Arctic Report Card 2023: From wildfires to melting sea ice, the warmest summer on record had cascading impacts across the Arctic

Rick Thoman, University of Alaska Fairbanks; 

Matthew L. Druckenmiller, University of Colorado Boulder, 

Twila A. Moon, University of Colorado Boulder
Tue, December 12, 2023 

THE CONVERSATION

Giovanna Stevens grew up harvesting salmon at her family’s fish camp on Alaska's Yukon River. Climate change is interrupting hunting and fishing traditions in many areas. AP Photo/Nathan Howard


The year 2023 shattered the record for the warmest summer in the Arctic, and people and ecosystems across the region felt the impact.

Wildfires forced evacuations across Canada. Greenland was so warm that a research station at the ice sheet summit recorded melting in late June, only its fifth melting event on record. Sea surface temperatures in the Barents, Kara, Laptev and Beaufort seas were 9 to 12 degrees Fahrenheit (5 to 7 degrees Celsius) above normal in August.

While reliable instrument measurements go back only to around 1900, it’s almost certain this was the Arctic’s hottest summer in centuries.


Summer heat extremes in 2023 and over time. NOAA, Arctic Report Card 2023


The year started out unusually wet, and snow accumulation during the winter of 2022-23 was above average across much the Arctic. But by May, high spring temperatures had left the North American snowpack at a record low, exposing ground that quickly warmed and dried, fueling lightning-sparked fires across Canada.

In the 2023 Arctic Report Card, released Dec. 12, we brought together 82 Arctic scientists from around the world to assess the Arctic’s vital signs, the changes underway and their effects on lives across the region and around the world.
Heat’s cascading effects throughout the Arctic

In an area as large as the Arctic, setting a new temperature record for a season by two-tenths of a degree Fahrenheit (0.1 degrees Celsius) of warming would be significant. Summer 2023 – July, August and September – shattered the previous record, set in 2016, by four times that. Temperatures almost everywhere in the Arctic were above normal.

A closer look at events in Canada’s Northwest Territories shows how rising air temperature, sea ice decline and warming water temperature feed off one another in a warming climate.


Arctic snow cover in 2023 and over time. NOAA, Arctic Report Card 2023

The winter snow cover melted early across large parts of northern Canada, providing an extra month for the Sun to heat up the exposed ground. The heat and lack of moisture dried out organic matter on and just below the surface; by November, 70,000 square miles (180,000 square kilometers) had burned across Canada, about a fifth of it in the Northwest Territories.

The very warm weather in May and June 2023 in the Northwest Territories also heated up the mighty Mackenzie River, which sent massive amounts of warm water into the Beaufort Sea to the north. The warm water melted the sea ice early, and currents also carried it west toward Alaska, where Mackenzie River water contributed to early sea ice loss along most of Northeast Alaska and to increased tundra vegetation growth.


Sea surface temperatures have been rising. NOAA, Arctic Report Card 2023

Similar warmth in western Siberia also contributed to quickly melting sea ice and to high sea surface temperatures in the Kara and Laptev seas north of Russia.

The Arctic’s declining sea ice has been a big contributor to the tremendous increase in average fall temperatures across the region. Dark open water absorbs the sun’s rays during the summer and, in the autumn, acts as a heating pad, releasing heat back into the atmosphere. Even thin sea ice can greatly limit this heat transfer and allow dramatic cooling of air just above the surface, but the past 17 years have seen the lowest sea ice extents on record.

Subsea permafrost: A wild card for climate

The report includes 12 essays exploring the effects of climate and ecosystem changes across the Arctic and how communities are adapting. One is a wake-up call about the risks in subsea permafrost, a potentially dangerous case of “out of sight, out of mind.”

Subsea permafrost is frozen soil in the ocean floor that is rich in organic matter. It has been gradually thawing since it was submerged after Northern Hemisphere ice sheets retreated thousands of years ago. Today, warmer ocean temperatures are likely accelerating the thawing of this hidden permafrost.

Just as with permafrost on land, when subsea permafrost thaws, the organic matter it contains decays and releases methane and carbon dioxide – greenhouse gases that contribute to global warming and worsen ocean acidification.

Known permafrost zones in the Northern Hemisphere. Greens are subsea permafrost. GRID-Arendal/Nunataryuk, CC BY-ND

Scientists estimate that nearly 1 million square miles (2.5 million square kilometers) of subsea permafrost remains, but with little research outside the Beaufort Sea and Kara Sea, no one knows how soon it may release its greenhouse gases or how intense the warming effects will be.
Salmon, reindeer and human lives

For many people living in the Arctic, climate change is already disrupting lives and livelihoods.

Indigenous observers describe changes in the sea ice that many people rely on for both subsistence hunting and coastal protection from storms. They have noted shifts in wind patterns and increasingly intense ocean storms. On land, rising temperatures are making river ice less reliable for travel, and thawing permafrost is sinking roads and destabilizing homes.

Highlights from the Arctic Report Card 2023. NOAA, Arctic Report Card 2023

Obvious and dramatic changes are happening within human lifetimes, and they cut to the core of Indigenous cultures to the point that people are having to change how they put food on the table.

Western Alaska communities that rely on Chinook salmon saw another year of extreme low numbers of returning adult salmon in 2023, scarcity that disrupts both cultural practices and food security. Yukon River Chinook have decreased in size by about 6% since the 1970s, and they’re producing fewer offspring. Then, in 2019, the year when many of this year’s returning Chinook salmon were born, exceptionally warm river water killed many of the young.

The returning Chinook salmon population has been so small during the past two years that fisheries have been closed even for subsistence harvest, which is the highest priority, in hopes that the salmon population recovers.

The inability to fish, or to hunt seals because the sea ice has thinned, is not just a food issue. Time spent at fish camps is critical for many Alaska Indigenous cultures and traditions, and kids are increasingly missing out on that experience.

As Indigenous communities adapt to ecosystem changes, people are also working to heal their landscapes.

A Sámi reindeer herder in traditional clothes counts new calves while preparing the herd for the arduous winter months. In Pictures Ltd./Corbis via Getty Images

In Finland, an effort to restore damaged reindeer habitat in collaboration with Sámi reindeer herders is helping to preserve their way of life. For many decades, commercial logging was allowed to tear up hundreds to thousands of square miles of reindeer peatland habitat.

The Sámi and their partners are working to replant turf and rewild 125,000 acres (52,000 hectares) of peatlands for reindeer grazing. Degraded peatlands also release greenhouse gases, contributing to climate change. Keeping them healthy helps capture and store carbon away from the atmosphere.

Temperatures in the Arctic have been rising more than three times faster than the global average, so it’s not surprising that the Arctic saw its warmest summer and sixth warmest year on record. The 2023 Arctic Report Card is a reminder of what’s a stake, both the risks as the planet warms and the lives and cultures already being disrupted by climate change.

This article is republished from The Conversation, a nonprofit, independent news organization bringing you facts and analysis to help you make sense of our complex world.

It was written by: Rick Thoman, University of Alaska Fairbanks; Matthew L. Druckenmiller, University of Colorado Boulder, and Twila A. Moon, University of Colorado Boulder.

Read more:


Meltwater is infiltrating Greenland’s ice sheet through millions of hairline cracks – destabilizing its structure


Arctic Report Card 2022: The Arctic is getting rainier and seasons are shifting, with broad disturbances for people, ecosystems and wildlife

Rick Thoman receives funding from the National Oceanic and Atmospheric Administration (NOAA) for serving as an editor for the Arctic Report Card.

Matthew L. Druckenmiller receives funding from the National Oceanic and Atmospheric Administration (NOAA) for serving as an editor for the Arctic Report Card.

Twila A. Moon receives funding from the National Oceanic and Atmospheric Administration (NOAA) for serving as an editor for the Arctic Report Card.

2023 Arctic Report Card proves "time for action is now," NOAA says

Emily Mae Czachor
Wed, December 13, 2023 

Not unlike the rest of the Earth, this summer was the hottest ever recorded in the Arctic, where scientists say human-caused climate change is heating things up faster than anywhere else in the world. Marked consequences of that have already been seen and felt in communities in and around the planet's northernmost polar region, and their domino effects could end up being even more severe and widespread than they are now.

