Stories about: Science

Blood stem cell transplants from any donor, without toxicity?

could stem cell transplants be made nontoxic?
(ADOBE STOCK)

Many blood disorders, immune disorders and metabolic disorders can be cured with a transplant of hematopoietic (blood-forming) stem cells, also known as bone marrow transplant. But patients must first receive high-dose, whole-body chemotherapy and/or radiation to deplete their own defective stem cells, providing space for the donor cells to engraft. These “conditioning” regimens are highly toxic: they wipe out the immune system, raising infection risk, and can cause anemia, infertility, other organ damage and cancers. And when the donor isn’t an exact match, patients’ immune systems must be suppressed for prolonged periods to prevent rejection.

As a result, most patients either don’t receive a transplant or must endure serious side effects. But if two new studies bear out in clinical trials, a far gentler conditioning treatment could enable stem-cell transplants for a much wider range of disorders, even possibly from unmatched donors.

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Can we mass-produce platelets in the lab?

Lab-grown platelets could someday be given to patients
Activated platelets (IMAGE: ADOBE STOCK)

Most of us have somewhere around a trillion tiny platelets zooming around our bloodstreams. Joseph Italiano, PhD, of Boston Children’s Hospital’s Vascular Biology Program, calls them the “Swiss Army knives of the blood.” In addition to their key role in clotting, platelets are important in immunity, wound healing, chemical delivery, blood vessel development and more.

At healthcare facilities, platelets are in constant demand for patients with blood diseases, or those receiving radiation or chemotherapy for cancer. But unlike other blood products, platelets can’t be stored for more than a few days. If there’s a snowstorm or other emergency preventing donors from giving platelets, a hospital can easily run out. So researchers have been trying to make platelets in a lab setting.

Two teams at Boston Children’s Hospital are tackling the problem in slightly different ways.

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Natural killer cells: A new angle on neuropathic pain

natural killer cells, peripheral nerve damage and neuropathic pain
Like an immune cleanup crew, natural killer cells (green) infiltrate a damaged axon. (IMAGE: ALEXANDER DAVIES / SEOUL NATIONAL UNIVERSITY AND UNIVERSITY OF OXFORD)

Scientists have known since the 1800s what happens to a totally crushed peripheral nerve in animals: the damaged axons are broken down in a process called Wallerian degeneration, allowing healthy ones to regrow. But humans rarely suffer complete axonal damage. Instead, axons tend to be partially damaged, causing neuropathic pain — a difficult-to-treat, chronic pain associated with nerve trauma, chemotherapy and diabetes.

The lab of Michael Costigan, PhD, in Boston Children’s Hospital’s F.M. Kirby Neurobiology Center is studying how the body’s immune system breaks down these damaged nerves. Their latest research, published today in Cell, may change our understanding of neuropathic pain and how to treat it.

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Drug repurposing and DNA mining: The hunt for new endometriosis treatments

endometriosis researchers Michael Rogers and Danielle Peterse
Michael Rogers and Daniëlle Peterse (PHOTO: MICHAEL GODERRE/BOSTON CHILDREN’S HOSPITAL)

Endometriosis is a common gynecological condition that may affect more than 1 in 10 reproductive-age women. Yet, there’s very little research into the disease and limited options for treatment. A team in the Vascular Biology Program at Boston Children’s Hospital is trying to change that.

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New technique images whole brains with incredible resolution

Overview of brain structures captured by new imaging technique
Combined expansion microscopy and lattice light-sheet microscopy allows for highly detailed images to be taken over large sections of the brain. (IMAGES COURTESY SRIGOKUL UPADHYAYULA, RUIXUAN GAO, AND SHOH ASANO)

Decades ago, discoveries about the brain’s intricate anatomy were made with careful dissection and drawings. Today, they’re made with super-resolution imaging and massive computing power capable of handling hundreds of terabytes of data.

