Up at 5AM: The 5AM Solutions Blog

The newest installments in the Map of Biomedicine blog posts take us down the routes that get drugs to patients, primarily in the United States. Of course, we are all patients at one time or other regardless of where we live. Without a doubt, the route to getting effective therapies from the lab to your local pharmacist is convoluted and expensive even if you live in a wealthy nation. If you don't, making the most effective treatments available to the people who need them most in middle- and low-income nations is more difficult.   

As I said in my last post, one of the key components of the Map of Biomedicine is how new treatments get developed. That’s one of the parts of the map that is highlighted, as shown below.

Last week, a Reddit user posted a link to an interesting project via the social media site’s You Should Know sidebar. It began, “YSK you can send a scoop of dirt from your backyard to a research group that will analyze it for new antibiotic elements and other medicines.”

Drug development is a long, expensive process with a very high failure rate. In a 2011 commentary in the journal Science Translational Medicine, NIH director Francis Collins described it like this:

On Sunday, the Wall Street Journal published a business story (login required for the full story) about a new approach to treating cancer, and particularly a few late stage cancers. According to the story, investors like Michael Milken, George Soros, Jeff Bezos and Paul Allen are among best-known names betting on an emerging sector of cancer drug development called immunotherapy. 

A team of researchers led by Michael Farzan from The Scripps Research Institute in Jupiter, FL may be on the cusp of identifying the biggest drug threat to HIV in the 30-year struggle against AIDS. Farzan and his team exploited the AIDS virus' own biomechanics to prevent it from invading healthy white blood cells. 

The National Institute on Aging estimates that about 5 million Americans over the age of 65 have Alzheimer's Disease (AD). In general, as people get older, they become more susceptible to this irreversible, degenerative brain disease. In fact, the prevalence of AD doubles every five years after age 65, and while AD is not "normal" aging, as the population ages the numbers of cases of AD will increase commensurately. To put that into perspective, by 2050, 20% of the population will be 65 years old and older.

Although any clinical applications are many years away, there is hopeful news in the world of antibiotics. Researchers from Northeastern University in Boston published a paper in Nature yesterday reporting that they had found a method of extracting antibiotics from dirt-dwelling bacteria. 

One of the challenges in drug development is enrolling participants in clinical trials that meet very specific criteria. The reason for this is sound: make the trial too broad and researchers risk missing meaningful data about a potential therapy's efficacy.

However, there is a tension between mitigating that risk and the need to reach as many people with horribly debilitating -- and often life-threatening -- illnesses as possible with a life-altering miracle.  Often multiple trials have to be conducted that test lots of different scenarios, and each one needs participants whose conditions, like the porridge and the bed in the fairy tale, are "just right."