Citing its latest Arctic Report Card — an annual assessment of how the region is faring environmentally and released this week — the National Oceanic and Atmospheric Administration warned that ongoing carbon emissions, in the United States and beyond, will only continue to drive dramatic changes in the Arctic that in turn contribute to extreme weather events in places far from there. Officials with the agency urged people to take action.

"The overriding message from this year's report card is that the time for action is now," said Rick Spinrad, the administrator of the NOAA, in a statement. "NOAA and our federal partners have ramped up our support and collaboration with state, tribal and local communities to help build climate resilience. At the same time, we as a nation and global community must dramatically reduce greenhouse gas emissions that are driving these changes."

In its 18th year, the Arctic Report Card summarizes the work of 82 authors from 13 countries. Those who contributed to the latest edition shared several stark takeaways, including the fact that summer surface air temperatures in the Arctic were the warmest observed in the Arctic since record-keeping began more than 100 years ago, as well as the fact that 2023 was the region's sixth-warmest year on record overall.

The report came out after the United Nations' weather agency declared earlier this year that the planet had experienced its hottest three-month stretch on record over the summer, with experts drawing distinct connections to between the soaring temperatures and devastating wildfires that scorched huge areas of land across multiple continents and depleted air quality to an extent that threatened human health. And, more recently, the European Union's Copernicus Climate Change Service announced that 2023 was globally the hottest year on record, too.

Places within and just outside of the Arctic circle faced consistent weather extremes this year, the new report noted, as precipitation in those areas rose above long-term averages during all four seasons. Local communities and Indigenous people across the polar region continued to suffer outsize consequences of the environmental shifts caused by climate change, it said. Storms of increasing intensity and frequency, as well as unpredictable fishing conditions drastically impacting food security and business for Indigenous people in Alaska, are some prominent examples of that.

The Alaska Arctic Observatory and Knowledge Hub contributed its observations to the Arctic Report Card in 2023 for the first time. The observatory, which works with coastal Indigenous observers to document long-term environmental changes and their impacts in northern Alaska, said the area has experienced "sea ice loss, warmer air and ocean temperatures, changing wind patterns, and increased intensity and frequency of coastal storms that contribute to flooding and erosion."

The observatory noted that extreme weather has affected cultural infrastructure, traditional harvests and activities, and travel safety over land and sea. Included in the report was a message sent by one observer, Bobby Schaeffer, to the Alaska observatory in September 2022, which said, "We had three strong storms. The July 18 storm had the strongest winds. Southwest winds to 50 mph brought in a storm surge that set the record... Wind, huge surf and a lot of rain. The second storm hit us on July 28 and Merbok on September 14 [to 18]... I think we lost more earth to the ocean than ever before."

Changes in the Arctic region directly impacted some of the extreme weather this summer across large and more southern parts of North America, with experts linking "unprecedented" polar temperature increases to the warmer spring and early snowmelt over northern Canada that laid the foundation for its worst wildfire season to date.

The consequences could extend further, as the 2023 report showed a continued decline in sea ice extent and melting on the highest point on Greenland's ice sheet — which has only happened five times in 34 years. A separate study on melting in Greenland, published in November, showed that ice shelved in the region lost more than 1/3 of its volume in the last 50 years because of rising temperatures. If that trend continues, scientists warned of "dramatic consequences" for the planet, since the Greenland ice sheet is one of the major contributors to rising sea levels across the world.

The 2023 Arctic Report Card showcased communities and organizations, like the Alaska Arctic Observatory, that are working on solutions to combat climate change and its far-reaching impacts.

In Finland, an organization called the Snowchange Cooperative has also helped create huge improvements to sprawling peatlands degraded through mining and industrial forestry. Rural Finnish and Indigenous Sámi communities worked with the organization to successfully restore more than 100,000 acres of mined and drained Finnish peatlands when the report was written. Another rural northern community in the remote Svalbard, Norway — the fastest-warming place on Earth — is also taking significant steps to cut emissions that are melting its surrounding glaciers.

Arctic suffered hottest summer on record: NOAA

Nick Robertson
Wed, December 13, 2023



Summer air temperatures in the Arctic were the highest ever recorded this year, the National Oceanic and Atmospheric Administration (NOAA) revealed in its annual report on the region.

It was the sixth-warmest year ever in the Arctic overall, as climate change raised temperatures globally. Sea ice levels also declined at record rates, with a domino effect impacting fisheries throughout Alaska and northern Canada.

“The overriding message from this year’s report card is that the time for action is now,” NOAA administrator Rick Spinrad said. “NOAA and our federal partners have ramped up our support and collaboration with state, tribal and local communities to help build climate resilience. At the same time, we as a nation and global community must dramatically reduce greenhouse gas emissions that are driving these changes.”

The average summer temperature this year was 43 degrees, with parts of northeast Alaska and northwest Canada reaching as much as 7.2 degrees above the average temperature from 1991-2020, according to the report.

Those higher temperatures lead to more green vegetation, which was near an all-time record this year, and dry out tundra, which encourages wildfires. Canada saw the worst wildfire season in its history in 2023, with innumerable wildfires raging from the Arctic to the U.S. border in the east and west.

Sea surface temperatures were also significantly above average, with parts of the Arctic Ocean reaching 9-13 degrees above normal levels, the report said. The increasing temperatures can lead to phytoplankton blooms, which can threaten ocean ecosystems.

As temperatures rise, ice sheet levels continue to fall. The 17 lowest ice sheet events have occurred in the last 17 consecutive years, with the lowest point annually in September. 2023’s ice sheet was the sixth-smallest on record, since 1979.

A June study estimated that summer arctic sea ice is already on its way out and that nothing can be done to save what is being taken away by consistent warming. Researchers estimated that the Arctic will be “practically” ice-free by the middle of the century during summers.

This year’s report was the first to include information from Alaska Arctic Observatory and Knowledge Hub, a network of indigenous Alaskans working with the University of Alaskan to track climate data.

Arctic warming threatens wider world with rising seas-US report

Tue, December 12, 2023

 Climate change thaws world's northernmost research station

By Timothy Gardner and Daniel Trotta

(Reuters) - The Arctic experienced the warmest summer on record this year, contributing to extraordinary wildfires and melting glaciers while threatening the rest of the world with problems including higher sea levels, a U.S. report said on Tuesday.

Summer surface air temperatures in the Arctic were the highest since at least 1900 as the Arctic continues to warm twice as fast as the rest of the globe because of human-caused climate change, according to the National Oceanic and Atmospheric Administration's (NOAA) 2023 Arctic Report Card.

The annual report showed more frequent extreme weather and climate events with global impact.

Warming across parts of northern Canada and the Canadian Arctic Archipelago coincided with below-normal precipitation over those areas, contributing to an extreme wildfire season there.

Greenland lost another 350 trillion pounds (158.7 billion metric tons) of mass from its ice sheet, extending a trend of losing land ice since 1998.

"Arctic warming has far-reaching long-term consequences beyond the region," the report said as land ice losses contribute to rising seas that threaten housing, transportation and businesses in coastal cities.

The loss to Greenland's ice sheet this year was well below the 22-year average because of abundant snowfall, but the heat still took its toll.

Summit Station, the highest point on the ice sheet, experienced melting for only the fifth time in the 34-year record, the report said. The cumulative melt-day area - a measure of the area that melts each day - approached an all-time record.

The report found that "irreversible climate harms caused by an overheating Arctic will continue to reverberate across North America and Eurasia," said Brenda Ekwurzel, the director of climate science at the Union of Concerned Scientists, who has conducted climate research in the Arctic but did not contribute to the report.

The report also detailed "unequivocal evidence of Arctic greening" as warmer temperatures, increased precipitation and melting permafrost result in shrubs and trees taking over grassland and tundra.

