New Drug Development May End Up Replacing Morphine

Today's post from sciencedaily.com (see link below) is an interesting new development in finding effective ways to block pain signals for people like neuropathy and cancer sufferers. New research has discovered new compounds which bind to specific molecules (opioid receptors) on nerve cells. Opioids do this already but we all know the dangers of opioids and addiction and the need for ever increasing dosages. These new compounds attach themselves to a different part of the nerve cell but work in the same way without the normal opioid side effects. That's the theory anyway and as with many of these promising developments, sometimes you wish they wouldn't tell us about them until they're almost in production. Getting patients' hopes up but then letting them wait for years can be demoralising in itself. However, it does sound very promising and this is an easy to read article even though it's looking at the science at a molecular level.

A Path to Lower-Risk Painkillers: Newly-Discovered Drug Target Paves Way for Alternatives to Morphine
This story is reprinted from materials provided by University of Michigan Health System June 10, 2013

 For patients managing cancer and other chronic health issues, painkillers such as morphine and Vicodin are often essential for pain relief. The body's natural tendency to develop tolerance to these medications, however, often requires patients to take higher doses -- increasing risks of harmful side effects and dependency.

Now, new research from the University of Michigan Health System and a major pharmaceutical company has identified a novel approach to moderate and severe pain therapy that paves the way for lower dosage painkillers. The findings appear in Proceedings of the National Academy of Sciences.

Drugs such as hydrocodone (the main ingredient of Vicodin) and oxycodone (Oxycontin) are often the best options for the treatment of moderate to severe pain for patients facing medical conditions ranging from a wisdom tooth extraction to cancer. The drugs bind to specific molecules (opioid receptors) on nerve cells in the brain and spinal cord to prevent the feeling of pain.

"We have for the first time discovered compounds that bind to an alternative site on the nerve opioid receptors and that have significant potential to enhance the drug's positive impact without increasing negative side effects," says co-author John Traynor, Ph.D., professor of pharmacology at the U-M Medical School.

"We are still in the very early stages of this research with a long way to go, but we believe identifying these compounds is a key step in revolutionizing the treatment of pain. This opens the door to developing pain relief medications that require lower doses to be effective, helping address the serious issues of tolerance and dependence that we see with conventional pain therapy."

Conventional drug treatments for pain work by targeting the so-called orthosteric site of the opioid receptor that provides pain relief. Targeting this site, however, is a double-edged sword because it is also responsible for all of the drug's unwanted side effects, such as constipation and respiratory depression. Tolerance also limits chronic use of the drugs because higher doses are required to maintain the same effect.

Using cell systems and mouse brain membranes, researchers have identified compounds that bind to a physically distinct and previously unknown "allosteric" site on the opioid receptor- a site that fine-tunes the activity of the receptor. Not only do these compounds act at a location that hasn't been studied as a drug target before but they bind to the receptor in a new way to enhance the actions of morphine -- which means lower doses can have the same impact.

"The newly-discovered compounds bind to the same receptor as morphine but appear to act at a separate novel site on the receptor and therefore can produce different effects. What's particularly exciting is that these compounds could potentially work with the body's own natural painkillers to manage pain," Traynor says.

"We know that conventional strong pain medications ultimately increase the risk of withdrawal symptoms and addiction, which is an especially serious issue with the current prescription drug abuse epidemic in our country. The implications of this work, if it translates to animal studies and then to humans, are highly significant to this area of study."

http://www.sciencedaily.com/releases/2013/06/130610192553.htm

End Of A Neuropathy Era

Today's post from neuropathy.org (see link below) marks the end of an era in that it announces the end of neuropathy.org which is the site of the American Neuropathy Association. The Neuropathy Association has long been a bulwark of information for neuropathy patients throughout North America and the world and it's somewhat surprising that they are ending their operations. In fact, they are passing the torch on to the Foundation for Peripheral Neuropathy, who will continue their work; so there will continue to be a US organisation representing neuropathy patients.

A MESSAGE FROM THE PRESIDENT AND CEO
Tina M. Tockarshewsky President and CEO December 2014 – Final Edition

Dear reader,

When The Neuropathy Association started 20 years ago, our main purpose was to bring awareness and legitimacy to peripheral neuropathy, as well as to offer support and outreach to millions suffering alone in the darkness of their unrecognized disease.

