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Derek Lowe The 2002 Model

Dbl%20new%20portrait%20B%26W.png After 10 years of blogging. . .

Derek Lowe, an Arkansan by birth, got his BA from Hendrix College and his PhD in organic chemistry from Duke before spending time in Germany on a Humboldt Fellowship on his post-doc. He's worked for several major pharmaceutical companies since 1989 on drug discovery projects against schizophrenia, Alzheimer's, diabetes, osteoporosis and other diseases. To contact Derek email him directly: Twitter: Dereklowe

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« Snow Versus Scientific Progress | Main | PhRMA And Why People Dislike the Drug Industry »

February 8, 2013

The Name of a Cure

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Posted by Derek

Here's an excellent article at Slate on "natural" medicines versus pharmaceuticals. You won't see too many mainstream articles that suddenly break out into chemical structures, but this one does, and to excellent effect.

Comments (27) + TrackBacks (0) | Category: Snake Oil


1. LittleGreenPills on February 8, 2013 4:21 PM writes...

I always cringe when someone asks me what I do.

After I tell them that I look for antibiotic and anticancer chemicals in plants, they say, "Wow, that's great cause the natural stuff is much safer."

Then I spend the rest of the conversation telling them that strychnine and cocaine and other nasties are natural. And that all of those little green pills they can buy to treat this or that "without chemicals" are hopefully doing nothing. If they do nothing you only waste your money. If they actually do something the odds are it will be bad not good.

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2. johnnyboy on February 8, 2013 4:26 PM writes...

I'm glad someone responded to that NYTM article in a mainstream publication. I had started reading that article , but gave up midway from irritation (so sad that I now read everything on my computer, so I can't throw annoying magazines across the room in the satisfying way I used to). Especially galling that's it's coming from the New York Times organization - it's more something I would have expected from Oprah magazine.

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3. paperclip on February 8, 2013 5:05 PM writes...

This reminds me of the discussion a while back about the father who wondered why his child had to take high school chemistry. Well, if the child can't stand hearing about moles and pH, it's still valuable to realize that *everything* is a chemical.

An economics class may be in order, too, if it drives home the point that people all around you want to take your money. People complain about greedy doctors and pharmaceutical companies, but fail to realize that supplement manufacturers are just as happy (if not more so) to put a price on what they're offering.

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4. NUChemist on February 8, 2013 6:25 PM writes...

The NYT is overrun with so-called "educated" liberals who are willing to throw sick people under the bus if it means they can stick it to the big, evil pharma corporations.

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5. Lane Simonian on February 8, 2013 7:28 PM writes...

Of course, they are all chemicals. That is the point. All chemicals can potentially be helpful or harmful and many have effects that are both positive and negative. The blanket assumption that all natural produces are either dangerous or ineffective and that all synthetic medicines are always more effective and pose few risks shows a profound bias against true science. Nothing scares a chemist and/or someone working in the pharmaceutical industry more than studies (most of them coming from outside of the United States) that certain natural products are more effective and safer than a human-made compound. It is an insult to both their egos and their pocketbooks.

Just a quick example. Peroxynitrite is a highly potent oxidant that produces inflammation and is linked to a whole series of diseases including rheumatoid arthritis, lupus, ulcerative colitis, Crohn's disease, esophagitis, atrial fibrilation, some forms of heart disease, some forms of cancer, some forms of stroke, ALS, multiple sclerosis, Parkinson's disease, and Alzheimer's disease. The compounds that best scavenge peroxynitrites and reverse some of their oxidative damage (and subsequent inflammation)are methoxyphenols in natural products. This includes eugenol in various essential oils, and coumaric acid, ferulic acid, vanillic acid, syringic acid, and sinapic acid in various spices, fruits, and vegetable. Methoxyphenols donate two electrons and two hydrogen atoms to completely scavenge peroxynitrites: ONOO- + 2h+ + 2 e- = NO2- + H20.

Ok, chemists develop a better synthetic version of methoxyphenols and at least some of the diseases that seemed resistant to all treatments may be treated effectively. Don't let your biases betray you and in the process a lot of other people as well.

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6. phlogiston on February 9, 2013 10:13 AM writes...

Wow Lane. I am now embarassed about working for the evil pharma industry. You've completely blown up our massive conspiracy to hide the truth about peroxynitriles bring the key to all of human biology. I'll just run down to my local hospitals cancer ward, tell them to stop everything and give the patients massive doses of methoxyphenols.

