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As dengue cases continue to rise in Brazil, the country is facing a massive public health crisis. The viral disease, spread by mosquitoes, has sickened more than a million Brazilians in 2024 alone, overwhelming hospitals.
The dengue crisis is the result of the collision of two key factors. This year has brought an abundance of wet, warm weather, boosting populations of Aedes aegypti, the mosquitoes that spread dengue. It also happens to be a year when all four types of dengue virus are circulating. Few people have built up immunity against them all.
Brazil is busy fighting back. One of the country’s anti-dengue strategies aims to hamper the mosquitoes’ ability to spread disease by infecting the insects with a common bacteria—Wolbachia. The bacteria seems to boost the mosquitoes’ immune response, making it more difficult for dengue and other viruses to grow inside the insects. It also directly competes with viruses for crucial molecules they need to replicate.
The World Mosquito Program breeds mosquitoes infected with Wolbachia in insectaries and releases them into communities. There they breed with wild mosquitoes. Wild females that mate with Wolbachia-infected males produce eggs that don’t hatch. Wolbachia-infected females produce offspring that are also infected. Over time, the bacteria spread throughout the population. Last year I visited the program’s largest insectary—a building in Medellín, Colombia, buzzing with thousands of mosquitoes in netted enclosures— with a group of journalists. “We’re essentially vaccinating mosquitoes against giving humans disease,” said Bryan Callahan, who was director of public affairs at the time.
At the World Mosquito Program’s insectary in Medellín, Colombia.These strips of paper are covered with Ades aegypti eggs. Dried eggs can survive for months at a time before being rehydrated, making it possible to ship them all over the world.
The World Mosquito Program first began releasing Wolbachia mosquitoes in Brazil in 2014. The insects now cover an area with a population of more than 3 million across five municipalities: Rio de Janeiro, Niterói, Belo Horizonte, Campo Grande, and Petrolina.
In Niterói, a community of about 500,000 that lies on the coast just across a large bay from Rio de Janeiro, the first small pilot releases began in 2015, and in 2017 the World Mosquito Program began larger deployments. By 2020, Wolbachia had infiltrated the population. Prevalence of the bacteria ranged from 80% in some parts of the city to 40% in others. Researchers compared the prevalence of viral illnesses in areas where mosquitoes had been released with a small control zone where they hadn’t released any mosquitoes. Dengue cases declined by 69%. Areas with Wolbachia mosquitoes also experienced a 56% drop in chikungunya and a 37% reduction in Zika.
How is Niterói faring during the current surge? It’s early days. But the data we have so far are encouraging. The incidence of dengue is one of the lowest in the state, with 69 confirmed cases per 100,000 people. Rio de Janeiro, a city of nearly 7 million, has had more than 42,000 cases, an incidence of 700 per 100,000.
“Niterói is the first Brazilian city we have fully protected with our Wolbachia method,” says Alex Jackson, global editorial and media relations manager for the World Mosquito Program. “The whole city is covered by Wolbachia mosquitoes, which is why the dengue cases are dropping significantly.”
The program hopes to release Wolbachia mosquitoes in six more cities this summer. But Brazil has more than 5,000 municipalities. To make a dent in the overall incidence in Brazil, the program will have to release millions more mosquitoes. And that’s the plan.
The World Mosquito Program is about to start construction on a mass rearing facility—the biggest in the world—in Curitiba. “And we believe that will allow us to essentially cover most of urban Brazil within the next 10 years,” Callahan says.
There are also other mosquito-based approaches in the works. The UK company Oxitec has been providing genetically modified “friendly” mosquito eggs to Indaiatuba, Brazil, since 2018. The insects that hatch—all males—don’t bite. And when they mate, their female offspring don’t survive, reducing populations.
None of these solutions are a quick fix. But they all provide some hope that the world can find ways to fight back even as climate change drives dengue and other infections to new peaks and into new territories. ““Cases of dengue fever are rising at an alarming rate,” Gabriela Paz-Bailey, who specializes in dengue at the US Centers for Disease Control and Prevention, told the Washington Post. “It’s becoming a public health crisis and coming to places that have never had it before.”
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We’ve written about the World Mosquito Program before. Here’s a 2016 story from Antonio Regalado that looked at early excitement and Bill Gates’ backing of the project.
That same year we reported on Oxitec’s early work in Brazil using genetically modified mosquitoes. Flavio Devienne Ferreira has the story.
And this story from Emily Mullin looks at Google’s sister company, Verily. It built a robot to create Wolbachia-infected mosquitoes and began releasing them in California in 2017. (The project is now called Debug).
From around the web
The FDA-approved ALS drug Relyvrio has failed to benefit patients in a large clinical trial. It was approved early amidst questions about its efficacy, and now the medicine’s manufacturer has to decide whether to pull it off the market. (NYT)
Wegovy: it’s not just for weight loss anymore. The FDA has approved a label expansion that will allow Novo Nordisk to market the drug for its heart benefits, which might prompt more insurers to cover it. (CNN)
Covid killed off one strain of the flu and experts suggest dropping it from the next flu vaccine. (Live Science)
Scientists have published the first study linking microplastic pollution to human disease. The research shows that people with plastic in their artery tissues were twice as likely to have a heart attack, stroke, or die than people without plastic. (CNN)
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An ultrasound, for example, might reveal that a fetus’s kidneys are smaller than they should be, but absent a glaring genetic defect, doctors can’t say why they’re small or figure out a fix. But if they can take a small sample of amniotic fluid and grow a kidney organoid, the problem might become evident, and so might a potential solution.
Exciting, right? But organoids can do so much more!
Let’s do a roundup of some of the weird, wild, wonderful, and downright unsettling uses that researchers have come up with for organoids.
Organoids could help speed drug development. By some estimates, 90% of drug candidates fail during human trials. That’s because the preclinical testing happens largely in cells and rodents. Neither is a perfect model. Cells lack complexity. And mice, as we all know, are not humans.
Organoids aren’t humans either, but they come from humans. And they have the advantage of having more complexity than a layer of cells in a dish. That makes them a good model for screening drug candidates. When I wrote about organoids in 2015, one cancer researcher told me that studying cells to understand how an organ functions is like studying a pile of bricks to understand the function of a house. Why not just study the house?
Big Pharma appears to agree. In 2022, Roche hired organoid pioneer Hans Clevers to head its Pharma Research and Early Development division. “My belief is that human organoids will eventually complement everything we are currently doing. I’m convinced, now that I’ve seen how the whole drug development process runs, that one can implement human organoids at every step of the way,” Clevers told Nature.
Organoids are trickier to grow than cell lines, but some companies are working to make the process automated. The Philadelphia-based biotech Vivodyne has developed a robotic system that combines organoids with organ-on-a-chip technology. The system grows 20 kinds of human tissue, each containing 200,000 to 500,000 cells, and then doses them with drugs. These “lab-grown human test subjects” provide “huge amounts of complex human data—larger than you could get from any clinical trial,” said Andrei Georgescu, CEO and cofounder of Vivodyne, in a press release.
According to Viodyne’s website, the proprietary machines can test 10,000 independent human tissues at a time, “yielding vivarium-scale output.” Vivarium-scale output. I had to roll this phrase around my brain quite a few times before I understood what they meant: the robot provides the same amount of data as a building full of lab mice.
Organoids could help doctors make medical decisions for individual patients. These mini organs can be grown from stem cells, but they can also be grown from adult cells that have been nudged into a stem-like state. That makes it possible to grow organoids from anyone for any number of uses. In cancer patients, for instance, these patient-derived organoids could be used to help figure out the best therapy.
Cystic fibrosis is another example. Many cystic fibrosis therapies are approved to treat people with specific mutations. But for people who have rarer mutations, it’s not clear which therapies will work. Enter organoids.
Doctors take rectal biopsies from people with the disease, use the cells to create personalized intestinal organoids, and then apply different drugs. If a given treatment works, the ion channels open, water rushes in, and the organoids visibly swell. The results of this test have been used to guide the off-label use of these medications. In one recent case, the test allowed a woman with cystic fibrosis to access one of these drugs through a compassionate use program.
Organoids are also poised to help researchers better understand how our bodies interact with the microbes that surround (and sometimes infect) us. During the Zika health emergency in 2015, researchers used brain organoids to figure out how the virus causes microcephaly and brain malformations. Researchers have also managed to use organoids to grow norovirus, the pathogen responsible for most stomach flus. Human norovirus doesn’t infect mice, and it has proved especially tricky to culture in cells. That’s probably part of the reason we have no therapies for the illness.
