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Letters to the Editor Issue 258

by Letters(more info)

listed in letters to the editor, originally published in issue 258 - November 2019

 

Robocath Successfully Carries Out its First Robotic Coronary Angioplasties in Humans

 

Republished from ala.com

http://ala.com/robocath-successfully-carries-out-its-first-robotic-coronary-angioplasties-in-humans/

 

Rouen, September 24, 2019 – Robocath, a company that designs, develops and commercializes cardiovascular robotic systems for the treatment of vascular diseases, today announces the success of its first two coronary angioplasties performed with assistance from its R-One™ robotic platform. The procedures were performed in France at Rouen University Hospital by Professor Durand and Professor Sabatier and at Clinique Pasteur in Toulouse by Doctor Fajadet.

R-One™ assists interventional cardiologists in performing coronary angioplasties. The robotic platform is designed to facilitate and enhance interventional procedures performed for the patient and offers a better working environment for physicians and the entire medical team.

This prospective clinical study is the first of its kind to be conducted in Europe. It involves six European centres, three of which are based in France (Rouen University Hospital, Caen University Hospital, Clinique Pasteur in Toulouse). The study will involve 60 patients and aims to demonstrate the safety and efficacy of the robotic-assisted platform R-One™ in coronary angioplasties.

 

Top Pr Durand-left, Pr Sabatier-right, Bottom Dr Fajadet Clinique Pasteur

Top Pr Durand-left, Pr Sabatier-right, Bottom Dr Fajadet Clinique Pasteur

 

Dr Philippe Bencteux, president and founder of Robocath, says: “These two successes mark a new era in the way interventional cardiology is practiced in Europe today. It is a project we have worked on for several years and the entire team and I are extremely proud of the success of these two procedures.”

Professor Eric Durand, interventional cardiologist at Rouen University Hospital, comments: “I feel particularly privileged to have been given the opportunity several years ago to participate in this project and to now arrive at this first procedure in a human with excellent results.”

“I am delighted with the success of these procedures. It is rewarding to see Rouen University Hospital continuing to support cutting edge innovations in the medical sector, nearly twenty years after conducting our first aortic valve implantation in the same operating room,” says Alain Cribier, Professor Emeritus in Interventional Cardiology and Inventor of TAVI (Transcatheter Aortic Valve Implantation).

Dr Jean Fajadet, co-director of the Interventional Cardiology Unit at Clinique Pasteur in Toulouse, continues: “I am very happy with the success of these procedures and confident regarding the study results. We are on the cusp of a major revolution in the field of interventional cardiology, thanks to the possibilities opened up by vascular robotics that we are developing at Clinique Pasteur.”

Professor Rémi Sabatier, interventional cardiologist at Caen University Hospital, adds: “It was an honor for me to participate to this first robotized angioplasty. I’m delighted to share the joy of the teams who accompanied us on this adventure, which I’m looking forward to continuing at Caen University Hospital.”

Lucien Goffart, CEO of Robocath, concludes: “It is a French success story that has been supported by all of our employees and by highly invested medical and technical teams, to whom I would today like to extend my warmest thanks and congratulations. It is a crucial step in our development and one that will pave the way for a transformation of the sector. This transformation involves all of the players in the industry and inevitably leads us to think about this industry in broader terms, thanks to the new possibilities offered by robotics, particularly in terms of the interoperability of equipment.”

About Rouen University Hospital

The cardiology department of the University Hospital of Rouen is a reference for the management of cardio-vascular diseases, the leading cause of death in the world and a major cause of call and consultation in the emergency department. The cardiology department was the first to implant a percutaneous aortic valve in 2002, a major medical advance. This intervention carried out by Professor Cribier and his team offers an alternative care to patients with severe aortic stenosis at high risk of surgical mortality. More than 250,000 people have benefited from this technique in the world to date. Rouen University Hospital intends to continue this dynamic of research and innovation internationally.

