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

Looking Forward: Science Stories to Watch for in 2014

BrightFutureThe year of 2013 was a rather big one in terms of technological developments, be they in the field of biomedicine, space exploration, computing, particle physics, or robotics technology. Now that the New Year is in full swing, there are plenty of predictions as to what the next twelve months will bring. As they say, nothing ever occurs in a vacuum, and each new step in the long chain known as “progress” is built upon those that came before.

And with so many innovations and breakthroughs behind us, it will be exciting to see what lies ahead of us for the year of 2014. The following is a list containing many such predictions, listed in alphabetical order:

Beginning of Human Trials for Cancer Drug:
A big story that went largely unreported in 2013 came out of the Stanford School of Medicine, where researchers announced a promising strategy in developing a vaccine to combat cancer. Such a goal has been dreamed about for years, using the immune system’s killer T-cells to attack cancerous cells. The only roadblock to this strategy has been that cancer cells use a molecule known as CD47 to send a signal that fools T-cells, making them think that the cancer cells are benign.

pink-ribbonHowever, researchers at Stanford have demonstrated that the introduction of an “Anti-CD47 antibody” can intercept this signal, allowing T-cells and macrophages to identify and kill cancer cells. Stanford researchers plan to start human trials of this potential new cancer therapy in 2014, with the hope that it would be commercially available in a few years time. A great hope with this new macrophage therapy is that it will, in a sense, create a personalized vaccination against a patient’s particular form of cancer.

Combined with HIV vaccinations that have been shown not only to block the acquisition of the virus, but even kill it, 2014 may prove to be the year that the ongoing war against two of the deadliest diseases in the world finally began to be won.

Close Call for Mars:
A comet discovery back in 2013 created a brief stir when researchers noted that the comet in question – C/2013 A1 Siding Springs – would make a very close passage of the planet Mars on October 19th, 2014. Some even suspected it might impact the surface, creating all kinds of havoc for the world’s small fleet or orbiting satellites and ground-based rovers.

Mars_A1_Latest_2014Though refinements from subsequent observations have effectively ruled that out, the comet will still pass by Mars at a close 41,300 kilometers, just outside the orbit of its outer moon of Deimos. Ground-based observers will get to watch the magnitude comet close in on Mars through October, as will the orbiters and rovers on and above the Martian surface.

Deployment of the First Solid-State Laser:
The US Navy has been working diligently to create the next-generation of weapons and deploy them to the front lines. In addition to sub-hunting robots and autonomous aerial drones, they have also been working towards the creation of some serious ship-based firepower. This has included electrically-powered artillery guns (aka. rail guns); and just as impressively, laser guns!

Navy_LAWS_laser_demonstrator_610x406Sometime in 2014, the US Navy expects to see the USS Ponce, with its single solid-state laser weapon, to be deployed to the Persian Gulf as part of an “at-sea demonstration”. Although they have been tight-lipped on the capabilities of this particular directed-energy weapon,they have indicated that its intended purpose is as a countermeasure against threats – including aerial drones and fast-moving small boats.

Discovery of Dark Matter:
For years, scientists have suspected that they are closing in on the discovery of Dark Matter. Since it was proposed in the 1930s, finding this strange mass – that makes up the bulk of the universe alongside “Dark Energy” – has been a top priority for astrophysicists. And 2014 may just be the year that the Large Underground Xenon experiment (LUX), located near the town of Lead in South Dakota, finally detects it.

LUXLocated deep underground to prevent interference from cosmic rays, the LUX experiment monitors Weakly Interacting Massive Particles (WIMPs) as they interact with 370 kilograms of super-cooled liquid Xenon. LUX is due to start another 300 day test run in 2014, and the experiment will add another piece to the puzzle posed by dark matter to modern cosmology. If all goes well, conclusive proof as to the existence of this invisible, mysterious mass may finally be found!

