Resistance Fighters

By John McCormick

THERE IS SO MUCH HAPPENING in science that I never have the slightest need to dig up some obscure discovery to write about here or elsewhere. Should I look into the NASA warp drive engine that violates Newton’s laws by not having a reaction mass? Should I write about the latest space telescopes and the number of new planets being discovered? How about the death of one-third of the Great Barrier Reef east of Australia? Or perhaps it’s time to look at Dark Matter again?

This time I want to explore some smaller or less-well-covered stories that have a more direct impact on your daily life because, let’s face it, although inventing a reactionless space drive is right up there with cheap fusion power for the next century it has absolutely zero impact on your real world life; nor does the discovery of new planets or what happens to the coral off the north shore of Australia.

How about drug-resistant bacteria and the lack of new antibiotics? Or, perhaps a way to determine if a loved one is really brain-dead or might recover from a brain injury? Or a way to treat the common cause of hospital death, a sepsis infection?

You probably didn’t hear about any of those discoveries that occurred in the past few weeks because CNN is busy with election blather and the death of an endangered animal in an Ohio zoo.

So, in this issue I’m going to look at science that has an immediate impact on almost everyone’s life, either directly or through friends and extended family, because who doesn’t know someone with a family member who has cancer, is in a hospital, or has a serious head injury?

Lacking Empathy

We’ll start off with an easy one; does a common pain medication make people insensitive to others?

What we call empathy is simply the ability to feel for what some other person or animal is going through in a tough time, either physically or emotionally, and it is probably the greatest civilizing factor that doesn’t result in massive killings in the name of some tribal god image.

Everyone sees the ever-lowering standards of civility in the United States and around the world, but now Ohio State University (OSU) researchers may have found a major cause; it is a simple painkiller—acetaminophen (paracetamo), also known as Tylenol, has been shown to reduce empathy in a placebo-based double-blind experiment.

Simply put, the study, published online in the journal “Social Cognitive and Affective Neuroscience,” indicated that student volunteers showed less concern over other people’s pain when they had taken Tylenol.

Another study at OSU demonstrated that acetaminophen intake also blunts positive emotions such as joy.

This finding, although not new, is important because each week nearly one-quarter of Americans take something that includes acetaminophen, and empathy is a civilizing influence—you may know it as The Golden Rule—“do unto others, etc.”

Acetaminophen is the most common drug used in the U.S. (and likely in many other countries) and, according to “Science Daily,” is found in more than 600 other medicines besides those labeled as the pain killer.

So, does your spouse, friend, neighbor, political leader ... act as if he or she didn’t really care how you feel? If so, the answer could be not that they are basically unfeeling and totally lack empathy, but that he or she had a muscle ache or headache and took a Tylenol.

But this shouldn’t be a major surprise because it was already known that specific areas of the brain are involved in empathy, so it is reasonable to expect chemicals that alter brain activity could affect the feeling of empathy.

The “Oxford Journal of Social Cognitive and Affective Neuroscience” stated as far back as 2011, “Empathy for the social suffering of friends and strangers recruits distinct patterns of brain activation”—in plain English, that means functional magnetic resonance imaging (fMRI) studies showed that people's brains actually showed certain activity when they were feeling empathy (affective pain regions).

Ibuprofen is now being studied at OSU to see if that NSAID (non-steroidal anti-inflammatory drug) also has the same effect on empathy.

But it is important to realize this isn’t a new result; there are a number of similar studies in the literature. Such as this article from “Psychological Science.” Or this article by C. Nathan DeWall and others.

Pull the Plug? Or Pray for a Miracle?

One of the biggest challenges facing doctors and patient relatives in hospitals is when or if you should remove life support from a comatose patient.

It turns out that an already common tool, positron emission tomography (a PET scan), can now be interpreted to determine which unconscious patients are actually brain-dead (vegetative state) or merely unconscious but with minimal brain activity as shown by the traditional method, an EKG that measures relatively strong electrical activity in the brain.

“This is really cool what these guys did here,” says neuroscientist Nicholas Schiff of Cornell University, who was not involved in the study. “We’re going to make great use of it.”

A PET scan actually generates antimatter (technically known as radionuclides in medical applications) in incredibly tiny quantities that can be used as a tracer. The positrons (positively charged antimatter equivalent of electrons) decay over a short period of time releasing gamma rays that are easily detectable.

A common PET scan tool that uses a fluorodeoxyglucose (FDG) tracer shows changes in the glucose (sugar used by the body’s cells and an indication of activity due to energy consumption) levels of the brain.

Unlike many clinical tools, PET scans are relatively simple and easy to conduct but previously they were used to detect disease—these new results show they can also indicate very low levels of brain activity.

The new study of 131 patients showed that the PET scan data could correctly distinguish between minimal consciousness and severe unresponsive wakefulness with eighty-nine percent accuracy.

This is an incredibly new tool helping both doctors and families determine which patients have any potential for eventually waking up.