www.chu-rouen.fr/

About Clinique Pasteur, Toulouse

As the first independent private clinic in France, Clinique Pasteur has been making use of its expertise in cardiology for more than 30 years, with its team of professionals striving for excellence and innovation every day. The clinic has a cardiac center created by health care professionals with patients in mind and was designed to optimize patient care in cardiology. Ultra-modern interventional cardiology units are equipped with highly technical facilities and, starting this year, now integrate robotic-assisted angioplasty in their daily practice.

www.clinique-pasteur.com/en

About Robocath

Founded in 2009 by Philippe Bencteux, MD, Robocath designs, develops and commercializes robotic solutions to treat cardiovascular diseases. As an active player in the evolving medical robotic industry, these innovative solutions aim to make medical procedures safer thanks to reliable technologies, while complementing manual interventions.

R-One™ is the first solution developed by Robocath. It uses a unique technology that optimizes the safety of robotic-assisted coronary angioplasty. This medical procedure consists of revascularizing the cardiac muscle by inserting one or more implants (stents) into the arteries that supply it with blood. Every 30 seconds, somewhere in the world, this type of procedure is performed.

R-One™ is designed to operate with precision and perform specific movements, creating better interventional conditions. Thanks to its open architecture, R-One™ is compatible with market-leading devices and catheter labs. It received the CE marking in February 2019.

Robocath aims to become the world leader in vascular robotics and develop the remote treatment of vascular emergencies, guaranteeing the best care pathway for all.

Based in Rouen (France), Robocath has more than 25 employees and is financially supported by regional investment funds (GO CAPITAL, NCI, Normandy participations), national investment funds (M Capital, Supernova Invest), by several business angels and financial institutions (Caisse d’épargne, BNP Paribas, Crédit Agricole) and Bpifrance.

www.robocath.com

Source and Contact

Andrew Lloyd & Associates
Céline Gonzalez / Jo Reeder
Tel: UK: + 44 1273 675 100
Tel: US: + 1 617 202 4491

Acknowledgement Citation

Republished from ala.com

http://ala.com/robocath-successfully-carries-out-its-first-robotic-coronary-angioplasties-in-humans/

 

 

 

DNA is Held Together by Hydrophobic Forces

by Bobo Feng et al.

 

Republished from mynewsdesk.com

https://www.mynewsdesk.com/uk/chalmers/pressreleases/dna-is-held-together-by-hydrophobic-forces-2922277  

 

Researchers at Chalmers University of Technology, Sweden, disprove the prevailing theory of how DNA binds itself. It is not, as is generally believed, hydrogen bonds which bind together the two sides of the DNA structure. Instead, water is the key. The discovery opens doors for new understanding in research in medicine and life sciences. The researchers’ findings are presented in the journal PNAS.[1]

 

DNA Hydrophic Environment

For DNA to be read, replicated or repaired, DNA molecules must open themselves. This happens when the cells use a catalytic protein to create a hydrophobic environment around the molecule. Illustration: Yen Strandqvist/Chalmers

 

DNA is constructed of two strands, consisting of sugar molecules and phosphate groups. Between these two strands are nitrogen bases, the compounds which make up organisms’ genes, with hydrogen bonds between them. Until now, it was commonly thought that those hydrogen bonds were what held the two strands together.

But now, researchers from Chalmers University of Technology show that the secret to DNA’s helical structure may be that the molecules have a hydrophobic interior, in an environment consisting mainly of water. The environment is therefore hydrophilic, while the DNA molecules’ nitrogen bases are hydrophobic, pushing away the surrounding water. When hydrophobic units are in a hydrophilic environment, they group together, to minimise their exposure to the water.

The role of the hydrogen bonds, which were previously seen as crucial to holding DNA helixes together, appear to be more to do with sorting the base pairs, so that they link together in the correct sequence. The discovery is crucial for understanding DNA’s relationship with its environment.

“Cells want to protect their DNA, and not expose it to hydrophobic environments, which can sometimes contain harmful molecules,” says Bobo Feng, one of the researchers behind the study. “But at the same time, the cells’ DNA needs to open up in order to be used.

