Adrian Liston

🇦🇺🇧🇪🇬🇧👨‍🔬🌈 Professor of Pathology & Head of Immunology at @Cambridge_Uni. Fellow & Welfare Tutor at @Catz_Cambridge. Founder & CSO at Aila Biotech.

[Adrian Liston @LabListon]

Two post-doc positions available in our lab!

It is a supportive environment and one which boosts careers! Historically, of our ~30 post-docs 27% have gone on to tenure-track positions, 27% did another post-doc, and 42% have gone on to positions in biotech or pharma.

[Adrian Liston @LabListon]

Love this. 5+10 is a good way to do it, too

[nature @Nature]

China has selected its first group of young researchers to receive funding for up to 15 years, in one of the longest research grants on offer to scientists globally

https://t.co/6RnYWeNs6e

[Seth Thomas Scanlon @ImmunoEditor]

Be sure to check out the current issue of #Science #Immunology! New content is added each week!

[Adrian Liston @LabListon]

@InVivoPodOnX Does it? I thought 23andMe was SNP typing not genome sequencing. In which case it doesn't capture the type of rare mutations that are most informative. When I used it I also didn't give any phenotype data at all, or have any ongoing contact with them.

[Adrian Liston @LabListon]

I find AI text falls in the uncanny valley, making it distinctly distasteful. Like text written by a committee of joyless business consultants.

[Neil Shubin @NeilShubin]

Why do I struggle even reading papers that are clearly AI? Writing is a window into another person’s brain, their thinking, values, and outlook. When I read AI text, I mostly feel they shortchanged themselves and me.

[Adrian Liston @LabListon]

@chr1sa @SynBio1 Personally, I'm happy to take a plane that never crashes over a car with seat warmers but which may also set fire to itself and lock all the doors.

You make a great case for regulation.

[Adrian Liston @LabListon]

@InVivoPodOnX I get where you are coming from - hearing American accents out-of-context is very jarring for me, while Americans probably consider them neutral accidents, making them not jarring. My accent is not British, but I live in the UK and didn't find the accents jarring.

[Adrian Liston @LabListon]

The best thing I’ve read on Twitter since it stopped being Twitter

[Peter Girnus 🦅 @gothburz]

I am a member of the Norwegian Nobel Committee.

There are five of us. Five people, appointed by a parliament most of the planet could not find on a map, who decide, once a year, which human being the world has agreed to call good.

I know. I know. I think about it on the tram.

We meet in a building on Henrik Ibsens gate, a street named after a man who wrote almost exclusively about people discovering they are frauds, which nobody on the committee finds funny except me. There is a room with a long table and the portraits of the dead laureates looking down, Mandela, the Dalai Lama, a great many earnest men in spectacles, and one portrait we do not discuss, which is Kissinger, 1973, awarded while the bombs were still falling, after which two of our predecessors resigned and the satirist Tom Lehrer said political satire was now obsolete. We keep him on the wall. A reminder. Every family has the uncle.

It is October in Oslo, which means the sun gives up around four in the afternoon like a civil servant, and it rains the particular Norwegian rain that isn’t quite falling, just hanging there, judging you. I arrive with wet shoes. I always arrive with wet shoes. There is coffee, because this is Norway and there is always coffee, we drink more of it per person than almost anyone alive, and someone’s wife has sent kanelboller, the cinnamon buns, and we sit, five Norwegians, damp, caffeinated, sugared, and we decide the moral standing of the entire species.

Let me tell you how it actually works, because the world imagines a cathedral and it is, I promise you, a book club with a mandate.

287 nominations this year. 208 people, 79 organizations. Anyone can nominate, that’s the secret nobody understands: a professor, a parliamentarian, a former laureate, so the “nominee” list is meaningless, it’s a suggestion box, and every autumn some congressman nominates his own golden retriever and the press writes “SHORTLISTED.” Nobody is shortlisted. There is no short list the public ever sees. There is us, and the coffee, and the rain, and the portraits, and a Norwegian stubbornness that is older than the prize itself.

We read reports. The institute’s advisers write them, thick dull documents, and we argue. Our chairman told the BBC once that in the final meeting “there is a high temperature.” High temperature, for a Norwegian, means someone slightly raised an eyebrow and then apologized for it. We don’t do high temperature. We do a long silence, and then Kristin says “well,” and everyone knows exactly what “well” meant, and it’s settled. That’s our shouting. “Well.” You’d have to be raised here to hear the violence in it.

