Below is the full list of guests scheduled to appear on this week’s Sunday talk shows:
ABC’s “This Week” — Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention; Gov. Jared Polis (D-Colo.)
NBC’s “Meet the Press” — Dr. Francis Collins, director of the National Institutes of Health; Sen. Amy Klobuchar( D-Minn.); Sen. Mike Braun (R-Ind.)
CBS’ “Face the Nation" — Dr. Vivek Murthy, U.S. surgeon general; Gov. Ned Lamont (D-Conn.); Maria Van Kerkhove, the World Health Organization's technical lead on COVID-19; Francis deSouza, CEO of the biotechnology company Illumina.
CNN’s “State of the Union” — Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases; Rep. Ilhan Omar (D-Minn.); Sen. Chris Murphy (D-Conn.); Gov. Tate Reeves (R-Miss.)
“Fox News Sunday” — Murthy; Gen. David Thompson, vice chief of space operation at U.S. Space Force; Sen. Joni Ernst (R-Iowa.)
Dr. Ben Carson, Former HUD Secretary & Founder/Chairman, The American Cornerstone Institute; Sen. John Kennedy (R-La.), Enes Kanter Freedom, Boston Celtics Center
The emerging omicron variant of the coronavirus should cause people to take more precautions, a respiratory expert said on Friday, the same day that Mayor Bill de Blasio said that he’d consider raising the minimum number of doses of coronavirus vaccine a person may have to prove that they’ve taken in order to be admitted into bars, restaurants, gyms, theaters, and other venues.
“With all of our approaches to COVID, we’re going to update them, because we’re dealing with some new challenges at this moment,” de Blasio said when asked about the issue Friday by WNYC host Brian Lehrer.
Despite the overall COVID situation, New York Gov. Kathy Hochul has repeatedly told New Yorkers that it’s “not a cause for alarm.”
Still, state and local leaders are concerned — not only with omicron’s spread, but more with the delta variant. Delta is behind the state now having its highest daily numbers of COVID-19 cases — more than 11,000 — since last January.
The combination of the rise in overall cases, along with the emerging omicron variant, prompted Dr. Purvi Parikh of the Allergy and Asthma Network and NYU Langone Medical Center to recommend some caution.
“I’m avoiding crowds now, knowing this variant,” she said. “I don’t really want to go to any indoor public places.”
She did say that as the holiday season continues to unfold, relatively small gatherings with family and friends should be okay, provided everybody is vaccinated.
The overall situation has the governor and mayor emphasizing vaccinations. “Vaccine we know is going to ensure that there’s less severe symptoms,” Gov. Hochul said. “The booster is something I would highly recommend. If you’re not vaccinated, get vaccinated.”
On Thursday, de Blasio issued a vaccination mandate for all 56,000 people who work at religious and private schools in the city to be vaccinated by Dec. 20.
Rabbi David Zwiebel, the chair of the Committee of NYC Religious and Independent Schools Officials, sent the mayor a letter asking him to reconsider.
Zwiebel said that vaccination rates are high in the city’s religious and private schools, but that “government should be using its bully pulpit to persuade, not its regulatory arm to coerce.”
Taiwan confirmed 11 imported COVID-19 cases on Saturday (Dec. 4), and 30 days without local infections, according to theCentral Epidemic Command Center(CECC).
The most recent local infection was reported a month before, on Nov. 4, while the death tally remained at 848 on Saturday.
The imported cases were five men and two women, aged from under-five to 59. Five had arrived from Indonesia, two each from Vietnam and the United States, and one each from Singapore and Cambodia. They entered the country between Nov. 19 and Dec. 2.
Eight were breakthrough cases, while the three who were not, included a Taiwanese girl under the age of 5 who arrived from Vietnam and a Taiwanese boy younger than 10 who traveled from Singapore. Most of the new cases announced Saturday were relatively young, with three teenagers and four individuals in their 20s.
