APE OF GOOD HOPE Self-medicating Uganda chimps may hold the key to new drugs
By Lucie Peytermann, Agence France-Presse
KAMPALA Ugandan and French scientists have for months been observing the behavior of a group of chimpanzees whose uncanny aptitude for self-medication could help their human cousins discover new drugs. The great apes' ability to treat ailments by adjusting their diet has long been observed by scientists, including world-renowned primatologist Jane Goodall, but a project in Uganda's Kibale forest offers a unique opportunity for pharmaceutical research. "It's the first time that a chimpanzee observation aimed at discovering new medicine for humans is conducted within a scientific framework," said Sabrina Krief, a French veterinarian and professor at the Paris National History Museum. Uganda is an ideal research ground for the scientists' double mission of better understanding the chimps' behavior and using them as guides toward new molecules-and potentially new drugs. "Uganda happens to be a country where eight of the 16 centers of endemic plants in the whole of Africa converge," said John Kasenene, professor of botanics at the University of Makerere in Kampala. The university is conducting the project in partnership with the Natural History Museum in Paris, France's National Center for Scientific Research, and the Uganda Wildlife Authority. Should a new drug be discovered through the project, the memorandum of understanding signed by all the partners includes a revenue-sharing clause. The Kibale equatorial forest, located some 250 kilometers west of the capital Kampala, offers a high concentration of primates. "There are very few research stations in the world where chimps have been so well accustomed to being in the presence of human observers," said Krief, who heads the chimp project there. The key moment in the observation is when one among the group of around 50 chimps she monitors gets sick. The primate's choice of food-what he pulls out of his medicine chest-is packed with information that could lead the scientists to new discoveries. "We want to compare which plants are used by the traditional healers or traditional practitioners, and the medicines used by chimpanzees. Is there a relation for the kind of treatment they go for?" Kasenene said. At dawn the team collects the animal's feces from under that night's nest and carry out a range of analyses. Krief explained how a chimp named Yogi, suffering from intestinal worms, ingested Aneilema aequinoctiale leaves in the morning and Albizia grandibracteata bark in the evening. Such plants have been used in traditional medicine in some areas and the Kibale team later confirmed through in vitro testing that they acted against parasites. Another male chimpanzee who had been feverish and weak was observed eating only Trichilia rubescens leaves for a whole day. The plants' molecules, later isolated by the scientists in a laboratory, were found to be effective against malaria. "These findings have allowed us to discover new plant molecules with significant properties against malaria, worms, or tumors," Krief said. Dennis Kamoga, a botanics researcher from Makerere University, is tasked with collecting samples from plants ingested by chimps that will later be analyzed in both France and Uganda. "What is surprising to me is that these chimps have no chemist, no lab.... They simply move in and collect plants and eventually find themselves getting cured," the 27-year-old marveled. "It's a proof that they are very close to us." Around 100 different kinds of plants have already been sampled in Kibale since the start of 2007. "It's quite rare to find active molecules but especially new molecules which might put us on the path to developing new pharmaceuticals," which is the ultimate goal of the project, Krief said. The French scientist said she hoped that, while advancing medicine for humans, the research project in Kibale could also contribute to "a better understanding and protection of the flora and the great apes" in the forest, both of which include critically endangered species.
Language enrichment Agnostication, blamestorming, and testiculation are just some of the new medical slang PARIS Doctors have always used a tribal vocabulary to communicate between themselves, but now their secret lingo is being enriched by the electronic media and urban slang. Paul Keeley, a consultant in the department of palliative medicine at Glasgow Royal Infirmary in Scotland, wrote in the British Medical Journal (BMJ) a sampling of new words that British doctors use among themselves. They include: o Disco Biscuits. The clubbers' drug ecstasy. As in: "The man in cubicle three looks like he's taken one too many disco biscuits." o Hasselhoff. Term for any patient who shows up in the emergency room with an injury for which there is a bizarre explanation. Source: Baywatch actor David Hasselhoff, who hit his head on a chandelier while shaving. The broken glass severed four tendons