Feb
20
2021

Two Articles Showed that Fish Oil Reduces Cardiovascular Disease and Mortality

Recently two articles showed that fish oil reduces cardiovascular disease and mortality.

British study recording the effects of fish oil over 10 years

For one thing, the British Medical Journal published an article comparing people who supplemented with fish oil with people who did not. In this case, the ones who supplemented had a lower risk of mortality and had lower cardiovascular disease than the control group. In brief, 427,678 subjects were enrolled in this British study between 2006 and 2010. Questionnaires at the beginning of the study revealed how many capsules of fish oil the subjects consumed. Hospital records and death certificates provided information about cardiovascular disease mortality at the end of 2018. Altogether, 31% of the subjects said that they were taking fish oil supplements regularly.

In short, here are the results of the study showing what fish oil did.

  • 7% lower cardiovascular events
  • 16% lower risk of cardiovascular disease mortality
  • 20% lower mortality risk from heart attacks
  • 13% lower risk of death from any cause (when compared to people who did not use fish oil)

Discussion

Given these points, the authors stated that it was the omega-3 fatty acids in fish oil that caused all the beneficial effects. This included lowering of blood pressure, triglycerides and reducing the heart rate. Fish oil was also responsible for improvement of endothelial function, inflammation and blood clotting. In addition, fish oil protects against cardiac arrhythmias. They stated: “Fish oil supplementation could be an inexpensive, quick, safe way of increasing an individual’s omega-3 fatty acid intake”.

Mayo Clinic study of taking higher doses of omega-3 polyunsaturated fatty acids

A study dated Sept. 17, 2020 showed the cardiovascular benefits of higher doses of omega-3 fatty acids. This was the second of two articles that showed that fish oil reduces cardiovascular disease and mortality. It was published in Mayo Clinic Proceedings. This metaanalysis involved 40 interventional studies and 135,000 patients. Two types of omega-3 fatty acids, namely EPA and DHA were studied with regard to the prevention of cardiovascular disease. EPA and DHA supplementation had the following effects.

  • 35% reduction of risk of a fatal heart attack
  • 13% reduction of heart attacks in general
  • 10% reduced risk of coronary heart disease occurrence
  • 9% reduction of mortality from coronary heart disease

The researchers described that the higher the dose of omega-3 fatty acid supplementation, the greater the protection.

An extra dose of 1000 mg per day of EPA and DHA reduced the risk of cardiovascular disease as follows. There was a reduction of cardiovascular disease by 5.8% and of heart attacks by 9%. I take 1800 mg of EPA/DHA twice a day, a total of 3600 mg per day.

Two Articles Showed that Fish Oil Reduces Cardiovascular Disease and Mortality

Two Articles Showed that Fish Oil Reduces Cardiovascular Disease and Mortality

Conclusion

Two independent studies of fish oil or omega-3 fatty acids came to similar conclusions.  Heart attacks and strokes are significantly reduced. And mortality in the group that used fish oil supplementation was also significantly reduced. An extra dose of 1000 mg per day of EPA and DHA reduced the risk of cardiovascular disease as follows. There was a reduction of cardiovascular disease by 5.8% and of a heart attack by 9%. Based on these findings the researchers recommended that patients should use EPA/DHA supplementation to reduce cardiovascular risk. EPA/DHA supplementation lowers blood pressure, triglycerides and the heart rate. Fish oil was also responsible for improvement of endothelial function, also for the prevention of inflammation and blood clotting. In addition, fish oil protects against cardiac arrhythmias. The end result is that you live a healthier life.

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Jan
23
2021

Review about Human Oncolytic Virus Research in 2020

The British Medical Journal published a review about human oncolytic virus research in 2020. That is to say, the BMJ published this report in July 2020. On the negative side, the report is rather complex with many technical terms. With this in mind, I will keep it as simple as possible for this summary. Notably, oncolytic viruses are a new way of treating cancer. Adenovirus was the most common oncolytic virus in use by cancer research in the past 20 years. It must be remembered, researchers applied this to mainly melanoma and gastrointestinal cancers. In the past I discussed the use of oncolytic viruses in a related post.

History of licencing of oncolytic viruses

  1. The first oncolytic virus was licenced in 2004 in Latvia. This was an RNA virus derived from the native ECHO-7 strain of a picornavirus, called Rigvir. This oncolytic virus was approved for treating melanomas.
  2. Shortly after, in 2005, China approved a genetically modified adenovirus, H101 as an oncolytic virus. The approval was for the treatment of nasopharyngeal carcinoma combined with chemotherapy.
  3. In 2015, the U.S. the FDA approved T-VEC (Talimogene laherparepvec), an attenuated herpes simplex virus, type 1. This new oncovirus encodes granulocyte-macrophage colony-stimulating factor (GM-CSF). This is effective for the local treatment of inoperable, recurrent melanoma. It works for cutaneous, subcutaneous and nodal lesions in patients with recurrent melanoma after initial surgery.

Review of 20 years of human oncolytic virus research

The investigators reported about 97 clinical trials with oncolytic viruses performed between 2000 and 2020. That is to say, this involved 3233 patients with cancer. Most of these trials were phase I (50.5%) trials. There were an additional 6.2% studies, which were phase I/II. 11.3% were phase II clinical trials and only 2.1% were phase III clinical trials. 29.9 % of the literature did not specify what type of trial the investigations were about. However, they likely belonged into the phase I category as they reported on first trials of a therapy on man.

Oncolytic viruses derive from various types of viruses 

The number of studies that used a certain virus-derivative are included in brackets. It must be remembered that most of the studies dealt with six viruses: adenoviruses (30), herpes simplex virus (HSV-1) (23), reovirus (19), poxvirus (12), Newcastle disease virus (NDV) (5) and measles virus (3).

Stimulation of the immune system through GM-CSF

In 24 studies the researchers introduced GM-CSF transgene into an oncolytic virus. GM-CSF is a glycoprotein that is normally produced by granulocytes, a type of white blood cell. In this case, it stimulates dendritic cells, the precursors of T cells to produce killer T cells. Notably, this stimulates the immune system to better fight cancer.

Types of cancer targeted with oncolytic viruses

It is important to realize that the majority of the studies treated melanoma cases and gastrointestinal cancers. Namely, gastrointestinal cancers included esophageal cancer, gastric (stomach) cancer, colorectal cancer and pancreatic cancer. There were 30 studies involving melanomas with 1000 patients. There were 76 clinical trials regarding gastrointestinal cancers with 577 patients.

Moreover, other cancers where oncolytic viruses were studied were head and neck cancer (15 studies) breast and gynecological cancers (31 studies), genitourinary cancers (26 studies), and sarcomas (16 studies).

Other drugs given along with oncolytic viruses

It must be remembered that of the 97 total studies 62.9% were clinical trials where oncolytic viruses were the only therapy. In 37.1% of the studies physicians gave the oncolytic viruses along with cytotoxic chemotherapy, immunotherapy or radiotherapy.