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7. Anonymous on February 9, 2013 10:16 AM writes...

Lane: And what happens to the methoxyphenol? A cation radical that wreaks havoc, perhaps?

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8. Lane Simonian on February 9, 2013 11:25 AM writes...

For #6, I would read the following article if you are interested.

If peroxynitrites are implicated in various diseases, it might be useful for pharmaceutical companies to study the efficacy of using peroxynitrite scavengers in treating these disease. At least one pharmaceutical company is doing so (Merck Millipore--not the same as Merck as was pointed out to me recently).

For #7, when the methoxyphenol curcumin reacts with peroxynitrite the product appears not to be cytotoxic at therapeutic doses. Whether this is true of all methoxyphenols still must be determined.

In the case of Alzheimer's disease, the only two compounds that have partially reversed the disease in small-scale human clinical trials are the methoxyphenol eugenol in rosemary essential oil (Jimbo, et al.) and the methoxyphenols in p-coumaric acid, ferulic acid, syringic acid, and vanillic acid in heat-processed ginseng.

In 1997, the late Mark A. Smith and colleagues noted that peroxynitrite-mediated damage is widespread in Alzheimer's disease. Why has it taken sixteen years despite promosing studies using peroxynitrite scavengers to treat Alzheimer's disease, for U.S. scientists and U.S. pharmaceutical companies to test whether reversing part of this damage may help treat Alzheimer's disease?

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9. Esteban on February 9, 2013 2:22 PM writes...

>> Why has it taken sixteen years despite promosing studies using peroxynitrite scavengers to treat Alzheimer's disease, for U.S. scientists and U.S. pharmaceutical companies to test whether reversing part of this damage may help treat Alzheimer's disease?

Because pharmaceutical companies have no desire to make billions of dollars of course.

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10. Anonymous on February 9, 2013 5:05 PM writes...

Merck Millipore? A production company? Working with proxy nitrite scavengers?

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11. MoMo (MoreMolecules) on February 9, 2013 5:13 PM writes...

So what is the difference? Using low dose methotrexate with its pleiotropic effects against many different targets and with a mechanism of action THAT IS REALLY UNKNOWN AND TOXICITIES TOO or using an extremely low dose of several drugs that also have antiinflammatory effects? Berberine, flavanoids and the others have favorable bioactivities you know!

Lane Simoniam you are partially correct, the Pharma industry is afraid and lobbies against such Ethnopharmcology and its use, but the smart guys in Pharma, which are dwindling in numbers and IQ, study all the angles and want nothing but the studies of these ancient therapies and possibly derivatives.

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12. Crimso on February 9, 2013 7:17 PM writes...

Quercetin has been demonstrated to be a topoisomerase II poison. I know the med chem people here know what that is. Those of you who don't see anything wrong with dosing up on quercetin might want to check that out. After you make the connection and think "Hey, that means it's an all-natural anticancer drug!" then you should also look at the nasty secondary leukemias topo II poisons cause.

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13. cynical1 on February 9, 2013 11:49 PM writes...

Sorry but I've deuterated quercetin and formulated it together with anything you can even imagine and patented it to cure everything.....seriously, everything! I'm banking on $700 million!

Since quercetin cures everything, deuterated quercetin is bound to be even better. (Fortunately, I don't need any data!!) . I'll give you all the 'data' you want.....later! I'll be meeting with the FDA to tell them that it's just a deuterated 'natural' medicine and so, not to worry.......just an extra mass unit which is already there in a certain percentage. No worries. And now let me deuterate the rest of the 'natural' medicines under the 501(b) (even though they're not even approved) and keep a roof over my head.......but I digress.

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14. Morten G on February 10, 2013 12:59 PM writes...

Give me a break!

I read the NYTM article when it came out and I thought great for her and her son that they don't have to give him any drugs any more, neither methotrexate nor crazy Chinese medicine drugs. Basically, she did a huge diet change for her son and she believes that that is what is keeping him healthy. Which you would know if you had read the article.
What I got from the Slate article is that Michelle Franci might be a good teacher and writer but she's a bad scientist. A good scientist is honest to a fault - they are also sceptical but they are most sceptical of themselves. In the NYTM article it is clearly said that she changed many parameters at the same time etc etc. Franci is of course right that administering multiple pharmacologically active herbs to a child has a much greater risk than a single compound with a known dose and known interactions but she is completely dishonest when she leaves out that a huge part of the "alternative treatment" was an entirely different diet.
Plenty of people have success with dietary changes against auto-immune diseases. The doctor should have been encouraging elimination diets rather than be sceptical.

