Research advances from the National Institutes of Health (NIH) Intramural Research Program (IRP) often make headlines. Read the news releases that describe our most recent findings:
Whether you’re shedding pounds with the help of effective new medicines, slimming down after weight loss surgery or cutting calories and adding exercise, there will come a day when the numbers on the scale stop going down, and you hit the dreaded weight loss plateau.
In a recent study, Kevin Hall, a researcher at the National Institutes of Health who specializes in measuring metabolism and weight change, looked at when weight loss typically stops depending on the method people were using todrop pounds. He broke down the plateau into mathematical models using data from high-quality clinical trials of different ways to lose weight to understand why people stop losing when they do. The study published Monday in the journal Obesity.
Findings from a small study of eight patients published in Clinical Infectious Diseases suggest that COVID-19 rebound is likely not caused by impaired immune responses. The study, led by scientists at the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, aimed to define the clinical course and the immunologic and virologic characteristics of COVID-19 rebound in patients who have taken nirmatrelvir/ritonavir (Paxlovid), an antiviral therapeutic developed by Pfizer, Inc. COVID-19 rebound is characterized by a recurrence of COVID-19 symptoms and/or a new positive viral test after having tested negative, according to the Centers for Disease Control and Prevention. According to the study authors, the results do not support the hypothesis that the five-day course of Paxlovid is too short for the body to develop a strong immune response to SARS-CoV-2, the virus that causes COVID-19.
Participants were selected from adults enrolled in an ongoing COVID-19 study at the NIH Clinical Center in Bethesda, Maryland, and other local hospitals. The study aims to better understand how SARS-CoV-2 affects white blood cells. Participants provide blood and other samples as well as access to their COVID-19 medical records as part of the study. The study to evaluate COVID-19 rebound included six participants (three men and three women with a median age of 42 years) who took Paxlovid within four days of initial symptom onset and then experienced recurrent symptoms; two participants (a 54-year-old man and 35-year-old woman) who experienced recurrent symptoms who did not take Paxlovid; and a control group of six people who had COVID-19 but did not experience symptom rebound. All participants were previously vaccinated and boosted against COVID-19, and none developed severe disease requiring hospitalization during acute infection or rebound. Investigators collected data on each participant’s clinical course and performed laboratory tests on blood and nasal swab samples.
Investigators found no evidence of genetic mutations that would suggest participants who experienced COVID-19 rebound were infected with a strain of SARS-CoV-2 that was resistant to Paxlovid. They also found no evidence of delayed development of antibodies in participants experiencing rebound after taking Paxlovid. Investigators detected robust SARS-CoV-2 T-cell responses in rebound patients. Overall, the level of T-cell responses was greater in rebound patients than in patients with early acute COVID-19 who did not experience rebound. Infectious SARS-CoV-2 was detected by viral culture in one out of eight rebound participants.
Colorized scanning electron micrograph of a cell infected with the Omicron strain of SARS-CoV-2 virus particles (purple), isolated from a patient sample.
Monica M. Bertagnolli, M.D., started today as the 16th director of the National Cancer Institute (NCI), part of the National Institutes of Health (NIH). She is the first woman to hold the position of NCI director. Dr. Bertagnolli succeeds Norman E. Sharpless, M.D., who stepped down as director in April 2022. Douglas R. Lowy, M.D., has been NCI’s acting director since April 30, 2022.
“I look forward to working with Dr. Bertagnolli to advance the President’s call to end cancer as we know it. Dr. Bertagnolli’s decades of cancer research expertise around patient-centered care and her work to create more inclusive clinical trials will be instrumental as we accelerate the rate of research and innovation to fight cancer,” said Secretary Xavier Becerra, U.S. Health and Human Services. “Cancer knows no bounds and neither should our efforts to prevent cancer deaths. Together, we will reignite and advance the President’s Cancer Moonshot initiative to save lives.”
“Dr. Bertagnolli brings exceptional experience to NIH as a surgical oncologist, professor, scientist and leader in the cancer research community,” said Lawrence A. Tabak, D.D.S., Ph.D., who is performing the duties of the NIH director. “She is ideally suited to lead NCI at a point in time when opportunities abound for major advancements in cancer research and cancer care.”
NCI Director Dr. Monica Bertagnolli. Photo courtesty of Brigham and Women’s Hospital
Former smokers who stick to a healthy lifestyle have a lower risk of dying from all causes than those who don’t engage in healthy habits, according to a new study by researchers at the National Cancer Institute (NCI), part of the National Institutes of Health. The reduced risk of dying was observed for specific causes, including cancer and heart and lung diseases. Lifestyle interventions have not been robustly studied in former smokers, and these new findings could have important implications for the 52 million former smokers in the United States.
Maintaining a healthy lifestyle — defined as doing things such as being physically active and having a healthy diet — was associated with a 27% reduction in the risk of death over the 19-year follow-up period, compared with not maintaining a healthy lifestyle.
