A Way Our of Our Antibiotic Crisis

August 28, 2015 by

July 24, 2015

By Medical Discovery News

A petri dish

Antibiotic resistance occurs when strains of bacteria that infect people – such as staph, tuberculosis, and gonorrhea – do not respond to antibiotic treatments. In America, 2 million people become infected with resistant bacteria every year and at least 23,000 die each year because of those infections. If nothing is done to stop or slow the resistance of bacteria to antibiotics, the World Health Organization (WHO) warns that we will find ourselves in a post-antibiotic world, in which minor injuries and common infections will be life-threatening once again.

The crisis arose primarily from three conditions. First, when people are given a weeks’ worth of antibiotics and stop taking them as soon as symptoms improve, they often expose the bacteria causing their infection to the medicine without killing it. This allows the bacteria to quickly mutate to further avoid the effects of the antibiotic. Second, antibiotics are over-prescribed. Most common illnesses like the cold, flu, sore throat, bronchitis, and ear infection are caused by viruses, not bacteria, so antibiotics are essentially useless against them. Yet they are prescribed 60-70 percent of the time for these infections. This once again provides bacteria in the body unnecessary contact with antibiotics. Third, tons of antibiotics are used every year in the agriculture industry. They are fed to livestock on a regular basis with feed to promote growth and theoretically for good health. But animals are also prone to bacterial infections, and now, to antibiotic-resistant bacteria, which spreads to humans who eat their meat or who eat crops that have been fertilized by the livestock. The good news is that the Food and Drug Administration (FDA) is working to focus antibiotic use on bacterial infections and regulate its use in livestock.

An easy solution to this problem might be to create new antibiotics, but it’s not that simple. It takes an average of 12 years and millions of dollars to research new antibiotics and make them available on the market, which is a huge investment considering they are normally only taken for up to 10 days. But there’s an even bigger challenge: microbiologists can only cultivate about 1 percent of all bacteria in the lab, including specimens that live in and on the human body. The ability to grow diverse bacteria is important because most antibiotics actually come from bacteria, produced as a defense against other microbes.

Slava Epstein, a professor of microbial ecology at Northeastern University, came up with an ingenious approach to solving this problem. He speculated that we are unable to grow these bacteria in the lab because we were not providing the essential nutrients they needed to grow. Working with soil bacteria, which are a huge source for developing antibiotics, he created the iChip. The iChip allows bacteria to grow directly in soil, which is their natural environment, while being monitored.

To date, about 24 potential antimicrobials have been identified from 50,000 bacteria that remain unable to grow in the lab. With possibly billions of bacteria left to grow and examine, the number of new drugs awaiting discovery is seemingly endless.

For a link to this story, click here.

Filed Under: Health Tagged With: , , , , , , , , , , , , , , , , , ,

It’s Not Just Venus or Mars Anymore

December 5, 2014 by

Dec. 5, 2014

By Medical Discovery News

It's Not Just Mars or Venus Anymore

While the gender gaps are closing, sometimes the differences between men and women seem as great as the differences between Venus and Mars. For example, men and women tolerate medications very differently. Due to this, the Food and Drug Administration (FDA) has recently changed the recommended dosage of the sleep aid Lunesta from two milligrams to one milligram because of its prolonged effects on women.

Women reported feeling drowsy in the morning hours after waking, raising concerns about the hazards of driving and working. While men and women are often prescribed the same dosages of medications, this case shows how men and women are not the same organism and drug dosing might need to take that into consideration.

For basic studies in the biomedical laboratory, many cells lines that are used experimentally are derived from tissues obtained from males, either human or animal. Even in the very early steps of identifying a drug and determining how it works, efforts are already focused on those of us with a Y chromosome.

Clinical trials are conducted before a new drug can be approved, and trials also favor males. In fact, white males remain the predominant subjects for drug trials today. Women were initially avoided in clinical trials because of concerns that they were pregnant or would become pregnant. Women also have cyclic hormones that alter metabolism and could interact with drugs. While this is precisely why women’s tolerance of a drug should be tested prior to its approval, researchers thought this complicated the early stages of the process. Once a drug is launched, the number of people using the drug expands and these side effects start to be reported. While an individual physician may notice patients have side effects, they do not have a wide view of the whole population’s reactions.

