Just as most of the energy and matter in the cosmos is invisible, most of the world’s bacterial species go unseen because they cannot be conventionally grown in the lab.

Now scientists are finding ways to sift through this so-called bacterial “dark matter”. On Tuesday, an international team announced in the journal Cell that they had identified a potential new antibiotic lurking unnoticed in the sandy soil of North Carolina. The compound, called clovibactin, employs an unusual method of killing bacteria that makes it tough for targets to develop resistance. While clinical trials in humans are several years away, the finding is a glimmer of hope in an increasingly drug-resistant world.

According to The Lancet, at least 1.2mn people died as a direct result of drug-resistant bacterial infections in 2019, more than from HIV or malaria. The phenomenon of antimicrobial resistance (AMR) — in which infections become untreatable as pathogens evolve resistance to drugs — is not just a public health challenge but a drain on the economy. A landmark 2016 UK review predicted that, by 2050, “superbugs” would kill 10mn a year and cumulatively cut world gross domestic product by $100tn.

The postwar years were the heyday of antibiotic research, yielding such compounds from soil bacteria as tetracyclines, a class of broad-spectrum antibiotics, from the 1940s, and vancomycin in the 1950s. But, with only about 1 per cent of bacterial species culturable in the lab, progress began stalling in the 1980s.

That stasis gave microbes the evolutionary upper hand. As Markus Weingarth, an antibiotics researcher at Utrecht University and co-author on the Cell paper, explains, battling drug resistance depends on finding new medicines that work in different ways: “Most antibiotics are derived from natural products and there may be really novel molecules waiting for us in the other 99 per cent, this bacterial dark matter.”

These understudied species are demanding; they require special nutrients, for example, or the presence of other micro-organisms to thrive. NovoBiotic Pharmaceuticals, founded by professors Kim Lewis and Slava Epstein from Northeastern University in Boston, has been tapping into that pool by collecting micro-organisms from soil samples, mimicking their natural environment in specially designed chambers, and so cultivating “domesticated” variants capable of growing in the lab. These variants are then screened for bug-killing properties, by being placed on plates with the bacteria Staphylococcus aureus (MRSA, a strain resistant to the antibiotic methicillin, is one of the most-feared superbugs).

The clovibactin plate showed a tell-tale “zone of inhibition”, where the staph bacteria had died off. Subsequent studies showed it could also clear several different bacterial infections in mice. Critically, Weingarth, together with colleagues at the University of Bonn, found it displayed an unusual modus operandi: latching on to three different components used to build the bacterial cell wall and essentially forming a deadly cage (its name derives from klouvi, meaning cage in Greek).

That three-pronged attack, Weingarth explains, makes it tough for a bacterium to evolve resistance. Clovibactin also targets the immutable parts of those wall components, additionally lowering the chances of resistance and potentially providing a drug with a long shelf-life. According to the company, the compound is effective in the lab against MRSA, bacterial pneumonia and vancomycin-resistant enterococcus; it is now being tested against other diseases, including anthrax and tuberculosis.

Success is by no means assured, but it is at least another candidate in a relatively empty pipeline. NovoBiotic has also previously identified teixobactin and darobactin from soil. The latter shows promise against “gram-negative” bacteria such as E. coli and salmonella, which have an additional protective membrane. MDR-GNB, or multi-drug resistant gram-negative bacteria, has become a grimly familiar acronym in hospitals.

The real AMR challenge, though, is perhaps not the science but the lack of market incentive. It takes at least a decade and perhaps a billion dollars to bring a new antibiotic to market — which must then be used only sparingly. The NHS is experimenting with delinking payments and volume; the Pasteur bill, currently with the US Congress, is floating a similar subscription-based model.

It would be wonderful to think that, with all those potential superbug slayers under our feet, someone, somewhere is going to hit AMR pay dirt. But that does presuppose governments being prepared to pay for the dirt.

This story originally appeared on: Financial Times - Author:Anjana Ahuja

The fizz may be about to go out of diet drinks. Next week, the International Agency for Research on Cancer, a research arm of the World Health Organization, is expected to list aspartame, an artificial sweetener 200 times sweeter than sugar and a staple of low-calorie drinks, as “possibly carcinogenic to humans”.

On the same day, a separate WHO committee will rule on how much risk the additive — found in thousands of products from chewing gum to yoghurts — poses to human health. The dual announcement is meant to end decades of scientific controversy but may instead stoke confusion on whether artificial sweeteners are good or bad for us. Any lingering sense of public uncertainty will be welcomed by a food and drinks industry skilled at downplaying the risks of its products.

