tag:blogger.com,1999:blog-86657838890603787222024-03-13T03:43:45.047-07:00A chemist on CreonI am a medicinal chemist living with exocrine pancreatic insufficiency and IBS, exploring the intricacies of digestive diseases and emerging therapies. I am my own content designer, fact checker and editor - a role pursued between column fractions and chemical reactions. Please feel free to point out any errors - this blog is for YOU!Unknownnoreply@blogger.comBlogger7125tag:blogger.com,1999:blog-8665783889060378722.post-87882000805975529512017-12-15T15:07:00.002-08:002017-12-15T15:07:57.185-08:00YOU contain multitudes!<div style="text-align: justify;">
<span style="font-family: "georgia" , "times new roman" , serif;">Bacteria have lived on our planet longer than any other being by billions of years. They have evolved during this time to live in some of the most inhospitable environments imaginable and continue to evolve as the planet changes. They are to be equally admired and feared, and they will ultimately outlive all other living beings. Throughout history bacteria have claimed more lives than <span style="color: red;"><span style="color: black;">all of the world wars combined</span><span style="color: black;"> and simultaneously (an often in an unrecognized manner) facilitated better health for most humans on the planet. Think about it, how many deadly ailments are bacterial in nature? Leprosy, tuberculosis, malaria, cholera, meningococcal disease, typhoid fever, tetanus, botulisim, listeriosis, bubonic plague, necrotizing fasciitis, Legionnaires' disease, scarlet fever, dysentry, bacterial pneumonia...the list goes on. It's no surprise that during the 1950s and 1960s tremendous effort was invested in the development of antibiotics. This 'antibiotic era' is responsible for some of our best defenses against harmful bacteria which include glycopeptides (ex. vancomycin), tetracyclines (ex. sumycin), macrolides (ex. erythromycin), polymyxins (ex. neosporin), </span></span></span>β<span style="font-family: "georgia" , "times new roman" , serif;">-lactams (ex. methicillin), etc. yet bacteria continue to evolve and adapt. On the heels of the antibiotic era was the era of antibiotic resistance - we currently battle some of the most evolved pathogenic beings including MRSA (methicillin-resistant staphylococcus aureus), VRSA (vancomycin-resistant staphylococcus aureus) and even instances of chlostridium difficile infections for which<span style="color: black;"> <a href="http://www.bbc.com/news/health-38609553" target="_blank">no known antibiotic is effective</a>.</span></span></div>
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<span style="font-family: "georgia" , "times new roman" , serif;">So is it all doom and gloom when it comes to bacteria? Far from it - these little guys are also responsible for helping us live happy and healthy lives, and you are covered in them! In fact, the average human has ten times as many bacterial cells in and around their body than human cells which make up the body. The largest concentration of bacteria in the human body is found in the digestive track, second only to the skin. The past decade has brought about an increased appreciation for the microbes within us as study after study links our gut microbiota with a variety of ailments. Huge movements to eat more bacteria in an effort to increase our microbiome diversity has brought foods like kimchi, sauerkraut and kombucha (all having been used for hundreds of years by a variety of cultures for their digestive health benefits) from the 'oriental' isle at the grocery store to the main display. And, of course, if you put the phrase 'improves gut health' onto almost any product you can expect customers to pay at least two to three times its actual worth. Go look in any drug store - you will be overwhelmed by the number of supplements containing a zillion strains of utterly unpronounceable bacteria all claiming to provide some benefit. However, the question remains: how much do we (this is a collective we, including scientists) <u>truely</u> understand about the precise role of bacteria in the pathophysiology of disease?</span><br />
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<span style="font-family: "georgia" , "times new roman" , serif;">This is one of the questions frequently brought up when discussing whether or not the FDA should play a role in the marketing and administration of probiotic supplements. A recent <a href="http://science.sciencemag.org/content/357/6346/39.full" target="_blank">policy piece in Science</a> summarized the state of affairs with respect to the role the FDA could play in the probiotic supplement industry, and it really boils down to how you define 'probiotic supplement.' Is it a food or is it a drug? Is it sold with the intention of <u>supporting</u> gut health or <u>influencing</u> a disease state? It is certainly a challenging question to answer, and most likely one which will not be answered anytime soon. Research into this area is still in the 'information gathering' phase. So what do we know so far and how can we make positive changes to promote our gut health with this limited information?</span><br />
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<span style="font-family: "georgia" , "times new roman" , serif;">1. We need both probiotics and <i>pre</i>biotics to support our gut microbiome. The probiotics are the 'good' bacteria - we need a variety of bacterial strains in a variety of ratios for optimum gut health. Everybody and every<i>body</i> will have a different probiotic profile which fits them the best, and this profile likely changes over the course of life. For optimum support of your own personal microbiome, you need to feed these little guys! This is where <i>pre</i>biotics come into play. Prebiotics are food sources on which the probiotics feed and YOU are responsible for feeding them the right sorts of foods. Examples of prebiotics include garlic, oats, onions, asparagus, leeks, flaxseeds, bananas, cocoa, etc.</span><br />
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<span style="font-family: "georgia" , "times new roman" , serif;">2. Consistency is KEY! The most significant time for microbiome development is during birth, when an otherwise sterile and undisturbed environment is introduced to the world and its microbes. After this event, especially as significant spans of time pass, the established microbiome becomes much more challenging to shift. There is not a 'one-size-fits-all' microbiome fix in a pill which can be taken daily to fix a gut-related problem. To truely influence your gut microbiome, diet and lifestyle modifications are a must! A plant-based diet (not necessarily excluding meat!) supplemented with lots of probiotic rich foods (think greek yogurt, kefir, kombucha, kimchi, tempeh...) adopted consistently as part of a reduced-stress and moderately active lifestyle is the best thing you can do for your gut!</span><br />
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<span style="font-family: "georgia" , "times new roman" , serif;">3. This process takes time - don't expect to immediately feel like your younger, care-free self in 24 hours. Explore new foods, keep a food and feeling diary, go outside and play, incorporate relaxation techniques and indulge in treats every once in awhile! Look back after a few months and then compare how you generally <i>feel</i>. This is an inside job.</span><br />
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<span style="font-family: "georgia" , "times new roman" , serif;">4. To further get to know your gut microbiome, pick up a copy of <a href="https://www.nytimes.com/2016/08/21/books/review/i-contain-multitudes-ed-yong.html" target="_blank"><i>I Contain Multitudes</i> by Ed Yong</a>. Your multitudes will thank you!</span><br />
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Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-8665783889060378722.post-12385768552589462682017-04-28T11:41:00.002-07:002017-04-28T13:27:54.830-07:00Could a silent virus trigger celiac disease? Scientists say...maybe...<div style="text-align: justify;">
<span style="font-family: "georgia" , "times new roman" , serif;">The gluten-free lifestyle has moved from relative obscurity to mainstream use. For most individuals, a gluten-free diet will be a passing obsession (although one which may result in increased attention to what is in food - which is a very good result) but for those with <i>celiac disease</i> it is a welcome societal movement. Celiac disease is an autoimmune condition which presents with gastrointestinal distress (pain, bloating, cramping), steatorrhea/diarrhea and malabsorption. Sounds a bit like IBS, right? Many of the clinical symptoms of celiac disease and IBS are identical, making a true celiac disease diagnosis challenging for both patient and practitioner. A person with true celiac disease has a specific and measurable autoimmune response to the ingestion of dietary gluten. IBS symptoms are often non-specific (i.e. varying severity, length, location, etc.) and worsen with a virety of triggers (gluten may be a trigger for IBS symptoms, but other dietary (lactose, soy, fructose) and lifestyle factors (chronic stress) influence this condition). Fortunately, diagnostic tests for celiac disease are becoming more common and often begin with a simple blood analysis - unfortunately, however, IBS has not lent itself to reliable diagnostic measures. Several specific criteria are used to confirm a diagnosis of celiac disease, although every body and everybody is different: </span><br />
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<span style="font-family: "georgia" , "times new roman" , serif;">1) HLA-DQA1 or HLA-DQB1 gene variants (this is very important - if you do not have the 'celiac gene mutation' you do not have celiac disease; <a href="https://www.beyondceliac.org/celiac-disease/non-celiac-gluten-sensitivity/" target="_blank">non-celiac gluten sensitivity</a> is a related condition which does not invoke a true <i>autoimmune</i> response but has been described as a gluten-related <i>inflammatory</i> response)</span><br />
