Antibiotic-Resistant Gonorrhea On the Rise

Last year I reported on this blog that there were signs that gonorrhea was becoming resistant to all known classes of antibiotics (this blog, July 14, 2011). This month the World Health Organization (WHO) reported that cases of the antibiotic-resistant gonorrhea have shown up in six countries – Norway, Sweden, Britain, France, Japan, and Australia.

The WHO is calling for more research into new treatment options. It also plans to monitor the use of antibiotics in an effort to encourage their correct use.

Gonorrhea used to be treatable with all known classes of antibiotics. It’s on its way to becoming virtually untreatable, or at least very difficult to treat. And that would be a problem for the more than 100 million people who become infected with the gonorrhea each year.

Mother Challenges Law Prohibiting Organ Sales

Thirteen years ago Doreen Flynn gave birth to a daughter with Fanconi anemia, a rare inherited blood disorder in which the bone marrow does not make enough red blood cells. Six years later Ms. Flynn underwent an in vitro fertilization (IVF) procedure and had two more daughters in the hope that one of them would be a suitable donor for her older daughter. But in an ironic twist of fate, embryonic screening failed to detect that they, too, would suffer from the disease. Now she has three daughters with the disease, instead of just one.

All three children will need bone marrow stem cells from an unrelated donor in order to survive. They could wait for a match to potential donors currently registered with the National Bone Marrow Donor Program, but there’s a problem; almost half of all potential donors fail to complete the donation procedure when they are matched to a recipient, leaving the recipient without the treatment he/she so desperately needs.

The National Organ Transplant Act of 1984 made it illegal to buy or sell "organs or organ parts".  Under the old rules that included bone marrow. Ms. Flynn wanted to see that change, so she became the lead plaintiff in a lawsuit that challenged the prohibition against selling bone marrow stem cells. The main argument in the lawsuit was that bone marrow, unlike a kidney or a lung, regenerates in a matter of weeks. Further strengthening the argument is the fact that the technology for collecting stem cells from bone marrow has changed since the National Organ Transplant Act was written. Instead of collecting the donor’s bone marrow by a needle inserted into the hip bone, donors now receive a drug to stimulate the production of the precursor cells. A machine then separates the precursor cells from whole blood by a technique called peripheral apheresis. In effect, Ms. Flynn's lawsuit argued that bone marrow stem cells should now considered more like body fluids such as blood plasma or sperm (which you can sell) than an organ such as a kidney or heart (which you cannot).

In December of 2011 the U.S. Court of Appeals for the 9th Circuit  ruled in favor of Ms. Flynn.  Bone marrow stem cells can now be sold, but only if they are collected from the bloodstream by apheresis, not from bone.  The court also stipulated that any payment would need to be in the form of scholarship vouchers or donations to charity.

It appears the new ruling will stand, because the U.S. Attorney General has decided not to ask the U.S. Supreme Court to review the case.

Bird Flu Papers Finally Published

After months of delay, two controversial papers about the bird flu virus have finally been published. The papers appear in May 2 issue of Nature and in the June 22 issue of Science.

Publication of both papers was held up because of the potentially dangerous nature of the information they contained; both papers documented methods that increased the airborne transmissibility of the bird flu virus in species other than birds. Although the current virus is highly contagious and deadly in birds and deadly to humans in the rare cases when humans have become infected, so far the virus has not shown the ability to be transmitted easily from birds to humans. And there is no documented case (yet) of transmission between humans; all infected humans have gotten the virus from birds.

Both papers contain basic information about genetic modifications of the virus that lead to increased transmissibility of the virus between mammals (ferrets). Government officials were worried that the information might be used by bioterrorists to create a strain of the virus that would be highly contagious between humans. When news of the papers’ potential publication first appeared back in December, the National Science Advisory Board for Biosecurity asked that publication be delayed so that the issue could be studied. However, after much discussion it has been decided that publication should be allowed after all.

