Henrietta Lacks parallels

Laura’s recent post about Rebecca Skloot’s visit to Emory on March 29 made me realize how long it’s been since I’ve posted anything here.

Skloot’s book on Henrietta Lacks, the woman whose cervical cancer became immortalized as Hela cells, has been well-reviewed. In recent interviews, Skloot describes how she had to earn Lacks’ daughter’s trust, which was difficult given the family’s past experience with scientists _and_ journalists.

This reminded me of two other situations I’ve read about recently.

The first was James Agee’s book Let Us Now Praise Famous Men. Christina Davidson talks about Agee’s and photographer Walker Evans’ relationship with the Alabama farming family they described in the book. Family members reportedly felt mistreated by Agee, Evans and their successors. It seems like Davidson had to walk a path resembling Skloot’s.

A similar theme emerges from Dorothea Lange’s iconic Migrant Mother photos. The children of Florence Owens Thompson, the Cherokee woman in the photos, resented becoming poster children for Depression-era poverty.

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Them’s fighting words

Rob Davis at Voice of San Diego cracks me up.

Recently he was in a protracted struggle with Mayor Sanders’ office over a CPRA (California Public Records Act) request. He had requested internal mayoral office e-mails dealing with plans for water cuts, and for whatever reason, Sanders’ people didn’t want to release them. So Rob bombards his readers with stories like “Pudgil Watch, Update 11” (Darren Pudgil is the mayor’s spokesman) and eventually threatens to sue.

I can’t discern whether Rob got anything useful at the end of all this process.

My experience with CPRA/FOIA requests is slim. A few years ago, I got great results from asking the San Diego County DPLU office for emails about Rancho Guejito. But subsequent requests to Supervisor Bill Horn’s office, eh, not much came back. Don’t know if they excluded interesting emails or simply never email about anything interesting.

Anyway, this time Rob has records describing the San Diego Airport Authority’s officials living well at the public’s expense. And he apparently has a sharp exchange with chairman Bob Watkins:

He suggested that a voiceofsandiego.org reporter couldn’t relate to business class travelers because the reporter didn’t make enough money. Watkins compared voiceofsandiego.org‘s examination of authority expenses to a “person who works for the Internal Revenue Service who’s making $40,000 a year and goes in and audits someone who lives in a $1 million home or $2 million home. They’re going to be skewed in terms of, ‘Wow, I don’t have that.'”

Them’s fighting words! I can imagine an offended reporter thinking “I could have been a rich slimeball like you, but I chose to serve the public honorably!”

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Watson out of touch

James Watson has a curious status in biology today. It would be impossible to find a scientist who would fail to acknowledge his accomplishments. At the same time, he is well known for making comments that would crush the reputation of other men.

This sentence in his recent NYT op-ed stuck out at me:

Hardly anyone I know works on Sunday or even much on Saturday, as almost no one believes that his or her current work will soon lead to a big cure.

Please! This sentence indicates that Watson hardly knows anyone who does the real physical work in the lab. Even though I don’t pipet all weekend anymore these days, I’m sure that plenty of graduate students and postdocs across the United States will be doing just that this weekend. All the evidence I get is that biomedical research is even more grueling and competitive now compared with a decade ago.

Let us keep in mind that Watson’s notorious book Double Helix describes science as a “clawing climb up a slippery slope, impeded by the authority of fools, to be made with cadged data…,with malice toward most and charity toward none.”

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Memory T cells

Alert to journal editors, especially in immunology/signal transduction:

There have been three high-profile papers on signal transduction pathways affecting memory T cells recently.

We have the metformin paper in Nature from Choi’s group at Penn. The mTOR rapamycin paper from Ahmed + Larsen at Emory. And the Wnt paper in Nature Medicine from NIH.

And how about sphingosine-1-phosphate?

Aren’t these all different facets of the same thing?

Amazingly, there was just a piece in Nature Reviews Immunology on “Immunoregulatory functions of mTOR inhibition” that only says this at the end: “Insight is also needed into the role of mTOR in memory.”