<span style="font-family: "georgia" , "times new roman" , serif;">2) Elevated antibody levels (tTG, IgA, IgG - these are the 'gluten antibodies' which can be quantified in the blood and used as a diagnostic marker for the autoimmune condition) </span><br />
<span style="font-family: "georgia" , "times new roman" , serif;">4) Vitamin A, D, E and K deficiencies (fat-soluble vitamins are less readily absorbed due to intestinal damage)</span><br />
<span style="font-family: "georgia" , "times new roman" , serif;">5) Damaged (atrophied) intestinal lining confirmed by small bowel biopsy</span><br />
<span style="font-family: "georgia" , "times new roman" , serif;">6) Environmental trigger resulting in decetable immune response</span><br />
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<span style="font-family: "georgia" , "times new roman" , serif;">Common factors 1-5 are easily tested for and confirmed by a gastrointestinal specialist - most of them are quantifiable and/or visually informative. The 'environmental trigger' aspect of celiac disease (6 listed above) has remained the most elusive requirement for disease onset. How do we even know that an environmental trigger is important? Scientists agree that environmental risk factors are <i>likely</i> to be a cause of consideration based (so far...) purely on statistics. Celiac disease occurs globally in 1 out of 100 people. However, only 3-4% of individuals who carry the HLA-DQA1 or HLA-DQB1 gene variants ever develop celiac disease - what happens or does not happen to the other 96-97% who never progress? These values are reported in a <a href="http://science.sciencemag.org/content/356/6333/44" target="_blank">recent study published in <i>Science</i></a> which reports the </span><b><span style="font-family: "georgia" , "times new roman" , serif;">first</span></b><span style="font-family: "georgia" , "times new roman" , serif;"><b> experimental observation</b> <b>of celiac disease onset after exposure to a known environmental trigger</b>. Their study, titled '<i>Reovirus infection triggers inflammatory responses to dietary antigens and development of celiac disease</i>' describes a controlled experiment in which genetically susceptible mice, living on a gluten-containing diet but showing no clinically diagnostic celiac disease symptoms, are exposed to a known reovirus. Onset of celiac disease after viral exposure was confirmed by a measurable increase in immune response pathways, specifically those which promote the production of T-cells (immune cells) which specifically respond to the gluten antigen. This particular immune response pathway is triggered by HLA-DQ2 and HLA-DQ8 molecules, which are coded for by the </span><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;">HLA-DQA1 or HLA-DQB1 gene variants. </span></span><br />
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<span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;">So, the mice had these genes and consumed a gluten-containing diet but did not show signs of celiac disease prior to viral exposure. What this study shows is that the externally applied environmental factor (the reovirus - which is avirulent and causes no 'viral symptoms') has 'turned on' the mutated gene (just like a ligh switch<span style="font-family: "georgia" , "times new roman" , serif;">). When the gene variant is 'turned off,' it is still <i>there</i> but it is not physiologically active, whereas when the gene is 'turned on' downstream physiological changes have been shown induce disease progression. Now, would the mice have eventually developed celiac disease if they had not been exposed to the reovirus? Maybe. Would they have developed celiac disease from some other environmental trigger? Maybe. What this</span></span> study provides is only one piece of the enormous jigsaw puzzle describing celiac disease - and most of the pieces are still scrambled in the box! There are likely thousands of additional environmental triggers which influence disease progression, and not every genetically susceptible individual who encounters a reovirus will go on to develop celiac disease. However, direct demonstration and observation of environmentally triggered change in gene expression promoting the development of celiac disease is a <b>HUGE</b> step towards understanding the complicated relationship between food and the immune system. I'll raise a glass of (gluten-free) beer to that!</span><br />
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Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-8665783889060378722.post-55649230477164222522017-04-10T15:09:00.003-07:002017-04-10T15:10:56.693-07:00Spotlight on Anthera and AzurRx for next-generation PERT<div style="text-align: justify;">
<span style="font-family: "georgia" , "times new roman" , serif;">The impact of FDA-approved pancreatic enzyme replacements cannot be overstated. In fact, the World Health Organization (WHO) includes pancreatic enzymes<span style="font-family: "georgia" , "times new roman" , serif;"> on the</span> 'Model List of Essential Medicines' for both <a href="http://www.who.int/medicines/publications/essentialmedicines/EML_2015_FINAL_amended_NOV2015.pdf?ua=1" target="_blank">adults</a> and <a href="http://www.who.int/medicines/publications/essentialmedicines/EMLc_2015_FINAL_amended_AUG2015.pdf?ua=1" target="_blank">children</a><span style="font-family: "georgia" , "times new roman" , serif;">. Th<span style="font-family: "georgia" , "times new roman" , serif;">ese 'living' list<span style="font-family: "georgia" , "times new roman" , serif;">s<span style="font-family: "georgia" , "times new roman" , serif;"> are</span> <span style="font-family: "georgia" , "times new roman" , serif;">assessed and updated</span></span></span></span> <u>every two years</u> to identify the '<i>minimum medicine needs for a basic health care system, listing the most efficacious, safe and cost effective medicines for priority conditions.</i>' For many, <span style="font-family: "georgia" , "times new roman" , serif;">especially those with cystic fibrosis or <span style="font-family: "georgia" , "times new roman" , serif;">living without a pancreas</span>, rep<span style="font-family: "georgia" , "times new roman" , serif;">lacement enzymes are lifesaving and life-sustaining.</span></span></span></div>
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<span style="font-family: "georgia" , "times new roman" , serif;">Research into next-generation replacement enzymes seeks to improve upon current challenges for those who use <span style="font-family: "georgia" , "times new roman" , serif;">PERTs</span> in whatever capacity - from supportive care, such as in mild to moderate pancreatic insufficiency, to life-long dependency. Amongst the concerns of those either making (R&D sector) or taking (patients) replacement enzymes are:</span><br />
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<li><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;">D</span>osing consistency<span style="font-family: "georgia" , "times new roman" , serif;">/</span>individualized dosing - there is no <i>one size fits all</i> method for pres<span style="font-family: "georgia" , "times new roman" , serif;">cribing enzymes <span style="font-family: "georgia" , "times new roman" , serif;">(especially <span style="font-family: "georgia" , "times new roman" , serif;">whe<span style="font-family: "georgia" , "times new roman" , serif;">n there are three types of enzyme in each pill!</span></span>), mos<span style="font-family: "georgia" , "times new roman" , serif;">t ind<span style="font-family: "georgia" , "times new roman" , serif;">ividuals on <span style="font-family: "georgia" , "times new roman" , serif;">pancreatic enzymes benefit most from the lipase</span></span></span></span></span></span></li>
<li><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;">E</span>nzyme source - due to personal<span style="font-family: "georgia" , "times new roman" , serif;"> or religio<span style="font-family: "georgia" , "times new roman" , serif;">us reasons, <span style="font-family: "georgia" , "times new roman" , serif;">enzymes derived from pigs is not an available dietary addition</span></span></span></span></li>
<li><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;">S</span>ide effects - bloating, gas<span style="font-family: "georgia" , "times new roman" , serif;">, stomach pain, diarrhea, constipation and nausea are all listed as side effects <span style="font-family: "georgia" , "times new roman" , serif;">for replacement enzymes at <span style="font-family: "georgia" , "times new roman" , serif;">normal dosing regimes</span>; </span></span>although rare, <span style="font-family: "georgia" , "times new roman" , serif;">long-standing enzyme overdose can lead to a condition called fibrosing colonopathy</span></span></li>
<li><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;">A</span>dditional required medicatio<span style="font-family: "georgia" , "times new roman" , serif;">n - it is very common to co-prescribe a prot<span style="font-family: "georgia" , "times new roman" , serif;">on pump inhibitor along<span style="font-family: "georgia" , "times new roman" , serif;">side replacement enzymes </span>to r<span style="font-family: "georgia" , "times new roman" , serif;">egulate gastric pH<span style="font-family: "georgia" , "times new roman" , serif;"> (and these come with their o<span style="font-family: "georgia" , "times new roman" , serif;">wn list of side effects!</span>)</span></span></span></span></span></li>
