Publisher Health

Researchers have known for some time that insulin plays a vital role in regeneration and growth in some types of neurons that relay environmental sensory information to our brains, such as sight. However, they know relatively little about the role of insulin in the sense of smell. Now, investigators at the Monell Chemical Senses Center have shown that insulin plays a critical role in the maturation, after injury, of immature olfactory sensory neurons (OSNs). The team published their findings in eNeuro earlier this month.
“Our findings suggest that applying insulin into the nasal passage could be developed as a therapy for injury caused by a host of issues,” said first author Akihito Kuboki, MD, a postdoctoral fellow in the lab of Johannes Reisert, PhD.”
Knowing that insulin is part of the body’s repair pathway for visual neurons, Kuboki suspected that the hormone might also play a role in the maturation of OSNs after injury. He also notes there are many insulin receptors in the olfactory region of the brain. Taking these factors into account, Kuboki concluded that insulin may also be involved in the sense of smell.
“Although scientists don’t yet have a clear idea of how it works, we know that insulin plays a key role in preventing cell death,” said Kuboki. “If insulin levels are reduced, diabetes patients have a high susceptibility to cell death, which can cause smell loss.” He is pursuing this research path to shed light on why people with diabetes often suffer from smell loss, or anosmia.
The research team induced diabetes type 1 in mice to reduce levels of circulating insulin reaching the OSNs. The reduced insulin interfered with the regeneration of OSNs, resulting in an impaired sense of smell. They analyzed how the structure of the olfactory tissue in the nasal cavity and the olfactory bulb is impaired by comparing the number of mature OSNs and how well the axons of OSNs reached the olfactory bulb. The team also recorded odorant-induced responses in the OSNs in the nasal cavity. An odor-guided behavioral task, in which the mice needed to find a cookie reward depending on their ability to smell, measured olfactory function.
In addition, the team injured OSNs, which have a unique ability to regenerate in mammals. This approach allowed the investigators to ask whether OSNs required insulin to regenerate, which they found to be true. What’s more, they discovered that OSNs are highly susceptible to insulin deprivation-induced cell death eight to 13 days after an injury. This time window indicates that during a critical stage newly generated OSNs are dependent on insulin. They also found that insulin must be applied to regenerating OSNs at this critical time point in the neurons’ growth to be able to restore a mouse’s sense of smell.
Also of significance, the team found that insulin promotes regeneration of regenerating OSNs in both type 1 diabetic and nondiabetic mice. “Even in nondiabetic mice, we found that insulin can promote the regeneration of OSNs, which suggests that this could be a therapy for olfactory dysfunction in patients without diabetes,” said Kuboki. Specifically, the team only examined the OSN regeneration process after injury in type 1-diabetic mice and did not examine the effects of type 2 diabetes, but plan to in the future.
“Our findings suggest that insulin plays important roles when OSNs need to regenerate after severe injury that induces cell death in many OSNs,” said Kuboki. “From this, we hope that an insulin spray can be potentially applied to treat smell loss for various reasons, including head trauma and viral infection.”
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Materials provided by Monell Chemical Senses Center. Note: Content may be edited for style and length.