ESA’s Rosetta Makes First Comet Landing:
This year, after over a decade of planning, the European Space Agency’s Rosetta robotic spacecraft will rendezvous with Comet 67P/Churyumov-Gerasimenko. This will begin on January 20th, when the ESA will hail the R0setta and “awaken” its systems from their slumber. By August, the two will meet, in what promises to be the cosmic encounter of the year. After examining the comet in detail, Rosetta will then dispatch its Philae lander, equipped complete with harpoons and ice screws to make the first ever landing on a comet.

Rosetta_and_Philae_at_comet_node_full_imageFirst Flight of Falcon Heavy:
2014 will be a busy year for SpaceX, and is expected to be conducting more satellite deployments for customers and resupply missions to the International Space Station in the coming year. They’ll also be moving ahead with tests of their crew-rated version of the Dragon capsule in 2014. But one of the most interesting missions to watch for is the demo flight of the Falcon 9 Heavy, which is slated to launch out of Vandenberg Air Force Base by the end of 2014.

This historic flight will mark the beginning in a new era of commercial space exploration and private space travel. It will also see Elon Musk’s (founder and CEO of Space X, Tesla Motors and PayPal) dream of affordable space missions coming one step closer to fruition. As for what this will make possible, well… the list is endless.

spaceX-falcon9Everything from Space Elevators and O’Neil space habitats to asteroid mining, missions to the Moon, Mars and beyond. And 2014 may prove to be the year that it all begins in earnest!

First Flight of the Orion:
In September of this coming year, NASA is planning on making the first launch of its new Orion Multi-Purpose Crew Vehicle. This will be a momentous event since it constitutes the first step in replacing NASA’s capability to launch crews into space. Ever since the cancellation of their Space Shuttle Program in 2011, NASA has been dependent on other space agencies (most notably the Russian Federal Space Agency) to launch its personnel, satellites and supplies into space.

orion_arrays1The test flight, which will be known as Exploration Flight Test 1 (EFT-1), will be a  short uncrewed flight that tests the capsule during reentry after two orbits. In the long run, this test will determine if the first lunar orbital mission using an Orion MPCV can occur by the end of the decade. For as we all know, NASA has some BIG PLANS for the Moon, most of which revolve around creating a settlement there.

Gaia Begins Mapping the Milky Way:
Launched on from the Kourou Space Center in French Guiana on December 19thof last year, the European Space Agency’s Gaia space observatory will begin its historic astrometry mission this year. Relying on an advanced array of instruments to conduct spectrophotometric measurements, Gaia will provide detailed physical properties of each star observed, characterising their luminosity, effective temperature, gravity and elemental composition.

Gaia_galaxyThis will effectively create the most accurate map yet constructed of our Milky Way Galaxy, but it is also anticipated that many exciting new discoveries will occur due to spin-offs from this mission. This will include the discovery of new exoplanets, asteroids, comets and much more. Soon, the mysteries of deep space won’t seem so mysterious any more. But don’t expect it to get any less tantalizing!

International Climate Summit in New York:
While it still remains a hotly contested partisan issue, the scientific consensus is clear: Climate Change is real and is getting worse. In addition to environmental organizations and agencies, non-partisan entities, from insurance companies to the U.S. Navy, are busy preparing for rising sea levels and other changes. In September 2014, the United Nations will hold another a Climate Summit to discuss what can be one.

United-Nations_HQThis time around, the delegates from hundreds of nations will converge on the UN Headquarters in New York City. This comes one year before the UN is looking to conclude its Framework Convention on Climate Change, and the New York summit will likely herald more calls to action. Though it’ll be worth watching and generate plenty of news stories, expect many of the biggest climate offenders worldwide to ignore calls for action.

