Published10 minutes agoSharecloseShare pageCopy linkAbout sharingImage source, Getty ImagesScientists have discovered they can boost people’s memory for a least a month by harmlessly stimulating parts of the brain with electricity. Volunteers performed better at word memorisation games, which tested both their immediate “working” memory and their long-term memory, experts found.Exactly what the results mean for day-to-day life is still unclear. But ideas range from helping old people cope with memory decline, to treating disease and aiding exam preparation.Dr Robert Reinhart, from Boston University, described the stimulation technique as “an entirely different approach to isolating and augmenting parts of the brain” which offered “an entirely new realm of potential treatment options”.People on the trial wore a cap filled with electrodes. A controlled electrical current, which feels similar to an itch or a tingle, was then used to precisely alter brainwaves in targeted regions of the brain. The volunteers underwent 20 minutes of stimulation daily for four days in a row. Throughout the study they had to memorise lists of words, which they were again asked to recall one month later. Dr Reinhart said the treatment “could cause selective memory improvement that lasts for at least one month”. The results, published in the journal Nature Neuroscience, showed those volunteers who were struggling with the memory games at the beginning of the experiment were those whose memory improved the most. How memory worksThe electrical signals changed the rhythm of brain activity – brainwaves – in the areas targeted. Scientists think the four rounds of stimulation reinforced those patterns and led to lingering improvements as the brain adapted and rewired itself – known as neuroplasticity. “It’s sort of connecting to the so-called language of the brain, that speaks to itself and communicates with itself through electrical impulses,” said Dr Reinhart.However, it takes different types of stimulation to boost the different types of memory: Working memory is for the here and now. It’s how you retain information in your mind – like taking notes in a class – and is vital in problem-solving and decision-making.Boosting it required low-frequency stimulation of the prefrontal cortex, at the front of the brainLong-term memory is where we bank information; it’s how we can remember our first day a school or a weddingBoosting it required high-frequency stimulation of the parietal cortex, at the back of the brainIn the word games – recalling those given at the start tests long-term memory, while recall after a month tests working memoryAll 150 people who took part in the trial were healthy, with no cognitive impairment, and were aged between 65 and 88. Becoming more forgetful is often a sign of age, but whether this form of stimulation could aid the aging brain in the real world, beyond word games, is still unknown. Dementia, including Alzheimer’s disease, is caused by a diseased brain with dying brain cells – leading to memory problems.The researchers are investigating whether the technology can be used in Alzheimer’s disease to stimulate the surviving brain cells, as well as in schizophrenia and obsessive compulsive disorder. Dr Susan Kohlhaas, the director of research at Alzheimer’s Research UK, said: “We don’t know if brain stimulation techniques have potential to help people with dementia but there is research under way in this area.”At present, the stimulation method used – transcranial alternating current stimulation – is only possible in research laboratories.So while you may be thinking of using cognitive enhancement to get through an exams – or just a pub quiz – the scientists say those sort of homegrown applications are for the distant future.Thinking caps and superbrainsHowever, researcher Shrey Grover said he can ultimately see them being used alongside more traditional methods which people use to keep their mind sharp, such as crosswords and Sudoku. “Any efforts to remain cognitively engaged are always welcome, this kind of approach is perhaps something that could be added on to things that people are already doing.”Follow James on Twitter.

