struggling to control an outbreak. But Majumder found she couldn’t easily get her hands on key data; the Arkansas Department of Public Health issued regular updates, but the agency did not archive previous updates on its website. Getting access to official data can be a time-consuming process.\u003c/p>\n\u003cp>“There is a lot of red tape to get data sharing privileges, even around something as simple as cumulative case counts over time,” she said.\u003c/p>\n\u003cp>The Northwest Arkansas Democrat-Gazette, however, was covering the outbreak closely, and its coverage provided important context for Majumder’s research. Some of the paper’s stories noted that the vaccine refusal rate in that region was higher than anywhere else in the state; others made clear disease was spreading in a local community of people from the Marshall Islands who had been vaccinated.\u003c/p>\n\u003cp>\u003cimg class=\"size-medium wp-image-440343 aligncenter\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/03/iStock-691796746-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-691796746-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-691796746-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-691796746-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-691796746-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-691796746-1920x1280.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-691796746-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-691796746-960x640.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-691796746-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-691796746-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-691796746-520x347.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">Both those factors proved key in helping public health officials better understand what was driving the outbreak, Majumder said.\u003c/p>\n\u003cp>The World Health Organization urges countries to augment their official disease surveillance efforts — which draw information from networks of doctor’s offices, hospitals, and public health laboratories — with what’s known as “event-based surveillance,” said Dr. Larry Madoff, editor of ProMED, the Program for Monitoring Emerging Diseases. The internet-based outbreak reporting system — which reports on human, animal, and plant disease outbreaks — operates under the auspices of the International Society for Infectious Diseases.\u003c/p>\n\u003cp>Event-based surveillance is more informal and relies on systems that pick up on media reports, rumors on social media, and the like. That’s the way news of the 2003 SARS outbreak emerged. Internet chatter about a disease that was sickening and killing people in China made its way to the WHO before Chinese authorities eventually disclosed the existence of an outbreak that had been raging for several months.[contextly_sidebar id=\"pHkMIHqxoK7nvOZ2Rw6M77aUOBH1WSHD\"]\u003c/p>\n\u003cp>“It is well-known that event-based surveillance depends on healthy, local journalism,” said Madoff, who is also director of the Massachusetts Department of Health’s division of epidemiology and immunization. “So it would be a reasonable assumption that the loss of local sources would increase the time required to discover an outbreak.”\u003c/p>\n\u003cp>Like HealthMap, ProMED casts its net globally. In some countries, there are not many local media sources, or if there are, those news sources aren’t available on the internet. In those places, ProMED has to rely on word-of-mouth — which may become the case in parts of the U.S. as local news outlets are shuttered, Madoff said.\u003c/p>\n\u003cp>He’s not sure if ProMED is starting to miss things because of the shrinking number of local news sources. “There’s a huge volume of information and we get what we get. So it’s hard to say what we’re missing, necessarily. But I can easily imagine that we might,” he said.\u003c/p>\n\u003cp>\u003cstrong>Social Media\u003c/strong>\u003c/p>\n\u003cp>Newspapers, of course, aren’t the only source of local news. But a town that can’t support a newspaper may not have radio and television stations either. Radio and TV stations may not archive their reports online, or those reports may not be archived in print form, meaning their archives are harder to search, Majumder said.\u003c/p>\n\u003cp>Social media cannot fill the gap created by the declining local news coverage, she and others involved in this type of research argued. “With Twitter … you are picking up a signal, but that signal might not be precise,” said Alessandro Vespignani, a professor at Northeastern University whose research focuses on modeling of epidemics. And social media reports can be simply wrong, he said — either by accident or design. News coverage “anchors” the signals picked up on social media, Vespignani said.[contextly_sidebar id=\"67Do4Phey2ezXlhxwIvDAmFbf798Cd3r\"]\u003c/p>\n\u003cp>“When you combine data from multiple data sources … including data collected from news alerts, we can gain a better handle on the situational awareness in a given community or country,” agreed Mauricio Santillana, an assistant professor at Harvard Medical School whose research focuses on use of novel data sources to track and forecast disease outbreaks.