News & Analysis Health Agencies Update Plant-Chemical Shows Promise mal iodine levels or mild iodine deficiency, for Pain Relief women with iodine-creatine ratios lower A chemical from the cactuslike plant than 50 μg/g had a 46% lower chance of be- Euphorbia resinifera found in Morocco coming pregnant in any menstrual cycle. reduces postsurgical pain in rats, according Women with milder iodine deficiencies of to a study by researchers from the National between 50 and 99 μg/g also took longer to Institutes of Health’s (NIH’s) Clinical Center. conceive than women with sufficient io- These findings are the latest in a string dine levels, but the difference wasn’t statis- of studies that suggest resiniferatoxin tically significant. may offer an alternative to opioid pain “Our findings suggest that women who relievers. In fact, the NIH’s Clinical Center arethinkingofbecomingpregnantmayneed already has a phase 1 clinical trial under more iodine,” said lead author James L. Mills, way to test whether an injection of the MD, a senior investigator at NICHD in a state- chemical into the central nervous system ment. “Iodine requirements increase dur- eases pain associated with advanced can- ingpregnancy,andthefetusdependsonthis cer. Resiniferatoxin is chemically similar to mineral to make thyroid hormone and to en- Researchers are investigating the use of a chemical capsaicin, the chemical that makes hot pep- sure normal brain development.” from the plant Euphorbia resinifera as a pain reliever. pers hot, but is 500 times more potent, Low iodine levels cause hypothyroid- according to the NIH. It blocks pain-related ism, which is linked to infertility, according The development of CRISPR-Cas9 signaling in nerve cells while leaving move- to Mills and his coauthors. They suggest that technologies, which use a bacterial de- ment unaffected. more research is needed to determine if the fense mechanism to very precisely edit Intherecentlypublishedstudy,research- US and European countries should try to in- DNA, as well as other gene-editing tools ers injected resiniferatoxin into the paw of crease iodine intake in women of childbear- like zinc finger nucleases (ZFN) and tran- rats prior to making an incision in the paw ing age. In the meantime, the NICHD sug- scription activatorlike effector nucleases, and measured pain-related behaviors for 10 gests that women consult their physician have greatly accelerated many fields of days after the surgery. They found that re- before changing their diet or taking supple- research. Genetic editing also has shown siniferatoxin-treated rats showed fewer ments to increase iodine levels. promise in treating certain diseases. An pain-related behaviors than untreated ani- experimental ZFN-mediated gene-editing mals. However, changes in transcriptional Accelerating Clinical Gene Editing therapy was recently used to treat a man gene expression in the spinal cord induced A new National Institutes of Health (NIH) with Hunter syndrome, a genetic meta- by surgery were unaffected by resinifera- program aims to speed the clinical transla- bolic disorder. But many challenges remain toxin treatment. tion of gene-editing technologies like clus- to wider clinical application of gene-editing The results suggest that resiniferatoxin tered regularly interspaced short palin- technologies, including potential risks asso- may be particularly helpful for postopera- dromic repeats–Cas9 (CRISPR-Cas9). ciated with off-target gene edits or im- tive pain because the pain relief from a local The Somatic Cell Genome Editing pro- mune reactions. injection can last from 7 to 14 days, which is gram will award $190 million to research- The project will focus on somatic cell longer than most surgical recovery periods. ers over 6 years. Participating scientists gene editing, which only edits nonreproduc- will work together to develop new ways to tive cells in the body. Any changes made to Iodine Deficiency May Impair Fertility deliver gene-editing tools, create better somatic cells are not inherited by a treated Women with moderate to severe iodine gene editors, and design ways to test the individual’s offspring. Gene-editing repro- deficiency may have a more difficult time safety and efficacy of clinical gene editing. ductive cells, or germ-line gene editing, conceiving, suggests an observational They will also develop a toolkit that can be would create heritable genetic changes and study by researchers from the NIH’s Eunice broadly shared. is more controversial because it raises the Kennedy Shriver National Institute of Child “Genome editing technologies such as specter of creating “designer children.” A re- Health and Human Development (NICHD). CRISPR-Cas9 are revolutionizing biomedi- cent National Academy of Sciences report Iodine deficiency is common in the US cal research,” said NIH Director Francis S. urged caution on germ-line gene editing, population and in pregnant women specifi- Collins, MD, PhD, in a news release. which has serious ethical implications. cally. The study included 467 women who “The focus of the Somatic Cell Genome Funding opportunities will be an- were trying to become pregnant between Editing program is to dramatically acceler- nounced within a month, according to the 2005 and 2009. It found that 44.3% had ate the translation of these technologies NIH. − Bridget Kuehn, MSJ urine iodine-creatine ratios of less than to the clinic for treatment of as many ge- Note: Source references are available through 50 μg/g. Compared with women with nor- netic diseases as possible.” embedded hyperlinks in the article text online. 760 JAMA February 27, 2018 Volume 319, Number 8 (Reprinted) jama.com © 2018 American Medical Association. All rights reserved. Kenneth M. Highfill/sciencesource.com
JAMA – American Medical Association
Published: Feb 27, 2018
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