"Stem-Cell Craze Spreads in Russia"

A tidbit from the AP today about quasi-legal stem cell treatments in Russia (via Wired News), "Stem-Cell Craze Spreads in Russia".  Evidently, treatments putatively consisting of adult and/or embryonic stem cells are being used as treatments for everything from cosmetic adjustments to MS.  The treatments are totally unregulated and at best skirt the edge of what is legal in Russia.  It is unclear where the cells are coming from, or whether those performing the injections have the skills and equipment to isolate stem cells in the first place.  No studies are being performed to follow the patients, or to find out if the treatments are causing harm.

This demonstrates the lengths people are willing to go in order to take advantage of new, unproven technologies.  It also suggests the extent of body modification we can expect when real treatments are demonstrated using stem cells, particularly those that have been genetically modified or coaxed to differentiate into particular tissue types.  Feather goatees will be passe.

Mining the Moleskine

I have carried lots of notebooks over the years, and I only recently found the Moleskine.  It is my favorite by far.  From time to time, I will delve into the pages of my Moleskine for a blog entry.

So, with no further ado...

1 December 2004 :: Tokyo

Robot_goddessAfter getting lost once again in Shinjuku station, finally finding my way to the right subway line, and stumbling into the four story metal robot-ninjapuppet-goddessqueen, I am now sitting happily at Segafredo in the upper lobby of Mori Tower, Roppongi Hills.  There are vast numbers (relatively) of Westerners in suits here, as well as meandering the mall.  But for all their ex-pat spending power, they are out-yenned by the many Japanese patronizing all the Western shops and restaurants.  With equivalent lines at Segafredo and the Starbuck's just downstairs, I wonder how distinctly the concepts of "Western", "European", and "American" are differentiated in the Japanese (and more generally Asian) mind.  Does it make a difference?  Does the conception of the US as a place and culture distinct from Europe, perhaps as exemplified by foreign policy,  come into decisions about where to shop, or with which brands to self-identify?

2 December 2004 :: Approximately the Int'l Date Line

This I wonder -- as clocks (developed largely to assist with navigation) brought about a general  public concern for the precise passage of time, and a common means to accurately measure it, what other tools and concepts so momentously impact the zeitgeist and human condition?  Not relativity and quantum mechanics, I think, because these are neither commonly understood nor measured, and as yet neither find application in common technology.  Indeed, at least for the time being we avoid quantum mechanics in our computers and make little or no mention of the effects of relativity on travelers or satellites.

What will be the tool or concept that changes our conception of biology?  Will it have a polysyllabic name we already know; genomics, metabolomics, proteomics, transcriptomics?  We barely know how to define those terms, and are not yet proficient in measuring any of them.  Perhaps revolution will be found in "molecular medicine", the reduction of health care to understandable, describable interactions of compounds dispensed with a foreknowledge of their effects.

And how will the concept of "molecular medicine", with its reduction of biology to mechanistic interactions and its probable reliance upon stem cell therapies -- even those drawn from the patient -- be received in the context of an apparently resurgent Christian philosophy wherein every cell that possesses the capability of generating a new life, a new individual, is held to have a soul?  What happens when it is demonstrated that stem cells removed from an adult can be reprogrammed and used to generate a new human being?  Will opponents argue that the line is too easy to cross?  Or will the potential health care benefits overwhelm the desire for a self-consistent philosophy?

The Thousand Dollar Genome

I have once again been hearing noises about the "thousand dollar genome" (TDG).  That is, a human genome read de novo for a USD 1000 or less.  Here (REVOLUTIONARY GENOME SEQUENCING TECHNOLOGIES -- THE $1000 GENOME), for example, is a request for proposals from the National Human Genome Research Institute to develop technology that would enable the TDG.

Based on my early efforts to quantify how the productivity and cost of sequencing were changing, Steward Brand asked me back in 2002 when we would get the TGD. 

Thousand_dollar_genome_3Here is the plot I generated in response (click on the figure thumbnail for a full-sized version).