\u003c/p>\n\u003cp>Majumder said she and colleagues would like to look at whether the growth of “news deserts” — communities without local news sources — has already had an impact on the amount of data HealthMap has been harvesting from under-covered parts of the United States.\u003c/p>\n\u003cp>One of the reasons the news desert map scared her, she said, was because she realized many of the places without local papers are also places where voters have been complaining of being left behind.\u003c/p>\n\u003cp>“What that means is they lose access to news which is very, very vital for knowing what’s going on in your town,” Majumder said. “But also from the public health surveillance point of view, we’re losing access to knowing what they need.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This \u003ca href=\"https://www.statnews.com/2018/03/20/news-deserts-infectious-disease/\" target=\"_blank\" rel=\"noopener\">story\u003c/a> was originally published by \u003ca href=\"https://www.statnews.com/\" target=\"_blank\" rel=\"noopener\">STAT, \u003c/a>an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"Scientists say a decline of the newspaper industry spells disaster for infectious disease surveillance.","status":"publish","parent":0,"modified":1521570643,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":33,"wordCount":1494},"headData":{"title":"As Towns Lose Their Newspapers, Disease Detectives Left Flying Blind | KQED","description":"Scientists say a decline of the newspaper industry spells disaster for infectious disease surveillance.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"As Towns Lose Their Newspapers, Disease Detectives Left Flying Blind","datePublished":"2018-03-20T18:30:43.000Z","dateModified":"2018-03-20T18:30:43.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"440341 https://ww2.kqed.org/futureofyou/?p=440341","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/03/20/as-towns-lose-their-newspapers-disease-detectives-left-flying-blind/","disqusTitle":"As Towns Lose Their Newspapers, Disease Detectives Left Flying Blind","nprByline":"Helen Branswell\u003cbr />STAT News","path":"/futureofyou/440341/as-towns-lose-their-newspapers-disease-detectives-left-flying-blind","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Maia Majumder was on Twitter earlier this month when she saw a map that terrified her.\u003c/p>\n\u003cp>The map recorded the number of local newspapers in each county across the United States. Large swaths were shaded light pink, denoting a county that had no local newspaper at all. As a record of the decline of the American newspaper industry, it was disconcerting.\u003c/p>\n\u003cp>But Majumder, a scientist who specializes in mathematical modeling, saw something different in the splotches of light pink: a disaster for infectious disease surveillance.\u003c/p>\n\u003cp>Epidemiologists rely on all kinds of data to detect the spread of disease, including reports from local and state agencies and social media. But local newspapers are critical to identifying outbreaks and forecasting their trajectories.\u003c/p>\n\u003caside class=\"pullquote alignright\">'“Local media is the bedrock of internet surveillance.’ \u003ccite>John Brownstein, Healthmap\u003c/cite>\u003c/aside>\n\u003cp>On the map, Majumder saw every county without a local newspaper as a community where health officials and disease researchers could be flying blind.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“We rely very heavily on local news. And I think what this will probably mean is that there are going to be pockets of the U.S. where we’re just not going to have a particularly good signal anymore,” said Majumder, a Ph.D. candidate at the Massachusetts Institute of Technology.\u003c/p>\n\u003cp>Majumder is a computational epidemiology research fellow at HealthMap, a 12-year-old disease detection project run by researchers from Boston Children’s Hospital. The website uses nontraditional data sources — reports from local news outlets and social media platforms among them— to track global infectious disease activity in real time.\u003c/p>\n\u003cp>\u003cimg class=\"size-medium wp-image-295309 aligncenter\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2050/12/newspapers-800x533.gif\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2050/12/newspapers-800x533.gif 800w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/newspapers-160x107.gif 160w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/newspapers-768x512.gif 768w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/newspapers-1020x680.gif 1020w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/newspapers-1920x1280.gif 1920w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/newspapers-1180x787.gif 1180w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/newspapers-960x640.gif 960w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/newspapers-240x160.gif 240w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/newspapers-375x250.gif 375w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/newspapers-520x347.gif 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">The information HealthMap gathers is used not only by public health authorities, but by researchers around the world who are studying things like the changing geographic distribution of diseases — think Zika — and the impact of climate change on disease patterns, said John Brownstein, one of the co-founders of the site.