“We believe that the cell keeps its DNA in a water solution most of the time, but as soon as a cell wants to do something with its DNA, like read, copy or repair it, it exposes the DNA to a hydrophobic environment.”

Reproduction, for example, involves the base pairs dissolving from one another and opening up. Enzymes then copy both sides of the helix to create new DNA. When it comes to repairing damaged DNA, the damaged areas are subjected to a hydrophobic environment, to be replaced. A catalytic protein creates the hydrophobic environment. This type of protein is central to all DNA repairs, meaning it could be the key to fighting many serious sicknesses.

Understanding these proteins could yield many new insights into how we could, for example, fight resistant bacteria, or potentially even cure cancer. Bacteria use a protein called RecA to repair their DNA, and the researchers believe their results could provide new insight into how this process works – potentially offering methods for stopping it and thereby killing the bacteria.

In human cells, the protein Rad51 repairs DNA and fixes mutated DNA sequences, which otherwise could lead to cancer.

“To understand cancer, we need to understand how DNA repairs. To understand that, we first need to understand DNA itself,” says Bobo Feng. “So far, we have not, because we believed that hydrogen bonds were what held it together. Now, we have shown that instead it is the hydrophobic forces which lie behind it. We have also shown that DNA behaves totally differently in a hydrophobic environment. This could help us to understand DNA, and how it repairs. Nobody has previously placed DNA in a hydrophobic environment like this and studied how it behaves, so it’s not surprising that nobody has discovered this until now.”

More information on the methods the researchers used to show how DNA binds together

The researchers studied how DNA behaves in an environment which is more hydrophobic than normal, a method they were the first to experiment with. They used the hydrophobic solution polyethylene glycol, and step-by-step changed the DNA’s surroundings from the naturally hydrophilic environment to a hydrophobic one. They aimed to discover if there is a limit where DNA starts to lose its structure, when the DNA does not have a reason to bind, because the environment is no longer hydrophilic. The researchers observed that when the solution reached the borderline between hydrophilic and hydrophobic, the DNA molecules’ characteristic spiral form started to unravel.

Upon closer inspection, they observed that when the base pairs split from one another (due to external influence, or simply from random movements), holes are formed in the structure, allowing water to leak in. Because DNA wants to keep its interior dry, it presses together, with the base pairs coming together again to squeeze out the water. In a hydrophobic environment, this water is missing, so the holes stay in place.

References

1. Bobo Feng, Robert P. Sosa, Anna K. F. Mårtensson, Kai Jiang, Alex Tong, Kevin D. Dorfman, Masayuki Takahashi, Per Lincoln, Carlos J. Bustamante, Fredrik Westerlund, and Bengt Nordén. Hydrophobic Catalysis and a Potential Biological Role of DNA Unstacking Induced by Environment Effects. Proceedings of the National Academy of Sciences of the United States of America (PNAS). 116 (35) 17169-17174; 27 August 2019; first published 14 August 2019. https://doi.org/10.1073/pnas.1909122116

Further Information and Contact

  • Bobo Feng, Postdoc, Chemistry and Chemical Engineering, Chalmers University of Technology +46 31-772 30 60, bobo.feng@chalmers.se
  • Bengt Nordén, Professor, Chemistry and Chemical Engineering, Chalmers University of Technology, +46 31 772 30 41, norden@chalmers.se

About Chalmers University of Technology

Chalmers University of Technology in Gothenburg conducts research and education in technology and natural sciences at a high international level. Chalmers was founded in 1829 and has the same motto today as it did then: Avancez – forward. The university has 3100 employees and 10,000 students, and offers education in engineering, science, shipping and architecture. The EU’s biggest research initiative – the Graphene Flagship – is coordinated by Chalmers who are also leading the development of a Swedish quantum computer.

Acknowledgement Citation

Republished from mynewsdesk.com

https://www.mynewsdesk.com/uk/chalmers/pressreleases/dna-is-held-together-by-hydrophobic-forces-2922277

 

 

 

Bacteria Injections Help the Immune System Fight Cancer

Published in Frontiers in Oncology

 

After decades of mouse studies, bacterial immunotherapy looks set for a comeback

Cancers evade destruction by convincing some immune cells to suppress others. But a surprising interlocutor can persuade the suppressors to defect, and the destroyers to redouble.