Side effects of treatment with oncolytic viruses

The safety profile for treatment with oncolytic viruses appears to be tolerable. Fever was common, as were chills. Some patients reported nausea and vomiting, flu-like symptoms, fatigue and pain. But these symptoms disappeared within a few days.

Suppression of the bone marrow for a period of time was common, but more so when there was a combination of  oncolytic viruses with chemotherapy. None of the patients transmitted viruses to household contacts or the healthcare team.

Antitumor activity in clinical trials with involvement of oncolytic viruses

An analysis of clinical responses to oncolytic virus therapy showed the following:

  • 1% had disease control, which broke down as follows (items 2,3 and 4)
  • 4% complete control (=cure)
  • 7% partial control
  • 12% stable disease
  • 9% No response to treatment with oncolytic viruses

HSV-1 derived oncolytic viruses had the best response. The responses were not as good with adenovirus, reoviruses and with vaccinia viruses.

Discussion

Researchers of the BMJ publication analysed 97 clinical trials regarding oncolytic viruses over the past 20 years. This showed a number of points worth mentioning.

  1. The goal of oncolytic virus therapy is to induce tumor cell death. Physicians could achieve this indirectly by stimulating the immune system. Oncolytic viruses can stimulate both the innate immune system and the tumor-specific adaptive immune response.
  2. In the earlier years a lot of clinical trials investigated the safety of oncolytic viruses. But it became clear that oncolytic viruses were safe and fairly well tolerated.
  3. Many clinical trials involved oncogenic viruses with GM-CSF recombinant genes. This gene makes the oncolytic virus produce the GM-CSF protein, which stimulates dendritic cells. The end result is that the immune system produces more killer T cells that attack cancer cells, which results in higher cure rates.

More problems with oncolytic viruses

  1. There are still many questions about how oncolytic viruses stimulate the immune system. More basic research is necessary in this field. Despite 20 years of research the cure rate of 3.4% and achieving partial control and stable disease in another 17.7% is not acceptable. Perhaps combinations with other cancer treatment methods may improve the cancer cure rates. The reviewers suggested one such combination, namely immune checkpoint blockade with oncolytic virus therapy.
  2. There is no resolution about which route of administering oncolytic viruses is best. Intratumor application in melanoma cases seems the be optimal. But other solid tumors are difficult to reach. In these cases, intravenous applications were a choice. In this case oncolytic viruses experience dilution in the blood and do not have a high enough concentration when they arrive at the cancer.
Review about Human Oncolytic Virus Research in 2020

Review about Human Oncolytic Virus Research in 2020

Conclusion

In a review researchers discussed the use of oncolytic viruses in cancer therapy over 20 years . Oncolytic viruses are derivatives mostly from adenoviruses, herpes simplex virus (HSV-1), reovirus, poxvirus, Newcastle disease virus (NDV) and the measles virus. In various clinical trials researchers found that disease control was achieve in only 21.1% of treated cases. There was a cure rate of 3.4%, but another 17.7% had partial control of the cancer or stable disease. But 78.9% of treated patients showed no response to treatment with oncolytic viruses. Obviously more research is necessary to improve the cure rates in cancer patients treated with oncolytic viruses. Clinical trials with combinations of immune checkpoint blockade and oncolytic virus therapy would also be helpful. All in all, oncolytic therapy is at this point not yet an effective form of treatment for cancer.

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Dec
12
2020

New Mobile Resuscitation Team Succeeded in Restoring Heartbeats

At the University of Minnesota, a new mobile resuscitation team succeeded in restoring heartbeats. This pilot project was 100% successful to restore heart circulation in cardiac arrest victims through a new mobile service carrying sophisticated equipment. To demonstrate, with a cardiac arrest the heart beat stops, and blood circulation to the heart and the whole body comes to a stop. This is to say, the oxygen deficit leads to death within only a few minutes. However, if a specialized medical team applies resuscitation methods, the body and heart survive until a cardiologist applies a cannulation procedure. This procedure involves inserting a heart catheter and placing a stent.

What is a cardiac arrest?

A cardiac arrest typically happens when one or more of the three coronary arteries get obstructed from hardening of the lining of the arteries (arteriosclerosis). This leads to a sudden lack of oxygen in the heart tissue and within minutes the electrical system within the heart causes ventricular fibrillation. This is a condition where the heart stops pumping blood. If resuscitation does not take place the person dies within minutes.

When cardiac arrest occurs in the community setting only about 6% of the patients survive. When cardiac arrest happens in the hospital setting approximately 24% survive.

Details of the Minnesota Mobile Resuscitation Consortium (MMRC) SUV program

Here is a summary of the study with details from The Lancet Nov. 13, 2020.

The response team treated 58 patients who met the criteria of the study.

  • The age of patients was from age 18 to 75, the mean age was about 57
  • 46 of 58 were male
  • Collection of cases was from December 1, 2019, to April 1, 2020
  • 100% of patients had successful cannulation procedures and all survived.
  • 58 of the patients were discharged home after a few days in hospital. They returned to normal daily activities or their lives were minimally disrupted.

Extracorporeal membrane oxygenation

The team used extracorporeal membrane oxygenation (ECMO) to oxygenate blood. This system uses a pump to circulate blood through an artificial lung back into the bloodstream. While the patient is in this holding pattern there is time to investigate the cause of the cardiac arrest. The cardiologist performs cardiac catheterization to identify where there is a blockage in one or several of the coronary arteries. When the blockage is identified the cardiologist places a stent to keep the narrowed coronary artery open.

Discussion

I mentioned before that patients with cardiac arrest in the community setting have a survival of only 6%. In the hospital setting approximately 24% of cardiac arrest patients survive. With the Minnesota pilot project described above 100% of cardiac arrest patients survived. This is an enormous achievement of the medical team. It is possible only because the team has three SUVs with the latest medical equipment. This way friends or relatives institute CPR until the resuscitation team arrives. The team provides ACLS (advanced cardiac life support). If necessary, physicians start extracorporeal membrane oxygenation (artificial lungs). A cardiologist performs cardiac catheterization to identify where there is a blockage in one or more of the coronary arteries. When the cardiologist identified the blockage, he places a stent to keep the narrowed coronary artery open. Following this the hospital discharges patients directly home. Within a few days they can return to work.

Curative versus preventive medicine

The Minnesota pilot project is a curative medicine project. By doing stent placement you can extend life, typically by 10 to 15 years. But on the long-term it is wiser to adopt a Mediterranean type diet with more vegetables and fruit and also avoiding sugar and processed food. If, in addition, you exercise regularly, you can avoid cardiac arrest as your coronary arteries stay wide open. You may live 20 years longer following such simple lifestyle changes. It is known for a long time that patients with cardiac arrest and no CPR have a poor survival rate.

