Posts Tagged With: Drug Developement

Could Bats be the Pharmacopoeia of the Future?

Tadarida_brasiliensis_outflight_Hristov_Carlsbad_Caverns

This is some of the research that contributed to the recently released Darwin’s Paradox: An international science mysteryhttp://amzn.to/2k8qJgi. Bats have a major role in this books, also the people who try to protect them when they become a target of fearful people during the pandemic.

Could Bats be the Pharmacopoeia of the Future?

Bats have long been considered a threat to humans, but it might be time for that to change.

Of the almost 5,000 mammal species, about 20% are bats, chiroptera (KIE-ROP-TER-A) to be scientific. There are more bats species than any other order except rodents, and they inhabit every continent except Antarctica. Bats are everywhere, and they’re nocturnal, and they fly. What could be scarier than 1,000 species of bats flying into your nightmares?

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How about over 3,000 species of viruses? The International Committee of Taxonomy of Viruses has identified over 3,000 virus species. Unfortunately, a large number of the viruses that are dangerous to people spend their vacations with bats. The list of viruses that are hosted by bats is both long and scary: hepaciviruses, pegiviruses, influenza A virus, hantavirus, paramyxoviruses, and of course lyssaviruses which include rabies.

Besides the viral threat, bats are vampires, as every school child can tell you. NOT! Only 3% of the bat species are vampires, and those are isolated to south and central America.

Recall the major pandemics (Black Plague, Spanish Flu, HIV/AIDS)? All caused by viruses. People die from viruses. Bats host viruses. Bats and Rats … maybe we’d be better off if we killed them all?

This has been the myth, legend, and superstition for millennia. With modern science, it’s time to reconsider.

Science is now asking the question, “Why do viruses that infect and kill humans and other mammals exist benignly in bats?”

If scientists can answer this question, find what protects the bats, we might be able to prevent future pandemics and even cure the common cold.

Chiroptera differ from other mammals in several ways. First, bats reached their current evolutionary point over 33.5 million years ago, while other mammals continued to evolve. Felines didn’t even appear until about 25 million years ago, and people, homo sapiens sapiens, didn’t show up until a few hundred thousand years ago.

Bat_in_the_tree_at_Boga_Lake,_Bangladesh

This might explain why bats are better at dealing with viruses. Some scientists suggest that given 30 million years bats had time to evolve better defenses than we could in a few hundred thousand. Bats also had strong evolutionary pressures since they live in large, dense colonies – ideal for spreading viral infections. This is very different from primates which evolved in small isolated groups.

Others suggest that it’s just a numbers game. Given a thousand species of bats, to our one, they had a better chance to get lucky. This is supported by the rodents which have even more species and also host lots of viruses.

The third line of investigation is the high metabolism required for flight. This, combined with the observation that bats don’t seem to get cancer, leads to the hypothesis that their DNA repair mechanisms work faster and better.

This third hypothesis brings up another bat anomaly: not only are they more resistant to viral diseases, but they also live longer than expected. Are these two related? Maybe?

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Regardless, the denizens of Chiroptera have antiviral secrets that we need and science is working to find them. Today more scientists study the biology of bats, and more bats are getting their DNA sequenced. Perhaps soon we will live longer and healthier because of those scary, night flying, echolocating bats.

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Categories: Bats, Viruses | Tags: , , , , , , , , | 1 Comment

Live Long and Prosper #science #health

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In the last two centuries, life expectancy has more than doubled from under 40 to over 70. This is the difference between parents burying their children and children not knowing both parents to today where grandchildren and grandparents are commonplace.

What has caused this dramatic extension in life expectancy? What has made living beyond 100 more common and childhood death more rare?

One suggestion might be antibiotics.

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20th century medicine was about antibiotics. Starting in 1911, over 100 different antibiotics were released. Some of the big ones were penicillin, tetracycline, doxycycline, amoxicillin, ciprofloxacin. Anitbiotics treat a wide range of diseases including: anthrax, whooping cough, pneumonia, botulism, and STDs. If you plan an international vacation, your doctor will give you ciprofloxacin for “traveler’s diarrhea.”

None of this would have been possible were it not for the 19th century discovery: GERMS! For 1000s of years prior to the 1800s, western medical theory was about humors. Health was controlled by the four humors: black bile, yellow bile, phlegm, and blood. When the humors were in balance you were healthy.

Streptococci

When they were out of balance, you’d get sick, and you might be told to exercise more, eat healthier, be positive, pray, or if you could afford it, a doctor might try to balance the humors with medicines and procedures. These included bleeding, laxatives, and expectorants.

Before we laugh at two millenia of western medical science, reread that previous paragraph. Much of that advice, with the exception of bleeding, is still offered today. Thus, if we are honest, we can see the attraction of this commonsense medicine that let so many die.

