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While scientists know antibiotic resistance is linked to the widespread use of antibiotics, understanding the physiology and microbiome of guts that have never been exposed to synthetic antibiotics might offer information to help address this resistance. Researcher Sharmily Khanam designed a study to tackle this gap in knowledge. She explains
Dr. Sharmily S. Khanam is a Postdoctoral Research Associate with the Department of Microbiology and Plant Biology at the University of Oklahoma. She explains her initial question in her research, namely what the microbial population in our ancestors was like and how resistant they were to the current antibiotics. She and her colleagues are therefore studying a population in a remote village in the Amazon Forest in Peru.
Currently they are studying the scope and extent of antibiotic resistance in the gut microbiome population of this ancestral-like population, comparing them with the gut microbial population, physiology, and antibiotic resistant population in the microbiome of people exposed to modern antibiotics. They are trying to see if our ancestral microbiome was well positioned to tolerate the modern day antibiotics. She explains that researchers need to fill the gap of knowledge in understanding the molecular mechanism involved in resistance to a diverse group of antibiotics.
She adds that at the same time, this will provide a foundation to investigate and characterize the molecular mechanism in the bacterial population and how that is related to host metabolism—the combination of host and microbial population is creating the outcome that scientists need to understand in order to interrupt this process and prevent resistance. She adds an explanation of their findings thus far and explains how this may help the medical community.
To learn more about this study, see her LinkedIn profile and Google scholar account.
Scarring of the liver leads to numerous health concerns and in this podcast, Dr. Friedman addresses these concerns and ways pharmaceutical companies are trying to prevent these diseases. He tells listeners
Dr. Scott L. Friedman is the Dean for Therapeutic Discovery and Chief of the Division of Liver Diseases at the Icahn School of Medicine at Mount Sinai. He has worked to address liver diseases since 1984 and considers himself a physician scientist who oversees clinical trials and program. He explains that the liver gets scarred as a consequence of a variety of insults, from hepatitis A and B to alcoholic disease to NAFLD and NASH. Progressive inflammation leads to scarring and then advanced scarring known as cirrhosis.
He tells listeners that any disease of the liver often begins with a fatty liver and explains the physiology of this, how liver regeneration can be impeded by fatty liver, and how the liver functions to handle any toxins that enter our bodies. He says that the main fibrotic or scaring disease targeted by pharmaceutical companies is NASH, which falls under the umbrella term NAFLD. He adds that a disease that is rising worldwide and part of liver disease is a full body disease known as metabolic syndrome, which includes type 2 diabetes, obesity, and other issues. He explains why liver disease is often overlooked and why this is a problem. He finishes with mentioning some new drugs, one of which should be available soon, to prevent this scarring.
For more, see helpful groups that address liver issues such as the American Liver Foundation, the Mt. Sinai web site, the American Association for the Study of Liver Disease, and the Fatty Liver Foundation.
Kathleen Mullin Bio:
Kathleen Mullin, M.D., is the Medical Director for Clinical Research at the New England Institute for Clinical Research and the Associate Medical Director at the New England Institute for Neurology and Headache (NEINH). Dr. Mullin is board-certified in neurology and headache medicine and after graduating from Tufts University and New York University School of Medicine, she completed her residency training at Columbia Presbyterian Hospital, followed by a fellowship in Headache Medicine at Montefiore Medical Center.
Prior to joining NEINH, Dr. Mullin was the Assistant Professor in the Department of Neurology at Montefiore. She was also Director of Clinical Trials, overseeing a busy clinical trials program. She has been a principle and a sub-investigator on numerous studies, with her work being published in peer-reviewed journals and presented at national meetings.
Newer migraine medications are designed to address a different arm of the pain source than traditional triptan therapy, an approach not usable by patients with vascular issues. Dr. Mullin explains
Kathleen Mullin, MD, is the Medical Director of the New England Institute for Clinical Research (NEICR) in Stamford and specializes in headache medicine. A neurologist by training, she continued working in headache medicine after a fellowship following medical school and has never looked back. She is a clinician who also helps companies run migraine medication trails on her patient population and has found a very effective new medication that's now FDA approved: Nurtec™.
She explains how this works differently than the common triptan line of medicines, which work to decrease inflammation through vascular shrinking. However, any patient with a vascular condition of any sort is not able to take these medicines. She explains how the migraine medication Nurtec™ binds with CGRP receptors; GCRP is a neuropeptide that we all have in our bodies. Migraine sufferers have an increased amount of them and blocking their ability to bind blocks their ability to cause pain. Therefore, medications that work this way are called CGRP antagonists. She discusses the success patients have had with this who haven't found relief with any other medication
She adds that headaches are wildly underdiagnosed and urges listeners to seek out medical help if they suffer from headaches. She says that if you ever had a headache that made you feel you had to cancel something, you probably had a migraine—so go to the doctor, she advises.