I’ve saved the weirdest and arguably creepiest applications for last. Some researchers are working to leverage the brain’s unparalleled ability to learn by developing brain organoid biocomputers. The current iterations of these biocomputers aren’t doing any high-level thinking. One clump of brain cells in a dish learned to play the video game Pong. Another hybrid biocomputer maybe managed to decode some audio signals from people pronouncing Japanese vowels. The field is still in extremely early stages, and researchers are wary of overhyping the technology. But given where the field wants to go—full-fledged organoid intelligence—it’s not too early to talk about ethical concerns. Could a biocomputer become conscious? Organoids arise from cells taken from an individual. What rights would that person have? Would the biocomputer have rights of its own? And what about rodents that have had brain organoids implanted in them? (Yes, that’s happening too).
Last year, researchers reported that human organoids implanted in rat brains expanded into millions of neurons and managed to wire themselves into the animal’s brain. When they blew a puff of air over the rat’s whiskers, they could record an electrical signal zipping through the human neurons.
In a 2017 Stat story on efforts to implant human brain organoids into rodents, the late Sharon Begley talked to legal scholar and bioethicist Hank Greely of Stanford University. During their conversation, he invoked the literary classic Frankenstein as a cautionary and relevant tale: “it could be that what you’ve built is entitled to some kind of respect,” he told her.
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In 2023, scientists reported that brain organoids hitched to an electronic chip could perform some very basic speech recognition tasks. Abdullahi Tsanni has the story.
Saima Sidik tells us how organoids created from the uterine lining might reveal the mysteries of menstruation. Here’s her report.
When will we be able to transplant mini lungs, livers, or thyroids into people? Ten years … maybe, said my colleague Jess Hamzelou in this past issue of The Checkup.
From around the web
An Alabama bill passed on Wednesday creates a “legal moat” around embryos. Under the new law, providers and recipients of IVF could not be prosecuted or sued for damaging or destroying embryos. But the law doesn’t answer the central question raised by Alabama courts last week: Are embryos people? (NYT)
More legal news. The Senate homeland security committee passed a bill this week that would block certain Chinese biotechs from conducting business in the US. The aim is to keep them from accessing Americans personal health data and genetic information. But some critics have raised supply chain concerns. (Reuters)
Some scientists have expressed concern that too many covid shots could fatigue the immune system and make vaccination less effective. But a man who got a whopping 217 covid vaccines showed no signs of a flagging immune response. (Washington Post)
Buckle up. Norovirus is coming for you. (USA Today).Small studies showing that ibogaine, a psychedelic derived from tree bark, can treat opioid addiction have renewed interest in this illegal drug. But some researchers question whether it could ever be a feasible therapy (NYT)
As a fetus grows in the womb, it sheds cells into the amniotic fluid surrounding and protecting it. Now researchers have demonstrated that they can use those cells to grow organoids, three-dimensional structures that have some of the properties of human organs—in this case kidneys, small intestines, and lungs. These organoids could give doctors even more information about how fetal organs are developing, potentially enhancing prenatal diagnoses of conditions like spina bifida.
These aren’t the first organoids produced from fetal cells. Other groups have grown them from discarded fetal tissue. But this group is among the first to grow organoids from cells taken from amniotic fluid, which can be extracted without harming the fetus.
“The entire concept is really groundbreaking,” says Oren Pleniceanu, a stem cell biologist and head of the Kidney Research Center at Sheba Medical Center and Tel-Aviv University who has also been working on organoids from amniotic fluid. This ability to get fetal cells from the amniotic fluid, “it’s like a free biopsy,” he says. But he points out that there’s still room for improvement when it comes to describing the cells that are present. “It’s not that easy to define which cells these are,” he says.
Researchers have known for decades that amniotic fluid holds fetal cells. That’s what allows doctors to diagnose conditions like Down syndrome and sickle-cell disease before birth via amniocentesis, in which a needle is used to take a sample of the fluid. The vast majority of these cells, 95% or more, are dead cells sloughed off by the fetus, says Mattia Gerli, a stem cell biologist at University College London and an author of a paper on the work published in Nature Medicine today. But what the researchers homed in on was the much smaller fraction of live cells in amniotic fluid.
First, they worked to determine what kinds of cells were there, mapping their identities and then using single-cell sequencing to assess where they originated. Next, the team placed three kinds of progenitor cells—kidney, lung, and small intestine—in a 3D culture to see if they would form organoids.
“We’re just taking them as they are and putting them into a droplet of gel. This is very low tech,” coauthor Paolo De Coppi, a pediatric surgeon at University College London and the Great Ormond Street Hospital, said in a press briefing.
It worked. The organoids grew, and they developed features of the tissue that the cells came from. Within weeks the lung organoids, for example, had beating, hairlike structures called cilia, like those found inside the lung.
As a pediatric surgeon, De Coppi often deals with congenital birth defects. Doctors can spot these defects using imaging, but they don’t have a good way to assess their severity or how they affect organ function. To look at whether their lung organoids might be able to provide some of that information, the team collected cells from fetuses with a rare condition called congenital diaphragmatic hernia (CDH). These fetuses have a gap in their diaphragm that allows organs from the abdomen to push up into the chest cavity and compress the lungs. “If the lung is being compressed, the lung doesn’t develop in the way it should,” De Coppi says. “So only 70% of these fetuses will survive.”
The team compared organoids grown from CDH fetuses with organoids grown from healthy fetuses. Initially both organoids looked the same. But when the researchers pushed them to differentiate to mimic the part of the lung closest to the windpipe, or the deeper portions of the lung, they saw some striking differences. Both healthy and CDH organoids developed cilia, but the pattern was different in CDH organoids, and they struggled more to differentiate. The CDH organoids also produced less surfactant, a substance that helps the air sacs in the lungs function properly.
CDH can be treated: surgeons place a balloon in the windpipe of the fetus to force the lungs to push back against the encroaching organs. When the researchers compared lung organoids grown from cells taken from amniotic fluid before and after the balloon procedure, they found that the treated organoids grew more like normal lung organoids, and their gene expression suggested that they were more developed.
These results point to two possible uses. Placing the balloon requires fetal surgery, and doctors don’t have a good way to figure out which fetuses might benefit and which will not. These personalized organoids might help them determine how underdeveloped the lungs are so they can make a more informed decision. And for those fetuses that undergo the procedure, the organoids could give doctors information about whether it worked.
These researchers aren’t the only ones to develop organoids from cells in amniotic fluid. In a preprint posted in October 2023, Pleniceanu and his colleagues report that they too managed to culture such cells into lung and kidney organoids. But rather than growing their organoids in a generic growing medium, they developing mediums that are designed to promote the growth of specific organoids—for example, one medium might enhance the growth of kidney organoids, another might prompt the development lung organoids.
Organoids are not, as their name suggests, miniature functioning organs. But these collections of cells do re-create some of the structure and complexity of organs. As a result, they can offer a unique window into human development. And because they carry the same genetic mutations as the fetus, they can also give doctors a peek at how that particular fetus is developing.
Organoids aren’t ready for the clinic yet, but the two teams envision many uses for these personalized fetal organ models. When an ultrasound detects some abnormality, organoids could reveal the underlying cause in real time, and perhaps point doctors to therapies that could be delivered while the organs are still developing. “You might be able to intervene, even before birth, which is pretty amazing,” Pleniceanu says. These organoids could also help researchers better understand abnormalities that aren’t the result of a genetic disorder and shed light on how environmental exposures affect development.
De Coppi points out that the pharmaceutical industry has begun using organoids derived from adult cells to identify new therapies. Now there’s the possibility of bringing those technological developments back into fetal development, he says, “because for the first time, we can actually access the fetus without touching the fetus.”
Update 3/4: This story has been updated with comments from Pleniceanu.
This article first appeared in The Checkup, MIT Technology Review’s weekly biotech newsletter. To receive it in your inbox every Thursday, and read articles like this first, sign up here.
The diabetes medication metformin has been touted as a miracle drug. Not only does it keep diabetes in check, but it can reduce inflammation, curb cancer, stave off the worst effects of covid, and perhaps even slow the aging process. No wonder it’s so popular. In the US, the number of metformin prescriptions has more than doubled in less than two decades, from 40 million in 2004 to 91 million in 2021.
Worldwide, we consume more than 100 million kilograms of metformin a year. That’s staggering.
All that metformin enters the body. But it also exits largely unchanged and ends up in our wastewater. The quantities found there are tiny—tens of micrograms per liter—and not likely to harm humans. But even small amounts can affect aquatic organisms that are literally swimming in it.
Lawrence Wackett, a biochemist at the University of Minnesota, got interested in this issue about a decade ago. Researchers had observed that at some wastewater treatment plants, the amount of metformin entering was much larger than the amount leaving. In 2022, Wackett’s team and two other groups identified the bacteria responsible for metabolizing the drug and sequenced their genomes. But Wackett still wondered which genes were responsible.
