Antibiotics do not prevent coronary heart disease

It has been postulated that perhaps a bacterial infection (with Clamydia pneumoniae) in the coronary arteries could be associated with increased risk of coronary artery disease. However, after several large studies with the use of antibiotics as a preventative measure, this does not appear to be effective. Certainly there is still a link between some sort of chronic inflammatory process and increased cardiovascular risk, but what that is continues to be unclear.

From: British Medical Journal (In other journals)

Antibiotics do not prevent coronary heart disease (excerpt)

...Despite mounting evidence that infection can trigger atherosclerosis, trials of antibiotics in people with coronary heart disease remain stubbornly negative. At least six trials, including a megatrial in nearly 8000 patients, have already reported that antibiotics against Chlamydia pneumoniae don't work as secondary prevention against heart disease. Two more large and negative trials published last week probably signal the end of the road for this particular line of inquiry.

In the first trial, 4012 adults with stable coronary heart disease were given azithromycin or placebo for one year. After four years of follow-up, 22.3% of the treatment group and 22.4% of controls had died from coronary heart disease or had had some kind of serious coronary event (risk reduction 1%, 95% CI -13% to 13%). In the second trial, 4162 patients who had been admitted with an acute coronary syndrome took gatifloxacin or placebo for 10 days each month. After a mean of two years' treatment 25.1% of the placebo group and 23.7% of the treatment group had died (from any cause) or had had some kind of serious coronary event or stroke (hazard ratio 0.95, 0.84 to 1.08; P = 0.41).

An accompanying editorial (pp 1706-9) says we should now stop trying to treat people who have heart disease with antibiotics against C pneumoniae. Instead we should be looking for other infective agents, such as viruses that might be the missing link between inflammation and atherosclerosis...

New England Journal of Medicine 2005;352: 1637-45, 1646-54

Experimental Alzheimer's gene therapy early success

In 2001 and 2002, a group in the US implanted genetically modified tissue into the brains of a group of patients with Alzheimer's disease. The tissue was modified to produce nerve growth factor (NGF) in the hopes that it would help retard and possibly even reverse the neurodegenerative disorder that is Alzheimer's.

The latest follow up of these patients suggest that cognitive decline has decreased by as much as 50% in this group of patients.

Although the cohort studied is very small (6 patients), this is fairly exciting news as all therapies to this date has been relatively ineffective.

From: BBC News

Alzheimer's gene therapy hailed (excerpt)

...Between 2001 and 2002, surgeons at San Diego's University of California placed genetically modified tissue into the brains of eight Alzheimer's patients.

It is designed to boost a naturally occurring protein that stops cell death and stimulates cell function.

Now six patients are showing signs that the implants have successfully slowed their disease, Nature Medicine reports...

...In the animals, the therapy restored old, shrinking brain cells back to near-normal size and quantity, as well as connections essential for communication between the cells...

...Professor Mark Tuszynski, the neurologist who led the research, said their latest follow up of these six patients suggested the treatment was working.

Memory tests suggest the gene therapy has slowed cognitive decline by as much as 50%...

...Brain scans also show that the patients' brains are more active than before.

When they carried out a post-mortem on the patient who died, they found some of the brain tissue that had been dying off through Alzheimer's had started to rejuvenate.

These areas were around the sites where the injections had been given...

...She [Harriet Millward, deputy chief executive of the Alzheimer's Research Trust] said they were currently funding research into drugs that mimic the action of nerve growth factor (NGF), the name given to the gene therapy involving stimulating cell function.

"In principle, if you can get the NGF into the brain successfully, this could offer a way of slowing down the decline of mental abilities in patients with Alzheimer's disease," she said...

Lethal injections may be cruel

The general idea of execution from lethal injection is that you first anaethetise the condemned, then give them a muscle relaxant and then the lethal component (usually potassium chloride which causes an asystolic arrest.

Now, a recent journal article in the Lancet has looked at the post-mortem blood concentrations of sodium thiopental and there are some shocking results. Although I won't debate on the meaning the range of the anaethetic levels, I find it extremely worrying that for some of the inmates, their thiopental levels were at trace levels. This means that they would have been fully aware as they were being executed.

Although I am not against the dealth penalty in some cases from a purely ethical point of view, I am generally against it from numerous administrative problems.

