3 Things the Coronavirus Task Force Must Address with Aysha Akhtar, President and CEO of the Center for Contemporary Sciences: Audio automatically transcribed by Sonix
3 Things the Coronavirus Task Force Must Address with Aysha Akhtar, President and CEO of the Center for Contemporary Sciences: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.
Saul Marquez:
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Saul Marquez:
Hey everyone, Saul Marquez here and welcome back to the Outcomes Rocket. Today, I have the privilege of hosting Dr. Aysha Akhtar. She’s a double Board-Certified Neurologist and Preventive Medicine Specialist wth a background in Public Health and is a US veteran. Previously, she served as Deputy Director of the US Army Traumatic Brain Injury Program, developing the Army’s brain injury prevention and treatment strategies for soldiers. As a commander in the US Public Health Service Commission Corps, Dr. Akhtar frequently deployed to assist with national public health emergencies. For a decade Aysha was a Medical Officer at the Food and Drug Administration, most recently in the Office of Counterterrorism and Emerging Threats, implementing studies on vaccine effectiveness and safety, and using her top-secret security clearance to develop national preparedness strategies for public health threats. She’s a published in peer-reviewed journals including Lancet Pediatrics, Journal of Public Health Policy, and reviews in the Neurosciences. Doctor Akhtar is a fellow of the Oxford Center for Animal Ethics. She’s the author of two books, “Our Symphony with Animals: On Health, Empathy, and Our Shared Destinies” and “Animals and Public Health”, which argues for the need for health institutions to include animals as part of the public in public health. She’s also a TED speaker and just really privileged to have her here to talk to us about the work that she’s up to at the Center for Contemporary Sciences. So so with that intro, Dr. Akhtar super, super grateful that you’re able to join us today.
Dr. Aysha Akhtar:
Thanks so much, Saul. I’m excited to be here.
Saul Marquez:
Absolutely. So before we dive into the work that you guys are doing at the Center for Contemporary Sciences, tell us about you. I mean, the work that you’ve done for our country and our soldiers is just incredible. Talk to us about what lights your fire and health care.
Dr. Aysha Akhtar:
Oh, yeah. Yeah. It’s funny how your career takes you into directions you would never have thought of. So I was working at the Food and Drug Administration, doing some vaccine studies at the time, and I learned about this thing called a Public Health Service Commission Corps, and I never heard of it before. But basically, it’s one of the uniformed services. It’s the arm that goes out, get deployed. So we’re doctors, scientists, epidemiologists, nurses, other health care workers who get deployed to assist with public health emergencies like the pandemic we’re currently facing.
Dr. Aysha Akhtar:
So I’ve helped with Ebola screening, with post-recovery after flooding in Louisiana, as well as some other things. So, yeah, I’m not in it anymore because I retired from the service in the army or separated. But, yeah, this is what we were doing. And I assume the public health service folks are very much involved with the pandemic response currently. And then after my work at the Food and Drug Administration, after I was working in the Office of Counterterrorism and Emerging Threats, we’re actually preparing for pandemics like this for emerging infectious diseases as well as biological threats that could be as a result of terrorist acts. But after working in that department, then I moved on to the Army and I was helping to develop clinical guidelines for how to prevent, how to screen, how these detect, and then how to treat soldiers with a traumatic head injury. And, you know, your listeners may be aware. Traumatic head injury has been getting a lot of attention over the last few years among soldiers, and it was under-recognized. And there are so many causes of traumatic head injury that include more than just direct impact from an object, for example. But even there’s a head injury that can result from the use of heavy weapons that cause this is recoil, for example, and so on. So that’s there isn’t much we can offer, unfortunately, for soldiers or for anyone with a traumatic head injury. And that’s really the case with most neurological diseases. There isn’t much. We can offer supportive care, but we don’t have anything or very little in the way of actually therapeutic care, care, medical drugs, and other therapeutics that can actually directly impact the disease and that’s part of the reason why I’m currently now heading out the Center for Contemporary Sciences, because we’ve seen that there has been a real problem in a sense with how medical research is conducted in many ways and that there is a need for real change in the procedure.
