Medical, Research, Science

The availability of cheap drugs offers hope for dementia sufferers

DEMENTIA

SCIENTISTS in Scotland have found a potential cure for the most common cause of dementia and strokes in old people – using cheap, everyday drugs.

Human trials are already being carried out after rats were treated with a combination of cilostazol and isosorbide mononitrate.

Researchers say once trials are complete they could be available to patients within two years.

The breakthrough comes days after new figures showed Scotland is facing a dementia “timebomb” as experts warn conditions such as Alzheimer’s will soon overtake heart disease as the biggest killer.

The drugs involved in the latest study repaired the deterioration of blood vessels in rats’ brains associated with a condition called cerebral small vessel disease, or SVD, and reversed the symptoms.

SVD is responsible for almost half of all dementia cases in the UK and accounts for one in five strokes. It can also aggravate the symptoms of Alzheimer’s disease.

Professor Anna Williams, group leader at Edinburgh University’s Medical Research Council (MRC) Centre for Regenerative Medicine, said: “We are very excited because it is the first time we have really got to the bottom of why this disease called cerebral small vessel disease happens.

“We gave rats some drugs that made the cells happier and managed to reverse the changes in the brain. We have found a way to reverse it. That is exciting for people with dementia.”

Professor Williams added: “The nice things about these drugs is that they are already tested on people, they are cheap and readily available so can quickly be given to people.”

Cilostazol and isosorbide mononitrate are commonly used by patients with heart and blood pressure ailments. Pills are available for around 60p and 20p respectively.

The research team discovered that SVD occurs when cells that line the small blood vessels in the brain become dysfunctional. This causes them to secrete a molecule into the brain, which stops production of myelin, a protective layer that surrounds brain cells, leading to brain damage. The drugs prevent this.

Experts hailed the breakthrough. A spokesperson for the charity Age Scotland, said: “Any development of this nature and any measures to combat dementia is good news indeed.”

The research, first published in Science Translational Medicine, was carried out at the MRC centre and the UK Dementia Research Institute at Edinburgh University. It was funded by the MRC, Alzheimer’s Research UK and the private Leducq Foundation, based in Paris.

Dr Sara Imarisio, head of research at Alzheimer’s Research UK, said: “The findings highlight a promising direction for research into treatments that could limit the damaging effects of blood vessel changes and help keep nerve cells functioning for longer.”

Researchers say further studies will be needed to test whether the treatment also works once the disease is firmly established, but trials will be over within a year.

Estimates indicate there are almost 47 million people living with dementia worldwide and the numbers affected are expected to double every 20 years, rising to more than 115 million by 2050.

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Health, Medical, Research, Science

Homeopathy: ‘Evidence’ that could resolve its legitimacy?

HOMEOPATHIC REMEDIES

THERE were 2,700 prescriptions for homeopathic remedies issued by NHS GP practices between December 2016 and May 2017. Clearly, there are patients – and doctors – who believe there may be something to the therapy.

. See also Why is a medical body giving accreditation to homeopathic medicine? It’s unscientific…

And while patients’ stories are far from proof that homeopathy works, it begs the question: is it simply a placebo effect or is it something more?

Proponents argue that key evidence showing a genuine benefit is often left out of major studies that claim to review all the available evidence.

According to Dr Peter Fisher, a rheumatologist and clinical director of research at the Royal London Hospital for Integrated Medicine, there have been 43 summaries of homeopathic trials and 21 showed an effect greater than a placebo.

“This is a proportion very similar to what studies of conventional treatments find,” says Dr Fisher.

He is also critical of the way the trials now used as evidence that homeopathy doesn’t work were run.

One key study published in The Lancet in 2005 found “weak evidence for a specific effect of homoeopathic remedies” and implied they were no more than placebos. However, Dr Fisher describes the research as “failing to meet elementary standards of quality and transparency.”

The study analysed eight out of more than 100 randomised controlled trials – the “gold standard” for proving treatments are better than a placebo, where one group gets the real therapy and the other a “fake”.

“But the rules as to what studies could be included were changed half-way through,” claims Dr Fisher. “This excluded 93 per cent of available trials and skewed the results against homeopathy. When the study was re-analysed using the original rules, good evidence for homeopathy emerged.”

On the other side of the debate, Professor Edzard Ernst has said that the British Homeopathic Association has misrepresented studies that it claimed showed homeopathy differs from a placebo. While the two sides are poles apart on what the evidence shows, all agree the principle behind homeopathy – super dilution – is a problem, flying in the face of science.

Compared with standard drug treatments, once a homeopathic remedy has been diluted thousands of times, there should be nothing left but water. But what if it could be shown that something clearly physical is going on?

Dr Steven Cartwright, a research biochemist formerly of the Sir William Dunn School of Pathology at Oxford University and now employed at Diagnox, a commercial lab, is looking at precisely that. He trained as a homeopath after a single dose “cured” the hayfever he’d had for years – “I was curious to find out more.”

Using a group of dyes that have some unusual properties, he believes he’s discovered a clue as to what is going on. The dyes change colour depending on the liquid they’re put into. In water, one might show up as red, but blue in alcohol.

Exactly why is not clear, but Dr Cartwright believes it could be because they respond to electrical and magnetic fields. When he mixed some regular shop-bought homeopathic remedies with the dyes they produced different colours. “You couldn’t see them with the naked eye but they showed up when looked at through a standard bit of lab equipment, a spectrophotometer,” he says.

He believes something in the remedy was affecting the dye. “I think it was probably picking up an electric or magnetic charge, possibly the result of the vigorous shaking that goes on during dilution,” he says.

What’s more, the effect was stronger the more diluted the remedy, and different remedies produced different colours.

“It’s too early to make any claims,” says Dr Cartwright. “There is a group in Brazil working to replicate it.

“We might have discovered a radical new medical mechanism. But let’s see.”

The NHS view remains as previously stated: that there is no robust evidence to support homeopathy.

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Health, Medical, Research, Science

Gene discovery for Alzheimer’s

MEDICAL RESEARCH

THE chance of developing Alzheimer’s from faulty genes could be reduced after a breakthrough by scientists.

About 14 per cent of people carry a gene called APOE4, which doubles the risk of getting Alzheimer’s.

But a new study by scientists at the Massachusetts Institute of Technology (MIT) shows it is possible to change the faulty gene into a less harmful variant with a lower chance of leading to Alzheimer’s.

It is hoped that in the future, stem cells with the altered gene could be introduced into the brains of Alzheimer’s sufferers to reverse the disease, a technique referred to as gene therapy.

The researchers took stem cells from a human donor and modified them to change the faulty gene to the lower-risk variant.

Study leader Li-Huei Tsai, said: “APOE4 is by far the most significant risk gene for late-onset, sporadic Alzheimer’s disease. However, there really has not been a whole lot off research done on it. We still don’t have a very good idea of why APOE4 increases the disease risk.”

. See also Alzheimer’s genes advance

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