A review published in Frontiers in Oncology[1] explains how bacteria can rally immune cells to attack tumours, via ancient lines of chemical communication with our immune system. Decoding these molecular signals is key to developing bacteria as a safe, targeted and effective treatment for cancer.

Coley’s Toxins

Over a century ago, surgeon William Coley successfully treated a variety of cancers with injections of heat-killed bacteria. Shocked? His contemporaries certainly were. Soon, the rise of radiotherapy and stricter drug safety laws confined “Coley’s toxins” to the laboratory.

But there, scientists continue to test bacteria like Salmonella, Clostridium and Listeria –which replicate inside host cells – on mice bearing tumours from breast, colon, skin and other cancers. After injection into the blood or tissues, these bacteria preferentially accumulate within tumours – arresting their growth and spread, and prolonging survival.

Mouse Studies

Now bacterial immunotherapy may soon return to the oncology clinic, says a review of these mouse studies. According to senior author Prof. Basel al-Ramadi of United Arab Emirates University, they show how “bacteria can reprogram the immune response to cancer” via targets in innate immunity. Serviced primarily by ‘myeloid cells’, this is the body’s evolutionarily ancient first line of defence.

Tumours produce signals that compel myeloid cells to suppress immune attack, help feed the cancer through new blood vessels, and even pave its way to spread around the body. But many bacterial components –old familiar signals to the vertebrate innate immune system – reverse this. Myeloid cells are drawn to the bacteria-infected tumour to become its enemies: killers that engulf and digest cancer cells; detectives that present incendiary evidence of the tumor called “antigens” to other immune cells; and disenchanted defenders that stop suppressing immune attack.

Crucially, the bacterially reprogrammed myeloid cells send a chemical call-to-arms to their highly specialized cousins: lymphoid cells. These then recognize infected cancer cells as foreign, applying toxins that force them to self-destruct. Lymphoid cells thus intensify anti-tumour effects, and can even prevent recurrence via long-lived cells that recall the tumour.

Return to the clinic

This immune memory and other potential advantages over chemo- and radiotherapy – like active penetration of tumours – make bacterial immunotherapy a hugely exciting prospect for human cancer treatment. Safe use requires bacteria be modified so that they cannot cause disease, but this has often made them less effective. Knowing which properties of bacteria contribute to anti-tumour immunity is allowing intelligent design of safe new strains – which can also produce antigens, pro-inflammatory proteins, or antibodies that augment tumour killing.

With promising results in early clinical trials, the slow but inexorable advancement back to the clinic continues for Coley’s toxins.

Reference

1. https://www.frontiersin.org/articles/10.3389/fonc.2018.00136/full

Source and Further Contact

Corresponding Author: Prof. Basel al-Ramadi: ramadi.b@uaeu.ac.ae

Source: Frontiers Press press@frontiersmedia.vuelio.co.uk 

Reply-To: Frontiers Press press@frontiersin.org

Frontiers

Frontiers is an award-winning Open Science platform and leading Open Access scholarly publisher. Our mission is to make research results openly available to the world, thereby accelerating scientific and technological innovation, societal progress and economic growth. We empower scientists with innovative Open Science solutions that radically improve how science is published, evaluated and disseminated to researchers, innovators and the public. Access to research results and data is open, free and customized through Internet Technology, thereby enabling rapid solutions to the critical challenges we face as humanity. For more information, visit http://www.frontiersin.org  @Frontiersin on Twitter.

