August 1, 2011

A Sugar-Coated Pill That Helps Fight Infection?

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August 1, 2011
Bottom Line's Daily Health News
In This Issue...
  • Turn Off Your Pain with 3 "Miracle Drops"
  • A Sugar-Coated Pill That Helps Fight Infection?
  • Are You or Your Loved Ones Taking Any of These Highly Prescribed Medicines?
  • You Could Go Deaf (After Taking ED Drugs)!

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A Sugar-Coated Pill That Helps Fight Infection?

Have you ever been plagued by an infection that felt as if it would never go away? They’re known as recurrent infections because of their unerring ability to outsmart the medicines intended to do them in. I am reminded of a colleague who developed a painful urinary tract infection (UTI) last year. After five or six days, it appeared to have gone, but in what was to become a recurring pattern, a UTI showed up again a month later, leading to another round of antibiotics. That course of antibiotics seemed to stop the infection, until, boom, a few weeks later, yet another infection developed. It took my friend months for complete recovery. We all know about the growing problem with antibiotic-resistant bacteria, but that’s not what was going on in this case.

There is now an explanation as to why these infections return again and again. And tantalizingly, there is a new study with mice that shows how a very common substance may help quickly resolve these infections the first time around.

Persistent, Not Resistant

The study I’m referring to was conducted by James Collins, PhD, professor of Biomedical Engineering at Boston University. He is a Howard Hughes Medical Institute investigator and recipient of a MacArthur Fellowship (sometimes called a MacArthur "genius grant"). But before we get to those findings, a bit of bacteria background is in order. Dr. Collins explains that while doctors studying infectious diseases have focused their attention on antibiotic-resistant bacteria for a number of years, it is only in the last few that they started paying attention to another type of bacteria that they’ve tagged as persistent bacteria. Here’s the difference -- regular bacteria become resistant because they mutate genetically in response to an antibiotic, thus making it increasingly difficult to create drugs that will be successful in getting rid of them. Persistent bacteria, on the other hand, do not mutate but have a physiological ability to become dormant -- in effect to go to sleep for a period of time. Familiar infections known to be associated with persistent bacteria include strep, tuberculosis, staph and many more.

When persistent bacteria are slumbering, they are invulnerable to antibiotics. This means that the medicine you take for an infection will wipe out the majority of the bacteria causing the illness, but not the few persisters, as they are called. Later, for reasons not yet understood, certain persisters activate and cause new infection -- and require another round of antibiotics. Persisters are nothing if not canny adversaries... a few will continue to remain asleep and invulnerable, ready to "wake up" later.

Waking All Persisters

Now, if there were some way to rouse all of the infection-causing bacteria into an active state at the same time, one course of common antibiotics would wipe out the whole bunch. The challenge, then, is to find a substance that would wake them all -- and this is where Dr. Collins’s research comes in. Dr. Collins discovered that if he added sugar to antibiotics, all persisters were activated so that they could no longer evade the antibiotics. His finding was robust indeed -- when he administered antibiotics with sugar through an IV to mice with E. coli bacteria, a common cause of UTIs, the antibiotics wiped out 99.9% of the persistent bacteria in just two hours, compared with eliminating none of the persistent bacteria in the mice whose antibiotic IV did not include sugar.

A Rare Win-Win?

The next step is to test the method with humans. Success, if it comes, could have important implications for treating resistant bacteria as well as persisters. It is quite possible that some cases of seemingly resistant bacteria are actually caused by persisters. Having a strategy to kill all persistent bacteria with just one round of antibiotics would dramatically reduce the usage of antibiotics, and that in turn would help slow development of resistant bacteria -- a real (and rare) win-win in our ongoing fight against bacteria. Dr. Collins says that combining sugar with an antibiotic is such a simple potential treatment that he is hopeful human studies will move ahead quickly. Many questions must be answered -- including whether there are persistent bacteria that would not be awakened by sugar... and whether sugar itself might worsen certain infections, for example, yeast infections. We’ll keep our eye on this research.

Source(s):

James Collins, PhD, professor of biomedical engineering at Boston University and a Howard Hughes Medical Institute investigator.



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You Could Go Deaf (After Taking ED Drugs)!

Remember the hilarious scene from the movie Something’s Gotta Give? Jack Nicholson, in the hospital with a suspected heart attack, refused to admit that he had taken Viagra... until the doctor began listing all the dangerous side effects. I thought about that scene when I read the research report I am about to share with you -- imagining it rewritten so that the doctor is talking away but the patient can’t hear a thing! Because it turns out that there is yet another nasty potential side effect of ED drugs like Viagra -- total hearing loss. While these drugs already carry a black-box warning stating that "sudden decrease or loss of hearing has been rarely reported," experts think the problem is serious enough to warrant further warnings from doctors.

What Did the Research Say?

Researchers in London just released a study that gathers information about 47 cases of sudden hearing loss associated with use of ED drugs -- and more with sildenafil (Viagra) than the others -- in North America, Europe, East Asia and Australia. If you find that number of cases underwhelming, you’ll want to know that this study left out 240 apparent cases that occurred here in the US because the researchers didn’t have sufficient detail. What’s different from the earlier warning: This study focused specifically on sudden sensorineural hearing loss (SSHL). It’s rare, but it can be devastating in that it sometimes results in permanent hearing loss.

It’s thought that SSLH is sometimes caused by a head trauma or infection, but in most cases, it seems to come out of nowhere. The London researchers looked exclusively at cases of SSHL that developed within 24 hours of taking an ED drug -- two-thirds of the total. Statistically, one-third of the victims of this condition never regain their hearing.

24-Hour Connection

I called otolaryngologist Eric Smouha, MD, director of otology and neurotology at The Mount Sinai Medical Center in New York City to learn more about the connection between ED drugs and SSHL. In his view, the association is inconclusive, though he did agree that the fact that all these men experienced hearing loss within 24 hours of taking the drugs was "pretty compelling."

He told me that further research is required to answer some important questions, specifically ...
  • Which of the drug users are at greatest risk for SSHL -- regular, occasional or first-time users?
  • Is there any physical condition that would put someone at higher risk?
  • Why did SSHL develop most often after men (and the occasional woman) took Viagra rather than one of the other drugs?
Until these questions can be answered, Dr. Smouha urges anyone who uses or is considering using Viagra or another ED drug to check with his doctor and bring up the question of effects on hearing.

And no doubt we will all be hearing much more about SSLH and ED drugs in the next few years, says Dr. Smouha. Even though the numbers of people currently known to be affected are small, this report is giving the problem a higher profile, and drug surveillance agencies around the world are going to take note. Once they start looking, who knows what they might find?

Source(s):

Eric Smouha, MD, director of otology and neurotology at The Mount Sinai Medical Center, New York City.


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Be well,


Carole Jackson
Bottom Line's Daily Health News


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