Higher greening was seen this year in the North American tundra with relatively low greening in the Eurasian Arctic, it said. So-called "peak tundra greenness" in the Arctic hit the third-highest level in 24 years of study.

Greening could speed climate change by releasing large amounts of carbon dioxide that had been stored in the permafrost.

(Reporting by Timothy Gardner in Washington and Daniel Trotta in Carlsbad, California, editing by Deepa Babington)

2023 Arctic summer was warmest on record, scientists say

Angeli Gabriel
Tue, December 12, 2023

2023 Arctic summer was warmest on record, scientists say


The average surface air temperature in the Arctic from July through September 2023 was the warmest summer on record at 43 degrees Fahrenheit, according to NOAA.

Dating back to 1940, the record also indicates that 2023 was the Arctic’s sixth-warmest year on record, with the average surface air temperature being 20 degrees Fahrenheit.

NOAA noted that since 1940, annual average temperatures in the Arctic have risen by .45 degrees Fahrenheit per decade. Plus, average summer temperatures have risen .31 degrees Fahrenheit per decade.

WORLD HAD ITS HOTTEST AUGUST ON RECORD DURING SIZZLING SUMMER, STUDY FINDS

These findings are part of NOAA’s annual 2023 Arctic Report Card, which documents how human-caused warming of the air, ocean and land is affecting communities and ecosystems across the Arctic.

In addition to warming surface air temperatures, the Arctic Report Card showed that the sea ice extent in the Arctic has continued to decline. According to NOAA, the 17 lowest Arctic sea ice extents on record have occurred during the last 17 years.

The record for the sea ice extent, which began in 1979, shows that the sea ice extent of 2023 was the sixth lowest in the past 44 years.

A polar bear is seen in the Franz Joseph Land archipelago in the Arctic Ocean.

Back on land, the Greenland ice sheet continued to lose mass despite above-average snow accumulation, NOAA said. The highest point on the ice sheet, known as Summit Station, reached a temperature of 32.7 degrees Fahrenheit and experienced melting for the fifth time in its 34-year record.

GREENLAND GLACIER MELTING FASTER THAN ORIGINALLY THOUGHT

The Greenland ice sheet, along with the Antarctic ice sheet, contain over 99 percent of freshwater ice on Earth, according to the National Snow and Ice Data Center. NSIDC noted that if both ice sheets were to melt completely, they would raise the sea level by approximately 223 feet.

Greenland Melt Extent 2023.

"The overriding message from this year’s report card is that the time for action is now," said Rick Spinrad, administrator of NOAA.

"NOAA and our federal partners have ramped up our support and collaboration with state, tribal and local communities to help build climate resilience," he added. "At the same time, we as a nation and global community must dramatically reduce greenhouse gas emissions that are driving these changes."

Supplementing the record is the knowledge of Indigenous groups who have lived and worked in the Arctic.

The 2023 Arctic Report Card includes two chapters that cover the importance of using Indigenous knowledge.

For example, one of those chapters describes the work of the Alaska Arctic Observatory and Knowledge Hub, which is a collaboration between the University of Alaska scientists and a network of Iñupiaq observers documenting long-term environmental change and social and cultural impacts on their northern Alaska communities.

In Europe, Indigenous and local knowledge was implemented to help restore peatlands and arboreal forests in Finland, NOAA said. Within the Scandinavian country, Indigenous Sámi people and Finnish villages are working with scientists to restore these wetland ecosystems and forests.

Eirsat-1, Ireland's 1st satellite, makes space history

Robert Lea
Wed, December 13, 2023 


Ireland has joined the space club with the launch of its first satellite to low-Earth orbit, setting the stage for students of all ages across the Emerald Isle to get involved in space science.

The Educational Irish Research Satellite-1 (Eirsat-1) blasted into space from Vandenberg Air Force Base in California atop a SpaceX Falcon 9 rocket on Dec. 1. Around an hour and a half after launch, the tiny satellite, which is not much larger than a house brick, unfolded and deployed its antenna.

Eirsat-1 made contact with its operators via ground stations here on Earth on Dec. 2, and it is operating as expected. By Dec. 4, ground control was happily receiving and uploading data from the tiny satellite.


Developed by around 50 students at University College Dublin (UCD), Eirsat-1 is still in commissioning mode but is expected to enter operational mode and start collecting science data as soon as next month.

Related: SpaceX launches Irish, South Korean satellites and lands its 250th rocket (video)

UCD Space Science postdoctoral researcher David Murphy, who has been involved in Eirsat-1 for six years, described the feeling of witnessing the satellite heading to space.

"It really was quite incredible. You see these launches streamed online all the time, but it's a completely different thing to see it with your own eyes and to have that investment of having a payload on the rocket," Murphy told Space.com. "We were completely overwhelmed, and the tears definitely started to flow."
Meet the Eirsat-1 experiments

Eirsat-1 carries three main instruments. They will investigate very different things, collecting data that could help solve some of science's most pressing mysteries as well as assisting future space missions.

"So it's got three scientific payloads on board," Murphy said. "Those are the Gamma-Ray Detector (GMOD), a thermal materials experiment ENBIO Module (EMOD), and then the Wave-Based Control (WBC) control algorithm."

GMOD will detect high-energy electromagnetic radiation called gamma rays outside the interference of Earth's atmosphere. The data it collects could help establish the sources of powerful blasts of this radiation, which are believed to be violent cosmic events such as supernovas — the explosions that happen when massive stars die — and the collision of neutron stars, black holes or even mixed mergers between the two. ​GMOD is estimated to be on course to detect around 10 gamma-ray bursts every year.

Eirsat-1's EMOD experiment is designed to test the thermal surface treatments SolarWhite and SolarBlack, which are currently being used close to the sun by the European Space Agency's Solar Orbiter mission, but in low-Earth orbit. It's thought that oxygen atoms around Earth not found where Solar Orbiter operates could erode spacecraft surfaces, so the data EMOD collects could be vital in developing surfaces for future spacecraft.

WBC is an experiment that uses generated magnetic fields within a spacecraft to interact with Earth's magnetic fields and control altitude. This tech could be adapted in the future to also control how satellites rotate, allowing spacecraft to ride on magnetic waves with low power and mass with zero moving parts.

"At the moment, it looks like we're going to have at minimum two and a half years in orbit with Eirsat-1," Murphy said.

"That is the nominal mission, but we will use this asset for as long as we have it to train students," he added, "enabling the next generation of space scientists and engineers to have real hands-on experience with a spacecraft."

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UCD PhD student and Eirsat-1 team member Bas Stijnen told Space.com that Eirsat-1 had been deployed at a slightly lower orbit than was desired, adding that this orbit would allow it to remain operational for around four years before it deorbits.

"The satellite was injected into an orbit that was on the low side, so the orbital lifetime is going to be relatively short. We're looking at three and a half, maybe four years before Eirsat-1 will de-orbit," Stijnen said. "We won't rush, but we have to make sure now to use the time that we have to conduct the science that we want to do."

As exciting as the satellite's science work sounds, Murphy said that it may well be the impact of Eirstat-1 on education and industry in Ireland that's the satellite's longest-lasting and most important legacy.

"Hopefully, we've inspired the next generation of students to build the next Irish satellite and the next Irish satellite after that and shown that it can be done in a university, and that this is something that many universities across Ireland can achieve," Murphy concluded. "Hopefully, it's just the start of ongoing space activities that we will have in Irish industry and education."

Mars' atmosphere swelled like a balloon when solar wind stopped blowing. Scientists are thrilled

Sharmila Kuthunur
Wed, December 13, 2023 

Artist's rendering of a solar storm hitting Mars and stripping ions from the planet's upper atmosphere.

Mars' atmosphere, once as thick as if not thicker than Earth's today, is leaking into space.

About 0.25 lbs of Mars' atmosphere (0.11 kg) is pushed away every second by the incessant solar wind, the speedy stream of charged particles routinely blasted from the sun which pervade the solar system and even reach beyond Pluto.

