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Showing posts with label Heart Disease. Show all posts
Showing posts with label Heart Disease. Show all posts

Saturday, January 25, 2014

Big Idea: Snake Oil Cures for Damaged Hearts 01-25

Big Idea: Snake Oil Cures for Damaged Hearts


Drugs derived from python blood may soon reverse heart failure.

python
Leslie Leinwand got plenty
 of skeptical looks from her coworkers in 2006 when she announced her newfound fascination with pythons. Leinwand, a molecular biologist at the University of Colorado at Boulder, was interested in the roots of heart disease, and she noted that the snakes manage to consume vast quantities of fat, yet their hearts stay lean and strong. But snake biology is very different from human biology, and it wasn’t clear that any lessons from pythons would translate.
Six years on, her gamble has paid off. Python blood contains a trio of molecules that rapidly bulk up and strengthen heart muscle, suggesting a new approach for combating cardiovascular disease—especially congestive heart failure, a chronic condition affecting 5.7 million Americans in which the heart becomes too weak to pump blood effectively.
Ideally, everyone would have a big, muscular heart like that of an elite athlete, kept strong through constant exercise, Leinwand says. Instead, many people develop enlarged hearts for the wrong reasons: Factors such as obesity and high blood pressure introduce so much stress that the heart stretches out to compensate. It gets bigger but less efficient. That can lead to heart failure, along with an increased risk of fatty buildup and heart attacks.
For years, researchers like Leinwand have looked for ways to promote the good type of heart growth and counteract the bad. Their lab animals of choice were mice and rats, whose physiology is similar to that of humans.
Then, in 2005, Leinwand read a paper in Nature  that made her rethink that approach. The article encouraged her to look beyond common lab animals in favor of Burmese pythons, creatures whose metabolic engines run in overdrive. A 20-foot-long python can fast for a year and then consume prey 1.6 times its body weight, equivalent to an average-size man’s swallowing a 300-pound steak in one gulp. Within a few days of feasting, a python’s metabolism increases 40-fold as the animal rapidly digests the meat and uses up oxygen.
For Leinwand, the most impressive thing about this feat was the ability of the creatures’ hearts to keep up—after all, the body can consume oxygen only as quickly as the heart can shuttle it around. To shoulder the load, python hearts grow 40 percent within a day or two of a good supper. The hearts add muscle at a breakneck pace, and their cells fill with beneficial proteins and enzymes.
Leinwand realized that pythons must have something in their blood that injects extra horsepower into the heart when activated by a large meal. A pill that could do the same for humans would go a long way toward treating and perhaps preventing heart failure. (Current drugs like ACE inhibitors improve blood flow but don’t actually strengthen the heart.)
At that point, it didn’t matter that Leinwand had never seen a Burmese python. She had found her next project. “I’m the sort of person who loves a challenge,” she says.

