Health – Page 66 – artdiamondblog.com

Purging Senescent Cells Makes Mice More Youthful and Vigorous

“CELL SUICIDE. A subdermal fat layer, middle, in a mouse purged of senescent cells. These mice can run much longer and have larger fat deposits.” Source of caption and photo: online version of the NYT article quoted and cited below.

(p. D3) Until recently, few people gave much thought to senescent cells. They are cells that linger in the body even after they have lost the ability to divide.

But on Nov. 2, in what could be a landmark experiment in the study of aging, researchers at the Mayo Clinic reported that if you purge the body of its senescent cells, the tissues remain youthful and vigorous.
. . .
. . . the startling result is plausible because it ties together an emerging body of knowledge about senescent cells. And it raises the possibility that attacks on the cells might postpone the diseases of aging and let people live out more of their life span in good health.
. . .
The finding was made in a strain of mice that age fast and usually die of heart arrhythmia. So despite their healthier tissues, the mice purged of senescent cells died at the usual age of heart problems. Dr. van Deursen’s team is now testing to see whether normal mice will live longer when purged of senescent cells.
The treatment was started when the normal mice were a year old, and they have now been treated for five months. Next month they will run treadmill tests to see if they are in better shape than a comparison group of untreated mice, Dr. van Deursen said.
The genetic method used to purge mice of senescent cells cannot be used in people. Instead of trying to remove senescent cells from elderly people, Dr. Peeper believes, it may be more effective to identify which of the factors that the senescent cells secrete are the source of their ill effects and to develop drugs that block these factors.
But Dr. van Deursen thinks it would be better to go after the senescent cells themselves. In his view it should be easy enough by trial and error to find chemicals that selectively destroy senescent cells, just like the targeted chemicals now used to treat certain kinds of cancer. And unlike the cancer cells, which proliferate so fast that they soon develop resistance, the senescent cells cannot replicate, so they should be easy targets.
Several companies and individuals have already approached the Mayo Clinic to explore developing such drugs. “They think it’s possible, and they are very enthusiastic,” Dr. van Deursen said. “So I can guarantee that there will be initiatives to find drugs that kill senescent cells and mimic the system that we have developed in the mouse.”
. . .
“If you remove the senescent cells you improve things considerably, but you can’t reverse the process or completely stop the aging because it has other causes,” Dr. van Deursen said. “Personally I think we can slow aging down, and over time we will become more and more successful.

For the full story, see:

NICHOLAS WADE. “In Body’s Shield Against Cancer, a Culprit in Aging May Lurk.” The New York Times (Tues., November 22, 2011): D3.
(Note: ellipses added.)
(Note: the online version of the story is dated November 21, 2011.)

Simple Heuristics Can Work Better than Complex Formulas

(p. C4) Most business people and physicians privately admit that many of their decisions are based on intuition rather than on detailed cost-benefit analysis. In public, of course, it’s different. To stand up in court and say you made a decision based on what your thumb or gut told you is to invite damages. So both business people and doctors go to some lengths to suppress or disguise the role that intuition plays in their work.
Prof. Gerd Gigerenzer, the director of the Max Planck Institute for Human Development in Berlin, thinks that instead they should boast about using heuristics. In articles and books over the past five years, Dr. Gigerenzer has developed the startling claim that intuition makes our decisions not just quicker but better.
. . .
The economist Harry Markowitz won the Nobel prize for designing a complex mathematical formula for picking fund managers. Yet when he retired, he himself, like most people, used a simpler heuristic that generally works better: He divided his retirement funds equally among a number of fund managers.
A few years ago, a Michigan hospital saw that doctors, concerned with liability, were sending too many patients with chest pains straight to the coronary-care unit, where they both cost the hospital more and ran higher risks of infection if they were not suffering a heart attack. The hospital introduced a complex logistical model to sift patients more efficiently, but the doctors hated it and went back to defensive decision-making.
As an alternative, Dr. Gigerenzer and his colleagues came up with a “fast-and-frugal” tree that asked the doctors just three sequential yes-no questions about each patient’s electrocardiographs and other data. Compared with both the complex logistical model and the defensive status quo, this heuristic helped the doctors to send more patients to the coronary-care unit who belonged there and fewer who did not.

For the full commentary, see:
By MATT RIDLEY. “MIND & MATTER; All Hail the Hunch–and Damn the Details.” The Wall Street Journal (Sat., December 24, 2011): C4.
(Note: ellipsis added.)

