Congrats to Campbell, Omura, and Youyou Tu on winning the 2015 Nobel Prize in Physiology or Medicine!! News story from NYT here!
William C. Campbell and Satoshi Omura won for developing a new drug, Avermectin. A derivative of that drug, Ivermectin, has nearly eradicated river blindness and radically reduced the incidence of filariasis, which causes the disfiguring swelling of the lymph system in the legs and lower body known as elephantiasis. They shared the $900,000 award with Youyou Tu, who discovered Artemisinin, a drug that has significantly reduced death rates from malaria.
A new study has shown that targeting two immune cells—Th2 and Th17—and their downstream, inflammatory effects is better than targeting just one pathway in the context of asthma. The researchers also show that blocking the Th2 pathway, which is a target of commonly-prescribed corticosteroid drugs, may unexpectedly boost conditions for Th17-driven inflammation. These results clarify how immune cells and their products contribute to asthma, and the work may enable researchers to design and test therapies that target both pathways. The study appears in the August 19, 2015, edition of Science Translational Medicine and included scientists from NIAID, the University of Leicester, and Genentech.
Many people have strong opinions about genetically modified plants, also known as genetically modified organisms or GMOs. But sometimes there’s confusion around what it means to be a GMO. It also may be much more sensible to judge a plant by its specific traits rather than the way it was produced – GMO or not.
This article is not about judging whether GMOs are good or bad, but rather an explanation of how plants with modified genomes are made. (There are non-plant GMOs, but in this article we will only refer to plant GMOs.) First of all, it’s necessary to define what we mean by a GMO. For the purposes of this discussion, I’m defining GMOs as plants whose genetic information (found in their genomes) has been modified by human activity.
Humans have changed the genomes of virtually all the plants in the grocery store
If we think of GMOs as plants that have genomes modified by humans, then quite a lot of the plants sold in any grocery store fit that description. But many of these modifications didn’t occur in the lab. Farmers select plants with superior, desirable traits to cultivate in a process known as agricultural evolution. Thousands of years of traditional agricultural breeding has changed plant genomes from those of their original wild ancestors.
Broccoli, for example, is not a naturally occurring plant. It’s been bred from undomesticated Brassica oleracea or ‘wild cabbage’; domesticated varieties of B. oleracea include both broccoli and cauliflower. Broccoli, along with any seedless variety of fruit (including what you think of as bananas), and most of the crops grown on farms today would not exist without human intervention.
However, these aren’t the plants that people typically think of when they think of GMOs. It’s easy to understand how farmers can breed better plants on farms (by choosing to plant seeds from the biggest or best-yielding plants, for example, imposing artificial selection on the crop species) so even though this activity changes plant genomes in ways nature wouldn’t have, most people don’t consider these plants GMOs.
Creating “lab” GMOs
Once plant genes had been studied enough, researchers could turn to backcrossing. This technique involves breeding the offspring back with the parents to try to get a desired, stable combination of parental traits. Genes previously linked to desirable plant traits, such as higher yield or pest-resistance, could be identified and screened for using molecular biology techniques and linkage maps. These maps lay out the relative position of genes along a chromosome, based on how often they are passed along together to offspring. Closer genes tend to travel together.
Researchers used molecular markers – specific, known gene sequences, present in the linkage maps – to select individual plants that contained both the new marker gene and the greatest proportion of other favorable genes from the parents. The combinations of genes passed to offspring are always due to random recombination of the parents’ genes. Researchers weren’t able to drive particular combinations themselves, they had to work with what arose naturally; so in this marker-assisted selection approach, there’s a lot of effort and time spent trying to find plants with the best combinations of genes.
In this system, a laboratory needs to screen the genomes, using molecular biology methods to look for particular gene sequences for desirable traits in the bred offspring. Sometimes a lab even breeds the plants in cases using tissue culture – a way to propagate many plants simultaneously while minimizing the resources needed to grow them.
Inserting non-plant genes into GMOs
In the early 1980s, the plant biotechnology era began with Agrobacterium tumifaciens. This bacterium naturally infects plants and, in the wild, creates tumors by transferring DNA between itself and the plant it has infected. Scientists use this natural property to transfer genes to plant cells from an A. tumifaciens bacterium modified to contain a gene of interest.
For the first time, it was possible to insert specific genes into a plant genome, even genes that do not come from that species – or even from a plant. A. tumifaciens does not affect all plants, however, so researchers went on to develop DNA-transferring methods inspired by this system which would work without it. They include microinjection and “gene guns,” where the desired DNA was physically injected into the plant, or covered tiny particles that were literally shot into the nuclei of plant cells.
