Posts about medical research

Massive Blast of Measles Vaccine Wiped Out Cancer In Study

Unfortunately these stories are not uncommon but the hoped for follow through of practical solutions that work at all are rare. But we keep learning and while the breakthroughs based on these news stories is rare we do keep finding new and better methods to cope with health issues.

Mayo Clinic trial: Massive blast of measles vaccine wipes out cancer

Stacy Erholtz was out of conventional treatment options for blood cancer last June when she underwent an experimental trial at the Mayo Clinic that injected her with enough measles vaccine to inoculate 10 million people.

The 50-year-old Pequot Lakes mother is now part of medical history.

The cancer, which had spread widely through her body, went into complete remission and was undetectable in Erholtz’s body after just one dose of the measles vaccine, which has an uncanny affinity for certain kinds of tumors.

Erholtz was one of just two subjects in the experiment and the only one to achieve complete remission. But the experiment provides the “proof of concept” that a single, massive dose of intravenous viral therapy can kill cancer by overwhelming its natural defenses, according to Dr. Stephen Russell, a professor of molecular medicine who spearheaded the research at Mayo.

Researchers have known for decades that viruses can be used to destroy cancer. They bind to tumors and use them as hosts to replicate their own genetic material; the cancer cells eventually explode and release the virus. Antiviral vaccines that have been rendered safe can produce the same effects and can also be modified to carry radioactive molecules to help destroy cancer cells without causing widespread damage to healthy cells around the tumors. The body’s immune system then attacks any remaining cancer that carries remnants of the vaccine’s genetic imprint.

Mayo started out giving patients 1 million infectious units and gradually cranked up the dosage — but it didn’t work until Erholtz and another patient were injected with 100 billion infectious units, he said.

While the treatment worked in Erholtz, whose tumors were primarily in her bone marrow, the results weren’t sustained in the second patient, whose tumors were largely confined to her leg muscles. Russell said researchers need to study how the nature of the tumor affects the lethality of the virus.

One challenge of health research on fatal health conditions is that the experimentation with people is usually limited to people that have no available options left from the approved treatments. So, in general they are very sick. And the great complexity of dealing with human immune systems, the variation in the disease and in people create a very difficult research environment. Thankfully we have many great scientists dedicated to finding new treatments.

Related: Virus Kills Breast Cancer Cells in LaboratoryVirus Engineered To Kill Deadly Brain TumorsUsing Bacteria to Carry Nanoparticles Into CellsWebcast of a T-cell Killing a Cancerous Cell

Study After Study Find No Benefits to Multivitamins

The largest study of its kind concludes that long-term multivitamin use has no impact on the risk of common cancers, cardiovascular disease or overall mortality in postmenopausal women.

“Dietary supplements are used by more than half of all Americans, who spend more than $20 billion on these products each year. However, scientific data are lacking on the long-term health benefits of supplements,” said lead author Marian L. Neuhouser, Ph.D., an associate member of the Public Health Sciences Division at the Hutchinson Center.

The study focused the effects of multivitamins because they are the most commonly used supplement. “To our surprise, we found that multivitamins did not lower the risk of the most common cancers and also had no impact on heart disease,” she said.

The study assessed multivitamin use among nearly 162,000 women enrolled in the Women’s Health Initiative, one of the largest U.S. prevention studies of its kind designed to address the most common causes of death, disability and impaired quality of life in postmenopausal women. The women were followed for about eight years.

Nearly half of the study participants – 41.5 percent – reported using multivitamins on a regular basis. Multivitamin users were more likely to be white, live in the western United States, have a lower body-mass index, be more physically active and have a college degree or higher as compared to non-users.

The study found no significant differences in risk of cancer, heart disease or death between the multivitamin users and non-users.

These findings are consistent with most previously published results regarding the lack of health benefits of multivitamins, Neuhouser said, but this study provides definitive evidence. Since the study did not include men, Neuhouser cautions that the results may not apply to them.

So what advice do Neuhouser and colleagues offer to women who want to make sure they’re getting optimal nutrition? “Get nutrients from food,” she said. “Whole foods are better than dietary supplements. Getting a wide variety of fruits, vegetables and whole grains is particularly important.”

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Search for Antibiotic Solutions Continues: Killing Sleeper Bacteria Cells

Killing Sleeper Cells and Superbugs with Assassin Janitors

Discovered in 2005 by scientists from Bayer Healthcare in Germany, ADEP4 killed a variety of different bacteria and cured lethal infections in mice and rats.

