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Links Between the Microbiome and Mental Health

Overview

The brain is affected by bodily changes—including microbiome composition—that influence cognition and behavior. This eBriefing will explore the interaction between the brain, gut & microbiome, with a focus on how the microbiome influences developmental, neuropsychiatric, and immune-related disorders, including socioaffective processing disorders such as autism.

In this eBriefing, You’ll Learn:

  • How the microbiome is seeded and maintained throughout life
  • How stress effects health of the microbiome
  • How changes in microbiome composition result in changes in behavior
  • The latest research in therapies targeting microbiome

Speakers

John Cryan, PhD
University College Cork

Kirsten Tillisch, MD
University of California, Los Angeles

Microbiome and Mental Health

John Cryan, PhD

University College Cork

John Cryan, PhD, is focused on understanding the interaction between brain, gut, and microbiome and how it applies to stress and immune-related disorders, including irritable bowel syndrome and obesity and neurodevelopmental disorders such as autism.  Dr. Cryan is a Professor & Chair of the Department of Anatomy & Neuroscience at the University College Cork in Ireland.  He spent four years at the Novartis Institutes for BioMedical Research in Basel Switzerland, as a LabHead, Behavioural Pharmacology prior to joining UCC and is a Senior Editor of Neuropharmacology and Nutritional Neuroscience and an Editor of British Journal of Pharmacology.

Kirsten Tillisch, MD

University of California, Los Angeles

Kirsten Tillisch, MD, was the first to demonstrate an effect of gut microbial manipulation with probiotics on emotional brain responses. Her ongoing research is focused on the role of the mind-body connection in chronic pain syndromes as well as the effects of mindfulness, hypnotherapy, and other non-drug therapies for irritable bowel syndrome. She is the Chief of Integrative Medicine at the Greater Los Angeles VA and a Professor of Medicine at the David Geffen School of Medicine at UCLA.

Further Readings

Cryan

Dinan TG, Cryan JF

Gut microbiota: a missing link in psychiatry

World Psychiatry. 2020 Feb;19(1):111-112

Minal J, Rea K, Spichak S, et al

You’ve got male: Sex and the microbiota-gut-brain axis across the lifespan

Front Neuroendocrinol. 2020 Jan;56:100815

Lyte JM, Gheorghe CE, Goodson MS, et al

Gut-brain axis serotonergic responses to acute stress exposure are microbiome-dependent

Neurogastroenterol Motil. 2020 May 11; e13881

Bassett SA, Young W, Fraser K, t al

Metabolome and microbiome profiling of a stress-sensitive rat model of gut-brain axis dysfunction

Scientific reports. 2019 Oct 1;9(1):14026

Cyran JF, Dinan TG

Decoding the role of the microbiome on amygdala function and social behaviour

Neuropsychopharmacology. 2018 Oct 19;44(1): 233-234

Tillisch

Tillisch K, Gupta A

The Role of the Microbiome in Mood

The Microbiome and the Brain, edited by D Perlmutter, CRC Press 2020, 107-120.

Tillisch K, Mayer EA, Gupta A, et al

Brain structure and response to emotional stimuli as related to gut microbial profiles in healthy women

Psychosom Med. 2017 Oct;79(8):905-913

Labus JS, Hollister EB, Jacobs J, et al

Differences in gut microbial composition correlate with regional brain volumes in irritable bowel syndrome

Microbiome. 2017 May 1;5(1):49

Tillisch K, Labus JS

Neuroimaging the microbiome-gut-brain axis

Microbial Endocrinology: The Microbiota-Gut-Brain Axis in Health and Disease, edited by M Lyte, JF Cryan, Springer 2014, 405-416.

Tillisch K, Labus JS, Kilpatrick L, et al

Consumption of fermented milk product with probiotic modulates brain activity

Gastroenterology. 2013 Jun;144(7):1394-401.

Maternal, Neonatal, and Early Infancy Vaccine Developments

Overview

Newborns have a limited ability to fight infectious pathogens. As a result, morbidity and mortality are high during the first few months of life, particularly in low- and middle-income countries. Active research is taking place, and great strides have been made to identify the factors that influence the risk of infection and disease in pregnant women and newborns. One promising approach—maternal, neonatal, and early infancy vaccines—has the potential to protect the health of mothers and children worldwide. Although several existing vaccines are safe and effective for use during pregnancy, no vaccines have been formally approved or licensed specifically for use in pregnant women.

On June 23, 2020, the New York Academy of Sciences hosted a symposium to explore challenges and achievements in the development and licensure of maternal vaccines. In a series of keynote and plenary presentations, the symposium covered recent findings regarding the maternal-to-newborn transfer of antibodies, lessons learned from the use of licensed vaccines during pregnancy, new targets for maternal immunization and contextual factors that influence the vaccination of pregnant women and their offspring.

Symposium Highlights:

  • Infectious disease is one of the leading causes of stillbirth and newborn death around the world.
  • Because antibodies can be transferred from the mother to the baby, boosting maternal antibodies can help protect the newborn against respiratory or invasive diseases.
  • Certain vaccines that are routinely used in the general population (e.g., influenza, pertussis), are also recommended for pregnant women to protect both mother and child.
  • Several pregnancy-specific vaccines, such as Group B Streptococcus, Respiratory Syncytial Virus, and Human Cytomegalovirus, are currently in different stages of development.
  • Contextual factors, like access to health care during pregnancy and after birth, are important determinants in the success of maternal and neonatal immunization worldwide.

Speakers

Stephen L. Brusatte
The University of Edinburgh

Sinéad Farrington
The University of Edinburgh

John Marioni
European Bioinformatics Institute and University of Cambridge

David P. Mills
The University of Manchester

Artem Mishchenko
The University of Manchester

Matthew Powner
University College London

Themis Prodromakis
University of Southampton

Edze Westra
University of Exeter

Sponsors

Promotional Partners

Keynote: Protecting Infants with Maternal Vaccination

Speaker

Shabir Madhi
University Witwatersrand

Prospects of Maternal Vaccination to Protect Young Infants

One of the United Nations’ Sustainable Development Goals is to reduce the global maternal mortality rate and eradicate preventable deaths in newborns and children under five by 2030. “Of all children under the age of five who die, roughly two thirds will in fact die within the first six months of life” explained vaccinologist Shabir Madhi. Hence, shielding newborns can really advance the fight against child mortality. Maternal and neonatal vaccines could prevent lethal infections at this vulnerable stage of life. However, to develop those vaccines, we need to understand the biological causes of early-life mortality.

Unfortunately, the quality of epidemiological and clinical data regarding child mortality is poor. Neonatal and fetal deaths are underreported and under-investigated, particularly in countries with the highest rates of early-life mortality. In low- and middle-income countries, autopsies of children are rare. As a result, our understanding of early-life mortality is still limited.

Top pathogens identified as the cause of death in newborns in a multi-country study conducted by the Child Health and Mortality Prevention Surveillance (CHAMPS) Network.

Madhi and his team are trying to fill this research gap. In a large study, Madhi and his colleagues collected tissue samples and clinical records of deceased children across seven countries in Africa and Southeast Asia. This diagnostic approach was sufficient to establish the chain of factors that may have ultimately caused the deaths of these infants. Madhi and his team also sought to ascertain the biological causes of stillbirth. Together, these studies revealed that infections accounted for about 20% of stillbirths and 54% of newborn deaths. Furthermore, the investigators were able to identify the top pathogens behind those infections, like K. pneumoniae, or E. coli. These findings can help inform the strategic development of maternal vaccines, a promising intervention in the fight against child mortality.

Further Readings

Madhi

Taylor AW, Blau DM, Bassat Q, et al

Initial findings from a novel population-based child mortality surveillance approach: a descriptive study

The Lancet Global Health. 2020 Jul;8(7):e909-e919

Nunes MC, Aquil AR, Omer SB, Madhi S

The Effects of Influenza Vaccination during Pregnancy on Birth Outcomes: A Systematic Review and Meta-Analysis

Am J of Perinatol. 2016 Sept;33(11): 1104-1114

Madhi S, Briner C, Maswime S, Mose S

Causes of stillbirths among women from South Africa: a prospective, observational study

The Lancet Global Health. 2019 Apr; 7(4):e503-e512

Madhi S, Polack FP, Piedra PA, et al

Respiratory Syncytial Virus Vaccination during Pregnancy and Effects in Infants

N Eng J Med. 2020 Jul 30;383(5):426-439

Maternal-Fetal Immunology and Physiology

Pat Furlong, Panelist
Parent Project Muscular Distrophy

Roman J. Giger
University of Michigan School of Medicine

Altered Mother-To-Newborn Transmission of Pioneering Microbiota and Child Health

The human body is host to a large number of microbes, such as bacteria and fungi. This community of microorganisms, or microbiota, occupies the gut, skin, and cavities. It plays a role in essential functions, like the promotion of immune responses and the production of vitamins. So it’s not surprising that changes to the composition of the microbiota are associated with various diseases. In his research, epidemiologist Noel Mueller studies how the gut microbiota affects metabolic health during early development.

The first exposure to these microbes occurs in the birth canal. This mom-to-newborn transfer of microbiota provides the baby with a healthy collection of microorganisms. Mueller and his team have found that babies delivered by cesarean section (CS) have less of these protective microbes. Instead, opportunistic pathogens are more likely to colonize these babies’ microbiota. The proportion of cesarean-delivered babies continues to increase worldwide. As a result, “even if [CS] poses a small relative risk in health outcomes, it can have a large impact at the population level,” Mueller explained.

During “vaginal seeding,” cesarean-delivered babies are inoculated with their mothers’ microbiota.

CS is associated with a higher risk of developing allergies, obesity, and asthma. Lack of exposure to the mother’s microbiota in the birth canal may be at the root of some of these disorders. Mueller and his collaborators investigated a simple intervention called “vaginal seeding,” which consists of inoculating cesarean-delivered babies with their mother’s microbiota. In this “bacterial baptism,” maternal vaginal microbiota is wiped in the neonate’s face, mouth, and body. Preliminary data suggest that vaginal seeding can restore some beneficial microbes that may otherwise be lacking in these babies. A large randomized controlled trial assessing the efficiency and safety of this technique is currently underway.

Antibody Transfer From Mother To Infant: The Physiology of Breast Milk

For Kirsty Le Doare, an expert in pediatric infectious disease, breast milk is like your grandmother’s chicken soup. “It contains all the nutrients that a baby needs to grow and thrive,” she said. In addition, breast milk also protects infants from infections. Hence, breastfed infants are less vulnerable to gastrointestinal and respiratory tract infections than formula-fed infants. However, it is still unclear how breast milk modulates the infant immune response.

Le Doare wants to change that through her research on age-related immune response to infectious diseases. She, along with her team, conducted a study with Gambian mother/infant pairs. They found that IgA antibodies for Group B Streptococcus (GBS) in breast milk reduced the likelihood of GBS colonization days after birth and increased the likelihood of GBS clearance later in life. Interventions like maternal vaccines can harness this form of neonatal protection against pathogens.

After some forms of maternal immunization, antibodies against certain pathogens persist in the breast milk for at least six months, protecting the neonate. Le Doare and her team are using novel culture models to understand how these antibodies fight pathogens. Although breast milk antibodies are a critical protective agent for the neonate, oligosaccharides in breast milk have also been found to lower the risk of infection. For instance, these sugar molecules can act as a decoy for pathogens, which bind to them and stay away from intestinal cells. A better understanding of these mechanisms could be leveraged to develop therapies to protect neonates against invasive diseases.

The Structure of the Human Placenta Enables Humoral and Cellular Immune Defense

According to virologist Lenore Pereira, 1%-3% of infants are infected with Human Cytomegalovirus (HCMV) every year. In about 25% of infected babies, HCMV can cause congenital disorders such as cerebral palsy, microcephaly, and deafness. Mothers that have strong neutralizing antibodies due to prior HCMV infection are less likely to transmit the infection to the baby, and most infants born of seropositive mothers are asymptomatic. However, the immune mechanisms that help prevent infection are not well understood.

HCMV infects the developing baby by crossing the uterine-placental interface and replicating in the placenta. Using ex vivo explants of first-trimester placentas, Pereira and her team have been able to identify the mechanisms of infection as well as the protective potential of some antibodies. Neutralizing antibodies, namely those that target a specific complex of glycoproteins in the surface of HCMV, reduce viral spread, infection, and cell death in early-gestation placentas.

The investigators also demonstrated that, in the maternal component of the placenta, HCMV infection induces an increase in effector-memory T cells. These cells may confer protection to the babies of seropositive mothers. These findings could lead to the development of antibody treatments that restrict HCMV infection and associated pregnancy complications from congenital infection.

Further Readings

Mueller

Mueller NT, Bakacs E, Combellick J, et al

The infant microbiome development: mom matters

Trends Mol Med. 2015 Feb;21(2):109-17

Mueller NT, Shin H, Pizoni A, et al

Birth mode-dependent association between pre-pregnancy maternal weight status and the neonatal intestinal microbiome

Scientific Reports. 2016 Apr 1;6(23133)

Shao Y, Forster SC, Tsaliki E, et al

Stunted microbiota and opportunistic pathogen colonization in caesarean-section birth

Nature. 2019;574(7776):117-121

Mueller NT, Hourigan SK, Hoffman DE, et al

Bacterial Baptism: Scientific, Medical, and Regulatory Issues Raised by Vaginal Seeding of C-Section-Born Babies

Journal Law Med Ethics. 2019;47(4): 568-578

Le Doare

Andreas NJ, Al-Khalidi A, Jaiteh M, et al

Role of human milk oligosaccharides in Group B Streptococcus colonisation

Clin Transl Immunology. 2016 Aug 26; 5(8):e99

Le Doare K, Holder B, Bassett A, Pannaraj PS

Mother’s Milk: A Purposeful Contribution to the Development of the Infant Microbiota and Immunity

Front Immunol. 2018 Feb 28;9(361)

Pereira

Pereira L

Congenital Viral Infection: Traversing the Uterine-Placental Interface

Annu Rev Virol. 2018 Sep 29;5(1):273-299

Pereira L,  Maidji E, McDonagh S, Tabata T

Insights into viral transmission at the uterine-placental interface

Trends Microbiol. 2005;13(4):164-174

Lessons from Current Vaccines & New Targets for Immunization

Speakers

Janet Englund, MD
Seattle Children’s Hospital

Stanley Plotkin, MD
Vaxconsult LLC, University of Pennsylvania

Ajoke Sobanjo-ter Meulen, MD, MSc
Bill & Melinda Gates Foundation

Maternal Vaccines Licensed for Adults: What Can Be Learned from Recent Experiences with Influenza, Pertussis and Tetanus Vaccines

Maternal immunization is not a new strategy, said pediatrician and infectious disease expert, Janet Englund. Englund discussed the history of maternal vaccines, whose popularity has ebbed and flowed throughout the years. As early as 1879, maternal immunization was used to confer protection from smallpox in infants.