MAVEN and MOM reach Mars:
2014 will be a red-letter year for those studying the Red Planet, mainly because it will be during this year that two operations are slated to begin. These included the Indian Space Agency’s Mars Orbiter Mission (MOM, aka. Mangalyaan-1) and NASA’ Mars Atmosphere and Volatile EvolutioN (MAVEN) mission, which are due to arrive just two days apart – on September 24th and 22nd respectively.

mars_lifeBoth orbiters will be tasked with studying Mars’ atmosphere and determining what atmospheric conditions looked like billions of years ago, and what happened to turn the atmosphere into the thin, depleted layer it is today. Combined with the Curiosity and Opportunity rovers, ESA’s Mars Express,  NASA’s Odyssey spacecraft and the Mars Reconnaissance Orbiter, they will help to unlock the secrets of the Red Planet.

Unmanned Aircraft Testing:
A lot of the action for the year ahead is in the area of unmanned aircraft, building on the accomplishments in recent years on the drone front. For instance, the US Navy is expected to continue running trials with the X-47B, the unmanned technology demonstrator aircraft that is expected to become the template for autonomous aerial vehicles down the road.

X-47BThroughout 2013, the Navy conducted several tests with the X-47B, as part of its ongoing UCLASS (Unmanned Carrier Launched Airborne Surveillance and Strike) aircraft program. Specifically, they demonstrated that the X-47B was capable of making carrier-based take offs and landings. By mid 2014, it is expected that they will have made more key advances, even though the program is likely to take another decade before it is fully realizable.

Virgin Galactic Takes Off:
And last, but not least, 2014 is the year that space tourism is expected to take off (no pun intended!). After many years of research, development and testing, Virgin Galactic’s SpaceShipTwo may finally make its inaugural flights, flying out of the Mohave Spaceport and bringing tourists on an exciting (and expensive) ride into the upper atmosphere.

spaceshiptwo-2nd-flight-2In late 2013, SpaceShipTwo and passed a key milestone test flight when its powered rocket engine was test fired for an extended period of time and it achieved speeds and altitudes in excess of anything it had achieved before. Having conducted several successful glide and feathered-wing test flights already, Virgin Galactic is confident that the craft has what it takes to ferry passengers into low-orbit and bring them home safely.

On its inaugural flights, SpaceShipTwo will carry two pilots and six passengers, with seats going for $250,000 a pop. If all goes well, 2014 will be remembered as the year that low-orbit space tourism officially began!

Yes, 2014 promises to be an exciting year. And I look forward to chronicling and documenting it as much as possible from this humble little blog. I hope you will all join me on the journey!

Sources: Universetoday, (2), med.standford.edu, news.cnet, listosaur, sci.esa.int

The Future is Bright: Positive Trends to Look For in 2014

Colourful 2014 in fiery sparklersWith all of the world’s current problems, poverty, underdevelopment, terrorism, civil war, and environmental degradation, it’s easy to overlook how things are getting better around the world. Not only do we no longer live in a world where superpowers are no longer aiming nuclear missiles at each other and two-thirds of the human race live beneath totalitarian regimes; in terms of health, mortality, and income, life is getting better too.

So, in honor of the New Year and all our hopes for a better world, here’s a gander at how life is improving and is likely to continue…

1. Poverty is decreasing:
The population currently whose income or consumption is below the poverty line – subsisting on less than $1.25 a day –  is steadily dropping. In fact, the overall economic growth of the past 50 years has been proportionately greater than that experienced in the previous 500. Much of this is due not only to the growth taking place in China and India, but also Brazil, Russia, and Sub-Saharan Africa. In fact, while developing nations complain about debt crises and ongoing recession, the world’s poorest areas continue to grow.

gdp-growth-20132. Health is improving:
The overall caloric consumption of people around the world is increasing, meaning that world hunger is on the wane. Infant mortality, a major issue arising from poverty, and underdevelopment, and closely related to overpopulation, is also dropping. And while rates of cancer continue to rise, the rate of cancer mortality continue to decrease. And perhaps biggest of all, the world will be entering into 2014 with several working vaccines and even cures for HIV (of which I’ve made many posts).

