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© 2011, 2012 Health Futures Digest
| Two potential cures for Type I diabetes are in or about to begin clinical trials. It would be needless to say that this could have a huge impact not only on the patients but also on the healthcare system as a whole, were it not for the fact that people who advocate for massive spending to increase the number of clinicians don’t appear to get it.
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| Potential Cures for Diabetes
Three groups of scientists (Chicago, Washington, and Harvard universities) have independently replicated a 2001 study in which severely diabetic mice recovered after being treated with Freund’s Complete Adjuvant, a mixture of water, oil, and parts of dead bacteria. The mixture stimulated the immune system cells attacking the pancreas so much that they self-destructed. No longer under siege, the mice pancreases recovered naturally, though it is not yet clear how. Lee Iococca has raised US$11 million to pay for human clinical trials of the therapy, and 600 patients have applied even though the trials are nowhere near ready. Meanwhile, clinical trials of another technique, that uses the patient’s own cells to prevent the immune system from attacking the pancreas, is getting underway. The phase 1 (safety) trial involves 15 adults who have had Type I diabetes for at least five years. If safety is established, a phase 2 trial will test the technique in about two dozen newly diagnosed patients. This method involves harvesting dendritic cells from the patient’s blood, which are then loaded with three synthetic molecules that block signals telling T-cells to attack insulin-producing pancreatic cells. The treated cells are then injected into the lower abdomen to intercept T-cells on their way to the pancreas. Diabetic mice given four to six injections over several weeks were cured, though that is no guarantee the therapy will work in humans. Xenotransplants to Cure Diabetes US researchers have cured diabetic monkeys using islet cells from pig pancreases. British researchers have cured type 1 diabetes by transplanting human pancreas cells, but there are not enough human donor pancreases to go around. Human clinical trials of the pig islet cell transplants could start by 2009, by which time it is hoped that problems with the anti-rejection drugs – which worked for the monkeys but would cause severe side effects in humans – will have been overcome. Brain Lesions Repaired in Hamsters An international team of MIT and Hong Kong University researchers has restored vision in hamsters whose optic nerve inside the brain had been deliberately gashed. The wounds were treated with a weak solution of ionic peptides — short amino acids — which built a molecular scaffold to bridge the gap in the nerve. After 30 days, axons had grown back and reconnected to the target tissue through the center of the cut instead of routing around the wound. None of 43 untreated control animals healed. The treated animals were able to turn their eyes and heads toward a sunflower seed in their peripheral vision, though their turning response was slower than normal. The scaffold eventually biodegraded and was eliminated naturally through the bloodstream and urine. This appears to be the first time a brain lesion has been successfully repaired. “Modern medicine is starting to sit up and pay attention” to turmeric, writes Hilary E. MacGregor in the Baltimore Sun . The US National Institutes of Health has funded at least eight studies of “this Asian wonder spice,” she says. The spice and its chemical constituent curcumin have the potential to prevent and treat cancer, cystic fibrosis, Alzheimer’s, arthritis, and other diseases. In India, people use turmeric “on their bandages as a disinfectant (Johnson & Johnson even makes turmeric Band-Aids for the Indian market) and sprinkle the powder on wounds to help them heal faster. People gargle with turmeric when they have laryngitis and rub it on the skin to cure cuts and psoriasis. They swallow it to treat bronchitis and chronic diseases such as diabetes. Indian brides and grooms apply turmeric and milk to their skin before marriage, to look more beautiful. And, as anyone who has ever prepared a curry knows, turmeric is an essential cooking ingredient, used to flavor, color and preserve.” Curcumin shuts down an inflammatory protein (TNF, or tumor necrosis factor) and has antioxidant properties. Inflammation and oxidative damage are contributors to the diseases mentioned above. Indians have much lower rates of certain cancers than Americans, and have 25 percent lower prevalence of Alzheimer’s among adults aged 70 to 79. A 2004 study showed that food laced with curcumin slowed the accumulation of beta amyloids — thought to contribute to Alzheimer’s — in mouse brains. “Mouse studies at the