\u003c/p>\n\u003cp>“Local media is the bedrock of internet surveillance — the kind of work that we do in terms of scouring the web looking for early signs of something taking place in a community,” explained Brownstein, chief innovation officer at Boston Children’s and a pioneer in the field of using sources other than public health data to do this type of work.\u003c/p>\n\u003cp>He pointed to the 2009 H1N1 influenza pandemic as an example of a case in which local reporting helped to bring an emerging disease threat to global attention.\u003c/p>\n\u003cp>\u003cstrong>Tracking an Outbreak\u003c/strong>\u003cbr>\nThe Centers for Disease Control and Prevention was the first agency to detect that two young children in California had been infected with a flu strain circulated in pigs. As officials were trying to figure out if the cases were blips or part of something bigger, however, disease detectives began crawling through recent media reports to determine whether unusual numbers of people with flu-like illness in Mexico had also been sickened by the new virus. It turned out they had been. The new virus was spreading.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>“It makes sense that if we see a reduction in local reporting, you’re not going to have that early signaling of something in a community,” Brownstein said.\u003c/p>\n\u003cp>Without local reporting, it’s also harder to follow an outbreak and assess its progress. Majumder used the example of the massive 2016-2017 mumps outbreak in northwestern Arkansas to illustrate the point.\u003c/p>\n\u003cp>She and colleagues were trying to figure out why the outbreak was so large — nearly 3,000 cases all told. Had the virus simply found its way into an area with lots of unvaccinated children? Or was something else driving transmission?\u003c/p>\n\u003cp>That’s the kind of information that is hugely helpful to public health authorities struggling to control an outbreak. But Majumder found she couldn’t easily get her hands on key data; the Arkansas Department of Public Health issued regular updates, but the agency did not archive previous updates on its website. Getting access to official data can be a time-consuming process.\u003c/p>\n\u003cp>“There is a lot of red tape to get data sharing privileges, even around something as simple as cumulative case counts over time,” she said.\u003c/p>\n\u003cp>The Northwest Arkansas Democrat-Gazette, however, was covering the outbreak closely, and its coverage provided important context for Majumder’s research. Some of the paper’s stories noted that the vaccine refusal rate in that region was higher than anywhere else in the state; others made clear disease was spreading in a local community of people from the Marshall Islands who had been vaccinated.\u003c/p>\n\u003cp>\u003cimg class=\"size-medium wp-image-440343 aligncenter\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/03/iStock-691796746-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-691796746-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-691796746-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-691796746-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-691796746-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-691796746-1920x1280.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-691796746-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-691796746-960x640.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-691796746-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-691796746-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-691796746-520x347.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">Both those factors proved key in helping public health officials better understand what was driving the outbreak, Majumder said.\u003c/p>\n\u003cp>The World Health Organization urges countries to augment their official disease surveillance efforts — which draw information from networks of doctor’s offices, hospitals, and public health laboratories — with what’s known as “event-based surveillance,” said Dr. Larry Madoff, editor of ProMED, the Program for Monitoring Emerging Diseases. The internet-based outbreak reporting system — which reports on human, animal, and plant disease outbreaks — operates under the auspices of the International Society for Infectious Diseases.\u003c/p>\n\u003cp>Event-based surveillance is more informal and relies on systems that pick up on media reports, rumors on social media, and the like. That’s the way news of the 2003 SARS outbreak emerged. Internet chatter about a disease that was sickening and killing people in China made its way to the WHO before Chinese authorities eventually disclosed the existence of an outbreak that had been raging for several months.