Acne Drug Prevents HIV Breakout

Janice E. Clements, Ph.D. (Credit: Image courtesy of Johns Hopkins Medical Institutions)

Johns Hopkins scientists have found that a safe and inexpensive antibiotic in use since the 1970s for treating acne effectively targets infected immune cells in which HIV, the virus that causes AIDS, lies dormant and prevents them from reactivating and replicating.

The drug, minocycline, likely will improve on the current treatment regimens of HIV-infected patients if used in combination with a standard drug cocktail known as HAART (Highly Active Antiretroviral Therapy), according to research published now online and appearing in print April 15 in The Journal of Infectious Diseases. “The powerful advantage to using minocycline is that the virus appears less able to develop drug resistance because minocycline targets cellular pathways not viral proteins,” says Janice Clements, Ph.D., Mary Wallace Stanton Professor of Faculty Affairs, vice dean for faculty, and professor of molecular and comparative pathobiology at the Johns Hopkins University School of Medicine.

“The big challenge clinicians deal with now in this country when treating HIV patients is keeping the virus locked in a dormant state,” Clements adds. “While HAART is really effective in keeping down active replication, minocycline is another arm of defense against the virus.”

Unlike the drugs used in HAART which target the virus, minocycline homes in on, and adjusts T cells, major immune system agents and targets of HIV infection. According to Clements, minocycline reduces the ability of T cells to activate and proliferate, both steps crucial to HIV production and progression toward full blown AIDS.

If taken daily for life, HAART usually can protect people from becoming ill, but it’s not a cure. The HIV virus is kept at a low level but isn’t ever entirely purged; it stays quietly hidden in some immune cells. If a person stops HAART or misses a dose, the virus can reactivate out of those immune cells and begin to spread.

The idea for using minocycline as an adjunct to HAART resulted when the Hopkins team learned of research by others on rheumatoid arthritis patients showing the anti-inflammatory effects of minocycline on T cells. The Hopkins group connected the dots between that study with previous research of their own showing that minocycline treatment had multiple beneficial effects in monkeys infected with SIV, the primate version of HIV. In monkeys treated with minocycline, the virus load in the cerebrospinal fluid, the viral RNA in the brain and the severity of central nervous system disease were significantly decreased. The drug was also shown to affect T cell activation and proliferation.

“Since minocycline reduced T cell activation, you might think it would have impaired the immune systems in the macaques, which are very similar to humans, but we didn’t see any deleterious effect,” says Gregory Szeto, a graduate student in the Department of Cellular and Molecular Medicine working in the Retrovirus Laboratory at Hopkins. “This drug strikes a good balance and is ideal for HIV because it targets very specific aspects of immune activation.”

The success with the animal model prompted the team to study in test tubes whether minocycline treatment affected latency in human T cells infected with HIV. Using cells from HIV-infected humans on HAART, the team isolated the “resting” immune cells and treated half of them with minocycline. Then they counted how many virus particles were reactivated, finding completely undetectable levels in the treated cells versus detectable levels in the untreated cells.

“Minocycline reduces the capability of the virus to emerge from resting infected T cells,” Szeto explains. “It prevents the virus from escaping in the one in a million cells in which it lays dormant in a person on HAART, and since it prevents virus activation it should maintain the level of viral latency or even lower it. That’s the goal: Sustaining a latent non-infectious state.”

The team used molecular markers to discover that minocycline very selectively interrupts certain specific signaling pathways critical for T cell activation. However, the antibiotic doesn’t completely obliterate T cells or diminish their ability to respond to other infections or diseases, which is crucial for individuals with HIV.

“HIV requires T cell activation for efficient replication and reactivation of latent virus,” Clement says, “so our new understanding about minocyline’s effects on a T cell could help us to find even more drugs that target its signaling pathways.”

The research was supported by grants from the National Institutes of Health.

Authors of the paper, in addition to Clements and Szeto, are Angela K. Brice, Sheila A. Barber and Robert F. Siliciano, all of Johns Hopkins. Also, Hung-Chih Yang of National Taiwan University Hospital.

Story Source:

Adapted from materials provided by Johns Hopkins Medical Institutions.

