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The Dorsal View

A case of ‘Brexit stage left’ for the EMA 

By now, you will of course be aware that the European Medicines Agency (EMA) will be located in Amsterdam in the wake of Brexit. It’s one of the first concrete indications of the practical realities of Britain’s ‘divorce’ from the EU — for a long time, Brexit has been an abstract concept with few tangible consequences.

Well, here’s one. And despite the charm offensive from Leo Varadkar and his cohorts, turning on the sweet-talk didn’t work and Dublin didn’t even make it to the final hurdle as a new home for the Agency.

It was a selection process so complicated and convoluted, it would put any hospital administrator to shame — it involved ministers from 27 EU countries and several rounds of votes. Each country had six votes in the first round, with three votes going to the first-choice location, two to the second choice, and one vote to the third choice.

In the first round, Milan received a total of 25 points, while Amsterdam and Copenhagen got 20 votes each. Bratislava received 15; Barcelona 13; Stockholm 12; Athens 10; Porto 10; Warsaw and Bucharest seven; Brussels and Helsinki five; Vienna four; and Bonn, Lille and Sofia three each (Ireland had withdrawn its bid at that stage).

Still awake? If you are indeed having trouble sleeping, there’s a 23-page document on the EU website explaining the process. That will do the trick.

Two more rounds of voting followed, after which only Amsterdam, Copenhagen and Milan remained in the picture. This was whittled-down to just Amsterdam and Milan, which were tied with each other.

So, following this labyrinthine process involving an unknown amount of expense and manpower, the final decision on the EMA’s new location was made by placing the names of the two cities into a bowl and picking one out! I kid you not.

To add insult to injury, Ireland also lost out to Paris in its bid to be the new location for the European Banking Authority following Brexit. This time, the process was a little more relaxed — instead of drawing the final winner out of a bowl, Paris was reportedly drawn out of a hat.

Ireland at least made it through to the final stage of the votes on this occasion.

After what we have been through in the past 10 years, the idea of a European banking regulator being based in Ireland would have been deliciously ironic.

And then there’s the Rugby World Cup bid… but nice try, Drico.

Gene genies?   

History is replete with instances of people who were willing to self-experiment in the interests of medicine/scientific advancement/evolutionary progress/fame/money/all of the above. The latest and most well-known of these is bioscientist Dr Josiah Zayner, who injected himself with genome-editing clustered regularly-interspaced short palindromic repeats (CRISPR) in an attempt to ‘bio-hack’ the muscles in his forearm.

His company, The Odin, allows any member of the public to purchase a CRISPR kit online. While people are advised that the kits are ‘not intended for human use’, history is also full of examples of spectacular human stupidity, so no doubt Dr Zayner’s kits are accompanied by a bullet-proof disclaimer.

A more medically-related advance in gene-editing therapy occurred last month, when, for the first time, US scientists attempted to edit a gene in vivo in an attempt to cure Hunter syndrome in a 44-year-old man. If you’re feeling a little rusty, Hunter syndrome — also called mucopolysaccharidosis II, or MPS II — is a lysosomal storage disease caused by a deficient or absent enzyme, iduronate-2-sulfatase. In the most severe cases, it can result in death or life-limiting disability.

Scientists in a California hospital applied zinc finger nucleases in an effort to target a deficient gene in the liver of Brian Madeux. It’s a very specific type of gene editing, as opposed to the sometimes broad-brush approach of regular CRISPR editing.

The initial results should be known sometime this month, and more definitive outcomes should be more observable in the first quarter of 2018.

Gene editing has its critics and there is understandable caution around the field. But if advancements in recent years are anything to go by, perhaps in our children’s lifetime, access to genetic manipulation could see an unrecognisable landscape in the treatment of inherited genetic conditions — do-it-yourself home CRISPR kits not withstanding.

But the genie is well and truly out of the bottle.

First time for everything

My thanks to the colleague who relayed this quick gag to me. All contributions are gratefully received at the email address below.

As the anaesthesia starts to kick-in, the trembling patient says to his surgeon: “Doctor, I’m so nervous… this is my first operation.”

The doc replies: “Calm down and don’t worry — it’s my first operation too.”

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