Beyond the breath: Exploring sex differences in tuberculosis outside the lungs

tubercbrainAbout six miles off the coast of Haifa, a dozen meters deep in the Mediterranean Sea at the site of a submerged prehistoric village called Atlit Yam, researchers in 2008 reported finding the ancient remains of a woman and a one-year-old baby embedded in ocean mud1. The skeletons dated back 9,000 years, and both had bone lesions that, along with molecular analysis, revealed infection with Mycobacterium tuberculosis, the bacterium that causes tuberculosis.


Continue reading “Beyond the breath: Exploring sex differences in tuberculosis outside the lungs”


Mutations as munitions: Neoantigen vaccines get a closer look as cancer treatment

nm0216-122-i1In 2010, the Dendreon company received the news it had been hoping for: the US Food and Drug Administration had approved its therapeutic cancer vaccine Provenge for prostate cancer. At the time of Provenge’s approval, the headlines hailed it as groundbreaking, and they noted a surge in the price of Dendreon’s stock as the company announced its $93,000 price tag for the therapy. But enthusiasm fizzled when the company later revealed that fewer people used the therapy than expected, and in November 2014 the company filed for bankruptcy. Continue reading “Mutations as munitions: Neoantigen vaccines get a closer look as cancer treatment”

Control Issues

HIVcontrolJazz found out she was HIV-positive when her daughter was born in 1990. Luckily, she did not transmit the virus to her baby, but the diagnosis threw her own life off the rails. She began using illicit drugs and living rough—“being around the wrong crowd of people,” as she puts it. Three years after her diagnosis, she was convicted for conspiracy to sell cocaine. She spent close to eight years in prison.

In hindsight, Jazz (who requested that Nature Medicine use this pseudonym) says she started acting recklessly because she assumed she had little time left to live. “I had a lot of friends who had [HIV], and I watched their struggle dealing with it and their passing away from it,” she says. “It really scared me, so I just abused myself.” As the years ticked by, though, Jazz never got sick the way many of her acquaintances did.

[Read more at Nature Medicine (paywall) or download PDF // April 7, 2014]

Polypill improves adherence but fails to win scientists’ hearts

Nicholas Wald’s flash of insight came about 15 years ago. While recovering from a serious illness at his wife’s family’s house in New York, he watched as his father-in-law swallowed multiple pills each day to treat his cardiovascular disease. “I thought, my goodness, the combined effect of these pills is very large, but the problem is they should have started giving them 30 years ago as a preventative treatment,” recalls Wald, an epidemiologist at the Wolfson Institute of Preventive Medicine at Barts and The London School of Medicine and Dentistry in the UK.

[Read more at Nature Medicine (paywall) or download PDF // October 7, 2013]

Heavy drugs draw heavy interest from pharma backers

It’s an age-old problem in drug development: a compound that seems to exert its desired effects against cells in a Petri dish, but flops in vivo, either in animal models or, later, in humans. One common reason for such failures is how the body metabolizes drugs. Enzymes in the liver can break down molecules quickly, substantially limiting their potency. They might produce toxic metabolites in the process to boot.

If you could fortify the chemical bonds that hold those drugs together, thereby modulating the metabolism of the compound, would they be more efficacious?  A trio of biotech companies has been banking on this prospect for the last decade, and their efforts are starting to trickle into the clinic.

[Read more at Nature Medicine (paywall) or download PDF // June 6, 2013]

Delays in updates to ethics guidelines for research spark concern

CommonRuleNearly two years ago, the US government office that oversees human research ethics launched the first-ever major revision to the so-called Common Rule, the 22-year-old regulation that governs the protection of human research subjects there. But the process set into motion by that agency—the Office of Human Research Protections (OHRP), a division of the US Department of Health and Human Services (HHS)—is dragging on. And a vocal contingent of bioethicists and researchers say the changes on the table are not enough to fix an outdated and overburdened system, advocating instead for a more fundamental rethink.

[Read more at Nature Medicine (paywall) or download PDF // May 7, 2013]

Momentum grows to make ‘personalized’ medicine more ‘precise’

In 2009, Wisconsin clinicians sequenced all the protein-coding DNA of a very ill 4-year-old boy named Nicholas Volker. They used the results to pinpoint a gene mutation at the root of his life-threatening gut inflammation, as well as to identify a risky but ultimately effective treatment. Nicholas’s story was hailed as one of the first successes in the long-promised goal of using sequencing to steer clinical decisions. But as the approach proliferates in the treatment of rare genetic diseases, cancers and other areas of medicine, researchers say it’s time to change both the name and the framework of a field that for more than a decade has been termed ‘personalized medicine’.

[Read more at Nature Medicine (paywall) or download PDF // March 6, 2013]

New tracking system proposed to help recall faulty devices

A miter saw, decorative lights, socks for toddlers—these were a few of the consumer goods recalled off of shelves across the US last month because they posed a danger to users. Recalling faulty pacemakers or catheters is much more difficult, however, because no system exists for tracking medical devices on the market. In an effort to remedy that and boost consumer safety, on 3 July the US Food and Drug Administration (FDA) outlined plans to create a new comprehensive monitoring system for medical devices.

[Read more at Nature Medicine (paywall) or download PDF // August 6, 2012]

Vaccines shoot for more precise population targets

When Marina Ulanova began looking at the prevalence of a severe bacterial infection in the rural communities of northwestern Ontario, what she found surprised her. A worldwide vaccination push in the early 1990s had effectively wiped out the most virulent strain of the Haemophilus influenzae pathogen, which can cause meningitis, pneumonia and bacteremia, among other illnesses. Yet Ulanova’s team at the Northern Ontario School of Medicine in Thunder Bay stumbled upon a different strain of H. influenzae that was wreaking havoc on the First Nations groups of the region.

Further laboratory analyses indicated a striking degree of uniformity in the genetic and phenotypic characteristics of the pathogenic bacterium. “It was amazing,” says Ulanova. “They all looked like they belonged to the same clone.” Yet the cases had clearly originated independently; many of the infected individuals lived in communities so remote that they didn’t have road access.

[Read more at Nature Medicine (paywall) or download PDF // April 5, 2012]

Breaking the Silence

BreakSilenceIt all started with an expression problem. Michael Gottesman and his lab members at the US National Cancer Institute in Bethesda, Maryland were studying a membrane protein involved in drug metabolism called P-glycoprotein to understand why some people develop resistance to chemotherapy during cancer treatment. But when the scientists tried to express large quantities of the protein in bacterial cells, they hit a wall.

“It was a real mess,” Gottesman recalls. “We couldn’t do it.”

The genetic code is read in triplets called codons, 64 of them representing just 20 amino acids. That means there is more than one codon for each amino acid, and different organisms preferentially use certain codons to make translation faster.

[Read more at Nature Medicine (paywall) or download PDF // December 6, 2011]