Now. This year. I will not say the name, because we never say the name, but you know the name.

A certain head of state wanted this prize the way a child wants a thing in a shop window, which is to say loudly, and in public, and with the full belief that wanting it was itself the argument. He said he deserved it. He said he’d ended eight wars, a number that grew most times he said it, like a fish. He had other heads of state phone us. Israel’s prime minister posted it on the internet, “Give him the Nobel.” The leaders of Cambodia and Pakistan announced they’d nominated him, as though announcing it were part of it, as though we tally mentions. A man flew around the globe collecting endorsements for a Norwegian committee the way you’d collect signatures for a petition to the council about a noisy dog.

And here, uff da, is the detail I treasure, the one that makes me smile into my coffee. The nomination deadline is the 31st of January. He took office on the 20th. So for all the phone calls, all the posts, all the gilded lobbying, the only nominations that could possibly count for this year’s prize were filed in the first eleven days of his term, before he had, by his own arithmetic, ended a single one of the eight wars. He campaigned all year for a prize whose window had shut while he was still hanging up his coat. We didn’t have to reject him. The calendar did. We just watched. Norwegians are very good at watching. We have long winters.

People think we sit there weighing his deeds. We don’t. That’s the thing I can’t make the world understand. We’re not grading his homework. We don’t owe anyone the prize for a ceasefire, however real, however loud the announcement. “He made peace” is not a sentence that ends in a medal, the way he believes it does, the way he believes every good thing ends in his name on it. The will of a dead Swede says the prize goes to whoever did the most for fraternity between nations. A dead Swede, I should add, who made his entire fortune inventing dynamite and selling arms, and spent his last years horrified at his own obituary, which called him a merchant of death, and so bought his way to immortality as a man of peace. The whole prize is one guilty arms dealer’s attempt to launder his name. We are, all of us, administering a dead man’s public relations. I find this clarifying. It keeps me humble. It should keep everyone humble, and it keeps, by my count, no one humble at all.

So who did we give it to?

An eighty-five-year-old woman. A judge. Born in Durban, under apartheid, granddaughter of a Tamil man who came to South Africa as indentured labor, a bus driver’s daughter from the poor Indian quarter, who became the first non-white woman to run a law practice in her province, who defended Mandela’s people when defending them was dangerous, who sat on the Rwanda tribunal and the court at the Hague, and who, at eighty-five, is right now a judge weighing whether a genocide is a genocide. When we told the world, our chairman said the rule of law “underpins the system we have set up to ensure peace,” and that “peace requires justice.” She wasn’t even in Oslo. She was in Nuremberg. In courtroom 600. The actual room where they tried the Nazis. You cannot stage that. God staged that, and God, it turns out, is a better satirist than any of us.

She did not phone us. She did not post. No prime minister demanded it for her on the internet. She had, as far as our deliberations are concerned, the one qualification the loud man could never manufacture, which is that she wanted the work and not the medal. The medal finds those people. It flees the ones who chase it. This is not a rule we wrote. It’s just the only pattern the hundred-odd years of our mistakes has ever shown.

The reaction from across the ocean was immediate. His spokesman posted that we “place politics over peace.” Ja. Perhaps. We’re five damp pensioners in a rainy city; of course it’s political, it was always political, it was political when we gave it to a sitting American president nine months into his first term for the promise of things he had not yet done, and we have been quietly embarrassed about that one for fifteen years, so believe me, we had a particular reason this year to prefer a woman with fifty years of verdicts behind her over a man with eight wars in front of him and a deadline already behind him.

Here is what he will never understand, the thing I’d tell him on the tram if he ever took one. We are the one prize he cannot buy, cannot post his way to, cannot have a friendly dictator phone in for him. Not because we’re incorruptible, nei, we’re as vain and wrong and human as the portraits on our wall. But because the entire point of the thing, the only power a small cold country’s book club has ever held, is that it goes to the person not performing the wanting. The moment you demand it, you’ve proven you don’t understand what it’s for, and proving that is itself the disqualification. He ran the most expensive campaign in the history of the prize and the campaign was the reason. He was never losing to Navi Pillay. He was losing to the concept.