It sounds counter-intuitive but a substance can be both a possible carcinogen and a low risk to health. The IARC is concerned only with establishing the former, which is essentially hazard-spotting. The agency judges a substance’s cancer-causing potential by looking at three types of data: epidemiological studies of humans; studies of animal exposure; and the physical mechanisms by which a substance might induce tumours.

On the strength of that data, substances are put into one of four categories: carcinogenic; probably carcinogenic; possibly carcinogenic; or not classifiable. Reuters reported recently that aspartame would be labelled “possibly carcinogenic”. That would put the sweetener, marketed under brand names such as Equal and Canderel, in the same category as gasoline and aloe vera extract. A formal announcement is tabled for 14 July, along with a paper in Lancet Oncology.

But the IARC pronouncement isn’t the critical one. Whether a hazard becomes a health risk depends on factors such as exposure, dose and preventive measures (sunshine is a largely unavoidable carcinogen, with sunscreen a mitigation). That is where the second WHO-linked committee, on food additives, comes in. Its statements — on acceptable daily intake and dietary exposure — will be the ones to watch out for.

The committee previously assessed aspartame, also known as E951, in 1981, setting an acceptable consumption limit at 40mg per kg of body weight per day — or 12 cans of Diet Coke a day for a 60kg person. That has reassured food safety agencies, including in the US, UK and EU. But doubts have accumulated since, partly because of observational studies that hint at slightly higher rates of cancer in consumers. A 2022 analysis of nearly 103,000 people reported that those who consumed higher levels of artificial sweeteners, including aspartame, were 1.15 times more likely overall to develop cancer than those who consumed none.

Observational studies, though, can point only to association, not cause and effect; other factors could be at play. Plus, “reverse causality” cannot be ruled out: people who are obese, and therefore already face a higher cancer risk, might be more likely to choose artificial sweeteners. The sheer variety of non-sugar sweeteners — including sucralose, saccharin and the plant-derived stevia — and their varying permutations in studies, also makes the science hard to read.

Animal studies can partly fill the evidence gap: Italy’s non-profit Ramazzini Institute reported more than a decade ago that aspartame-fed rats developed dose-related tumours. But rats are not humans. Both the charity Cancer Research UK and the UK’s Food Standards Agency maintain that aspartame is safe.

Nonetheless, IARC undertook its latest re-evaluation as a high priority because of “emerging cancer evidence in humans and in laboratory animals”. The International Sweeteners Association complained that “IARC is not a food safety body . . . aspartame is one of the most thoroughly researched ingredients in history”.

Those complaints artfully dodge an inconvenient truth, which is that evidence can change and that non-sugar sweeteners, including aspartame, are not the healthy option that many consumers believe. In May, the WHO recommended that non-diabetics steer clear of NSS because evidence suggests they do not reduce body fat and may be linked to an increased risk of type 2 diabetes, cardiovascular disease and death. The best approach, it says, is to eat a less sweet diet overall.

More widely, the additives are commonly found in ultra-processed foods, which have been linked to obesity and ill-health by, among others, campaigning doctor and author Chris van Tulleken. There is little to be lost, and potentially much to be gained, by going sour on sweeteners.

This story originally appeared on: Financial Times - Author:Anjana Ahuja

Egg plus sperm equals embryo. It is hard to think of a more basic rule in biology. Still, rethink it we must. Last week, at a stem cell conference in Massachusetts, researchers revealed they had created “synthetic” human embryos using neither eggs nor sperm. These structures, more correctly called embryo models, were instead grown from single living stem cells, which were derived from a real human embryo. It was not a one-off achievement: another team created an embryo model with a heartbeat.

This story originally appeared on: Financial Times - Author:Anjana Ahuja

Ultra-Processed People: Why Do We All Eat Stuff That Isn’t Food . . . and Why Can’t We Stop? by Chris van Tulleken (Cornerstone Press)

The bestselling polemic by doctor and television presenter van Tulleken argues that rising obesity rates are not down to a failure of willpower but instead the consequence of food corporations marketing “industrially produced edible substance”. These ultra-processed foods are tasty and cheap — but seem to bypass the body’s ability to regulate intake. Warning: may trigger the compulsive checking of ingredients on food packaging.

Divided: Racism, Medicine and Why We Need to Decolonise Healthcare by Annabel Sowemimo (Wellcome Collection)

Time to Think: The Inside Story of the Collapse of the Tavistock’s Gender Service for Children by Hannah Barnes (Swift Press)

Also deservedly shortlisted for the same accolade is this forensic and disturbing account of the rise and fall of London’s Tavistock clinic, a flagship NHS centre for children questioning their gender identity. Using extensive interviews and documentary evidence, investigative journalist Barnes pieces together how concerns about puberty blockers were sidelined and internal disquiet ignored. Patient stories punctuate a tale of catastrophic institutional failure.

