Monday
Jul142014

DNA Tracking and Genetic Privacy

As genetic information becomes more readily available, knowledge of an individual’s DNA is beginning to play a more important role in health and medical care. A full human genome can already be sequenced at a cost of less than $5,000, and the price is still dropping. However, the increasing availability of this information raises some serious privacy issues. With doctors and researchers exchanging the genetic information of patients, test subjects, and private clients, it has recently become possible to track people down using their DNA sequences and minimal outside information. A recent review in the journal Nature has examined the methods by which an interested party might cross-reference freely available databases to identify a name and home address based solely on a gene sequence and a date of birth. The authors were startled by how easy they found it to violate privacy in such a manner, and suggested a wide variety of encryption techniques to prevent third party access to exploitable information. Unfortunately, very few of these security protocols are in place, and for the time being, it seems that anyone with access to human genomes could track down their origins with little difficulty. 

~Andrew Wilson, Summer Research Intern

Source: http://www.nature.com/nrg/journal/v15/n6/full/nrg3723.html

Monday
Jul142014

Costly Immunity - Consequences of Rising Vaccine Prices

You walk into your local Starbucks and order your favorite coffee. It is the same coffee that you have been ordering for the past thirty years and you know just how you like it. You take out the 5 dollars that you usually pay, and the barista tells you that the total is $100 because of new environmental regulations. How do you react? You freak out, you refuse to pay, you vow to never go to Starbucks again.

Now lets look at a different but similar situation. Parents today are walking into family-practices and pediatrician offices around the country looking to get their children vaccinated to meet the requirements for summer camps or the upcoming school year. In 1986, about the time they themselves had been vaccinated as kids, parents paid $100 for all the vaccinations their children needed through the age of 18. Today that price is $2,196; nearly a 2100% increase over the past 28 years. Granted, the U.S. has experienced significant inflation over that time frame, however, when discounted to 2014 dollars, using CPI data from the US Bureau of Labor Statistics, the service still only would be projected to be worth $216 - approximately 10 times cheaper than the going rate.

So what has happened to push up the price of vaccines? After all, they are public health policy’s most effective weapon in the battle against infectious disease, and we want them to be as widely used as possible. Most vaccine producers will point to a growing number of mandatory vaccines, and rising production and development costs as the culprits for skyrocketing prices. Since 1986, another 8 vaccines have been added to the list of mandatory vaccines for school aged children and acquiring FDA approval is also much more expensive today than it has been in the past as studies proving the efficacy and the safety of vaccines must be much larger to accommodate growing public concern over a possible connection to autism. Yet, these complaints still do not justify the rising price of vaccinations.

Vaccine producers are pushing these price disparities. An example of price manipulation by pharmaceutical companies pointed out by Elisabeth Rosenthal in her article, “the Price of Prevention: Vaccine Costs are Soaring,” is the drug Prevnar, manufactured by Pfizer. As Ms. Rosenthal elucidates in her article, the predecessor of the current Prevnar vaccine experienced a 50% increase in price once it was labeled as a mandatory vaccination for school children, jumping from $80 to $120. There was no change in the production cost or formula to justify the price difference. The only thing that was different was that all American children were required to have the vaccination. With the sale of millions of vaccines guaranteed by the government, the company didn’t have to worry about selling at a competitive price, allowing it to boost profit margins.

Another example of pharmaceutical companies taking advantage of the profitable vaccine environment is with a later edition of Prevnar, Prevnar 13. In her article, Ms. Rosenthal notes that since Prevnar 13’s approval by the FDA in 2010, its price has increased at an average of 6% a year. According to data taken from the United States Bureau of Labor Statistics, that is about twice the rate of inflation associated with other medical care cost in the US over that time frame (2010: 3.4%; 2011: 3.0%; 2012: 3.7%; 2013: 2.5%).

These examples show that the price hikes that we are seeing in the vaccine market aren't being created only to cover the price of research and development of these drugs. After all, both of these price hikes occurred after the original market opening. That means that the drastic increase in prices that we are seeing is simply the pharmaceutical industries way of increasing profitability of a necessary service.

The vaccine price hikes are having two effects. First, they are driving up insurance prices. All preventative vaccines are part of the essential benefits that all insurance plans must cover as described in the Affordable Care Act. Thus, insurance companies pass on the increased costs to the general populace in the form of higher premiums. Second, these high vaccine prices are actually causing more physicians to not offer vaccinations. Many of the family practice physicians that Ms. Rosenthal interviewed for her article reported that either they themselves or their colleagues either no longer carry enough vaccines to vaccinate all children who need them, or are considering dropping coverage of vaccines. Physicians are losing money on vaccines, and pediatricians and family-practice doctors are already some of the lowest paid physicians in health care. Doctors can’t afford to continue to stock vaccinations that they are, according to the interviews in Ms. Rosenthal’s article, not fully reimbursed for. In the end, we all are held hostage by the leverage of the pharmaceutical industry.

~Jack Kent, Summer Research Intern


Check out a more in depth presentation of the issue in Ms. Rosenthal’s original article at http://www.nytimes.com/2014/07/03/health/Vaccine-Costs-Soaring-Paying-Till-It-Hurts.html?_r=0

Other sources used for this post:

Medical Care CPI: http://data.bls.gov/timeseries/CUUR0000SAM?output_view=pct_12mths

CPI from 1986 and 2014 used for discounting: http://www.usinflationcalculator.com/inflation/consumer-price-index-and-annual-percent-changes-from-1913-to-2008/

Monday
Jul072014

Facebook’s social experiment, ethics. 

Hello! If you’re reading this blog I’m pretty sure that you’ve read other articles on other social media sites and probably use Facebook to a certain degree. Apparently In January 2012, this global social networking website manipulated over 600,000 newsfeeds and showed the user more upbeat or more depressing news stories to see how that effects the users mood. If you ask me, that strikes some major ethical issues.