Published25 minutes agoSharecloseShare pageCopy linkAbout sharingImage source, Getty ImagesThe UK has become the first country to approve a dual vaccine which tackles both the original Covid virus and the newer Omicron variant.The upgraded vaccine should be available as an autumn booster and give better protection against variants. Moderna said it could supply 29 million doses this year, but exactly who will get them has yet to be announced. All over-50s and people in high-risk groups will be offered some form of booster from next month. The original vaccines used in the pandemic were designed to train the body to fight the first form of the virus that emerged in Wuhan, in China, at the end of 2019.The Covid virus has since mutated substantially, with a stream of new variants emerging that can dodge some of our immune defences. They have caused large surges in cases around the world. ‘Sharpened tool’Moderna’s vaccine targets both the original strain and the first Omicron variant (BA.1), which emerged last winter. It is known as a bivalent vaccine as it takes aim at two forms of Covid.The UK’s Medicines and Healthcare Products Regulatory Agency has considered the evidence and given the vaccine approval for use in adults.Dr June Raine, the regulator’s chief executive, said: “The first generation of Covid-19 vaccines being used in the UK continue to provide important protection against the disease and save lives. “What this bivalent vaccine gives us is a sharpened tool in our armoury to help protect us against this disease as the virus continues to evolve.”The results of experiments on 437 people showed the updated vaccine was safe and gave better immune protection against newer variants. Levels of antibodies that were able to stick to and disable Omicron (BA.1) were eight times higher with the new vaccine than Moderna’s old one. Tests against more recent Omicron variants (BA.4 and BA.5), which are causing the UK’s current wave, also showed higher levels of protection with the updated vaccine. However, while there is better protection against known variants, it is uncertain what we will be facing in the coming months and exactly how well the updated vaccine will perform. Stéphane Bancel, the chief executive officer of Moderna, said he was “delighted” the vaccine had been approved. He said: “This represents the first authorization of an Omicron-containing bivalent vaccine, this bivalent vaccine has an important role to play in protecting people in the UK from Covid-19 as we enter the winter months.”In the UK, the following people will be offered some form of booster:health and social care staffeveryone aged 50 and overcarers who are over the age of 16people over five whose health puts them at greater risk, this includes pregnant womenpeople over five who share a house with somebody with a weakened immune systemOriginally those aged 50-65 were not going to be jabbed. However, the immunisation campaign has been expanded because of the fast spread of variants, uncertainty about how the virus will mutate and the expectation that we will be more social this winter than in previous years – giving the virus more chance to spread.Who gets a winter booster?Moderna is not the only company updating its vaccines, Pfizer has also been developing vaccines that can target Omicron.Follow James on Twitter.More on this storyAll over 50s to get an autumn Covid booster15 July

Published16 hours agoSharecloseShare pageCopy linkAbout sharingImage source, Getty ImagesPig organs have been partially revived an hour after the animals were killed, in a breakthrough with the potential to transform medicine, say US researchers. The technique could increase the number of organs available for transplant and buy doctors more time to save a life if applied to people. The study also challenges assumptions about what happens in the moments between life and death.Experts said the findings were “truly remarkable” and “incredibly significant”.When the heart stops beating, the body is starved of oxygen and the nutrients it needs to survive. Organs swell in size, blood vessels collapse and cells – the building blocks of the body’s organs – begin to die. This cellular death was thought to be rapid and permanent, but researchers at Yale University have undone some of that damage in animals which have been dead for an hour. “We can restore some functions of cells, across multiple vital organs, that should have been dead,” said Prof Nenad Sestan.”These cells are functioning hours after they should not be.”From brain to bodyThe research team performed a similar feat on just pig brains in 2019. Now they have adapted their technology – called OrganEx – to work across a whole body. It uses:A synthetic blood to carry oxygen around the body. This does not clot so it can navigate the collapsing blood vessels within the pigA cocktail of 13 compounds to interrupt the chemical processes that culminate in cells dying (known as apoptosis) and to calm the immune systemA device to rhythmically pump the fluid around the body to mimic the pulse of a beating heart The experiments, published in the journal Nature, involved about 100 pigs and were given ethical approval before going ahead.Scientists deeply anaesthetised the animals and then stopped their hearts. After being dead for an hour, they were connected to the OrganEx system and given the restorative cocktail for six hours. The anaesthetic was maintained throughout the experiments.After the six hours, the scientists dissected the pigs’ organs such as the heart, liver and kidneys. and showed they were partially revived with some functions restored.There was restoration of electrical activity in the heart, and some heart muscle cells were able to contract. However, the organs were not functioning at the same level as before death.Researcher Dr Zvonimir Vrselja said: “Things are not as dead as we previously presumed – we have demonstrated that we can actually initiate cell-repair on a molecular level. We can persuade cells not to die.”At one point the pigs’ heads and necks began moving spontaneously. It could be a sign they were recovering some motor function, but that will need further investigation.Neuroscientist Dr David Andrijevic said it was a “quite startling moment”. However, he said it was “not indicative of any mental activity on the part of the pig”.Just like the experiment in 2019, there was evidence of repair in the brain. But there were no brainwaves or electrical activity that would suggest consciousness or awareness. Medical advance?It will take considerably more research before the technology could be adapted to be used on people. However, the initial aim is to preserve transplant organs for longer, so they can get to patients who need them. “I think the technology has a great deal of promise for our ability to preserve organs after they’re removed from a donor,” said Dr Stephen Latham, the director of Yale’s interdisciplinary centre for bioethics.More distant ambitions include making even more people suitable organ donors after death and even as a treatment.Commenting on the study, Dr Sam Parnia, director of critical care and resuscitation research at New York University, said the study was “truly remarkable and incredibly significant” and it could help explain reports of near-death experiences. He said the technology could also be used to buy more time for doctors to treat people whose bodies were starved of oxygen, such as those who died from drowning or heart attacks. He added that this could “bring such people back to life many hours after death”.Follow James on Twitter.