Now he knows. This week, he and his colleagues reported that they have identified two genes encoding proteins that can break down metformin. The study was published in the Proceedings of the National Academy of Sciences. These proteins are produced by at least five species of bacteria found in wastewater sludge across three continents. But here’s what struck me: This isn’t a coincidence. These bacteria evolved the ability to metabolize metformin. They saw an opportunity to capitalize on the ubiquity of the drug in their environment, and they seized it. “This happens all the time,” Wackett says. “Microbes adapt to the chemicals that we make.”
Here’s another example. In the 1960s, farmers began using a new weed killer called atrazine. For about a decade, scientists reported that the chemical appeared to degrade slowly in soil. But about a decade later, that changed. “Everybody was reporting, ‘No, it’s going away really fast—in weeks or a month.” That’s because bacteria evolved the capacity to metabolize atrazine to extract nitrogen. “There is selective pressure,” Wackett says. “The bacteria that figured out how to get that nitrogen out have a big selective advantage.”
This kind of bacterial evolution shouldn’t come as a surprise. We’ve all heard about how the rampant use of antibiotics in people and livestock is driving an antimicrobial resistance crisis. But for some reason, it never occurred to me that bacteria might be evolving in a way that could help us rather than harm us.
That’s good news. Because we have made a real mess of our water supply.
Let’s take a step back. This problem isn’t new. Scientists first detected pharmaceuticals in water more than 40 years ago. But concern has increased dramatically in the past 20 years. In 2008, the Associated Press reported that drinking water in the US was tainted with a wide variety of medications—everything from antibiotics to antidepressants to sex hormones.
It’s not just medicines. A dizzying number of personal care products also end up in the sewers—coconut shampoos and hydrating body washes and expensive face serums and … well, the list goes on and on. Wastewater treatment facilities were never designed to deal with these so-called micropollutants. “For the first 100 years or so of wastewater treatment, you know, the big thing was to prevent infectious diseases,” Wackett says.
Today, many wastewater treatment plants mix wastewater and air in a tank to form an activated sludge—a process that helps bacteria break down pollutants. This system was originally designed to remove nitrogen, phosphates, and organic matter—not pharmaceuticals. When bacteria in the sludge do metabolize drugs like metformin, it’s a happy accident, not the result of intentional design.
Certain technologies that rely on bacteria can do a better job of getting rid of these tiny pollutants. For example, membrane biological reactors combine activated sludge with microfiltration, while biofilm reactors rely on bacteria grown on the surface of membranes. There are even anaerobic “sludge blankets” (worst name ever), in which microbes convert contaminants to biogas in an oxygen-poor environment. But these technologies are expensive, and treatment facilities aren’t required to ensure that treated water is free of these contaminants. At least not in the US.
The European Commission is on its way to adopting new rules stipulating that by 2045, larger wastewater treatment facilities will have to remove a whole host of micropollutants. And in this case, the polluters—pharmaceutical and cosmetics companies—will pay 80% of the cost. The pharmaceutical industry is not a fan of this idea. Trade groups say the new rules will likely result in drug shortages.
In the US, the federal government is still trying to figure out how to deal with these pollutants. It’s tricky, because it’s not entirely clear what impact small quantities of pharmaceuticals in water will have on the environment and human health. And the risk varies depending on the medication in question. Some pose a clear threat. Oral contraceptives, for example, have caused fertility issues and sex switching in fish.
Could bacteria save us from estrogen too? Maybe. More than 100 estrogen-degrading microbes have been identified. We just need to find a way to harness them.
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In a 2023 issue of The Checkup, my colleague Jessica Hamzelou introduced us to the scientists who study the exposome—all the chemicals we eat, drink, inhale, and digest. Here’s the story.
Hamzelou also wrote about another pervasive pollutant: microplastics. They’re everywhere, and we still don’t really understand what they’re doing to us.
Microbes aren’t just for cleaning up wastewater. They can also help break down food. And some companies hope to build anaerobic digesters to help them do just that, reported Casey Crownhart last year.
Saima Sidik dove into the fascinating history of how MIT’s innovations in wastewater treatment helped stop the spread of infectious diseases.
From around the web
Long read: Jane Burns has devoted her life to solving the mystery of Kawasaki disease, a lethal childhood illness that comes on without warning. Now Burns and her oddball team of collaborators have the tools they need to pinpoint the cause. (NYT)
Older adults should get another covid booster this spring, according to new CDC recommendations. (Washington Post)
Public health officials are “flummoxed” about the Florida surgeon general’s lackluster response to a measles outbreak in the state. (NPR)
After decades of little innovation, biotech finally has a bevy of new drug candidates to treat psychiatric illnesses. “This is a renaissance in neuroscience.” (Stat)
This article first appeared in The Checkup, MIT Technology Review’s weekly biotech newsletter. To receive it in your inbox every Thursday, and read articles like this first, sign up here.
A ruling by the Alabama Supreme Court last week that frozen embryos stored in labs count as children is sending “shock waves” through the fertility industry and stoking fears that in vitro fertilization is getting swept up into the abortion debate.
The New York Times reports that one clinic, at the University of Alabama, has stopped fertilizing eggs in its laboratory, fearing potential criminal prosecution.
Fertility centers create millions of embryos a year. Some are frozen and others used in research, but most are intended to be transplanted into patients’ wombs so they can get pregnant.
The Alabama legal ruling is clearly animated by religion—there are lots of Bible quotes and references to “murder” when discussing abortion. But what hasn’t gotten as much notice is the court’s specific argument that an embryo is a child “regardless of its location.” This could have implications for future technologies in development, such as artificial wombs or synthetic embryos made from stem cells.
The case arose from an incident at an Alabama IVF clinic, the Center for Reproductive Medicine, in which a patient wandered into a storage area and removed a container of embryos from liquid nitrogen.
That’s when “the subzero temperatures at which the embryos had been stored freeze-burned the patient’s hand, causing the patient to drop the embryos on the floor,” the decision recounts. The embryos, consisting of just a few cells, thawed out and died.
Angered by the mishap, somefamilies then tried to collect financial damages. They sued under Alabama’s Wrongful Death of a Minor statute, which was first written in 1872, long before test-tube babies.
The question the court felt it had to decide: Do frozen embryos count as minor children or not?
The defendants argued, in part, that an IVF embryo can’t be a child or a person because it’s not yet in a biological womb. No womb, no baby, no birth, and no child. And this is where things start to get interesting and spiral into science fiction territory.
Justice Jay Mitchell, writing for the majority, pounced on what he called the “latent implication” of the defense’s argument. What about a baby growing to term an artificial womb? Would it also not count as a person, he asked, just because it’s not “in utero”?
According to their ruling, the wrongful-death act “applies to all unborn children, regardless of their location,” and “no exception” can be made for embryos regardless of their age, even if they’ve been in deep freeze for a decade. Nor does the law exclude any type of “extrauterine children” science can conceive.
It’s common for judges to wrestle with complex questions as they try to apply old laws to new technology. But what’s so unusual about this decision is that the judges ended up ruling on technology that hasn’t been fully invented.
“I think the opinion is really extraordinary,” says Susan Wolf, a professor of law and medicine at the University of Minnesota. “I can’t think of another case where a court powered its ruling by looking not only at technology not actually before the court, but number two, that doesn’t exist in human beings. They can’t make a binding decision about future technology that is not even part of the case.”
Bad law or not, the question the Alabama justices ruled on could soon be a real one.Several companies are actually developing artificial wombs to keep very premature infants alive, and other research labs are working with fluid-filled bottles in which they’ve grown mouse embryos until they are fetuses with beating hearts.
One startup company in Israel, Renewal Bio, says it wants to grow synthetic human embryos (the kind formed by stem cells) until they are 40 days old, or more, in order to collect their tissue for transplant medicine.
All this technology is racing along, so the question of the moral and legal rights of incubated human fetuses might not be hypothetical for very long.
Among the dilemmas lawyers and doctors could face: If a fetus is growing in a tank, would a decision to shut off its support systems be protected under liberal states’ abortion laws, which are typically based on the rights of a pregnant person? Would a fetus engineered solely to grow organs, lacking a brain cortex and without sentience, also still be considered a child in Alabama?
So while it’s obvious that the Alabama decision reflects the justices’ religious views rather than science, and that it could hurt people who just want to have a baby, maybe it is time to think about what the court calls the “many difficult questions” the wrongful-death case has raised about “the ethical status of extrauterine children.”
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For the first time, you can easily order GMOs to plant at home. The biotech plants on sale include a bright-purple tomato and a petunia plant that glows in the dark. (MIT Technology Review)
From MIT Technology Review’s archives
Last fall, my colleague Cassandra Willyard told us everything we need to know about artificial wombs. The experimental devices, she explained, are being developed to give premature babies more time to develop. So far, they’ve been tested on lambs, but human studies are being planned.
