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Subject: Biotech and Medical Sciences

  • [pib] CAR T-Cell Therapy

    Why in the News?

    The Department of Biotechnology (DBT) has been a key supporter of research projects focusing on CAR T-cell therapies for cancers.

    About CAR T-Cell Therapy:

    What is it?
    • Acronym  for Chimeric Antigen Receptor TCell Therapy;
    • Innovative  immunotherapy in which T-cells (a type of white blood cell) are genetically modified to express a receptor (CAR) that targets specific proteins on cancer cells.
    • T-cells are part of the immune system and help identify and eliminate infected or cancerous cells.
    Objective of the Therapy
    • To treat blood cancers, especially B Acute Lymphoblastic Leukemia (B-ALL) and Non-Hodgkin Lymphoma (B-NHL).
    • Aimed at patients whose disease relapsed or was resistant to conventional treatments (chemotherapy, radiation).
    • Specifically targets CD19, a protein found on the surface of B-cells, which includes cancerous B-cells.
    Implementation and Structural Mandate
    • Developed jointly by Indian Institute of Technology (IIT-Bombay) and Tata Memorial Center (TMC), Mumbai since 2015.
    • Approved by DCGI (Drug Controller General of India) in March 2021 for Phase 1 trials in children and adults with relapsed B-ALL and B-NHL.
    • Supported by academic grants from Department of Biotechnology and government agencies.
    • Trials were conducted at Tata Memorial Center (TMC), and other hospitals.
    Future Scope for Phase II
    • Phase 1 Trials: Conducted from 2021 to 2023 on children and adolescents with B-ALL and adults with B-NHL, with promising results matching international standards in terms of efficacy and safety.
    • Phase 2 Trials: Have been approved and are currently ongoing. These trials will expand on the efficacy and long-term safety of the therapy, including larger cohorts of patients.

    Future Scope: Holds the potential for expanding to other cancers, such as Multiple Myeloma, Glioblastoma, and Hepatocellular Carcinomas, based on continued research and results from Phase II trials.

     

    PYQ:

    [2022] Which one of the following statements best describes the role of B cells and T cells in the human body?

    (a) They protect the environmental allergens body.
    (b) They alleviate the body’s pain and inflammation.
    (c) They act as immuno-suppressants in the body.
    (d) They protect the body from diseases caused by pathogens.

  • [pib] National Tuberculosis Elimination Programme (NTEP)

    Why in the News?

    The Union Ministry of Health has re-strategized the National Tuberculosis Elimination Programme (NTEP) under the 100-Day TB Elimination Campaign to reduce TB cases and mortality through targeted interventions and a multi-pronged approach.

    Menace of TB in India:

    • According to the World Health Organization (WHO), India accounted for 26% of global TB cases and deaths in 2023.
    • The Indian Council of Medical Research (ICMR) conducted a National TB Prevalence Survey in 20 states, reporting 312 TB cases per lakh population.
      • The TB incidence rate decreased by 17.7%, from 237 per 100,000 in 2015 to 195 per 100,000 in 2023.
      • Similarly, TB-related deaths have declined by 21.4%, from 28 per lakh population in 2015 to 22 per lakh population in 2023.

    About the National TB Elimination Programme (NTEP):

    Details
    About
    • Former Name: Revised National Tuberculosis Control Programme (RNTCP)
    • Objective: To eliminate tuberculosis (TB) as a public health issue in India by 2025, as per PM Modi’s 2018 target.
    • Focus Areas: Early detection, complete treatment, prevention, and strengthening TB care and control services.

    Key Components of NTEP:

    • Universal Drug Susceptibility Testing (UDST): Early detection of drug-resistant TB.
    • Free Diagnosis and Treatment: Provided for all TB patients across India.
    • Nikshay: A case-based web-enabled TB information system for monitoring and case management.
    • Private Sector Engagement: Involving private healthcare providers for standardized care.
    Objectives under the National Strategic Plan 100-Day TB Elimination Campaign is an intensified effort launched to fast-track the detection and treatment of tuberculosis (TB) cases across the country.

    • Eliminate TB as a public health problem by 2025.
    • Achieve Universal Access to quality TB care.
    • Prevent the emergence of drug-resistant TB through early diagnosis and appropriate treatment.
    • Reduce the burden of TB through preventive interventions and awareness campaigns.
    • Ensure better case management through Nikshay, a case-based monitoring system.
    • 6. Engage with the private sector to ensure standardized and quality TB care.
    Steps taken by Govt
    • Universal Drug Susceptibility Testing (UDST): Early detection of drug-resistant TB.
    • Free Diagnosis and Treatment: Provided for all TB patients.
    • Nikshay System: Web-enabled case-based monitoring and management system for TB patients.
    • Private Sector Engagement: Ensuring standardized TB care by involving private healthcare providers.
    • National TB Prevalence Survey: Conducted to assess the TB burden in 20 states.
    • Enhanced Diagnostic Facilities: Including genetic and molecular tests for early detection.
    • Targeted Interventions for Vulnerable Populations: Focus on high-risk groups, including children and marginalized populations.
  • Marburg Virus outbreak in Rwanda

    Why in the News?