Published37 minutes agoSharecloseShare pageCopy linkAbout sharingImage source, Getty ImagesA man who has lived with HIV since the 1980s seems to have been cured in only the fourth such case, say doctors.He was given a bone marrow transplant to treat blood cancer leukaemia from a donor who was naturally resistant to the virus.The 66-year-old, who does not want to be identified, has stopped taking HIV medication.He said he was “beyond grateful” the virus could no longer be found in his body.The man is known as the “City of Hope” patient after the hospital where he was treated in Duarte, California.Many of his friends died from HIV in the era before antiretroviral drugs could give people a near-normal life expectancy.’I never thought I would see the day’Human immunodeficiency virus (HIV) damages the body’s immune system. This can lead to Aids (acquired immunodeficiency syndrome) and the body struggling to fight off infection.In a statement, the man said: “When I was diagnosed with HIV in 1988, like many others, I thought it was a death sentence.”I never thought I would live to see the day that I no longer have HIV.”However, he was given the therapy not for his HIV, but because he developed the blood cancer leukaemia at the age of 63.The man’s medical team decided he needed a bone marrow transplant to replace his cancerous blood cells. By coincidence, the donor was resistant to HIV.Image source, Getty ImagesThe virus gets into our body’s white blood cells by using a microscopic doorway – a protein called CCR5.However, some people, including the donor, have CCR5 mutations that bolt the door shut and keep out HIV.Cure remains ‘Holy Grail’The City of Hope patient was closely monitored after the transplant, and levels of the HIV became undetectable in his body.He has now been in remission for more than 17 months.”We were thrilled to let him know that his HIV is in remission and he no longer needs to take antiretroviral therapy that he had been on for over 30 years,” said Dr Jana Dickter, an infectious diseases doctor at City of Hope.The first time this happened was in 2011 when Timothy Ray Brown – known as the Berlin Patient – became the first person in the world to be cured of HIV.There have now been three similar cases in the past three years.The City of Hope patient is both the oldest patient to be treated in this way and the one who has lived with HIV for the longest time.However, bone marrow transplants are not going to revolutionise HIV treatment for the 38 million people in the world currently infected.Dr Dickter told me: “It’s a complex procedure with significant potential side effects. So, it’s not really a suitable option for most people living with HIV.”However, researchers are looking at ways of targeting the CCR5 doorway using gene therapy as a potential treatment.The case was reported at the Aids 2022 conference in Montreal, Canada.Commenting on the findings, Prof Sharon Lewin, president-elect of the International Aids Society, said: “A cure remains the Holy Grail of HIV research.”She said there had been a “handful of individual cure cases before” and they provided “continued hope for people living with HIV, and inspiration for the scientific community.”

Published8 hours agoSharecloseShare pageCopy linkAbout sharingImage source, Elliott MasonA “transformational” therapy has effectively cured people with the bleeding disorder haemophilia B, say British doctors. The treatment corrects a genetic defect that leaves people’s blood struggling to clot and stop bleeding. Elliott Mason, who was part of the trial which tested the therapy, says his life now feels “completely normal”. The medical team says the majority of adults with haemophilia could be cured in the next three years. From the day Elliott was born, he was unable to make enough of a crucial protein called clotting factor IX. When you cut yourself and it scabs over, clotting factor IX is one of the proteins that stops the bleeding. It meant Elliott grew up “anxious of getting hurt”, and teachers “wrapped me up in bubble wrap”. The sport he wanted to play – rugby – was completely off limits. “I didn’t like the fact that I was different and not able to do things,” he says.At one point, Elliott was having injections of factor IX every other day in order to prevent a deadly bleed. But he managed to stay healthy, unlike many others with haemophilia who face severe damage to their joints from the bleeding.”We have a lot of young patients in excruciating agony and there’s nothing we can do to reverse the joint damage,” says Prof Pratima Chowdary, from the Royal Free Hospital and University College London. Gene therapyElliot was given an engineered virus that was filled with the instructions for manufacturing the missing factor IX.The virus acts like a microscopic postman that delivers the blueprints to the liver, which then starts producing the clotting protein.It was a one-off infusion that took about an hour to drip into Elliott’s body. He recalls being “astonished” to see the amount of factor IX in his blood go from only 1% of normal levels to normal. Image source, Elliott MasonThe findings, published in the New England Journal of Medicine, showed nine out of 10 patients given the therapy no longer needed their clotting factor IX injections. “I’ve not had any treatment since I had my therapy, it’s all a miracle really, well it’s science, but it feels quite miraculous to me,” says Elliott, who now lives in London.”My life is completely normal, there’s nothing that I have to stop and think ‘how might my haemophilia affect this?’.” For Elliott, that includes skiing and riding a motorbike. ‘Very excited'”We’re very excited by the results,” said Prof Chowdary. She says there was a “transformational impact” about a year after the therapy, when suddenly people realised: “I don’t need to worry about my haemophilia at all.” This trial is just the latest in a series of breakthroughs in treating both haemophilia A and B. Haemophilia A trial results ‘mind-blowing’Prof Chowdary told me she’s now “looking for my next job”, as curing haemophilia “will be a reality for the majority of the adults in the next one to three years.”But there are still questions which need answering:How much will the gene therapies cost? Current clotting factor injections can cost between £150,000 and £200,000 per patient per year How long will the treatment last? Studies suggest it will be at least a decade, but nobody knows for sureHow early in life can the therapy be given? Before the age of 12 the liver is still developing, but scientists hope it will be an option from then onClive Smith, chairman of the Haemophilia Society, said: “This initial data is promising, but we continue to monitor gene therapy trials closely and cautiously, as with all new treatments. “If they are shown to be safe and effective, NICE [National Institute for Health and Care Excellence] and the NHS must work together to make these innovative treatments available.” Follow James on Twitter.