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>“It is well-known that event-based surveillance depends on healthy, local journalism,” said Madoff, who is also director of the Massachusetts Department of Health’s division of epidemiology and immunization. “So it would be a reasonable assumption that the loss of local sources would increase the time required to discover an outbreak.”\u003c/p>\n\u003cp>Like HealthMap, ProMED casts its net globally. In some countries, there are not many local media sources, or if there are, those news sources aren’t available on the internet. In those places, ProMED has to rely on word-of-mouth — which may become the case in parts of the U.S. as local news outlets are shuttered, Madoff said.\u003c/p>\n\u003cp>He’s not sure if ProMED is starting to miss things because of the shrinking number of local news sources. “There’s a huge volume of information and we get what we get. So it’s hard to say what we’re missing, necessarily. But I can easily imagine that we might,” he said.\u003c/p>\n\u003cp>\u003cstrong>Social Media\u003c/strong>\u003c/p>\n\u003cp>Newspapers, of course, aren’t the only source of local news. But a town that can’t support a newspaper may not have radio and television stations either. Radio and TV stations may not archive their reports online, or those reports may not be archived in print form, meaning their archives are harder to search, Majumder said.\u003c/p>\n\u003cp>Social media cannot fill the gap created by the declining local news coverage, she and others involved in this type of research argued. “With Twitter … you are picking up a signal, but that signal might not be precise,” said Alessandro Vespignani, a professor at Northeastern University whose research focuses on modeling of epidemics. And social media reports can be simply wrong, he said — either by accident or design. News coverage “anchors” the signals picked up on social media, Vespignani said.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>“When you combine data from multiple data sources … including data collected from news alerts, we can gain a better handle on the situational awareness in a given community or country,” agreed Mauricio Santillana, an assistant professor at Harvard Medical School whose research focuses on use of novel data sources to track and forecast disease outbreaks.\u003c/p>\n\u003cp>Majumder said she and colleagues would like to look at whether the growth of “news deserts” — communities without local news sources — has already had an impact on the amount of data HealthMap has been harvesting from under-covered parts of the United States.\u003c/p>\n\u003cp>One of the reasons the news desert map scared her, she said, was because she realized many of the places without local papers are also places where voters have been complaining of being left behind.\u003c/p>\n\u003cp>“What that means is they lose access to news which is very, very vital for knowing what’s going on in your town,” Majumder said. “But also from the public health surveillance point of view, we’re losing access to knowing what they need.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>This \u003ca href=\"https://www.statnews.com/2018/03/20/news-deserts-infectious-disease/\" target=\"_blank\" rel=\"noopener\">story\u003c/a> was originally published by \u003ca href=\"https://www.statnews.com/\" target=\"_blank\" rel=\"noopener\">STAT, \u003c/a>an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/440341/as-towns-lose-their-newspapers-disease-detectives-left-flying-blind","authors":["byline_futureofyou_440341"],"categories":["futureofyou_1060","futureofyou_1","futureofyou_73"],"tags":["futureofyou_141","futureofyou_61","futureofyou_1475","futureofyou_1476","futureofyou_294"],"collections":["futureofyou_1093"],"featImg":"futureofyou_440342","label":"futureofyou_1093"},"futureofyou_440006":{"type":"posts","id":"futureofyou_440006","meta":{"index":"posts_1591205157","site":"futureofyou","id":"440006","score":null,"sort":[1520291375000]},"guestAuthors":[],"slug":"does-opioid-use-lower-pain-tolerance","title":"Does Opioid Use Lower Pain Tolerance?","publishDate":1520291375,"format":"standard","headTitle":"Future of You | KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>When patients arrive in the emergency room, nearly all but those with the most minor complaints get an IV.\u003c/p>\n\u003cp>To draw blood, give medications or administer fluids, the IV is the way doctors and nurses gain access to the body. Putting one in is quick and simple, and it's no more painful than a mild bee sting.\u003c/p>\n\u003cp>Yet for some patients, this routine procedure becomes excruciating. On my shifts as an emergency physician, I began to notice a strange pattern. These hypersensitive patients often had a history of using opioids.\u003c/p>\n\u003cp>Shouldn't these patients be less susceptible to pain, instead of more so?