For centuries, tetanus toxoid was one of the leading causes of neonatal death. A landmark study in New Guinea demonstrated that maternal immunization with tetanus toxoid protects newborns. As a result, this vaccine has been routinely administered to pregnant women for years. Thanks to this, Englund said, 45 countries have been able to eradicate maternal and neonatal tetanus, a testament to the potential of maternal immunization to fight global epidemics.

In 2012, an outbreak of pertussis was observed in the US and other developed countries, including the UK. In October of that year, the UK introduced the maternal pertussis vaccine, which was associated with a dramatic decrease in the rate of neonatal pertussis. While most health authorities recommend that pregnant women get this vaccine during the third trimester, recent studies have shown that earlier is better; maternal immunization during the second trimester maximizes pertussis antibody transfer to the infant.

Pregnant women, Englund explained, are at a higher risk of severe influenza infections than non-pregnant women. Influenza infection during pregnancy is associated with preterm birth and low birth weight infants. Maternal influenza immunization is safe and it effectively protects the mother and the newborn. However, less than 50% of pregnant mothers in the US get vaccinated. Along with issues of insufficient insurance coverage, “vaccine hesitancy plays a very important role”, Englund lamented.

Human Cytomegalovirus Vaccines

Physician and vaccinologist Stanley Plotkin gave another presentation on cytomegalovirus (CMV). While co-speaker Lenore Pereira focused on the mechanisms of transplacental CMV transmission, Plotkin looked at the factors involved in CMV infection during pregnancy, immunity, and the status of CMV vaccine development status.

Many people, particularly in developing countries, become infected with cytomegalovirus (CMV) at some point in their lives. CMV infection does not cause obvious disease in most healthy individuals. However, in pregnant women, CMV can cross the placenta and infect the fetus. This can lead to congenital disorders such as microcephaly or deafness. CMV infection is also more serious for adults with weakened immune systems.

Plotkin explained that CMV infection during pregnancy usually occurs when mothers are exposed to toddlers carrying the virus. In developing countries, CMV infects most women before they become pregnant, and newborns are less likely to suffer from congenital disorders upon their mothers’ CMV infection. “We think that natural immunity is protective,” said Plotkin. In a pioneering study, his team found that vaccinating kidney transplant recipients with a weak strain of CMV protected them from contracting severe disease.

Candidate vaccines that are currently being developed to combat human cytomegalovirus infection.

One of the most promising vaccine candidates is the glycoprotein-B (gB) with MF59 adjuvant. This vaccine induces a strong antibody response, and these antibodies protect against CMV infection. Other CMV vaccines are also in the research and development phase. As these vaccines become approved and licensed, some of the first populations to be vaccinated will probably be transplant patients, young girls, and women of child-bearing age who have not been previously infected by CMV.

Updates on Group B Streptococcus (GBS) Vaccine Development

Ajoke Sobanjo-ter Meulen, infectious disease and global health expert, shed light on the current state of Group B Streptococcus (GBS) vaccine development. GBS is a pathogen commonly found in the gut or lower vaginal tract. Because it can cause life-threatening infections in pregnant women, newborns, and immunocompromised adults, it is associated with maternal and neonatal morbidity and mortality, preterm births, and stillbirths. Fatality rates due to GBS infection are higher in low- and middle-income countries.

If pregnant women in the US test positive for GBS colonization, they are treated with antibiotic prophylaxis, which significantly reduces disease during the first hours of life. However, a vaccine has a higher protective potential and it would be a much more feasible approach in low- and middle- income countries, where the diagnostic and therapeutic infrastructure required for that kind of treatment may not be available.

Burden of GBS disease around the world and the advantages of maternal GBS immunization over intrapartum antibiotic prophylactic (IAP) treatment

GBS vaccines given to women during pregnancy can significantly reduce maternal GBS colonization and disease, stillbirths and neonatal sepsis, and meningitis. In a modelling study, Sobanjo-ter Meulen and colleagues estimated that, by improving all of these health outcomes, a maternal GBS vaccine could prevent 90,000 infant deaths and 57,000 stillbirths worldwide. Several vaccine candidates are currently being developed. One challenge facing licensure trials is that, due to the low incidence, a sample size of about 40,000-60,000 pregnant women would be required to ascertain the efficacy of a maternal GBS vaccine.

According to Sobanjo-ter Meulen, public oversight and private investment could help overcome these challenges. That kind of partnership has helped advance the GBS6 vaccine, which demonstrated high safety and immunogenicity levels in healthy adults and is currently being evaluated in a phase-II trial in pregnant women in South Africa.

Further Readings

Englund

Steinhoff MC,  Katz J, Englund JA, et al

Year-round influenza immunisation during pregnancy in Nepal: a phase 4, randomised, placebo-controlled trial

Lancet Infect Dis. 2017 Sep;17(9):981-989

Kozuki N, Katz J, Englund JA, et al

Impact of maternal vaccination timing and influenza virus circulation on birth outcomes in rural Nepal

Int J of Gynaecol and Obstet. 2018 Jan;140(1):65-72

Plotkin

Plotkin SA, et al

The Status of Vaccine Development Against the Human Cytomegalovirus

J Infect Diseases. 2020 Mar 5;221(Supplement_1):S113-S122

Manicklal S, Emery VC, Lazzarotto T, et al

The “silent” global burden of congenital cytomegalovirus

Clin Microbiol Rev. 2013 Jan;26(1):86-102

Bernstein DI, Munoz FM, Callahan ST, et al

Safety and efficacy of a cytomegalovirus glycoprotein B (gB) vaccine in adolescent girls: A randomized clinical trial

Vaccine. 2016 Jan 12;34(3):313-319

Sobanjo-ter Meulen

Infant Vaccination and Barriers to Maternal Immunization

Speakers

Barney Graham, MD, PhD
National Institute of Allergy and Infectious Diseases (NIAID), NIH

Ruth Karron, MD
Johns Hopkins Bloomberg School of Public Health

Approaches to Infant Vaccination for Respiratory Syncytial Virus

The Respiratory Syncytial Virus (RSV) is a common cause of respiratory tract infections. In newborns, RSV infection can lead to severe disease, usually due to obstruction of small airways. One of the key goals in RSV vaccine development, said immunologist and virologist Barney Graham, is to protect children younger than six months of age from RSV infection.

A failed vaccine trial in the 1960s stalled RSV vaccine development. In the study, vaccinated children became more vulnerable to RSV infection and were more likely to experience severe illness than control groups. According to Graham, the field of RSV vaccine development has only regained speed within the last 10-15 years.

Graham’s work in the structure of RSV fusion protein (F) has been critical in recent advances in RSV vaccine development. This glycoprotein on the surface of RSV mediates viral entry into host cells. During cell entry, the structure of F proteins undergoes a conformational change. The prefusion and postfusion forms of F proteins have different properties as vaccine antigens. Graham and his collaborators led a phase-I clinical trial using a stabilized prefusion F protein. In young adults, this vaccine elicited a potent neutralizing activity, and it is currently being tested in phase-II maternal immunization trials.

A similar strategy can be generalized across other virus families, including coronaviruses. In fact, his work in structure-based immunogen design allowed  Graham and colleagues to rapidly solve the structure of the new coronavirus and has greatly contributed to the current efforts to develop a candidate vaccine.

Maternal Immunization: Overcoming Barriers to Uptake and Access

Vaccine research and development is not the only obstacle in maternal and neonatal immunization. “In the end, vaccines are only useful if they can be delivered,” said global health expert Ruth Karron, before discussing contextual factors that influence the successful implementation of maternal vaccines.

When it comes to pregnancy-specific vaccines, medical, social, and economic considerations are paramount. These vaccines are usually administered in the context of antenatal care. Without a robust antenatal care system, implementing an effective maternal immunization program can be challenging. For instance, vaccines that can be administered with some flexibility throughout the second or third trimester will be more likely to lead to successful outcomes in cases when pregnant women have limited opportunities to go to the doctor. Also, attitudes surrounding maternal immunization need to be considered. Vaccine hesitancy can be particularly acute when it comes to pregnancy, as some believe it can be harmful for the child or negatively affect fertility in the future. Failing to understand the effects or the burden of a specific disease can also be an obstacle. These issues have to be addressed broadly with all stakeholders, which include the pregnant women but also other community members, healthcare providers, and policymakers.

Factors that influence the successful deployment of pregnancy-specific vaccines. Slide: Ruth Karron.

Karron and her collaborators created ethical guidelines to include the interests of pregnant women and their offspring in the development of vaccines . Some of these guidelines are very relevant in the context of epidemics. As the current COVID-19 pandemic has revealed, pregnant women and their offspring are among the most severely affected by outbreaks. They are more vulnerable to infections, but they are also disproportionately affected by an overburdened health care system. In her work, Karron advocates for the inclusion of women of childbearing age and pregnant women at every stage of vaccine development and deployment.

Further Readings

Graham

Johnson JE, Gonzales RA, Olson SJ, et al

The histopathology of fatal untreated human respiratory syncytial virus infection

Mod Pathol. 2007 Jan;20(1)108-19

Graham BS, Gilman MSA, McLellan JS, et al

Structure of RSV fusion glycoprotein trimer bound to a prefusion-specific neutralizing antibody

Science. 2013 May 31;340(6136):1113-1117

Corbett KS, Edwards DK, Leist SR, et al

SARS-CoV-2 mRNA vaccine design enabled by prototype pathogen preparedness

Nature. 2020 Aug 5

Cancer Immunotherapy: Advances in Combination Therapies

Overview

Immunotherapy, which harnesses the immune system to target and attack cancer cells, has emerged as a revolutionary approach to cancer treatment. Despite its effectiveness for a wide range of cancers, eligibility for treatment is dependent on the patient’s immune system, age, and genetic profile, as well as how advanced the cancer is and whether it has responded to prior treatment. Current research aims to improve treatment strategies and better predict patient outcomes. On May 11-12, 2020, the New York Academy of Sciences hosted the annual Frontiers in Cancer Immunotherapy symposium. Experts in tumor immunology, cancer genetics, and computational biology discussed novel therapeutic targets, tumor evolution, and the mechanisms driving resistance to current treatment. Learn about the latest research advances in cancer immunotherapy in this summary.

Symposium Highlights

  • Computational neoantigen model predicts cancer patient outcomes.
  • Combination immunotherapy produces new T cells that extend patient survival.
  • Personalized cancer vaccines demonstrate therapeutic benefits.
  • New computational genomics tools provide pediatric cancer insight.
  • Immune checkpoint inhibitor associated toxicity yields new clinical syndrome.
  • Macrophage reprogramming can halt metastatic cancer progression.
  • Immune cell “neighborhoods” are altered during cancer progression.
  • Multi-specific CAR T cell therapy may reduce immunotherapy resistance.

Speakers

James Allison, PhD
MD Anderson Cancer Center

Mikala Egeblad, PhD
Cold Spring Harbor Laboratory

Benjamin Greenbaum, PhD
Memorial Sloan Kettering Cancer Center

Crystal Mackall, MD
Stanford University

Elaine Mardis, PhD
Nationwide Children’s Hospital

Garry Nolan, PhD
Stanford University

Jeffrey Sosman, PhD
Feinberg School of Medicine, Northwestern University

Catherine Wu, MD
Dana-Farber Cancer Institute and Harvard Medical School

Event Sponsor

Iovance Biotherapeutics

Advances Immune Checkpoint Therapies

Speakers

James Allison, PhD
MD Anderson Cancer Center

Benjamin Greenbaum, PhD
Memorial Sloan Kettering Cancer Center

Modeling Immune-Mediated Evolution

Benjamin Greenbaum examines immune interactions that contribute to cancer progression. His lab uses statistical physics and computational biology to study the role of neoantigens in tumor evolution. Neoantigens are mutated peptides present on the surface of cancer cells that have the potential to be immunogenic, meaning T cell receptors can recognize them for an immune response. The Greenbaum lab developed a mathematical model to understand the role of neoantigens. “The goal of this framework is to try to quantify the immunogenicity of neoantigens in an evolutionary model to better predict response to therapy,” said Greenbaum.

Mathematical model predicts whether or not a patient is likely to have immunogenic neoantigens.

In this model, the tumor is characterized by the presence of neoantigens that are likely to provoke an immune response as well as the likeliness of that neoantigen progressing in forward evolution. Using this approach, the Greenbaum lab was able to separate patients who responded to treatment versus those who did not for both melanoma and small-cell lung cancer. The team will apply this model to predict patient outcomes in the clinic.

Immune Checkpoint Blockade in Cancer Therapy: Historical Perspective, New Opportunities

A pioneer in the field of cancer immunotherapy, James Allison has devoted his career to studying T cell response regulation and developing strategies for cancer treatment. In 2018, he was awarded the Nobel Prize in Physiology or Medicine jointly with Tasuku Honjo “for their discovery of cancer therapy inhibition of negative immune regulation,” as well as the Dr. Paul Janssen Award for Biomedical Research. One of Allison’s primary research areas is the role of immune checkpoint molecules, which help prevent the immune system from attacking healthy tissue. Early work in the Allison lab found that blocking a major immune checkpoint protein, cytotoxic T-lymphocyte-associated protein 4 (CTLA-4), allows T cells to target and destroy tumors. The FDA approved anti-CTLA-4 therapy, which demonstrated success in clinical trials. The effects have been significant: in metastatic melanoma, a disease with a median survival of seven months, anti-CTLA-4 therapy extended the survival of approximately 20% of patients by ten years after a single round of treatment.