Another kind of artificial womb is used to keep very early embryos developing longer in the lab. A startup based in Israel called Renewal Bio says it hopes to grow “synthetic” human embryos this way longer than ever before as a way of bio-printing organs.
After the US Supreme Court overturned abortion protections in 2022, several American states moved to ban the practice. Anticipating that people may seek abortions anyway, we explained how to end a pregnancy with pills ordered from an online pharmacy.
Around the web
Elon Musk announced on X that the first volunteer to receive a brain implant from his company Neuralink can control a computer with it and can “move a mouse around the screen just by thinking.” Some commentators are annoyed at Musk for grabbing publicity while revealing few details about the study. (Wired)
China is the country with the world’s largest population. It has the most obese people—about 200 million of them. But new weight-loss drugs are in short supply there. (WSJ)
This spring I am looking forward to growing some biotech in my backyard for the first time. It’s possible because of startups that have started selling genetically engineered plants directly to consumers, including a bright-purple tomato and a petunia that glows in the dark.
This week, for $73, I ordered both by pressing a few buttons online.
Biotech seeds have been a huge business for a while. In fact, by sheer mass, GMOs are probably the single most significant product of genetic engineering ever. Except most of us aren’t planting rows of cotton or corn that can resist worms or survive a spritz of RoundUp, the big gene-splicing innovations that companies like Monsanto and Pioneer Hi-Bred first introduced in the 1990s.
What makes these new plants different is that you can buy them directly from their creators and then plant them in the yard, on a balcony, or just in a pot.
Purple tomatoes developed by Norfolk Health Produce.
NORFOLK HEALTHY PRODUCE
Purple tomato
Starting off my biotech shopping spree, I first spent $20 to order 10 tomato seeds from Norfolk Health Produce, a small company in Davis, California, that created what it calls the Purple Tomato. The seeds have a gene introduced from a snapdragon flower, which adds a nutrient, anthocyanin, that also gives the fruits their striking color.
According to Channa S. Prakash, a geneticist and dean at Tuskegee University, the tomato is the “the first-of-its kind GMO food crop marketed directly to home gardeners.”
The CEO of the company, Nathan Pumplin, was packing seeds when I reached him by phone. He claimed that anthocyanin has health benefits—it’s an antioxidant—but he agreed that the color is a useful sales pitch.
“I don’t need to make a label that says this red tomato is better for you than the other red tomato,” says Pumplin. “We can simply put out the purple tomato, and people say, ‘Oh my gosh, this tomato is purple.’ Its beauty is a distinguishing characteristic that people can just immediately see and understand.”
There is a plan to mass-produce the purple tomatoes for sale in supermarkets. But Pumplin says the company couldn’t ignore thousands of requests from regular gardeners. “It’s not the main focus of our business, but we are very interested in having people grow these at home,” he says. And “if home gardeners want to save the seed and replant it in their gardens for their own use, that is okay.”
A promotional video for Light Bio’s firefly petunia.
LIGHT BIO
Glowing flower
I next decided to shell out for the “firefly petunia,” so called because the plant is supposed to glow in the dark. It’s sold by Light Bio, a startup backed by the venture capital firm NFX .
The plant is such a novelty that it’s being sold in a preorder, with promises they will arrive by May. One petunia plant costs $29 plus $24 for shipping. The company’s marketing promises that your plant will unveil “mesmerizing luminescence after dusk” and that “its soothing light is produced from living energy, cultivating a deeper connection with the inner life of the plant.”
Finally, “Your nurturing care will be rewarded with even greater brilliance.”
It joins a short list of ornamental plants with gene modifications. Another is an orange petunia, approved in the US in 2021, that got its unusual color from a corn gene. (When some copies got loose prior to approval, officials in the US and Europe demanded its eradication in what became known as “the petunia carnage.”)
Karen Sarkisyan, a synthetic biologist at the MRC Laboratory of Medical Sciences in the UK, is one of the petunia’s creators, and also the chief scientist of Light Bio. His lab is interested in using bioluminescence as a reporter system—a plant could reveal, for instance, how it responds to a toxin or viral infection in lab experiments.
“In general, we’re trying to make useful things, so this is more of an exception,” he says of the firefly petunia. “The motivation was more about merging biology and art, rather than utility.”
Like a lot of things in biotech, making a glowing petunia was not easy to do—it’s the seemingly sudden result of decades of research into the chemistry that permits certain plants and animals to glow faintly.
Imposing those genetic circuits on plants did not work too well at first. Several years ago, for instance, a Kickstarter project that raised nearly $500,000 to make glowing roses failed to deliver on its promises after the project proved too difficult.
“It was fairly obvious … that there was no good technology at that time,” says Sarkisyan, who later played a role in discovering genes from a glowing fungus which, after being added to a petunia, made it shine brightly enough to work as a novelty item.
That work continues. Sarkisyan says the company is working on “increasing the brightness and making more colors.” It’s also working on making other types of plants glow, although which ones remain a secret. “I cannot really comment on specific species we’re working on,” he says, although he did show me a photo of a spectacular glowing chrysanthemum.
Plants made by Light Bio.
LIGHT BIO
Sarkisyan told me he sometimes likes to relax among the glowing plants and have a meditative experience. Ironically, he can only do that in the lab and not at home, since he lives in the UK. The country, which takes a stricter view on GMOs, has not approved the plants for sale (neither has Europe).
But he thinks the petunia could win over critics. “Especially with all the talk and concerns about the GM stuff, this is the first time there can be a safe, friendly, pleasant GM house plant in every home,” he says. “We think it’s a very interesting project because it is one of the first in consumer biotech. I do think we will see more and more in the future.”
My tomato seeds and glowing petunia haven’t arrived in the mail yet, and there’s still snow where I am. But come spring, I hope to be putting my first biotech crop in the ground.
This article first appeared in The Checkup, MIT Technology Review’s weekly biotech newsletter. To receive it in your inbox every Thursday, and read articles like this first, sign up here.
Lynn Cole had a blood infection she couldn’t shake. For years, she was in and out of the hospital. Each time antibiotics would force the infection to retreat. Each time it came roaring back.
In the summer of 2020, the bacteria flooding Cole’s bloodstream stopped responding to antibiotics. She was running out of time. Her doctors decided they had to try a different approach, and asked the US Food and Drug Administration to allow them to administer an experimental therapy, a virus known as a bacteriophage. Bacteriophages — or phages — are tiny viruses that infect and destroy bacteria.
What happened next? The details came out this week in a case study in mBio. The phages worked. Cole recovered with remarkable speed. But then the therapy failed. Cole’s case highlights the enormous promise of phage therapy, but it also shows just how much we have to learn.
Welcome back to the Checkup. Let’s talk phages. (Or rather, let’s talk about phages again.) What will it finally take to bring phage therapy into mainstream medicine?
Phage therapy has been around for more than a century, but it fell out of fashion throughout most of the world with the advent of antibiotics. The deepening antimicrobial crisis, however, has rekindled people’s interest and generated an enormous amount of excitement. Headlines have claimed that phages can “save the world” and that “one day, doctors might prescribe viruses instead of antibiotics.”
The excitement reached a fever pitch in recent years because of one particularly compelling story. In 2016, HIV researcher Tom Patterson picked up a deadly antibiotic-resistant infection in Egypt. His wife, infectious disease epidemiologist Steffanie Strathdee, helped hunt for the phage therapy that ultimately cured him. Strathdee gave a TED talk. She and Patterson wrote a book. She told her story in People magazine.
Stories like this have cast phages as a miracle cure. And these tiny viruses do have a lot of things going for them. They target bacteria with stunning specificity. “We think of phage as a targeted missile,” says Daria Van Tyne, an infectious disease researcher at the University of Pittsburgh and co-author of the new case study. This missile can “take out a specific species or strain that is causing the infection, but to leave other commensal bacteria unharmed.” What’s more, phages aren’t as likely to drive bacterial resistance as antibiotics. And they’re wildly abundant. “You can go to a drop of seawater and find trillions of phages,” Van Tyne adds.
But for many people, phages aren’t some miraculous elixir. In 2022, researchers published the largest series of case studies of phage therapy for antibiotic-resistant bacterial infections yet. Of the 20 people treated with phages, most with infections related to cystic fibrosis, 11 had a positive response to the therapy. However, only five managed to totally clear their infections. Another six had some partial response. The rest failed to respond or their results were inconclusive.
Let’s go back to Lynn Cole.
When Cole first received phage therapy, she had been dealing with a blood infection for nearly a month. Her doctors tried a variety of antibiotics with no effect. But 24 hours after they administered phage therapy, Cole’s infection was gone. She seemed cured.