\u003c/p>\n\u003cp>As I looked into it, I found that I was far from the first to notice the paradox of heightened pain sensitivity with opioid use. An English physician in 1870 \u003ca href=\"http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/year/2013/docId/9551\" target=\"_blank\" rel=\"noopener\">reported\u003c/a> on morphine's tendency to \"encourage the very pain it pretends to relieve.\" In 1880, a German doctor named Rossbach \u003ca href=\"https://academic.oup.com/painmedicine/article/16/suppl_1/S32/2472483\" target=\"_blank\" rel=\"noopener\">described\u003c/a> a similar hypersensitivity to pain with opioid dependence.[contextly_sidebar id=\"JdvyNC50xeYkStqD74JGNEYfNupPuvtu\"]\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>A century passed before the phenomenon received serious scientific attention. That is when American scientists \u003ca href=\"http://jpet.aspetjournals.org/content/177/3/509.long\" target=\"_blank\" rel=\"noopener\">showed\u003c/a> that rats exhibited increased sensitivity to pain after exposure to morphine, a phenomenon that became known as opioid-induced hyperalgesia.\u003c/p>\n\u003cp>By the 1990s, the \u003ca href=\"http://anesthesiology.pubs.asahq.org/article.aspx?articleid=1923441\" target=\"_blank\" rel=\"noopener\">evidence\u003c/a> of this unusual reaction in animals was strong, but whether it occurred in humans wasn't clear.\u003c/p>\n\u003cp>A hint came in 1994, when researchers \u003ca href=\"http://www.jpsmjournal.com/article/0885-3924(94)90203-8/pdf\" target=\"_blank\" rel=\"noopener\">found\u003c/a> that active heroin users were more sensitive to pain than expected. Other investigators took note, and by decade's end, a half-dozen studies had demonstrated similar results among heroin users as well as among recovering users on methadone.\u003c/p>\n\u003cp>But had these people used heroin because they had always been more sensitive to pain, perhaps from birth? The studies couldn't say.\u003c/p>\n\u003cp>In 2006, a group of Stanford researchers \u003ca href=\"http://www.jpain.org/article/S1526-5900(05)00826-6/fulltext\" target=\"_blank\" rel=\"noopener\">attempted\u003c/a> to tease apart this question. The scientists measured pain thresholds in patients with back pain before and after four months of oral morphine. The researchers found that the patients had become significantly more sensitive to pain by the study's end.\u003c/p>\n\u003cp>Another way that scientists have tried to approach the problem is by studying opioids used during surgery. Several \u003ca href=\"http://www.jcvaonline.com/article/S1053-0770(15)00049-X/fulltext\" target=\"_blank\" rel=\"noopener\">studies\u003c/a> have shown that patients randomized to receive higher doses of opioids during operations have worse pain afterward than patients who received smaller doses or a placebo. Similarly, giving short-acting opioids to healthy volunteers has been found to \u003ca href=\"https://insights.ovid.com/pubmed?pmid=14581110\" target=\"_blank\" rel=\"noopener\">heighten\u003c/a> their sensitivity to pain.\u003c/p>\n\u003cp>Taken together, these findings do seem to suggest that exposure to opioids can paradoxically increase pain, but Martin Angst, a Stanford anesthesiologist, points out a problem common to all of these studies: Were these patients just becoming tolerant to the painkillers?\u003c/p>\n\u003cp>\"Is this hyperalgesia? Is this tolerance?\" he told me. \"Nobody can say.\"\u003c/p>\n\u003cp>The questions have plagued much of the research. In pharmacology, tolerance refers to decreasing efficacy of a drug with repeated use. Not all medications are subject to this effect, but opioids certainly are. Over time, they simply don't work as well, and the original pain returns.\u003c/p>\n\u003cp>Doctors often increase the dose to counteract this effect, which works until the patient becomes tolerant to the increased amount of medicine. The result can be an upward spiral, with no clear end in sight.[contextly_sidebar id=\"tYIZr9XqaiXC4XWGHMvv6XDQ7lK72GDt\"]\u003c/p>\n\u003cp>But there is a drawback to this approach. If worsening pain is due to opioid-induced hyperalgesia rather than tolerance, then \"increasing the dose will only make the pain worse,\" explains Caroline Arout, a scientist at the New York State Psychiatric Institute. While tolerance is characterized by desensitization of neural pain pathways, which can be overcome by higher doses, opioid-induced hyperalgesia is the result of hypersensitization of those pathways, she says.\u003c/p>\n\u003cp>\"This could be a major factor in the opioid crisis,\" Arout says. \"People have worsening pain, and so their dose is often increased because they are thought to be tolerant.\" But the result is that some patients may find themselves taking dangerously high doses while their pain continues to intensify.\u003c/p>\n\u003cp>So how common is opioid-induced hyperalgesia? \"This is the million-dollar question,\" Stanford's Angst answers. \"We just don't know.\"\u003c/p>\n\u003cp>Although the current research isn't definitive, Angst says opioid-induced hyperalgesia strikes him as a serious problem. Addressing it may require adopting a new perspective on pain.