Antibiotic Resistant Bacterial Infections

Today it is estimated that 700,000-plus people die each year from a bacterial infection caused by antibiotic resistant bugs. And the number of such deaths could surpass those caused by cancer by the year 2050, according to a just published British study.

As anyone with any background in biology, even just a passing grade in high school, certainly should know that antibiotics such as penicillin, can’t have any effect on the flu or common cold virus, and therefore shouldn’t be given to anyone with those or any other viral disease, even life-threatening ones.

Antibiotics are totally ineffective against cancer or even prion diseases; nevertheless, it is difficult to hold a crying and obviously suffering child and not demand the doctor do something. So parents often pressure doctors to give little Judy or Johnnie a shot of antibiotics, thereby slightly but inevitably reducing the effectiveness of that antibiotic to cure really dangerous bacterial diseases.

Additionally, tons of antibiotics are fed to food animals in modern agriculture and some of that goes into the food chain and into the food you consume. Even if it didn’t, it still helps create superbugs.

Why do they do it? Simple; while animals can live healthy lives on the open range, crowd them into pens and make them live in filth and you have to medicate them to keep them healthy. In the quest for a decent profit, ranchers also feed antibiotics routinely to healthy animals because they grow up to five percent faster.

Because people tend to care more about the cost of beef or poultry than about how the animals live, this practice keeps prices low. Ranchers, who probably don’t show a two percent profit normally, must do everything legal they can to stay in business.

(I used to raise organic beef and mutton with a total consumption of antibiotics nearly reaching one dose per year, not per animal, but over hundreds of sheep and a dozen head of beef. See my book, “Sheep in the Rafters,” if you want more details. Click on the link in the sidebar on the right.)

What happens is that antibiotics kill off the weak bacteria, leaving only the strongest or most antibiotic resistant to multiply; we, as a civilization, have almost come to the point where the miracle of antibiotic medicines that fight infections has ended, less than a century since it began.

We have done this to ourselves.

It is too late to reduce the use of these miracle chemical compounds. Stopping their overuse is essential.

What we need is a more structured approach to using antibiotics and rapid development of new varieties that must be carefully guarded and only used when the human immune system can’t cope with an infection.

Manufacturing new antibiotics has been a very expensive and difficult challenge. But only a few weeks ago, according to “Science Magazine,” some Harvard researchers “described a powerful way to make new variations on the widely-used class of antibiotics known as macrolides,” and formed a new company to pursue the new science.

The traditional procedure, with no real clinical evidence to back it up, called for the use of a massive dose of antibiotics to quickly kill off an infection. The unfortunate side effect of this is that the really, really dangerous bacteria still survived and weren’t limited by any other bacteria competing with them.

Recently evolutionary biologists have suggested a better way is to use the minimal effective dose in any case where the patient’s immune system is strong enough to fight the infection if given a little help.

New Superbug Seen in U.S.

Along the same line we have a new superbug (meaning it is resistant to most or all antibiotic treatments) showing up in the U.S.

The American Society for Microbiology journal, “Antimicrobial Agents and Chemotherapy,” reports that a new variety of Escherichia coli is resistant to colistin, currently the last resort treatment for a stubborn bacterial infection. Colistin was retired from general use in the ’70s because it is highly toxic; that retirement is probably why it is still effective against everything except this new E. coli variant.

The gene responsible for the resistance is known as mcr-1 and it was first seen in China about a year ago. Since then, a variation of the common E. coli bacteria, which is found in almost every human gut, has shown up in some European hospitals. It has now reported for the first time in a 49-year-old woman in Pennsylvania.

E. coli is one of a class of bacteria classified as Gram-negative, based on the color it displays when stained and examined under a microscope.

The other kind, Gram-positive, appears so far to be less drug-resistant.

The Gram test, invented in the 1800s by (who else?) bacteriologist Hans Christian Gram, makes it relatively easy to quickly determine the kind of infection a patient has and, therefore, which class of antibiotics would be most effective.

[Top right is a Gram-positive bacteria, which retains a purple stain. Bottom right is a Gram-negative bacteria, which appears pink or red. Courtesy of Centers for Disease Control and Prevention.]

“The Lancet” (British medical journal) in its Infections Diseases publication reported that this polymyxin-class antibiotic-resistant infection initially showed up on Chinese poultry farms around 2013 and quickly spread to the human population.

This is a disaster in the battle to limit indiscriminate use of antibiotics on food animals. Even worse, if such a thing is possible, the mcr-1 gene that gives the bacteria its resistance is what is known as a “free floating” strand, which means it is easily shared with and spreads to other bacteria.

So, although the woman in question had a strain still treatable by other antibiotics, medical professionals are highly concerned that the mcr-1 gene will spread to some other bacteria that are resistant to everything except colistin.

According to the National Institute of Allergy and Infectious Diseases, the following Gram-negative bacteria are most commonly seen.

• Escherichia coli, which causes the majority of urinary tract infections.