About a month later, however, the infection returned. So the researchers found another phage that would work against the Enterococcus bacteria causing Cole’s infection, and began administering both phages. That seemed to do the trick.
For four months, Cole was infection-free. She left the hospital and went on vacation with her family. But then the infection returned. Cole was out of options. She entered hospice, and seven months later she died of pneumonia.
Van Tyne and her colleagues have spent the past couple of years trying to explain why their phages failed. They don’t yet have an answer, but they do have a hypothesis. A couple of weeks after Cole began receiving the second phage, she developed antibodies against both phages. “Possibly that played a role in limiting how well they were able to find their bacterial targets and kill them,” says Madison Stellfox, a physician and postdoc in Van Tyne’s lab. She posits that perhaps the antibodies coated the phages so they couldn’t enter the bacteria. Or maybe they helped the body clear the phages faster, so they didn’t have time to work.
Cole isn’t the only patient Van Tyne and her colleagues at the University of Pittsburgh have treated. Since Van Tyne started her own lab in 2018, she has developed a library that contains about 200 phages, most isolated from Pittsburgh’s wastewater. Those phages target six or seven species of bacteria. They use that library to develop personalized therapies for patients with life-threatening infections. “We’re trying to match clinical isolates from infected patients with phages that are active on them,” Van Tyne says.
The team has treated nearly 20 patients. Some have cleared their infections. Some, like Cole, have experienced temporary improvements. Some have had no response at all. But reassuringly, no one has been harmed by the therapy itself.
All these patients were treated under the FDA’s “compassionate use” program, which provides access to investigational therapies for people with life-threatening illnesses. Case studies can provide valuable insights, but they’re not a pathway to regulatory approval. To move phages into mainstream medicine, we need clinical trials.
Alexander Sulakvelidze, president and chief executive officer at the phage company Intralytix, has been working to develop phage products since the 1990s. In the Republic of Georgia, where he was born, phage therapy is routinely used to treat infections.
But in the US phage therapy was a hard sell. Intralytix, which launched in 1998, started with baby steps, first seeking approval for phage products to fight bacterial contamination in food products. Now, however, the company is generating revenues, and it has three clinical trials underway to test phage cocktails against three antibiotic-resistant bacteria. But these are trials to assess safety, not the large pivotal trials needed for FDA approval. “That’s why I’m saying it will be several years until [these therapies] see the light of day,” Sulakvelidze says.
The Los Angeles-based company Armata Pharmaceuticals, led by Deborah Birx (yes, that Deborah Birx), is also testing its phage therapies in trials. The company plans to launch an efficacy study, which could be used to seek regulatory approval, in the coming year, although it has yet to find a partner to help fund that endeavor. This kind of pivotal trial will help get pharma interested in phage therapy, and “that’s the only way it’s going to get completely commercialized,” Birx says. A pivotal trial will also provide some solid data on whether phages are effective. “It is worth moving forward to get a definitive answer,” she adds. “Because otherwise we’re just going to wait, and we’ll be sitting here 20 years from now saying ‘are phages important or not?’”
Read more from MIT Technology Review’s archive
Dig way back in our archives, and you’ll find a piece from 2001 about how phages could be turned into a new class of antibiotics. Paroma Basu has the story.
A phage cocktail saved a teen with cystic fibrosis from an antibiotic-resistant infection. Charlotte Jee gave us the details in 2019.
DNA sequencing and AI could make it easier for doctors to match infections with the right phage cocktail, Emily Mullin wrote in 2018.
From around the web
The CDC plans to ditch its Covid five-day isolation policy in favor of a policy that is based on symptoms. The new policy would allow people to stop isolating once their symptoms are mild and they’ve been fever-free for at least 24 hours without medication. (Washington Post)
Dengue is surging in Brazil, prompting Rio de Janeiro to declare a public health emergency. (NYT)
Deep dive: Environmental DNA could help provide an early warning of the next pandemic. (Undark)
A journal retracted three abortion studies that suggested that medication abortion is dangerous after it found that the conclusions were based on faulty assumptions and a misleading presentation of the data. (NYT)
On a warm, sunny day in Montevideo, Uruguay, the air is smogless and crisp. Inside a highly secured facility at the National Institute of Agricultural Research (INIA) are a sophisticated gene gun, giant microscopes, and tens of thousands of gene-edited flies, their bright blue wings fluttering against the walls of their small, white, netted cages.
These flies—shown to me on video by an INIA veterinarian, Alejo Menchaca—are a new weapon that may soon be unleashed against an enemy that kills cattle and costs the livestock industry millions of dollars every year: the New World screwworm, a parasite common in parts of South America and the Caribbean.
When a female screwworm fly attacks cattle, it lays eggs, which hatch and turn into worm-like larvae that screw down into the host animal, feeding on flesh along their way and damaging the animal’s skin. Left untreated, the animals eventually die in excruciating agony.
But Menchaca and colleagues have a plan. Using the genome-editing system CRISPR, they’ve developed what’s known as a gene drive, a type of genetic element that manipulates the reproductive process to spread farther and faster than an ordinary gene. They are about to move into the next stage of caged trials in the lab, with a view to eventually using the genetic tool to decimate the screwworm fly population. They have received a $450,000 grant from the Inter-American Development Bank (IDB) for the research.
“With gene drives, we can control these pests in precise and effective ways,” says Menchaca.
COURTESY OF ALEJO MENCHACA
Gene drives occur naturally in the wild, but the technology for making them deliberately is new and still pretty controversial. CRISPR allows scientists to cut specific genes in any organism’s DNA and replace them with new sequences. It can be used to tweak an animal’s DNA in a way that affects the species’ survival, often by making the females sterile, when it spreads in the population through breeding.
Some organizations have been trying to develop gene drives to eradicate mosquitoes. Target Malaria, supported by the Seattle-based Bill & Melinda Gates Foundation (BMGF), is currently the most advanced gene-drive project in the world. But even then, they have never gone beyond caged trials. The process of getting permission for field release efforts has crawled.
In 2020, the INIA researchers received permission from the Uruguayan government to test their techniques through the country’s existing National Program for Control of Screwworms. Right now, they’re experimenting with different components of the gene drive in gene-edited screwworm flies in the lab. The plan is to create a population of male screwworms with edited versions of genes that are essential for fertility in the female screwworms. When the engineered males are released into the wild, they should mate with females and pass on that gene.
Over successive generations, more and more female screwworms will inherit copies of the gene drive and become sterile, causing a population crash.
“The thing that’s attractive is if you knock a gene drive into the female, you could disrupt female development,” says Maxwell Scott, an entomologist at North Carolina State University who is working with the Uruguayan team. “It’s potentially a very efficient system.”
The situation is urgent. In July of last year, Panama declared a state of animal health emergency amid outbreaks of cattle screwworm throughout the country. And this February, more than 200 cases of screwworm attacks on animals were reported in Costa Rica, prompting the government to declare an emergency as well. In Uruguay, screwworm flies cost the livestock industry $40 million to $154 million a year. Agricultural export is the linchpin of Uruguay’s economy—over 80% of the goods the nation exports are agricultural products. Beef, which accounts for 20% of that, is worth $2.5 billion a year.
That makes the country’s search for new tools to combat the pests even more critical, says Carmine Paolo De Salvo, a rural development expert at the IDB. “The [Uruguayan] government is under constant pressure to do something about it,” he says.
Scientists have been trying to tackle screwworms for decades. One method, known as the sterile insect technique (SIT), was developed by researchers at the US Department of Agriculture in the 1950s. SIT involves sterilizing male screwworm flies with radiation. Then, using airplanes, the DNA-damaged males are dropped on the area of infestation. When they mate with wild female flies, the eggs that are produced do not hatch, slowing population growth and preventing the spread of the parasite.
That approach has worked in many countries, including parts of Central America, freeing livestock and wildlife by the millions from the painful grip of the pests. In the US, an area-wide eradication program using SIT worked so well that in 1966, the USDA declared screwworm eradicated within the nation’s borders. The benefits to the livestock industry were immense: producers saved up to $900 million, and the health of both wild and farm animals improved.
Even with sterile males, eradicating screwworms remains a stubborn challenge, however. To prevent the screwworms from returning, the US—along with Central and South American countries—still runs a permanent barrier zone of sterile flies on the Panama-Colombia border, requiring a continuous supply of billions of flies every year. This effort is too expensive, and it’s simply not powerful enough to eradicate screwworm in South America, where the pests are firmly established and difficult to surveil, researchers say. So the search has been on for alternative tools.
