Posts Tagged Public Health

Arsenic cures cancer!

Last week The Daily Mail boldly asked “Could arsenic be a miracle cure for cancer? Scientists say it had astonishing results when added to a leukemia drug”. It’s worth pointing out here, that even in the subheading bullet points the Mail Online downplayed their excitement a little, de-escalating from arsenic being a potential “miracle cure” to “makes chemotherapy more effective”.

Headline from the Mail Online reading "Could arsenic be a miracle cure for cancer? Scientists say it had astonishing results when added to a leukemia drug"

The Mail Online wasn’t the only one to cover this story. Medical News Today headlined “Poison or cure? Arsenic can help treat cancer, study finds” while Science Daily said “Arsenic in combination with an existing drug could combat cancer – An ancient medicine shows new promise” and Harvard Magazine asked “Is Arsenic a Key Ingredient in the Battle Against Cancer?”. So, the Mail Online seem to be in good company in reporting this apparently exciting news.

New use for a traditional medicine?

One thing all of these stories had in common was the detailing of arsenic in traditional Chinese medicine. Harvard Magazine quoted study author Kun Ping Lu: “In Chinese traditional medicine, “Arsenic has been used for thousands of years,” said Lu. “Its oxidized form is the active ingredient” for a concoction the Chinese called “magic bullet,” which was used to treat a specific kind of leukemia, APL”.

Arsenic, in fact, has been claimed to treat a whole range of diseases throughout history – in Ancient Greek times it was used to treat ulcers and in Chinese Traditional Medicine it’s been used for over 2000 years. Arsenic was once added to Indian Ayurvedic herbal remedies and when Paracelsus, an Italian Professor of Medicine from the 1500s was skeptical of the old methods of balancing humours to treat disease, he introduced arsenic as an alternative. Paracelsus, in fact, stumbled across a genuine therapeutic action of arsenic in its ability to treat syphilis – an indication for which arsenic was used well into the 20th Century until antibiotics came along.

an open brown medicine bottle laying on its side containing a white powder and labelled "acid arsenic"

But arsenic has not only been a persistent element in traditional medicine, it has also been used to treat cancer – first, to treat chronic myeloid leukaemia in the 1930s and later to treat acute promyelocytic leukaemia (APL). Arsenic trioxide (ATO) has been used to treat APL since its approval in 1995.

The study

The study the Mail Online et al. referenced was summarised in Nature Communications earlier this year in an article titled “Arsenic targets Pin1 and cooperates with retinoic acid to inhibit cancer-driving pathways and tumor-initiating cells”. The study is apparently based on three things:

  • A protein called Pin1 is important in cancer
  • Arsenic trioxide (ATO) is a treatment for cancer
  • All-trans-retinoic acid (ATRA) inhibits Pin1

A good introduction to any peer-reviewed article will use scientific literature to convince you that the question the researchers have asked is a valid one and set their work within the context of what is known in the field. At first glance, this article is particularly industrious in the effort to convince the reader on the three areas above. They strongly stress that “Pin1 is a critical “driver” and a unique drug target in cancer. Pin1 is hyperactivated in most human cancers and correlates with poor clinical outcome”.

ATO and leukaemia

ATO has been approved for use in a certain kind of leukaemia called acute promyelocytic leukaemia (APL) for many years and is successfully used in combination with ATRA in patients with APL. There are very few alternative treatments for this form of leukaemia and ATO combined with ATRA has low toxicity.

The underlying mechanism of this treatment is down to the existence of a protein called PML-RARα which causes APL. PML-RARα doesn’t exist in normal conditions however patients with APL have a genetic mutation which produces this fusion of the genes for two individual proteins PML and RARα – this generates the fusion protein, PML-RARα. It doesn’t really matter what PML-RARα does, only that it drives APL and it doesn’t exist outside of disease. Studies have shown that ATO binds to the PML part of this fusion protein and degrades it.

an image taken from one of the study figures showing the chemical structure of Pin1 and the chemical structure of ATO - the two are shown overlapping to indicate where ATO binds in Pin1

The chemical structure of Pin1 is shown with ATO (I) sitting within in apparent binding pocket on the protein. This image is adapted from the paper.

