Issue 106

Precision genetic medicine: The fourth wave of drug development

Hello friend! Welcome to Scrap Facts.

I'm a reporter covering health and science with insatiable curiosity. I love everything I learn, not all of which gets its own story. Each issue, I'll bring you some of my favorite facts that I picked up on the job or while out living life.

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May 9, 2021

The complete guide to the fourth wave of pharmaceuticals, and my swan song for Quartz.

Reader, a lot has happened since my last issue.

For one thing, I resigned from my role at Quartz last month. I’m incredibly grateful for each and every story that publication gave me to write, and for all the talented colleagues I got to work with along the way.

For another, it means that I had to decide what I wanted my final piece of work to be after nearly six years (five years, 11 months, and three days to be exact, since I started as an intern). I chose a massive overview of a topic that had been in the back of my mind for years, that only recently gained mainstream notoriety because of Covid-19.

Illustration credit: Beatrice Liu

Precision genetic medicine doesn’t sound sexy, but it’s the era of medicine that could cure whatever ails us in our lifetimes—20 years, by some estimates. This kind of medicine is modeled after our cellular biology, and how our bodies use and interpret our DNA into proteins and ultimately keep us strong and functioning.

If it sounds far out, keep in mind that the Pfizer-BioNTech and Moderna Covid-19 vaccines are a prime example of this kind of medicine. By introducing mRNA to our muscle cells, our muscle cells get the set of instructions to make the SARS-CoV-2 virus, which is enough to spook our immune systems into making antibodies.

But there’s all kinds of RNA you can introduce into your cells to make all kinds of proteins. Sometimes, you’d want to get the body to produce the proteins found on the outside cancer cells, to get your immune system to kill off those cells instead. Other times, you may want to get the body to stop producing deformed proteins from a mutation that makes us sick.

It’s easy breezy in theory, but in practice it’s been some 70 years in the making. Biologists and chemists have worked tirelessly together to make it happen. But now, it’s there time to shine: There were less than 10 approved therapies using these techniques before the Covid-19 pandemic; now that precision vaccines have proven themselves, it won’t be long before that number increases exponentially.

Some scrap facts on the topic to get you started:

  • DNA may be our master genetic code, but all life stems from RNA—which is why it’s a tool we use in at least three forms in our cells.

  • Alec Bangham, a biophysicist and clinician University College London, invented the first iteration of lipid nanoparticles to carry medicine in 1965. He called them “multilamellar smectic mesophases,” but for obvious reasons, “banghasomes” is the name that took off

  • Most cancer hides tells your immune system to ignore it. Cancer vaccines are actually just reintroducing the proteins on cancer cells to our immune systems to they can attack it.

  • “Blockbuster” drugs is a technical term that means a product pulls in more than $1 billion in revenue. Because drug companies love to pursue these products, rare diseases have often been ignored—or treatments have cost upwards of hundreds of thousands of dollars to make up for the small patient base.

  • Each of our cells have combinations of some 4,000 receptor proteins on their outside. Getting drugs to target cells requires figuring out the right combination of these receptors to match your therapy.

You can read my feature here: Huge thanks to Alex Ossola, a friend and the editor who made it all happen in my last weeks at Quartz.

As for me, I’m headed to Politico! I’ll be covering the US Food and Drug Administration—and hopefully lots of genetic medicine in that context.

Before I can continue Scrap Facts and Age, I’ll need to clear it with my new editors—but I’m optimistic we can work something out. I should be back in your inbox with new links to new stories in a jiffy.

That’s all for now—stay curious, friend ❤️

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Top image by E. Y. Smith; headshot by Matt Anzur.