Monday 27 June 2011

Yellow gold : Turmeric and its promise

Growing up in Southern India, we cultivated several vegetables and spices in our backyard, one of which was turmeric. Turmeric (Curcuma longa) belongs to the same family as ginger. It is rhizomatous herb and normally pieces of the rhizome are planted in the rainy months of July. In our hands, the plants did not require much care at all. No artificial fertilizers were used nor were the plants watered but only left to the mercy of nature. But our part of South India is blessed with rains anyway, at least then, before the global warming and stuff but that’s another story.

The rhizomes were harvested in the following summer. One signal that it was time for harvest was the death of the leaves. Once this occurred, the root tubers were all plucked out from the soil. This often coincided with the latter half of the summer vacations and was a joyous occasion for us when we were children. The tubers were then washed in water to remove the soil. By the time the mud was washed off our little palms would all be yellow. Imagine our delight when our hands turned read when we tried to wash it away with soap (Turmeric is a PH indicator turning from yellow to red in alkaline conditions). The tubers were then sun dried and pulverized to be used for culinary purposes.

Turmeric occupies a lofty place in Indian culture, well almost like gold. In fact nearly most of South Indian dishes use it as a seasoning. In Ayurveda, it is associated with a manifold health benefits. Apart from using turmeric powder to spice dishes, the fresh root tubers are ground and used as masques on the skin which issupposed to prevented sun induced damage and blemishes. It also plays an important role in auspicious ceremonies like weddings. In many sections of the Indian society the prospective bride and bridegroom have ritual baths with turmeric due to its edifying properties

For the last decade or so, turmeric has moved from the spice cupboards in Indian kitchens to the laboratory benches where researchers are investigating the overwhelming evidence of its' beneficial effects. It is estimated that turmeric has about 100 constituents. 5% of the rhizome comprises of essential oils and 5% curcumin, the latter is the best studied active substance. Curcumin is identified as responsible for most of the biological effects of turmeric although whether turmeric as a whole or curcumin is isolation is most effective is debated. Some believe that turmeric as a whole is superior than curcumin for some conditions (http://www.drweil.com/drw/u/QAA400915/Curcumin-or-Turmeric.html). Indeed, most research activity has centred around curcumin in isolation. Imagine the complexity if the labs were to investigate the individual compounds that make up turmeric.

Turmeric can rightly be called ‘ the mother of all spices’ . In fact evidence indicates that it is anti inflammatory, anti carcinogenic and anti diabetic to name a few of its health benefits. How turmeric exerts is manifold benefits is only starting to unravel as several labs around the world are investigating the molecular mechanisms of curcumin. Limited evidence suggests that turmeric and its active compound, curcumin, are effective for rheumatoid arthritis and other inflammatory diseases such as psoriasis, inflammatory bowel disease (IBS), inflammatory eye disease and familial adenomatous polyposis. Other inflammatory diseases where turmeric might play an important role are neurodegenerative diseases, including Alzheimer's disease, Parkinson's disease, multiple sclerosis. Indeed these diseases are less common among people living in the Asian subcontinent, where people regularly consume spices.

More in a future post

Check these links that review therapeutic roles curcumin:

Howes MJ, & Perry E (2011). The role of phytochemicals in the treatment and prevention of dementia. Drugs & aging, 28 (6), 439-68 PMID: 21639405

Rajasekaran SA (2011). Therapeutic potential of curcumin in gastrointestinal diseases. World journal of gastrointestinal pathophysiology, 2 (1), 1-14 PMID: 21607160

Wilken R, Veena MS, Wang MB, & Srivatsan ES (2011). Curcumin: A review of anti-cancer properties and therapeutic activity in head and neck squamous cell carcinoma. Molecular cancer, 10 PMID: 21299897

Park J, & Conteas CN (2010). Anti-carcinogenic properties of curcumin on colorectal cancer. World journal of gastrointestinal oncology, 2 (4), 169-76 PMID: 21160593

Pocernich CB, Bader Lange ML, Sultana R, & Butterfield DA (2011). Nutritional Approaches to Modulate Oxidative Stress in Alzheimer's Disease. Current Alzheimer research PMID: 21605052

Huang J, Plass C, & Gerhäuser C (2010). Cancer Chemoprevention by Targeting the Epigenome. Current drug targets PMID: 21158707

Saturday 11 June 2011

Dams on the Xingu

On June 1st Dilma Rousseff, the President of Brazil, controversially gave permission for the company Norte Energia to begin building a hydroelectric dam on the Xingu river in the northern state of Para. This follows the granting of a provisional licence in January by the previous president, Lula da Silva, to begin land clearance and road construction, and years of court cases. A total of eleven cases have been filed against the project by the Federal Public Prosecutor, over various irregularities, the last being overturned in February.


