Philip Bethge

Tag: medicine

  • Der Schatz im Silberfisch

    Antibiotika aus Fliegenblut, Wundsalben aus Madenspucke, Enzyme aus Käferkotze – Forscher entdecken den Wert der Insekten für Medizin und Ackerbau.

    Von Philip Bethge

    Des Totengräberkäfers Geschäft ist Leichenfledderei. Immer wenn etwas stirbt, im Wald oder auf der Flur, krabbelt er heran, gelockt vom Odem des Todes.

    Aus einigen Kilometer Entfernung kann das kaum zwei Zentimeter lange Insekt Witterung aufnehmen. Hat es ein totes Tier gefunden, einen Maulwurf etwa oder ein Vogeljunges, fängt es an zu buddeln und wird nicht müde, bis das Aas unter der Erde ist. Dort, in dieser Grabeshöhle, betupft der Käfer den Korpus mit Sekreten gegen die Verwesung. Ein anderer Saft verflüssigt den Kadaver dann zu Babybrei: Der Totengräber füttert seine Larven mit der stinkenden Fleischsoße.

    Appetitlich klingt das nicht. Doch Forscher sind begeistert von dem morbiden Kerbtier. Denn was der Totengräber mit seinen Körpersäften schafft, würde sich der Mensch gern zunutze machen.

    “Wie gelingt es einem so kleinen Käfer, eine komplette Maus zu konservieren und zu verflüssigen?”, fragt der Gießener Insektenforscher Andreas Vilcinskas, 51. “Das ist, als würde ich Sie anspucken und Sie lösten sich mit Haut und Haaren auf!”

    Der Totengräberkäfer sei ganz offenbar dazu in der Lage, extrem wirkungsvolle Konservierungsstoffe und Enzyme zu produzieren, sagt Vilcinskas. Und noch mehr erfreut den Forscher: “Ein solcher Kadaverbewohner muss eine tolle Immunabwehr haben.” Die einst, so die Hoffnung, auch dem Menschen Gesundheit schenken kann.

    Vilcinskas ist Leiter des Loewe Zentrums für Insektenbiotechnologie & Bioressourcen in Gießen. Krabbeltiere sind seine Leidenschaft. Doch nicht Antennenlänge oder Gliederzahl interessieren den Professor – er begeistert sich für die inneren Werte der Tiere. “Jedes einzelne Insekt ist ein prall gefüllter Wirkstoffschrank”, sagt der Entomologe. Die Sechsbeiner seien die erfolgreichste Tiergruppe auf Erden, “und ich bin überzeugt, dass ihre Vielfalt sich auch in den Molekülen widerspiegelt, die sie produzieren”.

    Vilcinskas glaubt, Wirkstoffe aus den kleinen Körpern gewinnen zu können, die Krankheitserreger bekämpfen oder Getränke haltbar machen; er hofft auf Medikamente ….

    –> Weiterlesen auf Spiegel.de

  • The Wizard of Stem Cell Science: Robert Lanza and the Dawning of a New Era of Hope

    Ethical worries have slowed medical research into applications for stem cells. But scientists like Robert Lanza have developed less controversial ways to derive stem cells from normal body cells rather than embryos and are already launching the first clinical trials.

    By Philip Bethge

    Stem cell researcher Robert Lanza hopes to save thousands of lives — and for a long time this caused him to fear for his own.

    “They bused these crazy people up from Kansas, and then they picnicked right outside our front door,” he says as he gazes out of his window at the gray winter landscape of Marlborough, Massachusetts. “The public thought we had these little buggy-eyed embryos here and were ripping apart their limbs to get these cells.”

    The physician always feared “somebody hiding in the bushes,” waiting to attack him. At the time, a doctor was threatened at a nearby fertility clinic, and a pipe bomb exploded at a bio lab in Boston.

    “Back then I thought that there was probably a 50-50 chance that I was going to get knocked off because I was so visible,” says the doctor. Then he leans back in his chair and laughs. Lanza likes to flirt with danger: “I said, okay, try to kill me — I’m still going to do what I think is right.”

    In Lanza’s case, doing what is “right” involves working with therapies based on human stem cells. The blind shall see again; the paralyzed shall walk again; the hemophiliac shall not bleed anymore. That may sound like something out of the Bible, but Lanza is no faith healer. In fact, the US business magazine Fortune called him “the standard-bearer for stem cell research.” The 57-year-old is the chief scientific officer at the US company Advanced Cell Technology (ACT) and one of the most flamboyant and controversial figures in this field of research.

    Militant anti-abortionists tried to hunt Lanza down because embryos had to die for his research. Just last year, the scientific journal Nature wrote that ACT has “a history of public blunders” and a reputation for “overhyping results.”

    At the same time, however, Lanza is writing medical history. For over one year now, eye patients in the US and the UK have been treated with cells from ACT laboratories — the first clinical stem cell trial worldwide.

    And there is a world premiere in the making: Lanza’s team has cultivated blood platelets that could be tested in hospitals as early as this year. The researcher and his team didn’t harvest the cells from embryonic stem cells, but rather from induced pluripotent stem (iPS) cells derived from normal body cells.

    “It took a decade,” says Lanza, “but now we are finally ready to move into the clinic with our stem cell therapies.”

    The Making of a Rebel Scientist

    Lanza is a slender man with short hair that stands on end, and he speaks so quickly that his sentences tend to be cut off. His laboratory is located in an ugly commercial building on the outskirts of Marlborough. It’s hard to imagine that a medical revolution is brewing in this dreary setting. The petri dishes, test tubes and steel containers filled with liquid nitrogen are teeming with human cells. The ACT “Master Cell Bank” cost $1 million (€770,000), says Lanza, “but these things grow like weeds once a stem cell line has been established.”

    The cell factory is currently producing batches of iPS blood platelets. Emergency wards have a huge demand for these helpers in the body’s natural clotting mechanism. Lanza explains that a lack of these elements can have dramatic consequences: His sister was seriously injured during an accident. The hospital didn’t have enough blood platelet concentrate. “She bled to death,” he says.

    Lanza wants to prevent something like that from ever happening again. His team has found ways to cultivate an “unlimited supply” of the cells. When frozen, he says, they can be kept for months. He is currently negotiating the final details of the planned study with the Food and Drug Administration (FDA). “We don’t need any embryos to make iPS,” Lanza says with pride. “If this type of stem cell works,” he adds, “the whole ethical controversy will be eliminated.”

    Venturing to start clinical trials now is seen as a bold step. But Lanza is used to falling out of line. Even back when he was a schoolboy — just after the genetic code had been deciphered — he decided to alter the genetic makeup of a white chicken to make it black. “So I went to my teacher and told him that I was going to change the genetic makeup of the birds,” Lanza recounts. “He said: ‘Lanza, you’re going to go to hell.’”

    This merely encouraged the 13-year-old. He cobbled together some laboratory equipment. To gain support for his experiment, the youngster boarded a bus in his hometown of Stoughton, close to Boston, and went “looking for a Harvard professor,” as he explains with a grin. At first, his journey appeared to end at the closed gates of Harvard Medical School. But Lanza soon saw “a short, balding guy” coming across the parking lot. “He was wearing khaki pants and had a bunch of keys,” he says. “I thought he was the janitor.” The boy had no idea that this was Stephen Kuffler, one of the most famous neurophysiologists of his time.

    Kuffler played along: He opened the door for Lanza, allowed the boy to explain to him how genetics worked, and pushed him up the stairs. This opened up a new universe for the up-and-coming scientist. He repeated his chicken experiment and landed his first publication in Nature.

    The Dawning of a New Medical Era

    Lanza likes to tell this story to visitors. It shows how zeal can overcome all obstacles. He is often compared to the main character played by Matt Damon in the film “Good Will Hunting,” a highly talented outsider who, like Lanza, comes from a humble background.

    “Right from the beginning, I probably didn’t follow the rules,” says Lanza with a certain amount of pride. He studied medicine at Harvard. In South Africa, he worked with Christiaan Barnard, the surgeon who performed the world’s first human heart transplant in 1967, and with Jonas Salk, who developed the polio vaccine in the 1950s. Then, in 1996, the world’s first cloned sheep, Dolly, was born in Britain — and Lanza sensed that his hour had arrived.

    “I knew right away that cloning could revolutionize medicine,” he says. With the help of cloned stem cells, the young researcher was convinced that a wide range of top-notch replacement parts could be created for the human body.

    The physician signed up with the biotech startup ACT. Working for the company in 2000, he cloned a gaur, an endangered wild bovine native to Southeast Asia. Later, his team managed to transform the frozen skin cells of a banteng into a living sample of this Asian wild cattle. The skin cells came from an animal that had died a quarter of a century earlier in the San Diego Zoo.

    For Lanza, these were just practice exercises. The ultimate goal for him was always people — and he was at just the right place for that: In 2001, then-ACT CEO Michael West went before the press and announced that his company had cloned a human embryo for the first time. West spoke of the beginning of “a new era of medicine.” Then all hell broke loose.

    —> Read original article at SPIEGEL Online International

    Obstacles Along the Way

    When Lanza harkens back to those days, he becomes more serious. Although the ACT embryos had only grown to tiny balls consisting of six cells, for anti-abortion activists and pro-lifers the researcher was now the Antichrist incarnate.

    “I remember that I went down to Tennessee, to the Bible country, and I went to one of those churches to explain what we were really doing. As I went through the door with the minister, a guy got up and shouted “Murderer! Murderer!” Lanza hired a bodyguard.