and an artery in his right arm. o Agnostication. A substitute for prognostication. Term used to describe the usually vain attempt to answer the question: "How long have I got, doc?" o Blamestorming. Apportioning of blame after the wrong leg or kidney is removed or some other particularly egregious foul-up happens. o 404 Moment. The point in a doctor's ward round when medical records cannot be located. Comes from Internet error message, "404-document not found." o Testiculation. Description of a gesture typically used by hospital consultant "when holding forth on subject on which he or she has little knowledge." Gesture is of an upturned hand with outstretched fingers pointed upwards, clutching an invisible pair of testicles. Other slang used by doctors, according to past letters to the BMJ, include UBI (for "unexplained beer injury"), PAFO ("pissed and fell over") and Code Brown, or a fecal incontinence emergency. CTD means "circling the drain," GPO signifies "good for parts only" and "Rule of Five" means that if more than five of the patient's orifices are obscured by tubing, he has no chance. A patient who is "giving the O-sign" is very sick, lying with his mouth open. This is followed by the "Q-sign"-when the tongue hangs out of the mouth-when the patient becomes terminal. As for genetic quirks or inbreeding, FLK means "funny-looking kid" and NFN signifies "normal for Norfolk," a rural English county. General practitioners may use LOBNH ("lights on but nobody home") or the impressively bogus Oligoneuronal to mean someone who is thick. But they also have a somewhat poetic option: "Pumpkin positive" refers to the idea that the person's brain is so tiny that a penlight shone into his mouth will make his empty head gleam like a Halloween pumpkin. M AFP
What's in a name? Medics joust over naming diseases after their discoverers PARIS Strange but true: If you are a doctor, one of the greatest honors to which you can aspire is to have a nightmarish disease named after you. Hundreds of so-called eponyms dot the medical textbooks, enshrining the name of a man or woman (Alzheimer, Parkinson, Hodgkin and so on) who became the first to identify some horrible ailment, describe symptoms, or devise a new diagnostic test. But the time-honored practice is under threat, judging by a fierce debate in the recent issue of the British Medical Journal. Antieponymists are lobbying for the tradition to be given the elbow. Names, especially when it comes to obscure conditions or procedures, can sow confusion and often are historically untruthful, wrote British renal physician Alexander Woywodt and American rheumatologist Eric Matteson. Many doctors are unable to remember what an eponym stands for, and some eponyms are understood differently by different people, they say. For instance, de Quervain's disease can mean either an inflammation of hand tendons or a rare thyroid disorder. And, said Woywodt and Matteson, some names are quite inappropriate, for they fail to honor others who contributed to the medical breakthrough or are tainted by history. This is the case of Hans Reiter and Friedrich Wegener, who are remembered respectively for the discovery of a form of arthritis and a skin infection called granulomatosis. Reiter took part in atrocious Nazi experiments on humans, while Wegener was a student of the Nazi doctrine of racial "purity." Nonsense, retorted proeponymist Judith Whitworth, director of the John Curtin School of Medical Research in Canberra, Australia. Eponyms bring color, tradition, and culture to medicine-and also provide a useful shorthand. "Do we really want to speak of congenital cyanotic heart disease due to ventricular septal defect, pulmonary stenosis, right ventricular hypertrophy, and aortic dextroposition rather than Fallot's tetralogy?" she asked. "Eponyms are here today to stay," she said. In other words-it's Hobson's choice. AFP
The other options Is there a room for complementary and alternative treatments in cardiovascular-disease management?
Mabelle Aban, Contributing Writer
In cardiovascular care, there are a lot of proven interventions, ranging from medicines to surgery to lifestyle modification. But even with the whole range of choices that patients have, some still go out and try complementary and alternative medicine (CAM.) "CAM is described as a group of diverse medical and health-care systems, practices, and products that are not presently considered to be part of conventional medicine," said Dr. Eugene Reyes in a presentation on the available CAMs in the country during the 2007 Philippine Heart Association annual convention. He also differentiated complementary from alternative medicine. "Complementary medicine is used together with conventional medicine," he explained. An example of this is the use of aromatherapy to help lessen patient discomfort following surgery. Alternative medicine is when one uses a food believed to treat hypertension instead of the drug that has been recommended by a doctor.