3. Education is on the rise:
More children worldwide (especially girls) have educational opportunities, with enrollment increasing in both primary and secondary schools. Literacy is also on the rise, with the global rate reaching as high as 84% by 2012. At its current rate of growth, global rates of literacy have more than doubled since 1970, and the connections between literacy, economic development, and life expectancy are all well established.

literacy_worldwide4. The Internet and computing are getting faster:
Ever since the internet revolution began, connection speeds and bandwidth have been increasing significantly year after year. In fact, the global average connection speed for the first quarter of 2012 hit 2.6 Mbps, which is a 25 percent year-over-year gain, and a 14 percent gain over the fourth quarter of 2011. And by the second quarter of 2013, the overall global average peak connection speed reached 18.9 Mbps, which represented a 17 percent gan over 2012.

And while computing appears to be reaching a bottleneck, the overall increase in speed has increased by a factor of 260,000 in the past forty years, and storage capacity by a factor of 10,000 in the last twenty. And in terms of breaking the current limitations imposed by chip size and materials, developments in graphene, carbon nanotubes, and biochips are promising solutions.

^5. Unintended pregnancies are down:
While it still remains high in the developing regions of the world, the global rate of unintended pregnancies has fallen dramatically in recent years. In fact, between 1995 and 2008, of 208 billion pregnancies surveyed in a total of 80 nations, 41 percent of the pregnancies were unintended. However, this represents a drop of 29 percent in the developed regions surveyed and a 20 percent drop in developing regions.

The consequences of unintended pregnancies for women and their families is well established, and any drop presents opportunities for greater health, safety, and freedom for women. What’s more, a drop in the rate of unwanted pregnancies is surefire sign of socioeconomic development and increasing opportunities for women and girls worldwide.

gfcdimage_06. Population growth is slowing:
On this blog of mine, I’m always ranting about how overpopulation is bad and going to get to get worse in the near future. But in truth, that is only part of the story. The upside is while the numbers keep going up, the rate of increase is going down. While global population is expected to rise to 9.3 billion by 2050 and 10.1 billion by 2100, this represents a serious slowing of growth.

If one were to compare these growth projections to what happened in the 20th century, where population rose from 1 billion to just over 6, they would see that the rate of growth has halved. What’s more, rates of population growth are expecting to begin falling in Asia by 2060 (one of the biggest contributors to world population in the 20th century), in Europe by 2055, and the Caribbean by 2065.

Population_curve.svgIn fact, the only region where exponential population growth is expected to happen is Africa, where the population of over 1 billion is expected to reach 4 billion by the end of the 21st century. And given the current rate of economic growth, this could represent a positive development for the continent, which could see itself becoming the next powerhouse economy by the 2050s.

7. Clean energy is getting cheaper:
While the price of fossil fuels are going up around the world, forcing companies to turn to dirty means of oil and natural gas extraction, the price of solar energy has been dropping exponentially. In fact, the per capita cost of this renewable source of energy ($ per watt) has dropped from a high of $80 in 1977 to 0.74 this past year. This represents a 108 fold decrease in the space of 36 years.

solar_array1And while solar currently comprises only a quarter of a percent of the planet’s electricity supply, its total share grew by 86% last year. In addition, wind farms already provide 2% of the world’s electricity, and their capacity is doubling every three years. At this rate of increase, solar, wind and other renewables are likely to completely offset coal, oil and gas in the near future.

Summary:
In short, things are looking up, even if they do have a long way to go. And a lot of what is expected to make the world a better place is likely to happen this year. Who knows which diseases we will find cures for? Who knows what inspirational leaders will come forward? And who knows what new and exciting inventions will be created, ones which offer creative and innovative solutions to our current problems?

Who knows? All I can say is that I am eager to find out!

Additional Reading: unstats.un.org, humanprogress.org, mdgs.un.org

Coming Soon: A Universal Flu Vaccine?

flu_vaccineScientists have been making great strides in coming up with treatments and cures for illnesses that were previously thought to be incurable. While some of these are aimed at eliminating pandemics that have taken millions of lives worldwide (such as HIV/AIDS) others are aimed at treating the more common – but no less infectious – viruses, like the common flu.

