NIH funds effort to resurrect abandoned drugs for new uses

The most visible project of the new translational medicine centre at the US National Institutes of Health (NIH) came a little closer to reality today, with the announcement of nine awards that pair academic scientists with compounds cast off by the pharmaceutical industry.  The aim of the plainly named Discovering New Therapeutic Uses for Existing Molecules programme is to re-employ abandoned drugs for new uses — and in the process, show Congress that NIH’s youngest centre is delivering for the US taxpayer.

The fledgling National Center for Advancing Translational Sciences (NCATS) says that it will oversee the spending of US$12.7 million on the ambitious projects, which aim to produce treatments for ailments including Alzheimer’s disease, schizophrenia, alcoholism and calcified heart valves. As Nature wrote last October, the awardees have their work cut out for them: all the compounds, donated by big pharmaceutical firms, have been shown to be safe in humans but were discarded for lack of effectiveness against their original targets or for business reasons.

The drugs for the just-announced projects come from AstraZeneca, Eli Lilly, Janssen Research and Development, Pfizer and Sanofi.

NCATS director Christopher Austin (profiled recently in Nature) called the announcement of the awards a “major milestone”. The compounds involved may not have made for “the best business case”, says Austin, who once worked in drug discovery at Merck, but “these [new] indications may be fantastic for patients and public health”.

But John La Mattina, Pfizer’s former research chief, suggests that the programme may not produce many new applications for abandoned drugs.  “I do hope that people can have success in this type of work,” he writes in a Forbes blog post. “But I believe successes are going to be rare.”

This type of drug resurrection effort clearly has appeal beyond US shores; last year, the UK Medical Research Council and AstraZeneca made awards in a similar programme.

Report calls for open access to US food inspections

It has been just over a year since a widespread salmonella outbreak in the the US led to the recall of half a billion eggs. In the ensuing food safety scare, egg producers at two Iowa companies were hauled up before Congress to explain the deplorable conditions – including oozing manure, live rodents and flies too numerous to count – in their henhouses.

Now a report released on 30 November by the National Research Council (NRC) puts that episode along with the broader issue of food inspection back in the public spotlight. In the report, an expert committee convened by the NRC at the request of the US Department of Agriculture came out strongly in favor of free, easy public access to the voluminous data gathered by the department’s Food Safety and Inspection Service (FSIS) on individual meat and egg processors. These data include results of laboratory tests for baterial contaminants such as salmonella, pathogenic E. coli, and listeria monocytogenes, records of facility inspections and enforcement actions taken as a result of inspections.

Currently, some of the inspection data can only be obtained by filing a request under the Freedom of Information Act while those data that are more accessible typically do not include the names of specific food-processing faciltiies. For instance, one might be able to find how many E. Coli tests the FSIS conducted in ground beef so far in 2011, and how many had positive results. Company names would be available only in cases of product recalls.

The committee of the NRC – which is part of the National Academies – was asked by the department to assess the implications of making virtually all inspection, enforcement, sampling and testing data publicly accessible over the internet and linked to specific, named facilties.

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Cancellation of VOICE trial arm a blow to HIV prevention

VOICElogo-300b.jpgIn a second setback in as many months, researchers running a major HIV prevention trial have cancelled one of its arms after learning that a vaginal gel was not effective in protecting women who use it from acquiring the virus.

In press releases issued on 25 November, the US National Institute of Allergy and Infectious Diseases in Bethesda, Maryland, which is funding the study in sub-Saharan Africa, and MicrobicideTrials Network (MTN) of Pittsburgh, Pennsylvania, which is running it, said that women using a vaginal gel containing the anti-retroviral drug tenofovir were just as likely to contract the AIDS-causing virus as those applying a placebo gel. Among both groups, about 6% of women were infected during the course of a year. The lack of effect was discovered in a 17 November review of study data by an independent data safety and monitoring board.

The HIV prevention trial, dubbed VOICE, for Vaginal and Oral Interventions to Control the Epidemic, is being conducted in more than 5,000 uninfected, sexually active women in Zimbabwe, Uganda and South Africa. The MTN researchers said in a press release that the cancellation, “although disappointing…adds a critical dimension to discussions about the future of tenofovir gel.”

In September, another arm of the trial, comprising women taking oral tenofovir tablets, was cancelled because an independent data-oversight board determined that the trial would not be able to prove the oral tablets effective. The latest cancellation also comes just two days after the Global Fund to Fight AIDS, Tuberculosis and Malaria announced that it is halting funding of new grants until 2014, owing to budget troubles.

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Quantifying bang for the biomedical research buck

AAMC.cover.jpgWith the 2012 budget of the National Institutes of Health (NIH) up in the air as Congress struggles to craft next year’s spending bills, the Association of American Medical Colleges (AAMC) has issued a report that will doubtless provide fodder to NIH-boosters on Capitol Hill.