Journal Reference:

1. Gregory L. Szeto, Angela K. Brice, Hung-Chih Yang, Sheila A. Barber, Robert F. Siliciano, Janice E. Clements. inocycline Attenuates HIV Infection and Reactivation by Suppressing Cellular Activation in Human CD4+ T Cells. The Journal of Infectious Diseases, 2010; 201 (8): 1132 DOI: 10.1086/651277

http://www.sciencedaily.com/releases/2010/03/100319202528.htm

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0bama 'confesses' to criminal activities to pass Socialist Medicine bill

In his interview with Bret Baier, Barry 0bama confessed that he and his follow co-conspirators in Congress have engaged, and will continue to engage in illegal and unconstitutional behaviour to fraudulently “pass” the socialist medicine bill. Mr. 0bama admitted that they are not concerned about the “process”, only the end result. The problem with that attitude is that there is only one Constitutionally approved process for passing legislation. To publically declare that he and congressional Democrat/Socialists are not concerned about the process is to pubically declare that the Constitution doesn’t matter. Worse, it is an admission that they believe “the ends justifies the means” and that “any means necessary” is more important that following the law and complying with the Constitution. This is nothing less than a blatant confession by Mr. 0bama and Democrats have, are and will continue to blatantly violate the law in order to get their way.

[Via http://ldmartin1959.wordpress.com]

Moments of Life

Today  I saw not of a 84 year-old diabetic European man meeting his arranged marriage wife of 64 years old who was admitted for schizophrenia and co-morbid Crohn’s disease, but I saw a loving husband sharing his moments of love with his dear wife of 42 years of marriage, over the few bits of chocolates and tea.

What I saw and experienced was LOVE.

Sometimes, demographics and pathologies are merely for statistical and medicinal use, least to say, the beauty of love and life are often taken for granted. Should we as doctors do as such?

[Via http://jingguo.wordpress.com]

Just some tidbits.

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Scienceroll.com: Weekly Introduction

I would like to share my favourite and ongoing projects with you so I can give you a proper introduction to Scienceroll.com. You can also find me on Twitter or on Friendfeed.

For news and articles about the impact of web 2.0 on medicine and healthcare, please follow the Medicine 2.0 Friendfood room.

For news and articles about personalized medicine and genetics, please follow the Gene Genie Friendfeed room.

Medicine 2.0 University Course: This is the third semester of the first university course that focuses on web 2.0 and medicine for medical students. Now, almost 100 students attend the 20 slideshows through 10 weeks and they fill a survey out before and after the course.

Medicine 2.0 Collection: I maintain the biggest collection of links and posts focusing on web 2.0 and medicine.

Webicina.com is my service that aims to help medical professionals and patients enter the web 2.0 era by providing them with e-courses, consulting and personalized packages.

PeRSSonalized Medicine is a free tool that lets you select your favourite resources and read the latest news and articles in one personalized place. You can create your own “medical journal” and as we are totally open to suggestions, let us add the journals, blogs and websites that you would like to follow.

Scienceroll Search is a personalized medical search engine powered by PolyMeta search and clustering engine. You can choose which databases to search in and which one to exclude from your list. It works with well-known medical search engines and databases and we’re totally open to add new ones or remove those you don’t really like.

List of biomedical and scientific community sites: More than 30 communities with links, descriptions and screenshots.

List of Biomedical video sites: Almost 40 sites featuring scientific or medical videos and videocasts.

[Via http://scienceroll.com]

Health 2.0 News: Virtual patients, Design Challenge and the Future

• PatientsLikeMe Reports High Rate of Adverse Event Reporting Among Its Members (Pharma Marketing Blog): Patientslikeme will certainly play an important role in driving the pharma sector towards social media.

• The 2010 DiabetesMine™ Design Challenge: The DiabetesMine blog presents this year’s Design Challenge in which innovations in diabetes can win prizes.

• WebMD + Social Media, NOT! (Chilmark Research): WebMD wanted to take a step towards web 2.0, but didn’t do it in the best manner.

• My name is Christopher. I have CF and was born in Novartis (Advertising and Health): A virtual patient promotes a new pharma-sponsored community site for patients dealing with cystic fibrosis. Does anyone think it’s a good idea?

