31 March 2006

A perfect storm of dots: Health, disease, transplants, and "the century of biology"

Today in SciDevNet: 'Disappointing' results from US Bird flu trial: Flu experts unanimously agree that the global capacity to produce vaccines is already insufficient.

10 March, on the Australian Broadcasting Corporation's News in Science: Diabetics fly far for pig cell transplants

People with diabetes are flying to a clinic in Mexico for an injection of pig cells, hoping this xenotransplant will cure them. But experts are worried about the risks involved with this so-called xenotourism or xenotravel, both to the patient and to the rest of the community .... Normally if you bring live animal material into Australia it has to go through quarantine. But when the animal material is inside someone, it's not exactly obvious."There is no quarantine status that says you must declare that you've had a porcine transplant," says Anthony d'Apice, whose research involves genetically modifying pigs to stop rejection of their pancreas and kidney cells when they are transplanted into non-human primates."

On 6 March 2006, Alexander G. Higgins (Associated Press) reported from Geneva:

The lethal strain of bird flu poses a greater challenge to the world than any infectious disease, including AIDS . . . the World Health Organization said Monday. Scientists also are increasingly worried that the H5N1 strain could mutate into a form easily passed between humans, triggering a global pandemic. It already is unprecedented as an animal illness in its rapid expansion. (WHO's Dr Margaret) Chan told more than 30 experts in Geneva that the agency's top priority was to keep the deadly H5N1 strain of bird flu from mutating.

"Should this effort fail, we want to ensure that measures are in place to mitigate the high levels of morbidity, mortality and social and economic disruption that a pandemic can bring to this world," she said ....

"In a globalized economy, with high volume of international travel, vulnerability to new disease threats is universal," she said. "It is the same for the rich and for the poor."

Yet The Next Generation of Diseases are in Hiding, Somewhere warned the New York Times, back in 2003. All the diseases mentioned in the article — SARS, monkeypox, new forms of flu — are zoonoses; diseases/pathogens that were no problem in the originating species, but are deadly in the new host. Hence the threat posed to humans by bird flu.

Any time a disease breaks a species barrier, it becomes virulent in the new species. Strangely, this fact is rarely noted when thinking about animal-to-human transplants. Animal organ donation has moved beyond science fiction to be talked of as a solution to shortages and the exploitation of the poor. Xenotransplantation is the jargon term for it, but animal-to-human transplantation is what it means. And that can mean whole organs or just cells, although there still are no legally binding global definitions.

For some commentators, animals are the new black to cure our ills, keeping us — or those with money, at least — alive and youthful. As the March 2005 article in Wired explained:

Transplant surgeons have long dreamed of using animals to make up the chronic organ shortfall in hospitals, but have been hindered by all sorts of problems. The most serious is that the human body’s immune system rejects foreign tissue after transplantation. The new method has the potential to avoid the immune-rejection problem and make xenotransplants a reality. And according to the scientist in charge, using pigs is morally preferable to using human stem cells. ‘Pig tissue avoids the ethical problems associated with human embryonic tissue’, said Yair Reisner, the head of the Gabrielle Rich Center for Transplantation Biology Research at the Weizmann Institute of Science in Israel.

Not a word about disease. No mention of the species barrier being torn down. Yet animal-to-human transplantation (xenotransplantation) and the making of chimera (mixed-species animals and even humans when we put other species into our bodies) deliberately tears down the species barrier, with what should be obvious consequences.

Wired is not alone. The New York Times/International Herald Tribune editorialised in May 2005 with It's science, not a chimera:

We are already partly down the path of mixing human and animal cells or organs. Although it once seemed odd and unsettling, no one worries much anymore about transplanting pig valves into human hearts or human fetal tissue into mice. The key reason may be that these manipulations don't visibly change the fundamental nature of either the human or the animal. People become much more concerned when they think a transplant may alter the mind or appearance of the recipient…

Again, no mention of disease.

WHO's watching?

Even the World Health Organisation promotes xenotransplantation, through its ‘partnerships and collaborators’ such as the International Xenotransplantation Association (the home page of which carries ads from ‘corporate sponsors’ include Genzyme Transplant, Wyeth, Roche, and Novartis) instead of acting to encourage responsible science in the public interest, such as stem cells that don't need to be cultured on another species. Singapore is successfully doing that today.