President Biden’s pledge to ship out doses that could have been used domestically was a step toward a global campaign, but activists say much more is needed.WASHINGTON — President Biden, heeding widespread calls to step up his response to the pandemic’s surge abroad, said on Monday that his administration would send 20 million doses of federally authorized coronavirus vaccine overseas in June — the first time he has pledged to give away doses that could be used in the United States.The donation is another step toward what Mr. Biden promised would be an “entirely new effort” to increase vaccine supplies and vastly expand manufacturing capacity, most of it in the United States. He also put Jeffrey Zients, the White House coronavirus response coordinator, in charge of developing a global strategy.“We know America will never be fully safe until the pandemic that’s raging globally is under control,” Mr. Biden said in a brief appearance at the White House. “No ocean’s wide enough, no wall’s high enough, to keep us safe.”With new cases and deaths plummeting as vaccination rates rise in the United States, the epicenter of the crisis has moved to India and other nations. A growing and bipartisan chorus of diplomats, health experts and business leaders has been pushing the president to do more to end what the AIDS activist Asia Russell calls “vaccine apartheid.”Mr. Biden said on Monday that 20 million doses of the Pfizer-BioNTech, Moderna and Johnson & Johnson vaccines — all approved for domestic use — would be sent abroad. That is in addition to the 60 million doses of AstraZeneca’s vaccine he pledged last month, though those doses are not approved for domestic use and cannot be released until regulators deem them safe.“He’s crossed the threshold into direct donations,” said J. Stephen Morrison, a global health expert at the Center for Strategic and International Studies, which teamed up with three other health institutes on Monday to release a plan to ramp up vaccine supply. “That’s an important shift.”International health activists want far more.“Donating 80 million doses of vaccines without a plan to scale up production worldwide is like putting a Band-Aid on a machete wound,” said Gregg Gonsalves, a longtime AIDS activist.Those 80 million doses amounted to five times the number that any other country had donated, Mr. Biden said, noting that taking the lead in helping the world beat back the coronavirus was a chance to reassert American authority. And unlike Russia and China, which have sought to use their vaccines as an instrument of diplomacy, the United States will not expect any favors in return, the president said.“We want to lead the world with our values, with this demonstration of our innovation and ingenuity, and the fundamental decency of the American people,” Mr. Biden said. “Just as in World War II America was the arsenal of democracy, in the battle against the Covid-19 pandemic our nation’s going to be the arsenal of vaccines for the rest of the world.”Mr. Biden’s announcement came not long after a World Health Organization news conference at which the director general, Dr. Tedros Adhanom Ghebreyesus, said that countries with high vaccination rates had to do more to help countries that were being hit hard by the coronavirus, or the entire world would be imperiled.“There is a huge disconnect growing where, in some countries with the highest vaccination rates, there appears to be a mind-set that the pandemic is over, while others are experiencing huge waves of infection,” Dr. Tedros said.Variants like B.1.617, first discovered in India and recently designated a variant of concern by the W.H.O., are contributing to the spread of infections and worry many researchers.Dr. Tedros called for well-supplied nations to send more of their vaccine allocations to harder-hit countries, and for vaccine developers and manufacturers to hasten delivery of hundreds of millions of doses to Covax, an international initiative dedicated to equitable distribution of the vaccine, noting an appeal by Henrietta Fore, UNICEF’s executive director.Mr. Biden took office vowing to restore the United States as a leader in global public health, and he has taken certain steps to do so: rejoining the World Health Organization, pledging $4 billion to an international vaccine effort and providing financial support to help Biological E, a vaccine manufacturer in India, produce at least one billion doses of coronavirus vaccines by the end of 2022.To broaden supply further, Mr. Biden recently announced he would support waiving intellectual property protections for coronavirus vaccines. But activists say simply supporting the waiver is not enough; Mr. Biden must create the conditions for pharmaceutical companies to transfer their intellectual property to vaccine makers overseas, they argue. They view his efforts as piecemeal.“We’re after 100 days into the administration, and what Biden should be delivering is a global battle plan against vaccine apartheid, and the announcement today is lines on a Post-it note,” Ms. Russell said, adding, “There must be a global strategy led by the U.S. that’s based on technology transfer, on forcing pharma to come to the table to share the recipe.”The pharmaceutical industry opposes waiving the Agreement on Trade-Related Aspects of Intellectual Property Rights, known as TRIPS. Vaccine manufacturers assert that a fix is already at hand as they aggressively expand production lines and contract with counterparts around the world to yield billions of additional doses.An open letter to the president, made public last week by a bipartisan group including business leaders, diplomats and a former defense secretary, argued that such a waiver “would make little difference and could do harm.”While global health activists are strongly in favor of the waiver, some said they welcomed the views of the business community. They see clear parallels to their work fighting the global AIDS epidemic.“It shows an unprecedented willingness of pharma and its allies in the private sector to admit what all of us having been saying for months — the private sector alone cannot and will not ensure global vaccine access,” James Krellenstein, a founder of PrEP4All, a nonprofit aimed at ensuring universal access to H.I.V. prevention and treatment, wrote in an email on Sunday. “It really shifts the burden to the Biden administration,” he added.The organizer of the open letter, Hank Greenberg, the chairman of Starr Companies and former chairman of American International Group, the insurance industry giant, said in an interview on Monday that Mr. Biden’s announcement did not go far enough.Mr. Greenberg, 96, a veteran of World War II, said he was inspired to write after a former chief executive of an A.I.G. subsidiary who later became the ambassador from the Philippines to the United States told him he was not able to get vaccinated. Like Mr. Biden, he used language that evoked the war effort.“If we don’t do it,” he asked, “who will?”

