Every day, however, help is arriving in the form of new medical advances from the Outside World, chicken soup for the bruised and battered warriors trying to hold the fort. Monday’s death sentence is Wednesday’s reprieve as scientists and researchers uncover new and exciting ways to trick the Grim Reaper, make time stand still, reinvigorate old and flagging minds and bodies. The Flying Pie, ever the helpmate, investigates and informs.
Mighty Mouse To The Rescue
Conventional spinal cord stimulation works by sending impulses along the cord through an implanted spinal cord stimulator, reducing the pain signals that reach the brain. However, each patient is prescribed a fixed dose of stimulation, which doesn’t take the individual’s movement into account, limiting its effectiveness. Now, researchers have developed Closed-Loop spinal cord stimulation, which gets feedback from the patient’s own spinal cord. The closed-loop system uses a stimulator which is able to communicate in real time with spinal cord neurons and modulate the dose of stimulation accordingly. This is the first such system to measure the spinal cord’s response to stimulation and adjust each pulse according to the patient’s activity. “With this technology, patients are getting measurable pain relief, sleeping better and taking less medication,” according to the Cleveland Clinic. “Pending approval, closed-loop stimulation could be a saving grace for chronic pain patients everywhere.”
Statins cause muscle pain in up to 10% of patients who take them, which doesn’t seem too bad unless one of them is you. A new agent called Bempedoic Acid provides an alternative approach to lowering LDL cholesterol while avoiding these side effects. Like statins, bempedoic acid works by blocking a key enzyme used by the body to make cholesterol. But unlike statins, it cannot accumulate in muscle, reducing the likelihood of muscle pain. “In clinical trials of the therapy, patients saw their LDL levels drop by an average of 21%,” the Cleveland Clinic stated. “If approved by the FDA, bempedoic acid could be another addition to the arsenal of cholesterol-lowering treatments available to patients.”
If You Cooperate, Rocco, We Can Grant You Immunity.”
One of the most vexing problems in medicine is how to keep the immune system from attacking the body itself. Immune researchers work on a biological defense system that’s comparable to the world’s greatest military. This army has millions of potential enemies but no clear leader; instead, it’s members are on constant patrol, a hair-trigger away from launching an attack. It’s a recipe for anarchy. Yet the majority of the time, the immune system knows when to hold back. Using processes we don’t fully understand, a healthy person’s immune system is able to draw a clear line between the body’s own tissues, which it leaves untouched, and invaders, which it identifies and destroys.
Occasionally, however, the immune system can be devastatingly destructive. The body’s tendency to reject organ transplants, attacking them as if they were dangerous foreign invaders, is well known. But more prevalent are autoimmune diseases, in which a person’s immune cells attack his own organs and tissues. Left unchecked, these malfunctions can result in one of more than 80 known conditions, including Type 1 diabetes, rheumatoid arthritis, lupus, multiple sclerosis, inflammatory bowel disease and the heartbreak of psoriasis. According to the Autoimmune Related Diseases Association, conditions like these affect more than 50 million Americans. That’s not soggy gingerbread.
The perfect immune-modulating drug would target only the part of the system causing the problem. As of now, however, most immunosuppressive drugs work by dampening the entire immune system, which leaves the patient susceptible to short-term problems like infections and long-term afflictions as severe as cancer. Uh-oh.
Enter Jeffrey Bluestone, 56, director of the Immune Tolerance Network and the Diabetes Center at the University of California at San Francisco. Bluestone has worked in labs for 30 years, wrestling with the idiosyncracies of the immune system. There have been many late nights. Sometimes, as the hours wore on and the energy of his crew faded, Bluestone was forced to resort to his ultimate weapon to restore the power levels; the music of Bruce Springsteen. “It was our version of partying,” he said.
Bluestone & company spent many long nights tweaking an organ-transplant drug called OKT3, which they thought might also be useful for autoimmune diseases like MS and Type 1 diabetes. Unfortunately, the drug had severe side effects, including cases in which it sent recipients’ immune systems into a kind of overdrive which could be fatal. Eventually, working through mice, the group succeeded in changing the drug’s structure to eliminate the side effects. Then they began investigating what else the drug could do.
Bluestone also began collaborating with Kevan Herold, an endocrinologist and researcher at the University of Chicago, investigating the possibilities of anti-CD3 monoclonal antibodies. Though not totally precise, anti-CD3 can be used for diabetes and a variety of other diseases. Versions of the drug are already being tested on psoriasis, Crohn’s disease and ulcerative colitis, and they’re thought to hold promise for rheumatoid arthritis and multiple sclerosis as well. “The number of diseases potentially affected is huge,” Herold says.
