CME INDIA Presentation by Dr. S. K. Gupta, MBBS MD (Med), FICP, FIMSA, FRCP (Edinburgh) CFM (France), Author of Book – ‘Journey of Covid in India,’ Honorary Consultant Physician and Internist, MAX Super Speciality Hospital, Secretary, Community Health Care Foundation, Director, Shivam Nursing Home, Clinical Assistant Professor, GS Medical College, CCSU, Uttar Pradesh.
The world was fighting Covid-19, and researchers were busy making vaccines, but Scientists continued to work silently in labs to make the most significant discoveries of 20-22. Vaccines made us escape death, and these discoveries might change how we live.
Changing the way, we live!
1. Reviving the Dead: Nectar to bring in life to dead
- Yale University scientists successfully revived the dead cells in the Liver, Heart, Kidneys, and *Brain of Pigs who had been dead for an hour. They did it by transfusing OrganEx, a customized solution, into the circulatory system of Pigs using a Pump similar to the Heart Lung Machine.
- Surprisingly, the organs started functioning again. Though, the pigs did not gain consciousness. The research might have tremendous implications for the supply of organs such as kidneys, livers and hearts for transplants.
- Can it be mustered as a step towards immortality?
- What was this Concoction of OrganEx akin to nectar or Amrit?
- OrganEx solution used in the above experiment consisted of nutrients for cells, anti-inflammatory medications and drugs to prevent cell death, and, interestingly, nerve blockers—to prevent the possibility of the pigs regaining consciousness.
- But imagine what if the nectar did not have nerve blockers? Could it have revived the brains of the dead? No answers, as authors preferred to refrain from controversies for ethical concerns.
2. Creating Life without Sperm or Eggs
- Researchers at the University of Cambridge and Caltech created an artificial embryo without using any sperm or egg cells. Instead, the embryo was created using mouse Stem cells. It developed a brain, a beating heart, and the foundations for all body organs.
- Stem cells carry the potential to develop into any organ in mammals. So, scientists simulated an environment where three types of stem cells could interact and develop connections, and the trick worked.
- Though many similar experiences in the past, but this was exciting because embryos reached a stage of multi-organ development.
- Research, if permitted, has the potential to harness human organs for transplantation. Interesting research could not be furthered beyond 14 days because of the national prohibitory laws.
3. Transplanting Human Brain in Rats to change their behaviour
- It is not a TV thriller but a fact. Scientists injected human nerve cells into the brains of lab (athymic) rats. Voila, they grew and developed connections with animals’ brain cells. However, the story does not end here. The brain tissue so developed, called the ‘brain organoid,’ guided and changed the behaviour of animals -A report from Scientists at Stanford published in the journal Nature.
- But scientists don’t plan to use the findings to spy information for gains. Scientists instead plan to use it to understand schizophrenia, bipolar disorder, and other neuropsychiatric disorders where human behaviour appears to be controlled by abnormal connections.
4. Soon, we might have a mini-Sun on earth – Nuclear Fusion
- Today’s Nuclear Reactors work on the principle of Nuclear Fission, while Fusion is the principle of energy production on the Sun. Fusion occurs when two atoms collide at high speed to form a heavier atom but still lighter than the combined mass of parent atoms; the residual mass is converted into energy as per Einstein’s formula E=mc2, e.g., two hydrogen atoms fuse to form one helium atom. The exact process powers the Sun and creates enormous amounts of energy—several times greater than fission.
- Scientists in California (Lawrence Livermore National Laboratory) successfully produced the first fusion reaction. The long-chased dream marked a significant breakthrough in harnessing the natural process similar to the Sun.
- Unlike fission, Fusion requires much smaller amounts of radioactive fuel and doesn’t leave behind much radioactive waste. For example, the amount of hydrogen in a glass of water could be enough to provide sufficient energy for a person’s lifetime.
- The milestone takes us one crucial step closer to powering our society with zero-carbon fusion energy.
5. Unheard of Advances in Cancer Treatment
Immunotherapy new ray of Hope
- In a trial of immunotherapy in 18 rectal-cancer patients – cancer vanished in every patient. No, it not just receded but vanished.
- Also, miraculous results were seen in a trial of a new metastatic-breast-cancer drug. Monoclonal antibodies targeted cancer cells with a mutant protein HER2, a nasty cancer culprit. The drugs dug out and destroyed cells featuring the mutant protein with stunning precision. In addition, another genetic mutation called KRAS, hitherto considered undruggable, was dodged using monoclonal antibodies, helping patients survive without their tumours getting worse.
- And finally, a much sought-after breakthrough in crucial early diagnosis of cancer.
- A blood test called Galleri does it quickly and is capable of screening for more than 50 types of cancer. It simply looks for circulating Tumor DNA in the blood. As for most discoveries test is expensive and not precise but reassuringly has a false positivity rate of less than 1 per cent.
- Such tests, once get affordable, precise, and freely available, might herald a hopeful future for cancer—with breakthroughs in both early detection as well as late treatment ready to fight cancer at both ends.