When it comes to the latter, the difficulty is not so much in creating a cure, as it is a cure all. The flu is a virus that is constantly evolving, changing with the seasons and with each host. This requires medical researchers to constantly develop new vaccines year after year to address the latest strain, as well as specialized vaccines to address different  types – i.e. H1N1, swine, avian bird.

flu_vaccine1Luckily, a research team at Imperial College London say they have made a “blueprint” for a universal flu vaccine. Their report appeared in a recent issue of Nature Medicine. In their report, they specified that the key to creating a universal vaccine lies in targeting the core of the virus, rather than its ever-evolving DNA.

Just last year, researchers at the Friedrich-Loeffler Institute in Riems Island, Germany sought to create a similar vaccine that would target the virus’ RNA structure rather than the key proteins found in the DNA. By contrast, the Imperial researchers set about looking into T-cells, the crucial part of the immune system that is thought to be able to recognize proteins in the core.

2009_world_subdivisions_flu_pandemicTheir research began with a series of clinical examinations of the 2009 swine flu pandemic, which was produced by the combining of earlier strains of pig and bird flu. The team then compared levels of one kind of T-cells at the start of the pandemic with symptoms of flu in 342 staff and students at the university. They showed that the higher the levels of the T-cells a patient had, the milder their symptoms were.

Researchers then teased out the specific part of the immune system that offered some pandemic flu protection and which part of the virus it was attacking. from there, They began developing a vaccine that would trigger the production of these cells – known as CD8 T cells. These cells would attack the invading flu virus, ignoring the outer protein structure and focusing on the core which it had encountered before.

Influenza_virus_2008765Prof Ajit Lalvani, who led the study, told the BBC:

It’s a blueprint for a vaccine. We know the exact subgroup of the immune system and we’ve identified the key fragments in the internal core of the virus. These should be included in a vaccine. In truth, in this case it is about five years [away from a vaccine]. We have the know-how, we know what needs to be in the vaccine and we can just get on and do it.

The benefits of such a vaccine would be profound and obvious. While many of us consider the seasonal flu to be an inconvenience, it is important to note that it kills between 250,000 and 500,000 people worldwide each year. While this is a fraction of the total number of deaths attributed to AIDS (1.6 to 1.9 million in 2010, it is still a significant toll. What’s more, new pandemics have the potential to take doctors by surprise and kill large numbers of people.
t-cellHowever, the Imperial College researchers admit that it is generally harder to develop a T-cell vaccine than a traditional one designed to provoke an antibody response. The challenge will be to get a big enough of a T-cell response to offer protection and a response that will last. So while the blueprint is in place, medical researchers still have a long road ahead of them.

Prof John Oxford, of Queen Mary University of London, put it this way:

This sort of effect can’t be that powerful or we’d never have pandemics. It’s not going to solve all the problems of influenza, but could add to the range of vaccines. It’s going to be a long journey from this sort of paper to translating it into a vaccine that works.

AI-fightingfluWhat’s more, there are concerns that a T-cell vaccine would be limited when it comes to certain age groups. Jenner Institute at Oxford University, explains:

Live attenuated influenza vaccines which are given by nasal spray and will be used in children in the UK from this autumn are much better at increasing the number of influenza-specific T cells, but these vaccines only work in young children who haven’t yet had much exposure to influenza virus, so we need an alternative approach for adults.

Interestingly enough, this approach of stimulating the production of T-cells bears a striking resemblance to the work being done at the Vaccine and Gene Therapy Institute at OHSU, where researchers are working towards a vaccine that could also cure HIV. This research also appeared in Nature Medicine last month.

So not only could we be looking at a cure for both HIV and the flu in the near future, we could be looking at the containment of infectious viruses all over the world. As these two cases demonstrate, advances in medical science towards antivirals appear to be tied at the hip.

Sources: bbc.co.uk, gizmodo.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