COURTESY OF ALEJO MENCHACA
It was Kevin Esvelt, a pioneering leader in CRISPR gene-drive systems, who first turned the team on to the idea of using one. Esvelt had been experimenting with engineering localized versions of gene drives to target Lyme disease in the US when he met the team of Uruguayan researchers on a tour of the MIT Media Lab. Shortly after that meeting, Esvelt was on a plane to Uruguay, where he met Menchaca and convinced Uruguayan officials to initiate a gene drive project to eradicate screwworms. This would have the advantage over SIT because while SIT reduces the number of successful births, the infertility conferred by the gene drive passes through multiple generations.
The team is looking to use an approach that Scott has successfully developed for livestock pests. In a recent study, Scott and his team tested it on the spotted-wing drosophila, an invasive fly that attacks soft-skinned fruit. The gene drive they developed for that study carried an edited version of the so-called doublesex gene, which is essential for the fly’s reproduction. In caged trials, they combined the engineered fly population with a population that didn’t have the gene edits, mimicking a real-world release. They found that the gene drive was copied at a rate of 94% to 99%—beyond the efficiency they had expected. “It was the first really efficient-homing gene drive for suppression of an agricultural pest,” says Scott. He hopes that a similar technique will work with screwworms and allow researchers to perform safer tests.
It won’t be a quick process. Assembling the gene-drive system, testing it, and securing approvals for field release could take many years, says Jackson Champer, a researcher at Peking University in Beijing, who is not part of the Uruguayan team. “It’s not an easy task; there have been many failed attempts at gene drives.”
Menchaca agrees. He says he and his colleagues aim to integrate their system into the flies and validate the technology in two to three years, adding that they hope to seek permission for field testing and will consider inviting companies to participate in scaling up the technology in the future.
However, Esvelt hopes the Uruguayan researchers will one day be able to release and test their altered screwworms in the wild. He believes that Uruguay’s robust regulatory environment makes the country a likely site for such experiments.
“This would be a project run effectively by Uruguayans, for the benefit of Uruguay, and may be offered eventually—if it works well—to a broader array of folks throughout South America,” he says.
In the late 1980s, at a federal research facility in Pensacola, Florida, Tamar Barkay used mud in a way that proved revolutionary in a manner she could never have imagined at the time: a crude version of a technique that is now shaking up many scientific fields. Barkay had collected several samples of mud — one from an inland reservoir, another from a brackish bayou, and a third from a low-lying saltwater swamp. She put these sediment samples in glass bottles in the lab, and then added mercury, creating what amounted to toxic sludge.
At the time, Barkay worked for the Environmental Protection Agency and she wanted to know how microorganisms in mud interact with mercury, an industrial pollutant, which required an understanding of all the organisms in a given environment — not just the tiny portion that could be successfully grown in Petri dishes in the lab. But the underlying question was so basic that it remains one of those fundamental driving queries across biology. As Barkay, who is now retired, put it in a recent interview from Boulder, Colorado: “Who is there?” And, just as important, she added: “What are they doing there?”
Such questions are still relevant today, asked by ecologists, public health officials, conservation biologists, forensic practitioners, and those studying evolution and ancient environments — and they drive shoe-leather epidemiologists and biologists to far-flung corners of the world.
The 1987 paper Barkay and her colleagues published in the Journal of Microbiological Methods outlined a method — “Direct Environmental DNA Extraction” — that would allow researchers to take a census. It was a practical tool, albeit a rather messy one, for detecting who was out there. Barkay used it for the rest of her career.
Today, the study gets cited as an early glimpse of eDNA, or environmental DNA, a relatively inexpensive, widespread, potentially automated way to observe the diversity and distribution of life. Unlike previous techniques, which could identify DNA from, say, a single organism, the method also collects the swirling cloud of other genetic material that surrounds it. In recent years, the field has grown significantly. “It’s got its own journal,” said Eske Willerslev, an evolutionary geneticist at the University of Copenhagen. “It’s got its own society, scientific society. It has become an established field.”
“We’re all flaky, right? There’s bits of cellular debris sloughing off all the time.”
eDNA serves as a surveillance tool, offering researchers a means of detecting the seemingly undetectable. By sampling eDNA, or mixtures of genetic material — that is, fragments of DNA, the blueprint of life — in water, soil, ice cores, cotton swabs, or practically any environment imaginable, even thin air, it is now possible to search for a specific organism or assemble a snapshot of all the organisms in a given place. Instead of setting up a camera to see who crosses the beach at night, eDNA pulls that information out of footprints in the sand. “We’re all flaky, right?” said Robert Hanner, a biologist at the University of Guelph in Canada. “There’s bits of cellular debris sloughing off all the time.”
As a method for confirming the presence of something, eDNA isn’t failproof. For instance, the organism detected in eDNA might not actually live in the location where the sample was collected; Hanner gave the example of a passing bird, a heron, that ate a salamander and then pooped out some of its DNA, which could be one reason signals of the amphibian are present in some areas where they’ve never been physically found.
Still, eDNA has the ability to help sleuth out genetic traces, some of which slough off in the environment, offering a thrilling — and potentially chilling — way to collect information about organisms, including humans, as they go about their everyday business.
The conceptual basis for eDNA — pronounced EE-DEE-EN-AY, not ED-NUH — dates back a hundred years, before the advent of so-called molecular biology, and it is often attributed to Edmond Locard, a French criminologist working in the early 20th century. In a series of papers published in 1929, Locard proposed a principle: Every contact leaves a trace. In essence, eDNA brings Locard’s principle to the 21st century.
For the first several decades, the field that became eDNA — Barkay’s work in the 1980s included — focused largely on microbial life. Looking back at its evolution, eDNA appeared slow to claw its way out of the proverbial mud.
It wasn’t until 2003 that the method turned up a vanished ecosystem. Led by Willerslev, the 2003 study pulled ancient DNA from less than a teaspoon of sediment, demonstrating for the first time the feasibility of detecting larger organisms with the technique, including plants and woolly mammoths. In the same study, sediment collected in a New Zealand cave (which notably had not been frozen) revealed an extinct bird: the moa. What is perhaps most remarkable is that these applications for studying ancient DNA stemmed from a prodigious amount of dung dropped on the ground hundreds of thousands of years ago.
Sometimes eDNA research is complicated because it could show DNA in a place where an animal doesn’t live, like the digested remains of a salamander that has been excreted by a bird far from where the salamander originally lived.
TERESA KOPEC/GETTY IMAGES
Willerslev had first come up with the idea a few years earlier while contemplating a more recent pile of dung: In between his master’s degree and Ph.D. in Copenhagen, he found himself at loose ends, struggling to obtain bones, skeletal remains, or other physical specimens to study. But one autumn, he gazed out the window at “a dog taking a crap on the street,” he recalled. The scene prompted him to think about the DNA in feces, and how it washed away with rain, leaving no visible trace. But Willerslev wondered, “‘Could it be that the DNA could survive?’ That’s what I then set up to try to find out.”
eDNA has the ability to help sleuth out genetic traces, offering a thrilling — and potentially chilling — way to collect information about organisms as they go about their everyday business.
The paper demonstrated the remarkable persistence of DNA, which, he said, survives in the environment for much longer than previous estimates suggested. Willerslev has since analyzed eDNA in frozen tundra in modern-day Greenland, dating back 2 million years ago, and he is working on samples from Angkor Wat, the enormous temple complex in Cambodia believed to have been built in the 12th century. “It should be the worst DNA preservation you can imagine,” he said. “I mean, it’s hot and humid.”
But, he said, “we can get DNA out.”
Willerslev is now hardly alone in seeing a potential tool with seemingly limitless applications — especially now as advances enable researchers to sequence and analyze larger quantities of genetic information. “It’s an open window for many, many things,” he said, “and much more than I can think of, I’m sure.” It was not just ancient mammoths; eDNA could reveal present-day organisms hiding in our midst.
Scientists use eDNA to track creatures of all shapes and sizes, be it a single species, such as tiny bits of invasive algae, eels in Loch Ness, or a sightless sand-dwelling mole that hasn’t been seen in nearly 90 years; researchers sample entire communities, say, by looking at the eDNA found on wildflower blossoms or the eDNA blowing in the wind as a proxy for all the visiting birds and bees and other animal pollinators.
The next evolutionary leap forward in eDNA’s history took shape around the search for organisms currently living in earth’s aquatic environments. In 2008, a headline appeared: “Water retains DNA memory of hidden species.” It came not from the supermarket tabloid, but the respected trade publication Chemistry World, describing work by French researcher Pierre Taberlet and his colleagues. The group sought out brown-and-green bullfrogs, which can weigh more than 2 pounds and, because they mow down everything in their path, are considered an invasive species in western Europe. Finding bullfrogs usually involved skilled herpetologists scanning shorelines with binoculars who then returned after sunset to listen for their calls. The 2008 paper suggested an easier way — a survey that required a lot less personnel.