    In the wake of the media coup, ACT started to founder. Investors withdrew from the company, and with George W. Bush in the White House, public funding for stem cell research dried up. “We went through multiple times where we lost the whole team,” says Lanza, who notes that they even had their phone disconnected for a while. “Rather than curing diseases, we were trying to resolve theological problems,” Lanza says bitterly. “And that’s not what I studied medicine for.”

    Talking about the issue has slowly made the doctor furious and, almost imperceptibly, his tone of voice is becoming shriller. Another story has to be told, that of a policeman standing in front of the door one day. Lanza was afraid that he would be arrested. But no: “He came into my office and said that he had a child who was slowly going blind,” the physician recalls. “He said that he had heard of these cells that could supposedly help, and I said: ‘Yes, I have these cells in a freezer, but I don’t have the $20,000 to test them on mice.’”

    Lanza had to turn the man away. It pains him to this day. “I don’t want to know how many people went blind because we lost our public funding,” he says angrily. “Nobody gets it; they say everything is fine; no, it’s not fine!”

    Changes in the Political Environment and Scientific Advances

    Attention shifted away from ACT. Instead, everyone started talking about Geron, another biotech company on the West Coast. Researchers there had succeeded in cultivating nerve cells from embryonic stem cells. With support from Christopher Reeve, the paralyzed “Superman,” there was renewed hope that spinal cord injuries could be healed. Three patients were treated using the therapy developed by Geron. But in November 2011, the company put the brakes on the research due to a lack of funds.

    That was the moment when Lanza realized that he once again had to play the role of stem-cell-research poster boy. But this time he had something to show for his efforts. Benefiting from progress that Geron had made, ACT had also managed to gain FDA approval for a clinical trial.

    Researchers had cultivated so-called retinal pigment epithelium (RPE) cells, which form a thin layer over the retina and keep the photoreceptor cells nourished and healthy.

    In July 2011, doctors at the University of California in Los Angeles (UCLA) injected the first two patients directly behind the retina, each with some 50,000 RPE cells from Lanza’s cell factory. There are now 36 patients in the US and the UK taking part in the trials. They either suffer from the hereditary Stargardt disease or age-related macular degeneration (AMD), both of which are conditions in which RPE cells slowly die, resulting in a loss of vision.

    Initial Success and Tempered Optimism

    One of the Stargardt patients is David Lee, from the northern English town of Leigh, just outside of Manchester. Following a routine eye checkup 25 years ago, Lee was told that he suffers from the disease. Over the ensuing years, he has had to idly stand by while he progressively loses his eyesight. “Watching television has become very hard, and reading is impossible without magnification,” the 47-year-old says.

    Then Lee heard about the stem cell trials and submitted an application to become a subject in the study. In late July 2012, he was operated on by a team working under surgeon James Bainbridge at Moorfields Eye Hospital in London. The doctors injected RPE cells in Lee’s left eye. “I was exceptionally happy about it,” he says.

    Lee regularly travels to London to have his eyes examined. His physicians are satisfied. The RPE cells from the bio lab are thriving in Lee’s retina. “I see definitely brighter on the eye that was operated on,” he says.

    He runs a bakery out of a small brick house in the center of Leigh, and he can still see just well enough to be able to sell cakes, pastries and bread. “I know that I won’t get my sight back”, Lee says. “But, for me, it would already be a big success not to lose any more of my sight.”

    Many of the patients report that the therapy is effective. “We have some surprisingly good visual outcome,” says Steven Schwartz, an eye surgeon at UCLA. He says that one of his patients can read a clock again and go shopping, while another can recognize colors again. In addition to AMD and Stargardt patients, Schwartz plans to integrate extremely nearsighted individuals into the test program soon. The FDA has already approved the clinical trials.

    Lanza is a “genius” and his work is “stellar,” Schwartz says. “The patients seem to tolerate the cells well,” he says. But the researcher warns against overly optimistic expectations, adding that it remains completely uncertain whether the innovative eye therapy will actually heal these ailments. He notes that the trials are mainly meant to test the safety of the procedure.

    Stem cells can transform into virtually any type of body cell. Once they have become differentiated, they tend not to cause any problems. But what happens if they continue to develop, and one of the RPE cells from the lab mutates in the eye and becomes malignant?

    “I worry that a single case of cancer in a stem cell model like this could set the field back enormously,” says Arthur Caplan, a bioethicist at the University of Pennsylvania. He is concerned that ACT may be pursuing its clinical trials far too aggressively. After all, the company has to placate its investors and outdo the competition.

    Competitors and Risks

    Indeed, Lanza will have to hurry up if he wants to be the first to come up with a clinically tested application for iPS cells. His greatest rival is located in Kobe, Japan, at the RIKEN Center for Developmental Biology. There, Dr. Shinya Yamanaka is working on groundbreaking stem cell therapies.

    And the Japanese researcher is a very capable contender. After all, he received the Nobel Prize in physiology or medicine last October for his method of producing iPS cells. Like Lanza, Yamanaka is striving to use stem cells to cure blindness from macular degeneration (AMD). But, unlike Lanza, he plans to use iPS cells.

    “Lanza is under tremendous pressure to show some positive results,” Caplan warns, adding that he is without a doubt a serious researcher. “But ACT has a history of overselling. They made a lot of promises in the past that just haven’t delivered.”

    Lanza is aware of the bad press. “Mistakes have been made,” he admits. But he remains feisty. For instance, he accuses Yamanaka, his Japanese counterpart, of venturing an experiment that is particularly risky. “We still don’t entirely understand how safe iPS cells are and how they work,” says Lanza. Using them to cultivate RPE cells to treat eye diseases is dangerous, he adds, because the cells could possibly become cancerous in patients’ eyes.

    “By contrast, we picked platelets for our first clinical trial with iPS because they have no nuclei,” he says. There is no chance of them growing out of control.

    Enthusiastic about the Future

    “Come have a look, I’m going to show you something else,” Lanza says at the end of the interview, as he opens a binder and pulls out a diagram that charts age relative to degree of paralysis. It has to do with multiple sclerosis. Lanza has studied mice that suffer from this crippling neurological disorder. The curve documents the sad fate of untreated animals: At the age of two, they drag their hind legs behind them. At the age of three, they are completely paralyzed.

    But it’s a completely different story among the mice that were treated with stem cells: The curve of this group can hardly be differentiated from that of healthy animals. “One shot of these cells and they are jumping around completely normal,” Lanza says with enthusiasm. The researcher treats the animals with so-called mesenchymal stem cells (MSCs), which are cultivated from embryonic stem cells or iPS cells. They resemble bone marrow cells and secrete substances in the body that work like a fountain of youth.

    “That’s the future,” Lanza says. He points to an entire list of diseases that could potentially be treated with MSC cells, including chronic pain, arthritis and Parkinson’s. “The biological potency of these cells is just incredible! And we can make them by the millions,” he exclaims.

    This is what Lanza is like when he’s in the grips of enthusiasm. His eyes sparkle and his gestures underscore each word. At moments like these, one senses how far his enthusiasm can take him.

    “Before ACT hired me, they gave me a task,” he explains. “I was asked to get all the Nobel laureates in the country to sign a letter to support embryonic stem cell research.”

    Lanza put his fax machine to work. Ever since then, he has had a stack of letters in his desk drawer — with the signatures of 70 Nobel Prize laureates.

    Translated from the German by Paul Cohen

    —> Read original article at SPIEGEL Online International

  • SPIEGEL Blog: Surrogate Mother (Not Yet) Sought for Neanderthal

    An interview published last week by SPIEGEL with American genetic scientist George Church has sparked frenetic media speculation about a supposed plan to bring the Neanderthal back from the dead. Church feels his remarks were mistranslated, but it was other media outlets that twisted his words.

    “Wanted: Surrogate Mother For Neanderthal,” screamed an article in the Berliner Kurier tabloid in the German capital on Tuesday, complete with an image of a grinning, bearded caveman. Britain’s Independent seemed positively creeped out by a Harvard professor who wanted to bring such beings back to life as some kind of “Palaeolithic Park.” Meanwhile, the Daily Telegraph implored: “Spare Neanderthals This Modern Freak Show.”

    Media and websites around the world — in Britain, Italy, Poland, Greece, Hungary, Russia, South Korea and Turkey — expressed interest in the idea of resurrecting the Neanderthal. By Wednesday morning, more than 600 sources on Google News had reported the story, with all citing SPIEGEL as their source. What happened?

    The source of the net furore was an interview SPIEGEL conducted with George Church. The Harvard University genetic researcher then provided an explanation to the Boston Herald for the sudden media fever. He blamed it on an error downstream of SPIEGEL. He said it had been incorrectly reported that he was looking for a surrogate mother to carry a Neanderthal clone.

    The sudden interest in the Neanderthal, our human cousin, may tell us a little bit about the diffuse fear of overly ambitious genetic researchers. But it tells us even more about the laws of tabloid journalism.

    In this case, the entire brouhaha arose in articles written outside of SPIEGEL’s domain. And it is important to us to communicate this because we make a significant effort to ensure that our stories are correctly translated when they appear on our English-language website. Occasionally mistakes slip through — as is inevitable with any site that relies heavily on translation — but when they do we are quick to correct them.

    In addition, we sent Church an English version of our interview the week before it went to print for authorization. This provided him with an opportunity to change any formulations that may have caused any room for misinterpretation. We did make some alterations later without checking, and have since apologized to him for introducing the word “hell,” which he did not say.

