Chris Cross – setting the record straight on Columbus Day

In previous years, we have honored explorer Christopher Columbus – on this, his day.  In previous years, we have also enjoyed the federal holiday. Not so, this year.  Today we are working.  And that may explain why this year we’re painting a slightly different picture of the famous Genoa-born son of a wool merchant.

For many years, Christopher Columbus was regarded as one of the great heroes of Western history. He was touted as the New World`s pivotal discoverer who subsequently brought civilization to its backward peoples.  Whatever hardships and cruelties were inflicted upon the natives was generally thought to be insignificant in comparison with the benefits of European science and religion. Yada, yada.  Turns out, Christopher Columbus wasn’t quite that smart.  For one, he sailed in the wrong direction, landed thinking he was in the West Indies, and started calling everyone Indians. And even his most ardent admirers acknowledge that Columbus was self-centered, ruthless, avaricious, and a racist.

During the latter part of the 20th century, a Native American awareness movement developed in the United States and elsewhere, which called Columbus’ legacy into question. To those critics, the year 1492 represented not just a major turning point in world history, but the starting gun for the destruction of native cultures. Exploration was quickly superseded by settlement and exploitation. War, slavery, disease, and death followed in their wake.

Both American and European lives were changed in what is sometimes referred to as the “Columbian Exchange.” Europeans became acquainted with corn, chocolate, potatoes, tomatoes, and various peppers and spices. These imports vastly changed the diet in the Old World. Tobacco also began to exert its impact. Life in the Americas was changed by the importation of chickens, goats, horses, oxen, cattle, donkeys, sheep, coffee, rice, bananas, sugarcane, wheat, and barley.

On a more lethal level, diseases also were apparently exchanged. The Europeans brought a host of infectious maladies unknown in the New World, the most damaging of which was smallpox. Some authorities have suggested that syphilis was contracted by Columbus’ crew members and taken back to Europe. And then there’s the teeny-weeny little detail that Columbus was not in fact the European discoverer of the New World. That feat was accomplished 500 years earlier by the Norse.

Nevertheless, we won’t beat up further on poor old Columbus. After all, he’s not here to defend himself these days.  And, just because we’re not celebrating his special day doesn’t mean we’re bitter (well, not much), nor does it mean that the voyages of Columbus don’t merit a place in history.

To all our readers who are enjoying the Columbus Day holiday – we say enjoy the day. To everyone else, we say – we’re right there with you!  Happy Monday.

Breaking Cancer News– 122 years later!

On December 3, 1890 William Russell, a pathologist in the School of Medicine at the Royal Infirmary in Edinburgh, gave an address to the Pathological Society of London.  In it he outlined his findings of “a characteristic organism of cancer” that he had observed microscopically in all forms of cancer that he examined, as well as in certain cases of tuberculosis, syphilis and skin infection.

On May 8, 2012, Catherine de Martel and Martyn Plummer from the International Agency for Research on Cancer in France announced: “Infections with certain viruses, bacteria, and parasites are one of the biggest and preventable causes of cancer worldwide.”

In case you haven’t already done the math, that means it’s taken 122 years for someone to take notice.

A hundred and twenty two years ago!  That’s the year Eiffel Tower was completed, it’s around the time that  serial killer Jack the Ripper was terrorizing London, the same year Thomas Edison used electric Christmas lights for the first time and the year Vincent Van Gogh, the Dutch painter, committed suicide.

How, you might ask, have scientists put men on the moon, developed the internet, flying cars and metal-free underwear bombs, but yet remain so ignorant about cancer and its origin?

How can the infectious causes of tuberculosis, leprosy, syphilis, smallpox, polio, malaria, and other viral and bacterial and parasitic diseases be so well understood, but the cause of cancer be unknown?

The fact that all cancers could conceivably be caused by an infectious agent now seems a distinct possibility. That, until now,  this has been overlooked, ignored, or unrecognized by twentieth century doctors is simply incredible.

According to de Martel and Plummer, one in six cancers, accounting for around two million cases a year, are caused by preventable infections. They claim “application of existing public-health methods for infection prevention, such as vaccination, safer injection practice, or antimicrobial treatments, could have a substantial effect on future burden of cancer worldwide.”

The percentage of cancers related to infection is about three times higher in developing than in developed countries. For example the fraction of infection-related cancers is around 3.3%in Australia and New Zealand to 32.7% in sub-Saharan Africa.

Many infection-related cancers are preventable, particularly those associated with human papillomaviruses (HPV), Helicobacter pylori (H. pylori), hepatitis B (HBV) and C viruses (HCV).

Of these infection-related cancers, cervical cancer accounts for around half of the cancer in women. In men, liver and gastric cancers accounted for more than 80%.

Dr. de Martel says: “Although cancer is considered a major non-communicable disease, a sizable proportion of its causation is infectious and simple non-communicable disease paradigms will not be sufficient.”

Clearly we need to start making up for 122 years of lost time and directing further research and treatment efforts into these preventable causes of cancer.  Since vaccines for HPV and HBV are available, and increasing their availability, and lowering the cost should be a priority for governments and health systems around the world.