But for a rare two days last December, some of that wind went away. Its sudden and dramatic disappearance caused the atmosphere on Mars' sun-facing side to swell by nearly four times its usual size — from its usual 497 miles (800 km) to over 1,864 miles (3,000 km). The peculiar event was recorded by a NASA orbiter named MAVEN (short for Mars Atmosphere and Volatile Evolution) which has been observing both Mars's atmosphere and its response to the sun's behavior since 2014. MAVEN's data showed other aspects of the Martian system, including the tear drop-shaped magnetosphere, the bow shock and the ionosphere expanded similarly.


"We're really off the charts here," Jasper Halekas, a professor of physics and astronomy at the University of Iowa and a member of the MAVEN team, said on Monday (Dec. 11) at the AGU conference being held this week in California and online. "This is something that we haven't seen at Mars before with MAVEN."

Related:  Lost in Space: How Mars' Atmosphere Evaporated Away

The atypical episode — the first in nearly a decade of MAVEN's career — occurred after a fast-moving region of a solar wind overtook its slower counterpart and swept up the latter's material, leaving behind a sparse region. The emptied storm reached Mars on Dec. 25, 2022, giving scientists a thrilling front-row seat to watch the planet's atmosphere balloon out, the way it might have been if it were circling a less 'windy' star.

"This was a Christmas present for us," said Halekas, who is leading a new study reporting this event. "Nature set up this perfect science experiment."

With MAVEN's data of the unexpected dynamics on Mars, Halekas and his colleagues studied how extreme solar events — and their absence — influence the planet's atmosphere, an insight valuable to understanding its evolution. The findings also have implications for our understanding of Earth-like planets outside our solar system and how they interact with their host stars, the team shared on Monday.

"We could look under the hood at what physics is going on, how the dynamics are working and really get a sense of those details," said MAVEN team member Skylar Shaver of the Laboratory for Atmospheric and Space Physics in Boulder.

Two days after the almost-vacant storm passed Mars, the atmosphere around the Red Planet settled down to its original state once again, but not before bouncing a little like a jiggling plate of Jell-O. A similar storm struck Earth in 1999, when our planet's atmosphere grew to five times its normal size. But there aren't often orbiting spacecraft positioned as well as MAVEN is now to study such events, the New Atlas reported.

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Shannon Curry, the principal investigator for the MAVEN mission, suspects events like this were common during Mars' early evolution 3 to 4 billion years ago, when our sun was more fiery than it is now and perhaps blasted out storms once a week or even every day. Such extreme events were likely responsible for parching the Red Planet, a world scientists presume once hosted liquid water and offered conditions friendly toward life. Extrapolating the latest MAVEN data to study Mars' evolution through time could shed light on how much its atmosphere eroded away and how fast the planet dried up, Curry said.

Curry added events like this may occur multiple times in the next two years as the sun's activity climbs to its peak, expected to occur in July 2025 if not late next year.

Nasa makes ‘almost unbelievable’ discovery of Mars’s protective layer
Vishwam Sankaran
Thu, December 14, 2023 



An extremely rare solar event that left a void in space resulted in “almost unbelievable” expansion of the Martian atmosphere by thousands of kilometres, Nasa revealed in a new study.

In December last year, Nasa’s Maven mission observed the sudden “disappearance” of a stream of charged particles constantly coming off the Sun, known as the solar wind – an event so powerful that it created a void in its wake as it traveled through the solar system.

Measurements revealed that the number of charged particles making up the solar wind dropped drastically during this event.

Without the pressure of the solar wind, the Martian atmosphere and magnetosphere expanded by thousands of kilometres, according to Nasa’s observations, being presented at the American Geophysical Union Fall Meeting in San Francisco.

“When we first saw the data, and how dramatic the drop in the solar wind was, it was almost unbelievable. We formed a working group to study the event, and we have found this period to be rich with incredible findings,” study co-author Jasper Halekas from the University of Iowa said.

Previous studies have shown that Mars, just like other planets in the Solar System, is constantly immersed in charged particles streaming from the Sun which exert pressure on the Red Planet’s sphere of magnetism that comes from the planet’s rotation.

The solar wind striking Mars drives much of the escape of its atmosphere.

During the December 2022 event, the density of the solar wind dropped by a factor of 100, and caused the pressure exerted on Mars to decrease, leading to the planet’s magnetosphere more than tripling in size.

The event was caused by faster-moving solar wind overtaking slower-moving wind, sweeping and compressing the two regions together.

This compression left behind a rare void of extremely low-density solar wind in its wake, Nasa scientists noted.

Researchers say this dramatic solar event and the Martian magnetosphere’s subsequent transformation can help better understand the physics driving water and atmosphere loss on Mars.

“MAVEN was designed to observe these types of interactions between the Sun and the Martian atmosphere, and the spacecraft provided exceptional data during this truly anomalous solar event,” Shannon Curry, another author of the study from the University of California, Berkeley said.

Such dramatic disappearing solar wind events are extremely rare, produced at a time of increasing solar activity, researchers say.

With the Sun currently moving towards the peak of its 11-year activity cycle, the latest findings can help provide an even better understanding of extreme solar events, they say.

“We are really getting to see how Mars responds when the solar wind is effectively removed. It makes for a great outlier study on what Mars would be like if it were orbiting a less ‘windy’ star,” Dr Halekas added.

Mars' Magnetosphere Suddenly Tripled in Size Last Christmas Day

Victor Tangermann

Wed, December 13, 2023 


Wide Magnet

On Christmas Day last year, NASA's MAVEN spacecraft observed something entirely unexpected and exceedingly rare while orbiting Mars.

Specifically, it appears to have noticed the almost complete "disappearance" of solar wind, the steady trickle of charged particles coming from the Sun, in the wake of a powerful solar event, according to NASA.

The sudden lack of pressure from solar wind allowed the Martian atmosphere and magnetosphere to suddenly expand by thousands of miles — more than triple its regular size — catching scientists by surprise.

"When we first saw the data, and how dramatic the drop in the solar wind was, it was almost unbelievable," said University of Iowa Jasper Halekas, lead author of a new study being presented at the ongoing American Geophysical Union Fall Meeting, in a NASA statement.

"We formed a working group to study the event, and we have found this time period to be rich with incredible findings," he added.
Solar Windswept

As a result of being assailed by the Sun's particles, the Martian atmosphere is slowly disappearing, a process known as "atmospheric escape."

On the day of that dramatic solar event in December 2022, much faster-moving particles appeared to leave a void of "extremely low-density solar wind" behind, according to NASA.

That allowed the suddenly unencumbered Martian atmosphere and ionosphere to balloon to more than triple its usual size, causing the ionosphere to become temporarily unmagnetized.

The event was picked up by MAVEN's scientific instruments, allowing scientists to get a better sense of how these processes work.

"We are really getting to see how Mars responds when the solar wind is effectively removed," Halekas said. "It makes for a great outlier study on what Mars would be like if it were orbiting a less ‘windy’ star."

"MAVEN was designed to observe these types of interactions between the Sun and the Martian atmosphere, and the spacecraft provided exceptional data during this truly anomalous solar event," MAVEN principal investigator Shannon Curry added.

Morning Person? You Might Have Neanderthal Genes to Thank.

Carl Zimmer
Thu, December 14, 2023

Neanderthal cranium and mandible of the Chapelle aux Saints (Correze) prehistorical museum in Quinson, France

 (Photo by Xavier Rossi/Gamma-Rapho via Getty Images)


Neanderthals were morning people, a new study suggests. And some humans today who like getting up early might credit genes they inherited from their Neanderthal ancestors.

The new study compared DNA in living humans to genetic material retrieved from Neanderthal fossils. It turns out that Neanderthals carried some of the same clock-related genetic variants as do people who report being early risers.

Since the 1990s, studies of Neanderthal DNA have exposed our species’ intertwined history. About 700,000 years ago, our lineages split apart, most likely in Africa. While the ancestors of modern humans largely stayed in Africa, the Neanderthal lineage migrated into Eurasia.

About 400,000 years ago, the population split in two. The hominins who spread west became Neanderthals. Their cousins to the east evolved into a group known as Denisovans.

