Released: the kraken

We might be done with Covid, but Covid’s not done with us. The Omicron variant XBB.1.5 — nicknamed “Kraken” — is quickly spreading in the US; it’s “the most transmissible subvariant that has been detected yet.”

It’s already responsible for three-quarters of infections in the Northeast, and it’s spreading through the rest of the country.

The good news: Symptoms are akin to a bad cold … for a lot of people.

The bad news: For the unvaccinated or those with just bad luck, it can get a lot worse — hospitalizations are up almost 17 percent week-to-week in the US. (That’s probably because of holiday get-togethers.)

The good news: Even with that jump, hospitalizations are waaaaaay down from the pandemic peak. Right now about 400 Americans a day are dying from it, although that will likely rise for a bit as those post-holiday hospitalizations catch up.

Wait … “Kraken”?

If the whole business of naming Covid variants seems like a mess to you, you’re not alone.

Where once we had Alpha and Delta and Omicron, we now have Basilisk, Minotaur, and Hippogryph. Some people have been referring to XBB.1.5 simply as “the Kraken.” A list compiled on Twitter reads less like an inventory of variants than like the directory of a mythological zoo.

That’s because — like the Weather Channel names every storm — most of these names aren’t official. Then again, if everyone calls it a duck, isn’t that what it is?

Alzheimer and plaque: It’s complicated

Another study challenges the idea that buildups of amyloid beta proteins is what causes Alzheimer’s. This one, out of USC, is a bit more nuanced. It found that it’s not the amyloid protein in general that’s the problem, but the type of protein.

Healthy brains also had plenty of amyloid proteins, but whether it was the dissolvable, non-fibrillar kind. The insoluble proteins are the ones that can start to clump together, like long hair in the shower drain — and those clumps are the the “plaques” seen in the disease.

So what makes some proteins clump and some remain soluble? It might be the amount of enzymes in the particular areas of the brain that are affected, meaning the focus should be on the process that creates the plaque, rather than the plaque itself.

Covid and diabetes?

Could Covid-19 raise your risk of diabetes? Sure, why not, considering all the other ways the disease messes with your body.

A preprint study by an international team of researchers (including some Americans, so you know it’s legit) found that “Mounting evidence shows association between Covid-19 and new diagnoses of diabetes.”

But wait! Remembering that correlation ain’t causation, the team pointed out that it’s possible that being treated for Covid simply means people are more likely to have diabetes detected.

Rocket-powered insulin tablets

We’ve written before about the problem with a tablet form of insulin — it dissolves before the drug can be released. The latest attempt to get around the issue comes out of China, where researchers created rocket-powered molecules that are pressed into pills designed to get through the stomach and into the colon.

The pills’ tiny particles contain insulin, magnesium, and starch:

The starch protected the tablets from stomach acid, allowing them to reach the colon intact. As they broke down, the magnesium microparticles reacted with water to generate a stream of hydrogen gas bubbles, which acted as micromotors^* that propelled insulin toward the colon’s lining to be absorbed.

^* That’s not a motor. That’s a rocket.

How big a deal is lecanemab?

Last week, the FDA approved Eisai’s $26,500-per-year Alzheimer’s treatment, lecanemab. (That’s a discount according to the company, which said “the value of the medication to society is around $37,000 a year.”)

Ah, but so many questions. Will insurance cover it? CMS is considering, and private insurers must be as well. Why isn’t it a gimme? Because of the last big Alzheimer’s drug, Aduhelm. Just the idea that Medicare might approve Aduhelm pushed Part B premiums up $10 a month. (CMS ended up approving it only for certain clinical trials.)

The big question … is it really worth it? Like Adulhelm, lecanemab only has limited effect on the disease, and it doesn’t help patients in the later stages. Oh, and 14 percent of trial patients had “serious adverse events” including brain swelling and bleeding.

So, is the potential for slight improvement worth it? Depends who you ask … and who’s paying.

For more details on the economic pros and cons of lecanemab , check out a recent blog post from Howard Gleckman.

More salted nuts

Eating 57g of almonds daily can boost the levels of “good” fat in your blood after exercise.

[I]mmediately after exercise, the concentration of the beneficial 12,13-DiHOME was 69% higher in blood plasma of participants in the almond group than in participants in the control group.

But: The study was funded by the Almond Board of California. So here’s your grain of salt:

Opening a door in tumor defense

Solid tumors can protect themselves with a layer of regulatory T cells — white blood cells that trick the body into ignoring the tumor. So how can you turn off this ‘regulation’ without affecting the entire body (which would be bad)?

If you’re UCLA biomed engineers, you create a tiny implanted device (they call it SymphNode) that shuts off those regulatory T cells in one area — the area around the tumor. Oh, and you have that device summon the body’s tumor-killing cells, too.

The researchers tested the SymphNode in mouse models of both breast cancer and melanoma. With breast cancer, the device shrank tumors in 80% of mice and prevented the spread of cancer in 100% of them.

The researchers have already formed a company with plans to sell it, of course, and they’re working on injectable versions that could augment existing chemotherapy regimes.