There’s a Shot for That

On May 14, 1796 Edward Jenner injected fluid from the cowpox blisters on the hands of dairymaid Sarah Nelmes, into James Phipps, an 8-year-old boy.  Jenner hoped the fluid from the cowpox lesion would somehow inoculate the boy against the smallpox scourge which at the time was killing over 400,000 Europeans a year. His hunch proved correct.

Today vaccines save 3 million lives per year worldwide. By training the human immune system to recognize and ward off dangerous pathogens, vaccines can protect against disease for decades, or even for a lifetime. Preventive vaccines work by introducing harmless microbial chemical markers, known as antigens, which resemble the markers on living microbes. The antigens train the immune system to recognize and destroy those microbes should they ever appear in the body. By injecting cowpox antigens into Phipps bloodstream, Jenner primed his immune system to attack the similar smallpox virus.

Now, medical scientists are taking Jenner’s ideas in a whole new direction. By exploiting a growing understanding of the immune system they are developing therapeutic vaccines targeting established diseases rather than trying to prevent them.

Last spring, the FDA approved Provenge, a personalized immunotherapy that activates a patient’s own immune cells to target and attack advanced prostate cancer. To make the Provenge prostate cancer vaccine, biochemists at Seattle’s Dendreon Corporation extract a sample of a patient’s own immune cells and bathe them in a chemical soup of prostate cancer antigens that are chemically linked to a cytokine that screams, “Attack this!”.  The activated immune cells are then injected back into the patient’s body to spread the call to arms.

While Provenge was the first of the new generation of therapeutic vaccines, it’s certainly not the last. BCC Research has identified 113 therapeutic vaccines in development, many of which are already in human trials. They even go so far as to estimate that the market for therapeutic vaccines will have an annual growth rate of 115% and reach an estimated $2.9 billion in 2014.

Other cancer vaccines are among the front runners. With a near-endless supply of patients willing to undergo novel treatments, cancer researchers have been among the most aggressive in experimenting with therapeutic vaccination. The Cancer Vaccine Collaborative is working on treatments that target multiple cancer antigens, which should trigger a more aggressive immune response and increase the odds of defeating tumors. All of which is good news for the 1.5 million Americans diagnosed with cancer each year.

While cancers cause a proliferation of diseased cells, some autoimmune diseases, cause the cells of the immune system to turn against healthy tissues. In diabetes, for example, the immune system attacks insulin-making pancreatic beta cells.

In multiple sclerosis, it’s the myelin sheaths that are designed to protect the nerves that come under attack.

Autoimmune vaccines hold the promise of shutting down these attacks. One promising approach boosts T-regulatory cells, a subgroup of the white blood cells. At the University of Calgary’s Diabetes Research Centre in Alberta, immunologist Pere Santamaria has attached a cocktail of antigens from pancreatic beta cells to synthetic iron oxide nanoparticles. This stimulates the development of T-regulatory cells into killer T cells that destroy the immune cells which cause the serial killer like autoimmune attack.

Santamaria’s team recently tested his vaccine in diabetes-prone mice. It restored normal blood sugar and insulin levels in animals that already had diabetes and prevented or slowed its onset in young mice that had not yet developed the disease. The team is now readying the vaccine for human trials and is designing related vaccines to treat other autoimmune diseases, including multiple sclerosis, rheumatoid arthritis, and inflammatory bowel disease.

If effective, such therapeutic vaccines could help the three million Americans with type 1 diabetes and the 400,000 people diagnosed with multiple sclerosis. Vaccines against dust mites and asthma are also in the works.

Some of the new therapeutic vaccines are actually designed to attack the body, albeit in a selective way. A new experimental heart-disease vaccine takes aim at unwanted biochemicals within the body, specifically low-density lipoprotein (LDL), better known as bad cholesterol. When large quantities of LDL cholesterol circulate through the bloodstream, it can be deposited on artery walls, leading to a buildup of plaque and triggering inflammation. Anti-cholesterol vaccines encourage the immune system to attack LDL and remove plaques. Scientists have also discovered that the vaccine lowers blood pressure and protects against the rupture of aneurysms, at least in mice.

Clinical trials in humans are expected to start later this year and if successful could help to prevent the 800,000+ deaths per year from cardiovascular disease.

Even more people could be helped by an anti-obesity vaccine. Nearly 75 million adults are classified as obese in the United States. Researchers are working on a vaccine that targets ghrelin – a gastrointestinal hormone that appears to stimulate appetite.

Others, are looking at vaccines to prevent addiction to cocaine, methamphetamines, opiates and nicotine.

It is too soon to know how and when these vaccines will come to market or how effective they will be, but it’s clear that therapeutic vaccines are coming and will be used against a host of the most prevailing public health issues of the 21^st century.

Happy Birthday Mr. President – Get well soon!

As many American’s celebrate Presidents’ Day,  SRxA’s Word on Health has been musing about the health of America’s founding father.  Although George Washington was physically strong, he was not the indominatable human force that popular history paints. He was often sick, particularly with infections. These were serious infections, many of them life-threatening.

Our research reveals that over the course of his lifetime, Washington suffered from diphtheria, malaria, smallpox, tuberculosis, dysentery, quinsy, pneumonia and epiglottitis.  In later life, he had dental problems, progressive deafness, short-sightedness and infertility.