Here’s how it works. Proteins need to fold into very precise shapes to do their jobs, and misfolded proteins are wastes of space. Bacteria dispose of these useless molecules with ClpP—a janitorial protein that digests other proteins. It works with a partner, which recognises misfolded proteins, unfolds them, and threads them through a hole in the middle of ClpP so they can be broken down. But ADEP4 opens ClpP up so it no longer needs its partner. The janitor now becomes an assassin, running amok and chopping up any protein it comes across, misfolded or not.

The Bayer scientists showed that ADEP4 can force fast-growing cells to self-destruct, but Lewis suspected that it would do the same to persisters. Afterall, ClpP’s partner requires energy to do its job, but ClpP itself doesn’t. Once ADEP4 opens it up, it should go about its fatal business even in a dormant cell.

Lewis’ team found that ADEP4 did effectively kills persister populations of Staphylococcus aureus, but the bacteria bounce back. ClpP isn’t essential, so the bacteria just inactivated it to evolve their way around ADEP4. This, says Lewis, is why Bayer stopped working on the drug.

His solution was to pair ADEP4 with another antibiotic called rifampycin. ADEP4 would kill off the majority of the persisters, and if any of the rest started growing again, rifampycin would finish them off. He predicted that the double-whammy would leave very few survivors, maybe just a thousand cells or so.

“That’s not what we saw,” he says. “What we saw was complete sterilisation.”

This is a very nice effort. As our efforts fail to find “magic bullet” antibiotics fail and antibiotic resistance increases combo drug solutions offer some hope. While this is good news, the overall state of our ability to treat bacterial infections continues to decline as our misuse of antibiotics has greatly increased the speed at which antibiotic resistance has developed in bacteria.

This solution only works on gram positive antibiotics. ADEP4 is too big to pass through the extra outer layers of the gram-negative bacteria like ecoli and salmonella.

Related: Entirely New Antibiotic Developed, Platensimycin (2006) (2013 update: Platensimycin is a very effective antibiotic in vivo when continuously administered to cells, however this efficacy is reduced when administered by more conventional means. Efforts continue to find a way to create delivery options that are successful in treating people.) – New Family of Antibacterial Agents Discovered (2009)Potential Antibiotic Alternative to Treat Infection (2012)

Medical Study Findings too Often Fail to Provide Us Useful Knowledge

There are big problems with medical research, as we have posted about many times in the past. A very significant part of the problem is health care research is very hard. There are all sorts of interactions that make conclusive results much more difficult than other areas.

But failures in our practices also play a big role. Just poor statistical literacy is part of the problem (especially related to things like interactions, variability, correlation that isn’t evidence of causation…). Large incentives that encourage biased research results are a huge problem.

Lies, Damned Lies, and Medical Science

He discovered that the range of errors being committed was astonishing: from what questions researchers posed, to how they set up the studies, to which patients they recruited for the studies, to which measurements they took, to how they analyzed the data, to how they presented their results, to how particular studies came to be published in medical journals. The systemic failure to do adequate long term studies once we approve drugs, practices and devices are also a big problem.

This array suggested a bigger, underlying dysfunction, and Ioannidis thought he knew what it was. “The studies were biased,” he says. “Sometimes they were overtly biased. Sometimes it was difficult to see the bias, but it was there.” Researchers headed into their studies wanting certain results—and, lo and behold, they were getting them. We think of the scientific process as being objective, rigorous, and even ruthless in separating out what is true from what we merely wish to be true, but in fact it’s easy to manipulate results, even unintentionally or unconsciously. “At every step in the process, there is room to distort results, a way to make a stronger claim or to select what is going to be concluded,” says Ioannidis. “There is an intellectual conflict of interest that pressures researchers to find whatever it is that is most likely to get them funded.”

Another problem is that medical research often doesn’t get the normal scientific inquiry check of confirmation research by other scientists.

Most journal editors don’t even claim to protect against the problems that plague these studies. University and government research overseers rarely step in to directly enforce research quality, and when they do, the science community goes ballistic over the outside interference. The ultimate protection against research error and bias is supposed to come from the way scientists constantly retest each other’s results—except they don’t. Only the most prominent findings are likely to be put to the test, because there’s likely to be publication payoff in firming up the proof, or contradicting it.

Related: Statistical Errors in Medical StudiesMedical Study Integrity (or Lack Thereof)Contradictory Medical Studies (2007)Does Diet Soda Result in Weight Gain?

