Breaking News

Diversifying brain research in Alzheimer's, delivering proteins a new way, & Marburg cases going unreported

March 30, 2023
Reporter, Morning Rounds Writer
Good morning. Like a parent with no favorite children, I can't pick the best item this morning. But do read Usha Lee McFarling's important profile of one neuroscientist and her herculean effort to better understand how dementia affects Black people, and then explore Jason Mast's curious story of how a grass grub beetle was the starting point for what could be a new way to deliver genetic medicine.

in the lab

This scientist is on a quest to fill knowledge gaps of how Alzheimer's affects Black people

Cognitive neuropsychologist Lisa Barnes poses for a portrait Olivia Obineme for STAT

Cognitive neuroscientist Lisa Barnes (above) has spent her career quietly pushing back on how few Black people like her family members are included in studies of dementia. She and others have posed critical questions about how the disease differs in Black populations, why cognitive testing relied on to clinically diagnose dementia may fail Black patients, and whether the disease progresses differently in them. Among her most-cited work is a study showing a gene variant tightly linked to Alzheimer's in white people isn't in Black people, even though it's found more frequently among them.

"It wasn't an aha moment, it was more like a duh moment," Barnes said of her decision to focus on studying Black populations. "Why wouldn't we?" Her commitment meant gaining the trust of a population where many of the people she hoped to study were deeply suspicious of medical science and its experiments. STAT's Usha Lee McFarling tells us how she succeeded where others have failed.


infectious disease

Marburg cases aren't being reported by Equatorial Guinea, WHO says

There's a growing outbreak of Marburg virus disease in Equatorial Guinea, but how many people are affected and where it's spreading are hard to establish. The WHO said yesterday it knows of confirmed cases beyond what the country has reported. So far Equatorial Guinea has acknowledged nine laboratory-confirmed cases, seven of whom have died. In addition, 20 other people with links to the confirmed cases died without being tested; they are considered probable cases. The country has been slow to release updates since the outbreak began in January, sparking fears at WHO that there may be undetected chains of transmission.

WHO's Mike Ryan is exasperated. "Any delay in releasing information about lab-confirmed cases, especially when it relates to newly affected areas, prevents the process of alerting communities and having them take action to protect themselves and their families." STAT's Helen Branswell has more.


Health

British Columbia plans to ban Ozempic sales to Americans

Amid high demand for a drug that helps control blood sugar in diabetes but can also lead to weight loss, a Canadian province will bar sales of Ozempic to Americans. In the first two months of the year, 15% of the roughly 16,000 Ozempic dispenses in British Columbia went to U.S. residents (the lion's share from just two pharmacies), the province said in a release yesterday. That compares to an average 0.4% of other drugs sold to Americans.

British Columbia hasn't experienced shortages of the drug, the province said, unlike months-long shortages last year in the U.S. of both Ozempic and Wegovy, a similar drug, last year. British Columbia stressed that while Ozempic can be prescribed off-label for weight loss, it should be dispensed in the province only as a diabetes treatment. Pharmacies there can fill prescriptions written by U.S. doctors if they're co-signed by a Canadian practitioner. STAT's Elaine Chen has more.



Closer Look

A new way to deliver proteins could solve a central challenge in genetic medicine

Drawing of a Scarabaeidae Costelyra zealandica - New Zealand grass grub beetleDes Helmore/Manaaki Whenua – Landcare Research

Delivery, delivery, delivery. Like location in real estate, getting gene therapy where it needs to go has been the steepest mountain to climb. Now an answer may be emerging from the lab of CRISPR pioneer Feng Zhang (here's a prescient profile), inspired by a New Zealand scientist studying the grass grub beetle (above) who discovered bacteria armed with poison darts. Writing in Nature, Zhang's team reports their tool can precisely send any protein of their choosing to any cell of their choosing. So far it's only in lab dishes and in mice and it cannot be used today to deliver CRISPR, but it adds to new delivery solutions advanced by top CRISPR labs.

Right now delivering proteins into patients' bodies means encoding them in lipid nanoparticles or in benign viruses. That limits where they can go. But the new tool engineered in the Zhang lab is among the world's smallest syringes, with a long body and a sharp spike. STAT's Jason Mast explains how it works.


addiction

In a first, Narcan goes over the counter

The overdose-reversing drug naloxone can now be sold without a prescription, the FDA said yesterday, making it the first opioid-treatment drug to be sold over the counter. Narcan is the brand name for the best-known form of naloxone, which can undo overdoses of opioids such as heroin and fentanyl as well as prescription versions including oxycodone. Most of the more than 100,000 U.S. overdose deaths a year are due to opioids, and most of them on potent synthetic versions such as fentanyl.

Narcan will become available over-the-counter by late summer. Already available in pharmacies in states that allow it, FDA approval means now it can be sold in convenience stores, supermarkets, and online retailers. But Narcan is just one version. As STAT's Lev Facher reported earlier this week, pharma companies are aggressively marketing high-cost naloxone products that divert resources from cheaper forms, off patent for nearly 40 years.


science

Gairdners honor achievements in protein structure, bacterial communication, and perinatal care

The Canada Gairdner Awards belong to a select club known as Nobel predictors, along with Lasker and Horwitz prizes. This year's Gairdners, announced today, honor work predicting protein structure, understanding how microbes behave, and developing low-cost global interventions in perinatal maternal and child health. The winners are:

  • Demis Hassabis and John Jumper, both of DeepMind, for creating AlphaFold, an AI-based technology for protein structure prediction, "with enormous potential to accelerate biological and medical research." 
  • Bonnie Bassler of Princeton, Peter Greenberg of the University of Washington School of Medicine, and Michael Silverman of the Agouron Institute for discovering how bacteria communicate, "yielding novel avenues for therapeutics against infectious diseases." 
  • José Belizán of the Institute for Clinical Effectiveness and Health Policy Argentina for developing programs that improve well-being and care during pregnancy, reduce morbidity and mortality, and promote equity in vulnerable populations, demonstrating "the importance of representation from low- and middle-income countries in global health research."

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Thanks for reading! More tomorrow,


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