 

 

 

Vitamin B12, Cancer and the Rumour Mill

by Rob Verkerk PhD
Founder, Scientific and Executive Director
Alliance for Natural Health International

 

The Science has Long Suggested  

There’s a string of papers that suggest that long-term use of vitamin B12 is protective against cancer, especially breast and cervical cancers. But one study has sown the seed of mistrust over a vitamin that has long been seen as the archetypal safe vitamin – at almost any dose. It’s also one that many people are deficient in, especially vegetarians and vegans. Being a one-carbon metabolism nutrient – one that’s essential for cell division, B12’s functions go way beyond simply reducing cancer. They affect almost every system in the body, especially cell division and blood cell formation, energy-yielding, neurological, psychological, immune and cardiovascular systems. The clinical benefits of the vitamin have also been well established. Examples include its ability to reduce the risk of ischaemic stroke and Alzheimer’s disease.

 

Vitamin B12

Vitamin B12

 

Enter the Rumour Mill

But, let’s not forget the effects of the rumour mill. This very well-oiled one that has variously put question marks over the value of multivitamins, folate, vitamin E and beta-carotene, is at it again. Even regulators are getting ‘worried’ about B12. As we write this, we’re busy providing the scientific case to help to reverse decisions by some European regulators to pull high dose vitamin B12 (over 500 mcg per daily dose = 20,000% of the EU Nutrient Reference Value) off the shelf.

What Fuelled the Rumour Mill?

There are two studies that lie at the heart of the concerns: one good ‘un and one dud. Let’s look at the dud first. Theodore Brasky and colleagues from the Fred Hutchinson Cancer Research Center in Seattle, along with another from the National Taiwan University, did an analysis of the Vitamins and Lifestyle (VITAL) cohort in the UK and published it in 2017. What they observed was an association between lung cancer and those taking multivitamins that contain vitamin B12 over 55 µg/day and vitamin B6, another one-carbon metabolic nutrient, over 20 mg/day. Astonishingly given their questionable sources of data and inherent biases, they concluded that multis are not only not protective against lung cancer, they might even be harmful, inducing more cancer.

The thing is, the data sources (including a questionnaire with a 23% response rate) included so many uncontrolled sources of variance and bias, but without any supporting blood measurements. It’s impossible to draw the conclusions the scientists did. Fortunately, an astute peer-reviewed response to the paper in the same journal, the following year, by two German scientists, Rima Obeid and Klaus Pietrzik, kicked the trash conclusions into touch (J Clin Oncol. 2018; 36(6): 626-627).  https://ascopubs.org/doi/full/10.1200/JCO.2017.75.9472

How to Make 2 and 2 Make 5

Now, to the good quality study. This one was published in 2016 by Johan Arendt and colleagues from the Department of Clinical Epidemiology at Aarhus Hospital in Denmark. https://www.sciencedirect.com/science/article/pii/S1877782115002854?via%3Dihub

These researchers carried out a cohort study based on data from Danish medical registries between the years 1998 and 2014. They looked at circulating vitamin B12 (cobalamin) levels in around 25,000 subjects one year prior to a cancer diagnosis, and compared these with about 60,000 cancer patients for whom blood cobalamin hadn’t been measured.  

What they found was enough to put a shiver up the spine of any die-hard B12 lozenge-lover or IV addict: sky high levels of B12 in those who died quickest. But like with all medical research – you’ve got to look beneath the covers. There you’ll find that Dr Arendt and colleagues were at pains to say these very high levels of B12 have absolutely nothing to do with dietary intake or any other external sources of B12.

The authors speculated: “these associations reflect underlying alterations in the Cbl [cobalamin] metabolism caused by the cancer.”  They went on to say, “We speculate that cancer causes changes in the Cbl metabolism which then give rise to high plasma Cbl levels. Our interpretation is thus that the cancer somehow induces high Cbl levels, not that high Cbl levels cause cancer or promote a more aggressive cancer.”

What they discovered is an anomaly in blood levels linked to what happens when people get cancer. B12 reserves in the liver, it seems, get mobilized as the body moves into rapid cell division and tumour-creation mode. Cancer is itself a complex imbalance relating to multiple systems, and it redirects metabolism in ways that allows it to recruit the nutrients it needs. You’ve all heard of sugar being one of them. Well, you can add folate and B12 to that list. Just remember: there’s no evidence that elevated vitamin B12 triggers or promotes cancer – in fact, our old friend B12 can act as a one-carbon nutrient to help multiple other systems, including the immune and mitochondrial systems, both of which are especially greedy for nutrients when they’re firing on all cylinders when under assault from cancer!