In this week’s Science, a team out of the Massachusetts Institute of Technology (MIT), the Janelia Research Campus of the Howard Hughes Medical Institute (HHMI), Harvard Medical School (HMS) and Boston Children’s Hospital, describes a technique capable of imaging whole brains at exquisitely high resolution, allowing scientists to distinguish tiny sub-cellular structures.

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Children raised in institutions have impaired memory and executive functioning at age 16

long-term effects of child institutionalization

An estimated 8 million children worldwide live in institutions where they experience neglect and deprivation. Last fall, a study of children reared in Romanian orphanages reported high levels of mental health problems when they reached adolescence. In particular, they had more difficult behaviors such as rule-breaking, excessive arguing with authority figures, stealing or assaulting peers. But if they were placed early with carefully vetted foster families through the Bucharest Early Intervention Project (BEIP) , these problems were reduced.

A new BEIP study, published yesterday in the Proceedings of the National Academy of Sciences, examined cognitive functioning. It found that institutionalized children, at ages 8 and 16, also have impaired memory and executive functioning compared with peers placed early in foster homes.

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Using multiple data streams and artificial intelligence to ‘nowcast’ local flu outbreaks

(PHOTO: ADOBESTOCK)

Because influenza is so contagious, it’s been challenging to track and forecast flu activity in real time as people move about and travel. While the CDC continuously monitors patient visits for flu-like illness in the U.S., its information can lag by up to two weeks. A new study led by the Computational Health Informatics Program (CHIP) at Boston Children’s Hospital combined multiple approaches, providing what appear to be the most accurate local flu predictions to date.

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Newborn DNA sequencing finds actionable disease risks in nearly 10% of enrolled babies

BabySeq study sequenced the DNA of 159 newborns
(PHOTO: AdobeStock)

Current newborn screening tests a baby’s blood for several dozen known, treatable conditions. Can full-on DNA sequencing at birth add more benefit? Interpreting sequencing results is complex: having a genetic variant doesn’t always mean having the disease, and many of the conditions identified may not currently be treatable.

To explore what DNA sequencing might turn up, the BabySeq study, an NIH-funded project, was in launched in 2015. A team led by Ozge Ceyhan-Birsoy, PhD of Partners HealthCare and Alan H. Beggs, PhD, now reports the comprehensive results of whole-exome sequencing in 159 infants. Their analysis is published in the American Journal of Human Genetics.

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CRISPR-Cas9 screen opens new targets for Ewing sarcoma, other childhood cancers

Ewing sarcoma research by Kimberly Stegmaier, MD
The TP53 pathway normally helps pull the plug on cancerous cells. While the pathway is intact in most pediatric cancers, research finds that drugs targeting the pathway can curb tumor cell proliferation in Ewing sarcoma. Photo: Kimberly Stegmaier, MD (SAM OGDEN / DANA-FARBER CANCER INSTITUTE)

While the genetic mutations driving adult cancers can sometimes be targeted with drugs, most pediatric cancers lack good targets. That’s because their driving genetic alterations often create fusion proteins that aren’t easy for drugs to attack.

“This is one reason why it is notoriously hard to make targeted drugs against childhood cancers — their cancer-promoting proteins often lack good pockets for drugs to bind to,” says Kimberly Stegmaier, MD.

However, that’s beginning to change.

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After 80 years, genetic causes of Diamond-Blackfan anemia come into view

Vijay Sankaran, MD and a patient with Diamond-Blackfan anemia
Hematologist Vijay Sankaran with Jack Farwell (PHOTO: MICHAEL GODERRE / BOSTON CHILDREN’S HOSPITAL)

In 1938, Louis K. Diamond, MD, and Kenneth Blackfan, MD, at Boston Children’s Hospital described a severe congenital anemia that they termed “hypoplastic” (literally, “underdeveloped”) because of the bone marrow’s inability to produce mature, functioning red blood cells. Eighty years later, the multiple genetic origins of this highly rare disease, now known as Diamond-Blackfan anemia, or DBA, are finally coming into view.

The largest study to date, published recently in the American Journal of Human Genetics, raises as many questions as it answers. But in the meantime, it provides a genetic explanation for nearly 80 percent of patients.

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