University of Texas M.D. Anderson Cancer Center,” writes MacGregor, “have shown that the spice blocks growth of a skin cancer, melanoma, and inhibits the spread of breast cancer into the lungs. One 2004 study with mice showed that adding curcumin to Taxol, or paclitaxel, a commonly prescribed chemotherapy for breast cancer, enhances the drug’s effect, making the therapy less toxic and just as powerful.” Human trials of curcumin tablets to treat pancreatic cancer, multiple myeloma, Alzheimer’s, and cystic fibrosis are underway at major medical institutions in the US. US and Australian researchers have discovered that inhalation of a simple and inexpensive salt water aerosol solution reduces lung damage in cystic fibrosis patients. The salt draws water from the lung tissues out on to their surface, thereby restoring a thin lubricant layer of water normally present on airway surfaces which carries excess amounts of mucus into the mouth, where it can be swallowed. The water layer is missing in people with cystic fibrosis, so they are unable to prevent mucus from clogging up their lungs, which ultimately results in respiratory failure. In first tests on a small group of cystic fibrosis patients, the aerosol significantly improved mucus clearance, lung function, and breathing symptoms. Patients in a longer and larger test (164 patients for almost a year) needed less antibiotics to treat lung infections, and were more able to attend work or school. Heating the Heart Stops Fibrillation A University of Michigan study has found that radiofrequency catheter ablation is “the best way to treat chronic atrial fibrillation,” writes Patricia Anstett in the Detroit Free Press . Current treatment with rhythm-correcting drugs such as amiodarone often don’t work and have strong side effects. In the procedure, a tiny heating coil is introduced via catheter to the upper-left chamber of the heart, where it heats tissue in a circle around the pulmonary vein. Of 146 patients in the study, “three-fourths” of the 77 who underwent ablation procedure (26 percent of them underwent it twice) had no heartbeat irregularities a year later. They also reported a steep drop in symptoms and their hearts’ left chambers returned to normal size. A drug used in cancer treatment has been found to reduce the effects of Hutchinson-Gilford Progeria Syndrome (HGPS, commonly known simply as progeria) in mice. Most children with the condition die from heart disease before the age of 15. UCLA researchers used a farnesyltransferase inhibitor (FTI) in 27 progeria mice. After 20 weeks, six of 14 untreated mice but only one of 13 FTI-treated mice had died, and there were only two rib fractures in the treated mice versus 14 in the untreated animals. The majority of treated mice also showed improvements in body weight, bone health, grip strength, and survival compared with the untreated mice. The researchers caution it is too early to talk of clinical trials of the therapy in children with progeria, but the research is a definite step in that direction. MIT and Harvard researchers have discovered a compound they call B2 that interferes with the progress of Huntington’s disease. It could form the basis for a drug to “stop the deadly sequence of cellular events that Huntington’s unleashes,” says the BBC News . Research to date has tended to focus on compounds that prevent or reverse the clumping of huntingtin proteins thought to contribute to the disease, but recent evidence suggests that the largest clumps may in fact be protective. B2 promotes the formation of large clumps. The compound also blocked proteasome disruption, which causes toxic effects, and may also be effective against Parkinson’s disease. The researchers are now working on a more potent version of the compound for animal tests. The X-Stop titanium vertebral prosthesis weighs mere ounces and resembles a half-inch bullet. It was approved in November 2005 for the treatment of chronic lower back pain. It acts as a sort of cushion between nerve sacks and nerves. Compared to more invasive approaches such as spinal fusion, “bullet” surgery cuts recovery time in half and reduces the risk of infection, provides more pain relief from spinal stenosis than steroid injections and costs thousands of dollars less than fusion — though at US$12,000 on average, it is hardly cheap. Patients with more than three damaged discs or who have severe osteoporosis are not candidates for this surgery. A patient’s job, activity level, weight and overall spine condition are also factors considered for suitability. Alexion Pharmaceuticals drug eculizumab has sharply reduced the need for blood transfusions in a late-stage clinical trial involving patients with the rare condition paroxysmal nocturnal hemoglobinuria or PNH, in the course of which red blood cells are destroyed by the immune system. PNH can lead to