“You could get DNA from that species directly out of the water,” said Philip Thomsen, a biologist at Aarhus University (who was not involved in the study). “And that really kickstarted the field of environmental DNA.”
Frogs can be hard to detect, and they are not, of course, the only species that eludes more traditional, boots-on-the-ground detection. Thomsen began work on another organism that notoriously confounds measurement: fish. Counting fish is sometimes said to vaguely resemble counting trees — except they’re free-roaming, in dark places, and fish counters are doing their tally while blindfolded. Environmental DNA dropped the blindfold. One review of published literature on the technology — though it came with caveats, including imperfect and imprecise detections or details on abundance — found that eDNA studies on freshwater and marine fish and amphibians outnumbered terrestrial counterparts 7:1.
In 2011, Thomsen, then a Ph.D. candidate in Willerslev’s lab, published a paper demonstrating that the method could detect rare and threatened species, such as those in low abundance in Europe, including amphibians, mammals like the otter, crustaceans, and dragonflies. “We showed that only, like, a shot glass of water really was enough to detect these organisms,” he told Undark. It was clear: The method had direct applications in conservation biology for the detection and monitoring of species.
In 2012, the journal Molecular Ecology published a special issue on eDNA, and Taberlet and several colleagues outlined a working definition of eDNA as any DNA isolated from environmental samples. The method described two similar but slightly different approaches: One can answer a yes or no question: Is the bullfrog (or whatever) present or not? It does so by scanning the metaphoric barcode, short sequences of DNA that are particular to a species or family, called primers; the checkout scanner is a common technique called quantitative real-time polymerase chain reaction, or qPCR.
Scientists use eDNA to track creatures of all shapes and sizes, be it tiny bits of invasive algae, eels in Loch Ness, or a sightless sand-dwelling mole that hasn’t been seen in nearly 90 years.
Another approach, commonly known as DNA metabarcoding, essentially spits out a list of organisms present in a given sample. “You sort of ask the question, what is here?” Thomsen said. “And then you get all of the known things, but you also get some surprises, right? Because there were some species that you didn’t know were actually present.”
One aims to find the needle in a haystack; the other attempts to reveal the whole haystack. eDNA differs from more traditional sampling techniques where organisms, like fish, are caught, manipulated, stressed, and sometimes killed. The data obtained are objective; it’s standardized and unbiased.
“eDNA, one way or the other, is going to stay as one of the important methodologies in biological sciences,” said Mehrdad Hajibabaei, a molecular biologist at University of Guelph, who pioneered the metabarcoding approach, and who traced fish some 9,800 feet under the Labrador Sea. “Every day I see something bubbling up that didn’t occur to me.”
In recent years, the field of eDNA has expanded. The method’s sensitivity allows researchers to sample previously out-of-reach environments, for example, capturing eDNA from the air — an approach that highlights eDNA’s promises and its potential pitfalls. Airborne eDNA appears to circulate on a global dust belt, suggesting its abundance and omnipresence, and it can be filtered and analyzed to monitor plants and terrestrial animals. But eDNA blowing in the wind can lead to inadvertent contamination.
In 2019, Thomsen, for instance, left two bottles of ultra-pure water out in the open — one in a grassland, and the other near a marine harbor. After a few hours, the water contained detectable eDNA associated with birds and herring, suggesting that traces of non-terrestrial species settled into the samples; the organisms obviously did not inhabit the bottles. “So it must come from the air,” Thomsen told Undark. The results suggest a two-fold problem: For one, trace evidence can move around, where two organisms that come into contact can then tote around the other’s DNA, and just because certain DNA is present doesn’t mean that the species is actually there.
Moreover, there’s also no guarantee that the presence of eDNA indicates that a species is alive, and field surveys are still needed, he said, to understand a species’ breeding success, its health, or the status of its habitat. So far, then, eDNA does not necessarily replace physical observations or collections. In another study, in which Thomsen’s group collected eDNA on flowers to look for pollinating birds, more than half of the eDNA reported in the paper came from humans, contamination that potentially muddied the results and made it harder to detect the pollinators in question.
Researchers can sample entire communities, for example by looking at the eDNA found on flower blossoms as a proxy for all the visiting birds and bees and other animal pollinators. But some research has shown significant amounts of human DNA on such samples, contamination which can muddy the results.
GETTY IMAGES
Similarly, in May 2023, a University of Florida team that previously studied sea turtles by the eDNA traces left as they crawl along the beach published a paper that turned up human DNA. The samples were intact enough to detect key mutations that might someday be used to identify individual people, suggesting that the biological surveillance also raised unanswered questions about ethical testing on humans and informed consent. If eDNA served as a seine net, then it indiscriminately swept up information about biodiversity and inevitably ended up with, as the UF team’s paper put it, “human genetic by-catch.”
While the privacy issues around footprints in the sand, so far, appear to exist mostly in the realm of hypothetical, the use of eDNA in legal litigation relating to wildlife is not only possible but already a reality. It’s also being used in criminal investigations: In 2021, for instance, a group of Chinese researchers reported that eDNA collected off a suspected murderer’s pants had, contrary to his claims, revealed that he’d likely been to the muddy canal where a dead body had been found.
The concerns about off-target eDNA, in terms of accuracy and its reach into human medicine and forensics, highlight another, much broader, shortcoming. As Hanner at the University of Guelph described the problem: “Our regulatory frameworks and policy tend to lag at least a decade or more behind the science.”
“Every day I see something bubbling up that didn’t occur to me.”
Today, there are countless potential regulatory applications for water quality monitoring, evaluating environmental impact (including offshore wind farms and oil and gas drilling to more run-of-the-mill strip mall development), species management, and enforcement of the Endangered Species Act. In a civil court case filed in 2021, the U.S. Fish and Wildlife Service evaluated whether an imperiled fish existed in a particular watershed, using eDNA and more traditional sampling, and found that they did not. The courts said the agency’s lack of protections for that watershed were justified. The issue does not seem to be whether eDNA stood up in court; it did. “But you really can’t say that something does not exist in an environment,” said Hajibabaei.
He recently highlighted the issue of validation: eDNA infers a result, but needs more established criteria for confirming that these results are actually true (that an organism is actually present or absent, or in a certain quantity). A series of special meetings for scientists worked to address these issues of standardization, which he said include protocols, chain of custody, and criteria for data generation and analysis. In a review of eDNA studies, Hajibabaei and his colleagues found that the field is saturated with one-offs, or proof-of-concept studies attempting to show that eDNA analyses work. Research remains overwhelmingly siloed in academia.
Biologists survey a stretch of the Little Tennessee River in North Carolina, looking for a threatened fish species called the spotfin chub. Counting fish is known to be extremely challenging, but eDNA can be used to detect rare and threatened species.
As such, practitioners hoping to use eDNA in an applied contexts sometimes ask for the moon. Does the species exist in certain location? For instance, Hajibabaei said, someone recently asked him if he could totally refute the presence of a parasite, proving that it had not appeared in an aquaculture farm. “And I say, ‘Look, there is no way that I can say that is 100 percent.’”
Even with a rigorous analytic framework, he said, the issues with false negatives and false positives are particularly difficult to resolve without doing one of the things eDNA obviates — more traditional collection and manual inspection. Despite the limitations, a handful of companies are already starting to commercialize the technique. For instance, future applications could help a company confirm whether the bridge it is building will harm any locally endangered animals; an aquaculture outfit determine if the waters where it farms its fish are infested with sea lice; or a landowner who is curious whether new plantings are attracting a wider range of native bees.
The problem is rather fundamental given eDNA’s reputation as an indirect way of detecting the undetectable — or as a workaround in contexts when it’s simply not possible to dip a net and catch all the organisms in the sea.
“It is very hard to validate some of these scenarios,” Hajibabaei said. “And that’s basically the nature of the beast.”
eDNA opens up a lot of possibilities, answering a question originally posed by Barkay (and no doubt many others): “Who is there?” But increasingly it’s providing hints that get at the “What are they doing there?” question, too. Elizabeth Clare, a professor of biology at York University in Toronto, studies biodiversity. She said she has observed bats roosting in one spot during the day, but, by collecting airborne eDNA, she could also infer where bats socialize at night. In another study, domesticated dog eDNA turned up in red fox scat. The two canids did not appear to be interbreeding, but researchers did wonder if their closeness had led to confusion, or cross-contamination, before ultimately settling on another explanation: Foxes apparently ate dog poop.
So while eDNA does not inherently reveal animal behavior, by some accounts the field is making strides towards providing clues as to what an organism might be doing, and how it’s interacting with other species, in a given environment — gleaning information about health without directly observing behavior.
