Category: Tom's Earlier Blogs
The UK Human Fertilisation and Embryology Authority (HFEA) has agreed in principle to screening and selection of embryos for couples who have the possibility of passing on a gene for breast cancer.
Previously genetic screening has only been carried out for embryos with the risk of having a gene that always causes disease, such as cystic fibrosis.
Now the HFEA are allowing screening of genes on a case by case basis that would give the individual an increased risk of disease, such as the BRCA1 gene, which raises the risk of cancer in adulthood by 60-80%.
This kind of approach can be seen as a move away from human genetic diversity and the concept of addressing the environmental influences of switching genes on or off, towards a genetic inbreeding and the kind of uniformity depicted by Huxley.
A previous entry on this column described how polyethylene glycol could be used to 'hide' the blood group antigens on a red blood cell, turning any transfused blood into something that looks like O negative to the recipient's immune system. The entry also mentioned another method using the galactosidase enzyme, which can transform group B blood into group O by removing the galactose from the blood cell surface. The problem with the enzyme-based method was that the enzymes used for converting blood (taken from green coffee beans) were relatively inefficient, and a lot of enzymes would be needed to do the job, not necessarily at a neutral pH, which could be detrimental to the blood cells.
It did not therefore seem like an April fool joke when the journal Nature Biotechnology reported on April 1st a method of transforming any blood into blood group O. The paper announces the discovery of "two bacterial glycosidase gene families that provide enzymes capable of efficient removal of A and B antigens at neutral pH with low consumption of recombinant enzymes". The researchers described how two bacteria, Elizabethkingia meningosepticum and Bacterioides fragilis, contain enzymes that can remove both A and B antigens from red blood cells. This still does not address the problem of the Rhesus antigen on the blood cells of Rhesus positive individuals, which means that to make universal donor blood that is acceptable for anyone in an emergency (O Rh negative), the blood would have to be taken from Rhesus negative donors, who are in the minority compared with Rhesus positive individuals.
Patient trials will be needed before the blood group conversion method can be used in live situations to ensure that the IgM antibodies against opposing blood group antigens are not activated.
A news article from the BBC suggests that the UK government may be overlooking research that contradicts the link between childhood obesity and exercise.
The government supports exercise for children, while apparently not acknowledging that other factors such as genetics, diet and socioeconomic status could be more significant in preventing childhood obesity. A long-term research programme, the EarlyBird Study was established to explore a possible causal link between the rising incidence of type 1 diabetes and insulin resistance. Type II diabetes, formerly known as "late onset", was renamed due to the increasing prevalence in children. Results from the EarlyBird Study assert that Type I and type II diabetes are the same disorder of insulin resistance, set against different genetic backgrounds.
The EarlyBird study has looked at many variables in 307 children from age 5 over an extended period of time, including anthropometrics, birth weight, body composition, fat distribution, dietary habits, energy expenditure, genetics, demography, heart rate variation and physical activity on insulin resistance and its metabolic correlates (including haematology profile, glucose, cholesterol, HDL cholesterol, triglycerides, uric acid, HbA1C, FSH, LH, serum IGF1, adiponectin, leptin, IGF-1, gonadotrophins and SHBG, C-reactive peptide hcCRP - a marker of inflammation, as insulin resistance is "fundamentally a state of low grade inflammation").
The findings of the study cast doubts on the government's strategy to halt the increase in childhood obesity by the end of the decade, largely by encouraging physical activity. Results from the programme so far have produced several published papers, some concluding that increasing exercise is not necessarily the best way to prevent obesity:
The programme director, Professor Terence Wilkin, said "children's activity levels had no bearing on their body mass index" (a measure of obesity risk in the growing child). His team has been unsuccessful in their appeal to government ministers for funding to continue the study. The BBC also quotes Professor Philip James, from the International Obesity Task Force, who said it was much easier for the government to concentrate on promoting sport rather than taking on the food industry, which has "enormous political and strategic power".
The EarlyBird Study is another example of the kind of research that should be promoted, as it is holistic in outlook, starting early in life, before diseases have become irreversible, it measures many variables and challenges the status quo, which is often maintained by vested financial and political interests. The following are some examples of other conclusions reached from the study:
Meanwhile, Canadian genetics research at Montréal's McGill University have found four additional SNPs implicated in type II diabetes. As well as the known TCF7L2 gene (transcription factor 7-like 2, on chromosome 10), the presence of multiple gene associations "constitute proof of principle for the genome-wide approach to the elucidation of complex genetic traits."