This is so even though the OECD/WHO 2001 Consultation on Xenotransplantation Surveillance Summary stated, in part:

With xenotransplantation, there is a potential risk of transmitting known zoonotic infections as well as new or unknown infectious agents of animal origin into human recipients and into the wider human population. The latter is an unquantifiable hazard…

Other views simply aren’t reported; views like those of Professor Peter Collignon, Director of Infectious Diseases & Microbiology, Canberra Clinical School, ANU and University of Sydney, who wrote, in Microbes and Infections 3, 2001, Éditions Scientifiques et Médicales Elsevier SAS:

What if we were trying to design the ideal experiment in which a new virus that would infect humans would be cross-transmitted from pigs to humans? We would be hard pressed to come up with a better experiment than what is planned to be done with xenografts (and on a massive scale). Once established into a new human host, human to human transmission has occurred for many of these agents (HIV, influenza, hepatitis B, SV40).

Yet today this is the hottest trend in biotech, the new panacea. Take 21 February 2006, for example. On that day alone here are a few of the stories:

The University of Michigan announced a "milestone" in type 1 diabetes research using pig islet cells. "The goal is to have suitable donor pigs available by the time the University has refined the immunosuppressive treatment to a point that makes it safe for clinical trials to begin." (That same day , Australian scientists announced a milestone for the same type 1 diabetes research , using notpigs, but seaweed.)

Massachusetts a leader in pig-human hybrids, ran the headline of the Lowell Sun, reporting that "Newborn piglets have had human blood, sheep have lived with human livers, and human cells have been introduced into mice brains."

And the Saturday Evening Post, in Saluting American Innovation announced, "Researchers are on the verge of overcoming the organ donor shortage through xenotransplantation--or pig to human organ transplant."

It isn’t as if the information isn’t available. It's just not an issue in the media, and discounted when policy is made. Now, while programs about historical plagues are hot, the plaguemakers of the future, acting in greater secrecy than in the past, act unchecked. The dots exist. Who's going to connect them?

What is happening around the world should be your right to know, particularly as this is one of the most secretive, and well-connected industries in the world. We need xenotransplantation to be a major issue. And for that, the public needs to know what the implications of this technology truly are. For that, media and reporters must finally work in the public interest. For that, patient confidentiality is a danger to the world, but it is the practice as it exists.

Even where chickens are concerned, the necessaries to stop the spread of disease are not being carried out: monitoring, notification, quarantine, culling. Too expensive! As one Nigerian government worker said when asked why they are doing almost nothing to monitor, quarantine, and cull: "It's suicide," he said.

What is needed is a global strategy to fight disease, and for that, we need to promote safe science, not push action plans, as the US does, for an interim technology with a permanent legacy. To paraphrase the New York Times, chimeras and xenotechnology isn’t just science. Mixing species in the name of health is like scattering landmines in the name of peace. The difference, though, is that with landmines, you can sometimes dig them out before they kill, but once a disease or pathogen finds a new host, it's impossible to dig it out.

As the New York Times said, back in that doom 'n gloom article in 2003:

But for many diseases, the world does not put the clues together in time . . . We have been warned. But must epidemics always catch humanity by surprise?

But hell, this might sound like another doom 'n gloomsayer rant. Perhaps it's just a matter of perspective, when you look at the picture that the dots make when you connect them. Just as war can be fun, biology could be so much fun that it's a children's game.

Here's an excerpt from Make me a Hipporoo by physicist and futurist Freeman Dyson, New Scientist, 11 February 2006

When children start to play with real genes, evolution as we know it will change forever .

It has become part of the accepted wisdom to say that the 20th century was the century of physics and the 21st century will be the century of biology . . . . Domesticated biotechnology, once it gets into everyone's hands, will give us an explosion of diversity of new living creatures . . . Designing genomes will be a personal thing, a new art form as creative as painting or sculpture. Few of the new creations will be masterpieces, but all will bring joy to their creators and variety to our fauna and flora.

The final step in the domestication of biotechnology will be biotech games, designed like computer games for children down to kindergarten age, but played with real eggs and seeds rather than with images on a screen.

Australian scientists didn't even breed the cane toad to be lethal. They just transported it from one place to another, and now, as with new diseases that we don't even understand, we cannot expunge the cane toad from Australia. It just spreads, adapts, and kills.

Adaptation acts as if it possesses intelligence. Will we?

16 March 2006

The breakers' laundry

There's no industrial-strength laundry quite like a tumble in the sea followed by a stretch in the sun.

