The Morning Drill: April 18, 2012

Warren Buffett

Good Wednesday morning!

On to today's dentistry and health headlines:

Michigan State professor, Greater Lansing dental firm developing saliva test for oral cancer detection

A Michigan State University surgeon and a Greater Lansing dental firm are working to create a simple test that could detect oral cancer, ultimately saving lives.

Barry Wenig, a professor in MSU's College of Human Medicine's Department of Surgery, and Delta Dental of Michigan's Research and Data Institute are studying some 100 patients as part of their clinical trial.

The team is looking for biomarkers, which confirm the presence of oral cancer, in patients with white lesions or growths in their mouth and tonsil areas.

Wenig and his associates are in the process of developing a saliva test that would identify the presence of biomarkers, MSU News reports. It would inform dentists and physicians which patients need treatment and which one could avoid invasive biopsies.

"Most white lesions are benign, so a majority of people who develop them are getting biopsies that are not needed," Wenig told MSU News. "Conversely, a simple test would allow us to identify those patients with malignant lesions and get them into treatment quicker."

Wenig said only 60 percent of those afflicted with oral cancer live longer than five years past diagnosis. That poor survival rate is attributed to late detection, he said.

"The key challenge to reduce the mortality and morbidity of oral cancer is to develop strategies to identify and detect the disease when it is at a very early stage," he said.

Study Hints at Why Gums Suffer With Age

New research from Queen Mary, University of London in collaboration with research groups in the USA sheds light on why gum disease can become more common with old age.

The study, published in Nature Immunology, reveals that the deterioration in gum health which often occurs with increasing age is associated with a drop in the level of a chemical called Del-1.

The researchers say that understanding more about Del-1 and its effects on the body's immune system could help in the treatment or prevention of serious gum disease.

Periodontitis is a disease of the gums which causes bleeding and bone loss which can, over time, lead to loss of teeth. It affects about 20 per cent of the UK population and is caused by an over-active immune response to bacteria that grow in the mouth.

As people age they are more likely to suffer from inflammatory diseases, including gum disease.

The new research investigated gum disease in young and old mice and found that an increase in gum disease in the older animals was accompanied by a drop in the level of Del-1. This protein is known to restrain the immune system by stopping white blood cells from sticking to and attacking mouth tissue.

Mice that had no Del-1 developed severe gum disease and elevated bone loss and researchers found unusually high levels of white blood cells in the gum tissue.

When they treated the gums of the mice with Del-1, the number of white blood cells dropped, and gum disease and bone loss were reduced.

The researchers say their findings could be the basis for a new treatment or prevention of gum disease.

Warren Buffet, Prostate Cancer Patient: ‘Excellent’ Prognosis; a Reason to Screen?

Like most men diagnosed with stage I — or early stage — prostate cancer, Warren Buffett is almost certain to die of something else. Especially given that the diagnosis comes at age 81.

Stage I disease is contained within the prostate gland, typically slow-growing, and very curable, experts say. Doctors not involved with his treatment tell the Health Blog there is every reason to believe Buffett’s assertion that his condition will affect little but his summer travel schedule.

“I wouldn’t think it would influence anything, frankly,” says Christopher Logothetis, head of urologic oncology at M.D. Anderson Cancer Center,  Houston.  While the revered investor’s decision to undergo two months of daily radiation treatments could lead to “some reduced energy,” Logothetis adds, “for a person as involved, skilled and inspired as he is, concluding that he won’t be affected is a fair assumption.”

Buffett didn’t reveal the level of his PSA test, the marker that prompted him and his doctors to perform a biopsy that led to the diagnosis.  Nor did he give any details on the tumor volume, grade  or his Gleason score, all commonly used in judging a patient’s long-term prognosis — factors doctors say could have contributed to his decision to undergo treatment.

Still, at his age, “a substantial number of men may not need treatment,” says Peter Carroll, chief of urology at University of California, San Francisco.  Rather than risk potential side effects, including incontinence and impotence for some treatments, they opt for “active surveillance” to monitor their tumor for evidence that a more aggressive approach is necessary.

The quandary was described by the WSJ’s Melinda Beck  in a recent series on prostate cancer available here and here.

US Supreme Court ruling supports generic drug makers

The US Supreme Court ruled that generic drug makers can challenge big-name pharmaceutical firms in court to stop them from broadening the scope of their patent descriptions.

The measure overturns a 2010 appeals court ruling and confirms an earlier decision by a federal judge that ordered the US subsidiary of Danish laboratory Novo Nordisk to narrow the description of its patent on repaglinide, an anti-diabetes drug sold under the name Prandin.

Caraco Pharmaceutical Laboratories, the US subsidiary of the Indian firm Sun Pharmaceutical Industries, is seeking to produce a generic version of Prandin.

However Novo Nordisk amended the wording of his patent to extend it, and block the Caraco's request to the US Food and Drug Administration (FDA) to produce a generic version of the drug.

The FDA cannot approve the sale of a drug that breaks patent protection laws.

In a unanimous decision by the nine Supreme Court justices on Tuesday, Justice Elena Kagan wrote that "a generic company can employ the counterclaim to challenge a brand's overbrand use code."

"We accordingly hold that Caraco may bring a counterclaim seeking to 'correct' Novo's use code," the ruling read.

Enjoy your morning!