Donated bodies are powering gene-edited organ research

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.

Hooked up to a ventilation machine, a person can be dead in the eyes of the law, medical professionals, and loved ones, yet still alive enough to be useful for medical research. Such brain-dead people are often used for organ donation, but they are also of increasing importance to the biotech world. 

This week, we reported how surgeons at the University of Pennsylvania connected a pig liver to a brain-dead person in an experiment that lasted for three days.

The point was to determine whether the organ—which was mounted inside a special pumping device—could still do its job of cleaning up toxins from the body, and possibly lead to a new approach for helping patients with acute liver failure.

Using entire bodies in this way—as an experimental “decedent model”—remains highly unusual. But there’s been an upsurge in requests for bodies as more companies start testing animal-to-human organ transplants using tissues from specially gene-edited pigs.

“In order to get to humans, you have to go through steps. You can’t say ‘I am going to try it tomorrow,’ as you did 50 years ago,” says Abraham Shaked, the surgeon at Penn who directed the experiment.

To learn how common it is to use bodies as experimental models, I checked in with Richard Hasz, CEO of Gift of Life Donor Program, a nonprofit that arranges for organ donation in Pennsylvania, New Jersey and Delaware, and which provided Penn with the body used in the liver experiment.

“It’s definitely a new model. But sometimes we repeat things that have happened before. We have been around 50 years, and this is the second time it’s been requested,” says Hasz.

The previous time was in the 1980s, when researchers at Temple University sought out brain-dead bodies as a “no risk” way to test an early artificial heart made from plastic and metal. They wanted to see how it fit in a chest and test surgical techniques before trying the mechanical heart in a living patient.

Starting in 2021, though, donation organizations again started hearing from surgeons who needed brain-dead people, sometimes called “beating-heart cadavers.”  That was because several companies had developed gene-edited pigs and doctors were ready to start trying their organs.

According to a tally from the biotech company eGenesis, of the 10 pig-to-human transplant experiments that have taken place in the US since 2021, two have been in living people, but the other eight have involved brain-dead bodies.

The main use of such bodies is as organ donors. Although most people don’t realize it, says Hasz, only that relatively rare 1% to 2% of people who experience brain death while under medical care can have their organs collected.

“It’s a big misconception that anyone who has died in a car accident or outside the hospital can be an organ donor. You have to have died in the ICU from a devastating neurological injury to your brain,” he says.

It’s that brain-dead but beating-heart state that provides the time—sometimes a day or two—to move the body to a central location, find a suitable recipient, and allow surgeons to remove the organs.

Organizations like Hasz’s are the ones that approach families, transport the bodies, and help match organs to recipients.  Last year Gift of Life helped arrange for 1,734 transplants of organs taken from 693 donors.

The family of the patient in this case—really, the “decedent,” since he’d been declared brain dead—wanted to see his organs donated. But there weren’t any takers; sometimes factors like cancer, age, or infections make organs less desirable.

So Hasz approached the family about another option. Would they agree to let his body be used in an experiment with a pig liver?  The whole concept was new to them, but they quickly agreed, he says.

“Our team tried to shepherd this family to understand all the ins and outs of what that would mean—the length of time, the goals, the fact that it would be an extracorporeal support—and provide them with all that information,” he says.

This time the experiment lasted only 72 hours, as that’s about how long a pig liver would be needed to support a real patient. Hasz says other families might be comfortable with longer experiments, but probably not anything indefinite: “We can maintain a body with mechanical support once they are declared medically and legally dead, but families have a desire for closure, funeral services, and depending on the family, they may limit it to one day or one month.”

Hasz says his team will be looking for more body donors to support further experiments with pig livers. And he expects many will agree. “We depend every day in organ transplant on the kindness of strangers who are at their worst possible moment, but they can set that aside and think of others,” he says. “Having talked to many families over the years, I am always surprised and humbled by their willingness to say yes.”

Read more from MIT Technology Review’s archive

Last year, MIT Technology Review’s Mortality Issue explored how technology is sometimes blurring the line between life and death. News editor Charlotte Jee wrote my favorite story in the issue, which described how chatbots can create  “digital clones” that let people speak to their dead relatives.

We said donated organs only come from brain-dead individuals. But there are some exceptions. In 2015 we wrote about a device that could revive hearts that had stopped beating, making them available for transplant.

Pig-to-human organ transplants made our 2023 list of 10 Breakthrough Technologies because they could end the organ shortage. We took a deep dive into one entrepreneur’s plans to make it happen.

Around the web

A lab in China reported experiments with a coronavirus that is 100% fatal to mice and could harm humans. It caused brain damage and turned their eyes white. Some scientists condemned the risky research as “madness.” (New York Post)

Perverse incentives, no real negotiation, and profiteering middlemen. Those are among the five key reasons drug prices in the US are nearly twice those in some European countries. (New York Times)

No one can resist a cute animal story—I think that’s why efforts to test anti-aging drugs in pets get so much media attention. But now people are howling about the $7-million-a-year Dog Aging Project, whose organizers say they’re about to lose their government funding. The project has been testing the life-span effects on dogs of a drug called rapamycin. (Science)

These AI-powered apps can hear the cause of a cough

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.

This week I came across a paper that uses AI in a way that I hadn’t heard of before. Researchers developed a smartphone app that can distinguish tuberculosis from other diseases by the sound of the patient’s cough.

The method isn’t foolproof. The app failed to detect TB in about 30% of people who actually had the disease. But it’s simpler and vastly cheaper than collecting phlegm to look for the bacterium that causes the disease, the gold-standard method for diagnosing TB. So it could prove especially useful in low-income countries as a screening tool, helping to catch cases and interrupting transmission.

In the new study, a team of researchers from the US and Kenya trained and tested their smartphone-based diagnostic tool on recordings of coughs collected in a Kenyan health-care center—about 33,000 spontaneous coughs and 1,200 forced coughs from 149 people with TB and 46 people with other respiratory conditions. The app’s performance wasn’t good enough to replace traditional diagnostics. But it could be used as an additional screening tool. The sooner people with active cases of TB are identified and receive treatment, the less likely they will be to spread the disease. 

This new paper is one of dozens that have come out in recent years that aim to use coughs and other body sounds as “acoustic biomarkers”—sounds that indicate changes in health.  The concept has been around for at least three decades, but in the past five years, the field has exploded. What changed, says Yael Bensoussan, a laryngologist at the University of South Florida, is the growing use of AI: “With artificial intelligence, you can analyze a larger quantity of data faster.”