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15. Michelle Francl on February 10, 2013 11:20 PM writes...

I read the article before I wrote the response in Slate. I'm a good enough scientist to know that I am not competent to rigoroulsy evaluate the dietary part of Meadow's regimen for her son or her claims about "leaky gut". I am a chemist, not a nutritionist or gastroenterologist.

My intent was not to evaluate the efficacy of either the drug or diet regimen, but to bring to light the potential risks in administering drugs in a form that many people would not recognize as being such.

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16. RB Woodweird on February 11, 2013 8:02 AM writes...

NUChemist sez:
"The NYT is overrun with so-called "educated" liberals who are willing to throw sick people under the bus if it means they can stick it to the big, evil pharma corporations."

Orrin Hatch. Boom!

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17. drug_hunter on February 11, 2013 9:55 AM writes...

In the skirmish between Francl (#15) and Morten G (#14) Francl wins, hands down. Morten berates Francl for not writing a completely different article than the one she wrote. How silly. Her response is competent and requires no further elaboration.

BTW: "bad scientist" ? "Completely dishonest" ? Who is this Morten G guy kidding? This isn't a yahoo stock message board.

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18. nitrosonium on February 11, 2013 1:00 PM writes...

how is naproxen an analog of asprin?

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19. darwinsdog on February 11, 2013 3:11 PM writes...

MF, You have done the general public a service with your article. Thank you.

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20. ab on February 11, 2013 5:32 PM writes...

"Nothing scares a chemist and/or someone working in the pharmaceutical industry more than studies (most of them coming from outside of the United States) that certain natural products are more effective and safer than a human-made compound. It is an insult to both their egos and their pocketbooks."
Wow Lane, how did you know? Jeez, you've obviously spent tons of time as a researcher at a pharmaceutical company. I mean, my ego would just never recover if someone other than me found a cure for my Dad's COPD. And if my grandma could chew some leaves and cure her arthritis, I mean, I'd do whatever I could to make sure she never found that out. It would be too insulting! Good thing my late mother in law never realized that all she had to do to cure her stomach cancer was chew more spices and essential oils. I mean, I would have been SOOO embarrassed! [/sarcasm]

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21. Lane Simonian on February 12, 2013 12:47 AM writes...

But herein lies the problem. You have already predetermined that spices and essential oils will not work in the treatment of any disease despite any or all evidence to the contrary. Several clinical trials show otherwise for Alzheimer's disease, for instance. If these studies turn out to be correct on a larger scale, then you are not the only one who should be embarrassed (sarcasm aside).

#14 makes a good point about failing to discuss diet in the critique in Slate. That's an important aspect of the story left out. The author is qualified to judge chemicals in or derived from plants, but not the effects of nutrition. That does not seem like a very good excuse.

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22. ab on February 12, 2013 11:35 AM writes...

No Lane, you are wrong: I have NOT predetermined that spices and essential oils will not work in the treatment of any disease. Your assumptions are as irritating as they are predictable: someone who has never spent a day in her life doing actual research in an actual lab is certain that she's got it all figured out.

If you actually were to spend any significant amount of time CREATING NEW KNOWLEDGE (i.e. performing laboratory research) - and I'm not holding my breath for that one - you'd realize that there are a near infinite number of "really promising" avenues in the treatment of any disease. Unfortunately, the vast majority of them, upon exploration, turn out to be dead ends.

Your comment, "Several clinical trials show otherwise...If these studies turn out to be correct on a larger scale..." is a perfect example. You write in other comments as if the science was settled: spices and essential oils cure AD. And the only thing preventing these treatments from reaching the masses is the ego and inertia of scientists. Please. If I had a dollar for every study I saw that was poorly powered, poorly controlled, and in which the active ingredient was poorly defined, but "looked really promising," I wouldn't have to work for a living.

Lane, if the evidence is so overwhelming, why don't you write up a proposal, pitch it to some VC's, and start your own company? It's an obvious winner, everyone will be able to see that, and you'll not only be rich, you'll improve the lives of thousands, maybe millions.

I know why you won't do it: writing grants and performing basic research is hard work, and the gratification comes slowly or not at all. Why go through all that when you can just sit behind a computer, demonize researchers, and feel good about your quest for Truth and Justice?

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23. Morten G on February 12, 2013 11:36 AM writes...