A recent review summarizes eight new methods for altering genes in plants. These are molecular biology techniques that use different enzymes or nucleic acid molecules (DNA and RNA) to make changes to a plant’s genes. One route is to alter the sequence of a plant’s DNA. Another is to leave the sequence alone but make other epigenetic modifications to the structure of a plant’s DNA. For instance, scientists could add arrangements of atoms called methyl groups to some of the nucleotide building blocks of DNA. These epigenetic modifications, while not altering the order of the DNA or of genes, change how genes can be expressed and thus the observable traits a plant has.
GMO doesn’t mean glyphosate-resistant
Calling a plant a genetically modified organism means only that – its genome has been modified by the activity of humans. But lots of people conflate the idea of a GMO plant with one that’s been created to be resistant to the herbicide glyphosate, also known by the brand name Roundup. It’s true that the most well-known GMO crops currently grown contain a gene that makes them resistant to glyphosate, which allows farmers to spray the chemical to kill weeds while allowing their crop to grow. But that’s just one example of a gene inserted into a plant.
The so-called “fish tomato” contains an antifreeze protein (gene name afa3), found naturally in winter flounder, that increases frost tolerance in the tomato plant. The tomato doesn’t actually contain fish tissue, or even necessarily DNA taken from fish tissue – just DNA of the same sequence present in the fish genome. The Afa3 protein is produced from the afa3 gene in the tomato cells using the same machinery as other tomato proteins.
The U.S. National Institutes of Health (NIH) has for more than 60 years supported research to improve the health and prolong the lives of people in the United States and around the world. Mean life expectancy worldwide has doubled to more than 70 years, due in large part to medical and public health interventions developed with NIH funding. Now, in the face of serious fiscal constraints, the idea has reemerged from some congressional leaders and disease constituency groups to more closely align NIH funding for disease research with disease burden in the United States. Although the nation must maintain robust research support for diseases that cause illness and death among large numbers of Americans, it would be unwise to deemphasize diseases that exact their largest toll elsewhere in the world. The United States has a vital interest in the health of people around the globe, rooted in an enduring tradition of humanitarian concern as well as in enlightened self-interest. Engagement in global health protects the nation’s citizens, enhances the economy, and advances U.S. interests abroad.
The media gets a bad rap – sometimes deserved – for sensationalizing, trivializing, and generally making mincemeat of good science. The negative consequences can be enormous, leading to science skepticism that bleeds into counterproductive public policy. But just as often the media gets it right, capturing science as the workhorse it is, explaining how science addresses human challenges and what that means for people we all can relate to.
Effective communication is critical if science is to earn and maintain public support. More and more leaders of universities are talking about making it both a recognized and rewarded component of academic success for faculty to engage in public outreach.
Last week, I shared our updated fact sheet on Infectious Disease. This week, we release our newest updated fact sheet on Alzheimer’s disease (In 2014, $15.9 billion was spent on Easter in the United States.That amount could fund NIH sponsored Alzheimer’s research for more than 28 years!).
As many times as we repeat the alarming statistics on the prevalence of Alzheimer’s – with the human and economic toll it is taking on our families and our society – the message hasn’t fully broken through. The drum beat must become louder and louder, until we convince policymakers of the need for more research to drive medical progress.
In recent years, the US has witnessed multiple outbreaks of vaccine-preventable illnesses, including pertussis (whooping cough) and measles. In the same time frame, vaccine refusal rates have gone up, and an increasing number of parents are requesting modified vaccine schedules that differ from the one recommended by the American Academy of Pediatrics (AAP).
The majority of parents do have their children vaccinated on schedule. It’s a small number of parents who refuse all vaccinations for their children. A slightly larger minority want their children to receive some but not all vaccines or want a different vaccination schedule.
Why do these groups disregard AAP recommendations about vaccination? A 2011 study suggests it has a lot to do with fear of vaccines’ negative side effects. Some parents worry about the “chemical composition” of vaccines or multiple vaccines being given at once. Some don’t believe vaccines are effective. Others feel the illnesses some vaccines protect against, like influenza or varicella (chickenpox), aren’t that serious. Importantly, though not the focus of this article, the AAP Committee on Bioethics notes that some parents might refuse vaccines due to cost issues or barriers to accessing appropriate health services.
Although research overwhelmingly supports the safety and effectiveness of vaccines and indicates that the risk of negative side effects from childhood vaccines is extremely small, many parents still have concerns about vaccine safety.
Parents today have access to incredible amounts of information via the internet, which has been shown to significantly affect parents’ vaccine attitudes. Within this wealth of information about immunization, it can be challenging for parents to separate what’s reliable from what’s not. And, we tend to seek out, pay more attention to, and recall information that we suspect might be true. This is called biased assimilation. So a parent who believes vaccines are dangerous might preferentially register information supporting that view.