Covid also helped drive interest in cough analysis. The pandemic gave rise to 30 or 40 startups focusing on the acoustics of cough, Bensoussan says. AudibleHealthAI launched in 2020 and began working on a mobile app designed to diagnose covid. The software, called AudibleHealth DX, is currently being reviewed by the FDA. And now the company is now branching out to influenza and TB.

The Australian company ResApp Health has been working on acoustic diagnosis of respiratory diseases since 2014, well before the pandemic. But when covid emerged, the company pivoted and developed an audio-based covid-19 screening test. In 2022, the company announced that the tool correctly identified 92% of positive covid cases just from the sound of a patient’s cough.  Soon after, Pfizer paid $179 million to acquire ResApp.

Bensoussan is skeptical that these kinds of apps will become reliable diagnostics. But she says apps that detect coughs—any coughs—could prove to be  valuable health tools even if they can’t pinpoint the cause. Coughs are especially easy for smartphones to capture. “It’s a sea change to have a common device, the smartphone, which everyone has sitting by their bedside or in their pocket to help observe your coughs,” Jamie Rogers, product manager at Google Health, told Time magazine. Google’s newest Pixel phones have cough and snore detection available.

Bensoussan also thinks cough-tracking apps could be game-changers for clinical trials where coughs are one of the things researchers are trying to measure. “It’s really hard to track cough,” she says. Researchers often rely on patients’ recall of their coughing. But an app would be far more accurate. “It’s really easy to capture the frequency of cough from a tech perspective,” she says. 

And it’s not just coughs that can reveal clues about our health status. Bensoussan is leading a $14 million project funded by the NIH to develop a massive database of voice, cough, and respiratory sounds to aid in the development of tools to diagnose cancers, respiratory illnesses, neurological and mood disorders, speech disorders, and more. The database captures a wide variety of sounds—coughing, reading sentences or vowel sounds, inhaling, exhaling, and more. 

“One of the big limitations is that a lot of these studies have private data sets that are secret,” Bensoussan says. That makes it difficult to validate the research. The database that she and her colleagues are developing will be publicly available. She expects the first data release to happen before June.

As more data becomes available, expect to see even more apps that can help alert us to health problems on the basis of cough or speech patterns. It’s too soon to say whether those apps will make a significant difference in diagnosis or screening,  but we’ll keep an ear out for any new developments.  

Read more from MIT Technology Review’s archive

Vocal cues could provide a way to diagnose PTSD, traumatic brain injuries, mood disorders, and even heart disease, Emily Mullin wrote in this story from 2017. 

AI tools might perform well  in the lab but falter in the chaos of the real world. Will Douglas Heaven unpacked what happened when Google Health implemented a tool in Thailand to screen people for an eye condition linked to diabetes. 

In a previous issue of The Checkup, Jessica Hamelzou outlined why we shouldn’t let AI make all our health-care decisions: “Doctors may be inclined to trust AI at the expense of a patient’s own lived experiences, as well as their own clinical judgment.” 

From around the web

Safe bathrooms equipped with motion sensors have eliminated overdose deaths at a Boston clinic that serves unhoused individuals in the city’s infamous “methadone mile”—further proof that supervised consumption sites would save lives. (STAT)

Now that we’ve got new blockbuster weight-loss drugs, some companies are looking to develop longer-lasting treatments and preventatives. But some say an obesity-free future won’t come from pharma. “We are not going to be able to treat our way out of this problem, or medicalize our way out of this problem,” says William Dietz, director of the Global Center for Prevention and Wellness at George Washington University. “What we need to do is to come to terms with the kind of environmental forces which are driving obesity, and generate the political will necessary to address those factors.” (STAT) 

Advances in neuroscience have sparked worries that brain-computer interfaces might someday read people’s minds or hamper free will. Now “neurorights” advocates are racing against the clock to push for laws that would protect against the misuse and abuse of neurotechnology. (Undark)

Gene editing had a banner year in 2023

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.

Welcome back to The Checkup. This will be our last issue of 2023, so this week I’ve been reflecting on our biotechnology coverage over the past year. As I scrolled through our archives, I was struck by the vast number of stories we wrote about gene editing.

It really shouldn’t have come as a surprise. Perhaps no technology has more power to transform medicine, and its vast potential is just beginning to be realized. Gene editing can be used to delete, insert, or alter portions of our genetic code. We’ve been able to modify DNA for years, but newer technologies like CRISPR mean that we can do it faster, more accurately, and more efficiently than ever before. In 2023, we saw the first approval of a CRISPR-based gene-editing therapy. And many more are to come. So let’s take a look at the developments that made news this year. What is the promise of gene editing, and what are the current pitfalls?

Lucky breaks and next steps 

Casgevy, the first CRISPR therapy, has already been approved in the UK and US to treat sickle-cell disease. And it’s now on the cusp of approval in the European Union. Sickle-cell disease is caused by a mutation in the hemoglobin gene that leads to a characteristic crescent moon shape of the red blood cells. The treatment doesn’t address the underlying cause of the disease; instead, it disables another gene, one that hampers production of a type of hemoglobin that people normally produce only in the womb and as babies. With that gene out of commission, production of this second type of hemoglobin resumes. The therapy works because cells with fetal hemoglobin won’t form sickles. You can read more about the fascinating backstory on the development of Casgevy in this story by my colleague Antonio Regalado. 

Why go at it in this roundabout way? Current versions of CRISPR work best as a pair of scissors, creating snips that disable genes. That limits its usefulness. New versions of CRISPR will allow researchers to alter the genetic code or even insert new genes, which will make it possible to address a wide variety of genetic diseases.

Verve Therapeutics, for example, is testing an approach called base editing. Jessica Hamzelou covered this technique in depth in this story in January: “There are four DNA bases: A, T, C, and G. Instead of cutting the DNA, CRISPR 2.0 machinery can convert one base letter into another. Base editing can swap a C for a T, or an A for a G.” According to Kiran Musunuru, cofounder and senior scientific advisor at Verve, “It’s no longer acting like scissors, but more like a pencil and eraser.”

Verve’s therapy, now being tested in a small clinical trial, swaps out a single base in a gene for a protein called PCSK9, which is linked to high cholesterol. (The therapy was one of MIT Technology Review’s 10 Breakthrough Technologies 2023.) That change disables the gene, which means that the body makes less PCSK9 and cholesterol levels fall. In November the company announced interim results: a single injection of the therapy reduced LDL levels in the blood by up to 55% in 10 people with a genetic condition that causes high cholesterol.

