Friday, May 18, 2007
Vaccine for hypertension?
It sounds most unlikely. As far as I can tell, hypertension is more a symptom than a disease. Do I detect an upcoming iatrogenic disaster here?
British scientists have developed a vaccine to control high blood pressure which could save tens of thousands of lives a year in the UK alone. Based on a protein found in limpets, it would need a course of just three jabs, with a booster every six months.
High blood pressure, which affects a third of all adults, doubles the risk of dying from heart disease or stroke and is blamed for 60,000 deaths a year in Britain. It is currently treated with pills, but they can cause side-effects and some patients simply stop taking them. Now the Cheshire-based drug firm Protherics says its vaccine will make it much easier for people to control their blood pressure. "Improving compliance in this way could save thousands from life-threatening complications such as heart attack or stroke," said the company's Dr Andrew Heath.
The jab, which has been successfully tested on people, uses the limpet protein to attack a hormone called angiotensin, which is produced by the liver. Angiotensin raises blood pressure by narrowing arteries. The vaccine, however, turns the body's immune system against the hormone.
Protherics is planning trials of an improved version of the jab, which is ten times more effective at stimulating the immune system than its original formula. People who have tried it have suffered few side-effects, although one in ten did complain of a brief, flu-like illness. A successful jab would guarantee its manufacturers a healthy share of the 12 billion pounds spent around the world annually on blood pressure medicines.
Ideally, patients would be given an initial course of three injections, with a week or fortnight between each jab. A booster shot every six months, or even once a year, would keep blood pressure low. The Swiss firm Cytos Biotechnology is developing a similar vaccine which uses an empty virus shell to spur the immune system into action. Zurich-based Cytos, which is also developing anti-smoking, obesity and flu vaccines, has already shown that its jab is effective at lowering blood pressure. But the reduction was less than that achieved by tablets already available on prescription. Further trials are due to later this year.
British heart doctors welcomed news of the jab, which should be on the market within five years. Professor Graham Mac-Gregor of the Blood Pressure Association said: "Raised blood pressure is the most important cause of death from strokes and heart attacks in the UK. "If you have to take blood pressure tablets, you have to take them for the rest of your life and some people find that difficult. "Finding other ways and better ways of trying to lower blood pressure without side- effects would be very much welcome."
Dr Mike Knapton of the British Heart Foundation said: "More than one in five heart attacks in Western Europe is caused by a history of high blood pressure. A vaccine is an interesting approach but more research will be needed."
It is not known how much the vaccines will cost but they are not expected to be much more expensive than current blood pressure tablets, some of which cost just a few pence a day. Available privately at first, the jabs will not be offered on the NHS unless the Government's drugs rationing body, the National Institute for Clinical Excellence, decides their benefits outweigh the costs. In time, the vaccine may be given to ward off problems in young men and women with a family history of heart disease.
Some blood pressure tablets already available work by targeting angiotensin, either by cutting production of the hormone or by stopping it from working properly. But many people stop taking the daily tablets simply because there are no obvious signs that they are boosting their health. Others give up after suffering side effects. Beta blockers, a major type of blood pressure pill, can cause fatigue, cold hands and feet, nausea, diarrhoea and impotence. They have also been linked to the risk of stroke.
Last month experts from the London School of Economics warned that the stress of modern life could be spawning an epidemic of heart disease, with half of Britons suffering from high blood pressure by 2025. A growing reliance on fat and salt-laden fast food, coupled with long working hours, is blamed for sending blood pressure soaring.
Source
Cure for baldness! -- Maybe
In a discovery that could lead to a cure for baldness, it has been shown for the first time that hair can be regrown. The research overturns a longstanding belief that loss of hair follicles in adulthood is permanent. An American team of scientists found that, under the right conditions, skin has the ability to revert to a more primitive state and then regenerate normally, producing new hair.
The research was carried out in mice and involved researchers cutting away a piece of skin tissue. "We've found that we can influence the skin to heal in a way that includes all the normal structures of the skin, such as hair follicles and oil glands," said the team leader, George Cotsarelis, a University of Pennsylvania dermatologist. The new hair the mice produced was indistinguishable from their existing hair.
Professor Cotsarelis said the findings could have applications for a range of hair-loss conditions, not just male baldness. The researchers also found they could suppress the growth of hair in the healing skin. This meant hairy people might also benefit in future, he said.
