The race to diminish peanut allergies in kids - Axios
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The race to diminish peanut allergies in kids

Illustration: Lazaro Gamio / Axios

Drug companies are racing to get the FDA's green light for immunotherapies to treat kids with peanut allergies — a breakthrough that might actually reduce their allergies, not just treat an allergic attack when it happens. They're testing everything from oral medicines to skin patches to vaccines and nasal sprays, with some companies hoping their products will reach the market by 2019.
Why it matters: Roughly 2% of all American children have a peanut allergy — which is one of the most dangerous food allergies — and alleviating reactions could save lives. Peanut allergy therapies also have drug companies seeing dollar signs, with a potential global market of up to $8 billion.
"If you had told me 40 years ago that AIDS would be a treatable disease and we would have [no FDA-approved drugs] for food allergies, I would have totally laughed at you. But here we are." -James Baker Jr., CEO of the consumer advocacy group Food Allergy and Research and Education
How it works: Immunotherapies aim to desensitize children's immune systems so their allergic reactions are not as severe.
Where it stands: There are almost 40 peanut allergy studies underway and listed on clinicaltrials.gov, and nearly 40 others completed recently.
"This is clearly an unmet need," says Gerald Nepom, director of Immune Tolerance Network, a mostly NIH-funded entity. The only current available remedy for patients is to avoid peanuts and carry an epinephrine shot at all times.
What to watch: The two therapies likely to seek regulatory approval first are a skin patch called Viaskin Peanut, by the French company DBV Technologies, and a pill called AR101, by California-based Aimmune Therapeutics.
Both are designed to deliver small amounts of peanut protein to "train the immune system to see peanut protein in a harmless sort of way," Nepom says.
  • DBV's small bandage-like patch would be for 4- to 11-year-old children. Hugh Sampson, DBV's chief scientific officer, tells Axios the patches work by transmitting the peanut protein through the skin to so-called Langerhans cells that then transport it to lymph nodes in order to reach the immune system.
  • Late-stage trials for the patch recently found it missed one of the benchmarks for the level of efficacy normally needed for FDA approval, although earlier trials had shown promise. Sampson says they'll still submit their application.
  • Aimmune's pill is currently being tested in patients 4 to 55 years old who take a pill daily for about 20 weeks with increasing dosages of peanut protein. Their application will likely go to the FDA in the first quarter of 2018.
In comparing the two trials so far, Baker says the skin patch showed lower efficacy but few side effects, while the pill had a higher rate of efficacy but wasn't tolerated as well by the patients. He says while it may take time to get either of these to the market, either would be welcomed as "we have nothing out there right now."
Early-stage trials: There are also dozens of other therapies in earlier testing stages.
The market: If approved, the launch prices of the products will be closely watched, given the outcry over egregious drug industry pricing practices. Aimmune believes its market will yield $1 billion in sales in the U.S., but some venture capital firms think the overall market will be even larger, since peanut allergies are often lifelong conditions.
Vamil Divan, a pharmaceutical industry analyst at Credit Suisse, says Aimmune's pill could command a price of more than $5,000 during the six-month ramp-up stage and then $400 per month "for maintenance." He estimates Aimmune could be collecting $1.3 billion of revenue and almost $600 million of profit by 2023.
The big questions:
  • How health insurers will cover the treatments.
  • Whether parents of kids with peanut allergies will pay a lot out of their own pockets when they buy the treatments.
  • How long kids will stay on the therapies before consuming small quantities of peanuts on their own.

Editor's note: We updated the quote in the third graph to clarify that Baker was talking about FDA-approved drugs.

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The mental health crisis among young Americans, by the numbers

Illustration: Sam Jayne / Axios

One in five American young adults under the age of 25 lives with a mental illness or behavioral disorder, NBC reports, citing the Centers for Disease Control and Prevention.

The big picture: Per the CDC's research, the state of young adult mental health in the U.S. is only worsening, with the suicide rate among teenage girls reaching a 40-year high in 2015. Here's a look at the numbers that tell the story of this crisis.

The numbers:

  • 15 million, or 1 in 5, American children and young adults battle mental illnesses or learning disorders.
  • 10 million, or two-thirds of them, are undiagnosed or aren't receiving treatment.
  • Among children ages 3 to 17: 6.8% are diagnosed with ADHD, 3.0% suffer from anxiety, 2.1% suffer from depression
Featured

New dinosaur discovery highlights fake fossil concerns

Visitors to the American Museum of Natural History examining a replica of a 122-foot-long dinosaur on display. Photo: Mary Altaffer / AP

The distinction between authentic and fake dinosaur fossiles is similar to that of artwork: sometimes blatantly obvious, and other times apparent to only experts. Some are questioning whether a fossil of a new dinosaur called Halszkaraptor— with "a bill like a duck but teeth like a croc's, a swanlike neck and killer claws," according to the AP — is real.