Face coverings have been a political flash point for more than a year. But now, the backlash is directed at people who don’t plan to take them off.Whenever Joe Glickman heads out for groceries, he places an N95 mask over his face and tugs a cloth mask on top of it. He then pulls on a pair of goggles.He has used this safety protocol for the past 14 months. It did not change after he contracted the coronavirus last November. It didn’t budge when, earlier this month, he became fully vaccinated. And even though President Biden said on Thursday that fully vaccinated people do not have to wear a mask, Mr. Glickman said he planned to stay the course.In fact, he said, he plans to do his grocery run double-masked and goggled for at least the next five years.Even as a combination of evolving public health recommendations and pandemic fatigue lead more Americans to toss the masks they’ve worn for more than a year, Mr. Glickman is among those who say they plan to keep their faces covered in public indefinitely.For people like Mr. Glickman, a combination of anxiety, murky information about new virus variants and the emergence of an obdurate and sizable faction of vaccine holdouts means mask-free life is on hold — possibly forever.“I have no problem being one of the only people,” said Mr. Glickman, a professional photographer and musician from Albany, N.Y. “But I don’t think I’m going to be the only one.”Whether made of bedazzled cloth or polypropylene, masks have emerged as a dystopian political flash point during the pandemic. A map of states that enforced mask mandates corresponds closely with how people in those states voted for president.Last year, protesters staged rallies against official requirements to wear masks, built pyres to burn them in protest and touched off wild screaming matches when confronted about not wearing them inside supermarkets.But as more Americans become vaccinated and virus restrictions loosen, masks are at the center of a second round in the country’s culture brawl. This time, people who choose to continue to cover their faces have become targets of public ire.In interviews, vaccinated people who continue to wear masks said they are increasingly under pressure, especially in recent days; friends and family have urged them to relax, or even have suggested that they are paranoid. On a recent trip to the grocery store, Mr. Glickman said he was stared down by a man who entered, unmasked.“I’m confused,” the retired news anchor Dan Rather wrote on Twitter last week as backlash mounted on the platform to those still masked. “Why should people care if someone wants to wear a mask outside?”Following the latest guidance from the Centers for Disease Control and Prevention, at least 20 states repealed mask mandates or issued orders that gave vaccinated people exemptions from wearing masks. This week, Gov. Andrew M. Cuomo announced that starting Wednesday, New York State would also follow the C.D.C. A handful of other states said they were still reviewing their rules.But for some people, no newfound freedom will persuade them to reveal their faces just yet. After a year, they say they have grown accustomed to the masks and glad for the extra safety they provide.A day after the C.D.C.’s announcement, George Jones, 82, a retired mail carrier, stood in the sunshine outside of the General Grant Houses where he lives in Harlem and said his blue surgical mask — though uncomfortable and inconvenient — would stay put for at least another year.“I’m in no hurry; why should I be in a hurry?” said Mr. Jones, who became fully vaccinated about a month and a half ago. Until New York City reaches a higher level of vaccination — just 40 percent are completely vaccinated — he believes it’s too risky to unmask. “Being around is more important. That’s what counts. I’m an old man — I’d like to be around as long as I can.”On Broadway, a group of young men walked past him, with not a mask in sight. Mr. Jones said he understood: “Young people, they figure they’re invulnerable — and I hope they are.”Public health data shows that masking and social distancing have most likely had far-reaching positive impacts, beyond slowing the spread of Covid-19. While over 34,000 adults died from influenza in the 2018-19 season, this year deaths are on track to remain in the hundreds, according to C.D.C. data. Mask wearers say their seasonal allergy symptoms seem to be lessened.Leni Cohen, 51, a retired kindergarten teacher from New York City who has a compromised immune system, said she planned to continue wearing a mask when she helped out as a substitute teacher. But what she would like more is for her students to stay masked.“Kindergartners, while adorable, are quick to share their secretions,” Ms. Cohen wrote in an email listing the illnesses, including colds, strep throat, pneumonia, influenza and parvovirus, that she has caught from her students over the years.“This year is so different!” she continued. “The kids are not sucking on their hair or putting classroom objects or thumbs in their mouths. Their mouths and noses are covered, so I’m (mostly) protected from their sneezes and coughs. I can see keeping up with masks. It is the safest I’ve ever felt in a classroom full of 5- and 6-year-olds.”Barry J. Neely, 41, a composer from Los Angeles, fell ill with the coronavirus in March 2020 and battled symptoms for months. He has also struggled with guilt over whether he had inadvertently infected people he came in contact with before his diagnosis — which came at a time when the government discouraged mask use.He now plans to wear a mask whenever he feels under the weather, in perpetuity.