The two groups lived for hundreds of thousands of years, hunting game and gathering plants, before disappearing from the fossil record about 40,000 years ago. By then, modern humans had expanded out of Africa, sometimes interbreeding with Neanderthals and Denisovans.

And today, fragments of their DNA can be found in most living humans.

Research carried out over the past few years by John Capra, a geneticist at the University of California, San Francisco, and other scientists suggested that some of those genes passed on a survival advantage. Immune genes inherited from Neanderthals and Denisovans, for example, might have protected them from new pathogens they had not encountered in Africa.

Capra and his colleagues were intrigued to find that some of the genes from Neanderthal and Denisovans that became more common over generations were related to sleep. For their new study, published in the journal Genome Biology and Evolution, they investigated how these genes might have influenced the daily rhythms of the extinct hominins.

Inside the cells of every species of animal, hundreds of proteins react with one another over the course of each day, rising and falling in a 24-hour cycle. They not only control when we fall asleep and wake up, but also influence our appetite and metabolism.

To explore the circadian rhythms of Neanderthals and Denisovans, Capra and his colleagues looked at 246 genes that help to control the body clock. They compared the versions of the genes in the extinct hominins to the ones in modern humans.

The researchers found more than 1,000 mutations that were unique only to living humans or to Neanderthals and Denisovans. Their analysis revealed that many of these mutations probably had important effects on how the body clock operated. The researchers predicted, for example, that some body-clock proteins that are abundant in our cells were much scarcer in the cells of Neanderthals and Denisovans.

Next, the scientists looked at the small number of body-clock variants that some living people have inherited from Neanderthals and Denisovans. To see what effects those variants had on people, they probed the UK Biobank, a British database holding the genomes of a half-million volunteers.

Along with their DNA, the volunteers provided answers to a long list of health-related questions, including whether they were early risers or night owls. To Capra’s surprise, almost all the ancient body-clock variants increased the odds that the volunteers were morning people.

“That was really the most exciting moment of the study, when we saw that,” Capra said.

Geography might explain why the ancient hominins were early risers. Early humans lived in Africa, fairly close to the equator, where the duration of days and nights stays roughly the same over the course of the year. But Neanderthals and Denisovans moved into higher latitudes, where the day became longer in the summer and shorter in the winter. Over hundreds of thousands of years, their circadian clocks may have adapted to the new environment.

When modern humans expanded out of Africa, they also faced the same challenge of adapting to higher latitudes. After they interbred with Neanderthals and Denisovans, some of their descendants inherited body-clock genes better suited to their new homes.

All of these conclusions, however, stem from a database limited to British people. Capra is starting to look at other databases of volunteers with other ancestries. If the links hold up, Capra hopes ancient body clocks can inspire some ideas about how we can adapt to the modern world, where circadian rhythms are disrupted by night shifts and glowing smartphones. These disruptions don’t just make it hard to get a good night’s sleep; they can also raise the risk of cancer, obesity and a host of other disorders.

Michael Dannemann, an evolutionary geneticist at the University of Tartu in Estonia who was not involved in the new study, said one way to test Capra’s variants would be to engineer various human cells in the lab so that their genes were more like those of Neanderthals and Denisovans. Then scientists could grow clusters of the cells and watch them go through their daily cycles.

“This step forward not only advances our knowledge of how Neanderthal DNA influences present-day humans,” he said, “but also offers a pathway to expanding our understanding of Neanderthal biology itself.”

c.2023 The New York Times Company

Sickle cell affects more families in Africa and India, but new gene therapies are out of reach

LAURA UNGAR
Updated Thu, December 14, 2023 







Sickle Cell Therapy Inequity
Gautam Dongre, of the National Alliance of Sickle Cell Organizations, sits for a portrait with his daughter, Sumedha, 13, at their residence in Nagpur, India, Wednesday, Dec. 6, 2023. Dongre recalls how his newborn son, Girish, cried constantly from stomach and leg pain. Doctors couldn’t figure out what was wrong and didn’t diagnose him with sickle cell for 2 1/2 years. When Sumedha was born, he and his wife had her tested immediately and learned she had the disease too. (AP Photo/Ajit Solanki)


Gautam Dongre’s two children in India and Pascazia Mazeze’s son in Tanzania live with an inherited blood disorder that turns blood cells into instruments of pain.

Now that new gene therapies promise a cure for their sickle cell disease, Dongre says he's "praying the treatment should come to us.”

But experts say the one-time treatment is out of reach in India and Africa — places where the disease is most common. Vast inequities cut much of the world off from gene therapy in general.

While access to all sorts of medicine is limited in developing countries, the problem is especially acute with these therapies, which are among the most expensive treatments in the world.

Beyond their sky-high prices, these therapies are extremely complex to give patients because they require long hospitalizations, sophisticated medical equipment and specially trained doctors and scientists. So far, the two gene therapies for sickle cell have only been approved in wealthier countries: both of them in the U.S., and one in Britain and Bahrain as well.

“The vast, vast majority of patients live in an area where they have no access to this kind of therapy,” said Dr. Benjamin Watkins, who treats sickle cell in New Orleans and is also involved in pediatric work internationally. “We as medical professionals, and as a society, have to think about that.”

Access to gene therapies was a major focus of this year’s international summit on human genome editing in London. A subsequent editorial in the journal Nature said high prices leave low- and middle-income countries “entirely in the lurch” and could stymie progress across the field.

Some scientists worry that new cures won’t reach their potential, future treatments may never be invented and the prospect of wiping out diseases like sickle cell will remain a distant dream.

STRUGGLING FOR BASIC TREATMENT

For gene therapy to even be an option, people in developing nations must stay alive long enough to get it. There, sickle cell disease is more likely to disable or kill than in wealthy regions. Late diagnosis is common and basic care can be hard to come by.

While gene therapy "is a huge leap forward … we can’t forget about those patients,” said Watkins, of Children’s Hospital New Orleans.

Sickle cell disease begins its assault on the body at birth, affecting hemoglobin, the protein in red blood cells that carries oxygen. A genetic mutation causes the cells to become crescent-shaped, which can block blood flow and cause problems such as excruciating pain, organ damage and stroke.

The only other cure is a bone marrow transplant, which must come from a closely matched donor and brings a risk of rejection.

Global estimates of how many people have the disease vary, but some researchers put the number between 6 million and 8 million. It’s more common in malaria-prone regions because carrying the sickle cell trait helps protect against severe malaria. More than 1 million people with sickle cell disease live in India, studies show, and more than 5 million are in sub-Saharan Africa.

Dongre, who lives in Nagpur in central India, has seen the struggles in his own family and among people he’s met as a leader in the National Alliance of Sickle Cell Organizations in India. For many years, awareness of the disease has been lacking, he said, even among some health professionals.

Dongre recalled how his newborn son Girish cried constantly from stomach and leg pain. Doctors couldn’t figure out what was wrong and didn’t diagnose him with sickle cell for 2 1/2 years. When their daughter Sumedha was born, he and his wife had her tested immediately and learned she had the disease too.

Other patients go undiagnosed for a decade or more. Lalit Pargi, who lives in Udaipur in northern India, said he wasn’t diagnosed until he was 16 despite having the tell-tale yellow eyes and skin of jaundice, a common sign of sickle cell. That meant a childhood filled with inexplicable pain.

‘GOD AND GOOGLE’

Available treatments can reduce the bouts of pain known as “crises." Dongre’s children, now 19 and 13, take a medicine called hydroxyurea, a decades-old chemo drug that helps prevent the formation of sickle-shaped red blood cells and control the disease. Both have been hospitalized for pain episodes, especially when they were younger.

Other patients in rural areas are dying at very young ages without getting the right treatments, Dongre said.

In July, Indian Prime Minister Narendra Modi launched a sickle cell “elimination mission” that combines awareness, education, screening, early detection and treatment. Dongre lauded the effort but said the country faces huge obstacles to meet its goals.

The situation is much the same in East Africa's Tanzania, where the health ministry has partnered with drug company Novartis, which makes sickle cell medicine, to improve access to diagnosis and treatment.