\u003c/p>\n\u003cp>Pain is a critical adaptation for survival, even in the era of modern medicine. \"Think of pain in a different way, as a very useful thing to the body,\" he says. Pain in the abdomen can sometimes herald appendicitis, or some other dangerous infection. And chest pain is a cardinal symptom of heart attacks.\u003c/p>\n\u003cp>\"When we overwhelm the system with large doses of opioids — does the system fight back?\" Angst asks.\u003c/p>\n\u003cp>\"We have to accept that there are limitations to any biological system, and if you exceed them, then bad things will happen,\" he says. \"And one of those things may be opioid-induced hyperalgesia.\"\u003c/p>\n\u003chr>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Clayton Dalton is a resident physician at Massachusetts General Hospital in Boston.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit \u003ca href=\"http://www.npr.org/\" target=\"_blank\" rel=\"noopener\">http://www.npr.org/\u003c/a>.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=When+Opioids+Make+Pain+Worse+&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n","blocks":[],"excerpt":"An emergency room doctor noticed that patients with a low pain threshold were regular opioid users.","status":"publish","parent":0,"modified":1520993591,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":25,"wordCount":847},"headData":{"title":"Does Opioid Use Lower Pain Tolerance? | KQED","description":"An emergency room doctor noticed that patients with a low pain threshold were regular opioid users.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Does Opioid Use Lower Pain Tolerance?","datePublished":"2018-03-05T23:09:35.000Z","dateModified":"2018-03-14T02:13:11.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"440006 https://ww2.kqed.org/futureofyou/?p=440006","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/03/05/does-opioid-use-lower-pain-tolerance/","disqusTitle":"Does Opioid Use Lower Pain Tolerance?","source":"Hope/Hype","nprByline":"Clayton Dalton\u003cbr />NPR Shots","nprImageAgency":"Lorenzo Gritti for NPR","nprStoryId":"586621236","nprApiLink":"http://api.npr.org/query?id=586621236&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"https://www.npr.org/sections/health-shots/2018/03/03/586621236/when-opioids-make-pain-worse?ft=nprml&f=586621236","nprRetrievedStory":"1","nprPubDate":"Mon, 05 Mar 2018 15:37:00 -0500","nprStoryDate":"Sat, 03 Mar 2018 06:00:00 -0500","nprLastModifiedDate":"Mon, 05 Mar 2018 15:37:17 -0500","path":"/futureofyou/440006/does-opioid-use-lower-pain-tolerance","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>When patients arrive in the emergency room, nearly all but those with the most minor complaints get an IV.\u003c/p>\n\u003cp>To draw blood, give medications or administer fluids, the IV is the way doctors and nurses gain access to the body. Putting one in is quick and simple, and it's no more painful than a mild bee sting.\u003c/p>\n\u003cp>Yet for some patients, this routine procedure becomes excruciating. On my shifts as an emergency physician, I began to notice a strange pattern. These hypersensitive patients often had a history of using opioids.\u003c/p>\n\u003cp>Shouldn't these patients be less susceptible to pain, instead of more so?\u003c/p>\n\u003cp>As I looked into it, I found that I was far from the first to notice the paradox of heightened pain sensitivity with opioid use. An English physician in 1870 \u003ca href=\"http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/year/2013/docId/9551\" target=\"_blank\" rel=\"noopener\">reported\u003c/a> on morphine's tendency to \"encourage the very pain it pretends to relieve.\" In 1880, a German doctor named Rossbach \u003ca href=\"https://academic.oup.com/painmedicine/article/16/suppl_1/S32/2472483\" target=\"_blank\" rel=\"noopener\">described\u003c/a> a similar hypersensitivity to pain with opioid dependence.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>A century passed before the phenomenon received serious scientific attention. That is when American scientists \u003ca href=\"http://jpet.aspetjournals.org/content/177/3/509.long\" target=\"_blank\" rel=\"noopener\">showed\u003c/a> that rats exhibited increased sensitivity to pain after exposure to morphine, a phenomenon that became known as opioid-induced hyperalgesia.\u003c/p>\n\u003cp>By the 1990s, the \u003ca href=\"http://anesthesiology.pubs.asahq.org/article.aspx?articleid=1923441\" target=\"_blank\" rel=\"noopener\">evidence\u003c/a> of this unusual reaction in animals was strong, but whether it occurred in humans wasn't clear.\u003c/p>\n\u003cp>A hint came in 1994, when researchers \u003ca href=\"http://www.jpsmjournal.com/article/0885-3924(94)90203-8/pdf\" target=\"_blank\" rel=\"noopener\">found\u003c/a> that active heroin users were more sensitive to pain than expected. Other investigators took note, and by decade's end, a half-dozen studies had demonstrated similar results among heroin users as well as among recovering users on methadone.\u003c/p>\n\u003cp>But had these people used heroin because they had always been more sensitive to pain, perhaps from birth? The studies couldn't say.