“It’s not hard to wear a mask,” Mr. Neely said. “It’s not hard in the least.” He is taking his cue from several East Asian countries, he added, where wearing a mask when you’re feeling sick is not just socially acceptable but seen as considerate.People who choose to wear masks even as federal and state restrictions are loosening have become targets of public ire.Cindy Schultz for The New York Times“If I possibly spread a virus a year ago, and then learned that wearing a mask is important to prevent spreading this virus, then what’s the harm in wearing it if I have the common cold?” he said.For a number of so-called perma-maskers, the decision is informed by trauma: They endured the coronavirus or witnessed loved ones die, and they say taking off their mask makes them feel terrifyingly vulnerable.After contracting the coronavirus, Mr. Glickman fell ill with pneumonia. He still experiences gastrointestinal problems and neurological symptoms, including extreme lightheadedness and problems with his sight. “Floaters” swim in his field of vision, and on one occasion, he said, everything turned yellow.Post-coronavirus trauma appears to be common: A survey of nearly 400 Covid patients by doctors at Agostino Gemelli hospital in Italy showed 30 percent developed post-traumatic stress disorder after a severe illness.“There is an element of precaution that is brought on by the emotional and psychological impact with what I went through,” Mr. Glickman said of his masking. “I don’t think it is necessarily unjustified. I think it is somewhere in the middle.”Ms. Cohen, the schoolteacher, also said she recognized possible downsides: “At first, I thought, ‘This is great, I’m never going to get sick again!’” she said, of her plan to wear a mask to teach kindergarten going forward. “Then I realized when I’m trying to teach vowels they can’t see my mouth.”A few say they’ve been surprised to find that they’ve grown to enjoy being hidden behind a mask, expressionless and anonymous.“As a woman, we feel like we have to, when we go out in public, put on a little bit of makeup, eyeliner, blush,” said Keela Samis, 57, an attorney from St. Petersburg, Fla., who is vaccinated and does not plan to stop wearing a mask. “With a mask I don’t have to. It simplified my life.”Ms. Samis added: “Even if I’m the only person on planet Earth that continues to wear the mask, if that’s what makes me feel comfortable, I’ll wear the mask.”

Some 16 million Americans are believed to have alcohol use disorder, and an estimated 93,000 people in the U.S. die from alcohol-related causes each year. Both of those numbers are expected to grow as a result of heavier drinking during the COVID-19 pandemic.
Yet, in a new study involving data from more than 200,000 people with and without alcohol problems, researchers at Washington University School of Medicine in St. Louis found that although the vast majority of those with alcohol use disorder see their doctors regularly for a range of issues, fewer than one in 10 ever get treatment for drinking.
The findings are published in the June issue of the journal Alcoholism: Clinical & Experimental Research.
Analyzing data gathered from 2015 through 2019 via the National Survey on Drug Use and Health, the researchers found that about 8% of those surveyed met the current criteria for alcohol use disorder, the medical diagnosis for those with an addiction to alcohol. Of these people who met the criteria, 81% had received medical care in a doctor’s office or spent time in a hospital or clinic during the previous year. But only 12% reported they had been advised to cut down on their drinking, 5% were offered information about treatment, and 6% received treatment, some of whom were not referred by their doctors but sought out treatment on their own.
“It’s not that these people aren’t in the health-care system,” said first author Carrie M. Mintz, MD, an assistant professor of psychiatry. “But although they see doctors regularly, the vast majority aren’t getting the help they need.”
Mintz and her colleagues evaluated data from 214,505 people. The researchers first wanted to learn whether people with alcohol use disorder had access to health care and if they did, whether they had been screened about their alcohol use; they were considered to have been screened if their doctors simply had asked how much they drink. The researchers also evaluated whether people with drinking problems had been advised to cut down on drinking, had received additional information about treatment, or had received treatment or counseling.

In a world that’s changing fast, the Long Term Ecological Research (LTER) Network can seem almost an anachronism. Yet the patience and persistence that have generated 40 years of careful, reliable science about the Earth’s changing ecosystems may prove to be just what’s needed in this rapidly shifting world. We can’t wait for a crystal ball — and we don’t have to. By harnessing decades of rich data, scientists are beginning to forecast future conditions and plan ways to manage, mitigate, or adapt to likely changes in ecosystems that will impact human economies, health and wellbeing.