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A recent paper from Max Cooper’s lab at Emory has provided an example of an alternative path for evolution, one that disturbs and complicates our picture of how the immune system might have evolved.

Like discovering a place where everyone drives steam turbine-driven cars. Makes me think about Stephen Jay Gould and how evolution doesn’t always have a defined direction leading up to humans.

A review: the cut-and-error-prone-paste process of V(D)J recombination, which assembles antibody genes, seems to have jumped into the early vertebrate genome hundreds of millions of years ago.

When and how did this happen? John Travis’ essay makes the point that recently this process is looking less like a “big bang” and more gradual. But then came the lampreys.

T cells and B cells are two arms of the immune system that resemble each other. One responds to peptides displayed by MHC, a useful tool for fighting viruses inside our cells. The other makes antibodies that bind to antigens and can secrete the antibodies, which are great for clearing nasty pathogens from the blood.

Both have receptors on their surfaces that get rearranged by V(D)J, and the genes look similar. One possible order of events is this: there was a primordial “antigen receptor” bearing cell. V(D)J invades the genome, then this primordial cells splits off into T and B.

But no! Lampreys have cells that look like T and B, without V(D)J or the genes that make it possible, RAG1 and RAG2. One set of cells make secreted “variable lymphocyte receptors” and the other doesn’t. One looks like T and the other looks like B, judging from the genes they express.

Lampreys use another genetic shuffling tool to assemble their VLR genes – looks like gene conversion.

It’s worth pointing out that mice and people get most of their immunological diversity from V(D)J but rabbits and chickens don’t, using gene conversion/hypermutation (a process that may have predated V(D)J).

So it looks like the distinction between T and B may have existed first, before V(D)J complicated matters.

Still puzzling is the apparent absence of MHC and a thymus in lampreys, so what T cells respond to and where they develop in lampreys is unclear.

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Evolution of VDJ

Our immune systems have the impressive ability to handle a wide variety of nasty bugs, but when you look “under the hood” at the genes involved, it can look like a Rube Goldberg machine.
Antibody genes get taken apart and put back together in a semi-random way that generates a vast armory of tools, all varying slightly from each other. This process, known as V(D)J recombination, generates the diversity (many genetically different cells within one person!) necessary to respond to what nature throws at us.
It’s hard to believe that a process like this could emerge bit by bit through evolution, but the immune system was actually a centerpiece of the 2005 Kitzmiller v. Dover trial, where a Pennsylviania school district’s requirement to teach “intelligent design” was successfully challenged.
John Travis, as part of a series of essays celebrating Charles Darwin’s life and work in Science, describes this in greater detail. He lays out how scientists have gradually built their understanding of how V(D)J recombination may have been at first “planted” in animals’ immune systems and blossomed later on.

By the way, one of the papers that emerged from my time in David Schatz‘s lab is on the evidence list for the trial! I was thrilled to discover this even several years later. My fellow graduate student Alka Agrawal was first author of the paper. She went on to win a prize for an essay explaining the significance of our work.

RAG-mediated transposition and a model for the origins of split antigen receptor genes. (A) Possible structure of the original transposable element that integrated into the germ line of an ancestral vertebrate. Dashed arrows indicate the direction of transcription of the RAG1 and RAG2 genes. (B) The current "split" nature of immunoglobulin and T cell receptor genes is proposed to have arisen from RAG-mediated transposition of one or two excised elements into a primordial receptor gene exon (dark green), thereby dividing the exon into two or three gene segments, each flanked by one or two recombination signals (black and white triangles). These gene segments would represent the evolutionary precursors of current V, D, and J gene segments. Different patterns of gene duplication (right) would result in the "mammalian" or "cluster" configurations of gene segments characteristic of the heavy-chain locus of mammals or cartilaginous fishes, respectively. The constant region exons (C) are represented as a single gray rectangle.