Why it's happening: There's a large market for fossils, which has led people "trying to earn a buck" to forge them for cash, Ed Yong writes at the Atlantic.

  • Forgers can make fossils appear more dramatic or novel by adding feathers, reconstructing tiny features, or even gluing specimens together to make them appear as one.
  • But one of the red flags about Halszkaraptor for Steve Brusatte from the Unviersity of Edinburgh is its murky past. Per Yong, the fossil traveled from Mongolia to Japan and Britain, and then France, which gives "few reassurances and many chances for tampering."
  • Philip Currie, at the Unviersity of Alberta, was one of the scientists called in to test Halszkaraptor's authenticity. He used a synchorotron to observe the "continuity of the bones and the rocks," and said he's "at least a 9" out of 10 on how sure he is that the fossil is real.
  • Currie told the Atlantic the only way to be absolutely positive, is if another team finds another fossil of the same specimen on their own.

Keep in mind: Fake fossils generally have "little impact" on our knowledge of dinosaurs, the Atlantic reports, because they aren't typically the subject of scientific research.

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Hormonal birth control linked to breast cancer, study says

A one-month pack of hormonal birth control pills. Photo: Rich Pedroncelli / AP

Women who use hormonal birth control — pills or devices that release hormones — are at a slightly higher risk for breast cancer, per a new study published in the New England Journal of Medicine.

Why it matters: It "upends widely held assumptions about modern contraceptives for younger generations of women," who think hormonal contraceptives are safer than old methods that contained higher amounts of estrogen, the New York Times reports.

The numbers: Scientists studied 1.8 million Danish women for over a decade and found those who used hormonal contraceptives had about a 20% increased risk of developing breast cancer. Among women who used hormonal birth control for more than 10 years, the risk rose to 38%. The study estimates 55 cases of breast cancer among every 100,000 women who do not use hormonal contraceptives and 68 cases among every 100,000 who do.

The bottom line: The study showed a relatively small increased risk for cancer among women who used these forms of contraceptives. Still, “there was a hope that the contemporary preparations would be associated with lower risk ... This is the first study with substantial data to show that’s not the case," David J. Hunter, a professor of epidemiology and medicine at the University of Oxford, told the NYT.

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Map of Southern California fires

Here's a look at where fires have been detected in Southern California as of 4 p.m. Eastern Time using data from NASA's MODIS and VIIRS instruments.

Data: NASA's MODIS and VIIRS instruments, CAL FIRE; Map: Lazaro Gamio / Axios
Featured

A rare fossil find and a new horseshoe crab

Vaderlimulus horseshoe crab fossil. Photo: New Mexico Museum of Natural History & Science

Before there were birds, mammals and dinosaurs, horseshoe crabs were here. Over the past 450 million years, these relatives of scorpions and spiders (not crabs) passed through five mass extinctions. They stuck to the coasts for the most part so there was little pressure for them to evolve. The horseshoe crabs you see today look similar to their earliest ancestors.

What's new: A recent fossil find in Idaho indicates that in the time in between some ancient horseshoe crabs were more diverse than previously thought. The 245-million-year-old specimen, from when the state sat on the coast of the supercontinent Pangea, is "a missing puzzle piece," Allan Lerner, a research associate in paleontology at the New Mexico Museum of Natural History and Science, tells Axios.

The past: Every now and again, horseshoe crabs ventured out — or rather in — to freshwater environments. When they did, their morphology is thought to have changed. The fossil record during this time is sparse though because horseshoe crabs lack an exoskeleton with minerals that can be preserved except under exceptional conditions.

The discovery: The fossil found in Idaho is so far the only specimen of a new genus called Vaderlimulus with a large — "extravagant would be a good word," Lerner says — helmet and small body that evolved as it expanded into a freshwater environment. Eventually it went extinct though Lerner says they aren't sure why.

The future: This discovery shows horseshoe crabs used to be diverse. But today, only four species remain, and they're in decline due to human actions.

"We shouldn't take for granted that because they have lived as long as they have they will survive," Lerner says.

