China’s domestically developed, long-acting experimental AIDS drug is undergoing a final review by the China Food and Drug Administration, the last stage in the approval process.

Different from traditional oral drugs that require daily use, but it’s a heavy burden for patients to take medicine every day for years. As a result, long-acting drugs are the future direction in developing innovative AIDS medicine. For Chinese patients, the number of oral drugs available in the domestic market is very limited, so there is an urgent need for drugs to solve the problem of drug resistance.

Zhao Yan, a treatment specialist at the National Center for AIDS said seven or eight oral drugs for AIDS are currently provided to patients for free. “The injection solution could give an alternative to patients ... if it could be included in the country’s health insurance system,” she said.

“Now very few patients are using drugs from the health insurance system, both because no differentiated drugs are provided and because the procedure is more complex and could harm their privacy,” she said. “New drugs will be broadly used only if the system can embrace more varieties of drugs.”

Albuvirtide went into the research and development stage in 2002 and entered phase three of clinical trials—a step to assure safety and effectiveness before market approval—in 2014. Phase three is the last round of clinical trials for new drug tests in China. If the drug can pass the reviews of the country’s drug watchdog, usually at least two rounds, it can then enter the market. The time needed for the review ranges from months to years.

Clinical trials showed that the new drug performs even better than the oral drugs being used. Most of the oral drugs for AIDS being used in China are generic drugs developed in the 1970s and „80s that are not so efficient. In terms of safety and effectiveness, evidence so far showed that Albuvirtide is better than most second-line drugs—drugs used when first-line standard drugs fail—in developed countries because of lower toxicity (毒性) and fewer side effects.

Worldwide, a number of long-acting AIDS drug are in development. None has been approved for sale. Only Albuvirtide and a few in the United States have entered phase three of clinical trials.

Serving Up Hope

Food allergies have been on the rise. In the US, it is now estimated that over 10 percent of the adult population has an allergy to peanuts, shellfish, dairy or another type of food. In the UK, the past three decades have seen hospital admissions for food allergies rise fivefold. Thankfully, we are building up the armory needed to reverse this trend so that, one day, such potentially deadly reactions become a thing of the past.

The most common types of food allergies are triggered by antibodies that we make called immunoglobulin (免疫球蛋白) E or IgE. These antibodies were discovered in the mid-1960s and kick-started an era of allergy research that is still going strong today. The early findings have spawned thousands of studies that paint an intricate (复杂的) picture of how allergies work, suggesting ways in which we can prevent and treat them.

When someone has a food allergy, IgE is involved in triggering a response when the immune system comes into contact with that food. Essentially, the body sees that part of your meal as an enemy, releasing histamine (组织胺) and other inflammatory chemicals in an attempt to deal with it. This causes symptoms ranging from itchiness and sneezes to wheezing (喘气) and anaphylactic shock (过敏性休克). The result can be anything from a mild inconvenience to death.

The old saying "prevention is better than the cure" holds true for food allergies. My colleagues and I use the so-called six Ds as a guide to preventative measures during childhood: diet, dirt, dogs, dry skin, detergents (清洁剂) and vitamin D. Studies have found that people have a lower risk of developing an allergy when, as youngsters, they eat a diverse diet and do so often, have healthy vitamin D levels, live in a home with a dog, avoid dry skin and are exposed to dirt, allowing them to develop a good microbiome (微生物组). The use of harsh detergents has also been associated with an increase in IgE.

Clearly, for many people that have food allergies, such early life prevention is no longer an option. However, other approaches are taking shape.

Most of the interventions we currently use target the immune system in an effort to retrain its response to allergens. One technique, known as allergen immunotherapy (免疫疗法), involves slowly building up exposure to a problem food. By starting in very small doses, the body appears to be able to be retrained to no longer see it as a threat. However, immunotherapy needs regular exposure to allergens, which can cause side effects.

Allergy vaccines are another option. These work by reshaping the body's immune response to a particular food so it doesn't end in illness.

As we gain evidence and experience with each of these approaches, we are moving closer to being able to treat all food allergies.

Imagine a simple blood test that could flag most kinds of cancers at the earliest, most curable stage. Liquid biopsies could, in theory, detect a tumor (肿瘤) well before it could be found by touch, symptoms or imaging. Blood tests could avoid the need for surgeons to cut tissue samples and make it possible to reveal cancer hiding in places needles and scalpels cannot safely reach. They could also determine what type of cancer is taking root to help doctors decide what treatment might work best to destroy it.

Liquid biopsies are not yet in hand, because it is hard to find definitive cancer signals in a tube of blood, but progress in recent years has been impressive. Last year the journal Science published the first big prospective study of a liquid biopsy for DNA and proteins from multiple types of cancers. Though far from perfect, the blood test called CancerSEEK found 26 tumors that had not been discovered with conventional screenings.

Liquid biopsies can rely on a variety of biomarkers in addition to tumor DNA and proteins, such as free-floating cancer cells themselves. But what makes the search difficult, Ana Robles, a cancer biologist of the National Cancer Institute, explains, is that “if you have an early-stage cancer or certain types of cancer, there might not be a lot of tumor DNA,” and tests might miss it. The ideal blood test will be both very specific and very sensitive so that even tiny tumors can be found. To tackle this challenge, CancerSEEK looks for cancer-specific mutations (突变) on 16 genes, and for eight proteins that are linked to cancer and for which there are highly sensitive tests.

Simple detection is not the only goal. An ideal liquid biopsy will also determine the likely location of the cancer so that it can be treated. “Mutations are often shared among different kinds of cancer, so if you find them in blood, you don’t know if that mutation is coming from a stomach cancer or lung cancer,” says Anirban Maitra, a cancer scientist at the Anderson Cancer Center. To solve that problem, some newer liquid biopsies look for changes in gene expression. Such changes, Maitra notes, are “more organ-specific”.

On the nearer horizon are liquid biopsies to help people already diagnosed with cancer. Last year the government approved the first two such tests, which scan for tumor DNA so doctors can select mutation-targeted drugs. Scientists are working on blood tests to detect the first signs of cancer recurrence (复发) in patients who have completed treatment. This work is moving fast, but does it save lives?

That is the question companies such as Thrive and Grail must answer for their broadly ambitious screening tests. “These companies have to prove that they can detect early cancer and, more important, that the early detection can have an impact on cancer survival,” Maitra observes.