Artists impression of the dam

The Belo Monte dam complex will in fact consist of 3 dams. The first, Pimental Dam, will be 36 metres tall, over 6 kilometres long, and will create a lake with a surface area of 129 square miles. This will supply one power station. Two canals will channel water down to another reservoir created by the Belo Monte dam, which will supply another power plant. The Belo Monte dam will be 90 metres tall but only 3.5 kilometres wide, and create a lake of 42 square miles. The whole complex is expected to cost 16 billion US$, with power cables costing a further US$ 2 billion.

For good or ill this is going to affect a lot of people.

Advantages

On the positive side, an immense amount of energy will be generated, the Belo Monte dam is the third largest hydroelectric project in the world after the Three Gorges Dam in China and the Itaipu dam between Brazil and Paraguay. Itaipu already supplies 19% of Brazil's energy needs and virtually all of Paraguay's. The planned capacity of Belo Monte is unclear, as we will see below, but it is claimed by EletroBras, the state electricity company to at least supply the state of Para (population 7.5 million). This of course is all power that would otherwise have to generated by fossil fuels or nuclear energy. Once built, the running costs will be minimal, and electricity will be provided continuously (well, again, see below) for over 50 years. It's not true that will be no carbon emissions. Studies of other Brazilian dams have found that as the water level falls and rises every year, vegetation flourishes in the tropical climate, only to be submerged and decay, releasing methane. But the amount is probably much less than an equivalent coal fired power station.

The location, with a natural drop in elevation, allows the use of a relatively low wall, and thus smaller reservoir, to generate power requiring a much bigger reservoir elsewhere. Thus, the argument goes, if you are going to have a dam, this is the place to have it.


Aluminium at Barcarena

Approximately 18,000 jobs will be created by the construction project, and another 25,000 indirectly, although of course most of these will cease when construction is finished. More long term will be aluminium processing plants powered by the dam, with a view to export to China. The planned Brazilian-Chinese bauxite processing plant at Barcarena, Para, will be the largest in the world. There are also existing Japanese and American plants which will be expanded. This gives Brazil a much higher value export product than simple ore.

Disadvantages

The disadvantages can be divided into social, practical and environmental.

Social
For a start over 20,000 people will be directly displaced. These people will need to be resettled. Then there are the people downstream, mainly from the Juruna and Arara tribes. As they will not be directly affected they have not been offered resettlement, but as the river is a major food supply and transport network, falling levels will possibly cause displacement anyway. This will probably be exasapated by increased levels of water borne diseases from more stagnant pools. In fact, the vast majority affected by this project will be indigenous peoples, and this has aroused a lot of resentment, and threats of violence.

In contrast, an estimated 100,000 migrants from other parts of Brazil will enter the area. It is not clear what infrastructure will be in place to support them.

Practical

A number of studies have cast doubt on the economic viability of the project. The ex-President of Sapesp, the Sao Paulo state water company , has claimed it will be one of the most inefficient hydroelectric power projects in Brazilian history. Mainly because of the seasonal nature of water supply via the Xingu river, so that it will be at 30% capacity or less from June to October.
Actually there is a solution to that - another dam. Although the intention is vehemently denied, a further dam at Altamira up stream would create a 2,000 sq mile lake and a year round water supply, making the whole project much more viable. It would also displace another estimated 25,000 people. The long term intention to build another dam would be easier to dismiss if the turbine capacity of the planned power stations were not considerably more than the likely water flow.


Another artists impression

Environmental

Construction of the dam required an environmental licence from IBAMA, the Brazilian environmental agency, and this was granted in February 2010. Controversially. Two IBAMA presidents and at least two senior officials have resigned claiming undue government pressure to approve the licence. Even now, the licence is technically provisional with many requirements yet to be met before a full licence can be granted, but that is moot as a judge has ruled that work can commence without a full licence.

Large amounts of forest will inevitably be lost. One concern is the loss of biodiversity as a number of species are found only within the area affected by the dam, and it is extremely unlikely they would survive the drying out and/or flooding of their habitats. This apparently includes the Plant eating piranha Ossubtus xinguense (actually it's omnivorous and will eat worms and shrimps) and the Xingu poison dart frog Allobates crombie, amongst others.