Featured

The complicated ethics of womb transplants

The delivery of a baby born to a woman who received a uterus transplant at Baylor University Medical Center in Dallas. Photo: Baylor University Medical Center at Dallas

The first baby has been born to a mother in the United States from a transplanted uterus as part of a clinical trial conducted at Baylor University Medical Center in Dallas, TX.

Why it matters: Although it may mean more options for parents who can’t have children due to medical reasons or complications, it also raises some ethical questions.

The concerns:

  • The procedure is complicated, risky, and still experimental. It may be difficult to explain that risk adequately to women in order to receive informed consent for the procedure. But that shouldn’t halt progress on it, the trial's principal investigator Giuliano Testa argued on NPR this week.
  • There are also potential risks to the baby in a procedure that is still experimental. One is the use of strong immunosuppresive drugs in the mothers. Liza Johannesson, who pioneered the procedure in Sweden where eight babies have been born to mothers with transplanted uteruses in recent years and who has now joined the Baylor team, tells NPR: “Females have been giving birth after kidney and liver transplants for many, many years on immunosuppressive drugs. So we know what the effect of immunosuppressive drugs has on pregnancies, on babies, on recipients.”
  • The cost: Testa estimates $200,000 - $250,000, which could limit who can receive the procedure. And, there are other safe and less costly options including surrogacy and adoption. “We have other options that are safer for the fetus and the would-be mom. I’m not ready to say ‘Don’t do it,’ but you have to really proceed with caution here," bioethicist Arthur Caplan from the New York University School of Medicine told STAT in 2016, after the first uterus transplant in the U.S.
Featured

After Sandy Hook, gun rush led to 60 additional accidental deaths

Data: Levine & McKnight, Science, 2017 DOI:11 etc.; Note: Death rate deviation data is December of previous year to April of current year; Chart: Axios Visuals

In the five months after the mass shooting at Sandy Hook Elementary School, gun sales rose and people took their guns out of storage. This exposure led to at least 60 more accidental deaths than would otherwise have happened — and 20 of them were children, according to a new study published Thursday in the journal Science.

The details: These charts show monthly changes away from the expected seasonal rate of gun purchases and accidental firearm deaths in children. Following Sandy Hook, both spike dramatically.

"This event should have awakened people to what can we do in our society, but too many people took the opposite tact and caused more harm to themselves and others," David Hemenway, who conducts research on injury prevention at Harvard and was not involved in the study, tells Axios.

What they did: The researchers calculated the average rate of accidental firearm deaths for adults and children in the United States from 2008-2015, and measured deviations from that rate. They compared that to data on background checks, Google searches for 'buy gun' as a proxy for gun sales and searches for 'clean gun' to account for people taking their guns out of storage.

Finally, they broke the national data down state-by-state to check that the relationship between mass shootings, gun purchases, and gun deaths wasn't coincidental. Because the trend was true in each individual state, and not just in the national average, the association was stronger.

What they found: Background checks and Google searches for buying guns and about gun maintenance increased following Sandy Hook, indicating increased gun exposure — the rush stopped when the legislation failed . A large jump in accidental deaths in both adults and children occurred during that time. Then, as people learned how to use their guns or put them into storage, death rates returned to normal.

"It's really about exposure," says study author Phillip Levine, an economist at Wellesley College. "Regardless of how many guns there are, if they're all stored properly, the risk of accidental deaths is limited. It has to be about what's occurring that's leading them to not be stored properly at that moment."

What's happening: After mass shootings, particularly ones that raise the specter of gun control legislation, it's well documented that gun purchases rise, though the trend appears to have stopped since the election of a congress and president that are against gun control. This is one of the first studies to link those legislative battles and gun sale trends to accidental deaths.

Yes, but: There are a lot of factors at play during these watershed events, so it's difficult to put the blame solely on discussions of gun control, says Hemenway.

What's next: Levine would like to parse out the long-term effects of these gun purchases. There's little evidence of an increase in murders after shootings, but it makes sense to assume that more guns could lead to more murders or gun-involved domestic violence in the long run. But because so many other factors influence gun violence, it's extremely difficult to sort out any trend, says Levine.

Hemenway would like to see research into the impacts of multiple guns in a household. "The difference between 0 and 1 is enormous. Between 1 and 5, we just don't know."

A Catch-22: There are proven ways to reduce gun violence, notes economist and sociologist Philip Cook in policy piece that ran with the study. Concealed carry laws, laws that ban those convicted of domestic abuse from purchasing guns, and extended sentences aimed at curbing armed robbery all appear to measurably reduce gun violence. But in the initial act of passing such legislation, it's possible gun deaths may temporarily go up.