From: New Scientist

Execution by injection far from painless (excerpt)

15:49 14 April 2005
NewScientist.com news service
Alison Motluk

...Execution by lethal injection may not be the painless procedure most Americans assume, say researchers from Florida and Virginia.

They examined post-mortem blood levels of anaesthetic and believe that prisoners may have been capable of feeling pain in almost 90% of cases and may have actually been conscious when they were put to death in over 40% of cases.

Since 1976, when the death penalty was reinstated in the US, 788 people have been killed by lethal injection. The procedure typically involves the injection of three substances: first, sodium thiopental to induce anaesthesia, followed by pancuronium bromide to relax muscles, and finally potassium chloride to stop the heart.

But doctors and nurses are prohibited by healthcare professionals’ ethical guidelines from participating in or assisting with executions, and the technicians involved have no specific training in administering anaesthetics...

...But Kyle Janek, a Texas senator and anaesthesiologist, and a vocal advocate of the death penalty, insists that levels of anaesthetic are more than adequate. He says that an inmate will typically receive up to 3 grams - about 10 times the amount given before surgery. “I can attest with all medical certainty that anyone receiving that massive dose will be under anaesthesia,” he said in a recent editorial...

...The authors of the new study argue that it is simplistic to assume that 2 to 3 grams of sodium thiopental will assure loss of sensation, especially when the people administering it are unskilled and the execution could last up to 10 minutes. They also point out that people on death row are extremely anxious and their bodies are flooded with adrenaline - so would be expected to need more of the drug to render them unconscious.

Without adequate anaesthesia, the authors say, the person being executed would experience asphyxiation, a severe burning sensation, massive muscle cramping and cardiac arrest - which would constitute the “cruel and unusual” punishment expressly forbidden by the US constitution’s Eighth Amendment.

Koniaris's team collected post-mortem data on blood levels of sodium thiopental in 49 executed inmates. Even where the same execution protocol and the same blood sampling procedure was used, they found that levels varied dramatically - from 8.2 to 370 milligrams per litre. In other inmates, mere trace levels were recorded...

...If these post-mortem concentrations reflect levels during execution, the authors say, 43 of the 49 inmates studied were probably sentient, and 21 may have been “fully aware”. Because a muscle relaxant was used to paralyse them, however, inmates would have been unable to indicate any pain.

Ironically, US veterinarians are advised not to use neuromuscular blocking agents while euthanising animals precisely so they can recognise when the anaesthesia is not working.

People in the US assume that lethal injection is highly medicalised, and therefore humane, says Koniaris. “But when you look at it critically, it’s anything but medical,” he says. “It’s a perverted medical practice.”

He says the people carrying it out are unskilled, the procedure is not monitored - the executioners step behind a curtain when delivering the lethal drugs - and there is no follow-up to ensure that everything worked as intended...

Journal reference: The Lancet (vol 365, p 1412)

New test for cancer user lasers

German researchers have developed a technique of detecting malignant cells by using lasers to measure the elasticity of individual cells. Cancer cells tend to be much more "springy" than ordinary cells.

Because it measures individual cells, it can detect cancer from a much smaller biopsy and in addition, can detect the spread of cancer where it hasn't formed a tumour yet.

This is really quite revolutionary stuff and may significantly change how we diagnose and stage cancers in the future.

From: New Scientist

Laser beams sort stem cells by springiness (excerpt)

18:22 12 April 2005
NewScientist.com news service
Shaoni Bhattacharya

...Using an “optical stretcher”, which pushes and pulls individual cells to measure their elasticity, Josef Käs and Jochen Guck from the University of Leipzig in Germany successfully separated adult stem cells from human blood.

They say they can also pick out cancerous cells from biopsies as small as just 50 cells - traditional methods need between 10,000 and 100,000 cells to give a diagnosis. Furthermore, the researchers say this is the first test able to identify metastatic cancer cells - those which are prone to spreading through the body to form secondary tumours - without actually locating any metastatic tumours.

“We have developed a very good way to recognise different cells based on something known since the 1950s - that very different cells have very different skeletons,” says Käs...

...Cells from most organisms have an internal scaffolding, called a cytoskeleton, which keeps their shape and helps them move. But this structure is less strong in cells which either have no reason to organise themselves, like primitive stem cells, or because they “de-differentiate”, like cancer cells - which lose the special characteristics of the tissues in which they originated.

This means that stem cells and cancerous cells are more springy than other cells. And metastatic cells are suppler still.