Bluestone is optimistic that an anti-CD3 drug will gain FDA approval soon and come to market, though he is reluctant to make assumptions. “We’re on the verge,” he claims, “but it ain’t over til it’s over. If it does get approved in the next year or two, that would be very exciting. I would finally feel that all the work we’ve done would have a dramatic impact on human health.”
Is anybody awake up there at FDA headquarters? If not, will somebody please turn on a little Bruce Springsteen?
Somewhere, Timothy Leary Is Smiling
The Headless Horseman is galloping through the village unabated, challengers speared by his trusty lance, unseated by the strength of his blow or cowering in horror at the mere sight of this terror. He would smile if he could, laugh if he had the means, tell his opponents to retire in ignominy if he had the words. Also known as Alzheimer’s Disease, the phantom takes no prisoners—it’s one and done for the opposition.
Experimental drugs, one after another, have failed to alter his path, yet another just last week when a promising new weapon designed to fight the formation of the disease’s signature amyloid plaque in the brain was dismissed. What can you do in a case like that, what can you do but spit in your hat? All of us have family, friends, neighbors who have fallen victim to the fiend. We wail in dismay, rend our garments, curse the day the monster was born. We plod sadly through nursing homes, hospitals, hospice houses looking for signs of life, a glint of light, a sliver of memory, mostly to no avail.
Then, out of the night when the full moon is bright comes the horseman known as Shlomi Raz. Say what? Don’t laugh. Shlomi is the founder and CEO of a biomedical startup called Eleusis, and Shlomi has a plan. According to Raz, the problem with conventional single-target approaches to Alzheimer’s is that they don’t take into account the multiple dysregulated processes in the disease’s complex pathobiology. The Shlomi approach to the problem is anything but conventional.
Eleusis is investigating the anti-inflammatory potential of psychedelics as medicines, specifically the application of sub-perceptual doses of LSD in halting the progression of Alzheimer’s disease at its earliest detectable stage. “When I put together the entire picture of what psychedelics were doing,” Raz said, “it became quite clear that this could be a therapy to modify the course of Alzheimer’s disease. LSD in particular seemed like an attractive candidate for such a therapeutic approach since it’s capable of potent and prolonged activation of the serotonin and dopamine neurotransmission receptors implicated in Alzheimer’s, and specifically the serotonin 2A receptor.”
“If you look at the symptoms of Alzheimer’s and the disease progression, not only is the loss of 2A receptor expression correlated with cognitive impairment and toxic amyloid burden, but you also have a significant increase in the incidence of depression and anxiety, which are psychiatric conditions known to be significantly influenced by serotonin 2A receptor function. Given the extensive clinical evidence of LSD’s efficacy in treating alcoholism, depression, anxiety and other indications, could all this just be a coincidence?”
The horseman known as Shlomo thinks not. He’s saddled up and ready to ride down the Timothy Leary Trail. Maybe, like Leary, “He’ll take you up, he’ll bring you down, he’ll plant your feet back firmly on the ground. He flies so high, he swoops so low, he knows exactly which way he’s gonna go.” Let’s hope so for all our sakes.
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| They claim 3D printing can do anything. Can they make us an ELEPHANT? |
HELP!
It’s coming. Here are 5 of the most important medical advances for 2020.
1. A Dual-Acting Osteoporosis Drug. Osteo the Bonesapper causes your bones to become weak and brittle, effectively increasing their risk of fracture. This loss of bone occurs silently and progressively, often without symptons until the first crack. Providing more bone-strengthening power, the recent FDS-approved dual-acting drug romosozumab is giving patients with osteoporosis more control in preventing additional fractures.
2. Expanded Use Of Minimally Invasive Mitral Valve surgery. The mitral valve allows blood flow from the heart’s left atrium to the left ventricle. Alas, in 1 out of 10 individuals over the age of 75, the mitral valve is defective, causing regurgitation. Nobody likes that. 2020 will see an expansive use of a minimally invasive valve repair device in a population of patients who have failed to get symptom relief from other therapies.
3. Drugs For Heart Failure With Preserved Ejection Fraction. We all know about ejection fraction from reading last week’s Flying Pie, right kiddies? With preserved ejection fraction, the heart is unable to fill properly with blood, leaving less of it available to be pumped out to the body. Currently, recomendations for this treatment are directed at accompanying conditions and mere symptom relief. But SGLT2 Inhibitors, a class of medications used in the treatment of Type 2 diabetes, is now being explored in HFpEF, alluding to a potential new treatment option.