A couple of Gigerenzer’s relevant books are:
Gigerenzer, Gerd. Gut Feelings: The Intelligence of the Unconscious. New York: Penguin Books, 2007.
Gigerenzer, Gerd. Rationality for Mortals: How People Cope with Uncertainty. New York: Oxford University Press, USA, 2008.

Adipotide Kills Fat Cells in Obese Mice and Monkeys

Source of graphic: online version of the WSJ article quoted and cited below.

(p. A6) A drug that kills a type of fat cell by choking off its blood supply caused significant weight loss in obese monkeys, potentially setting the stage for a new pharmaceutical approach to attacking obesity, according to a study released Wednesday.

After four weeks of treatment, obese monkeys given daily injections of the drug, called adipotide, lost an average of 11% of their body weight. They also had big reductions in waist circumference and body-mass index and, importantly, striking improvement in their ability to process insulin, researchers said. The drug had no effect on weight when given to lean monkeys.
Results of the study, performed at M.D. Anderson Cancer Center in Houston and published online by the journal Science Translational Medicine, confirmed a 2004 report from the same research team showing marked weight loss in mice treated with the agent.
. . .
The researchers’ 2004 paper showing a 30% weight loss in obese mice drew skepticism. Randy J. Seeley, director of the diabetes and obesity center at the University of Cincinnati, figured destroying white fat cells would make animals–and people–sick. But his own lab eventually replicated the mouse study, using rats instead, and now he is intrigued.
“This is really new stuff,” Dr. Seeley said of the latest results. “There’s no way to know if this will become a therapy or not, but at least it opens up a new way to think about therapies, and we have not had a lot of those.” He isn’t involved with the research.

For the full story, see:
RON WINSLOW. “Drug Offers Hope in Obesity Fight; Treatment Targeting Fat Cells Caused Significant Weight Loss in Monkeys; Human Trials to Begin Soon.” The Wall Street Journal (Thurs., November 10, 2011): A6.
(Note: ellipsis added.)
(Note: the last two sentences quoted above appeared in the online, but not the print, version of the article.)

“One of the monkeys used in the study. Obese monkeys lost an average of 11% of their body weight after four weeks of treatment.” Source of caption and photo: online version of the WSJ article quoted and cited above.

Creative Destruction Helps Us Be Well

WSJ review quoted and cited below.

Dr. Eric Topol’s credible and thought-provoking comments on the over-use of stents appeared in entries in this blog in August 2006 and in December 2006.

(p. A15) “The U.S. government has been preoccupied with health care ‘reform,’ but this refers to improving access and insurance coverage and has little or nothing to do with innovation,” even though, as Dr. Topol notes, adopting new approaches would improve care and lower costs. . . .
. . .
“The Creative Destruction of Medicine”–an allusion to economist Joseph Schumpeter’s description of “creative destruction” as an engine of business innovation–is a venture capitalist’s delight, describing dozens of medical technologies that show great promise. The book also provides colorful anecdotes about Dr. Topol’s own sampling of these products, as both a doctor and stand-in patient.
. . .
. . . , full adoption of the new tools will require the Food and Drug Administration to alter the way it evaluates products. The FDA, he says, should allow the testing of drugs on patients who are selected for their prospect of deriving a benefit. Right now, the FDA usually requires drugs to be tested in a scattershot fashion on large populations. With drugs being tested on cancer patients, he notes, the “FDA insists on a body count to be able to quantify how much and how long the new drug improves survival”–even though diagnostic markers can sometimes reveal in advance which patients are unlikely to gain a benefit.
Dr. Topol worries that doctors will resist technologies that empower patients because the tools will also diminish the doctors’ gatekeeper role. The American Medical Association, for example, battled firms that provide genetic information directly to patients. “This arrangement ultimately appears untenable,” the author writes, “and eventually there will need to be full democratization of DNA for medicine to be transformed.”

For the full review, see:
SCOTT GOTTLIEB. “BOOKSHELF; Digital Doctoring; It’s hard to fake sleep to avoid your spouse’s bedtime chatter when a ‘Zeo clock’ is displaying your real-time brain waves.” The Wall Street Journal (Fri., February 3, 2012): A15.
(Note: ellipses added.)
(Note: the online version of the review has the title “BOOKSHELF; Digital Doctoring; The digital revolution can spur unprecedented advances in the medical sciences, argues Eric Topol in “The Creative Destruction of Medicine”.”)