CRISPR 3.0, which allows scientists to replace bits of DNA or insert new chunks of genetic code, is still being tested in animals. One company, Prime Medicine, plans to seek FDA approval to launch a human trial of a treatment for chronic granulomatous disease, a genetic immune disorder, in 2024 .

Pitfalls remain, at least for now. 

The only approved CRISPR therapy isn’t a simple fix. Patients have to undergo a bone-marrow transplant: after chemotherapy to destroy their faulty cells, stem cells are extracted, edited in the lab, and then reinfused. Jimi Olaghere, one of the few people to have received the therapy, wrote about how arduous this was. The cell collection process left him so weak he needed blood transfusions. And the chemo meant “dealing with nausea, weakness, hair loss, debilitating mouth sores, and the risk of exacerbating the underlying condition.” All told, he spent 17 weeks in the hospital.

Given the complexity of the treatment, you won’t be surprised to learn that it’s expensive—it costs an estimated $2.2 million. That price tag means it’s out of reach for many, especially people in low-income countries.

Vertex is already exploring strategies to make sickle-cell therapies more accessible and affordable. Antonio spoke to the company’s head of research, David Altshuler, about some of the strategies earlier this month.  One of the more promising approaches might not involve gene editing at all.

“One question I get a lot is: How are we going to get to the rest of the world?” Altshuler said. “And I think the answer is not by trying to do bone-marrow transplants in the rest of the world. It’s just too resource intensive, and the infrastructure is not there. I think the goal will be achieved sooner by finding another modality, like a pill that can be distributed much more effectively.”

Safety concerns abound. Gene editing is permanent, and one of the biggest concerns is that these therapies might miss the mark and create “off-target” effects. Regulators were so concerned about this possibility that an FDA advisory committee met in November to assess whether Vertex would need to provide additional data to prove Casgevy’s safety. (They ultimately decided the existing data was sufficient for approval.) The company plans to follow up with patients for 15 years to confirm safety.

Most experts think base editing, which doesn’t involve snipping, should be safer than the CRISPR scissors. But even there, safety has been front and center in discussions. The positive results in Verve’s trial of base editing to treat high cholesterol were partly overshadowed by the fact that two participants had heart attacks, and one of them died.

The epic patent dispute over CRISPR has long been another potential hiccup for possible therapies. But this month Antonio reported on a partial resolution. Vertex agreed to pay tens of millions of dollars to competitor Editas and the Broad Institute for the right to use Broad’s CRISPR patent, thus avoiding a potential lawsuit. “It’s not yet clear if the license agreement points to an end of the fierce patent fight between Broad and Berkeley. That has been continuing before a US patent court, with Berkeley still trying to overturn its rival’s claims,” he wrote.

Despite the pitfalls, it’s clear that gene-editing therapies, when they work, can be transformational. Olaghere detailed his experience as a trial participant.  “I started to experience things I had only dreamed of: boundless energy and the ability to recover by merely sleeping. My physical symptoms—including a yellowish tint in my eyes caused by the rapid breakdown of malfunctioning red blood cells—virtually disappeared overnight,” he wrote. “Most significantly, I gained the confidence that sickle-cell disease won’t take me away from my family, and a sense of control over my own destiny.”

Another thing

• Hunter-gatherer societies may still retain many of the microbes that people living in industrialized societies lack. That’s why scientists are racing to catalog their microbiome. But there’s a catch, writes senior reporter Jessica Hamzelou. “We don’t know whether those in hunter-gatherer societies really do have ‘healthier’ microbiomes—and if they do, whether the benefits could be shared with others.” What’s more, members of these communities say some research is being conducted without regard for ethics or equity. “Taking advantage of an Indigenous population and using their microbes to try to reinstate health in somebody from a wealthy, industrialized nation, I think, is a problematic thing to do,” Justin Sonnenburg, a microbiome scientist at Stanford University, told her.

From around the web

• A New York Times investigation delves into the increasingly popular practice of snipping “tongue-ties” in babies, an often unnecessary procedure being aggressively pushed by some lactation consultants and dentists. A heartbreaking must-read. (NYT)
• Studies call into question the benefit of spinal cord stimulation for pain (Medpage) 
• Researchers are testing a new non-hormonal male birth control pill in a clinical trial in the UK.. (Stat)
• Chemotherapy drug shortages are robbing cancer patients of the therapies they desperately need and highlighting systemic problems in the generic drug market. (NYT) But there are some possible fixes. (NYT)
• The high lead levels in some applesauce pouches, which sickened more than 100 children in the US, came from the cinnamon that was added. Regulators are still trying to work out why the cinnamon contained lead. (Washington Post)

The first CRISPR cure might kickstart the next big patent battle

That’s a real nice CRISPR cure you have there. It would be a pity if anything happened to it. 

Okay. Drop the tough-guy accent and toss the black fedora aside. But I do believe that similar conversations could be occurring now that a historic gene-editing cure is coming to market, as soon as this year.

By the middle of December, Vertex Pharmaceuticals, based in Boston, is expected to receive FDA approval to sell a revolutionary new treatment for sickle-cell disease that’s the first to use CRISPR to alter the DNA inside human cells. (Vertex has already received regulatory approval in the UK.)

The problem is that the US patent on editing human cells with CRISPR isn’t owned by Vertex—it is owned by the Broad Institute of MIT and Harvard, probably America’s largest gene research center, and exclusively licensed to a Vertex competitor, Editas Medicine, which has its own sickle-cell treatment in testing.

That means Editas will want Vertex to pay. And if it doesn’t, Broad and Editas could go to the courts to claim patent infringement, demand royalties and damages, or even try to stop the treatment from being sold with an injunction.

“I imagine we’ll see a lawsuit by the end of the year,” says Jacob Sherkow, an expert on gene-editing patents at the University of Illinois College of Law. “It’s the moment patent litigators in this space have been waiting for.”

Now for some disclaimers. Yes, I work for MIT. No, I don’t benefit directly from the CRISPR patents. But others around here do. I recently talked to a scientist who, despite having only a secondary role in some follow-up CRISPR research, told me they have been receiving yearly royalty checks sometimes equaling their salary.

Back in 2014, MIT Technology Review broke the story of the infamous battle to control the patents on CRISPR—and almost a decade later the dispute remains one of the foundational narratives around the genetic super-tool, which can be programmed to cut DNA at precise locations. 