SharecloseShare pageCopy linkAbout sharingImage source, SPLIf you’re still reeling from the Covid pandemic, well sorry but there’s another virus to get to grips with. This time it’s monkeypox and there are around 80 confirmed cases in 11 countries, including the UK, that would not normally expect to have the disease. So what is going on? Is it time to worry or are we getting overly excited having just lived through Covid?Let’s be clear: this is not another Covid and we’re not days away from lockdowns to contain the spread of monkeypox. However, this is an unusual and unprecedented monkeypox outbreak. It has taken scientists who specialise in the disease by complete surprise and it is always a concern when a virus changes its behaviour.Until now, monkeypox was pretty predictable. The virus’s natural home is wild animals, which are actually thought to be rodents rather than monkeys. Somebody in the rainforests of Western and Central Africa comes into contact with an infected creature and the virus makes the jump across species. Their skin erupts in a rash, which blisters and then scabs over. The virus is now outside its usual home and struggles to spread so it needs prolonged close contact to keep going. So outbreaks tend to be small and burn out on their own. Small numbers of cases have cropped up elsewhere in the world before, including the UK, but all can be immediately linked to somebody travelling to an affected country and bringing it home. That is no longer the case. For the first time the virus is being found in people with no clear connection to Western and Central Africa It is not clear who people are catching it from Monkeypox is spreading during sexual activities with most cases having lesions on their genitals and the surrounding areaMany of those affected are gay and bisexual young men “We’re in a very new situation, that is a surprise and a worry,” Prof Sir Peter Horby, the director of the University of Oxford’s Pandemic Sciences Institute, told me.While he says this is “not Covid-Two”, he said “we need to act” to prevent the virus getting a foothold as this is “something we really want to avoid”.Dr Hugh Adler, who has treated patients with monkeypox, agrees: “It’s not a pattern we’ve seen before – this is a surprise.”So what’s going on?We know this outbreak is different, but we don’t know why. There’s two broad options – the virus has changed or the same old virus has found itself in the right place at the right time to thrive. Monkeypox is a DNA virus so it does not mutate as rapidly as Covid or flu. Very early genetic analysis suggests the current cases are very closely related to forms of the virus seen in 2018 and 2019. It is too early to be sure, but for now there is no evidence this is a new mutant variant at play.Image source, Science Photo LibraryBut a virus doesn’t have to change in order to take advantage of an opportunity, as we have learned from unexpected large outbreaks of both Ebola and Zika virus in the last decade. “We always thought Ebola was easy to contain, until that wasn’t the case,” said Prof Adam Kucharski, from the London School of Hygiene and Tropical Medicine. It’s not clear why gay and bisexual men are disproportionately affected. Are sexual behaviours making it easier to spread? Is it just coincidence? Is it a community that is more aware of sexual health and getting checked out? It may also be getting easier for monkeypox to spread. The mass smallpox vaccinations of the past would have given older generations some protection against the closely related monkeypox. “It is probably transmitting more effectively than in the smallpox era, but we’re not seeing anything suggesting it could run rampant,” said Dr Adler, who still expects this outbreak to burn itself out.Image source, UKHSAUnderstanding how this outbreak started will help predict what happens next. We know we’re only seeing the tip of the iceberg as the cases being detected don’t fit into a neat picture of this person passed it on to that person etc. Instead many of the cases appear unrelated, so there are missing links in a chain that seems to spread across Europe and beyond. A recent massive superspreading event, in which large numbers of people gathered and caught monkeypox at the same venue such as a festival and then took it home to different countries, could explain the current situation.The alternative explanation for so many unconnected people getting infected is if the virus has actually been bubbling along unnoticed for quite some time involving a lot of people. Either way, we can expect to continue to find more cases. “I don’t think the general public need to be worried at this stage, but I don’t think we’ve uncovered all of this and we are not in control of this,” said Prof Jimmy Whitworth, from the London School of Hygiene and Tropical Medicine. But remember we are not in the same situation as we were with Covid. Monkeypox is a known virus rather than a new one, and we already have vaccines and treatments. It is mostly mild, although it can be more dangerous in young children, pregnant women and people with weak immune systems. But it spreads more slowly than Covid and the distinctive and painful rash makes it harder to miss than a cough that could be anything. This makes the job of finding people who may have been infected and vaccinating those at risk of catching it easier. However, the World Health Organization’s regional director for Europe, Hans Kluge, has warned that “as we enter the summer season… with mass gatherings, festivals and parties, I am concerned that transmission could accelerate”.Follow James on Twitter