RAG-mediated transposition and a model for the origins of split antigen receptor genes. (A) Possible structure of the original transposable element that integrated into the germ line of an ancestral vertebrate. Dashed arrows indicate the direction of transcription of the RAG1 and RAG2 genes. (B) The current "split" nature of immunoglobulin and T cell receptor genes is proposed to have arisen from RAG-mediated transposition of one or two excised elements into a primordial receptor gene exon (dark green), thereby dividing the exon into two or three gene segments, each flanked by one or two recombination signals (black and white triangles). These gene segments would represent the evolutionary precursors of current V, D, and J gene segments. Different patterns of gene duplication (right) would result in the "mammalian" or "cluster" configurations of gene segments characteristic of the heavy-chain locus of mammals or cartilaginous fishes, respectively. The constant region exons (C) are represented as a single gray rectangle.

Travis points out that more recently, scientists have found that enzymes resembling RAG1 and RAG2, the “scissors” that cut the DNA to initiate V(D)J, have been found in sea urchins (ie before vertebrates emerged), and it’s not clear what they do there.

Travis writes:

Their existence in the urchin suggests that the transposon [jumping DNA] with these enzymes invaded animals far earlier than had been thought but was lost in most lineages except for jawed vertebrates, which adapted them to perform VDJ recombination. That’s an easier version of the story for some immunologists to swallow, as it allows more time for mutations to deactivate the jumping ability of a transposon and convert its DNA to a new job.

Clearly, our picture of how VDJ evolved will continue to change as more genomic/wet biological information becomes available for species close to the vertebrate/invertebrate line, like lampreys. That leads me to my next post…

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Stem cell discussion at BIO convention

The public’s expectations for advances and cures in the stem cell field are ahead of reality, biotechnology executives and venture capitalists said Monday.

I attended a discussion at the BIO convention now underway in Atlanta on stem cell technology. It was worthwhile to get an idea what top industry people are saying, even if there wasn’t a ton of breaking news.

Scientists are forging ahead, most obviously with the recent discovery that it is possible to convert differentiated cells back into stem cells without introducing new DNA. Still, regulatory, patent and financial issues will probably slow the clinical development of stem cell technology over the next decade, said venture capitalist Steve Burrill, part of a four-member panel at BIO Monday.

Every company smaller than $1 billion, and that includes much of the field, the capital markets will neglect, Burrill said.

“These are some of the most complex biologics anyone has worked with. Cells are just going to be harder,” said Richard Gregory of Genzyme.

Other panelists: Paul Grayson of Fate Therapeutics, Ian Ratcliffe of StemGent

Outside the United States, desperate patients are being offered unproven stem cell “treatments” as a way to treat several neurological diseases. Someone on the panel (Gregory?) said he’d been to Beijing and was apprehensive about possible outcomes. But at the same time, some US companies may look to more flexible regulatory regimes as a way around a conservative FDA.

Some suggested that a field emphasizing transdifferentiation, directly converting one type of donated differentiated cells from patients into another that can be used for therapy, may grow out of the stem cell field. (Harvard’s Doug Melton was mentioned reverently.) This would have the advantages of avoiding early-stage embryos and probably reduce the ability of introduced cells to cause tumors.

Moderator Aaron Rowe, a writer with Wired, at one point asked the panel “How would you reform the FDA,” since the regulatory environment was so uncertain.

Panelists discussed the wisdom of allowing patients to take on considerable risks of volunteering for stem cell trials. Although I did not mention it during the discussion, I worry about a potential Jesse Gelsinger scenario. If a patient dies, everyone will ratchet back risk, even if he/she could grasp what he was getting into.

James Wilson makes this point in an essay in Science. Well worth reading.

(Commentary on Wilson)

Burrill had a elegant summary, saying that AIDS activists had changed the risk vs reward profile of clinical research, allowing patients in urgent need to take on more risk. Then Vioxx came along and made the FDA and industry more conservative, swinging the pendulum back.