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<span style="font-family: "georgia" , "times new roman" , serif;">Two up-and-coming biotech companies are slowly gaining attention in the PERT <span style="font-family: "georgia" , "times new roman" , serif;">community and market. Their research is addressing </span>several of the challenges listed above<span style="font-family: "georgia" , "times new roman" , serif;"> and is made possible by the smallest of creatures - <span style="font-family: "georgia" , "times new roman" , serif;">bacteria and ye<span style="font-family: "georgia" , "times new roman" , serif;">ast</span></span></span>!</span></div>
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<span style="font-family: "georgia" , "times new roman" , serif;"><a href="https://www.anthera.com/" target="_blank">Anthera Pharmaceuticals</a> is a small biotech company in California focusing on a next-generation pancreatic enzyme replacement therapy which <span style="font-family: "georgia" , "times new roman" , serif;">aims to reduce patient pill burden</span>. <span style="font-family: "georgia" , "times new roman" , serif;">T</span>he most common ways for PERTs to fail is patient non-compliance, fundamentally forgetting to take enzymes prior to <u>every</u> meal and snack. This often means taking up to 6 pills 4-5 times per day, every day, to ensure therapeutic benefit. <span style="font-family: "georgia" , "times new roman" , serif;">One way to re<span style="font-family: "georgia" , "times new roman" , serif;">duce the <u>quantity</u> of daily pills is to <span style="font-family: "georgia" , "times new roman" , serif;">improve the <u>quality</u> of the enzymes in each pill</span><span style="font-family: "georgia" , "times new roman" , serif;">. The proprietary <span style="font-family: "georgia" , "times new roman" , serif;">enzyme blen<span style="font-family: "georgia" , "times new roman" , serif;">d in Ant<span style="font-family: "georgia" , "times new roman" , serif;">hera's <i>Sollpura</i> <span style="font-family: "georgia" , "times new roman" , serif;">drug candidate is biologically engineered (this means made from a biological organism such as a bacteria<span style="font-family: "georgia" , "times new roman" , serif;"> - no p<span style="font-family: "georgia" , "times new roman" , serif;">igs involved</span></span>!) and<span style="font-family: "georgia" , "times new roman" , serif;"> features crystalline and cross-linked enzymes. Crystallization and cross-linking bring stability to the enzyme molecules, ensur<span style="font-family: "georgia" , "times new roman" , serif;">ing that <span style="font-family: "georgia" , "times new roman" , serif;">low gastric pH and the presence/absence of bile salts do no effect their <span style="font-family: "georgia" , "times new roman" , serif;">availability</span>. In addition, <i>Sollpura</i> has been formulated into <span style="font-family: "georgia" , "times new roman" , serif;">both a</span> tablet and sachet (water-soluble!) form, the later being particularly attractive for pediatric cystic fibrosis patients with pancreatic insufficiency. <i></i><span style="font-family: "georgia" , "times new roman" , serif;">The </span><i>Sollpura </i>formulations <span style="font-family: "georgia" , "times new roman" , serif;">are</span> currently in two clinical trials<span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;">. </span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span><br />
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<span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><a href="http://www.azurrx.com/" target="_blank">AzurRx BioPharm</a><span style="font-family: "georgia" , "times new roman" , serif;"><a href="http://www.azurrx.com/" target="_blank">a</a> is a <span style="font-family: "georgia" , "times new roman" , serif;">publically tra<span style="font-family: "georgia" , "times new roman" , serif;">ded biopharmaceutical company <span style="font-family: "georgia" , "times new roman" , serif;">working in the areas of <span style="font-family: "georgia" , "times new roman" , serif;">gastrointestinal and microbiome-related disorders and diseases. Their drug candidate, <i>MS1819 lipase</i> is currently in phase IIa clinical trials (to <span style="font-family: "georgia" , "times new roman" , serif;">profile the safety and efficacy in comparison with currently available PERTs</span>). As the name suggests, this <span style="font-family: "georgia" , "times new roman" , serif;">produce is either</span> a lipase-only enzyme capsule or <span style="font-family: "georgia" , "times new roman" , serif;">one which features a significant percentage of lipase <span style="font-family: "georgia" , "times new roman" , serif;">with respect to<span style="font-family: "georgia" , "times new roman" , serif;"> amylase and protease. <span style="font-family: "georgia" , "times new roman" , serif;">A<span style="font-family: "georgia" , "times new roman" , serif;">s described on</span> their</span> <a href="http://www.azurrx.com/science-technology/digestive-enzymes" target="_blank">website</a><span style="font-family: "georgia" , "times new roman" , serif;">, although amylas<span style="font-family: "georgia" , "times new roman" , serif;">e<span style="font-family: "georgia" , "times new roman" , serif;">s and proteases are produced alongsi<span style="font-family: "georgia" , "times new roman" , serif;">de lipases in the pancreas, <span style="font-family: "georgia" , "times new roman" , serif;">only supplementation of the lipase is <span style="font-family: "georgia" , "times new roman" , serif;">thought to be ne<span style="font-family: "georgia" , "times new roman" , serif;">cessary for treatment of EPI. In fact, proteases in currently approved PERTs have been implicated in the cause of fibrosing colonopathy, a rare but very serious side effect of taking replacement enzymes. <span style="font-family: "georgia" , "times new roman" , serif;">Looking to the micro<span style="font-family: "georgia" , "times new roman" , serif;">scopic world for answers</span></span><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;">, <i><span style="font-family: "georgia" , "times new roman" , serif;">MS1819 lipase</span></i></span></span></span></span></span></span></span></span></span> has <span style="font-family: "georgia" , "times new roman" , serif;">also been biologically engineered <span style="font-family: "georgia" , "times new roman" , serif;">- but this time from <u>yeast</u> rather than bacteria! <span style="font-family: "georgia" , "times new roman" , serif;">Yes, t</span>he same microorgani<span style="font-family: "georgia" , "times new roman" , serif;">sms which <span style="font-family: "georgia" , "times new roman" , serif;">serve us by <span style="font-family: "georgia" , "times new roman" , serif;">fermenting <span style="font-family: "georgia" , "times new roman" , serif;">wheat</span> to make bread<span style="font-family: "georgia" , "times new roman" , serif;">, grapes to make wine and</span> hops to make <span style="font-family: "georgia" , "times new roman" , serif;">beer</span> have been engineered to produce highly potent <span style="font-family: "georgia" , "times new roman" , serif;">and stable lipases for treating EPI. </span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span><br />
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<span style="font-family: "georgia" , "times new roman" , serif;">Anthera and AzurRx are just two of a growing number of biopharmaceutical companies approaching pancreatic enzyme improvements using non-traditional (biological) methods. The use of microorganisms such as bacteria, yeast and algae for the production of valuable materials including antibiotics (many of which are also on the WHO's Model List of Essential Medicines), food and even <a href="http://www.sapphireenergy.com/" target="_blank">crude oil</a> demonstrates the viability and influence of biologically-derived products. A biological approach to enzyme production may provide not only a renewable and reliable method for enzyme production (with the potential to tailor enzymes on an individual basis) but may help alleviate the burden we place on animal-derived healthcare products.</span></div>
Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-8665783889060378722.post-15047680642100188382017-03-08T14:35:00.000-08:002017-03-12T19:31:01.293-07:00PERT - Pancreatic Enzyme Replacement Therapy<div style="text-align: justify;">
<span style="font-family: "georgia" , "times new roman" , serif;">So what is the deal with all of these enzymes? There are loads out there - you are very likely to find at least 20 different plant-derived enzymes at your local health food store. Many are coupled with a cocktail of probiotics and additional nutritional support, labeled with the words <i>vegan</i>, <i>vegetarian</i> and <i>all natural</i> to distinguish them from their porcine-derived cousins. Many individuals report very positive results from taking these enzymes and probiotics, but the jury is still out as to whether this is a quantifiable test or another well documented case of the placebo effect (which is not bad, by the way - I once recovered from an aggressive bout of bronchitis only after a reluctantly writte<span style="font-family: "georgia" , "times new roman" , serif;">n</span> prescription for the world's weakest and most ineffective antibiotic, just the thought of having medicinal help improved my health almost overnight...). Certainly a combination of digestive enzymes and probiotics never hurt anyone and in fact, a little digestive help is always appreciated.</span></div>