    An outbreak of Marburg Virus (Bleeding Eyes) disease (MVD) has killed and infected many in Rwanda.

    rwanda
    Location of Rwanda

    About Marburg Virus:

    Overview • Causes Marburg Virus Disease (MVD), also known as Marburg Hemorrhagic Fever.
    • Belongs to the filovirus family (same as Ebola).
    • Discovered during outbreaks in 1967 in Marburg and Frankfurt, Germany.
    Case Fatality Rate ranges from 24% to 88%, depending on the strain and treatment effectiveness.How does it spread?Animal to Human Transmission: Spread primarily from Rousettus bats, especially Egyptian fruit bats found in caves or mines.
    Human to Human Transmission: Spread through direct contact with blood and bodily fluids (saliva, vomit, feces, semen, and breast milk). Also transmitted indirectly through contaminated surfaces or clothing.
    Symptoms and Treatment • Early signs include fever, headache, muscle aches, chills, nausea, vomiting, and severe diarrhoea.

    • Progresses to bleeding from various body parts, and death typically occurs 8-9 days after symptoms due to blood loss and organ failure.
    No approved vaccine or antiviral treatment. Supportive care includes hydration, symptom management, and blood transfusions. Experimental vaccines are being studied.

    Why is it a Global Concern? High Fatality Rate: MVD’s case fatality rate (24%-88%) makes it one of the deadliest diseases.
    Spread: Ongoing outbreaks, primarily in Africa, but now affecting Rwanda and Tanzania.
    Public Health Threat: Human-to-human transmission and rapid spread pose significant challenges.
    Economic Impact: Outbreaks disrupt local economies, healthcare systems, and global trade due to travel restrictions and quarantine measures.

     

    PYQ:

    [2015] Among the following, which were frequently mentioned in the news for the outbreak of Ebola virus recently?

    (a) Syria and Jordan

    (b) Guinea, Sierra Leone and Liberia

    (c) Philippines and Papua New Guinea

    (d) Jamaica, Haiti and Surinam

  • ecDNA Challenges Law of Genetics

    Why in the News?

    A recent study published in theNature’ has shown that Extrachromosomal DNA (ecDNA) is present in approximately 50% of cancer types, playing a significant role in tumor evolution and genetic heterogeneity.

    What is ecDNA?

    Details ecDNA stands for extrachromosomal DNA, which is small, circular DNA found in the nucleus of cells, separate from regular chromosomes.
    • Forms when DNA breaks off from chromosomes, often due to damage or errors in cell division.
    • Can carry extra copies of oncogenes, which promote cancer growth.
    • Initially thought to be unimportant, recent studies show it plays a major role in cancer.
    How ecDNA Contributes to Cancer and Drug Resistance Helps Tumors Grow: ecDNA contains extra copies of oncogenes that help cancer cells grow faster and become more aggressive.
    Drug Resistance: The extra oncogenes make the cancer harder to treat with standard drugs by producing more harmful proteins.
    Faster Tumor Evolution: ecDNA allows cancer cells to evolve rapidly, making them more resistant to treatments like chemotherapy and enabling the tumor to grow even when drugs are used.

     

    How ecDNA Challenges Genetics Laws?

    • Mendel’s Law says that genes on different chromosomes are inherited independently, meaning they are passed on randomly to the next generation.
    • ecDNA breaks this rule by grouping genes together and passing them on as a cluster during cell division.
    • This allows cancer cells to inherit beneficial genes more easily and helps the tumor grow faster.
    • Unlike regular chromosomes, which are distributed randomly during cell division, ecDNA is passed on together as a package.
    • This process gives cancer cells an advantage by making sure they inherit helpful genetic combinations that support cancer growth and resistance to drugs.
  • [pib] National AYUSH Mission (NAM)

    Why in the News?