There are CAMs that involve mind-body interaction, such as meditation (yoga), mental healing, and prayer, which are all potentially effective. Reyes said it has been shown in a randomized study that prayer is "really effective." There are also manipulative and body-based interventions, which include chiropractic, osteopathic medicine, and massage. "They are considered complementary, not alternative," Reyes said. There are also energy treatments, like the toning of water, which is currently still being studied. Lastly, there are the "biologically based treatments, which use substances found in nature, such as herbs, foods, and vitamins. Examples include dietary supplements, herbal products, and the use of other so-called 'natural' but as yet scientifically unproven therapies" for cardiovascular conditions. When a certain product, be it a food supplement, any substance or therapeutic intervention, claims effectiveness and safety, there has to be enough evidence, said Reyes. Some may present anecdotes, case reports, and observational studies as evidence. However, these are not enough. "We base our treatments solely on randomized control trials (RCTs)," he said, adding that RCTs serve as the gold standard in determining treatment protocols. Among the biological interventions, only the omega-3 fatty acid is now classified under the list of conventional therapies after being subjected to numerous high-quality RCTs. Omega-3 PUFA has been adopted as a conventional therapy for post-myocardial infarction to reduce risk for … cardiovascular death, said Reyes. Reyes said that minerals such as potassium and magnesium are not alternative treatments, but complement the "way we treat cardiovascular disease, especially hypertension." He noted that while there are no RCTs, there are at least 30 observational studies documenting that a diet low in potassium is associated with hypertension. In the Dietary Approaches to Stop Hypertension (DASH) trial, for instance, potassium was used in the active intervention arm, "but this was not controlled." Long-term RCTs with sufficient sample size on magnesium are also needed, he said. Several RCTs have been done on coenzyme Q10 on hypertension and its specific blood-pressure-lowering effects. Said Reyes: "It was able to drop BP (systolic) from 165 to 147. The problem is that, if you take it, it is more expensive than the conventional treatment that we are using. For angina, it's still under question. For cardiomypathy and heart failure, there are … conflicting data. So I suggest that we need better research in evaluating coenzyme Q10." Similarly, upon evaluating the reported cardiovascular benefits of taurine and vitamin C, Reyes stressed the need for more data to support their claimed benefits. With regard to vitamin E, he said: "For skin beautification, it is effective, but not for preventing CV disease." This is in reference to the studies that "revealed no clinical relevant effect on BP in hypertensive patients already under controlled treatment." Used by many body builders, L-arginine (NO2) is used by some to help lower blood pressure. In one available RCT on hypertension, it led to a minimal drop in systolic pressure. Reyes noted that in the VINTAGE MI study, which studied post-myocardial infarct patients, the subjects were given up to three grams of L-arginine per day. However, there were six deaths in the L-arginine arm and no deaths in the placebo arm, so the study was stopped prematurely. "So be careful with food supplements containing L-arginine," Reyes warned.
With regard to botanicals and herbs, the one most commonly thought of as "cardioprotective" is garlic. Several RCTs have been done on the use of garlic for cardiovascular diseases, control of hypertension, and cholesterol lowering. However, "there is controversy regarding the effect, because some studies show a drop in BP, some [show] no effect at all," he said. Studies that looked into its LDL-lowering effect, meanwhile, did not show garlic's efficacy. Another commonly used herb is hawthorn. Hawthorn supposedly exerts a mild blood-pressure-lowering effect, and as shown in one RCT, "it's effective." Still, Reyes stressed that this is a small RCT, and "no long-term trial has been done yet." Another popular herbal medicine is sambong, which is believed to treat hypertension and it is noted to induce diuresis among patients. With only a single local RCT behind it, it was shown not cause a significant reduction in blood pressure. Of the 167 herb records as of September 2005, only a few have RCTs. Said Reyes: "There is a need for more studies to document the effectiveness and safety of these herbs and herbal extracts." He also wanted to emphasize that "natural is not equivalent to safe." These herbal products may contain substances that may cause adverse effect when taken in or when it interacts with other substances. Effects of toxicity should also be another concern. He concluded: "The overall quality of RCTs and evidence for herbal medicine and alternative medicine are poor but improving. The benefits of alternative and herbal medicines as part of the treatment for cardiovascular diseases are still controversial."
This chimp remembers TOKYO Young chimpanzees have an extraordinary memory that is far better than that of adult humans, a Japanese study said. The research, published in Current Biology, said young chimpanzees can remember numbers flashed on a computer screen after just one glance. The researchers, led by Prof. Tetsuro Matsuzawa of the Primate Research Institute at Kyoto University, said the findings suggested that humans lost a similar ability in order to gain other skills. "The capacity of the brain is limited. Perhaps humans gave up older skills in order to acquire new skills, such as languages," Matsuzawa said. "Maybe the same is true as youngsters become adults," he said, noting that chimps' memory capability declined with age. The young chimps are considered to have "eidetic imagery," or the capability to retain an accurate, detailed image of a complex scene or pattern. In the multiyear study, the team looked at three pairs of chimpanzees-three mothers and their offspring born in 2000-and tested them against nine human university students. The apes were taught the order of single-digit Hindu-Arabic numerals and then tested on how they could remember them when displayed in random combinations. The team flashed the numbers "1" through "9" on a screen at various time intervals-0.65 seconds, 0.43 seconds, and 0.21 seconds. The numbers were then replaced by blank squares and the subjects were asked to use the touch-screen to mark the original order. The young chimpanzees performed better than the university students in both speed and accuracy even when they are interrupted by loud noises, the study said. "Humans were slower than all of the three young chimpanzees in the response," it said. "In general, the performance of the three young chimpanzees was better than that of the three mothers." The study is the latest confirming the high intelligence of chimpanzees, who are among humans' closest relatives. Washoe, a chimp who could communicate 250 words in sign language and was considered the first animal to crack the language barrier with humans, died at age 42 in October in the United States. AFP |