The report, The Economic Impact of Publicly Funded Research Conducted by AAMC-Member Medical Schools and Teaching Hospitals, claims that federal- and state-funded research at these institutions added nearly US$45 billion to the US economy in 2009. The research, it adds, supported nearly 300,000 jobs, or 1 in every 500 positions in the country.

In case politicians are slow to grasp the point, AAMC president Darrell Kirch made it crystal-clear in this accompanying press release: "Through this study we…can see how important this work is as an economic driver, funneling billions into the economy and providing hundreds of thousands of high-skilled jobs as well as indirect employment in communities around the country.”

The report was compiled by the economic consulting firm Tripp Umbach for the AAMC, which represents all of the country’s 135 medical schools and is a leading lobbyist for NIH funding.

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Reimagining disease by mining patients’ molecular data

precision-med-final260.jpgIn 2011, a patient newly diagnosed with type II diabetes will likely receive the same drug, metformin, that was first approved in 1957. What’s more – in the absence of information on the underlying molecular mechanisms of her particular case – that patient will likely end up taking a one-size-fits-all pill rather than a drug tailored for her unique disease subtype. Nor are there tests available that would allow her family members to pinpoint their genetic-based risk for the disease.

A new report issued today by the National Academy of Sciences, aims to change all that. Requested last year by Francis Collins, director of the National Institutes of Health (NIH), the report was intended to advise Collins on the need for, and feasibility of, a whole new classification of human diseases based on molecular biology. Today, the committee responded by saying that not only should a new taxonomy of diseases be developed, but that making it happen will require a vast network of databases integrating emerging molecular research with clinical data from patients. In an era of electronic medical records, the report says, such a goal is a achievable and the results would be transformative.

In its 66 pages, the report (you can read a briefer version of it here), concludes that the new classification system emerging from such a network would define diseases by their underlying molecular causes and drastically improve scientists’ access to patients’ information even while they are being treated. It adds that legal safeguards, like the Genetic Information Nondiscrimination Act, should preserve patient privacy, but that the highest sensitivity to the privacy issue, which will “make or break” the initiative, must be used.

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Obama’s prescription for medication shortage

drugshortageGraph300.jpgUS President Barack Obama today issued an executive order aimed at battling shortages of important and sometimes crucial prescription drugs that are impacting patient care and clinical trials of new medications.

“The shortage of prescription drugs drives up costs, leaves consumers vulnerable to price gouging and threatens our health and safety,” the president said. “This is a problem we can’t wait to fix”.

In this press release, the White House noted that reported shortages of prescription medicines nearly tripled between 2005 and 2010.

And according to this Congressional testimony by Charles Penley of the American Society of Clinical Oncology before the House Energy and Commerce Committee’s health subcommittee in September, over 150 clinical trials sponsored by the National Cancer Institute involve drugs that are in short supply. (Last month, Nature wrote about the problem’s impact on cancer clinical trials here.)

Using the limited, but still considerable, power of an executive order to attack the problem, Obama directed the Food and Drug Administration (FDA) to broaden required reporting by manufacturers when shortages or discontinuations of certain drugs loom, and to speed up agency reviews that can help prevent shortages, or respond to them. (The reviews include examinations of new manufacturing sites, drug suppliers, and manufacturing changes.) To underpin the effort, Obama directed more money towards staffing the FDA’s Drug Shortages Program office.

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Universal HPV vaccination for boys recommended

gard300.jpgRepublican presidential candidate Michele Bachmann may have railed recently in opposition to vaccinating schoolgirls against the cancer-causing human papilloma virus (HPV), but experts who advise the US Centers for Disease Control and Prevention (CDC) seem prepared to up the ante.

Today, on a vote of 13 in favor with one abstention, the CDC’s Advisory Committee on Immunization Practices said that 11- and 12-year-old boys, like their female counterparts, should receive the series of three immunizations against the virus, which infects some 20 million Americans and causes cancer of the cervix, vulva, vagina, penis, and anus as well as genital warts. Studies like this one in The New England Journal of Medicine also implicate HPV as a cause of oropharyngeal (throat) cancer.

The committee, whose recommendations are widely expected to be signed off by top CDC officials in coming months, said that the vaccinations could begin in boys as young as nine years old, and that 13-to-21-year-old males who have not been vaccinated should receive catch-up vaccinations.

Anne Schuchat, the director of the CDC’s National Center for Immunization and Respiratory Diseases, called the vote a “milestone in the nation’s battle against cancer.” Noting that the virus strains covered by the vaccine are responsible, for instance, for 80% of anal cancers, she added: “The committee did feel that the burden of disease in males justified routine vaccination. They felt there was likely to be additional benefit to girls and women by reducing the spread of the virus.”