SharecloseShare pageCopy linkAbout sharingImage source, Getty ImagesHow long animals live is linked to how quickly their genetic code mutates, a study suggests. Researchers discovered that mammals – from tigers to humans – have roughly the same number of mutations by the time they die of old age. But short-lived animals tend to burn through their allowance more rapidly, the analysis of 16 species indicates. The researchers say it helps explain why we age and sheds light on one of cancer’s most perplexing mysteries. Experts said the findings, by researchers at the Wellcome Sanger Institute, were “staggering” and “thought-provoking”.Mutations are changes that creep into the instruction manual for building and running our bodies – our DNA.Those mutations have long been known to be at the root of cancer, but whether they were important for ageing has been debated for decades. Researchers at Wellcome say they have produced “the first experimental evidence” suggesting they are. They analysed how quickly mutations occur in species with different life expectancies. They looked at DNA from a cat, black and white colobus, dog, ferret, giraffe, horse, human, lion, mouse, naked mole rat, rabbit, rat, ring-tailed lemur and a tiger. The study, published in the journal Nature, showed mice rattle through nearly 800 mutations a year during their short lives, which last just under four years. And the longer animals live, the fewer mutations they pick up each year. Dogs have around 249 annual mutations, a lion 160 and a giraffe 99. Humans averaged 47.Image source, Getty ImagesOne of the researchers, Dr Alex Cagan, said the pattern was “striking” and it was “really surprising and exciting” that all the animals in the study converged on “about 3,200″ mutations across their lifetime. If people’s DNA mutated at the same rate as that of mice, we would die with more than 50,000 genetic alterations.”Despite having different lifespans, at the end of life the mammals had the same number of mutations,” Dr Cagan told the BBC.”This is the number, but what does it mean? It’s a mystery to us,” he said.It could be the cells in the body reach a critical number of mutations and then conk out. There are also ideas that “a few [cells] behaving badly” start to take over critical tissue, such as in the heart, as we age, so organs do not function properly. Ageing, however, is unlikely to be down to a single process inside our bodies’ cells. Telomere shortening and epigenetic changes are also thought to play a role. However, if mutations are involved, then it poses the question whether there are ways of slowing the genetic damage or even repairing it. The researchers want to see whether this pattern holds true for all life or just for mammals. They are aiming to add fish to the analysis, including a Greenland shark, which can live to over 400 years old and is the longest-living vertebrate in the world.Cancer paradoxIn cancer science there is a conundrum known as “Peto’s paradox” – why don’t big, long-living animals have sky-high rates of cancer?The more cells there are in your body and the longer you live, the greater the chance that one of them becomes cancerous. This should be terrible news for elephant and whales.”Whales have trillions more cells [than us]. They shouldn’t exist as they’d have cancer before adulthood,” says Dr Cagan.Big animals tend to live longer, so their slower mutation rate could help explain the paradox, but the researchers say this is far from the whole story. Image source, Getty ImagesNaked mole rats and giraffes both live to broadly the same age, with similar mutation rates, despite giraffes being thousands of times larger.”You’d expect the giraffe’s mutation rate to be even lower, but it’s like body size doesn’t matter,” said Dr Cagan. Instead, the researchers argue that other methods of suppressing cancer must have evolved – which could inspire new cancer therapies. For example, elephants have more copies of a chunk of DNA that suppresses tumours. Dr Alexander Gorelick and Dr Kamila Naxerova, from Harvard Medical School, said the gulf between a human’s 47 mutations a year and a mouse’s 800 was huge..”This difference is staggering, given the large overall similarities between human and mouse genomes.”These results are thought-provoking.”Dr Simon Spiro, a wildlife veterinary pathologist at the Zoological Society of London, said: “Animals often live much longer in zoos than they do in the wild, so our vets’ time is often spent dealing with conditions related to old age. “The genetic changes identified in this study suggest that diseases of old age will be similar across a wide range of mammals, whether old age begins at seven months or 70 years.”Follow James on Twitter