The National Science Foundation established the LTER Network more than 40 years ago to provide an alternative to funding models that favored constant innovation over continuity. The model has proven to be extraordinarily successful at both.
This month, in the Ecological Society of America’s open-access journal Ecosphere, LTER researchers present examples of how changing populations — of fish, herbs, trees, kelp, birds and more — both reflect and influence the structure and resilience of ecosystems. The research collection contains 25 vignettes of the unexpected lessons drawn from long term research on populations of plants, animals and microbes — just one small slice of the usable knowledge being generated by this program.
Ecologist Peter Groffman, who led the special collection, says the program is well-positioned to detect big changes. “Climate change is affecting ecological systems in really complex ways that are difficult to see and assess,” Groffman said. “Observing from one point in time or through one method only reveals a slice of the situation. The scientists in the LTER Network combine long-term observations, experiments, models and theory to build up a more comprehensive picture.”
He also highlights the program’s team-oriented approach as being instrumental to its success. “The collaborative and inclusive nature of the network greatly facilitates our ability to address the very hardest questions in ecology and environmental science, and to share that information with the world,” he explained. “We appreciate the National Science Foundation’s vision of a lasting network that makes this environmental problem-solving possible.”
Examples cluster around five main themes: State change. Ecologists have known for decades that one small additional push could tip an ecosystem from prairie to shrubland or from mangrove forest to estuary. But just recognizing a true state change, let alone anticipating and avoiding such transitions, has been largely out of reach. At the Konza Prairie LTER, experimental manipulations of fire frequency, grazing, climate and nutrients allow researchers to identify signs of an impending shift from prairie to juniper woodland, factors (such as decreased fire frequency) that would exacerbate these shifts, and the conditions that would be needed to support restoration. Connectivity. Bringing together researchers from multiple disciplines in one location allows LTER researchers to discern the connections between air, water, plants, microbes, soil and humans that are difficult for individual researchers to capture. In the McMurdo Dry Valleys of Antarctica, summer temperatures normally hover around the freezing point. The summer of 2002 was slightly warmer and windier than average, but solar radiation held steady. Suddenly, streams flowed, soil organisms flourished, and lake productivity increased in this otherwise dry and frozen landscape. Liquid water closed the connections among landscape components that otherwise remained quite separate. LTER researchers, thoroughly familiar with the usual range of conditions, were able to capture and analyze every nuance of the change. Time lags. Time lags are the ultimate “cold case” in ecology. Something — a change in management practices, a fire or hurricane, the gain or loss of a species — changes the way an ecosystem responds years or decades later. Without knowing the history of the system, it is easy to mistake the final straw for the underlying cause. Two decades of slowly warming sea surface temperatures, punctuated by the decadal excursions of El Niño and the Pacific Decadal Oscillation, appeared to produce no discernible change in krill populations of the California Current Ecosystem. Only when researchers also included the previous 40 years of observations by a related project did they detect an increase in krill populations — driven by higher concentrations of nutrients in deeper ocean layers. Cascading effects. Multi-layered, complex linkages in ecosystems can cause changes to propagate in ways that are difficult to anticipate. In the simplest example, reduced predation releases pressure on a population of grazers. More grazers survive, which in turn decimates the plant life at the bottom of the food chain. At Gull Lake in Michigan, increased growth of Microcystis, a toxic cyanobacterium, followed the arrival of zebra mussels in the early 1990s. Typically, Microcystis does better in warmer water, but as water temperatures increased at Gull Lake, Microcystis populations declined. Multiple experiments suggested that the presence of zebra mussels facilitated the growth of Microcystis, perhaps by grazing on the cyanobacterium’s competitors. When a heat wave caused a massive die-off of zebra mussels in Gull Lake, the microcystin toxin declined by ~80%, thus providing a whole-lake confirmation of the experimental results. Resilience. What qualities allow an ecosystem to retain its basic functions in the face of changing conditions? Or to return to the same basic form after a major disturbance? With temperature, nutrients, storms, water, and biodiversity all changing at once in the real world, controlled experiments allow LTER researchers to disentangle interacting influences on resilience. The BioCON experiment, established in 1997 at Cedar Creek LTER, separates the effects of biodiversity loss, increased nitrogen, and increased carbon dioxide, with nitrogen additions decreasing species richness by 16%. In the related TeRaCON experiments, researchers found that high biodiversity can mitigate microclimatic conditions by the equivalent of 2 degrees Celsius.