New Mobile Resuscitation Team Succeeded in Restoring Heartbeats

New Mobile Resuscitation Team Succeeded in Restoring Heartbeats

Conclusion

The University of Minnesota introduced a pilot project where mobile resuscitation teams succeeded in restoring heartbeats in record time. When needed they also used artificial lungs (extracorporeal membrane oxygenation) to stabilize the patient’s condition. A cardiologist did cardiac catheterization to identify whether there was a blockage in one of the coronary arteries. When the cardiologist identified the blockage, the specialist placed a stent to keep the narrowed coronary artery open. Before this program cardiac arrest survival was 6% in the community setting and 24% in the hospital setting. With the Minnesota pilot project described above 100% of cardiac arrest patients survived. The Minnesota team wants to slowly expand their program to other states. And in the long term they want to make it the standard of care for cardiac arrest management in all of the US.

Nov
07
2020

Removal of Senescent Cells Can Extend Life

Several animal and human studies by the Mayo Clinic showed that removal of senescent cells can extend life. Researchers Xu et al. showed in 2018 that senescent cells weaken the body. Senescent cells are damaged cells that are still living. They can cause the release of inflammatory cytokines. The researchers showed in mouse experiments that intermittent senolytics increased life expectancy by 36%. Senolytics are drugs that dissolve senescent cells; the senolytic cocktail consisted of dasatinib plus quercetin.

In these mouse experiments their risk of dying was reduced by 65% compared to control mice that did not take senolytics.

Senescent cells causing premature aging

In the past 5 years research on aging and on chronic diseases made a lot of progress. Researchers realized that the accumulation of senescent cells is what causes both. All this happens because the process of apoptosis, the removal of dead cells, is impaired in the aging person. It appears that in older age there is a problem with dying cells and their removal. Instead they linger on and start producing cytokines, which cause inflammation. This can damage other cells and lead to organ failures. All this explains why older people often get chronic diseases and do not reach their normal lifespan. The accumulation of senescent cells also blocks regenerative factors that improve one’s health.

Senolytics

Dasatinib is a kinase inhibitor that was developed to treat acute myelogenous leukemia in adults and children. Researchers did animal experiments with a combination of dasatinib and quercetin for several years. They also have started smaller pilot clinical trials in humans. It appears that the human findings are very similar to the animal findings. But more research is needed to answer questions about side-effects and effects of removal of senescent cells.

Details about animal experiments with senolytics

The Mayo Clinic research showed that old mice treated with senolytics (dasatinib and quercetin) live 36% longer than controls that did not receive senolytics. Another part of this series of experiments showed that senescent cells are indeed what kills prematurely. They took senescent cells from old mice and transplanted them into young mice. Soon the young animals showed deterioration health wise and they died prematurely. Another control group were older mice that received senescent cells from old mice. They too died prematurely. Treatment with senolytics (dasatinib and quercetin) improved physical functioning and also survival.

Details about human trials regarding senolytics

For three days 11 participants received senolytics (dasatinib and quercetin). The effect of the drugs was evident for 11 days. The subjects took 100 mg of dasatinib daily and 500 mg of quercetin twice per day for 3 consecutive days. This dose was repeated twice more on a weekly basis for a total of 3 weeks. These patients had idiopathic pulmonary fibrosis. This is an incurable disease where senescent cells accumulate. These patients showed significantly improved gait speed, walking endurance, chair rise test performance and scores of other physical performances. All this occurred on day 5 after the initial dose of senolytics.

Alternative senolytics, so removal of senescent cells can extend life

Dasatinib as a senolytic has significant side effects.

For this reason, researchers looked for alternatives. Theaflavins, isolated from black tea fits this bill. It is non-toxic, but it is also effective as a senolytic. Researchers from Life Extension have developed a senolytic product containing theaflavins and quercetin. Instead of regular quercetin they included quercetin phytosome, which has 50-times more potent bioavailability. One capsule contains 74 mg of quercetin phytosome (the equivalent of 1250 mg of regular quercetin) and 275 mg of theaflavins.

Discussion

Future research needs to show whether or not the Life Extension senolytic indeed does what it promises. It claims that only one capsule per week stimulates apoptosis, reduces cytokines and increases longevity. I would like to see a clinical study that examines all these parameters. One measure of longevity is to determine the length of leukocyte telomeres. All the other laboratory tests are readily available. Research in this field will certainly continue and scientists will likely develop other senolytics.

Removal of Senescent Cells Can Extend Life

Removal of Senescent Cells Can Extend Life

Conclusion

The accumulation of senescent cells causes both aging and chronic diseases. Research showed that in older age the process of apoptosis, the removal of dying cells, is incomplete. As a result dying cells accumulate. They produce inflammatory cytokines, can damage other healthy cells and lead to chronic organ failure. In addition, cancer cells can develop and the patients can die prematurely. Senolytics are substances that clear out senescent cells. In mouse experiments they have already led to improved survival and health. Clinicians performed a clinical trial on patients with idiopathic pulmonary fibrosis, which is an incurable disease where senescent cells accumulate. They showed significantly improved gait speed, walking endurance, chair rise test performance and scores of other physical performances. One pill once per week with dasatinib and quercetin can achieve this. More research in this area can clarify why senolytics work and what the side effects are.

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Oct
10
2020

Medical Myths about Aging

Medical myths about aging are easy to debunk. Many people believe that it is inevitable that they become disabled as they age, their lives become unbearable, without passion, boring and full of pain. Some aspects of your health may decline with age, none of the myths discussed below is inevitably happening in everyone. Studies showed that a positive outlook on aging and life in general will help you to live longer and stay healthier.  Here I discuss 7 common myths about aging.

Myth 1: Everyone will experience physical deterioration

It is common for people to experience reduced muscle strength, increased blood pressure, excessive fat accumulation and osteoporosis. A study with 148 older patients showed that an expectation of reduced fitness in older age actually resulted in less physical activity when older age arrived.

But you can maintain good cardiovascular function and good muscle strength with a regular exercise program.  This study showed that men and women can reduce mortality by exercising regularly, even in older age.

Myth 2: Older adults cannot exercise

There are several reasons why older people stop exercising or are afraid to start exercising. People use the excuse of their arthritis getting worse from exercise. But studies showed the opposite: joint function improves and joint pains are getting better with exercise. Your muscles get stronger and you are less likely to fall. Your heart and lungs are improving their functions and your mentation improves. Exercise increases the HDL cholesterol, which reduces the risk for heart attacks and strokes.

Myth 3: As we age, we need less sleep

For many years there was the notion that older people need less sleep. What was not known then was that people above the age of 60 have no appreciable secretion of melatonin from the pineal gland. But when they replace their melatonin deficiency by taking a nighttime dose of 3 mg at bedtime, they will sleep better and longer. They may need a second dose of melatonin in the middle of the night. We need 7 to 8 hours of sleep at night for our diurnal hormone rhythm.

This will also slow down our aging clock.

Myth 4: Your brain slows as you age

Dementia is common when you get older. 13.9% have it at age 71 and older. 37.4% have dementia over the age of 90. But the majority, namely 86.1% in the 71+ age group and 62.6% above the age of 90 do not have dementia. A Mayo Clinic study showed that when the person engaged in artistic activities in midlife or later in life the risk for mild cognitive impairment (MCI) development was reduced by 73%, involvement in crafts reduced it by 45% and engagement in social activities by 55%. In a surprise finding the use of a computer late in life was associated with a 53% reduction in MCI development. These are very significant observations.

