Tuesday, July 5, 2016

Morning Rounds by Megan Thielking

Welcome back from the weekend, folks! Here's what you need to know about science and medicine today. 

Pediatricians call for overhaul of chemical exposure regulations

Pediatricians and public health experts are calling on the federal government to pay closer attention to chemicals that can harm children's health. Neurodevelopmental disorders among children have spiked 17 percent in the last decade, and toxic chemicals may be partially to blame, they say. “The current system in the United States for evaluating scientific evidence and making health-based decisions about environmental chemicals is fundamentally broken,” the authors say in a call to action published in Environmental Health Perspectives. Their to-do list: overhaul how government agencies determine the health risks of chemical exposure, change how chemical use is regulated in business, and examine how scientific evidence is (or isn’t) used in making regulatory decisions.

NIH prepping to roll out precision medicine news

The NIH is planning to reveal some exciting news about the Precision Medicine Initiative this week, including collaborations with health providers to get patients enrolled in the research, NIH director Dr. Francis Collins told STAT. 

But come January, will the initiative survive under a new administration? Collins said there's a "very good chance of a smooth continuation" of precision medicine and of the administration's other medical research initiatives, including the BRAIN Initiative and Vice President Joe Biden's cancer moonshot. That’s because they have broad support in Congress, giving them a good shot at continued funding. "Nobody I've talked to in the Congress thinks of these as, 'Oh, those are Obama's projects,' " Collins said.

Lab Chat: Boosting the immune system by giving T cells a push

A close-up look at human tonsils, with activin A (in red) more plentiful in areas with T lymphocytes (in green). (La Jolla Institute for Allergy and Immunology)

Scientists have discovered a way to potentially create stronger, more robust vaccines by hijacking a newly discovered signaling protein that helps certain immune cells grow. Many vaccines work by getting the body’s antibodies to respond, and immune cells called Tfh, or T follicular helper cells, are key to that process. Here’s what Shane Crotty of the La Jolla Institute told me about the findings, published in Nature Immunology.

What role do T cells play in producing antibodies?

B cells make antibodies, but they don't do it on their own. For most antibody responses to infections, B cells require help every step of the way from T cells. Specifically CD4 T cells. And it turns out that the help has to come from a specialized type of CD4 T cell: a T follicular helper cell, Tfh. Since Tfh cells are required for most antibody responses, it is valuable to understand what triggers Tfh cell development. This has been unknown. We tested 2,000 different human proteins and discovered that an unusual protein called Activin A can potently induce Tfh cells.

What's the application of that finding?

Since you need Tfh cells for protective antibody responses against almost all viruses and bacteria, it would be valuable to be able to better make Tfh cells for vaccines, to get better antibody responses against things like Zika virus or HIV. Triggering activin A may accomplish that. In contrast, there are also diseases where people make “bad’ immune responses against their bodies, autoimmune diseases ... it would be very valuable to shut down those antibody responses. Blocking Tfh cells may do that, and therefore blocking activin A may do that.

sponsor content by dartmouth-hitchcock

Unraveled: Prescriptions to repair a broken health care system

“We know more about what’s in a cereal box than we do about what’s in the health care system,” says Dartmouth-Hitchcock CEO Dr. James Weinstein. Our health system continues to grow in complexity, challenging patients to know what care to receive and what care to avoid. In the new book Unraveled: Prescriptions to Repair a Broken Health Care System, Weinstein makes the case that to transform our health system, it must be more patient-centered. Read more.

Inside STAT: Biotech's big bet on hacking a pain gene

Reports of individuals who could walk on hot coals or sustain great injury without feeling pain long baffled scientists — that is, until, they discovered a genetic mutation that can flip pain on and off. It’s the same mutation that’s responsible for causing excruciating pain at random in other patients. Now, biotech companies like Genentech and Biogen are making big bets that they can develop drugs to toggle that pain relief switch on and off without running the risk of addiction. Damian Garde takes you on the race to develop better, safer pain relief — read here.

Obama administration launches effort to address health issues in jails

Local jails are home to a huge public health crisis — 64 percent of inmates suffer from mental illness, 68 percent have a substance abuse disorder, and 44 percent have chronic health problems. Now, the White House is launching the Data-Driven Justice Initiative to address those issues. They’ll comb through records to identify individuals who regularly come on the radar of police and emergency room staff. Then, they’ll try to connect those people with physical and mental health care to slash ER visits and run-ins with police at the same time. The Obama administration has 67 city, county, and state-level governments on board already.

Spaghetti spat boils on with a new healthy diet study

The back-and-forth over carbs gets new ammunition with a study out today that claims eating pasta is associated with a healthy BMI and a slimmer waist. That’s the finding Italian researchers came to after studying the diets and health outcomes of more than 23,000 people. But before you get excited twirling spaghetti onto your fork over that headline, know that there’s the same catch as always with this type of study. It’s just an observed association — there’s no way to parse out how individual food choices affect a person’s overall health. 

How a school-wide HPV vaccine program paid off

Young women who receive all three doses of the HPV vaccine go on to have lower levels of abnormal cervical cells than those who don’t, according to a new study of more than 10,000 women vaccinated through a school program in Alberta. They are also more likely to get cervical cancer screenings at the recommended intervals, according to the study, published in the Canadian Medical Association Journal. That suggests vaccination and screening programs could work well together to prevent cervical cancer cases. 

What to read around the web today

  • Hospitals increasingly turn to nocturnists. Boston Globe
  • A tender hand in the presence of death. New Yorker
  • How software bugs could upend years of research. The Register

More reads from STAT

Thanks for reading! More tomorrow,


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