A cure for AIDS coming out of BYU?
The SLTrib is reporting today that a new compound invented by Paul D. Savage, a scientist at BYU, may be able to “finally kill the HIV/AIDS virus, not just slow it down as current treatments do.” If this claim is valid, this will obviously be the biggest medical breakthrough the world has seen in a long time. Any insights or thoughts on this breaking news?
I bet it involves echinacea.
Comment by Tim J. — February 7, 2006 @ 12:12 pm
Whoa, let’s not get too excited. First of all, it is a long way from test tube to human. There are a whole host of issues to be dealt with.
I was unable to find the term “Ceragenins” anywhere. I did find this paper by Unutmaz having to do with antimicrobial peptides derived from amphibians.
It looks like what we’re really talking about is a cream or ointment that could be used in a prophylactic manner. They may hope to use the molecules systemically, but there are hurdles of efficacy and toxicity to pass. We are a long way from talking about a cure, I think.
So my impression is that it is interesting, but hyped by the Tribune. It will be interesting to see what the forthcoming paper actually claims.
Comment by Jared — February 7, 2006 @ 12:36 pm
It’s pretty early to be talking about this. The study hasn’t been published nor replicated and it is limited to the test tube phase. i.e. way far away from even clinical trials let alone a cure.
Still BYU has done some good work in medicine in the past. People might remember that the COX inhibitors were developed at BYU. Of course those were in the news the last few years due to the heart problems pain killers based on them were causing. So they were taken off the market under a big scandal over whether Merck knew about the problems.
Comment by Clark Goble — February 7, 2006 @ 12:47 pm
or Noni Juice. sprinkled over a taco salad.
Seriously, if the stuff really works, what a huge benefit to world health! Go Dr. Savage!
Comment by Chad Too — February 7, 2006 @ 12:48 pm
Clark’s right. I worked in a drug design lab for a short time and while they have all kinds of ways to quantify the activity of compounds in vitro and they even have some somewhat powerful methods to optomize a given molecule for in vitro activity, all bets are off when you move to a more complicated system. You can have a molecule that is awesome in vitro that is ineffective or impractical when you try to treat a diseased animal. You can’t really get excited about a given candidate until you have some promising results in animals.
Comment by Tom — February 7, 2006 @ 1:50 pm
A cure, and one the virus doesn’t overcome long term, may be unlikely, but a personal cream that uses that stuff would sure beat condoms as an STD prophylactic.
Comment by Steve EM — February 7, 2006 @ 3:38 pm
Funny you mention that, Steve. Another lab in my department is developing a lubricant that’s buffered to maintain a pH that inhibits transmission of HIV and other pathogens. This and some similar products are in clinical trials right now, I think. They will never be as effective a barrier as condoms, but they’ll probably be an easier sell to some men.
Comment by Tom — February 7, 2006 @ 4:01 pm
Tom, in my experience, most gals hate them too. Although you’re right, not as much as men.
Comment by Steve EM — February 7, 2006 @ 6:48 pm
The problem of finding a condomless treatment for HIV is that it would probably lead to huge increases in other diseases that are sexually transmitted. Further, as you noted Steve, given the rate of mutations in HIV, it might open the door for a later pandemic.
I’d note that most scientists investigating HIV vaccines still strongly encourage condom use. For precisely those sorts of reasons. (As well as the fact that no treatment is 100% effective – so no condoms might actually increase mutation success)
Comment by Clark Goble — February 7, 2006 @ 7:19 pm
Clark (#7): “The problem of finding a condomless treatment for HIV is that it would probably lead to huge increases in other diseases that are sexually transmitted.”
It’s pretty complicated. I’m not sure that a condomless treatment would lead to huge increases in other STD’s in the countries/areas (e.g. Africa, Southeast Asia, and poor urban areas elsewhere) where HIV is a major problem. It doesn’t seem like condom use is currently limiting the spread of STD’s in these areas to any significant extent because condoms are simply not being used. In this case, microbicidal gels would not be replacing condoms; they would mean prophylaxis where there was no prophylaxis. They would have the added benefit that women who don’t get to decide whether and under what conditions they have sex might be able to provide some measure of protection for themselves. As you rightly point out, though, you can’t ignore the potential negative consequences. Proponents of gels do the complicated estimates and calculations and conclude that the net effect would be positive. There are probably opponents who come to different conclusions. Epidemiology is outside of my area of expertise, so I couldn’t really judge who’s right.