The continuum of vaccine attitudes
Vaccine attitudes fall on a continuum. At one end, there are parents who are completely in favor of vaccines, and at the other end are parents who oppose vaccines. In between there is a broad and complex spectrum of parents who are vaccine-hesitant or vaccine-uncertain. The common thread among all parents – no matter their vaccination choices – is that they’re trying to do what they feel is best for their children.
With parents who fall towards the vaccine-opposing end of the spectrum, health-care providers can experience difficulty when trying to change attitudes about vaccines. These parents may have strong feelings and be very confident in what they believe to be true about vaccines. But parents somewhere in the middle of the spectrum, who are hesitant or uncertain about vaccines, are oftentimes less set in their beliefs about vaccination. That’s why some researchers stress the importance of proactive intervention efforts aimed at the very broad group of vaccine-hesitant parents. Parents on this part of the continuum are typically receptive to information about vaccination from trusted health-care providers. Thus, the way nurses and physicians communicate with these parents about vaccination is very important.
How should health-care providers talk about vaccines?
There is a wealth of research examining communication about vaccines, and researchers are still identifying what methods tend to work well. Communication about vaccination occurs in a variety of ways, from one-on-one conversations with doctors and nurses to large-scale outreach from health departments, such as billboards and radio ads.
What can make the provider-parent discussion about childhood vaccination a complex one is that parents’ decisions and attitudes vary, depending, for example, on the type of vaccine. And, in many cases when parents have negative attitudes about vaccines, they’re often based on erroneous information or hearing emotional narrative accounts about adverse reactions from a vaccine. It can also be very challenging for health-care providers to correct people’s misperceptions about risks.
There are a few strategies that health-care providers can use when talking about immunization with vaccine-hesitant parents. In clinical settings, although potentially time-consuming in already-short appointments, it’s important to address parents’ specific concerns. Clinicians should discuss vaccines from multiple perspectives, like the benefits of vaccination (preventing illness for oneself and others), as well as the risks of not vaccinating (being susceptible to illness). Research suggests that tailoring the discussion to parents’ concerns can positively affect the provider-parent relationship and foster trust.
Since health-care providers can help build public trust in vaccines, communicating accurate information about risks should be part of the conversation. Here, it might be tempting to avoid discussion about the risk of any negative side effects of vaccination, even though the risk is very low. But risk communication is vital.
The AAP suggests tailoring the conversation to the parents, understanding and responding to their specific concerns. Physicians should talk to parents about managing common side effects and what to do if a more serious reaction occurs. For some parents, quantifying the risks of vaccinating versus not vaccinating could be helpful. Providing written materials to explain risk is another strategy. It is important to note, however, that more research is needed. Several researchers urge caution about some vaccine communication strategies for fear they may “backfire” and decrease parents’ intentions to vaccinate their children.
What about discussing herd immunity?
A 2013 study on what influences adults to the get the flu shot suggests people may be more likely to get vaccinated if their peers do it. Among adults, evidence also suggests awareness of herd immunity – or when a critical threshold of individuals is vaccinated so as to make it harder for an illness to spread – can have a positive effect on one’s intention to be vaccinated. Though adults are most concerned about their personal risk of getting sick, they can also be sensitive to the societal benefits of vaccination. However, when it comes to parents deciding whether to vaccinate their children, it may be more important to focus on the direct benefits of immunization for the child. Though mentioning societal benefits of vaccination will likely not hurt.
To presume or not presume?
In order to increase vaccine uptake among parents for their children, some researchers recommend a “presumptive” approach, which assumes parents are going to vaccinate their children. This is compared to a “participatory” approach in which the health-care provider asks parents about their preferences on vaccination. These investigators question the appropriateness of shared decision making in the context of vaccine decisions.
However, other researchers advocate for a “guiding” approach. Here the focus is on addressing vaccine-hesitant parents’ concerns and helping them to understand vaccines’ importance and necessity. It differs from a “directive” approach wherein the provider essentially instructs parents to vaccinate.
More research is needed to determine which interventions and ways of communicating information about vaccination are most effective at reducing parents’ vaccine hesitancy and refusal. What is clear from existing research is that respectful, tailored communications and recommendations to immunize coming directly from the health-care provider are associated with increased vaccination uptake.
Given international trends, the United States will relinquish its historical international lead in biomedical research in the next decade unless certain measures are undertaken.
This is the issue that wakes me up at night when I try to contemplate the future of where biomedical research can go in the United States. (Young Scientists) are finding themselves in a situation that is the least supportive of that vision in 50 years. They look ahead of them and see the more senior scientists struggling to keep their labs going and suffering rejection after rejection of grants that previously would have been supportive. And they wonder, ‘Do we really want to sign up for that?’ And many of them, regrettably, are making the decision to walk away.