Saul Marquez:
Well, there is a huge opportunity there, and it’s unfortunate that there’s nothing that could be done at this point therapeutically. So it’s a really interesting dilemma that we’re in. And I love to hear more about what you guys are doing at the center to help with some of those challenges. Doctor, can you tell us a little bit about what you guys are doing?
Dr. Aysha Akhtar:
Yeah. So throughout my career, I started to become more aware of one of main limitations, one of the main rollbacks in medical research, and that’s really the continued use of animals in experimentation to try to inform human health and human care and pharmaceutical development. And I started to question that use for a long time. And now more and more scientists are starting to question the use of animals as well. There’s more data that’s being published much more frequently now in peer-reviewed scientific journals that are really calling into question this kind of system that we’ve developed that really heavily uses animals. And what the data is starting to show more and more is despite the similarities between humans and other animals in many basic biological processes, its the differences between species that are causing a lot of problems. And what we’re finding is that the use of animals, in general, its not to say it never works, but in general is largely ineffective in predicting what we’re going to see in humans, largely ineffective in helping us understand human diseases and in developing pharmaceutical agents. If you look at the FDA’s own statistics, is that between 90 to 95 percent of the drugs that pass preclinical tests end up failing when tried in humans.
Dr. Aysha Akhtar:
So what that means is that 90 to 95 percent of the drugs that were found to be safe and effective in animal tests end up failing in humans, and most fail because they end up being unsafe and/or ineffective in humans. And so there is.
Saul Marquez:
That’s a big number.
Dr. Aysha Akhtar:
Its a huge number, right? Can you imagine if you were hopping on a plane and the pilot said, ladies and gentlemen, we have about a five percent chance of landing safely at our destination.
Saul Marquez:
Get me off this plane.
Dr. Aysha Akhtar:
Exactly. And you would demand an overhaul of the entire airline industry. But this acceptance of the dismal failure rate in the development of our drugs that we put into our own bodies has just been going on for decades. And so there is a drastic need for change. And at the Center for Contemporary Science, this is really our goal is to truly help transform the medical sciences, to move away from the use of animals, and to actually embrace the use of these cutting edge, really innovative, exciting new testing methods that are based on human biology.
Saul Marquez:
Well, I think that’s phenomenal. And so what is the alternative then? What things can we do or can we start thinking about?
Dr. Aysha Akhtar:
So one of the testing methods that has really just been gathering a lot of enthusiasm, a lot of excitement is the organ on a chip methodology. And so basically with an organ on a chip, what you do is you distill an organ, let’s say a lung, into its micro components, onto a microchip. And at the micro level is where everything happens anyway. That’s where a disease takes place at the molecular level and the micro level disease takes place where a drug works or doesn’t work or a drug causes toxic effects. And so if you look at the lung on a chip, for example, it actually breathes. It functions like a full living lung or close to a living for living lung. I won’t say exactly like a full lung. And there’s always room for improvement and improvement is constantly happening. And so there’s so many companies out there and academic institutions now are jumping on board with creating these organs on a chip. So there’s a lung on a chip, a kidney on a chip, a gut on a chip, a mini human brain on a chip, a liver on a chip, and so on. And ultimately, what these innovators hope to do is connect all the different organs on a chip with a lymphatic system, a circulatory system, kind of a nervous system, and so on to create the human body on a chip, which is so exciting. It’s just one of the most exciting developments that has happened in a long time.
Saul Marquez:
That is so interesting. I’ve never heard of this before and I’m so intrigued. So talk to us about the chip and does it contain. Tell us what the contents of this chip are and how it actually works.
Dr. Aysha Akhtar:
So I wish I could give you all the full details because it’s not I haven’t we don’t create these chips. We’re Helping those who create these chips. But basically they’re derived from human cells or human lung cells, for example, that have been that are placed in a kind of medium that allows for their growth and their longevity as much as possible. Now, there’s always room. There’s continual refinement of the medium to make it as faithful to an actual living biological system, the living, human biological system as possible. So these chips are not perfect by any means, but these are just one type of testing method. There are also many organs now that are being grown and many of them are being produced through 3D printing now, which is just amazing. And so you’ve got these mini-organs again, like mini human brains, and these are not conscious brains. These are just miniature versions of brains, many brains, many hearts, and so on. And so, again, there’s a lot of activity going on in that place. So the thing to really emphasize is that there’s no one testing method is going to give us all the answers we need.