ATO and Pin1

But the authors of this study were interested in the effect of arsenic on a completely different protein – Pin1.

They don’t really explain why they thought arsenic might remove Pin1 in cancer cells. They used a technique to identify ATRA as a drug of interest, but it seems like they only looked at ATO because it’s already used in combination with ATRA.

In their study the authors find that treating cancer cells with arsenic in the lab reduces the levels of Pin1. They also show that ATO and ATRA combined, reduce cancer cell growth and reduce tumour size in mice. And they go some way towards explaining the mechanism behind these interactions and discounting alternative explanations for their findings.

In many ways, it’s a solid paper.

So why am I skeptical?

There are a few reasons, though, to be wary of the findings in this paper and the way it has been presented. Firstly, it’s the particularly hyped up nature of the story – arsenic has been used to treat leukaemia since the mid-1990s, this isn’t really news. But it does make me wonder if there’s a particular reason this article might be so strongly endorsed.

The authors also don’t really explain why they picked arsenic in the first place other than they’re interested in ATRA and Pin1… In fact they’re very, very interested in Pin1.

They argue “that Pin1 is a critical “driver” and a unique drug target in cancer” – which is particularly interesting because as a cancer researcher with a PhD in cancer cell biology, I’ve never even heard of this protein. They reference three papers to support their claim but two of them are from the group’s own lab – the final paper they reference, an article titled “Pin1 in cancer” is from a separate source. This unrelated (and therefore, unbiased to some degree) article argues that Pin1 is hyperactivated in around 10% of all cancers. That number is pretty high, but it is certainly not enough to say that Pin1 is a “critical driver” in “most human cancers”.

So why are the authors so keen on Pin1? The suggestion that it’s a “unique drug target” might give us a clue.

five stacks of silver coins increasing in height from left to right

At the end of the article is the heading “Competing interests” under which is stated “K.P.L. and X.Z.Z. are inventors of Pin1 technology, which was licensed by BIDMC to Pinteon Therapeutics. Both Dr. Lu and Dr. Zhou own equity in, and consult for, Pinteon. Their interests were reviewed and are managed by BIDMC in accordance with its conflict of interest policy. The remaining authors declare no competing interests.”

Pinteon Therapeutics is a “private venture backed biotechnology company focused on the discovery and development of breakthrough therapeutics targeting Pin1” and we can therefore assume that this company will make money from the generation of Pin1 inhibitors that can be used to treat cancer.

Of course, Pin1 inhibition might well make for an interesting cancer target – there’s no disputing that – but its promise might well be overstated both in this article and in the media coverage of the article.

Me? I’m suspending judgement until we see more compelling evidence.

 

Dr Alice Howarth, PhD

Alice is a cell biologist and cancer researcher who works in the Institute of Translational Medicine at the University of Liverpool. She is the Treasurer of the Merseyside Skeptics Society and co-hosts the popular sceptical podcast Skeptics with a K. In her free time she Instagrams photos of her ridiculous dog, Lupin and watches Buffy the Vampire Slayer ad infinitum. Find her at DrAlice.blog or @AliceEmmaLouise on social media.

, , , , , ,

No Comments

The Potato Famine Diet

I’m not a fan of ‘the past’. There’s too much of it quite frankly, most of it is messy and violent, full of bad people with bad ideas and there’s no internet. (Yep, sorry folks, I’m one of those dreaded ‘millennials’ that are apparently ruining everything, sorry……..#notsorry)

I feel in the minority however, most people these days love the past! They’re obsessed with it. So much so they will stop at nothing to take us back to it!

It may surprise you that I am not actually talking about politics (for once). I’m talking about food. More specifically I’m talking about diets. There’s a trend in faddy diets and ‘clean’ eating at the moment that focusses on going ‘back to basics’, going back to a simpler time and eating like our ancestors did. They obviously make a convincing argument, the whole ‘wellness’, ‘clean eating’ movement are extremely popular and don’t seem to be going anywhere. (Dammit). So with that in mind…….

tomatoes, garlic and a red pepper on a wooden chopping board

Looking for a diet that’s based on a famine that killed over 1 million people!? Well look no more my friend because I present to you the ‘Irish peasant diet’!………seriously. That’s a thing.