    • The National AYUSH Mission (NAM) is an important Centrally Sponsored Scheme aimed at promoting and developing the AYUSH systems of medicine across the country.
      • In addition to NAM, Central Sector Schemes like the AYURSWASTHYA Yojana and the AYURGYAN Scheme play a crucial role in advancing the mission’s objectives

    About AYURGYAN and AYURSWATHYA Scheme

    Details
    AYURSWASTHYA Yojana • Under the Ministry of AYUSH to promote AYUSH healthcare and education.
    • Has two key components:

    1. AYUSH and Public Health: Promotes AYUSH interventions for community health care.
    2. Upgradation of Facilities to Centre of Excellence: Improves standards of AYUSH medical units and establishes advanced centers in AYUSH and Allopathic institutions (both Govt. and Private).

    • Funding: Maximum assistance of ₹10 crore for Centre of Excellence upgrades for 3 years.

    AYURGYAN Scheme • Created by merging two schemes under one umbrella.
    • Focuses on promoting AYUSH education and research.
    • Aims to develop quality standards and expand AYUSH education and healthcare services across India.
    Training of healthcare professionals in AYUSH and supporting research initiatives to improve efficacy and standards of traditional medicine.

    Back2Basics: National AYUSH Mission (NAM)

    Category Details
    Overview   Launched in September 2014 under the Ministry of Health and Family Welfare during the 12th Five Year Plan.
    • Aimed at promoting and strengthening traditional systems of medicine: AYUSH (Ayurveda, Yoga, Unani, Siddha, Homeopathy).
    Focuses on improving healthcare infrastructure in rural and remote areas, enhancing access to AYUSH services and promoting holistic health across India.
    Implementation and Structure • Initially implemented by the Department of AYUSH, now under the Ministry of AYUSH for nationwide execution.
    • Works in partnership with States and UTs to address healthcare gaps in underserved areas.
    Provisions under NAM Promotion of AYUSH Systems: Integrates AYUSH into the mainstream healthcare system, especially in rural and underserved areas.
    Support to State/UTs: Provides financial support for establishing AYUSH dispensaries, clinics, colleges and hospitals.
    Strengthening AYUSH Health Services: Financial assistance for expanding AYUSH services, especially in remote areas.
    Research & Development (R&D): Supports research for developing better treatments and standardizing practices in AYUSH.

    PYQ:

    [2019] How is the Government of India protecting traditional knowledge of medicine from patenting by pharmaceutical companies?

  • [pib] India’s First Indigenous Antibiotic: Nafithromycin

    Why in the News?

    The Ministry of Science & Technology has launched Nafithromycin, India’s first indigenous antibiotic to combat drug-resistant infections.

    About Nafithromycin:

    Details
    About • It was developed with the support of the Biotechnology Industry Research Assistance Council (BIRAC), a unit under the Department of Biotechnology, to combat antimicrobial resistance (AMR).
    • It aims to treat Community-Acquired Bacterial Pneumonia (CABP) caused by drug-resistant bacteria.
    ( Awaiting final approval from CDSCO for manufacturing and public use.)
    Features   Developed over 14 years of clinical trials in the U.S., Europe, and India.
    10 times more effective than azithromycin. (3 doses to combat Drug-Resistant Pneumonia)
    Minimal side effects, no significant drug interactions, and food-independent.
    Significance   It targets both typical and atypical pathogens.
    • It addresses a global health issue, especially CABP, contributing to over 2 million deaths annually.
    • Offers a more effective, faster, and safer treatment for drug-resistant pneumonia.
    • Demonstrates successful public-private collaboration between the government and Wockhardt Pharmaceuticals.
    • A cost-effective solution for treating resistant infections in low-resource settings.

     

    PYQ:

    [2019] Which of the following are the reasons for the occurrence of multi-drug resistance in microbial pathogens in India?

    1. Genetic predisposition of some people
    2. Taking incorrect doses of antibiotics to cure diseases
    3. Using antibiotics in livestock farming
    4. Multiple chronic diseases in some people

    Select the correct answer using the code given below.

    (a) 1 and 2
    (b) 2 and 3 only
    (c) 1, 3 and 4
    (d) 2, 3 and 4

  • Should packaged food content be labelled?

    Why in the News?

    A report by the Access to Nutrition Initiative (ATNi), a global non-profit, reveals that food and beverage companies generally sell less healthy products in low- and middle-income countries (LMICs) than in high-income countries (HICs).

    What does the report published by the Access to Nutrition Initiative state? 

    • Lower Health Ratings in LMICs: The report assessed 52,414 products from 30 of the world’s largest food and beverage manufacturers. It found that products sold in LMICs had an average Health Star Rating (HSR) of 1.8, whereas those in HICs averaged 2.3. This indicates that the portfolios of these companies are less healthy in poorer markets.
    • Healthier Product Sales: Only 30% of the assessed companies have a strategy to price their healthier products affordably for lower-income consumers. This lack of accessibility contributes to dietary issues in these regions.
    • Micronutrient Data Availability: The report highlighted that micronutrient data were available for a smaller proportion of products in LMICs compared to HICs, complicating efforts to address nutritional deficiencies.
    • Call for Action: The ATNi challenges companies to derive at least 50% of their sales from healthier products by 2030, a target that only a small fraction currently meets.