Using the optical technique, cells from a sample are pushed one by one into a gap between two opposing infrared lasers. As the light from each laser beam enters the cell, it changes momentum because the cell has a higher refractive index. This gives the cell a “kick back”, explains Käs, and when the beam leaves the cell it gives it a “kick forward”.

The kicks in opposite directions stretch the cell, and the amount by which the cell extends can be measured and used to identify it from a population of cells. Two beams are needed to keep the cell in a stable configuration...

...The optical stretcher can already test 3600 cells per minute. And as well as being highly specific, it does not require the use of expensive chemical markers currently needed to identify stem cells, he says...

Pregnant smokers affect asthma risk in their grandchildren

A recent study published in Chest has shown that children with a materal grandmother who smoked in pregnancy have twice the risk of developing asthma. Possible mechanisms include some form of genetic imprinting with substances from cigarettes affecting the genes of eggs of the developing foetus or perhaps some sort effect from stress hormones in utero.

This effect appears to be independent of passive smoking.

From: New Scientist

Pregnant smokers increases grandkids' asthma risk (excerpt)

22:00 11 April 2005
NewScientist.com news service
Gaia Vince

...A child whose maternal grandmother smoked while pregnant may have double the risk of developing childhood asthma compared with those with grandmothers who never smoked, say researchers from the University of Southern California, US. And the risk remains high even if the child’s mother never smoked.

It has been known for some time that smoking while pregnant can increase the risk of the child developing asthma, but this is the first time that the toxic effects of cigarette smoke have been shown to damage the health of later generations. The researchers believe that the tobacco may be altering which genes are switched “on” or “off” in the fetus’s reproductive cells, causing changes that are passed on to future generations.

Frank Gilliland, professor of preventative medicine at the Keck School of Medicine in Los Angeles, US, and colleagues interviewed the parents of 338 children who had asthma by the age of five and a control group of 570 asthma-free children. They found that children whose mothers smoked while pregnant were 1.5 times more likely to develop asthma that those born to non-smoking mothers.

But children whose grandmothers smoked when pregnant had, on average, 2.1 times the risk of developing asthma than children with grandmothers who never smoked. Even if the mother did not smoke, but the grandmother did, the child was still 1.8 times more likely to develop asthma. Those children whose mother and grandmother both smoked while pregnant had their risk elevated by 2.6 times...

...Gilliland believes the trans-generational repercussions of smoking indicate that tobacco chemicals are having a two-pronged effect: by directly damaging the female fetus’s immature egg cells - putting future children at risk - and also by damaging parts of the fetus’s cells that are responsible for determining which genes will be expressed.

This second type of effect - called an epigenetic effect - could potentially alter which genes are expressed in the child’s immune system which, in turn, Gilliland suspects, may increase the child’s susceptibility to asthma...

...But Marcus Pembrey, an epigenetics expert and director of genetics at the Avon Longitudinal Study of Parents and Children in Bristol, UK, says that the results Gilliland found were unlikely to have an epigenetic basis. “Since the effect has passed down the mother’s line, the increase in asthma risk is more likely to be due to other factors. For example, the mother can pass stress hormones, metabolites or immune cells (lymphocytes) to the fetus while it is in utero, so these are more likely to affect the child’s health later on...”

...Martyn Partridge, chief medical adviser to Asthma UK says: “The suggestion of an association with grand-maternal smoking is intriguing and whilst the authors’ postulated explanations for this are very reasonable, confirmation of the association in other studies should be the next step...”

Journal reference: Chest (vol 127, p 1232)

vitualis is now on broadband!

I just got connected to TPG ADSL internet last week but my wireless ADSL router just came in today... The internet experience is SOOO much better with this increase in bandwidth. I almost can't understand how I ever tolerated dial-up!

Valdecoxib (Bextra) has been withdrawn from sale

The FDA in the US has ordered Pfizer to remove valdecoxib (Bextra) from sale. This is the second COX-2 inhibitor that has been removed from the market (with Merck voluntarily removing rofecoxib (Vioxx) about half a year ago.

Valdecoxib, like rofecoxib, much more selective for COX-2 compared to COX-1 and also like rofecoxib, there has been relatively clear trial data to suggest that it increases the risk of strokes and heart attacks.

