February 8, 2024
Reporter, Morning Rounds Writer
Good morning. Helen Branswell has a stunner on the empty seats on a federal vaccine advisory committee.

exclusive

Committee overseeing vaccine policy is seeing an exodus of expertisecdc

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The Advisory Committee on Immunization Practices is a critical government advisory committee, one charged with charting U.S. vaccination policy and making timely decisions on how vaccines should be used in this country. Now, STAT’s Helen Branswell reports in an exclusive story, there are eight vacancies on what in recent years has been a 15-person panel. One dates back more than a year and the other seven to July. There is no chairperson.

Four of the seven remaining members are due to finish their terms at the end of June, a cumulative exodus of expertise from the committee, whose role in crafting American vaccine policy is foundational. While the FDA approves vaccines for sale, rules on how those vaccines are used are set by the CDC, but on the advice of the ACIP. “I truly don’t know what the holdup would be,” said Kelly Moore, a former ACIP member who is the CEO of the nonprofit organization Immunize.org. Read more.


gene therapy

Created to heal skin wounds, it also helped preserve a boy’s vision

Calling epidermolysis bullosa a difficult disease is surely an understatement. EB causes the skin to be so fragile that the tiniest touch causes blisters or tears. Some patients have eye problems, too, when their eyelids fuse to their eyes. For Antonio Vento Carvajal, the growth of the eyes’ white tissue over his corneas meant he could barely see out of his right eye. When he was 13 years old, he began receiving a gene therapy known as B-VEC to see if it could close his wounds and prevent new blisters.

Could it also help his eyes? After experiments in mice and "compassionate use" clearance from the FDA, the researchers dropped B-VEC into his eyes. Now Antonio’s vision in his right eye is 20/25, not far from normal. In a NEJM paper published yesterday, the researchers describe how B-VEC delivers to cells a healthy version of the gene mutated in the disease. STAT’s Andrew Joseph has more.


immunology

How stealthy memory cells contribute to allergies

When different labs in different countries independently reach the same scientific conclusion, it strengthens each of them, authors of two papers appearing yesterday in Science Translational Medicine would agree. In fact, after meeting at a 2022 conference, the two researchers agreed to submit their work to the same journal. Each paper illuminates an important pathway in allergic reactions — a group of memory cells as the source of antibodies. Their work could lead to a better understanding of how to treat certain allergies. 

The papers, one from Maria Curotto de Lafaille in the U.S. and another from Josh Koenig in Canada and his collaborators in Denmark, delve into the biological process that makes the IgE antibodies needed for a pathogenic immune response. What’s stumped scientists has been how immune cells remember allergens that provoke reactions that can be life-altering and life-threatening. STAT’s Isabella Cueto explains the science and the scientists’ paths to get there.



closer look

Can testosterone to treat symptoms of menopause?AP070518019123

Reed Saxon/AP 

When you think of hormonal treatments for menopause, which are gaining ground after abruptly falling out of favor following concerning results from the Women’s Health Initiative in 2002, you might not think of testosterone. There actually is more testosterone than estrogen in a premenopausal woman's body, but those levels fall over time, and after menopause a loss of bone density and a depletion of energy can follow. 

Some doctors prescribe testosterone to treat these symptoms, but the FDA has not approved a product for this use. And there isn’t a robust body of research to resolve disagreements in the field or to inform these decisions by doctors or patients, STAT’s Annalisa Merelli tells us. “My specialty is midlife women’s health and menopause management, and I’m shocked at how little data and recognition there is in female medicine on the role of this hormone,” Anna Barbieri of Icahn School of Medicine at Mount Sinai told her. Read more on the varying views.


pandemic

Offering mental health and mild exercise therapy helped some people with long Covid

Exercise as a therapy for long Covid has been spurned by patients who can face intense fatigue and worsening of other health issues after physical or mental activity. It’s called post-exertional malaise. A new study posted yesterday in BMJ that tested a self-paced approach to exercise, offered in weekly group sessions, might change some minds. 

Working with patients, U.K. researchers designed a trial called REGAIN to test a way to provide mental health therapy and exercise guidance to people with long Covid without making their conditions worse. People enrolled in the online program said their health improved more than people who received standard care, which was a one-hour advice session on how to cope with such problems as fatigue, shortness of breath, brain fog, and muscle aches. “We're not under any illusions. REGAIN is not a panacea,” study co-author Gordon McGregor said. “We believe that these findings will assist clinicians with treatment strategies.” I have more here.


Public health

CDC releases new syphilis testing recommendations

With more than 200,000 cases reported in 2022 and a nearly 80% increase in incidence since 2018, syphilis is a growing concern in the U.S. STAT's Annalisa Merelli tells us that for the first time, the Centers for Disease Control and Prevention has published new testing recommendations for syphilis, including the first-ever recommendations regarding laboratory testing.

The guidelines recommend using both tests that detect the presence of Treponema pallidum, the bacterium that causes syphilis, as well as tests that detect the antibodies for it, so as to be able to distinguish between active and past infections. The recommendations also highlight the public health role laboratories play, and the importance of their reporting the results of testing to be able to monitor the epidemic. The CDC also wants to update the terminology of syphilis testing, which dates back to the mid-20th century, and reflects a now-obsolete understanding of the disease. Read more.


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  • Years into an addiction crisis, a med school lecture still minimized opioid risks, STAT

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