The dispute pitted Broad Institute gene whiz Feng Zhang against the researchers who eventually earned the Nobel for developing CRISPR editing: Jennifer Doudna of the University of California, Berkeley, and Emmanuelle Charpentier, now with the Max Planck Institute in Germany.

Doudna and Charpentier might have the Nobel, but Zhang’s head-turning claim that he was the real inventor of CRISPR genome editing has so far won out in the US, despite vigorous and ongoing efforts by Berkeley at appeals. Although Broad’s intellectual property quest got little result in Europe, its CRISPR patent still reigns supreme here, in the world’s biggest drug market. 

And really, what’s the point of such a hard-won triumph unless it’s to enforce your rights? “Honestly, this train has been coming down the track since at least 2014, if not earlier. We’re at the collision point. I struggle to imagine there’s going to be a diversion,” says Sherkow. “Brace for impact.”

The Broad Institute didn’t answer any of my questions, and a spokesperson for MIT didn’t even reply to my email. That’s not a surprise. Private universities can be exceedingly obtuse when it comes to acknowledging their commercial activities. They are supposed to be centers of free inquiry and humanitarian intentions, so if employees get rich from biotechnology—and they do—they try to do it discreetly.

There are also strong reasons not to sue. Suing could make a nonprofit like the Broad Institute look bad. Really bad. That’s because it could get in the way of cures.

“It seems unlikely and undesirable, [as] legal challenges at this late date would delay saving patients,” says George Church, a Harvard professor and one of the original scientific founders of Editas, though he’s no longer closely involved with the company.  

If a patent infringement lawsuit does get filed, it will happen sometime after Vertex notifies regulators it’s starting to sell the treatment. “That’s the starting gun,” says Sherkow. “There are no hypothetical lawsuits in the patent system, so one must wait until it’s sufficiently clear that an act of infringement is about to occur.”

How much money is at stake? It remains unclear what the demand for the Vertex treatment will be, but it could eventually prove a blockbuster. There are about 20,000 people with severe sickle-cell in the US who might benefit. And assuming a price of $3 million (my educated guess), that’s a total potential market of around $60 billion. A patent holder could potentially demand 10% of the take, or more.

Vertex can certainly defend itself. It’s a big, rich company, and through its partnership with the Swiss firm CRISPR Therapeutics, a biotech co-founded by Charpentier, Vertex has access to the competing set of intellectual-property claims—including those of UC Berkeley, which (though bested by Broad in the US) hold force in Europe and could be used to throw up a thicket of counterarguments.

Vertex could also choose to pay royalties. To do that, it would have to approach Editas, the biotech cofounded by Zhang and Church in Cambridge, Massachusetts, which previously bought exclusive rights to the Broad patents on CRISPR in the arena of human treatments, including sickle-cell therapies.

It’s pretty clear Editas would like to ink a deal. On November 14, at a meeting with stock analysts, Editas CFO Erick Lucera said his company has at least two people working pretty much full time making calls and trying to get other companies developing CRISPR treatments to pay up. Indeed, he said, cashing in on the patents and bringing in revenue from them is a “pillar” of the Editas business model.

“I think there’s a lot of companies that probably are going to have to have a conversation with us about using our license from a freedom-to-operate standpoint, and we are open to those discussions,” Lucera told analysts. “We’re not talking about any particular licenses until they’re signed … But I think you all know the companies that are out there.”

You know who you are, Vertex Pharmaceuticals. Tug the fedora for emphasis.

When I contacted Vertex, and later CRISPR Therapeutics, spokespeople at both companies sent me identical replies: “I won’t have anything to say about CRISPR patents.” Okay, then. Maybe a deal is already in the works. 

One final thought. If you were to discover a super-technique like CRISPR, it might be smarter to sell non-exclusive rights to all comers. Let a thousand flowers bloom. But that isn’t what happened. Instead, universities sold exclusives to develop CRISPR drugs to startups founded by their own researchers. Thus they planted the seeds of incurable dispute.

On its website, the Broad Institute explains why they did it. It says: “Exclusivity is necessary to drive the level of investment needed to develop certain technologies to the point that they are safe, effective, and capable of precise editing in specific cell types.”

Broad is correct that the CRISPR exclusive to Editas brought investment into that company, but a share of it was then used to fund the CRISPR patent fight. In fact, Editas financial reports indicate the company has been spending roughly $10 million on it per year. 

So now, after spending that kind of money, its investors would be absolutely right to demand a return—with a lawsuit if necessary.

“That can be considered the initial sin,” says Ulrich Storz, a patent attorney in Germany who recently wrote a detailed review of the CRISPR situation for the Journal of Biotechnology. “Of course a company wants exclusivity. But why did the university play that game?”

The pain is real. The painkillers are virtual reality.

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.

I hate needles. I am a grown woman who owns a Buzzy, a vibrating, bee-shaped device you press against your arm to confuse your nerves and thus reduce pain during blood draws. I once was so anxious a nurse gave me a n iPad so I could watch Moana while getting blood taken.

That’s why I was so excited to read about Smileyscope, a VR device for kids that recently received FDA clearance. It helps lessen the pain of a blood draw or IV insertion by sending the user on an underwater adventure that begins with a welcome from an animated character called Poggles the Penguin. Inside this watery deep-sea reality, the cool swipe of an alcohol wipe becomes cool waves washing over the arm. The pinch of the needle becomes a gentle fish nibble.  

Studies suggest the device works. In two clinical trials that included more than 200 children aged 4 to 11, the Smileyscope reduced self-reported pain levels by up to 60% and anxiety levelsby up to 40%.

But how Smileyscope works is not entirely clear. It’s more complex than just distraction. Back in the 1960s, Ronald Melzack and Patrick Wall posited that pain signals travel through a series of “gates” in the spinal cord that allow some to reach the brain and keep others out. When the brain is occupied by other stimuli, the gates close and fewer pain signals can get through. “And that’s the mechanism of action for virtual reality,” says Paul Leong, chief medical officer and co-founder of Smileyscope.

Not all stimuli are equally effective. “[In] traditional virtual reality you put on the headset and you go somewhere like a beach,” Leong says. But that kind of immersive experience has nothing to do with what’s happening in the real world. Smileyscope aims to reframe the stimuli in a positive light. Mood and anxiety can also affect how we process pain. Poggles the Penguin takes kids on a thorough walk-through of a procedure before it begins, which might reduce anxiety. And experiencing an underwater adventure with “surprise visitors” is undoubtedly more of a mood-booster than staring at clinic walls, waiting for a needle prick.

