[HN Gopher] Huntington's disease treated for first time
       ___________________________________________________________________
        
       Huntington's disease treated for first time
        
       Author : _zie
       Score  : 394 points
       Date   : 2025-09-24 11:37 UTC (11 hours ago)
        
 (HTM) web link (www.bbc.com)
 (TXT) w3m dump (www.bbc.com)
        
       | petesergeant wrote:
       | More information on the approach:
       | https://www.uniqure.com/programs-pipeline/huntingtons-diseas...
       | 
       | > AMT-130 consists of an AAV5 vector carrying an artificial
       | micro-RNA specifically tailored to silence the huntingtin gene,
       | leveraging our proprietary miQURE(tm) silencing technology. The
       | therapeutic goal is to inhibit the production of the mutant
       | protein (mHTT)
       | 
       | and the actual announcement: https://uniqure.gcs-web.com/news-
       | releases/news-release-detai...
       | 
       | > 75% slowing of disease progression as measured by Unified
       | Huntington's Disease Rating Scale (p=0.003)
       | 
       | > 60% slowing of disease progression as measured by Total
       | Functional Capacity (p=0.033)
       | 
       | > 88% slowing of disease progression as measured by Symbol Digit
       | Modalities Test (p=0.057)
       | 
       | > 113% slowing of disease progression as measured by Stroop Word
       | Reading Test (p=0.0021)
       | 
       | > 59% slowing of disease progression as measured by Total Motor
       | Score (p=0.1741)
        
         | basisword wrote:
         | What do those progression numbers mean in terms of outlook? For
         | example, if someone is treated before showing symptoms (as they
         | know they inherit it) is the progression slowing enough to give
         | them a normal life expectancy and quality of life?
        
           | CookiesOnMyDesk wrote:
           | It's covered in the article
           | 
           | >It means the decline you would normally expect in one year
           | would take four years after treatment, giving patients
           | decades of "good quality life", Prof Sarah Tabrizi told BBC
           | News.
           | 
           | >The first symptoms of Huntington's disease tend to appear in
           | your 30s or 40s and is normally fatal within two decades -
           | opening the possibility that earlier treatment could prevent
           | symptoms from ever emerging.
        
             | didgeoridoo wrote:
             | I don't think this quite answers the curiosity of whether
             | starting treatment e.g. at birth would virtually eliminate
             | morbidity, or whether it only slows the decline once it has
             | started.
             | 
             | Consider that the disease typically manifests in your 30s
             | -- does this mean it would begin 4x later (and thus
             | basically never manifest), or that your 15 year progressive
             | decline from ~35-50 would take 4x longer (giving you a
             | normal lifespan, albeit perhaps with some limitations in
             | your later years)?
        
               | sleight42 wrote:
               | To me, as an HD widower, it would have meant that my dead
               | wife would had lived until 2043 and had a decade more of
               | a mostly normal life.
        
         | bjornsing wrote:
         | Why does it have to be delivered through brain surgery?
        
           | JoshTriplett wrote:
           | Guessing: bypassing the blood-brain barrier.
        
           | adcoleman6 wrote:
           | I'm assuming the viral vector can't pass the blood-brain
           | barrier.
        
             | bjornsing wrote:
             | But it doesn't take 10+ hours to surgically get a virus
             | across the blood-brain barrier, right?
        
               | devilbunny wrote:
               | The video specifies that the drug is infused over 8-10
               | hours. Probe placement - again, as depicted in the video,
               | because I don't see a real methods section - should take
               | about 1-2 hours. The video isn't clear if this is
               | interactive MRI or just a preop scan that is then loaded
               | into a stereotactic navigation system in a regular
               | operating room, but the former would add another hour at
               | least. MRI is not fast.
        
           | Sebalf wrote:
           | The major hurdle of current gene therapies is delivery to the
           | tissue where the defective gene product is causing damage.
           | For instance lipid nanoparticles are only being used to
           | deliver gene therapies to the liver, because if you inject
           | them they just end up there and not much anywhere else. In
           | this case they are using an virus called "adeno asociated
           | virus 5" (AAV5), which does not naturally infect the brain
           | AFAIK. The blood brain barrier (basically just extra
           | impermeable blood vessels), as well as other immunological
           | features in brain tissue, evolved specifically to keep the
           | brain as unaffected as possible from anything bad going on in
           | the body, seeing as any infection/poisoning of the brain is
           | varying degrees of catastrophic and would easily kill you in
           | the ancestral environment.
           | 
           | I don't know the details of why AAV5 in particular is their
           | vector of choice in this case, but for whatever reason thats
           | what they've gone with. AFAIK there are no viral or other
           | vectors that consistently infect all brain tissue when
           | injected/ingested, so maybe that's just the best option
           | available. Anyways, it seems that in order to get it to the
           | actual brain tissue that is damaged by the huntington protein
           | (all of it? One particular area?), the best way is to inject
           | it where it needs to go. If you could just pump it into the
           | CSF that would perhaps make things a little bit more
           | tolerable, seeing as you could then just do a spinal tap and
           | inject it that way, but apparently that doesn't work. Or
           | maybe a generalized AAV5 infection has more side effect then
           | targeted injections. Just speculating here.
        
