Weekly Health Digest: Misdiagnosis and Race, Experimental Drugs, and Autoimmune Diseases

Women and people of color bear the brunt of medical misdiagnosis

By Liz Szabo, KFF Health News

Every year, 12 million adults get misdiagnosed in the United States. Charity Watkins, a Black woman who recently gave birth, was one of them. In particular, after expressing concerns of exhaustion, Watkins was diagnosed with postpartum depression and the flu— instead of heart failure, which would have killed her if not caught sooner by a chest X-ray. While these circumstances may seem intense, they are not uncommon for underrepresented patients to experience.  According to Dr. David Newman-Toker, “Women and racial and ethnic minorities are 20 percent to 30 percent more likely than white men to experience a misdiagnosis”. 

Rising maternal mortality rates in the United States demonstrate these racial disparities as well. As reported by the CDC, “non-Hispanic Black mothers are 2.6 times as likely to die compared to non-Hispanic White moms”. Dr. Jennifer Lewy also noted that “Black women with childbirth-related heart failure are typically diagnosed later than White women”. This transfers over to mental health issues as well– as studies have demonstrated that “Black people with depression are more likely than others to be misdiagnosed with schizophrenia” and that “people of color are less likely than white people to be diagnosed early with dementia”. 

Moving forward, healthcare professionals are encouraged to truly reflect on how racial biases affect both their decision-making skills and their confidence in treating patients. For example, as mentioned by Dr. Karen Lutfey Spencer, many doctors are “more confident when diagnosing white men” and only “4.5 percent of images in general medical textbooks feature patients with dark skin”. Spreading awareness about these issues within America’s healthcare system will allow people of color who are seeking medical care to “reclaim power” in their lives.

By Manju Karthikeyan

Experimental Drug Cuts Off Pain at the Source, Company Says

By Gina Kolata, The New York Times

While opioids are effective at alleviating extreme pain, there has been an increase in regulatory measures due to their addictive nature. As a result, addicted individuals have later sought illegal and dangerous substances such as heroin and fentanyl. In response to this issue, researchers at Vertex Pharmaceuticals have diligently worked to develop a non-addictive, pain-treating drug that directly targets the pain source without impacting the brain. 

To create this drug, researchers studied genetic mutations that affect the peripheral nerves, nerves that relay information between the brain and the body. Eventually, two types of important genetic mutations were found: one which triggers intense pain sensations and another which completely prevents the ability to feel pain. 

Identifying the specific genes that affect pain transmission allowed scientists to begin their work on creating a new pain-treating drug. Vertex Pharmaceuticals spent the past twenty years working on this drug development and ultimately created a new drug called “VX-548,” which they plan to apply for market approval later this year. 

 Clinical trials tested on individuals experiencing surgical pain have proven the drug’s successful effectiveness in treating acute pain, and Professor Dr. Henry Kranzler, the director of the Center for Studies of Addiction at the University of Pennsylvania’s Perelman School Of Medicine, referred to VX-548 as “a therapeutic breakthrough.” Nevertheless, non-addictive treatments for chronic pain, and not just acute pain, still need to be created. Fortunately, Vertex Pharmaceutical has initiated research to enhance the drug’s treatment capabilities. 

By Julia Roth

Why Do Women Have More Autoimmune Diseases? Study Points to X Chromosome 

By Saanvi Nayar, The New York Times

A recent research study, conducted by geneticist and dermatologist Dr.Howard Chang, has produced data pointing towards the second X chromosome as the culprit for increased rates of autoimmune diseases in women. 

Autoimmune diseases classify disorders developed later in life, when the immune system becomes overactive, attacking healthy cells. The X chromosome at the center of the study refers to sex chromosomes; the 23rd chromosome pair XY produces male sex organs, while XX produces female sex organs. 

The second X in women is silenced, with Xist molecules wrapping the chromosome to prevent the replication of potentially harmful proteins. Dr.Chang’s work as a geneticist inspired his research, as his identification of proteins involved in prevalent autoimmune diseases is paramount to the process of Xist molecules attaching to the membrane. His research was centered around mice, with females predisposed to developing the autoimmune disease, lupus. The male mice were genetically modified to host a second X chromosome, and the results showed that they were significantly more predisposed to developing lupus after this genetic engineering. 

Dr.Chang theorizes that through the natural aging process, dying cells in female bodies expel Xist molecules, “confusing the immune system.” However, considering the complex functions of the Xist molecules and the breadth of information yet to be discovered about the function of the silenced X chromosome, various researchers do not believe the data derived from this study is indicative of any breakthrough. However, Dr. Chang, and colleagues studying genetics and autoimmune diseases, do believe that this research presents an innovative approach to linking causation amongst these fields.

By Saanvi Nayar

Items contributed by: Manju Karthikeyan, Julia Roth, Saanvi Nayar