You can’t blame your metabolism any more

Ah, teenagers and their metabolisms, burning through those calories and letting them feed with abandon.

Guess what? It’s not true. A worldwide team of researchers found that human metabolism doesn’t change the way you might expect.

The short version: Babies and infants have really high metabolisms, but then it declines about 3 percent a year until your 20s, when it’s stable for decades. There is no teenage engine roaring.

In fact, the researchers discovered that energy expenditures during these middle decades – our 20s, 30s, 40s and 50s — were the most stable. Even during pregnancy, a woman’s calorie needs were no more or less than expected given her added bulk as the baby grows.

So no, your metabolism doesn’t slow down in middle age. It doesn’t slow down, in fact, until after age 60 — and even then it’s gradual. The fault for middle-age spread lies not in our cells, but in ourselves.

Breakthroughs

Latest vaccine data: The Moderna mRNA vaccine seems to offer better protection from breakthrough infections than the Pfizer vaccine.

The study found that in July in Florida, where Covid cases are at an all-time high and the delta variant is prevalent, the risk of a breakthrough case was 60% lower for Moderna recipients as compared to Pfizer recipients.

What oughta be a law?

You tell us. Seriously. It’s time for GPhA to start planning its 2021–22 legislative agenda, and that usually comes from membership — folks on the front lines.

Vaccine protocol expansion in 2015? Member idea. Medicaid audit protections? Ditto. Expanded point-of-care testing, the Pharmacy Patient Protection Act, the Audit Bill of Rights, anti-steering … all these came from members.

So let’s ask again: What oughta be a law?

If there’s a law or policy issue you want to see changed — something that will improve patient care or the practice of pharmacy — tell us about it!

It’s crazy easy: Just e-mail a brief explanation of the issue to our VP of public policy, Greg Reybold, at greybold@gpha.org. Yes, it’s that simple.

Your deadline: Friday, August 16, by 5:00 p.m. EDT.

Targeting T cells

So you’ve got mice with solid tumors. If it was a blood cancer, say, you could use CAR T-cell therapy to attack it, but that doesn’t work for solid tumors. The problem is that “CAR T cells are so potent that they may also attack normal tissues” — the “CAR” protein can target healthy cells.

So how do you tell the CAR T cells to attack only tumors? According to UC San Diego bioengineers, you use ultrasound. Specifically, they re-engineered CAR T cells so they only express that CAR protein when ultrasound energy is applied.

Then it’s just a matter of pointing the ultrasound at the tumors and letting the T cells do their thing.

In mice that were treated with the new CAR T cells, only the tumors that were exposed to ultrasound were attacked, while other tissues in the body were left alone. But in mice that were treated with the standard CAR T cells, all tumors and tissue expressing the target antigen were attacked.

Want some love?

Our friends at APhA are calling for nominations for the 2022 APhA Immunization Champion Awards. And yes, you can nominate yourself*.

If you’ve gone above and beyond the call of duty when it comes to raising vaccination rates, you might be in line for an award — especially during the Covid-19 pandemic.

Click here for more info and to submit your nomination — you must be an APhA member, and you have until September 15, 2021. The awards will be presented at APhA2022, March 18–21, 2022.

*Not responsible if you grow hair on your palms.

Want some money?

Pharmacy residents: You’ve got about 10 days — till August 23, 2021 — to apply for an APhA Foundation Vaccine Confidence Incentive Grant. That’s $5,000 for a winning proposal that will “incorporate delivery of vaccinations within individual practices and/or communities” by increasing confidence and increasing update in underserved areas.

Meanwhile, student pharmacists and pharmacists have a shot at a $1,000 Innovation in Immunization Practices Incentive Grant — check that same link for the details.

Through the nose wisely

You’re going to be hearing a lot more about nasal delivery of Covid-19 meds. That’s because, while vaccines are great for keeping the virus at bay where it does the most damage, it still tends to live in the nasal passages. One sneeze can infect a whole roomful of people.

The latest comes from the U.K.’s Lancaster University, where virologists have developed an intranasal Covid-19 vaccine that (they say) not only induces an immune response, but also keeps the virus from replicating in the noses and lungs … of hamsters, anyway.

[T]wo doses of the intranasal vaccine were found to significantly reduce the virus “shedding” from the nose and lungs of the hamsters — suggesting the vaccine has the potential to control infection at the site of inoculation. This should prevent both clinical disease and virus transmission, to halt the spread of the COVID-19 pandemic.

Fungi fights radiation

We all know that gut microbes affect, well, everything — probably even the stock market. For example, we know that radiation therapy for cancer doesn’t work as well for mice that are first given antibiotics.

But there’s a twist.

Old idea: The gut bacteria killed by the antibiotics are necessary for the radiation to work.

New idea: Without bacteria, gut fungi proliferate — and its they that interfere with the therapy.

How they proved it: When researchers at Cedars-Sinai Medical Center in Los Angeles gave mice with cancer an antifungal drug, radiation therapy worked better. Ditto when they created fungus-free mice.

How does it work? Their best guess is that…

…this likely means that bacteria are important for generating activated T cells after radiation therapy, while fungi promote macrophages that destroy these tumor-killing T cells.

So the goal, as one of them put it, is “to develop the optimal microbiome composition—a mixture of some bacteria and some fungi that are the perfect balance—but we are trying to figure out what that is.”

Latest news from the mean streets

It’s bad enough that street drugs are being laced with fentanyl. The new threat: drugs laced with benzodiazepines. They call ’em “benzo-dopes.” (I believe that means they call the drugs “benzo-dopes,” but it might be referring to the users.)

Canadian health officials are seeing a pretty big rise in the number of confiscated opioids that test positive for benzos, notably etizolam, which is hard to detect.

Benzos take longer to have an effect than opioids, “meaning someone can experience delayed overdose symptoms.” They can also fall unconscious — never a good thing. And while naloxone can help with an opioid overdose, it doesn’t work on benzos.

Is a new wave of overdose on its way? I guess we’ll find out.

While we’re talking benzos and opioids…

Even when a patient has a legitimate reason to visit several prescribers, if one doc gives them an opioid and other gives them a sedative, there’s a much higher risk of overdose than if the same person prescribes both.

This from a University of Michigan study of more than 529,000 patients over two years. It found the risk of overdosing was 20 percent greater when two prescribers were involved.

For example, if a psychiatrist prescribes a benzodiazepine to a patient whose primary care doctor is already prescribing opioids, that may be more dangerous than if the primary care doctor writes both prescriptions.”

Tools like prescription drug monitoring programs can help, but one researcher pointed out that “these high-tech solutions would not be needed if doctors did a better job of taking a complete medical history.”

Sure, why not approve GHB?

The FDA has approved Xywav — known to crime enthusiasts as gamma-hydroxybutyrate or GHB. Yep, that GHB. Its a newer version of Xyrem, and it’s to be used to treat “’idiopathic hypersomnia,’ a mysterious condition in which people sleep nine or more hours a day, yet never feel rested.”

But boy are there a lot of questions and yellow flags.

Start with side effects: “As of June 30, the F.D.A. had recorded more than 27,000 ‘serious adverse events’ for patients taking Xyrem or Xywav, including 753 deaths.”

Now add the lack of solid data that it works (only one small clinical trial), the potential for abuse, and the idea that anyone with a bit of daytime drowsiness might be able to get a prescription.

Meanwhile the company is running ads in Times Square and generally trying to push the drug for other conditions, “including insomnia, depression, and fibromyalgia.” So far, the FDA has turned it down.