Exercise Reduces Anxiety While Also Promoting the Growth of New Neurons

Exercise reorganizes the brain to be more resilient to stress

These findings potentially resolve a discrepancy in research related to the effect of exercise on the brain — namely that exercise reduces anxiety while also promoting the growth of new neurons in the ventral hippocampus. Because these young neurons are typically more excitable than their more mature counterparts, exercise should result in more anxiety, not less. The Princeton-led researchers, however, found that exercise also strengthens the mechanisms that prevent these brain cells from firing.

From an evolutionary standpoint, the research also shows that the brain can be extremely adaptive and tailor its own processes to an organism’s lifestyle or surroundings, Gould said. A higher likelihood of anxious behavior may have an adaptive advantage for less physically fit creatures. Anxiety often manifests itself in avoidant behavior and avoiding potentially dangerous situations would increase the likelihood of survival, particularly for those less capable of responding with a “fight or flight” reaction, she said.

The anxiety-reducing effect of exercise was canceled out when the researchers blocked the GABA receptor that calms neuron activity in the ventral hippocampus.

Interesting research (with mice) that explores how exercise makes us more resilient to stress. I know for me, exercise seems to help relieve stress.

Related: Feed your Newborn NeuronsNew Neurons are Needed for New MemoriesRegular Aerobic Exercise for a Faster Brain (2007)Inactivity Leads to 5.3 Million Early Deaths a YearHow Aerobic Exercise Suppresses Appetite

Drugmakers Are Desperate to Know Why Placebos Are Getting More Effective

Fascinating article from Wired: Placebos Are Getting More Effective. Drugmakers Are Desperate to Know Why.

The fact that an increasing number of medications are unable to beat sugar pills has thrown the industry into crisis. The stakes could hardly be higher. In today’s economy, the fate of a long-established company can hang on the outcome of a handful of tests.

Potter discovered, however, that geographic location alone could determine whether a drug bested placebo or crossed the futility boundary. By the late ’90s, for example, the classic antianxiety drug diazepam (also known as Valium) was still beating placebo in France and Belgium. But when the drug was tested in the US, it was likely to fail. Conversely, Prozac performed better in America than it did in western Europe and South Africa. It was an unsettling prospect: FDA approval could hinge on where the company chose to conduct a trial.

In one study, Benedetti found that Alzheimer’s patients with impaired cognitive function get less pain relief from analgesic drugs than normal volunteers do. Using advanced methods of EEG analysis, he discovered that the connections between the patients’ prefrontal lobes and their opioid systems had been damaged. Healthy volunteers feel the benefit of medication plus a placebo boost. Patients who are unable to formulate ideas about the future because of cortical deficits, however, feel only the effect of the drug itself. The experiment suggests that because Alzheimer’s patients don’t get the benefits of anticipating the treatment, they require higher doses of painkillers to experience normal levels of relief.

Benedetti often uses the phrase “placebo response” instead of placebo effect. By definition, inert pills have no effect, but under the right conditions they can act as a catalyst for what he calls the body’s “endogenous health care system.” Like any other internal network, the placebo response has limits. It can ease the discomfort of chemotherapy, but it won’t stop the growth of tumors. It also works in reverse to produce the placebo’s evil twin, the nocebo effect. For example, men taking a commonly prescribed prostate drug who were informed that the medication may cause sexual dysfunction were twice as likely to become impotent.

Moreover, a pill’s shape, size, branding, and price all influence its effects on the body. Soothing blue capsules make more effective tranquilizers than angry red ones, except among Italian men, for whom the color blue is associated with their national soccer team—Forza Azzurri!

Medical research presents significant difficulties. The funding of the health care system also distorts behavior and pushes companies to focus on being able to justify selling drugs instead of focusing on finding effective solutions. Even without incentives distorting behavior, the challenges are difficult enough. Adding the distortions just makes it worse.

It is wonderful we have so many scientists accepting these challenges and spending their careers fighting the odds to help find us wonderful health breakthroughs.

Related: The Majority of Clinical Trials Don’t Provide Meaningful EvidenceSystem for Approving New Medical Options Needs ImprovementMedical Study Integrity (or Lack Thereof)Discussing Medical Study Results

Appropriate Technology Health Care Solution Could Save 72,000 Lives a Year

We need more medical solutions that serve the majority of humanity instead of just the rich. Some medical research is innately costly and therefore require large costs to pay back the investment. But too little concern is shown for solutions that help people (with so much focus only on solutions that will make organizations rich).

