The Future of Medicine: The HIV Prevention Pill

https://i2.wp.com/cdn3.vox-cdn.com/uploads/chorus_image/image/35164636/Andrew_Cuomo_2013__2_.0_standard_640.0.jpgEarlier this month, New York State governor Andrew Cuomo did something very meaningful and unexpected. In an effort to drastically cut the rate of new infections in the state, he announced that he was backing the development of Truvada – the controversial HIV prevention pill. The pill was officially endorsed by the CDC in May, but this is the first time that a high-level elected official has recommended its use.

Currently, about 3,000 new HIV infections are reported in New York state each year. Cuomo wants to reduce that to 750 by 2020, and to do so, he has introduced a three-pronged strategy. Parts one and two focus on more HIV tests and getting more people with HIV to see physicians. But the third part, which includes making Truvada readily available, has the potential to cause a stir since some believe that an HIV-prevention pill promotes lower rates of condom use.

truvada_0Luckily, a recent scientific study conducted by the University of California at San Fransisco found no link between use of the drug and condom use. More importantly, the drug has a proven track record when it comes to preventing HIV. Recent reports state that it cuts infection rates by more than 90 percent, and people who take the drug every day are 99 percent protected from the onset of infection.

Furthermore, despite its $13,000-a-year price tag, the drug is covered by most insurers. So, its continued obscurity appears to have more to do with marketing than anything else. In truth, many people who are at risk for HIV still aren’t aware of the drug’s existence. And despite the CDC’s recent backing, its manufacturer, Gilead, has yet to market the drug for HIV prevention, even though it is currently used as part of treatment regimens.

http://cbsnewyork.files.wordpress.com/2014/03/479278263_10.jpg?w=620&h=349&crop=1This is why Cuomo’s announcement, which took place during Pride Weekend, was so important. By backing the drug formally, and encouraging physicians to get the word out, he is helping to promote awareness and curb HIV infection rates. Naturally, there are those who think Cuomo’s announcement is part of a ploy to get votes from members of the LGBTQ community.

Given the recent decline in condom use among teens of all sexual orientations, this is certainly good news. While a drug like this does nothing to prevent the acquisition of other STIs – such as gonorrhea or chlamydia – it is important to remember that these diseases are treatable and non-fatal. Ultimately, having an HIV prevention drug available will ensure that there is a preventive measure in place that people are more likely to use.

HIV-budding-ColorBeside the Truvada endorsement, the state is also set to start enforcing a 2010 law that requires doctors to regularly offer HIV testing to patients between the ages of 13 and 65. And the state recently repealed a law that asked doctors and nurses to obtain written consent from patients before performing HIV tests, because the requirement acted as a barrier to testing.

As a recent article in The New York Times points out, the most notable aspect of the state’s rejuvenated approach to combating HIV is the combined economics of the strategies involved. None of these methods should lead to increased spending because they don’t include new medical breakthroughs. Instead, the state will probably end up saving money since every prevented HIV case saves about $400,000 in medical costs.

https://i2.wp.com/media.sacbee.com/static/weblogs/photos/images/2011/jun11/gay_pride_ny_sm/gay_pride_ny_09.jpgAnd this is just one of many HIV preventions that has been proven safe, effective, and ready to market. Between bee-venom nanoparticle treatments, vaccines, and even topical creams that have been proven to eliminate the virus, the coming decades are likely to see a severe drop in the number of deaths associated with the disease. And by mid century, who knows? The disease that became the plague of the 20th century may finally be history!

Source: theverge.com, nytimes.com

Biggest Scientific Breakthroughs of 2013

center_universe2The new year is literally right around the corner, folks. And I thought what better way to celebrate 2013 than by acknowledging its many scientific breakthroughs. And there were so many to be had – ranging in fields from bioresearch and medicine, space and extra-terrestrial exploration, computing and robotics, and biology and anthropology – that I couldn’t possibly do them all justice.

Luckily, I have found a lovely, condensed list which managed to capture what are arguably the biggest hits of the year. Many of these were ones I managed to write about as they were happening, and many were not. But that’s what’s good about retrospectives, they make us take account of things we missed and what we might like to catch up on. And of course, I threw in a few stories that weren’t included, but which I felt belonged.