• Protecting Your Professional Image in the 21st Century (BiteSize Bio): A timely entry about why and how to be cautious online. Have you checked the settings of your Facebook or Twitter account recently?

• Health care of the future? (Hans Oh’s eHealth Blog):

1. Checklists
2. Behavioral Economics
3. Patient Portals
4. Payment Innovations
5. Evidence-Based Decision Making
6. Accountable Care Organizations
7. Virtual Visits
8. Regenerative Medicine
9. Surgical Robots
10. Genetic Medicine

• Quantified Self Business Models (The Quantified Self):

The session began with McCabe of ContagionHealth describing her company, whose first product is a social game that allows people to exchange exercise challenges. What on the surface looks like a fun diversion and micro-motivator is actually an insertion strategy for new tools of mapping human psychology and social influence, McCabe explained. The group is already experimenting with segmenting users (for instance, into “doms” and “subs” according to whether they prefer influencing or being influenced). This is invisible to the user, who sees only an invitation to play with their friends. Right now, McCabe and her partner Andrey Petrov hope to make money by licensing the platform to employee wellness programs.

[Via http://scienceroll.com]

finally it's friday

I realise I complain a lot these days about work, hours, people, patients; you name it I’m complaining about it. I haven’t figured whether it’s orthopaedics, the department, the people, the patients or just me that is the cause of all the moaning. A pretty good guess would be a combination of everything.

But as the light begins to glimmer towards the end of these four months I feel the rose tinted glasses beginning to gloss things over.  So before I forget it all, here’s a snapshot of what really was at times AWFUL-paedics.

First morning. Half past seven meeting. Rota shennaginans begin.  JUST PICK A ROTA PEOPLE. (I felt like screaming then thought about first impressions and all that.) Then we stood awkwardly in a corner of the Trauma Meeting which was and still is Trauma for everyone involved not just the poor patients. Patient admitted in middle of meeting.  Nurse appeared demanding fluids and a catheter. Didn’t know the drill so ran through and after a bit of fumbling, the demented fractured neck of femur (little did I know, a sight only to become all too familar) had a catheter in situ and I returned to a fraught trauma meeting, registrars being grilled, voices raised. I was thanking my lucky stars it was NOT me standing up presenting.

I survived that first day. Surprisingly in one piece.

Then came the first weekend on. I was just getting used to life without an SHO (senior house officer), my go-to-guy if you like, one up from me; when the shit hit the fan people. Big Time. One of the fractured NOFs (neck of femurs or hips to you non surgeons) took a turn for the worst and arrested. Thrown. In. At. The Deep. End. I guess it was autopilot. We went through the motions and she came back round. Well, in the loosest sense. Her heart beat returned but unfortunately little else about her did. But I am thankful to say that at least her family was at her side when she did pass on later that day.

I sat down to gather my thoughts and sort out the notes. But I was stumped. Floored. Staring into space. A tap on my shoulder brought me back but I couldn’t hold it in any longer. I cried. I scared the arrest team doc who appeared to be much more comfortable with arrests than emotionally labile house officers. I cried some more. Silent sobs. Washed my face. Questioned my decisions. My actions. And then bed 404 needed laxatives prescribed and I thought, “Thank goodness..that, my friends I can do.” Bed 409 had a sore belly, bed 432 had a sore leg, bed 236 wanted methadone (though preferably heroin if possible) and life continued. I thought I was broke. Done. Knackered. Never-going-to-function-again. But life goes on. Patient’s are always there needing one thing or another, never quite letting you get too self absorbed, keeping you in the real world.

Then the ICE came and the snow, oh and the ICE. And so we are in the middle of one of the coldest winters and I am where? You guessed it orthopaedics. One of the busiest winters yet for the unit. Great. It never stopped.

And now the ice has gone. There are busy days and quieter days, a bit like waves hitting the beach. Sometimes they come crashing down and you’re not sure whether you’ll come up. Sometimes they gently roll up, leaving you with time to go to the toilet, eat lunch and laugh.

I’m left with nights before it’ll be back to medicine. Thank goodness.

[Via http://thepurplecoat.wordpress.com]