             | bjornsing wrote:
             | I guess it needs to get across the blood-brain barrier. But
             | that shouldn't take 10+ hours of surgery, I don't think.
        
               | mattkrause wrote:
               | Surgery can be slow, and brain surgery doubly so.
               | 
               | The brain is slightly elastic, so you'd want to advance a
               | needle glacially slowly (microns/second) into it so it
               | ends up at the right position. The injection itself is
               | also done slowly (microliters/minute) so you don't cause
               | pressure damage.
               | 
               | They might also do some intraoperative imaging (some ORs
               | have MRI or CT machines), which slows things down, and of
               | course there's tons of cleaning and repair work
               | afterward.
        
           | jmcgough wrote:
           | The brain-blood barrier typically only allows small, non-
           | polar molecules to pass through into the brain, which
           | complicates a lot of neuro/psych treatments.
        
         | saretup wrote:
         | What does 113% slowing mean? I thought if the speed is x then
         | 80% slowing means the speed is now 0.2x
        
           | nicoburns wrote:
           | Perhaps it means the effects of the disease are actually
           | reversed?
        
             | tkfoss wrote:
             | "The data also shows the treatment is saving brain cells.
             | Levels of neurofilaments in spinal fluid - a clear sign of
             | brain cells dying - should have increased by a third if the
             | disease continued to progress, but was actually lower than
             | at the start of the trial."
        
         | sleight42 wrote:
         | It always seemed that an mRNA treatment was going to be the way
         | forward for treating HD, speaking as an HD widower.
         | 
         | And here my government is actively working to suppress mRNA
         | therapies because of fucking politics. Fuck them.
        
           | AudiomaticApp wrote:
           | This isn't an mRNA treatment. The m in mRNA stands for
           | "messenger", not micro. mRNA covid vaccines don't mess with
           | the genome anything like this treatment does, and indeed,
           | this treatment is much more dangerous than any vaccine would
           | be.
        
         | qnleigh wrote:
         | Thanks for sharing this information. Do you (or anyone else
         | here) know if these trends might be expected based on how the
         | treatment works? For example, given than the treatment is only
         | injected into certain parts of the brain, could we expect that
         | some aspects of the disease will be treated better than others?
        
       | OskarS wrote:
       | This is incredible, what a miraculous thing for sufferers and
       | their families. Feels rare to see such a such an unquestionably
       | good news story these days.
        
       | tomrod wrote:
       | Quick skimmed, is there a peer reviewed paper?
        
         | mbreese wrote:
         | I don't see one yet -- but the main people mentioned in the
         | article have a long publication record on Huntington's. This
         | trial has been going on for a while and this is an interim
         | media report. I don't think they've reached an endpoint yet.
         | 
         | I believe this is the clinical trial they are reporting on:
         | https://clinicaltrials.gov/study/NCT04120493
         | 
         | This trial also appears be open at UCSF...
        
           | tomrod wrote:
           | Awesome
        
       | goatherders wrote:
       | Wow. Just an incredible medical development
        
       | karmelapple wrote:
       | What part of this discovery was made thanks to NIH and/or NSF
       | funding from the USA, or the NIHR in the UK?
       | 
       | I don't ask to strictly bring up politics, but instead to try and
       | address the broad lack of understanding of how medical
       | breakthroughs like this are made.
       | 
       | It's not done just by drug companies. The article says:
       | 
       | > UniQure says it will apply for a licence in the US in the first
       | quarter of 2026 with the aim of launching the drug later that
       | year.
       | 
       | That's true, but that doesn't talk about the tens to hundreds of
       | research papers that have been published over likely decades to
       | make this discovery a reality. And it doesn't talk about how much
       | public money went into this discovery.
       | 
       | Many people reading this article probably have a vague idea that
       | more than just this company was involved, but I feel it is not at
       | all clear to the vast majority of people, since the vast majority
       | of people are not involved in biomedical research.
       | 
       | I wish there was an easy way to figure out how many dollars, how
       | many grants, how many researchers, went into achieving this
       | breakthrough. And that the media would put that into news
       | articles like this. Trace all the citations back a few orders,
       | and I bet you'll find a massive number of NIH and NIHR grants.
       | 
       | There is unfortunately not more massive, bipartisan public outcry
       | in the US over defunding the essential basic research the NIH
       | does... and it's not new to the current administration, since it
       | was attempted to be done back in 2017, too [1].
       | 
       | Scientists need better messaging or else we're going to stop
       | having breakthroughs like this... and the breakthroughs are
       | already going to slow down thanks to things like the $783 million
       | in cuts to NIH grants that the US SCOTUS authorized in August
       | [2].
       | 
       | 1. https://pmc.ncbi.nlm.nih.gov/articles/PMC5468112/
       | 
       | 2. https://www.scotusblog.com/2025/08/supreme-court-allows-
       | trum...
        