Mazeze scrambled for information after her son, Ian Harely, was diagnosed.

“I Googled and Googled and I couldn’t sleep,” said Mazeze, executive director of the Tanzania Sickle Cell Warriors Organization. “After that, I was praying. It was God and Google.”

Her son is now 10 and takes hydroxyurea and folic acid for anemia. They’ve helped, but haven’t eliminated pain episodes like the one that put him in the hospital for two weeks earlier this year.

Still, Mazeze counts herself lucky she can afford treatment at all.

“We have people in Tanzania who can’t even manage folic acid,” she said. “Folic acid for a month is 1,000 Tanzanian shillings – less than a dollar,” while out-of-pocket costs for hydroxyurea can be more than 35 times that.

‘SIGNIFICANT CHALLENGES'

Such stark realities make the cost of gene therapies an insurmountable obstacle, experts say. The price tags for the two sickle cell therapies in the U.S. are $3.1 million and $2.2 million although the cost for gene therapies can vary by country.

The process of giving the therapies is just as big a hurdle.

Patients must go to the hospital, where stem cells are removed from their blood in a process that requires specialized equipment. One treatment, made by Vertex Pharmaceuticals and CRISPR Therapeutics, involves sending the cells to a lab as quickly as possible to keep them fresh and using a gene-editing tool called CRISPR to knock out a gene. The cells must be sent back in liquid nitrogen so they stay frozen until they’re ready to use.

The other therapy, made by Bluebird Bio, doesn't use CRISPR but involves the same process for patients. In both cases they must undergo chemotherapy before they get back their altered cells by IV, and spend weeks in the hospital. The process can stretch on for months.

“The infrastructure doesn’t exist to make it possible in many parts of the world,” said Dr. David Altshuler, chief scientific officer at Vertex. “There’s great unmet need, but there are also significant challenges.”

Not only do many medical centers lack things like specialized equipment, but health care systems themselves are comparatively skeletal. For example, World Health Organization data shows India and Tanzania both have less than a quarter of the per-capita hospital beds the U.S. has.

Scientists say one possible solution — though not an immediate fix — is to develop easier-to-administer versions of the new therapies. Altshuler said Vertex is trying to find ways to provide the same benefits without requiring chemo, which comes with serious risks such as infertility. His team is working on making a pill that wouldn’t edit genes but would have the same goal: helping the body produce a fetal form of hemoglobin since the adult form is defective in people with sickle cell.

Other scientists are also working on simpler potential cures, including Dr. Stuart Orkin, one of the scientists whose work led to the development of the Vertex therapy.

Orkin said he's not sure if next-generation treatments like pills will necessarily be affordable.

“Someone's going to want to be compensated for the development of that pill,” although foundations could help bring it to the developing world, said the Harvard Medical School pediatrics professor, who is paid by the Howard Hughes Medical Institute, which also supports The Associated Press' Health and Science Department. Experts said governments will likely also be instrumental in getting cures to patients.

Dongre said he hopes gene therapy for sickle cell eventually makes it to India. If it does, he’d like his children to be among the first to get it. Mazeze said she may wait to see how other patients fare but will consider it for her son too.

Both agreed that patients in all countries — rich or poor — should have the option.

“We all are part of one single planet,” Dongre said.

___

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.


FDA approves gene-editing treatment for sickle cell

Talia Naquin
Wed, December 13, 2023



(WJW) – Breakthrough treatments for sickle cell disease have been approved by the U.S. Food and Drug Administration (FDA).

On Dec. 8, the FDA approved Casgevy and Lyfgenia. They’re the first cell-based gene therapies for the treatment of sickle cell patients 12 and older.

See the research here

Casgevy is also the first FDA-approved treatment to use a novel genome editing technology.

Sickle cell affects about 100,000 people in the U.S. Sickle cell disease is a group of inherited blood disorders.

It causes red blood cells to develop a crescent or ‘sickle’ shape, which limits the delivery of oxygen to the body.

“Sickle cell disease is a rare, debilitating and life-threatening blood disorder with significant unmet need, and we are excited to advance the field, especially for individuals whose lives have been severely disrupted by the disease by approving two cell-based gene therapies today,” said Nicole Verdun, M.D., director of the Office of Therapeutic Products within the FDA’s Center for Biologics Evaluation and Research. “Gene therapy holds the promise of delivering more targeted and effective treatments, especially for individuals with rare diseases where the current treatment options are limited.”

Casgevy is the first FDA-approved therapy utilizing CRISPR/Cas9, a type of genome editing technology. Patients’ hematopoietic (blood) stem cells are modified by genome editing using CRISPR/Cas9 technology.

CRISPR/Cas9 can be directed to cut DNA in targeted areas, enabling the ability to accurately edit (remove, add, or replace) DNA where it was cut.

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The modified blood stem cells are transplanted back into the patient where they engraft (attach and multiply) within the bone marrow and increase the production of fetal hemoglobin (HbF), a type of hemoglobin that facilitates oxygen delivery.

With Lyfgenia, the patient’s blood stem cells are genetically modified to produce a gene-therapy derived hemoglobin that functions similarly to hemoglobin A, which is the normal adult hemoglobin produced in persons not affected by sickle cell disease. These modified stem cells are then delivered to the patient.

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Both products are made from the patients’ own blood stem cells, which are modified and are given back as a one-time, single-dose infusion as part of a blood stem cell transplant.

“These approvals represent an important medical advance with the use of innovative cell-based gene therapies to target potentially devastating diseases and improve public health,” said Peter Marks, M.D., Ph.D., director of the FDA’s Center for Biologics Evaluation and Research.


Only 1 Michigan hospital to initially offer new sickle cell gene editing treatment

Kristen Jordan Shamus, Detroit Free Press
Thu, December 14, 2023 

When 17-year-old Gabriella Ngang dreams about the future, she envisions one without the debilitating pain that sometimes renders her unable to walk, the pain that forced her to quit cheerleading, the pain that keeps her from swimming.

Swimming is too risky for Gabriella, who goes by Gabby, because a dip in water can send her sickle cell disease into a crippling pain crisis that could trigger a weekslong hospitalization.

“If it’s too cold or it's too hot, it might trigger the pain,” said Gabriella, a senior at Farmington High School. “Or if I don't have enough oxygen or if I’m already in pain, it might trigger it. ... It's kind of hard to describe the waves of pain that just keep hitting you."


Gabby Ngang, 17, of Farmington Hills, sits at the dining room table in her home alongside her mother Vivian Ngang, 53, on Dec. 7, 2023. The Farmington Hills High School senior has sickle cell anemia. The FDA is poised to approve two gene editing treatments for sickle cell disease that could be a cure for Gabriella.

But now there's hope for Gabby and the roughly 100,000 Americans like her who suffer from the inherited blood disorder. Two new, blockbuster gene therapy treatments for sickle cell disease were approved last week by the U.S. Food and Drug Administration for Americans ages 12 and older.

However, getting swift treatment might not be easy for the vast majority of patients, given that the manufacturers have authorized only 36 U.S. hospitals to begin using the therapies in the near future. And the price tag is extremely high — $2 million to $3 million per treatment.

Just one Michigan hospital has authorization to begin gene therapy to treat sickle cell disease patients in the first quarter of 2024. That's Children's Hospital of Michigan in Detroit, which is among 27 U.S. hospitals that can use lovo-cel, which has the brand name Lyfgenia. The other newly FDA-approved gene therapy, exa-cel, which has the brand name Casgevy, isn't initially being offered at any Michigan site.
Doctors hope the treatments last a lifetime

Sickle cell disease affects the shape of red blood cells, making them crescent or sickle shaped. The misshapen cells can cluster together and get stuck in blood vessels, impairing their ability to carry oxygen. The disease can cause strokes, organ damage, severe pain and early death.

The genetic disorder is most prevalent among people of African descent, occurring in 1 in every 365 births among Black Americans and about 1 in every 16,300 Hispanic American births, according to the U.S. Centers for Disease Control and Prevention.