Rowe tried to get panelists to come up with a two-word catchy phrase describing small molecules that can guide stem cell differentiation. He conjured up an image of postdocs poring over heat maps, playing the appropriate signaling pathways like violinists, but the panel rejected this picture as too ambitious.

Some of the products the panelists discussed:

Genzyme’s Mozobil, a stem cell mobilizer

Fate Therapeutics is planning a phase Ib trial for a small molecule that could aid homing by stem cells in bone marrow transplants.

Technology challenges discussed:

Growing pluripotent cells in suspension culture (without feeder cells) – I don’t know if this is really possible, because stem-ish cells will always need various ligands, properly arranged, to make them happy. Maybe some kind of artificial matrix.

I would add: quality control assays to ensure that a batch of cells is not tumorigenic, isn’t missing chromosomes, stuff like that.

The San Diego Biotechnology Network’s blog also has a post about the same session from Mary Canady, emphasizing Fate Therapeutics more.

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The blue whales of crystallography

Fun tour through the big protein complexes crystallographers are stalking these days, such as ribosome, spliceosome, nuclear-pore, HIV trimer, G-protein coupled receptor…

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Wow: a VDJ crystal structure!

Recently my heart was filled with joy to see a paper published by the laboratory where I did my PhD.

David Schatz’s lab at Yale has obtained a crystal structure of part of the protein RAG-1 bound to DNA. My congratulations to first author Fang Fang Yin.

RAG-1 and its sister RAG-2 form the scissors that cut the DNA in immature white blood cells during VDJ recombination, a process where the developing immune system slices and reassembles antibody genes in a unique, partly random way.

Because VDJ recombination can happen in a different way in each cell, the immune system has a library of millions of antibodies that can react with many different antigens out in the environment.

The signals on the DNA that mark off the gene segments that get cut and pasted together again come in two flavors. They look like this:

Antibody gene segment — CACAGTG – 12 letters – ACAAAAACC


Antibody gene segment — CACAGTG – 23 letters – ACAAAAACC

The puzzle that attracted me to this area of research was this: the RAGs need one of each kind, 12 and 23, to cut the DNA. That’s weird.

Another weird aspect is that the part of the DNA opposite the CACAGTG is turned into a hairpin, with one strand of the DNA double-helix joined to the other.

We can imagine a process like this: the RAG proteins grab one of each signal and pull them together, forming a loop. What do the proteins look like when this loop forms? What are the geometric requirements for assembling this complex?

These are the questions I was trying to answer, or at least move closer to answering, during my PhD research.

Besides being a fascinating puzzle and the centerpiece of the adaptive immune system, VDJ recombination has connections to:

  • DNA repair, because all sorts of monkey wrenches can interfere with the immune system’s ability to smush the DNA back together again
  • Evolution, because the transposon-like arrangement suggests how antibodies suddenly appeared in vertebrate biology millions of years ago

When I started it hadn’t rigorously been proven that the RAGs actually cut DNA directly. With the help of Thomas Leu, a postdoc from Switzerland, I put together a system for examining how they cut DNA in the test tube. I also did some experiments where I crosslinked the RAGs to the DNA with UV light.

But actually getting a crystal structure, that’s really impressive and difficult. Now David’s group (and other scientists) can start to build a model of the whole complex.

X-ray crystallography might not allow visualization of an entire ready-to-cut structure with both 12 and 23 signals because the whole shaky bridge might be too flexible for crystals to form.

The structure published in Nature SMB doesn’t include the CACAGTG part, which is where the DNA gets cut, or RAG2, which is necessary for cleavage to occur.

But it does show that two RAG proteins intertwine and that unit binds to two separate ACAAAACC elements at once. That’s a great step forward.

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Impressive visitor

Organ donation advocate Bobby Howard gave an impressive talk to the Emory Transplant Center today. He said that when he started his work with Lifelink Georgia 14 years ago, just 8 percent of donated kidneys in GA came from African Americans, but that figure has increased to more than 30 percent now.

African Americans receive the majority of kidney transplants in GA, because of the prevalence of diabetes and hypertension leading to renal failure, he said.

