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Comment Re:So not their own stem-cells... (Score 1) 65

The stem cells were from a separate donor. The very first sentence of the study's abstract is: "Zimislecel is an allogeneic stem cell–derived islet-cell therapy."

allogeneic: denoting, relating to, or involving tissues or cells that are genetically dissimilar and hence immunologically incompatible, although from individuals of the same species.

Comment Re:Off Insulin onto immunosuppressants for life... (Score 1) 65

If they used the patient's own stem cells as the initial source, then the immune-suppressants wouldn't be needed, but that would DRASTICALLY raise the cost.

Ironically this is not the case.Type 1 Diabetes by definition is an autoimmune attack by the body on its own cells. Using more of those same cells won't stop the immune attack. It's possible that a more selectively targeted immune suppressant may be sufficient to use if it's the patient's own cells; e.g. the calcium-channel blocker Verapamil has been shown to slow down the attack, but periodic re-infusions of beta cells would probably still be necessary.

Comment Re:Off Insulin onto immunosuppressants for life... (Score 1) 65

Most diabetics use a base long acting insulin. Insulin Glargine has a 24 hour action time, Insulin Degludec is 42 hours... So it's a once a day thing, and adjustments play out over days...

It is emphatically not a once-a-day thing.Type 1 diabetics (who aren't on an insulin pump) use both a base long acting insulin AND a rapid mealtime/correction insulin. This can be 10+ shots per day, and requires constant vigilance to keep blood glucose in range. The insulin pumps use only rapid insulin, but have other downsides; scarring, internal 24/7 exposure to a teflon cannula, and 100% dependency on the technology working properly at all times to keep the patient safe. If the continuous glucose monitor fails (e.g. by sending incorrectly high readings), the pump can silently overdose insulin, leading to very bad outcomes. To reduce the chance of this happening, most pumps are set to maintain an unhealthily high blood sugar level, which can have its own long term health consequences. (E.g. with manual injection one can target an optimal range of 80-90 mg/dL, but pumps generally won't allow a target below 110 mg/dL.)

Comment Re:Why not use the patients own cells? (Score 3, Informative) 65

Using the patient's immune cells won't work. They got diabetes because their immune system destroyed its own cells. The clearest viable path is a technology called encapsulated beta cells. See my other comment for references.

This is true, for now. Targeted immunosuppression therapies may eventually make patient-derived cells a more viable option; e.g. Anokion is currently working on "inverse vaccines" for T1D, which in conjunction with patient-derived stem-cell-based beta cells may provide an effective cure. Verapamil (a calcium-channel blocker) has also shown effectiveness in slowing down beta cell destruction, without broadly compromising the immune system. That sort of drug, combined with periodic stem-cell reinfusions, could also in principle provide a practical cure. My 7yo daughter was diagnosed with T1D at age 4 (no family history), and we are hopeful that one of these therapies may become available for her in the next decade or two.

Comment Re: Best regular plate ever: (Score 1) 186

A family friend was once assigned â2GRT269â(TM), and had to replace it with a custom plate to avoid embarrassment. Then thereâ(TM)s â8DYX247â(TM), which some unfortunate Tesla owner is currently driving around with. But I actually wouldnâ(TM)t mind having â3XIV159â(TM) for my car. (Get it? A Pi plate! â3 14 159â(TM).)

Comment Re:I'll Pass (Score 1) 81

This is eugenics. (With all the baggage that entails.) There are very few cases where such an approach could even theoretically do actual good, and they all depend on a degree of scientific knowledge and technology (and global availability) that we don't have yet.

Imagine we had a magical free CRISPR shot that could repair a "broken" genetic base pair. Only a tiny fraction of diseases, those caused by a single well-defined gene (e.g. Tay-Sachs, cystic fibrosis) would be fixable this way. Most "genetic" diseases (such as T1D) are caused by constellations of tens or hundreds of interacting genes, with all sorts of unrelated side-efffects, and with environmental and probabilistic components as well. There is no straightforward genetic fix for them; that's why they haven't been bred out of the population despite millions of years of natural selection.

In any case, pretty much everyone on the planet (including you) has a handful of not-so-great genetic mutations, and probably two or three badly screwed-up recessive ones. The only current practical (to the wealthy) approach, if pre-screening is available, is to choose not to have kids with someone who shares the same problematic genes that you have, or if you are a match and want kids anyway, to use IVF and pre-screen embryos. (Ethical takes on this vary.) It's also a slippery slope; how bad does a gene have to be in order to take this approach?