Taiwan’s latest total number of 16,648 coronavirus cases included 14,590 domestic cases and 2,004 imported ones. Of the 848 fatalities, 836 were the result of local infections, with New Taipei City registering 412 deaths and Taipei City 321.
Since the beginning of the pandemic, Keelung reported 29 deaths, Taoyuan 27, Changhua 15, Hsinchu County 13, Taichung five, Miaoli three, Yilan and Hualien two each, and Hsinchu City, Tainan, Kaohsiung, Nantou, Yunlin, Pingtung and Taitung one each. The 12 other deaths were imported cases.
A total of 36 COVID cases originated from last year’s journey by the Taiwan Navy’s "Goodwill Fleet," two were infected on board a flight, one case was classified as unresolved, and 14 cases were being investigated. A total of 111 earlier cases were removed from the list of confirmed cases.
South African scientists are warning that reinfections among people who’ve already battled COVID-19 appear to be more likely with the new omicron variant than with earlier coronavirus mutants.
A research group has been tracking reinfections in South Africa and reported a jump with the arrival of omicron that they hadn’t seen when two previous variants, including the extra-contagious delta variant, moved through the country.
The findings, posted online Thursday, are preliminary and haven’t yet undergone scientific review. Nor did the researchers say what portion of the reinfections were confirmed as omicron cases — or whether they caused serious illness.
But the timing of the reinfection spike suggests that omicron “demonstrates substantial population-level evidence for evasion of immunity from prior infection,” they wrote.
“Previous infection used to protect against delta, and now with omicro,n it doesn’t seem to be the case,” one of the researchers, Anne von Gottberg of the University of Witwatersrand, said at a World Health Organization briefing on Thursday.
The study also did not examine the protection offered by vaccination. Coronavirus vaccines trigger different layers of immune response, some to fend off infection and others to prevent severe disease if someone does become infected.
“We believe that vaccines will still, however, protect against severe disease,” von Gottberg said.
Dr. Michael Ryan, the head of emergencies at WHO, said reinfection turns up in the nose but it doesn’t necessarily translate into severe disease, while vaccines have generally shown to help protect the rest of the body.
“The data we’re really looking to see is going to be around severity of infection and whether or not the vaccines continue to protect against severe disease, hospitalization and death,” Ryan said. “And right now, there’s no reason to suppose that they won’t. We just haven’t got the details yet.”
The newest variant was discovered just over a week ago by scientists in South Africa and Botswana, and it’s now been found in multiple countries. Much remains unknown about the new variant, including whether it is more contagious, as some health authorities suspect, whether it makes people more seriously ill, and whether it can thwart the vaccine.
But learning how much protection is provided by prior infection is important, especially in parts of the world where much of the population remains to be vaccinated.
The study suggests “omicron will be able to overcome natural and probably vaccine-induced immunity to a significant degree,” Paul Hunter, a professor of medicine at the University of East Anglia, said in a written response to the findings. Just how much “is still unclear though it is doubtful that this will represent complete escape.”
And with the arrival of this new variant all the depressingly familiar potential pain points come tumbling back — along with some brand-spanking new ones.
On Thanksgiving (just nine days ago) we could really believe that COVID was winding down. Yes there was Delta and hot spots, but we were on a path. Then on Black Friday, (giving new meaning to the day) Omicron hit, and soon after cases all over the U.S.
We don’t know what Omicron means for us yet — other than maybe cancelling a holiday trip to Europe, (as my family is contemplating right now). The ambiguity is excruciating: How fatal is Omicron? How contagious? How resistant to vaccines? We’re even uncertain how to pronounce it, (either way: “OH-mee-kraan” or “AH-muh-kraan”). For millions around the world the stakes could be deadly.
Consider too, the people in the business of making COVID-19 vaccines. Talk about going into scramble-the-jets mode. Like us, these scientists and executives were beginning to get into a routine. Only instead of settling into a back-to-work cadence and taking real vacations again, they were finding a rhythm of rollout and deployment for their COVID fighting medicines.