         | amelius wrote:
         | It's standing on the shoulders of giants, and the one on top
         | gets to reap all the benefits.
        
           | mattkrause wrote:
           | Even that quote is a bit of a disservice to modern science:
           | it's a massive pyramid made of thousands and thousands of
           | individual contributions, including many bits of deep
           | background and outright "failures".
           | 
           | Biology is tough in that you can't just "reason" your way to
           | success; it often really does require trying something to see
           | if an approach works.
        
         | jmcgough wrote:
         | > Scientists need better messaging or else we're going to stop
         | having breakthroughs like this
         | 
         | Sure, but it's really sad that scientists need to justify their
         | funding to the public - they already spend so much time
         | justifying it to the NIH and others for funding.
         | 
         | So many people have had their careers jeopardized by finding
         | pulled mid-project. I am really concerned about our research
         | pipeline, because my post-doc friends are all applying to jobs
         | outside the US now.
        
           | mattkrause wrote:
           | This is where the funders really ought to step up.
           | 
           | A spokesperson from (say) NINDS really ought to be shouting
           | to anyone who will listen about how excited they are to see
           | their <many year>, <many dollar> investment in Huntington's
           | pay off.
           | 
           | I'd love it if they highlighted some of the especially
           | "weird" studies that went into this to demonstrate how
           | important _fundamental_ research is and how it goes in
           | unexpected directions.
        
           | drstewart wrote:
           | >Sure, but it's really sad that scientists need to justify
           | their funding to the public
           | 
           | No, it's not sad that you need to justify the use of public
           | money.
           | 
           | Unless you think it's sad that the military needs to justify
           | their funding to the public to get more. The military could
           | have a $2 trillion dollar budget but people would ask "why!"
           | when it clearly doesn't need to be justified. Agree?
           | 
           | Here's another thing you'll no doubt agree on: we should fund
           | science with no justifications - I say that we need a $100b
           | invested into more research into the link between vaccines
           | and autism. No justification needed, of course.
        
             | conception wrote:
             | You missed the second part of that sentence buddy.
             | 
             | Your examples would match if every base commander had to
             | write public messaging on their bases' budgets and
             | projects.
        
             | xphos wrote:
             | > No, it's not sad that you need to justify the use of
             | public money.
             | 
             | You don't ask your plumber which computer network you
             | should build for a fortune 500 company for the same reason
             | I don't ask a computer programmer how to fix leaky pipes.
             | People who study in an area actually have much stronger
             | basis for having opinions rather than keyboard warriors who
             | are upset that there mythological studies have been
             | debunked time and time again. That's not science that is
             | cult behavior. If you want to influence that decision
             | process work in that field and provide justifications for
             | that vaccine research and some new angle that's been
             | missed. The American public is not a intelligent member of
             | the medical community there opinion should not have the
             | same weight in day to day operations as the medical
             | community. They can allocate an amount we want to do
             | research and should ask the NIH to do board research
             | because that is effective and has an overwhelmingly strong
             | record having done the background research for basically
             | ever medical advancement made for a long long time.
             | 
             | So, no I think we should allow a panel of experts to
             | evaluate what is worth funding in research. Give the NIH a
             | budget to hire a panel of field experts like they have been
             | for a long time and fund research that panel says is worth
             | it. Autism and vaccine linkage is studied and has been
             | shown several times to have no strong correlation with
             | vaccination. The idea we need to study that more is stupid
             | and experts say it is stupid because it steals funding from
             | actual research into other environmental factors that
             | haven't been studied yet. Maybe its PFAS chemicals maybe
             | its something else.
        
               | zdragnar wrote:
               | That's a fantastic way to fall victim to grift. Your
               | "panel of experts" can easily be as biased as anyone
               | else.
               | 
               | When you give people vast authority on the basis of their
               | expertise (even assuming the expertise is genuine),
               | anything that challenges it becomes not a novel idea
               | worth exploring, but a direct challenge to their
               | authority.
               | 
               | Planck's principle- that science advances one funeral at
               | a time- is rather apropos here.
        