    How does a Health Star rating system work? 

      • The Health Star Rating (HSR) system is a front-of-pack labeling initiative that rates food products on a scale from 0.5 to 5 stars based on their nutritional profile.
    • The rating is calculated by assessing:
      • Risk Nutrients: Total energy, saturated fat, sugars, and sodium.
      • Positive Nutrients: Protein, fiber, fruits, vegetables, nuts, and legumes.
    • A score above 3.5 stars is considered healthier, while lower scores indicate less healthy options. This system allows consumers to easily compare similar products and make informed dietary choices.

    Why have non-communicable diseases become so common in India? 

    Non-communicable diseases have become increasingly prevalent in India due to several factors:

    • Dietary Shifts: There has been a significant increase in the consumption of highly processed foods that are high in sugars and fats, contributing to obesity and diabetes.
      • According to the Indian Council of Medical Research (ICMR), unhealthy diets account for over 56% of the total disease burden in India.
    • Affordability Issues: More than 50% of Indians cannot afford a healthy diet, exacerbating nutritional deficiencies alongside rising obesity rates.
    • Lifestyle Changes: Reduced physical activity and urbanization have also played roles in this epidemic, leading to a dual burden of undernutrition and obesity.

    Can front-of-pack labelling help?

    Front-of-pack labeling could significantly influence consumer behavior and public health outcomes:

    • Effectiveness of Warning Labels: Studies from countries like Chile and Mexico show that mandatory warning labels on sugary beverages have led to decreased consumption. This suggests that clear labeling can help consumers make healthier choices.
    • Need for Mandatory Policies: Activists argue that voluntary measures taken by companies have been insufficient. They advocate for mandatory regulations on front-of-pack labeling to effectively communicate nutritional information related to high sugar, fat, and sodium content.

    Conclusion: The Access to Nutrition Initiative report emphasizes the urgent need for healthier food portfolios in LMICs (Low- and Middle-Income Countries), equitable pricing, and front-of-pack labeling to combat non-communicable diseases. These steps align with SDG 3 (Good Health and Well-being), promoting healthier lives globally.

    Mains PYQ:

    Q Can the vicious cycle of gender inequality, poverty and malnutrition be broken through microfinancing of women SHGs? Explain with examples. (UPSC IAS/2021)

  • What is High-Altitude Sickness?

    Why in the News?

    The tragic death of a trekker scaling Garur Peak in Uttarakhand, underscores the dangers of high-altitude sickness in the Himalayas.

    What is High-Altitude Sickness?

    • Causes: High-altitude sickness, or Acute Mountain Sickness (AMS), occurs when the body struggles to acclimatise to elevations above 8,000 feet (2,400 metres) due to reduced oxygen levels.
    • Symptoms: Early signs include headache, nausea, fatigue, and shortness of breath. If untreated, it may escalate to:
      • High-Altitude Pulmonary Edema (HAPE): Fluid in the lungs, causing breathing difficulties.
      • High-Altitude Cerebral Edema (HACE): Fluid in the brain, leading to confusion, hallucinations, and coma.

    Prevention and Treatment

    • To prevent AMS, experts recommend a slow ascent with rest days every 3-4 days above 3,000 meters and avoiding sleeping elevation increases of more than 500 meters per day.
    • Medications:
      • Acetazolamide: Aids acclimatisation.
      • Dexamethasone: Reduces severe inflammation.
      • Nifedipine: Prevents HAPE in high-risk individuals.
        Note: Medications are not foolproof and are to be taken under medical guidance.
  • [pib] Postage Stamp released on Sickle Cell Eradication – 2047

    Why in the News?

    Madhya Pradesh marked a significant milestone in public health by unveiling a commemorative postage stamp dedicated to the Sickle Cell Eradication – 2047 initiative.

    What is the Sickle Cell Disease (SCD)?

    • SCD is a genetic disorder where red blood cells take a crescent shape, impairing circulation and causing complications like anaemia, organ damage, pain episodes, and a shortened lifespan.
      • It predominantly affects marginalized tribal populations.
    • Symptoms: Common symptoms include chronic anaemia, painful episodes (sickle cell crisis), and delayed growth and puberty.
    • Treatment: Treatments include blood transfusions, hydroxyurea to reduce pain episodes, and gene therapy or stem cell transplantation for long-term management.
    • India’s Mission:
      • Union Budget 2023-24 announced a mission to eradicate sickle cell anaemia by 2047, focusing on awareness and screening for individuals aged 0-40.
      • Anaemia Mukt Bharat Strategy: It provides bi weekly iron Folic acid supplementation to all under five children through ASHA workers.

