The Path to a Better Tuberculosis Vaccine Runs Through Montana
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A team of Montana researchers is playing a key role in the development of a more effective vaccine against tuberculosis, an infectious disease that has killed more people than any other.
The BCG (Bacille Calmette-Guérin) vaccine, created in 1921, remains the sole TB vaccine. While it is 40% to 80% effective in young children, its efficacy is very low in adolescents and adults, leading to a worldwide push to create a more powerful vaccine.
One effort is underway at the University of Montana Center for Translational Medicine. The center specializes in improving and creating vaccines by adding what are called novel adjuvants. An adjuvant is a substance included in the vaccine, such as fat molecules or aluminum salts, that enhances the immune response, and novel adjuvants are those that have not yet been used in humans. Scientists are finding that adjuvants make for stronger, more precise, and more durable immunity than antigens, which create antibodies, would alone.
Eliciting specific responses from the immune system and deepening and broadening the response with adjuvants is known as precision vaccination. “It’s not one-size-fits-all,” said Ofer Levy, a professor of pediatrics at Harvard University and the head of the Precision Vaccines Program at Boston Children’s Hospital. “A vaccine might work differently in a newborn versus an older adult and a middle-aged person.”
The ultimate precision vaccine, said Levy, would be lifelong protection from a disease with one jab. “A single-shot protection against influenza or a single-shot protection against covid, that would be the holy grail,” Levy said.
Jay Evans, the director of the University of Montana center and the chief scientific and strategy officer and a co-founder of Inimmune, a privately held biotechnology company in Missoula, said his team has been working on a TB vaccine for 15 years. The private-public partnership is developing vaccines and trying to improve existing vaccines, and he said it’s still five years off before the TB vaccine might be distributed widely.
It has not gone unnoticed at the center that this state-of-the-art vaccine research and production is located in a state that passed one of the nation’s most extreme anti-vaccination laws during the pandemic in 2021. The law prohibits businesses and governments from discriminating against people who aren’t vaccinated against covid-19 or other diseases, effectively banning both public and private employers from requiring workers to get vaccinated against covid or any other disease. A federal judge later ruled that the law cannot be enforced in health care settings, such as hospitals and doctors’ offices.
In mid-March, the Bill & Melinda Gates Medical Research Institute announced it had begun the third and final phase of clinical trials for the new vaccine in seven countries. The trials should take about five years to complete. Research and production are being done in several places, including at a manufacturing facility in Hamilton owned by GSK, a giant pharmaceutical company.
Known as the forgotten pandemic, TB kills up to 1.6 million people a year, mostly in impoverished areas in Asia and Africa, despite its being both preventable and treatable. The U.S. has seen an increase in tuberculosis over the past decade, especially with the influx of migrants, and the number of cases rose by 16% from 2022 to 2023. Tuberculosis is the leading cause of death among people living with HIV, whose risk of contracting a TB infection is 20 times as great as people without HIV.
“TB is a complex pathogen that has been with human beings for ages,” said Alemnew Dagnew, who heads the program for the new vaccine for the Gates Medical Research Institute. “Because it has been with human beings for many years, it has evolved and has a mechanism to escape the immune system. And the immunology of TB is not fully understood.”
The University of Montana Center for Translational Medicine and Inimmune together have 80 employees who specialize in researching a range of adjuvants to understand the specifics of immune responses to different substances. “You have to tailor it like tools in a toolbox towards the pathogen you are vaccinating against,” Evans said. “We have a whole library of adjuvant molecules and formulations.”
Vaccines are made more precise largely by using adjuvants. There are three basic types of natural adjuvants: aluminum salts; squalene, which is made from shark liver; and some kinds of saponins, which are fat molecules. It’s not fully understood how they stimulate the immune system. The center in Missoula has also created and patented a synthetic adjuvant, UM-1098, that drives a specific type of immune response and will be added to new vaccines.
