The Observatory

Jan. 23, 2017

Diabetes in America

29.1 million (9.3%)
was the number of Americans who had diabetes in 2012.

79 million
was the number of Americans age 20 and older who had prediabetes
in 2010.

86 million
was the number of Americans age 20 and older who had prediabetes
in 2012.

21 million
was the number of Americans who were diagnosed with diabetes in 2012.

8.1 million
was the estimate of the number of Americans with diabetes who remained undiagnosed in 2012.

11.8 million (25.9%)
was the number of Americans age 65 and older with diabetes, diagnosed and undiagnosed, in 2012.

1.4 million
is the number of Americans diagnosed with diabetes every year.


New Studies

Biomarker in blood may help predict recovery time for sports concussions. Researchers at the National Institutes of Health (NIH) have found that the blood protein tau could be an important new clinical biomarker to better identify athletes who need more recovery time before safely returning to play after a sports-related concussion. The study, supported by the National Institute of Nursing Research (NINR) with additional funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), was published online last month in the journal Neurology.

Despite the millions of sports-related concussions that occur annually in the United States, there is no reliable blood-based test to predict recovery and an athlete’s readiness to return to play. The new study shows that measuring tau levels could potentially be an unbiased tool to help prevent athletes from returning to action too soon and risking further
neurological injury.

In the study, researchers evaluated changes in tau following a sports-related concussion in male and female collegiate athletes to determine if higher levels of tau relate to longer recovery durations. To measure tau levels, a group of 632 athletes first underwent pre-season blood plasma sampling and cognitive testing to establish a baseline. They were then followed during the season for any diagnosis of a concussion, with 43 of them developing concussions during the study. For comparison, a control group of 37 teammate athletes without concussions was also included in the study, as well as a group of 21 healthy non-athletes. Following a sports-related concussion, blood was sampled from both the concussed and control athletes at six hours, 24 hours, 72 hours, and seven days post-concussion.

Concussed athletes who needed a longer amount of recovery time before returning to play (more than 10 days post-concussion) had higher tau concentrations overall at six, 24, and 72 hours post-concussion compared to athletes who were able to return in 10 days or less. These observed changes in tau levels occurred in both male and female athletes, as well as across the various sports studied. The findings indicate that changes in tau measured in as short a time as within six hours of a sports-related concussion may provide objective clinical information to better inform decision-making about predicted recovery times and safe return to play.

Genetics play a significant role in immunity, new research finds. Nearly three quarters of immune traits are influenced by genes, new research from King’s College London reveals. The study, published in Nature Communications, adds to a growing body of evidence that the genetic influence on our immune system is higher than previously thought.

Researchers from King’s analyzed 23,000 immune traits in 497 adult female twins from the TwinsUK cohort. They found that adaptive immune traits—the more complex responses that develop after exposure to a specific pathogen, such as chickenpox—are mostly influenced by genetics. They also highlight the importance of environmental influences, such as diet, on shaping the innate immunity (the simple core immune response found in all animals) in adult life.

The findings could help to improve understanding of the immune system and the interaction of environmental factors. It could also form the basis of further research into treatments for various diseases, including rheumatoid arthritis and psoriasis.

“Our genetic analysis resulted in some unusual findings, where adaptive immune responses, which are far more complex in nature, appear to be more influenced by variations in the genome than we had previously thought,” says Dr. Massimo Mangino, lead researcher from King’s College London. “In contrast, variation in innate responses (the simple non-specific immune response) more often arose from environmental differences. This discovery could have a significant impact in treating a number of autoimmune diseases.”

“Our results surprisingly showed how most immune responses are genetic, very personalized, and finely tuned,” adds Professor Tim Spector, Director of the TwinsUK Registry at King’s. “What this means is that we are likely to respond in a very individualized way to an infection such as a virus, or an allergen such as a house dust mite causing asthma. This may have big implications for future personalized therapy.”

Infectious Diseases

Lung-specific Ebola infection found in recovering patient. Scientists have found potential evidence of Ebola virus replication in the lungs of a person recovering from infection, according to new research published in PLOS Pathogens. The findings could aid research into new treatment approaches and better understanding of how the virus is transmitted.

From 2013 to 2016, West Africa experienced an unprecedented outbreak of hemorrhagic Ebola. Lab studies, animal studies, and observations of evacuated patients treated in Europe and the United States have suggested that Ebola might cause lung damage by replicating itself in lung tissue. However, no direct evidence yet exists for lung infection by the Ebola virus.

To better understand how the lungs might be involved in Ebola, researchers tracked the presence of Ebola virus genetic material in the lungs and the blood of a single patient during treatment and recovery. The patient was a healthcare worker who was evacuated from West Africa and treated in Rome.

Specifically, the scientists monitored the patient’s lung levels of viral RNA fragments known to be associated with Ebola replication, and compared these with viral RNA levels in the patient’s blood. They found that viral RNA and viral replication markers remained in the lungs for about five days after they were no longer detectable in the blood.

The results suggest that Ebola virus may have been replicating in the lungs. It is possible that the lungs simply provided a protective environment that allowed RNA to linger longer than it did in the blood. However, researchers note, the presence of RNA for both total and replication markers in the lungs supports the possibility of active replication.

“We demonstrated a long persistence EBOV replication markers within the respiratory tract, compared to plasma,” the authors explain. “This suggests a major role of the respiratory tissues in the pathogenesis of Ebola virus disease.”