Back in 1859, Mrs. Cornelius wrote in "The Young Housekeeper's Friend": A sailor's red flannels, that have been, during a long voyage, often tied to a rope and towed through the waves, look better and feel softer than those washed at home.

Yet red flannels is not the picture that most readily comes to mind when the sea and sun collude. Even sailors' eyes whiten under prolonged exposure at sea — and sea, sun, and waves make airy froth, that white openwork fabric that skirts every lively seashore.

As the great openworker Don Marquis wrote in "The Cruise of the Jasper B":
A breeze blew in from the bay and stirred his window curtains;

it was salt in his nostrils. . . . And, staring out into the breathing night, he saw a succession of pictures. . . .

Stripped to a pair of cotton trousers, with a dripping cutlass in one hand and a Colt's revolver in the other, an adventurer at the head of a bunch of dogs as desperate as himself fought his way across the reeking decks of a Chinese junk, to close in single combat with a gigantic one-eyed pirate who stood by the helm with a ring of dead men about him and a great two-handed sword upheaved. . . . This adventurer was — Clement J. Cleggett! . . .

Sorry about the content in the second paragraph. I included it so that you could admire his craft, but who wants to have their reading about curtains at a window broken by pirates, Colts, dogs and cutlasses? In his defence, his head might have been turned by the sight of stars in that black night — the reverse of white openworked curtains stirred during the day and night.

There's much that is delicate and stirred by sea, yet the sea itself is careless as a coin-o-matic or a laundress who is treated shoddily.

The sea tears the delicate apart, but as with a scrap of lace that becomes a treasure, the sea makes treasures as its breakers deliver the wash, free for the taking.

Perhaps that's why sea urchins are found on many beaches.

09 March 2006

Spider in the library

A spider ran down my back at the library yesterday when I looked at the "new books" table and a glossy fat book looked back at me. I disturbed the peace with "Hal Duncan's Vellum!"

I love spiders, Vellum, and libraries — and ever since our local country library hasn't had to use up virtually all its budget to pay for bricks and architects , the book selection has become a delight and constant surprise. Our library system is so popular that there are crowds waiting for the doors to open, at every branch. The librarians keep us country folk abreast of what's being written around the world in the way of fiction; and as for non-fiction, recent acquisitions span everything from a large section on religions and sects, to fetish clothing and fetish wheels, to the latest books from whistleblowers in many administrations.

Today privatisation has taken over the international mindset more than is noted. Music for oneself (though others hear whether they want to or not), single-serve food in heavy metal tins that take longer to open than the insides do to eat, screens that command our singular attention. As a package for cookies made in Australia says, "You don't have to share us with anyone else."

A library is such an anachronism, such a precious holdover that I'm surprised that they all haven't disappeared (though they have been degraded in many places). I love sharing books. I love the look of a book that is well read, and that doesn't mean a book that is chart-popular.

But even more than that, I love the role of libraries in societygood libraries, that is (with budgets large enough to pay for books).

They stand for human rights and knowledge and dissemination of ideas, without censorship. They stand for an equal playing field, not trickle-down chances. They have been the making of countless people who have taken what they learned from library resources and built something new — be it a "new" language in a "new" land, or something you can touch or an idea that touches you. And importantly, private dignity is respected and a person's intelligence is assumed rather than discounted.

One day I was just leaving when an older couple came in and stood just inside the front door. He turned to her and said, "How do you spell prostate?"

08 March 2006

The heavy on medieval farts

In our anal-retentive times, farts are sprinkled like Bacos into comedy. Cheap and nasty, there is no thought of doing something with them. Their existence is enough, and they produce sniggers rather than thought. Yet farts were raw meat to the story chefs of other times, and fart comedy rose to great heights in the Middle Ages. Take Chaucer, who adored working with farts. In "The Summoner's Tale", the fart let into a greedy friar's hand rivals a stallion's for its sound. Yet the fart is not the comedy, nor the plot. It is only an element, like a golden ring. The friar has the weighty problem now of dividing the fart equally amongst the other friars.

Indeed, farts were treated so creatively in the Middle Ages that the topic is worth writing about. I'm no expert, so I began to look, and lo! I found the title that said it all: On Farting: Bodily Wind in the Middle Ages, by Valerie Allen and John Thompson, listed for September 2005 release by Palgrave.