CME INDIA Learning Edge
Spotlight on some pivotal breakthroughs in 2022
Inclisiran – Silencing the Cholesterol, Speaking up the Prognosis
- Inclisiran is a newly developed drug that helps fight high LDL cholesterol.
- Silencing PCSK9 with inclisiran is a simple, effective, and well-tolerated approach to substantially improving outcomes in patients at high risk of cardiovascular and cerebrovascular events.
- In clinical tests Inclisiran, in conjunction with statins, has shown to lower LDL cholesterol in the body by more than 50%.
- It achieves this by blocking the actions of the so-called PCSK9 protein, which prevents the recycling of LDL receptors in our body.
The wonder word – Tirzepatide
- It is a drug that promises to combat one of the most common chronic illnesses in the world: type 2 diabetes.
- Tirzepatide’s unprecedented efficacy for weight loss in patients without diabetes was the top trending clinical topic.
Tackling Post-partum depression
- Anti-inflammatory effects of allopregnanolone in human macrophages for the first time and suggest that inhibition of pro-inflammatory cytokines/chemokines may contribute to its therapeutic actions.
- It may play an integral role in the modulation of pro-inflammatory signaling across the lifespan and contribute to protection from both systemic and neuroinflammatory disease.
- It might be treatment of choice for post-partum depression as well as other inflammatory conditions.
Mavacamten emerged as a new hope
- Mavacamten markedly improves the health status of patients with symptomatic obstructive hypertrophic cardiomyopathy.
- It has made headlines in 2022.
- This new medication reduces abnormal contractions caused by genetic variants, targeting the underlying condition directly.
Severe Paralysis Curing Implants
- Now, researchers have developed a new implant that is able to reverse paralysis in patients with complete spinal cord injuries.
- The device uses specially designed electrodes, which bring the brain back into communication with the patient’s lower body.
- Epidural electrical stimulation (EES) targeting the dorsal roots of lumbosacral segments restores walking in people with spinal cord injury (SCI).
Precision Medicine illuminates
- Huge new technologies pave way for understanding genomic testing, utilization, coverage, pharmacogenomics in Clinical Guidelines, evaluating the clinical and economic Value of Sequencing-Based Diagnostic.
Overcoming organ failure with 3D-Printing Organs
- The process of 3D printing typically begins with obtaining a sample of a patient’s own cells.
- Then it is grown and expand outside the body in a sterile incubator or bioreactor. These cells are then fed with nutrients called ‘media’ and mixed with a gel that acts as a glue.
- This mixture is then loaded into a printing chamber to build tissues by building the material up layer by layer.
- We know that every organ is not compatible with every patient – this leads to a lot of shortages and long waiting lists.
- 3D-printing, specifically bioprinting, tries to step in here, and recreate these organs from the ground up.
CRISPR Gene Editing Technology that edits genomes
- CRISPR is a powerful tool for editing genomes.
- It allows researchers to easily alter DNA sequences and modify gene function.
- It has many potential applications.
- It includes correcting genetic defects, treating and preventing the spread of diseases.
- In popular usage, “CRISPR” (pronounced “crisper”) is shorthand for “CRISPR-Cas9.”
- “CRISPR” is widely considered to be one of the biggest scientific and medical advancements of the decade.
- This genome editing technology cuts DNA sequences at specific genetic locations to alter it. Cancer is one of these diseases that stems from a change in DNA.
- Researchers now hope to find a new approach to fighting this threat by altering these fraudulent DNA sequences.
- Other potential candidates for CRISPR treatment – blood disorders, blindness, diabetes, HIV and many more.
References:
- Rogula S, Błażejowska E, Gąsecka A, Szarpak Ł, Jaguszewski MJ, Mazurek T, Filipiak KJ. Inclisiran-Silencing the Cholesterol, Speaking up the Prognosis. J Clin Med. 2021 Jun 2;10(11):2467. doi: 10.3390/jcm10112467. PMID: 34199468; PMCID: PMC8199585.
- https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00763-7/fulltext
- Rowald, A., Komi, S., Demesmaeker, R. et al. Activity-dependent spinal cord neuromodulation rapidly restores trunk and leg motor functions after complete paralysis. Nat Med 28, 260–271 (2022). https://doi.org/10.1038/s41591-021-01663-
- Karagiannis, T., Avgerinos, I., Liakos, A. et al. Management of type 2 diabetes with the dual GIP/GLP-1 receptor agonist tirzepatide: a systematic review and meta-analysis. Diabetologia 65, 1251–1261 (2022). https://doi.org/10.1007/s00125-022-05715-4
- Balan I, Aurelian L, Williams KS, Campbell B, Meeker RB, Morrow AL. Inhibition of human macrophage activation via pregnane neurosteroid interactions with toll-like receptors: Sex differences and structural requirements. Front Immunol. 2022 Jul 29;13:940095. doi: 10.3389/fimmu.2022.940095. PMID: 35967446; PMCID: PMC9373802.
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