The week’s most astounding developments from the neobiological frontier.

June 10, 2021

When the FDA hits the accelerator, who pays for the gas?

On Monday, the FDA approved the monoclonal antibody Aduhelm (aducanumab), the first new Alzheimer’s drug to hit the market in 18 years. That same day, drugmaker Biogen announced a yearly “maintenance dose” of its drug would cost $56,000 per person. Two phase-3 clinical trials of Aduhelm were stopped early in 2019 for failing an interim “futility analysis.” But later that year, Biogen announced plans to seek approval anyway after analysis of a subset of patients in one of the trials suggested it worked. A year later, an independent FDA advisory panel voted overwhelmingly against approving it, and after Monday’s announcement, one member of the panel resigned in protest. On the flip side, the Alzheimer’s Association released a statement calling the drug approval “a new day,” and by Wednesday’s closing bell, Biogen stock was trading 34 percent higher than it was last week.

There’s no mystery to why Wall Street is betting big on aducanumab. It bears four key hallmarks of a blockbuster drug: a chronic condition, a high price, a huge demand, and nothing else like it on the market. Analysts predict the cost for Aduhelm will largely be shouldered by U.S. taxpayers through Medicare, leaving many people with Alzheimer’s on the hook to pay the standard 20 percent out-of-pocket coinsurance rate for Medicare prescriptions—which will be more than $10,000 a year.

Quantum entanglement microscope

The phenomenon Albert Einstein once called “spooky action at a distance” just got a whole lot closer. A team at the University of Queensland in Brisbane, Australia, has developed a sensor for an optical imaging method known as stimulated Raman scattering gain microscopy, which can generate high-resolution maps of biological tissues. The sensor takes advantage of quantum entanglement between distant light photons (Einstein’s so-called spooky action) to improve signal-to-noise ratios and extract more information from an image without increasing light intensity. In a press release, Warwick Bowen, who led the research, said in addition to microscopy, the new sensor will improve technologies from navigation systems to MRI machines. Nature

Artist’s impression of the new quantum microscope. University of Queensland

Infecting mosquitos to prevent dengue

An unusual clinical trial in Indonesia has demonstrated the efficacy of a novel approach for fighting dengue fever, a mosquito-borne viral disease that strikes some 50–100 million people in the world each year. Dividing a 26-square kilometer stretch of Yogyakarta, Indonesia, into 24 smaller plots, researchers last year released into half of them Aedes aegypti mosquitos infected with Wolbachia pipientis, a bacteria known to confer dengue resistance in the insects. The results show that people in the mosquito-release areas were 77.1 percent less likely to have dengue and 86.2 percent less likely to be hospitalized with the disease. This holds promise for controlling dengue as well as Zika, chikungunya, yellow fever, and Mayaro virus, which are all spread by the same mosquito. New England Journal of Medicine

AI helps Google design next-gen AI

Google researchers have used reinforcement learning, a type of AI, to address a thorny problem in computer hardware design known as chip floorplanning. This is a long, iterative process during which the circuit block architectures of integrated silicon chips are optimized for speed and energy. It takes months and months of intense toil by experts, and because the process has never been automated, chips today are still designed essentially as they have been for 50 years—by hand and hard work. But the Google team reports their AI was able to design chip floorplans in under six hours, and they already used it to design the next generation of AI accelerator chips. Nature

Bad news for Mother Teresa

We can’t all be a selfless saint like Mother Teresa, and according to a recent study at Northwestern University, that might actually be better for our health. In a longitudinal study that followed 6,325 adults over 23 years, scientists examined the balance of the social support people gave and how much they received relative to all-cause mortality risk. The results showed that people who gave more than they received or who received more than they gave both had a higher mortality risk than those who gave and received social support in more equal amounts. Though we have long known the importance of social relationships on human wellness and longevity, this study helps reveal how our social exchanges influence our physical health. Acts of kindness can still be good for your health, but if you want to live longer, make sure you’re also open to accepting them as well. PNAS

Promising peptide protects monkey brains after stroke

Tissue plasminogen activator (tPA) can be a wonder drug for stroke victims if given within a few hours, because it can completely dissolve clots and dramatically improve recovery—but only for people experiencing ischemic strokes. For those who suffer hemorrhagic strokes, tPA is about the worst thing to administer because it activates proteases on cells lining the blood vessels, which risks making the stroke far worse. So tPA is only ever started after a brain scan confirms it’s the one and not the other type of stroke, eating up precious time. A team of doctors at Xijing Hospital in Xi’an, China, have targeted a protein in the brain called MD2, which is expressed during both types of stroke. They designed a peptide called Tat-CIRP to target MD2 and showed it could protect against both types of stroke in mice and against ischemic stroke in monkeys. Science Translational Medicine

An engineering theory of evolution

A team of engineers at the University of Bristol has developed a new concept for biologically engineered systems they call an “evotype,” which is intended to capture the evolutionary potential of human-designed biological systems and to provide a framework for developing new biotechnologies that can evolve over time. “It is essential that we learn to build evolutionarily stable biosystems that can continue to operate under unavoidable evolutionary forces,” they say in a perspective this week. Nature Communications

Anima Techne. Simeon Castle

Fewer than 1 in 10 Americans eat enough fiber, study finds

A study presented this week by researchers at Texas Woman’s University found yet another alarming trend in the American diet. After analyzing all the responses of almost 15,000 U.S. adults who participated in the National Health and Nutrition Examination Survey (NHANES) between 2013–2018, the researchers report that only 5 percent of men and 9 percent of women are getting their recommended daily amounts of dietary fiber. People who don’t consume enough dietary fiber are at higher risk of heart disease and diabetes. Nutrition 2021

Baby Bear Project shows whole genome sequencing can speed diagnosis and reduce costs for newborns

For infants admitted to neonatal intensive care units, genetic disorders are often suspected but routinely underdiagnosed, a systemic limitation that contributes to neonatal mortality as well as rising costs of healthcare testing and hospital admissions. In a recently published study performed across 5 regional hospitals, Project Baby Bear used rapid whole-genome sequencing (rWGS) and rapid precision medicine (RPM) to screen 184 acutely ill Medi-Cal newborns for genetic disorders. Over an average time of 3 days, 74 infants (40%) were found to have rare genetic diseases that explained their admission and would result in at least one change in medical care for 58 babies (32%). The precise diagnoses not only improved accuracy and quality of care for infants, but also were shown to significantly reduce medical costs as they led to shorter hospital stays, less testing, and fewer major procedures. American Journal of Human Genetics