    A Storm of Coverage

    It should quickly be obvious to anyone following the hype over the Neanderthal surrogate mother closely that the storm of coverage didn’t break out until a week after the interview was published. Last Friday, we posted the interview, which we had requested from George Church because we had been fascinated by his latest book. The title alone, “Regenisis,” seemed promising.

    And Church didn’t disappoint in his interview. He laid out the great future he believes the still relatively young research field of “synthetic biology” will have. Regardless whether he was discussing the cloning of humans, the genetic optimization of Homo sapiens, the manipulation of the genetic code of all life forms or the re-creation of the Neanderthal, nothing was treated as taboo in his interview. In other words, it offered plenty of fodder for both controversy and thrilling entertainment.

    The interview first appeared in the German-language print edition of SPIEGEL on Monday, Jan. 14, and the raft of outraged reader letters reflected the intense interest the interview generated. Church has always presented himself as a bold and argumentative visionary who won’t hesitate to consider anything that might be scientifically feasible.

    Initially, few media outlets picked up the story. Nor did that change after we posted a short article focusing primarily on Church’s remarks on the potential for resurrecting the Neanderthal on SPIEGEL ONLINE in German. The hype machine got going shortly after that.

    It was only then that the story was given the decisive spin — by other media outlets. Early tweets on the interview, may have helped to set the tone, like one person who tweeted: “My life’s new ambition: Mate with a Neanderthal woman.” A short time later, the first journalist stumbled across the interview’s emotive word: “surrogate.” That’s when headlines like the one that appeared in the Daily Mail — “Harvard professor seeks mother for cloned cave baby” — were born. Subsequent tweets are already discussing the possibility of a film being made of the story.

    The question of whether a surrogate mother could be used for a possible future Neanderthal clone does in fact pop up in the interview. In the question, we cite a passage in Church’s book in which he writes that, “a whole Neanderthal creature itself could be cloned by a surrogate mother chimp — or by an extremely adventurous female human.”

    No Want Ad Implied

    It would have to be clear to anyone who gives that passage in the interview a critical read — and the same applies to both the German and English versions — that it is in no way intended as some kind of want or personal ad. Church didn’t mean it that way and we didn’t understand it to mean that either. Really, what Church was explaining is that he considers the rebirth of the Neanderthal to be technically possible. He also explains the steps that would be necessary to get there. The last step, someday, would be the search for a surrogate mother. He also says that he believes the chances are good that he might experience the birth of the first Neanderthal clone within his lifetime. We thought that statement alone was a bit of a reach, particularly given that Church is 58 years old today.

    We’re sorry that Church, who provided us with such fascinating insights into his research, has now become the victim of media hype. In the course of the past two decades, he told the Boston Herald, he has done perhaps 500 interviews about his research and this is the first one to spiral out of control quite like this.

    What’s perhaps most bizarre about the entire media hysteria over Church’s interview is that potential surrogate mothers are now contacting the geneticist. His concern — at least if things get to that stage — that he will have difficulty finding potential surrogate mothers appears to be unfounded.

    *Editor’s Note: At the request of George Church, five changes have been made to the above text. In particular, he wanted to avoid the impression that he had blamed a translation error on the part of DER SPIEGEL for the confusion that ensued following the interview’s publication.

     

  • Interview with George Church: Can Neanderthals Be Brought Back from the Dead?

    In a SPIEGEL interview, synthetic biology expert George Church of Harvard University explains how DNA will become the building material of the future — one that can help create virus-resistant human beings and possibly bring back lost species like the Neanderthal.

    –> Update: The Interview has sparked frenetic media speculation about a supposed plan to bring the Neanderthal back from the dead. Church feels his remarks were mistranslated, but it was other media outlets that twisted his words.

    George Church, 58, is a pioneer in synthetic biology, a field whose aim is to create synthetic DNA and organisms in the laboratory. During the 1980s, the Harvard University professor of genetics helped initiate the Human Genome Project that created a map of the human genome. In addition to his current work in developing accelerated procedures for sequencing and synthesizing DNA, he has also been involved in the establishing of around two dozen biotech firms. In his new book, “Regenesis: How Synthetic Biology Will Reinvent Nature and Ourselves,” which he has also encoded as strands of DNA and distributed on small DNA chips, Church sketches out a story of a second, man-made Creation.

    SPIEGEL recently sat down with Church to discuss his new tome and the prospects for using synthetic biology to bring the Neanderthal back from exctinction as well as the idea of making humans resistant to all viruses.

    SPIEGEL: Mr. Church, you predict that it will soon be possible to clone Neanderthals. What do you mean by “soon”? Will you witness the birth of a Neanderthal baby in your lifetime?

    Church: I think so, but boy there are a lot of parts to that. The reason I would consider it a possibility is that a bunch of technologies are developing faster than ever before. In particular, reading and writing DNA is now about a million times faster than seven or eight years ago. Another technology that the de-extinction of a Neanderthal would require is human cloning. We can clone all kinds of mammals, so it’s very likely that we could clone a human. Why shouldn’t we be able to do so?

    SPIEGEL: Perhaps because it is banned?

    Church: That may be true in Germany, but it’s not banned all over the world. And laws can change, by the way.

    SPIEGEL: Would cloning a Neanderthal be a desirable thing to do?

    Church: Well, that’s another thing. I tend to decide on what is desirable based on societal consensus. My role is to determine what’s technologically feasible. All I can do is reduce the risk and increase the benefits.

    SPIEGEL: So let’s talk about possible benefits of a Neanderthal in this world.

    Church: Well, Neanderthals might think differently than we do. We know that they had a larger cranial size. They could even be more intelligent than us. When the time comes to deal with an epidemic or getting off the planet or whatever, it’s conceivable that their way of thinking could be beneficial.

    SPIEGEL: How do we have to imagine this: You raise Neanderthals in a lab, ask them to solve problems and thereby study how they think?

    Church: No, you would certainly have to create a cohort, so they would have some sense of identity. They could maybe even create a new neo-Neanderthal culture and become a political force.

    SPIEGEL: Wouldn’t it be ethically problematic to create a Neanderthal just for the sake of scientific curiosity?

    Church: Well, curiosity may be part of it, but it’s not the most important driving force. The main goal is to increase diversity. The one thing that is bad for society is low diversity. This is true for culture or evolution, for species and also for whole societies. If you become a monoculture, you are at great risk of perishing. Therefore the recreation of Neanderthals would be mainly a question of societal risk avoidance.

    SPIEGEL: Setting aside all ethical doubts, do you believe it is technically possible to reproduce the Neanderthal?

    Church: The first thing you have to do is to sequence the Neanderthal genome, and that has actually been done. The next step would be to chop this genome up into, say, 10,000 chunks and then synthesize these. Finally, you would introduce these chunks into a human stem cell. If we do that often enough, then we would generate a stem cell line that would get closer and closer to the corresponding sequence of the Neanderthal. We developed the semi-automated procedure required to do that in my lab. Finally, we assemble all the chunks in a human stem cell, which would enable you to finally create a Neanderthal clone.

    SPIEGEL: And the surrogates would be human, right? In your book you write that an “extremely adventurous female human” could serve as the surrogate mother.

    Church: Yes. However, the prerequisite would, of course, be that human cloning is acceptable to society.

    SPIEGEL: Could you also stop the procedure halfway through and build a 50-percent Neanderthal using this technology.

    Church: You could and you might. It could even be that you want just a few mutations from the Neanderthal genome. Suppose you were to realize: Wow, these five mutations might change the neuronal pathways, the skull size, a few key things. They could give us what we want in terms of neural diversity. I doubt that we are going to particularly care about their facial morphology, though (laughs).

    SPIEGEL: Might it one day be possible to descend even deeper into evolutionary history and recreate even older ancestors like Australopithecus or Homo erectus?

    Church: Well, you have got a shot at anything where you have the DNA. The limit for finding DNA fragments is probably around a million years.

    SPIEGEL: So we won’t be seeing the return of the caveman or dinosaurs?

    Church: Probably not. But even if you don’t have the DNA, you can still make something that looks like it. For example, if you wanted to make a dinosaur, you would first consider the ostrich, one of its closest living relatives. You would take an ostrich, which is a large bird, and you would ask: “What’s the difference between birds and dinosaurs? How did the birds lose their hands?” And you would try to identify the mutations and try to back engineer the dinosaur. I think this will be feasible.

    SPIEGEL: Is it also conceivable to create lifeforms that never existed before? What about, for example, rabbits with wings?

    Church: So that’s a further possibility. However, things have to be plausible from an engineering standpoint. There is a bunch of things in birds that make flying possible, not just the wings. They have very lightweight bones, feathers, strong breast muscles, and the list goes on.

    SPIEGEL: Flying rabbits and recreated dinosaurs are pure science fiction today. But on the microbe level, researchers are already creating synthetic life. New bacteria detect arsenic in drinking water. They create synthetic vaccines and diesel fuel. You call these organisms “novel machines”. How do they relate to the machines we know?

    Church: Well, all organisms are mechanical in the sense that they’re made up of moving parts that inter-digitate like gears. The only difference is that they are incredibly intricate. They are atomically precise machines.

    SPIEGEL: And what will these machines be used for?

    Church: Oh, life science will co-opt almost every other field of manufacturing. It’s not limited to agriculture and medicine. We can even use biology in ways that biology never has evolved to be used. DNA molecules for example could be used as three-dimensional scaffolding for inorganic materials, and this with atomic precision. You can design almost any structure you want with a computer, then you push a button — and there it is, built-in DNA.

