(Nature) – An analysis of more than 1,000 mouse models of cancer has challenged their ability to predict patients’ response to therapy. The study, published today in Nature Genetics catalogues the genetic changes that occur in human tumours after they have been grafted into mouse hosts. Such models, called patient-derived xenografts (PDXs), are used in basic research and as ‘avatars’ for individual patients. Researchers use these avatar mice to test a bevy of chemotherapies against a person’s tumour, in the hope of tailoring a treatment plan for the patient’s specific cancer.
(Nature) – Ronald’s myriad tissues, and those of almost 1,000 other anonymous deceased donors, are now the basis of a first-of-its-kind database. Supported by the US National Institutes of Health, the US$150-million Genotype-Tissue Expression (GTEx) project is amassing data about gene sequences and activity, and other information, across 44 types of tissue, from blood vessels to 10 different brain regions. “It’s creating a ‘Google Maps’ of the body,” says Kristin Ardlie, a geneticist at the Broad Institute of MIT and Harvard in Cambridge, Massachusetts, who is part of the project’s data-analysis team. It routinely releases new data, which are freely available to qualified researchers.
(New Scientist) – The most versatile stem cells ever created could enable researchers to better understand the biological mechanisms behind many failed early pregnancies. Pentao Liu of the Sanger Institute in Cambridge, UK, and his team developed the stem cells from cells taken from very young mouse embryos. They gave these cells a cocktail of chemicals to prevent them from maturing, trapping them in a very young, primordial state.
(Gizmodo) – But there are rare, new alternatives of doctors incentivizing altruistic donations. One such promising idea is UCLA’s new “take-a-kidney-leave-a-kidney” voucher program. It solves the problem of what doctors are calling “chronological incompatibility”—friends and family who would be willing to provide kidneys to relatives who might not need one until after the donor is dead or available to donate. Now they can pay their kidney forward and get a voucher for their recipient, who will be able to move up the transplant list. So far, the program has spurred at least 25 donations. Yet, 25 donations pales when you consider that 13 Americans died today, and every day, waiting for a kidney, according to the National Kidney Foundation.
Hastings Center Report (vol. 47, no. 3, 2017) is available online by subscription only.
- “Defending Opioid Treatment Agreements: Disclosure, Not Promises” by Joshua B. Rager and Peter H. Schwartz
- “Closed Financial Loops: When They Happen in Government, They’re Called Corruption; in Medicine, They’re Just a Footnote” by Kevin De Jesus-Morales and Vinay Prasad
- “Crowdsourcing the Moral Limits of Human Gene Editing?” by Eric T. Juengst
Bioethics (vol. 31, no. 5, 2017) is available online by subscription only.
- “Can Neuroscience Contribute to Practical Ethics? A Critical Review and Discussion of the Methodological and Translational Challenges of the Neuroscience of Ethics” by Eric Racine et al.
- “Moral Enhancement Meets Normative and Empirical Reality: Assessing the Practical Feasibility of Moral Enhancement Neurotechnologies” by Veljko Dubljevi? and Eric Racine
- “The Voluntary Nature of Decision-Making in Addiction: Static Metaphysical Views Versus Epistemologically Dynamic Views” by Eric Racine and Simon Rousseau-Lesage
- “Respect for Autonomy in Light of Neuropsychiatry” by Sabine Müller
- “The Mitochondrial Replacement ‘Therapy’ Myth” by Tina Rulli
- “Human Dignity and Human Enhancement: A Multidimensional Approach” by David G. Kirchhoffer
- “The Place of Crowdfunding in the Discovery of Scientific and Social Value of Medical Research” by Lorenzo del Savio
- “In Defense of Artificial Replacement” by Derek Shiller
- “Objection to Conscience: An Argument Against Conscience Exemptions in Healthcare” by Alberto Giubilini
- “Ways Out of the Patenting Prohibition? Human Parthenogenetic and Induced Pluripotent Stem Cells” by Hannah Schickl, Matthias Braun, and Peter Dabrock
The American Journal of Bioethics (vol. 17, no. 6, 2017) is available online by subscription only.
- “Bringing Transparency to Medicine: Exploring Physicians’ Views and Experiences of the Sunshine Act” by Susan Chimonas, Nicholas J. DeVito, and David J. Rothman
- “When Respecting Autonomy Is Harmful: A Clinically Useful Approach to the Nocebo Effect” by John T. Fortunato, Jason Adam Wasserman, and Daniel Londyn Menkes
The New England Journal of Medicine (vol. 376, no. 21, 2017) is available online by subscription only.
- “Accelerated Approval and Expensive Drugs — A Challenging Combination” by W.F. Gellad and A.S. Kesselheim
- “Sharing Clinical and Genomic Data on Cancer — The Need for Global Solutions” by The Clinical Cancer Genome Task Team of the Global Alliance for Genomics and Health
(The Atlantic) – Human Dx might help doctors confirm their suspected diagnoses or think of things to rule out. At Mary’s Center, one man came in complaining of headaches and nausea, and the Human Dx physicians suggested a blood test called an ESR. Another time, Nundy used it to confirm a suspected case of rheumatoid arthritis before putting a low-income patient on a heavy-duty course of medications. Experienced doctors use Human Dx for their most difficult cases, and newer providers use it to hone their skills. Johns Hopkins Hospital and other teaching hospitals are now using it to train medical residents.