The findings, which appeared Sept. 22, 2022, in JAMA Network Open, come from an analysis of a large group of former smokers who participated in the NIH-AARP Diet and Health Study.
“I was surprised to see the robust associations [with lifestyle],” said Maki Inoue-Choi, Ph.D., of the Division of Cancer Epidemiology and Genetics at NCI, lead author of the paper. “Former smokers who adhered to evidence-based recommendations for body weight, diet, physical activity, and alcohol intake had a lower risk of mortality than former smokers who didn't adhere to these recommendations.”
A medication for heart problems and high blood pressure may also be effective for treating alcohol use disorder, according to a new study by researchers at the National Institutes of Health and their colleagues. The study presents converging evidence from experiments in mice and rats, as well as a cohort study in humans, suggesting that the medication, spironolactone, may play a role in reducing alcohol drinking. The research was led by scientists at the National Institute on Drug Abuse (NIDA) and the National Institute on Alcohol Abuse and Alcoholism (NIAAA), both parts NIH, and Yale School of Medicine, New Haven, Connecticut. A report of the new findings is published in Molecular Psychiatry.
“Combining findings across three species and different types of research studies, and then seeing similarities in those data, gives us confidence that we are onto something potentially important scientifically and clinically. These findings support further study of spironolactone as a potential treatment for alcohol use disorder, a medical condition that affects millions of people in the U.S.,” said Lorenzo Leggio, M.D., Ph.D., chief of the Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, a joint laboratory of NIDA and NIAAA, and one of the senior authors.
Currently there are three medications approved for alcohol use disorder in the United States, and they are an effective and important aid in the treatment of people with this condition. Given the diverse biological processes that contribute to alcohol use disorder, new medications are needed to provide a broader spectrum of treatment options. Scientists are working to develop a larger menu of pharmaceutical treatments that could be tailored to individual needs.
NIH study shows the role of transcription factors in facilitating cell regeneration
National Institutes of Health researchers have discovered a specific network of proteins that is necessary to restore hearing in zebrafish through cell regeneration. The study, led by investigators at the National Human Genome Research Institute (NHGRI), may inform the development of treatments for hearing loss in humans. The findings were published in Cell Genomics.
Although hair cell loss cannot be replaced in humans, many animals, including zebrafish, can restore hearing after injury through the regeneration of hair cells. The regenerative properties of zebrafish hair cells prompted researchers to use this animal to understand some fundamental properties of regeneration.
Hearing loss affects around 37.5 million Americans, and most cases come from the loss of hearing receptors known as “hair cells” in the inner ear. Bristles that stick out of these microscopic hair cells move and bend when sound travels into our ears, resulting in electric signals sent through nerves and into our brains that allow us to process sound.
Confocal image of adult zebrafish hair cells (green) in the auditory organ of the inner ear.
New findings could improve the development and efficacy of therapies
By combining traditional eye imaging techniques with adaptive optics — a technology that enhances imaging resolution — researchers at the National Eye Institute (NEI) have shown for the first time how cells across different tissue layers in the eye are affected in people with choroideremia, a rare genetic disorder that leads to blindness. Their study, which was funded by the NEI Intramural Research Program, is published in Communications Biology. NEI is part of the National Institutes of Health.
Johnny Tam, Ph.D., head of the NEI Clinical and Translational Imaging Unit combined adaptive optics with indocyanine green dye to view live cells in the retina, including light-sensing photoreceptors, retinal pigment epithelium (RPE), and choroidal blood vessels. His team was able to see in detail the extent to which choroideremia disrupts these tissues, providing information that could help design effective treatments for this and other diseases. The retina’s RPE is a layer of pigmented cells essential to the nourishment and survival of photoreceptors.
Choroideremia affects men more than women because the gene responsible for the disease is located on the X chromosome. Since men have only one copy of the X chromosome, a mutation in the gene causes males to develop more severe symptoms, while females — who have two copies of the X chromosome — usually have milder symptoms, having one working copy of the gene on the other X chromosome.
“One major finding of our study was that the RPE cells are dramatically enlarged in males and females with choroideremia,” said Tam. “We were surprised to see many cells enlarged by as much as five-fold.”
RPE cells (see circled examples) in a male participant with choroideremia, showing that enlarged RPE cells can be detected using Dr. Tam’s multimodal imaging approach.
Gene augmentation rescues cilia defects in light-sensing cells derived from patients with blinding disease
Researchers from the National Eye Institute (NEI) have developed a gene therapy that rescues cilia defects in retinal cells affected by a type of Leber congenital amaurosis (LCA), a disease that causes blindness in early childhood. Using patient-derived retina organoids (also known as retinas-in-a-dish), the researchers discovered that a type of LCA caused by mutations in the NPHP5 (also called IQCB1) gene leads to severe defects in the primary cilium, a structure found in nearly all cells of the body. The findings not only shed light on the function of NPHP5 protein in the primary cilium, but also led to a potential treatment for this blinding condition. NEI is part of the National Institutes of Health.