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<span style="font-family: "georgia" , "times new roman" , serif;">The enzymes and probiotics you find in the store are different to those available by prescription - in quite a number of ways! The first and most obvious difference is the requirement for a prescription (or not), meaning the FDA has become involved. I was astonished to learn that the first FDA approval for porcine-derived pancreatic enzyme replacement therapy was in 2009!<span style="font-family: "georgia" , "times new roman" , serif;"> <span style="font-family: "georgia" , "times new roman" , serif;">Until 1991, <span style="font-family: "georgia" , "times new roman" , serif;">replacement enzymes sailed along on the free market<span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"> -</span> and there were loads of them. In<span style="font-family: "georgia" , "times new roman" , serif;">consisten<span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;">cies</span> in form<span style="font-family: "georgia" , "times new roman" , serif;">ulation and quality<span style="font-family: "georgia" , "times new roman" , serif;">, </span>result<span style="font-family: "georgia" , "times new roman" , serif;">ing</span> in adverse<span style="font-family: "georgia" , "times new roman" , serif;"> side effects, eventually caught the attention of the FDA. <span style="font-family: "georgia" , "times new roman" , serif;">As of 2012</span>,<span style="font-family: "georgia" , "times new roman" , serif;"> there are only <u>six</u> FDA-approved replacement pancreatic enzyme<span style="font-family: "georgia" , "times new roman" , serif;"> formulations: Creon, <span style="font-family: "georgia" , "times new roman" , serif;">Zenpep, Pancreaze, Ultresa, Viokace and Pertyze.</span></span></span></span></span></span></span></span></span></span></span></span><br />
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<span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;">A second, and equally obvious difference b<span style="font-family: "georgia" , "times new roman" , serif;">etween store bought enzymes and pres<span style="font-family: "georgia" , "times new roman" , serif;">cription enzymes is the price ($$!!).<span style="font-family: "georgia" , "times new roman" , serif;"> In order <span style="font-family: "georgia" , "times new roman" , serif;">to be approved for use in chronic disease (such as Cystic Fibrosis)<span style="font-family: "georgia" , "times new roman" , serif;">, pharmaceutical companies <span style="font-family: "georgia" , "times new roman" , serif;">must formulate a supplement which delivers the appropriate enzymes in the appropriate amounts at the appro<span style="font-family: "georgia" , "times new roman" , serif;">p<span style="font-family: "georgia" , "times new roman" , serif;">riate time. This is no small feat. The <span style="font-family: "georgia" , "times new roman" , serif;">internal environment which the supplements must withstand <span style="font-family: "georgia" , "times new roman" , serif;">before reaching the duode<span style="font-family: "georgia" , "times new roman" , serif;">num is severe - the pH of stomach aci<span style="font-family: "georgia" , "times new roman" , serif;">d is <span style="font-family: "georgia" , "times new roman" , serif;">between <span style="font-family: "georgia" , "times new roman" , serif;">1 and 3. Your <span style="font-family: "georgia" , "times new roman" , serif;">gastric acid, which can be destructive to other tissues such as your esophagus and intestines, </span></span></span></span></span></span></span></span></span></span></span></span></span></span></span> <span style="font-family: "georgia" , "times new roman" , serif;">provides a massive service for the rest of the body. Not only <span style="font-family: "georgia" , "times new roman" , serif;">does it help to break down complex proteins in food (a low pH value is required for this!) but it also serves as <span style="font-family: "georgia" , "times new roman" , serif;">a primary defense against bacteria<span style="font-family: "georgia" , "times new roman" , serif;"> and viruses. Not many lifeforms can withstand the stomach acid, <span style="font-family: "georgia" , "times new roman" , serif;">but one common exception, </span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><a href="http://www.mayoclinic.org/diseases-conditions/h-pylori/basics/definition/con-20030903" target="_blank"><i><span style="font-family: "georgia" , "times new roman" , serif;">h</span>elicobact<span style="font-family: "georgia" , "times new roman" , serif;">er <span style="font-family: "georgia" , "times new roman" , serif;">p</span>ylori</span></i></a>,</span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span> <span style="font-family: "georgia" , "times new roman" , serif;">has been linked to a variety of gastric ailments</span></span><span style="font-family: "georgia" , "times new roman" , serif;">. The enzyme s<span style="font-family: "georgia" , "times new roman" , serif;">upplements therefore <i>must</i> <span style="font-family: "georgia" , "times new roman" , serif;">hold up against this acid<span style="font-family: "georgia" , "times new roman" , serif;"> - many lipases (which help with fat breakdown) are irreversibly deactivated <span style="font-family: "georgia" , "times new roman" , serif;">by stomach acid<span style="font-family: "georgia" , "times new roman" , serif;">. This is why<span style="font-family: "georgia" , "times new roman" , serif;"> </span></span>replacement enzymes are <span style="font-family: "georgia" , "times new roman" , serif;">often</span> prescribed with a <span style="font-family: "georgia" , "times new roman" , serif;">proton pump inhibitor (PPI) to help raise gastric pH to the 3 or 4 level</span>. The <span style="font-family: "georgia" , "times new roman" , serif;">price you or your insurance pays towards <span style="font-family: "georgia" , "times new roman" , serif;">replacement enzymes is not driven by the enzymes themselves b<span style="font-family: "georgia" , "times new roman" , serif;">ut by the protective (enteric) coating required to ensure proper enzyme concentration in the duod<span style="font-family: "georgia" , "times new roman" , serif;">enum. In addition to <span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;">completely protected</span> tablet formulation, each tablet contains enzymes which are <span style="font-family: "georgia" , "times new roman" , serif;">further <span style="font-family: "georgia" , "times new roman" , serif;">encapsulated in microspheres or microbeads. <span style="font-family: "georgia" , "times new roman" , serif;">More enzyme protection means more background R&D which is supplemented by the price of their product.</span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span><br />
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<span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;">One final difference between store bought and prescription enzymes <span style="font-family: "georgia" , "times new roman" , serif;">is the enzyme source. Most (but not necessarily all) <span style="font-family: "georgia" , "times new roman" , serif;">over the counter <span style="font-family: "georgia" , "times new roman" , serif;">digestive enzymes are plant derived. Prescription enzymes are solely porcine-derived, meaning that there are c<span style="font-family: "georgia" , "times new roman" , serif;">urrently <span style="font-family: "georgia" , "times new roman" , serif;">no <span style="font-family: "georgia" , "times new roman" , serif;">F<span style="font-family: "georgia" , "times new roman" , serif;">DA-appro<span style="font-family: "georgia" , "times new roman" , serif;">ved pancreatic enzymes whic<span style="font-family: "georgia" , "times new roman" , serif;">h are harvested from any<span style="font-family: "georgia" , "times new roman" , serif;">thing other than pigs. Why pigs? It turns out that pigs are a very close model <span style="font-family: "georgia" , "times new roman" , serif;">for humans in many ways, including their pancreatic enzyme composition. A<span style="font-family: "georgia" , "times new roman" , serif;">nimal-derived enzy<span style="font-family: "georgia" , "times new roman" , serif;">mes and molecules are commonly used in the production of food and medical therapies. For example, <a href="https://en.wikipedia.org/wiki/Rennet" target="_blank">rennet</a> is a<span style="font-family: "georgia" , "times new roman" , serif;"> collection of enzymes <span style="font-family: "georgia" , "times new roman" , serif;">produc<span style="font-family: "georgia" , "times new roman" , serif;">ed by cows which is used for making cheese. The commonly pres<span style="font-family: "georgia" , "times new roman" , serif;">cribed blood thinner <a href="https://en.wikipedia.org/wiki/Heparin" target="_blank">Heparin</a> is also derived from co<span style="font-family: "georgia" , "times new roman" , serif;">ws<span style="font-family: "georgia" , "times new roman" , serif;"> - a</span>lthough formulations of Heparin may be prepared from other farm livestock, the FDA approved and regulated Heparin is solely bovine-produced. Porcine and bovine derived products have been deemed safe and effective for <span style="font-family: "georgia" , "times new roman" , serif;">human use, but they <span style="font-family: "georgia" , "times new roman" , serif;">pose a problem for <span style="font-family: "georgia" , "times new roman" , serif;">select groups of peop<span style="font-family: "georgia" , "times new roman" , serif;">le including those allergic to pork or those who do not co<span style="font-family: "georgia" , "times new roman" , serif;">nsume pork<span style="font-family: "georgia" , "times new roman" , serif;"> or porcine-derived products. Recently<span style="font-family: "georgia" , "times new roman" , serif;">, a few small biopharmaceutical companies have taken up <span style="font-family: "georgia" , "times new roman" , serif;">the challen<span style="font-family: "georgia" , "times new roman" , serif;">ge <span style="font-family: "georgia" , "times new roman" , serif;">and have demonstrated production of digestive enymes from <a href="http://www.azurrx.com/science-technology/programs" target="_blank">yeast</a> (Azu<span style="font-family: "georgia" , "times new roman" , serif;">rRx MS1819 in phase II clinical trials</span>) and <a href="https://www.anthera.com/product-pipeline/sollpura/" target="_blank">bacteria</a><span style="font-family: "georgia" , "times new roman" , serif;"> (Anthera's Sollpura studies).</span> Although Anthera's bacterially-derived enzymes failed to show improvement over currently available <span style="font-family: "georgia" , "times new roman" , serif;">t<span style="font-family: "georgia" , "times new roman" , serif;">herapies (which meant clinical trial fail<span style="font-family: "georgia" , "times new roman" , serif;">ure</span>), interest in non-porcine derived enzymes has hit the drug development p<span style="font-family: "georgia" , "times new roman" , serif;">ipeline!</span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span><br />