    What are the key facts about the Sickle Cell Eradication – 2047 Initiative?

    Details
    Aims and Objectives Complete eradication of sickle cell anemia by 2047.
    Awareness and screening in tribal communities.
    Accessible diagnosis and treatment, with tools like HPLC.
    Genetic counseling for prevention.
    Technology-driven monitoring via mobile app and National Sickle Cell Portal.
    Features of the Program Newborn screening and prenatal diagnostics at AIIMS Bhopal.
    Nationwide expansion to 17 states by 2047.
    Advanced testing with HPLC machines.
    Community engagement through support groups and education.
    Implementation   Collaborations with institutions like AIIMS Bhopal, Sankalp India, and healthcare providers.
    Phased rollout starting with high-prevalence regions in Madhya Pradesh.
    Government funding for infrastructure and tech development.
    Digital technology for data collection and case management.

     

    PYQ:

    [2023] Consider the following statements in the context of interventions being undertaken under the Anemia Mukt Bharat Strategy :

    1. It provides prophylactic calcium supplementation for pre-school children, adolescents and pregnant women.
    2. It runs a campaign for delayed cord clamping at the time of child-birth.
    3. It provides for periodic deworming to children and adolescents.
    4. It addresses non-nutritional causes of anaemia in endemic pockets with special focus on malaria, hemoglobinopathies and fluorosis.

    How many of the statements given above are correct?

    (a) Only one
    (b) Only two
    (c) Only three
    (d) All four

  • Growing epidemic

    Why in the News?

    Global diabetes cases surged from 200 million in 1990 to over 800 million in 2022, with adult prevalence doubling from 7% to 14%, according to The Lancet report.

    What are the WHO’s targets for diabetes diagnosis and management by 2030?

    • The World Health Organization (WHO) aims for 80% of people with diabetes to be diagnosed.
    • The target is for 80% of diagnosed individuals to achieve good glycemic control, which is crucial for preventing complications associated with diabetes.

    What is the current state of diabetes prevalence in India?

    • As of 2022, India has the highest number of people with diabetes globally, totalling 212 million, significantly up from around 200 million in 1990.
    • The prevalence of diabetes among adults in India rose from 7% in 1990 to 14% in 2022.
    • India also leads in the number of untreated diabetes cases, with 133 million individuals over the age of 30 remaining undiagnosed, compared to 78 million in China.
    • The increase is partly attributed to improved data collection methods that include individuals with elevated fasting plasma glucose and glycated haemoglobin (HbA1c), capturing a broader population affected by diabetes.

    What strategies can India implement to achieve these targets?

    • Targeted Screening and Lifestyle Interventions: India can adopt Finland’s approach of identifying high-risk individuals through targeted screening and offering lifestyle interventions, including dietary changes and exercise, to prevent diabetes.
    • Enhance Public Awareness Campaigns: Community-based implementation and awareness programs align with SDG 3 (Good Health and Well-being) by promoting healthy lifestyles, preventing diabetes, and ensuring equitable access to healthcare for all, especially vulnerable populations.
    • Improve Access to Healthcare Services: Ensure that diagnostic facilities for blood glucose testing are widely available and affordable. Strengthen primary healthcare services to facilitate easier access to diabetes care and management.

    Steps taken by the government:

    • National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases, and Stroke (NPCDCS): Launched to promote awareness, early diagnosis, and management of non-communicable diseases (NCDs) including diabetes. This program aims to reduce risk factors through lifestyle modifications and improve access to healthcare services.
    • Collaboration with WHO and Other Organizations: India collaborates with the World Health Organization (WHO) and other international bodies to align its diabetes management strategies with global best practices and targets, including those set for 2030.

    Way forward: 

    • Strengthen Preventive Healthcare: Focus on early detection through widespread screening, robust public awareness campaigns, and targeted interventions for high-risk groups, emphasizing healthy lifestyle promotion.
    • Enhance Integrated Care Systems: Scale up access to affordable diabetes care, strengthen primary healthcare services, and integrate technology for monitoring and management to achieve WHO’s glycemic control targets by 2030.

    Mains PYQ:

    Q  Stem cell therapy is gaining popularity in India to treat a wide variety of medical conditions including leukaemia, Thalassemia, damaged cornea and several burns. Describe briefly what stem cell therapy is and what advantages it has over other treatments. (UPSC IAS/2017)