Pharmokinetics is the study of what happens to drugs administered to a living organism, and could explain some reasons why men and women handle the same medication differently. For starters, men and women have a number of basic physiological differences. Firstly, women tend to have a lower body weight and body volume. Therefore, the concentration of a drug is often higher in a woman. Women also have a lower gastric emptying, slower gastrointestinal motility, and different absorption rate that can alter the amount of a drug that gets to the blood and is distributed throughout the body. They have different glomerular filtration in their kidneys, which reduces the rate at which drugs are cleared out of the body and therefore leads to higher and more prolonged drug levels. Women experience greater sensitivity to beta blockers, which are used to treat heart conditions; opioids, which are used to control pain; and antipsychotics.

The pharmacodynamics (how drugs function) in female and male bodies can be quite different also. Aspirin is a great example. It is less effective at lowering subsequent heart attacks in women when given the standard preventive dose. They may need higher doses to prevent a second cardiovascular episode.

Recently, the National Institutes of Health (NIH) has required that all cell, animal, and human studies it funds have a balanced representation of both genders. While this may increase the cost of developing therapeutics, it will certainly expand our understanding of how medicines affect the genders differently and improve drugs for everyone.

For a link to this story, click here.

Filed Under: Health Tagged With: , , , , , , , , , , , , , , , , , , , , , , , , ,

I Spy for Heart Disease

August 29, 2014 by

Aug. 29, 2014

By Medical Discovery News

Heart in chest

While a shrink ray like the kind used in science fiction is still stuck in the future, miniature devices are not. Tiny devices have been created to perform a variety of tasks, from an implantable telescope to improve vision in those with macular degeneration to the new pacemaker in clinical trials that is about the size of a large vitamin pill. Now, researchers have developed a catheter-based device smaller than the head of a pin that can provide real-time 3D images of the heart, coronary arteries, and other blood vessels. This is an important invention as the casualties of heart disease continue to rise. Statistically, one in four people will have a heart attack. 

Many Americans are at risk for developing coronary artery disease (CAD) due to the buildup of cholesterol and plaque. If there is a rupture or breakage of the plaque, creating a blood clot, that can result in a heart attack with little to no warning. Traditional diagnostic tests such as stress tests and echocardiograms show how much blood is flowing to the heart. If there are regions of the heart that are not getting as much blood as others, it might be a sign of clogged coronary arteries. However, blood flow can also appear to be normal even with plaque buildup.

Currently, there are a variety of methods that provide images of what is going on inside arteries, including magnetic resonance imaging (MRI), multi-detector Computerized Tomography (CT) scans, and injecting an iodine-based contrast agent into arteries through a catheter. But all these look at the inside of the body from the outside, which is why this new device gives an unprecedented way of viewing the heart.

This invention combines ultrasound imaging with computer processors on a single chip only 1.4 millimeters wide. The body’s signals are processed on the chip then transmitted through 13 tiny cables to a computer monitor, so doctors have a visual of the heart and arteries. The prototype took 60 images per second using very little power, therefore generating little heat. This would allow cardiologists to take real-time images of blood vessels in and around the heart to more precisely determine the extent of blockages. These images also have much higher resolution compared to those taken with machines outside the body.

The next step is to conduct studies using the device on animals to determine its safety and efficacy and to develop potential applications of this technology. Eventually, this data will be submitted to the Food and Drug Administration (FDA) to gain permission to perform clinical trials on humans. Extensive testing will be required before the FDA will approve the device for general use. The developers, a group of engineers at the Georgia Institute of Technology, are also working to shrink the device even further to .4 millimeters so it can generate images of even smaller blood vessels.

Having clearer images of blood vessels would allow surgeons to have a more complete understanding of the blockage they are dealing with before they operate. Hopefully, in the future use of this device will prevent heart attacks and save many people’s lives.

For a link to this story, click here.

Filed Under: Health Tagged With: , , , , , , , , , , , , , ,

First in the No. 2 Business

June 13, 2014 by

June 13, 2014

By Medical Discovery News

Antibiotic resistance among disease-causing bacteria is a growing and dangerous problem. Bacteria resistant to one or antibiotics, like Staph and Strep, are approaching catastrophic levels. Bacteria so resistant to common antibiotics that few if any drugs are available to treat them have been dubbed superbugs. One widely feared bacterium, called Clostridium difficle or C. diff for short, causes intestinal disease so severe that it can become life-threatening. It kills almost 15,000 Americans every year, mostly the elderly. Super-resistant forms of this microbe are almost impossible to treat with antibiotics. 

This bacterium produces a powerful toxin that destroys intestinal cells and can rupture small blood vessels. It also causes abnormal intestinal behavior, mainly excess water that produces diarrhea. It’s an unpleasant and painful prospect for those infected with C. diff. 