So without further ado, here are the top 12 biggest breakthroughs of 2013:

1. Voyager 1 Leaves the Solar System:

For 36 years, NASA’s Voyager 1 spacecraft has travelling father and farther away from Earth, often at speeds approaching 18 km (11 miles) per second. At a pace like that, scientists knew Voyager would sooner or later breach the fringe of the heliosphere that surrounds and defines our solar neighborhood and enter the bosom of our Milky Way Galaxy. But when it would finally break that threshold was a question no one could answer. And after months of uncertainty, NASA finally announced in September that the space probe had done it. As Don Gurnett, lead author of the paper announcing Voyager’s departure put it: “Voyager 1 is the first human-made object to make it into interstellar space… we’re actually out there.”

voyager12. The Milky Way is Filled with Habitable Exoplanets:

After years of planet hunting, scientists were able to determine from all the data gathered by the Kepler space probe that there could be as many as 2 billion potentially habitable exoplanets in our galaxy. This is the equivalent of roughly 22% of the Milky Way Galaxy, with the nearest being just 12 light years away (Tau Ceti). The astronomers’ results, which were published in October of 2013, showed that roughly one in five sunlike stars harbor Earth-size planets orbiting in their habitable zones, much higher than previously thought.

exoplanets23. First Brain to Brain Interface:

In February of 2013, scientists announced that they had successfully established an electronic link between the brains of two rats. Even when the animals were separated by thousands of kms distance, signals from the mind of one could help the second solve basic puzzles in real time. By July, a connection was made between the minds of a human and a rat. And by August, two researchers at the Washington University in St. Louis were able to demonstrate that signals could be transmitted between two human brains, effectively making brain-to-brain interfacing (BBI), and not just brain computer interfacing (BCI) truly possible.

brain-to-brain-interfacing4. Long-Lost Continent Discovered:

In February of this year, geologists from the University of Oslo reported that a small precambrian continent known as Mauritia had been found. At one time, this continent resided between Madagascar and India, but was then pushed beneath the ocean by a multi-million-year breakup spurred by tectonic rifts and a yawning sea-floor. But now, volcanic activity has driven the remnants of the long-lost continent right through to the Earth’s surface.

Not only is this an incredibly rare find, the arrival of this continent to the surface has given geologists a chance to study lava sands and minerals which are millions and even billions of years old. In addition to the volcanic lava sands, the majority of which are around 9 million years old, the Oslo team also found deposits of zircon xenocryst that were anywhere from 660 million to 1.97 billion years old. Studies of these and the land mass will help us learn more about Earth’s deep past.

mauritia5. Cure for HIV Found!:

For decades, medical researchers and scientists have been looking to create a vaccine that could prevent one from being infected with HIV. But in 2013, they not developed several vaccines that demonstrated this ability, but went a step further and found several potential cures. The first bit of news came in March, when researchers at Caltech demonstrated using HIV antibodies and an approach known as Vectored ImmunoProphylaxis (VIP) that it was possible to block the virus.

Then came the SAV001 vaccine from the Schulich School of Medicine & Dentistry at Western University in London, Ontario, which aced clinical trials. This was punctuated by researchers at the University of Illinois’, who in May used the “Blue Waters” supercomputer to developed a new series of computer models to get at the heart of the virus.

HIV-budding-ColorBut even more impressive was the range of potential cures that were developed. The first came in March, where researchers at the Washington University School of Medicine in St. Louis that a solution of bee venom and nanoparticles was capable of killing off the virus, but leaving surrounding tissue unharmed. The second came in the same month, when doctors from Johns Hopkins University Medical School were able to cure a child of HIV thanks to the very early use of antiretroviral therapy (ART).

And in September, two major developments occurred. The first came from Rutgers New Jersey Medical School, where researchers showed that an antiviral foot cream called Ciclopirox was capable of eradicating infectious HIV when applied to cell cultures of the virus. The second came from the Vaccine and Gene Therapy Institute at the Oregon Health and Science University (OHSU), where researchers developed a vaccine that was also able to cure HIV in about 50% of test subjects. Taken together, these developments may signal the beginning of the end of the HIV pandemic.

hiv-aids-vaccine6. Newly Discovered Skulls Alter Thoughts on Human Evolution:

The discovery of an incredibly well-preserved skull from Dmanisi, Georgia has made anthropologists rethink human evolution. This 1.8 million-year old skull has basically suggested that our evolutionary tree may have fewer branches than previously thought. Compared with other skulls discovered nearby, it suggests that the earliest known members of the Homo genus (H. habilis, H.rudolfensis and H. erectus) may not have been distinct, coexisting species, but instead were part of a single, evolving lineage that eventually gave rise to modern humans.

humanEvolution7. Curiosity Confirms Signs of Life on Mars:

Over the past two years, the Curiosity and Opportunity rovers have provided a seemingly endless stream of scientific revelations. But in March of 2013, NASA scientists released perhaps the most compelling evidence to date that the Red Planet was once capable of harboring life. This consisted of drilling samples out of the sedimentary rock in a river bed in the area known as Yellowknife Bay.