The book under review is:
Topol, Eric. The Creative Destruction of Medicine: How the Digital Revolution Will Create Better Health Care. New York: Basic Books, 2012.

Stem Cell Therapy for Dry Macular Degeneration

“Dr. Steven Schwartz, a retina specialist at the University of California, Los Angeles, conducted the trial with two patients.” Source of caption and photo: online version of the NYT article quoted and cited below.

(p. B7) LOS ANGELES — A treatment for eye diseases that is derived from human embryonic stem cells might have improved the vision of two patients, bolstering the beleaguered field, researchers reported Monday.
The report, published online in the medical journal The Lancet, is the first to describe the effect on patients of a therapy involving human embryonic stem cells.
. . ..
Both patients, who were legally blind, said in interviews that they had gains in eyesight that were meaningful for them. One said she could see colors better and was able to thread a needle and sew on a button for the first time in years. The other said she was able to navigate a shopping mall by herself.
. . .
. . . , researchers at Advanced Cell Technology turned embryonic stem cells into retinal pigment epithelial cells. Deterioration of these retinal cells can lead to damage to the macula, the central part of the retina, and to loss of the straight-ahead vision necessary to recognize faces, watch television or read.
Some 50,000 of the cells were implanted last July under the retinas in one eye of each woman in operations that took about 30 minutes.
One woman, Sue Freeman, who is in her 70s, suffered from the dry form of age-related macular degeneration, a leading cause of severe vision loss in the elderly.

For the full story, see:
ANDREW POLLACK. “Stem Cell Treatment for Eye Diseases Shows Promise.” The New York Times (Thurs., January 26, 2012): B7.
(Note: ellipses added.)
(Note: the online version of the article was dated January 25, 2012.)

“Sue Freeman said her vision improved in a meaningful way after the treatment, which used embryonic stem cells.” Source of caption and photo: online version of the NYT article quoted and cited above.

California Vegan Defends Freedom to Choose McDonald’s

“Ellsworth Wareham, 97, in Loma Linda, Calif. Mr. Wareham was a heart surgeon who stopped working only two years ago. He is a vegan, but says choice is part of the “great American system.”” Source of caption and photo: online version of the NYT article quoted and cited below.

(p. A15) . . . last week, when the City Council approved Loma Linda’s first McDonald’s restaurant, many residents bemoaned the decision, worrying that the officials were jeopardizing the city’s reputation as a paragon of healthy lifestyles.
. . .
. . . , Dr. Rigsby [said] . . . he would support having a citywide vote on whether fast-food outlets should be banned entirely from the city. “If this is something that people are really opposed to, that’s how we should deal with it.”
What would happen during such a vote is anyone’s guess. Ellsworth Wareham, who stopped working as a heart surgeon only two years ago, at 95, is often used as an example of someone with more energy than someone half his age. Dr. Wareham attributes his health at least partly to the fact that he has been a vegan for the last 30 or 40 years (he does not remember precisely).
Eating at home, he said, is the best way to ensure that one is eating healthy food. He is certainly not about to let the impending arrival of McDonald’s raise his blood pressure.
“I don’t subscribe to the menu that these dear people put out, but let’s face it, the average eating place serves food that is, let us say, a little bit of a higher quality, but the end result is the same — it’s unhealthy,” he said.
“They can put it right next to the church as far as I am concerned,” Dr. Wareham added. “If they choose to eat that way, I’m not going to stop them. That’s the great American system.”

For the full story, see:
JENNIFER MEDINA. “LOMA LINDA JOURNAL; Fast-Food Outlet Stirs Concerns in a Mecca of Healthy Living.” The New York Times (Mon., December 19, 2011): A15.
(Note: ellipses added.)
(Note: the online version of the article is dated December 18, 2011.)