Despite this, "I don't think one should take away that you shouldn't bother trying," says Levine.


Alison Snyder contributed reporting to this story.

Featured

New paper: China is going head-to-head with the U.S. in AI

Alibaba's Jack Ma increasingly goes after the same market as Amazon. (Mark Lennihan / AP)

China's massive churn of raw data and determination to own the technologies of the future put it in a head-to-head race with the United States for dominance in artificial intelligence, according to a new paper co-authored by Kai-fu Lee, China's most prominent VC and the former head of Google China.
Why it matters: AI is widely expected to be the next broad technological advance that revolutionizes global business and whole economies. If Lee is right, China's advantages give it a strong chance to win the economic and geopolitical muscle that will accrue to whoever grabs the lead in AI research and applications. "A very good scientist with a ton of data will beat a super scientist with a small amount of data," Lee wrote, along with Eurasiagroup's Paul Triolo. "This is not always well understood, but it is critical to determining which companies–and countries–will take the global lead in AI development."

Here are key takeaways from the paper:

  • China's No. 1 advantage is its huge data sets and flexibility to use them in AI applications: Chinese use phones to pay for goods 50X more than Americans; they use them for food delivery 10X more than the US; and shared bicycles 300X more. All of that churns out data. "This single advantage will be insurmountable by other countries," the paper says.
  • Another advantage: China puts up few bureaucratic roadblocks, such as local and federal governments that sometimes embroil tech issues in "endless debates," and labor attempting to delay projects such as autonomous trucks.
  • Chinese self-driving tech is two years behind the US, but its companies will later at least co-lead in autonomous vehicles, in addition to optics and "Internet AI," business built around the amassing of data.
  • Beijing will become a co-leader with Silicon Valley as an AI innovation center.
  • China's Alibaba will hold its own against Amazon, and Tencent will "lead Facebook." Baidu will continue to lag Google in AI.
Featured

A black hole from the dawn of light

Artist’s conception of the most-distant supermassive black hole ever discovered. Illustration: Robin Dienel / Carnegie Institution for Science

Astronomers have found a black hole with a mass 800 million times greater than that of the Sun. The finding from 690 million years after the Big Bang, reported today in the journal Nature, may help scientists to better understand the evolution of the early universe when the first galaxies, stars and elements formed.

“It was the universe's last major transition and one of the current frontiers of astrophysics," astronomer Eduardo Bañados from the Observatories of the Carnegie Institution for Science said in a press release.

Some history: After a rapid phase of expansion immediately after the Big Bang, the plasma of electrons and protons in the universe began to cool about 400,000 years later and the particles clumped together to form neutral hydrogen gas. There was no light in the universe then until gravity formed matter into the first stars and galaxies. Their birth released ultraviolet light that pushed electrons out of the neutral hydrogen gas, putting it in the form we still see the gas in today — and the universe in a new phase where it was transparent to light.

What they saw: Using NASA's Wide-field Infrared Survey Explorer (WISE) and ground-based telescopes in Chile and New Mexico, they detected light from a quasar, bright disks of gas and dust that form as black holes draw in matter. The spectrum of light emitted indicated neutral hydrogen surrounds it — placing it in one of the universe'se key transitions.

"We have an estimate now, with about 1 to 2 percent accuracy, for the moment at which starlight first illuminated the universe," MIT's Rob Simcoe, an author of the study, told NPR.

It's size, given the universe was just 5% of its current age, is also confounding. “This black hole grew far larger than we expected in only 690 million years after the Big Bang, which challenges our theories about how black holes form," study co-author Daniel Stern of NASA's Jet Propulsion Laboratory said in a press release.

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The secrets hiding under Europa's ice

Jupiter's icy moon Europa. Photo: NASA / JPL-Caltech / SETI Institute

Europa, the second moon of Jupiter, is encased in a thick crust of ice. Sitting far from the Sun, it's one of the last places you would expect to harbor life. But due to its elliptical orbit around Jupiter — it periodically swings closer and further from the giant planet — the differences in gravity flex and squeeze the core, heating it to molten temperatures.

The end result: Buried under 100 kilometers of rock-hard ice is a globe-spanning liquid water ocean. More liquid water than on the Earth. But is there life?

Why it matters: New simulations suggest the icy shell is broken into segments that shift, flex, and subduct, just like the Earth's crust. Essential nutrients on the surface could then make their way to the ocean, providing a possible pathway for life —permanently locked away from sunlight — to survive.