blood clots, anemia, severe abdominal pain, difficulty swallowing, and erectile dysfunction. In the 87-patient clinical trial, about half the patients given the drug had stable hemoglobin levels over six months without needing a transfusion, versus none of those getting a placebo, and some patients returned to normal activities without morphine. Alexion will probably charge US$100,000 to $200,000 a year for the drug. Alexion originally wanted to target the drug against rheumatoid arthritis, but when it did not work any better than existing RA drugs, Alexion “came to realize,” as Andrew Pollack puts it, “that drugs for rare diseases can be very lucrative if their price is high enough.” A new laser called the CliRpath is claimed to “dramatically” reduce the risk of diabetic amputation compared to bypass, angioplasty, and plaque-scrapers for peripheral artery disease, according to Sameh Fahmy writing for HealthLeaders . The “cool wavelength” laser “sort of vaporize[s] the plaque and debris,” according to a Vanderbilt University Medical Center vascular surgeon interviewed for the article. A study published in February found that 92 percent of patients who underwent the procedure did not have to undergo amputation within a six-month time frame, and claimed that without the procedure, about half would have lost a limb. In comparison, a study of the new SilverHawk plaque-scraper found that 82 percent of patients avoided amputation within six months. However, there have been no studies directly comparing the new technologies with older procedures. “Really, the patient needs to see a specialist who really has an understanding of all of the different options out there and could provide those services and help guide the patient in terms of the best option for that particular situation,” he says. University of Wisconsin-Madison researchers have synthesized human collagen — “the glue of the human body” as UPI reporter Astara March puts it. Collagen is part of the structural support of every organ in the body, and comprises 75 percent of the skin cells. It holds together muscles, tendons, bones, and teeth, and pads the joints. Its possible uses include medical applications such as wound healing and treatment for arthritis to non-biological applications such as in sensors. The synthetic human collagen is very stable. Animal studies are planned. Collagen from cows is currently used for some cosmetic procedures and other health applications but is not liked because it could transmit diseases such as mad cow disease and because it can cause allergic reactions. Post-bariatric Body Contouring Source: Advisory Board Clinical Strategy Watch (subscription service), Mar 16, 2006″>Source article Many patients require second, third, and even fourth surgeries to restore body shape after losing significant amounts of weight following bariatric surgery, Knight Ridder reports. Between 2000 and 2004, the number of body-contouring procedures nationally increased by 77 percent, and the American Society of Plastic Surgeons estimates that the 106,000 body-contouring surgeries performed in 2004 are only a fraction of the number now being performed, and of those, nearly 56,000 involved patients who had experienced “massive weight loss.” The surgeries typically take between six to eight hours, cost from US$15,000 to $25,000 (up to $50,000 in extreme cases), and are seldom covered by insurance. China Achieves World’s Second Face Transplant A Chinese man disfigured after a bear attack received a face transplant at the Xijing military hospital, Xian, China. Specifically, he received a new cheek, upper lip, and nose from a single donor. The first face transplant, conducted in France last November, gave a woman new lips, chin, and nose. The number of cancer deaths dropped to 556,902 in 2003, down from 557,271 the year before, according to the National Center for Health Statistics. It is the first annual decrease in total cancer deaths since 1930, and the declining rates have surpassed the increasing size of the population. Source article”>Source article Harvard and MIT researchers have laced an FDA-approved biodegradable polymer nanoparticle with prostate cancer drug docetaxel, and attached aptamers – proteins — that latch onto cancer cells but not healthy cells. They also doped the nanoparticles with polyethylene glycol molecules, which protect against the tumor cells’ defensive response. In mice, “A single injection of our nanoparticles completely eradicated the tumors in five of the seven treated animals and the remaining animals had significant tumor reduction compared to the controls,” one of the researchers is quoted in Scientific American as saying. The technique could be applied to almost any disease, but much more testing will be required before it is ready for human trials. |
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