“There are a lot of ways to distract people,” says Beth Darnall, a psychologist and director of the Stanford Pain Relief Innovations Lab. But the way Smileyscope goes about it, she says, is “really powerful.”

Researchers have been working on similar technologies for years. Hunter Hoffman and David Patterson at the University of Washington developed a VR game called SnowWorld over two decades ago to help people with severe burns tolerate wound dressing changes and other painful procedures. “We created a world that was the antithesis of fire,” Hoffman told NPR in 2012, “a cool place, snowmen, pleasant images, just about everything to keep them from thinking about fire.” Other groups are exploring VR for postoperative pain, childbirth, pain associated with dental procedures, and more.

Companies are also working on virtual reality devices that will address a much tougher problem: chronic pain. In 2021 RelieVRx became the first VR therapy authorized by the FDA for pain. (The FDA keeps a list of all authorized VR/AR devices.) The tool aims to teach people how to manage chronic pain, which is entirely different from the temporary sting of a needle stick. “It’s vastly more complex on every level,” says Darnall, who helped develop RelieVRx and now serves as ​​chief science advisor for AppliedVR, which markets the device.

Chronic pain is long term, and often life altering. “You have now literal changes in your nervous system as a consequence of experiencing pain long term,” Darnall says. “You have stored tension, you have maybe persistent anxiety, your activity levels have changed, you have sleep problems.” The alarm bell rings long after the danger has passed, for months, years, or even decades. 

With RelieVRx, the intention isn’t to distract, it’s to teach pain relief strategies that physicians already know work, such as mindfulness, cognitive-behavioral therapy, and relaxation. “We are helping people unlearn some physiologically hardwired pain processes that over time become unhelpful,” Darnell says. “It’s fundamentally skills-based.” Patients use the device six minutes a day for eight weeks, and that seems to be enough for many of them to acquire skills to manage their own pain. At three months, 30% were still experiencing a reduction in pain intensity.  

RelieVRx has another benefit, too: it’s meant for home use. That means people don’t necessarily have to schedule appointments with a therapist to receive behavioral pain treatment, which makes therapy more accessible. “It’s dismantling barriers to this type of effective nonpharmacologic care,” Darnall says. That’s good news for the 50 million people in the US who experience chronic pain that can’t be controlled with medication. It’s one more option for a condition that is notoriously tough to treat.

VR won’t be a panacea for people with chronic pain or for anxious kids who need shots, and it’s not risk-free. It can cause nausea, headaches, and motion sickness. But the technology could prove exceedingly useful for some people. People like me.  

Providing patients with an escape during painful procedures may not seem like a medical necessity. In most cases, the procedure can be performed successfully either way. But pain is powerful, and a patient’s experience can directly influence future interactions with the medical system. “These experiences in childhood are really sentinel to developing behaviors in later life,” Leong says. “Every time you have a needle, that’s an opportunity for something to go well, or terribly. And if it goes terribly, the next time you go back you’re dreading it.”

That dread can have serious ramifications. Maybe you stop going to the clinic, or you avoid getting treatment. In fact, Leong founded Smileyscope because he had a patient with cystic fibrosis who had been so traumatized by the medical procedures he received as a child that he had “disengaged with care,” he says. The man wanted Leong to put him under anesthesia just to have a routine blood draw. “And I just thought, there’s got to be a better way,” he says. 

Now, there just might be. 

Read more from Tech Review’s archive

Long before AppliedVR had a device authorized to address chronic pain, Rachel Metz covered the company’s efforts. 

Could virtual reality “forest bathing” mimic the health impacts of actually spending time in a forest? Some scientists think so, reports Charlie Metcalfe. 

Using virtual reality to relax during surgery may reduce the need for anesthetic. Rhiannon Williams has the story. 

From around the web

Big milestone: The UK has approved the world’s first CRISPR gene editing therapy to treat two blood disorders. (Reuters)

A special gene editing technique called base editing has been used to alter DNA in humans in an attempt to lower cholesterol. Verve Therapeutics presented interim trial results at a meeting of the American Heart Association over the weekend. The data suggest that the therapy holds promise but also raised safety concerns. (Nature) 

Here’s a new worry about ChatGPT: data manipulation. The latest version put together a startlingly accurate fake dataset that made one type of eye surgery appear much more effective than another. (MedPage Today) 

Why high lead levels have been found in pouches of cinnamon applesauce is still a mystery, but the CDC says 22 children have high lead levels in their blood as a result. (CNN)

How scientists are being squeezed to take sides in the conflict between Israel and Palestine

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.

We don’t usually delve into war and politics here in The Checkup, but this week is an exception. The spreading human devastation of the Israel-Gaza conflict has led to tensions and strife in the scientific community. Some of the academic biologists whose work we follow have already had their careers damaged from the blowback to their online statements. Reactions to the war are also raising questions about freedom of speech, and of thought—issues that are core to science.

On October 7, Hamas—the organization in command of the Gaza Strip, and which is designated a terrorist group by the US—launched a surprise attack into Israel, during which it killed more than 1,400 people and took hostages. Israel has been responding with a campaign of air strikes on Gaza that are rapidly raising the body count, with thousands more killed, according to news reports.

For a nation of fewer than 10 million, Israel plays an outsize role in science and medicine. It’s a land of biotech startups, the nation where covid-19 vaccines were first tried at scale, and home to many prominent biologists, among them Jacob Hanna, a stem-cell expert whose work we have covered and whose predictions about the direction of cutting-edge science I value.

Hanna is an Israeli citizen and a professor at the state-funded Weizmann Institute of Science in Rehovot, Israel. But he’s also a Palestinian from a Christian background whose social media profile has an image saying “F*ck the Occupation” as well as “Arab and Jews refuse to be enemies.”

A day after the attack, Hanna posted a public comment: “Barbarism has many forms. Occupation & 18 year old siege is also one of them,” he wrote, in a reference to the confinement of Palestinians to Gaza.

Hanna immediately came under withering scrutiny from other scientists, including some at his university. Why wasn’t he first and foremost condemning Hamas? Researchers questioned whether he should keep his funding, and Jonathan Kipnis, an immunologist at Washington University in St. Louis, said Hanna should leave Israel if he doesn’t like it.

“Maybe then he should move to Gaza and be the best scientist there and support his brethren,” Kipnis wrote on X, the site formerly known as Twitter. (Kipnis would later tell me, “It was a stupid tweet of mine, which I deleted and apologized.”)