What is certain is that it is not just the area under the construction that will be affected. The influx of tens of thousands of migrants will consume a huge area of forest for building of homes and roads, and then farm land to support them.

Further Reading

Fearnside, P. (2006). Dams in the Amazon: Belo Monte and Brazil’s Hydroelectric Development of the Xingu River Basin Environmental Management, 38 (1), 16-27 DOI: 10.1007/s00267-005-0113-6

Sousa Júnior, W.C. and Reid, J. 2010. Uncertainties in Amazon hydropower development: Risk scenarios and environmental issues around the Belo Monte dam. Water Alternatives 3, 249-268

Sunday 5 June 2011

Painting with the same brush: herbal medicine

Britons spend 4.5 billion GBP (60 billion GBP worldwide) on alternative medicine treatments, with the 150,000 alternative therapists in the UK being visited by one in five UK residents.

The above is a fact gleaned from the Economist, one of my favourite magazines which occupy a lofty position along with National Geographic, Nature, PNAS, and Science. They have, however, a rather interesting (and persistent) stance on alternative medicine: ‘Virtually all alternative medicine is bunk; but the placebo effect is rather interesting’.

Alternative medicine is a comprehensive term referring to a mish mash of traditional, indigenous, and unconventional medical practices such as acupuncture, aromatherapy, chiropractic, homeopathy, reflexology, reiki, and many more. Indeed, some of the practices does merit healthy scepticism. I cannot deny that there are quacks in alternative medicine and that many (if not all) do exaggerate the supposed benefits of the drugs/treatments. But then, all conventional medicine cannot be discarded as dangerous chemicals and expensive treatments which expand the bank accounts of GPs and pharmas. Neither can all unconventional medicine be discarded as outdated, bizarre, and toxic. It is up to the patient to make a well-informed decision. But it is highly debatable whether herbal medicine/ethnopharmacology should be painted with the same brush.

The Economist grudgingly admits that a few treatment (‘mostly herbs containing active drug molecules, do have proven benefits’). Yet, their conclusion is that it is none other than the placebo effect, i.e. ‘the strange and inadequately explained tendency of certain medical conditions to respond to anything the patient thinks is directed at treating them, even when the treatment in question could not possibly have a direct effect on the disease’. In other words, a treatment, per se, would have no effect on the condition, but the belief in its efficacy works wonders, resulting in somatic changes. Apparently, this works most effectively with psychological problems (or anything pertaining to emotions) such as depression and pain. And ‘the alternative-medicine industry plainly excels as a placebo delivery service’. The article concludes by pointing out that practitioners of conventional medicine could be less clinically detached, and more caring and attentive to the patient.

The fact is that many (not ‘few’ as claimed by the Economist) of the conventional medicines are/were derived from herbal products (Analgesics such as Aspirin from Salix, Morphine, Codeine from Papaver somniferum; Digitalin from Digitalis purpurea; Malarial drugs such as Quinine from Cinchona and Artemsinin from Artemisia annua; Reserpine from Rauwolfia serpentina; Physostigmine from Physostigma venenosum; Tubocurarine from Chondrodendron; for cancer-Vinblastine/Vincristine from Catharanthus roseus/Vinca rosea, Etoposide from Podophyllum, Paclitaxel/Docetaxel/Taxol from Taxus, Combretastatins from Combretum caffrum….. to state a few).

Many such herbal remedies have been used since time immemorial in indigenous medicines around the world. Indeed, adopting these remedies directly may pose the concerns of drug toxicology, side effects, and general effectiveness. It is equally likely that their effects may not be significant, whilst studies by pharmas (on their chemically synthesised products) might show significant results (one must not overlook the importance of sample size in getting significant results!). Furthermore, pharmas have more than sufficient capital to invest in large-scale research to test drug efficacy and toxicology prior to clinical trials. An ethnopharmacological research team lacks such resources.

Ma et al (2005) identified plant-derived medicines as becoming the next major commercial development in biotechnology. Their abstract states: ‘The advantages they offer in terms of production scale and economy, product safety, ease of storage and distribution cannot be matched by any current commercial system; they also provide the most promising opportunity to supply low-cost drugs and vaccines to the developing world’. Perhaps one emphatic evidence is in the form of the numerous clinical trials being conducted in the US on plant-derived medicines .

