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Brainstorm Health: Nobel Prize Winners, Shire Sues Allergan, Las Vegas Mass Shooting

The Nobel Prize in physiology or medicine was awarded today to three Americans who helped elucidate the rhythm of life, pinpointing some of the biological mechanisms that keep our internal body clocks ticking away.

Jeffrey C. Hall and Michael Rosbash, who collaborated for years at Boston’s Brandeis University, along with Michael Young at the Rockefeller University in New York, were jointly awarded the $1.1 million (9 million Swedish krona) prize. By studying the genetics of fruit flies, the three managed to isolate a gene, called period, involved in setting the body’s natural daily rhythm; Hall and Rosbash then showed what happens with the protein (“PER”) encoded by that gene. PER works a bit like sand in an hourglass, at least metaphorically; it accumulates at night in cells and then breaks down and dissipates during the day, oscillating “over a 24-hour cycle, in synchrony with the circadian rhythm,” as the Nobel Assembly at the Karolinska Institutet explained in an accompanying news release. Young then went on to discover two more genes, called timeless and doubletime, that also appear to keep the body’s 24-hour-a-day hormonal, blood pressure, and temperature rhythms in a healthy meter, as they orchestrate a dance of feedback loops, protein checks, and delicate adjustments.

The selection of this trio of scientists by the Nobel committee came as a surprise. Many expected the greatest prize in medicine this year to go to someone like MD Anderson’s Jim Allison, whose seminal discoveries of immune system checkpoints led to our modern successes (if still fledgling ones) with immunotherapy for cancer—or to the scientists who developed the gene editing tool known as CRISPR.

But that said, this year’s prize is an acknowledgment—apart from the important work of its recipients—of the critical importance of sleep and balance in human health. It is, in that way, gratifying to see an award for achievement in medicine and physiology recognize a fundamental scientific underpinning of wellness. The links between sleep, hormonal balance, and health are not the gloppy realm of “soft science,” the Nobel committee seems to be acknowledging. They are the domain of serious medical research.

Although the Nobel judges did not mention this in their citation this morning, there is something else worth noting about our circadian patterns: They occupy a space that defies mere biological reductionism. In short, they seem to be the sum of more than their so-called “mechanisms of action.”

The circadian clock anticipates and adapts our physiology to the different phases of the day. Our biological clock helps to regulate sleep patterns, feeding behavior, hormone release, blood pressure, and body temperature. SOURCE: “The 2017 Nobel Prize in Physiology or Medicine—Press Release.” Nobel Media AB 2014.
Nobel Media AB 2014

There are other bodily rhythms, indeed, that follow the same rule-less rule. The heart’s own pacemaker, for instance, keeps its miraculous syncopation via a shifting current of sodium, potassium, calcium, and other ions, carried through protein channels. “The activation, de-activation and inactivation of these channels proceed in a rhythmic fashion in synchrony with the pacemaker frequency,” writes Denis Noble, author of one of my favorite all-time books, The Music of Life: Biology Beyond Genes. But there seems to be no primary mover in this rhythm—in the kinetic cycle that keeps our beating hearts beating. “The oscillation is…a property of the system as a whole, not of the individual channels or even of a set of channels…” Noble says.

Life is rhythm. The swirling molecular interactions of our bodies, taking place without break in a jam-packed pool heated to nearly 100 degrees Fahrenheit, occur with an unseen orchestration—one that we struggle daily to comprehend. In their lifelong work Hall, Rosbash, and Young got us a little bit closer. We should sing their praises today—and then, in true homage, get a good night’s sleep.

Clifton Leaf, Editor in Chief, FORTUNE
@CliftonLeaf
clifton.leaf@fortune.com

DIGITAL HEALTH

V.A. staff could soon use telemedicine to help vets. A proposed federal rule seeks to make it easier for U.S. Department of Veterans Affairs medical providers to use telehealth services in order to reach patients across state lines. In recent years, the VA has been under fire for long patient waiting lists for the growing number of veterans who require medical care. (MobiHealthNews)

INDICATIONS

Shire, Allergan head to court over Restasis patent following unusual Native tribe transfer. Drug maker Shire is suing Allergan, the manufacturer of Botox and many other major medical products, alleging anti-competitive actions meant to keep the company’s rival dry eye drug off the market. The suit follows an unprecedented deal in which Allergan transferred patents for its drug Restasis over to a Native tribe in order to strike down certain intellectual property challenges on the basis of sovereign immunity. (Reuters)

THE BIG PICTURE

Las Vegas is the worst mass shooting in modern U.S. history. On Sunday, a gunman killed more than 50 people attending a music festival in Las Vegas and injured at least 400 more. It’s the 273rd mass shooting in America (defined by shooting incidents in which at least four people other than the gunman were shot); gun violence has steadily climbed the list of killers of young people, joining the ranks of automobile accidents and drug overdoses. (Fortune)

REQUIRED READING

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Facebook, Google Criticized Over Las Vegas Shooting Misinformationby Tom Huddleston, Jr.

Social Capital Hires a Partner to Lead Its New Growth Unitby Polina Marinova

Produced by Sy Mukherjee
@the_sy_guy
sayak.mukherjee@fortune.com

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