stethoscope.jpgMajor medical advancements in research this century are transforming diseases and common health problems bringing hope to millions. From alzheimers to glaucoma, MS to migraines, and diabetes to dental crowns, breakthroughs are rapid and real. Here are nine developments set to change the medical landscape this decade.

Cell Transformation

The Harvard Stem Cell Institute reported they have successfully transformed one type of fully developed adult cell, a process which could lead to benefits for patients with diabetes, heart disease, strokes and other major illnesses. Benefits come without the moral and ethical debates about using infant stem cells, and without the need for expensive, ongoing anti-rejection drugs needed when cells are introduced from outside of the human body. Biologists working with mice identified three crucial molecular switches, that when flipped, completely converted a common cell in the pancreas into a precious insulin producing cell. The lab is already experimenting with human cells and Douglas Melton, the lab’s co-director thinks they will be ready for human trials within five years.

Alzheimers

Two new drugs which show effectiveness in treating Alzhiemers are in clinical trials. Flurizan from Myriad Genetics is finishing the trials now and expected to be available in one year. It reduces proteins that cause “plaque buildup between brain cells” which is one of the underlying causes of the disease. A second drug called PRX- 03140 from EPIX Pharmaceuticals is changing brain wave activity in trial patients. Within just two weeks the participants taking PRX-03140 showed improvement on memory tests, while one was able to speak full sentences again. PRX-03140 is about 5 years from market as the trials are in the early stage now.

Blindness

In March, 2008 scientists at the University of Utah’s School of Medicine successfully used cloned Robo4 (a protein found in our blood vessels) to reverse macular degeneration and diabetic retinopathy in mice. Robo4 inhibits abnormal blood vessel growth and stabilizes the blood vessels of the eye. This makes it more effective than current forms of treatment which only halt progress of the disease. Leaders at the medical school indicate Robo4 offers great hope in these two eye disease areas where progress has been hard to come by and that they are working to start clinical trials soon.

Also in the area of preventing and treating the form of blindness known as glaucomais is a relatively new procedure called canaloplasty. This is a minimally-invasive surgical technique which uses a 250 micron microcatheters to access the eye’s drainage channels and utilizes them to remove fluid from the eye. iScience Interventional, manufacturer of these microcatheters, received expanded indications for use from the FDA this year for their microcatheters to treat Primary Open Angle Glaucoma (POAG) and POAG occurs in approximately 90% of all glaucoma patients. Researchers in Canada, the US and Europe have been gathering clinical results on the safety and effectiveness of canoplasty trials. The procedure would eliminate the need for ongoing, expensive glaucoma treatment medications.

Dental Crowns

With a new computerized system, dentists are now able to fit a new, permanent crown in about 90 minutes. First, the tooth is prepped and then sprayed with titanium dioxide to create contrast. Next, the dentist uses a tiny TV camera, to take a series of three dimensional images. Working on the computer the dentist puts the TV images together, adds a bite record that shows how the teeth fit together. The computer designs the crown and it can be adjusted on the spot for less contact or a better bite. The crown design is transferred from the computer to a machine, which cuts and refines the custom crown in about 15 minutes.  Dr. Alan Ripps of the Louisiana State University School of Dentistry in New Orleans says “It’s extremely accurate.

Today, the equipment that makes the same-day crowns costs about $150,000, and few offices have them. However, the cost for the crowns is about the same as the conventional variety and are generally covered by insurance.

Diabetes

In March, 2008 the FDA approved the Abbot Free Style Navigator® Continuous Monitoring System for people with diabetes and it is available now by prescription. Through a sensor inserted in the upper arm or the abdomen the Navigator provides data 24/7 on changing blood sugar levels, alerting users to take action before dangerous high or low levels occur. The sensor is not effected by showers, swimming or other normal life activities. The sensor is accompanied by a pager-sized receiver that produces audible alarms preset by the diabetic and their physician. It also stores the blood sugar readings for up to 60 days providing a track record for your physician’s analysis.

Addressing blood glucose monitoring is a model being developed by Gerard Cote at Texas A and M. A sheath of tiny fluorescent particles (smaller than a strand of human hair) is inserted into a diabetic patient’s wrist. The sheath is invisible to the naked eye, but when you shine a small laser on it, the sheath glows and changes colors in response to changes in blood sugars. The patient wears a wrist watch like device that provides a digital readout of the glucose levels and alerts the diabetic person to dangerous levels. This is 5 years away from general availability, but Houston-based Bio Tex is also developing a model using a similar technologies.

Migraines

In June, 2008 the Ohio State University Medical Center announced that they have developed a new hand held device that can help 13% of migraine sufferers, whose headaches are preceded by what is known as an aura. The device sends a painless magnetic pulse through the brain that scrambles the brain’s signals leading from the “aura phase” of the condition to the nausea-tinged, throbbing headache that inevitably follows. In the trial involving 201 migraine sufferers ages 18 – 68, nearly 40% of sufferers (who had the device that actually transmitted the impulses, as opposed to placebos) saw their headaches drop 50% or more. The hope is to have the device on the market by January, 2009. NeuraLieve (which funded the study and provided the equipment) is in the process of obtaining clearance to do so from the FDA. Members of both groups took home the device, a portable box with handles that weighs about 3 pounds.

Brain injuries

In May, 2008 Louisiana State University researchers found that exposing the people with brain injuries to a high-level oxygen chamber can stimulate the brain to repair itself. Tested on over 500 patients with trauma from brain injuries and neurological conditions like Parkinsons, the medical school has seen major improvements in basic cognition, word finding, balance, etc. when the chamber is used. Multiple treatments in the hyperbaric chamber, cost roughly $200 each and are typically done over several months. Because it is still experimental, treatments are not currently covered by insurance. However, the improvements from breathing the pure oxygen are returning the trial patients to levels of prior functionality.

Multiple Schlerosis

Doctors working in the Oregon Health and Science University and Portland V.A. Medical Center have developed an experimental vaccine for MS called Neurovax. Neurovax increased the number of disease-fighting white blood cells in the immune system for all 40 patients who received the treatment once per month in a clinical trial. Neurovax is an improvement over current MS drugs as it does not have flu-like side effects. Next steps are to execute a large enough trial through a minimum of two years so that researchers can see the immediate and longer term differences between the vaccinated patients and the placebo group. You can get more information on this MS drug by logging on to www.ohsu.edu/ms

(Written with additional help from Geri)

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