The cost hasn't changed dramatically recently, and at the current pace we we won't get the TDG until sometime after 2020.  With 3 billion (3x109) bases in the human genome, we need to hit USD .3x10-6 per base (which is .3 microbucks, 300 nanobucks, 300 nanodollars per base -- nanoeconomics anyone?) to reach the Thousand Dollar Genome.  However, the numbers on the plot are primarily based on instruments that use slab gel electrophoresis and capillary electrophoresis.  Thus as new technologies emerge we could very well get to the TDG much more rapidly.

Recombination vs. Reassortment

Here is a story in today's Wired News about Henry Niman and his ideas about viral evolution in the Avian Flu (H5N1).  While the text of the story is a bit unclear about the difference between recombination and reassortment, one of the associated images is quite nice.  This is yet another take on the specific mechanisms of viral evolution.  The figure defines reassortment as the emergence of a new strain via the replacement of whole genes from another (related) virus, and defines recombination as the insertion of fragments of genes into a new viral strain from another genome, potentially from the host.

Ignoring what labels are used, it seems the important point is that there may be two mechanisms for introduction of new sequences into an influenza viral genome; 1) inclusion of whole genes into a segmented genome or 2) insertion of gene fragments from another strain or species within a given viral gene.

Niman seems to think that not only is there evidence that the current H5N1 strain is evolving via the second mechanism, but that this is also the origin of the Spanish Flu (see my post "The Spanish Flu Story"), despite the fact that there appears to be a historically low occurrence of homologous recombination in negative sense RNA viruses (see my post "A Confluence of Concerns").

Reverse Genetics for H5N1 Vaccine

Just as I was banishing my ignorance about how the forthcoming trial vaccine for H5N1 was produced, a trio of excellent articles from the Wall Street Journal and Fortune landed in my Inbox, facilitating my education.  The short story is that the virus grown in chicken eggs as the source of an attenuated vaccine is not actually H5N1.  The genes that cause the virus to be so fatal to eggs have been replaced with genes from less virulent strains, while the HA protein on the surface of the virus is modified so that it is more stable.

Alas, because the WSJ doesn't allow you to look at their list of stories in the print edition without a subscription, I can't even provide links to the stories.  Fortune, evidently, is more forthcoming.  Here are the titles, etc;

"A primer on the Threat of Avian Flu...", by Gautam Naik, and "Avian Flu Poses Challenge to Global Vaccine Industry...", by David Hamilton and Gautam Naik; both are from the 28 Feb, 2005 issue of the WSJ.  "The Coming War Against Bird Flu", by David Stipp, will appear in the 7 March, 2005 issue of Fortune.

The upshot of the three articles is that the vaccine is produced in sterile chicken eggs via a recombinant virus that is a modified version of H5N1.  This strategy requires a large number of those eggs, which are not easy to come by, and produces a vaccine that prompts the production of antibodies against a virus that may, or may not, be similar to the wild type H5N1.  That is what human trials will have to determine.

Thus my initial concerns (here and here) about this issue were not so far off target.  Stipp's article does an excellent job describing the production of the vaccine, and associated challenges.  It is pretty clear we need to come up with alternative means of producing vaccines, preferably rapid synthetic approaches that are deployable from a distributed infrastructure.

UPDATE (7 March 2005): I stumbled over this article in The Scientist, "H5N1 vaccine strain in a week", from 29 January 2004, which opens;

A prototype vaccine strain of the H5N1 flu virus causing havoc in Asia will probably be ready next week, John Wood of the UK National Institute for Biological Standards and Control (NIBSC) told The Scientist today (January 29). However, months of other hurdles remain before it may be ready for public health use.

The article describes several genetic manipulations of the H5N1 strain that will make it easier to produce in chicken eggs, beginning with the removal of, "a stretch of 4 or 5 basic amino acids at the hemagglutinin cleavage site that allows the virus to replicate in every organ of a chicken's body, rather than respiratory and gut tissue normally infected".

