Rare Encouraging News in HIV and Parkinson’s Disease
HIV/AIDS and Parkinson’s Disease are two areas of medical research where good news is hard to come by, as researchers encounter countless setbacks in trying to translate promising laboratory findings into clinical practice. Both diseases have seen progress in the past decade in ex post facto treatments – preventing the maturity of HIV into AIDS with antiretroviral treatment or reducing the motor symptoms associated with Parkinson’s. But drugs that seemed to offer a cure for either disease, or in the case of Parkinson’s a mere brake to the progression of symptoms, have consistently disappointed in human trials.
That changed – slightly – this week, as two highly-publicized studies were published offering faint glimmers of hope on both disease fronts. Grabbing the most headlines was the first-ever demonstration of a successful HIV vaccine in a study conducted in Thailand but funded by the U.S. Army and the National Institutes of Health. The caveats are flying hot and heavy – the researchers saw only a 31% decrease in the number of HIV cases after treatment with a vaccine and a booster drug, one of the HIV strains protected against is specific to southeast Asia, and mystery lingers over why this particular combination of drugs was protective where so many others have failed. The two drugs used in the Thai trial – one a “primer” and one a “booster” – had themselves failed in previous large clinical trials. But the first small success in protecting against the deadly virus nevertheless encouraged many HIV/AIDS researchers; Dan Barouch, an immunologist at the Beth Israel Deaconess Medical Center in Boston, Massachusetts, told Nature “It’s the largest step forward that’s ever occurred in the HIV-vaccine field, but there’s a tremendous amount of more work that will need to be done.”
Somewhat obscured in the all the HIV/AIDS vaccine news was a finding that could be relevant to even more people: the first demonstration of a drug that could delay the progression of Parkinson’s disease. Scientists have used dopaminergic agonists for decades to counteract motor symptoms such as muscle tremor and rigidity, but as neurons die off, the symptoms outpace the drugs. No drugs have been proven to stall this progressive worsening of the disease…until Thursday, when authors from several universities revealed that a drug already on the market called rasagline was modestly successful in this goal.
Good news, to be sure, but again to be taken with a grain of salt. The New England Journal of Medicine study was funded, unsurprisingly, by the pharmaceutical company that makes rasagline (Teva Pharmaceuticals) and one of the study’s clinical investigators, William Weiner at the University of Maryland, made an eyebrow-raising comment to ABC News: “I would not have agreed to stressing the neuroprotection angle so strongly. [The outcome] may be statistically significant but it is surely not clinically meaningful.”
Un Jung Kang, director of the Parkinson’s Disease and Movement Disorders Center at the University of Chicago Medical Center, agreed via e-mail that the effect shown in the paper may be marginal for patients, but suggested that the drug’s availability and safety may make it worth trying in light of the new results. “Given the fact that this medication is relatively safe and widely used already, even such a small effect may influence clinicians and patients to take the medication in the hope of modifying the disease progression,” Kang wrote.
Full Moon Fever Fails to Impact Operating Rooms
Anesthesiologists have something of a reputation, fairly or unfairly, for odd behavior. So it makes sense that the journal Anesthesiology would put out one of the odder findings this week, in a paper about whether the timing of heart surgery affects its outcome. Sounds boring, right? Well read to the bottom of the release, where author Daniel Sessler of the Cleveland Clinic throws out this non-sequitur: “Our results also suggest that the supposed effect of moon phase on medical complications is merely an urban legend.” Wha?
Kudos to Jeanna Bryner of LiveScience, who caught that quote and turned it into a very funny article about the urban legend that full moons have an effect on hospital business. The study was actually designed to look at day of the week, hour of the day, and day of the year to see if there was any effect of fatigue or rotations upon surgical performance. The authors decided to throw moon phase into the mix as well (hey, what’s another spreadsheet column?), and cite a couple studies that did find a moon effect: one that saw a small uptick in dogs and cats admitted to veterinary emergency rooms during full moons, and one that found an increase in intracranial aneurysms during the full moon. As the quote above indicates, no such effect of moon phase was seen for heart surgery outcome, though perhaps the well-esteemed surgical talent of the Cleveland Clinic obfuscated any effects of the lunar cycle.
(Thanks to friend-of-the-blog Lisa Spengler for the tip)
Speaking of the moon, NASA found a whole bunch of water there, and on Mars as well. Alzheimer’s disease numbers are expected to rise as people live longer, and lack of sleep ain’t helping. And butterflies use GPS in their antennae. Have a good weekend.