Over the years, the community’s needs grew exponentially alongside our growing understanding of the complexities...and pervasiveness...of the global neuropathy epidemic. We expanded beyond the patients who founded the organization during their IVIG infusion time to include patients with all types of neuropathy, as well as the family members, caregivers, healthcare professionals and researchers dedicated to helping them. We reached out to media and policy makers nationally and locally to make sure they understood the extreme challenges our community faced due to lack of proper care, therapies, and cures. From the halls of Congress to Today show viewers’ TV screens and up into the night skies over famous landmarks, we gave neuropathy the exposure it had never had before. The ultimate goal has been and continues to be that, through research, education, and greater awareness, we would learn the causes and how to treat, prevent and/or cure the over 100 different types of neuropathy.

The Neuropathy Association and its supporters and volunteers over the years can take great pride in what we have accomplished together in two decades. And despite the fact that the search for cures continues, the milestones reached to date have been significant. Our innovative educational and social media programs have received high praise and inspired others to follow our lead. Our advocacy work resulted in appointments on high-level and influential federal government advisory councils. Our research grants program yielded significant findings, including discovering key genes for hereditary neuropathies. Our support groups comforted and counseled thousands every year. Thanks to partnerships with our community and our corporate partners, there is an ever-increasing rate of clinical trials in development...and keep in mind that ALL of the FDA-indicated therapies available today only came to market within the past 10 years!

At the end of 2007, no one anticipated the national economic downturn. At the time, the Association had just completed a major re-organization and new strategic directions, but like all other nonprofit and for profit organizations we, too, were not prepared for the national financial crisis, reduced foundation funding, or the impact of new restrictions and tighter regulations put on companies that had helped to financially support us in the past. Then followed the drastic Medicare cuts suffered by healthcare professionals specializing in neuropathies that have severely compromised their business and forced many professionals out of business...that, in turn, has hurt you as well as us.

With so many in the neuropathy community struggling...and with new times needing new approaches to getting the job done, it became mission critical for the Association to find a new way to do business...and find a new battleplan to bring our community the cures and treatments we so desperately need...

When 2015 starts this week, the new year will begin a new chapter for our neuropathy community. Recently, you received communication from us by email and mail sharing that The Neuropathy Association has decided to dissolve and close its doors, passing the torch of our mission to the Foundation for Peripheral Neuropathy. It is a bittersweet and difficult decision for us but a necessary one to move our mission forward in the new way that is necessary. Please know that our decision was a thoughtful one that was based on our commitment to high-level service for you and took into account our options according to New York law. In doing so, we have chosen a strategic partner that we fully support and trust will achieve our mutual goals in the future. The decision to close our doors is difficult, but the decision to select the Foundation for Peripheral Neuropathy to continue to work on behalf of The Neuropathy Association’s donors is the right choice. We believe the result will be a single and powerful charitable 501(c)(3) organization that will capitalize on the strengths of both organizations to better serve the neuropathy community. (See lead article below)

We encourage you to join us in supporting the Foundation for Peripheral Neuropathy as they move forward with our collective mission and continue to cultivate and grow the programs we started for you. The future is exciting and the possibilities are within our grasp...let’s seize the day and make it happen!

On behalf of the Association, I want to thank everyone who has worked with us over the years as community volunteers, support group leaders, national and chapter board members, and advisory council members...your leadership kept our mission strong for two decades. I also thank everyone who generously donated monies, time, and talents to support our programs...you helped to make us the trusted community resource millions could turn to for help. And, finally, I want to express my great thanks and deep appreciation to the staff team working tirelessly with me for so many years: Natacha Pires, director of medical and public affairs, and Paul Guidos, director of operations. 24/7/365 the staff team committed themselves to the mission of this organization and to helping as many of the 20 million Americans as they could…their work and their legacy lives on in the improvements in neuropathy patient education, the greater national awareness, and significant care improvements big and small that many of us today benefit from that were not available just a few short years ago.