Now they may have to reconfigure everything to fight Omicron. Fortunately, when it comes to Messenger RNA (mRNA) vaccines at least, (such those from Pfizer and Moderna), adaptability is at the very core of the science. Still it will be a pretty major pivot.
Just to give you an idea, in an interview with the Financial Times this week, Moderna CEO Stéphane Bancel predicted existing vaccines will struggle with Omicron. “There is no world, I think, where [the effectiveness] is the same level ... we had with [the] Delta [variant],” Bancel said. “I think it’s going to be a material drop. I just don’t know how much because we need to wait for the data. But all the scientists I’ve talked to ... are like, ‘This is not going to be good.’”
On the other hand, Yahoo Finance’s Anjalee Khemlani, (who’s been doing an awesome job covering all things COVID-19 for us), points out here that Pfizer (PFE) CEO Albert Bourla and partner BioNTech (BNTX) CEO Uğur Şahin both expressed confidence in their vaccine against Omicron.
And so as the medical world shifts to a yet-to-be-determined degree, a question comes to mind: Who will pay for all this? In fact, who’s paid for all the COVID-19 fighting to date? As I’m sure you’ve noticed, vaccines are 100% free. But nothing’s really free, right?
The simple answer is that mostly we pay, or rather, the government does through our tax dollars, (though insurance companies and hospitals have also been assuming some costs). Following that money as it wends its way through the system is far less simple though, and it also raises the question of who owns the rights to the vaccines and what’s a fair rate of return for a product that was funded to a large degree by public dollars. Then there’s the matter of what the obligations these companies have when it comes to providing vaccines not only to U.S. citizens but to the rest of the world.
Note that the fight against COVID-19 also entails tests and medicine, but I’m just going to focus on vaccines, as it's a critical and deep topic that also happens to be rich with drama.
First you should know that the U.S. government has been in the business of funding vaccines long before COVID-19. Yes there have been ups and downs here, and if you ask scientists there’s never enough money, but no one can deny its significance.
“We’ve had a large public health infrastructure that does vaccination forever and ever,” says Sherry A. Glied, an economist and the dean of the Robert F. Wagner Graduate School of Public Service at New York University. “A lot of vaccines are provided for free by public health departments and a lot of vaccines are provided with no out-of-pocket cost because insurers are required to cover them. For the most transmissible, communicable diseases that are vaccine preventable, people should be able to get them at no cost either through public health or by insurance. It’s true of most childhood vaccines as well. Even the flu vaccine — most people are getting it for free one way or another. The COVID vaccine falls into that bucket.”
Vaccine funding takes several forms. For instance, there’s BARDA (Biomedical Advanced Research and Development Authority), an office of the U.S. Department of Health and Human Services, which “works with the biomedical industry, using grants and other assistance, to promote advanced research, innovation and the development of medical devices, tests, vaccines and therapeutics.”
BARDA has given U.S. medical companies billions of dollars for vaccine research (such as for a HIV vaccine) well before COVID, including hundreds of millions to help create “the mRNA platform ... to produce vaccines in response to the threat of pandemic flu,” according to this Health Affairs Blog.
Once COVID-19 hit however, government spending went into overdrive. This BARDA website maps out the vast sums the government has put out to fight the pandemic. Focus on just the vaccine efforts page and you can see that billions went to seven companies; Pfizer, Moderna, Janssen (part of Johnson & Johnson), Sanofi, AstraZeneca, Novavax and Merck — the latter of which is “no longer supported,” afterMerck failed to produce a vaccine.
(Sidebar here: Merck has been focusing instead on a therapeutic oral medicine (aka pill) that won preliminary approval this week and could be available as early as next month. There have been questions however about the efficacy and safety of the pill. “In the coming weeks, the FDA may also authorize a similar pill from Pfizer that appears to be significantly more effective than Merck’s,” according to The New York Times.)