Summer Books 2023

All this week, FT writers and critics share their favourites. Some highlights are:

Monday: Environment by Pilita Clark
Tuesday: Economics by Martin Wolf
Wednesday: Fiction by Laura Battle
Thursday: Critics’ picks
Friday: Politics by Gideon Rachman
Saturday: History by Tony Barber

Join our online book group on Facebook at FT Books Café

This story originally appeared on: Financial Times - Author:Anjana Ahuja

It is not quite “partial resurrection”, as some have dramatically dubbed it, but the novel technique does involve restarting limited blood circulation in organ donors who have just been declared dead. The procedure, which sustains organs inside the body rather than on external machines, has stirred global interest over the past few years because it can substantially increase the supply of transplantable organs.

This story originally appeared on: Financial Times - Author:Anjana Ahuja

The announcement will not surprise Chris van Tulleken, a London-based podcaster, television presenter and infectious disease doctor. In Ultra-Processed People, a fearless investigation into how we have become hooked on ultra-processed food, or UPF, van Tulleken identifies sweeteners as just one component of a modern nutritional landscape in which “most of our calories come from food products containing novel, synthetic molecules, never found in nature”. We are no longer eating food, one academic memorably tells him, but “industrially produced edible substance”. Those substances are formed using a mix of cheap ingredients, machine processing and synthetic additives such as stabilisers and flavourings.

This story originally appeared on: Financial Times - Author:Anjana Ahuja

Ping! Up pops a message from your boss, chasing the report you should have delivered yesterday. Other distractions come thick and fast: a colleague texts to say he is ill; another interrupts your frantic typing of the executive summary to remind you that an online seminar starts in five minutes.

This story originally appeared on: Financial Times - Author:Anjana Ahuja

It was, in early January 2020, the most sought-after genome in the world. Virologists were desperate to learn the exact genetic sequence of the mystery virus spreading out of Wuhan, so that they could come up with tests and vaccines.

This story originally appeared on: Financial Times - Author:Anjana Ahuja

A clown comes knocking on your door with a fun message for your kids. They can have a toy for free — if you buy them a meal from a fast-food restaurant. Would you invite him in?

This story originally appeared on: Financial Times - Author:Anjana Ahuja

Every emerging technology has its dreamers and schemers. That is certainly true of human genome editing, the focus of a high-profile global summit held this week at the Francis Crick Institute in London.

This story originally appeared on: Financial Times - Author:Anjana Ahuja

The perfect drug would be effective, free of side-effects, cheap and easy to administer. Lecanemab, which won accelerated approval from the US Food and Drug Administration on Friday to treat early-stage Alzheimer’s disease, can claim to meet one of those criteria — but only to a degree.

It does not halt or reverse the decline associated with the neurodegenerative condition, which erodes memory, language and the ability to live independently, but it is the first Alzheimer’s drug to pull off a statistically significant, if modest, slowing in the rate of that decline. That is a step up from current drugs that treat only symptoms: a landmark success in a desert strewn with pharmaceutical failures.

This story originally appeared on: Financial Times - Author:Anjana Ahuja

The Covid outbreak is officially three years old on January 30, which marks the moment in 2020 when the World Health Organisation declared the respiratory disease a public health emergency of international concern. But this month’s anniversary offers little to celebrate in the wake of China’s chaotic and abrupt lurch from zero-Covid to full-Covid.

Beijing has dramatically reduced testing, junked contact tracing and is scrapping most quarantine requirements; some regions now permit infected people with mild or no symptoms to go to work. The pandemic virus is thus free to circulate unobserved in a sixth of the world’s population — just as the rest of the globe is clamouring for normality. As the third year of the outbreak closes amid reports of overflowing hospitals in China and fresh restrictions on air travellers, and with the Chinese new year holiday fast approaching, the pandemic seems somehow both more familiar and less predictable than ever.

This story originally appeared on: Financial Times - Author:Anjana Ahuja

Laboratory-grown meat has come a long way since 2013, when Google co-founder Sergey Brin bankrolled the first burger made from meat cells grown outside an animal. The patty, which cost about $330,000 to make, stoked an investor appetite for cultured meat and highlighted the technology’s perceived potential as a kinder, more climate-friendly way of feeding the world.