\u003c/p>\n\u003cp>In 2006, a group of Stanford researchers \u003ca href=\"http://www.jpain.org/article/S1526-5900(05)00826-6/fulltext\" target=\"_blank\" rel=\"noopener\">attempted\u003c/a> to tease apart this question. The scientists measured pain thresholds in patients with back pain before and after four months of oral morphine. The researchers found that the patients had become significantly more sensitive to pain by the study's end.\u003c/p>\n\u003cp>Another way that scientists have tried to approach the problem is by studying opioids used during surgery. Several \u003ca href=\"http://www.jcvaonline.com/article/S1053-0770(15)00049-X/fulltext\" target=\"_blank\" rel=\"noopener\">studies\u003c/a> have shown that patients randomized to receive higher doses of opioids during operations have worse pain afterward than patients who received smaller doses or a placebo. Similarly, giving short-acting opioids to healthy volunteers has been found to \u003ca href=\"https://insights.ovid.com/pubmed?pmid=14581110\" target=\"_blank\" rel=\"noopener\">heighten\u003c/a> their sensitivity to pain.\u003c/p>\n\u003cp>Taken together, these findings do seem to suggest that exposure to opioids can paradoxically increase pain, but Martin Angst, a Stanford anesthesiologist, points out a problem common to all of these studies: Were these patients just becoming tolerant to the painkillers?\u003c/p>\n\u003cp>\"Is this hyperalgesia? Is this tolerance?\" he told me. \"Nobody can say.\"\u003c/p>\n\u003cp>The questions have plagued much of the research. In pharmacology, tolerance refers to decreasing efficacy of a drug with repeated use. Not all medications are subject to this effect, but opioids certainly are. Over time, they simply don't work as well, and the original pain returns.\u003c/p>\n\u003cp>Doctors often increase the dose to counteract this effect, which works until the patient becomes tolerant to the increased amount of medicine. The result can be an upward spiral, with no clear end in sight.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>But there is a drawback to this approach. If worsening pain is due to opioid-induced hyperalgesia rather than tolerance, then \"increasing the dose will only make the pain worse,\" explains Caroline Arout, a scientist at the New York State Psychiatric Institute. While tolerance is characterized by desensitization of neural pain pathways, which can be overcome by higher doses, opioid-induced hyperalgesia is the result of hypersensitization of those pathways, she says.\u003c/p>\n\u003cp>\"This could be a major factor in the opioid crisis,\" Arout says. \"People have worsening pain, and so their dose is often increased because they are thought to be tolerant.\" But the result is that some patients may find themselves taking dangerously high doses while their pain continues to intensify.\u003c/p>\n\u003cp>So how common is opioid-induced hyperalgesia? \"This is the million-dollar question,\" Stanford's Angst answers. \"We just don't know.\"\u003c/p>\n\u003cp>Although the current research isn't definitive, Angst says opioid-induced hyperalgesia strikes him as a serious problem. Addressing it may require adopting a new perspective on pain.\u003c/p>\n\u003cp>Pain is a critical adaptation for survival, even in the era of modern medicine. \"Think of pain in a different way, as a very useful thing to the body,\" he says. Pain in the abdomen can sometimes herald appendicitis, or some other dangerous infection. And chest pain is a cardinal symptom of heart attacks.\u003c/p>\n\u003cp>\"When we overwhelm the system with large doses of opioids — does the system fight back?\" Angst asks.\u003c/p>\n\u003cp>\"We have to accept that there are limitations to any biological system, and if you exceed them, then bad things will happen,\" he says. \"And one of those things may be opioid-induced hyperalgesia.\"\u003c/p>\n\u003chr>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Clayton Dalton is a resident physician at Massachusetts General Hospital in Boston.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit \u003ca href=\"http://www.npr.org/\" target=\"_blank\" rel=\"noopener\">http://www.npr.org/\u003c/a>.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=When+Opioids+Make+Pain+Worse+&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/440006/does-opioid-use-lower-pain-tolerance","authors":["byline_futureofyou_440006"],"programs":["futureofyou_54"],"categories":["futureofyou_1062","futureofyou_1"],"tags":["futureofyou_952","futureofyou_61","futureofyou_938","futureofyou_379","futureofyou_294"],"featImg":"futureofyou_440007","label":"source_futureofyou_440006"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.","airtime":"SUN 2pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Possible-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.possible.fm/","meta":{"site":"news","source":"Possible"},"link":"/radio/program/possible","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/possible/id1677184070","spotify":"https://open.spotify.com/show/730YpdUSNlMyPQwNnyjp4k"}},"1a":{"id":"1a","title":"1A","info":"1A is home to the national conversation. 