Because the virus is so widespread, it is less and less effective to vaccinate as young people get older and become sexually active; in addition, the body’s response in terms of generating antibodies to HPV is strongest at age 11 or 12, Schuchat said.

The vaccine is made by Merck and marketed as Gardasil. The company put out this press release after the vote today. The Food and Drug Administration approved Gardasil for preventing genital warts in young females and males in 2006 and 2009 respectively, and anal cancer in both sexes in 2010.

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Q&A: MIT biologist to head NIH’s basic sciences institute

Kaiser.jpgChris Kaiser, a cell biologist who heads the department of biology at the Massachusetts Institute of Technology in Cambridge, will become director of the basic biosciences institute at the National Institutes of Health (NIH), the agency has announced.

Kaiser will move to NIH’s Bethesda, Maryland campus in early April 2012 to take the helm of the National Institute of General Medical Sciences (NIGMS), at US$2 billion the fourth-largest of the NIH’s 27 institutes and centres.

“He’s a magnificent choice. I can’t imagine a better person,” says Jeremy Berg, the former NIGMS director, who stepped down in June. Berg, who has known Kaiser since junior high school where they were both children of Stanford professors, says that Kaiser is “a basic scientist’s basic scientist. He really believes that understanding fundamental processes is absolutely crucial if we’re ever going to understand human biology well enough to make differences in human health.”

Kaiser, an NIGMS grantee himself since 1992, has worked with yeast to elucidate the basic mechanisms of protein folding and intracellular transport — work leading to the discovery of numerous genes and related mutations.

He is is also co-author of the fifth and sixth editions of a widely used textbook, Molecular Cell Biology, a job, says Berg, that is good preparation for his new gig, because it “gets you past the gels and plates of your lab and really thinking about where a field is and how much progress has been made.”

The NIGMS supports training and basic research that lays the foundation for discoveries across the life sciences from cell biology and biophysics to genetics and developmental biology. The roughly 4,500 grants it supports comprise some 10% of the NIH’s total.

Kaiser will be taking the reins of the institute at a time when both the NIGMS and the NIH as a whole are facing some major challenges. Grant success rates are at historic lows. And a proposed reorganization of NIH to create a new translational medicine center will mean that some programmes that are currently part of the National Center for Research Resources (NCRR) will be shifted over to the NIGMS — a plan that Berg vocally opposed.

Nature caught up with Kaiser to find out about his plans for NIGMS:

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Partnership aims to sequence 10,000 autistic genomes

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A research project launched today will blend the muscle of a huge Chinese genome sequencing center with the funding prowess and ambition of a high-profile American advocacy group, to create the world’s largest library of sequenced genomes from people with autism.

The American group Autism Speaks and Shenzhen-based BGI say in this press release that they plan to fully sequence 10,000 genomes in the next two years — genomes drawn mainly from families with two or more children with the poorly-understood disorder, which is marked by impaired communication and repetitive movements.

Most of the families are already participants in the Autism Genetic Resource Exchange, a US-based repository of DNA samples and relevant clinical and medical information from families with two or more children with autism. But researchers will also collect and sequence new samples from some 1,000 Chinese individuals, working with collaborators from Fudan University Medical School in Shanghai.

While a trove of papers have in recent years begun to tease out the genetic elements of autism, they have identified mutations in only about 15% of affected individuals. And while many studies have identified, for instance, point mutations and copy number variations — deletions or duplications of entire genes — few have systematically sequenced those portions of the vast three-billion-base-pair genome that do not code directly for proteins. It is suspected that abnormalities there may be responsible for some percentage of autism cases by, for example, altering the normal regulation of gene expression.

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Professor pleads not guilty in Huntsville murders

bishop.jpgAmy Bishop, the biology professor who allegedly gunned down three colleagues at the University of Alabama in Huntsville in 2010, entered a not-guilty plea, “by reason of mental disease or defect”, in an Alabama courtroom yesterday.

Today, the judge in Madison County circuit court ordered that Bishop’s trial begin on 19 March, 2012. He also unsealed court records in the case.

The prosecution is seeking the death penalty for the mother of four, who was denied tenure at the university eleven months before the shootings.

The unsealed records reveal that Bishop’s lawyers in May asked the court to declare the death penalty (as applied in Alabama) to be unconstitutional, partly on the grounds that court-appointed lawyers for death-penalty defendants in the state receive “grossly inadequate” wages and that there are no state-specified standards for their performance beyond five years of criminal law experience. Four days later, the request was denied.

Bishop, 46, opened fire with a 9-millimeter pistol during a biology faculty meeting in a small conference room on 12 February, 2010. Three of her colleagues were killed and three were wounded. Nature wrote about the events of that day, and the faculty’s first steps toward recovery, in detail here. We also reported on the department one year after the shootings here.

A Massachusetts grand jury has since indicted Bishop on charges of murdering her 18-year-old brother in 1986. That death had originally been ruled accidental.