Thursday, 22 September 2011

Drugs That Are as Smart as Our Diseases


Drugs That Are as Smart as Our Diseases



Here's a paradox. Every week seems to bring news from a research laboratory of an ingenious candidate cure about to enter clinical trials for a serious disease. Yet the productivity of drugs coming out of clinical trials has been plummeting, and the cost per drug has been rocketing skyward. The more knowledge swells, the more pharmaceutical innovation fails. What's going on?
This week's promising drug candidate is colchicine, a toxin found in Colchicum, the strange flower that comes up in the fall after its leaves have disappeared (also known as the naked lady or the autumn crocus). By attaching colchicine to a trigger that activates in the presence of a tumor, researchers at the University of Bradford in England have developed a potentially potent cancer therapy.

RIDLEY disease
John S. Dykes
Meanwhile, somebody in the pharmaceutical industry has had the bright idea of funding research on sponges, having concluded that these simple organisms cannot have survived the best part of a billion years on the ocean floor without inventing smart chemical tricks for defeating bacteria. More than 100 promising antibacterial compounds have already emerged from sponge research.
Genetics is also a big part of our golden age for possible new cures. Reading the genes of pathogens and cancer cells helps to identify targets for therapy, and gene sequencing has gotten cheaper far faster than would be predicted by Moore's Law, which famously holds that transistor density on a silicon chip doubles—while the cost halves—every two years.
But the very opposite of Moore's Law is happening at the downstream end of the R&D pipeline. The number of new molecules approved per billion dollars of inflation-adjusted R&D has declined inexorably at 9% a year and is now 1/100th of what it was in 1950. The nine biggest drug companies spend more than $60 billion a year on R&D but are finding new therapies at such a slow rate that, as a group, they've little chance of recouping that money.
Meanwhile, blockbuster drugs are losing patent protection at an accelerating rate. The next few years will take the industry over a "patent cliff" of $170 billion in global annual revenue. On top of this, natural selection is producing resistant disease strains that undermine the efficacy not only of existing antibiotics and antivirals but (even faster) of anti-cancer drugs. Many people believe that something is terribly wrong with the way the industry works.
The problem, some think, is that science—to mix clich├ęs—is scraping the bottom of the biological barrel after plucking the low-hanging fruit. Others say that generations of research biochemists have led each other into an intellectual cul-de-sac. This may be right. Human biochemistry is supremely intricate and robust. It employs redundancy and network complexity to achieve these features, so it's unlikely to be changed easily by the simple or solitary molecules that have been deployed to achieve most of our cures.
On this view, the goal of most pharmaceutical research—identifying a "target" for drug action—is misconceived. Biochemical networks are designed to work around the loss of any one node: "There is no single soldier we can shoot whose demise would significantly affect the performance of the army," says Malcolm Young of the drug-discovery firm e-Therapeutics.
Drugs must be designed to nudge whole networks rather than single targets. For instance, to develop a treatment for the hospital infection Clostridium difficile, e-Therapeutics drew a sort of spider's web of how all the proteins on the outside of the bacterium interacted. From that web, they identified crucial nodes in the network and, by trial and error, selected a combination of molecules that could attack those nodes.
A similar approach is showing promise for cancer and even neurological disease. It means hitting multiple targets simultaneously, the targets chosen by network analysis. Where diseases are complex, the cures will be complex, too.

Courtesy - WSJ

Wednesday, 21 September 2011

WHO says $1.20 a person could curb chronic diseases


WHO says $1.20 a person could curb chronic diseases

The World Health Organization (WHO) headquarters are pictured in Geneva November 9, 2009. REUTERS/Denis Balibouse

LONDON | Sun Sep 18, 2011 5:36pm EDT

(Reuters) - Poorer countries could introduce measures to prevent and treat millions of cases of cancer, heart disease, diabetes and lung disease for a little as $1.20 per person per year, the World Health Organization (WHO) said on Sunday.
In a study released on eve of the first United Nations high-level meeting on chronic, or non-communicable diseases (NCDs), the WHO said there are many cheap steps governments could take to stem a tide of expensive-to-treat, life-threatening diseases which could bankrupt health systems.
Non-communicable diseases -- such as heart attacks and strokes, cancers, diabetes and chronic respiratory disease -- account for more than 63 percent of all deaths worldwide, killing 36 million people a year.
The WHO predicts that the global NCD epidemic will accelerate in the next two decades so that by 2030 the number of deaths from these diseases could reach 52 million a year.
NCDs are often thought of as diseases of the wealthy world, where fatty foods, sedentary lifestyles and high consumption of tobacco and alcohol have become part of normal life for many.
But in recent decades such risk factors and illnesses have become far more prevalent in poorer nations, where access to doctors and medicines is limited, and knowledge on and commitment to prevention is patchy.
"Nearly 80 percent of these deaths (from NCDs) occur in low and middle income countries," said Ala Alwan, the WHO's director for NCDs and mental health. "The challenge to these countries is tremendous, but this study proves that there are affordable steps all governments can take to address non-communicable diseases."
The WHO's list of recommendations includes measures that target whole populations, such as excise taxes on tobacco and alcohol, legislating for smoke-free indoor workplaces and public places, as well as campaigns to reduce levels of salt and trans fats in foods, and public awareness programs about improving diets and increasing physical activity.
Other steps include screening, counseling and drugs for people at risk of heart disease, cervical cancer screening and hepatitis B immunization to prevent liver cancer.
The two-day UN meeting, starting on September 19 in New York, is the only second-ever such high-level meeting to be held on a threat to global health -- the first was a decade ago on HIV/AIDS -- and has been billed as a "once in a generation" chance to tackle the predicted wave of NCDs.
In a separate study released on Sunday, the World Economic Forum said the global economic impact of the five leading NCDs -- cancer, diabetes, mental illness, heart disease, and respiratory disease -- could reach $47 trillion in the next 20 years if nothing is done to prevent them.
Alwan said the WHO's recommendations would "help countries with limited resources work out what the 'best buys' are and what they will cost."
"Implementing them would save literally millions of lives over the next 15 years," he added.

Courtesy - Reuters