    SPIEGEL: DNA as the building material of the future?

    Church: Exactly. And it’s amazing. Biology is good at making things that are really precise. Take trees for example. Trees are extremely complicated, at least on a molecular basis. However, they are so cheap, that we burn them or convert them into tables. Trees cost about $50 a ton. This means that you can make things that are nearly atomically precise for five cents a kilo.

    SPIEGEL: You are seriously proposing to build all kinds of machines — cars, computers or coffee machines — out of DNA?

    Church: I think it is very likely that this is possible. In fact, computers made of DNA will be better than the current computers, because they will have even smaller processors and be more energy efficient.

    SPIEGEL: Let’s go through a couple of different applications of synthetic biology. How long will it take, for example, until we can fill our tanks with fuel that has been produced using synthentic microbes?

    Church: The fact is that we already have organisms that can produce fuel compatible with current car engines. These organisms convert carbon dioxide and light into fuels by basically using photosynthesis.

    SPIEGEL: And they do so in an economically acceptable way?

    Church: If you consider $1.30 a gallon for fuel a good number, then yeah. And the price will go down. Most of these systems are at least a factor of five away from theoretical limits, maybe even a factor of 10.

    SPIEGEL: So we should urgently include synthetic life in our road map for the future energy supply in Germany?

    Church: Well, I don’t necessarily think it’s a mistake to go slowly. It is not like Germany is losing out to lots of other nations right now, but there should be some sort of engineering and policy planning.

    –> Read original interview at SPIEGEL Online International

    Is Church Playing God?

    SPIEGEL: Germans are traditionally scared of genetically modified organisms.

    Church: But don’t forget: The ones we are talking about won’t be farm GMOs. These will be in containers, and so if there’s a careful planning process, I would predict that Germany would be as good as any country at doing this.

    SPIEGEL: There has been a lot of fierce public opposition to genetic engineering in Germany. How do you experience this? Do you find it annoying?

    Church: Quite to the contrary. I personally think it has been fruitful. And I think there are relatively few examples in which such a debate has slowed down technology. I think we should be quite cautious, but that doesn’t mean that we should put moratoriums on new technologies. It means licensing, surveillance, doing tests. And we actually must make sure the public is educated about them. It would be great if all the politicians in the world were as technologically savvy as the average citizen is politically savvy.

    SPIEGEL: Acceptance is highest for such technology when it is first applied in the medical industry …

    Church: … yes, and the potential of synthetic life is particularly large in pharmaceuticals. The days of classic, small molecule drugs may be numbered. Actually, it is a miracle that they work in the first place. They kind of dose your whole body. They cross-react with other molecules. Now, we are getting better and better at programming cells. So I think cell therapies are going to be the next big thing. If you engineer genomes and cells, you have an incredible amount of sophistication. If you take AIDS virus as an example …

    SPIEGEL: … a disease you also want to beat with cell therapy?

    Church: Yes. All you have to do is take your blood cell precursors out of your body, reengineer them using gene therapy to knock out both copies of your CCR5 gene, which is the AIDS receptor, and then put them back in your body. Then you can’t get AIDS any more, because the virus can’t enter your cells.

    SPIEGEL: Are we correct in assuming you wouldn’t hesitate to use germ cell therapy, as well, if you could improve humans genetically in this way?

    Church: Well, there are stem cell therapies already. There are hematopoietic stem cell transplants that are widely practiced, and skin stem cell transplants. Once you have enough experience with these techniques you can start talking about human cloning. One of the things to do is to engineer our cells so that they have a lower probability of cancer. And then once we have a lower probability of cancer, you can crank up their self-renewal properties, so that they have a lower probability of senescence. We have people who live to be 120 years old. What if we could all live 120 years? That might be considered desirable.

    SPIEGEL: But you haven’t got any idea which genes to change in order to achieve that goal.

    Church: In order to find out, we are now involved in sequencing as many people as possible who have lived for over 110 years. There are only 60 of those people in the world that we know of.

    SPIEGEL: Do you have any results already?

    Church: It’s too early to say. But we collected the DNA of about 20 of them, and the analysis is just beginning.

    SPIEGEL: You expect them all to have the same mutation that guarantees longevity?

    Church: That is one possibility. The other possibility is that they each have their own little advantage over everybody else. What we are looking for is protective alleles. If they each have their own answer, we can look at all of them and ask, what happens if you put them all in one person? Do they cancel each other out, or do they synergize?

    SPIEGEL: You seriously envisage a new era, in which genes are used as anti-aging-cures?

    Church: Why not? A lot of things that were once left to luck no longer have to be if we add synthetic biology into the equation. Let’s take an example: virus resistance …

    SPIEGEL: … which is also achievable using synthetic biology?

    Church: Yes, it turns out there are certain ways to make organisms of any kind resistent to any viruses. If you change the genetic code …

    SPIEGEL: … you are talking about the code that all life forms on Earth use to code their genetic information?

    Church: Exactly. You can change that code. We’re testing that out in bacteria and it might well be possible to create completely virus-resistant E. coli, for example. But we won’t know until we get there. And I am not promising anything. I am just laying out a path, so that people can see what possible futures we have.

    SPIEGEL: And if it works in bacteria, you presumably could then move on to plants, animals and even humans? Which means: no more measles, no more rabies, no more influenza?

    Church: Sure. And that would be another argument for cloning, by the way, since cloning is probably going to be recognized as the best way of building such virus resistance into humans. As long as it is safe and tested slowly, it might gain acceptance. And I’m not advocating. I’m just saying, this is the pathway that might happen.

    SPIEGEL: It all sounds so easy and straightforward. Aren’t biological processes far more complicated than you would like to lead us to believe?

    Church: Yes, biology is complicated, but it’s actually simpler than most other technologies we are dealing with. The reason is that we have received a great gift that biology has given to us. We can just take a little bit of DNA and stick it into a human stem cell, and all the rest of it is self-assembled. It just happens. It’s as if a master engineer parked a spacecraft in our back yard with not so many manuals, but lots of goodies in it that are kind of self-explanatory. You pick up something and you pretty much know what it does after a little study.

    SPIEGEL: Do you understand that there will be people who feel rather uncomfortable with the notion of changing the genome of the human species?

    Church: I think the definition of species is about to change anyway. So far, the definition of different species has been that they can’t exchange DNA. But more and more, this species barrier is falling. Humans will probably share genes with all sorts of organisms.

    SPIEGEL: First you propose to change the 3-billion-year-old genetic code. Then you explain how you want to create a new and better man. Is it any wonder to you when people accuse you of playing God?

    Church: I certainly respect other people’s faith. But, in general, in religion you wouldn’t want people to starve. We have 7 billion people living on this planet. If part of the solution to feed those people is to make their crops resistant to viruses, then you have to ask: Is there really anything in the Bible that says you shouldn’t make virus-resistant crops? I don’t think there’s anything fundamentally more religiously problematic about engineering a dog or a cow or a horse the way we have been doing it for 10,000 years versus making a virus-resistant crop.

    SPIEGEL: Virus-resistant crops is one thing. Virus-resistant humans is something altogether different.

    Church: Why? In technology, we generally don’t take leaps. It’s this very slow crawl. We are not going to be making a virus-resistant human before we make a virus-resistant cow. I don’t understand why people should be so deeply hurt by that kind of technology.

    SPIEGEL: Apart from religious opposition, biotechnology also generates very real fears. Artificial lifeforms which might turn out to be dangerous killer-bugs. Don’t we need special precautions?

    Church: We have to be very cautious, I absolutely agree. I almost never vote against caution or regulations. In fact, I requested them for licensing and surveillance of synthetic biology. Yes, I think the risks are high. The risks of doing nothing are also high, if you consider that there are 7 billion people who need food and are polluting the environment.

    SPIEGEL: Mr. Church, do you believe in God?

    Church: I would be blind, if I didn’t see that faith in an overall plan resulted in where we are today. Faith is a very powerful force in the history of humanity. So I greatly respect different kinds of faith. Just as I think diversity is a really good thing genetically, it’s also a good thing societally.

    SPIEGEL: But you’re talking about other people’s faith. What about your own faith?

    Church: I have faith that science is a good thing. Seriously, I’d say that I am very much in awe of nature. In fact, I think to some extent, “awe” was a word that was almost invented for scientists. Not all scientists are in awe, but scientists are in a better position to be in awe than just about anybody else on the planet, because they actually can imagine all the different scales and all the complexity. A poet sees a flower and can go on and on about how beautiful the colors are. But what the poet doesn’t see is the xylem and the phloem and the pollen and the thousands of generations of breeding and the billions of years before that. All of that is only available to the scientists.

    SPIEGEL: Mr. Church, we thank you for this conversation.

    Interview conducted by Philip Bethge and Johann Grolle.

    –> Read original interview at SPIEGEL Online International

  • A Future of Self-Surveillance? Tech Pioneers Track Bodily Functions Day and Night

    Using smartphone apps and sensors, high tech pioneers are monitoring their own bodily functions such as heart rates, sleep patterns and blood. The ‘self trackers’ dream of a digitalized medicine that will enable people to lead healthier lives by getting around-the-clock updates on what goes on inside their bodies

    By Philip Bethge

    Larry Smarr’s large intestine appears to float in the middle of the room, nestled like a stuffed sausage between his other virtual organs.

    Smarr, a computer science professor, adjusts the dark-tinted 3D glasses perched on his nose and picks up an electronic pointer. “And this is where the wall of my colon is inflamed,” he says, pointing out a spot where the intestinal walls are indeed noticeably swollen.