Howard (more about him) is originally from Pittsburgh (where I grew up) and a former pro football player. He was a very effective speaker.

What I found interesting was: he said when he started out, the main objection to organ donation he experienced was from religious people who wanted to have all their organs when they got to heaven.

That was relatively easy to address compared with the remaining issue: mistrust of the healthcare system. People he talks with are worried that declared organ donors will receive inadequate care because doctors only want their organs! Given the experience of various minority communities with medicine, such mistrust makes sense even if it does impair organ donation and saving lives.

Makes me wonder if everyone was a declared organ donor, how would that affect transplant waiting lists? That deserves another post.

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A simple dinner

I just started reading “A Free Life” by Ha Jin and was struck by this paragraph. The main characters Nan and Pingping have Nan’s friend Danning, who is a link to Nan’s literary aspirations, over for dinner.

Dinner was simple: eggplant stuffed with minced pork, a salad of assorted vegetables, preserved eggs, braised shrimp, and dumplings filled with beef and napa cabbage.

My wife and I were quite pleased with our first few successful preparations of pork pot stickers, (a rough equivalent of the last dish only) but it took work. Making all of those other dishes wouldn’t be simple to me!

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Georgia stem cell/embryo legislation

My interpretation of the modified bill that passed the State Senate Thursday is that it would impact future stem cell research in Georgia less than the original.

From the AP:

The bill’s sponsor said it permits research on existing embryonic stem cell lines, which had been allowed under the Bush administration. It also allows new embryonic stem lines to be brought into the state. The bill does not say whether unused embryos created for fertility treatments could be donated to stem cell research.

That last point will need to be resolved.

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Chili verde recipe

Last week I participated in a chili cook-off at work. My chili verde recipe got third place, behind a more traditional beef chili with cubed steak and black beans and a chicken stew with flavorful broth.

Here is a recreation of my improvisation, which was adapted from a recipe by Rick Bayless:

3 pounds pork shoulder, cut into 1-inch cubes
1 large or 2 small onions, roughly chopped
4-6 cloves garlic, chopped
12 tomatillos, quartered
2 cups pickled jalapenos
1 tablespoon vegetable oil
1 teaspoon ground cumin
1 teaspoon salt
Saute onions and garlic in oil in a wide saucepan or Dutch oven with enough heat so that you get some golden color.
Add tomatillos and distribute so that mostly the tomatillos are facing the floor of the pan. Sprinkle salt and cumin all around. Now add the jalapenos, and then the pork on top.
Turn down the heat (how low depends on how your stove achieves barely simmering). The tomatillos will gradually release their water. Cook for six hours on low heat. If arranged properly, some of the pork pieces should brown as they cook.
Remove pieces of pork with tongs or slotted spoon and set aside. Take sauce and put in a blender along with:
1 cup chopped cilantro
1 cup chopped Italian parsley
Add back pork and two 16-ounce cans cannellini beans, drained.
Store before reheating and serving, or reheat and serve immediately.
Before serving, add:
 juice of two limes
1 tablespoon Worcestershire sauce
salt, pepper and chopped pickled jalapenos to taste.

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I didn’t know the young woman who was fatally burned at UCLA working with t-butyl lithium. It appears that several errors intersected after the reagent spilled and caught fire: she was wearing a flammable sweater, the fume hood wasn’t down far enough, she didn’t run toward the emergency shower.

My first job working in a chemistry lab was at UCLA. It was just for the summer and I didn’t distinguish myself in any big way. I dropped a jug of organic solvent (heptane, perhaps) on my foot and the glass broke. Embarassing, but at least there was no spark!

I also remember a big liquid nitrogen tank having its valve stuck open and the lab folk wheeled it out onto a balcony so it could vent.

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Stem cells in the Wild East

An Israeli boy with the inherited disease ataxia telangiectasia apparently received neural stem cell treatments in Moscow a few years ago.
Now he has a brain tumor, Israeli physicians report in PLOS Medicine.
Critical quote from the paper:
“This is the first report of a human brain tumor developing from transplanted neural stem cells.”