According to the interviewees at NPR, even if we read every detail on Facebook’s user agreement, we still don’t fully understand that there is someone on the other end manipulating our newsfeed in such a way that influences are mood and possibly our behavior. Although I appreciate that Facebook filters out majority of my 800+ “friends’” news and just gives me information of friends that are actually close to me, manipulations that can possibly affect me or another individual negatively without our consent is difficult to swallow. In my opinion, worst case scenario, someone who was originally depressed could have become more depressed due to this experiment and hurt themselves or others.

I think some users (myself included) utilize Facebook without realizing the enormous amount of data that the company holds and their integrity should come into question when they perform in such manner. I think a social science experiment that went through a federal/university regulated IRB would have a much harder time getting such protocol approved.

~Will, Summer Research Intern

What do you guys think? The original NPR interview can be found through the link below:

http://www.npr.org/2014/07/01/327248369/facebooks-newsfeed-study-was-it-ethical-or-a-violation-of-privacy

Tuesday
Jun242014

The Correlation between Traditional Reading Time and Scholarly Success in Youth

The American Academy of Pediatrics (AAP) will soon begin instructing its nearly 60,000 Pediatricians to emphasize that parents read aloud to their children as much as possible from birth (Rich, 2014). This new recommendation stems from surveys and studies that point to the increasing literacy and vocabulary gaps between children of lower income families and those of higher income families. A very common study performed decades ago notes that, because of such gaps, higher-income children have on average heard 30 million more words by the age of 3 than lower-income children (Hart & Risley, 1995); such vast differences in verbal exposure put low-income children at a disadvantage once they are in school with higher-income peers. There is speculation as to whether this disadvantage in addition to many other socioeconomic disadvantages experienced by lower-income children can perpetuate the poverty cycle in low-income communities. Regardless, such recommendations from the AAP include breastfeeding (which correlates with higher child intelligence), immunizations, a ban on screens (television, phones, and tablets alike) until age two, and other child-rearing tips that are backed by well-trusted and long-standing research. Taking such recommendations seriously may be the first step in mending the wealth disparity currently present and growing in the United States.

~Lindsey Rogers, Summer Research Intern

Hart, B., & Risley, T. R. (1995). Meaningful differences in the everyday experience of young american children. Baltimore, MD: Paul H. Brookes Publishing Co. Retrieved from http://www.amazon.com/Meaningful-Differences-Everyday-Experience-American/dp/1557661979

Rich, M. (2014, June 24). Pediatrics group to recommend reading aloud to children from birth. New York Times. Retrieved from http://www.nytimes.com/2014/06/24/us/pediatrics-group-to-recommend-reading-aloud-to-children-from-birth.html?_r=0

Friday
Jun202014

Autism - A metabolic Disorder?

This summer I am working on a project evaluating a possible connection between Autism Spectrum Disorder (ASD) and neuroinflammation. However, while we work on our project, it is always a good idea to keep an eye out for what others in the field are investigating. It was with this in mind that I sat down to read a new paper by Naviaux et al. that was published in this week's edition of Nature. In the paper Dr. Robert Naviaux and his collaborators set out to test the use of Suramin as a potential drug for relieving autistic symptoms in an animal model, and met some promising results.

The basis of the research that the Naviaux lab performed is that while there is a mixture of factors that can lead to the development of ASD, there is a hypothesized underlying cause of all cases. Specifically Naviaux and his colleagues believe that ASD and other developmental disorders can be acquired when a metabolic response called the cell danger response (CDR) is triggered. However, because this believed foundation of all cases of Autism Spectrum Disorder is metabolic, it should be treatable using the proper metabolic intervention.

To test out their theory, the researchers in the Naviaux lab used the maternal immune activation (MIA) or Poly IC mouse model. In this model a pregnant female mouse is injected with a double stranded segment of polyinosinic:polycytidylic (poly I:C) acid. This injection is used to simulate a viral infection and triggers an immune response which results in the injected mouse's progeny having characteristics associated with ASD and schizophrenia.

When the offspring of the mice were 6.5 months old they gave the mice an injection of either saline, as a control, or Suramin, a drug used as an antipurinergic therapy. They found that while the MIA mice showed ASD-like characteristics pre-injection, the mice injected with a single dose of Suramin had improved social interactions at the same level as mice not from the MIA model. An improvement was even seen five weeks after the Suramin injection, when all of the chemical had washed out of the mice, indicating that the injection of Suramin developed some form of metabolic memory or change that outlasted the drug itself.  

While these results were incredibly promising, there are some limitations of applying the findings of this study to humans. The MIA mouse model is not a perfect model for ASD in humans as it may have a different underlying mechanisms than ASD. Also, chronic use of suramin is associated with toxic side effects making it less likely to be a drug used in human treatment anytime soon.

Regardless of limitations, these results are really exciting for a couple different reasons. First, a single dose of an antipurinergic therapy is capable of reversing the characteristics in the MIA model, meaning that we could possibly find the same results in humans. Also, not only did the drug reverse the characteristics, but the changes incurred by treatment had a lasting effect. It may be naive to hope that we can one day cure autism with a miracle shot, but hopefully we will soon be hearing about the discovery of a drug that has similar effects in humans as the Suramin in MIA .

To read more about the study check out the original paper: “Reversal of autism-like behaviors and metabolism in adult mice with single-dose antipurinergic therapy,” as written by JC Naviaux, MA Schuchbauer, K Li, L Wang, VB Risbrough, SB Powell and RK Naviaux at

http://www.nature.com/tp/journal/v4/n6/full/tp201433a.html.

~Jack Kent, Summer Research Intern