Heart of a Snake
In early 2006 Leinwand ordered 20 baby pythons from a reptile supplier and set up a colony in an empty laboratory downstairs from hers. For the first experiment, she drew blood from a couple of snakes, fed them a big rodent meal, then took another sample. The post-meal blood looked like a cardiologist’s worst nightmare. “The blood became so filled with fat that it was almost milky,” Leinwand recalls.
In humans, fat in the bloodstream tends to produce fatty deposits on arterial walls and in the heart itself. Yet when Leinwand inspected the snakes’ hearts, she could not find any accumulating fat deposits. She realized that whatever chemical was strengthening the heart was also preventing the buildup of fat. She still had no idea how the pythons did it or whether the process would work in other animals, but she was determined to find out.
Part of the issue was settled when Cecilia Riquelme, a postdoc in Leinwand’s lab, drew blood from recently fed pythons and applied it to a dish of living rat heart cells. Within two days the cells had grown significantly and were filled with helpful proteins and enzymes. Riquelme’s simple experiment suggested that mammals, perhaps including humans, could benefit from the heart-bolstering chemical machinery of pythons.
Leinwand was emboldened to identify that machinery in python blood. It was no easy task: Blood contains thousands of compounds, and any combination of 2 or 20 could have held the secret to heart health. So she isolated compounds in pre-meal blood samples and looked to see if their concentrations shot up after feeding. Whenever she found a candidate, she injected it into mice, hoping their hearts would grow.
After two years and dozens of dead ends, Leinwand finally found a compound that strengthened mouse hearts. She tried it on unfed pythons too, and it triggered the same effect, as if they had consumed a giant meal. The crucial recipe was a mixture of myristic acid, palmitic acid, and palmitoleic acid, all of which were isolated from the milky part of the blood that Leinwand had observed in her first experiment. Ironically, a trio of fatty compounds held the key to strengthening the heart, which in turn 
prevented other fats from clogging up the works. Leinwand’sresults appeared in Science last October.
Python TherapyNow Leinwand wants to observe python blood’s effect on at-risk test subjects. Over the next several months she will breed mice with high blood pressure and inject them with the key fatty acids. She hopes the trial will show that a python-inspired pill could treat heart 
failure by reversing damage and adding heart muscle. Leinwand is also injecting healthy mice to see if python blood can prevent symptoms of heart failure before they start.
Although human drug trials are several years away, Leinwand has cofounded a company to fund her research. Her colleagues hope this work will keep her occupied for a long while. “Everyone has made me promise not to bring another exotic animal into the lab,” she says. “They think one is enough.”

Exotic Medicine

Pythons are not the only exotic animals whose body fluids have inspired serious drug research. A variety of outlandish reptiles, arachnids, and mammals also have 
the potential to overturn their frightening reputations and help fight disease.


Gila monsters  These nearly two-foot-long lizards use their poisonous bite to prey on small animals in the southwestern United States. But scientists figured out how to harness the monsters’ venom, and in 2005 the Gila-inspired drug Byetta was approved as a treatment for type 2 diabetes.
T
arantulas  Scientists at the University of 
Buffalo discovered a compound in tarantula saliva that could disable the faulty mechanism that destroys healthy muscle in some people with muscular dystrophy. The researchers are now raising money to start a small-scale clinical trial.
Vampire Bats  The saliva of these blood-consuming predators contains an anticoagulant, dubbed draculin by the researchers who found it, that can dissolve blood clots. A new drug based on that chemical, currently in human trials, could give doctors more time to treat people who have just suffered a stroke.

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Thursday, November 7, 2013

Can You Reverse Heart Disease? 11-08


Is Heart Disease Reversible?


Can You Reverse Heart Disease?



What may be possible if you have coronary artery disease.

Imagine that you’ve just left your cardiologist’s office. He’s told you that you have to make some changes. Your blood pressure is way over the limit at 170 over 100 and your LDL cholesterol (that’s the “bad” kind) is hovering right around 200. He conducted an exercise cardiac stress test, putting you on the treadmill and increasing the speed and elevation periodically while monitoring your heart -- and he didn’t like the results.

The diagnosis: coronary artery disease (CAD).

Besides surgery or medication, is there anything you can do to modify the course of CAD? The answer to that is, clearly, yes -- as long as your doctor is on board. Making some simple but significant changes in what you eat, how often you exercise, how much you weigh, and how you manage stress can help to put the brakes on heart disease.

But can you actually reverse heart disease, not just slow it down? The answer to that question is much more controversial. Here are two expert's views.

Yes, You Can!


Dean Ornish, MD, founder and president of the Preventive Medicine Research Institute and clinical professor of medicine at the University of California, San Francisco, says that you absolutely can reverse at least some of the damage of even severe heart disease. Indeed, one of his six best-selling books is titledDr. Dean Ornish's Program for Reversing Heart Disease.

In his 2007 book The Spectrum, Ornish describes patients waiting to undergo a heart transplant -- those with the worst possible damage -- who enrolled in his program while on the transplant list. Some of them, he says, improved so much that they no longer needed a transplant.

