Category: Emory University

The Recovering Americans and the ‘Top Secret’ Ebola Treatment

On By A.P.In Africa, CDC, Centers for Disease Control and Prevention, Ebola, Ebola Consolidation Case Management Center, ebola vaccine, Emory University, Emory University School of Medicine, Kebmodee, Kent Brantly, Liberia, Mapp Biopharmaceuticals, Margaret Chan, Medicine, monoclonal antibody, National Institutes of Health, NIAID, NIH, Samaritan's Purse, Sanjay Gupta, Science, World Health Organization, zMappLeave a comment

Because Kent Brantly is a physician who has watched people die of Ebola, there was an especially chilling prescience to his assessment last week, between labored breaths: “I am going to die.”

His condition was grave. But then on Saturday, we saw images of Brantly’s heroic return to U.S. soil, walking with minimal assistance from an ambulance into an isolation unit at Emory University Hospital.

“One of the doctors called it ‘miraculous,'” Dr. Sanjay Gupta reported from Emory this morning, of Brantly’s turnaround within hours of receiving a treatment delivered from the U.S. National Institutes of Health. “Not a term we scientists like to throw around.”

“The outbreak is moving faster than our efforts to control it,” Dr. Margaret Chan, director of the World Health Organization, said on Friday in a plea for international help containing the virus. “If the situation continues to deteriorate, the consequences can be catastrophic in terms of lost lives, but also severe socioeconomic disruption and a high risk of spread to other countries.”

In that light, and because Ebola is notoriously incurable (and the strain at large its most lethal), it is overwhelming to hear that “Secret Serum Likely Saved Ebola Patients,” as we do this morning from Gupta’s every-20-minute CNN reports. He writes:

Three top secret, experimental vials stored at subzero temperatures were flown into Liberia last week in a last-ditch effort to save two American missionary workers [Dr. Kent Brantly and Nancy Writebol] who had contracted Ebola, according to a source familiar with details of the treatment.

Brantly had been working for the Christian aid organization Samaritan’s Purse as medical director of the Ebola Consolidation Case Management Center in Monrovia, Liberia. The group yesterday confirmed that he received a dose of an experimental serum before leaving the country.

In Gupta’s optimistic assessment, Brantly’s “near complete recovery” began within hours of receiving the treatment that “likely saved his life.” Writebol is also reportedly improved since receiving the treatment, known as zMapp. But to say that it was a secret implies a frigid American exceptionalism; that the people of West Africa are dying in droves while a classified cure lies in wait.

The “top-secret serum” is a monoclonal antibody. Administration of monoclonal antibodies is an increasingly common but time-tested approach to eradicating interlopers in the human body. In a basic monoclonal antibody paradigm, scientists infect animals (in this case mice) with a disease, the mice mount an immune response (antibodies to fight the disease), and then the scientists harvest those antibodies and give them to infected humans. It’s an especially promising area in cancer treatment.

In this case, the proprietary blend of three monoclonal antibodies known as zMapp had never been tested in humans. It had previously been tested in eight monkeys with Ebola who survived—though all received treatment within 48 hours of being infected. A monkey treated outside of that exposure window did not survive. That means very little is known about the safety and effectiveness of this treatment—so little that outside of extreme circumstances like this, it would not be legal to use. Gupta speculates that the FDA may have allowed it under the compassionate use exemption.

A small 2012 study of monoclonal antibody therapy against Ebola found that it was only effective when administered before or just after exposure to the virus. A 2013 study found that rhesus macaques given an antibody mix called MB-003 within the 48-hour window had a 43 percent chance of surviving—as opposed to their untreated counterparts, whose survival rate was zero.

This Ebola outbreak is the largest in the history of the disease, in terms of both cases and deaths, 729 887 known so far. As Chan warned in her call for urgent international action, the outbreak is geographically the largest, already in four countries with fluid population movement across porous borders and a demonstrated ability to spread by air travel. The outbreak will be stopped by strategic quarantines and preventive education, primarily proper handling of corpses. More than 60 aid workers have become infected, but many more will be needed to stem the tide.

Dr. Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Disease (NIAID), is encouraged by the antibody treatment.

“Obviously there are plans and enthusiasm to expand this,” Fauci told me. “The limiting factor is the extraordinary paucity of treatment regimens.” Right now the total amount available, to Fauci’s knowledge, is three treatment courses (in addition to what was given to Brantly and Writebol).