One of the most promising molecules being used to juice up the immune system response to vaccines is a saponin molecule from the bark of the quillay tree, gathered in Chile from trees at least 10 years old. Such molecules were used by Novavax in its covid vaccine and by GSK in its widely used shingles vaccine, Shingrix. These molecules are also a key component in the new tuberculosis vaccine, known as the M72 vaccine.
But there is room for improvement.
“The vaccine shows 50% efficacy, which doesn’t sound like much, but basically there is no effective vaccine currently, so 50% is better than what’s out there,” Evans said. “We’re looking to take what we learned from that vaccine development with additional adjuvants to try and make it even better and move 50% to 80% or more.”
By contrast, measles vaccines are 95% effective.
According to Medscape, around 15 vaccine candidates are being developed to replace the BCG vaccine, and three of them are in phase 3 clinical trials.
One approach Evans’ center is researching to improve the new vaccine’s efficacy is taking a piece of the bacterium that causes TB, synthesizing it, and combining it with the adjuvant QS-21, made from the quillay tree. “It stimulates the immune system in a way that is specific to TB and it drives an immune response that is even closer to what we get from natural infections,” Evans said.
The University of Montana center is researching the treatment of several problems not commonly thought of as treatable with vaccines. They are entering the first phase of clinical trials for a vaccine for allergies, for instance, and first-phase trials for a cancer vaccine. And later this year, clinical trials will begin for vaccines to block the effects of opioids like heroin and fentanyl. The University of Montana received the largest grant in its history, $33 million, for anti-opioid vaccine research. It works by creating an antibody that binds with the drug in the bloodstream, which keeps it from entering the brain and creating the high.
For now, though, the eyes of health care experts around the world are on the trials for the new TB vaccines, which, if they are successful, could help save countless lives in the world’s poorest places.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
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How Useful Are Our Dreams
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What’s In A Dream?
We were recently asked:
❝I have a question or a suggestion for coverage in your “Psychology Sunday”. Dreams: their relevance, meanings ( if any) interpretations? I just wondered what the modern psychological opinions are about dreams in general.❞
~ 10almonds subscriber
There are two main schools of thought, and one main effort to reconcile those two. The third one hasn’t quite caught on so far as to be considered a “school of thought” yet though.
The Top-Down Model (Psychoanalysts)
Psychoanalysts broadly follow the theories of Freud, or at least evolved from there. Freud was demonstrably wrong about very many things. Most of his theories have been debunked and ditched—hence the charitable “or at least evolved from there” phrasing when it comes to modern psychoanalytic schools of thought. Perhaps another day, we’ll go into all the ways Freud went wrong. However, for today, one thing he wasn’t bad at…
According to Freud, our dreams reveal our subconscious desires and fears, sometimes directly and sometimes dressed in metaphor.
Examples of literal representations might be:
- sex dreams (revealing our subconscious desires; perhaps consciously we had not thought about that person that way, or had not considered that sex act desirable)
- getting killed and dying (revealing our subconscious fear of death, not something most people give a lot of conscious thought to most of the time)
Examples of metaphorical representations might be:
- dreams of childhood (revealing our subconscious desires to feel safe and nurtured, or perhaps something else depending on the nature of the dream; maybe a return to innocence, or a clean slate)
- dreams of being pursued (revealing our subconscious fear of bad consequences of our actions/inactions, for example, responsibilities to which we have not attended, debts are a good example for many people; or social contact where the ball was left in our court and we dropped it, that kind of thing)
One can read all kinds of guides to dream symbology, and learn such arcane lore as “if you dream of your teeth crumbling, you have financial worries”, but the truth is that “this thing means that other thing” symbolic equations are not only highly personal, but also incredibly culture-bound.
For example:
- To one person, bees could be a symbol of feeling plagued by uncountable small threats; to another, they could be a symbol of abundance, or of teamwork
- One culture’s “crow as an omen of death” is another culture’s “crow as a symbol of wisdom”
- For that matter, in some cultures, white means purity; in others, it means death.