Using its battery of onboard instruments, NASA scientists were able to detect some of the critical elements required for life – including sulfur, nitrogen, hydrogen, oxygen, phosphorus, and carbon. The rover is currently on a trek to its primary scientific target – a three-mile-high peak at the center of Gale Crater named Mount Sharp – where it will attempt to further reinforce its findings.

mt_sharp_space8. Scientists Turn Brain Matter Invisible:

Since its inception as a science, neuroanatomy – the study of the brain’s functions and makeup – has been hampered by the fact that the brain is composed of “grey matter”. For one, microscopes cannot look beyond a millimeter into biological matter before images in the viewfinder get blurry. And the common technique of “sectioning” – where a brain is frozen in liquid nitrogen and then sliced into thin sheets for analysis – results in  tissue being deformed, connections being severed, and information being lost.

But a new technique, known as CLARITY, works by stripping away all of a tissue’s light-scattering lipids, while leaving all of its significant structures – i.e. neurons, synapses, proteins and DNA – intact and in place. Given that this solution will allow researchers to study samples of the brains without having to cut them up, it is already being hailed as one of the most important advances for neuroanatomy in decades.


9. Scientists Detect Neutrinos from Another Galaxy:

In April of this year, physicists working at the IceCube South Pole Observatory took part in an expedition which drilled a hole some 2.4 km (1.5 mile) hole deep into an Antarctic glacier. At the bottom of this hole, they managed to capture 28 neutrinos, a mysterious and extremely powerful subatomic particle that can pass straight through solid matter. But the real kicker was the fact that these particles likely originated from beyond our solar system – and possibly even our galaxy.

That was impressive in and off itself, but was made even more so when it was learned that these particular neutrinos are over a billion times more powerful than the ones originating from our sun. So whatever created them would have had to have been cataclysmicly powerful – such as a supernova explosion. This find, combined with the detection technique used to find them, has ushered in a new age of astronomy.

antarctic_expedition

10. Human Cloning Becomes a Reality:

Ever since Dolly the sheep was cloned via somatic cell nuclear transfer, scientists have wondered if a similar technique could be used to produce human embryonic stem cells. And as of May, researchers at Oregon Health and Science University managed to do just that. This development is not only a step toward developing replacement tissue to treat diseases, but one that might also hasten the day when it will be possible to create cloned, human babies.

cloning

11. World’s First Lab Grown Meat:

In May of this year, after years of research and hundred of thousands of dollars invested, researchers at the University of Maastricht in the Netherlands created the world’s first in vitro burgers. The burgers were fashioned from stem cells taken from a cow’s neck which were placed in growth medium, grown into strips of muscle tissue, and then assembled into a burger. This development may prove to be a viable solution to world hunger, especially in the coming decades as the world’s population increases by several billion.

labmeat112. The Amplituhedron Discovered:

If 2012 will be remembered as the year that the Higgs Boson was finally discovered, 2013 will forever be remembered as the year of the Amplituhedron. After many decades of trying to reformulate quantum field theory to account for gravity, scientists at Harvard University discovered of a jewel-like geometric object that they believe will not only simplify quantum science, but forever alters our understanding of the universe.

This geometric shape, which is a representation of the coherent mathematical structure behind quantum field theory, has simplified scientists’ notions of the universe by postulating that space and time are not fundamental components of reality, but merely consequences of the”jewel’s” geometry. By removing locality and unitarity, this discovery may finally lead to an explanation as to how all the fundamental forces of the universe coexist.

amplutihedron_spanThese forces are weak nuclear forces, strong nuclear forces, electromagnetism and gravity. For decades, scientists have been forced to treat them according to separate principles – using Quantum Field Theory to explain the first three, and General Relativity to explain gravity. But now, a Grand Unifying Theory or Theory of Everything may actually be possible.