Here's the publisher's synopsis:
The study of the fart in medieval culture participates in the widespread and productive contemporary study of the body, its practices and its hermeneutics. As a consequence of the cultural materialist interest in the quotidian, recent criticism has moved away from an abstracted conception of selfhood toward an appreciation of how the concrete daily regimens of bodily "habitus, generally taken for granted, shape the horizon of our cultural and individual consciousness. The fart, in its parodying of language and its logic of affinity, leads us ultimately to the problem of hermeneutics, of the art of interpretation itself. Although much of the medieval preoccupation with flatulence originates from the aesthetic of comic inversion, whereby farts "sing" or parody human language or are mistaken for departed souls, it also reflects a more serious interest in bodily health. A multifarious typology of the fart will permit a better understanding of the phenomenon's protean wealth of meaning.

Now this is one book that deserves a public reading.

The synopsis reminded me of a recent letter in Nature titled "Pressure also leads to worthless publications" in which Lindomar B. de Carvalho from the International Center for Condensed Matter Physics asked, "Are you wasting your time any more reading something fraudulent than reading something worthless?"

06 March 2006

"Simply put, now is the time"

In response to my post here yesterday about South Dakota's anti-abortion law, Faren brought up this blazing column by Mark Morford in the San Francisco Chronicle. "It is time," he says, for South Dakotan women to "Get the hell out, right now."

Now, his column speaks to Americans, yet the impacts of American law and internal policies are felt around the globe.

So this quote from Morford means something to all of us, no matter where we live.
"I think the stars are aligned," said Matthew Michels, South Dakota House Speaker and Republican, referring to the appointments of Alito and Roberts to the Supreme Court. "Simply put, now is the time."
We've got so much to deal with in the world. To have to fight against the erosion of what should be basic human rights is a tragedy of ridiculous proportions.

It is time. It is time for, amongst much else, Supreme Court term limits.

05 March 2006

Marmots and Oysters

And the Oysters sat on their haunches
while the Marmots slid so sleek

So the Oysters asked the Marmots
Could we be as sleek in a Week?

Oh my dears!
rang the cockle-shelled beaches
at the Marmots' blithe reply,
astringently pricking the
tear-ducts of Oysters
who generally

(Though Marmots can whistle and scamper,
Oysters only sit and sigh.)

For it's Oysters fat we covet
while Marmots sleek, cavort
and lemon and vinegar are the fate
of the world's Oyster cohort.

However, now
those times might change
as Humans covet sleekness.
The lean, delicious Marmots
have a just-so-natural meatness,
and would be advised to, oh my dear!

develop fat and meekness.

But if she wasn't religious, well, having the baby'd serve her right

From PBS Newshour's South Dakota Bans Abortion, March 3, 2006
(South Dakota Senator) BILL NAPOLI: My calls have been running 3-1 in favor of this bill.
FRED DE SAM LAZARO: Napoli says most abortions are performed for what he calls "convenience." He insists that exceptions can be made for rape or incest under the provision that protects the mother's life. I asked him for a scenario in which an exception may be invoked.

Bill NapoliBILL NAPOLI: A real-life description to me would be a rape victim, brutally raped, savaged. The girl was a virgin. She was religious. She planned on saving her virginity until she was married. She was brutalized and raped, sodomized as bad as you can possibly make it, and is impregnated. I mean, that girl could be so messed up, physically and psychologically, that carrying that child could very well threaten her life.

Senator Napoli reminds me powerfully of Senator Opal, a fervent Dry with a large following, who was caught in a mixup of envelopes when he'd written to his bootlegger to complain about an overcharge. P.G. Wodehouse exposed him in Hot Water, but even then, it was only between the sheets.

This is probably the right time to say publicly that I was raped but at the time I wasn't a virgin, and I had also, unfortunately, outgrown my religiosity. Nor was I sodomized as bad as you can possibly make it, but I did think I was gonna die, and he did say he was gonna kill me, and he did pull me into a park that was so dangerous that after it happened I had to ask him to walk me out of it so I'd be safe. But I guess that doesn't count, as when it happened, I was on my way to my boyfriend's house, to fornicate.

This is also the time to say that I have had an abortion, and it was not convenient. Nor was it convenient to the mother of five in the same room who had a hard time paying to travel from a state in which abortion was banned to where it was legal and safe. It was not convenient to the other teary mess of a girl in the room, the kind described as face like the back of a bus but you don't have to look at her in the dark. She thought he loved her . . .

Abortion is never convenient.
Nor is it murder.
However, this sort of thing is.
See it in action, but don't look if obscenity disturbs you.