    A supercomputer combined MRI images of the 63-year-old professor to create the three-dimensional illusion now projected on the wall. It gives the impression that the viewer could go for a stroll inside the researcher’s abdomen. (more…)

  • Antibiotics Prove Powerless as Super-Germs Spread

    Antibiotics were once the wonder drug. Now, however, an increasing number of highly resistant — and deadly — bacteria are spreading around the world. The killer bugs often originate in factory farms, where animals are treated whether they are sick or not. By SPIEGEL Staff

    The pathogens thrive in warm, moist environments. They feel comfortable in people’s armpits, in the genital area and in the nasal mucous membranes. Their hunting grounds are in the locker rooms of schools and universities, as well as in the communal showers of prisons and health clubs.

    The bacteria are transmitted via the skin, through towels, clothing or direct body contact. All it takes is a small abrasion to provide them with access to a victim’s bloodstream. Festering pustules develop at the infection site, at which point the pathogens are also capable of corroding the lungs. If doctors wait too long, patients can die very quickly.

    This is precisely what happened to Ashton Bonds, a 17-year-old student at Staunton River High School in Bedford County, in the US state of Virginia. Ashton spent a week fighting for his life — and lost. This is probably what also happened to Omar Rivera, a 12-year-old in New York, who doctors sent home because they thought he was exhibiting allergy symptoms. He died that same night.

    The same thing almost happened at a high school in the town of Belen, New Mexico. Less than two weeks ago, a cheerleader at the school was hospitalized after complaining about an abscess. Twelve other female students had been afflicted with suspicious rashes. All the students tested positive for a bacterium that the US media has dubbed the “superbug.”

    The school administration in Belen believes that the bacterium was spread on mats in the school’s fitness and wrestling rooms. The facility was thoroughly disinfected 40 times, and yet the fear remains.

    Fears of a Pandemic

    Microbiologists refer to this bacterium as community-acquired methicillin-resistant Staphylococcus aureus, or ca-MRSA. The terrifying thing about it is its resistance to almost all common antibiotics, which complicates treatment. And, in contrast to the highly drug-resistant hospital-acquired MRSA (ha-MRSA) strains, which primarily affect the elderly and people in hospitals and nursing homes, ca-MRSA affects healthy young people. The bacterium has become a serious health threat in the United States. Doctors have already discovered it in Germany, although no deaths have been attributed to it yet in the country.

    The two bacteria, ha-MRSA and ca-MRSA, are only two strains from an entire arsenal of pathogens that are now resistant to almost all available antibiotics. Less than a century after the discovery of penicillin, one of the most powerful miracle weapons ever produced by modern medicine threatens to become ineffective.

    The British medical journal The Lancet warns that the drug-resistant bacteria could spark a “pandemic.” And, in Germany, the dangerous pathogens are no longer only feared “hospital bugs” found in intensive care units (ICUs). Instead, they have become ubiquitous.

    About two weeks ago, consumers were alarmed by the results of an analysis of chicken meat by the environmentalist group Friends of the Earth Germany (BUND), which found multidrug-resistant bacteria on more than half of the chicken parts purchased in supermarkets.

    The dangerous bacteria have even been detected on one of Germany’s high-speed ICE trains. Likewise, more than 10 percent of the residents of German retirement homes have been colonized by MRSA bacteria. In their case, every open wound is potentially deadly. The pathogens have also been found on beef, pork and vegetables.

    Another alarming finding is that about 3 to 5 percent of the population carries so-called ESBL-forming bacteria in the intestine without knowing it. Even modern antibiotics are completely ineffective against these highly resistant bacteria.

    Diminishing Defenses

    When the neonatal ICU at a hospital in the northern German city of Bremen was infested with an ESBL-forming bacterium last fall, three prematurely born babies died.

    Infestation with multidrug-resistant bacteria is normally harmless to healthy individuals because their immune systems can keep the pathogens under control. Problems arise when an individual becomes seriously ill.

    “Take, for example, a person who is having surgery and requires artificial respiration and receives a venous or urinary catheter,” explains Petra Gastmeier, director of the Institute of Hygiene and Environmental Medicine at Berlin’s Charité Hospital. “In such a case, the resistant intestinal bacteria can enter the lungs, the bloodstream and the bladder.”

    This results in urinary tract infections, pneumonia or sepsis, which are increasingly only treatable with so-called reserve antibiotics, that is, drugs for emergencies that should only be administered when common antibiotics are no longer effective.

    The Spread of Killer Bugs

    Recently, an even greater threat has arisen. With the spread of ESBL-forming bacteria, reserve antibiotics have to be used more and more frequently, thereby allowing new resistances to develop. In fact, there are already some pathogens that not even the drugs of last resort in the medical arsenal can combat.

    In India, where poor hygiene and the availability of over-the-counter antibiotics encourage the development of resistance, an estimated 100 to 200 million people are reportedly already carriers of these virtually unbeatable killer bacteria. There is only one antibiotic left — a drug that is normally not even used anymore owing to its potentially fatal side effects — that is still effective against these killer bacteria. In serious cases, people who become infected with these types of pathogens dieincreasingly only treatable with so-called reserve antibiotics, that is, drugs for emergencies that should only be administered when common antibiotics are no longer effective.

    The Spread of Killer Bugs

    Recently, an even greater threat has arisen. With the spread of ESBL-forming bacteria, reserve antibiotics have to be used more and more frequently, thereby allowing new resistances to develop. In fact, there are already some pathogens that not even the drugs of last resort in the medical arsenal can combat.

    In India, where poor hygiene and the availability of over-the-counter antibiotics encourage the development of resistance, an estimated 100 to 200 million people are reportedly already carriers of these virtually unbeatable killer bacteria. There is only one antibiotic left — a drug that is normally not even used anymore owing to its potentially fatal side effects — that is still effective against these killer bacteria. In serious cases, people who become infected with these types of pathogens die of urinary tract infections, wound infections or pneumonia.

    The killer bugs have also reached England, presumably through medical tourists who traveled to India for cosmetic surgery, and they have reportedly already infected several hundred people. A few cases have also turned up in Germany.

    Israel even experienced a nationwide outbreak a few years ago. Within a few months, about 1,300 people were afflicted by an extremely dangerous bacterium that killed 40 percent of infected patients. Even today, the same bacterium still sickens some 300 people a year.

    (–> Read original story at SPIEGEL ONLINE)

    The Post Antibiotic Era

    This rapid spread has caused many to wonder whether more and more people in Germany will soon die of infectious diseases that were supposedly treatable, as happened in centuries past. Unfortunately, there are many indications that this might ultimately be the case.

    “We are moving toward a post-antibiotic era,” predicts Yehuda Carmeli of the Tel Aviv Sourasky Medical Center. “But it won’t happen on one day or at the same time in every part of the world. And that’s the tragedy, because this means that it is not perceived as a serious problem.”

    The World Health Organization (WHO) recently warned against an impending medical catastrophe. And, in The Lancet, leading healthcare experts published an urgent appeal: “We have watched too passively as the treasury of drugs that has served us well has been stripped of its value. We urge our colleagues worldwide to take responsibility for the protection of this precious resource. There is no longer time for silence and complacency.”

    In fact, the carelessness with which doctors and farmers are jeopardizing the effectiveness of one of the most important groups of drugs borders on lunacy. Some 900 metric tons of antibiotics are administered to livestock each year in Germany alone. Instead of treating only those animals that are truly sick, farmers routinely feed the medications to all of their animals. Likewise, some 300 metric tons of antibiotics are used to treat humans each year, far too often for those merely suffering from a common cold.

    A Foe We Helped Become More Flexible

    This large-scale use inevitably leads to the spread of resistant bugs. Indeed, antibiotics offer ideal growth conditions to individual bacteria that have naturally become resistant through a small change in their genetic makeup. Simply put, they benefit from the fact that the antibiotics still kill off their competitors, the non-resistant bacteria.

    In many cases, a genetic mutation isn’t even necessary to allow a resistant bacterium to develop. Bacteria can incorporate bits of genetic material from other pathogens. For example, for millions of years, the gene for ESBL resistance lay dormant in the ground, where it was part of a complicated ecosystem of bacteria, penicillin-producing fungi and plant roots. Again and again, the gene was incorporated by human intestinal bacteria — as useless ballast. It was only the large-scale use of antibiotics that provided the ESBL-forming bacteria with the opportunity to proliferate.

    Recent studies show that quantities of antibiotics much smaller than previously thought can lead to the development of resistance. In retrospect, the uncontrolled dispensing of antibiotics has proven to be a huge mistake. “In the last 30 years, we have contaminated our entire environment with antibiotics and resistant bacteria,” says Jan Kluytmans, a microbiologist at Amphia Hospital, in the southern Dutch city of Breda. “The question is whether this is even reversible anymore. Perhaps we can prevent only the worst things from happening now.”

    Shocking Levels of Antibiotic Abuse on Farms

    Since a large share of resistant bacteria come from barns, it will be critical to drastically reduce the use of antibiotics in agriculture. Remarkably often, farmers, feedlot operators and veterinarians are themselves carriers of multidrug-resistant bacteria. Kluytmans has even demonstrated that the pathogens found in humans are very often genetically identical with the bacteria detected on meat.

    It’s virtually impossible to become infected by eating such meat, at least as long as it’s well-cooked. The risk arises when raw meat comes into contact with small wounds. What’s more, even vegetable crops can become contaminated when liquid manure is spread onto fields.