For more about Nurtec™, see https://www.nurtec.com/ .
Chief Academic Officer at Beth Israel Lahey Health, Dr. Gyongyi Szabo, joins the show to discuss her research on the role of inflammation in innate immunity and liver disease. In this episode, you will learn:
For nearly 20 years, Dr. Szabo has been studying innate immunity, innate cell function, and signal transduction pathways. The focus in her lab is on various types of liver diseases that have an inflammatory component, which accounts for almost all liver injuries and chronic liver diseases. The goal of her research is to gain a better understanding of what causes the inflammatory response in certain liver diseases with the hopes of intervening with certain medications or treatments that would benefit patients suffering from liver disease.
She discusses the difference between innate and adaptive responses of the immune system, how the evolutionary-preserved pattern-recognition receptors that are normally activated by pathogens can also recognize damage-associated molecular patterns, thus leading to low-level systemic inflammation, in what ways her research might lead to an effective treatment for alcohol-related liver disease, and more.
Dr. Schilsky is a professor of medicine and surgery and medical director of liver transplantation at Yale, and he joins the show today to discuss issues related to the liver and liver transplantation. Tune in to learn the following:
Dr. Schilsky had the privilege of witnessing the transition of organ transplantation from the imaginary world, to the world of practical application, to the world of successful application. He has seen firsthand the influence of pharmacology and advanced techniques on the outcomes in this field, and perhaps most importantly, increased quality of life and lifespan enjoyed by patients. For Dr. Schilsky, this is precisely where his interests exist: in the space where patient care and science marry.
He discusses acute and chronic injuries to the liver, the safeness of acetaminophen, infectious causes of liver diseases, the crucial balance between liver injury and regeneration, the relationship between NSAIDs and kidney malfunction and other disorders, non-alcoholic fatty liver disease, when and why life-saving bariatric surgeries may be performed, the absence of signs in early stages of liver diseases, whether or not liver diseases tend to happen in certain locations of the liver, and so much more.
Learn more at https://liverfoundation.org/ and https://www.niddk.nih.gov/health-information/liver-disease.
This podcast explores how readily available genomic testing and databases of human genetic information raise ethical concerns. Dr. McGuire discusses
Dr. McGuire is the Leon Jaworski Professor of Biomedical Ethics and Director of the Center for Medical Ethics and Health Policy at Baylor College of Medicine. She specializes in ethical issues of genetic testing and genomic research. Modern technologies and commercialization put human genetic information at the forefront of medical ethics revolving around multiple health issues. For example, she begins the conversation by addressing gene editing, which has brought a lot of attention: it offers great promise, but also raises ethical concerns about how we influence nature.
She also discusses privacy issues from direct-to-consumer genetic testing and genealogy information. She advises listeners to use caution and understand that who can access the information depends on the company you are using. She reviews different company policies but also the ways the fine print may include provisions the consumer can miss. Ultimately, these companies have created a business model to amass this data and sell it to pharmaceutical companies to develop health initiatives like new drugs.
She talks about the extent to which HIPA and GINA, a newer suite of laws that directly address genomic research and human genetic testing information, meet the needs for protection yet could be tightened. She also brings up newer technologies and reproduction issues, some mass testing programs, and how balancing competing health issues with a global health emergency is a rising issue.
For more, follow the work of the American Society for Bioethics and Humanities and see the web site for the Center for Medical Ethics and Health Policy at Baylor Medicine at https://www.bcm.edu/centers/medical-ethics-and-health-policy.
Bugworks Research, Inc., is a company focused on producing a next generation antibiotic in light of antibiotic resistance. Dr. Datta details surrounding issues, including
Dr. Santanu Datta is the CSO of Bugworks, Inc., and has been working in the field of infectious disease for decades. He begins telling listeners about the background of antibiotic development, highlighting the difference it has made. He explains why it has been difficult to develop new antibiotics from both a market and scientific perspective. He also explains the mechanisms of antibiotic and bacteria interaction, from the parts the antibiotics have traditionally targeted to the types of adaptations and evolutions bacteria are able to make to impede antibiotics, resulting in antibiotic resistance.
He then talks about his company's work to make a new broad spectrum antibiotic that targets the most dangerous bacteria hospitals face in one antibiotic, from E. coli to Staphylococcus aureus to other common bacteria in hospital patients. Therefore, doctors may use this in an IV form when they don't have time to wait for test results because of the health risks to the patient. Dr. Datta explains that his new generation antibiotic targets two parts of the bacteria at once, limiting its ability to escape unharmed. One of the targets includes the enzyme bacteria require for replication. He also explains their approval process as they head towards phase 1 and adds that they are funded by Carb-x.