“Our studies show that, with significant lifestyle changes, blood flow to the heart and its ability to pump normally improve in less than a month, and the frequency of chest pains fell by 90% in that time,” Ornish says. “Within a year on our program, even severely blocked arteries in the heart became less blocked, and there was even more reversal after five years. That’s compared with the natural history in other patients in our study, in which the heart just got worse and worse.”

Those lifestyle measures include exercise -- Ornish calls for people to walk at least half an hour a day, or an hour three times a week. Your cupboards, refrigerator, and dinner table will also need a total transformation if you expect to have a chance of actually reversing heart disease, not just preventing it or stopping its progression.

“Just making moderate changes in your diet may be enough to prevent heart disease, but it won’t be enough to reverse it,” Ornish says.

Ornish's plan categorizes foods from 1-5, ranging from most to least healthful. To actually reverse heart disease, you have to stay in Category 1.

In essence, that means becoming a vegetarian, filling your plate with fruits and vegetables, whole grains, legumes, soy products, nonfat dairy, and egg whites, and keeping away from fats, refined sugar, and carbohydrates. “You want to eat foods in their natural form as much as possible," Ornish says.

Ornish’s program also calls for regular yoga, meditation, and stress reduction.

If you have serious heart disease and are extremely motivated, you may be able to make such major changes, but they are difficult to sustain, says Lori Mosca, MD, MPH, PhD, professor of medicine and director of preventive cardiology at Columbia University Medical Center and the author of Heart to Heart: a Personal Plan for Creating a Heart Healthy Family.

“You have to live a very strict lifestyle, way beyond even the normal heart-healthy life,” she says. “And even then, I wouldn’t say you can ‘reverse’ heart disease, because that implies you had something and now you don’t. With very strict changes you can regress heart lesions, but they shrink -- they don’t go away. You can’t cure heart disease, but you can slow its progression.”
Mosca instead emphasizes slowing heart disease, and preventing it in the first place, through lifelong efforts to eat heart healthy, get regular physical activity, avoid smoking, and maintain a healthy weight.
On the diet side, that means embracing variety. “I don’t think that dietary approaches that are highly restrictive are sustainable,” she says. To keep heart disease in check, she advises:
Embrace the USDA’s new “MyPlate” program (similar to a visual she’s had on her Web site for years), in which half your plate is loaded with fruits and vegetables, and the other half is evenly divided between lean proteins and high-quality carbs such as brown rice.
  • Limit the saturated fat in your diet to less than 7% of calories.
  • Choose heart-healthy sources of fat, such as salmon and other fish rich in omega-3 fatty acids, nuts, and olives.
Ornish agrees that for most people who are just looking to either prevent heart disease or slow it down, going entirely “Category 1” isn’t needed. “If you need to reverse a life-threatening illness, you’re well advised to live as much as you can on the healthiest end of the spectrum,” he says. “But if you’re just trying to stay healthy, it’s unsustainable to say, ‘Never eat certain foods.’ It’s much more sustainable to just move in a healthier direction.”
And if you slip up and eat something that’s really not heart-healthy (a bacon cheeseburger, say, or a gooey doughnut) -- don’t beat yourself up. “If you indulge one day, then eat healthy the next. If you don’t exercise one day, do more the next,” says Ornish. “Guilt, shame, and anger are toxic to the heart, so forgive yourself and move on.”
Once you start making those changes, you might find that the rewards spur you to make more.
“We found that the more people changed their diet and lifestyle, the more they felt better, no matter how old or sick they felt,” Ornish says. “The better you feel, the more you want to keep doing it. The myth is that a pill is easy and diet and lifestyle changes are hard, but the data show that less than half the people prescribed Lipitor still take it after a year. Taking a pill to prevent something bad happening is fear-based, and it can be boring. But making healthy changes to your life makes you feel good, so you’re not just living longer, but better.”