Pfizer is relatively luck that it still has celecoxib (Celebrex) up its sleave. Being the first COX-2 inhibitor, it is not as selective for COX-2 as the later agents. As such, it is probably just about as safe as traditional NSAIDs. That being said, the case for its gastrointestial safety is also somewhat dubious.

From: New Scientist

FDA orders suspension of popular painkiller (excerpt)
* 18:39 07 April 2005
* NewScientist.com news service
* Gaia Vince

...The controversial anti-inflammatory painkiller, Bextra, has been removed from sale in the US because of heart risks, it was announced on Thursday.

In a U-turn that will please many patients' groups, the US Food and Drug Administration (FDA) asked Pfizer, which makes Bextra (valdecoxib), to remove it from sale. Yet as recently as February 2005, the FDA concluded that Bextra's benefits outweighed its risks and refused to call for the drug's removal, against the advice of a panel of doctors and scientists...

...Bextra is the second in the class of non-steroidal anti-inflammatory (NSAID) medicines, known as Cox-2 inhibitors, to be removed from sale due to heart risks. In September 2004, the Cox-2 drug Vioxx (rofecoxib) was voluntarily removed from sale by its manufacturer, Merck, following a series of studies showing that the drug might double the risk of heart attack and stroke among long-term users.

Studies since then have shown that the two other drugs in the same class - Bextra and Celebrex (celecoxib), both manufactured by Pfizer - can markedly increase the risk of heart attacks and strokes, and medical experts have campaigned for both drugs to be removed from sale. As well as asking Pfizer to remove Bextra from sale in the US, the FDA has asked it to add additional warning labels to Celebrex, highlighting the increased cardiovascular risks...

...The FDA has concluded that "the overall risk versus benefit profile of Bextra is unfavourable", whereas "the benefits of Celebrex outweigh the potential risks in properly selected and informed patients". Bextra has also been associated with reports of "serious and potentially life-threatening skin reactions, including death", it says.

Cox-2 inhibitors were hailed as a revolutionary painkiller for conditions such as arthritis when they first went on sale in 1998. Unlike older NSAIDs, such as aspirin and ibuprofen, Cox-2 inhibitors were thought to be safer to use in certain groups of patients because they did not cause gastrointestinal bleeding and ulcers, and so were prescribed widely.

But Merck, Pfizer and the FDA have been accused of responding too slowly to mounting evidence of the drugs' links to cardiovascular risks. The FDA has also been accused of attempting to hinder the publication of a report of Vioxx's side effects, though FDA management denies the allegation.

Pfizer has said in a statement that it disagrees with the FDA's decision to withdraw Bextra, although it has complied. It will hold further discussions with the government agency about returning the drug to market...

Mechanism of steroid resistance in COPD

Many patients with chronic obstructive pulmonary disease do not respond or respond poorly to therapy with corticosteroids. Now, researchers have discovered why this is the case. Apparently, low levels of histone deacetylase 2 (HDAC2) limit the degree to which steroids can exhibit their anti-inflammatory effects.

Interestingly, the old asthma drug theophylline appears to boost the level of HDAC2 in the lungs. Theophylline itself is not without problems as it has a fairly narrow therapeutic range.

From: BBC News

Lung disease therapy breakthrough (excerpt)
...A team from Imperial College London has discovered why chronic obstructive pulmonary disease (COPD) is resistant to steroid therapy...

...Details were presented at a British Endocrine Societies meeting...

...COPD is an umbrella term covering a range of lung diseases, including chronic bronchitis and emphysema.

It is estimated to affect 6% of the UK population, and it is the fourth most common cause of death in the country.

Steroids would normally be effective at treating inflammatory diseases such as COPD.

However, COPD patients do not respond to steroid therapy...

...Inflammation is caused by specific genes triggering the production of certain key chemicals.

It is possible to block inflammation by switching off these genes, using an enzyme called Histone Deacetylase 2 (HDAC2).

Steroids usually aid this process by mopping up HDAC2, and targeting the appropriate genes.

However, the Imperial team found HDAC2 levels are very low in COPD patients, so steroids have little chance to have any effect.

Working on lung cells, they found they could raise levels of HDAC2 - and allow steroids to do their work - by administering low doses of a cheap and widely available drug, theophylline...

..."We hope that the clinical trials of theophylline will be successful so that we can finally offer an effective therapy to COPD sufferers..."