Cheng-Ming Chuong, of the University of Southern California pathology department, said the study, which was published in the journal Nature, could have even wider implications for medicine. "[It is] an unexpected finding that could change our current understanding of repair and regeneration in adult mammals", said Professor Chuong, who was not a member of the team.
The team showed that the healing process triggered an embryonic state in the skin in which dormant genes were re-awakened. These genes instructed stem cells to move to the area of the injury and begin to make new hair follicles. By increasing or reducing the levels of the proteins produced by these genes, known as wnt proteins, the team was able to increase or decrease the number of new hair follicles that grew.
A University of Melbourne researcher, Justine Ellis, said the role played by wnt proteins in hair follicle regeneration was one of the study's most important finds. It might be possible to develop treatments for baldness, based on these proteins, which would not require the skin to be cut. But she said the hair would still be subject to the conditions that made it fall out in the first place. If regeneration could be coupled to an effective treatment that prevents hair loss "then we might really be onto something". Dr Ellis said new treatments based on the mice study could take years to develop. "This research is in its infancy in its applications for the human scalp."
Male baldness is about 80 per cent genetic and Dr Ellis was a member of the Australian team that discovered the first gene linked to male baldness. Several genes are thought to be involved in the condition, she said, and understanding what was wrong with the genes, and the cellular mechanisms they affected that made the hair fall out, could also lead to new ways to overcome hair loss. She said some men were happy being bald, and some women like the look. "But it can also really blow a man's confidence when he loses a lot of hair. Finding a cure or a way to stop hair loss is really important for some people."
Source
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Just some problems with the "Obesity" war:
1). It tries to impose behavior change on everybody -- when most of those targeted are not obese and hence have no reason to change their behaviour. It is a form of punishing the innocent and the guilty alike. (It is also typical of Leftist thinking: Scorning the individual and capable of dealing with large groups only).
2). The longevity research all leads to the conclusion that it is people of MIDDLING weight who live longest -- not slim people. So the "epidemic" of obesity is in fact largely an "epidemic" of living longer.
3). It is total calorie intake that makes you fat -- not where you get your calories. Policies that attack only the source of the calories (e.g. "junk food") without addressing total calorie intake are hence pissing into the wind. People involuntarily deprived of their preferred calorie intake from one source are highly likely to seek and find their calories elsewhere.
4). So-called junk food is perfectly nutritious. A big Mac meal comprises meat, bread, salad and potatoes -- which is a mainstream Western diet. If that is bad then we are all in big trouble.
5). Food warriors demonize salt and fat. But we need a daily salt intake to counter salt-loss through perspiration and the research shows that people on salt-restricted diets die SOONER. And Eskimos eat huge amounts of fat with no apparent ill-effects. And the average home-cooked roast dinner has LOTS of fat. Will we ban roast dinners?
6). The foods restricted are often no more calorific than those permitted -- such as milk and fruit-juice drinks.
7). Tendency to weight is mostly genetic and is therefore not readily susceptible to voluntary behaviour change.
8). And when are we going to ban cheese? Cheese is a concentrated calorie bomb and has lots of that wicked animal fat in it too. Wouldn't we all be better off without it? And what about butter and margarine? They are just about pure fat. Surely they should be treated as contraband in kids' lunchboxes! [/sarcasm].
Trans fats:
For one summary of the weak science behind the "trans-fat" hysteria, see here. Trans fats have only a temporary effect on blood chemistry and the evidence of lasting harm from them is dubious. By taking extreme groups in trans fats intake, some weak association with coronary heart disease has at times been shown in some sub-populations but extreme group studies are inherently at risk of confounding with other factors and are intrinsically of little interest to the average person.
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Hypertension,When to Treat?
The blood pressure treatment guideline is based on the famous Framingham Study which showed the health benefits of blood pressure reduction. The 18 year Framingham Blood Pressure study found increased risk of heart disease and death in people with increased blood pressure 140 to 160, and even more risk above 160.
If you examine the original data from the Framingham study you will find computer smoothing of the data as published in the medical journals. This gives a smooth gradual line of increasing mortality as blood pressure goes up between 140 and 160. This is called the Linear Model. However, if you examine the raw data, as S. Port did as published in Lancet 1/15/2000, you will find a non-linear threshold of increased risk above 160 systolic, and no increased mortality below 160.
For a more complete review of this controversy in Blood Pressure guidelines, see my newsletter
Blood Pressure Pills for Hypertension, When to Treat? by Jeffrey Dach MD
Jeffrey Dach MD
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