Even such classically Freudian things as dreaming of one’s mother and/or father (in whatever context) will be strongly informed by one’s own waking-world relationship (or lack thereof) with same. Even in Freud’s own psychoanalysis, the “mother” for the sake of such analysis was the person who nurtured, and the “father” was the person who drew the nurturer’s attention away, so they could be switched gender roles, or even different people entirely than one’s parents.
The only real way to know what, if anything, your dreams are trying to tell you, is to ask yourself. You can do that…
- by reflection and personal interrogation (see for example: The Easiest Way To Take Up Journaling)
- or by externalising parts of your subconscious (as in Internal Family Systems therapy)
- or by talking directly to your subconscious where it is, by means of lucid dreaming.
The idea with lucid dreaming is that since any dream character is a facet of your subconscious generated by your own mind, by talking to that character you can ask questions directly of your subconscious (the popular 2010 movie “Inception” was actually quite accurate in this regard, by the way).
To read more about how to do this kind of self-therapy through lucid dreaming, you might want to check out this book we reviewed previously; it is the go-to book of lucid dreaming enthusiasts, and will honestly give you everything you need in one go:
Lucid Dreaming: A Concise Guide to Awakening in Your Dreams and in Your Life – by Dr. Stephen LaBerge
The Bottom-Up Model (Neuroscientists)
This will take a lot less writing, because it’s practically a null hypothesis (i.e., the simplest default assumption before considering any additional evidence that might support or refute it; usually some variant of “nothing unusual going on here”).
The Bottom-Up model holds that our brains run regular maintenance cycles during REM sleep (a biological equivalent of defragging a computer), and the brain interprets these pieces of information flying by and, because of the mind’s tendency to look for patterns, fills in the rest (much like how modern generative AI can “expand” a source image to create more of the same and fill in the blanks), resulting in the often narratively wacky, but ultimately random, vivid hallucinations that we call dreams.
The Hybrid Model (per Cartwright, 2012)
This is really just one woman’s vision, but it’s an incredibly compelling one, that takes the Bottom-Up model and asks “what if we did all that bio-stuff, and then our subconscious mind influenced the interpretation of the random patterns, to create dreams that are subjectively meaningful, and thus do indeed represent our subconscious?
It’s best explained in her own words, though, so it’s time for another book recommendation (we’ve reviewed this one before, too):
Enjoy!
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The Philosophy Gym – by Dr. Stephen Law
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If you’d like to give those “little gray cells” an extra workout, this book is a great starting place.
Dr. Stephen Law is Director of Philosophy at the Department of Continuing Education, University of Oxford. As such, he’s no stranger to providing education that’s both attainable and yet challenging. Here, he lays out important philosophical questions, and challenges the reader to get to grips with them in a systematic fashion.
Each of the 25 questions/problems has a chapter devoted to it, and is ranked:
- Warm-up
- Moderate
- More Challenging
But, he doesn’t leave us to our own devices, nor does he do like a caricature of a philosopher and ask us endless rhetorical questions. Instead, he looks at various approaches taken by other philosophers over time, and invites the reader to try out those methods.
The real gain of this book is not the mere enjoyment of reading, but rather in taking those thinking skills and applying them in life… because most if not all of them do have real-world applications and/or implications too.
The book’s strongest point? That it doesn’t assume prior knowledge (and yet also doesn’t patronize the reader). Philosophy can be difficult to dip one’s toes into without a guide, because philosophers writing about philosophy can at first be like finding yourself at a party where you know nobody, but they all know each other.
In contrast, Law excels at giving quick, to-the-point ground-up summaries of key ideas and their progenitors.
In short: a wonderful way to get your brain doing things it might not have tried before!
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Eat to Beat Depression and Anxiety – by Dr. Drew Ramsey
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Most of us could use a little mood boost sometimes, and some of us could definitely stand to have our baseline neurochemistry elevated a bit. We’ve probably Googled “foods to increase dopamine”, and similar phrases. So, why is this a book, and not just an article saying to eat cashews and dark chocolate?