Dr. Aysha Akhtar:
No one testing method is ever going to be perfect, but it’s going to take a combination of multiple testing methods. So let’s say organs on a chip, maybe many organs, other types of cell cultures, bioinformatics. Computers in silicon modeling and then pathology results and autopsy results and imaging results and then ultimately clinical trials that will really give us the best, the most faithful information about what’s happening in the human body. And so this is really the direction we need to go. When you think about it, so we know now and this has been coming up a lot with the COVID vaccine testing. There’s a reason why we say we need to have a diverse group of people represented in clinical trials because we know that what may be safe and effective and useful in you Saul, may not be safe or effective in me or my husband or a child or a nursing or pregnant woman, for example, or someone from Asian heritage, for example, and so on.
Dr. Aysha Akhtar:
We know that no one human can predict what we’re going to see in another human right. And that’s the reason for the call for diversity in clinical trials. So when you think about it, how can we expect a mouse, a mouse’s biology to predict what we’re going to see in humans or even a non-human primate? If we look at the use of non-human primates, for example, there have been more than 90 vaccines. I don’t know if you know about the attempt to find HIV vaccines. It has been for decades attempts to find a vaccine to help prevent HIV, to protect people from contracting HIV. So billions of dollars have poured into this line of work. Decades of time, and lots of non-human primates have been used. And until recently, many of those studies included chimpanzees, our closest relatives, right? You would think that at least chimpanzees and non-human primates would be good models for human diseases. But despite that, more than about 90 HIV vaccines that have passed those past testing on non-human primates ended up all every single one of them ended up failing in human clinical trials, every single one. And to go further, some of them were found to even increase the risk of HIV in humans. Wow. So it’s just some examples of just how interspecies differences can really lead us down the wrong line of investigation.
Saul Marquez:
Well, you’re really bringing a topic, especially now when we’re dealing with coronavirus and vaccination and how are we getting to the endpoint and just something that we all need to be thinking about further. And I guess you think about these things, Aysha, it’s like this is one of these things that I guess has gone unquestioned for a long time. So I think it’s really interesting and important that you guys are doing the questioning on how we do it, because, sure, you can’t expect everything to be accurate, but it’s got to be better than ninety-five percent failure rate.
Dr. Aysha Akhtar:
Right! Thank you for those kind words. Fortunately, we’re not the only ones. So there are many more scientists who are now jumping on board and saying that we need something better. We need to have testing methods that are based on human biology. So what we are doing at the Center for Contemporary Sciences is helping these innovators who are creating these new techniques. We are trying to increase scientific and public knowledge about these new techniques and how they can be used instead of animals to really accelerate our understanding of human diseases or to really accelerate the development of better treatments. And we see our role as bridge builders really to bring a lot of different groups together to build collaboration so that these tools are not only being developed to not only get the investment, the funding they need, but they are actually getting into the hands of the researchers who can use them, and that our government agencies are putting more effort into further developing, further refining and further funding of these tools.
Saul Marquez:
Wonderful. Just super important work that you and your team are up to there in enabling this type of progress. And so does anything come to mind when you think about some maybe improvement of outcomes and maybe in the future and the question will be more around like where do you see this going?
Dr. Aysha Akhtar:
I think this is going to be the future of biomedical research. Actually, I know this will be the future of medical research. Animals won’t be used and instead we will have testing methods that are based on human biology. It makes a lot of sense. These testing methods can be a lot cheaper. Initially, there may be a cost to switch over, but over time they will be a lot cheaper to use. They can be used much more efficiently, much faster and so on. We don’t have outcomes in the sense that you’re looking for yet, as you said, because this is still a relatively new field. When you look at the history of biomedical research, there have been side by side comparisons of different types of testing methods, different in vitro tests or batteries of in vitro tests compared with the animal tests, for example, to look at a toxicity of a particular compound or so on. And so there are studies that have compared, which is that looked at these two different methods and looked at which is better. Is it the animal test or is it the in vitro test? Almost inevitably, it turns out that the in vitro tests tend to be better, but there are not a lot of studies in that area or if there are a lot of them, still are proprietary studies that are held closely by the pharmaceutical agents and the contract research organizations. So they’re not published. And as you know, in the medical world, a lot of things go unpublished and that’s not a good thing either.