1A brings on great guests and frames the best debate in ways that make you think, share and engage.","airtime":"MON-THU 11pm-12am","imageSrc":"https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/1a.jpg","officialWebsiteLink":"https://the1a.org/","meta":{"site":"news","source":"npr"},"link":"/radio/program/1a","subscribe":{"npr":"https://rpb3r.app.goo.gl/RBrW","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=1188724250&at=11l79Y&ct=nprdirectory","tuneIn":"https://tunein.com/radio/1A-p947376/","rss":"https://feeds.npr.org/510316/podcast.xml"}},"all-things-considered":{"id":"all-things-considered","title":"All Things Considered","info":"Every weekday, \u003cem>All Things Considered\u003c/em> hosts Robert Siegel, Audie Cornish, Ari Shapiro, and Kelly McEvers present the program's trademark mix of news, interviews, commentaries, reviews, and offbeat features. 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You ask the questions. You decide what Bay Curious investigates. 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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. 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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":{"site":"news","source":"kqed","order":"2"},"link":"/podcasts/mindshift","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/mindshift-podcast/id1078765985","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5","npr":"https://www.npr.org/podcasts/464615685/mind-shift-podcast","stitcher":"https://www.stitcher.com/podcast/kqed/stories-teachers-share","spotify":"https://open.spotify.com/show/0MxSpNYZKNprFLCl7eEtyx"}},"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/","meta":{"site":"news","source":"npr"},"link":"/radio/program/morning-edition"},"onourwatch":{"id":"onourwatch","title":"On Our Watch","tagline":"Police secrets, unsealed","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":"1"},"link":"/podcasts/onourwatch","subscribe":{"apple":"https://podcasts.apple.com/podcast/id1567098962","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5ucHIub3JnLzUxMDM2MC9wb2RjYXN0LnhtbD9zYz1nb29nbGVwb2RjYXN0cw","npr":"https://rpb3r.app.goo.gl/onourwatch","spotify":"https://open.spotify.com/show/0OLWoyizopu6tY1XiuX70x","tuneIn":"https://tunein.com/radio/On-Our-Watch-p1436229/","stitcher":"https://www.stitcher.com/show/on-our-watch","rss":"https://feeds.npr.org/510360/podcast.xml"}},"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":{"site":"news","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"}},"our-body-politic":{"id":"our-body-politic","title":"Our Body Politic","info":"Presented by KQED, KCRW and KPCC, and created and hosted by award-winning journalist Farai Chideya, Our Body Politic is unapologetically centered on reporting on not just how women of color experience the major political events of today, but how they’re impacting those very issues.","airtime":"SAT 6pm-7pm, SUN 1am-2am","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Our-Body-Politic-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://our-body-politic.simplecast.com/","meta":{"site":"news","source":"kcrw"},"link":"/radio/program/our-body-politic","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/our-body-politic/id1533069868","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5zaW1wbGVjYXN0LmNvbS9feGFQaHMxcw","spotify":"https://open.spotify.com/show/4ApAiLT1kV153TttWAmqmc","rss":"https://feeds.simplecast.com/_xaPhs1s","tuneIn":"https://tunein.com/podcasts/News--Politics-Podcasts/Our-Body-Politic-p1369211/"}},"pbs-newshour":{"id":"pbs-newshour","title":"PBS NewsHour","info":"Analysis, background reports and updates from the PBS NewsHour putting today's news in context.","airtime":"MON-FRI 3pm-4pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/PBS-News-Hour-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.pbs.org/newshour/","meta":{"site":"news","source":"pbs"},"link":"/radio/program/pbs-newshour","subscribe":{"apple":"https://itunes.apple.com/us/podcast/pbs-newshour-full-show/id394432287?mt=2","tuneIn":"https://tunein.com/radio/PBS-NewsHour---Full-Show-p425698/","rss":"https://www.pbs.org/newshour/feeds/rss/podcasts/show"}},"perspectives":{"id":"perspectives","title":"Perspectives","tagline":"KQED's series of of daily listener commentaries since 1991","info":"KQED's series of of daily listener commentaries since 1991.","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Perspectives-Podcast-Tile-703x703-1.jpg","officialWebsiteLink":"/perspectives/","meta":{"site":"radio","source":"kqed","order":"15"},"link":"/perspectives","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/id73801135","npr":"https://www.npr.org/podcasts/432309616/perspectives","rss":"https://ww2.kqed.org/perspectives/category/perspectives/feed/","google":"https://podcasts.google.com/feed/aHR0cHM6Ly93dzIua3FlZC5vcmcvcGVyc3BlY3RpdmVzL2NhdGVnb3J5L3BlcnNwZWN0aXZlcy9mZWVkLw"}},"planet-money":{"id":"planet-money","title":"Planet Money","info":"The economy explained. 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