The long and short is that you must draw conclusions based on the overall evidence. You’ll now perhaps appreciate how the 2017 analysis of the VITAL cohort, coupled with a misreading of the Danish study by Arendt and colleagues in 2016, has caused a fair number to add 2 and 2 incorrectly.

When 2 and 2 Makes 4, in the Absence of the Rumour Mill

So – go forth – and don’t be fearful of vitamin B12, other than being concerned you might not be getting enough of the stuff. And if you’ve chosen to limit meat from your diet – it’s especially important you get additional B12, and you’ll benefit especially when it’s a few thousand percent over the level recommended by governments.

Get B12, MMA and Homocysteine Checked

What we also know is that for those who deficient in circulating cobalamin, high dose B12, B12 injections or IV B12, can be the only way of getting you into the optimal zone.

If you’re in any doubt about your B12 status, we suggest you get your blood cobalamin levels tested along with the closely related methylmalonic acid (MMA) and homocysteine. That’s something your nutritional practitioner or functional medicine doctor or health professional can help you get sorted.

Acknowledgement Citation

Republished from ANH International 

https://www.anhinternational.org/news/vitamin-b12-cancer-and-the-rumour-mill

 

 

Engineered T Cells May Be Harnessed to Kill Solid Tumor Cells

Novel immunotherapy extends therapy now used in fighting leukemia. There is now a multitude of therapies to treat cancer, from chemotherapy and radiation to immunotherapy and small molecule inhibitors. Chemotherapy is still the most widely used cancer treatment, but chemotherapy attacks all the rapidly dividing cells that it locates within the body, whether they're ultimately harmful or beneficial.

A new Tel Aviv University study led by Dr Yaron Carmi of TAU's Sackler Faculty of Medicine finds that a form of immunotherapy used to treat the blood cancer leukemia may be effective in treating other kinds of cancer as well. A form of leukemic immunotherapy known as chimeric antigen receptors (CAR) T-cell therapy may also be effective in killing solid tumor cells coated in specific antibodies, the researchers say. The study was published in the Journal of Clinical Investigation on August 26.[1]

"Chemotherapy damages all fast-growing cells, including hair follicles and cells that line the gastrointestinal tract, and this attack on healthy cells causes serious side effects, which include hair loss, nausea, mood changes, pain, anaemia, nerve and muscle problems, and kidney issues," explains Dr Carmi. "Immunotherapy, on the other hand, is a type of biological therapy that uses the body's own immune system to seek out and destroy cancer cells. Engineered T cells have been proven very successful in treating blood cancer but attempts to use them to fight solid cancers have been disappointing.

"Our engineered cells have now shown efficacy in attacking solid tumors as well," Dr. Carmi says.

CAR T-cell therapy is a form of immunotherapy that uses altered T cells to fight cancer. T cells are a type of lymphocyte, or white blood cell, that plays a central role in the immune response. T cells are collected from the patient and modified in the lab to produce structures called CARs on their surface. These receptors allow the T cells to attach to a specific antigen on the tumor cells and kill them.

Side effects from immunotherapy may include severe inflammation, caused by an overactive immune system working to fight tumor cells.

"Patients who utilize CAR T-cell therapy experience significantly fewer side effects than with chemotherapy," adds Dr Carmi. "And while chemotherapy is only effective while the drug is in the body, immunotherapy provides long-lasting protection against cancer.

"Our lab discovered a distinct subset of helper T cells, also known as CD4+ T cells, that express the high-affinity receptor for IgG [an antibody] and efficiently kill tumor cells coated with these antibodies," explains Dr. Carmi. "This method uses CAR T-cell therapy and combines it with antibody specificity. Based on this discovery we were able to engineer novel T cells with enhanced tumor-killing activity and higher specificity, compared with other T cell-based therapies for cancer.