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<span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;">Your en<span style="font-family: "georgia" , "times new roman" , serif;">zyme prescription and therapy response <span style="font-family: "georgia" , "times new roman" , serif;">rate depend on a number of factors, in<span style="font-family: "georgia" , "times new roman" , serif;">cluding diet and lifestyle, weight, underlying condition and often <span style="font-family: "georgia" , "times new roman" , serif;">preference of your GI doctor or insurance. <span style="font-family: "georgia" , "times new roman" , serif;">Under dosing can lead to further pancreatic problems including fibrosis<span style="font-family: "georgia" , "times new roman" , serif;"> and calcifications while over dosing burdens the colon and can result in fibrosing colonopathy. It is therefore imperative that patients are open and honest with physicians about <span style="font-family: "georgia" , "times new roman" , serif;">symptoms (even if the tought of <span style="font-family: "georgia" , "times new roman" , serif;">saying them out loud makes you super <span style="font-family: "georgia" , "times new roman" , serif;">uncomfortable!</span></span>) and be diligent about taking the prescribed dosage <span style="font-family: "georgia" , "times new roman" , serif;">with meals. <span style="font-family: "georgia" , "times new roman" , serif;">Know that a lot of <span style="font-family: "georgia" , "times new roman" , serif;">research hours and intense investigation, along with scrutiny<span style="font-family: "georgia" , "times new roman" , serif;">, accompany your tablets to ensure you are safe and experience only minimal side effects. </span></span>It feels daunting at first, taking several pills every time you eat, but th<span style="font-family: "georgia" , "times new roman" , serif;">e payoff is (hopefully) symptom<span style="font-family: "georgia" , "times new roman" , serif;">-free dining and <span style="font-family: "georgia" , "times new roman" , serif;">enjoyable living!</span></span></span></span></span></span></span></span></span></span></span></span> </span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span><br />
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Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-8665783889060378722.post-91625473329305705662017-02-23T16:56:00.004-08:002017-02-23T16:56:48.764-08:00All that glitters is gold!<div style="text-align: justify;">
<span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;">Malfunction and disease of the pancreas almost inevitably leads to <span style="font-family: "georgia" , "times new roman" , serif;">questions about pancreatic cancer. Does a family history of pancreatic cancer increase <span style="font-family: "georgia" , "times new roman" , serif;">the odds that pancreatitis may lead to cancer? If I <span style="font-family: "georgia" , "times new roman" , serif;">develop EPI, will I also develop diabetes and ultimately pancreatic cancer? What if I already have both diabetes and EPI<span style="font-family: "georgia" , "times new roman" , serif;">, am I twice as likely to develop pancreatic cancer? Five times as likely?</span></span></span></span></span></span></span> The short answer: We don't really know. Nobody <span style="font-family: "georgia" , "times new roman" , serif;">can predict with perfect accuracy wh<span style="font-family: "georgia" , "times new roman" , serif;">ether or not a cancerous state will develop from a set <span style="font-family: "georgia" , "times new roman" , serif;">of <span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;">symptoms<span style="font-family: "georgia" , "times new roman" , serif;"> or conditions</span></span></span></span></span></span>. And the problem with statistics is that 80% are made up on the spot ;) Everybody and every <i>body</i> is unique and comes with a unique set of circumstances including <span style="font-family: "georgia" , "times new roman" , serif;">family history, environment, diet and lifestyle</span>. <span style="font-family: "georgia" , "times new roman" , serif;">Fear develops from missing explanations and an<span style="font-family: "georgia" , "times new roman" , serif;">swers<span style="font-family: "georgia" , "times new roman" , serif;"> which lead to</span> uncertainties about future <span style="font-family: "georgia" , "times new roman" , serif;">prog<span style="font-family: "georgia" , "times new roman" , serif;">nos<span style="font-family: "georgia" , "times new roman" , serif;">es and<span style="font-family: "georgia" , "times new roman" , serif;"> </span></span>life expectency.</span></span></span></span> </span></div>
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<span style="font-family: "georgia" , "times new roman" , serif;">What, in part, makes pancreatic cancer so terri<span style="font-family: "georgia" , "times new roman" , serif;">fying and ultimately </span>devastating is <span style="font-family: "georgia" , "times new roman" , serif;">its relatively calm early stages coupled with a lac<span style="font-family: "georgia" , "times new roman" , serif;">k of r<span style="font-family: "georgia" , "times new roman" , serif;">outine testing for high risk popula<span style="font-family: "georgia" , "times new roman" , serif;">tions</span></span></span></span>. In general, the <span style="font-family: "georgia" , "times new roman" , serif;">beginning phases</span> of pancreatic cancer do not present with any defined diagnostic characteristics. No pain, no swelling, no palpable lumps and bumps, etc. And again, due to the location of the pancreas (tucked nicely behind the stomach), even if there were palpable masses we would not <span style="font-family: "georgia" , "times new roman" , serif;">always </span>be able to <span style="font-family: "georgia" , "times new roman" , serif;">assess</span> them. Imaging techniques in the form of MRI, ultrasound and CT scans have come a very long way in terms of resolution and diagnostic success. <span style="font-family: "georgia" , "times new roman" , serif;">However, e</span>arly stages of pancreatic cancer (stages I and II) are often not distinguishable<span style="font-family: "georgia" , "times new roman" , serif;"> because of the organs and bones which envelop the pancreas and distort visualization of the fin<span style="font-family: "georgia" , "times new roman" , serif;">e structure (think about looking at a flower through a window full of fingerprints, you can see its a flower but can you count how many pedals it has?)</span></span>. There<span style="font-family: "georgia" , "times new roman" , serif;">fore, pancreatic cancer is most commonly diagnosed in its <span style="font-family: "georgia" , "times new roman" , serif;">most advanced <span style="font-family: "georgia" , "times new roman" , serif;">stage (stage III)</span></span></span>, <span style="font-family: "georgia" , "times new roman" , serif;">excluding</span> options such as surgical removal <span style="font-family: "georgia" , "times new roman" , serif;">or</span> preventative care. Stage III indicates a systemic disease, typically extending beyond the confines of this tiny gland.</span></div>
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<span style="font-family: "georgia" , "times new roman" , serif;">The fear of pancreatic cancer, even when your 'chances' seem low, is justified and not simply misplaced anxiety. But rest <span style="font-family: "georgia" , "times new roman" , serif;">as easily as possible</span>, because <span style="font-family: "georgia" , "times new roman" , serif;">c</span>ancer research is one of the government's top funding priorities (President Obama signed the <a href="https://www.congress.gov/bill/114th-congress/house-bill/6" target="_blank">21st Cenury Cures Act</a> in 2015 - hopefully this will not be affected by current legislation) and a recent research report demonstrates a specific advancement in the detection of early stage pancreatic cancer using a simple blood test. <span style="font-family: "georgia" , "times new roman" , serif;">Don't run to the doctor yet, this test is still in the 'proof of concept' phase<span style="font-family: "georgia" , "times new roman" , serif;">, but a few major advantages of this test include <span style="font-family: "georgia" , "times new roman" , serif;">low cost (relative to similar tests), short processing time, high <span style="font-family: "georgia" , "times new roman" , serif;">accuracy and small sample v<span style="font-family: "georgia" , "times new roman" , serif;">olume. <span style="font-family: "georgia" , "times new roman" , serif;">We are talking a sample volume comparable to <span style="font-family: "georgia" , "times new roman" , serif;">having your finger pricked for a <span style="font-family: "georgia" , "times new roman" , serif;">blood glucose test...just a drop! </span></span></span></span></span></span></span></span></span><br />