To Hanna, the replies were “racist and condescending,” and he hasn’t changed his views. (He is against all violence and calls Hamas a “terrible violent and terrorist organization.”) But he also doesn’t want to only single out Hamas. Doing so, he says, would just be playing what he calls “the condemnation games” with people who are themselves unwilling to denounce Israel’s past actions toward Palestinians. 

But the pressure campaign has done its work. Hanna deleted his post about barbarism and several others. “I decided I don’t want politics on my feed anymore, and I don’t want fights,” he told me. “The posts were not intended to provoke fights. l was airing my thoughts and my frustration.”

Doing that has become risky. Some Israeli universities have said they will show “zero tolerance” for anyone who expresses “support for terrorism,” and there are reports of Arab Israeli students being disciplined for posts on social media sites.   

Meanwhile, here in the US, big donors and former university presidents have been insisting that academic institutions clearly condemn the Hamas attack, and not engage in “both-sidesism.” 

They want these organizations to acknowledge the massacre by Hamas. And they have a point. The Israeli military this week held a screening for journalists of uncensored footage from the attack, with scenes of people being dragged from cars, killed in their homes, or shot while hiding under tables.

The push to elicit condemnations of Hamas has been effective, causing the University of Pennsylvania and the University of California, San Diego, among others, to issue stronger statements. And the campaign continues. About 50 researchers at the university where Hanna works, for instance, signed a draft letter to the American Association for Cancer Research after it issued a vague statement on the conflict. In the reply, which we’ve seen, the Israeli researchers complain that the statement “bluntly fails to acknowledge the atrocities and their perpetrators. For example, the words “Hamas,” “Islamic Jihad,” or “terror attack” are not even included in the letter.”

It’s not as if scientists don’t ever take sides in political conflict. At the annual meeting of the European Society for Gene and Cell Therapy, which is being held in Brussels this week, the society is not accepting attendees whose entry is paid for by institutions in Russia or Belarus, citing Russia’s invasion of Ukraine.

“We know that many academics in Russia are opposed to the war in Ukraine,” the society says. “But we cannot accept your registration.”

Josh Dubnau, a geneticist at Stony Brook University, told me I was making a mistake in comparing the two situations. “Side-taking in Ukraine means denouncing an occupation,” he says. “The Ukrainians who are fighting back are fighting an army from a foreign nation that is targeting civilians.” 

In Israel and Gaza, he says, there is no such moral clarity, as both sides are killing civilians. Dubnau says the issue he’s concerned with is the efforts to “censure speech” of those scientists who are “criticizing Israeli atrocities.”

“It’s a kind of McCarthyism,” he believes, referring to the scare over communists in the 1950s in the US, which led to blacklists in Hollywood and at universities.

If so, one its first victims may be fruit fly biologist Michael Eisen, a prominent and outspoken advocate of “open” publishing, and—until this week—the editor of the influential journal eLife. 

On October 14, Eisen posted a satirical article from the Onion titled “Dying Gazans Criticized For Not Using Last Words To Condemn Hamas.” He added a summary of his own views in his post on X: “The Onion speaks with more courage, insight and moral clarity than the leaders of every academic institution put together. I wish there were a @TheOnion university.”

In response, eLife, which is backed by the Howard Hughes Medical Institute, fired him on Tuesday. In a statement, it said Eisen had previously been warned about his (notoriously brash) communication style, and that a “further incidence of this behavior” had led to the decision.

The situation at eLife, which depends on university scientists as editors, has led to a flurry of resignations—among both Eisen’s supporters and those who thought his comments amounted to intimidation of Israelis.  

Fede Pelisch, a member of eLife’s board, said on Wednesday he would resign because he disagreed with the decision to fire Eisen. In his own open letter, Pelisch says: “I have heard numerous concerns from people that now do not feel comfortable voicing their opinion if it does not conform to the orthodoxy.” He believes that “people feel silenced,” which he calls a “very harmful consequence for a Journal that is meant to ‘promote a research culture that values openness, integrity and equity, diversity and inclusion.”

So what are the consequences for science? Back in Israel, Hanna says his lab is at half speed as the conflict continues. And he’s still hurting, too. The brother of one of his students was killed in an air strike on a church in Gaza, he says. When I asked him for details about how biology research could be further affected in Israel, he wrote me this: 

“To my Israeli Jewish friends and colleagues in academia and biotech. Jealous of you that you are allowed to express feelings of pain and identification with your victimized innocent people without being put under house arrest and without being threatened with harm and cancellation. The threat of cancellation is relevant to companies, labs, individual scientists or all the above combined through funding, investment, recruiting. In the longer term, what is the ability of such ecosystem to become really international and diverse to attract talent, or is it sending signals of fascism and McCarthyism that might occasionally erupt, which means many don’t want to be part of such a system.”

Sadly, this war is likely still in its early days. Yesterday, it was revealed that Israel had briefly sent tanks into the Gaza Strip, and a ground invasion seems imminent. As the violence escalates, so will the fallout.

From our archives

Technology Review is an editorially independent publication of MIT. You can read or listen to MIT president Sally Kornbluth’s October 10 statement on events in the Middle East here: “Our community and the violence in Israel and Gaza.”

Small, high-tech, and communitarian—that’s why Israel was such an important player in covid-19 early on. The country was first to try vaccinating all its citizens, and in 2021, we reported on how it instituted a “green pass” system to encourage reopening.

When he’s not being told to quiet down, Jacob Hanna is turning stem cells into super-realistic models of human embryos. He even started a company to grow these synthetic embryo for several weeks and then collect their primitive organs for transplant medicine. I wrote about the startup, called Renewal Bio, and its controversial concepts last year.

In other news

Three people living with HIV been treated with the gene-editing tool CRISPR. Doctors hope the treatment will act as kind of antivirus software, removing the HIV from their bodies. (MIT Technology Review)

More than 40 states have sued Meta, the owner of Facebook and Instagram, charging it with causing digital addiction. They contend that “the company knowingly used features on its platforms to cause children to use them compulsively.” (New York Times)

How chill is cannabis? The widely legalized drug probably doesn’t treat anxiety as well as the promoters claim. (Wall Street Journal)

Ketamine is easier to prescribe than ever, and the FDA is not happy about it

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 year or so ago, I talked with a man who said ketamine saved his life. He had been depressed, contemplating suicide, and then found a psychiatrist who prescribed him ketamine lozenges. Ketamine is used as an anesthetic, but some studies suggest it also holds promise as a treatment for depression and other psychiatric disorders. So many doctors prescribe the medication to people with those conditions, even though it’s not approved to treat them.