NIAID did some of the original research that led to the development, but this is owned by Mapp Biopharmaceuticals. “They are certainly trying to scale up,” Fauci said, “but I’ve heard that their capability is such that it’s going to be months before they have a substantial number of doses, and even then they’re going to be limited.”

“We’re hearing that the administration of this cocktail of antibodies improved both Dr. Brantly and Ms. Writebol, but you know, we don’t know that,” Fauci said, noting the sample size (two) of this small, ad hoc study. Proving effectiveness would require a much larger group of patients being compared to an untreated group. “And we don’t know that they weren’t getting better anyway.”

Thanks to Kebmodee for bringing this to the attention of the It’s Interesting community.

http://www.theatlantic.com/health/archive/2014/08/the-secret-ebola-treatment/375525/

Scientists have identified the age at which most childhood memories fade and are lost forever

On By A.P.In brain, childhood amnesia, Emory University, memory, neuroplasticity, Neuroscience, Patricia Bauer, Psychological Science, psychologist, psychology, Psychology and Aging, Science, The Brain1 Comment

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Most adults struggle to recall events from their first few years of life and now scientists have identified exactly when these childhood memories fade and are lost forever.

A new study into childhood amnesia – the phenomenon where early memories are forgotten – has found that it tends to take affect around the age of seven.

The researchers found that while most three year olds can recall a lot of what happened to them over a year earlier, these memories can persist while they are five and six, but by the time they are over seven these memories decline rapidly.

Most children by the age of eight or nine can only recall 35% of their experiences from under the age of three, according to the new findings.

The psychologists behind the research say this is because at around this age the way we form memories begins to change.

They say that before the age of seven children tend to have an immature form of recall where they do not have a sense of time or place in their memories.

In older children, however, the early events they can recall tend to be more adult like in their content and the way they are formed.

Children also have a far faster rate of forgetting than adults and so the turnover of memories tends to be higher, meaning early memories are less likely to survive.

The findings also help to explain why children can often have vivid memories of events but then have forgotten them just a couple of years later.

Professor Patricia Bauer, a psychologist and associate dean for research at Emory college of Arts and Science who led the study, said: “The paradox of children’s memory competence and adults’ seeming “incompetence” at remembering early childhood events is striking.

“Though forgetting is more rapid in the early childhood years, eventually it slows to adult levels.

“Thus memories that “survived” early childhood have some likelihood of being remembered later in life.”

Professor Bauer and her colleagues studied 83 children over several years for the research, which is published in the scientific journal Memory.

The youngsters first visited the laboratory at the age of three years old and discussed six unique events from their past, such as family outings, camping holidays, trips to the zoo, first day of school and birthdays.

The children then returned for a second session at the ages between five years old and nine years old to discuss the same events and were asked to recall details they had previously remembered.

The researchers found that between the ages of five and seven, the amount of the memories the children could recall remained between 63-72 per cent.

However, the amount of information the children who were 8 and nine years old dropped dramatically to 35 and 36 per cent.

When the researchers looked closely at the kind of details the children were and were not able to remember, they found marked age differences.

The memories of the younger children tended to lack autobiographical narrative such as place and time. Their memories also had less narrative, which the researchers believe may lead to a process known as “retrieval induced forgetting” – where the action of remembering causes other information to be forgotten.

As they children got older, however, the memories they recalled from early childhood tended to have these features.

Professor Bauer said: “The fact that the younger children had less-complete narratives relative to the older children, likely has consequences for the continued accessibility of early memories beyond the first decade of life.

“We may anticipate that memories that survive into the ninth or tenth year of life, when narrative skills are more developed, would continue to be accessible over time.”

http://www.telegraph.co.uk/science/science-news/10564312/Scientists-pinpoint-age-when-childhood-memories-fade.html

Could Pot Help Veterans With PTSD? Brain Scientists Say Maybe

On By A.P.In Andrew Holmes, anxiety circuitry, Atlanta, brain, cannabinoids, cannabis, Cannabis sativa, Drugs, Emory University, Emory University School of Medicine, extinction therapy, fear circuitry, Georgia, Jon Hamilton, Kerry Ressler, marijuana, Medicine, military, National Institute of Mental Health, National Institute on Alcohol Abuse and Alcoholism, National Institute on Drug Abuse, Neuropsychiatric Disease, Neuroscience, neuroscientist, post-traumatic stress disorder, pot, psychiatrist, Psychiatry, psychology, psychotherapy, PTSD, Science, tetrahydrocannabinol, THC, VeteransLeave a comment

pot

by Jon Hamilton

Veterans who smoke marijuana to cope with post-traumatic stress disorder may be onto something. There’s growing evidence that pot can affect brain circuits involved in PTSD.

