Five kinds of Alzheimer’s

This is a Big Deal: It seems that there isn’t a single “Alzheimer’s disease” but rather multiple versions — five of them, to be specific. That’s what an international team found after examining the cerebral-spinal fluid of 600 people (and publishing in Nature Aging.)

Those different subtypes have variations in how they present themselves and — critically — they react differently to treatment, including having different side effects. That might explain why treatment seems to be so hit-and-miss.

This could mean some drugs only work in one Alzheimer’s type. Amyloid focused medication, for instance, may treat a subtype with increased amyloid production but potentially harm a subtype with decreased production.

Obviously more research is needed, but if these findings are accurate it could upend the entire Alzheimer’s-treatment landscape.

The latest legislative update

GPhA’s VP of public policy, Melissa Reybold, has penned the latest of her 2024 legislative updates. The legislative session is just getting started, so she had time to check out the Georgia Board of Pharmacy meeting, too. Read all about it!

Federal scientists: Make marijuana C-III

Scientists from the FDA and the National Institute on Drug Abuse have written a 250-page review and now recommend “that the Drug Enforcement Administration make marijuana a Schedule III drug, alongside the likes of ketamine and testosterone, which are available by prescription.”

The DEA still considers marijuana a schedule-I drug — as dangerous as heroin or LSD and without any medical use; clearly that’s not the case. (GPhA has no official position on the legalization of marijuana, but that doesn’t mean certain facts aren’t obvious.)

The review by federal scientists found that even though marijuana is the most frequently abused illicit drug, “it does not produce serious outcomes compared to drugs in Schedules I or II.”

Marijuana abuse does lead to physical dependence, the analysis noted, and some people develop a psychological dependence. “But the likelihood of serious outcomes is low,” the review concluded.

Still, the DEA’s position makes marijuana illegal to possess on the federal level, even though 24 states have made it legal for recreational use and 38, including Georgia, have legalized it to some extent for medicinal use. Even parts of Georgia have decriminalized it (Atlanta, Clarkston, Forest Park, Savannah, South Fulton, Statesboro, as well as unincorporated Fulton County and Macon–Bibb County), meaning possession of certain amounts is subject to the equivalent of a traffic ticket.

Will this be the impetus for a federal change? We’ll see.

AIP on the road

The folks from GPhA’s Academy of Independent Pharmacy are still on their statewide “DIR Hangover Preparation Tour” — now in North Georgia. That’s where they met with Will Crowley, owner of Crowley Drug Company in Calhoun.

Here we’ve got (l to r) AIP VP Jonathan Marquess; Will Crowley, PharmD; and Member Service Rep Ashton Sullivan

Fun fact: Will started Crowley Drug nine years ago — from scratch!

Stopping flu’s spread

Stopping the flu virus from getting in (or getting hold) protects one person, but why not find a way to stop the virus from getting out, too?

NYU researchers think they’ve found a way to do just that, which could lead to treatments that not only protect the patient, but prevent the virus from spreading.

There’s been plenty of talk about viruses’ spike protein, but this research looked at the other side — the sialic acid (SA) receptors on cells that the spike protein attaches to. They used an enzyme that makes those receptors less receptive, thus keeping the virus from attaching even when it got past the immune system.

[K]eeping virus particles from attaching to SAs limits more than just the entry of influenza A viral infections, but also hinders their exit (shedding) and transmission from mouse to mouse.

This could keep a small outbreak from becoming large, and a large outbreak from spreading further. (Or farther. I always mix those up.)

An epilepsy drug — for arthritis

Finding a totally new use for an existing drug is always good news (because it means a shorter path to approval). One of the latest: epilepsy drugs might slow down the joint degeneration that comes with arthritis.

It seems there’s a sodium channel called Nav1.7 that produces electrical impulses in muscles (and is thus related to epilepsy) but — and here’s the kicker — “the same Nav1.7 channels are also present in non-excitable cells that produce collagen and help maintain the joints in the body.”

So maybe a drug that blocks Nav1.7 to treat epilepsy might also help slow the progression of osteoarthritis. In fact, Yale researchers found, it does just that:

[D]rugs used to block Nav1.7 — including carbamazepine, a sodium channel blocker currently used to treat epilepsy and trigeminal neuralgia — also provided substantial protection from joint damage in the mice.

Omega-3s vs lung fibrosis

Omega 3 fats, like those in fish and nuts (and, you know, supplements) keep turning out to do some serious good for people. The latest: They seem to slow the progression of pulmonary fibrosis.

A study out of UVA looked at the health records of 300 people with interstitial lung disease. The researchers found…

… that higher levels of omega-3 fatty acids in the blood plasma were associated with better ability to exchange carbon dioxide and longer survival without the need for a lung transplant. This did not vary much regardless of smoking history or whether the patients had cardiovascular disease.

Why does it work? Dunno, so you know the mantra: More research is needed.

Frankincense is more than a perfume

If we were a tabloid, the headline would be “Frankincense treats breast cancer!” But we’re not. The actual story is that an extract from the tree that produces frankincense seems to slow the spread of breast cancer cells — in a small study in the lab.

The extract — Boswellia — has some interesting anti-cancer properties, according to researchers at the Medical University of South Carolina. Why it works and how important this discovery is, is still up in the air. But it’s these small breakthroughs that eventually lead to the big ones.

Nifty research tool

Despite it coming for our jobs here at GPhA Buzz, we kinda like playing with AI. A lot of new tools are coming out using the same technology as ChatGPT but with different data sets in their libraries.

One that caught our attention is called Consensus, which lets you ask questions about research on a particular subject to see what conclusions have been reached (and the papers describing them).

Essentially, Consensus has read a gadzillion research papers for you, so rather than just do a keyword search like some kind of ranch hand, you ask your question in plain English.

Just for fun, we used the previous story as a test. “Can Boswellia extract affect breast cancer?” we prompted. Consensus found 10 papers that suggested that yes, it might. The summary:

These studies suggest that Boswellia extracts, containing boswellic acids and their derivatives, can potentially affect breast cancer by reducing inflammation, targeting molecular pathways, and exhibiting cytotoxicity against treatment-resistant and triple-negative breast cancer cells.

It’s free, so perhaps worth a gander….