         | oulipo2 wrote:
         | I'm pretty sure some of it is direct funding by governmental
         | agencies, but even if that wasn't the case, all the basis of
         | the theory, and the groundwork was laid by researchers and
         | universities using those grants. You need public money for a
         | healthy society
        
         | sleight42 wrote:
         | There's little money to be made with HD. It's a 1 in 30,000
         | disease. There's been little reason for anyone other than state
         | sponsors to support its treatment. Add this to the reason's to
         | be disgusted by capitalism. Spoken as a widower of an HD wife.
        
           | missedthecue wrote:
           | I'm sorry to hear about the passing of your wife.
           | 
           | How common a disease is doesn't have much to do with
           | treatment efforts. Cystic Fibrosis has practically been cured
           | by Big Pharma and only ~40,000 people in the entire US have
           | it.
        
             | pkaye wrote:
             | That is because the Cystic Fibrosis foundation funded some
             | of the research and drug development to make the first
             | treatment possible. They had to essentially operate in a VC
             | model to get the treatments that these CF patients need.
             | 
             | https://www.cff.org/about-us/our-venture-philanthropy-model
        
               | missedthecue wrote:
               | Most disease categories have advocacy and funding groups,
               | with varying amounts of success. The point is that rare
               | diseases get new treatments all the time from private
               | for-profit firms. In fact, orphan diseases are extremely
               | profitable, and the FDA offers fast tracked approval
               | decisions, making them an enticing niche to focus on.
        
           | kulahan wrote:
           | It really has nothing to do with capitalism. There are
           | special grants in the US for researching rare diseases,
           | specifically to ensure money isn't the barrier.
           | 
           | As an aside because I'm pedantic about the language,
           | apostrophes are _never_ used to show pluralism.
        
             | jjtheblunt wrote:
             | > apostrophes are never used to show pluralism.
             | 
             | in Dutch they are for some words, e.g., 1 ski, 2 ski's. i
             | have no idea how that arose historically.
        
               | kulahan wrote:
               | The Nords are a pox upon us all. TIL though, thanks - I
               | probably should've been clear I only meant in English :)
        
             | karmelapple wrote:
             | I am scared that special grants to research rare diseases
             | will go away, too.
             | 
             | If we're trying to figure out what the most benefit for
             | each taxpayer dollar is, then a rare disease won't win out
             | over, say, cancer research.
             | 
             | Someone may consider researching a rare disease as "waste,"
             | even though to everyone including the previous poster who
             | is a widow because of HD, it is far from a waste.
             | 
             | When there is not much of a profit motive to do something -
             | whether going to the moon or fighting a rare disease -
             | public money is the best way to do it. And even throwing a
             | fairly small percentage at it can create big achievements.
             | 
             | And that's one reason I'd like to see how much money and
             | time went into this. We might be surprised that it's fairly
             | small in the grand scheme of biomedical research costs!
        
         | melagonster wrote:
         | We even do not need to calculate NIH grants; I am pretty sure
         | that all databases that were used here are from NCBI. If there
         | were no NIH, all research would be impossible in modern
         | biology.
        
         | stevenwoo wrote:
         | The problem is the soundbite of some of these studies on the
         | surface is ridiculous to lay people but even good studies with
         | bad sound bites are used as weapons against science funding in
         | the USA. The shrimp on a treadmill study is still used as
         | argument against science funding today.
         | https://www.npr.org/2011/08/23/139852035/shrimp-on-a-treadmi...
        
           | privatelypublic wrote:
           | I always thought the shrimp was a random meme. This is even
           | better!
           | 
           | My understanding is There's also studies of "duh!" Things, so
           | theres a paper to cite instead of an assumption.
        
         | caycep wrote:
         | I think it is a UK study. It actually has been going on for a
         | number of years, I've seen one of the PIs giving a number of
         | big conference talks (Tabrizi) for a while
        
       | siva7 wrote:
       | Medical progress has been insane in the last few years through
       | technological breakthroughs. It's not out of reach to think that
       | most types of cancers will be curable 20 years from now on.
        
         | calewis wrote:
         | I think its like WW2, loads of amazing tech came from war.
         | Covid was a bit like that for bioTech.
        
         | singulasar wrote:
         | Let's hope the defunding of medical research can stop so this
         | can become true
        
         | lawlessone wrote:
         | it's great, it feels like the first mRNA vaccine opened a dam.
        