The article cites Klaus Stohr as saying, "The H5N1 virus kills chicken eggs, the normal medium for growing flu vaccine viruses, so the WHO laboratories are using reverse genetics to lower the pathogenicity of the virus to chickens and to get a high yield in the egg cultures", and describes the additional genetic manipulations; "Using other lab strain flu plasmids containing the other components of the viral genome, the team will then reassort the pieces into a nonpathogenic vaccine strain." 

Finally, the article suggests that, "Sufficient amounts of safety-tested prototype vaccine virus will probably be available for the necessary 1 to 2 months of clinical trials in the next 4 weeks".  The date of this article, again, was 29 January, 2004.

Looks like we are well on our way, circa January 2004, to producing a lovely vaccine against a bug that doesn't actually exist in nature.  We clearly need an alternative to attenuated (or killed) whole virus vaccines.  When I have time, I will post what I have been learning about DNA vaccines.

Detecting and Diagnosing Avian Flu

"Bird fly outbreaks may go unnoticed in humans", a news piece in the 26 February, 2005 issue of New Scientist, reports that human cases of Avian Flu (H5N1) may be misdiagnosed.  Several patients in SE Asia have presented with symptoms unusual for the flu, and only after death did they test positive for the virus.  The piece also reports that the WHO is "analysing blood samples from people in areas affected by h5N1 to see how many carry antibodies against the virus".

The difficulty here is that it can take up to several weeks (say, one to three, depending on the etiology of the bug) for the adaptive immune response to produce antibodies against a pathogen.  It appears that people are dying within that time frame, which means that testing for antibodies is unlikely to be a useful diagnostic tool, at least given standard assay sensitivities.  Using reverse-transcriptase PCR (RT-PCR), it may be possible to detect the RNA genome of the bug, but clinical PCR is a true art.  It is often quite difficult to see anything via PCR in a clinical sample, unless you can really clean it up via purification.  That purification, however, particularly in the case of RNA, tends to reduce the sensitivity of the assay by removing or destroying the target nucleic acids before the amplification step.

Unrealistic H5N1 Vaccine Expectations?

I still haven't been able to determine what magical means will be used to produce a vaccine against the H5N1 strain of Avian Flu.  Press is very thin on how production and testing of the vaccine is going.  Yet policy decisions are being made based on the notion that the vaccine will be available in quantity soon.

A press release on the CIDRAP site from the World Health Organization notes that WHO will probably recommend governments start stockpiling vaccines against H5N1.  The release also cites unnamed "U.S. officials" who say that clinical trials of vaccines from Chiron and Sanofi-Pasteur are supposed to start soon, while also noting that, "H5N1 may not match the pandemic strain, the vaccine's shelf life of up to 2 years is relatively short, and, because companies have not yet begun clinical trials, licensing of the vaccine is months away."

And in another release, the CIDRAP site quotes Michael Osterholm, who is director of the University of Minnesota Center for Infectious Disease Research and Policy, "We don't have a pandemic strain of vaccine yet, and we don't have any idea whether any of the vaccines to date would be efficacious."  In the Technological Challenges to Vaccine Development section of the Pandemic Influenza overview at CIDRAP, we find; "Highly pathogenic avian strains cannot be grown in large quantities in eggs because they are lethal to chick embryos."

To the extent that we should trust the popular press on this issue, as part of a short story on What You Need to Know About Avian Flu, the 9 February, 2004 issue of Business Week states, "Vaccines are usually produced in chicken eggs, but H5N1 is lethal to fertilized eggs."

Yet a 24 February, 2005 story on Newsday.com says, "Two million doses of vaccine are being stored in bulk form for possible emergency use and to test whether it maintains its potency," while 8000 doses are, "nearly ready to be shipped to the National Institute for Allergy and Infectious Diseases for clinical trials."

Perhaps the vaccine about to enter trials is from source other than chicken eggs?