Conventional drugs too have side effects which we often overlook- after all, we blindly trust our GPs, believing that any medicine prescribed is fool-proof (reading the medicine's own fine print should throw at least some light on this). Extracting the active ingredients from a herb (thanks to coming across its usage in some traditional medicine), commercialising it and reaping the benefits, only to criticise the practice which had already identified its benefits centuries ago- a dog biting the hand that feeds?

What next? Chucking out vegetables?

References :
Ma, J. K-C., Chikwamba, R., Sparrow, P., Fischer, R., Mahoney, R., and R.M. Twyman (2005). Plant-derived pharmaceuticals – the road forward. Trends in Plant Science, Vol. 10, Issue 12, pp. 580-585.

Alternative medicine: Trust me, I've got a licence

Regulating alternative medicine: But does it work?

Medicine: There is no alternative





Image: Gingko biloba (© Creativ Studio Heinemann/Westend61/Corbis)

Thursday 2 June 2011

Super bugs and Super sleuths : E.coli outbreak in Europe

Earlier this week on Monday came reports from Germany that 6 people who consumed raw vegetables were killed and hundreds rendered ill . Initial investigations pointed towards consumptions of raw cucumber, lettuce and tomatoes. The fatalities were attributed to hemolytic-uremic syndrome, or HUS, from E. Coli. Since then, more people have died and the infection has spread to different parts of Europe . Cases have been reported from Sweden, Austria, Denmark, France, Netherlands, Norway, Spain, Switzerland and the United Kingdom. At the initial stages opinions about whether the strain was new differed between scientists. Scientists at the Beijing Genomic Institute called it a new "super-toxic" E. coli strain whilst the U.S. Centers for Disease Control and Prevention said that it was a known strain.

Today the WHO announced that the German strain was novel and that it had never been isolated before in humans. With the death toll having risen to 18, whilst over 1000 people remain ill, German scientists are desperately trying to sequence the bacterial genome. The news from WHO also indicates that the strain had never been found in any animals which signifies that it could have come directly from the environment into humans. The scientific community is awaiting with bated breath for the results from sequencing of the genome of this deadly strain of bacteria . The sequence of this strain of E.coli might explain the differential infection pattern observed- the bacteria is mostly infecting adults, and generally women.

Emergence of super-bugs are of grave concern. In April, the Lancet reported bacteria carrying a gene that confers resistance to a major class of antibiotics identified in samples of drinking water and sewage effluents from New Delhi. This gene blaNDM-1 encodes the enzyme New Delhi metallo-β-lactamase 1 (NDM-1). Bacteria can pass genes easily through plasmids. The enzyme blocks the activity of a range of antibiotics. NDM-1-positive strains of both species have previously been found in hospitals in India and Pakistan and have already been seen in the United Kingdom and elsewhere in patients, some of whom had previously been in hospitals in the Indian subcontinent.

The problem with virulent bacteria as with most infectious agents is that it is hard to be confined. As of now, the source of the German E.coli strain has not been pin pointed. With bacterial outbreaks such as this there is nothing called a ‘local problem’ but a ‘global problem’ and combating it requires a concerted effort where the blame game doesn’t help much.

References:

German E. coli outbreak caused by previously unknown strain (Nature, June 2nd, 2011)

World health officials scramble to stem deadly E. coli outbreak (CNN, June 2nd, 2011)

EHEC outbreak: Rare strain of E. coli unknown in previous outbreaks (WHO, June 2nd, 2011)

Kumarasamy KK, Toleman MA, Walsh TR, Bagaria J, Butt F, Balakrishnan R, Chaudhary U, Doumith M, Giske CG, Irfan S, Krishnan P, Kumar AV, Maharjan S, Mushtaq S, Noorie T, Paterson DL, Pearson A, Perry C, Pike R, Rao B, Ray U, Sarma JB, Sharma M, Sheridan E, Thirunarayan MA, Turton J, Upadhyay S, Warner M, Welfare W, Livermore DM, & Woodford N (2010). Emergence of a new antibiotic resistance mechanism in India, Pakistan, and the UK: a molecular, biological, and epidemiological study. The Lancet infectious diseases, 10 (9), 597-602 PMID: 20705517

Poirel L, Hombrouck-Alet C, Freneaux C, Bernabeu S, & Nordmann P (2010). Global spread of New Delhi metallo-β-lactamase 1. The Lancet infectious diseases, 10 (12) PMID: 21109172

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