Ketamine is actually pretty easy to find. I’ve gotten social media ads for online ketamine clinics, and you probably have too. According to the FDA, it might be a little too available. Last week, the agency issued a warning against the use of compounded versions of ketamine to treat psychiatric disorders, especially oral dissolving versions that make it possible to use the medication at home. “The lack of monitoring for adverse events, such as sedation and dissociation, by an onsite health care provider may put patients at risk,” the letter states.

So how did we get here? Let’s take a step back.

Ketamine is FDA approved for general anesthesia. It is not approved for the treatment of any psychiatric disorder, a point that the warning letter makes abundantly clear. (The nasal spray, Spravato, which is FDA approved to treat depression, contains esketamine, which is only one of the two molecular forms found in ketamine.) 

But just because ketamine isn’t FDA approved for psychiatric problems  doesn’t mean doctors can’t prescribe it for such uses. They can and often do. It’s called off-label use. When used for anesthesia, ketamine is delivered intravenously or as an injection, both of which require a health-care professional. And many clinics offer ketamine this way for depression too.

But compounding pharmacies can create custom-made formulations of ketamine that can be taken at home, including nasal sprays and oral versions. These formulations are not FDA approved, meaning the agency has not verified their safety or effectiveness—hence the warning letter. 

Ketamine has become especially readily available in the past several years. When the government relaxed the rules around telehealth access to controlled substances during the pandemic, a new opportunity arose. Suddenly doctors could prescribe ketamine without ever seeing the patient in person, and then pharmacies could ship out an oral formulation to take at home. “Startup companies cropped up almost overnight,” according to one Medscape article. 

Ketamine, like all drugs, does come with some risks. At high doses, the medication can induce a trance-like state, where users feel numb and dissociated from their body. It can spark hallucinations. Ketamine can also cause sedation, slow breathing, and elevated blood pressure.

But Boris Heifets, an anesthesiologist and neuroscientist at Stanford, doesn’t see the warning letter as primarily as an expression of concern over the safety of compounded ketamine. “If you read closely, it’s actually pretty flimsy,” he says of the case made for the dangers. He views the letter more as an attempt to curtail the rampant spread of telehealth ketamine clinics, which rely on compounding pharmacies to prepare the drug in ways that make it convenient to take at home. “The public health issue is that people are being indiscriminately prescribed the drug that has abuse liability, and with minimal supervision,” he says.

So is at-home ketamine safe? William Dudney, a psychiatrist in Tampa, Florida, has been offering patients ketamine for five years in the form of “troches,” waxy lozenges about the size of a Chiclet. The troche gets tucked between the lip and gum until it melts. His patients do take ketamine at home, but he prescribes troches that contain very low doses—between 35 and 70 milligrams.

Some doctors prescribe much higher doses. On various Reddit threads, patients who make use of online ketamine clinics say they’ve started their treatment with 450 mg doses and ramped up to 900 or even 1,200 mg per session. 

“It is way too much, way too fast,” Dudney says. “This 400-to-600-milligram craziness—this is for people who are seeking a hallucinatory experience. Hallucinations and dissociations are considered side effects, and that’s not the purpose. That’s recreational abuse.”

The latest warning from the FDA is actually the second risk alert the agency has issued addressing compounded ketamine. The first came last year and targeted nasal sprays. Heifets says these letters are intended to put pressure on the supply side. “They’re basically raising an alarm,” he says. “If you are supplying ketamine for these off-label practices, be sure you know exactly what you’re doing, because there may be some regulatory action here.” Will it be enough to chill the rampant off-label use of ketamine? Probably not. But there are signs the industry’s meteoric rise may be slowing anyway. 

In a previous version of The Checkup, we predicted that the ketamine bubble might be about to burst. The shuttering of some high-profile clinics this year, coupled with increased regulatory attention, suggests maybe it already has. 

Another thing

Whether a ketamine “trip” is necessary to experience the antidepressant benefits of the drug is a matter of some debate. And it’s a question Heiferts and his colleagues tried to answer in a unique study that just came out on Thursday.

One of the difficulties in trying to assess the efficacy of ketamine is that blinding is nearly impossible. Patients know whether they got the real thing or a placebo. But this study was designed to offer a clever workaround. The researchers enrolled 40 participants with moderate to severe depression who also happened to be undergoing surgery. They gave half of them ketamine as part of their anesthetic protocol. Because the participants were under anesthesia, they had no way of knowing whether they received ketamine or not.

The study design also gave the scientists a chance to examine whether the experience of ketamine—the trip—is required for the drug to work. Because the patients were under anesthesia, “they’re not having any particular conscious experience,” Heiferts says.

The results weren’t quite what the researchers expected. The participants who received ketamine during anesthesia did experience a large improvement in their depression symptoms. But so did participants in the placebo group. I asked Heiferts what he makes of these results. “I think expectancy is incredibly powerful,” he says. “This study does not show that ketamine is ineffective.” What it shows, he says, is that it was possible to match ketamine’s effect size by providing the placebo group with that same expectation of benefit coupled with a landmark event: surgery. “You have expectations that something is going to change afterwards, and you step through a door. That’s basically what we’ve re-created with surgery,” he says.

Read more from Tech Review’s archive

Psychedelics are undeniably having a moment, and the therapy might prove particularly beneficial to women, wrote Taylor Majewski in this feature from 2022.

But will the moment last? In a previous issue of The Checkup, Jessica Hamzelou argued that the psychedelic hype bubble might be about to burst.

How do psychedelics change our mental state? Scientists are using natural-language processing to analyze people’s trips.

Emery Brown has been studying anesthesia for more than a decade to understand how different anesthetics affect the brain. Now he and his colleagues plan to harness these compounds as tools to study the brain’s inner workings, writes Adam Piore in this profile of Brown from earlier this year.