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<span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;">The components which make up our blood provide</span> <span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;">a <span style="font-family: "georgia" , "times new roman" , serif;">micro<span style="font-family: "georgia" , "times new roman" , serif;">scopic <span style="font-family: "georgia" , "times new roman" , serif;">view of </span></span></span></span></span>our overall health. A metabolic blood panel measures values of vitamins and minerals and our bodies absorb from food and supplements<span style="font-family: "georgia" , "times new roman" , serif;">;</span> a complete blood count measures the quantity and quality of red and white blood cells<span style="font-family: "georgia" , "times new roman" , serif;">;</span> our blood glucose level is measured <span style="font-family: "georgia" , "times new roman" , serif;">by a</span> blood test<span style="font-family: "georgia" , "times new roman" , serif;">;</span> the list goes on. <span style="font-family: "georgia" , "times new roman" , serif;">Our organs and body systems use <span style="font-family: "georgia" , "times new roman" , serif;">circulating blood to send out </span></span>signaling molecules (known as <i>extracellular vessicles</i>) <span style="font-family: "georgia" , "times new roman" , serif;">which help keep <span style="font-family: "georgia" , "times new roman" , serif;">all of the processes which occur in the body in sync</span></span>. If you were able to <i>listen</i> to the blood it would sound like a crowded stadium after the victory touchdown - loud and indecipherable. A <a href="https://biodesign.asu.edu/tony-hu/research" target="_blank">research group</a> from <span style="font-family: "georgia" , "times new roman" , serif;">Arizona State University has developed a <a href="http://www.nature.com/articles/s41551-016-0021" target="_blank">method</a> which selectively 'amplifies' the presence extracellular vessicles sent out from pancreatic cancer cells (<span style="font-family: "georgia" , "times new roman" , serif;">like turning up the mic at a concert</span>). Using their technique, even when relatively few pancreatic cancer derived extracellular vessi<span style="font-family: "georgia" , "times new roman" , serif;">cles are in <span style="font-family: "georgia" , "times new roman" , serif;">circulation (such as <span style="font-family: "georgia" , "times new roman" , serif;">in the very early stages of disease</span>), visu<span style="font-family: "georgia" , "times new roman" , serif;">alization of the signaling molecules provides <span style="font-family: "georgia" , "times new roman" , serif;">support for a<span style="font-family: "georgia" , "times new roman" , serif;"> rapid</span> and <span style="font-family: "georgia" , "times new roman" , serif;">early diagnosis. The <span style="font-family: "georgia" , "times new roman" , serif;">visualization of the cells occurs with the help of gold nanoparticles, conveniently tagged with a <span style="font-family: "georgia" , "times new roman" , serif;">targeting antibody<span style="font-family: "georgia" , "times new roman" , serif;"> <span style="font-family: "georgia" , "times new roman" , serif;">that</span></span></span> binds to <span style="font-family: "georgia" , "times new roman" , serif;">a specific <span style="font-family: "georgia" , "times new roman" , serif;">overexpressed <span style="font-family: "georgia" , "times new roman" , serif;">surface protein</span></span> on the <span style="font-family: "georgia" , "times new roman" , serif;">cancer derived vessicle. Think about a puzzle piece which only has one match out of <span style="font-family: "georgia" , "times new roman" , serif;">millions of possibilities - that's <span style="font-family: "georgia" , "times new roman" , serif;">how well designed the <span style="font-family: "georgia" , "times new roman" , serif;">antibody/antigen for this test is.</span></span></span> W<span style="font-family: "georgia" , "times new roman" , serif;">ith the gold nanoparticles attached (two separate nanoparticles <span style="font-family: "georgia" , "times new roman" , serif;">- one nanosphere and one nanorod</span>) <span style="font-family: "georgia" , "times new roman" , serif;">each tagged cell will <span style="font-family: "georgia" , "times new roman" , serif;">light up<span style="font-family: "georgia" , "times new roman" , serif;"> <span style="font-family: "georgia" , "times new roman" , serif;">- mapping out the <span style="font-family: "georgia" , "times new roman" , serif;">presence and quantity <span style="font-family: "georgia" , "times new roman" , serif;">of <span style="font-family: "georgia" , "times new roman" , serif;">pancreatic cancer derived c</span>ells in t<span style="font-family: "georgia" , "times new roman" , serif;">he</span> blood. This is almost like intercepting a secret message <span style="font-family: "georgia" , "times new roman" , serif;">reading its contents</span> in order to pre<span style="font-family: "georgia" , "times new roman" , serif;">vent further damage<span style="font-family: "georgia" , "times new roman" , serif;"> -</span></span> think of <a href="https://en.wikipedia.org/wiki/Cryptanalysis_of_the_Enigma" target="_blank">Alan Turing breaking the enigma code</a><span style="font-family: "georgia" , "times new roman" , serif;">. </span> </span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span><br />
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<span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;">Blood tests for cancer markers <span style="font-family: "georgia" , "times new roman" , serif;">are <span style="font-family: "georgia" , "times new roman" , serif;">certainly not new technology, nor is the use of gold nanoparticles as diagnostic tools. <span style="font-family: "georgia" , "times new roman" , serif;">However, this demonstrated</span> use o<span style="font-family: "georgia" , "times new roman" , serif;">f gold nanoparticles allows for <span style="font-family: "georgia" , "times new roman" , serif;">the possibility of a routine screening method for high risk populations, whether through family history or <span style="font-family: "georgia" , "times new roman" , serif;">isolated pancreatic disease</span></span>. <span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;">Wit<span style="font-family: "georgia" , "times new roman" , serif;">h all forms of cancer and illness<span style="font-family: "georgia" , "times new roman" , serif;">, early detection is key<span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;">, and <span style="font-family: "georgia" , "times new roman" , serif;">with pancreatic cancer, </span>may mean the difference between 5 years and 50 years. That's a lot <span style="font-family: "georgia" , "times new roman" , serif;">of life to be lived.</span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span><br />
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Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-8665783889060378722.post-62631391399898787052017-02-17T16:16:00.002-08:002017-02-17T16:16:26.069-08:00A split personality<div style="text-align: justify;">
<span style="font-family: "georgia" , "times new roman" , serif;">The pancreas is a small pear shaped gland which hides behind the stomach, sneakily out of view and reach for physical exams and routine imaging. A fully functional pancreas performs an immense service to the body by aiding digestion and regulating blood glucose <span style="font-family: "georgia" , "times new roman" , serif;">levels</span>. These two broad functions <span style="font-family: "georgia" , "times new roman" , serif;">have led to two <span style="font-family: "georgia" , "times new roman" , serif;">pancreatic 'personalities'</span> </span>('exocrine pancreas' and the 'endocrine pancreas') <span style="font-family: "georgia" , "times new roman" , serif;">based on <span style="font-family: "georgia" , "times new roman" , serif;">excretion</span></span> from the pancreas through a duct (exocrine) or the bloodstream (endocrine). Pancreatic malfunction may be isolated to the exocrine pancreas or endocrine pancreas individually or may manifest as complete pancreatic disease (both endocrine and exocrine insufficiency). Luckily, the exocrine pancreas and endocrine pancreas do not work alone - a variety of other glands and organs participate in your exocrine and endocrine systems. Keeping everything in check can become a challenge when one or the other pancreatic functions is compromised.</span></div>
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<span style="font-family: "georgia" , "times new roman" , serif;">The exocrine pancreas works in collaboration with the stomach, small intestine, liver and large intestine (in addition to other organs and processes occuring simultaneously) to break down the fats, carbohydrates, sugars and proteins consumed through food and drink. The role of the pancreas in this process is twofold: to neutralize stomach acid by excreting a basic bicarbonate solution and supply your intestines with digestive enzymes used to break down components of foods. For example, lipase produced by acinar cells in the pancreas acts by cleaving lipid bonds in triglycerides to make fatty acids. Our bodies can more readily absorb these fatty acids and use them in a variety of metabolic pathways, most notably in the regulation of inflammation. The exocrine pancreas also produces and excretes amylases and proteases to break down carbohydrates and proteins, respectively. Quite a heavy burden on one single gland, making its malfunction all the more significant. Exocrine pancreatic insufficiency (EPI) is a digestive condition in which, for a variety of reasons, the pancreas is either not able to produce or not able to excrete the bicarbonate and enzymes required for complete food digestion. EPI is not a disease of its own, but a symptom often recogni<span style="font-family: "georgia" , "times new roman" , serif;">zed too late for preventative treatment</span>. The<span style="font-family: "georgia" , "times new roman" , serif;"> clinical presentation</span> of EPI (<span style="font-family: "georgia" , "times new roman" , serif;">postprandial epigastric pain and steatorrhea</span>) <span style="font-family: "georgia" , "times new roman" , serif;">does not develop <span style="font-family: "georgia" , "times new roman" , serif;">until over 90% of <span style="font-family: "georgia" , "times new roman" , serif;">pancreatic <span style="font-family: "georgia" , "times new roman" , serif;">enzyme out<span style="font-family: "georgia" , "times new roman" , serif;">put is lost. <span style="font-family: "georgia" , "times new roman" , serif;">In the meanti<span style="font-family: "georgia" , "times new roman" , serif;">me, a</span></span>s the a<span style="font-family: "georgia" , "times new roman" , serif;">cinar cells slowly <span style="font-family: "georgia" , "times new roman" , serif;">succumb to damage and cease enzyme production, the remaining organs and glands in the exocrine system <span style="font-family: "georgia" , "times new roman" , serif;">make up the deficit (our bodies have incredible reserve capacities!). <span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;">A few <span style="font-family: "georgia" , "times new roman" , serif;">examples: <span style="font-family: "georgia" , "times new roman" , serif;">s</span></span>alivary am<span style="font-family: "georgia" , "times new roman" , serif;">ylase (made in the mouth)<span style="font-family: "georgia" , "times new roman" , serif;"> begins the is<span style="font-family: "georgia" , "times new roman" , serif;"> </span>initial breakdown of starches as you chew and gastric lipase (made in the <span style="font-family: "georgia" , "times new roman" , serif;">stomach</span>) <span style="font-family: "georgia" , "times new roman" , serif;">facilitates lipid hydrolysis. These enzymes differ<span style="font-family: "georgia" , "times new roman" , serif;"> to those produced by the pancreas and offer only partial resemblan<span style="font-family: "georgia" , "times new roman" , serif;">ce to the role pancreatic enzymes play in <span style="font-family: "georgia" , "times new roman" , serif;">digestion. T<span style="font-family: "georgia" , "times new roman" , serif;">reatment regimes for EPI include a lo<span style="font-family: "georgia" , "times new roman" , serif;">w fat diet (max. 20g of fat with no supplemental enzymes) or what is know<span style="font-family: "georgia" , "times new roman" , serif;">n as PERT - Pancreatic Enzyme Replacement Therapy. <span style="font-family: "georgia" , "times new roman" , serif;">F<span style="font-family: "georgia" , "times new roman" , serif;">uture posts will discuss the pros and cons of PERT and what products are on the market for EPI treatment.</span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></div>
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<span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;">The endocrine pancreas is a whole different ballgame<span style="font-family: "georgia" , "times new roman" , serif;">, and one which enjoys attention from the media as well as the medical community. The body's relationship <span style="font-family: "georgia" , "times new roman" , serif;">with the endocrine pancreas is the key to management of types I and II diabetes (<span style="font-family: "georgia" , "times new roman" , serif;">T1D and T2D, respectively</span>). In addition to<span style="font-family: "georgia" , "times new roman" , serif;"> the production of digestive enzymes (from the exocrine pancreas), the endocrine pancreas is responsible for the production and distribution of insulin. Insulin is a hormone, made by islet cells in the pancreas, which regulates metaboli<span style="font-family: "georgia" , "times new roman" , serif;">sm<span style="font-family: "georgia" , "times new roman" , serif;"> - specifically<span style="font-family: "georgia" , "times new roman" , serif;"> <span style="font-family: "georgia" , "times new roman" , serif;">regarding <span style="font-family: "georgia" , "times new roman" , serif;">blood glucose levels<span style="font-family: "georgia" , "times new roman" , serif;"> - </span>every <span style="font-family: "georgia" , "times new roman" , serif;">second of every <span style="font-family: "georgia" , "times new roman" , serif;">minute of every hour of every day. Even w<span style="font-family: "georgia" , "times new roman" , serif;">hen you sleep. Whilst the exocrine pancreas takes a break between meals, the endocrine pancreas works around the clock to keep you<span style="font-family: "georgia" , "times new roman" , serif;"> feeling at your best. Malfunction of the endocrine pancreas is <span style="font-family: "georgia" , "times new roman" , serif;">termed</span> 'diabetes<span style="font-family: "georgia" , "times new roman" , serif;">,' of <span style="font-family: "georgia" , "times new roman" , serif;">which types I and II are the most common (gestational diabetes descri<span style="font-family: "georgia" , "times new roman" , serif;">bes a thir<span style="font-family: "georgia" , "times new roman" , serif;">d type, which occurs rarely during <span style="font-family: "georgia" , "times new roman" , serif;">the later stages of pregnancy</span></span></span>). Type I diabetes is an autoimmune disorder in wh<span style="font-family: "georgia" , "times new roman" , serif;">ich the <span style="font-family: "georgia" , "times new roman" , serif;">islet cells in the pancreas are attacked by the immune system and produce little to no insulin. Those who<span style="font-family: "georgia" , "times new roman" , serif;"> have T1D are required to <span style="font-family: "georgia" , "times new roman" , serif;">constantly monitor their blo<span style="font-family: "georgia" , "times new roman" , serif;">od glucose levels and dose with synthetic insulin to control hormone balance<span style="font-family: "georgia" , "times new roman" , serif;"> <span style="font-family: "georgia" , "times new roman" , serif;">- e</span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;">very <span style="font-family: "georgia" , "times new roman" , serif;">second of every <span style="font-family: "georgia" , "times new roman" , serif;">minute of every hour of every day. Even w<span style="font-family: "georgia" , "times new roman" , serif;">hen <span style="font-family: "georgia" , "times new roman" , serif;">they</span> sleep. Type II diabetes occurs when the body becomes resistent to insulin, for example, when sugar consumption prom<span style="font-family: "georgia" , "times new roman" , serif;">pts a constantly high blood glucose level. The <span style="font-family: "georgia" , "times new roman" , serif;">endocrine pancreas is not able to supply the correct amount of hormone to bring these levels back down <span style="font-family: "georgia" , "times new roman" , serif;">and the misuse of insulin becomes systemic. <span style="font-family: "georgia" , "times new roman" , serif;">T<span style="font-family: "georgia" , "times new roman" , serif;">2D is more common than T1D, and its occurence is growing at a rapid rate<span style="font-family: "georgia" , "times new roman" , serif;"> as we tend toward to more heavily processed and sug<span style="font-family: "georgia" , "times new roman" , serif;">ar filled diet. A variety of <span style="font-family: "georgia" , "times new roman" , serif;">management techniques for T2D <span style="font-family: "georgia" , "times new roman" , serif;">have been reported, and the condition is <i>reversible</i>, meaning that diet and lifestyle modifications have significant influence on the severity of <span style="font-family: "georgia" , "times new roman" , serif;">symptoms<span style="font-family: "georgia" , "times new roman" , serif;"> - good news!</span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></div>
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<span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;">The pancreas, although hidden deep in the abdominal cavity, has huge influences on our daily lives<span style="font-family: "georgia" , "times new roman" , serif;">. It<span style="font-family: "georgia" , "times new roman" , serif;">s dual personality dictates what we <span style="font-family: "georgia" , "times new roman" , serif;">are able to <span style="font-family: "georgia" , "times new roman" , serif;">eat<span style="font-family: "georgia" , "times new roman" , serif;">, which can be<span style="font-family: "georgia" , "times new roman" , serif;"> challenging</span></span><span style="font-family: "georgia" , "times new roman" , serif;"> in a <span style="font-family: "georgia" , "times new roman" , serif;">society which is very food<span style="font-family: "georgia" , "times new roman" , serif;">-</span>centric. But being food driven is not bad. We find commonality, c<span style="font-family: "georgia" , "times new roman" , serif;">ulture and enjoyment out of food<span style="font-family: "georgia" , "times new roman" , serif;"> - as we should! <span style="font-family: "georgia" , "times new roman" , serif;">Taking care of your pancreas involves knowing your limits, specifically with resp<span style="font-family: "georgia" , "times new roman" , serif;">ect to a<span style="font-family: "georgia" , "times new roman" , serif;">lcohol and fast foods, and giving your system a break when requested. <span style="font-family: "georgia" , "times new roman" , serif;">The next time you <span style="font-family: "georgia" , "times new roman" , serif;">enjoy a burger, savor the moment and thank your pancreas for the help<span style="font-family: "georgia" , "times new roman" , serif;">!</span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span> </span></div>
Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-8665783889060378722.post-74312103491045158702017-02-09T14:43:00.003-08:002017-02-10T17:21:02.645-08:00The 'angry organ' <div style="text-align: justify;">