The Congressional Budget Office has calculated that BARDA alone has spent over $19 billion on vaccines, (there are other agencies like the Defense Department that have provided funding too, see below), at least half of that spend was buying vaccines for the American public from Pfizer, Moderna and J&J (from biggest to smallest). Overall, Moderna has received some $9 billion from the government while Pfizer has received over $10 billion from the government, but with important differences.
Unlike Moderna, Pfizer took no money from the government to develop the vaccine, as “Pfizer’s chief executive, Albert Bourla, said he didn’t want any government interference,” according to the Boston Globe.
The Globe story also notes that “in exchange for assuming the risk of developing the vaccine, Pfizer charged the government more for each dose in its initial contract, about $19.50, compared with $15 a dose on average charged by Moderna. Moderna’s vaccine also has had a far bigger impact on the biotech [company] than Pfizer’s vaccine has had on the pharmaceutical giant. Moderna, an 11-year-old company, had never gotten a product to market before the FDA cleared the vaccine. In contrast, the 172-year-old Pfizer is one of the world’s biggest drugmakers, with dozens of products on the market.”
Got that right, and the proof is in the stock chart. Since March 1, 2020, Pfizer is up a tidy 70%, but that pales compared to Moderna (MRNA), which is up over 1100%. Moderna CEO Bancel’s 7.9% stake in the company is now worth $11.2 billion. Whoa.
Let’s drill down into Cambridge Mass.-based Moderna a bit more, because it’s the purest-play (now major) pharma-biotech COVID company and because many in the scientific community were skeptical of the company as it hadn’t produced a product and because it had what some called a secretive culture. The company proved the skeptics wrong and succeeded wildly, but now finds itself embroiled in battles on a number of fronts, which I’ll get to below.
Moderna makes money from three buckets; the smallest it calls collaboration revenue, which is money it garners from licensing fees and royalties, The second bucket is grant revenue from BARDA, the Defense Advanced Research Projects Agency (or DARPA) and the Bill and Melinda Gates Foundation.
But the real action has been in bucket No. 3 or product sales or sales of the COVID vaccine. Revenue there was $10.7 billion over the past nine months through September, up from zero the prior year. Much of that money as we’ve seen came from BARDA — as well as DOD and other agencies — and from foreign governments as well. “Investment in the research was basically done by pre-purchasing doses of vaccines,” says Cynthia Cox, vice president at the Kaiser Family Foundation. “Generally speaking that’s the way that governments tend to finance it.”
As noted the $15 a dose for each vaccine the U.S. has reportedly been paying Moderna is an average. For instance, here’s a DOD contract that seems to suggest it paid $16.50 per dose. In fact prices for vaccines are all over the map (literally), based on efficacy, dosage (for instance the Johnson & Johnson vaccine is a single dose) or whether a country or the EU contributed to the funding of the vaccine’s development. For instance this BMJ article reports that the EU, which did not subsidize the Moderna vaccine, pays $18 per dose.
If you assume that most of Moderna’s sales were to the U.S. government at that $15 per dose rate and go back to that $10.7 billion in revenue, the math works out to 713 million doses, which directionally matches the number, 770 million, the company says it has made (see chart below.) Bloomberg notes that Moderna would have sold more if not for logistical problems, which it conveyed to Wall Street early last month, with its stock tanking on the news.
Moderna COVID vaccine shipments. Chart via Bloomberg.
Earlier this year, BMJ reported that “Israel ... acknowledged paying $23.50 per dose on average to Pfizer and Moderna to obtain early shipments. Uniquely, Israel agreed to give Pfizer anonymised health data from all of its citizens as part of the deal.”
Another interesting note from BMJ is that “AstraZeneca and Johnson & Johnson have committed to not making a profit from the pandemic, while Moderna and Pfizer did not. AstraZeneca reserved the right, however, to declare the pandemic phase over and take profits from later vaccine sales.”