From around the web

A fascinating new study sheds light on what might be causing neurological problems in people with long covid: lower serotonin levels caused by lingering virus in the gut. (New York Times)

Scientists found that a dietary supplement reverses declining fertility in older mice. This “undeniably groundbreaking” work provides a potential path to new fertility treatments for humans. (Nature)

A City University neuroscientist whose research propped up an experimental Alzheimer’s drug has been accused of scientific misconduct, and now some scientists are calling for the clinical trials to be suspended. (Science)

Wearable devices outperform human observers when it comes to tracking changes in the movement of people with Parkinson’s disease, a finding that could help scientists better assess the effectiveness of experimental therapies. (New York Times)

The FDA has greenlighted a pivotal in vivo trial of a gene-editing therapy. This one, from Intellia Therapeutics, is a CRISPR-based therapy for a rare type of amyloidosis that stops the heart from functioning properly. (Fierce Biotech)

Scientists just drafted an incredibly detailed map of the human brain

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.

When scientists first looked at brain tissue under a microscope, they saw an impenetrable and jumbled mess. Santiago Ramon y Cajal, the father of modern neuroscience, likened the experience to walking into a forest with a hundred billion trees, “looking each day at blurry pieces of a few of those trees entangled with one another, and, after a few years of this, trying to write an illustrated field guide to the forest,” according to the authors of The Beautiful Brain, a book about Cajal’s work.

Today, scientists have a first draft of that guide. In a set of 21 new papers published across three journals, the teams report that they’ve developed large-scale whole-brain cell atlases for humans and non-human primates. This work, part of the National Institutes of Health  BRAIN Initiative, is the culmination of five years of research. “It’s not just an atlas,” says Ed Lein, a neuroscientist at the  Allen Institute for Brain Science and one of the lead authors. “It’s really opening up a whole new field, where you can now look with extremely high cellular resolution in brains of species where this typically hasn’t been possible in the past.”

Welcome back to The Checkup. Let’s talk brains.

What is a brain atlas, and what makes this one different?

A brain atlas is a 3-D map of the brain. Some brain atlases already exist, but this new suite of papers provides unprecedented resolution of the whole brain for humans and non-human primates. The human brain atlas includes the location and function of more than 3,000 cell types in adult and developing individuals. “This is far and away the most complete description of the human brain at this kind of level, and the first description in many brain regions,”  Lein says. But it’s still a first draft. 

The work is part of the BRAIN Initiative Cell Census Network, which kicked off in 2017 with the aim of generating a comprehensive 3-D reference brain cell atlas for mice (that project is still in the works). The results reported on October 12 were part of a set of pilot studies to validate whether the methods used in mice would work for bigger brains. Spoiler: those methods did work. Really well, in fact.

What did these initial studies find?

The human brain is really, really complex. I know, shocker! Thus far, the teams have identified more than 3,300 cell types. And as the resolution gets even higher (that’s what they’re working on now), they’re likely to uncover many more. Efforts to develop an atlas of the mouse brain, which are further along, have identified 5,000 cell types. (For more, check out these preprints: 1 and 2)

But underneath that complexity are some commonalities. Many regions, for example, share cell types, but they have them in different proportions. 

And the location of that complexity is surprising. Neuroscience has focused much of its research on the outer shell of the brain, which is responsible for memory, learning, language, and more. But the majority of cellular diversity is actually in older evolutionary structures deep inside the brain,  Lein says. 

How did they make these atlases?

The classic neuroscience approach to classifying cell types relies on either cell shape–think of star-shaped astrocytes–or the cells’ type of activity–such as fast-spiking interneurons. “These cell atlases capitalize on a new suite of technologies that come from genomics,”  Lein says, primarily a technique known as single-cell sequencing.

First, the researchers start with a small piece of frozen brain tissue from a biobank. “You take a tissue, you grind it up, you profile lots of cells to try to make sense of it,”  Lein says. They make sense of it by sequencing the cells’ nuclei to look at the genes that are being expressed. “Each cell type has a coherent set of genes that they typically use. And you can measure all these genes and then cluster all the types of cells on the basis of their overall gene expression pattern,” Lein says. Then, using imaging data from the donor brain, they can put this functional information where it belongs spatially.

How can scientists use these brain cell atlases?

So many ways. But one crucial use is to help understand the basis of brain diseases.  A reference human brain atlas that describes a normal or neurotypical brain could help researchers understand depression or schizophrenia or many other kinds of diseases, Lein says. Take Alzheimer’s as an example. You could apply these same methods to characterize the brains of people with differing levels of severity of Alzheimer’s, and then compare those brain maps with the reference atlas. “And now you can start to ask questions like, ‘Are certain kinds of cells vulnerable in disease, or are certain kinds of cells causal,” Lein says. (He’s part of a team that’s already working on this.) Rather than investigating plaques and tangles, researchers can ask questions about “very specific kinds of neurons that are the real circuit elements that are likely to be perturbed and have functional consequences,” he says. 

What’s the next step?

Better resolution. “The next phase is really moving into very comprehensive coverage of the human and non-human primate brain in adults and development.” In fact, that work has already begun with the BRAIN Initiative Cell Atlas Network, a five-year, $500 million project.  The aim is to generate a complete reference atlas of cell types in the human brain across the lifespan, and also to map cell interactions that underlie a wide range of brain disorders.

It’s a level of detail that Ramon y Cajal couldn’t have imagined. 

Another thing

Gene editing helped chickens resist bird flu. “It could take decades to work through the necessary technical and regulatory steps, but researchers say CRISPR gene editing could eventually save countless chickens’ lives—and transform animal farming,” writes Abdullahi Tsanni.  

Read more from Tech Review’s archive

Brain atlases have been around for a minute. In 2013, Courtney Humphries reported on the development of BigBrain, a human brain atlas based on MRI images of more than 7,000 brain slices. 

And in 2017, we flagged the Human Cell Atlas project, which aims to categorize all the cells of the human body, as a breakthrough technology. That project is still underway. 

Cell atlases could help provide the data needed for AI to build a virtual cell, argue Priscilla Chan and Mark Zuckerberg in an op-ed published last month. 

From around the web

An experimental RSV vaccine launched in the 1960s worsened symptoms of the illness rather than providing protection. A months-long investigation into the history of RSV research reveals that the families who participated in these trials knew little about the risks. This is a long one, but worth it. (Undark)

A fascinating commentary on the new class of weight-loss drugs and the problems it can’t solve. Ozempic mania is “an example of how the American penchant for solving structural issues by fixing individual bodies is excellent at creating demand without solving social problems,” writes Tressie McMillan Cottom. (New York Times)

The FDA is launching an advisory committee on digital health technologies. (FDA)

One of the terrifying things we always hear about the 1918 flu is how hard it hit the young and healthy. But genetic research suggests that people with chronic diseases or nutritional deficiencies were twice as likely to die than healthy people. (New York Times)