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<span style="font-size: small;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;">The recent explosion of interest in our gut microbiomes <span style="font-family: "georgia" , "times new roman" , serif;">ha<span style="font-family: "georgia" , "times new roman" , serif;">s </span></span></span></span>prompted renewed interest<span style="font-family: "georgia" , "times new roman" , serif;"> in digestive diseases by both academic and pharmaceutical research communiti<span style="font-family: "georgia" , "times new roman" , serif;">es.</span></span> <span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;">However, for every unique individual there is a unique digestive system and a un<span style="font-family: "georgia" , "times new roman" , serif;">iqu<span style="font-family: "georgia" , "times new roman" , serif;">e microbiome<span style="font-family: "georgia" , "times new roman" , serif;"> and </span></span></span>therefore the possibility for unique disease or combination of <span style="font-family: "georgia" , "times new roman" , serif;">disorders</span>. D</span></span>espite high incidence</span>, however, some of the most well understood yet severely under-researched and clinically ignored digestive maladies remain low priority for research funding allocation. Several of these diseases and disorders include malfunction and mis-regulation of critical components of our digestive system<span style="font-family: "georgia" , "times new roman" , serif;"> - the liver, <span style="font-family: "georgia" , "times new roman" , serif;">colon, intestin<span style="font-family: "georgia" , "times new roman" , serif;">es and (<span style="font-family: "georgia" , "times new roman" , serif;">my fa<span style="font-family: "georgia" , "times new roman" , serif;">vorite</span></span>) <span style="font-family: "georgia" , "times new roman" , serif;">the pancreas</span></span></span>.</span> </span></span></div>
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<span style="font-size: small;"><span style="font-family: "georgia" , "times new roman" , serif;"><br /></span></span>
<span style="font-size: small;"><span style="font-family: "georgia" , "times new roman" , serif;">Increased hospitalizations due to acute and chronic pancreatitis alon<span style="font-family: "georgia" , "times new roman" , serif;">e</span> <span style="font-family: "georgia" , "times new roman" , serif;">constitute a heavy burd<span style="font-family: "georgia" , "times new roman" , serif;">e</span>n on </span>the US healthcare system. Chances are, you know at least one individual hospitalized from pancreatitis - annual admissions have risen to <a href="https://www.niddk.nih.gov/health-information/health-statistics/Documents/Digestive_Disease_Stats_508.pdf" target="_blank"><span style="font-family: "georgia" , "times new roman" , serif;">nearly half a million Americans</span></a>. Too much to eat or drink around the holidays? Th<span style="font-family: "georgia" , "times new roman" , serif;">e <span style="font-family: "georgia" , "times new roman" , serif;">resulting abdominal pain may be from the stomach<span style="font-family: "georgia" , "times new roman" , serif;"> as most pe<span style="font-family: "georgia" , "times new roman" , serif;">ople suspect</span></span>, but there is a good chance it is from the pancreas (which hides just <i>behind</i> the stomach and is often neglected in Emergency Room settings). </span></span>Other diseases and disorders which have a pancreatic component are types I and II diabetes (T1D and T2D, respectively), cystic fibrosis and Shwachman-Diamond syndrome (the later two being extremely rare). Both endocrine and exocrine pancreatic insufficienc<span style="font-family: "georgia" , "times new roman" , serif;">ies</span> are <span style="font-family: "georgia" , "times new roman" , serif;">a symptom</span> of <i>some</i> form of pancreatic malfunction, and it is well established that pancreatic cancer<span style="font-family: "georgia" , "times new roman" , serif;"> comes with</span> a higher mortality rate than most (although <a href="http://cen.acs.org/articles/95/web/2017/02/Pancreatic-cancer-biomarker-bolsters-nanoparticle.html?utm_source=Newsletter&utm_medium=Newsletter&utm_campaign=CEN" target="_blank"><span style="font-family: "georgia" , "times new roman" , serif;">recently published research</span></a> <span style="font-family: "georgia" , "times new roman" , serif;">may <span style="font-family: "georgia" , "times new roman" , serif;">improve <span style="font-family: "georgia" , "times new roman" , serif;">detection of early stage (I and II) pancreatic cancer</span></span></span>).</span></span></div>
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<span style="font-size: small;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;">Describing and treating</span> diseases of the pancreas proves challenging due to the highly <span style="font-family: "georgia" , "times new roman" , serif;">sensitive and often <span style="font-family: "georgia" , "times new roman" , serif;">extremely reactive nature of th<span style="font-family: "georgia" , "times new roman" , serif;">is</span> gland<span style="font-family: "georgia" , "times new roman" , serif;">. Physicians avoid pa<span style="font-family: "georgia" , "times new roman" , serif;">lpating or working anywhere near th<span style="font-family: "georgia" , "times new roman" , serif;">e</span> 'angry organ' due to the likelyhood of induced pancreatitis.<span style="font-family: "georgia" , "times new roman" , serif;"> <span style="font-family: "georgia" , "times new roman" , serif;">Due to the <span style="font-family: "georgia" , "times new roman" , serif;">increased</span> volume of </span></span>reported pancreatic disorders and <span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;">comparative inexperience</span></span> in dealing with the pancreas (as oppo<span style="font-family: "georgia" , "times new roman" , serif;">sed to the liver or stomach, for example</span>) both in the lab and on the operating table, a <span style="font-family: "georgia" , "times new roman" , serif;">pr<span style="font-family: "georgia" , "times new roman" , serif;">omising <span style="font-family: "georgia" , "times new roman" , serif;">research <span style="font-family: "georgia" , "times new roman" , serif;">arena exists and is <span style="font-family: "georgia" , "times new roman" , serif;">in desperate need<span style="font-family: "georgia" , "times new roman" , serif;"> of attention</span></span></span></span></span>. <span style="font-family: "georgia" , "times new roman" , serif;">Pancreatitis (inflammation of the pancreas)<span style="font-family: "georgia" , "times new roman" , serif;">, which is a component of <span style="font-family: "georgia" , "times new roman" , serif;">most pancreatic diseases and <span style="font-family: "georgia" , "times new roman" , serif;">disorders, may be broadly</span></span></span> classified into three categories - acute (short liv<span style="font-family: "georgia" , "times new roman" , serif;">ed, <span style="font-family: "georgia" , "times new roman" , serif;">often related to a<span style="font-family: "georgia" , "times new roman" , serif;">n isolated</span> incident</span></span>), chronic (persistent, often related to alcohol consumption or gall<span style="font-family: "georgia" , "times new roman" , serif;"> stones</span>) and <span style="font-family: "georgia" , "times new roman" , serif;">idiopathic<span style="font-family: "georgia" , "times new roman" , serif;"> (a fancy term for 'unknown cause'). The mechanisms of action through which <span style="font-family: "georgia" , "times new roman" , serif;">acute and chronic pancreatitis occur are <span style="font-family: "georgia" , "times new roman" , serif;"><i>more</i> thoroughly documented (click <a href="http://www.nejm.org/doi/pdf/10.1056/NEJMra1505202" target="_blank">here</a> for a <span style="font-family: "georgia" , "times new roman" , serif;">recent r<span style="font-family: "georgia" , "times new roman" , serif;">eview about acute pancreatitis</span></span>)</span><span style="font-family: "georgia" , "times new roman" , serif;">, but <span style="font-family: "georgia" , "times new roman" , serif;">an increasing number of individuals present <span style="font-family: "georgia" , "times new roman" , serif;">with idiopathic pancreatitis. Much like <span style="font-family: "georgia" , "times new roman" , serif;">a </span>diagnosis of fibromyalg<span style="font-family: "georgia" , "times new roman" , serif;">ia, the diagnosis of idiopathic pancreatitis is often one of elimination when no other obvious cause for symptoms is discovered. The root cause of discomfort and additional symptoms may <span style="font-family: "georgia" , "times new roman" , serif;">remain elusive fo<span style="font-family: "georgia" , "times new roman" , serif;">r years or never fully resolve. </span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span><br />
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<span style="font-size: small;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;">An understanding of the many personalities of the pancreas, and how <span style="font-family: "georgia" , "times new roman" , serif;">each persona</span> interacts with the rest of our digestive system, may <span style="font-family: "georgia" , "times new roman" , serif;">explain</span> points of malfunction and misdiagnosis<span style="font-family: "georgia" , "times new roman" , serif;"> - and hopefully <span style="font-family: "georgia" , "times new roman" , serif;">provide relief for thos<span style="font-family: "georgia" , "times new roman" , serif;">e of us still asking <span style="font-family: "georgia" , "times new roman" , serif;">'what <span style="font-family: "georgia" , "times new roman" , serif;">is going on and why is this happening?'</span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></div>
<br />Unknownnoreply@blogger.com0