Thursday, June 27, 2013

The Supreme Court: Human Genes Cannot be Patented

The Supreme Court has finally reached a verdict; human genes in their natural form cannot be patented because they are “products of nature”, and not the invention or creation of a commercial company. The decision was a major blow to a company called Myriad Genetics, which has long held that it owns the patent rights to the two genes that confer a high risk of breast cancer, called BRCA1 and BRCA2. Based on its alleged patents, the company had vigorously defended its right to be the sole provider of lucrative tests for the two genes. In the process, it had prevented researchers from studying the genes and kept other companies from developing similar tests for the presence of the genes. That kept the price of the tests for the two genes (predictors of risk for breast cancer) high and earned big profits for Myriad.

However, the Supreme Court didn’t rule entirely against Myriad Genetics. In another part of its decision, the court ruled that synthetic forms of the genes (created in a laboratory) would be patentable. Myriad did indeed create synthetic forms of the gene, which could now fall under patent protection. Nevertheless, the two rulings taken together represent a partial defeat for Myriad Genetics and a victory for gene researchers and other biotech companies. The ruling means that the two breast cancer genes, as well as the all other genes previously “discovered” by researchers, remain in the public domain, available to anyone.

For more on the subject of gene patenting, go to a previous blog post titled "Can Genes be Patented?"

Wednesday, June 26, 2013

The Testosterone Replacement Therapy Craze

We’ve all seen the ads promoting gels and pills to treat “low T”, or testosterone deficiency. The ads make testosterone replacement therapy sound like a no-brainer (Hey, I can look better; feel better; get the girl; etc.), but do you really need more testosterone?

The number of men over 40 with prescriptions for testosterone has tripled since 2001, according to a report in JAMA Internal Medicine. And that raises concerns. Do all these men actually have “low T”, with symptoms of mood swings, hot flashes, fatigue, sexual dysfunction, and a reduced muscle mass/increased fat mass?

Testosterone deficiency is due to a medical condition called hypogonadism. The Endocrine Society recommends testosterone replacement therapy to treat hypogonadism, but a blood test for testosterone is required for accurate diagnosis. According to the JAMA report, more than 25% of the men who were prescribed testosterone never even had a blood test. And of those who were tested, it is not clear how many were actually “low T”.

This may be another classic situation where intense advertising has lead to increased demand, regardless of actual need. Men who think they need testosterone for their perceived symptoms should have a blood test first, and they should be prescribed testosterone only if their testosterone is below normal limits for their age. Testosterone levels decline naturally with age, by the way. Testosterone therapy was never intended to improve sexual prowess or make a 50-year-old feel like a 20-year-old again, despite what the advertisements imply.

Monday, June 24, 2013

Transplanting Adult Organs Into Children

On June 12 a young cystic fibrosis patient named Sarah Murnaghan finally received a much-needed transplant of an adult lung. What makes this news is that Sarah is only 10 years old.

Adult lungs are not readily available for transplant, and children’s lungs are just plain rare. Because children are smaller than adults, adult lungs have to be resized to fit them, adding an additional level of risk of failure. Therefore the organization that oversees transplants, the Organ Procurement and Transplantation Network (OPTN), had developed a policy of not considering adult lung transplants for children under the age of 12. But following an urgent request by her parents, last week, a federal judge ruled that younger children should be eligible for adult lungs, opening the way for Sarah to receive her lungs and for other children to be considered as well.

Not everyone is happy about the new development. For years, the OPTN has done its best to allocate scarce organs equitably and fairly. The recent ruling disturbs some people because it implies that seeking help from the courts (as Sarah’s parents did) is a legitimate way to deal with what are clearly complex medical and ethical decisions. I’m as glad as anyone that little Sarah was saved by a lung transplant. But given that there are too few transplantable organs available, do we want medical professionals and ethicists to make such decisions based on certain principles of fairness and medical effectiveness, or do we want the decisions made by judges and lawyers based on who shouts the loudest?