Why do governments pay for vaccines anyway? Presumably there are altruistic reasons, i.e., saving lives, but also to be honest, paying for vaccines is cheaper than the alternative. For example, even at that high price Israel paid for its vaccines ($23.50 per dose) BMJ says that vaccinating that country’s entire population costs the economy only as much as two days of lockdown.
And of course there’s the huge cost of an unvaccinated populace. “It’s costing Americans billions of dollars over the last several months to hospitalize people who could've had their hospitalization prevented if they had gotten the vaccine,” says Cynthia Cox. Cox looked at the cost of “people hospitalized after June, when they would've been able to be fully vaccinated. We accounted for the fact that vaccines are not able to prevent all hospitalizations. Even after accounting for that and lowballing the cost of hospitalization, it still adds up to a few billion dollars over the last few months.”
Cox also points out there are inevitable incremental costs even with vaccinated populations that are less recognized. “There’s the cost of administering the vaccine. It’s not just about producing the vials — you also have to get the shots into arms. Through [recently passed] legislation, insurance companies are required to cover the cost of administering the drug.”
Dr. Gerard Brogan, chief revenue officer for Northwell Health and professor of emergency medicine at Zucker School of Medicine in New York, adds more color here: “Reimbursement for vaccines were roughly $30 for the material, and the cost was another roughly $60 to administer the vaccine,” he says. “A portion of the staff, syringes, needles, alcohol wipes, all of those things are needed to administer the vaccine safely. For us as a health system, it was roughly $2 million to $3 million per month we were spending unreimbursed to perform this public health function.”
At the core of all this though are the vaccines. And as such you can see how critical a company like Moderna has become not only to the United States, but to the world. It’s in a complicated position and the sailing is not so smooth. Besides its aforementioned growing pains, the company must compete against industry behemoth Pfizer.
In an interview with Anjalee Khemlani, Pfizer CEO Albert Bourla noted that “we changed, dramatically, our strategy. We had invested to produce 1.3 billion doses for 2021, when we realized the situation, we put way more investments into the system and we were able to raise the volumes to 3 billion for this year, and 4 billion for next year.” Bloomberg reports that Pfizer recently raised its 2021 forecast for vaccine sales to $36 billion.”
Moderna, on the other hand, expects 2021 sales of $15 billion to $18 billion from the COVID-19 vaccines and up to $22 billion next year. Why the difference?
First of all big companies like Pfizer have factories already in place, plus existing relationships with suppliers and seasoned supply-chain experts. Also Pfizer’s vaccine for children has been approved in the U.S., while Moderna’s higher-dose vaccine still awaits approval. (And unlike Moderna, Pfizer has tThat COVID-19 pill in its pipeline which could reduce demand for vaccines.)
Then there’s Moderna’s nasty little tiff with the National Institutes of Health (NIH), which The New York Times first reported early last month. In a nutshell, Moderna is saying that NIH scientists who worked on developing the mRNA vaccine early on shouldn’t be credited with inventing the vaccine, because Moderna says, “only Moderna’s scientists designed” the actual vaccine. The Times notes:
“The dispute is about much more than scientific accolades or ego. If the three [NIH] scientists are named on the patent along with the Moderna employees, the federal government could have more of a say in which companies manufacture the vaccine, which in turn could influence which countries get access. It would also secure a nearly unfettered right to license the technology, which could bring millions into the federal Treasury.” Watch this space. It could get ugly.
Another bugaboo for Moderna is that some medical experts take issue with the company's plan to distribute vaccines to the rest of the world. Doctors Without Borders has called for Moderna to immediately share its vaccine technology and know-how with the World Health Organization. Ditto for the People’s Vaccine Alliance.
“The four-year timeline proposed by Moderna to bring vaccines to low- and middle-income countries is unconscionable,” writes Carrie Teicher, a physician, epidemiologist and director of programs at Doctors Without Borders in an opinion piece in STAT. “It means that Moderna and the world’s governments are choosing to let countless people die preventable deaths ... it’s the responsibility of the U.S. government to force Moderna to share its technology immediately.”