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Wary of a cure for the common cold

Yesterday’s U of Maryland Science paper about the genomes of common cold viruses tempted reporters and editors into writing some over-enthusiastic headlines and leads about “curing the common cold”.
Hey – it’s just a bunch of genomes!

The press release didn’t seem too overblown though.
The researchers found that human rhinoviruses are organized into about 15 small groups that come from distant ancestors. The discovery of these multiple groups explains why a “one drug fits all” approach for anti-viral agents does not work.”

And Nick Wade (NYT) was appropriately gloomy about the translational aspects:

“Because colds are mostly a minor nuisance, drug developers say, people would not be likely to pay for expensive drugs. And it would be hard to get the Food and Drug Administration to approve a drug with any serious downside for so mild a disease.”

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Low energy

Well, I haven’t blogged much recently. It’s because:

1. I’m discouraged. When I worked at the NCT, I saw writing stories that incorporated scientific issues as a way to get a different, more science-targeted job some day. Now, I miss covering environmental issues, but Georgia issues seem lame compared to San Diego County. What kind of job do I really want?

Sending out freelancing queries seems like shouting into the wind. Some months ago, I sent out a handful of queries related to Rancho Guejito with little response. Having gone to Santa Cruz should help “get the foot in the door” a tiny bit (a quantum of solace, heh). But I imagine it helps people in DC who pester editors regularly, not boring old QE who worked for a local newspaper.

2. It feels like working. Should I be blogging everything I run into having to do with stem cells? I probably cast too wide a net when coming up with the scheme for this blog initially.

3. One colleague said I should avoid writing criticism of anything as long as my name and university affiliation are out there. Well, criticism is a big part of blogs. Hard to write under that directive.

Now that I’ve complained a bit, I have to think some more about how to restart this blog under a framework that will be more FUN. Sustainability – it’s not just an environmental buzzword.

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The monsters of chemistry

This recent post exemplifies why I love Derek Lowe’s Pipeline blog.

Having hydrogen azide meet fluorine is sort of like kids talking about Godzilla vs King Kong. Even after years in the lab, it’s still possible to have a child-like glee about chemistry, whether it’s super-reactive reagents or stuff that stinks.

Makes me remember the time I dropped an inch of copper wire into a beaker of nitric acid. Interesting to watch-

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The author steps forward

I’ve decided to identify myself, as well as disclose where I work.

Since I took a university job about a year ago, I’ve wanted to try writing independently as a freelance journalist. My goals: see if it’s compatible with my job (which I enjoy), explore interesting areas of science and keep in touch with issues I used to cover at the North County Times.

Many freelance journalists have blogs and use them to develop and support their work. For people with a day job, I’ve seen several approaches to the question of: do you identify yourself and your employer?

A. Be open and hope for the best. No secrets. Many of the folks on Science Blogs (good example) take this approach.

B. Identify employer but leave name off blog, like this.

C. Identify self but not employer, although the employer is not a total secret. This seems to work for Derek Lowe, whose Pipeline blog I’ve enjoyed for years.

D. Don’t identify self or employer. If your blog is full of frustration and indignation over life as a postdoc, this might be a good idea.  But it means scrubbing your comments of anything that could give away who you are.

A certain prosecutor/press critic might also fall into category D, although people seem to know who he is (and that blog appears to have evolved into a joint endeavor).

I’d love to hear how other life sciences-oriented bloggers with day jobs handle this issue.

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Not junk DNA, Zimmer says

Book author and Discover blogger Carl Zimmer criticizes those who wrote about a recent Science paper, saying essentially: “Enhancers aren’t junk DNA, and nobody who knows what enhancers are ever thought so.”

They took their cue from the headline of the press release. Oops.

An enhancer is essentially a control button on the DNA determining when a certain gene gets turned on or not. Most of the time, scientists find enhancers somewhere near their favorite gene, while trying to figure out what pieces of DNA can account for where and when it gets turned on.