Combination immunotherapy aims to extend the lives of a greater percentage of patients compared to mono-immunotherapies.

However, Allison wondered why this treatment wasn’t successful for all patients. After the discovery of another checkpoint inhibitor protein, programmed cell death protein 1 (PD1), Allison’s lab decided to use mass spectrometry to examine T cell populations before and after anti-CTLA-4 therapy, anti-PD1 therapy, and therapy combining both of these treatments. Although new T cell phenotypes arise following all three treatments, the combination therapy produces a synergistic effect that leads to the greatest increase in particular T cells that help target tumors. “It seems to be this that is responsible for the increase in efficacy, not just the combination of the effects of the monotherapies alone,” said Allison. His future work aims to enhance our understanding of combination checkpoint blockade therapy to extend the lives of more patients.

Further Readings

Greenbaum

Dudley JC, Lin M-T, Le DT, Eshleman JR

Microsatellite Instability as a Biomarker for PD-1 Blockade

Clin Cancer Res. 2016;22(4):813-820

Balachandran VP, Łuksza M, Zhao JN, et al

Identification of unique neoantigen qualities in long-term survivors of pancreatic cancer

Nature. 2017;551(7681):512-516

Łuksza M, Riaz N, Makarov V, et al

A neoantigen fitness model predicts tumour response to checkpoint blockade immunotherapy

Nature. 2017;551(7681):517-520

Sarkizova S, Hacohen N

How T cells spot tumour cells

Nature. 2017;551(7681):444-446

Allison

Wei SC, Anang N-AAS, Sharma R, et al

Combination anti-CTLA-4 plus anti-PD-1 checkpoint blockade utilizes cellular mechanisms partially distinct from monotherapies

Proc Natl Acad Sci USA. 2019;116(45):22699-22709

O’Shea JJ, Paul WE

Mechanisms underlying lineage commitment and plasticity of helper CD4+ T cells

Science. 2010;327(5969):1098-1102

Wei SC, Sharma R, Anang N-AAS, et al

Negative Co-stimulation Constrains T Cell Differentiation by Imposing Boundaries on Possible Cell States

Immunity. 2019;50(4):1084-1098.e10

Wei SC, Levine JH, Cogdill AP, et al

Distinct Cellular Mechanisms Underlie Anti-CTLA-4 and Anti-PD-1 Checkpoint Blockade

Cell. 2017;170(6):1120-1133.e17

Topalian SL, Hodi FS, Brahmer JR, et al

Safety, activity, and immune correlates of anti-PD-1 antibody in cancer

N Engl J Med. 2012;366(26):2443-2454

Leach DR, Krummel MF, Allison JP

Enhancement of antitumor immunity by CTLA-4 blockade

Science. 1996;271(5256):1734-1736

Beyond Immune Checkpoint Inhibitors

Speakers

Elaine Mardis, PhD
Nationwide Children’s Hospital

Catherine Wu, MD
Dana-Farber Cancer Institute and Harvard Medical School

Driving T cells into Tumors: A Role for Personal Cancer Vaccines

Catherine Wu works to enable more specific tumor targeting. She explained that one critical challenge is increasing the number of patients—right now, approximately 30%—with lasting responses to immunotherapies. Therapeutic vaccines may provide a solution. Wu said that these vaccines would, “stimulate antigen-specific immunity against determinants that are expressed in the cancer, and in doing so, increase the breadth and diversity of tumor-specific T cells.” Toward this goal, her lab has developed personalized vaccines for patients. The process begins with identifying specific mutations in a patient’s tumor using DNA and RNA sequencing. Next, human leukocyte antigen (HLA) typing is performed, and then personalized HLA-binding peptides are predicted. Excitingly, these vaccines, in combination with checkpoint blockade therapy, have demonstrated success in high-risk melanoma and glioblastoma patients. To improve HLA predictions, her lab has also developed an approach using mass spectrometry to examine antigen processing. To date, they have expanded from 16 to 95 HLA alleles that cover different racial groups such that they have 95% global coverage. This work represents an unprecedented advancement in distinguishing tumor-presenting epitopes.

Immunogenomics and the TME in Pediatric CNS Cancers

Elaine Mardis uses genomics to understand cancer progression and advance immunotherapeutic treatments. Specifically, her work focuses on understanding pediatric cancers. Unlike adult cancers, pediatric cancers have few druggable targets and are generally less well understood. By using and innovating computational approaches to characterize the tumor microenvironment and cancer progression, the Mardis lab provides unprecedented insight into pediatric cancers. For example, patient tumors are analyzed using exome sequencing and RNA sequencing with multiple analyses. Mardis has also developed a platform for neoantigen prediction called pVACtools, which aims to identify neoantigens from genomic fusion breakpoints. This work led to the discovery that recurrent pediatric central nervous system cancers contain immune cells in the tumor microenvironment that have been recruited from the periphery. This likely provides an immune-suppressive context based on checkpoint blockade, but neoantigen alterations may allow for the immune system to be engaged. However, new approaches may be required to extend immunotherapy to pediatric cancers because there are significant differences in the immune system based on age.

Further Readings

Wu

Sarkizova S, Klaeger S, Le PM, et al

A large peptidome dataset improves HLA class I epitope prediction across most of the human population

Nat Biotechnol. 2020;38(2):199-209

Purroy N, Wu CJ

Coevolution of leukemia and host immune cells in chronic lymphocytic leukemia

Cold Spring Harb Perspect Med. 2017;7(4)

Keskin DB, Anandappa AJ, Sun J, et al

Neoantigen vaccine generates intratumoral T cell responses in phase Ib glioblastoma trial

Nature. 2019;565(7738):234-239

Ott PA, Hu Z, Keskin DB, et al

An immunogenic personal neoantigen vaccine for patients with melanoma

Nature. 2017;547(7662):217-221

Hacohen N, Fritsch EF, Carter TA, Lander ES, Wu CJ

Getting personal with neoantigen-based therapeutic cancer vaccines

Cancer Immunol Res. 2013;1(1):11-15

Mardis

Hundal J, Kiwala S, McMichael J, et al

pVACtools: A Computational Toolkit to Identify and Visualize Cancer Neoantigens

Cancer Immunol Res. 2020;8(3):409-420

Hundal J, Carreno BM, Petti AA, et al

pVAC-Seq: A genome-guided in silico approach to identifying tumor neoantigens

Genome Med. 2016;8(1):11

Newman AM, Liu CL, Green MR, et al

Robust enumeration of cell subsets from tissue expression profiles

Nat Methods. 2015;12(5):453-457

Berger MF, Mardis ER

The emerging clinical relevance of genomics in cancer medicine

Nat Rev Clin Oncol. 2018;15(6):353-365

Toxicity, Tumor Response, and Microenvironment

Speakers

Mikala Egeblad, PhD
Cold Spring Harbor Laboratory

Jeffrey Sosman, PhD
Feinberg School of Medicine, Northwestern University

Immune Related Toxicities: Mechanisms and Disease Outcome

Jeffrey A. Sosman is an oncologist and cancer immunotherapy researcher studying immunotherapy toxicity. Although cancer immunotherapies have transformed the therapeutic landscape, these treatments have a variety of toxic effects that limit treatment potential. Fairly common toxicities include rashes, joint and tissue diseases, colitis and hepatitis, while more rare toxicities include encephalitis and myocarditis. Dr. Sosman presented a case study on a patient that developed immune checkpoint inhibitor (ICI) associated myocarditis, which he defined as a new clinical syndrome. Immune checkpoint inhibitors prevent natural “brakes” in the immune system so that T cells can attack cancer cells. Although myocarditis is rare in ICI-treated patients (less than 0.1%), this toxicity has a 50% mortality rate. Sosman shared that onset of ICI-associated myocarditis is highly unpredictable, though it can occur early on in treatment. He also noted that patients treated with combinations of immune checkpoint therapies are at higher risk for developing this toxicity. Future work aims to better predict serious toxicity and to understand the relationship between toxicity and tumor response.

Regulation of Cancer Progression by the Tumor Microenvironment

Mikala Egeblad studies the tumor microenvironment in cancer. Her lab has examined the role of bacterially derived lipopolysaccharides (LPS) in cancer progression, which is understood to influence macrophages within the tumor phenotypically. Specifically, the effect of LPS depends on the presence of either pro-inflammatory signals (IFNγ), which create tumoricidal macrophages, or anti-inflammatory signals (IL-4 and -13, TGFβ), which produce tumor-promoting macrophages. However, LPS cannot be used to treat cancer because of its toxicity in humans. Considering a novel therapeutic approach, Egeblad said, “we wanted to see if we could take tumor-promoting macrophages and reprogram them to become tumoricidal.” Their approach involved the use of monophosphoryl lipid A (MPLA), an LPS derivative that is already used as a vaccine adjuvant.

Macrophages can be programmed to become tumoricidal or tumor-promoting.

They hypothesized that if they delivered MPLA and IFNγ to tumors, macrophages would become tumoricidal. The lab observed that tumors from both mice and patients with breast cancer contained anti-tumor macrophages following treatment, which stopped metastatic progression. Egeblad and her team plan to elucidate how long lasting the responses are and whether they can be further improved by combining this treatment with checkpoint blockade immunotherapy.

Further Readings

Sosman

Johnson DB, Balko JM, Compton ML, et al

Fulminant Myocarditis with Combination Immune Checkpoint Blockade

N Engl J Med. 2016;375(18):1749-1755

Postow MA, Sidlow R, Hellmann MD

Immune-Related Adverse Events Associated with Immune Checkpoint Blockade

N Engl J Med. 2018;378(2):158-168

Pallin DJ, Baugh CW, Postow MA, Caterino JM, Erickson TB, Lyman GH

Immune-related Adverse Events in Cancer Patients

Acad Emerg Med. 2018;25(7):819-827

Weber JS, Kähler KC, Hauschild A

Management of immune-related adverse events and kinetics of response with ipilimumab

J Clin Oncol. 2012;30(21):2691-2697

Weber JS, Yang JC, Atkins MB, Disis ML

Toxicities of immunotherapy for the practitioner

J Clin Oncol. 2015;33(18):2092-2099

Egeblad

Barnes BJ, Adrover JM, Baxter-Stoltzfus A, et al

Targeting potential drivers of COVID-19: Neutrophil extracellular traps

J Exp Med. 2020;217(6).

Zuo Y, Yalavarthi S, Shi H, et al

Neutrophil extracellular traps in COVID-19

JCI Insight. 2020;5(11)

Kolaczkowska E, Kubes P

Neutrophil recruitment and function in health and inflammation

Nat Rev Immunol. 2013;13(3):159-175

Albrengues J, Shields MA, Ng D, et al

Neutrophil

traps produced during inflammation awaken dormant cancer cells in mice

Science. 2018;361(6409)

Immunopathology and Engineered Immune Cells

Speakers

Crystal Mackall, MD
Stanford University

Garry Nolan, PhD
Stanford University

Pathology from the Molecular Scale on Up

Garry Nolan has developed multiple technologies to improve our understanding of both normal immune function and immunopathologies. One such tool termed CODEX (CO-Detection by indexing) modifies traditional fluorescent microscopes for high-dimensional imaging so that users can obtain spatial and quantitative insight into cells within complex tissues. As a multiplexed imaging platform, CODEX allows users to stain tissue with 50-120 antibodies that have unique barcodes that can be annealed to fluorophores for visualization. Interestingly, Nolan’s lab has used this technology to identify specific “neighborhoods” of immune cells, defined as tissue regions within each cell that have a similar surrounding of cell types. They have also discovered that cellular neighborhoods communicate with each other and can change during various stages of cancer. This information provides critical insight into disease progression that may inform clinical outcomes in the future.

Next Generation CAR T Cells

Crystal Mackall studies the basis of tumor-immune interactions to develop new cancer immunotherapies. Specifically, her lab works to improve chimeric antigen receptor T cell (CAR T cell) therapy, in which a patient’s T cells are engineered to express a synthetic receptor that recognizes an antigen on their tumor. Despite its effectiveness, some patients become unresponsive to this treatment over time. “As we think about the future of this field, we need to talk about the issue of resistance,” said Mackall, “we need to unpack it and identify where and how these cells are failing.” The loss of specific antigen expression has been identified as a significant contributor to resistance, as it can eliminate the ability of CAR T cells to recognize the tumor.

Challenges such as the loss of antigen expression can lead to immunotherapy resistance.

To address this problem, Mackall’s lab engineered a “multi-specific CAR” to simultaneously target two antigens. Even if one antigen’s expression is lost over time, the other will still be targeted which may reduce resistance. In a clinical trial, she found that this therapeutic strategy was well tolerated in both children and adults with leukemia and lymphoma. Mackall’s lab will further optimize the engineering of other multi-specific CARs to overcome resistance.

Further Readings

Mackall

Maude SL, Laetsch TW, Buechner J, et al

Tisagenlecleucel in Children and Young Adults with B-Cell Lymphoblastic Leukemia

N Engl J Med. 2018;378(5):439-448

Takeda and the New York Academy of Sciences Announce 2020 Innovators in Science Award Winners

The 2020 Innovators in Science Award winners include a biochemist/molecular geneticist from Cold Spring Harbor Laboratory and brain disorder researcher from the Korea Advance Insitute of Science and Technology.

New York, NY | July 8, 2020 and Osaka, Japan | July 8, 2020 – Takeda Pharmaceutical Company Limited (“Takeda”) (TSE:4502) and the New York Academy of Sciences announced today the Winners of the third annual Innovators in Science Award for their excellence in and commitment to innovative science that has significantly advanced the field of rare disease research. Each Winner receives a prize of US $200,000.

Senior Scientist Award: Adrian R. Krainer

The 2020 Winner of the Senior Scientist Award is Adrian R. Krainer, Ph.D., St. Giles Foundation Professor at Cold Spring Harbor Laboratory. Prof. Krainer is recognized for his outstanding research on the mechanisms and control of RNA splicing, a step in the normal process by which genetic information in DNA is converted into proteins. Prof. Krainer studies splicing defects in patients with spinal muscular atrophy (SMA), a devastating, inherited pediatric neuromuscular disorder caused by loss of motor neurons, resulting in progressive muscle atrophy and eventually, death. Prof. Krainer’s work culminated notably in the development of the first drug to be approved by global regulatory bodies that can delay and even prevent the onset of an inherited neurodegenerative disorder.