Roughly 5-15 percent of the population carries this bacterium in their digestive system naturally, but it is kept in check by the rest of the bacterial population. But an underlying disease, antibiotics, another infection, or chemotherapy can weaken bacterial systems, allowing C. diff to expand into an infection. And a super-resistant version of C. diff can be a real problem.

As gross as it may sound, fecal transplants are getting lots of attention as an option for C. diff infections. First tried in the late 1950s, the rationale for this approach is that the disease occurs because the bacterial populations are disrupted, so providing a source of normal bacteria restores the ecology of the intestine and prevents C. diff from growing. 

Where exactly does one find fecal matter for such a transplant? It’s not as if anyone wants to ask family or friends to share their poop. Actually, there are major regulatory obstacles for fecal transplants. For instance, the fecal source must test negative for disease-causing bacteria, viruses, and parasites. Basically, it’s not something anyone can find at Whole Foods or on Amazon.

So a group of enterprising graduate students at the Massachusetts Institute of Technology (MIT) who observed a friend’s struggle with C. diff formed a company to distribute safe, certified fecal matter for transplant. OpenBiome collects, tests, and distributes fecal matter like a blood bank distributes blood. Samples are certified by Food and Drug Administration (FDA) procedures, which cost about $3,000. Then they are frozen at super-cold temperatures (-112 degrees) and shipped to hospitals and physicians. Currently, the company operates as a nonprofit and only collects a shipping and processing fee for transplant material.

We already know that our normal bacterial systems, which together make up our microbiome, help protect us from skin, urogenital, and oral diseases. Changes in our microbiome may also contribute to an underlying disease like diabetes. There is still much to be discovered about these organisms that call our bodies home, especially since we house 10 times more microbes than our own cells!

For a link to this story, click here.

Filed Under: Uncategorized Tagged With: , , , , , , , , , ,

Thalidomide: A Nightmare Revisited

September 22, 2013 by

Spet. 20, 2013

By Medical Discovery News

While thalidomide is now being tapped for its cancer-fighting properties, it has a more notorious history. Starting in 1957, doctors recommended thalidomide as a mild over-the-counter sleeping pill supposedly safe enough for even pregnant women. That it also reduced morning sickness made it even more popular. The company that made thalidomide aggressively marketed the drug in 46 countries even after the wife of an employee who took the drug before its release gave birth to a child with no ears. Within two years, an estimated 1 million people in West Germany were taking the drug daily. However, thousands of babies born with severely malformed limbs revealed that this drug was not safe, but that connection was not made until 1961.

German pharmaceutical company Chemie Grünenthal GmbH originally developed thalidomide to treat convulsions, but users reported feeling sleepy. During testing, the company discovered that it was almost impossible to take enough thalidomide to be fatal. The company did not test the drug’s effects during pregnancy. Though approved for use in Germany and elsewhere in Europe, a U.S. Food and Drug Administration medical officer named Frances Oldham Kelsey denied its license because there was insufficient clinical evidence about its side effects. This decision limited the impact of the drug in America. In 1962, President John F. Kennedy awarded Kelsey the President’s Medal for Distinguished Federal Civilian Service. 

Warnings of the drug’s possible toxicity began to emerge in 1959. Adults taking the drug reported peripheral neuritis or inflammation of the nerves and the resulting nervous system damage. Even after an Australian and a German physician independently linked thalidomide to birth defects in 1961, it was four months before the company withdrew the drug from the market, and it was banned even later in some countries. It is thought that at least 100,000 pregnant women were affected by the drug leading to more than 90,000 miscarriages. Even a single dose of thalidomide during early pregnancy may cause severe birth defects. About 40 percent of babies exposed to the drug die before or soon after delivery. Over 10,000 children were born with thalidomide-related birth defects such as missing or shortened limbs. Still others were born deaf and blind, some had curved spines and some had damaged hearts and brains and many other abnormalities.

The company refused to pay compensation for many years until 1970 when they established a $28 million fund in return for legal immunity. When those funds were depleted, the German government paid compensation to victims. In 2009, Grünenthal provided another $63 million in compensation. The company did not publicly apologize for its actions until August 2012.  However, dissatisfaction with that statement and the level of compensation by the company continues.

Researchers are actively seeking drugs that work similarly to thalidomide but without the side effects. The thalidomide tragedy prompted creation of and reforms in the laws and policies that govern drug testing and approval, reducing the chances of another such incident, but it must not be forgotten lest history repeats itself.

For a link to this story, click here.

Filed Under: Uncategorized Tagged With: , , , , , , , , , ,