This is not scatology
Hard to resist the lure of scatology when writing about fecal transplants, especially if one is a lifelong smart-ass. But this lifelong smart-ass will try, if only to differentiate what I write about this startling-sounding and still novel approach to curing disease. Differentiate it, that is, from the coy self-conscious naughtiness other bloggers have brought to the table.
Hard also to imagine that anyone within the sound of my voice doesn’t know that a fecal transplant is just what it sounds like, the transfer of feces from a healthy person into a sick one. And that it has been awesomely successful–an unheard-of 90% cure rate–against Clostridium difficile, which is also just what it sounds like, a difficult bacterium that is difficult to get rid of, debilitating, and sometimes fatal.
Last May, the US Food and Drug Administration, alarmed at the unregulated swift adoption of fecal transplants, not just for C. diff infection but experimentally for other conditions, announced that it was regulating human feces as a drug. This meant that docs must file an Investigational New Drug (IND) application before performing a transplant. The point was to make transplants safer and standardize the treatment. But the paperwork was a hassle and an annoying and time-consuming delay in getting a cure to suffering patients.
The result: uproar and, after six weeks, an exception made for C. diff treatment. However, as a commentary just published in Nature has observed, FDA’s fecal transplant regulatory policy is complicating research into its use in other conditions, such as inflammatory bowel diseases and obesity. Both of these–and other disorders–have been linked by researchers to derangement of the billions of microbes that reside in the human gut and are necessary for life.
The researchers propose that FDA look upon the feces used in transplants not as a new drug but rather as a tissue product. Or perhaps FDA should even devise a new classification, as the agency has done for blood. Those moves, the authors say, “would keep patients safe, ensure broad access and facilitate research.” Regulating feces as tissue would require careful record-keeping and screening for communicable diseases, which are, they say, exactly the safety precautions needed for fecal transplants.
That step would also permit studies of long-term safety of feces transfer. At the moment, safety–especially long-term safety–is a big question mark. The researchers acknowledge that there are potential risks with fecal transplants, for example transfer of disease organisms along with microbes that fight disease.
Two of the authors have helped launch what they call a stool bank. In its first 3 months of operation, the nonprofit OpenBiome, working under the FDA compassionate exception for C. diff, has supplied more than 100 treatments to a dozen hospitals. Other hospitals are developing their own stool banks.
Current treatments consist of minimally processed fecal material whose microbial residents are–this is a bit scary–unknown. But the researchers say progress is being made on identifying specific good guys. “Knowledge gleaned from transplantation of natural systems could inform the design of synthetic communities tailored to treat specific diseases,” they say, and these products could then be regulated appropriately as drugs.
This proposal to regulate feces as tissue is brand new, and of course it remains to be seen how FDA will react, and how quickly. But the proposal was greeted with little glad cries by Jonathan Eisen, the Davis evolutionary biologist, who blogged, “it kind of blew my mind.”
Eisen’s blog, The Tree of Life, is one of the better sources for keeping up with microbe research. Christine Gorman also wrote about the paper at the SciAm editors’ blog Observations.
Pseudoscience reports on the Shroud of Turin and astrology
Knight Science Journalism Trackers Paul Raeburn and Faye Flam both vented on the topic of pseudoscience this week.
Paul noted with approval a post at Achenblog, the blog of Washington Post science writer Joel Achenbach, a dazzling writer that I don’t read much now that the Post is paywalled. Achenbach expatiated on a HuffPo post with the incomprehensible but irresistible hed “Shroud of Turin Formed by an Earthquake? Scientists Say Face of Jesus Image Caused By Neutron Emissions.”
Achenbach used the piece to argue that self-interest, rather than lofty goals like educating the public, is what drives good science writers to get it right. If they prove untrustworthy, readers will abandon them. Paul agrees. Me too.
Meanwhile, Flam zeroed in on a National Science Foundation poll that found, once again, that most people know zilch about science, that many reject the theory of evolution (“only a theory”), and that astrology is widely believed to be based on solid science.
My first thought, when I encountered the NSF survey a few days ago, was that the respondents were hazy about the word “astrology,” and that many confused it with astronomy, which they knew to be scientific. Flam thought so too, and found some research to back it up. But she also found research suggesting that respondents didn’t confuse the two terms, or maybe that they thought astrology and astronomy meant the same thing.
So much for the confusion hypothesis; no comfort there. And a comment posted on Flam’s post is even more disheartening. The comment links to a 2011 survey of college students showing that respondents didn’t confuse astrology with astronomy, and that most believed the stars and planets affected their lives. Here’s the best part: the survey respondents were all astronomy students.
The Washington Post swears off treating health press releases as news
We are accustomed to news aggregation sites, even science sites, reprinting press releases as if they were news stories. Hey, it’s a lot cheaper than putting together original material.
But it was a jolt to learn, also from Tracker Paul Raeburn, that the Washington Post‘s Health & Science section had also succumbed to routinely treating this promotional material as news. Not even rewriting releases and adding a quote or two from an outside source, another common practice, but just reprinting them.
Paul complained, and within a few days the Post altered the practice. The new policy (actually, I trust, a return to the old policy) now is: No more releases masquerading as news. Wow. Not often a blogger gets to change the world, not to mention change for the better the science and health information available to hundreds of thousands of people.
It does invite a question, though, about how the practice got started in the first place.
Kickstarting climate change reporting
Six freelance journalists are trying crowd-funding to underwrite their reporting on climate issues, according to Bud Ward at the Yale Forum on Climate Change and the Media. The journalists are calling their project Climate Confidential and are trying to get support from 800 people by March 8. They had raised some $9000 from 300 people by February 20.
Doing the math, that works out to about $4000 per journalist and about $500 per story. Which seems a modest enough stipend. So modest, in fact, that I’m wondering how they can manage. Apparently they intend to produce a sort of insider newsletter that will go to their supporters under various subscription models. A full year prepaid will be $55. There are lots of entrepreneurs who have built successful newsletter businesses, especially in and around Washington, DC. But they charge an awful lot more than $55 per sub.
I see that the Tracker has also picked up this news from the Yale Forum. But my post didn’t come via the Tracker. HT to Fred Powledge. Also, Happy Birthday.
The climate is changing
Last summer I wrote about my sense that the climate-change debates had mostly moved away from outright denial of global warming and were focusing more on arguing about the right policies, if any, for coping.
I won’t pretend it was an original thought. Dot Earth’s Andy Revkin has returned to it once more, recounting a talk by political scientist David Victor of the University of California, San Diego. Victor proposes a systematics of opponents of action against climate change.
Victor divides them into three groups: shills, skeptics, and hobbyists. It’s not denialism at all, he says. “Instead, what we are seeing is what psychologists call “motivated reasoning” —people hear about something they abhor and they find reasons to justify their dissent. Believing that the science is “uncertain” is one of those reasons.”
I know what shills are, viz Fox News, and in my post I described a variety of skeptics with different positions on regulation. “Hobbyists” is a delightful term, but it’s not terribly descriptive. It suggests to me that Victor thinks some climate warriors are simply in it for entertainment. Am I surprised? I am not. That’s what Internet trolls do too.