The Tragedy, The Enemy, and The Perfect Day
Friday's Chariot Ride: 1/10/24
The Tragedy
I didn’t comment on the murder of Brian Thompson, the United Healthcare CEO, a few weeks ago. I didn’t feel like I had anything intelligent to add. It was shocking, and I didn’t think there was anything to say about it. It turns out that this murder has become a catalyst for a movement calling for the destruction of insurance companies given that they dare to sometimes deny claims. Indeed, today, the news around UnitedHealthcare is a mass movement of support for the organization after tragically losing what appears to be a decent man; rather, stockholders are pressing UnitedHealth to review their policies to reduce the number of denied claims.
I don’t know whether or not UnitedHealth’s policies deny more claims than makes business sense for them, perhaps they do, but denying a claim for someone who is not covered is not a monstrous act. It’s not as though UnitedHealth has the ability to conjure up healthcare and they are refusing to use that power to all denied claimants. Indeed every accepted claim is actually a claim on the money of some other healthy person paying for insurance—hoping that they won’t get sick, but desiring to be ready if they do—and on the time of the doctors and pharmacologists who will cure them.
Insurance companies perform the valuable service of creating the possibility of a risk-tolerant life plan.
In honor of the health insurance companies who are being unjustly maligned, the rest of today’s Flight of Phaethon will center on incredible up-and-coming treatments that, hopefully, you’ll never need, but if you do, your insurance companies could make them available to you.
The Enemy
As long as there has been humanity, there has been malaria. Malaria claims hundreds of thousands of lives annually, with children in sub-Saharan Africa among the hardest hit. The disease is caused by Plasmodium parasites and transmitted through mosquito bites. If you're infected, it's hell. If you're lucky enough to survive, you might not ever fully recover.
Current malaria treatments rely heavily on drugs that have saved tons of lives but which some malaria strains have begun to resist. On the vaccine front, the first malaria vaccine to receive approval has shown moderate efficacy, particularly in young children. These drugs have saved an estimated 1 million lives annually, but with still over 600,000 deaths every year and millions of cases still occurring, we have a long way to go.
Luckily, researchers at the NIH have recently identified a novel class of antibodies that target a previously overlooked part of the malaria parasite. Among them, one antibody, dubbed MAD21-101, has shown extraordinary promise. In mice, it provided robust protection against infections caused by Plasmodium falciparum, the most lethal strain of the malaria parasite.
What makes these antibodies so exciting is that they zero in on a part of the parasite called pGlu-CSP, a distinct section of the parasite’s protein that becomes visible and vulnerable after you get bit by the mosquito, but before it works its way into your liver. Current vaccines don’t target this region, meaning this discovery could open an entirely new avenue for immune-based prevention. Early studies suggest that this approach could offer transformative protection, potentially shielding millions from infection.
Malaria is one of man's oldest and greatest remaining external foes. I would love to live in a world where it has been vanquished.
A Perfect Day for a Zebrafish
Yesterday I talked about the incredible technology around smart cell-circuits, which could be a groundbreaking new method of doing targeted bioengineering. However, when it comes to biology, one of the things that always strikes you is that, if there’s a problem that living beings face, nature has solved it somewhere. It might take us a while to figure out where and how it’s been solved, but it probably has.
Enter the zebrafish. The zebrafish has an incredibly unique ability among vertebrates: it can regenerate 60% of its heart tissue after an injury within 6 months—which is utterly unparalleled among mammals. By contrast, a young, healthy human can change out like .5% of their heart tissue per year—and that number decreases with age.
The reason the zebrafish is so uniquely able to regenerate its heart tissue is that it possesses a special protein, called Hmga1. Recently, scientists took mice with damaged hearts and exposed them to Hmga1 during their recovery processes. What they found was actually staggering: the Hmga1 stimulated cell growth and regeneration in the damaged hearts—and it stimulated it only in the areas where there was damage.
I think it’s a very new, tentative result because I couldn’t find very much quantitative data, but if this actually works without a hitch in mice, then I would be extremely excited for a Hmga1 treatment in humans to help people with cardiovascular disease.