“Collectively, rare diseases affect millions of families worldwide, who urgently need and deserve our help. I’m extremely honored to receive this recognition for research that my lab and our collaborators carried out to develop the first approved medicine for SMA,” said Prof. Krainer. “As basic researchers, we are driven by curiosity and get to experience the thrill of discovery; but when the fruits of our research can actually improve patients’ lives, everything else pales in comparison.”

Early-Career Scientist Award: Jeong Ho Lee

The 2020 Winner of the Early-Career Scientist Award is Jeong Ho Lee, M.D., Ph.D, Associate Professor, Korea Advanced Institute of Science and Technology (KAIST). Prof. Lee is recognized for his research investigating genetic mutations in stem cells in the brain that result in rare developmental brain disorders.

He was the first to identify the causes of intractable epilepsies and has identified the genes responsible for several developmental brain disorders, including focal cortical dysplasias, Joubert syndrome—a disorder characterized by an underdevelopment of the brainstem—and hemimegalencephaly, which is the abnormal enlargement of one side of the brain. Prof. Lee also is the Director of the National Creative Research Initiative Center for Brain Somatic Mutations, and Co-founder and Chief Technology Officer of SoVarGen, a biopharmaceutical company aiming to discover novel therapeutics and diagnosis for intractable central nervous system (CNS) diseases caused by low-level somatic mutation.

“It is a great honor to be recognized by a jury of such globally respected scientists whom I greatly admire,” said Prof. Lee. “More importantly, this award validates research into brain somatic mutations as an important area of exploration to help patients suffering from devastating and untreatable neurological disorders.”

The 2020 Innovators in Science Award Ceremony and Symposium

The 2020 Winners will be honored at the virtual Innovators in Science Award Ceremony and Symposium in October 2020. This event provides an opportunity to engage with leading researchers, clinicians and prominent industry stakeholders from around the world about the latest breakthroughs in the scientific understanding and clinical treatment of genetic, nervous system, metabolic, autoimmune and cardiovascular rare diseases.

“At Takeda, patients are our North Star and those with rare diseases are often underserved when it comes to the discovery and development of transformative medicines,” said Andrew Plump, M.D., Ph.D., President, Research & Development at Takeda. “Insights from the ground-breaking research of scientists like Prof. Krainer and Prof. Lee can lead to pioneering approaches and the development of novel medicines that have the potential to change patients’ lives. That’s why we are proud to join with the New York Academy of Sciences to broadly share and champion their work — and hopefully propel this promising science forward.”

“Connecting science with the world to help address some of society’s most pressing challenges is central to our mission,” said Nicholas Dirks, Ph.D., President and CEO, the New York Academy of Sciences. “In this third year of the Innovators in Science Award we are privileged to recognize two scientific leaders working to unlock the power of the genome to bring innovations that address the urgent needs of patients worldwide affected by rare diseases.”

About the Innovators in Science Award

The Innovators in Science Award grants two prizes of US $200,000 each year: one to an Early-Career Scientist and the other to a well-established Senior Scientist who have distinguished themselves for the creative thinking and impact of their research. The Innovators in Science Award is a limited submission competition in which research universities, academic institutions, government or non-profit institutions, or equivalent from around the globe with a well-established record of scientific excellence are invited to nominate their most promising Early-Career Scientists and their most outstanding Senior Scientists working in one of four selected therapeutic fields of neuroscience, gastroenterology, oncology, and regenerative medicine.

Prize Winners are determined by a panel of judges, independently selected by The New York Academy of Sciences, with expertise in these disciplines. The New York Academy of Sciences administers the Award in partnership with Takeda.

For more information please visit the Innovators in Science Award website.

About Takeda Pharmaceutical Company Limited

Takeda Pharmaceutical Company Limited (TSE:4502/NYSE:TAK) is a global, values-based, R&D-driven biopharmaceutical leader headquartered in Japan, committed to bringing Better Health and a Brighter Future to patients by translating science into highly-innovative medicines. Takeda focuses its R&D efforts on four therapeutic areas: Oncology, Rare Diseases, Neuroscience, and Gastroenterology (GI).

We also make targeted R&D investments in Plasma-Derived Therapies and Vaccines. We are focusing on developing highly innovative medicines that contribute to making a difference in people’s lives by advancing the frontier of new treatment options and leveraging our enhanced collaborative R&D engine and capabilities to create a robust, modality-diverse pipeline. Our employees are committed to improving quality of life for patients and to working with our partners in health care in approximately 80 countries. For more information, visit https://www.takeda.com.

For more information, visit https://www.takeda.com/newsroom/

Game Changers: Scientists Shaping the Future of Research in the UK

On March 5, 2020, the New York Academy of Sciences celebrated the Laureates and Finalists and winners of the 2020 Blavatnik Awards for Young Scientists in the United Kingdom. The one-day symposium featured fast-paced, engaging research updates from nine scientists working in diverse fields within life sciences, chemistry, and physical sciences and engineering. This year’s Blavatnik UK honorees are probing the deepest mysteries ranging from the universe to the human mind, tackling longstanding questions that have occupied scientists and philosophers for millennia. Is there life beyond our Solar system? How is knowledge organized in the brain? What is the fundamental nature of gravity? Find out how this game-changing group of young scientists is working to answer these questions in this summary of the symposium.

Symposium Highlights

  • Environmental factors can influence the defense strategies bacteria use to fend off invading viruses. Insights into this process are advancing the potential for phage therapy as an alternative to antibiotics.
  • New analytical and computational tools are revealing the neural machinery that allows the brain to create models of the world and facilitates decision-making and behavior.
  • Chemists can exploit chirality to create novel molecules with a wide variety of applications in drug design, consumer electronics, and catalysis.
  • The scientific community is closer now than ever to realizing the commercial potential of nuclear fusion as a source of clean energy.
  • The first viable theory of massive gravity might help explain some of the biggest mysteries in physics, including the accelerated expansion of the universe.

Hosted By

Victoria Gill
Science Correspondent
BBC News

Speakers

Tim Behrens, DPhil
University of Oxford and University College London

Ian Chapman, PhD
UK Atomic Energy Authority

Matthew J. Fuchter, PhD
Imperial College London

Stephen M. Goldup, PhD
University of Southampton

Kirsty Penkman, PhD
University of York

Claudia de Rham, PhD
Imperial College London

Eleanor Stride, PhD
University of Oxford

Amaury Triaud, PhD
University of Birmingham

Edze Westra, PhD
University of Exeter

Program Supporter

Changing the Game in Life Sciences

Speakers

Eleanor Stride, PhD
University of Oxford

Edze Westra, PhD
University of Exeter

Tim Behrens, DPhil
University of Oxford & University College London

Engineering Bubbles

Mechanical engineer Eleanor Stride never planned to design drug delivery systems. She was “convinced I wanted to spend my career designing Aston Martins,” until a chance discussion with a supervisor piqued her interest in therapeutic applications of engineered microbubbles. Just two microns in diameter, microbubbles can be used as ultrasound contrast agents, but Stride sees a role for these tiny tools in the fight against cancer. “In many cases, the problem with cancer drugs [is] how we deliver them,” she said, explaining that systemic chemotherapy agents often cannot penetrate far enough into tumors to be effective. These drugs can also cause side effects and damage healthy tissues.

Microbubbles can help sidestep these challenges, safely encapsulating drug molecules within a stabilizing shell.  The shell can be functionalized with magnetic nanoparticles, allowing clinicians to direct the bubbles’ aggregation at tumor sites and visualize them with ultrasound. As the bubbles compress and release in response to the ultrasound beam, the oscillation helps the bubbles penetrate into the surrounding tissue. “If we increase the ultrasound energy, we can destroy the bubble, allowing us to release the drugs on demand,” said Stride, noting that molecules released from a single 2-micron microbubble can circulate up to 100 times that diameter, pumping drugs deep into tumor tissues. This approach is highly localized—drugs are only released at the tumor site—which eliminates the potential for systemic toxic effects.

Ultrasound-stimulated oscillation of microbubbles creates a vortex in surrounding fluids. The vortex pumps drug molecules deep into tumor sites.

In 2019, Stride and a team of collaborators published the results of trials using oxygen-loaded magnetic microbubbles to treat malignant pancreatic tumors. In animal models, tumors treated with microbubble-delivered drugs showed dramatic spikes in cell death and also shrank in size, “which can mean the difference between a surgeon being able to remove a tumor or not,” said Stride. Additional experiments have helped hone techniques for external magnetic control of microbubbles within blood vessels to ensure precise, targeted drug delivery—a critical step toward tailoring this method for use in humans. Stride and her collaborators aim to launch a clinical trial in pancreatic cancer patients “in the very near future.”

Insights From Bacteria-Phage Interactions

As the fight against viruses dominates the news cycle, 2020 Blavatnik Awards UK Finalist Edze Westra shared an update from the front lines of a viral war billions of years in duration: the “evolutionary arms race” between bacteria and the viruses that infect them, called phages. The interactions between bacteria and phages—the most abundant biological entities on Earth—have profound implications for the development of phage-based therapies as alternatives to antibiotics.

Phages are often successful killers, but bacteria have evolved sophisticated immune strategies to resist attacks. Understanding how and when bacteria deploy each of these defensive tactics is key to designing phage therapies to treat bacterial infections.

Like humans, bacteria utilize both innate and adaptive immune responses to invading pathogens. In bacteria, innate immunity relies on the modification of surface structures to prevent phages from attaching. This system is effective, yet it creates no “record,” or memory, of which phages it encounters. The adaptive immune system, however, allows bacteria to build a database of previously encountered pathogens in the form of bits of genetic material snipped from invading phages and incorporated into the bacterium’s own DNA. The adaptive immune system, known as CRISPR immunity, forms the basis of CRISPR-Cas genome editing techniques. “There’s a critical balance between these two systems, and both are critical for survival,” said Westra, whose research aims to determine the factors that influence whether a bacterium mounts an innate or adaptive immune defense against a particular phage.

Using Pseudomonas aeruginosa, an antibiotic-resistant pathogen that often infects cystic fibrosis patients, Westra determined that a bacterium’s environment—specifically, the level of available nutrients—determined which defensive strategy was utilized. In high-nutrient environments, almost all bacteria deployed an innate immune response to phage attacks, whereas in lower nutrient settings, CRISPR immunity dominated.

The level of available nutrients influences which immune strategy bacteria use to defend against phage attacks.

In experiments using moth larvae, Westra discovered that infections were more severe when bacteria utilized CRISPR immunity, whereas bacteria that evolved innate immunity often caused less aggressive infections. “If we can manipulate how bacteria evolve resistance to phages, this could potentially revolutionize the way we approach antimicrobial resistance, with major benefits to our healthcare,” Westra said.

Building Models of the World

Computational neuroscientist Timothy Behrens is fascinated with the basic functions and decisions of everyday life—the process of navigating our home or city, the steps involved in completing household tasks, the near-subconscious inferences that inform our understanding of the relationships between people and things. Behrens designs analytical tools to understand how neuronal activity in the brain gives rise to these thought processes and behaviors, and his research is illuminating how knowledge is organized in the brain.

The activities of grid cells and place cells are well understood. By creating spatial maps of the world, grid and place cells allow us to navigate familiar spaces and locate items, such as car keys. Behrens explained that much less is known about how the brain encodes non-spatial, abstract concepts and sequence-based tasks, such as loading, running, and emptying a dishwasher. Over the past several years, Behrens and his collaborators have demonstrated that abstract information is similarly mapped as grid-like codes within the brain. “On some level, all relational structures are the same, and all are handled by the same neural machinery,” he said. This insight helps explain the effects of diseases like Alzheimer’s, which targets grid and place cells first and impacts both spatial and non-spatial knowledge.

Relational information is encoded by the same neural machinery that encodes spatial and navigational maps.

In another line of research, Behrens is probing a phenomenon called replay, during which the brain revisits recent memories as a means to consolidate knowledge about current events and anticipate future ones. Behrens illustrated the concept by showing patterns of neuronal activity as a rat runs around a track, then rests. Even at rest, the rat’s brain displays millisecond-long flashes of neuronal activity that mimic those that take place during running. “He’s not running down the track anymore, but his brain is,” said Behrens. Replay also underlies the human ability to understand a simple story even when it’s told in the wrong order. “Our knowledge of the world tells us…what the correct order is, and replay will rapidly stitch together the events in the correct order.”

Computational tools developed in Behrens’ lab have been shared with thousands of scientists around the globe as they pursue new hypotheses about the neural computations that control cognition and behavior. “It’s an exciting time to be thinking about the brain,” Behrens said.

Further Readings

Stride

Beguin E, Shrivastava S, Dezhkunov NV, et al.

Direct Evidence of Multibubble Sonoluminescence Using Therapeutic Ultrasound and Microbubbles

ACS Appl Mater Interfaces. 2019 Jun 5;11(22):19913-19919

Beguin E, Bau L, Shrivastava S, Stride E.

Comparing Strategies for Magnetic Functionalization of Microbubbles

ACS Appl Mater Interfaces. 2019 Jan 16;11(2):1829-1840

Westra

Alseth EO, Pursey E, Luján AM, et al.

Bacterial Biodiversity Drives the Evolution of CRISPR-based Phage Resistance in Pseudomonas Aeruginosa

Nature. 2019 Oct;574(7779):549-552

Westra ER, van Houte S, Gandon S, Whitaker R.