It’s dark now. Four o’clock dark. The buns are gone. Kristin said “well” an hour ago and we all went home. I’m on the tram with my wet shoes, and somewhere across the water a very powerful man is explaining to a camera that the prize is rigged, that we’re corrupt, that he’ll win it next year, and he genuinely might, we’re only five idiots and we’ve been wrong before, Kissinger is still on the wall.

But not this year. This year an old woman in Nuremberg, in the room where the law once stared down the exact kind of man who thinks wanting a thing loudly enough should make it his, got a phone call she didn’t ask for.

That’s the job. We don’t reward the man who ends the war and announces it.

We reward the woman who spent fifty years deciding what a war was.

He’ll never see the difference. That’s rather the whole point of him.

Takk for i dag. I have to change trams.

[Peter Girnus 🦅 @gothburz]

I am a member of the Norwegian Nobel Committee.

There are five of us. Five people, appointed by a parliament most of the planet could not find on a map, who decide, once a year, which human being the world has agreed to call good.

I know. I know. I think about it on the tram.

We meet in a building on Henrik Ibsens gate, a street named after a man who wrote almost exclusively about people discovering they are frauds, which nobody on the committee finds funny except me. There is a room with a long table and the portraits of the dead laureates looking down, Mandela, the Dalai Lama, a great many earnest men in spectacles, and one portrait we do not discuss, which is Kissinger, 1973, awarded while the bombs were still falling, after which two of our predecessors resigned and the satirist Tom Lehrer said political satire was now obsolete. We keep him on the wall. A reminder. Every family has the uncle.

It is October in Oslo, which means the sun gives up around four in the afternoon like a civil servant, and it rains the particular Norwegian rain that isn’t quite falling, just hanging there, judging you. I arrive with wet shoes. I always arrive with wet shoes. There is coffee, because this is Norway and there is always coffee, we drink more of it per person than almost anyone alive, and someone’s wife has sent kanelboller, the cinnamon buns, and we sit, five Norwegians, damp, caffeinated, sugared, and we decide the moral standing of the entire species.

Let me tell you how it actually works, because the world imagines a cathedral and it is, I promise you, a book club with a mandate.

287 nominations this year. 208 people, 79 organizations. Anyone can nominate, that’s the secret nobody understands: a professor, a parliamentarian, a former laureate, so the “nominee” list is meaningless, it’s a suggestion box, and every autumn some congressman nominates his own golden retriever and the press writes “SHORTLISTED.” Nobody is shortlisted. There is no short list the public ever sees. There is us, and the coffee, and the rain, and the portraits, and a Norwegian stubbornness that is older than the prize itself.

We read reports. The institute’s advisers write them, thick dull documents, and we argue. Our chairman told the BBC once that in the final meeting “there is a high temperature.” High temperature, for a Norwegian, means someone slightly raised an eyebrow and then apologized for it. We don’t do high temperature. We do a long silence, and then Kristin says “well,” and everyone knows exactly what “well” meant, and it’s settled. That’s our shouting. “Well.” You’d have to be raised here to hear the violence in it.

Now. This year. I will not say the name, because we never say the name, but you know the name.

A certain head of state wanted this prize the way a child wants a thing in a shop window, which is to say loudly, and in public, and with the full belief that wanting it was itself the argument. He said he deserved it. He said he’d ended eight wars, a number that grew most times he said it, like a fish. He had other heads of state phone us. Israel’s prime minister posted it on the internet, “Give him the Nobel.” The leaders of Cambodia and Pakistan announced they’d nominated him, as though announcing it were part of it, as though we tally mentions. A man flew around the globe collecting endorsements for a Norwegian committee the way you’d collect signatures for a petition to the council about a noisy dog.

And here, uff da, is the detail I treasure, the one that makes me smile into my coffee. The nomination deadline is the 31st of January. He took office on the 20th. So for all the phone calls, all the posts, all the gilded lobbying, the only nominations that could possibly count for this year’s prize were filed in the first eleven days of his term, before he had, by his own arithmetic, ended a single one of the eight wars. He campaigned all year for a prize whose window had shut while he was still hanging up his coat. We didn’t have to reject him. The calendar did. We just watched. Norwegians are very good at watching. We have long winters.