Physical activity reduces risk for dementia

Apart from stimulating your brain, physical activities also significantly reduce the risk for dementia. A synopsis of 11 such studies showed that dementia is reduced by 30% when physical activity is started in midlife and the person is aging compared to non-exercisers.

Myth 5: Osteoporosis occurs only in women

There is a serious misunderstanding about osteoporosis. Several factors work together that can cause osteoporosis. Women in menopause are more likely to develop it due to the missing ovarian hormones estrogen and progesterone. These hormones work together and stimulate vitamin D induced calcium deposition into bone as well as decreasing bone resorption.

Vitamin K2 also deposits calcium into the bone. In postmenopausal women who take bioidentical hormone replacement, vitamin D and K2 the bone density remains strong. Unfortunately, the opposite is true in postmenopausal women who take synthetic hormones. Synthetic hormones have side chains that do not fit the natural hormone receptors of a woman. This is why osteoporosis persist. And, yes, men get osteoporosis, but typically 10 years later. Typically, they get into andropause where testosterone production declines 10 years later.

Myth 6: People stop sex as they age

With age men can develop erectile dysfunction (ED) and women vaginal dryness, both of which can interfere with having sex. A large study showed that only 0.4% of men in the age group 18-29 had ED. In the age group of 60-69 there were 11.5% who suffered from ED. What this means though is that 88.5% of men age 60-69 did not suffer from ED. Fortunately for those who have ED drugs like Cialis and Viagra can correct their problem and they can have regular sex. What a change from 25 years ago when none of these drugs were available (approval of Viagra by FDA in 1998 and of Cialis in 2003).

Bioidentical hormone replacement beyond menopause and andropause preserves your normal sex drive as well. There are additional benefits of bioidentical hormones. They have positive effects on the heart, brain, bones and the muscle mass.

Myth 7: It is too late to stop smoking now

One of the myths that many older smokers like to say is that it would be too late to stop smoking. They think the damage to heart and lungs is permanent and quitting now is too late. Fact is that quitting smoking immediately improves your blood circulation and gives you more oxygen. In just 1 year the risk of getting a heart attack is cut into half. In 10 years, the risk of a heart attack or stroke is the same as that of non-smokers. There is a reduction of getting lung cancer by half.

Medical Myths About Aging

Medical Myths about Aging

Conclusion

There are all kinds of medical myths about aging. We may think that physical deterioration is inevitable. Or we believe that older people cannot exercise. And we cannot help it, but our brain slows down as we get older. And there is the question whether we need less sleep as we age. Osteoporosis is a disease of women, is it not? These older couples, they don’t have sex any more, do they? And is it too late to stop smoking now that I am 65 years old? All of these myths exist, but there is a need to debunk them.

The truth behind the medical myths about aging

I explained in detail what the medical truths are behind these questions. Many of these myths have developed in the past. But with regular exercise, balanced nutrition (Mediterranean diet) and a positive attitude much of these old myths can be overcome. Bioidentical hormone replacement when hormones are missing is another powerful tool. Yes, we all age. But we are still living and can enjoy life as long as it lasts.

Sep
05
2020

How to Manage Clot Formation with Covid-19

A publication in the Canadian Medical Association Journal describes how to manage clot formation with Covid-19. A significant amount of cases among Covid-19 patients come down with clotting problems. This means that an infection with SARS-CoV-2 (or Covid-19 coronavirus) may initially present with a fever and cough. But a few days later it can suddenly turn into a dangerous disease with severe clots, multiple organ failures and death.

Clot occurrence with Covid-19

It is important to realize that most patients with SARS-CoV-2 do not need hospitalization. But physicians admit 10 to 15% of patients to the hospital. Of these 20% end up with treatment in the Intensive Care Unit (ICU). Of all the hospitalized patients between 5% and 30% develop some form of thrombotic event. Notably, complications of clot formation can be a stroke, a heart attack, a pulmonary embolism or a deep vein thrombosis in the leg. In a recent study from the US 400 random hospitalized patients with Covid-19 144 patients were admitted to the ICU. 4.8% had radiologically confirmed deep vein thrombosis. Overall there were 9.5% with thrombotic events that developed during the hospital stay.

How does a coagulopathy develop with Covid-19?

Truly, SARS-CoV-2 enters the body cells through an interaction of its viral spike protein with the angiotensin-converting enzyme 2 (ACE2) receptor. To explain, numerous organs and tissues express this receptor. This includes lung alveolar type 2 epithelial cells, endothelium, the brain, heart and kidneys. To emphasize, ACE2 leads to angiotensin II degradation. With the SARS-CoV-2 stimulation of the ACE2 receptor there may be an accumulation of angiotensin II, which causes a procoagulant state. Injury of the endothelium explains inflammation in the lining of the blood vessels in multiple organs. Commonly affected organs are lungs, heart, kidneys and intestines. The inflammatory reaction is what can lead to clot formation. When part of an organ has died off because of mini clots that destroyed part of the organ, this process can eventually lead to organ failure. Lung failure, heart failure and kidney failure can develop in these sick patients.

Adequate vitamin D blood levels are important for the immune system

By all means, vitamin D is very important for the integrity of the immune system. With vitamin D blood levels below 15 to 20 ng/mL (37.5–50 nmol/L) the immune system is paralyzed, and any viral or bacterial infection tends to overwhelm the body. Of course, this is the reason why the mortality due to Covid-19 coronavirus is highest in patients with these low vitamin D blood levels. People with secondary illnesses (diabetes, arthritis, autoimmune diseases, cancer) and patients above the age of 60 have the lowest vitamin D blood levels and have the highest mortality rates. This publication describes this in more detail.

Best vitamin D blood level is in the upper normal range (50-80 ng/mL)

Above a vitamin D blood level of 30 ng/mL (=75 nmol/L) a patient’s immune system is functioning normally. However, the immune system is strongest at a vitamin D blood level of 50–80 ng/mL (125–200 nmol/L), which is the upper range of the normal level for vitamin D in the blood.

Keep in mind that vitamin D toxicity occurs only above 150 ng/mL (375 nmol/L).

Specific effects of vitamin D on Covid-19

There are three major effects that vitamin D has.

  1. A strengthening of the epithelial barrier not allowing the coronavirus to penetrate into the lung tissue as easily.
  2. Release of defensins and cathelicidin, two crucial antiviral polypeptides that eradicate any virus in the system.
  3. Interruption of the “cytokine storm”, an overwhelming inflammation which is responsible for viral pneumonia to develop. Without the cytokine storm there is no damage to the lungs and people do not need treatment in the ICU. This is particularly important for people above the age of 60 and for people with pre-existing diseases.

In like manner, with the stabilizing effect of vitamin D regarding the immune function more severe forms of Covid-19 can turn into less severe forms with a better outcome.