About 4,000 Michiganders suffer from it, said Dr. Alexander Glaros, medical director of the Comprehensive Sickle Cell Center at Children’s Hospital of Michigan in Detroit.

“About 2,500 live in the city of Detroit,” he said. “We, at Children's, have about 800 patients from ages 0 to 25, and we're one of the biggest sickle cell centers in the country.”

The new gene-editing treatments alter a patient's own stem cells, allowing the body to make healthy, round red blood cells rather than sticky, sickle-shaped cells. Although the treatments haven't been researched long enough to describe them as curative, doctors are hopeful a single treatment will last a lifetime for patients like Gabby.

She's eager to try it.

“I'm happy about the new gene therapy and the new treatments that are coming out for sickle cell," she said. "I want to just live out my life the way I want to live it out, and advocate more for people with sickle cell, too, and gene therapy, if I get the treatment."
How gene editing works against sickle cell

That's a big if.

Gabby's mother, Vivian Ngang, is trying to find a way to get gene therapy for Gabby, but she knows that, at least for now, only lovo-cel is likely to be available in Michigan by the end of the first quarter of 2024, according to bluebird bio, the pharmaceutical company that developed the treatment.

Gabby Ngang, 17, of Farmington Hills, holds her family dog alongside her mother Vivian Ngang, 53, at their home on Dec. 7, 2023. The Farmington Hills High School senior has sickle cell anemia. The FDA is poised to approve two gene editing treatments for sickle cell disease that could be a cure for Gabriella.

Lovo-cel reengineers a patient’s own stem cells by adding a functional beta hemoglobin gene.

Those stem cells first are extracted from the patient and altered in a lab using a virus as a carrier for the modified beta hemoglobin gene. The person then undergoes high-dose chemotherapy, which wipes out the immune system. Doctors then reintroduce the genetically repaired stem cells, rebooting the person’s immune system so it can begin to produce red blood cells without sickling.

“Centers will be onboarded to deliver Lyfgenia on a rolling basis," bluebird said in a news release issued Friday. "Today, 27 (qualified treatment centers) are ready to receive patient referrals and we anticipate the full network will be fully activated by the end of Q1 2024,”

Children’s Hospital of Michigan didn’t provide details to the Free Press about the timing of when treatments will begin for its patients, but Glaros issued the following statement: “As the first medical center in Michigan to offer patients the option of a similar gene therapy for beta-thalassemia earlier this year, we are pleased to see the FDA’s decision. … We look forward to reviewing the details and moving ahead from there as expeditiously as possible on behalf of our patients.”

The University of Michigan Health told the Free Press it, too, is "actively engaged" in efforts to "introduce gene therapy for sickle cell disease and other inherited disorders that affect red blood cells." It said it is "strategically planning" to make both gene therapies available within the next year.

Corewell Health Helen DeVos Children’s Hospital in Grand Rapids issued a statement to the Free Press on Wednesday, saying its goal is to work through the logistics to be able to offer gene therapy "in the future" to its roughly 100 children and adolescent patients with sickle cell disease.
Treatment requires long hospital stays

Although lovo-cel is the treatment that's likely to be available first in Michigan, Ngang would prefer that her daughter undergo the exa-cel gene therapy treatment instead.

"The cancer risk is my concern with lovo-cel," Ngang said of the black-box warning the FDA issued along with its approval of the treatment. In clinical trials, two of the patients who were treated in lovo-cel later developed leukemia.

"My preference is exa-cel. If it means us waiting or going somewhere else to get that treatment, we'll do that. If they roll it out and (Children's Hospital of Michigan) is not among the hospitals, I am looking into Ohio and/or Chicago."

Exa-cel works differently and has not been associated with leukemia or other blood cancers. Instead of adding a new functioning beta hemoglobin gene, exa-cel disrupts the malfunctioning BCL11A gene that causes the sickling of red blood cells after a baby with the genetic disorder is born. Once that faulty gene is disrupted, the body then reverts back to the use of fetal hemoglobin to produce healthy red blood cells.

Both exa-cel and lovo-cel require high-dose chemotherapy and potentially long hospital stays.

Vertex Pharmaceuticals and CRISPR Therapeutics co-created exa-cel. The companies have authorized only nine U.S. medical centers to be among the first to offer exa-cel therapy. They are:

Boston Medical Center in Boston


Children’s National Hospital in Washington, D.C.


City of Hope Children’s Cancer Center in Los Angeles


Medical City Children’s Hospital in Dallas


Methodist Children’s Hospital in San Antonio


Nationwide Children’s Hospital in Columbus, Ohio


The Children’s Hospital at TriStar Centennial in Nashville, Tennessee


The Ohio State University Comprehensive Cancer Center – James Cancer Hospital and Solove Research Institute in Columbus

University of Chicago/Comer Children’s Hospital in Chicago

“The administration of Casgevy requires specialized experience in stem cell transplantation; therefore, Vertex is engaging with experienced hospitals to establish a network of independently operated, authorized treatment centers throughout the U.S. to offer Casgevy to patients,” the company said in a statement.

“Additional (authorized treatment centers) will be activated in the coming weeks.”
'Everyone deserves access to this treatment'

Though there's hope in these new treatments, access is a big concern, said Melissa Creary, an assistant professor in health management policy and global public health at the University of Michigan's School of Public Health.

"Who's going to actually be able to get access to this gene-editing technology?" asked Creary, who also has sickle cell disease. "When these innovative therapies come to market, but it's not going to be necessarily widely available, that there is more burden for folks to get to where the technology is being offered.

"Everyone deserves access to this treatment. I think everyone deserves access to a great quality of life. ... And therein lies the issue. There will not be enough options for all the people who deserve therapy to get it."

For many people living with the disease, uprooting their lives to temporarily move to a city where the treatment is available simply isn't an option.

"What does it mean to pack up a patient and a support system to go to that place, to be able to afford to live in that place, to step away from a job for three to six months?" Creary asked. "There are a lot of questions of how people are going to actually be able to benefit from this therapy."
Patient share of costs unknown

Cost is a concern, too.

Bluebird set its pricing for lovo-cel at $3.1 million per person “in recognition of the value the therapy may deliver through robust and sustained clinical benefits and the estimated lifetime impact” that could come by eliminating or reducing the number of pain crises that patients face, the number of hospitalizations and other medical treatments they require over a lifetime and its impact on future earnings and opportunities.

The Cambridge, Massachusetts-based pharmaceutical company said people with sickle cell disease face lifetime medical costs that can amount to $4 million-$6 million. In addition, 1 in 4 will have a stroke by age 45, and the average person with the disease will lose as much as $1.3 million in lifetime earnings because of how their illness limits job opportunities.

Vertex and CRISPR estimate their exa-cel therapy will cost about $2 million.

"How do we begin to wrap our mind around the cost?" Creary asked. "I think we can assume that no one's going to be responsible for paying the full $2 (million) to $3 million, but there is still going to be a very heavy responsibility of cost. We don't know what that is yet.

"We do know that the majority of people living with sickle cell disease are on Medicaid, which means that we're going to have to depend on CMS (the Centers for Medicare and Medicaid Services) and the federal government to be able to offer a level of financial support. Given the ways that health policy has worked out around Medicaid in terms of expansion on the federal level, and in terms of how it actually gets operationalized internally state by state, there's still a lot of questions to figure out how Medicaid programs are going to be able to afford to support a really expensive therapy like this. "

Creary is concerned that although these therapies could be transformative for so many people, affordability and access hurdles will further deepen health inequities and pile on to an already heavy history of medical neglect and injustice for Black and brown Americans.

"While I want to be excited about innovation, I want to still move toward an acknowledgment that we still have to treat people with great dignity outside of offering access to technology," Creary said.

Gene-editing therapy for people with sickle cell disease is an important advance, but those who need treatment also deserve equitable care, she said.