    The exhaust gases emitted by giant feedlots for pigs and chickens could also pose a danger greater than previously thought. These meat factories blow bacteria, viruses and fungi into the air. The government of the western German state of North Rhine-Westphalia has commissioned a study to determine whether feedlots are discharging multidrug-resistant bacteria, thereby endangering people in the surrounding areas.

    Last year, North Rhine-Westphalia was also the first German state to systematically investigate the use of antibiotics in chicken farms. The horrifying conclusion was that more than 96 percent of all animals had received these drugs — sometimes up to eight different agents — in their short lives of only a few weeks. “That was the proof that the exception — namely, treating disease — had become the rule,” says Johannes Remmel, a Green Party member and the state’s consumer protection minister.

    Abysmal Feedlot Conditions

    As the results of the investigation suggest, factory farming is to blame. The bigger an operation, the more antibiotics are administered to individual animals. Investigators also noted that the duration of antibiotic use was usually very short — shorter than specified in the licensing requirements. This saves money, but it also promotes the formation of resistance.

    The fact that livestock farmers mix antibiotics into feed has to do with production conditions in feedlots:

    • To produce veal, animals from different sources that are too weak for milk and beef production — and likewise more susceptible to infectious diseases — are often jammed into enclosures.
    • Pigs are usually kept in very small spaces, making them very aggressive and causing them to fight. Their wounds have to be treated with antibiotics.
    • In the past, it took 80 days until a chicken was ready for slaughter. Today it’s only 37 days. Chicken farmers have a profit margin of only a few cents per animal. To minimize losses through disease, poultry producers and their veterinarian helpers use antibiotics as a preventive tool.

    However, factory farming is also possible without the uncontrolled use of antibiotics. Dairy cows, for example, are usually not given these drugs since antibiotics would interfere with the production of cheese and yogurt. Nevertheless, there are still plenty of inexpensive milk products on supermarket shelves.

    “In the Netherlands,” says Kluytmans, “the use of antibiotics in feedlots was even reduced by about 30 percent within two years — partly as a result of stricter regulations for veterinarians. That’s more than we administer to humans.” Unfortunately, he adds, the use of antibiotics in feedlots is practically a matter of religious belief.

    Efforts to Combat Antibiotics Abuse

    In early January, Ilse Aigner, Germany’s minister of food, agriculture and consumer protection, unveiled a package of measures aimed at curbing the use of antibiotics in farm animals. The measures include stricter controls that would make it more difficult to add antibiotics urgently needed in human medicine to animal feed. Germany’s federal government is also considering suspending veterinarians’ right to dispense medicine. In contrast to doctors practicing medicine on humans, who prescribe drugs to be purchased at pharmacies, veterinarians can even directly sell drugs to farmers and feedlot owners, which means they stand to profit handsomely from the large-scale use of antibiotics.

    However, Remmel, the consumer protection minister of North Rhine-Westphalia, believes that Aigner’s proposals are “deceptively packaged,” and he is calling for exact specifications on the amounts of antibiotics that can be used.

    Similarly, there is also little control over the use of antibiotics in human medicine. In Germany, in particular, doctors prescribe antibiotics as they see fit, whereas in the Netherlands doctors must first consult with a microbiologist.

    “Just as in pain therapy, there really ought to be experts for treatment with antibiotics,” says Gastmeier, the director of the Institute of Hygiene and Environmental Medicine at Berlin’s Charité Hospital “But young doctors, in particular, are often relatively uninformed.” Indeed, in medical school, they learn very little about the proper use of antibiotics.

    Little Research into New Antibiotics

    Still, even more responsible prescribing practices will hardly be able to stop the advance of resistant bacteria in the long term. What’s more, no new antibiotics can be seen on the horizon. Only four pharmaceutical companies worldwide are still working on developing new agents.

    “Antibiotics have a serious problem,” says Wolfgang Wohlleben of the Institute of Microbiology at the University of Tübingen, in southwestern Germany: “They actually work.” Indeed, the drugs can get the better of an infection within a few hours or days, and then they are no longer needed. By contrast, patients taking drugs to fight high blood pressure or diabetes often have to take them for the rest of their lives — which translates into steady, reliable profits for pharmaceutical companies.

    Yet another factor making antibiotic-related R&D unattractive is the fact that doctors can only prescribe a new antibiotic in the most extreme of emergencies lest it lose its efficacy within a short amount of time.

    Given these circumstances, major pharmaceutical companies stopped searching for new antibiotics years ago. Nowadays, only small start-ups or university-based researchers are interested in the field.

    Abandoned by Big Pharm

    In reality, the search for new drugs should be getting easier rather than more difficult. In the 1990s, the large pharmaceutical companies spent several million euros searching for weaknesses in the genetic makeup of bacteria. But although the researchers were actually successful, the subsequently developed drugs never made the final leap into clinical use.

    “In the end, the risks of antibiotic research were simply too great for companies,” says pharmacist Julia Bandow, who went into academia to continue studying antibiotics after working for the US-based pharmaceutical giant Pfizer for six years.

    But without the large pharmaceutical companies, there can be little hope of progress. After all, testing a drug in human subjects takes years and costs millions. And, as Bandow says of her fellow academics, “We can’t do it alone.”

    If pharmaceutical companies refuse to invest in the necessary studies, it’s critical for the government to step in. At the least, politicians could make the development of antibiotics more attractive, for example, by extending the time before patents expire so as to allow companies to earn returns on their investments for longer. But, so far, these are all nothing but ideas.

    “At some point in the coming years,” says microbiologist Kluytmans, “there will be a disaster involving resistant pathogens with many casualties. Only then will something change.”

    BY PHILIP BETHGE, VERONIKA HACKENBROCH, LAURA HÖFLINGER, MICHAEL LOECKX and UDO LUDWIG

    Translated from the German by Christopher Sultan

  • ‘Starfish, Daisies and Raying Purple Forms’: Oliver Sacks on the Wonder of Sight

    Oliver Sacks (© Luigi Novi / Wikimedia Commons)
    Oliver Sacks (© Luigi Novi / Wikimedia Commons)

    In a SPIEGEL interview, New York neurologist and author Oliver Sacks discusses his new book, “The Mind’s Eye,” which explores how creative people compensate for their sight disorders or blindness. He also discusses his own “face blindness,” which makes it difficult to recognize people.

    (–> photo-gallery OPTICAL ILLUSIONS)

    SPIEGEL: Dr. Sacks, five years ago, you were diagnosed with a melanoma in your right eye. You thought you would die soon. What has happened since?

    Sacks: Well, obviously, I didn’t die. I was told that a melanoma in the eye is more benign than I previously thought, but in those early weeks after the diagnosis, I was still very prone to fear and a sort of black humor. Fortunately, that fear has largely gone away. My feeling now is that time is doubly precious.

    SPIEGEL: How is your eye these days?

    Sacks: I am actually a little shy about it. I feel it does look bad …

    SPIEGEL: … not at all!

    Sacks: … well, I bled into the eye and I can’t see through it. So I regard the eye as being out of action. And whether I will recover any sight in it, I don’t know.

    SPIEGEL: Did the tumor change your perception?

    Sacks: When this presented itself, I noticed that a segment of my vision was missing. I always use the ceiling fan for checking my visual fields. And in the three weeks while I was waiting for surgery, I went from missing one blade to missing three blades. After surgery, my vision was becoming distorted, so that, for example, people looked as if they were elongated and tilted over to one side, almost insect-like. And faces had these strange, sort of puffy protoplasmic extrusions. There was a Francis Bacon exhibit here a while back that reminded me of that.

    SPIEGEL: Did you see things that weren’t there?

    Sacks: You mean hallucinations? Yes, I did, and I do have them. I tend to see things like little starfish, daisies and raying purple forms … let me bring you something … I kept one or two notes … so that’s my journal (he returns with a huge pile of notebooks).

    SPIEGEL: In your new book, you describe the blind spot in your right eye as a “gaping nowhere.”

    Sacks: Wait, I’ll show you what it looked like, I made a drawing of it. See, it has more or less the shape of Australia. It causes me a lot of trouble when I bump into people or lamp posts, but it sometimes fills me with wonder, too. One day, for example, I looked at my foot with my right eye and sort of amputated it with my blind spot, a little above the ankle. But when I moved my foot a little, wiggling the toes, the stump seemed to grow a translucent pink extension with a ghostly protoplasmic halo around it. As I continued wiggling my toes, this took on a more definite form until, after a minute or so, I had a complete phantom foot.

    (-> read original article at SPIEGEL ONLINE international)

    SPIEGEL: You specialize in treating patients with neurological disorders. Now you’ve turned into a case study yourself. Do you see this as some sort of dark irony?

    Sacks: I do think that it’s a particular irony. Stereo vision for example, which you can only truly have with two eyes, has always been very important for me. From the age of 10 or even earlier, I have loved stereo photography and stereograms. For many people, this loss probably sounds trivial, maybe because they’re not so conscious of having it; and if they lose it, they hardly notice it. But for people like me, it’s really bad.

    SPIEGEL: There are other ways for the brain to calculate depth: perspective, movement, shadows. People with vision in only one eye can even drive motorcycles.

    Sacks: But they can’t experience depth! And they don’t know what they miss. I once asked a friend, Sue Barry, who was cross-eyed all her life, if she could imagine stereo vision and she said, “Sure I can.” But later, through vision therapy and with the help of special glasses, she gained stereo vision and found herself in a truly spectacular new world. She loved it and came to me and said: “I was wrong.” No one without it can imagine what stereo vision is like, just as a totally colorblind person can’t imagine what color is like.