Treatment of patients with Covid-19 who have clotting problems

Patients need to be assessed with respect to their risk of developing clots. This publication describes that high risk patients have elevated D-dimer levels. When blood clots dissolve the body produces D-dimer, a protein fragment. Normally the D-dimer test is negative in a person that does not produce clots. But in sick patients with Covid-19 who form clots this blood test typically shows D-dimer >2500 ng/mL. In addition the tests show high platelet counts (more than 450 × 109/L), C-reactive protein (CRP) >100 mg/L and an erythrocyte sedimentation rate (ESR) >40 mm/h.

Indeed, with this constellation of blood tests in a severe Covid-19 case in the ICU setting, the physician uses heparin intravenously or subcutaneously to counter clot formation. However, this needs to be balanced against the risk of causing severe internal bleeding.

Separate from the anticoagulant effect, heparin seems to also suppress inflammatory cytokine levels. In addition, heparin suppresses neutrophil chemotaxis and migration. Physicians rescued many patients from death using heparin therapy.

Risk versus benefit clinical trials of heparin therapy are required

At this point there are only retrospective clinical trials available to describe risk versus benefit of heparin therapy. Some show no difference, others do. There are two international clinical trials on their way to shed more light on this situation. Until the results of these clinical trials are available, physicians need to treat patients to the best of their knowledge.

How to Manage Clot Formation with Covid-19

How to Manage Clot Formation with Covid-19

Conclusion

Clot formation in sick Covid-19 patients is responsible for many deaths in Covid-19 patients. The SARS-CoV-2 (or Covid-19 coronavirus) causes a cytokine storm with injury to the lining of the arteries. This can affect multiple vital organs and the condition may lead to organ failure. This activates the clotting system and causes clots all over the body. When this process occurs, patients get very sick and the death rate climbs. Physicians were able to rescue some patients with heparin therapy. Two international clinical trials are on the way. Hopefully  these trials answer questions about this newer treatment method. The downside of heparin therapy is the complication of massive bleeding, which causes deaths as well. When it comes to Covid-19, don’t rely on curative medicine. Strengthen your immune system by preventative therapy like vitamin D3 that can interrupt the cytokine storm.

And even with a “well-prepared” immune system it is extremely important to follow all the guidelines of distancing, disinfecting and wearing face masks. We need all the help we can get!

Part of this was previously published here.

 

Aug
29
2020

Health Benefits from Vitamin C Supplements

Notably, there are health benefits from vitamin C supplements as I will explain below. A recent publication in the Journal of Intensive Care stated that vitamin C may lower ventilator time for sick patients in the ICU. In this case, researchers performed  a meta-regression analysis. It is important to realize that higher doses of vitamin C changed the need for ventilation. Vitamin C given intravenously or by mouth significantly reduced the need for ventilation in sick patients. To explain, the researchers pooled eight clinical trials and compared them to a control group who did not receive vitamin C treatment. In detail, the researchers noted that there was a 14% reduction with regard to ventilator use in the treatment group. To clarify, they had received vitamin C infusions while patients who did not receive vitamin C infusions served as controls.

Five of the clinical trials involved patients who received 10 hours or more ventilation treatment. Certainly, these patients were sicker than the average ICU patients. They experienced a 25% reduction of ventilator time after receiving between 1 and 6 grams of vitamin C. The physicians gave this intravenous or orally.

History of Mega doses of vitamin C

Indeed, in the 1940’s mega doses of vitamin C were given intravenously in an attempt to treat polio. Eventually, in the late 1960’s Linus Pauling called high doses of vitamin C the “healing factors for diseases”. But subsequent clinical investigations showed that vitamin C had limitations. The Oregon State University website reports that some of the claims about vitamin C in the past went overboard. Here are some points about vitamin C that we need to remember.

  • Vitamin C is an important cofactor in many enzymatic reactions, such as the biosynthesis of collagen, carnitine and neuropeptides. In addition, the regulation of gene expression requires vitamin C and vitamin C is an important antioxidant.
  • A prospective cohort study showed that higher vitamin C blood levels lowered the risk of high blood pressure, coronary heart disease and strokes.

More effects of vitamin C

  • Patients in need of a surgical procedure benefitted from vitamin C. Researchers showed that vitamin C was a valuable adjunct to conventional medicine in cardiovascular disease  Vitamin C reduced arrhythmia and myocardial injury following cardiac procedures.
  • There is insufficient evidence that regular vitamin C intake prevents cancer. Randomized controlled clinical trials reported no effect of vitamin C on cancer.
  • 10 grams per day of vitamin C has no association with toxic or adverse effects in most people. However, some adults are more sensitive to vitamin C and develop gastrointestinal disturbances and diarrhea with megadoses of vitamin C. For these people physicians recommend  taking up to 2 grams per day of vitamin C.

Vitamin C and disease prevention

Several clinical trials involving vitamin C supplements showed significant positive effects on patients. Below I am briefly reviewing these clinical trials.

Endothelial function

Endothelial function was improved with doses of above 500 mg of vitamin C. This likely is the reason that there is a reduction of cardiovascular disease in people who consume 1000 mg of vitamin C daily.

High blood pressure

Vitamin C at 500 mg daily lowers high blood pressure. A clinical trial found that 500 mg of vitamin C daily lowers the systolic blood pressure by 3.84 mm mercury and the diastolic blood pressure by 1.48 mm mercury. Over several years’ time this can prevent premature heart attacks and strokes.

Vitamin C and the immune system

Vitamin C is a powerful antioxidant. It can neutralize reactive oxygen species, which are produced when the immune cells fight viruses and bacteria. Neutrophils, lymphocytes and phagocytes are all supported by vitamin C. Vitamin C and E co-operate in their antioxidant functions. Vitamin C is essential for a strong antibody response with bacterial or viral infections. I take 1000 mg of vitamin C once daily.

Heart failure, strokes and heart attacks

Many studies showed some effects on reduction of heart attacks, strokes and congestive heart failure. With respect to strokes there was a 42% risk reduction over 9.5 years when the highest vitamin C plasma level was compared to the lowest level. But results regarding heart attack prevention and prevention of CHF were only marginal.

Cancer and vitamin C

Stomach cancer: there was a 45% reduction of stomach cancer when high vitamin C plasma level cases were compared to low plasma level cases.

Colon cancer: A pooled study based on 13 prospective cohort studies showed that vitamin C supplementation reduced colon cancer risk by 19%.

Large B cell lymphoma: After 11 years of follow-up the Women’s Health Initiative found that vitamin C supplementation reduced diffuse large B cell lymphoma by 31%.

Researchers could not show significant effects of vitamin C on other cancers.

Type 2 Diabetes (=adult onset diabetes)

A large European study going on for 12 years showed a strong inverse relationship between blood levels of vitamin C and the onset of diabetes. Patients with the highest vitamin C blood levels had a 62% lower risk of developing diabetes. Physicians compared this to low level vitamin C controls.

Mortality reduction with vitamin C supplementation

In the EPIC-Norfolk prospective study a clear inverse relationship was found with higher vitamin C blood levels and a reduction in risk of all-cause mortality.