• Acinetobacter baumanii, which causes disease mainly in healthcare settings. In addition, wound infections caused by Acinetobacter have been found in U.S. military personnel who were deployed to Iraq and Afghanistan.

• Pseudomonas aeruginosa, which causes bloodstream infections and pneumonia in hospitalized patients. It is a common cause of pneumonia in patients with cystic fibrosis.

• Klebsiella pneumoniae, which causes many types of healthcare-associated infections, including pneumonia, urinary tract infections, and bloodstream infections.

• Neisseria gonorrhoeae, which causes the sexually transmitted disease gonorrhea, is the second most commonly reported notifiable disease in the U.S.

Sepsis Deaths May Be Curbed With Chemotherapy Drug

Sepsis is responsible for about a quarter-million deaths in the U.S. each year.

Sepsis itself isn’t an infection; rather, it is the body’s reaction to infections. Inflammation is often the root cause of death from many diseases such as the common flu, or staph infections caused by Staphylococcus aureus, often occurring in a hospital setting (MRSA and other diseases that are hard to treat).

Sepsis causes low blood pressure, difficulty breathing, weakness, and can lead to organ failure.

In reality, sepsis is caused by the chemicals released into the bloodstream by the body’s own powerful immune system.

Statins are known to reduce the inflammation caused by some diseases but have proven ineffectual against the most serious septic infections.

(See my Newsblaze article, “Why Does Swine Flu Kill Healthy People?,” for information related to the cytokine storm that can overwhelm the body when a healthy person’s immune system reacts to the flu.)

Now molecular biologist Ivan Marazzi of the Icahn School of Medicine at Mount Sinai in New York City and colleagues have found that a chemotherapy drug, camptothecin, can reduce mortality in septic mice by ninety percent.

This is, of course, an early animal test but because sepsis can and often does kill within hours, and there are few other treatments (and no really effective one) I would expect some doctors to use this FDA-approved drug off-label (perfectly legal) in a last ditch effort to prevent death.

Camptothecin’s cancer killing action is due to its blocking of the enzyme topoisomerase I, which, in part, seems to help orchestrate the immune system’s response.

Patients who already have an influenza infection are particularly at risk of bacterial infection-triggered sepsis.

According to “Science Magazine,” immunopathologist Peter Ward of the University of Michigan, Ann Arbor, molecular biologist Murat Kaynar of the University of Pittsburgh School of Medicine in Pennsylvania, and others find these tests extremely interesting although they caution against putting too much faith in these early results.

In addition to the fact that there is really no other good method of treating advanced sepsis, the powerful chemotherapy drug would only need to be given in relatively small amounts—far less than in treating cancer.

Air Rage

Something really frightening occurs when you are trapped in an aircraft and one of the other passengers freaks out. We know why this is happening with increasing regularity. A few changes in airline procedures, such as deciding who gets aboard first, can make all the difference.

According to a report by the National Academy of Sciences, the incidents of so-called “air rage,” unreasonably aggressive behavior against cabin attendants and fellow passengers, is closely related to the increase in first-class seating.

This is a mental health issue.

It appears that air rage is actually triggered by economy class passengers confronted with the fact that a privileged group is getting better food, more comfortable seating, and generally superior treatment. This causes normal tensions resulting from the cattle-car crowding of economy class seating to boil over.

According to a recent report published in the Proceedings of the National Academy of Sciences, “researchers found that flights with a first-class section were nearly four times more likely to have air rage incidents in their economy class, and that these incidents of belligerent behavior or emotional outbursts became nearly twelve times more likely among first-class passengers and more than twice as likely among economy-class passengers if people were made to board from the front of the plane and walk through the first-class section together.”

“Stark differences in class” are thought to be the base cause of many recent incidents of social unrest.

New Hope for Heart Patients

There is new clinical data that show many more heart patients could benefit from aggressive treatments. A new study shows many more should get bypass surgery.

Until now, most heart patients with some kinds of coronary artery disease were denied coronary artery bypass grafts (CABG) because it was thought few would benefit from the expensive and dangerous operation.

However, a long-term study by the National Institutes of Health (NIH) funded by the National Heart, Lung, and Blood Institute (NHLBI), has shown that a far greater number of patients would benefit from the CABG surgery than previously considered.

CABG improves blood flow to the heart muscle by using implants to bypass the arteries already clogged with cholesterol plaque.

In particular, those with left ventricular dysfunction (the left side doesn’t pump properly) and heart failure were thought too risky to perform CABG. Since the 1970s, they were essentially excluded from anything but pain medication and experienced poor outcomes (they soon died).

It is estimated that by 2030 there will be nearly eight million individuals in the U.S. with left ventricular dysfunction. Advances in the management of cardiovascular disease and its risk factors may lead to more people surviving mild cases and eventually becoming advanced chronic cases. 

John McCormick is a physical science and technology journalist, and author with more than 17,000 bylines to his credit. He is a member of The National Press Club and the AAAS. He recently launched the canine celebrating website, A to Z Dogs.