Dr. Drew Ramsey takes a holistic approach to health. By this we mean that to have good health, the whole body and mind must be kept healthy. Let a part slip, and the others will soon follow. Improve a part, and the others will soon follow, too.
Of course, there is only so much that diet can do. Jut as no diet will replace a Type 1 Diabetic’s pancreas with a working one, no diet will treat the causes of some kinds of depression and anxiety.
For this reason, Dr. Ramsey, himself a psychiatrist (and a farmer!) recommends a combination of talking therapy and diet, with medications as a “third leg” to be included when necessary. The goal, for him, is to reduce dependence on medications, while still recognizing when they can be useful or even necessary.
As for the practical, actionable advices in the book, he does (unsurprisingly) recommend a Mediterranean diet. Heavy on the greens and beans, plenty of colorful fruit and veg, small amounts of fish and seafood, even smaller amounts of grass-fed beef and fermented dairy. He also discusses a bunch of “superfoods” he particularly recommends.
Nor does he just hand-wave the process; he talks about the science of how and why each of these things helps.
And in practical terms, he even devotes some time to helping the reader get our kitchen set up, if we’re not already ready-to-go in that department. He also caters to any “can’t cook / won’t cook” readers and how to work around that too.
Bottom line: if you’d like to get rewiring your brain (leveraging neuroplasticity is a key component of the book), this will get you on track. A particular strength is how the author “thinks of everything” in terms of common problems that people (especially: depressed and anxious people!) might have in implementing his advices.
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In the Realm of Hungry Ghosts – by Dr. Gabor Maté
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We’ve reviewed books by Dr. Maté before, and this one’s about addiction. We’ve reviewed books about addiction before too, so what makes this one different?
Wow, is this one so different. Most books about addiction are about “beating” it. Stop drinking, quit sugar, etc. And, that’s all well and good. It is definitely good to do those things. But this one’s about understanding it, deeply. Because, as Dr. Maté makes very clear, “there, but for the grace of epigenetics and environmental factors, go we”.
Indeed, most of us will have addictions; they’re (happily) just not too problematic for most of us, being either substances that are not too harmful (e.g. coffee), or behavioral addictions that aren’t terribly impacting our lives (e.g. Dr. Maté’s compulsion to keep buying more classical music, which he then tries to hide from his wife).
The book does also cover a lot of much more serious addictions, the kind that have ruined lives, and the kind that definitely didn’t need to, if people had been given the right kind of help—instead of, all too often, they got the opposite.
Perhaps the greatest value of this book is that; understanding what creates addiction in the first place, what maintains it, and what help people actually need.
Bottom line: if you’d like more insight into the human aspect of addiction without getting remotely wishy-washy, this book is probably the best one out there.
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An Underrated Tool Against Alzheimer’s
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Dementia in general, and Alzheimer’s in particular, affects a lot of people, and probably even more than the stats show, because some (estimated to be: about half) will go undiagnosed and thus unreported:
Alzheimer’s: The Bad News And The Good
At 10almonds, we often talk about brain health, whether from a nutrition standpoint or other lifestyle factors. For nutrition, by the way, check out:
Today we’ll be looking at some new science for an underrated tool:
Bilingualism as protective factor
It’s well-known that bilingualism offers brain benefits, but most people would be hard-pressed to name what, specifically, those brain benefits are.
As doctors Kristina Coulter and Natalie Phillips found in a recent study, one of the measurable benefits may be a defense against generalized (i.e. not necessarily language-related) memory loss Alzheimer’s disease.
Specifically,
❝We used surface-based morphometry methods to measure cortical thickness and volume of language-related and AD-related brain regions. We did not observe evidence of brain reserve in language-related regions.