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The development of dementia, often from Alzheimer’s disease, late in life is associated with abnormal blood levels of dozens of proteins up to five years earlier, according to a new study led by researchers at the Johns Hopkins Bloomberg School of Public Health. Most of these proteins were not known to be linked to dementia before, suggesting new targets for prevention therapies.
The findings are based on new analyses of blood samples of over ten thousand middle-aged and elderly people — samples that were taken and stored during large-scale studies decades ago as part of an ongoing study. The researchers linked abnormal blood levels of 38 proteins to higher risks of developing Alzheimers within five years. Of those 38 proteins, 16 appeared to predict Alzheimer’s risk two decades in advance.
Although most of these risk markers may be only incidental byproducts of the slow disease process that leads to Alzheimer’s, the analysis pointed to high levels of one protein, SVEP1, as a likely causal contributor to that disease process.
The study was published May 14 in Nature Aging.
“This is the most comprehensive analysis of its kind to date, and it sheds light on multiple biological pathways that are connected to Alzheimer’s,” says study senior author Josef Coresh, MD, PhD, MHS, George W. Comstock Professor in the Department of Epidemiology at the Bloomberg School. “Some of these proteins we uncovered are just indicators that disease might occur, but a subset may be causally relevant, which is exciting because it raises the possibility of targeting these proteins with future treatments.”
More than six million Americans are estimated to have Alzheimer’s, the most common type of dementia, an irreversible fatal condition that leads to loss of cognitive and physical function. Despite decades of intensive study, there are no treatments that can slow the disease process, let alone stop or reverse it. Scientists widely assume that the best time to treat Alzheimer’s is before dementia symptoms develop.

A randomized double-blind controlled trial of convalescent plasma for adults hospitalized with severe COVID-19 found that mortality at 28 days in the treatment arm was half the rate seen in the control arm (12.6% vs. 24.6%), although treatment was not associated with other improvements in clinical status.
The study was led by investigators from the Center for Infection and Immunity at Columbia University Mailman School of Public Health; Columbia University Irving Medical Center; ICAP at Columbia University; Instituto Nacional de Infectologia and Hospital Federal dos Servidores do Estado in Rio de Janeiro, Brazil; University of Washington; and New York Blood Center. The results are published in the Journal of Clinical Investigation.
According to the investigators, one possible explanation for the discrepancy between lack of clinical improvement and improved survival is that severely ill Covid-19 patients survived but remained hospitalized at their baseline status. The study also reports trends towards improved clinical status among patients who received convalescent plasma less than seven days after symptom onset and those who received convalescent plasma with higher-titers of neutralizing antibody and concomitant corticosteroids.
The investigators conducted this randomized, double-blind, placebo-controlled trial among adults hospitalized with severe and critical COVID-19 at 5 sites, including 73 patients enrolled in New York City and 150 enrolled in Rio de Janeiro. Patients were randomized in a 2:1 ratio to receive a single transfusion of either convalescent plasma or normal control plasma.
The median age of participants was 61 years and two-thirds of them were male. In a subset of nasopharyngeal swab samples from Brazil that underwent viral genomic sequencing, no evidence of neutralization-escape mutants was detected.
“We should not close the door prematurely on research into the therapeutic value of convalescent plasma research for severe COVID-19, particularly in the context of emerging viral variants in low- and middle-income countries,” says first and corresponding author Max R. O’Donnell, MD, associate professor of medicine and epidemiology, and member of the Center for Infection and Immunity at Columbia Irving Medical Center. “Locally donated convalescent plasma has the potential to be highly responsive to local viral ecology and sustainable, since many countries already have the infrastructure needed to collect and transfuse donated plasma.”
“This is the first clinical trial sponsored by the Global Alliance for Preventing Pandemics. It illustrates the role of international collaborations in responding to emerging infectious diseases,” says W. Ian Lipkin, MD, director of the Center for Infection and Immunity and John Snow Professor of Epidemiology at Columbia University Mailman School of Public Health.

Alcohol appears to have an immediate — or near-immediate — effect on heart rhythm, significantly increasing the chance that an episode of atrial fibrillation (AFib) will occur, according to new data presented at the American College of Cardiology’s 70th Annual Scientific Session.