In 10 February, 2005 testimony before the The Committee on Government Reform, Jesse L. Goodman, Director of the Center for Biologics Evaluation and Research at the FDA, while describing how the Department of Health and Human Services will spend roughly a billion dollars over the next few years on influenza related activities, said; "While work remains to obtain sufficient vaccine yields and evaluate cell-based vaccines for their safety and effectiveness, moving from an egg-based production to a cell-culture production can potentially shorten the time needed to produce vaccine as well as decrease the risk of contamination inherent in egg-based production."  That is, there isn't yet a functional alternative to using chicken eggs to produce vaccine.

So what gives?  I can only speculate that details about the vaccine are being closely held until more is learned about how it behaves in humans.  But with so many sources suggesting the vaccine can't be grown in eggs, I have to wonder what tricks Chiron and Sanofi-Pasteur have come up with to produce it in bulk.  Perhaps it is a low yield process and they have concentrated the virus produced from a much larger number of eggs?

I wish someone would come out and clearly explain where the vaccine is coming from and how it is produced.  The issues of what infrastructure exists to make vaccines, how much can be made, and whether it will be effective are quite critical for charting our course as we prepare for a potential pandemic.

Ch 5 of Learning to Fly is Online

Here is part of "The Second Coming of Synthetic Biology", the fifth chapter of my book, Learning to Fly: the past, present, and future of Biological Technology.  More at: www.BiologyIsTechnology.com.

Chapter 5.  The Second Coming of Synthetic Biology

"I must tell you that I can prepare urea without requiring a kidney of an animal, either man or dog.”   With these words, in 1828 Friedrich Wohler announced he had irreversibly changed the world.  In a letter to his former teacher Joens Jacob Berzelius, Wohler wrote that he had witnessed, “The great tragedy of science, the slaying of a beautiful hypothesis by an ugly fact.”  The beautiful idea to which he referred was vitalism, the notion that organic matter, exemplified in this case by urea, was animated and created by a vital force and that it could not be synthesized from inorganic components.  The ugly fact was a dish of urea crystals on his laboratory bench, produced by heating inorganic salts.  Thus was born the field of synthetic organic chemistry.

Around the dawn of the 19th century, chemistry was in revolution right along with the rest of the western world.  The study of chemical transformation, then still known as alchemy, was undergoing systematic quantification.  Rather than rely on vague and mysterious incantations, scientists such as Antoine Lavoisier wanted to create what historian of science and technology Bruce Hevly calls an “objective vocabulary” for chemistry.  Through careful measurement, a set of clear rules governing the synthesis of inorganic, non-living materials gradually emerged.

In contrast, in the early 1800s the study of organic molecules was primarily concerned with understanding how molecules already in existence were put together.  It was a study of chemical compositions and reactions.  Unlike the broader field of chemistry taking shape from alchemy, making new organic things was of lesser concern because it was thought by many that organic molecules were beyond synthesis.  Then, in 1828, Wohler synthesized urea.  Suddenly, with one experiment, the way scientists did organic chemistry changed.  The ability to assemble organic molecules from inorganic components altered the way people viewed a large fraction of the natural world because they could conceive of building much of it from simpler pieces.  Building something from scratch, or modifying an existing system, requires understanding more details about the system than simply looking at it, poking it, and describing how it behaves.  This new approach to chemistry helped open the door to the world we live in today.  Products of synthetic organic chemistry dominate our environment, and the design of those products is possible only because understanding the process of novel assembly revealed new principles.

It was this step of moving to Synthetic Chemistry, and then to an engineering of chemistry, which radically changed the way people understood chemistry.  Chemists had to learn rules that weren’t apparent before.  In the same way that Chemical Engineering changed our understanding of nature, as we begin engineering biological systems we will learn considerably more about the way biological pieces work together.  Challenges will arise that aren’t obvious just from watching things happen.  With time, we will understand and address those challenges, and our use of biology will change dramatically in the process.  The analogy at this point should be clear; we are well on our way to developing Synthetic Biology.