However, reduced hippocampal volume was observed for monolingual, but not bilingual, older adults with AD. Thus, bilingualism is hypothesized to contribute to reserve in the form of brain maintenance in the context of AD.❞
Read in full: Bilinguals show evidence of brain maintenance in Alzheimer’s disease
This is important, because while language is processed in various parts of the brain beyond the scope of this article, the hippocampi* are where memory is stored.
*usually mentioned in the singular as “hippocampus”, but you have one on each side, unless some terrible accident or incident befell you.
What this means in practical terms: these results suggest that being bilingual means we will retain more of our capacity for memory, even if we get Alzheimer’s disease, than people who are monolingual.
Furthermore, while we’re talking practicality:
❝…our subsample may be characterized as mostly late bilinguals (i.e., learning an L2 after age 5), having moderate self-reported L2 ability, and relatively few participants reporting daily L2 use (33 out of 119)❞
(L2 = second language)
This is important, because it means you don’t have to have grown up speaking multiple languages, you don’t even have to speak it well, and you don’t have to be using your second language(s) on a daily basis, to enjoy benefits. Merely having them in your head appears to be sufficient to trigger the brain to go “oh, we need to boost and maintain the hippocampal volume”.
We would hypothesize that using second language(s) regularly and/or speaking second language(s) well offers additional protection, and the data would support this if it weren’t for the fact that the sample sizes for daily and high-level speakers are a bit small to draw conclusions.
But the important part is: simply knowing another language, including if you literally just learned it later in life, is already protective of hippocampal volume in the context of Alzheimer’s disease.
Here’s a pop-science article about the study, that goes into it in more detail than we have room to here:
Bilingualism linked to greater brain resilience in older adults
Want to learn a new language?
Here are some options where you can get going right away:
If you are thinking “sounds good, but learning a language is too much work”, then that is why we included that third option there. It’s specifically for one language, and that language is Esperanto, arguably the world’s easiest language and specifically designed to be super quick and easy to get good at. Also, it’s free!
Do, kial ne lerni novan lingvon rapide kaj facile? 😉
Want to know more?
For ways to reduce your overall Alzheimer’s risk according to science, check out:
Take care!
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Blueberry & Banana Collagen Baked Oats
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Good news for vegans/vegetarians! While we include an optional tablespoon of collagen powder in this recipe, the whole recipe is already geared around collagen synthesis, so it’s very collagen-boosting even with just the plants, providing collagen’s building blocks of protein, zinc, and vitamins C and D (your miraculous body will use these to assemble the collagen inside you).
You will need
- 2 cups oats, whence the protein and zinc
- 1 cup milk (your preference what kind; we recommend almond for flavor; whether you choose plant or animal though, it should be fortified with vitamin D)
- 2 bananas, peeled and mashed
- 4 oz blueberries, whence the vitamin C (frozen is fine) (chopped dried apricots are also a fine substitute if that’s more convenient)
- 1 oz flaked almonds, whence the protein and zinc
- 1 tbsp pumpkin seeds, whence the protein and zinc
- 1 tbsp flax seeds, whence the protein and zinc
- Optional: 1 tbsp maple syrup
- Optional: 1 tbsp collagen powder, dissolved in 1 oz hot water
Method
(we suggest you read everything at least once before doing anything)
1) Preheat the oven to 350℉ / 180℃.
2) Mix the oats with 2 cups boiling water; allow to stand for 10–15 minutes, and then drain any excess water.
3) Mix the mashed bananas with the remaining ingredients except the milk and blueberries, stirring thoroughly.
4) Add the softened oats, and stir those in thoroughly too.
5) Add the milk and blueberries, in that order, stirring gently if using fresh blueberries, lest they get crushed.
6) Pour the mixture into an 8″ square cake tin that you have lined with baking paper, and smooth the top.
7) Bake for about 40 minutes or until firm and golden brown. Allow to cool; it will firm up more while it does.
8) Cut into squares or bars, and serve or store for later.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
We Are Such Stuff As Fish Are Made Of ← our main feature about collagen
Take care!
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