The Case Against Fluoridating Public Water Supplies

(p. A18) Last week, Pinellas County, on Florida’s west coast, voted to stop adding fluoride to its public water supply after starting the program seven years ago. The county joins about 200 jurisdictions from Georgia to Alaska that have chosen to end the practice in the last four years, motivated both by tight budgets and by skepticism about its benefits.
Eleven small cities or towns have opted out of fluoridating their water this year, including Fairbanks, Alaska, which acted after much deliberation and a comprehensive evaluation by a panel of scientists, doctors and dentists. The panel concluded that in Fairbanks, which has relatively high concentrations of naturally occurring fluoride, the extra dose no longer provided the help it once did and may, in fact, be harmful.
. . .
The movement to stop fluoridating water has gained traction, in large part, because the government has recently cautioned the public about excessive fluoride. A report released late last year by the Centers for Disease Control and Prevention linked fluoride to an increase among children in dental fluorosis, which causes white or yellow spots on teeth. About 40 percent of children ages 12 to 15 had dental fluorosis, mostly very mild or mild cases, from 1999 to 2004. That percentage was 22.6 in a 1986-87 study.
Fluorosis is mostly a cosmetic problem that can sometimes be bleached away. But critics argue that spotted teeth are a warning that other bones in the body may be absorbing too much fluoride. Excessive fluoride can lead to increases in bone fractures in adults as well as pain and tenderness.
“Teeth are the window to the bones,” said Paul Connett, a retired professor of environmental chemistry and the director of the Fluoride Action Network, which advocates an end to fluoridated water.
Experts say that one possible factor in this increase may be that fluoridated water is consumed in vegetables and fruit, and juice and other beverages as well as tap water. And the consumption of beverages continues to increase.
. . .
The conclusion among these communities is that with fluoride now so widely available in toothpaste and mouthwash, there is less need to add it to water, which already has naturally occurring fluoride. Putting it in tap water, they say, is an imprecise way of distributing fluoride; how much fluoride a person gets depends on body weight and water consumed.
Doctors, scientists and dentists, including Dr. Bailey of the Public Health Service, mostly agree that fluoride works best when applied topically, directly to the teeth, as happens with brushing.
“The fact that no one really knows what dosage a given person receives from fluoridated water makes the subject of benefits and harms very difficult to quantify,” said Rainer Newberry, a professor of geochemistry at University of Alaska, Fairbanks, who sat on the committee that studied the issue prior to the June vote in Fairbanks. “And this presumably explains the number of studies with diverging conclusions.”

For the full story, see:
LIZETTE ALVAREZ. “Looking to Save Money, More Places Decide to Stop Fluoridating the Water.” The New York Times (Fri., October 14, 2011): A18.
(Note: ellipses added.)
(Note: the online version of the article is dated October 13, 2011.)

Bright Prospects for Longer Life

Source of book image: online version of the WSJ review quoted and cited below.

(p. A13) “We are at the cusp of a revolution in medicine and biotechnology,” Ms. Arrison announces, “that will radically increase not just our life spans but also, and more importantly, our health spans.”
. . .
She recounts advances in stem-cell research, pharmaceuticals and synthetic biology. And the tinkering with genes still goes on. We learn about Dr. Cynthia Kenyon at the University of California in San Francisco, who discovered that the life span of the tiny worm Caenorhabditis elegans could be doubled by partially disabling a single gene. Further improvements on the technique resulted in worms living six times longer than normal. “In human terms,” Ms. Arrison says, “they be the equivalent of healthy, active five-hundred-year-olds.” That may be a bit much to expect, but Ms. Arrison says she is confident that “human life expectancy will one day reach 150 years.”
. . .
What is more, technology heavyweights are paying attention, including Bill Gates (if he were a teenager today, Mr. Gates once said, he’d be “hacking biology”) and Jeff Bezos (“atom by atom we’ll assemble small machines that will enter cell walls and make repairs”). Larry Ellison, of Oracle, started a foundation more than a decade ago to support anti-aging research; the institution donates about $42 million a year.

For the full review, see:
NICK SCHULZ. “BOOKSHELF; Bioengineering Methuselah; Human beings living to be 150? And you thought Social Security and Medicare were in trouble now.” The Wall Street Journal (Weds., AUGUST 31, 2011): A13.
(Note: ellipses added.)

The book under review is:
Arrison, Sonia. 100 Plus: How the Coming Age of Longevity Will Change Everything, from Careers and Relationships to Family and Faith. New York: Basic Books, 2011.

When Christopher Hitchens Will Visit Nebraska

“Christopher Hitchens, after being released from the Texas hospital where he was treated for esophageal cancer.” Source of caption and photo: online version of the NYT article quoted and cited below.

A few times I have had the pleasure of seeing Christopher Hitchens interviewed. His wit is always wonderful and he skewers much that deserves skewering. I admire his perseverance at being productive, even as he battles a difficult cancer. And I admire him for sticking to his reasoned principles, even when it might be easier to accept Pascal’s Wager.
I have enjoyed the few reviews by Hitchens that I have read. I have purchased, but not yet read, two of his books—when I have read, I will write.
ADDENDUM: I wrote the above words back on November 10th, scheduled to run today. Yesterday I saw in the paper that Hitchens died on Thursday, December 15, 2011.