4. 3D Printing. Already widely used in other industries, 3D printing will enable prototyping, customization, research and manufacturing for healthcare. Surgeons can now replicate patient-specific organs with 3D to help prepare for procedures, and many medical devices and surgical tools can be 3D printed. 3D makes it easier to develop cost-effective and comfortable prosthetic limbs for patients and also print tissues and organs for transplant. 3D is now also used in dentistry and orthodontics.
5. Genomics. Artificial intelligence and machine learning help advance genomic medicine--when a person’s genomic info is used to determine personalized treatment plans and clinical care. In pharmacology, oncology, infectious diseases and other areas, genomic medicine is making an impact. Computers make the analysis of genes and gene mutations which cause medical conditions much quicker. This helps the medical community better understand how diseases occur, but also how to treat a condition or even eradicate it. There are many research projects in place covering such medical conditions as organ transplant rejection, cystic fibrosis and cancers to determine how best to treat these conditions through personalized medicine.
Do You Believe In Magic?
Sure. What’s life without a little fairy dust, some well-paced hocus-pocus, a kindly miracle here and there? Remember the Venetian Treacle, Doctor Dingle’s Snake Oil Treatment, the Philosopher’s Stone? Cure-alls have a colorful history, now expanded to include the wonders of CBD oil. Does the stuff actually do everything it’s touted to do—everything from curing gout to removing female mustaches to shrinking up that extra toe? Well, maybe not. But Bill Killeen sleeps better using it, Siobhan Ellison has less shoulder and neck pain, and the stuff kept our old pal, Irana Maiolo, from jumping off a building. So, much better than a placebo. Even if it does perform, however, there are ten thousand brands, that many different strengths, priced anywhere from moderately expensive to you-must-be-kidding. What to do? The Flying Pie elucidates.
CBD has been touted for a wide variety of health benefits but the strongest scientific evidence is for its effectiveness in treating some of the worst childhood epilepsy syndromes, such as Dravet syndrome and Lennox-Gastaut, which typically do not respond to antiseizure medications. In numerous studies, CBD was able to reduce the number of seizures and in some cases stop them altogether. The FDA has approved the first-ever cannabis-derived medicine for these conditions; it’s called Epidiolex, and it contains CBD.
CBD oil is commonly used to address anxiety and insomnia. Studies suggest CBD may help with both falling asleep and staying asleep. The oil also offers another option for treating different types of chronic pain. A study from the European Journal of Pain illustrated (using an animal model) that CBD applied on the skin could help lower pain and inflammation due to arthritis. Another study demonstrated the mechanism by which CBD inhibits inflammatory and neuropathic pain, two of the most difficult types of chronic pain to treat.
Everything has side effects, and so does CBD oil. Some people complain of nausea, fatigue and irritability (but not those merry souls, Bill & Siobhan). CBD can increase Coumadin levels in the blood for anyone using that blood thinner, and it can raise the levels of certain other medications in your blood by the exact same mechanism that grapefruit juice does. Also, the most effective therapeutic dose of CBD has not been determined, so it’s a play-it-by-ear proposition.
As with all products, there are contenders and pretenders. There’s plenty of junk on the market, so who do you trust? Internet reviews are stacked with phony “independent” outfits which are merely pawns (and salesmen) for CBD manufacturers. Forbes Magazine, however, is not one of them. Forbes mentions Verma Farms, Goodbody Botanicals (UK), Plant People, The Grass & Co. (UK) and Australian Life as worthy companies. LA Weekly likes Balance CBD, Green Roads, Lazarus Naturals, Ananda Hemp and Joy Organics. You can see from the disparity here that settling on one universally-accepted brand is no easy matter. Better to do one’s own research and choose for yourself. That’s what our Fairfield neighbor Greg Poe did, eventually speaking with the owner of Donatti CBD Therapy in Pagosa Springs, Colorado. Greg liked his rap, bought a couple of bottles and gave one to us. We’re satisfied customers and Donatti isn’t paying us off, although we’re certainly open to the prospect. Donatti is also one of the more reasonably priced oils on the market.
So there’s a bundle of info for the denizens of Septuagenaria to digest. Your health is our business, so we here at The Flying Pie will continue poring over the latest discoveries, prying into pending research, examining the results of arcane studies, all in the interests of customer longevity. After all, we’re all on this highwire together. And all of us are working without a net.
That’s all, folks….
bill.killeen094@gmail.com
