Sometimes, the Nobel Prize in Physiology or Medicine is awarded for a discovery or invention that already is improving the practice of medicine and saving lives. Sometimes it is awarded for very basic research that might someday affect medical practice and human health. Such is the case with this year’s Nobel Prize in Physiology or Medicine, which was awarded to Sir John Gurdon of Great Britain and Dr. Shinya Yamanaka. If I had to put into one sentence the message of today’s Prize, it would be this: our cells are a lot smarter and more flexible than we once imagined, and capitalizing on that fact could greatly improve the treatment of many human diseases. The work of Gurdon and Yamanaka led the way to today’s work on stem cells, which could someday be used to treat human diseases. The 2012 Nobel Prize in Medicine, like many before it, demonstrates that people with the curiosity and courage to ask what appear to be ridiculous questions, and a society that supports their work, can change our world for the better.
Researchers at Kansas State University have developed a blood test that rapidly detects breast cancer (as well as non-small cell lung cancer) in very early stages, long before symptoms appear or the cancer can be seen by other methods. The experimental test identifies enzyme patterns that differ from one type of cancer to another. According to the researchers, the test can detect very early breast cancers (stages 0 and 1), as well as early lung cancers (stages 1 and 2), within an hour, with 95% accuracy. However, they tested only 32 participants with various stages of breast or lung cancer, as well as 12 people without cancer. Whether finding cancer that early makes a difference for treatment and survival remains to be seen.
This summer, Harvard Health Publications hosted a group of mobile health startup companies, all part of the first Rock Health Boston class. I had the pleasure of attending their end-of-program demonstrations. It was 1) fun and 2) inspiring to see the future of medicine as told by young, savvy, energetic teams. All seven startups have similar goals—using the Web or apps to provide faster, better access to health care and to identify health issues before they become huge problems. Speaking before a standing-room-only crowd of potential investors, reviewers, and friends at the Broad Institute in Cambridge, the companies made polished pitches that had come a long way from those they offered upon their arrival at Harvard Health Publications in June. The seven companies include (in alphabetic order): Home Team Therapy, NeuMitra, NeuroTrack, NoviMedicine, Podimetrics, Reify Health, and RxApps.
Results of a study presented at the annual meeting of the American Society of Clinical Oncology in Chicago indicates that an experimental drug combination could be effective against HER-2-positive breast cancer. The new therapy, called trastuzumab emtansine (T-DM1), combines a monoclonal antibody with a potent chemotherapy agent. The combination is exciting because Herceptin guides the cell-killing chemotherapy agent to HER-2 receptors on breast cancer cells. This focused attack targets cancer cells and largely bypasses healthy cells, which the chemotherapy drug would otherwise damage. In the study, which included nearly 1,000 women with HER-2-positive breast cancer that had spread either within the breast or elsewhere in the body, 65.4% of the women taking T-DM1 were still alive after two year, compared to 47.5% of those on standard treatment for this type of cancer. In addition, women on T-DM1 experienced far fewer side effects.
Some encouraging Alzheimer’s news from Sweden: a vaccine called CAD106 appears to be safe and ramps up the body’s immune system against a protein likely involved in Alzheimer’s. The hope is that this vaccine will slow the progression of Alzheimer’s disease, and possibly even stop it. The vaccine is designed to activate the body’s immune system against beta amyloid, a protein fragment that forms deposits called amyloid plaques between nerve cells in the brain. Three-quarters of those who received CAD106 developed antibodies against beta amyloid protein. Virtually all of them—including those getting the placebo—reported one or more side effects, ranging from inflammation of the nose and throat to headache, muscle pain, and fatigue. None, though, developed meningoencephalitis, an inflammation of brain tissue that derailed work on an earlier version of the vaccine. The next step in the development of CAD106 is a larger clinical trial to confirm the vaccine’s safety and to see if it is effective at slowing the relentless progression of Alzheimer’s disease.
Exercise makes cells burn extra energy—that’s one way it helps control weight. It also generates a newly discovered hormone, called irisin, that transforms energy-storing white fat cells into energy-burning brown fat cells. Irisin also appears to help prevent or overcome cellular changes that lead to type 2 diabetes. The hormone does this by helping transform energy-storing white fat cells into energy-burning brown fat cells. White adipose tissue, more commonly known as body fat, is the tissue that dimples thighs, enlarges waists and derrieres, and pads internal organs. Each white fat cell stores a large droplet of fat. Brown fat, in comparison, is chock full of energy-burning mitochondria. Its main function is to generate body heat by burning fat. A team led by Dr. Bruce Spiegelman, professor of cell biology and medicine at Harvard Medical School, has identified irisin in mice and humans and showed how irisin transforms white fat cells into brown ones, at least in mice.
When you polish off a piece of chocolate cake and immediately start thinking about having another, you might suspect that eating for pleasure may trigger overeating. A new study out of Italy, where they know a thing or two about good food, supports this notion. Researchers from Naples and Salerno found that eating for enjoyment […]
An experimental approach to virtual colonoscopy could eliminate the unpleasant day-before bowel prep that keeps many people from having this potentially life-saving test. Virtual colonoscopy uses computed tomography (CT) scanning with X-rays, instead of a scope, to check the colon for cancers and precancerous polyps. Earlier version have required bowel cleaning, just like regular colonoscopy. A Harvard-based team led by Dr. Michael Zalis uses sophisticated computer software to make stool in the colon disappear. It’s a little like Photoshopping blemishes from still photos. “Laxative-free CT colonography has the potential to reach some of the unscreened population and save lives,” says Dr. Zalis, an associate professor of radiology at MGH and director of CT colonography at MGH Imaging.
Eating yogurt or taking a so-called probiotic when you have to take antibiotics may help prevent the diarrhea that often accompanies antibiotic treatment. That’s the conclusion of a study just published in the Journal of the American Medical Association. A team of California-based researchers combined the results of 63 randomized trials pitting probiotics versus placebo among almost 12,000 men and women taking antibiotics. Those who took antibiotics plus probiotics were 42% less likely to develop diarrhea as those who got the placebo. About one in three people who take antibiotics develop diarrhea. Antibiotics kill these “good” microbes along with bacteria that are causing an infection. This upsets the balance of the normal flora in the intestines. The result is often loose, watery stools known as antibiotic-associated diarrhea.
A test used to give doctors a close-up view of the pancreas, called endoscopic retrograde cholangiopancreatography (ERCP), often cause a painful inflammation of the pancreas (pancreatitis). According to report in the New England Journal of Medicine, a single dose of indomethacin, a powerful nonsteroidal anti-inflammatory drug, can help prevent this post-procedure problem. About half a million Americans have ERCP each year. As many as one in six develop pancreatitis afterward. In a randomized controlled trial that included men and women who had just undergone ERCP, administration of an indomethacin suppository right after the procedure cut the rate of post-ERCP pancreatitis almost in half. Once a person has pancreatitis, the chances he or she will have it again go up. That’s why the New England Journal report is good news for anyone who needs to undergo ERCP.