Further research will be needed to better understand the potential role of lung infection in Ebola and whether it may be a factor in human-to-human transmission of the virus.

Zika Virus

Researchers identify key proteins that may make Zika so deadly. During the past year, scientists have learned that Zika can cause a range of dangerous health problems, including birth defects such as microcephaly and neurological problems such as Guillain-Barré syndrome. But they have not known which Zika protein or proteins are causing harm, or exactly how these proteins cause damage.

Now, a new study by scientists at the University of Maryland School of Medicine (UM SOM) has for the first time identified seven key proteins in the virus that may be the culprits behind this damage. The study is the first comprehensive description of the Zika virus genome. It was published last month in the Proceedings of the National Academy of Sciences.

“The mechanism of this virus has been a real mystery,” says lead researcher Richard Zhao, PhD, a professor of pathology at UM SOM. “These results give us crucial insight into how Zika affects cells. We now have some really valuable clues for future research.”

To test the virus, Zhao used fission yeast, a species that in recent years has become a relatively common way to test how pathogens affect cells. Fission yeast was originally used to make beer (!), particularly in Africa, where it originated. Over decades, fission yeast has been used by many scientists to find out mechanisms and behavior of cells.

For the experiment, Zhao and his colleagues separated each of the virus’s 14 proteins and small peptides from the overall virus. He then exposed yeast cells to each of the 14 proteins, to see how the cells responded. Seven of the 14 proteins harmed or damaged the yeast cells in some way, inhibiting their growth, damaging them, or killing them.

Zhao and his colleagues will continue to work on Zika. The next step is to understand more about how these seven proteins work in humans. It may be that some are more damaging than others, or perhaps all work in concert to cause harm. Zhao is now beginning research on how the virus interacts with rat and human cells, in collaboration with one of the study’s co-authors.

MSU receives $1M USAID grant to fight Zika. Michigan State University (MSU) has landed a highly competitive grant from the United States Agency for International Development (USAID) to fight the Zika virus in Mexico. The $1 million grant was awarded to Zhiyong Xi, MSU associate professor of microbiology and molecular genetics, to build a mosquito factory in Yucatan, Mexico. The laboratory will be modeled after a facility in Guangzhou, China, a center that Xi leads in partnership with Sun Yat-sen University.

“Traditional efforts to control disease-ridden mosquitoes have relied heavily on chemical insecticides and have failed to have an impact on diseases such as dengue fever,” says Xi. “They are unlikely to be efficient for Zika control because the same mosquito species transmit both diseases. There is a critical need to develop novel intervention strategies to control Zika transmission.”

In China, Xi breeds millions of male mosquitoes infected with Wolbachia bacteria weekly. That strain is naturally found in many species of mosquitoes but is not dangerous to humans. When the infected males are released into the wild, they mate with females, which renders them sterile.

As part of a one-two punch, the researchers also will seed Wolbachia-infected females to establish a viral-resistant population. Once the resistant population grows to a certain density, males carrying a second Wolbachia strain are released to further suppress the population. By reducing both mosquito density and the ability of mosquitoes to transmit viruses, the project, when fully deployed, expects to arrest disease transmission immediately, Xi says.

Building on the initial success in Guangzhou, Xi will coordinate efforts in Yucatan with multiple agencies of the Mexican government, the governor of Yucatan, and Universidad Autonoma de Yucatan to breed and conduct field tests in the region.

Xi’s grant is part of USAID’s Combating Zika and Future Threats Grand Challenge, which funded 21 projects from 900 submissions. USAID is investing up to $30 million in groundbreaking innovations from researchers around the world to address the current Zika outbreak and to improve the ability to prevent, detect, and respond to future infectious disease outbreaks.


Chemically modified insulin is available more quickly. When a hydrogen atom is replaced by an iodine atom in insulin, the hormone retains its efficacy but is available more rapidly to the organism. Researchers at the University of Basel were able to predict this effect based on computer simulations and then confirm it with experiments. The results have been published in the Journal of Biological Chemistry.

Insulin is formed in the pancreas and regulates the blood glucose level. In the body it is stored as a zinc-bound complex of six identical molecules, called a hexamer. However, the physiologically active form is a single insulin monomer. Only when the body requires insulin the hexamer divides into monomers available for blood sugar regulation.

Researchers attempt to control this disassembly process by developing artificial insulin preparations, in order to optimize clinical treatment of diabetes mellitus. By means of chemical modifications, the release and availability of insulin can be improved. One possible approach is to strategically replace individual atoms in a targeted manner. This results in what is known as an insulin analog, which differs from natural insulin in both structure and properties. For the Basel study, researchers exchanged a single hydrogen atom with an iodine atom, which modulated intermolecular interactions that resulted in more rapid insulin disassembly and release.

Introducing the iodine atom improved the insulin’s availability, while the affinity for the insulin receptor and the biological function remained unchanged when compared to the natural hormone. These advantageous properties were first predicted by a combination of quantum chemistry and molecular dynamics simulations. In a next step, the stability changes of the chemically modified insulin were directly probed by using crystallographic and nuclear magnetic resonance experiments, which confirmed the computations.

The use of halogen atoms is a promising approach for compound optimization in medicinal chemistry. A future clinical application of the insulin analog, which differs from natural insulin by only a single atom, is quite conceivable.