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news updates NOBEL PRIZES 2020 HCV discoverers honoured The 2020 Nobel Prize in Physiology or Medicine is awarded to Harvey J Alter, Michael Houghton and Charles M Rice for the discovery of the hepatitis C virus. Alter studied the transmission of hepatitis as a result of blood transfusions and showed the existence of a third, blood-borne viral pathogen —other than HAV and HBV. Houghton and his colleagues identified the new kind of RNA virus that belonged to the Flavivirus family on the basis of genetic material from infected chimpanzees and named it the hepatitis C virus. A team led by Rice characterised a portion of the hepatitis C genome responsible for viral replication using genetic-engineering techniques demonstrating its role in causing liver disease. This pioneering work has paved the way for the development of screening methods that have dramatically reduced the risk of acquiring hepatitis from contaminated blood and has led to the development of effective antiviral drugs. The harsh and poorly effective treatments of yesteryears for the infection have been replaced by drugs that directly block the virus. HCV induced hepatitis is now almost a curable disease and the lesions associated with infection are often reversible. Clinical studies have shown that shortterm anti-viral treatment cures more than 95% of the patients, including advanced cases who failed to respond to previous therapeutic modalities. 71 million people worldwide are chronically infected with hepatitis C, which causes nearly 400,000 deaths per year, mostly from cirrhosis and liver cancer, according to WHO. In 2016, spurred by the development of effective treatments for hepatitis C and expanding access to hepatitis B vaccination, the 194 member states of the WHO committed to eliminating viral hepatitis as a public health threat by 2030. I am overwhelmed at the moment, but so pleased that this originally obscure virus has proven to have such a large global impact. Harvey J. Alter, M.D Senior Scholar NIH Clinical Center’s Department of Transfusion Medicine, USA You cannot stop an epidemic as large as [Hepatitis C] or Covid[-19] just with good therapy — you absolutely have to have a vaccine to really curb the transmission across the world. Michael Houghton Professor, Department of Medical Microbiology & Immunology University of Alberta, Canada It shows you what can be done if people really mobilise and work together. Charles M Rice Rockefeller University, New York City 8 / FUTURE MEDICINE / November 2020
CRISPR-Cas9 back in spotlight Emmanuelle Charpentier and Jennifer Doudna shared the Nobel Prize for Chemistry for developing the precise genome-editing technology. Charpentier, now at the Max Planck Unit for the Science of Pathogens in Berlin, and Doudna, at the University of California, Berkeley, have developed CRISPR–Cas9 gene-editing tools, a technology that allows to make precise edits to the genome and has swept through laboratories worldwide since its inception in the 2010s. Using these, researchers can change the DNA of animals, plants and microorganisms with extremely high precision. This technology, which has had a revolutionary impact on the life sciences, is contributing to new cancer therapies and may make the dream of curing inherited diseases come true. Using the CRISPR/Cas9 genetic scissors, it is now possible to modify genes in cells and change the code of life over the course of a few weeks. “There is enormous power in this genetic tool, which affects us all. It has not only revolutionised basic science, but also resulted in innovative crops and will lead to ground-breaking new medical treatments,” said Claes Gustafsson, chair of the Nobel Committee for Chemistry, announcing the prize. Clustered regularly interspaced short palindromic repeats (CRISPR) is a microbial ‘immune system’ that prokaryotes use to prevent infection by viruses called phages. The CRISPR system gives these microbes the ability to recognize precise genetic sequences that match a phage or other invaders and target these sequences for destruction using specialized enzymes. These enzymes, known as CRISPRassociated proteins (Cas), including one called Cas9, have been identified previously. But Charpentier identified another key component of the CRISPR system, an RNA molecule that is involved in recognizing phage sequences, in the bacterium Streptococcus pyogenes, which can cause disease in humans. In a collaboration, the duo isolated the components of the CRISPR–Cas9 system and showed that the system could be programmed to cut specific sites in isolated DNA. Their programmable gene-editing system continues to tweak and improve CRISPR and to identify other gene-editing tools. This tool has contributed to many important discoveries in basic research, and plant researchers have been able to develop crops that withstand mold, pests and drought. In medicine, clinical trials of new cancer therapies are underway. Emmanuelle Charpentier Jennifer A Doudna Emergency department must in medical colleges: NMC The National Medical Commission (NMC) has made it clear that all medical colleges offering MBBS courses must have a Department of Emergency Medicine. Releasing the latest “minimum requirements for MBBS admission regulations 2020” for public comments, the apex regulator mandated that the emergency department should have at least 30 beds. The regulations will be applicable to medical colleges being established from the 2021-22 academic session. The draft guidance stipulates the infrastructural facilities requirements for medical colleges offering 100, 250 and 500 admissions annually. All the institutions offering undergraduate education are required to have a college building, laboratories, tutorial rooms, library, hostels and bed distributions. For medical colleges November 2020 / FUTURE MEDICINE / 9
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