Recommended dietary allowance for vitamin C

The official dietary recommendation for vitamin C in adults is 90 mg daily for males and 75 mg daily for females. However, in view of the above mentioned clinical trials I would recommend the following. Supplement with 500 mg to 1000 mg of vitamin C daily to have enough vitamin C reserves. The reason I say this is that the official dietary recommendation was based on preventing scurvy, the historic insufficiency disease of vitamin C. In addition, as mentioned before, vitamin C is safe to take up to 10 grams per day. Many physicians recommend taking a smaller amount of vitamin C found to prevent strokes, high blood pressure, type 2 diabetes, improve endothelial function and strengthen the immune system.

Health Benefits from Vitamin C Supplements

Health Benefits from Vitamin C Supplements

Conclusion

In my review I discussed health benefits from vitamin C supplements. Briefly, doctors noted that severely sick patients on respirators in the ICU setting were able to reduce the ventilator use.  This was significant after they received between 1 and 6 grams of intravenous or oral vitamin C. However, patients with the highest vitamin C supplementation had a 62% lower risk of developing diabetes than low level vitamin C controls. Vitamin C lowered high blood pressure moderately and prevented strokes by 42%. Vitamin C stimulates the immune system together with vitamin D, A, E and some trace minerals. There are many more health benefits from vitamin C supplements. The official dietary recommendation for vitamin C in adults is 90 mg daily for males and 75 mg daily for females. However, I take 1000 mg of vitamin C daily as the evidence shows that this is healthier.

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Jul
18
2020

Key Factors for Centenarians

A study from Washington State University (WSU) showed some of the key factors for centenarians to survive. The publication of the study goes back to June 17, 2020. In general, it was common knowledge that genetics plays a role in 25% to 35% of centenarians for their survival. That is to say, the remainder is the result of lifestyle factors. It is important to realize that the environmental factors play a significant role in the survival of centenarians, said Rajan Bhardwaj, a second-year WSU medical student. He and his research team determined what allowed centenarians to reach an age of 100 or above. Briefly, they identified the following factors that were necessary.

Three factors identified by the Washington State University study

  • walkability of the neighbourhood, which encourages regular exercising
  • belonging to the higher socioeconomic class
  • a high percentage of working population in the neighborhood (a mixed population) was also important

In the discussion the authors of the WSU study said that “blue zones” of centenarians had been mentioned before in the literature. To clarify, these are areas in the world where more than the average of centenarians live. Dan Buettner used the term “blue zones” in a National Geographic article about where centenarians were located.

The blue zones

He wrote a book about the location of the 5 blue zones. Notably, they are located in Sardinia (Italy), the islands of Okinawa and a group of Seven Day Adventists in Loma Linda. California. In addition, the Nicoya Peninsula of Costa Rica, and the island of Icaria, Greece complete the 5 blue zones. Specifically, Dan Buettner described the following characteristics of the lifestyle of centenarians.

  • They engage in regular physical activity
  • Mostly eating a plant-based diet including legumes
  • Calorie intake is moderate
  • Moderate intake of alcohol, mostly wine
  • Having a purpose in life
  • Engaged in family life
  • Having an active spiritual life
  • Reducing stress
  • Engaged in social life

Other attributes of centenarians

Dr. Thierry Hertoghe gave a presentation in Las Vegas on Dec. 14, 2019 where he stated that centenarians are positive thinkers. This was at the 27th Annual World Congress on Anti-Aging Medicine. In particular, the topic of his talk was “Positive Psychological Attitudes of Centenarians “. Dr. Hertoghe is an endocrinologist in Belgium. He took an interest in people above the age of 100. These people, he felt, are special people with a very optimistic outlook on life. Dr. Hertoghe went on to say that centenarians have a will to live. Indeed, they adapt to changes; they have a sense of purpose, and they stay active.

More positive attributes of centenarians

Other psychological features, by the same token, show that they have a positive mood and they avoid stress and anxiety. Another key point is that they have self-determination. It must be remembered also that they are very sociable, have close family ties, love their relationships and often have a strong religious faith. In addition, there is a connection between their basic values, beliefs and spirituality. Truly, centenarians insist on their freedom and they have a feeling of youth. For one thing, centenarians have their own centenarian spirit where they can feel young or old.

In the following I am reviewing some of the details that Dr. Hertoghe gave.

The will to live

For one thing, it takes courage to grow old, and all centenarians have this. They say “Life is worth living”. Essentially, they have a certain resiliency in a world that has an obsession about youth. Despite negative experiences they had to overcome they do not give up and they enjoy life as much as they can. A Finnish study examined 400 individuals aged 75-90 and followed them for 10 years. Group 1 who wished to live less than 5 years had a mortality rate of 68%. Group 2 wished to live for 5-10 years. They had a mortality of 45.6%. The last group, group 3 wanted to live more than 10 years. Surprisingly, their mortality was only 33.3%. Be careful what you wish for!

Adaptability

In other words, this describes the capacity to overcome adversity and your ability to adjust. In a study of 7400 Chinese centenarians’ resilience to changes was measured with psychometric psychological tests. The majority of subjects did not qualify for being resilient. However, 9% of male centenarians and 6% of female centenarians had the resiliency where they qualified for high adaptability. This high resilience group had a 2%-4% lower mortality risk. They had a 36%-55% higher probability of not developing cognitive impairment. That is to say, they rated themselves to be in good health and having a “good life” satisfaction. These resilient centenarians had a 7%-12% higher probability of not developing a physical disability. In essence, these high resilient centenarians had no short-term health decline.

Remaining active

If a centenarian remains active and moves about several hours per day, the body functions are preserved. Anna Mary Robertson Moses who was known by her nickname “Grandma Moses” took up painting at age 78. She died at age 101 in 1961.

Positive emotions

One study of 54 Ashkenazi Jewish older adults (aged 98-107) compared those with positive emotions to those with negative emotions. The researchers noted that a positive attitude about life allowed centenarians to live longer.

A study involving 2282 Mexican Americans aged 65 to 99 showed that positive affect scores were a predictor for the following. Subjects with a high positive affect had a 52% lower probability of becoming physically disabled. They were 36% less likely than the negative controls to lose their walking speed. In addition, they were 47% less likely to die during the two-year observation period than their negative controls.

Nurses’ Health Study and Veterans Affairs Normative Aging Study

Two studies, the Nurses’ Health Study (NHS) and men from the Veterans Affairs Normative Aging Study measured optimism. The researchers found that those with the highest optimism scores had a 1.5-fold higher probability in women and 1.7-fold in men to survive to age 85. This was compared to a control with the lowest optimism scores. Dr. Hertoghe provided 19 more studies that showed the effects of positive emotions regarding long term survival. For brevity reasons I will not dwell on them here.

What is the centenarian spirit?

When people are older than 100 years, they often have a mix of humor and eccentricity; they express emotions openly and they are happy people. They accept the death of spouses, siblings and significant others.