The Irish ‘peasant’ diet

I spotted an article on twitter from The Irish Independent titled ‘Is this Ireland’s answer to the Med diet?’ In which it went on to describe how research had found that a diet from mid-Victorian Ireland in poor, rural communities made them healthier than their city dwelling counterparts, they were living longer and contracting fewer diseases, and therefore we should adopt a similar diet now.

The ‘diet’ consisted of vegetables, milk and fish. Sounds pretty healthy right? What’s my issue here?

The average life expectancy of a man in Ireland during the 1800’s was 40 years old. Sanitation was basic, people were starving and healthcare was minimal if there at all. The reality is that ‘peasants’ were eating what was available to them. Sure, it was a ‘low-calorie’ diet but when you look at all other lifestyle factors that might not count for much. The article mentions that Tuberculosis cases in rural areas were lower compared to cities and attributes that to die. But let’s remember that in Victorian city slums, people were living in unsanitary conditions, closely packed together with limited access to clean water and that tends to help diseases, like tuberculosis, spread like wildfire. The article also talks about the benefits ‘peasants’ had due to their ‘low caloric intake’……….aka. STARVING TO DEATH.

lots of potatoes

Following the logic of that article I have a few of my own ideas on ‘limiting caloric intake’: How about the 1930’s ‘Stalin Diet’?, or maybe the 1940’s ‘Warsaw Ghetto Diet’? or if you fancy something a little more up to date why not the 1980’s ‘Ethiopia Diet’? Sound flippant? So does basing a diet on a tragedy that killed over a million people…

Maybe I’m wrong though, maybe these Victorian peasants weren’t starving because they had no food, maybe they were the early pioneers of the ‘Keto’ diet! – the diet based on the idea of putting your body in a state of ketosis to lose weight. It’s unlikely though….unless they were so determined to make their diet work that the death of millions didn’t prompt them to rethink their methods…..anyway, I digress.

We are living in a world that has never been more medically and scientifically advanced. Life expectancy and our ability to treat and cure disease has never been better and yet people are desperate to go backwards. Back to a simpler time, when we didn’t have the big scary GMO’s and nasty (un-defined) chemicals in our food. A simpler time, when disease amongst the poor was rife and living beyond 50 was a significant achievement.

The article does what a lot of the ‘it was better in the old days’ types tend to do which is cherry pick ‘evidence’. They select the positives and ignore everything else, presenting a false, rose tinted view which ignores the inequality and suffering of many in favour of pushing an agenda……….still talking about diets. Definitely diets…….

The article gives the opinions from a few nutritionists, one of which says…

“Peasants may also have experienced periods of food scarcity. Whilst this is clearly not always beneficial and malnutrition would have been a concern, we now understand that limiting caloric intake can trigger biological processes that support health and help prevent disease.”

two hands held outwards together cupped in a form of request

I had to read this quote several times to fully understand the point she was trying to make. Food scarcity is ‘not always beneficial’? When is a lack of availability of a basic human resource ever ‘beneficial’ exactly? It’s fine though because we now know that those malnourished peasants were clearly just paving the way for the ‘faddy’ diets of the future right? This take is flippant and condescending. This ‘peasant diet’ is nothing more than fetishizing and trivialising poverty.

A symptom of a wider problem?

If we move away from the past and take a look at the present this patronising attitude towards poverty is everywhere. Although instead of praising the poor on their dietary ‘choices’ we now condemn them.