For more, see the company's web site at https://bugworksresearch.com/
Environmental toxicologist Martin Wagner joins the show today to discuss the effect of plastics and other endocrine-disrupting agents on human health and the ecosystem at large. In this episode, you will learn:
Wagner began studying plastics while obtaining his PhD, and has since focused largely on trying to determine what compounds exist in the products we consume, how those compounds function, and what effect they have on human and environmental health. Many of these chemicals are known to disturb hormone signaling in the body, which can lead to all types of ailments. Despite this, they have become "almost invisible to us because they are just so pervasive in our everyday life," says Wagner.
Following his PhD studies, Wagner began focusing on an area of research where he saw a void: while most researchers were looking at marine plastic pollution, Wagner wanted to look at microplastic and nanoplastic pollution on freshwater systems like lakes and rivers. In light of the recent increase in public attention on and awareness of the environmental impact of single-use plastics, Wagner has recentered his work on this topic with the goal of emphasizing not just the use of plastics and the impact on the environment, but also the significance of the chemical compounds within these plastics.
He discusses the details of past and recent studies in the field, what it means for a plastic product to have a certain dispersion factor and why this is significant, what items are found most often on European beaches and what's being done about it, surprising sources of plastic pollution, why recycling only works well for a few types of plastic, and more.
To learn more about Wagner's work or reach out with questions, contact him through Twitter.
Daniel Heller runs a lab developing nanomaterials for the treatment and detection of cancer and other diseases. He explains this technology by describing
Daniel A. Heller, PhD, runs the Daniel Heller Lab at Memorial Sloan Kettering Cancer Center. They're making sensors to detect signs of cancer at the earlies stages, like ovarian cancer, which is often detected at later stages when it is hardest to treat. Currently, they're creating sensors that would be implanted in patients at higher risk to detect ovarian cancer. He explains that the sensors identify biomarkers, which appear at higher levels in certain areas of the body like fallopian tubes, for example, before they appear in the blood where they are normally detected but too late for effective treatment.
He explains that nanotechnologists are working alongside the popularity of fitness trackers like the Apple watches, hoping to merge that trend with medical advancement. These trackers shoot light to measure bodily functions like your pulse. Heller and his colleagues thought that they could get at these key biomarkers through something similar, a wearable device, which can use light to compare and measure indicators but noninvasively. A nanotube in the body can send infrared signals to this wearable device.
He describes how these can offer an accumulative measure—so even if the cancer is at a very early stage, and a single time point measure wouldn't find significant biomarker levels, if clinicians do accumulative measures, they should be able to catch it. Then, they can tell if they are increasing or measure their rate of change, also called the biomarker velocity.
For more, find him on twitter through @HellerLab and see the lab web site at https://www.mskcc.org/research/ski/labs/daniel-heller
Azra Raza is the Chan Soon-Shiong Professor of Medicine and Director of the Myelodysplastic Syndromes (MDS) Center at Columbia University in New York, a practicing oncologist, and author of The First Cell: And the Human Costs of Pursuing Cancer to the Last. She joins the show to discuss several incredibly important topics, including the following:
"Today…we are curing 68% of the cancers, and that's great, but what are we curing them with? Slash, poison, burn: surgery, chemotherapy, radiation…the same treatments we were using…with a few rare exceptions…it is shocking that in this day and age of such advanced technology we are using such paleolithic caveman treatments..." says Dr. Raza, who has devoted over 30 years of her life to the early detection and prevention of cancer while working firsthand with countless cancer patients.
She continues by explaining that these treatments (surgery, chemotherapy, and radiation) were initially given as stop-gap measures, and despite the efforts of thousands of scientists over the course of the last several decades, a more successful treatment has not been developed. Why? According to Dr. Raza, a big part of the answer has to do with the fact that cancer is heterogeneous; it's a moving target that's continually evolving and picking up new mutations.
So, what's the solution? In Dr. Raza's view, the solution is early detection and prevention of the development of cancer, rather than attempts to treat it once it's already advanced, and she emphasizes the need to use every available resource to this end, including genomics, metabolomics, proteomics, and transcriptomics. She explains the financial burden of pursuing this research pathway, how she's trying to overcome it, and so much more.
"On a daily basis I am seeing patients, and it is their stories that are the motivation for me…I am looking at everything through the prism of human anguish…to separate human suffering and pain from the need to find the answers is criminal, because the motivation has to be…to reduce human suffering."
Tune in to hear the full conversation, and visit https://azraraza.com/ to learn more about Dr. Raza's mission.
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