Seven years later, Singapore became the first country to sell lab-grown meat — nuggets formed from a hybrid of chicken and plant proteins — to diners and shoppers. The year after, the sector attracted $1.9bn of venture capital. Now another hurdle has been cleared, this time in the US: the Food and Drug Administration announced last month it had completed a “pre-market consultation” on lab-grown chicken, and raised no safety concerns with its maker, Upside Foods. The US Department of Agriculture still needs to carry out inspections before approval is granted but the path to commercialisation looks clearer.

This story originally appeared on: Financial Times - Author:Anjana Ahuja

Age Proof: The New Science of Living a Longer and Healthier Life
by Rose Anne Kenny, Lagom £20

Shortlisted for the 2022 Royal Society Science Book Prize, this is at the respectable end of the self-help genre. Rose Anne Kenny, professor of medical gerontology at Trinity College Dublin, offers readable advice on staying happier and healthier into old age: get a good night’s sleep, have a social life and eat well, fasting occasionally. Oh, and keep having sex.

The Expectation Effect: How Your Mindset Can Transform Your Life
by David Robson, Canongate Books £10.99

And Finally: Matters of Life and Death
by Henry Marsh, Jonathan Cape £16.99

Henry Marsh, an eminent neurosurgeon and author, contemplates life as he grapples with a diagnosis of advanced cancer. This reluctant doctor-turned-patient reflects — not always proudly — on how he treated his own patients, as well as on what ultimately matters. A haunting memoir from someone who has spent a career at the fragile border between life and death, now confronting the prospect of his own crossing.

Books of the Year 2022

All this week, FT writers and critics share their favourites. Some highlights are:

Monday: Business by Andrew Hill
Tuesday: Environment by Pilita Clark
Wednesday: Economics by Martin Wolf
Thursday: Fiction by Laura Battle
Friday: Politics by Gideon Rachman
Saturday: Critics’ choice

Join our online book group on Facebook at FT Books Café

This story originally appeared on: Financial Times - Author:Anjana Ahuja

Respiratory syncytial virus is a little-known and hard-to-spell seasonal scourge that, like flu, most seriously affects children and older people. It usually triggers coughs and colds but can cause serious breathing difficulties in a small minority of infants.

RSV is so common that more than 80 per cent of UK children are infected by their second birthday — but case numbers plummeted during the Covid-19 pandemic. Measures such as masking, plus school and nursery closures, intended to slow the spread of Covid, also put the brakes on infection rates. Now the virus is resurgent, particularly in the US, with the wave hitting earlier than expected.

This story originally appeared on: Financial Times - Author:Anjana Ahuja

The late Queen Elizabeth II spent the last 16 months of her life mourning the loss of Prince Philip, her beloved consort of 73 years whom she called her “strength and stay”. The sovereign’s sorrow reminded me of my mother’s grief at losing my father, her husband and chief tea-maker for 52 years. Mum has not drunk a drop of tea in the two years since.

The death of a spouse is not merely a psychological trauma: evidence suggests it can measurably harm the physical health of the surviving partner. While it is never possible to determine the exact role that bereavement plays in the long-term health of a specific individual, large-scale studies point to a phenomenon called the “widowhood effect”, in which the risk of a person dying rises after their spouse passes away.

This story originally appeared on: Financial Times - Author:Anjana Ahuja

The constant swirl of cold and damp can make for an early grave. More people expire in the winter than in warmer months due to an increase in heart attacks, stroke, respiratory disease (including Covid), flu, falls and hypothermia.

The approaching change of season coupled with the prospect of soaring energy costs prompted researchers to warn last week of an impending “public health and humanitarian crisis” as people struggle to heat their homes. Sir Michael Marmot, a health equity researcher at University College London, together with paediatricians Ian Sinha and Alice Lee at Alder Hey Children’s Hospital in Liverpool, wrote in the British Medical Journal that the health consequences will be felt not just by the elderly but also by the young, whose maturing respiratory systems may be impaired for life.

Rising energy costs also place additional physical and mental health burdens on those least able to shoulder them. Low-income families are already more likely to live in cramped, poorly insulated housing in areas with high pollution. These factors, along with food poverty, collectively chip away at health: the children who attend Alder Hey’s respiratory clinic live in some of England’s most deprived postcodes. If levelling-up is a true Conservative aim, then the government has a duty to minimise these stresses, rather than compounding them by allowing warmth to become an unaffordable luxury.

Where climate change meets business, markets and politics. Explore the FT’s coverage here.

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This story originally appeared on: Financial Times - Author:Anjana Ahuja