There is a great deal of ignorance when it comes to poverty and the realities of living with austerity. This can be seen clearly in the approach to advising or criticising poor people on their diet. You might see ‘clean eaters’, chefs and other middle class ‘foodies’ telling people to stop buying ready meals, cheap takeaways and processed food, or as Mr Jamie Oliver calls it, ‘crap’, and instead get down to our local farmer’s markets at the weekend, buy fresh produce, prepare fresh meals for their families everyday and just live a ‘better, healthier life’. They see these changes as easy and simple, insinuating that a failure to do so is just down to laziness and a lack of self-care.

three bacon cheeseburgers on a wooden board

What they fail to understand or even consider is the restrictions that exist on many, when it comes to what food is available to them. Much like the ‘peasant diet’, it isn’t about choice. The truth is that, now, in 2018, ‘junk’ food is widely available, it’s convenient and it’s affordable. Many families and individuals in this country are living hand to mouth or having to rely on foodbanks (a polite reminder that it is 2018). They can’t afford (whether it is time of money) to get out to a market every weekend. As Anthony Warner (aka The Angry Chef) said, “We need to stop mistaking the markers of inequality for the causes of inequality”.

Don’t get me wrong, I’m sure a lot of people giving advice are well meaning, but they’re not helping. They’re just being patronising.

Oh, and another thing! Seeing as I’m on the subject. What is the obsession with poor people owning TV’s? It is often always a criticism of people on benefits or below the poverty line that they have a tv. The TV always gets a mention. I have 3 issues with this…

  1. They’re often always described as being a ‘big’, or ‘massive’ or ‘huge’ flatscreen tv……ALL tv’s are flatscreen’s these days. It’s just a TV.
  2. Who cares if they own a TV?! We don’t know the circumstances of how they came to own that TV or how much it cost. That TV is a source of entertainment for that family or individual, why is that an issue?
  3. It’s 2018, people have TV’s. What kind of Dickensian vision of poverty do the upper and middle classes of this country have of poor people?! And more importantly, is that vision how they think the poor should be?

There are many reasons why someone might struggle to eat a healthy balanced diet. Disability, chronic illness, employment or lack of, isolation, a potato famine. We need to stop blaming and misrepresenting people in poverty for things they cannot control, all that does is gloss over the chronic failings in our ability as a society to care for our most vulnerable in times of vast inequality, it ignores all other lifestyle factors and it completely disregards people suffering in order to justify an agenda that leads to widening inequality and punishing the poor just for being poor………………………………..…………….DIETS! DEFINITELY STILL TALKING ABOUT DIETS!…..

 

Karin McClure

Karin has been actively involved in skepticism for 4 years and has been involved with the Merseyside Skeptics for 3 years. She has given talks on the pseudoscience around diets and health at QED
Skepti-camp, Ignite Liverpool and Merseyside Skeptics and has been interested in diet and health for 3 years. Karin is also an artist and has sold her work at events around the country and online, information can be found on her website lunalynes.wordpress.com where she also shares posts about her experiences with mental health, as well as art updates.

2 Comments

Gene edited crops arrive in the UK!

The observant skeptic might have noticed a brief flurry of media activity at the end of May that discussed a field trial of gene edited crops that is being conducted at Rothamsted Research in Hertfordshire (1, 2).

You might think, “So what”? There have been loads of field trials on genetically modified crops over the years, why is this news?

Not so, this trial is different as the devil is in its details. This is a trial of both genetically modified (GM) crops AND a trial of gene edited (GE) crops.

This is the first UK field trial of GE crops so although the difference might seem minor it could be extremely important for the future of scientific research and crop improvement in the UK and throughout Europe.

In general, GM involves the addition of foreign genes to your crop of interest. Classically this has included genes from bacteria that confer herbicide or insect resistance. However more recently has included the production of Golden Rice (3) and purple tomatoes (4) both of which have potential health benefits.

All skeptics will know that the debate surrounding the use of GM has been extremely controversial and currently the growth of these crops is prevented throughout the EU. The regulation of these crops is complex but unfortunately in the court of public opinion the positive case for the use of GM has been mostly lost due to the activity of those organisations that fundamentally oppose this technology.

Gene Editing is similar to breeding…but better.

GE is subtly but importantly different to GM. This technique allows the precise modification of genes that are already in the organism without the long term addition of a foreign gene (5). In turn this could alter some growth attribute of the plant. This allows scientists to use their knowledge of plant biology to predict how this alteration will alter crop growth, test it in the lab before applying for a field trial license if the results look good.