"Our engineered cells have the potential to overcome barriers usually faced by CAR T-cell therapy and have shown efficacy in solid tumors. This finding has the capability to change the way cancer is treated, demonstrating that the immune system can be utilized to identify and fight all types of cancer."

The researchers are now testing their configuration of engineered T cells in preclinical mouse models of cancer and in human samples. They hope to start a phase I clinical trial within three years.

Reference

  1. Diana Rasoulouniriana, Nadine Santana-Magal, Amit Gutwillig, Leen Farhat-Younis, Yariv Wine, Corey Saperia, Lior Tal, Haim Gutman, Alexander Tsivian, Ronen Brenner, Eiman Abu Bandora, Nathan E. Reticker-Flynn, Peleg Rider, Yaron Carmi. A distinct subset of FcγRI-expressing Th1 cells exert antibody-mediated cytotoxic activity. Journal of Clinical Investigation, 2019; 129 (10): 4151 DOI: 10.1172/JCI127590  https://www.jci.org/articles/view/127590

Contact and Further Information

George Hunka < <ghunka@aftau.org> >

Jordan Isenstadt Marino <jisenstadt@marinopr.com>

 

 

UK Healthcare Professionals Review Alternatives to Antibiotics, Compile GP & Patient Plan

  • Increasing research blames widespread antibiotic use for the emergence of antibiotic resistance bacteria, which is currently one of the biggest threats to global health;[1]
  • Antibiotic resistance is currently responsible for an estimated 700,000 deaths a year;[2]
  • Leading UK healthcare professionals gathered to explore the feasibility of reinvigorating selfcare and natural approaches to reduce the call on antibiotic prescriptions;
  • Workshop attendees reviewed a draft GP action plan and patient guide to home care approaches in the absence of antibiotics.   

On Thursday 3rd October, leading UK healthcare professionals gathered in London to discuss alternatives to antibiotics, amidst growing concerns about the emergence of antibiotic resistant bacteria – currently one of the biggest threats to global health.[3] Antibiotic resistance is responsible for an estimated 700,000 deaths a year and could be responsible for 10 million deaths by 2050, recent research warns.[4] The NHS and NICE agree that antibiotics should no longer routinely be used to treat common, self-limiting infections.

Earlier this year, the government published a 20-year vision and five-year action plan to combat the rise and spread of antimicrobial resistance (new strains of microbes, primarily bacteria, that resist treatment with existing medicines). A major focus of the plan is “to make sure current antibiotics stay effective by reducing the number of resistant infections and supporting clinicians to prescribe appropriately.”[5] As a result of the government’s commitment to “reducing the use of antibiotics in humans by 15%”,[6] it is anticipated that many patients will be left asking what they can take, and many GPs left wondering what to prescribe.

At the Chelsea Physic Garden on 3 October, Professor Michael Depledge, Dr Amit Bhargava and Professor Debbie Sharp were among those exploring the feasibility of reinvigorating selfcare approaches to reduce the call on antibiotic prescriptions. Self-care examples discussed include over-the-counter remedies like pelargonium, andrographis and mushroom supplements to reduce the impact of infections, or building immunity against regular infections with exercise, probiotics, or zinc supplements. The discussions and conclusions from the event will feed into a draft evidence-base, especially for GPs and health policy makers, and self-care guide for the public. After both documents have been reviewed at the event, immediately afterwards they will then be published on the College of Medicine’s Our Health Directory on-line resource and offered for publication and promotion by other public health bodies.

The event was co-hosted by the College of Medicine, whose Chairman is Dr Michael Dixon (National Clinical Lead for Social Prescription, NHS England).  The recent commitment by NHS England to ‘social prescribing’ acknowledges that supporting individual and community self-care can be a useful complement to professional intervention. The College of Medicine, under Dr Michael Dixon’s leadership, is in the forefront of developing these opportunities:

“In the face of a potential healthcare calamity from widespread resistance to antibiotics, we should do all we can to reduce unnecessary demand. The College of Medicine is set up to look outside the box for creative solutions. We are very excited at the prospect of a new toolkit of evidence-based self-care options, empowering patients and parents to take the initiative in getting through everyday infections, rather than demanding an inappropriate antibiotic from their GP.”

