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Why are women more likely to develop autoimmune disorders? 

February 2, 2024
Reporter, Morning Rounds Writer
Good morning. Leave it to Jonathan Wosen to weave a connection between autoimmune diseases and calico cats.

addiction

New rules would ease access to methadoneAP_17139618129799

Kevin D. Liles/AP

Methadone is a proven treatment for opioid addiction, helping about 60% of people avoid an overdose. But regulations surrounding treatment — frequent drug testing, participation in counseling sessions, and showing up daily to receive a single dose — have earned it the nickname "liquid handcuffs." Now, for the first time in more than 20 years, the federal government is updating its rules around methadone treatment to make it more accessible.

As of April, clinic doctors will be able to prescribe larger doses to new patients and also write scripts for "take home" medication so patients can go to clinics less often. These changes reflect pandemic modifications: Studies have shown that with that wider access, methadone misuse and overdoses involving methadone did not increase. "The easier we make it for people to access the treatments they need, the more lives we can save," Andrea Palm, HHS deputy secretary, said in a statement. STAT's Lev Facher has more.


in the lab

Mice may hold clues to why women are more likely to develop autoimmune disorders

It's pretty clear that women are more likely than men to develop autoimmune disorders, making up 90% of lupus patients and 95% of those with Sjögren's syndrome, for example. To understand why, scientists have looked at X chromosomes. Females carry two copies while males have one — except people with Klinefelter's syndrome. They have two X's and one Y, and while biologically male, they have an increased risk of autoimmunity compared to XY males. That caught the eye of Stanford scientists, who figured something on the X chromosome contributes to autoimmunity.

Now the team reports in Cell that they've found that something in mice: Xist, an RNA molecule that joins proteins to keep female cells from activating a double (and deadly) dose of X chromosome genes. That molecule can steer the body toward the friendly fire that defines autoimmune disorders. "This is like a completely different and novel explanation for female bias in immune disease," said Howard Chang, the study's senior author. STAT's Jonathan Wosen has more, including caution from an outside observer and a note that calico cats are an example of X inactivation.


public health

Latest Covid booster offers 54% protection against infection

Uptake of the latest Covid-19 booster may not be where public health experts would like to see it, but new data from CDC say its roughly 54% protection against infection is both significant and what's expected. Ruth Link-Gelles, the vaccine effectiveness program lead in the CDC's National Center for Immunization and Respiratory Diseases, told STAT's Helen Branswell the "50% added protection against Covid-19 is really going to be a meaningful increase in protection, especially for those at highest risk."

In a good year, influenza vaccines offer protection in this range, Arnold Monto of the University of Michigan pointed out. The CDC study, published yesterday, showed that the updated vaccine was essentially equally effective at protecting against the strain targeted by the vaccine — XBB.1.5 — and the JN.1 subvariant, which emerged after the vaccine was made. JN.1 is currently the dominant virus circulating in the U.S. Helen has more.



closer look

Texas board pushed to define 'emergency' exemption of abortion banAP23339736138417

Eric Gay/AP 

The two sides of the abortion divide in Texas agree on one thing: The state's medical board should define what constitutes a medical emergency allowing an exemption to the ban on abortion. Two high-profile abortion supporters filed a petition in January asking the board to say what would be grounds for a legal abortion. And Joe Pojman, executive director of the anti-abortion group Texas Alliance for Life, said, "We think that timing is overdue for the Texas Medical Board to act." 

The petition requires a response by mid-March. Without specific guidance on what exactly constitutes an emergency, doctors and hospitals now fear prosecution. Pregnant patients whose lives are at risk have had to leave the state for abortions. "The cost of making that judgment and being deemed wrong are huge," said Dallas OB-GYN Damla Karsan, who unsuccessfully sought a court's permission to perform an abortion for her patient Sarah Cox in December. STAT's Olivia Goldhill has more.


health

Optometrist waves a caution flag on myopia treatment gaining popularity in China

Helping near-sighted children see better has gone way beyond glasses. There are special eye drops and contact lenses to stop myopia from progressing. More recently, reports from China have said low-level red-light therapy delivered directly to the eye brings far better results. Seeing that some children's myopia even regressed caught the attention of Lisa Ostrin of the University of Houston College of Optometry.

After looking more deeply into the clinical trials of the treatment, Ostrin urges caution in a new paper published in the College of Optometrists' journal, Ophthalmic and Physiological Optics. Low-level red-light devices may actually cause more harm than good. "We see from the clinical trials that it absolutely is slowing myopia," she said. "But there's no explanation right now for the mechanism of how that's happening." For example, it could prevent the retina from growing normally, damaging it even as it treats the myopia. STAT's Annalisa Merelli has more.


health

High school football players have brain changes

High school football players already have differences in their brains compared to swimmers, cross-country runners, and tennis players, a new study in JAMA Network Open says, contrary to thinking that says it takes years of head impacts to change brain structure. Researchers studied 205 male football players and 70 other male athletes at five Midwestern high schools. Using advanced neuroimaging techniques, they found structural and physiological differences in brain regions that have been linked to mental health and well-being.

Football players had cortical thinning and changes in brain folding as well as lower brain signaling and coherence in frontal and medial parts of the brain, but increased signaling and coherence in the occipital lobe. "These findings suggest playing football may be associated with a different trajectory of cortical maturations and aging processes," the authors write, recommending a longer study to track "subtle yet cumulative changes in brain structure and neurophysiological effects due to repetitive head impacts."


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What we're reading

  • Deer are beta-testing a nightmare disease, The Atlantic

  • Harvard professor's papers contain copied images, science sleuth claims, Wall Street Journal
  • A Tennessee lawmaker helped pass a strict abortion law. He's now trying to loosen it, NPR
  • Raleigh-Durham challenges Boston as biomanufacturing hub of the future, Boston Globe
  • Opinion: Medicare has different standards than the FDA. That's how it should be, STAT

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