Importantly GE is a modern cousin of mutagenesis, a process that has been the genetic basis of conventional breeding throughout the history of agriculture. Over millennia humans have selected new crop varieties that are more nutritious or better suited to different growth conditions, the results of which is the food we eat every day.

Conventional breeding relies on random mutagenesis that ultimately takes many years to develop new varieties. GE allows scientists to target these specific mutations to improve crop growth and therefore remove the years that breeding can take. Importantly the end-products of GE are essentially identical to the products of conventional breeding so why should they be regulated differently?

A figure depicting the difference between genetic modification and genome editing as described in the text

The newly approved field trial at Rothamsted is really a test-case for the regulation of GE crops. The scientists have produced varieties of the potential oil crop Camelina sativa that will allow them to better understand lipid metabolism. At this time the crops won’t be used for food or feed but critically the UK Government Advisory Committee on Releases to the Environment (ACRE) has determined that this GE crop does not need to be regulated like GM crops, mostly because it contains NO foreign DNA (6).

This indicates that in future ACRE will regulate GE crops differently to GM crops and therefore might offer future opportunities for scientists and breeders to develop potentially useful crop varieties.

Unsurprisingly the EU is in regulatory limbo

This decision comes in the light of continued EU delays in a ruling that will decide the fate for the growth of GE crops across Europe. Recently there have been promising noises coming from the EU but as yet this decision has not appeared (7). The decision by ACRE shows that, like Brazil, Argentina, Sweden and the USA (8), the UK has a progressive and evidence-based position for the use of GE crops and is potentially great news for scientific research.

Skeptics: get the facts!

Over the coming months I predict that we will hear plenty about the debate about GE crops so I urge skeptics to arm themselves with facts about the differences between GM and GE. This will allow us to inform our family, friends and colleagues about the benefits of GE and that it really uses the same technique as conventional breeding but is just much cheaper, quicker and more precise!

Promising times ahead for the UK plant science community.

 

Dr Geraint Parry, PhD

Geraint is the national coordinator for GARNet, which is a network that supports uptake of new technologies and knowledge dissemination amongst UK and international plant scientists. He is the science communication manager of the EU INDEPTH COST Action (https://www.brookes.ac.uk/indepth/) as well as being the secretary for the Multinational Arabidopsis Steering Committee. He tweets for GARNet from @GARNetweets and personally @liverpoolplants

 

 

(1)- https://www.rothamsted.ac.uk/news/where-gm-meets-ge

(2)- https://t.co/G77fhPCc9S

(3)- http://www.isaaa.org/kc/cropbiotechupdate/article/default.asp?ID=16278

(4)- http://www.norfolkplantsciences.com/

(5)- The process of gene editing does involve the addition of a foreign gene but is removed during preparation for field trials.

(6)- https://www.gov.uk/government/publications/acre-advice-application-for-a-trial-of-gm-camelina-18r0801

(7)- https://www.rothamsted.ac.uk/articles/edits-mutations-and-gm

(8)- https://www.theguardian.com/science/2018/apr/07/gene-editing-ruling-crops-plants

 

,

No Comments

NHS Wirral and The North West Friends Of Homeopathy: A Typical Wednesday Evening Out

I’ve had a rather interesting evening. Last week, MSS member and local councillor Darren Dodds alerted me to the fact that Wirral NHS were holding an open meeting to discuss whether to continue funding homeopathy in the region, with the recommendation being very much ‘No, we absolutely shouldn’t’. Needless to say, I agree with this recommendation, and wanted to go along to let them know that I – and by extension the hundred or more local MSS members – applaud their step in the right direction. Interested parties should read the report they came up with, it’s really pretty good. Some highlights:

The paper concludes that the lack of evidence on efficacy and cost-effectiveness of homeopathic therapies means that it should not be a high priority for the PCT at this time. It is recommended that NHS Wirral does not commission homeopathictherapies.

The key risk is that NHS Wirral fails to maintain its reputation as an evidence-based commissioning PCT.