The Ecology and Evolution of Microbial CRISPR-Cas Adaptive Immune Systems

Philos Trans R Soc Lond B Biol Sci. 2019 May.13;374(1772):20190101

Behrens

Liu Y, Dolan RJ, Kurth-Nelson Z, Behrens TEJ

Human Replay Spontaneously Reorganizes Experience

Cell. 2019 Jul 25;178(3):640-652.e14

Constantinescu AO, O’Reilly JX , Behrens TEJ

Organizing Conceptual Knowledge in Humans With a Gridlike Code

Science. 2016 Jun 17;352(6292):1464-1468

Behrens TEJ, Muller TH, Whittington James CR

What Is a Cognitive Map? Organizing Knowledge for Flexible Behavior

Neuron. 2018 Oct 24;100(2):490-509

Changing the Game in Chemistry

Speakers

Matthew J. Fuchter, PhD
Imperial College London

Stephen M. Goldup, PhD
University of Southampton

Kirsty Penkman, PhD
University of York

Exploiting Molecular Shape to Develop Materials and Medicines

Consider the handshake: a greeting so automatic it takes place without thinking. Two right hands extend and naturally lock together, but as Matthew Fuchter explained, that easy connection becomes impossible if one party offers their left hand instead. The fumbling that ensues stems from a type of asymmetry called chirality. Chiral objects, such as hands, are mirror-image forms that cannot be superimposed or overlapped, and when one chiral object interacts with another, their chirality dictates the limits of their interaction. Chirality can be observed throughout nature, from the smallest biological molecules to the structures of skyscrapers.

In organic chemistry, molecular chirality can be exploited to tremendous advantage. Fuchter explained that the shape of molecules “is not only critical for their molecular properties, but also for how they interact with their environment.” By controlling subtle aspects of molecular shape, Fuchter is pioneering new strategies in drug design and devising solutions to technological problems that plague common electronic devices.

The notion of pairing complementary molecular geometries to achieve a specific effect is not unique to drug design—such synchronicities can be found throughout nature, including in the “lock and key” structure of enzymes and their substrates. Fuchter’s work aims to invent new drug molecules with geometries perfectly suited to bind to specific biological targets, including those implicated in diseases such as malaria and cancer.

Only one of these two chiral molecules has the correct orientation, or “handedness” to bind to the receptor site on the target protein.

Fuchter is also exploring applications for chirality in a field where the concept is less prominent—consumer electronics. Organic LED, or OLED, technology has “revolutionized the display industry,” allowing manufacturers to create ultra-thin, foldable screens for smartphones and other displays. Yet these features come at a steep efficiency cost—more than half of the light generated by OLED pixels is blocked by anti-glare filters added to the screens to minimize reflectiveness. A novel solution, in the form of chiral molecules bound to non-chiral OLED-optimized polymers, induces a chiral state of light called circularly polarized light. These circularly polarized, chiral light molecules are capable of bypassing the anti-glare filter on OLED screens. Fuchter noted that displays are far from the only technology that stands to be impacted by the introduction of chiral molecules. “Our research is generating new opportunities for chiral molecules to control electron transport and electron spin, which could lead to new approaches in data storage,” he said.

Making Use of the Mechanical Bond

Most molecules are bound by chemical bonds—strong, glue-like connections that maintain the integrity of molecules, which can be both simple, such as hydrogen, and highly complex, such as DNA. 2020 Blavatnik Awards UK Finalist Stephen Goldup’s work focuses on a less familiar bond. Mechanical bonds join molecules in a manner akin to an interconnected chain of links—the components retain movement, yet cannot separate.

Mechanically interlocked molecules have the potential to yield materials with “exciting properties,” according to Goldup, but in the decades since they were first synthesized, they have largely been regarded as “molecular curiosities.” Goldup’s lab is working to push these molecules beyond the laboratory bench by characterizing the properties of interlocked molecules and probing their potential applications in unprecedented ways. His work focuses on two types of mechanically bound molecules—catenanes, in which components are linked together like a chain, and rotaxanes, which consist of a ring component threaded through a dumbbell-shaped axle.

Goldup’s lab has taken cues from nature to introduce additional elements into rotaxanes, resulting in novel molecules with a variety of potential applications. For example, much as enzymes contain “pockets” within which small molecules can bind, rotaxanes too contain a space that can trap a molecule or ion of interest. Rotaxanes that bind metal ions have unique magnetic and electronic properties that could be used in memory storage devices or medical imaging. Inspired by proteins and enzymes that bind DNA, Goldup’s lab has also designed rotaxanes in which DNA itself is the “axle.” In theory, these molecules can be used to effectively “hide” portions of DNA and alter its biological behavior.

Just as enzymes bind small molecules with their structures, rotaxanes can bind molecules in the cavity between the ring and the axle.

Perhaps most significantly, Goldup’s lab has solved a longstanding obstacle to studying rotaxanes: the difficulty of making them. The problem lies in the fact that rotaxanes can be chiral even when their components are not, making it extremely challenging to synthesize a distinct “hand,” or version, of the molecule. Recalling Matthew Fuchter’s example of how an awkward left-hand/right-hand handshake differentiates the “handedness” of two chiral objects, Goldup explained how his lab developed a technique for synthesizing distinctly “left” or “right” handed rotaxanes by utilizing a chiral axle to build the molecules. “Our insight was that by making the axle portion chiral on its own, when we thread the axle into the ring, the rotaxanes we make are no longer mirror-images of each other. They have different properties, and they can now be separated,” he said. Once separate, the chiral portion of the axle can be chemically removed and replaced with other functional groups.

Goldup’s lab is conducting experiments with new mechanically-locked molecules—including chiral rotaxane catalysts— to determine where they may outperform existing catalysts.

Amino Acids as a Portal to the Past

Scientists have multiple methods for peering into the history of Earth’s climate, including sampling marine sediment and ice cores that encapsulate environmental conditions stretching back millions of years. “But this is an incomplete picture—akin to a musical beat with no notes,” said Kirsty Penkman, the 2020 Blavatnik Awards UK Laureate in Chemistry. The records of life on land—fossil records—provide “the notes to our tune, and if we know the timing, that gives us the whole melody,” she said.  Archaeologists, paleontologists, and climate scientists can harmonize fossil records with climate history to understand the past, yet their efforts stall with fossils older than 50,000 years—the limit of radiocarbon dating.

Penkman’s lab is developing dating methods for organic remains that reach far deeper into the history of life on Earth. Their strategy relies not on the decay of carbon, but the conversion of amino acid molecules from one form to another. Continuing the theme of chirality from previous presentations, Penkman explained that amino acids exist in two mirror-image forms. However, the body only synthesizes amino acids in the “left-handed,” or L-form. This disequilibrium shifts after death, when a portion of L-amino acids begins a slow, predictable conversion to the right-handed, or D-form. The older the fossil, the greater the balance between D and L isomers. This conversion process, called racemization, was first proposed as a dating method in the 1960s. Yet, it became clear that some of the fossil amino acids were vulnerable to environmental factors that impact the racemization rate, and therefore the date.

About 15 years ago, Penkman discovered that minute stores of proteins within the remains of snail shells are entrapped in intracrystalline voids. These tiny time capsules are unaffected by environmental factors. Studies have since confirmed that shells found in older horizons, for example deeper underground, contain higher ratios of D-amino acids versus those found at younger sites, thus validating the technique.

Calcitic snail shells found at older horizons have higher ratios of D-amino acids than those found at younger horizons.

Snail shells are often found in archeological sites, a serendipity that has led to astonishing findings about early human migration. Shells found alongside several Paleolithic tools “dated as far back as 700,000 years,” according to Penkman. “We’ve successfully shown that early humans were living in Northern Europe 200,000 years earlier than previously believed,” she said.

Penkman’s team has analyzed remains of ostrich eggshells at some of the earliest human sites in Africa, discovering fully preserved, stable sequences of proteins in shells dating back 3.8 million years. Mammalian remains are the next frontier for Penkman’s lab. They have analyzed amino acids in ancient tooth enamel—including that of a 1.7-million-year-old rhinoceros—and are developing microfluidic techniques to sample enamel from early human remains.

Further Readings

Fuchter

Yang Y, Rice B, Shi X, et al.

Emergent Properties of an Organic Semiconductor Driven by its Molecular Chirality

ACS Nano. 2017 Aug 22;11(8):8329-8338

Yang Y, Correa da Costa R, Fuchter MJ, Campbell AJ

Circularly polarized light detection by a chiral organic semiconductor transistor

Nat. Photonics. 2013 July 21;7:634–638

Goldup

Jamieson EMG, Modicom F, Goldup SM

Chirality in Rotaxanes and Catenanes

Chem Soc Rev. 2018 Jul 17;47(14):5266-5311

Lewis JEM, Beer PD, Loeb SJ, Goldup SM

Metal Ions in the Synthesis of Interlocked Molecules and Materials

Chem Soc Rev. 2017 May 9;46(9):2577-2591

Galli M, Lewis JEM, Goldup SM

A Stimuli-responsive Rotaxane–Gold Catalyst: Regulation of Activity and Diastereoselectivity

Angewandte Chemie International Edition. 2015

Penkman

Penkman KEH, Kaufman DS, Maddy D, Collins MJ

Closed-system Behavior of the Intra-crystalline Fraction of Amino Acids in Mollusk Shells

Quaternary Geochronology. 2008. Feb-May; 3, 1–2:2-25

Demarchi B, Hall S, Roncal-Herrero T, et al

Protein Sequences Bound to Mineral Surfaces Persist Into Deep Time

eLife. 2016 Sep 27;5:e17092

Penkman KEH, Preece RC, Bridgland DR, et al

A Chronological Framework for the British Quaternary Based on Bithynia Opercula

Nature. 2011 Jul 31;476(7361):446-9

Changing the Game in Physical Sciences and Engineering

Speakers

Amaury Triaud
University of Birmingham

Ian Chapman
UK Atomic Energy Authority and Culham Centre for Fusion Energy

Claudia de Rham
Imperial College London

Worlds Beyond Our Solar System

For millennia, humans have wondered whether life exists beyond our planet.  Amaury Triaud, 2020 Blavatnik Awards UK Finalist believes we are closer to answering that question now than at any other time in history. The study of exoplanets—planets that orbit stars other than the Sun—offers what Triaud believes is “the best hope for finding out how often genesis happens, and under what conditions.”

The search for exoplanets has revealed remarkable variety among stars and planets in our galaxy. “The universe is far more surprising and diverse than we anticipated,” said Triaud. Astronomers have identified thousands of exoplanets since 1995, and now estimate that there are more planets in the Milky Way than stars—”something we had no idea about ten years ago,” Triaud said. Many exoplanets orbit stars so much smaller than the Sun that these stars cannot be seen with the naked eye.  Yet these comparatively small stars provide “optimal conditions” for exoplanet hunters.

Exoplanets are often detected using the transit method—as an orbiting planet passes in front of a star, its shadow temporarily dims the star’s brightness. The larger the planet relative to the star, the greater its impact on the brightness curve and the easier for astronomers to detect. While monitoring a small star 39 light-years from Earth, TRAPPIST-1, a team of astronomers, including Triaud, discovered an exoplanet system comprised of seven rocky planets similar in size to Earth, Venus, and Mercury.

“The next question is to find out whether biology is happening out there,” said Triaud, joking that the biology of interest is not little green men, but rather green algae or microbes similar to the ones that fill our atmosphere with oxygen. The presence of oxygen “acts like a beacon through space, broadcasting that here on Earth, there is life,” said Triaud, explaining that the only way to gauge the presence of life on exoplanets is through atmospheric analysis. Using transmission spectroscopy, Triaud and other astronomers will look for exoplanets that possess an atmosphere and chemical signatures of life, such as oxygen, ozone, or methane, in the atmospheric composition of exoplanets.

Measurements of spectral signatures in a planet’s atmosphere can reveal the presence of gases associated with life, including oxygen and methane. 

Such analyses will begin with the launch of the James Webb telescope in 2021.  In the meantime, a land-based mission called Speculoos, based partially in Chile’s Atacama desert, is monitoring 1,400 stars in search of additional exoplanets. “It’s rather poetic that from one of the most inhospitable places on Earth, we are on the path to investigating habitability and the presence of life in the cosmos,” Triaud said.

The Path to Delivering Fusion Power

“There’s an old joke that nuclear fusion is 30 years away and somehow always will be,” said 2020 Blavatnik Awards UK Finalist Ian Chapman, but he insists that the joke will end soon. According to Chapman, the “ultimate energy source” is entering the realm of reality. “We’re now in the delivery era, where fusion lives up to its potential,” he said. Low-carbon, low-waste, capable of producing tremendous amounts of energy from an unlimited fuel source—seawater—and far safer than nuclear fission, fusion power has a long list of desirable qualities. Chapman is the first to acknowledge that fusion is “really hard,” but his work is helping to ease the challenges and bring a future of fusion into focus.

Nuclear fusion relies on the collision of two atoms—deuterium, or “heavy” hydrogen, and tritium, an even heavier isotope of hydrogen. Inside the Sun, these atoms collide and fuse, producing the heat and energy that powers the star. Replicating that process on Earth requires enough energy to heat the fuel. of deutrium and tritium gases to temperatures ten times hotter than the Sun, a feat that Chapman admits “sounds bonkers, but we do it every day.”

Within fusion reactors called tokamaks, this superhot fuel is trapped between arrays of powerful magnets that “levitate” the jet as it spins around a central magnetic core, preventing the fuel from melting reactor walls. Yet this is an imperfect process, explained Chapman, and due to fuel instabilities, eruptions akin to “throwing a hand grenade into the bottom of the machine” happen as often as once per second. Chapman devised a method based on his numerical calculations for preventing these eruptions using additional magnet arrays that induce three-dimensional perturbations, or “lobes” at the edge of the plasma stream. Just as a propped-open lid on a pot of boiling water allows steam to escape, these lobes provide a path to release excess pressure.

An array of magnets near the plasma edge creates perturbations in the fuel stream, allowing pressure to escape safely.

Chapman’s technique has been incorporated into the “the biggest scientific experiment ever undertaken by humankind”—a massive tokamak called ITER, roughly the size of a football stadium and equipped with a central magnet strong enough to lift an aircraft carrier. Scheduled to begin producing power in 2025, ITER aims to demonstrate the commercial viability of nuclear fusion. “We can put 50 megawatts of power into the machine, and it produces 500 megawatts of power out,” said Chapman. “That’s enough to power a medium-sized city for a day.”

Even before ITER’s completion, Chapman and others are setting their sights on designing less expensive fusion devices. Late last year, the UK committed to building a compact tokamak that offers the benefits of fusion with a smaller footprint, and Chapman is the leader of this project.