(p. C1) HOUSTON — Christopher Hitchens, probably the country’s most famous unbeliever, received the Freethinker of the Year Award at the annual convention of the Atheist Alliance of America here on Saturday. Mr. Hitchens was flattered by the honor, he said a few days beforehand, but also a little abashed. “I think being an atheist is something you are, not something you do,” he explained, adding: “I’m not sure we need to be honored. We don’t need positive reinforcement. On the other hand, we do need to stick up for ourselves, especially in a place like Texas, where they have laws, I think, that if you don’t believe in Jesus Christ you can’t run for sheriff.”

Mr. Hitchens, a prolific essayist and the author of “God Is Not Great: How Religion Poisons Everything,” discovered in June 2010 that he had Stage 4 esophageal cancer.
. . .
(p. C5) On balance, he reflected, the past year has been a pretty good one. He won a National Magazine Award, published “Arguably,” debated Tony Blair in front of a huge audience and added two states to the list of those he has visited. “I lack only the Dakotas and Nebraska,” he said, “though I may not get there unless someone comes up with some ethanol-based cancer treatment in Omaha.”

For the full story, see:
CHARLES McGRATH. “A Voice, Still Vibrant, Reflects on Mortality.” The New York Times (Mon., October 10, 2011): C1 & C5.
(Note: ellipsis added.)

Some Traits (Including Some Diseases) Depend on Many Genes Rather than a Single Gene

(p. D3) A new exploration of how evolution works at the genomic level may have a significant impact on drug development and other areas of medicine.
The report, published in Nature last week, offers new evidence in a longstanding debate about how organisms evolve. One well-known path to change is a heavily favorable mutation in a single gene. But it may be well known only because it is easy to study. Another path is exploitation of mildly favorable differences that already exist in many genes.
. . .
Three biologists at the University of California, Irvine, Molly K. Burke, Michael R. Rose and Anthony D. Long, followed populations of fruit flies through 600 generations and studied the whole genome of some 250 flies in order to see what kinds of genetic change they had undergone.
. . .
The conventional view is that evolutionary change is generally mediated by a favorable mutation in a gene that then washes through the whole population, a process called a hard sweep because all other versions of the gene are brushed away. The alternative, called a soft sweep, is that many genes influence a trait, in this case the rate of maturation, and that the growth-accelerating versions of each of these genes become just a little more common. Each fly has a greater chance of inheriting these growth-promoting versions and so will mature faster.
In sequencing their subjects’ genomes, the researchers found that a soft sweep was indeed responsible for the earlier hatching. No single gene had swept through the population to effect the change; rather, the alternative versions of a large number of genes had become slightly more common.
. . .
Haldane favored the single mutation mechanism, but Fisher and Wright backed multiple gene change.
. . .
The demise of the Haldane view “is very bad news for the pharmaceutical industry in general,” Dr. Rose said. If disease and other traits are controlled by many genes, it will be hard to find effective drugs; a single target would have been much simpler.

For the full story, see:
NICHOLAS WADE. “Natural Selection Cuts Broad Swath Through Fruit Fly Genome.” The New York Times (Tues., September 21, 2010): D3.
(Note: ellipses added.)
(Note: the online version of the article is dated September 20, 2010.)

Global Warming Reduces Bubonic Plague in U.S.

(p. D6) Global warming may have one minor but previously unknown benefit, scientists said this month: it may be cutting down cases of bubonic plague in the United States.
. . .
A study in this month’s issue of The American Journal of Tropical Medicine and Hygiene tracked climatic conditions in 195 counties in 13 Western states, from Washington to Texas, that reported even one plague case since 1950.
Cases have dropped over time, and the study concluded that rising nighttime temperatures since 1990 had helped. Warmer nights melt winter snowpacks earlier, leading to drier soil in rodent burrows. When the soil gets too dry, fleas die.

For the full story, see:
DONALD G. McNEIL Jr. “GLOBAL UPDATE; United States: Decrease in Bubonic Plague Cases May Be an Effect of Climate Change.” The New York Times (Tues., September 21, 2010): D6.
(Note: ellipsis added.)
(Note: the online version of the article is dated September 20, 2010.)