Q: I am interested in trying a fast regime since I found out accidentally that fasting relieved my pain. The couple of times I just didn't eat all day for some reason I felt good then I asked my doctor only to be scolded. But I asked my acupuncturist and she said that she believed it could work but to be very careful. I am not overweight. How often would you suggest one to do these 8 day fasts? I have suffered from Rheumatoid arthritis for 20 years and am on humira and herbs. I do yoga and walk and eat pretty healthy. Thank you, peace. Michelle
Humira is an injectable protein that blocks the inflammatory effects of tumor necrosis factor alpha (TNF a), an inflammatory cytokine. The medication has potentially serious side-effects, and the extent to which these are currently present, combined with the risk of getting further side-effects are compared with the symptom relief gained from using it form part of the decision process (cost-benefit ratio) when choosing this therapy. Easily obtainable alternatives to pharmaceutical medication with few side-effects that have a long history in the treatment of inflammatory arthritis and have incidentally been shown in studies to decrease TNF a include the spice turmeric and the rhizome of ginger.
The reason fasting can relieve the pain of rheumatoid arthritis may be related to reduced lectin intake and the possibility that some lectins (such as wheat and lentil) may promote inflammation in joint cartilage.
Strict fasting, or the abstention from all food while drinking only water, also has a long history in natural medicine, and is safe when carried out in proportion to your constitution and vitality, although any fast longer than two days should be supervised. Sometimes it may be better to start with a modified fast (e.g. vegetable juice only). Fasting is a good way of finding out exactly which foods are causing the pain: by gradually introducing foods one at a time after a period of abstention until the pain returns. The best way to do this is with the support of a naturopathic physician who will carry out tests for blood group and secretor status, and help with the introduction of foods which are most likely to be of benefit to individuals of a particular type while monitoring nutritional status.
Although some published research and much anecdotal evidence exists to show the benefits of yoga for patients with osteoarthritis, there is little published evidence for a therapeutic effect on those with rheumatoid arthritis, although yoga is often cited as a suitable low impact mobility exercise. In the Western world, yoga is seen as simply a collection of physical postures. The word originates however from one of the six schools of Hindu philosophy, focusing on meditation as a path to self-knowledge and liberation, a means to both physiological and spiritual mastery. Another form of spiritual self-discipline which has been used in scientific studies is Falun Gong, an ancient Chinese Qigong. This has been shown to alter gene expression of practitioners in favour of enhanced immunity, downregulation of cellular metabolism, and alteration of apoptotic genes in favor of a rapid resolution of inflammation. The cost-benefit ratio may be good, as the therapy involves the low-risk activities of daily reading of Falun Gong books and daily practice of exercises lasting 1-2 hours, although participants in the study had been practitioners for between 1-5 years.
Many pharmaceutical companies provide Continuing Medical Education (CME) for prescribing physicians. Although these programmes run by drug companies do not overtly market their drugs, physicians may get the impression that a disease or condition is underdiagnosed and best treated with a prescription. Following on from the previous column about the influence of pharmaceutical companies on medical research there is now a resource listing ways for physicians to complete their CME credits without being influenced by the bias of drug companies.
The online resource, PharmedOut is an independent project run by Georgetown University School of Medicine staff members for physicians and other prescribers:
PharmedOut is one of more than 20 programmes funded by a $21 million grant from the Attorney General Consumer and Prescriber Grant Program that are intended to teach physicians and nurses to more critically evaluate information from pharmaceutical companies about prescription drugs. Ironically the funding for the grant comes from a drug company, a settlement from a court case about unlawful marketing of a drug:
The grant will fund programs designed to provide health care professionals and consumers information relating to prescription drugs, including the way in which drugs are marketed.
Mini syllabi available on PharmedOut include:
* Your Friendly Drug Rep
* Why You Get Samples
* Industry Sponsored Research
* Disease Mongering
* Direct to Consumer (DTC) Promotion
Resources also include many links to other websites of similar organisations. The CME suggestions include the National Center for Complementary and Alternative Medicine (NCCAM) video lecture series, along with many other options.