As for the possibility that condomless prophylaxis would lead to selection of resistant strains, I’m pretty sure this wouldn’t be a problem with the gels I know about. I can’t conceive of any mutation that would make HIV resistant to inactivation in acidic environments, for example.
One more thing, a gel that would be effective at preventing transmission of HIV would also be effective to some degree against other pathogens, and it would also be spermicidal.
Comment by Tom — February 7, 2006 @ 9:14 pm
I tried to comment earlier, but my comments weren’t getting through. They were getting caught in the T&S spam filter, so the same may be true here.
Anyway, I couldn’t find the term “Ceragenins” anywhere. I found this paper by Unutmatz. It’s all in the context of a topic prophylactic.
Whether it could be used systemically or not, I don’t know, but I wouldn’t hold my breath.
Resistance after establishment of infection would be my concern. (Aside from efficacy and toxicity.)
Comment by Jared — February 7, 2006 @ 10:06 pm
Maybe this will make the AIDS cure of the Week page.
Comment by Darren — February 8, 2006 @ 1:40 am
I’ll believe it when I see it. For myself.
Comment by annegb — February 8, 2006 @ 3:37 am
Who knows, Darren, maybe it will…
However, lots of things kill HIV. Bleach for one. But nobody is going around injecting bleach into their bodies to kill HIV. Granted, after the person who has had bleach injected dies, the HIV particles *will* die, too… But that’s not the point.
Test tube results don’t always translate into real-world applications. Keep in mind, this is coming from the same state which “produced” Cold Fusion a number of years ago… (On the other hand, the Utah Teapot is a beautiful 3D model…)
All that said, if the compound *does* prove viable, more power to ‘em….
Comment by Bryan — February 8, 2006 @ 4:34 pm
Hehe. I was sort of thinking “cold fusion” when I saw the article too Bryan.
By the way — cool blog (thanks for the link, Darren). I like your tag:
Comment by Geoff J — February 8, 2006 @ 4:48 pm
BTW, on COX inhibitors, they sure beat the alternatives. People in pain management are having a fit these days.
Comment by Stephen M (Ethesis) — February 8, 2006 @ 8:36 pm
I thought though Stephen that a lot of studies have shown that the COX inhibitors don’t have a significant effect better than high doses of ibuprofen. My mom was on the COX drugs for her knee and it did have an impact on her.
Comment by Clark Goble — February 8, 2006 @ 10:46 pm
I believe the BYU group discovered the COX-2 enzyme on which the COX-2 inhibiters function. I think the 3 marketed inhibitors were developed later by Pfizer (Celebrex and Bextra) and Merck (Vioxx). COX-2 inhibitors are non-steroidal anti-inflammatory drugs (NSAIDs), not pain killers per se. I honestly think many Physicians like to call them pain killers to wash their hands of patients that probably need an opiate, but that our misguided war on drugs and screwed up culture discourages (who should care about addiction if it’s managing chronic pain).
The BYU group wasn’t looking for an anti-inflammatory per se, but rather a cancer prophylactic via COX inhibition. Older NSAIDs, such as aspirin, ibuprophen, etc, inhibit both the COX-1 and COX-2 enzymes and have a life threatening side effect of stomach bleeding if used often. The controversial COX-2 inhibitors are indeed no more effective anti-inflammatories than the older NSAIDs. The claim, sometimes disputed, for the COX-2 inhibitors was they could be used continually without worry of stomach bleeding. Then came the post launch circulatory system failure side effects for at least some of these newer NSAIDs.
Comment by Steve EM — February 9, 2006 @ 10:23 am
But the Cox-2 inhibitors only caused circulatory system failure in older patients (60+) taking quite high doses as a chemotherapy cocktail. One reason Bextra getting pulled caused such a tumult is because 10 mg a day is mostly effective in treating ankylosing spondilitis and various forms of juvenile arthritis. Patients need to take 200 mg/day of Celebrex, and often methotrexate and Enbrel to get the same benefit. As methotrexate has been linked to birth defects (even when taken by the father) and Enbrel is prohibitively expensive for those without prescription plans, there are some of us who are looking forward to a day when Bextra goes back on the market. (Though certainly not as critical as producing a cure for AIDS).
And, yes, older NSAIDS cause so many GI problems that patients have a choice of pain in the legs/back or in the stomach.
Comment by Rob — February 9, 2006 @ 12:09 pm
Sorry, not really relevant to the AIDS @ BYU discussion, just wanted to make you aware of some of the issues surrounding COX-2
Comment by Rob — February 9, 2006 @ 12:28 pm