    SPIEGEL: All your case studies seem to have a common theme: the remarkable ability of the brain to compensate and adapt. How do you cope?

    Sacks: I don’t think that I have adapted very well. I use a stick now because high curbs are a special danger for me. They look like horizontal lines on the ground. If a room is cluttered, rather than seeing objects in space, I see surfaces which are sometimes on top of each other. I wish I could paint because the world looks to me very much like a canvas with shapes and colors.

    SPIEGEL: To what degree can the mind compensate for the loss of input? In other words, how colorful can a blind person’s world possibly be?

    Sacks: Oh, very colorful! Zoltan Torey for example, an Australian, who was blinded in an industrial accident when he was 21, visualizes things to the point where he shocked his neighbors by replacing the gutters on the roof of his house at night. If you talk to Zoltan, you don’t feel he’s blind. He seems to be looking at you because he visualizes you in a very vivid, detailed manner. However, of course, if you very quietly turn your back at him, he wouldn’t know.

    SPIEGEL: Is it some kind of virtual reality he is creating?

    Sacks: No, he does not form a perceptual world. It doesn’t have, for example, all the details; imagery can never be as rich in detail as reality. Zoltan would go on what information he had. Since he was not blind from birth, he has visual memories that he can call on.

    SPIEGEL: In theory at least, is anyone who becomes blind later in life capable of compensating with more or less detailed imagery?

    Sacks: Not necessarily. John Hull, who corresponds with me by mail, lost his vision when he was in his forties. He describes his state as one of “deep blindness” — a total absence of any imagery. Two years after becoming blind, Hull couldn’t evoke the image of his wife or his children. He said he couldn’t even say which way around the number three went.

    SPIEGEL: Does he miss the images?

    Sacks: No. He even seems to like his condition. He feels he lives in an authentic, autonomous world, in his words one of “concentrated human condition.”

    SPIEGEL: Are you surprised that people’s minds react so differently in comparable circumstances?

    Sacks: Originally, I was very surprised. But, these two, I now realize — and I’ve seen dozens of blind people — are extremes. People adapt in different ways, they come up with all sorts of things. Ten to 15 percent of the people who lose their sight hallucinate — and not just little things, but faces and scenes and animals. Others don’t hallucinate at all.

    (-> read original article at SPIEGEL ONLINE international)

    SPIEGEL: Is there something like a psychological resilience that makes some people cope better than others?

    Sacks: Well, I mean, Zoltan feels that John Hull was too passive and too acquiescent, to put it bluntly. If you are asking how much of it is a decision to do things and how much is physiology, that’s really a difficult question to answer.

    SPIEGEL: Lillian Kallir, a celebrated musician and one of your patients, lost her ability to read music. Later on, she couldn’t read words anymore or identify objects. What’s different when the mind, and not the eye, loses the ability to see?

    Sacks: When Lillian wrote to me, she was very puzzled. She asked, “How come I can see tiny little letters, and I can’t make sense of them?” This is perception stripped of meaning. You may occasionally experience this yourself. Proust gives an example of this when he wakes up one morning and he doesn’t know where he is or who he is, and he says, “Memory comes down like a rope from heaven.” For Lillian, however, memory doesn’t come back.

    SPIEGEL: How did Lillian describe her experience to you?

    Sacks: The whole visual world was confusing for her. Once she took my medical bag instead of her own purse although they looked totally different. But Lillian stayed calm and found ways of living with this. At home, for example, she organized things by color or by position, so that she could identify them, even though they didn’t carry any visual meaning for her. Also, she still had rough categories for things. I remember showing her a picture of a wolf. She wasn’t able to identify it. But she thought that it maybe was a baby elephant. So she could see it was an animal.

    SPIEGEL: Some of your patients seem to even gain something from their impairments, for example the painter who lost his color vision but found an even stronger aesthetic identity by working in black and white. Can the tragedies you report on ultimately become opportunities for growth?

    Sacks: Well, one wouldn’t wish any of these conditions on anyone, yet there may be a positive side. When the left temporal lobe of the brain gets damaged, people may have a sudden heightened visual facility, and, for example, start painting. People with certain other conditions turn out to be better than normal at reading facial expressions and at hearing expressions of voice. This is not an instantaneous thing. It takes a while to develop. It’s a way to survive and to organize their new world in new ways.

    SPIEGEL: You once compared the brain to an “orchestra that conducts itself, with an ever-changing score and repertoire.” Are the off-key performances of this orchestra more widespread than we think?

    Sacks: I believe that most of us have small frailties and flaws in how we make sense of the world. In fact, there is an impairment which I myself share with a lot of people: I have trouble recognizing faces. It is quite distressing. If you have this condition, you always fear that people might think that you don’t care or that you are not sufficiently attentive. However, the recognition of faces doesn’t depend on attention. It’s pre-attentive. People who are face blind have to learn to pay unusual attention to the way people are dressed, the way they stand, their voice or the way they move.

    SPIEGEL: If you’d meet us five minutes after our conversation in the elevator, would you recognize us?

    Sacks: I probably wouldn’t. Although I noticed you were both tall people, but then — there are lots of tall people (laughs).

    SPIEGEL: Why is it so difficult for the brain to make sense of the visual world?

    Sacks: Because it requires the orchestration of 40 or 50 different areas in the brain. These areas have to do with meaning, with association, emotion and so forth. Fortunately, we are not a blank sheet when we are born. We already have all sorts of potentials, and these have to be developed by experience. I am fascinated, for example, by our ability to read. There is no part of the brain that has been shaped by evolution for reading. Reading has only been around for 5,000 years. The reason why we were able to learn how to read is our inherent potential for shape recognition.

    SPIEGEL: Let’s say we could understand the processes of perception, cognition, language and thinking. Would we then be able to enter the inner world of somebody and put ourselves in somebody else’s mind?

    Sacks: A very primitive thought reading is possible already, with the medical imaging that is available today. If you ask people to imagine a piece of music, to recite a poem internally or to imagine a color, you will find particular parts of the brain light up. However, the more sophisticated thought reading will never become a reality because there’s novelty and uniqueness in everyone. Everyone’s brain develops in a particular way. Even if you could, theoretically, transmit your brain cells to someone else, they wouldn’t know what to make of it.

    SPIEGEL: Why not?

    Sacks: Because the language of uniqueness and subjectivity will never be replaced by the language of physiology. For example, if you think of a certain wonderful moment — when there was that marvelous time when your were 22 and in the love and the moon was rising in a starlit sky — how is this moment imprinted in the brain? We don’t know. Our methods are so crude. There are millions and millions of neurons with tens of thousands of connections to others. The degree of it all is unimaginable. Our medical imagery is getting better and better, but I don’t think that we can ever catch up.

    SPIEGEL: Dr. Sacks, we thank you for this interview.

    Interview conducted by Philip Bethge and Rafaela von Bredow

    (-> read original article at SPIEGEL ONLINE international)

  • Brooke the Immortal: An American Child May Hold Secrets to Aging

    Brooke Greenberg is almost 18, but she has remained mentally and physically at the level of a toddler. An American physician is trying to uncover the child’s secret. He wants to give mankind the gift of eternal life.

    By Philip Bethge

    It is possible that the key to immortality is hidden in this delicate girl, who is only about 76 centimeters (2 feet, 6 inches) tall and weighs seven kilograms (15.4 pounds). Her arms and legs are as fragile as the branches of a young tree. Her laugh sounds like the whimper of a puppy; she has hazel eyes. And when Brooke Greenberg wants her mother she stretches out her tiny arms, shakes her head slowly, and twists her face into a lopsided moue.

    “Come here, Brooke, yes, you are a pretty girl.” Melanie Greenberg, 49, picks up the fragile looking child and gently strokes her back. “She loves being held,” says Greenberg, a mother of four. Brooke’s sisters are named Emily, Caitlin and Carly. Brooke is the second youngest. She will be 18 in January.

    Other girls her age are driving, going out dancing and sleeping with their first boyfriends. But for Brooke it’s as if time had stood still. Mentally and physically, the girl remains at the level of an 11-month-old baby.

    “Brooke is a miracle,” says her father, Howard Greenberg. “Brooke is a mystery,” says Lawrence Pakula, her pediatrician. “Brooke is an opportunity,” says Richard Walker, a geneticist with the University of South Florida College of Medicine. They all mean the girl from Reisterstown, a small town in the US state of Maryland, who may hold the answer to a human mystery. At issue is nothing less than immortality: Brooke Greenberg apparently isn’t aging.

    She has no hormonal problems, and her chromosomes seem normal. But her development is proceeding “extremely slowly,” says Walker. If scientists can figure out what is causing the disorder, it might be possible to unlock the mysteries of aging itself. “Then we’ve got the golden ring,” says Walker.

    He hopes to simply eliminate age-related diseases like cancer, dementia and diabetes. People who no longer age will no longer get sick, he reasons. But he also thinks eternal life is conceivable. “Biological immortality is possible,” says Walker. “If you don’t get hit by a car or by lightning, you could live at least 1,000 years.”

    An Unprecedented Case

    Brooke Greenberg was born prematurely on Jan. 8, 1993 at Sinai Hospital in Baltimore, Maryland. She weighed only 1,800 grams (about four pounds) at birth. It soon became clear that she wasn’t normal. Almost all of her organ systems were altered. Her hips were dislocated, so that her legs pointed awkwardly toward her shoulders. She’d hardly been born before she was placed in a cast.