Before going further, it is worth noting that this is not the original incantation of the phrase “synthetic biology”.  Whatever the reception this time around, the first time it was a flop.  In her history of the modern science of biology, Making Sense of Life, Evelyn Fox Keller recounts efforts at the turn of the 20th Century to discover the secret of life through construction of artificial, and synthetic, living systems; “To many authors writing in the early part of the [20th] century, the [path] seemed obvious: the question of what life is was to be answered not by induction but by production, not be analysis but by synthesis.”(Keller, p.18)  This offshoot of experimental biology reached its pinnacle, or nadir, depending on your point of view, in attempts by Stephané Leduc to assemble purely physical and chemical systems that demonstrated behaviors reminiscent of biology.  As part of his program to demonstrate “the essential character of the living being”(ibid, p.28) at both the sub-cellular and cellular level, Leduc constructed chemical systems that he claimed displayed mitotic division, growth, development, and even cellular motility.  He described these patterns and forms in terms of the well-understood physical phenomena of diffusion and osmotic pressure.  It is important to note that these efforts to synthesize life-like forms relied as much on experiment as upon theory developed to describe the relevant physics and chemistry.  That is, this was a specific program to use physical principles to explain biological phenomena.  These efforts were described in a review paper at the time as “La Biologie synthetique”(ibid, p.31-32).

While the initial reception to this work was somewhat favorable, Leduc’s grandiose claims about the implications of his work, and a growing general appreciation for complicated biological mechanisms determined through experiments with living systems, led to something of a backlash against the approach of understanding biology through construction.  By 1913, one reviewer wrote, “The interpretations of M. Leduc are so fantastic…that it is impossible to take them seriously”(ibid, p.31).  Keller chronicles this episode within the broader historical debate over the role of construction and theory in biology.   History regards the folks in the synthetic camp, and related efforts to build mathematical descriptions of biology, particularly in the area of growth and development, as poorly regarded by their peers.  Perhaps inspired by the contemporaneous advances in physics, it seems that the mathematical biologists and the synthetic biologists of the day pushed the interpretation of their work further than was warrented by available data.

In response to what he viewed as theory run rampant, Charles Davenport suggested in 1934 that, “What we require at the present time is more measurement and less theory…There is an unfortunate confusion at the present time bewteen quantitative biology and bio-mathematics…Until quantitative measurement has provided us with more facts of biology, I prefer the former science to the latter”(ibid, p.86).  I think these remarks are still valid today.  Leduc, and the approach he espoused, failed because real biological parts are more complex, and obey different rules, than his simple chemical systems, however beautiful they were.  And it is quite clear that vast forests have been felled to publish theory papers that have little to do with the biology we see out the window.  But theory, drawn from physics, chemistry, and engineering, does have a role to play in describing biological systems.  Resistance to the tools of theory has been, in part, cultural.  There has always been a certain tension in biology over the utility of mathematical and physical approaches to the subject;

To put it simply, one could say that biologists do not accept the Kantian view of mathematics (or, rather, mathematization) as the measure of a true science; indeed, they have often actively and vociferously repudiated any such criterion.  Nor have practicing biologists shown much enthusiasm for the use of mathematics as a heuristic guide in their studies of biological problems.(Keller, p. 81)

Fortunately, this appears to be changing.  Mathematical approaches are flourishing in biology, particularly in the interpretation of large data sets produced by genomic and proteomic studies.  Physicists and engineers are making fundamental contributions to the quantitative understanding of how individual proteins work in their biological context.  But I think it is important to acknowledge that not all biologists think a synthetic, bottom up, approach will yield truths applicable to complex systems that have evolved over billions of years.  Such concerns are not without merit, because as the quotation from Charles Davenport suggests, biology has traditionally had more success when driven by good data rather than theory.  The challenge today is to build quantitatively predictive design tools based on the measured device physics of real biological parts, and to implement designs within organisms in ways that work in the real world...

More at: www.BiologyIsTechnology.com.