SharecloseShare pageCopy linkAbout sharingImage source, Getty ImagesWe have the technology to start a new era in medicine by precisely matching drugs to people’s genetic code, a major report says.Some drugs are completely ineffective or become deadly because of subtle differences in how our bodies function.The British Pharmacological Society and the Royal College of Physicians say a genetic test can predict how well drugs work in your body. The tests could be available on the NHS next year.Your genetic code or DNA is an instruction manual for how your body operates. The field of matching drugs to your DNA is known as pharmacogenomics.It would have helped Jane Burns, from Liverpool, who lost two-thirds of her skin when she reacted badly to a new epilepsy drug.She was put on to carbamazepine when she was 19. Two weeks later, she developed a rash and her parents took her to A&E when she had a raging fever and began hallucinating. The skin damage started the next morning. Jane told the BBC: “I remember waking up and I was just covered in blisters, it was like something out of a horror film, it was like I’d been on fire.” Image source, Jane BurnsHer epilepsy medicine caused Stevens-Johnson syndrome, which affects the skin and is far more likely to happen in people who are born with specific mutations in their genetic code. Mrs Burns says she was “extremely, extremely lucky” and said she supports pharmacogenomic tests.”If it saves your life, then it’s a fantastic thing.”Nearly everyone is affectedJane’s experience may sound rare, but Prof Mark Caulfield, the president-elect of the British Pharmacological Society, said “99.5% of us have at least one change in our genome that, if we come across the wrong medicine, it will either not work or it will actually cause harm.”More than five million people in the UK get no pain relief from codeine. Their genetic code does not contain the instructions for making the enzyme that breaks codeine down into morphine and without it, the drug’s a dud.The genetic code of one in 500 people puts them at higher risk of losing their hearing if they take antibiotic gentamicinPharmacogenomics is already used for some medicines. In the past, 5-7% of people would have a bad reaction to the HIV drug abacavir and some died. Testing people’s DNA before prescribing the drug means the risk is now zero.Scientists have looked at the 100 most prescribed drugs in the UK. Their report says we already have the technology to roll out genetic testing to guide the use of 40 of them.The genetic analysis would cost about £100 and could be done using either a sample of blood or saliva.Initially, the vision is to perform the test when one of the 40 drugs is prescribed. In the long term, the ambition is to test well ahead of time – possibly at birth if genetic testing of newborns goes ahead, or as part of a routine check-up in your 50s. Precision”We need to move away from ‘one drug and one dose fits all’ to a more personalised approach, where patients are given the right drug at the right dose to improve the effectiveness and safety of medicines,” said Prof Sir Munir Pirmohamed, from the University of Liverpool.”What we’re doing is really going to a new era of medicine, because we’re all individuals and we all vary in the way we respond to drugs.” He said that as we age and are prescribed more and more drugs, there’s a 70% chance that by the age of 70 you will be on at least one drug that is influenced by your genetic make-up. Lord David Prior, the chairman of NHS England, said: “This will revolutionise medicine.”He said pharmacogenomics “is the future” and “it can now help us to deliver a new, modern personalised healthcare system fit for 2022”.Follow James on Twitter

SharecloseShare pageCopy linkAbout sharingA vaccine has been used to free a man who was trapped at home by a Covid infection that lasted for more than seven months. It is the first time that a vaccine has been used to “treat” Covid rather than “prevent” it. Ian Lester, 37, has a weakened immune system that was unable to defeat the virus on its own. He says he became a prisoner in his home in Caerphilly, Wales, as he isolated for months on end. Ian was born with Wiskott-Aldrich syndrome, which makes it harder for him to fight off infections. Even a common cold can linger. He shielded during the first wave of Covid, but coronavirus eventually found him in December 2020. He had one of the classic symptoms – a slight loss of sense of taste and smell – which cleared up within a month. For most of us that would be the end of it, but Ian’s Covid journey was only just beginning. His doctors wanted him to keep on testing because his weakened immune system meant there was a risk he could be contagious for longer than normal.But month after month, test after test came back positive. Ian had to give up work at the opticians where he’d be in close contact with others and stay at home. Initially he tried to make the most of it, and the Christmas tree stayed up through January, but eventually the isolation took its toll.”People would feel like it’s going to be a long holiday, but after the three-month mark it wasn’t,” Ian told me.Slowly every day began to feel the same – a pattern of cooking, TV, reading, playing guitar and just waiting for his wife Katie to get home.Ian said: “It was like living in groundhog day, you just end up sitting there staring at the wall. “It slowly became my prison cell, especially when it got to the summertime and the restrictions were lifting for