The data revealed that just one glass of wine, beer or other alcoholic beverage was associated with twofold greater odds of an episode of AFib occurring within the next four hours. Among people having two or more drinks in one sitting, there was a more than threefold higher chance of experiencing AFib. Using an alcohol sensor placed on participants’ ankles, which passively monitored alcohol intake, the investigators found that every 0.1% increase in inferred blood alcohol concentration over the previous 12 hours was associated with an approximate 40% higher odds of an AFib episode. Evidence from those sensors also demonstrated that the total alcohol concentration over time also predicted the chance AFib would occur.
“Alcohol is the most commonly consumed drug in the world, and there is still a lot we don’t understand about what it does to our bodies and, in particular, our hearts,” said Gregory M. Marcus, MD, cardiologist and professor of medicine at the University of California, San Francisco, and the study’s lead author. “Based on our data, we found that alcohol can acutely influence the likelihood that an episode of AFib will occur within a few hours, and the more alcohol consumed, the higher the risk of having an event.”
AFib is the most common heart rhythm disorder. It is often characterized by a rapid, chaotic and fluttery heartbeat. Marcus said that people can experience a range of symptoms. Some may not feel anything, while others are overcome with severe shortness of breath, fatigue, fainting or near fainting spells and a disconcerting sensation that the heart is beating out of control. AFib also results in costly use of health care services, including visits to the emergency department, hospitalizations and procedures each year. Over time, AFib can lead to heart failure, stroke and dementia if untreated.
Researchers enrolled 100 patients with paroxysmal or intermittent AFib, which tends to go away within a short period of time (unlike chronic AFib). Patients in the study were 64 years old on average; the majority were white (85%) or male (80%). Past medical history, medications and lifestyle habits were assessed through chart reviews and patient interviews. Each participant was fitted with a wearable heart monitor that continuously tracked their heart rhythm and an ankle sensor to objectively detect when more than two to three drinks were consumed on a given occasion. Participants were asked to press a button on the heart monitor each time they had an alcoholic drink. Finger stick blood tests measuring alcohol consumption in the previous few weeks were also used to corroborate self-reported drinking events. Because researchers used repeated measurements from the same individual, they served as their own control over time. Overall, more than half (56) had an episode of AFib during the four-week study.
“Patients have been telling us that alcohol is a trigger for AFib for a long time, but it’s been hard, if not impossible, to study because there is a critical temporal relationship that requires a real-time assessment of alcohol intake and heart rhythm,” Marcus said. “This is the first study to objectively demonstrate and quantify the real-time relationship between alcohol consumption and AFib episodes. While this study was limited to people with intermittent AFib, it’s reasonable to extrapolate the fact that in many people alcohol may be the main trigger for an initial episode.”
Marcus said there may be other factors — such as race/ethnicity, sex, genetics or other environmental exposures — that influence alcohol’s effect on the heart in various ways and need to be studied. In addition, people often pair alcohol with foods that are high in sodium, while some pour a drink because they feel stressed, so there may be other things that play a role. The findings also run counter to previous reports about the potentially protective role of alcohol on heart health when used in moderation.

Researchers at the Francis Crick Institute have found out how microscopic structures called lipid droplets may help to prevent a high-fat diet causing kidney damage. The work in fruit flies, published in PLoS Biology opens up a new research avenue for developing better treatments for chronic kidney disease.
Eating foods high in fats can cause inflammation and metabolic stress in the kidneys, leading to chronic disease, which in severe cases requires dialysis or a transplant. And with obesity on the rise globally, it’s a growing problem — around 10% of people in the UK are living with chronic kidney disease.
Scientists at the Crick have been studying a common characteristic of the disease, the appearance of lipid droplets inside kidney cells, to solve a long-standing mystery of whether this protects or harms kidney function.
Working with electron microscopy experts at the Crick, the team used the sophisticated genetic methods available in the fruit fly (Drosophila) to show that lipid droplets protect the renal system against damage from excess dietary fats.
When fed a high-fat diet, lipid droplets accumulate inside nephrocytes, the flies’ equivalent of human kidney cells called podocytes. Here, the droplets act as a ‘safe haven’ for storing excess fats away from the rest of the cell. An enzyme called ATGL sits on the surface of lipid droplets and helps to dispose of the stored fats in a safe way. ATGL does this by feeding the fats in a digestible form to nearby mitochondria, where they can be broken down into less toxic molecules.