From the age of 17 to almost the end of his life, Washington had recurrent attacks of malaria. Malaria was then common in Virginia. Interestingly, an effective treatment for malaria had been discovered in the previous century. But, for some reason, Washington did not receive the treatment until 1784, when he was in his 50s.

At age 19 Washington spent time on Barbados. Around this time George developed a severe case of smallpox, which ultimately left his skin scarred for life. Shortly after returning from Barbados, Washington developed tuberculosis.

Washington had a tendency to become depressed when ill. He was haunted by premonitions of death, perhaps because his father and half-brother both died prematurely. Thomas Jefferson wrote that Washington was, in all aspects of his life, “inclined to gloomy apprehensions.”

In 1759 Washington married Martha Dandridge Custis. He was 26, she was a 28 year old widow who had borne four children during her previous marriage. Martha never became pregnant during her 40-year marriage to Washington. Given her previous fertility, it could well be concluded that the difficulty was not with her but with her husband.

Washington’s height, sterility, large hands, pockmarks, plus certain personality features and even his well-documented dental problems have led to the suggestion he had XYY syndrome.

By middle age Washington had no teeth left. Washington’s clumsy, ill-fitting dentures distorted his lips. This undoubtedly contributed to his dour expression.

No one is quite sure what killed Washington. He was in fine health at age 67 when he developed hoarseness and a sore throat. There was little alarm until he awoke in the middle of the night with difficulty breathing, almost unable to talk. A doctor was summoned, but Washington did not wait, ordering an employee to bleed him. The doctor arrived and, according to the principles of the day, bled him again. Eventually, Washington requested no further bleeding be performed, but he was bled again anyway. The bleedings inflicted by Washington’s doctors hastened his end. Some 80 ounces of blood (about 35% of his total blood volume) were removed in 12 hours.

One of the three doctors attending him objected to continued bleeding, arguing instead for tracheotomy which would have been  life-saving in epiglottitis. However, back then this treatment was considered experimental and dangerous.

Nevertheless, a  fourth physician, arrived at Mount Vernon the day after Washington died. The doctor hoped that Washington was in a suspended state, from which he could be aroused and then treated with tracheotomy.  It was proposed that the body be thawed gradually, first in cool water and then with warm blankets and rubbing of the skin, with the subsequent performance of a tracheotomy, artificial respiration at the tracheotomy site, and transfusion of lamb’s blood.

Sadly, we will never know if this would have worked as Martha Washington vetoed the plan!

Return of the Andromeda Strain?

The discovery of an exotic, infectious virus reveals leads to treatments for common lung diseases. Sounds like the plot of a new sci-fi novel turned movie?  Beautiful scientists battling a new superbug from outer space!

Not so, this one is all home grown and 100% non-fiction. According to the CDC, there have been three recent outbreaks of monkeypox in the United States.

Monkeypox is a rare viral disease that occurs mainly in the rain forest countries of central and west Africa. First discovered in laboratory monkeys in 1958, it has since shown up in rodents, squirrels, mice, rats, and rabbits. In 1970, monkeypox was reported in humans for the first time and in June 2003, the first documented infection occurred in the United States, most likely from imported pet prairie dogs.

Monkeypox infections in humans have been on the rise. Up to 10% of those infected, die of the disease. It can be caught from infected rodents, pets and monkeys and is thought to be transmitted by respiratory droplets during direct and prolonged face-to-face contact. Researchers attribute the rise of monkeypox infections to the end of smallpox vaccinations, which provided protection due to the similar nature of the two pox viruses.

Signs and symptoms of infection include fever, headache, muscle aches, backache, swollen lymph nodes, a general feeling of discomfort, and exhaustion. Within 1 to 3 days (sometimes longer) after the appearance of fever, the patient develops a papular rash. Death, when it occurs, is generally due to pneumonia.

But until now there have been few studies to look at how monkeypox infection damages the lungs. In the latest study, researchers at the Oregon National Primate Research Center infected macaque monkeys with the virus and followed the course of infection in the lungs of individual animals.

What they found was not only does the infection from monkeypox virus increase production of inflammatory proteins, it also decreases production of proteins that keep lung tissue intact and lubricated.

“Going into this study, we thought monkeypox caused disease primarily by inducing inflammation in the lung, and that leads to pneumonia,” said lead author Joseph Brown, a systems biologist at the Department of Energy’s Pacific Northwest National Laboratory. “We were surprised to see how badly the virus wrecked the structural integrity of the lungs.”

The results suggest that inflammation contributes to disease but it may not be the main component. Interfering with the structural proteins may play a major role.

Ultimately, this type of research could have wider implications than viral infection. “This study serves as a great reference for pulmonary diseases,” said co-author Josh Adkins. “It opens up the doors for other lung fluid studies.”

If these results can be reproduced in people, doctors might be able to give surfactants – lubricating chemicals that aid in gas exchange – to help the lung function in patients with altogether more common diseases such as bronchitis, emphysema or even flu.

As always, SRxA’s Word on Health will keep you informed of all developments.