The headline of the Slate article is "Don’t Take Medical Advice From the New York Times Magazine".
Francl (very sorry about misspelling your name earlier btw) is not going to cure anyone of their "chemophobia" when she gives the appearance of not having more than skimmed the NYTM article.
When I read Meadows' account I mainly get the message that dietary changes seems to have helped their son. This is from the NYTM article:

"To be clear: There is no proof that it was Walker’s regimen that drove away Shane’s and Shepherd’s arthritis. Shane’s case makes a stronger argument, since he didn’t take methotrexate. Still, his arthritis may have gone into spontaneous remission, and a study of one is not much of a study at all.

Methotrexate works for many kids, and its effects can kick in later than the expected four-to-six-week window. We tried so many things at once for Shepherd that there’s no way to know for sure what worked, or what combination of things had an effect. Dr. Imundo remains unmoved. But Dr. Kahn says he believes the dietary regimen may have contributed to his recovery. “I’m mystified by children on a daily basis,” he told me. “I’ve seen kids paralyzed, unbelievably critically ill. I don’t know why they get better. The main thing is, if a kid’s better, run with the football, you know? I’m thrilled.”"

Then she goes on to talk about some of the things researchers are currently investigating with relation to gut microbiomes, diet, and inflammation.

I think the points made about Chinese medicine are valid and extremely important but they are going to get dismissed when you aren't honest.
And I want to offer an alternative explanation to why people don't like taking pharmaceutical drugs - it means that we are seriously ill. The logic doesn't hold of course but people feel like the seriousness of a disease is proportional to the number of prescriptions and hospitalisations.

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24. Lane Simonian on February 12, 2013 1:11 PM writes...

I am just saying if the same type of compound (methoxyphenols) works in several human clinical trials (however small; some were double-blinded) and it treats the putative cause of Alzheimer's disease (peroxynitrites), companies that are currently spending millions of dollars trying to reduce amyloid plaque levels (which only slightly reduces peroxynitrite levels) might invest their money more wisely. I am not in a position to do this myself. All I can do is to try to persuade the people who can.

You say you have not predetermined that spices and essential oils cannot treat any disease, but then why are you so dismissive of that possibility. First people say there is no scientific evidence for it. Then, they see the evidence and say it is not good enough. There are many reasons for being dismissive some good; some less so. But dismissing promising routes to treat seemingly intractable disease is never good.

I did not write the following, but I agree with the anonymous author's conclusion

[Clinical trials with over-the-counter supplements have concentrated either on
items which suppress inflammation, or on antioxidants which scavenge oxygen
derived free radicals. Most of these items have proved to be worthless in the
treatment of Alzheimer's disease. Similarly most drugs used to treat Alzheimer's
disease do little to slow the deterioration, but instead offer a mild temporary
symptom relief. However, evidence has been accumulating that the primary driver
of Alzheimer's disease is a nitrogen derived free radical called peroxynitrite,
which may mediate both amyloid and tau accumulation as well as their toxicity.
Excellent results have been obtained with peroxynitrite scavengers, with
reversals of Alzheimer's disease in human clinical trials being repeatedly
demonstrated. IMHO, the only thing which may be preventing the abolition of
Alzheimer's disease is the mental inertia of scientists, as well as the
bureaucrats who fund them. Unfortunately, most bureaucrats keep throwing money
into repeatedly testing discredited interventions, while ignoring successful
ones. Common sense is anything but...]

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25. Mother_Nature on February 12, 2013 1:48 PM writes...

I can proudly say my wise ancestors used all natural remedies to treat their illness. That was way before any of this greedy pharmaceutical companies starting to sell snake oil to sick people. Also, they enjoyed eating only the freshest cleanest natural organic food they themselves grew in their backyard. Not surprisingly, they enjoyed their very healthy lifestyles.

Hmm. Strangly, they all died and none are living at this point. Very strange.

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26. Austin on February 12, 2013 9:07 PM writes...

You are ignorant if you believe that promising preliminary data has not been passed over due to unprofitability.

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27. BioDueDiligence on February 13, 2013 1:47 PM writes...

Thanks for briging this piece to our attention. The chemophobia and "artificial" phobia described are all too common and really hard to counter as phd scientists. This sentiment, along with the rest of his quakcery, is on full display in Dr Oz's pregnancy "guidebook" - which of course has no references to back up his ridiculous advice. Also nice to see something other than anti-science drivvel on Slate (re vaccines, cost of drug development, etc).

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