       | ksajadi wrote:
       | This is off topic, slightly but I think a good place to say this:
       | 
       | I wish the media outlets would mention the fact that at least one
       | of the scientists in this post is an immigrant in the UK. (in
       | this case I'm not sure 1st or 2nd gen)
       | 
       | In the current climate of anti-immigrantion rhetoric around the
       | world, simple things like that might help a little with the
       | perception of immigrants as freeloaders.
       | 
       | Just a thought.
        
         | mjburgess wrote:
         | This seems helpful, but I think the misattribution of a general
         | "anti-immigrant" sentiment to immigration detractors is part of
         | the problem.
         | 
         | Very few detractors in the west have any issues with highly
         | qualified immigrants occupying scientific or research roles.
         | Being opportunistic with which kind of immigrants one offers as
         | Good is partly what's aggravating the issue. It's a radical
         | kind of dismissiveness and denialism which is provoking people
         | and ignoring their issues.
         | 
         | The broad western detraction against immigration at the moment
         | is targeted at specific waves of mass immigration with specific
         | compositions that have specific effects on the places those
         | immigrants have landed.
         | 
         | People are primarily concerned about the ability of state,
         | social and corporate institutions to absorb immigrants at this
         | pace and scale without significant zero-sum effects. And, in
         | addition, the significant amount of state support segments of
         | those populations (eg., esp. asylum seekers) have to receive at
         | a time when gov. are under inflationary pressures, debt
         | pressures, etc. and cannot service their own welfare
         | obligations.
         | 
         | Going, "oh but we get good cancer research from immigration!"
         | is so dismissive to these concerns, that the backfire against
         | this messaging is one of the major contributors to people's
         | disaffection.
         | 
         | The idea that people need to be told that there are people who
         | want to immigrate that are in our national interest to absorb,
         | is just plainly absurd. This is uncontroversial and obvious.
        
           | stinkbeetle wrote:
           | This isn't addressing the main point of your comment, but a
           | side issue:
           | 
           | > Very few detractors in the west have any issues with highly
           | qualified immigrants occupying scientific or research roles.
           | Being opportunistic with which kind of immigrants [...].
           | 
           | I'm not a detractor of any individual immigrant, certainly
           | not a very skilled one. But I _am_ dumbfounded when I hear
           | people say how wonderful immigration is  "for the economy",
           | "for the health system", etc., because we can lure all these
           | bright people over from poor countries with offers they can't
           | get at home.
           | 
           | Like... Mozambique needs good doctors and nurses too. Sudan
           | needs good engineers. Syria needs entrepreneurs.
           | 
           | I don't begrudge the immigrant one bit for moving to get more
           | money or a better life or whatever it is that motivates them,
           | and they sure do contribute to the place they move to. But
           | harvesting the best and brightest minds from poor countries
           | on an industrial scale isn't something that sits too well for
           | me at all. The merits and effects could be debated and
           | disagreed, but it certainly requires much deeper thought than
           | just the greed driven "good for my economy, good for my
           | healthcare, good for me" type quips.
           | 
           | I actually think of it as neocolonialism. The most valuable
           | resource in this day and age is people, and wealthy countries
           | are plundering the human capital from the poor ones like they
           | did with resources in previous centuries. Throwing a bit of
           | charity at them whenever the next outbreak or famine or civil
           | war rolls around doesn't make up for it.
        
           | lkey wrote:
           | "Very few detractors in the west have any issues with highly
           | qualified immigrants occupying scientific or research roles."
           | Laughable, these 'few' reside in the highest seats of power
           | and exist among the 'advisors' to the cabinet.
           | 
           | "It's a radical kind of dismissiveness" People keep telling
           | me I'm wrong in the wrong way, if they were nicer I'd
           | consider their opinions. This is an irrational position to
           | stake out, it should go without saying.
           | 
           | "The broad western detraction against immigration at the
           | moment is targeted at specific waves of mass immigration with
           | specific compositions that have specific effects on the
           | places those immigrants have landed."
           | 
           | This is such a laborious way to say "poor, brown or both". Do
           | you get tired of dancing around like this?
           | 
           | "People are primarily concerned about the ability of state,
           | social and corporate institutions"
           | 
           | If you were actually "concerned", you'd advocate for
           | punishing _institutions_ that use cheap (or  'free' if you
           | steal their passport) immigrant labor, rather than targeting
           | those that arrived to fill those positions. Do you have an
           | understanding of why this never happens?
           | 
           | It goes without saying that much of the 'specific immigrant
           | labor' you despise is used to fill the welfare obligations
           | related to care-taking that you are _also_ deeply concerned
           | about.
           | 
           | "dismissive to these concerns" I was assured that 'tone
           | policing' was the domain of the 'woke', yet here it is a
           | second time in the same comment.
           | 
           | "uncontroversial and obvious." You might want to speak to
           | your fellow travelers about _which_ are  'good' immigrants
           | and which are 'bad'. It suffices to say that if they agree
           | _in general_ , but disagree about which group is good, then
           | it is not actually 'uncontroversial'.
        