Experiments in animals show that tetrahydrocannabinol, the chemical that gives marijuana its feel-good qualities, acts on a system in the brain that is “critical for fear and anxiety modulation,” says Andrew Holmes, a researcher at the National Institute on Alcohol Abuse and Alcoholism. But he and other brain scientists caution that marijuana has serious drawbacks as a potential treatment for PTSD.

The use of marijuana for PTSD has gained national attention in the past few years as thousands of traumatized veterans who fought in Iraq and Afghanistan have asked the federal government to give them access to the drug. Also, Maine and a handful of other states have passed laws giving people with PTSD access to medical marijuana.

But there’s never been a rigorous scientific study to find out whether marijuana actually helps people with PTSD. So lawmakers and veterans groups have relied on anecdotes from people with the disorder and new research on how both pot and PTSD works in the brain.

An Overactive Fear System

When a typical person encounters something scary, the brain’s fear system goes into overdrive, says Dr. Kerry Ressler of Emory University. The heart pounds, muscles tighten. Then, once the danger is past, everything goes back to normal, he says.

But Ressler says that’s not what happens in the brain of someone with PTSD. “One way of thinking about PTSD is an overactivation of the fear system that can’t be inhibited, can’t be normally modulated,” he says.

For decades, researchers have suspected that marijuana might help people with PTSD by quieting an overactive fear system. But they didn’t understand how this might work until 2002, when scientists in Germany published a mouse study showing that the brain uses chemicals called cannabinoids to modulate the fear system, Ressler says.

There are two common sources of cannabinoids. One is the brain itself, which uses the chemicals to regulate a variety of brain cells. The other common source is Cannabis sativa, the marijuana plant.

So in recent years, researchers have done lots of experiments that involved treating traumatized mice with the active ingredient in pot, tetrahydrocannabinol (THC), Ressler says. And in general, he says, the mice who get THC look “less anxious, more calm, you know, many of the things that you might imagine.”

Problems with Pot

Unfortunately, THC’s effect on fear doesn’t seem to last, Ressler says, because prolonged exposure seems to make brain cells less sensitive to the chemical.

Another downside to using marijuana for PTSD is side effects, says Andrew Holmes at the National Institute on Alcohol Abuse and Alcoholism. “You may indeed get a reduction in anxiety,” Holmes says. “But you’re also going to get all of these unwanted effects,” including short-term memory loss, increased appetite and impaired motor skills.

So for several years now, Holmes and other scientists have been testing drugs that appear to work like marijuana, but with fewer drawbacks. Some of the most promising drugs amplify the effect of the brain’s own cannabinoids, which are called endocannabinoids, he says. “What’s encouraging about the effects of these endocannabinoid-acting drugs is that they may allow for long-term reductions in anxiety, in other words weeks if not months.”

The drugs work well in mice, Holmes says. But tests in people are just beginning and will take years to complete. In the meantime, researchers are learning more about how marijuana and THC affect the fear system in people.

At least one team has had success giving a single dose of THC to people during something called extinction therapy. The therapy is designed to teach the brain to stop reacting to something that previously triggered a fearful response.

The team’s study found that people who got THC during the therapy had “long-lasting reductions in anxiety, very similar to what we were seeing in our animal models,” Holmes says. So THC may be most useful when used for a short time in combination with other therapy, he says.

As studies continue to suggest that marijuana can help people with PTSD, it may be unrealistic to expect people with the disorder to wait for something better than marijuana and THC, Ressler says. “I’m a pragmatist,” he says. “I think if there are medications including drugs like marijuana that can be used in the right way, there’s an opportunity there, potentially.”

http://www.npr.org/blogs/health/2013/12/23/256610483/could-pot-help-veterans-with-ptsd-brain-scientists-say-maybe

New study links testicle size to father role

On By A.P.In Dr. D, Emory University, Emory University School of Medicine, fatherhood, Kebmodee, Proceedings of the National Academy of Sciences, testicle, testicle sizeLeave a comment

testivcle

A link between the size of a father’s testicles and how active he is in bringing up his children has been suggested by scientists.

Researchers at Emory University, US, said those with smaller testicles were more likely to be involved with nappy changing, feeding and bath time.

They also found differences in brain scans of fathers looking at images of their child, linked to testicle size.