Cheap vinegar test cut cervical cancer deaths in India; could help many poor countries

This low-tech visual exam cut the cervical cancer death rate by 31 percent, the study found. It could prevent 22,000 deaths in India and 72,600 worldwide each year, researchers estimate.

More progress against cervical cancer may come from last month’s announcement that two companies will drastically lower prices on HPV vaccines for poor countries. Pilot projects will begin in Asia and Africa; the campaign aims to vaccinate more than 30 million girls in more than 40 countries by 2020.

India continues to invest in medical research for solutions that are affordable to a majority of the world. The rich health care companies largely neglect the majority to focus on the most wealthy.

Related: Using Available Technology (Cellphone) as a MicroscopeDangerous Drug-Resistant Strains of TB are a Growing Threat‘Refrigerator’ Without Electricity

Webcast: Examining the Scientific Basis Around Exercise and Diet Claims

Tim Noakes is the Director of UCT/MRC Research Unit for Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Science, University of Cape Town and Professor, Discovery Health Chair of Exercise and Sports Science, University of Cape Town.

Tim examines some questions on science and exercise and health in the webcast. He shows the problem with drinking too much during exercise and the correlation of hospital admissions correlated to the sport drinks marketing and changing of the official drinking guidelines. He also discusses the outdated ideas related to lactic acid and muscles.

He is currently studying the science of food and human health and is skeptical of low fat health claims: “No evidence that dietary fat is related to heath disease.” He is certainly more knowledgable than I but I would still be cautious of completely accepting that premise. It does seem to me there is lots of evidence that claims of causation between eating a high fat diet and heart disease were too strong (many other factors were critical – such as weight, exercise, genetics, unsaturated fat v. saturated fat…).

Tim Noaks: “50% of what we teach is wrong; the problem is we don’t know which 50% it is. Our job as educated people is to spend our lifetime trying to figure out which 50% is which. Until it is disproven accept that for which the evidence appears solid and logical and is free of covert or overt conflicts of interest, because unfortunately industry is driving what you believe in many many things. But don’t ever dismis lightly that for which there is credible evidence… and there is such clear evidence the diets we are eating are horrendous.”

As I have said before, scientific literacy is critical to allow us to make those judgements about what is credible evidence and what are outright lies, foolish claims or highly suspicious claims tainted by conflicts of interest.

Related: Can You Effectively Burn Calories by Drinking Cold Water?Static Stretching Decreases Muscle StrengthLack of Physical Activity Leads to 5.3 Million Early Deaths a YearScience Continues to Explore Causes of Weight GainStudy Finds Obesity as Teen as Deadly as Smoking

Cell Aging and Limits Due to Telomeres

When cells divide the process fails to copy DNA all the way to the end. Telomeres are are the end of DNA strands, as essentially a buffer of material that won’t cause information to be lost when part of the telomere isn’t copied. As DNA is copied, as new cells are created, the length of telomeres at the end is reduced. Once the telomeres are gone the cell will no longer divide.

The 2009 Nobel Prize in Physiology or Medicine went to 3 scientists for discovering how the chromosomes can be copied in a complete way during cell divisions and how they are protected against degradation. The Nobel Laureates have shown that the solution is to be found in the ends of the chromosomes – the telomeres – and in an enzyme that forms them – telomerase.

There is some debate over the benefit of the mechanism of cells not dividing do to lack of telomere. This can prevent cancerous cells from replicating (once they replicate to the extent that the necessary telomere buffer is gone). It is also seen that as telomeres get shorter the cells become more likely to become cancerous.

Cancer also can stimulate the production of telomerase which can stop telomeres from getting shorter as cells divide and thus allow the cancer cells to keep dividing (thus producing more cancer cell and increasing the amount of cancerous cells). Using telomerase to allow health cells to avoid the limits of division is being researched.

Are Telomeres the Key to Aging and Cancer? (University of Utah)

An enzyme named telomerase adds bases to the ends of telomeres. In young cells, telomerase keeps telomeres from wearing down too much. But as cells divide repeatedly, there is not enough telomerase, so the telomeres grow shorter and the cells age.

Cells normally can divide only about 50 to 70 times, with telomeres getting progressively shorter until the cells become senescent, die or sustain genetic damage that can cause cancer.

shorter telomeres are associated with shorter lives. Among people older than 60, those with shorter telomeres were three times more likely to die from heart disease and eight times more likely to die from infectious disease.