Junk is a word that more accurately describes a pseudogene (it looks like a gene, but it doesn’t work anymore) or a repeating element (debris from a kind of internal virus), not an enhancer.

In this recent case, it seems they found the enhancer first, without knowing what gene it controls. More precisely, they found it by computer, comparing human and monkey DNA to find sequences that were highly conserved in vertebrates but had rapidly evolved in the transition from monkey to human.

This particular piece DNA makes embryos turn blue in interesting places. Evo-devo coolness.

Whoever wrote the press release (at Yale, even) called the enhancer junk, and the scientists who did the work let it go by. Perhaps they figured that something inexact was OK if it got some attention. Or maybe they thought people would understand “once thought of as junk DNA” as meaning decades ago rather than months ago.

Having people misunderstand something in a way you didn’t anticipate is a typical problem faced by a science writer!

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Nanotech easier as cosmetics than drugs

Rick Weiss, who used to work at the Washington Post, has been doing some impressive work for Science Progress, a site run by the liberal think tank Center for American Progress.

He’s been reporting on a series of meetings the FDA has been holding, and along the way, pointing out the challenges in regulating or even defining nanotechnology. One major point is that nanotech in cosmetics or clothing faces less regulation than if it’s sold as a drug.

The folks I know who work with nanotech want to diagnose and treat cancer with it, so they’ll have to endure the acid test of a clinical trial. Notably, the “nanoshell” technology developed by Halas and West at Rice appears to be entering its first clinical trials.

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More mutations

It appears that simply cataloguing mutations in cancer cells doesn’t reveal how they drive growth + metastasis. There are too many to make sense of:


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Stem cells = gene therapy?

A Stanford bioethicist compares the possible hazards of stem cells with the challenges gene therapy faced a decade ago.

I don’t feel I have enough experience with university IRBs to judge whether stem cells need more regulatory oversight. Before reading this, I didn’t realize the FDA had placed a hold on the first clinical trial using a ES-cell-derived product. I aim to pay closer attention to this issue.

The clinical trial in question would deal with spinal cord injury. It appears that experts in cardiac muscle repair also disagree over whether enough is known about how stem cells work in that arena.

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Ag Biotech in China

Richard Stone lays out big plans for research on genetically modified plants in China. It makes me want to compare dollar figures with the US and evaluate how much the European attitude towards ag biotech has softened in the last few years.

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Expensive toys

A LA Times article exploring the familiar idea that CT scans are profitable for some doctors but zap patients with too many X-rays to be worth the nice pictures.

Even MRIs for breast cancer aren’t useful, according to a recent study.

The lesson here seems to be doctors need to pay more attention to evaluating new imaging technology’s concrete benefits to patients.

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Changing Strategies vs Cancer

Sharon Begley did a decent job of outlining where cancer research is headed in Newsweek.

She did pick some easy-to-hit targets, such as the idea that cancer can be “conquered.” Similarly, there are probably just as many, if not more, visionary proposals that NCI review panels laugh at today as in 1982.

Yes, animal models are limited. But when somebody has a compound from green tea or a peptide-conjugated anti-tumor missile that kill tumor cells in culture, what tests do scientists need to complete before trying them out on desperate people?

Begley cites three trends for the future: biomarker-directed treatment, more attention to the tumor’s surroundings and prevention. All three make sense with what I’ve seen being discussed at my institution.

With justification, she cites Herceptin and Gleevec as expensive successes. But Avastin as proof that anti-angiogenesis was a good idea, I dunno. This NYT piece this summer calls attention to how expensive Avastin is (tens of thousands of dollars per year), given its limited benefit.

What bothered me about it was that I’ve heard cancer researchers talk about combining Avastin with other agents, as if that were a good bet for the future. Even more expensive! Maybe they can slice and dice the patient pool using biomarkers, so that they can spot the ones who will benefit. Maybe Genentech will drop the price if volume increases as efficacy is shown for more cancers.

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