(Reuters) – Nearly 40 percent of U.S. physicians are reluctant to seek mental health care out of fear that it might imperil their medical license, a recent study suggests. The reluctance was more pronounced in states where licensing applications questioned doctors about mental health conditions going back more than a year. Physicians in those states were at least 20 percent more likely to report they would be reluctant to seek psychological treatment than doctors in states that asked only about current impairment.
(BBC) – Fertility tests marketed at women worried they have left it too late to have a baby, can be a “waste of money”. Ovarian reserve tests, which can cost £100 or more, measure hormones in blood to give an idea of how many eggs a woman has. Latest research in the Journal of the American Medical Association found the tests did not predict a woman’s chance of conceiving, however. Women must be told this, experts say. The tests were originally developed by IVF clinics to predict how a woman having fertility treatment might respond to the drugs used to stimulate the ovaries to produce eggs. But some companies have been marketing them to women as a fertility MOT.
(STAT News) – Almost a year ago I began thinking about how to tell the story of what happened to my circle of friends. I hoped that by examining how the drugs took hold in my hometown, I could illustrate how the same thing can and does happen everywhere. The new STAT documentary, “Runnin’,” includes candid and thoughtful interviews with friends who lost family members and others who abused opioids themselves.
(UPI) – Researchers at the University of Washington analyzed survey data from the National Health and Aging Trends Study for racial disparities in end-of-life care, reporting no significant differences in the quality of end-of-life-care among patients. Analysis of the survey, which included more than 1,700 interviews of Medicare enrollees age 65 and older as part of the National Health and Aging Trends Study from 2011 to 2015, showed no significant racial differences in the quality of end-of-life care among patients.
(New Scientist) – The battle between sports cheats and testers is poised to enter a whole new arena. The World Anti-Doping Agency has extended its 2003 ban on “gene doping” to include all forms of gene editing – but it is not clear the agency has the means to enforce this ban. WADA already bans the use of genetically modified cells and gene therapy if they have “the potential to enhance sport performance”. From 2018, the list will also include “gene editing agents designed to alter genome sequences and/or the transcriptional or epigenetic regulation of gene expression”.
(ABC News) – On Thursday, U.S. Food and Drug Administration advisers will consider whether to recommend approval of a gene therapy that improved vision for these three youths and some others with hereditary blindness. It would be the first gene therapy in the U.S. for an inherited disease, and the first in which a corrective gene is given directly to a patient. Only one gene therapy is sold in the U.S. now, a cancer treatment approved in August that engineers patients’ blood cells in the lab.
(CNN) -POLST forms, formally known as Physician Orders for Life Sustaining Treatment, have become a staple in care for the fragile or seriously ill. They document in detail what kind of medical treatments patients want — or don’t want — at the end of life. Nearly every state in the U.S. has a program; dozens are established or developing. But in Oregon, where the documents were developed in the early 1990s, organizers have taken a step to ensure that final medical wishes are honored. Officials at OHSU have partnered with a California technology firm, Vynca, to allow health care providers to electronically find any of the 172,000 active forms in Oregon’s POLST registry with a single click, no matter where they were filed.
(CBC News) – More than 2,000 Canadians have ended their lives legally with the help of a doctor, and most of them were suffering from terminal cancer. According to the latest report from Health Canada, there were 1,982 medically assisted deaths in the one-year period after it became legal in June 2016. There have been another 167 in Quebec since it was legalized in that province in December 2015, the report said. The total has been rising faster, with 803 assisted deaths in the first six months after it became legal nationally and 1,179 in the following six months from January to June 2017.
(Quartz) – Nigeria’s population of over 190 million, the highest on the African continent, is projected to hit 397 million by 2050, making it the world’s third most populous country after China and India. But there are still thousands of Nigerian couples, like Adamu and Fibi, unable to conceive naturally and for a long time they suffered in silence. Infertility is not an openly-discussed topic in modern Nigerian cultures. It is rare to find couples willing to acknowledge their struggle to conceive. There is often a lot of pressure to have children from society and extended family. And in many of Nigeria’s mostly patriarchal cultures a lot of that pressure falls on the woman.
(The Guardian) – A genetic test that accurately predicts the risk of developing breast cancer could soon be used on high-risk groups. Researchers behind the test say it could reduce the number of women choosing pre-emptive mastectomy surgery as they will be able to make more informed decisions about their care. The blood test looks at 18 genetic variations, or single-nucleotide polymorphisms (SNPs), known to affect the chances of getting breast cancer.
(Nature) – When the Navajo Nation opens its first oncology centre next year in Tuba City, Arizona, clinicians there may be able to offer a service that has been banned on tribal lands for 15 years: analyzing the DNA of Navajo tribe members to guide treatments and study the genetic roots of disease. That’s because the Navajo, the second-largest Native American group in the United States, are considering whether to lift their longstanding moratorium on genetic research. The tribal government banned DNA studies in 2002 to prevent the misuse of its members’ genetic material.