Excellent stuff. Still, it seems we weren’t the only ones made aware of the open meeting – also invited were patients currently or formerly using homeopathy, and the ‘North West Friends of Homeopathy‘. This latter group are most interesting, and I’ll come back to them a little later in more detail, but first it’s worth pointing out that I appeared on local radio with a member of the group on Monday morning, in an exchange that might amuse, and will certainly give a far better impression of who John Cook is than I could ever do justice with words. UK-based readers can listen here, it starts around the 2hour 13minute mark and lasts about 10 minutes. I’ll wait.

For those not able, willing or interested in listening, what we have from John is a charming ability to hog a conversation, and the maniacal insistence that the date of the meeting was aired. Clearly, John wanted his supporters to arrive mob-handed. Fair enough, he probably feels he has a strong case. As it was, when I arrived with a couple of other MSS members there were maybe 40 or so people present, a number which I presume to be in excess of the general norm for these meetings.

John, having lobbied for inclusion, was amongst the speakers, joined by Dr. Hugh Neilsen BA MA BM BCh MRCP FFHom (it’s worth pointing out that his name is actually Hugh Nielsen, and the NWFoH’s own website, while painstaking in it’s detail of Hugh’s many qualifications, mispells the name of their own president), and the panel was completed by two local GPs who were involved in making the recommendation, and who spent the evening ranging between bemused, compassionate and at times startled. Startled, not least, by the quite spectacular opening by John, the homeopath’s friend (which I imagine is rather like a Fisherman’s Friend, but lacking in clout), in which he directed a quite flattering string of insults at me directly, and at the Merseyside Skeptics Society. Read the rest of this entry »

, , , , , , , , , , ,

13 Comments

Mad Journalist Syndrome

On the 14th January, Simon Jenkins published an article online at the Guardian’s Comment is Free section entitled: “Swine Flu is as Elusive as WMD. The Real Threat is Mad Scientist Syndrome.”, in which he criticised both scientists and the government for what he saw as scare tactics and misinformation in the handling of the swine flu outbreak. The article annoyed me a little, but I had food in the oven, and as I’m a man who lives on his stomach (to paraphrase Dr. Bruce Banner, you wouldn’t like me when I’m hungry), I forgot about it and went about my merry way.

A week later, the article began to surface from the sea of my subconscious and I grew increasingly irked. I gradually came to realise that it was a much more frustrating article than I had initially given it credit for. Read the rest of this entry »

, , ,

5 Comments

Panic And Blame – The Daily Mail’s Bread And Butter

Alex Gibson,  friend of the MSS and board member of the National Federation of Atheist, Humanist and Secular Student Societies, drops in to offer his thoughts on the ‘great big swine flu pandemic scandal conspiracy’ in  the Daily Mail.

Today’s headline: newspaper accuses pharmaceutical companies of manufacturing the panic about the swine flu pandemic to sell more drugs.

This, of course, is the same newspaper that did its best at the time to report the facts and not create panic with articles such as this, this, this and this. I can’t bring myself to look at the articles that the Daily Express was putting out at the time: if the Mail is the malicious kid at school who spread nasty rumours about people, the Express is the gullible, panicky person he talks to first.

The article, in its rush to expose how Big Pharma leaned on the World Health Organisation to get swine flu bumped up to pandemic status, ignores the fact that swine flu met the WHO’s very basic criteria for a pandemic. Like any good conspiracy theory, it starts to unravel when you actually look at the facts. If there was any pressure from some Tamiflu-selling corporate mastermind it was fairly pointless, since swine flu far and away fit the bill for a pandemic anyway. Avian flu didn’t, and neither did SARS – two glitzy media diseases that you’d think would be ripe for making money.

The real spleen-buster is the Mail complaining that in the UK there have been “just 251 deaths overall”. They sound terribly disappointed by this. Poor show, swine flu. There is, of course, no mention of the UK’s excellent free healthcare services and the fact that worldwide about 13,000 people have died, but that’s not even the important bit. Read the rest of this entry »

, , , , ,

No Comments