    The first six years were torture for Brooke and her parents. On one occasion, seven holes in the child’s abdominal wall had to be repaired. Because food kept entering her windpipe instead of her stomach, a gastric feeding tube had to be inserted. She fell into a 14-day coma when she was four. Then doctors diagnosed a brain tumor (the diagnosis later proved to be incorrect). “The Greenbergs had gone out already and made the preparations, buying a coffin and talking to the rabbi,” pediatrician Pakula recalls.

    Pakula practices in a medical building near the Greenbergs’ house. He wears a tie adorned with cartoonish hippopotamuses. A tall stack of paper — Brooke’s file — sits on his desk. “This can’t be lost,” says the doctor, placing his hand on the documents. He knows what a treasure the file represents.

    The most surprising thing about Brooke is that she hardly ages at all. Her body stopped growing when she was two years old. She hasn’t grown a centimeter or gained a pound. Pakula injected the girl with growth hormones, but nothing happened. He studied the medical literature and consulted specialists worldwide. “She was presented to everybody who was anybody in the medical world at the time,” says the 77-year-old pediatrician, “but she didn’t match anything any physician had seen before.”

    The Greenbergs waited and hoped — one year, two years, 10 years — but nothing happened. Their daughter’s facial features have remained unchanged. There are no signs of puberty. “Brooke’s nurses, her teachers, even her father can’t consistently sort photos of her chronologically,” says Pakula. Only the girl’s hair and fingernails are growing normally.

    ‘She’s a Miracle’

    At the family’s house in Reisterstown, Howard Greenberg points to photos on the walls: Brooke at three, next to her one-year-old sister Carly, who was already bigger than she was at the time; Brooke in a playsuit on her 12th birthday; Brooke at 14, at her Bat Mitzvah, the Jewish rite of initiation.

    Greenberg hurries from picture to picture. Brooke looks the same in all the photos. Her mouth is always slightly lopsided and her eyes just a tough too far apart. “She’s a miracle.” It’s something that has to be said, again and again. “What’s she missing in life? Nothing. She hasn’t got a worry in the world. She isn’t broken. We’re the ones who are broken.” This is the father’s way of explaining away his daughter’s condition. “If you look at it that way, it makes it much more bearable,” he says later on.

    At first Melanie Greenberg took care of Brooke on her own, but now she has help. Feeding Brooke through the tube takes 10 hours a day. She goes to a school for disabled children from 7:30 a.m. to 3:30 p.m. Much of the rest of the time she spends in her room, sitting in her bed and watching television, or bobbing back and forth in her light-blue baby swing.

    “She can do this all day,” says Melanie Greenberg, lifting her daughter into the air and carefully placing her on her thin little legs, with her feet twisted inward. “It was not easy, it was very hard,” she says, “but I’m sure there is a reason for Brooke to be here. Something is in her, something that could help millions of people.The Disassociated Body

    Richard Walker, a retired professor of medicine and specialist in the biology of aging, lives in a house on a lagoon in the coastal town of Indian Rocks, Florida. He became aware of Brooke Greenberg in 2005. “I thought right away that she had a unique mutation in key genes that control development and aging,” he says. Walker contacted the Greenbergs and convinced the father to let him take a sample of Brooke’s blood so that he could study her genetic makeup. He examined the number and condition of the chromosomes. He analyzed the so-called telomeres at the ends of chromosomes, the length of which provides information about the age of cells. He filled tiny reagent reservoirs made of biochips with pieces of genetic material, and tested the activity of a wide range of genes.

    The results are as sobering as they are fascinating. “We haven’t found anything unusual so far,” says Walker, “but that wasn’t a disappointment; it was actually an incentive to keep on searching.”

    The girl’s uniqueness lies precisely in the fact that her genetic material seems normal, whereas she is obviously not normal, says the professor. Despite the surprisingly unremarkable genetic analysis, complete chaos prevails inside the girl’s body.

    Her brain is hardly more developed than an infant’s, but her bones have a biological age of about 10 years. Her teeth, including her baby teeth, are like those of an eight-year-old. The length of the telomeres, on the other hand, corresponds to her actual age. In addition, the development of various organ systems, like the digestive tract, is what the professor calls “disassociated.”

    “Different parts of her body are developing at different rates, as if they were not a unit but parts of separate organisms,” Walker explains. He believes that there is only one explanation — a failure of central control genes.

    Normally, a carefully orchestrated genetic program allows a tiny egg cell to grow into an adult body. But if this master plan is impaired, the marvel of growth goes awry. Walker believes that this is precisely what has happened with Brooke. Genes that play an important role in physical development are either inactive or defective. “If we identify those genes, we might be able to understand the development and subsequently the aging of the body,” says the scientist.

    An Eccentric Theory

    Walker believes that aging is merely the continuation of the body’s development. He uses the image of a house to illustrate his point. First the house is built. When it’s finished — or, in the case of the body, when sexual maturity is reached — the construction crew would normally leave the site. But in normal people the construction workers stay and keep building, according to a plan that’s been fulfilled and a construction supervisor who says nothing but nonsense. Soon the crew builds things like contorted bay windows and shaky dormers. Supporting beams are suddenly sawed off, and then walls start falling. Finally the building collapses completely — and death catches up with the body.

    “Aging happens when developmental genes merely run out of meaningful information and subsequently cause chaos,” Walker says. His idea is to simply shut off the master genes of development. This, he hopes, will put a stop to the aging process. If Walker is right, the consequences will be dramatic. A body manipulated in this fashion would no longer change, but would only perform repair work. Eternal life would be within reach.

    All this talk has exhausted the professor. He sits in his heavy armchair and gazes out at the glittering water. A dinghy and a motorboat are tied to his private jetty directly in front of the deck, and a surfboard is lying nearby. The doctor sails, surfs and skis. He is 71. He loves his life.

    Does he want to be immortal?

    “Of course I want to live forever,” he says. “I could study mathematics; I could learn so many more things. It would be the greatest gift in the world.” Many people, says Walker, imagine that eternal life would be nothing but hardship and senescence. “But that’s not how it would be,” says Walker. Ideally development would be arrested just after a person reaches sexual maturity.

    And the social consequences? Who would be allowed to live forever, and who wouldn’t? Who would be allowed to have children?

    Walker hesitates. “These are ethical questions, not scientific questions,” he says. “These would be arguments made by philosophers and priests.”

    ‘Highly Unlikely’

    Walker’s theories are controversial. The British biologist Aubrey de Grey, for example, holds his American colleague in high esteem, but believes that aging and development are not related. The Brooke Greenberg case, says de Grey, has “absolutely nothing to do with aging.” He points to the phase of life between the ages of 20 and 40, in which the body hardly changes at all. “Is it likely that the developmental gene expression suddenly stops during this time and then starts up again? No, this is highly unlikely,” he says.

    De Grey favors the standard theory that the body’s cells simply wear out over the years, and that they accumulate toxins and lose their ability to regenerate. He has identified seven causes of death, like cell loss or changes in genetic material, which he hopes to combat with stem-cell therapy or special injections.

    But Walker doesn’t challenge the criticism. “The deterioration of the body’s cells is precisely a consequence of the unregulated activity of development genes,” he argues. His theory is seductive in a sense. While biologists like de Grey tamper with the countless symptoms of growing old, Walker simply wants to do away with aging altogether.

    “Imagine we could stop the degenerative changes of the body,” he says enthusiastically. “The onset of age-related diseases like diabetes, Alzheimer’s, dementia and many forms of cancer could be prevented.”

    To prove his theory, Walker needs people like Brooke Greenberg, in whom the developmental master genes fail. He’s already discovered two similar cases. Six-year-old Gabrielle K., from Billings, Montana, born Oct. 15, 2004, also doesn’t seem to be aging much at all. At the same time her chromosomes, just like Brooke Greenberg’s, seem completely normal.

    Nicky Freeman, a 40-year-man who seems to be trapped in a boy’s body, lives in Esperance in Western Australia. His biological age is estimated at 10 years.

    All in the Genes

    Can Gabrielle or Nicky point the way to the fountain of youth? Walker doesn’t know yet. He is focusing his attention on Brooke at the moment. He wants to sequence the girl’s entire DNA, together with experts from Duke University in Durham, North Carolina. If they find mutations in Brooke’s genetic makeup, Walker plans to identify the corresponding genes in laboratory rats and then block them. He reasons that if the genetically manipulated remain young, researchers will in fact have put a stop to their development.

    “Brooke holds the key to everything,” says Walker. He’s anxious to press on with his work, because he feels that his time is running out. But Howard Greenberg is stalling. He has long felt that he is protecting a valuable treasure in his red brick house. He’s even hired lawyers to examine the issue of the rights to Brooke’s genome. The father knows time is on his side. Doctors tell him that with good medical care his daughter can live a long time.

    In the Greenberg home, Melanie has now attached a bag containing a complete nutritional formula to her daughter’s feeding tube. The brownish flood runs through a tube into Brooke’s small body.

    Howard Greenberg looks down at his daughter. Wearing a red-and-white striped T-shirt and white pants, the girl rocks back and forth in his baby swing, as monotonously as a pendulum.

    “I always thought she would die way before me, but I don’t think that anymore,” says the 53-year-old after a pause. “Brooke can live forever. She’ll always be here.”

    Translated from the German by Christopher Sultan

    (—> read original article at SPIEGEL ONLINE International)