GMO Herpes vs severe cancer pain

What happens when the pain gets to be too much?  What happens when the drugs stop working?  The physicians are giving you as much as you can take without dying, and youre still living with 7, 8, 9 levels of pain, every waking moment?  Some of the talk behind physician assisted suicide is to let people decide when enough is enough, and to permanently end their pain-filled hellish existence.

But what if there were options?

What if herpes could bring your pain levels down from 7, 8, 9… to 1-2?  What if herpes could take you from ‘I want to end my own life’ to ‘I can handle this’?

What if I told you this idea is not the mad rantings of an insane virology graduate student, but a reality that has already occurred?

Gene Therapy for Pain: Results of a Phase I Clinical Trial

The basic idea behind this research is simple: Pain is caused by signals from nerves (nociceptors).  Herpes likes nerves.  Lets make a GMO herpes that delivers human preproenkephalin, the gene we have that codes for a pre-endogenous-opiate.  Use herpes to make the cells that respond to pain, make the anti-pain molecule.

This was one of the most depressing, yet hopeful, papers I have ever read.

The patients in this study were 10 terminal cancer patients, with pain in the 7-9 range, and taking maximal doses of morphine.  They gave the patients either 107, 108, or 109 GMO viruses.  There were no placebos, and all of the patients knew what they were getting into.  Here is the sad part:

Because of the terminal nature of subjects underlying cancer, by 2 months post-dosing there was only 1 patient surviving in the 107 pfu cohort, and 2 each in the 108 and 109 cohorts. By 3 months after dosing, there was only 1 patient remaining in the 107 and in the 108 cohorts.

Here is the good news:  The 107 dose didnt do anything for the patients.  The 108 dose drastically lowered pain scores (down to the 1-2 range !!!!), but eventually they started to creep back up.  109 GMO herpes dropped the pain scores, and they creeped up too, but more slowly.  Sure, this patient population and study design isnt perfect, and the outcome isnt perfect, but this is the first time we have tried this in humans. A trial turning out this successful is a great starting point for optimizing this kind of therapy.

And, you dont have to have these viruses injected into your spine or anything crazy (which can come with its own complications)– its just a regular ol shot.

Certainly this will have applications outside of cancer, and it doesnt do anything about the cancer… So yeah, the cancer is still going to kill you.  But if you didnt go insane from the pain while it was doing it…

Comments

  1. #1 Poodle Stomper
    September 17, 2012

    Speaking of viruses… Lipkin study shows no XMRV-like anythings…the world is not surprised other than the crazies who still won’t believe it even though St. Judy took part in the study.

    Viral infection ruled out as cause of ME

    VIRUSES have nothing to do with chronic fatigue syndrome (CFS), despite earlier evidence of a link, a study has shown.

    The new findings deepen the mystery surrounding the cause of the debilitating condition, also known as myalgic encephalomyelitis (ME).

    Scientists dismissed previous claims that two viruses, known as XMRV and pMLV, may underlie CFS. “The bottom line is we found no evidence of infection with XMRV and pMLV,” said Dr Ian Lipkin, a member of the research team at Columbia University in New York City. “These results refute any correlation between these agents and disease.”

    In 2009 and 2010, separate studies found the two viruses in the blood of CFS patients, raising hopes of identifying an easily treatable cause of the condition. But since then, other investigators have been unable to confirm the results.

    http://www.scotsman.com/news/health/viral-infection-ruled-out-as-cause-of-me-1-2531721

  2. #2 Poodle Stomper
    September 18, 2012

    Alternate link: http://well.blogs.nytimes.com/2012/09/18/chronic-fatigue-syndrome-back-to-square-1/

    “In the study, none of the researchers reported finding mouse leukemia viruses in any of 293 blood samples, half from people with chronic fatigue syndrome and half from those without it.”

    I guess “none of the researchers” includes Judy “I swear it’s not a contamination, oh crap we’re busted now it was a contamination I just didn’t report it” Mikovits?

  3. #3 Mark Bells
    September 18, 2012

    Perfect plot for a sci-fi movie – sexually transmitted disease that makes you feel better (What’s So Bad About Feeling Good? 1968, Shivers, 1975…actually most David Cronenberg films )

  4. #4 Ted Dahlberg
    September 24, 2012

    Now that is some impressive thinking merely to come up with the idea. And that it then seems to work so well… see, this is why science is cool.

  5. #5 Neetu
    sqjrJvyjWlES
    September 28, 2012

    kiwiski,I’m sorry I’m confused as to your point. You say the frrtautsion is with science as well, but then go back to talking about individual results, to my reading.The science community reports negative trials, as scientific publications; the media may chose not to, however the newspaper editor (TV producer, etc) might consider it of less interest, for example. The science community doesn’t make that call.From the point of view of the science community it’s ‘reporting the results of a trial’ that’s not about if they were negative or positive, just that you did a trial and these were the outcomes. When you’re funded to do a trial you definitely want to publish regardless of the outcome. A scientist’s career needs publications and trials are big efforts. (I’m writing about scientists at universities or research institutes.)You can quibble that negative results don’t get the same profile in the research literature in my experience (and generalising) the size [read: ‘strength’] of the trial and how important the treatment that is being trialled factor into how likely a high-profile publication will result (i.e. regardless of if the outcomes are positive for the treatment or not).Regards of this a point here is that researchers who specialise in the issue will see the lower-profile publications, but the media may not necessarily. I think people outside of science don’t appreciate just how big the scientific literature is; media report on a tiny fraction of it.

  6. #6 Gurdur
    October 4, 2012

    I just tweeted again about this great post, and I am also going to blog about it and refer back to this post.

  7. #7 Patrick
    October 6, 2012

    Poodle Stomper, you do realize that the vast majority of empirical evidence points to ME/CFS being a mostly or entirely a psychological condition? Most likely an iatrogenic/psychosomatic one at that (i.e. the belief in the existence of CFS/diagnosis of CFS is a primary cause of its symptoms).

    There’s no mystery to it. The only significantly effective treatments for CFS are cognitive behavioural therapy and physical exercise. Which surprisingly is exactly what the vast majority of mental illnesses are responsive to as well.

    If it walks like a duck, quacks like a duck, and there’s absolutely no compelling evidence that its anything other than a duck, its a duck.

    The iatrogenic/psychosomatic nature of the condition is evidenced by the fact that CFS sufferers have extremely low response to placebo’s (which is why things like SSRIs aren’t an effective treatment). This is because there’s such a strong belief that “no, something really is wrong with me” (which is essentially the cause of the mental illness) that there’s no room for them to believe a pill could make them better.

    It would be interesting to see placebo studies done of CFSers where they are told an explanation for the placebo that fits with the iatrogenic nature of the condition (i.e. heres some gene therapy that’s going to make you resistant to the effects of the virus)

    The fact CFS researchers get death threats:

    http://blogs.discovermagazine.com/loom/2011/08/21/chronic-fatigue-syndrome-death-threats-for-scientists/

    also indicates its an iatrogenic condition. If it weren’t, why else would people be so hostile to those who dispute its “real” nature. The only other researchers who get more death threats are those that work with animal rights and abortion.

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