Saul Marquez:
Yeah. Now, for sure, there’s a gap there. And I mean, is there any word on the margin of improvement, one versus the other?
Dr. Aysha Akhtar:
The the word on the street, I would say, is that like these organs on a chip are ending up being much more effective. And there’s even my office at the Food and Drug Administration. When I was there in the office of Counterterrorism Emerging Threats, we gave millions of dollars to contract out for the use of the lung and the liver on-chip. I believe it was the liver on the chip as well to be used because we knew that the animal tests were not sufficient in predicting the toxicity of different drugs. So we knew there was a need to move into a different direction. I wasn’t there, unfortunately, to see the final analysis so that I don’t have. But this is something that we are looking into and we hope to find data that looks at more of these outcomes that we can actually publish on our website.
Saul Marquez:
Well, I think it’s great, exciting to think about the promise of this work as you think about what you’re most excited about in the work that you guys are up to. What would that be?
Dr. Aysha Akhtar:
As a neurologist, I can’t tell you how many how miserable it is to tell a patient that you have Parkinson’s disease or your mom has Alzheimer’s disease or to diagnose some young person with amyotrophic lateral sclerosis or Lou Gehrig’s disease, because I know that there is almost nothing that we can offer to those patients. They are horrible diseases to be diagnosed with. I wouldn’t wish it on my worst enemy. They’re just truly horrible diseases to live with and we have nothing. And so I’m so excited about the possibility that one day I can offer patients something. Two of the workshops that we’re going to be initiating this summer through a Center for Contemporary Science is one is to look at Parkinson’s disease and the other is to look at Alzheimer’s disease. And we’re gathering a group of experts to really look at how could we use these new technologies to really accelerate the understanding of those diseases and then ultimately drug development and to create actual roadmaps for the larger biomedical community to follow. And so we’re really excited about that and the impact it can have on those diseases. We’re also going to be having one on vaccine efficacy studies, which, of course, is very timely with the pandemic. So I’m very excited about the possibility that one day we can tell patients who have neurological diseases that we actually do have something we can offer. And there’s something that can truly significantly improve your lives and maybe even cure the diseases you have.
Saul Marquez:
Well, that, Dr. Akhtar, is a feature that all of us could certainly subscribe to. And so your organization does great work. It is a nonprofit. And so there are opportunities for those interested to help with the mission. What’s the best place for them to do that? And where can they learn more and how they can help?
Dr. Aysha Akhtar:
Yes, we welcome help. Obviously, as we said, we’re a nonprofit, so we welcome financial contributions and we welcome the opportunity to form partnerships with other scientific institutions, investors, with funders who want to learn more about these new tools that they may be interested in funding. So our website is ContemporarySciences.org. You can look at Center for Contemporary Sciences is the full name of our organization.
Saul Marquez:
Fantastic. There’s a lot of different links and ways for you to learn how you can collaborate, contribute to the fantastic work that Dr. Akhgar and her team are up to over there. What would you leave us with here as far as things to be thinking about as we close today’s podcast?
Dr. Aysha Akhtar:
I would say that we are looking for anyone who has a fresh new approach to biomedical research. We would love to hear from you if you have a new approach that again, is based on human biology. If you have a new idea. Please reach out to us. We would love to hear about this idea. We would love to try to collaborate with you and work with you. I think again, the sky’s the limit here as far as the possibilities in testing methods that could be developed. And so we’re very excited about what’s ahead in our near future.
Saul Marquez:
Well, we thank you for the work you’re doing and certainly the promise that it holds for all of our future listeners. Just if you found inspiration in today’s episode with Dr. Akhtar, take action. Don’t just think about it. Reach out, learn more, figure out ways that you could do your part to further that mission. So Aysha, thank you so much. This has been super interesting. And we’re rooting for you guys.
Dr. Aysha Akhtar:
Thank you so much, Saul. It was great being here.
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