Good News About America

In the United States, polio is a disease from the days of yore, long since eradicated. But in Africa and South Asia, while vaccination programs lead by the WHO have lead to a decline in new outbreaks, many people are still suffering from its effects.

30-year-old physiotherapist Sanjay Kumar has developed a low-cost treatment for helping paralyzed survivors regain their mobility; the process takes one to two months and costs about $30-$35 per patient.  Patients are given plaster casts, which are cut and replaced weekly, using wooden wedges to straighten the muscles.

An infrequently-updated blog about the work is available here.

Transexamic acid, or TXA, is a drug commonly used in wealthy countries to stop bleeding during elective surgeries; it costs about $9 per dose.  A recent study involving more than 20,000 trauma patients found that by administering the drug to people within 8 hours of the injury, the patients had a 15 percent lower chance of dying from a hemorrhage and a 10 percent lower chance of dying from any other cause.

The World Health Organization is being urged to include TXA on its List of Essential Medicines, which would likely result in the drug seeing more use in poor countries; however, it is expected to see more use in developed countries as well.  The drug works by interfering with the breakdown of clots, which reduces bleeding.

In 2004, California voters, unhappy with funding restrictions imposed by then-president George Bush, approved $3 billion in funding for stem cell research.  Scientists happily began the process of basic research that could eventually lead to cures for a number of serious conditions.  What have they found so far?

One important discovery made with the money from the California initiative is how to generate pluripotent cells; these are cells that have many of the same properties as embryonic stem cells. (Ironically, opponents of embryonic stem cell research cite these pluripotent cells as proof that the research that created them is unnecessary, because they can be used instead!)  Scientists have also learned to grow cells more efficiently and gained a better understanding of how cells work. The influx of money has also encouraged other scientists to move to California, drawn by the promise of a supportive environment for basic research.

While President Obama’s reversal of the Bush restrictions on stem cell research in March of last year have permitted scientists across the country to join those in California in working in this area, the field is complicated and has a number of regulations meant to ensure that ethical guidelines are followed.  A blog post I ran across today, by a scientist working in stem cell research, offers a brief discussion of some of the issues involved.  Under Bush, only 22 embryonic stem cell lines were available to researchers using federal funding (which is to say, pretty much all of them outside of California); scientists are now in the process of gaining access to many of the more than 1,000 new lines that have been created worldwide in the past decade.  New lines must undergo a complex vetting procedure before they can be used; currently over 60 lines are available, but many of them have restrictions on how they can be used.

Research is ongoing with both embryonic and adult stem cells.  The difference is that embryonic stem cells can be grown into any type of cell, while adult stem cells can only make the cells in the type of tissue they’re taken from.  Both types are very valuable, but embryonic cells are more versatile and less susceptible to aging. Recently they have been used to create a type of cell that’s lost after spinal cord injury; in tests, the cells have restored injured rodents their ability to walk.  Research in using stem cells to treat hearing loss, Parkinson’s disease, and many other problems is ongoing.

In related news, scientists have recently grown a liver in the lab.  While an actual liver is required, diseased and damaged livers that would not be suitable for transplants can be used; the cells are removed and replaced with stem cells grown from the patient’s skin, which removes the risk of rejection.

Traditionally, pharmaceutical companies have concentrated on making new drugs that will help most of the people, most of the time. With today’s population, though, it becomes cost-effective to research drugs that will work only for a small percentage of the population, but will be more effective for that percentage than anything else on the market.  Pfizer, for example, has an anti-cancer drug designed for 4% of lung cancer patients that has a 90% success rate within that group.

Two drug makers, Takeda Pharmaceutical and Celgene, recently tested a combination of treatments aimed at patients with the blood disease multiple myeloma; in  trials with 66 patients, every patient responded to treatment, seeing his or her cancer reduced by at least half.

The rapid development of new drugs also underscores the importance of basic research; improvements in our understanding (and this is true of most if not all fields, not just medicine) often comes from academic labs; that knowledge is then used by private labs to create commercial applications.  Because much of this research is embarked on with no particular end in mind, for long-term or uncertain benefit, government funding is required.  The Department of Defense recognizes that more knowledge inevitably leads to more benefits, even if those benefits are unknown and may not manifest for some time; as such, the DoD provides much of the funding for basic research in this country.

What do acupuncture and the cancer drug deoxycoformycin have in common?  According to a new study, acupuncture may relieve pain by triggering a chemical called adenosine, which is a painkiller naturally used by the body.  The cancer drug, on the other hand, helps keep up adenosine levels.

Which brings up the question: does this mean that acupuncture may be particularly effective at relieving pain in cancer patients?

Researchers at the University of Wisconsin have been studying why apples can protect against illness (thus, the famous saying). Tests have shown that the apple peel contains antioxidants that can slow the growth of cancer cells. After breast and prostate cancer cells were treated with apple peel extract, they grew more slowly and survived for less time.

These results were reported in the UK-based Daily Mail.

Progress has been made in treating two types of cancer, the New York Times reports.  Lung cancer and melanoma, two of the hardest cancers to treat, has reacted positively to two new treatments.

The lung cancer treatment works only for the 5% of patients who have a specific genetic abnormality, but shrank the tumors significantly in the majority of the patients.  Individual genetic makeup causes patients to respond differently to drugs; as genetic screening becomes more practical and populations increase, it has become practical to target medicines directly to a small percentage of the population with a particular genetic makeup.

For attacking melanoma, on the other hand, researchers are using a drug, called ipilimumab, that allows the immune system to more strongly attack the cancer.  While the drug has possible side effects – 7 of 540 patients who took it died after their immune systems attacked their own organs – it shows promise against multiple types of cancer.  It works by blocking a protein that slows down T cells, which fight disease.

Researchers at Columbia University Medical Center have invented a technique using stem cells to regrow lost teeth in as few as nine weeks.  A three-dimensional scaffold is created and infused with growth factor, after which stem cells are encouraged to migrate over it. Rather than growing the tooth outside the body and then implanting it, it can be grown in the socket. By contrast, an implant takes up to six months, and if it fails, it may take up to a year and a half for the replacement implant.  The university has filed patent applications and is actively seeking partners to commercialize the technology.

A recent study measuring biochemical changes that occur during exercise has found good news for those who can’t find the time, or energy, for long workouts: just ten minutes of exercise triggers metabolic changes that last for at least an hour.

But people who are in better shape get more benefit even from brief periods of exercise.  So get off the couch and get started!

The dog won’t stop sniffing you?  Maybe there’s a reason…

Current blood tests checking for prostate cancer are iffy, but it turns out that dogs – whose sense of smell is 100,000 times more powerful than humans – can be trained to recognize the scent of a chemical produced by cancerous cells.  In a recent study, trained dogs were presented with 66 urine samples, half of which were from men with cancer; 63 of the samples were correctly categorized.