The Nature of Gravity

Claudia de Rham, the 2020 Blavatnik Awards UK Laureate in Physical Sciences and Engineering, concluded the day’s research presentations with an exploration of nothing less than “the biggest mystery in physics today.”  For decades, cosmologists and physicists have grappled with discrepancies between observations about the universe—for example, its accelerated expansion— and Einstein’s general theory of relativity, which dictates that gravity should gradually slow that expansion. “The universe is behaving in unexpected ways,” said de Rham, whose efforts to resolve this question stand to profoundly impact all areas of physics.

Understanding the fundamental nature of gravity is key to understanding the origin and evolution of the universe. As de Rham explained, gravity can be detected in the form of gravitational waves, which are produced when two black holes or neutron stars rotate around each other, perturbing the fabric of spacetime and sending rippling waves outward like a stone tossed into a pond. But gravity can also be represented as a fundamental particle, the graviton, similar to the way light can be considered as a particle, the photon, or an electromagnetic wave.  Unlike the other fundamental particles such as the photon, the electron, the neutrino, or even the famously elusive Higgs boson, the graviton has never been observed. In theory, the graviton would, like all fundamental particles, exist even in a perfect vacuum, a phenomenon known as vacuum quantum fluctuation. Unknown in Einstein’s day, vacuum quantum fluctuations, when factored into the general theory of relativity, do predict an accelerated expansion of the universe. “That’s the good news,” said de Rham. “The bad news is that the predicted rate of expansion is too fast by at least 28 orders of magnitude.”

This raises the possibility that “general relativity may not be the correct description of gravity on large cosmological scales,” said de Rham. If the graviton had mass, however, it would impact the behavior of gravity on the largest scales and could explain the observed rate of expansion.

Signal patterns from gravitational wave events can serve as models for estimating the mass of the graviton. By comparing the expected signals produced by either a massless particle or a high-mass particle with actual signal patterns from detected events, physicists can place an upper and lower boundary on the graviton’s potential mass.

The idea of a massive graviton has been considered—and refuted—by physicists as far back as the 1930s. Several years ago, de Rham, along with collaborators Andrew Tolley and Gregory Gabadadze, “realized a loophole that had evaded the whole community.” Together, they derived the first theory of massive gravity. “Through gravity, we can now connect small vacuum fluctuations with the acceleration of the universe, linking the infinitely small with the infinitely large,” de Rham said.

Determining the mass of the graviton requires the most precise scale imaginable, and de Rham believes that gravitational wave observatories are perfectly suited to the task. Whether her theory will hold up in future tests remains to be seen, but when it comes to solving this epic mystery, “the possibility is now open.”

Further Readings

Triaud

Gillon M, Triaud AH, Demory BO, et al.

Seven temperate terrestrial planets around the nearby ultracool dwarf star TRAPPIST-1

Nature. 2017 Feb 22;542(7642):456-460

Gillon M,  1 , Jehin E, Lederer SM, et al

Temperate Earth-sized Planets Transiting a Nearby Ultracool Dwarf Star

Nature. 2016 May 12;533(7602):221-4

de Wit J, Wakeford HR, Gillon M, et al

A Combined Transmission Spectrum of the Earth-sized Exoplanets TRAPPIST-1 B and C

Nature. 2016 Sep 1;537(7618):69-72

Chapman

Kirk A, Harrison J, Liu Y, et al.

Observation of Lobes Near the X Point in Resonant Magnetic Perturbation Experiments on MAST

Phys Rev Lett. 2012 Jun 22;108(25):255003

Chapman IT, Morris AW

UKAEA Capabilities to Address the Challenges on the Path to Delivering Fusion Power

Philos Trans A Math Phys Eng Sci. 2019 Mar 25;377(2141):20170436

Claudia de Rham

de Rham C.

Massive Gravity

Living Rev Relativ. 2014;17(1):7.

de Rham C, Gabadadze G, Tolley AJ

Resummation of Massive Gravity

Phys Rev Lett. 2011 Jun 10;106(23):231101

de Rham C, Deskins JT, Tolley AJ, Zhou S.

Graviton Mass Bounds

Rev. Mod. Phys. 89 (2017), 025004

Panel Discussion: Hopes for the Future

Speakers

Ian Chapman, PhD
UK Atomic Energy Authority

Kirsty Penkman, PhD
University of York

Eleanor Stride, PhD
University of Oxford

Edze Westra, PhD
University of Exeter

Victoria Gill
BBC News (Moderator)

Several Laureates and Finalists of the 2020 Blavatnik Awards in the UK joined BBC science reporter Victoria Gill for the final session of the day, a wide-ranging panel discussion that touched on issues both current and future-looking.

Two themes—fear and opportunity— emerged as powerful forces shaping science and society, especially as it relates to climate change and the threat of emerging infectious disease. Gill noted that climate change is “the biggest challenge ever to face humanity,” and that many efforts to raise awareness of its impacts focus on bleak projections for the future. Asked for insights on shifting the tone of climate change communications, Kirsty Penkman acknowledged that “there needs to be a certain level of fear to get people’s attention.” She then advocated for a solutions-oriented plan rooted in the fast pace of scientific progress in clean energy, among other areas. “This is an amazing opportunity,” she said. “Humans are ingenious….in the last 120 years we’ve moved from a horse-drawn economy to a carbon-based economy, and in 5 or 20 years we could be in a fusion-based economy. We have the potential to open up a whole new world.” Eleanor Stride suggested combatting complacency by emphasizing the power of small changes in mitigating the impact of climate change. “One billion people making a tiny change has a huge impact,” she said.

The specter of a coronavirus pandemic had not yet become a reality at the time of the symposium. But Edze Westra presciently detailed the challenges of containing a highly contagious emerging pathogen in a “tightly connected world.” He commented that detecting and containing emerging diseases hinges on the development of new diagnostics, and that preventing future outbreaks will require cultural shifts to limit high-risk interactions with wildlife. For zoonotic diseases such as the novel coronavirus, “it’s all about opportunity,” Westra said.

Panelists also looked to the future of science, touching on issues of equality, discrimination, and diversity, and emphasizing the importance of raising the bar for science education. Stride noted that children are natural scientists, gravitating toward problem-solving and puzzles regardless of nationality or gender. “But something happens later,” she said, lamenting the drop in interest in science as children progress in school. “One of the things that gets lost is that creativity, which is what science really is—we’re coming up with a guess and trying to gather evidence for it—we’re not just learning a huge number of facts and regurgitating them,” she said.

In the wake of Brexit, panelists expressed concern about potential difficulties in attracting international students to their labs. “Diversity is so important,” said Penkman. “Getting ideas from all around the world from people with different backgrounds is essential to making science in the UK—and the world—the best it can be.” In her closing comments, Penkman said that ultimately, the trajectory of science comes down to the people in the field. “My eternal optimism is in the people I work with and the people I talk to when I visit schools—it’s that innate interest and curiosity. Whenever I see it, I feel that is the future of science,” she said.

Seeking a Sustainable Plant-based Meat Source

Researchers are coming up with creative new ways to make plant-based meat alternatives more appealing to consumers, but what will it take for the public to embrace this seemingly unknown food source?

Published June 1, 2020

By Sara Donnelly, PhD

Image courtesy of barmalini via stock.adobe.com.

Vegetarianism and even veganism are not new ideas — in fact one of the first mentions of vegetarianism comes from Pythagoras in 500 BCE. Buddhists and other religious groups have long advocated the practice for humane reasons.

The term vegan was coined more recently in 1944, to distinguish those who do not eat any animal-derived products from those who still consume dairy and eggs. Veganism has long been viewed as an extreme lifestyle choice, however, in recent years, the popularity of plant-based diets has been on the rise.

In 2017, six percent of U.S. consumers identified as vegan. While this is still a tiny percentage of the population, it represents a 600 percent increase over the previous three years.

People may choose not to eat meat due to health reasons or concern over animal welfare, but growing awareness of the contribution of food production to climate change has begun to expand the conversation around the need for the broader adoption of a plant-based diet.

According to the Food and Agriculture Organization of the United Nations, food production is responsible for 14.5 percent of worldwide greenhouse gas emissions. It is estimated that if everyone in the U.S. were to give up eating meat and dairy, it would reduce the country’s carbon emissions by 70 percent.

Reducing the prevalence of meat and animal products in the American diet will not be easy, as ideas and preferences about food are deeply rooted in cultural and societal norms. Even with greater understanding of the health and environmental implications, many people struggle with the idea of replacing their Thanksgiving turkey, or their celebratory steak, with a plant-based alternative.

Meat Diets Associated with Higher Standards of Living

Eating meat is also associated with increasing wealth, and as the standard of living has increased over the last 50 years in countries such as China, so too has their meat consumption, despite government policies advocating for lower intake.

A number of new plant-based meat alternatives have recently been developed that aim to ease the transition for those who want to make the switch. Several of these products have garnered significant media attention, but why all the hype? What makes the Impossible Burger “impossible?” and why would you want to go “Beyond Meat”?

While they take different approaches, companies such as Impossible Foods and Beyond Meat aim to create plant-based products that are almost indistinguishable from the real thing, which they believe will lure even the most die-hard meat eaters away from animal-derived products.

According to Principal Scientist, Dr. Laura Kliman, of Impossible Foods, “You can’t just tell people to stop eating meat, so at Impossible we’re not redesigning the product. We’re just redesigning the process to make it, and we’re delivering all the deliciousness, the nutrition, the versatility, that people expect out of meat but we’re making it from plants, which is inherently more sustainable.”

Impossible has a lofty mission to “replace the need for animal farming by the year 2035”. To do that, they take a rigorous scientific approach to replicate the taste and texture of meat. As Kliman says “taste is only a small part of it, flavor is mostly aroma.” In order to identify and recreate the aroma of meat, she uses the Gas Chromatography-Olfactometry technique, in which beef is broken down into its component chemicals and each of those is associated with a particular smell.

Finding Plant-Based Compounds

The scientists then turn their attention to the plant world to find plant-based compounds with the same characteristics. For Impossible this means they now have a “technology platform, or pipeline” that allows them to do the same for other meat products — for example the recently released Impossible Pork. A similar pipeline approach is used to replicate the texture of meat.

For Impossible, their “secret sauce”, what Kliman says provides the “explosion of meaty flavor” is heme, a chemical found in all plants and animals. In humans, it forms part of hemoglobin, the protein complex that carries oxygen around the body in the bloodstream. To replicate the taste of animal heme, Impossible scientists turned to leghemoglobin, a variant that naturally occurs in soy. They then devised a way to produce it in genetically modified yeast, in order to meet production demands and minimize its environmental impact. According to the company, their process uses 87 percent less water, 96 percent less land, and emits 89 percent less greenhouse gases than it takes to produce traditional beef burgers.

Plant-based alternatives to meat are produced from soy, potato, rice, mung bean, or pea protein and also contain fats to give them the appealing sizzle as they hit the pan. While eating a plant-based diet is often viewed as the healthier option, it is important to realize that eating “Beyond Meat” or an “Impossible Burger” is not necessarily beneficial for health.

Less Cholesterol, More Fiber and Sodium

These products have a similar fat content to beef burgers, and while they have less cholesterol and more fiber than a typical meat patty of the same weight, they do contain more sodium. Professor Kent Kirshenbaum is an organic chemist at New York University, and former scientific advisor to Beyond Meat, who is currently on the board of the Good Food Institute, a non-profit that promotes alternatives to animal food products.

“There is no easy way to answer this question,” he says. “Is it potentially beneficial to move to plant-based sources of food rather than animals? Yes, and I could spend a lot of time telling you why, especially moving away from red meat. However, for those people who are concerned about ultra-processed foods as potentially having deleterious health consequences, they’re absolutely right, this could turn out to be a problem. We don’t know what it is about processed foods that gives rise to health problems, so we really don’t know what the long-term effect is going to be.”

At a Restaurant Near You

From restaurants like David Chang’s Nishi, to Burger King and Dunkin’ Donuts, the Impossible Burger and Beyond Meat products are widely available, and Taco Bell recently announced it will offer plant-based fare within a year. However, not all restauranteurs are so enthusiastic. Chef Silvia Barban, former “Top Chef” competitor and current proprietor of LaRina in Brooklyn, N.Y., offers many vegetarian options on her menu, but none of them contain plant-based meat alternatives. Barban prefers to use her culinary skills to turn locally sourced vegetables into a delicious meal. “I want to sustain the local farmers. I want to try to make great dishes with everything that we have around”, says Barban.

However, in her personal life she finds these plant-based products an easy substitute in dishes like tacos or ramen, when she needs a quick and tasty lunch or late meal after work. While Barban thinks that plant-based meat alternatives are a great addition to fast food, or fast casual restaurant menus, she has no plans to incorporate them in her own menu: “I just use vegetables and I treat them the right way and make it super flavorful. For example, I like to do a beet tartar. It’s vegetarian. It looks like meat, but it’s not — it’s beets and it’s delicious!”

Rethinking How We Eat and Produce Food

It is clear that for our health and the environment, we need to rethink what we eat and how we produce our food. A recent report from EAT-Lancet Commission states that achieving a sustainable and healthy diet worldwide is possible by 2050, but will require a dramatic shift in our approach to eating and agriculture as well as require significant effort and investment from all sectors.

While the report suggests that meat consumption should actually increase in parts of the world where malnutrition is prevalent, in North America, there needs to be a substantial decrease in the amount of meat and dairy consumed. Thus, solutions to the problems of developing a sustainable global food supply chain will take many forms. In western nations, hi-tech plant-based meat alternatives, will almost certainly play a major part in this revolution.

“This is here to stay. Even if part of what’s going on is some element of hype, we don’t have any choice but to drastically reform our food systems, it has to happen,” says Kirshenbaum. “The population is just growing too quickly. Economies around the world are expanding and people are becoming wealthier, which has generally been associated with greater consumption of meat. Just from a global sustainability standpoint, this has to happen.”

Also read: Challenges in Food and Nutrition Science

Challenges in Food and Nutrition Science

The New York Academy of Sciences’ work in nutrition science aims to address global issues such as food security which affects infants, adolescents and the aging population.