             | mjburgess wrote:
             | I personally don't care about immigration. I have yet ever
             | to be negatively affected by it, and have tended to find
             | immigrants more pleasant than my own citizens. I'm more
             | worried about our aging, obsese, immobile populations who
             | arent breeding, and need 3-to-1 worker ratios to support,
             | that we cannot provide. I am, personally, relatively open
             | borders -- for at least that reason. I am more motivated by
             | welfare demands and geopolitics, both of which benefit from
             | larger active populations in our borders.
             | 
             | However, what I want doesn't really matter. It's a
             | democracy, and half of a country will not be ignored. You
             | either listen and find some way to give them what they want
             | in the least objectionable way; or they will take what they
             | want, and take revenge on you for your obstinacy. They will
             | do to you what you insist on doing to them: not listening
             | to you at all as they enact the most extreme form of
             | policies which they agree with.
             | 
             | You speak as if your views express those of a powerful
             | majority who will impose them on your detractors. This a
             | dangerous power fantasy. The castle has been ransacked, the
             | draw bridge is down, and you've no army left.
             | 
             | You either draw up terms of surrender, or they will be
             | drawn up for you.
        
               | AnimalMuppet wrote:
               | > The castle has been ransacked, the draw bridge is down,
               | and you've no army left.
               | 
               | Well, no, not that either. You're making the same mistake
               | from the other side. The side you say has "no army left"
               | _also_ is half the country. And _that_ half of a country
               | will not be ignored either.
               | 
               | Both sides demand to be listened to, but neither side is
               | willing to compromise or to admit defeat, even
               | temporarily.
               | 
               | So I expect that power will continue to swap back and
               | forth, that when in power both sides will do their best
               | to implement their plans, and when they are out of power
               | they will suffer the other side's vengeance for their
               | obstinacy. I don't see it improving soon. I suspect we'll
               | see at least another two election cycles of this
               | viciousness.
        
               | mjburgess wrote:
               | Maybe. Certainly if detractors go to excess then they'll
               | breed resentment from the supporters, and round and
               | round.
               | 
               | At the moment though, i think there's lots of people
               | speaking as if it were 2022 and all of that ammunition
               | has now been expended and the stores are bare
        
           | eszed wrote:
           | I'll point out that educational achievement and upward
           | economic mobility in second-generation immigrants is
           | generally excellent. That holds true regardless of their
           | parents' education or income level.
           | 
           | Over a longer view, accepting a construction worker now,
           | because his daughter might cure cancer later, might be an
           | advantageous bargain.
        
         | Hasz wrote:
         | I strongly disagree with this. While I am generally pro-
         | immigration, injecting a political view into an article
         | ostensibly about a new scientific discovery is how science
         | loses credibility and objectivity. See the "trust the science"
         | phrase weaponized during COVID in the US.
         | 
         | Let people draw all the inferences they want about the origins
         | of the scientists involved, but a hamfisted paragraph about a.b
         | scientist being an immigrant from y country does not have a
         | place here.
        
           | whatsupdog wrote:
           | Also it sends a message that only scientists are welcome as
           | immigrants. There's millions of immigrants who contribute
           | positively to the society, who aren't scientists.
        
             | Supermancho wrote:
             | > Also it sends a message that only scientists are welcome
             | as immigrants.
             | 
             | This is not a conclusion I would make without trying to
             | make an anti-immigrant argument.
        
         | ericmcer wrote:
         | This is disingenuous.
         | 
         | There has been a strong push back against illegal-immigration
         | in the west. The media has completely reframed the discussion
         | to "How can they be opposed to immigration" because if they
         | said "how can they be opposed to illegal-immigration" their
         | argument would fall apart pretty quickly.
         | 
         | No one with a brain is arguing that immigration doesn't provide
         | tremendous value.
        
           | lawlessone wrote:
           | >How can they be opposed to immigration" because if they said
           | "how can they be opposed to illegal-immigration" their
           | argument would fall apart pretty quickly.
           | 
           | Isn't this also disingenuous? A significant proportion of the
           | groups against immigration are against any immigration and
           | have been floating trial balloons for "remigration" for non-
           | white citizens.
        