everyone else, you could see family and friends starting to get back to a real life, and I was still getting these positive results.” Ian started to become ill again after the three-month mark. Fatigue, headaches, insomnia, and a tight chest all set in, he was struggling to concentrate and every three to four weeks there would be a build-up of sticky mucous on his lungs. It was never enough to need hospital treatment, but it was clear his body wasn’t easily shrugging off Covid.”I was worried that I’d keep on getting worse and worse and worse and never get rid of it,” he said.Scientists and doctors were monitoring the battle between the virus and Ian’s immune system at Cardiff University and at the Immunodeficiency Centre for Wales in the University Hospital of Wales. The analysis showed Ian had a long-term infection, it was not just “dead virus” being detected, and his symptoms were not long-Covid. “Ian really didn’t have much of an immune response at all against the Covid virus,” Dr Mark Ponsford, a clinician scientist at Cardiff University, told the BBC.They could not find antibodies that would stick to and neutralise the coronavirus, and there were only limited signs of T-cells, another wing of the immune system, that could attack Covid. At the time, in the early summer of 2021, there were limited treatments, so the medical team decided to try something radical. Instead of giving a vaccine to prevent an infection, they decided to use the Pfizer vaccine to treat one. The difference in Ian’s body “was like night and day”, says Dr Ponsford. The first dose started to build his immunity, but it took a second dose to reach the point where his body could fight off the virus. By the end of August, Ian was testing negative again. So why was the vaccine able to clear the infection, when months of having the virus did not build up enough immunity?Prof Stephen Jolles, clinical lead at the Immunodeficiency Centre, said: “This infection was burbling along, but with his [weakened] immune system it was just not enough to kick off a response sufficient to clear it. “So the vaccine really made a huge difference, in antibodies and T-cells, and utilised and squeezed every last drop out of what his immune system could do.” On the day Ian was finally clear of Covid he was “ecstatic” and says “I couldn’t believe it to tell you the truth”. He celebrated with a day on the beach and a portion of fish and chips with Katie. “Everything’s back to normal now,” he says.The researchers think this approach can be used in more people with weakened immune systems who are struggling to fight off the infection. There are anti-viral drugs now that were not available when Ian had Covid, but the team think vaccines could offer a cheaper and more durable option. Follow James on Twitter

SharecloseShare pageCopy linkAbout sharingImage source, Getty ImagesThe frontiers of organ transplantation have been pushed further than ever before. The first organs taken from genetically engineered pigs have been put into people and the recipient of the first pig heart managed to survive for two months. So how close are we to using pigs for a limitless supply of organs to solve the global shortage? Silence descends on the operating theatre and the tension builds until it’s almost a physical presence in the room.Surgeons have just connected a pig’s kidney to a human body. The clamps have been released and human blood is now flowing into the pig organ. “You could have heard a pin drop,” says transplant surgeon Dr Jayme Locke.Success or failure will be determined in moments and there is now just a single question on everyone’s minds: “Pink or black?”If the body unleashes a horrendous assault on the foreign organ – holes will be ripped in every cell in the pig tissue and the organ will clot from the inside out. It will go splotchy, then blue, then completely black within minutes.If “hyperacute rejection” is avoided, the organ will blush pink with the flow of blood and oxygen. “It turned beautiful and pink… the sense of relief, the sense of joy and hope just filled the room. We might have high-fived as well,” said Dr Locke, from the University of Alabama at Birmingham, in the US.This operation was just one of a series of medical breakthroughs that have renewed interest in the field of xenotransplantation.Image source, Steve WoodUsing animal organs in the human body is an old idea, and has ranged from “zest for life” chimpanzee testicle implants to replacement kidneys and hearts taken from our primate relatives. The latter often ended in death soon afterwards. The problem is, our immune system treats the transplanted organ like an infection and attacks. The focus these days is on pigs, as their organs are roughly the right size and we have centuries of experience farming them.But the challenge of hyperacute rejection – keeping organs pink, not black – is the same. You can’t just pop down to the farm, choose a pig and transplant its organs. It’s taken huge advances in genetic engineering to alter pigs’ DNA so their organs are more compatible with our immune systems. Inside Health is broadcast on BBC Radio 4 on Tuesdays at 2100 GMT – and Wednesdays at 1530 GMT. It is also available as a podcast on BBC Sounds.Listen to Pig organs for transplant patientsThe recent kidney