"It doesn't address the ways in which people are treated when they enter the health care system. It doesn't address the lower quality of health care because the patients are Black and brown. It doesn't address the limited opportunities that many people with sickle cell disease have access to because of these systems," she said.
'I knew one day something would come up'

Winter is the hardest season for Gabby. The cold, blustery air almost always brings a stint in the hospital because of a pain crisis, her mother said.

Every trip to the hospital means Gabby misses school, misses work, misses hanging out with friends and family, misses singing in the Detroit Youth Choir and doing all the other things she loves.

Neither her twin sister nor her older brother have the disease.

Gabby Ngang, 17, of Farmington Hills, stops to look at photos of her and her twin sister and other family members at her home on Dec. 7, 2023. The Farmington Hills High School senior has sickle cell anemia. The FDA is poised to approve two gene editing treatments for sickle cell disease that could be a cure for Gabriella.More

"Sometimes, she gets really angry with that," Ngang said. "'Why me? Why me? Why me?' she asks. I say, 'You are the privileged one.' I usually tell her 'You're the chosen one. I don't have an answer for that. I didn't ask for you to get it. They didn't ask me to choose who should have it, but God chose you. So we have got to deal with it. It's been a family trauma.'"

Still, the Ngangs have never given up hope that an innovation like gene therapy would come along and take Gabby's pain away.

"With all the medical research, I knew one day something would come up," Ngang said. "They're doing it for cancer and other illnesses. Why not sickle cell?"

Contact Kristen Shamus: kshamus@freepress.com. Subscribe to the Free Press.

This article originally appeared on Detroit Free Press: Only 1 Michigan hospital to initially offer new sickle cell gene editing treatment

At ASH, doctors acclaim new sickle cell gene therapies, but are cautious on details

Gwendolyn Wu and Ned Pagliarulo
Wed, December 13, 2023 

The Food and Drug Administration’s approval Friday of two gene therapies for sickle cell disease opens up their use by as many as 20,000 people in the U.S.

But in their first year on the market, and maybe for a year or two after that, physicians expect the uptake of the powerful, but complex treatments to be gradual at best.

“I think it'll be a slow ramp up,” said Akshay Sharma, a pediatric hematologist at St. Jude Children’s Research Hospital who was an investigator in testing. “Most of us clinicians are taking a very cautious approach, because many of us are looking for long-term data before we start saying, ‘Hey, everybody should get it.’”

The reasons are many. Fewer than 100 people received the therapies in clinical testing, the earliest treated of whom have now been followed for four or five years. While the data show dramatic benefit — treatment eliminated the pain crises associated with sickle cell — there are still outstanding questions on safety and on their use in sicker individuals, such as those who have a history of stroke.

The personalized treatments are also cumbersome to manufacture and require “conditioning” chemotherapy beforehand that carries risks of its own, particularly infertility. They’ll be among the most expensive medicines sold, too, priced at $3.1 million for Bluebird Bio’s Lyfgenia and $2.2 million for Vertex Pharmaceuticals and CRISPR Therapeutics’ Casgevy. Working out payment and getting insurers onboard may take time.

"I anticipate very few patients that first year for both products, maybe for the first couple of years,” said Alexis Leonard, also a pediatric hematologist at St. Jude’s.
Who should receive gene therapy?

While sickle cell is considered a rare disease, it still affects an estimated 100,000 people in the U.S., a figure President Joe Biden cited in a statement hailing Lyfgenia and Casgevy as “major breakthroughs.”

The indications approved by the FDA — 12 years or older with recurrent sickle cell crises — significantly shrink the number of people who could receive treatment. Vertex estimates about 16,000 people will be eligible, while Bluebird believes that number to be higher than 20,000.

Notably, the FDA did not restrict use of either Lyfgenia or Casgevy in people who have matched stem cell donors, the only other curative therapy for the blood disease. (Regulators in the U.K., where Casgevy was approved weeks prior, chose to exclude these individuals from the drug’s approved labeling.)

People with matched stem cell donors were not enrolled in testing of either treatment, so insurers might balk at paying for gene therapy in these individuals.

“I don't know if I would be as enthusiastic in recommending this over a matched sibling donor transplant,” said Sharma. “But the label clearly doesn't say that.”

Physicians also expressed uncertainty about treating sickle cell patients with a history of stroke with either therapy. Bluebird did enroll five such people in its trial before changing its study criteria, while Vertex excluded them.

“Stroke is a major indication for transplant so that should change,” said John Tisdale, a branch chief at the National Institutes of Health who specializes in sickle cell research, at a Monday session during the American Society of Hematology’s annual meeting. “The companies have been reluctant to accept the risk of [central nervous system] bleeding while trying to figure out if the approach works.”

Vertex’s study also capped the age of participants at 35, meaning physicians wanting to prescribe Casgevy won’t have data on its use in older individuals with sickle cell, who may have more organ damage as a result of their disease. They may also be unable to tolerate the chemotherapy conditioning.
How quickly can centers get up to speed?

Initially, only a handful of treatment centers around the country will offer Casgevy or Lyfgenia.

Vertex will make its drug available at nine sites across six states and Washington, D.C., while Bluebird said that 27 centers in 12 states are now ready to receive patient referrals. Both companies envision a broader network, but discussions at ASH made clear that the process for onboarding new hospitals will take time.

“We got approval [Friday], but that doesn't mean that all these centers are ready to provide the therapy,” said Leonard, of St. Jude’s, who presented at ASH Saturday on the topic. She noted a survey of 50 hospitals by the National Alliance of Sickle Cell Centers. Only 32 had participated in a gene therapy clinical trial, which Leonard described as an experience gap.

Prospective treating centers need comprehensive care teams that can include pain specialists, pulmonologists, infectious disease doctors and social workers. They also need access to a blood bank, space to draw and collect patient stem cells, cell processing facilities and fertility preservation services.

“The first step to getting these therapies is you have to be a qualified treatment center,” said Leonard. “We actually went to the Vertex and asked them, ‘What's your definition?’ And we got a very wishy-washy, no answer.”

In an email, a Vertex spokesperson said the company has been in “close dialogue” with all of its targeted authorized treatment centers. Many of these prefer to complete contracting discussions until after Casgevy’s approval, the spokesperson added.
Are there alternative treatments?

Matched bone marrow transplants can be a curative option for sickle cell. But only a small minority of patients, about 15% or so, have a donor who’s a suitable genetic match. Even then, the transplants still require patients to be healthy enough to undergo preconditioning with the toxic chemotherapy busulfan.

Research presented at ASH Monday suggested haploidentical, or half-match, transplants could be used in more patients, and with a gentler conditioning regimen. Haploidentical transplants use stem cells from family members such as parents, aunts, uncles or cousins, greatly broadening the pool of people who may be donors for a person with sickle cell.

The study, which was funded by the NIH, found that haploidentical transplants with a modified, less toxic regimen still led to good outcomes.

Adetola Kassim, director of Vanderbilt University's adult sickle cell disease program and an investigator, described how the studied procedure boosted hemoglobin levels as well as gene therapy. He noted, too, that transplants are about one-fifth the cost of the new therapies.

“The ideal curative therapy profile should offer protection from sickle cell related complications,” Kassim said during a Monday presentation at ASH. “[But] it also must be accessible and available to most patients.”

More broadly, researchers are looking at other ways to prepare patients for gene therapy, such as by using medicines known as antibody-drug conjugates for conditioning. Not only could these drugs be gentler on older people or those with organ damage, they could also preserve fertility. Further out, gene therapies involving an inside-the-body, or “in vivo” approach, could sidestep preconditioning altogether.

Ultimately, gene therapy offers new promise for treating sickle cell, said Tisdale. The NIH scientist included in his presentation a nod to Rodrick Murray, an early volunteer to receive sickle cell gene therapy in the U.S.

Murray was declared sickle cell-free two years after therapy, but died in 2020 from complications of leukemia he developed from preconditioning. The data recorded while tracking his treatment effects helped doctors adjust the treatment for later clinical trial participants.

“He told me he wanted to do this not for himself, but for other patients with sickle cell disease,” Tisdale said. “I was really happy to be in communication with his wife … on Friday to let her know he succeeded.”

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