         | JetSetWilly wrote:
         | I have a feeling this migrant didn't get off a dinghy with all
         | the other engineers and scientists so probably isn't raising a
         | lot of concern for most. Conflating "immigration is too high"
         | with "anyone who thinks immigration is too high is a racist who
         | thinks they are all freeloaders" doesn't work anymore, no
         | amount of media propaganda will change that.
        
       | jmclnx wrote:
       | This needs to be said, with Trump's cutting of College Basic
       | Research Funds, many of these great breakthroughs will occur in
       | other Countries. The US is/was the lead in biotech, it is now
       | giving up its lead. That means one of the US largest industries,
       | employing many with high pay, will shrink, due to US policies. In
       | a few years it may not exist unless funding is restored soon. I
       | personally know people who's grants have been cancelled due to
       | these cuts.
       | 
       | But, glad to see other Countries funding their research. I wonder
       | in face of one of the largest blunders made by the US, are they
       | increasing funds ?
        
         | sleight42 wrote:
         | Even more: mRNA. Trump is trying to kill mRNA research because
         | he sees it as tied to the politics of COVID.
         | 
         | Good science is not political. Politicians making it so are
         | idiots at best and evil at worst. See also "Hanlon's Razor"
        
         | kennywinker wrote:
         | There's another connection here, between trump and huntingtons.
         | 
         | Folk singer Woody Guthrie wrote the song "old man trump" about
         | fred trump (donny's dad), while suffering from huntingtons and
         | living in a building owned by fred.
        
       | sleight42 wrote:
       | Tearing up at this.
       | 
       | I lost my first wife to HD in 2013. She was one of the lucky few
       | whose optimism and love of humanity stayed with her through to
       | the end.
       | 
       | If there is a God, I'll never accept it as "loving" as HD is as
       | cruel a slow torture as it comes.
       | 
       | EDIT: Also, a Trump NIH would never have done the years of work
       | to lead up to this sort of treatment. They've been working to
       | suppress mRNA-based treatments because of politics.
       | 
       | Get your politics out of good science, you heartless assholes.
        
       | kjsingh wrote:
       | It is strange times as I watch House MD series for first time
        
         | kennywinker wrote:
         | Unfortunately this discovery is coming a little late for 13
        
       | trallnag wrote:
       | "If one of your parents has Huntington's disease, there's a 50%
       | chance that you will inherit the altered gene and will eventually
       | develop Huntington's too."
       | 
       | Have they never heard of genetic diagnostics? For example with a
       | combination of preimplantation generic testing and in-vitro
       | fertilization you can prevent passing on known genetic mutations
       | to the next generation.
        
         | kennywinker wrote:
         | While technically possible, that option isn't really available
         | to most people. Tho I suppose 17 hour brain surgery with gene
         | therapy is also not available to most people, so fair enough.
         | 
         | Anyway, they're just describing the heritability of the disease
         | there.
        
           | senkora wrote:
           | An optimal society would provide no-cost embryo screening and
           | IVF to couples with the gene for HD, because that cost is
           | certainly far <50% of the lifetime cost of living with HD in
           | treatment costs, lost income, and lost QALY's.
           | 
           | I hope that we can work towards such a society.
           | 
           | (And of course this research is still worth doing to help the
           | population who already have the illness)
        
             | software-is-art wrote:
             | Thats actually the case in New Zealand
        
       | w10-1 wrote:
       | (non-expert)
       | 
       | This is promising but needs publication and expert review.
       | 
       | Here's the actual company statement from today:
       | https://uniqure.gcs-web.com/news-releases/news-release-
       | details/uniqure-announces-positive-topline-results-pivotal-phase-
       | iii
       | 
       | There's also a June 2024 article:
       | https://www.cgtlive.com/view/huntington-disease-gene-therapy-
       | nets-rmat-designation
       | 
       | That explains a bit more: (1) neuro-surgery introduces gene-virus
       | to putamen and caudate nucleus; (2) virus delivers gene that
       | produces micro-RNA; (3) the micro-RNA blocks the messenger RNA of
       | the bad gene, reducing bad protein production.
       | 
       | The 2023 study is said to have 39 patients (BBC and their recent
       | statement reports 29). The reported findings may be significant
       | but seem small (e.g., low dose: 0.39 of 14.1 points). Earlier
       | they reported composites from the Unified HD Rating Scale, which
       | has the usual caveats for the behavioral and functional sub-
       | measures (vs. the more reliable motor and cognitive). Today's
       | statement instead focuses on the more objective measures instead
       | of the composite.
       | 
       | Earlier, high-dose responders reportedly didn't just stabilize
       | but got better -- unclear how. The more recent findings report
       | that the disability still progressed, but slowed relative to
       | "propensity-matched" controls. (Note 4 of 10 controls opted to
       | join the trial after 12 months.)
       | 
       | Both mention improvement in NfL (neurofilament light chains),
       | which is an objective but nonspecific (and highly variable)
       | measure of the degree of neuronal decomposition. The statement
       | quantifies this at ~8% -- unclear if this level is convincing.
       | 
       | For such an invasive treatment for a slowly progressing,
       | relatively rare disease, they're probably gathering and
       | publishing data as fast as possible. The short-term results seem
       | good, and it will be good to see long-term results over time.
       | 
       | It's possible some effect seen is due e.g., to immune adjuvants
       | or something else during the therapy, and I would want experts to
       | review the propensity matching.
       | 
       | I would be concerned that the micro-RNA produced either also
       | binds with epitopes from other messenger RNA or induces some
       | immune response. Remember, there's no reversal agent or half-life
       | elimination for such genetic treatments.
       | 
       | So: room for hope but also for caution.
        