Avian Flu Uncertainties

(First, here is the NIH Focus on the Flu site.  Decent general info there.)

Klaus Stohr is the chief of the World Health Organization's global influenza program.  He is worried that we are overdue for a flu pandemic.  In this profile in The Lancet, he is attributed with the observations that flu pandemics occur on average every 27 years, that the last one hit 37 years ago in 1968, and that between 2 and 7 million people could die in the next pandemic.

As a veterinarian and influenza specialist, Dr. Stohr obviously knows a lot more about flu bugs than do I.  However, his statistics may need a second look, particularly for incidents in the past 100 years.  Arnold Monto notes in his New England Journal of Medicine perspective "The Threat of an Avian Influenza Pandemic" (27 Jan 2005) that, "There have been three influenza pandemics during the past century -- in 1918, 1957, and 1968."  It is true that the average interval between these three events is just under 30 years.  I don't know how many data points Dr. Stohr is working with, but the width of the distribution, in this case, is hardly even computable for pandemics this century.  The interval between events is just as likely to be 40 years as it is 30 (not so comforting, I admit).  In any event, given the state of modern medicine, travel, and sanitation (and the variability in all those things across the globe) nobody should be drawing firm statistical conclusions from the three most recent data points.  The point of this is that because this bug is not behaving as expected, perhaps we should reevaluate our expectations.

How much do we really know about pandemic strains?  Perhaps a good place to start is examining how similar the three 20th century strains were.  Not very, I am beginning to think.  Although each were a novel type A virus of avian origin, Monto observes that, "In 1957 and 1968, the new viruses had components of previous human viruses as well as avian viruses...it was determined retrospectively that in both cases, there had been a reassortment of avian and human genes -- most likely the result of the coinfection of a host by two different viruses."  Monto then notes that the 1918 strain appears to have resulted from mutation in an avian strain (see my post, The Spanish Flu Story).  So, we are down to two pandemic strains, out of only three total, that arose through the historically low probability process of reassortment (see the end of my post, A Confluence of Concerns).  The numbers aren't looking good for deriving general principles about potential pandemic flu strains.

Adding to the confusion is the fact that, according to Monto, "The genetic characteristics of [H5N1] are still completely avian; neither mutation nor the sharing of genetic material with a human virus has taken place."  (I don't entirely understand this statement in light of assertions that H5N1 is becoming more pathogenic in poultry -- how else would this occur than by mutation?  Or is recombination amongst avian strains the assumed mode of increase pathogenesis?)  Klaus Stohr himself, in a 27 Feb, 2005 editorial in NEJM, "Avian Influenza and Pandemics -- Research Needs and Opportunities", wonders;

Why has H5N1 not reassorted with a human influenzavirus?  It certainly has had ample opportunity to do so...Unprotected workers [destroying infected poultry have] had intense exposure, as did health care workers.  Virologic surveillance has demonstrated the concurrent circulation of human viruses.  Hence, one conclusion is tempting: if H5N1 could reassort, it should have done so by now.  The explanation may lie in sheer statistical luck.

Hmmm.  That's not so satisfying. 

The last thing I want to do here is undermine the efforts of experts to understand what is going on and to try to prevent a pandemic.  However, I can't square public statements about the risk we face with what data I find in the literature.  There is definitely a troublesome lack of information about how flu bugs work, how the evolve, and what we might do to stop them, particularly with vaccines.  This press release, dated 27 May 2004, from the National Institutes of Allergy and Infectious Disease, says vaccines against H5N1 will be made by Chiron and Aventis Pasteur using the traditional chicken egg method.  While I have informally heard that H5N1 is so lethal that it kills chicken embryos before they can produce an adequate amount of virus to use as a vaccine, I still haven't been able to confirm whether or not it is technologically possible to produce an H5N1 vaccine this way.

So what do we do?  Stohr, again; "Substantial gaps in knowledge remain, making the ability of science to guide policy imperfect at a critical time."

Indeed.