Ruling forces pharmacists to follow prescription

In the US, there has been a number of increasing higher profile cases of pharmacists refusing to dispense oral contraceptive drugs. In some cases, they have subjected women to moral and religious lectures. In rare cases, the chemist had refused to give back the prescription.

The Governor of the state of Illinois has issued an emergency rule that forces chemists to follow the presciption.

IMHO, this is a rather heavy-handed approach but probably necessary as it seems that whatever professional body that governs pharmacists has been asleep at the wheel.

When it gets right down to it, pharmacists are dispensers. The doctor makes the prescription and the pharmacist is there to provide a service to fullfil that presciption.

I respect that some pharmacists may have certain moral objections to certain medications, but frankly, they should keep that objection to themselves. Giving lectures on morality is highly inappropriate.

If a pharmacist doesn't want to follow through with a presciption, I believe that their minimum duty involves immediately contacting the doctor who wrote the presciption. If it is for a "moral" objection, they should further immediately refer the patient to a pharmacist who can fullfil that prescription.

From: The Sydney Morning Herald

Ruling forces chemists to follow script for the pill (excerpt)
April 4, 2005

...The Governor of the US state of Illinois, Rod Blagojevich, has issued an emergency rule that requires pharmacies to accept and fill prescriptions for contraceptives without delay.

The decree comes after a growing number of complaints nationwide that some pharmacists are refusing to dispense birth control pills and the morning after pill...

...The ruling was issued on Friday and took effect immediately, although Mr Blagojevich, a Democrat, said it would later go through a review process to become permanent.

It came in response to complaints that on February 23 a pharmacist in Chicago refused to fill prescriptions for two women. Mr Blagojevic joined reproductive rights groups in describing the refusals as part of a concerted push by conservative groups to decrease the availability of contraceptives...

..."It's not just in the Loop [central Chicago]; this is happening all over the country," he said. "There's a pattern of this behaviour. This is not just a coincidence but part and parcel of a larger campaign."

Women in at least 12 states, including Texas, North Carolina and California, have reported encountering pharmacists who are unwilling to fill their prescriptions. "We've heard stories about them being turned away or referred to other pharmacies," said Karen Pearl, national president of the Planned Parenthood Federation of America.

"Even more alarmingly, some women are being denied birth control, and the pharmacist keeps their prescription. They are also being given moral lectures, religious lectures. Women are being told contraception is abortion, which it is not."

The director of the Illinois Department of Financial and Professional Regulation, Fernando Grillo, said the new rule "clarifies a duty we believe has always existed". The agency has filed a complaint against the Chicago pharmacy, which could result in a fine or licence suspension...

John Paul II

Pope John Paul II died in his bed at 9:37pm last night (2 April 2005) Rome time or at 5:37am (3 April 2005) Australian Eastern Standard Time.

Opinion piece on Schiavo from New Scientist

There is an excellent opinion article in the New Scientist on the Schiavo case.

From: New Scientist

Terri Schiavo dies as politics and medicine collide
* 18:20 01 April 2005
* NewScientist.com news service
* Shaoni Bhattacharya

Terri Schiavo, whose medical care became an issue that bitterly divided US public opinion, passed away on Thursday morning, two weeks after doctors removed her feeding tube in response to a court ruling. She had been in a vegetative state since 1990.

Schiavo, 41, died in her hospice bed in Pinellas Park, Florida, US. Her case has provoked fierce wrangling in the US and raised fundamental legal, ethical and scientific questions.

After having a heart attack in 1990, Schiavo suffered extensive brain damage. She was diagnosed as being in a persistent vegetative state (PVS) whereby a patient has no higher brain function or consciousness, but does retain some basic responses such as waking, sleeping and reflex reactions.

After seven years of legal battles, Schiavo’s feeding tube was removed for the final time on 18 March. Her husband Michael, who fought to have the tube removed, believed it was what she would have wanted in the absence of a “living will”.

But her death has prompted recriminations. President George W Bush offered his sympathies to Schiavo’s parents, who fought to keep her under medical care, believing she had some vestige of consciousness. The Vatican called Schiavo's death a "violation of the sacred nature of life".

However, the scientific evidence strongly backed the diagnosis of PVS, say physicians, and a large majority of the US public were in favour of withdrawing her life support.
Capacity for suffering

“I would say the mainstream of neurology and medicine would all agree she was in PVS,” says Timothy Quill, director of the Center for Palliative Care and Clinical Ethics at the University of Rochester Medical Center in Rochester, New York. He says the CAT scans and brain wave evidence showing that Schiavo was severely brain damaged and had no brain activity in her cerebral cortex were “very strong”.

