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Photographs: John Curtis
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Attacking a tumor’s longevity via telomerase
Telomerase, the protein that keeps cells alive by adding new bits of
DNA to chromosomes, may be a target for treatment against cancer, according
to David R. Corey, Ph.D., an associate professor of pharmacology
and biochemistry at the University of Texas Southwestern Medical Center
in Dallas. At Cancer Center grand rounds in March, Corey suggested that
oligonucleotides could inhibit telomerase, which is found in 80 percent
of solid tumors.
Although its normal job is to repair telomeres, which maintain chromosomes,
telomerase confers a kind of immortality on tumors. Corey found that certain
oligonucleotides, small clusters of nucleic acids, caused tumor cells
to grow more slowly and eventually die. When the oligonucleotides were
withdrawn, the tumor cell grew at a normal rate.
“You would not ever think about giving a telomerase inhibitor as
a primary treatment to try to shrink the tumor,” Corey said. “Instead,
after initial chemotherapy and radiation, you would remove most of the
tumor volume and then start treating with telomerase inhibitors and hope
that, in combination with other drugs, they would help keep the tumor
from recurring.”
Smallpox an unlikely threat, says Horstmann lecturer
When smallpox reached the New World, it quickly decimated the indigenous
population, said John M. Neff, M.D., professor of pediatrics at
the University of Washington and the Children’s Hospital in Seattle. A
similar, devastating outbreak is unlikely today, Neff told an audience
in April for the Dorothy Horstmann Lecture at pediatric grand rounds.
With the disease eradicated since the 1970s, Neff said, the threat would
come from misuse of stores of smallpox under guard in Russia and the United
States or from rogue countries that might have obtained the virus. The
possibility that these nations or groups have the virus is circumstantial,
said Neff, who studied smallpox for the U.S. Public Health Service in
the 1960s and ’70s. Furthermore, he said, its use as a bioterrorist agent
would backfire. “It won’t be contained in any one country.”
Neff expressed a greater concern over the risks of vaccination.
Neff called for destroying all remaining samples of the virus. “I
don’t think the gains of keeping it around outweigh the gains of getting
rid of it, and to destroy it makes a very positive statement to the rest
of the world,” he said.
From the right, a different take on bias in medicine
The same day that Sally Satel, HS ’88, spoke on political correctness
at the medical school, an Institute of Medicine (IOM) report alleging
racial and ethnic bias in medicine hit the news. The report was, for Satel,
a practicing psychiatrist and a fellow of the American Enterprise Institute,
a perfect example of what she feels is going wrong with medicine. “I
worry that residents,” she said, “are sometimes being taught
to see patients as members of victim groups rather than individuals.”
Political agendas, from both the right and left, she said, are fueling
misperceptions about medicine.
“No one is debating that there are health disparities or, in certain
situations, different uses of certain procedures,” Satel told an
audience at a Program for Humanities in Medicine lecture in March. “But
the IOM report managed to leave out some studies that showed comparable
outcomes in blacks and whites.” More important, there are almost
no data comparing the treatment of minorities by minority doctors and
white doctors, she said.
“Alleging prejudice on the part of doctors with so little evidence
is inflammatory and engenders distrust of the medical profession,”
said Satel, author of PC, M.D.: How Political Correctness is Corrupting
Medicine.
Technology as a weapon against suffering
During his 28 years as a biomedical engineer, Robert S. Langer,
Sc.D., has received four honorary doctorates, published 700 articles and
is the only active member of all three national academies: the Institute
of Medicine, the National Academy of Engineering and the National Academy
of Sciences. Yet the acknowledgement of his work that reached the widest
audience came not from the academy, but from a popular television show—ER.
An episode two years ago featured a “chemotherapy wafer” that
was implanted into a character’s brain to treat a tumor. The device is
one of many to come out of Langer’s lab at MIT, where he develops drug
delivery devices and polymer scaffolds on which to build replacement tissue.
“Drug delivery and tissue engineering are still at an embryonic stage,”
he told an audience in April at the Yale Engineering Sesquicentennial
Distinguished Lecture Series. “There are so many things we don’t
know. It is my hope that scientists, engineers and clinicians will be
able to develop new principles to try to create new technologies and entities
that will relieve suffering and prolong life.”
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