Published June 1, 2020

By Carina Storrs, PhD

According to the United Nations, malnutrition is “a trap from which people cannot easily escape.” And it is a trap that affects every country in the world. In 2015, ending hunger and ensuring access to nutritious food was named one of the U.N.’s 17 Sustainable Development Goals (SDG) for 2030. Efforts to reduce malnutrition stretch back decades and have taken many forms. These include global initiatives that increase access to nutritious foods; government policies that promote healthy diets and set nutrition standards; nonprofit groups that operate food pantries and kitchens; and researchers who study malnutrition and evaluate interventions.

Within the vast landscape of approaches to combat malnutrition, The New York Academy of Sciences Nutrition Science Program has been focusing on where it can make the greatest contributions to nutrition science research. Over the last four years, it has focused on important nutrition science interventions, including the control and prevention of thiamine and micro-nutrient deficiencies and bolstering evidence-based nutrition models.

These activities support a priority for the Academy — addressing global issues such as food security that affect infants, adolescents and the aging population. “Today we can say that the Nutrition Program at the New York Academy of Sciences has become a center of reference on a number of those issues,” said Gilles Bergeron, PhD, Senior Vice President for Nutrition Science at the Academy.

The Academy’s reputation as a neutral convener of experts representing all sides of an issue, makes it the ideal catalyst to assess current scientific evidence writ large. In the case of the Nutrition Program, it also actively evaluates data, and participates in ongoing research needed to design future large-scale programmatic activities.

Filling Knowledge Gaps

For its research on thiamine deficiency, a problem that mainly occurs in low and middle-income countries (LMIC) due to insufficient dietary intake of the B1 vitamin, the Academy’s nutrition science team, together with the Bill & Melinda Gates Foundation, convened a task force in 2017 to take stock of existing data. The team is now collaborating with researchers internationally on several projects to fill in knowledge gaps, determine best solutions to tackle this public health problem, and to assess the prevalence of thiamine deficiency in understudied regions of Africa, such as Madagascar and The Gambia.

Thiamine deficiency can easily go unrecognized, as it did for decades in parts of Asia such as Bhutan and Northern India, because the symptoms are so vague, ranging from the loss of appetite in infants and children, to tingling in hands and feet in adults. But left untreated, thiamine deficiency can rapidly lead to death, and there is increasing evidence that sub-clinical cases — which almost never get detected — can cause long-term cognitive delays and motor skill problems. “We are starting to work on strategies to prevent thiamine deficiency and to raise awareness of its prevalence, which is much, much broader than I think anyone expected,” said Megan Bourassa, PhD, a biochemist and the Academy’s Associate Director of Nutrition Science.

The Academy’s Nutrition Science Program has brought much-needed attention to the issue of thiamine deficiency, according to Frank Wieringa, MD, PhD, senior researcher at the Institut de Recherche pour le Développement (IRD) in Montpellier, France. “In 2012, we knew as much about thiamine deficiency as we did in 1950, there was hardly any progress in those 60, 70 years,” said Wieringa, who served on the Program’s task force and is part of its Scientific Advisory Group.

A High Prevalence of Thiamine Deficiency in Cambodia

Wieringa found a high prevalence of thiamine deficiency in Cambodia, even though the problem has generally been less well recognized by the medical community there than in other parts of Southeast Asia such as Laos. He and his collaborators, including the Academy nutrition team, are currently testing the optimal dose of thiamine to give lactating women in Cambodia. Early data will be available this spring and the hope is to eventually fortify salt with the optimal thiamine dose, much like salt is already iodine-fortified.

On a separate but related front, the Academy has taken on the challenge of trying to improve the myriad of computer models that can guide policy makers, researchers and aid groups in deciding how to tackle malnutrition despite limited resources. The models, which have been developed by academic, governmental and humanitarian groups, can make predictions about important policy questions such as:

  • Which nutrition issue is the most pressing in a particular setting?
  • Should attention be directed at certain micronutrient deficiencies or on bigger issues of stunting and underweight populations?
  • Which intervention(s) would be most cost-effective?
  • What is the best mix of interventions to achieve multiple concurrent objectives?

With competing models, policy makers may only use the tools that are promoted by the donor they work with (be it The World Bank, USAID or other); and not necessarily the one that is most appropriate for their goals. There needs to be a greater recognition of the diversity of needs and the fit-for purpose of specific modeling tools to the specific task.

The Nutrition Modeling Consortium

Over the last three years, the Academy, with funding from the Bill & Melinda Gates Foundation, has brought together various modelers and launched the Nutrition Modeling Consortium to try to increase awareness of the models in LMIC. Such a partnership was developed to foster collaborations and shared experiences between countries regarding the use of models in decision making.

The Consortium has given modelers the “unique opportunity to sit down and really dig into what these models can do,” said Stephen Vosti, PhD, Adjunct Professor at University of California, Davis, and member of the Consortium. Vosti and his colleagues created MINIMOD, a tool to help plan and manage the most cost-effective micronutrient interventions in LMIC.

So far, the researchers have identified strategies for reducing vitamin A deficiency in Cameroon and plan to deploy the tool to look at other micronutrient deficiencies in countries such as Malawi and Nigeria. MINIMOD could also be used to assess the risk of interventions leading to overconsumption of micronutrients, which is a particular concern in the United States and other developed countries, according to Vosti.

Undernourishment Impacts More than 800 million Globally

With more than 800 million people around the world experiencing undernourishment in 2017, the stakes for the Nutrition Science Program, as well as the many other efforts featured in this issue, could not be higher. Ensuring that all the world’s people have access to adequate nutrition achieves multiple societal objectives. Healthy people are productive people who can work and contribute to long-term economic sustainability.

And a proper diet is foundational in enabling people to fight off disease. It is arguably a gender issue as well. In societies where male children are often more valued than females, girls may not receive adequate nutrition in their formative years, which will impact their ability to bear healthy children of their own.

“Access to nutritious food is a common thread to all population segments,” said Bergeron. “What we do at the Academy is not just about starving children in remote parts of the world, although we recognize the need. Obesity, antibiotics in animal food production, adolescent women nutrition as well as nutrition for the aging, are issues that need to be addressed in developed countries as well.

Here in the United States, it is estimated that one in every 10 adults who are 20 years or older has diabetes. For seniors (65 years and older), that figure rises to more than one in four. The cost of diagnosed diabetes is an estimated $245 billion — money that could go to crucial nutrition programs both in the U.S. and around the world for a healthier society at large.”

Nutrition Science is Ensuring a Healthy Start in Life

A supermarket display of fresh produce.

Minimizing nutrient deficiencies and ensuring that babies are breastfed optimally are two ways advocates are supporting the healthy development of babies in lower-income countries around the world.

Published May 1, 2020

By Nicholette Zeliadt

About a decade ago, pediatrician Philip Fischer, M.D., began to hear heartbreaking stories about babies in Cambodia who were believed to have “beriberi,” a vitamin deficiency so uncommon in the U.S. that he knew of it only from textbooks as a scourge of the 19th century.

He went to Cambodia to learn more and try to help his colleagues there. They encountered infants so deathly ill, listless, and short of breath that they were often unable to cry and incapable of feeding. And yet miraculously most of them would make a full recovery within thirty minutes of receiving a shot of the vitamin they were lacking: thiamine, also known as vitamin B1.

Fischer and his colleagues found that about six percent of babies in Cambodia don’t live to see their first birthdays, and up to half of those deaths could be attributed to thiamine deficiency.

“That was pretty concerning to us,” said Fischer, professor of pediatrics at the Mayo Clinic in Rochester, Minnesota.

The team is now working to determine the extent of the health problems caused by thiamine deficiency in babies and establishing guidelines for diagnosing it.

The body can’t make its own thiamine, so it has to get it through the diet. Whole grains, nuts, and pork are particularly good natural sources, and today some staples such as wheat flour are typically fortified with it.

In Cambodia, however, as in many countries in Southeast Asia, more than half the diet is made up of white rice, which contains little thiamine, largely due to the processing of the rice, which involves removing the outer layer containing the thiamine. Newborn babies typically get their thiamine through breastmilk, but if their mother is deficient, then the breastmilk is, too.

Philip Fischer, MD
Professor of Pediatrics, Mayo Clinic

The most recent estimates suggest that at least 38 percent of infants in Cambodia are thiamine deficient. Similar deficiencies have been found elsewhere across Southeast Asia, parts of India and Bhutan, and several countries in Africa.

“This is more widespread than we thought,” said Kyly Whitfield, Ph.D., assistant professor of applied human nutrition at Mount Saint Vincent University in Halifax, Nova Scotia.

An increased risk of death due to this deficiency is not the only concern: some evidence suggests that having too little thiamine in early childhood may cause lasting impairments in cognitive abilities.

Whitfield foresees a day when families in developing countries can get the thiamine they need through fortified foods, such as salt. She and her colleagues are already testing thiamine supplements in the region to establish how much thiamine a woman needs to consume in order to prevent beriberi in both herself and her infant.

The studies involving Whitfield, Fischer, and their colleagues reflect several initiatives underway that aim to use the latest developments in infant nutrition science to help families in developing nations nurture healthier babies. Prioritizing adequate nutrition for pregnant and lactating women and their babies is critical not only for women’s health, but also for that of future generations and the productivity of these nations.

Multiple Micronutrient Deficiencies

Robert Black, MD
Professor of International Health, Johns Hopkins University

Many people in developing countries have deficiencies of multiple vitamins and minerals simply because they don’t have enough food to eat or their diet lacks variety. Pregnant women are especially vulnerable because they require even more nutrients than usual. And it’s not just their own health at stake; their children have an increased likelihood of stillbirth, premature birth, and a variety of birth defects, among other health problems. They also have an increased risk of death before age five and tend to perform more poorly than their peers in school.

It is difficult for a pregnant woman to consume all the nutrients she needs through diet alone. In fact, in most developed countries, pregnant women routinely take prenatal supplements containing multiple micronutrients (sometimes referred to as MMS). By contrast, in most developing countries, pregnant women usually receive a supplement containing only two: iron and folic acid (IFA) — the only two micronutrients that the World Health Organization (WHO) currently recommends that all pregnant women take.

“Women in low- and middle-income countries have many deficiencies that are not currently being addressed,” said Robert Black, M.D., professor of international health at Johns Hopkins University in Baltimore, Maryland.

Clayton Ajello, Dr. PH
Senior Technical Advisor, Vitamin Angels Alliance

Indeed, two recent systematic reviews of the scientific literature found evidence that multiple micronutrient supplements are better than supplements of iron and folic acid alone at reducing the risk of a child being born preterm, with low birth weight, or small for gestational age. And the supplements appear to be safe; they do not raise the risk of any adverse events.

“MMS does everything that IFA does, and more,” said Clayton Ajello, Dr. P.H., senior technical advisor for Vitamin Angels Alliance, a nonprofit that provides MMS to mothers and children worldwide.

Because of these added benefits, both Ajello and Black advocate for developing countries with high rates of nutrient deficiencies to replace IFA supplements with MMS, especially in countries where such deficiencies are widespread among women of childbearing age. Progress is slow, in large part because current supplies are nowhere near what is needed to meet the needs of the estimated 206 million women who become pregnant in developing countries each year. However, supplies will increase as more and more countries adopt MMS, Ajello says.

It Takes a Village

Minimizing nutrient deficiencies in pregnant and breastfeeding women is a key part of ensuring the development of healthy babies. Equally important are efforts to ensure that babies are breastfed optimally. The WHO recommends that all babies be breastfed within an hour of birth and continue exclusively for six months. After that, babies should start eating other foods but continue nursing until they are at least two years old.

Melissa E. Glassman, MD, MPH, IBCLC
Medical Director, Newborn Clinic and ACN Breastfeeding Support Program in Newborn Clinic
Assistant Clinical Professor of Pediatrics
Division of Child and Adolescent Health
Columbia University Vagelos College of Physicians and Surgeons

Beyond simply providing a baby with its only source of nutrients for the first six months of life, breastmilk protects babies from infections and aids the development of their immune systems. Breastfed infants have lower rates of gastro-intestinal and respiratory infection and lower rates of death from infections overall as compared to non-breastfed infants.

Studies suggest that programs to promote breastfeeding may be an important way to reduce mortality in young children.

“But establishing breastfeeding can be difficult for many women, especially if they don’t have guidance and support,” said Melissa Glassman, M.D., a pediatrician at New York Presbyterian Hospital and Columbia University Irving Medical Center, and the founder and medical director of the hospital’s Newborn Clinic, which provides outpatient care to newborns with Medicaid insurance after they are discharged from the hospital. “It becomes more difficult to raise your baby if you don’t know how to do it and you’re not surrounded by a village that can help you.”

New mothers often do not know what to expect when breastfeeding for the first time. For instance, many have trouble getting a newborn to latch onto the breast properly, causing pain and difficulty with feeding.

And first-time mothers may not immediately recognize cues that their baby is hungry, resulting in too few feeding sessions and weight loss in the infant. What’s more, breastfeeding can be physically exhausting: newborns typically feed at least eight times a day, and each feeding session can last as long as an hour. If women don’t know to expect these feeding patterns, they often assume that they’re not making enough milk and their baby is going hungry. All of these factors may prompt women to give up on breastfeeding too soon.

“There’s nothing worse than a woman wanting to breastfeed, then developing problems with breastfeeding that she doesn’t know how to fix, and not having the support she needs to address these problems,” said Glassman, who provides breastfeeding support to women from a wide range of socioeconomic backgrounds — from those with commercial insurance who visit her at a ColumbiaDoctors practice — to the primarily immigrant population with public insurance who visit the Newborn Clinic. “If we can get women comfortable and on the right foot early with breastfeeding, that will get moms on the path for long-term successful breastfeeding and all the associated health benefits for both mom and baby.”

Also read: The Organic Chemistry of Milk for Developing Babies

New Age Therapeutics: Cannabis and CBD

CBD has become the ingredient driving a billion-plus dollar market of consumer products — researchers are sorting the hype from the hope.

Published May 1, 2020

By Sonya Dougal, PhD

Image courtesy of Gelpi via stock.adobe.com.

