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Thursday, May 19, 2016

Morning Rounds by Megan Thielking

Happy Thursday, everyone! Here's what's driving the day in science and medicine. 

Senate makes moves on three-parent embryos

A bill that would ban mitochondrial replacement therapy — the technique used to produce a "three-parent embryo" — is being looked over by a Senate committee for a first reading today. The technique is a tweak on in vitro fertilization that can eliminate the risk of a mother with mitochondrial disease passing the condition on to her child. It’s done by either taking the DNA of a mother and placing into the egg of a healthy female donor, or by creating an embryo with a mother and father’s DNA and then replacing its nucleus with one from a healthy female donor. The FDA prohibits the practice, but an expert panel recently recommended the FDA approve it for clinical trials to help women with mitochondrial disease. The practice was approved for use in the UK last year.

WHO weighs threat of yellow fever outbreak

Today, an "emergency committee" will weigh in on how, exactly, the WHO should respond to the yellow fever outbreak in Angola. The panel of outside experts will discuss whether the outbreak ought to be classified as a global public health emergency. More here

Lab Chat: Why scientists are stripping soap out of drugs

Drug particles suspended in a solution almost completely free of surfactants. (JONATHAN LOVELL, UNIVERSITY OF BUFFALO)
A new drug-making technique could significantly cut down on side effects of injectable medications. Chemicals called surfactants are used to make drugs dissolve in water, but the chemicals can cause allergic reactions and other problems when administered. Here’s what study author Jon Lovell of University of Buffalo told me about the new technique, described in this morning’s Nature Communications.

What are surfactants, and what’s the problem with them?

Most drugs don’t dissolve in water very well. To get them to dissolve in water, quite often people in the pharmaceuticals industry use surfactants, which are basically soap. Soap is able to get things to dissolve in water, so that’s the approach for many injectable drugs. The problem with that is there can be side effects from the soap itself, and the soap can affect the behavior of the drug as well.

How does your technique address those issues?

It minimizes the amount of surfactant used; it’s called surfactant stripping. We dissolved the hydrophobic drug in a special surfactant that when you lower the temperature, it stops having a surfactant quality. The drug that is remaining is still in what’s called micelle form, but at the lower temperature, the surfactant is in what’s called unimer form, which is much smaller than the micelle form. So we can strip out the unimer surfactant because it can pass through small pores in the cellular membrane. The drug is too big to do so and remains behind. There’s a bare minimum amount of surfactant left to keep the drug soluble.

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Research doesn’t end on a medicine’s approval

Research is a critical part of developing new and innovative medicines, but doesn’t end once a medicine is approved by the FDA. That’s when post-approval research and monitoring begin; helping patients and physicians better understand a medicine’s full value. This research uses data known as real-world evidence, derived from patients, providers and payers. A broader use of real-world evidence can lead to a greater understanding of treatment options, providing more hope for patients. Learn more here.

House passes Zika funding bill

A clash with the Obama administration is on the horizon after the House passed a $622 million Zika funding bill late Wednesday. That's far less money than the administration asked for, and only about half of what the Senate offered in their version of the bill, passed Tuesday. The House measure saw a deeply divided vote, almost completely along party lines. More on what's to come from David Nather here

What to make of dueling antimicrobial findings

Two new studies on the potential dangers of a popular antimicrobial have come to two very different conclusions. There’s been concern that triclosan — an antimicrobial commonly used in soaps and toothpastes — poses a threat to human health. One study, published in the journal mSphere, finds that triclosan doesn’t make a significant impact on the human microbiome or function of the endocrine system. But another new study, this one published in PLOS ONE, finds that triclosan can change the bacterial communities thriving in the gut of an animal model. 

The mSphere findings came out of a randomized trial of 13 people who were either given household products containing triclosan or products without, which they used for four months. The PLOS finding came from a study of zebrafish fed the antimicrobial. Neither study provides robust evidence of the real, long-term effects of triclosan. "One thing that’s not especially clear is how much triclosan the human gut encounters on a daily basis," Thomas Sharpton, an Oregon State microbiologist and author of the PLOS ONE study, explained to me. The dueling conclusions suggest there's a need for a deeper dive into triclosan's effects. 

Inside STAT: Why there still isn't a cure for sickle cell disease

We’ve known for 50 years what causes sickle cell disease, but there’s no cure for it, no moonshot, no ice bucket challenge. Fewer than a dozen labs in the US are dedicated to studying sickle cell disease. “Sickle cell patients have never been at the front of the line,” said Dr. David Nathan, a past president of Dana-Farber, who played a part in discovering the only drug that partially treats sickle cell. “This work, especially clinical trials, is hugely expensive, and the National Institutes of Health and private foundations haven’t prioritized it.” What will it take to actually get to a cure? Sharon Begley explores that question here.

The tiny animal behind recent salmonella outbreaks

There’s an unsuspecting culprit behind a recent salmonella outbreak — tiny turtles. The CDC says there have been outbreaks in four states since mid-January tied to contact with small turtles. Turtles with shells less than four inches long have been banned as pets for decades because of their potential to spread salmonella. The agency says 38 people have been hospitalized, though no deaths have been reported in connection with the outbreaks. More than 40 percent of the people who’ve fallen ill were children age 5 or younger. For more on turtles and salmonella, read this

Asian Americans report better health than the general population 

Asian adults in the US are in much better health than the rest of the general population, according to new data out from the CDC this morning. Chinese adults are about half as likely as all other adults in the US to have multiple chronic conditions; just 11.3 percent of Chinese adults have more than one long-term health problem. Asian adults were also about half as likely to have reported serious psychological distress in the past month than all US adults (1.7 percent compared to 3.2 percent, respectively). 

What to read around the web today

  • America's health segregation problem. The Atlantic 
  • Clearing up the confusion about metabolism. Vox
  • Reflecting on stealth research and Theranos. JAMA

More reads from STAT

  • As takeover talks drag on, Baxalta employees find themselves in merger limbo
  • Sexist state laws hold back many nurse practitioners
  • Valeant price hikes will pay for generous executive retention bonuses. 

Thanks much for reading! If you like this newsletter, pass it along to a friend. More tomorrow morning, 

Megan

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