While telomere shortening has been linked to the aging process, it is not yet known whether shorter telomeres are just a sign of aging – like gray hair – or actually contribute to aging.

Related: The Naked Mole Rat is the Only Known Cancerless AnimalWebcast of a T-cell Killing a Cancerous CellRNA interference webcast

CDC Again Stresses Urgent Need to Adjust Practices or Pay a Steep Price

Untreatable and hard-to-treat infections from Carbapenem-resistant Enterobacteriaceae (CRE) germs are on the rise among patients in medical facilities. CRE germs have become resistant to all or nearly all the antibiotics we have today. Types of CRE include Klebsiella pneumoniae Carbapenemase (KPC) and New Delhi metallo-beta-lactamase (NDM). By following the United States Center for Disease Control (CDC) guidelines, we can slow the penetration of CRE infections in hospitals and other medical facilities and potentially spread to otherwise healthy people outside of medical facilities.

The CDC has worked with hospitals to successfully apply these measures. The CDC worked with Florida to stop a year-long CRE outbreak in a long-term acute care hospital. With the improved use of CDC recommendations (such as educating staff; dedicating staff, rooms, and equipment to patients with CRE; and improving use of gloves and gowns) the percentage of patients who got CRE at the facility dropped from 44% to 0.

One travesty has been how poorly health care professionals have been about prescribe antibiotics wisely We need to improve and follow CDC antibiotics guidelines (stop the overuse of antibiotics) and use culture results (for patients undergoing treatment) to modify prescriptions, if needed. Antibiotic overuse contributes to the growing problems of Clostridium difficile (c-diff) infection and antibiotic resistance in healthcare facilities. Studies indicate that nearly 50% of antimicrobial use in hospitals is unnecessary or inappropriate (per CDC web site).

Israel decreased CRE infection rates in all 27 of its hospitals by more than 70% in one year with a coordinated prevention program. The USA is at a critical time in which CRE infections could be controlled if addressed in a rapid, coordinated, and consistent effort by doctors, nurses, lab staff, medical facility leadership, health departments/states, policy makers, and the federal government.

As I have been saying for years the damage we are creating due to our actions around the use and abuse of antibiotics is likely to kill tens of thousands, or more people. Because the deaths are delayed and often not dramatic we have continued dangerous practices for years when we know better. It is a shame we are condemning so many to increased risks. The CDC, and others, are doing good work, unfortunately too much bad work is continuing in the face of evidence of how dangerous that is.

Related: CDC Urges Increased Effort to Reduce Drug-Resistant Infections (2006)Key scientific articles on Healthcare Associated Infections via CDCOur Dangerous Antibiotic Practices Carry Great RisksDangerous Drug-Resistant Strains of TB are a Growing Threat

How Corn Syrup Might Be Making Us Fat

How Corn Syrup Might Be Making Us Hungry–and Fat by Katherine Harmon

…Glucose lowered the activity of the hypothalamus but fructose actually prompted a small spike to this area. As might be expected from these results, the glucose drink alone increased the feelings of fullness reported by volunteers, which indicates that they would be less likely to consume more calories after having something sweetened with glucose than something sweetened with more fructose.

Fructose and glucose look similar molecularly, but fructose is metabolized differently by the body and prompts the body to secrete less insulin than does glucose (insulin plays a role in telling the body to feel full and in dulling the reward the body gets from food). Fructose also fails to reduce the amount of circulating ghrelin (a hunger-signaling hormone) as much as glucose does. (Animal studies have shown that fructose can, indeed, cross the blood-brain barrier and be metabolized in the hypothalamus.) Previous studies have shown that this effect was pronounced in animal models…

Most of the science indicates calories consumed is by far the dominant factor in weight gain. Different foods with the same calories can affect how hungry you feel. Thus the biggest factor in reducing weight gain seems to be reducing calories and one way to help is to eat food that leaves you feeling full and avoid foods that don’t.

The science is not completely clear though on whether certain diets can have a significant affect above and beyond calorie levels. I am skeptical of such claims, however. There are concerns beyond calories for healthy eating – getting a well balanced diet is important.

Healthy physical activity is also important. Burning off calories with exercise allows more consumption without weight gain. And exercise is important for health not just to avoid gaining weight.

Related: Researchers Find High-Fructose Corn Syrup Results in More Weight GainDoes Drinking Diet Soda Result in Weight Gain?Waste from Gut Bacteria Helps Host Control WeightModeling Weight Loss Over the Long TermHow Caffeine Affects Your Body

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