Maybe. That issue is obviously all tied up with the $10 billion Moderna received from the Feds — and its incipient patent dispute with NIH.
Moderna may have sound business and legal cases in all this — and a bright future as well. But executives there may discover that optics, never mind humanity, matter even more. And that maybe they aren’t mutually exclusive either.
University of Virginia School of Medicine researchers have developed a noninvasive way to remove faulty brain circuits that could allow doctors to treat debilitating neurological diseases without the need for conventional brain surgery.
The UVA team, together with colleagues at Stanford University, indicate that the approach, if successfully translated to the operating room, could revolutionize the treatment of some of the most challenging and complex neurological diseases, including epilepsy, movement disorders and more. The approach uses low-intensity focused ultrasound waves combined with microbubbles to briefly penetrate the brain's natural defenses and allow the targeted delivery of a neurotoxin. This neurotoxin kills the culprit brain cells while sparing other healthy cells and preserving the surrounding brain architecture.
"This novel surgical strategy has the potential to supplant existing neurosurgical procedures used for the treatment of neurological disorders that don't respond to medication," said researcher Kevin S. Lee, PhD, of UVA's Departments of Neuroscience and Neurosurgery and the Center for Brain Immunology and Glia (BIG). "This unique approach eliminates the diseased brain cells, spares adjacent healthy cells and achieves these outcomes without even having to cut into the scalp."The Power of PING
The new approach is called PING, and it has already demonstrated exciting potential in laboratory studies. For instance, one of the promising applications for PING could be for the surgical treatment of epilepsies that do not respond to medication. Approximately a third of patients with epilepsy do not respond to anti-seizure drugs, and surgery can reduce or eliminate seizures for some of them. Lee and his team, along with their collaborators at Stanford, have shown that PING can reduce or eliminate seizures in two research models of epilepsy. The findings raise the possibility of treating epilepsy in a carefully-targeted and noninvasive manner without the need for traditional brain surgery.
Another important potential advantage of PING is that it could encourage the surgical treatment of appropriate patients with epilepsy who are reluctant to undergo conventional invasive or ablative surgery.
In a new scientific paper in the Journal of Neurosurgery, Lee and his collaborators detail the ability of PING to focally eliminate neurons in a brain region, while sparing non-target cells in the same area. In contrast, currently available surgical approaches damage all cells in a treated brain region.
A key advantage of the approach is its incredible precision. PING harnesses the power of magnetic-resonance imaging (MRI) to let scientists peer inside the skull so that they can precisely guide sound waves to open the body's natural blood-brain barrier exactly where needed. This barrier is designed to keep harmful cells and molecules out of the brain, but it also prevents the delivery of potentially beneficial treatments.
The UVA group's new paper concludes that PING allows the delivery of a highly targeted neurotoxin, cleanly wiping out problematic neurons, a type of brain cell, without causing collateral damage.
Another key advantage of the precision of this approach is that it can be used on irregularly shaped targets in areas that would be extremely difficult or impossible to reach through regular brain surgery. "If this strategy translates to the clinic," the researchers write in their new paper, "the noninvasive nature and specificity of the procedure could positively influence both physician referrals for and patient confidence in surgery for medically intractable neurological disorders."
"Our hope is that the PING strategy will become a key element in the next generation of very precise, noninvasive, neurosurgical approaches to treat major neurological disorders," said Lee, who is part of the UVA Brain Institute.
Yi Wang et al. Noninvasive disconnection of targeted neuronal circuitry sparing axons of passage and nonneuronal cells. Journal of Neurosurgery, 2021 DOI: 10.3171/2021.7.JNS21123
Cedars-Sinai researchers have found that blocking the action of a protein called interleukin 6 (IL-6), part of the immune system, could resolve the delirium that often accompanies urinary tract infection (UTI) in elderly patients. Their study in laboratory mice, published in theJournal of Neuroinflammation,could pave the way for clinical trials of IL-6 inhibitors as a treatment for UTI-associated delirium in humans.