In saying goodbye and closing our doors, we should all know that great work has been accomplished to move the mission forward...and we should all feel hopeful about the opportunities ahead of us. May our greatest hope for cures be realized soon, and may you continue to fight for the care and quality of life improvements you deserve. It has been my honor to fight for you over past 10 years, and thank you for the privilege of working on your behalf as your national advocate. The experiences have enriched my life, and I am grateful for every wonderful person I have met over the years, every candid conversation, and every wisdom you have taught me.

I wish each and every one of you good health and every happiness in the New Year.

Sincerely,


Tina M. Tockarshewsky
President and CEO

http://www.neuropathy.org/site/MessageViewer?em_id=15881.0

LASER DEVICE MAY END PINPRICKS FOR DIABETICS

Princeton University researchers have developed a way to use a laser to measure people's blood sugar, and, with more work to shrink the laser system to a portable size, the technique could allow diabetics to check their condition without pricking themselves to draw blood

We are working hard to turn engineering solutions into useful tools for people to use in their daily lives," said Claire Gmachl, the Eugene Higgins Professor of Electrical Engineering and the project's senior researcher. "With this work we hope to improve the lives of many diabetes sufferers who depend on frequent blood glucose monitoring."

In an article published June 23 in the journalBiomedical Optics Express, the researchers describe how they measured blood sugar by directing their specialized laser at a person's palm. The laser passes through the skin cells, without causing damage, and is partially absorbed by the sugar molecules in the patient's body. The researchers use the amount of absorption to measure the level of blood sugar.

Sabbir Liakat, the paper's lead author, said the team was pleasantly surprised at the accuracy of the method. Glucose monitors are required to produce a blood-sugar reading within 20 percent of the patient's actual level; even an early version of the system met that standard. The current version is 84 percent accurate, Liakat said.

"It works now but we are still trying to improve it," said Liakat, a graduate student in electrical engineering.

When the team first started, the laser was an experimental setup that filled up a moderate-sized workbench. It also needed an elaborate cooling system to work. Gmachl said the researchers have solved the cooling problem, so the laser works at room temperature. The next step is to shrink it.

"This summer, we are working to get the system on a mobile platform to take it places such as clinics to get more measurements," Liakat said. "We are looking for a larger dataset of measurements to work with."

The key to the system is the infrared laser's frequency. What our eyes perceive as color is created by light's frequency (the number of light waves that pass a point in a certain time). Red is the lowest frequency of light that humans normally can see, and infrared's frequency is below that level. Current medical devices often use the "near-infrared," which is just beyond what the eye can see. This frequency is not blocked by water, so it can be used in the body, which is largely made up of water. But it does interact with many acids and chemicals in the skin, so it makes it impractical to use for detecting blood sugar.

Mid-infrared light, however, is not as much affected by these other chemicals, so it works well for blood sugar. But mid-infrared light is difficult to harness with standard lasers. It also requires relatively high power and stability to penetrate the skin and scatter off bodily fluid. (The target is not the blood but fluid called dermal interstitial fluid, which has a strong correlation with blood sugar.)

The breakthrough came from the use of a new type of device that is particularly adept at producing mid-infrared frequencies -- a quantum cascade laser.

In many lasers, the frequency of the beam depends on the material that makes up the laser -- a helium-neon laser, for example, produces a certain frequency band of light. But in a quantum cascade laser, in which electrons pass through a "cascade" of semiconductor layers, the beam can be set to one of a number of different frequencies. The ability to specify the frequency allowed the researchers to produce a laser in the mid-infrared region. Recent improvements in quantum cascade lasers also provided for increased power and stability needed to penetrate the skin.

To conduct their experiment, the researchers used the laser to measure the blood sugar of three healthy people before and after they each ate 20 jellybeans, which raise blood sugar levels. The researchers also checked the measurements with a finger-prick test. They conducted the measurements repeatedly over several weeks.

The researchers said their results indicated that the laser measurements readings produced average errors somewhat larger than the standard blood sugar monitors, but remained within the clinical requirement for accuracy.

"Because the quantum cascade laser can be designed to emit light across a very wide wavelength range, its usability is not just for glucose detection, but could conceivably be used for other medical sensing and monitoring applications," Gmachl said.