By the way, humor has a strong predictive survivor value. In a study that researchers conducted over 15 years, there was a clear positive effect of humor regarding mortality. A sense of humor reduced the all-cause mortality by 48% in males. In women humor lowered mortality regarding cardiovascular disease by 73%. Humor reduced death due to infections in women by 83%. Men had a non-significant reduction of all‐cause mortality by 12% and a significant lower mortality due to infections by 74%. Dr. Hertoghe cited three more publications that showed the power of humor in reducing disease and disability.

The fasting mimicking diet helps you to reach a longer life

clinical trial with 100 subjects was undertaken by Dr. Longo and his research team. He measured markers after 3 cycles of a fasting mimicking diet for 5 days every month. They found that the FMD reduced aging markers, improved diabetes and reduced susceptibility for cancer and cardiovascular disease. In another publication Dr. Longo and co-authors describe how autoimmune diseases can be improved by the use the fasting mimicking diet for 5 days every month.

Another publication by Dr. Longo describes that “age-related disorders including diabetes, cardiovascular disease, cancers and neurological disorders such as Alzheimer’s disease, Parkinson’s disease and stroke” can be prevented by fasting mimicking diet for 5 days every month.

Even cancer prevention and cancer treatment can be helped by the fasting mimicking diet.  The FMD makes chemotherapy more tolerable.

Key Factors for Centenarians

Key Factors for Centenarians

Conclusion

As we reviewed the factors that lead to longevity, we learnt that engaging in regular moderate exercise is one of the key factors. But belonging to the higher socioeconomic class and living in a mixed neighborhood with people from all walks of life is also important. We also reviewed the blue zones according to Dan Buettner. Mostly eating a plant-based diet including legumes with moderate calorie restriction prolongs your life. Add to this moderate intake of alcohol, mostly wine, and having a purpose in life. Augment this further with being engaged in family life, having an active spiritual life and reducing your stress level.

Living longer is a matter of fulfilling these longevity factors

With all of this you are on your way to become a centenarian. A review by Dr. Hertoghe in a lecture given at an Anti-Aging Conference in Las Vegas in 2019 added more criteria centenarians have. He provided references regarding the will to live, being adaptable, remaining active and harboring positive emotions. The more of these factors you can adopt, the longer you will live. At the same time, you will avoid getting diseases like heart attacks, strokes or cancer, which leads to a longer and healthier life.

The above text contains parts of this blog. The part about the fasting mimicking diet was published here before.

Jul
11
2020

Fat Deposits Mean Higher Covid-19 Risk

A new study showed that fat deposits mean higher Covid-19 risk. This study was reviewed here.

The article is based on the June 10, 2020 publication of the British Medical Journal.

They did large population studies showing that obesity is an independent risk factor for severe disease and death from Covid-19. One study with 428,225 participants had 340 admitted to hospital with confirmed Covid-19 coronavirus. 44% of them were overweight and 34% were obese. Another study, the OpenSAFELY study used linked electronic health records. 17,425, 445 participants were included and 5,683 Covid-19 deaths occurred. In this study there were 29% overweight and 33% obese persons. The researchers noted a dose-response relationship between excess weight and severity of Covid-19. The researchers removed confounding factors like age, sex, ethnicity, and social deprivation.

Critical illness and death rates in overweight and obese people

They realized that critical illness caused by Covid-19 was increased compared to normal-weight people as follows.

  • Covid-19 risk 44% higher in overweight people
  • Covid-19 risk 97% higher in people with obesity

This means that the risk for serious illness from Covid-19 was 1.44-fold for overweight persons and 1.97-fold for obese persons compared to normal-weight controls. The OpenSAFELY study also looked at the death rates from Covid-19 for people with obesity. Two obesity categories were investigated: obesity with a BMI of 30-34.9 and BMI of greater than 40 compared to normal-weight controls. Here are the death rates.

  • BMI of 30-34.9: 1.27-fold increased risk
  • BMI of greater than 40: 2.27-fold risk

Possible mechanisms explaining fat deposits mean higher Covid-19 risk

The researchers mentioned three possible mechanisms why overweight and obese people may have higher Covid-19 disease and death rates than normal-weight controls.

First, angiotensin converting enzyme-2 is found with higher frequency in fat cells of overweight and obese persons. Researchers are aware of the fact that the Covid-19 coronavirus uses this enzyme to enter body cells. It may also be the reason that fat cells become reservoirs that can shed virus for much longer than in normal-weight people with less fat cells. They pointed out that others have seen this also and found it with other viruses. In the case of influenza A, obesity prolonged viral shedding by 42% compared to normal-weight controls. And with H1N1 influenza obesity was an independent risk factor for hospitalization and death.

Weaker immune system, more lung resistance

Secondly, any virus can weaken the host’s defence of the immune system. Researchers showed this previously with the influenza virus. But now with Covid-19 coronavirus the cytokine storm due to a weak immune system is a major factor in making the viral infection worse. A lack of vitamin D is another factor in promoting the cytokine storm.

Third, obesity decreases lung function and it is difficult to improve this. There is greater lung resistance in the airways and it is difficult to expand the lungs in obese patients. When the doctor transfers patients with obesity to the intensive care unit, it is more difficult to increase their oxygen saturation with artificial ventilation.

Unhealthy environment, so fat deposits mean higher Covid-19 risk

The researchers point out that we live in a very unhealthy environment. In 2016 there were 1.9 billion people worldwide who were overweight or obese. These figures are rapidly rising. Presently about 65% to 70% are overweight or obese in the UK or the US. Obesity causes high blood pressure, heart disease, strokes, type 2 diabetes and cancer. We are all surrounded by processed food with extra salt, sugar, wheat and other unhealthy ingredients. The high mortality and deaths rates of Covid-19 in overweight and obese people point to the problem that society has.

Reduce salt, sugar and saturated fats in food

The culprits are salt, sugar and saturated fats. Merchants and food producers must reduce them in processed food. In the UK new government regulations have already resulted in lower salt content in foods. As a result, there is less high blood pressure and cardiovascular disease is in decline. All nations need to reduce salt, sugar, and saturated fat. When the weight comes down, we all are less prone to catching dangerous viruses.

Fat Deposits Mean Higher Covid-19 Risk

Fat Deposits Mean Higher Covid-19 Risk

Conclusion

The pandemic has taught us a new lesson, namely that overweight and obese people are at higher risk of contracting Covid-19 coronavirus. In a research paper of the British Medical Journal concrete figures showed that the Covid-19 risk is 44% higher in overweight people and that it is 97% higher in people with obesity. The OpenSAFELY study also showed that obese people with a BMI of 30-34.9 have a 1.27-fold increased risk of catching Covid-19. But morbidly obese people with a BMI of greater than 40 have a 2.27-fold risk of catching Covid-19. There is a clear linear dose-response curve between the amount of fat a person accumulates and the risk for Covid-19.

Cut out junk food and decrease your risk for Covid-19

Covid-19 is directly related to the amount of junk food we eat. As a result we can say that eating junk food increases the Covid-19 risk. The opposite is true also: sensible eating and cutting out junk food makes you lose some pounds, and your risk for Covid-19 decreases.