Older women are among the most susceptible to developing UTIs, an infection of the bladder and urethra that causes urinary urgency and pain. UTIs also can cause delirium in older people, resulting in a sharp decline in mental abilities that triggers disoriented thinking.
"Up to one-third of elderly patients hospitalized with UTIs can experience some degree of confusion and reduced awareness of their surroundings," said Shouri Lahiri, MD, director of the Neurosciences Critical Care Unit and Neurocritical Care Research at Cedars-Sinai and senior author of the study. "Delirium affects millions of patients a year in the U.S., contributing to longer hospital stays, long-term cognitive problems and increased mortality. Delirium can be a tipping point from which patients never fully recover. This is well established. What is less well established is why this is happening."
To better understand the specific biological mechanisms behind UTI-associated delirium, Lahiri and colleagues observed laboratory mice with and without UTIs in specially designed mazes. In an arena where the animals could move about freely, uninfected mice spent more time in the center of the chamber. Those with UTIs huddled in the periphery, suggesting they had higher levels of anxiety, a common symptom of delirium.
In a Y-shaped maze with three arms to explore, uninfected mice tended to explore all three arms, while mice with UTIs kept returning to the same one, suggesting a lapse in short-term memory, another feature of delirium.
The investigators also observed structural changes in the brains of mice with UTIs.
In a previous study led by Lahiri, published in February in the American Journal of Respiratory Cell and Molecular Biology, investigators found a connection between ventilator-induced lung injury and delirium. Lahiri and colleagues theorized that in both cases this was because of the reaction of IL-6, which helps regulate immune response, to the lung injury or the UTI.
"Occasionally, when the response of IL-6 is excessive, our research indicates that there can be brain injury," Lahiri said. "IL-6 induces changes within the neurons that our studies connected with delirium-like behavior. This is the first time this type of structural and functional change has been demonstrated. We've now shown two distinct models of this connection, one non-infectious and one infectious."
In the current study, when investigators treated some of the infected mice with antibodies that blocked the effects of IL-6, the delirium-like behavior of those animals resolved. "Treatment with anti-IL-6 antibody in the UTI group normalized all the brain changes, both structural and functional," Lahiri said. "A wealth of studies have shown a link between IL-6 and delirium, but only this study and our previous study have shown that IL-6 may play a direct pathological role in delirium."
If symptoms are treated early, he added, full recovery is possible, and the next step is to design clinical trials with anti-IL-6 antibodies as a treatment for patients with UTI-induced delirium.
"Dr. Lahiri and his team have built a research framework with implications far beyond this study," said Nancy Sicotte, MD, chair of the Department of Neurology who holds the Women's Guild Distinguished Chair in Neurology at Cedars-Sinai. "Building on these efforts could improve outcomes for many of our patients."
Lahiri believes the model he and co-investigators created could be used to study delirium in other conditions associated with increased incidence of UTI. These include those with pre-existing neurologic disorders like Alzheimer's disease, Parkinson's disease, stroke and multiple sclerosis where delirium can be hard to distinguish from the underlying disease but is important to treat.
"A huge population stands to benefit from these investigations," he said. "We're looking to apply this model to these other systemic disease conditions and states where the brain dysfunction caused is potentially reversible."
Mohammad Harun Rashid, Nicklaus A. Sparrow, Faizan Anwar, Gena Guidry, Ambart E. Covarrubias, Haoming Pang, Chandrakumar Bogguri, S. Ananth Karumanchi, Shouri Lahiri. Interleukin-6 mediates delirium-like phenotypes in a murine model of urinary tract infection. Journal of Neuroinflammation, 2021; 18 (1) DOI: 10.1186/s12974-021-02304-x