Acute respiratory infections (ARTIs), such as cough, sore throat, and sinusitis, are common and costly for both individuals and the NHS. At present 1 in 3 people in the UK will take a course of antibiotics in a single year for minor infections such as these.[7]

Pukka Herbs, who co-hosted the event with the College of Medicine, conducted a ground-breaking clinical trial of a natural alternative to antibiotics for adults with an acute cough, sore throat and sinusitis, with the University of Southampton earlier this year. Euan MacLennan, Herbal Director of Pukka Herbs, also works as a Medical Herbalist in an integrated NHS practice in London and spoke of his experience working within the NHS without antibiotics and said:

“In medicine, we have a duty to act in the best interests of our patients. Sometimes this involves using innovative methods to safeguard health and the effectiveness of medicines, now and in the future. Research tells us that plant-based medicines are both safe and effective for the treatment and management of infectious conditions. Research also tells us that patients who exercise choice and empowerment in their healthcare have better clinical outcomes. It is time to open discussion around the use of herbal medicines for the treatment of minor, self-limiting conditions in primary care.”

Professor Michael Depledge, from the European Centre for Environment and Human Health at Exeter Medical School, chaired the event and said:

“Today’s workshop has shown that it is not just a question of GPs reducing antibiotic prescription to avoid escalating antibiotic resistance, there is a much broader issue regarding patient expectations. There is a need for education and public engagement to increase awareness of the adverse consequences of antibiotic use. This will require an integrated and collaborative approach that involve improved awareness of nutrition and lifestyles that foster health, as well as testing the robustness of evidence that herbal alternatives do exist for the treatment of certain infections, otherwise treated by antibiotics.”

References and Notes

1.         https://www.who.int/news-room/fact-sheets/detail/antibiotic-resistance

2.         https://www.antibioticresearch.org.uk/about-antibiotic-resistance/

3.         https://www.who.int/news-room/fact-sheets/detail/antibiotic-resistance

4.         https://www.antibioticresearch.org.uk/about-antibiotic-resistance/

5.         https://www.gov.uk/government/news/antimicrobial-resistance-uk-launches-5-year-action-plan-and-20-year-vision

6.         https://www.gov.uk/government/news/antimicrobial-resistance-uk-launches-5-year-action-plan-and-20-year-vision

7.         https://www.gov.uk/government/news/antimicrobial-resistance-uk-launches-5-year-action-plan-and-20-year-vision

About Pukka Herbs’ Research

In addition to the andrographis clinical trial, Pukka Herbs has research partnerships underway with five universities and hospitals, as part of its increased investment in human research to explore how herbs can provide solutions in some key clinical areas such as cancer, cognitive decline and anti-microbial resistance. One such study is underway at the Cancer Biology Research Centre at the University of Tel Aviv. The safety and efficacy of Pukka’s Wholistic Turmeric capsules are being examined in a randomized, placebo-controlled clinical study of patients with a particular type of large bowel polyp that can become cancerous; people will take the supplement for 6 months after which the polyps and bowel health will be examined.

At a time when consumers call for greater transparency with regard to clinical research, In 2018, Pukka expanded its herbal research provision, appointing a new Head of Herbal Research and a Herbal Research Specialist, who are building research collaborations with universities, and engaging with young scientists through internships. As well as an in-house team of herbal research and education experts, Pukka is also home to over 22% employees who are educated to degree level or above in some form of plant medicine.

Further Information

For more information, please contact Kate Willacy, PR & Communications Lead, Pukka Herbs: Tel: 07702106220;  kate.willacy@pukkaherbs.com

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    by Sandra Goodman PhD The latest scientific research regarding Nutrition and Cancer. Full details at

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    Diploma in Āyurvedic Medicine, 4-year self-paced distant learning program in Āyurvedic medicine.

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    Specialist online health store focused on hydration, body pH balance and quality nutrition.

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  • Beginner's Guide to ME

    Essential reading for people/carers with ME/CFS serious debilitating illness. Counteracts bad advice

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