However, there had been suggestions that Schiavo was in a category called “minimum brain function” rather than a vegetative state. “There are people who aren’t in PVS - they have a little bit of consciousness and a little bit of alertness,” he explains.

But Quill notes that even if this were the case - as Schiavo’s parents have argued - the same ethical and medical questions would still be raised. “The debate really should have been, in my mind, what would she want under the circumstances?” If anything, he told New Scientist, while patients in PVS have no feelings and therefore do not suffer, had Schiavo been in a state of minimal consciousness the “capacity for suffering would have been greater”.

Ron Cranford, a neurologist at the Hennepin County Medical Center in Minneapolis, and a witness in the case echoes this view. He told reporters that Schiavo’s rights were trampled on when her likely wishes were disregarded.
Responses to stimuli

In a television interview with NBC, Cranford defended the PVS diagnosis, saying that seven of eight neurologists who had examined her for a 2002 trial said she was in a vegetative state “beyond any doubt whatsoever”. That she was not was in this state was wishful thinking on the part of parents who dearly love their daughter, he added.

But after the ruling by a Florida judge to remove Schiavo’s feeding tube, the state governor Jeb Bush tried, unsuccessfully, to have the tube re-inserted. William Cheshire, a neurologist at the Mayo Clinic in Jacksonville, Florida, testified that his review of Terri Schiavo raised “serious doubt” about the PVS diagnosis. He said she showed some responses to stimuli.

However, Cheshire had not examined Schiavo in person and had only reviewed her medical records and videotapes of her at the hospice. He is also a director at the Center for Bioethics and Human Dignity, a group which aims to explore the contribution of "biblical values" to the bioethical debate.

Quill says that in PVS patients, the base of the brain still functions so that some reflex reactions remain. For example, “if you touch their eyes with Kleenex, they blink”. If a lot of video was shot and, taken together “it appears the person is responding”, he says.
Regaining function

Extremely few PVS patients have ever been known to regain any brain function. And these patients improved only minimally within the first three months of their condition, notes Quill.

“I think in our culture everything gets politicised - even medical evidence. You see people using medical evidence to try to push their own political agenda.” But he says it is reassuring that US public opinion polls showed that people felt “Congress should have kept their nose out of this”.

Schiavo’s body will now go for autopsy. Quill says he expects it will confirm that she had “severe, severe brain injury” but will not be able to answer whether she had any consciousness.

New potential target of treatment for osteoarthritis

Researchers from the US and Australia have recently published in Nature their work on aggrecan, a component in cartilage. Apparently it acts somewhat like a "shock absorber" in the cartilage.

By creating mice that didn't have the enzyme to break down aggrecan, they showed that cartilage destruction was largely protected against.

I will be interesting to see where this research goes. I can several potential problems... Firstly, I presume that aggrecanase is actually supposed to be there, probably in part in remodeling damaged cartilage. Drugs to block aggrecanase may well weaken a joint over time. That being said, OA itself can lead to severe joint destruction.

From: BBC News

Hope for new arthritis treatment (excerpt)
...Inhibiting a single enzyme may be enough to block the development of arthritis, research suggests...

...Cartilage contains a crucial component called aggrecan, which functions like a shock absorber, helping the tissue bear load and resist compression.

Normal healthy cartilage has lots of aggrecan, but in arthritis aggrecan is destroyed by a family of enzymes called the aggrecanases, and the cartilage loses its shock-absorbing capacity.

The researchers, from US company Wyeth and Australia's University of Melbourne and Murdoch Children's Research Institute, have discovered one particular member of the aggrecanase family, aggrecanase-2, plays a crucial role in this destructive process.

They genetically engineered mice that lacked a part of one such enzyme, aggrecanase-2.

They found that these animals were largely protected from cartilage destruction...

...The researchers said their work is the first to show that mutations in a single gene can halt cartilage degradation.

They believe it could be possible to fight arthritis by developing drugs designed to inhibit the human form of aggrecanase-2.

Dr Elisabeth Morris, of the US team, told the BBC News website a new potential preventative treatment would be a significant breakthrough for osteoarthritis as current drugs purely focused on relieving pain.

The condition is the most common form of arthritis, and some studies suggest it may affect as many as 30% of adults...