Enter any drugstore, vitamin chain, big box store, e-commerce site, gas-station convenience store or street corner bodega and you’ll find CBD products — in shampoos, oils, vapes, gummies and even treats for people and pets. Many of these products come with creative claims of the therapeutic benefits of CBD, true or not.

Such mass market hype and wishful thinking aside, Epidiolex®, an FDA-approved breakthrough treatment for rare drug-resistant epilepsies, is currently the only CBD product (cannabidiol) demonstrated to be effective by controlled studies in people.

CBD was previously known as the non-intoxicating sibling of the psychoactive intoxicant THC (tetrahydrocannabinol) — both cannabinoids produced in the marijuana plant. Traditional medicines have used cannabis for millennia, yet the United States first placed legal restrictions on its use in the 1920s and 1930s. In 1970, marijuana became illegal under Schedule I of the U.S. Controlled Substances Act.

CBD, though, received an enormous boost when the Farm Act of 2018 allowed the legal growth and sale of hemp products which include CBD. However, THC remained illegal, along with CBD produced from marijuana. These changes have only added to the ambiguity of CBD’s status from the perspectives of both law and science.

Imagine You’re a Caveman: The Human Endocannabinoid System

In the 1980s and 1990s, researchers identified cannabinoid receptors in humans (CB1 for THC and CB2 for CBD). What they were uncovering was the human body’s own endocannabinoid system (ECS).

“It’s a system as ancient as our immune system and our central nervous system. They co-evolved and our endocannabinoid system acts as a bridge between the two,” says Yuval Cohen, CEO and Director of Corbus Pharmaceuticals. “It’s designed to help us recover from trauma and is absolutely essential to life.”

To illustrate his point, Cohen said: “Imagine you’re a caveman and you just got mauled by a saber-toothed tiger. You are injured, you’re bleeding, you’re going into shock, you’re scared, you’re in a ton of pain; the wound is swollen and tender. You’re a hot mess. And that is where your endocannabinoid system kicks in. Without it, you’re going to die in that cave. It’s that simple.”

He is describing what many CBD promoters claim as general benefits of CBD in any form: pain management, seizure control, physical and psychological trauma relief, and tissue healing. Cohen, himself, sees the endocannabinoid system as an increasingly more explored therapeutic target for new treatments of disease.

Corbus is rationally designing synthetic signaling molecules to target the human ECS receptor molecule CB2 more selectively than a plant molecule could. Corbus’ lead product candidate, lenabasum, is designed to resolve chronic inflammation and fibrotic processes without interfering with the central nervous system.

Patient-Driven Advances

Yuval Cohen, Ph.D.
CEO and Director, Corbus Pharmaceuticals, Inc.
Photo: Corbus Pharmaceuticals

Elizabeth Thiele, M.D., Ph.D., Director of the Pediatric Epilepsy Program at Massachusetts General Hospital, has firsthand experience with the pain and courage of parents who have exhausted existing medical options for treating extremely ill children. “I think what has really set this whole CBD story apart is that it was the patient community that drove the interest. It wasn’t big pharma saying ‘Here’s this drug we had in trials’,” she said.

Dr. Thiele has direct knowledge of a couple of related cases. One family moved from Maine to Colorado so they could access a CBD product for their daughter’s debilitating, treatment-resistant

epilepsy. A second family, from California, became interested in medical marijuana when their son had trouble with the restrictions of dietary therapy. But they encountered the same difficulty many experience with extracts: consistency of the product. Eventually, the California boy became patient one for Epidiolex in the United States.

“When I first got involved with this, one of my colleagues told me I was risking my career and another that I was wasting my time,” said Thiele. “But my approach has always been that I get parents who are desperate for treatments for their child and I need to support them.”

Still, Thiele firmly warns against trying CBD products whose contents you cannot confirm: “Right now, the only data we have is that purified CBD can be effective in helping children with refractory epilepsy. Parents should be very leery of claims of CBD curing or being good for everything.”

Above and Beyond Caveat Emptor

Margaret Haney, Ph.D.
Professor of Neurobiology at Columbia University Medical Center

When states legalize something, people assume it is safe. But experts at government agencies and university-affiliated research institutes continue to seek accurate data about potential health risks associated with cannabinoids, especially for people who may be more vulnerable because of age, neurological development, pregnancy, or interactions with other medications.

THC can affect fetal and adolescent neurological development, but CBD’s effects are still being determined. Data  collected during studies of Epidiolex, for example, revealed that CBD affected availability levels of the antiepileptic clobazam, requiring dosage adjustments.

Scientists are actively studying the therapeutic potential of CBD with the removal of hemp from Schedule I.

Among her responsibilities, Susan Weiss, Ph.D., National Institute on Drug Abuse, Director, Division of Extramural Research, represents NIDA in talks on cannabis, marijuana and CBD. “Our goal is to get a better understanding, to get more knowledge and to be able to present evidence in an unbiased fashion,” she said. “We are also interested in developing therapeutics for cannabis use disorder.”

The Legal Hurdles

But NIDA research is not immune to legal ambiguity, jurisdictional conflicts, and their consequential impact on science. “Our researchers can’t actually purchase products from dispensaries because they would be in violation of federal law,” Weiss said. “As a result, NIDA must depend on people self-reporting what they’re using. But we don’t have access to those products to get a good sense of their dangers.”

Margaret Haney, Ph.D., Professor of Neurobiology, Columbia University Medical Center, is a leading researcher on cannabis use disorder but also explores the science behind specific areas of therapeutic value for THC and CBD. “I feel like there’s an anti-science moment right now where people are just believing,” she said. “They’re distrustful of pharma but not of the person selling them CBD at the farmer’s market. People aren’t aware that it’s just snake oil all over again.”

According to Haney, what most stands in the way of large-scale rigorous clinical studies is the DEA Schedule I status for cannabis and cannabinoids, which essentially shuts down the ability to conduct these studies. “If scientists could treat cannabis and its constituents as Schedule II, that would open things up tremendously,” she said.

The Entourage Effect

Ziva Cooper, Ph.D., Research Director of the UCLA Cannabis Research Initiative and Associate Professor in the Jane and Terry Semel Institute for Neuroscience and Human Behavior, understands the strong arguments for the purity, precision and predictability that synthesized THC or CBD molecules can provide in a rationalized drug design approach. But as a pharmacologist she wonders if potential benefits may be lost the further away a drug molecule moves from the whole plant.

“You want to know what the individual constituents do, but then there is this idea that the whole plant can offer greater therapeutic potential because it has all these different chemical components — some call this the entourage effect,” said Cooper.

“This hypothesis hasn’t really been tested in the clinic yet. We’re hoping to begin studying that very soon to determine if these different molecules in the plant work together to improve the potential therapeutic effects of cannabis. Will the combination of these chemicals be effective? What can we expect it will do? What are the risks we should be aware of? I’m confident that over the next 10 to 15 years we’ll actually be able to answer some of these questions,” said Cooper.

Dan Zenowich, a freelance health writer, contributed to this story.

Also read: What Near-Death and Psychedelic Experiences Reveal about Human Consciousness

Finding New, Sustainable Uses for Food Waste

A "super flour" product displayed on a table.

According to the EPA, organic waste is the largest component of landfills. Researchers are working with businesses to develop innovative ways to reduce this problem.

Published May 1, 2020

By Charles Ward

Bertha Jimenez wasn’t a beer drinker when she came across spent grain for the first time.

A mechanical engineer by training and now the CEO of Rise Products, Jimenez recounted her tour of Brooklyn Brewery, a craft beer brewery located in the Williamsburg section of Brooklyn, N.Y.

“I’m interested in how waste from one industrial activity is usable in another,” she said. “So as we walked around the plant, I wanted to know what happened to the source grains after the beer was made.”

Within a year, Jimenez founded Rise, a start-up that converts spent grain into specialty flours sold directly to bakeries. Rise developed a proprietary conversion process, slogged through prototypes and proof-of-concepts, and learned about food safety standards. She built a regional B2B customer base, secured grants, raised private capital, and signed a Service Provider Agreement with Anheuser-Busch.

“People like to feel like they’re doing something sustainable, something good,” she said. “But at the end of the day we don’t eat ideology, you know?”

The Challenge of Food Waste

Jimenez is just one example of the way the scientific community has deeply engaged with the challenge of food waste: as entrepreneurs, researchers, academics, regulatory policy specialists, or NGO advisors.

The U.S. Department of Agriculture (USDA) estimates 31 percent of food produced in the U.S. is loss, with an annual economic value of $161.6 billion. Globally, the U.N. Food and Agricultural Organization (FAO) estimates 1.3 billion tons of food are lost every year in agricultural production, post-harvest storage, processing and distribution, and consumption.

New policy priorities reflect an emerging consensus among food production experts that these are unacceptable numbers for a global food system already stressed by a growing population and climate change. Goal number 12 of the U.N.’s Sustainable Development Agenda is to “ensure sustainable food consumption and production patterns.” Targets include cutting per-capita global food waste in half at the retail and consumer level by 2030, and reducing food loss from production and supply chains. The U.S. Environmental Protection Agency (EPA) and USDA share a similar goal, to cut food loss and waste in half, also by 2030.

Multiple Missions

Upcycling spent grain from breweries.
Photo credit: Rise Products, Inc

For Elise Golan, Ph.D., Director of Sustainable Development for the USDA, food waste is a resource efficiency challenge. She works closely with colleagues at the EPA, and references the EPA’s well-known “Food Recovery Hierarchy” inverted pyramid, which visually represents the flow of food from “upstream” agriculture source to “downstream” table, and the parallel opportunities to conserve resources at every stage of the chain.

“We look at reasons for waste, and ask if there are cost-effective ways to reduce it,” she explained. “If we’re producing food that is wasted, [by reducing it] we can conserve the land, water, chemical- and non-chemical inputs that go into that food.”

The USDA’s more active food recovery interventions, Golan notes, are prompted by opportunities to create efficiency all along the value chain. As one relatively upstream example, she points to a pilot collaboration between the USDA’s Agricultural Research Service and The Wonderful Company, a California-based producer of pistachios. The project has the potential to turn mountains of discarded pistachio shells into “carbon black” for use in plastics as an alternative to petroleum-based compounds.

“They’ve done it in a very cost-effective, energy saving way,” said Golan. “It is really is a big win for the environment.”

Food Waste as an Economic Catalyst

If the USDA is working on food waste from the top down, Juan Guzman, Ph.D., is working from the bottom up. Guzman is the head of Capro X, a Cornell University spin-off that uses bioconversion technology to turn the acid whey left over from Greek yogurt production into specialty chemicals. In commercial terms, Capro X is what is classically called a “category creator.”

Guzman thinks of himself first as an entrepreneur, and speaks in terms of business cases: return-on-investments, stakeholder buy-in, and use of science-based innovation to create entirely new markets. When he started Capro X, the commercial imperatives were self-evident: New York yogurt manufacturers needed cheaper ways to get rid of large quantities of acid whey, which they had to truck long-distance for waste-water treatment.

Alternative Sourcing for Industrial Products

At the same time, dairy farmers, generally, were under pressure to develop new products as milk consumption declined. And global agribusiness giants, like Nestlé, Archer Daniels Midland and Cargill, are always seeking alternative sourcing for industrial products, like commercially farmed palm oil, which Capro X intends to produce.

“I just see so much opportunity in using biology to extract value out of things that people are willing to pay to get rid of,” said Guzman, pointing to the historic precedent of ethanol, which made the planting of corn on previously surplus or marginal farm acreage a hugely viable commercial proposition. “For yogurt manufacturers, we’re talking about waste streams measured in the millions of pounds, with one facility alone generating a quarter of a million pounds a day of pure lactose sugar for conversion,” Guzman continued. “And there are hundreds of plants in the U.S.“

For the market to scale, investor interests will have to see the opportunity, and put in capital. In the meantime, Guzman is building his new market one customer at a time. Capro X’s value proposition includes installing the acid whey treatment equipment at dairy farms. He keeps the specialty products, and farmers are spared the expense of trucking away waste. Guzman said he has learned that farmers like the idea of sustainable waste practices, but they are not necessarily willing to pay a price premium for them.

Identify, Measure, Attempt to Solve

Mary Muth, Ph.D., is an agricultural economist who serves as the Director of Food, Nutrition, and Obesity Policy Research at RTI, a not-for-profit organization dedicated to using science for good. Muth has conducted food waste research from every angle: malnutrition, resource efficiency, economic impact, and ethical imperative. She believes that scientific interest in the problem of food-waste is still cresting.

She also points out that that commercial application of food-waste research is still largely voluntary. Some companies see it as a reputation management opportunity, a way to promote corporate social responsibility. A few others have developed niche products. Seismic economic incentives for waste-aware practice don’t yet exist.

“It will probably take some significant disruption in the food supply to bring around big scale change,” Muth said.

Christine Beling, a project engineer and New England regional director of Brownfields and Sustainable Materials Management at the EPA, is as good a witness as any to what seems to be an incremental and steady advance towards reduced food waste. The EPA prefers composting as an alternative to landfills for food waste, and Beling says that a sign of progress is landfill bans of organic waste by four of the six New England states in her region. She notes that in 2015, the EPA calculated that just 5.3 percent of 39 million tons of food waste was diverted for composting; two years later, the figure was 6.3 percent.

“That’s a relatively big jump,” she observed. “If you go back to the late ’90s or early 2000s, it was one percent. I think you can see the trend.”

Entering the Mainstream Conversation

Beling points to a variety of legislative, academic, and NGO attention on food waste and recovery. In 1996, President Bill Clinton signed the Bill Emerson Good Samaritan Food Donation Act, which provides liability protections to nonprofit organizations when they donate food. In 2019, Harvard University launched its Food Law & Policy Clinic, which trains students in the use of legal and policy tools to address food system issues.

Beling also calls attention to the birth of new NGOs like ReFed, founded in 2015, to bring data- and economics-driven tools to help solve food waste problems. And in 2016, the Ad Council and the Natural Resources Defense Council co-sponsored the “Save the Food” national public service campaign.

“The emphasis may be different depending on what part of the world you’re in, but overall there’s a whole shift,” said Beling. “Ten years ago, people didn’t want to deal with food waste. Now, everybody’s dealing with it because it’s in the mainstream conversation.”


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