13. Bioprinting Explodes:

The year of 2013 was also a boon year for bioprinting – namely, using the technology of additive manufacturing to create samples of living tissue. This began in earnest in February, where a team of researchers at Heriot-Watt University in Scotland used a new printing technique to deposit live embryonic stem cells onto a surface in a specific pattern. Using this process, they were able to create entire cultures of tissue which could be morphed into specific types of tissue.

Later that month, researchers at Cornell University used a technique known as “high-fidelity tissue engineering” – which involved using artificial living cells deposited by a 3-D printer over shaped cow cartilage – to create a replacement human ear. This was followed some months later in April when a San Diego-based firm named Organova announced that they were able to create samples of liver cells using 3D printing technology.


And then in August, researchers at Huazhong University of Science and Technology were able to use the same technique create the world first, living kidneys. All of this is pointing the way towards a future where human body parts can be created simply by culturing cells from a donor’s DNA, and replacement organs can be synthetically created, revolutionizing medicine forever.

14. Bionic Machinery Expands:

If you’re a science buff, or someone who has had to go through life with a physical disability, 2013 was also a very big year for the field of bionic machinery. This consisted not only of machinery that could meld with the human body in order to perform fully-human tasks – thus restoring ambulatory ability to people dealing with disabling injuries or diseases – but also biomimetic machinery.

ArgusIIThe first took place in February, where researchers from the University of of Tübingen unveiled the world’s first high-resolution, user-configurable bionic eye. Known officially as the “Alpha IMS retinal prosthesis”, the device helps to restore vision by converted light into electrical signals your retina and then transmitted to the brain via the optic nerve. This was followed in August by the Argus II “retinal prosthetic system” being approved by the FDA, after 20 years of research, for distribution in the US.

Later that same month, the Ecole Polytechnique Federale de Lausanne in Switzerland unveiled the world’s first sensory prosthetic hand. Whereas existing mind-controlled prosthetic devices used nerve signals from the user to control the movements of the limb, this new device sends electrostimulus to the user’s nerves to simulate the sensation of touch.

prosthetic_originalThen in April, the University of Georgia announced that it had created a brand of “smart skin” – a transparent, flexible film that uses 8000 touch-sensitive transistors – that is just as sensitive as the real thing. In July, researchers in Israel took this a step further, showing how a gold-polyester nanomaterial would be ideal as a material for artificial skin, since it experiences changes in conductivity as it is bent.

15. 400,000 Year-Old DNA Confuses Humanity’s Origin Story:

Another discovery made this year has forced anthropologist to rethink human evolution. This occurred in Spain early in December, where a team from the Max Planck Institute for Evolutionary Anthropology in Leipzig, Germany recovered a 400,000 year-old thigh bone. Initially thought to be a forerunner of the Neanderthal branch of hominids, it was later learned that it belonged to the little-understood branch of hominins known as Denisovans.

Human-evoThe discordant findings are leading anthropologists to reconsider the last several hundred thousand years of human evolution. In short, it indicates that there may yet be many extinct human populations that scientists have yet to discover. What’s more, there DNA may prove to be part of modern humans genetic makeup, as interbreeding is a possibility.

Ending HIV: New Vaccine Holds Promise for a Cure

hiv-aids-vaccineScientists and researchers have been making great strides in the fight against HIV/AIDS in recent years. In addition to developing vaccines that have shown great promise, there have even been some treatments that have been shown to eliminate the virus altogether. And it seems that with this latest development, which was published in Nature earlier this month, there might be a treatment that can double as a cure.

Developed at the Vaccine and Gene Therapy Institute at the Oregon Health and Science University (OHSU), this new vaccine proved successful in about fifty percent of the clinical subjects that were tested, and may be able to cure patients who are currently on anti-retroviral drugs. If successful, this could mean that a preventative vaccine and cure could come in the same package, thus eliminating HIV altogether.

vaccineCurrently, anti-retroviral drugs and HIV vaccine typically aim at improving the immune response of the patient in the long term. However, they are limited in that they can never completely clear the virus from the body. In fact, aside from a very few exceptional cases, researchers have long believed that HIV/AIDS could only be contained, but not completely cured.