         | cogman10 wrote:
         | If the approach works, wouldn't this also be really good news
         | for other progressive generic disorders?
        
         | meindnoch wrote:
         | >Remember, there's no reversal agent or half-life elimination
         | for such genetic treatments.
         | 
         | Another virus that removes/breaks the inserted gene?
        
           | vibrio wrote:
           | The bane of most gene therapy research is lack of
           | persistence. With how serious and morbid HD is, I'd guess
           | patients will take their chances.
        
       | lostlogin wrote:
       | > In the UK, the NHS does pay for a PS2.6m-per-patient gene
       | therapy for haemophilia B.
       | 
       | A misleading data point. This group of people were treated so
       | poorly by the state that something had to be done. I don't think
       | this is setting a benchmark.
       | 
       | https://haemophilia.org.uk/public-inquiry/the-infected-blood...
        
         | Shortness8 wrote:
         | Don't often comment on HN but have to point this out as a med
         | student in the UK: the cost-benefit roughly works out for those
         | in favour of giving the therapy when the alternative is a
         | lifetime of coming to hospital 3 times a week for Factor IX
         | infusions, and the additional cost of stays in hospital for
         | bleeds/haemarthroses and the complications thereof. Of course,
         | this also ignores the human cost, particularly the extra
         | care/stress around avoiding cuts/bruises in every aspect of
         | life. In this respect these gene therapies appear lifechanging
         | for those who suffer from the disease. [1]
         | 
         | I will also say I know the team who wrote the guidelines for
         | use of these therapies. I believe they were mostly finished
         | before the infected blood scandal became a big story. Politics
         | didn't come into it.
         | 
         | [1]: https://www.bbc.co.uk/news/articles/c4nnn51rdrzo
        
       | ourmandave wrote:
       | Has anybody thought about changing the name from Huntington's
       | disease to after the lead person or team that found the cure?
        
         | edm0nd wrote:
         | Is that a thing that happens in the medical field?
         | 
         | Are we going to rename Polio to The Bill & Melinda Gates
         | Foundation?
        
           | ourmandave wrote:
           | Polio is short for Poliomyelitis, but I'd call it Jonas Salk
           | disease.
        
       | presidentender wrote:
       | One of my mom's best friends when I was a kid had Huntington's.
       | She was a few years older than mom, and her sons were a few years
       | older than my brother and I. One of them chose to get tested. The
       | other chose not to. I remember thinking that was foolish, but I
       | was seven years old. In retrospect, it's strange that a seven-
       | year-old was privy to such things.
        
         | onionisafruit wrote:
         | I chose not to get tested when the test was new. I still
         | haven't, but I feel confident I dodged the bullet based on my
         | age vs my relatives' age of onset. I used to wonder if I could
         | take the news of having HD. Now I wonder how life would have
         | been different knowing for sure I don't have it.
        
       | tsoukase wrote:
       | Huntington's is among the best candidates for a genetic cure:
       | well known gene and mechanism, definitive pre symptomatic
       | diagnosis, slow progression.
       | 
       | But I am still reluctant. It's phase 1/2 (ie exploratory) and the
       | phase 3 is the hard part that takes many years. Also it's disease
       | slowing not stopping.
        
         | missedthecue wrote:
         | The FDA has already agreed that data collected from this trial
         | could be used to support a future BLA, and UniQure said this
         | morning they're moving ahead with the BLA. In other words,
         | uniQure likely will not need to run another trial before
         | obtaining FDA approval for AMT-130.
        
       | idw wrote:
       | The Science Media Centre (UK) has a round up of expert reactions
       | https://www.sciencemediacentre.org/expert-reaction-to-announ...
        
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