Friday, September 30, 2005

Friday Hope Blogging

This week, the focus is on preventing or curing disease. The big news here is Effect Measure's tentatively optimistic report on the possibility that statins - which are widely used, relatively inexpensive anti-cholesterol drugs - may be able to prevent deadly cytokine storm reactions in H5N1 patients.

The idea that statins might be helpful for sepsis or influenza is based on more than speculation about mechanism. In 2004 Almog et al. (Circulation, Aug 17 2004;110(7):880-885) reported that patients admitted to the hospital with acute bacterial infections and who were on statins for more than a month for other reasons had a dramatically reduced incidence of severe sepsis (19% versus 2.2%) and reduced admission to the Intensive Care Unit (12.2% vs. 3.7%). An interesting point is that patients on statins might be expected to be at greater risk because they are taking a medication for a pre-existing medical condition.
I wouldn't advise anyone to run out and start eating statins like candy, but this is the first H5N1 treatment/prophylaxis story I've read that gives me any hope at all. Keep your fingers crossed!

As I'm sure anyone reading this knows, the rise of drug-resistant bacteria is a huge and growing problem, largely because of our cavalier, resolutely cornucopian policy of overusing and misusing them. While research is ongoing into new forms of antibiotics, other researchers have been taking aim at bacterial defenses themselves, at the genetic or molecular level.

Yesterday, Nature reported on a discovery about the defense mechanism of E. coli against the body's production of nitric oxide:
The discovery of this mechanism is just the first step in what Spiro hopes will be a line of research aimed at disrupting the mechanism by which the bacteria rids itself of the poisonous nitric oxide.

"If we can interfere with the mechanism, it could lead to better antibiotics and better treatments," said Spiro.
Another group of researchers has been conducting directed-evolution experiments to see how drug resistance forms, and how it can be inhibited:
A team of scientists in Argentina and Mexico identified mutations that increased the efficiency of a bacterial enzyme that renders penicillin and cephalosporin antibiotics useless. The results could lead to more effective enzyme inhibitors by giving drug designers a sneak peek at the next generation of resistance.
Last, there's some promising news from the Washington University School of Medicine. Scientists report that a new antibody has an unexpected method of preventing illness, which could have applications to the prevention of pediatric dengue fever, among other things:
A monoclonal antibody that can effectively treat mice infected with West Nile virus has an intriguing secret: Contrary to scientists' expectations, it does not block the virus's ability to attach to host cells. Instead, the antibody somehow stops the infectious process at a later point.

"This was a complete surprise to us, but it gives us some very useful insights," says senior author Daved Fremont, Ph.D., associate professor of pathology & immunology and of biochemistry & molecular biophysics at Washington University School of Medicine in St. Louis. "Based on what we've learned, we are now developing therapeutic antibodies for related viruses that also are effective at stopping the process of infection after the virus attaches to host cells."

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