Sunday, January 03, 2010

Another "magic bullet" dream

Publicity first; evidence later. Not a good sign. Interferon has been around for years anyway and is of very limited use

A lozenge designed to fight off all cold and flu bugs has been created by scientists. It would be taken once a day before breakfast and would cost only 20p a day. The lozenge could be sold over-the-counter in as little as two years. It would prime the immune system to attack every cold and flu bug including 'normal' winter flu, swine flu and bird flu.

The lozenge, which tastes like a sweet and dissolves in the mouth, could be used to clear up sniffles in healthy people and prevent life-threatening infections in the elderly and in asthma and cystic fibrosis sufferers. It has already been tested on people and the first results are due within weeks.

Researcher Professor Manfred Beilharz said: 'This is the golden fleece everyone has been looking for.' The Veldona lozenge contains tiny amounts of interferon alpha, which was nicknamed the 'Crown jewel' of virology when it was discovered 50 years ago. Interferon alpha is a protective protein that the body naturally makes when attacked by a virus. When the lozenge dissolves in the mouth, the protein is released and the immune system is tricked into thinking there is a bug nearby and gets ready for a fight.

Professor Beilharz, who has devoted 15 years to the research, said: 'The outposts of the immune system say, "Hey, we've got a virus, let's gear up and get ready for it before the infection spreads too far."'

The professor has already shown that very low doses of the protein can save the lives of mice exposed to an otherwise lethal cocktail of the flu virus. These 'stunning' results prompted a government-funded trial of the lozenge on 200 adults in Western Australia. Half took the lozenge once a day before breakfast, half took a dummy sweet and all noted any cold and flu symptoms each week, including time off work.

If the results are good, the lozenges, which were developed by U.S. firm Amarillo Biosciences, could be fast-tracked onto pharmacy shelves within two to three years. They could be taken year-round, but people are most likely to rely on them over the winter.

Professor Beilharz, chairman of the department of microbiology and immunology at the University of Western Australia in Perth, expects them to be sold over-the-counter, rather than on prescription, and to be much cheaper than current anti-flu drugs. Tamiflu, which has been stockpiled by governments around the world to treat swine and bird flus, costs up to £5 a tablet. The lozenges could cost as little as 20p each, or £6 a month.

Professor Beilharz said: 'This medicine is quite cheap to manufacture and very low dosage and doesn't seem to have any side-effects of any significance.' Unlike the flu vaccine, which has to be frequently reformulated to fight whichever strains of the bug are circulating, it would be a 'one-size-fits all' drug. This is because interferon alpha primes the immune system to fight a range of viruses, including all cold and flu bugs.

The professor said: 'The vaccine is only good for a particular variant and there may have to be another one the next year, whereas our little baby is not just good against influenza, it is good against all winter cold variants.'

The professor does not expect the drug to completely ward off flus and colds, but symptoms will be greatly eased. He said: 'When the infection comes along, it still infects but the immune system quashes it in a couple of days. 'So you will have some symptoms but they will be rather mild and you will go on as normal.'

Interferon alpha was used by the Russians to treat colds and flus during the Cold War but never took off elsewhere. But injections of much higher doses are used to treat diseases, including multiple sclerosis. Professor Hugh Pennington, Britain's leading microbiologist, cautioned that the side-effects of interferon could be worse than the flu itself.

But he added: 'If you can work out the right dose and the right kind of interferon so people don't feel grotty, and it works, it will be a real breakthrough. So let's wait and see.'


Engineer shows surgeons better way to fix his heart

A heart repair kit designed by a man suffering from a potentially lethal condition has proved so successful that it is being used on other cardiac patients. Tal Golesworthy, 54, an engineer by training, was suffering from a defect in his aorta — the main artery for carrying oxygenated blood — that left it in danger of splitting, which would have caused instant death. He was so unimpressed by conventional techniques for treating it that he decided to create his own.

Usually the damaged section of the artery is cut out and replaced with a piece of tubing, but Golesworthy came up with a made-to-measure knitted polyester sleeve, which was wrapped round the aorta to give it extra support. The result was so good that Golesworthy has joined forces with his doctors and set up a company to market the device. The operation has since been carried out on a further 19 people by a team at London’s Royal Brompton hospital, and another three patients are booked in for surgery this month. Details of the first results are to be described to cardiac surgeons in a medical publication this month.

Golesworthy suffers from Marfan syndrome, a condition which affects up to 12,000 people in Britain. The genetic defect can cause abnormal growth of bones including fingers and toes, but most importantly causes weakness of connective tissue. The consequence is that the neck of the aorta where it leaves the heart gradually stretches under the burden of carrying freshly oxygenated blood round the body. It can reach a diameter of 2-4in, compared with a normal 1in, before fatally splitting.

Golesworthy says he had severe anxieties about the old-style surgery, and the fact he would have had to take anticoagulant drugs for the rest of his life to stop clots forming. “I just thought the operation sounded awful,” said Golesworthy, from Tewkesbury, Gloucestershire. “The doctors were being asked to do an engineering job when they weren’t engineers. I decided there had to be a better way.”

He set about devising a means of wrapping the aorta in a sleeve to prevent it expanding, and came up with a solution called Ears — external aortic root support — which is now being marketed through his firm, Exstent. Each sleeve is created using scans of the individual patient’s aorta and computer-assisted drawing to produce a bespoke device.

Although the technology could be applied to other heart conditions, news of the surgical breakthrough has spread first among families affected by Marfan syndrome, many of whom have seen relatives die suddenly from heart attacks in young adulthood.

The youngest to have the surgery so far is Ami Coxill-Moore, whose parents successfully argued for her to receive an Exstent at 16, even though an ethics committee initially stipulated that the experimental patients had to be at least 18. “To us it was obvious it was less risky and an altogether better operation,” said Coxill-Moore, who is taking a gap year and hoping to study English and linguistics at York University. “I am just very grateful I’ve had it done.”

The British Heart Foundation is watching the project with interest. “We welcome it as a new development, but we have to be certain these things are safe in the long as well as the short term, before we can recommend them,” said Peter Weissberg, its medical director.


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