Take another possibility: large-scale biomonitoring. Indeed, for the last three years, more people than ever before have participated in a bold experiment that is already up and running: the collection of environmental samples from public sewers to track viral Covid-19 particles and other organisms that infect humans. Technically, wastewater sampling involves a related approach called eRNA, because some viruses only have genetic information stored in the form of RNA, rather than DNA. Still, the same principles apply. (Studies also suggest RNA, which determines which proteins an organism is expressing, could be used to assess ecosystem health; organisms that are healthy may express entirely different proteins compared to those that are stressed.) In addition to monitoring the prevalence of diseases, wastewater surveillance demonstrates how an existing infrastructure designed to do one thing — sewers were designed to collect waste — could be fashioned into a powerful tool for studying something else, like detecting pathogens.
Clare has a habit of doing just that. “I personally am one of those people who tends to use tools — not the way they were intended,” she said. Clare was among the researchers who noticed a gap in the research: There was a lot less eDNA work done on terrestrial organisms. So, she began working with what might be called a natural filter, that is worms that suck blood from mammals. “It’s a lot easier to collect 1,000 leeches than it is to find the animals. But they have blood-meals inside them and the blood carries the DNA of the animals they interacted with,” she said. “It’s like having a bunch of field assistants out surveying for you.” Then, one of her students thought the same thing for dung beetles, which are even easier to collect.
Clare is now spearheading a new application for another continuous monitoring system — leveraging existing air-quality monitors that measure pollutants, such as fine particulate matter, while also simultaneously vacuuming eDNA out of the sky. In late 2023, she only had a small sample set, but had already found that, as a byproduct of routine air quality monitoring, these preexisting tools doubled as filters for the material she is after. It was, more or less, a regulated, transcontinental network collecting samples in a very consistent way over long periods of time. “You could then use it to build up time series and high-resolution data on entire continents,” she said.
A researcher examines equipment on a pollution measurement station in London, England, which was originally placed in 1996. Routine air quality monitoring station are, more or less, a transcontinental network of filters for eDNA that operate in a consistent way over long periods of time.
LEON NEAL/GETTY IMAGES
In the U.K. alone, Clare said, there are an estimated 150 different sites sucking a known quantity of air, every week, all year long, which amount to some 8,000 measurements a year. Clare and her co-authors recently analyzed at a tiny subset of these — 17 measurements from two locations — and were able to identify more than 180 different taxonomic groups, more than 80 different kinds of plants and fungi, 26 different species of mammal, 34 different species of birds, plus at least 35 kinds of insects.
Certainly, other long-term ecological research sites exist. The U.S. has a network of such facilities. But their scope of study does not include a globally distributed infrastructure that measures biodiversity constantly — including the passage of migrating birds overhead to the expansion and contraction of species with climate change. Arguably, eDNA will likely complement, rather than supplant, the distributed network of people, who record real-time, high-resolution, tempo-spatial observations on websites such as eBird or iNaturalist. Like a fuzzy image of an entirely new galaxy coming into view, the current resolution remains low.
“It’s sort of a generalized collection system, which is pretty much unheard of in biodiversity science,” said Clare. She was referring to the capacity to pull eDNA signals out of thin air, but the sentiment spoke to the method as a whole: “It’s not perfect,” she said, “but there’s nothing else that really does that.”
This article first appeared in The Checkup, MIT Technology Review’s weekly biotech newsletter. To receive it in your inbox every Thursday, and read articles like this first, sign up here.
Visit any health-care facility, and one of the first things they’ll do is clip a pulse oximeter to your finger. These devices, which track heart rate and blood oxygen, offer vital information about a person’s health. But they’re also flawed. For people with dark skin, pulse oximeters can overestimate just how much oxygen their blood is carrying. That means that a person with dangerously low oxygen levels might seem, according to the pulse oximeter, fine.
The US Food and Drug Administration is still trying to figure out what to do about this problem. Last week, an FDA advisory committee met to mull over better ways to evaluate the performance of these devices in people with a variety of skin tones. But engineers have been thinking about this problem too. In today’s Checkup, let’s look at the problem with pulse oximeters—why they are biased and what technological fixes might be possible.
To understand the problem, you first have to understand how pulse oximeters work. Most of these devices clamp onto some part of the body—usually a fingertip, but sometimes they need to be placed on earlobes or toes. One side of the clamp contains LEDs that emit light in two different wavelengths—red and infrared. A sensor on the other side of the clamp measures how much of that light passes through the tissue. The hemoglobin in oxygenated blood and deoxygenated blood absorbs these wavelengths differently, and by calculating the ratio of the red-light measurements to the infrared-light measurements—the R value—the device can tabulate blood oxygen saturation.
Here’s the problem: other factors can affect how much light is absorbed. Dark nail polish, for example, can throw off the reading. Or tattoos. Or melanin. “If a person has a darker skin tone, they’re going to be absorbing more light,” says Maggie Delano, an engineer at Swarthmore College who is interested in inclusive engineering design. Imagine there are 100 photons of light going through a finger. Some get absorbed by blood, some by bone, and some by melanin in the skin. “So if someone has a darker skin tone, maybe five photons get through instead of 20,” Delano says. “If your electronics don’t compensate for that in some way, there can be errors in that result.”
Those errors can have real clinical consequences. Blood oxygen is one of the key vital signs doctors use to determine whether someone needs to receive oxygen or be admitted to the hospital.
Engineers are working to fix this problem in a variety of ways. At Tufts, Valencia Koomson and her colleagues have developed a device that can detect when the signal quality is poor or when the user has a darker skin tone and compensate by sending more light through. “We’re dealing with very weak optical signals that have to transverse through tissues with lots of [other] elements that absorb and scatter light,” she told Inverse. “It’s very similar to when you’re riding a car and you go through a tunnel. You lose signal because of the absorption of the materials in the tunnel, such that the signal being transmitted from the cell-phone tower is too weak to be processed by your phone.”
Koomson and her colleagues are collaborating with a medical-device manufacturing company to develop a prototype for clinical trials. Because their team was named a finalist in a recent challenge by Open Oximetry, they’ll be able to validate the device for free in the Hypoxia Lab at the University of California, San Francisco.
Neal Patwari, a mechanical engineer at Washington University in St. Louis, wants to keep the pulse oximeter’s hardware the same, but swap out the algorithm. A pulse oximeter takes four different measurements, two in each wavelength. One measurement takes place as the heart pushes blood through the arteries, when blood flow is at a maximum, and the other happens between pulses, when blood flow is at a minimum. Those four numbers get fed into an algorithm that calculates ratios—actually, one ratio divided by another. That gives you the R value. But, “when you take two numbers and divide them, you can get some strange effects when the denominator is noisy,” Patwari says. And one of the factors that can increase noisiness is darkly pigmented skin. He hopes to find an algorithm that doesn’t rely on ratios, which could offer up a less biased R value.
Whether any of these strategies will fix the bias in pulse oximeters remains to be seen. But it’s likely that by the time improved devices are up for regulatory approval, the bar for performance will be higher. At the meeting last week, committee members reviewed a proposal that would require companies to test the device in at least 24 people whose skin tones span the entirety of a 10-shade scale. The current requirement is that the trial must include 10 people, two of whom have “darkly pigmented” skin.
In the meantime, health-care workers are grappling with how to use the existing tools and whether to trust them. In the advisory committee meeting on Friday, one committee member asked a representative from Medtronic, one of the largest providers of pulse oximeters, if the company had considered a voluntary recall of its devices. “We believe with 100% certainty that our devices conform to current FDA standards,” said Sam Ajizian, Medtronic’s chief medical officer of patient monitoring. A recall “would undermine public safety because this is a foundational device in operating rooms and ICUs, ERs, and ambulances and everywhere.”
But not everyone agrees that the benefits outweigh the harms. Last fall, a community health center in Oakland California,filed a lawsuit against some of the largest manufacturers and sellers of pulse oximeters, asking the court to prohibit sale of the devices in California until the readings are proved accurate for people with dark skin, or until the devices carry a warning label.
“The pulse oximeter is an example of the tragic harm that occurs when the nation’s health-care industry and the regulatory agencies that oversee it prioritize white health over the realities of non-white patients,” said Noha Aboelata, CEO of Roots Community Health Center, in a statement. “The story of the making, marketing and use of racially biased pulse oximeters is an indictment of our health-care system.”
No surprise that technology perpetuates racism, wrote Charlton McIlwain in 2020. That’s the way it was designed. “The question we have to confront is whether we will continue to design and deploy tools that serve the interests of racism and white supremacy.”
We’ve seen that deep-learning models can perform as well as medical professionals when it comes to imaging tasks, but they can also perpetuate biases. Some researchers say the way to fix the problem is to stop training algorithms to match the experts, reported Karen Hao in 2021.
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