Lipid droplets are essential for the protective process as when the scientists used genetic methods to prevent their formation, the fats left free inside the nephrocytes caused substantial damage and impaired kidney function.
Alex Gould, head of the Physiology and Metabolism Laboratory at the Crick and lead researcher of the study says: “It has been known for many years that lipid droplets pop up in a wide range of diseases, all the way from diabetes to brain cancer. What’s been far less clear is whether they are making things better or worse.”
“It’s exciting to find that lipid droplets are an essential part of the kidney’s fight back against fat overload. These fascinating structures are turning out to be so much more than tiny balls of fat, and we now want to find out whether their protective role in the kidney also applies to other disease contexts.”
The scientists also found that boosting the expression of the ATGL enzyme in fruit flies was able to repair most of the damage caused by a high-fat diet, restoring normal function to the kidney cells.
Fruit flies are a useful model for understanding the biology of kidney disease in humans because there are important similarities in the renal systems of both species, including the presence of the ATGL enzyme.
Ola Lubojemska, who carried out much of this work in the Physiology and Metabolism Laboratory at the Crick, explains: “These findings are at an early stage but open up a new direction for clinical research into chronic kidney disease. It may, for example, be possible to develop a drug that boosts the ATGL enzyme in renal patients. This would allow excess dietary fats to be more efficiently detoxified by kidney cells, thus improving kidney function.”
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Researchers from the Francis Crick Institute, Royal Marsden, UCL and Cruces University Hospital have found that cells from different parts of kidney tumours behave differently, and surprisingly, cells within the centre of a tumour are the most aggressive and have the highest chance of spreading around the body.
Cancers can spread to other parts of the body, with cells taking hold as secondary tumours which make the disease much harder to treat. Understanding the mechanics of this spread, a process called metastasis, could lead to new treatments that block this migration.
In their multidisciplinary study published today (17 May) in Nature Ecology and Evolution, scientists led by the Litchfield lab at UCL and the Turajlic, Swanton, and Bates labs at the Crick, analysed 756 cancer biopsy samples from different regions within tumours from the TRACERx Renal study.
They found that cells at the centre of tumours have a less stable genome and a higher potential to spread to secondary sites around the body. By contrast cells at the tumour edge had lower rates of metastasis, as well as lower rates of growth and genetic damage.
“Cancer cells in the central zone of the tumour face harsh environmental conditions, as there’s a lack of blood supply and oxygen. They have to adapt to survive, which makes them stronger and more aggressive. This also means they are more likely to successfully evolve into cells that can disseminate and take hold in distant organs,” says Kevin Litchfield, paper author and group leader at the UCL Cancer Institute.
The results highlight a need to pay close attention to the tumour centre to understand how cancer spreads and to find the cancer cells of greatest threat to the patient. It also shows the importance of developing treatments that target the unique environmental conditions found within the tumour core, in order to successfully eliminate the most aggressive tumour cells.
The scientists also looked at how genetically different populations of cancer cells grow within a tumour. Using a unique map building tool to reconstruct the growth of tumour cells, they found that, while most tumours follow a pattern where populations of cells grow in the local area — like a plant growing up and outwards — two cases demonstrated a “jumping” pattern where cells took hold in a new region of the tumour by seemingly ‘jumping’ over other populations of tumour cells.
The researchers are now planning to reconstruct 3D tumour maps, which will provide an even clearer visualisation of the spatial patterns within tumours.
Samra Turajlic, head of the Crick’s Cancer Dynamics Laboratory, Consultant Medical Oncologist at the Royal Marsden NHS Foundation Trust and the Chief Investigator of TRACERx Renal, said: “Cancer spread is one of the biggest barriers to improving survival rates. In the context of the TRACERx Renal study we previously resolved the genetic make up of different tumour areas, but until now, there has been no understanding of how these differences relate spatially. The most critical question is the part of the tumour from which cancer cells break away and migrate making cancer incurable.
“Using this unique clinical cohort and a multidisciplinary approach, including mathematical modeling, we identified with precision the place in the tumour where genetic chaos emerges to give rise to metastases. Our observations shed light on the sort of environmental conditions that would foster emergence of aggressive behaviour. These findings are a critical foundation for considering how we target or even prevent distinct populations of cells that pose the biggest threat.”
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