But other factors, such as cultural expectations, also played a role.

Levels of promiscuity and testicle size are strongly linked in animals, those with the largest pair tending to mate with more partners.

The researchers were investigating an evolutionary theory about trade-offs between investing time and effort in mating or putting that energy into raising children. The idea being that larger testicles would suggest greater commitment to creating more children over raising them.

The study, in Proceedings of the National Academy of Science, looked at the relationship between testicle size and fatherhood in 70 men who had children between the ages of one and two.

The team at Emory University in Atlanta performed brain scans while the men were shown pictures of their children.

It showed those with smaller testicles tended to have a greater response in the reward area of the brain than those with a larger size.

MRI scans showed a three-fold difference between the volumes of the smallest and largest testicles in the group.

Those at the smaller end of the spectrum were also more likely, according to interviews with the man and the mother, to be more active in parenting duties.

One of the researchers, Dr James Rilling, told the BBC: “It tells us some men are more naturally inclined to care-giving than others, but I don’t think that excuses other men. It just might require more effort for some than others.”

The exact nature of any link is not clear.

The researchers believe the size of the testicles, probably through the hormone testosterone, is affecting behaviour. But it is not clear if the process of having a baby may have some effect on the father.

“We know, for instance, that testosterone levels go down when men become involved fathers,” said Dr Rilling.

Further studies, involving analysing the size before and after becoming a father, are still needed.

Cultural and societal expectations on the role of the father are also not accounted for in the study.

All of the men were from the Atlanta area so the relative impact of society and biology has not been measured.

http://www.bbc.co.uk/news/health-24016988

Thanks to Dr. D and Kebmodee for bringing this to the attention of the It’s Interesting community.

Stone Age skull-smashing culture discovered

On By A.P.In American Journal of Physical Anthropology, Barcelona, early human, Emory University, Juan José Ibañez, Liv Nilsson Stutz, Neolithic society, New Scientist, skull smashing, Spain, Spanish National Research Council, Stone Age, Stuart Campbell, Syria, University of ManchesterLeave a comment

skull

An unusual cluster of Stone Age skulls with smashed-in faces has been found carefully separated from the rest of their skeletons. They appear to have been dug up several years after being buried with their bodies, separated, then reburied. Although collections of detached skulls have been dug up at many Stone Age sites in Europe and the Near East – but the face-smashing is a new twist that adds further mystery to how these societies related to their dead.

Juan José Ibañez at the Spanish National Research Council in Barcelona says the find may suggest that Stone Age cultures believed dead young men were a threat to the world of the living.

No one knows why Neolithic societies buried clusters of skulls – often near or underneath settlements. Some think it was a sign of ancestral veneration. “When people started living together [during the Neolithic period], they needed a social cement,” says Ibañez. Venerating ancestors might have been a way of doing this. But the violence demonstrated towards the skulls in the latest cluster suggests a different story.

The 10,000-year-old skulls were found in Syria. Like those found in other caches, they have been cleanly separated from their spines, suggesting they were collected from dead bodies that had already begun to decompose. Patterns on the bone indicate that some had been decomposing for longer than others, making it likely that they were all gathered together for a specific purpose.

Most of the skulls belonged to adult males between 18 and 30 years old. One – belonging to a child – was left intact; one was smashed to pieces; the remaining nine lacked facial bones. “There was a pattern,” says Ibañez. “The top of the skull and the jaw were there, but they were missing all of the bones in between.” His team believes the facial bones were smashed out with a stone and brute force. “There were no traces of cutting,” he says (American Journal of Physical Anthropology, DOI: 10.1002/ajpa.22111).

Ibañez reckons Stone Age people believed they would receive some benefit – perhaps the strength of the young men the skulls once belonged to – by burying them near or beneath their settlements. Why the faces were smashed in invites speculation.

It may have been an act of spite or revenge, says Ibañez. Or the skulls may have been brought together to create a “community of the dead”, perhaps in order to spiritually interact with the living.

“The post-mortem violence suggests young men were seen as carrying a particular threat,” says Stuart Campbell at the University of Manchester, UK. Destroying their facial structures may have been a way of destroying the individuals’ identities, he says.

Liv Nilsson Stutz at Emory University in Atlanta, Georgia, says the act could have helped deal with grief. “Taking away facial identity could be a way of separating the dead from the living,” she says.

http://www.newscientist.com/article/mg21528784.400-stone-age-skullsmashers-spark-a-cultural-mystery.html