Tl;dr: the genome is far more complicated than you think, and for 99% of human ailments, genetic manipulation would not even theoretically work to solve them.

Comment Re:I'm not sure this is new? (Score 1) 81

There has been significant research into finding ways to get the beta cells to regenerate themselves (e.g. https://www.ncbi.nlm.nih.gov/p...), as well as "inverse vaccines" (e.g. Anokion: https://anokion.com/pipeline/) to selectively "untrain" the immune system to attack the pancreas. Also research into ways to physically shield transplanted beta cells from both immune rejection and autoimmune attack. (e.g. Vertex Pharmaceuticals: https://www.vrtx.com/our-scien...)

Meanwhile, there are selective, relatively low-impact autoimmune blockers such as teplizumab or verapamil that can substantially slow down T1D progression without causing full-on immune suppression, and research is finding improved ways all the time. There is reason to be hopeful.

Comment Re:Using one's own stem cells? (Score 3, Interesting) 81

Did you know before she was born that she had diabetes? If not, how did you think to save the cord blood? Granted, I had one kid, and that was nearly 40 years ago before saving cord blood was even considered, I'd imagine. Even so, we had no idea that there might even be a reason to do so.

There is no T1D in our family histories; in fact, ironically, 23andMe had identified both of us (mother and father) as having substantially below-average risk for T1D. We banked the cord blood (in 2018) mostly on a "why not?" basis, thinking that it might possibly turn out useful for other family members in the future, or perhaps something we could donate for science or for someone else's use. We never expected that our daughter herself might benefit from it! And she can't (yet), but maybe one of these days.

Comment Re:Using one's own stem cells? (Score 1) 81

If this is a genetic defect, ones own stemcells must be first repaired, that may be a crispr-cas9 kind of technique.

The "genetic defect" (to the extent T1D has a genetic predisposition) relates to the immune system, not the beta cells themselves. So no "repair" would be needed to create workable beta cells this way.

FWIW, the genetic susceptibility to T1D is present in about 1/4 of the population, but only 1-2% of those will ever develop the disease, based on unknown (likely environmental or probabilistic) factors.

Comment Re:The ghost of (Score 2) 81

I'm sure you're aware, but Wilford Brimley's "diabeetus" refers to Type 2, a metabolic disorder. This article (and this therapy) is specific to Type 1 diabetes, an autoimmune disorder. (Technically this type of therapy might also be helpful for some Type 2 cases, but it's initially focused on type 1.)

Comment Using one's own stem cells? (Score 4, Interesting) 81

My 6yo daughter has T1D, and we banked her cord blood when she was born. If her own stem cells could be used to generate these insulin-producing cells, it would avoid the need for broad-spectrum immunosuppressive drugs. (Although the autoimmune attack itself would also need to be selectively suppressed to prevent the T1D recurring.) Holding out hope that these therapies start to become available sooner than later!

Comment Re:It just makes no sense (Score 1) 305

You're only considering the combustion of the fuel in the rocket, not all the energy involved in preparing the launch.

With the rocket being reusable, most of the external energy per launch will be in preparing the fuel. LOX currently costs around $40 per ton, so 3500 tons of it cost $140k. Suppose ALL of this cost is to pay for electricity for refinement/liquification/cooling, at 10c/kWh. That implies 1400 MWh to produce the fuel, which would produce ~400kg of CO2 per MWh [based on the US average energy mix], working out to 560 metric tons of CO2 per flight. (Plus somewhat less to chill the liquid methane.) Of course, this part of the process could also be powered by renewables, making the CO2 footprint that much smaller; the same can't be said for jet fuel of course. And not all of the cost of LOX is the energy cost of refinement, so the actual CO2 emissions are probably significantly lower than these ballpark figures.

Comment Re:It just makes no sense (Score 1) 305

One Starship launch alone produces an estimates 76,000 tons of CO2

That 76k figure is laughably incorrect. For one thing, Starship EP2P flights would not use the Super Heavy booster at all; suborbital trajectories combined with reentry gliding would enable Starship-only flights to have a range of ~10,000km. Furthermore, Starship (without Super Heavy) uses about 300 tons of liquid methane per flight, so it would produce about 900 tons of CO2 per flight. For comparison, an Airbus A380 produces around 750 tons of CO2 per flight. Meanwhile, Elon has stated that the expected seating capacity for Earth point-to-point Starship transport would be around 1000 passengers, which exceeds a typical A380 flight (~500 passengers) by ~2x. So the CO2-per-passenger cost of Starship Earth point-to-point travel could actually end up somewhat lower than for A380, in the best case.

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