People think we sit there weighing his deeds. We don’t. That’s the thing I can’t make the world understand. We’re not grading his homework. We don’t owe anyone the prize for a ceasefire, however real, however loud the announcement. “He made peace” is not a sentence that ends in a medal, the way he believes it does, the way he believes every good thing ends in his name on it. The will of a dead Swede says the prize goes to whoever did the most for fraternity between nations. A dead Swede, I should add, who made his entire fortune inventing dynamite and selling arms, and spent his last years horrified at his own obituary, which called him a merchant of death, and so bought his way to immortality as a man of peace. The whole prize is one guilty arms dealer’s attempt to launder his name. We are, all of us, administering a dead man’s public relations. I find this clarifying. It keeps me humble. It should keep everyone humble, and it keeps, by my count, no one humble at all.

So who did we give it to?

An eighty-five-year-old woman. A judge. Born in Durban, under apartheid, granddaughter of a Tamil man who came to South Africa as indentured labor, a bus driver’s daughter from the poor Indian quarter, who became the first non-white woman to run a law practice in her province, who defended Mandela’s people when defending them was dangerous, who sat on the Rwanda tribunal and the court at the Hague, and who, at eighty-five, is right now a judge weighing whether a genocide is a genocide. When we told the world, our chairman said the rule of law “underpins the system we have set up to ensure peace,” and that “peace requires justice.” She wasn’t even in Oslo. She was in Nuremberg. In courtroom 600. The actual room where they tried the Nazis. You cannot stage that. God staged that, and God, it turns out, is a better satirist than any of us.

She did not phone us. She did not post. No prime minister demanded it for her on the internet. She had, as far as our deliberations are concerned, the one qualification the loud man could never manufacture, which is that she wanted the work and not the medal. The medal finds those people. It flees the ones who chase it. This is not a rule we wrote. It’s just the only pattern the hundred-odd years of our mistakes has ever shown.

The reaction from across the ocean was immediate. His spokesman posted that we “place politics over peace.” Ja. Perhaps. We’re five damp pensioners in a rainy city; of course it’s political, it was always political, it was political when we gave it to a sitting American president nine months into his first term for the promise of things he had not yet done, and we have been quietly embarrassed about that one for fifteen years, so believe me, we had a particular reason this year to prefer a woman with fifty years of verdicts behind her over a man with eight wars in front of him and a deadline already behind him.

Here is what he will never understand, the thing I’d tell him on the tram if he ever took one. We are the one prize he cannot buy, cannot post his way to, cannot have a friendly dictator phone in for him. Not because we’re incorruptible, nei, we’re as vain and wrong and human as the portraits on our wall. But because the entire point of the thing, the only power a small cold country’s book club has ever held, is that it goes to the person not performing the wanting. The moment you demand it, you’ve proven you don’t understand what it’s for, and proving that is itself the disqualification. He ran the most expensive campaign in the history of the prize and the campaign was the reason. He was never losing to Navi Pillay. He was losing to the concept.

It’s dark now. Four o’clock dark. The buns are gone. Kristin said “well” an hour ago and we all went home. I’m on the tram with my wet shoes, and somewhere across the water a very powerful man is explaining to a camera that the prize is rigged, that we’re corrupt, that he’ll win it next year, and he genuinely might, we’re only five idiots and we’ve been wrong before, Kissinger is still on the wall.

But not this year. This year an old woman in Nuremberg, in the room where the law once stared down the exact kind of man who thinks wanting a thing loudly enough should make it his, got a phone call she didn’t ask for.

That’s the job. We don’t reward the man who ends the war and announces it.

We reward the woman who spent fifty years deciding what a war was.

He’ll never see the difference. That’s rather the whole point of him.

Takk for i dag. I have to change trams.

[Adrian Liston @LabListon]

@dr73450 @dwlz Okay, I teach in Cambridge, not Oxford, but these are not typical exam questions for medicine or natural sciences. They look like a parody of a humanities exam

[Adrian Liston @LabListon]

Now, I’m not an engineer, but I rather suspect that engineers have a comprehensive model of materials and forces prior to building their bridge. They don’t just slap something up and then see if it hold empirically.

Medicines are the same.