Jun
27
2020

A New Antibiotic, Teixobactin Can Overcome Antibiotic-Resistant Superbugs

A new antibiotic, teixobactin can overcome antibiotic-resistant superbugs. The discovery of teixobactin took place in 2015. It is a peptide with 11 amino acid units. Teixobactin is derived from a gram-negative bacterium, Eleftheria terrae. It is the first of a new class of antibiotics that can kill superbugs. Two examples, for instance are methicillin-resistant Staphylococcus aureus and resistant Mycobacterium tuberculosis. Researchers have been battling with difficult solubility of teixobactin and problems synthesizing this peptide in the laboratory. Teixobactin binds to the membranes of the bacteria it fights. This is a new mechanism for this new class of antibiotics, different from conventional antibiotics.

Mechanisms of fighting bacteria resistant to conventional antibiotics

But it is exactly this quality that is necessary to fight the antibiotic-resistant bacteria. The researchers showed that teixobactin binds weakly to a component of the bacterial cell wall, called “Lipid II”. But they found a second mechanism, namely blocking precursors of cell membrane synthesis in the bacteria they fight. Because of these unique mechanisms it is possible for them to fight a multitude of bacteria resistant to conventional antibiotics. Teixobactin has a unique molecular structure, which makes it difficult for resistant bacteria to develop resistance to it.

Antibiotic resistance

Resistance to antibiotics is a worldwide problem. There are several factors that worked together to make antibiotic resistance such a big issue. For instance, in the past many doctors prescribed antibiotics for any viral cold, even knowing that antibiotics only work against bacteria. Aside from this, the agricultural practice of using antibiotics as a growth stimulator is also an important factor for antibiotic resistance to develop. It is the bacteria that become resistant, not the human body. Several clinical entities involving resistant bacteria exist that show the magnitude of the problem.

Flesh-eating disease

Necrotizing fasciitis (or flesh-eating disease) can develop when you swim in contaminated waters and the bacterium, Vibrio vulnificus enters through skin sores or wounds. The CDC warns that you should stay out of salt water or brackish water, if you have a skin wound. The flesh-eating bacteria, Vibrio vulnificus can become very aggressive, once it has entered the body. Right now, 1 out of 5 people who get infected will die and many people require ICU treatment. Others need limb amputations. All of this can happen within only 1 or 2 days of becoming ill. The hope is that with the development of teixobactin as an injectable medication or as an oral pill there will no longer be deaths, amputations and scarring due to this bacterium, as the antibiotic will very quickly eradicate Vibrio vulnificus. I have previously written about what hospitals can do to fight superbugs.

The most common antibiotic-resistant bacteria

Here is a brief review of the most common antibiotic-resistant bacteria.

Mycobacterium tuberculosis

Since the 1950’s and 1960’s tuberculosis was treatable with a combination of two antibiotics over a period of six months to two years. But in the last 10 years more and more resistant strains of tuberculosis have developed. This is called multi-drug-resistant TB. In 2013 statistics showed that 3.7% of newly diagnosed tuberculosis cases were multi-drug-resistant TB. Many of these cases can be traced back to prisons and homeless shelters.

Methicillin-resistant Staphylococcus aureus (MRSA)

MRSA has become a common resistant bacterium that can present with difficult to treat boils in the skin, but also as a fulminant infection as necrotizing fasciitis (or “flesh-eating disease”). About 1/3 of the cases of flesh-eating disease are caused by MRSA.

Clostridium difficile (C. difficile)

This gut bacterium is naturally resistant to many antibiotics. The rest of the gut bacteria usually suppress the growth of C. difficile. But many patients can get overgrowth of C. difficile in their gut following treatment with antibiotics. Recolonization with probiotics can help to reintroduce a balanced bowel flora. In the US about 500,000 individuals come down every year with diarrhea due to C. difficile. This leads to approximately 15,000 deaths yearly.

Vancomycin-resistant Enterococci (VRE)

Physicians find enterococci in the gut and the female genital tract of patients. They can become resistant when the patient is treated with vancomycin for another infection. The VRE can then become a problem of its own with difficult to treat infections in the genital tract of females, the gut or in wounds from surgery. It has become a problem in immunocompromised patients.

The gonorrhea causing bacteria

In the last 70 to 80 years Neisseria gonorrhoea, the cause of gonorrhea, has been treated with only one antibiotic, but gradually the bacterium developed antibiotic-resistance. Lately, with more and more resistant strains of Neisseria gonorrhoea, the CDC has recommended to treat gonorrhea with two overlapping antibiotics.

Carbapenem-resistant Enterobacteriaceae (CRE)

There are two problem bugs among this category of enterobacteria, Klebsiella species and Escherichia coli (E. coli). These bacteria reside in hospitals where they can accumulate and are present in patients with immune system compromise. Medical devices like catheters and ventilators transmit these bacteria. Once a patient is sick with CRE, there is a danger of blood poisoning (septicemia), which has a high death rate.

How do regular antibiotics kill bacteria and how can they become resistant?

Normally, when antibiotics are not resistant, they interfere with the cell membrane production of the bacteria. Specifically, conventional antibiotics prevent bacteria from synthesizing a molecule, called peptidoglycan. Without peptidoglycan bacteria are not stable enough to survive in humans. But there are other mechanisms as explained in this link how antibiotics manage to kill bacteria.

Now I like to address the question how bacteria can become resistant to conventional antibiotics. This happens with overuse of antibiotics, i.e. prescribing antibiotics when a person suffers from a viral illness where antibiotics do not work. Other overuse comes from agriculture where cattle in feed lots get antibiotics as growth promoters. The FDA is strongly criticizing this practice, because residuals of antibiotics in beef can alter the bowel flora in man. The antibiotics kill all the sensitive bacteria. But the resistant bacteria, that have undergone mutations and adapted to the antibiotics, will survive.

Why teixobactin and analogues can avoid resistance

Since the detection of teixobactin many analogues have been synthesized. A new antibiotic, teixobactin can overcome antibiotic-resistant superbugs. The teixobactin analogues need more fine tuning, but they will be a breakthrough in the treatment of resistant bacteria. As this peptide attacks two targets on bacteria, it is not easy for bacteria to develop resistance against these new antibiotics.

A New Antibiotic, Teixobactin Can Overcome Antibiotic-Resistant Superbugs

A New Antibiotic, Teixobactin Can Overcome Antibiotic-Resistant Superbugs

Conclusion

Resistant bacteria have become a serious health concern in the last decade. Physicians overprescribing antibiotics and farmers feeding antibiotics to cattle in feedlots as growth promoters were the driving forces. In 2015 came the breakthrough and discovery of teixobactin. This is a peptide with 11 amino acid units. Teixobactin is a derivative of a gram-negative bacterium, Eleftheria terrae. A new antibiotic, teixobactin can overcome antibiotic-resistant superbugs. In the meantime, researchers have been able to improve solubility by developing teixobactin analogues. More research is necessary. But all of the researchers who work in this field claim that this will very soon be extremely useful for patients with super bugs. This super-antibiotic will be a weapon fighting super bugs. Before the release of this medication clinical trials will be the next step.