Interestingly, both papers reported that modification of the virus to make it more transmissible also reduced its virulence. In fact, none of the ferrets infected with the modified viruses died. Whether the modified virus would also be less virulent in humans isn’t known. But if so, that would certainly reduce the value of the current papers to potential terrorists.

Finding New Uses for Old Drug Candidates

Testing potential drug candidates for safety and effectiveness is a long and expensive process.  Sometimes candidate drugs make it through the first part of the testing process (for safety) and then, either because they weren’t effective for their original purpose or for a business reason the drug company gives up on them.

A lot of money and time has already been invested in some of these drugs just to prove they are safe.  The National Institutes of Health thinks that some of these abandoned drugs could still be useful - the question is, for what?  To find out, NIH has launched a pilot project in which they’ll provide 20 million dollars in grant money in 2013 so that researchers can study these compounds, with the understanding that drug companies will make the drug candidates available to researchers.  The drug companies will retain ownership of the compounds, but the researchers will have the right to publish their findings.

It looks like a win-win situation for all.   Researchers will get access to novel compounds and the right to publish their findings.  The drug companies get free help from academic researchers in determining new uses for compounds that they otherwise would have abandoned.  And for a mere 20 million dollars in government seed money, perhaps some of these abandoned compounds will turn out to be useful after all.

Head Trauma and Brain Injuries in Soldiers

It’s becoming clear that that repeated head trauma in athletes may lead to a form of permanent brain damage called chronic traumatic encephalopathy (CTE). What about military veterans who have been exposed to blasts from roadside bombs- are they at risk for CTE, too? The answer may be “yes”, because apparently even a single strong blast can cause acute traumatic brain injury, the probable precursor to CTE. The problem of CTE actually may become much more common among veterans than in athletes – there are over 200,000 veterans who have been diagnosed with acute traumatic brain injury. No one knows how many of these veterans might develop CTE later in life.

The military is very interested in understanding how CTE could be prevented, of course. Some interesting clues were found in a recent report on brain injury in an animal model. First, researchers exposed mice to modestly traumatic blasts and documented that the mice later suffered from learning and memory deficits and the physical signs of acute traumatic brain injury. Interestingly, they then found that if they immobilized the mice’s heads during the blast, the injuries did not occur. In other words, it may not be the blast’s shock wave itself that causes the injury. Instead, the secondary high-speed blast wind apparently causes a rapid “bobble-head” movement of the head, and it is this rapid movement that may cause the injury.

I’m not sure how these new findings will lead to better prevention of CTE - perhaps helmets that reduce head movement during a blast?

Biodiesel Fuel Production Facility Planned

Two years ago a startup alternative energy company called Joule Unlimited received a patent for a process that uses genetically engineered bacteria to make biodiesel fuel from nothing more than sunlight, water, and CO2 (this blog, Sept. 20, 2010). This year the company raised $70 million in private equity to fund the construction of its first biodiesel production facility, to be built in New Mexico where harvesting solar energy is feasible.

Joule Unlimited’s biodiesel patented process is not all that different from what plants do. Plants use the same basic ingredients (sunlight, water, and CO2) to make sugars and starches. Humans can make biofuels from the sugars and starches in plants (think ethanol production from corn), but it’s expensive and requires prime agricultural land that could be put to other uses, such as growing food. Joule Unlimited’s genetically engineered bacteria make biodiesel directly. The company estimates that the process could generate up to 15,000 gallons of biodiesel per year on land that is unsuitable for agriculture, using non-potable water.

This technology could solve several problems at once if it works. One is what to do with all the excess CO2 currently being released into the atmosphere by the burning of fossil fuels. Joule Unlimited’s process turns it back into fuel, simultaneously helping to solve the second problem – a shortage of non-polluting fuel!

Disclosure: I do not have any financial interest in Joule Unlimited. I just think the company has an idea worth watching.