The OHSU team, led by Dr. Louis Picker, has been working on its own vaccine for the past 10 years. In that time, their research has shown that an immune response can in fact go beyond containment and systematically wipe the virus out of the body. As with most early vaccine candidates, the study revolves around SIV – a more aggressive virus than HIV that can replicate up to 100 times faster and, unchecked, can cause AIDS in only two years.

HIV_virusPicker and his research team created the vaccine by working with cytomegalovirus (CMV), another virus which is itself persistent, but doesn’t cause disease. In their initial tests, the vaccine was found to generate an immunoresponse very similar to that generated by CMV, where T-cells that can search and destroy target cells were created and remained in the system, consistently targeting SIV-infected cells until the virus was cleared from the body.

For the sake of their clinical trials, simian subjects were used that were infected by the HIV virus. When treated with the team’s vaccine, half of the subjects initially showed signs of infection, but those signs gradually receded before disappearing completely. This sets it apart from other vaccines which also generate an immunoresponse, but one which fades over time.

HIVAccording to Dr. Picker, it is the permanency of the T-cells that allows the immunoresponse to be consistent and slowly eradicate the virus, eventually eliminating it completely from the system. Says Dr. Picker of their trials and the possibilities for the vaccine:

The virus got in, it infected some cells, moved about in various parts of the body, but it was subsequently cleared, so that by two or three years later the monkeys looked like normal monkeys. There’s no evidence, even with the most sensitive tests, of the SIV virus still being there... We might be able to use this vaccine either to prevent infection or, potentially, even to apply it to individuals who are already infected and on anti-retroviral therapy. It may help to clear their infections so ultimately they can go off the drugs.

Currently, Picker and his the team are trying to understand why some of the vaccinated animals did not respond positively, in the hopes of further increasing the efficacy of the vaccine. Once these trials are complete, it could be just a hop, skip and a jump to getting FDA approval and making the vaccine/cure available to the open market.

Cure_for_HIVImagine, if you will, a world where HIV/AIDS is on the decline, and analysts begin predicting how long it will take before it is eradicated entirely. At this rate, such a world may be just a few years away. For those working in the field of medicine, and those of us who are around to witness it all, it’s an exciting time to be alive!

And be sure to enioy this video from OHSU where Dr. Picker speak about their vaccine and the efforts to end HIV:


Sources:
gizmag.com, nature.com

Ending HIV: Foot Cream Kills HIV Cells!

HIV-budding-ColorThe fight to end HIV has been long and ongoing. But in recent years, researchers have made some incredible breakthroughs in terms of treatment and vaccines. Well as it turns out, the fight may be getting a punch in the arm from a most unlikely source – an anti-fungal foot cream! Yes, not only does this common drug kill HIV, it is even more effective than some of today’s most cutting-edge drugs.

In a study performed at Rutgers New Jersey Medical School, the drug Ciclopirox was shown to completely eradicate infectious HIV when applied to cell cultures of the virus. But what was even more impressive was the fact that the virus didn’t bounce back when the drug was withheld. This means that, unlike most anti0viral drugs, it may not require a lifetime of use to keep HIV at bay.

ciclopiroxThe same group of researchers had previously shown that Ciclopirox – which was approved by the FDA and Europe’s EMA to treat foot fungus – inhibits the expression of HIV genes. Now they have found that it also blocks the essential function of the mitochondria, which results in the reactivation of the cell’s suicide pathway, all while sparing surrounding healthy cells.

This is key since one of the worst aspects of HIV – one that makes it particularly persistent, even in the face of strong antiviral treatments – is its ability to disable a cell’s altruistic suicide pathway. This “self-destruct protocol” is typically activated when a cell is damaged or infected. With the introduction of Ciclopirox, these cells are tricked into pulling a double negative, disabling the disabling of the suicide pathway.

HIVNaturally, the cream will have to be tested on humans before its efficacy as a topical HIV treatment can be tested. However, the fact that it’s already been deemed safe for one type of human use could make the regulatory process faster than usual. In fact, the researchers have noted that another FDA-approved drug now thought to help subdue HIV (called Deferiprone) skipped animal studies and went straight to human trials in South Africa.

Naturally, the Rutgers team hopes they too can go directly from their culture studies to human trials, and that the case involving Deferiprone will pave the way for a more streamlined testing process. This is likely, seeing as how there have been many breakthroughs in recent months and everyone – from researchers to patients to medical authorities – want to make treatments available as soon as possible.

Source: news.cnet.com