“It’s so sad to see little kids going blind from early onset LCA. NPHP5 deficiency causes early blindness in its milder form, and in more severe forms, many patients also exhibit kidney disease along with retinal degeneration,” said the study’s lead investigator, Anand Swaroop, Ph.D., senior investigator at the NEI Neurobiology Neurodegeneration and Repair Laboratory. “We’ve designed a gene therapy approach that could help prevent blindness in children with this disease and one that, with additional research, could perhaps even help treat other effects of the disease.”
LCA is a rare genetic disease that leads to degeneration of the light-sensing retina at the back of the eye. Defects in at least 25 different genes can cause LCA. While there is an available gene therapy treatment for one form of LCA, all other forms of the disease have no treatment. The type of LCA caused by mutations in NPHP5 is relatively rare. It causes blindness in all cases, and in many cases it can also lead to failure of the kidneys, a condition called Senior-Løken Syndrome.
Treating patient-derived retinal organoids with AAV-NPHP5 restores rhodopsin localization in photoreceptor outer segments. Top: Retinoids stained for DNA (blue), NPHP5 (red), and rhodopsin (green). Below: Close-up view of organoid photoreceptor layer stained green for rhodopsin.
At the National Institutes of Health, a surgical team successfully implanted a patch of tissue made from patient cells with the goal of treating advanced “dry” age-related macular degeneration (AMD), also known as geographic atrophy. Dry AMD is a leading cause of vision loss among older Americans and currently has no treatment.
The patient received the therapy as part of a clinical trial that is the first in the United States to use replacement tissues from patient-derived induced pluripotent stem (iPS) cells. The surgery was performed by Amir H. Kashani, M.D., Ph.D., associate professor of ophthalmology, Wilmer Eye Institute, Johns Hopkins School of Medicine with assistance by Shilpa Kodati, M.D., staff clinician, NEI. The procedure was performed at the NIH Clinical Center in Bethesda, Maryland, under a phase 1/2a clinical trial to determine the therapy’s safety.
This iPS cell derived therapy was developed by the Ocular and Stem Cell Translational Research Section team led by Kapil Bharti, Ph.D., senior investigator at the National Eye Institute (NEI), part of NIH, in collaboration with FUJIFILM Cellular Dynamics Inc., and Opsis Therapeutics, based in Madison, Wisconsin. Safety and efficacy of this cell therapy was tested by the NEI preclinical team. Clinical-grade manufacturing of this cell therapy was performed at the Center for Cellular Engineering, Department of Transfusion Medicine, Clinical Center, NIH.
Left shows an image of the full-RPE-patch (2 x 4 mm). Each dot is an RPE cell with the borders stained green. Each patch contains approximately 75,000 RPE cells. Right image shows patch RPE cells at higher magnification.
Researchers have published two papers describing how they identified a potential new pathway for treating a sporadic form of amyotrophic lateral sclerosis (ALS). The studies were published as part of a cooperative research agreement between the National Institute of Neurological Disorders and Stroke (NINDS), part of the National Institutes of Health, and the Switzerland-based biotechnology company GeNeuro Inc.
One unusual side effect of hundreds of thousands of years of evolution is that the human genome now contains DNA sequences from ancient retroviruses — referred to as human endogenous retroviruses (HERVs). Though most remain dormant, reactivation of HERVs have been implicated in several neurodegenerative diseases, including ALS.
The first of these papers shows that a specific HERV produces a protein that can be found in the cerebrospinal fluid (CSF) of people with ALS. This protein, called HERV-K ENV, is toxic when added to neurons grown in laboratory dishes. In addition, a special kind of mouse genetically designed to create HERV-K ENV develops symptoms very similar to ALS. Adding the CSF from people with ALS to lab-grown neurons resulted in damage to the cells. When a synthetic antibody designed specifically to recognize HERV-K ENV was added as well to those neurons, the toxic effects were reduced. These findings together suggest that the improper activation of the HERV-K ENV gene could be the cause of the symptoms seen in certain cases of sporadic ALS.
A prospective study of half a million tea drinkers in the United Kingdom has shown that higher tea intake was associated with a modestly lowered risk of death. The study, led by researchers at the National Cancer Institute, part of the National Institutes of Health, is a large and comprehensive analysis of the potential mortality benefits of drinking black tea, which is the most common type of tea consumed in the U.K.
Past studies finding a modest association between higher tea intake and lower risk of death have mainly focused on Asian populations, who commonly drink green tea. Studies on black tea have yielded mixed results.
In the new study, the researchers found that people who consumed two or more cups of tea per day had a 9% to 13% lower risk of death from any cause than people who did not drink tea. Higher tea consumption was also associated with a lower risk of death from cardiovascular disease, ischemic heart disease, and stroke. The association was seen regardless of preferred tea temperature, the addition of milk or sugar, and genetic variations affecting the rate at which people metabolize caffeine.