[Brian S. Kim @itchdoctor]

Yes. In fact, I have started a biotech company based on conviction of outcome while our MOA paper was (and is) still tied up in reviews at a glam journal. We have published papers post-drug approval showing elegant MOA. MOA while valuable, is quite academic. Drug utility is anything but academic - it’s more of a real world engineering question - did your drone fly? Does your bridge hold the load? Is your drug working regardless of what Reviewer 3 thinks? That’s why it’s such a vastly different skill set prior to the outcome - conviction in face of uncertainty (prior to drug) vs. data to prove certainty (prior to publication).

[Adrian Liston @LabListon]

@simocristea @SimonLermenAI Literally there are people arguing that 100 deaths would be a small price to pay for the extra speed of bypassing regulation.

Safety has to come first, and the people arguing that this cannot be assessed prior to a clinical trial are being duplicitous

[Adrian Liston @LabListon]

@simocristea @SimonLermenAI That’s why I said “another point”, because of course these companies are going to use AI for trial design.

Understanding the biology derisks the trial. People in this thread are happy to have hundreds of patients die in an AI-drug trial. I am not

[Adrian Liston @LabListon]

@ShahabBakht You don’t enter a clinical trial starting from zero, unless you are willing to kill people. Which plenty of people on Twitter today are.

[Adrian Liston @LabListon]

Clinical trials are *not* the Wild West of “give it a go”. Clinical trials are started after enough confidence in safety and efficacy has already been met to warrant the risk to humans.

Crazy that tech-to-bio bros with unlimited cash don’t know this.

[Shahab Bakhtiari @ShahabBakht]

Parkinson's patients get deep brain stimulation surgery every day without us fully knowing why it works; and yet, it clearly does.

Clinical trials are just there to test safety and efficacy, not figure out the underlying mechanism.

[Adrian Liston @LabListon]

Yes, 100 dead patients from an AI designed drug being fast-tracked past regulation onto a clinical trial would be a bad thing.

This cowboy approach cannot be allowed into experimental medicine. These are real lives being dismissed.

[Jack | amatica health @JackHadfield14]

This framing assumes over prioritising safety has no downside. It means telling a stage 4 cancer patient they can’t take a drug that passed a phase 3 trial, and must die of their cancer instead, while experts debate how it works. It’s their body and their choice.

For that patient the choice isn’t wait safely vs take a risky drug. It’s die waiting vs a chance of living. That’s why patients already inject untested compounds at unregulated clinics in Mexico.

Millions die while we wait and nobody gets blamed. If 100 people died from an AI designed drug it would be called a catastrophe, even though most of them would have been dead within months anyway.

Patients know new drugs can go wrong. The alternative is extreme suffering or death. We aren’t impatient because we want the next shiny update, we’re impatient because many of us will die before it arrives.

Drug regulation is already too strict. With AI now moving biology this fast, the priority should be loosening it, not tightening it. Right now a patient who will die from their disease in a few months, or take their own life because of the suffering, usually can’t get access to promising drugs still in trials or try combinations that might work better together but carry more side effect risk. They just have to die.

If we were being logical, those patients could enroll in a program, try the drug or any combination they want, and record the outcome so it feeds back into the science. Relying on slow, admin heavy trials with tightly selected groups as the only way to learn about new treatments is the least efficient and least ethical option we have. It exists to protect pharma and regulators from blame, not to reduce suffering and death. Now that some people could realistically be cured in the next decade instead of waiting 20 years for trial funding and long term outcome studies, we should be moving away from it fast.

For weight loss or baldness, be as rigorous as you like. Framing this around stage 4 cancer is detached from what patients actually face. The people debating it don’t pay for the delay, the patient does.

[Adrian Liston @LabListon]

@Quantum_Naut @anindyadeeps Sure, same is true for existing labs with proven records. Let’s do a fair comparison - give my lab half the money this start up gets and see if we can’t get double the tangible output

[Adrian Liston @LabListon]

@anindyadeeps Boasting of a “bitter lesson” to come when you are essentially doing performative money burning doesn’t create good will.

The question isn’t whether this approach can work, it is whether this approach is more efficient. Dumpster trucks of money for nothing says no.

[Adrian Liston @LabListon]

@OmicsOmicsBlog @eryney_ok A press release?

[Adrian Liston @LabListon]

@simocristea @SimonLermenAI Another point is that trial design can be hacked. If the clinical trial is designed by AI for the purpose of the drug passing, then the clinical trial is intrinsically flawed.

Unknown biology also means that a drug that "works" may still be a net negative.