and heart transplants have taken organs from the specially designed “10-gene pig”.It has one genetic tweak to prevent any donated organs responding to human growth hormones and growing out of control. Another key alteration removes a sugary molecule, called alpha-Gal, which sticks to the surface of pig cells and acts like a gigantic flashing neon sign marking the tissue as absolutely alien. A wing of our immune system, called the complement system, is constantly patrolling the body looking for alpha-Gal. That’s why organs can be rejected and killed moments after they are transplanted. Two other “neon signs” were genetically removed and six human ones added in, acting like a camouflage net over the pig cells to help hide them from the immune system. The resulting 10-gene pigs are then raised in sterile conditions so they are suitable for transplant. The kidney and the heartThe pair of pig kidneys were transplanted into the brain-dead body of Jim Parsons in September 2021. He’d wanted to be an organ donor when he died and when his kidneys were donated, pig kidneys were put in their place with permission from his family.Dr Locke describes the moment one of the kidneys started making urine as “remarkable” and feels xenotransplantation can “really change people’s lives, and to be blunt, save their lives”. She’s expecting to start clinical trials later this year. Image source, Parsons familyThat operation was a three-day-long experiment, but meanwhile, surgeons at the University of Maryland Medical Center were about to go one step further. Their patient, David Bennett, 57, had severe heart failure. He was not deemed suitable for a human heart transplant and was being kept alive by an Ecmo machine, which supported his heart and lungs.Mr Bennett described having a pig heart as a “shot in the dark”.A 10-gene pig was driven to the hospital and on 7 January, its heart was placed inside David Bennett’s chest. The operation was tricky because Mr Bennett’s diseased heart had swollen, so connecting the blood vessels to the smaller pig-heart was a challenge.Again there was the nervous moment to see whether the heart would be rapidly rejected, but it was beating and stayed pink. Dr Muhammad Mohiuddin, the hospital’s director of cardiac xenotransplantation, said he did not expect to witness this “in my lifetime”.When I spoke to him on the one-month anniversary of the operation he said there were no signs of the organ being rejected, but Mr Bennett was still frail.”We put a new Ferrari engine in a 1960s car. The engine is working great but the rest of the body has to adjust,” he said.Image source, UMSOMBut Mr Bennett died two months after the transplant. The cause, and therefore the implications for xenotransplantation, is still uncertain.Mr Bennett was very frail before the operation and it is possible that even the new heart was not enough. No signs of organ rejection have been reported, but if detailed analysis of the heart shows signs of the immune system attacking it, the 10-gene pig may need further modifications to make its organs suitable for the human body. Alternatively, it could come down to anatomy, and pig hearts may not be up to the job in a human body. Our hearts have to work much harder to fight gravity than a pig’s because we walk on two legs rather than four. Chris Denning, a professor of stem cell biology at the University of Nottingham, said overcoming hyperacute rejection meant the heart transplant would be considered “a success”. He said if the issue was frailty, then xenotransplantation “could be successful in the future” but if it came down to anatomy then it could “be potentially a show-stopper”.The hospital plans to continue doing clinical trials. Image source, University of Maryland School of MedicinePig hearts do not have to be as good as a human heart to still save huge numbers of lives, according to Prof John Wallwork, one of the UK’s most eminent transplant surgeons. Many people die waiting for a transplant.Prof Wallwork, who conducted the world’s first heart-lung-liver transplant and was an early pioneer of xenotransplantation, says it’s better to give 1,000 people a 70% chance of survival with a pig heart than 100 people an 85% chance with a human heart. “So if it’s not quite as good as human transplantation, then we’ve still done more good than not doing the 1,000 patients,” he said.Xenotransplantation has always felt like the next big thing in transplant medicine. There’s no doubt a series of landmark operations have been performed, but only more research will tell us whether the field – and its grand dreams – will ever come of age. Dr Locke added: “Our goal would be to have one 10-gene edited pig be able to save a patient with kidney failure, a patient with liver failure, a patient with heart failure and a patient with end-stage lung disease.”That would be a remarkable accomplishment and I genuinely believe that we will be there during my lifetime.”Follow James on Twitter More from Inside HealthSickle cell: ‘The revolutionary gene-editing treatment that gave me new life’Asthma: Why switching inhaler could be better for you and the planetVegan ready meals: How healthy are they?More on this storyMan given genetically modified pig heart diesThree ethical issues around pig heart transplants