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The 19th century changed all this (or did it?) with the discovery of specific germs for “anthrax, cholera, tuberculosis, leprosy, diphtheria, gangrene … plague, scarlet fever, tetanus, typhoid fever, pneumonia, gonorrhea and meningitis.”

This was all good, but germ theory and antibiotics only sometimes helped when people got sick. Penicillin was given credit for saving many lives in World War II, but the real gains came from preventions more than cures.

CSIRO_ScienceImage_1977_Bat_Lyssavirus

The reasons that so many children and grandparents are alive is the long list of diseases that people growing up today have never seen — all thanks to vaccines.

Children are routinely protected from: chickenpox, diphtheria, influenza b, hepatitis A and B, measles, mumps, whooping cough, polio, pneumoccal, rotavirus, rubella, and tetanus. If you don’t recognize some of these diseases, it is not because they aren’t terrible or contagious, but because of vaccinations.

Bordetella_pertussis

Beyond these vaccines, if you are going to travel you might also get shots for meningitis, typhoid, and yellow fever.

The extension in life expectancy is not about cures, but about prevention.

The history of vaccination peaked during the period of 1880s (rabies) to 1950s (polio). However smallpox vaccination started much earlier in Asia with clear documentation in China during the 16th century, and vaccination development continues today, especially with the efforts to prevent Malaria.

Categories: Diseases | Tags: , , , | Leave a comment

One pill makes you smaller… #SFRTG #IARTG #Kindle

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One pill makes you larger, and one pill makes you small
And the ones that mother gives you, don’t do anything at all

Grace Slick of the Jefferson Airplane

This is some of the research that contributed to the recently released Darwin’s Paradox: An international science mysteryhttp://amzn.to/2k8qJgi. “Doctor” Brian is in Mozambique and has been given pills to test for activity against a new disease. This raises all of the ethical issues associated with off-label drug use.

Grace Slick might have been singing about prescription drugs [I was there and I’m not talking]. If so, those pills would have been used off label. Off label is when a legal drug is used for something other than its FDA-approved indication. For example, drugs approved for bipolar disease or schizophrenia are often prescribed for depression, and blood thinners are prescribed for hypertensive and coronary heart disease.

This is legal. The FDA does not regulate the practice of the medicine, only the drug companies. For example, over three-quarters of children discharged from a hospital receive at least one off-label prescription.

What do you think about your doctor prescribing medications for you that have not been fully tested for safety or efficacy? What do you think about your doctor enrolling you, often without your knowledge, in an ad hoc science experiment?

Drugs are used off-label for many reasons. If a drug is generic, no one is motivated to spend the time and money to run the clinical trials required to get an indication approved, regardless of how safe and effective it is, or isn’t. Even if a drug is not generic, the approval process might not be deemed cost effective. Ironically, the larger the off-label market, the less a drug company would be motivated to fund a clinical trial. They (and the patients) are already benefiting from the sales, so why bother with the testing?

This is the conflict. If the doctors prescribe and the drug companies sell — all without clinical trials — who is protecting you? For example, estrogen medications were prescribed extensively to menopausal women to prevent coronary disease. It wasn’t until a government-sponsored trial found them to increase, not decrease, the risk of stroke and heart attack that this was curtailed.

You can think of each off-label prescription as a tiny clinical trial, without informed consent, without controls, without records, and without oversight. What do you think about being a test subject knowing that there is little chance that the result of your sacrifice and risk will add to scientific knowledge or benefit those who come after you?

Some might tell you the system is even more sinister. It turns out that drugs for rare diseases can be declared as orphan products. In this case the FDA streamlines (cuts corners) the approval process. This is good for those rare diseases, but once the drug is approved, it can be used off-label for whatever the doctors decide. This can be a cost-saving way for drug companies to get to market. For this reason, among others, drug companies are forbidden from promoting off-label uses. Regardless, drug companies have been penalized billions of dollars for violating the rules.

Who is protecting your well being? How can this system work at all?

This anxiety ignores one important fact of life. The fact of your unique DNA. People are different, and EVERY prescription (FDA approved or off label) is a science experiment. People respond individually to drugs. Side effects differ from patient to patient, ranging from benign headaches or muscle cramps to life-threatening reactions. Even popular over-the-counter (OTC) drugs like Tylenol(R) pose risks.

Doctors are the ones who read all that fine print and journals articles to be prepared and watchful for negative reactions from ALL prescriptions whether for FDA-approved or off-label.

In summary, around a billion off-label prescriptions are written each year with the overwhelming majority benefiting the patient. Like ALL medicine, there are benefits and risks, and doctors are the ones who balance them. Without doctors writing off-label prescriptions, millions would be suffering needlessly. It is the doctors who contribute the judgment that the bureaucracy can not.

So as Grace Slick recommended, “Go ask Alice,” especially if she is a doctor.

I am not an MD and am not giving medical advice.

For more information: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3538391/

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Categories: Pharmaceutical Industry | Tags: , , , | Leave a comment

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