Ricki Lewis

I hate the phrase “humans and animals” or derisively calling someone an animal. We’re not plants, fungi, bacteria, or protozoa, nor are we above other members of the animal kingdom, at least evolutionarily speaking. In recent weeks, with eclectic examples of prominent human males behaving badly dominating the news, I think of the wider biological lens.

Were the media moguls who forced parts of their anatomy into their female employees, the beloved TV star drugging and assaulting dozens of women, and the privileged schoolboys allegedly groping girls at long-ago parties just acting as biology dictates? Does the rush of power and/or the confusion of an alcoholic haze prevent some XYs from temporarily accessing the regions of their brains that might allow thinking to overcome the testosterone rush and halt their aggression, while dampening the hippocampus so that they later can convincingly claim to have no recall?

I don’t think so.

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In the dystopian society of Nobel prizewinner Kazuo Ishiguro’s Never Let Me Go, cloned people are raised to provide organs for the wealthy.

So stark and terrifying is Ishiguro’s imagined world that I never thought I’d read something similar in a work of nonfiction, let alone in a top medical journal. But a Perspective in the September 6 New England Journal of Medicine (NEJM), "Voluntary Euthanasia – Implications for Organ Donation," eerily echoes some aspects of the 2005 novel (and forgettable 2010 film): choosing to donate one’s organs before death, minus the coercion and cloning.

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Many scientists trace their childhood inspiration to the towering skeletons of dinosaurs that still reign over the regal lobbies of the American Museum of Natural History, myself included. But “natural history” has a different meaning in medical research, especially in evaluating new treatments for rare diseases. Searching PubMed under “natural history study” turns up a curious 75,000 or so entries, including rare diseases and museum taxidermy.

A medical natural history study looks at how a disease unfolds over time, in real patients, to provide a point of comparison and variability for evaluating new treatments. A neurologist, for example, might know how to handle an otherwise healthy child with ADHD; a youngster with ADHD as part of Sanfilippo syndrome presents a different clinical picture. A natural history study provides an idea of what to expect.

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The firing of CBS CEO Les Moonves for his alleged history of revolting attacks on women and the upcoming one-year anniversary of Ronan Farrow’s seminal New Yorker piece on Harvey Weinstein and of Alyssa Milano’s #MeToo tweet echoing Tarana Burke’s 2006 call-to-action, got me pondering the Y chromosome.

Genomically speaking, the diminutive Y is the only thing that distinguishes males from females (see “Y Envy"). Both sexes have X chromosomes, and although mitochondrial DNA passes from females to all offspring, we all have mitochondria. Only the Y is the male’s alone.

If size matters, the Y chromosome loses. The human X has about 1500 protein-encoding genes compared to the Y’s 231, some of which have counterparts on the X. Only a handful of Y genes, in the “male-specific region” of the chromosome, are uniquely male. They include the SRY gene that determines maleness and a few others that control fertility.

So the Y chromosome can tell us some interesting things about the male of the species.

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The Food and Drug Administration recently approved the first drug based on RNA interference (RNAi). Unlike media darlings gene therapy and gene editing, RNAi silences genes. The first approval is a milestone two decades in the making.

The new drug, Onpattro (patisiran), treats the tingling, tickling, and burning sensations from the rare condition hereditary transthyretin-mediated amyloidosis, aka hATTR. About 3,000 people have it in the US. Alnylam Pharmaceuticals provides this “first-of-its-kind RNA interference (RNAi) therapeutic.” Like other new nucleic-acid based treatments, it’s pricey. The cost per year for the every-third-week intravenous infusion is $450,000.

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A choreography of mutational events drives cancer cells to invade and metastasize, changing the biology in ways that enable the errant cells to resist treatments. While the traditional slash-and-burn approaches of chemotherapy and radiation attack rapidly-dividing cells, targeted treatments zero in on the altered proteins that reflect precise genetic changes in tumor cells. These are the somatic (“body”) mutations in just the affected cells, not the inherited mutations present in all of a patient’s cells.