You decide.

Saturday, June 22, 2013

DNA Samples Can be Taken During an Arrest

In 2009, a Maryland man named Alonzo King was arrested and charged with assault for pointing a shotgun at a group of people. Unfortunately for Mr. King, according to Maryland law a DNA sample can be taken from anyone who is merely arrested, regardless of whether or not he/she is later convicted. Mr. King’s DNA sample matched a sample taken from an unsolved rape case six years earlier. He is now serving life without parole.

The Maryland Court of Appeals overturned Mr. King’s conviction on the grounds that the DNA sample constituted an “unreasonable search” not linked to the assault charge. The case was appealed to the Supreme Court. And just this month the Supreme Court ruled by a 5-4 vote that yes, it IS constitutional to collect DNA samples from people who have merely been arrested for serious crimes, as opposed to eventually convicted. According to the Supreme Court, a DNA sample not that much different from other currently used forms of identification, such as fingerprints and mugshots. In the Supreme Court’s opinion, the state’s interest in identification outweighs a person’s expectation of privacy.

Taking DNA samples after arrests for certain crimes is already the rule in 28 states. So if you are arrested for a serious crime in the future, the police may take a cheek swab for DNA analysis. Your DNA can then be checked against DNA samples already in the state’s database, and also against a national database maintained by the FBI. I hope your record is clean…

Wednesday, June 19, 2013

Increased Atmospheric CO2, Pollen Counts, and Allergies

The increased use of fossil fuels (coal, oil, gas) in the past 60 years has caused a marked rise in the levels of CO2 in the atmosphere, from about 310 parts per million (ppm) in 1950 to nearly 380 ppm in 2013. The rise in CO2 has, in turn, resulted in a sharp increase in pollen counts.

It makes perfect sense from a biological perspective. As you know, plants require C02 for their metabolic processes, just as we require oxygen for ours. In the pant metabolic process known as photosynthesis, plants combine CO2 and water, producing sugars and oxygen releasing oxygen into the atmosphere. The 25% rise in CO2 over the past 60 years represents a rich new supply of CO2 for plant photosynthesis. As a result, many plants are growing faster and more vigorously than in the past. They’re also producing more pollen; pollen counts have more than doubled in the past five years in some areas, according to an article in USA Today.

Unfortunately, what has been good for plants has not been so good for allergy sufferers. There has been a noticeable rise in the incidence of allergies such as hay fever, and also allergic asthma, in areas with high pollen counts. That’s not likely to change any time soon, since nothing much has been done to curb the steady rise in CO2.

This might be a good time to consider a career as an allergist. Someone’s going to need to diagnose, test, and treat all those new allergy sufferers (smile)!

Monday, June 17, 2013

A Freshwater Aquifer is in Danger of Depletion

The High Plains aquifer, a vast reserve of underground water that stretches from Wyoming and South Dakota all the way to Texas, is slowly being depleted. Some wells in Kansas and Texas have become so non-productive that farmers have had to abandon them.

The culprit is the recent widespread use of groundwater for irrigation of crops. Starting in the 1940s, crop irrigation from wells became practical and widespread, and many farmers switched to high-value, water-thirsty crops like corn instead of crops that relied on natural rainfall. By 1990, about 95% of all water being drawn from the High Plains aquifer was for irrigation, according to a U.S. Geological Survey report. As a result, there has been a decline in the production of many wells. And once the groundwater is depleted, it could take decades or even hundreds of years to replenish it.

Farmers in the area are well aware of the problem, but there is essentially no easy solution. Some farmers have abandoned once-productive fields. Others have switched to less water-thirsty crops like milo or cattle, in the hope of continuing to farm for awhile longer. In the long run, the Midwestern states that have depended on the High Plains aquifer will have to learn to get by with less groundwater than in the past.

The problem of maintaining adequate supplies of freshwater is, of course, worldwide. As water gets scarcer, efforts to conserve it will only intensify.