Two new papers introduce tools to better match patients to targeted treatments or immunotherapies, based on interpreting the mutations behind a cancer’s initiation and spread. One is a machine learning tool called Cerebro, the other a scale for physicians to rank the evidence that a particular targeted treatment will work against a tumor with specific mutations.

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Once upon a time, in a cave in the Altai Mountains of southern Siberia, different types of ancient peoples were having sex.

A new report in Nature from Svante Pääbo, the Max Planck Institute for Evolutionary Anthropology superstar, and his team introduces the young teen “Denisova 11.” I’ll call her Eleven, in honor of the beloved character in the TV show Stranger Things. She was a type of archaic human called a Denisovan, pronounced “Denise-o-van.”

The title of the new paper tells the whole tale: “The genome of the offspring of a Neandertal mother and a Denisovan father.”

Introducing Denise

The research team introduced the first Denisovan, named Denise, in 2010, based on a preliminary genome sequence from her finger bone, discovered in 2008 in the cave. Denise lived 32,000 to 50,000 years ago and had dark skin and brown eyes and hair. Her genome included some Neanderthal sequences, so it was clear there’d been some mixing of genomes going on.

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Popular accounts of the peopling of North America paint a picture of a lone long-ago trek across the Bering Land Bridge and then south along the Pacific coast, a view based largely on DNA evidence. But other clues point to people also traversing “ice-free corridors” that emerged from melting glaciers like terrestrial tentacles.

A new paper in Science Advances reviews the evidence for more than one way into North America. It concludes that people followed at least two routes, coastal and interior, and that the view over the land bridge “commonly disseminated in the popular press is a prematurely narrow interpretation of current evidence.” The journal held a news conference with three of the investigators.

"We’ve seen conflicting narratives about the timing and the nature of the peopling of the Americas. We wanted to evaluate this claim and provide a framework to discuss the process – not based on speculation but on a critical review of current evidence. Rather than confusion, there is growing congruence of the archeological, paleoecological, and genetic records," said co-author and archaeologist Ben Potter, professor of anthropology at the University of Alaska, Fairbanks.

More philosophically, the report beautifully illustrates scientific inquiry, operating in a blind-man-and-the-elephant sort of way, revealing not alternate facts, but multiple solutions to a shared challenge – a search for habitable land. It also touches on ways to avoid so-called in
"helicopter research," in which wealthy nations send expeditions to probe the health and lives of poorer people, without involving them in the work.

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On November 1, Laura King Edwards’s inspiring book “Run To The Light” will be published, by Bedazzled Ink.

The memoir is an astonishing tale of a sister’s love and how she is coping with a tragic and inevitable future for her younger sibling. It’s also the tale of how one family’s activism has led to a gene therapy in development to treat Taylor’s inherited neurological condition.

The book is also about running – blindfolded.

“Run to the Light” sets up the story in just the second sentence: “We found out my little sister was dying on a parched morning in the summer of 2006, just a few weeks shy of her eighth birthday and a month after my wedding.”

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Anyone watching the recent 60 Minutes segment on CRISPR would conclude that the gene editing technology is on the brink of pouring forth a cascade of cures. But a recent study reveals a mess of missing and moved chromosome parts in the wake of deploying the famed “molecular scissors.”

Invented in 2012, CRISPR brilliantly borrows a bacterial defense against infection. The “clustered regularly interspaced short palindromic repeats” are simple DNA sequences that serve as landing strips in a genome where engineered “guide RNAs” deliver an enzyme to a desired gene, amending or obliterating it. When the enzyme snips across the double helix, natural DNA repair ensues. Cas9 is an oft-used enzyme.

Precision

Unlike conventional gene therapy that adds a gene, sometimes hovering in a DNA loop outside a chromosome, CRISPR swaps in or removes a gene at a precise spot. But it took 27 years for the FDA to approve the first gene therapy, Luxturna, to treat a specific form of hereditary blindness, last December. So CRISPRed drugs won’t be hitting CVS or Walgreen’s shelves anytime soon.

The new report, in Nature Biotechnology, from researchers at the Wellcome Sanger Institute, isn’t the first to find a CRISPR glitch, and it certainly won’t be the last.

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