BLG 699 Lecture Notes - Lecture 10: Rheumatoid Arthritis, Esomeprazole, Adalimumab

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icici541

31 Aug 2022

School

Ryerson University

Department

Biology

Course

BLG 699

Professor

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Shock or dismay experienced by the potential buyers of a particular product on discovering its high or increased price. New drugs for cancer and rare diseases come with big price tags. Drugs don"t work, if people can"t afford them . Supports trump"s initiative to lower the prices of very expensive prescription drugs. This initiative is supposedly the first plan that would actually reduce the prices and not just prevent price increase. Assumed to lower prices from 80% 26% more than what other wealthy nations pay. The monthly supply cost increased 54 percent. The three month supply rose 113 percent. Humira, by abbvie, treats rheumatoid arthritis, among other conditions that cause inflammation. The typical monthly treatment soared 126 percent. Biologic medicines: the biggest driver of rising drug prices. Biologic drugs (larger molecules) such as monoclonal antibodies are a costlier process than many traditional drugs (small-molecules)

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Neurosicence/Biology Question

A pharmaceutical company is developing a new drug which up-regulates cholinergic signaling in the brain (e.g. causes more ACh to be produced and released). They believe this will work as a general âintelligence boosterâ and make people who take it smarter. Their approach is based on scientific observations that cholinergic signaling is associated with attention and spatiotemporal memory formation, that damage to cholinergic nuclei in the basal forebrain interfere with the ocular dominance shift (which is a form of experience-dependent plasticity), that cholinergic neurons are some of the first to die in Alzheimerâs disease and presage intellectual decline, and on models suggesting that muscarinic signaling increases the contribution of intracortical projections associated with âthoughtâ as opposed to âsensory processingâ.

You are hired as a consultant for a venture capital firm that is considering investing in this drug. What is the strongest single argument you can make for why this drug is unlikely to work as advertised (i.e. unlikely to make people that take it smarter)?

Under normal conditions, healthy heart cells (cardiac myocytes)prefer fatty acids as their fuel which ultimately results in energy being generated from oxidative phosphorylation through the electron transport chain. We will talk about how fatty acids are oxidatively metabolized in lecture 10. The condition ischemic cardiomyopathy is a result of narrowing of heart arteries which leads to decreased blood flow and a decrease in oxygen delivery to the muscle cells of the heart. In the ischemic heart, metabolism shifts from fatty acid oxidation to glucose metabolism via glycolysis to generate ATP and supply energy needs. a) Please explain why the ischemic heart shifts from energy generated by fatty acids to energy generated by glucose. b) In the ischemic heart, an increase in glycolysis is not associated with an increase in glycolytic enzyme expression. What is the general means by which the increase in glycolysis is mediated if it is not via an increase in enzyme expression? c) In ischemic cardiomyopathy, the decreased blood flow to the heart results in a decrease in blood glucose moving through hart arteries. Given that glycolysis is increased in the ischemic heart, discuss two potential ways that heart cells can acutely (in a rapid time period) increase glucose levels to supply the increased demand for glycolysis.

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Imagine that researchers are conducting a randomized controlled trial of a high-fiber supplement as a preventive measure in persons at increased risk of type 2 diabetes. People enrolled in the study are disease-free at the time they agree to participate in the trial, but they all have a family history of type 2 diabetes and are considered at high-risk (80%) to develop the disease during their lifetime. The 10,000 participants who start the trial are healthy individuals who are randomly allocated to receive either high-fiber supplements or placebo for several years. As you can imagine, this study will be quite expensive and will require a large infrastructure of personnel and materials to carry it out successfully.

Because type 2 diabetes has reached epidemic proportions in the United States, the potential benefits of this research are important at a population level. Unfortunately, high-fiber supplements have also been shown in a few studies to be associated with gastrointestinal blockage (which can be life-threatening) and reduced nutrient absorption, which may lead to anemia, osteoporosis, and other debilitating chronic diseases. The supplements may also reduce absorption of certain medications and cause gastrointestinal distress. The potential side effects of continuous high-fiber supplementation are only partially understood, and long-term effects are unknown.

1. What are the potential risks and benefits to be considered when designing this study?

2. When the side effects and long-term effects of a potential preventive measure are largely unknown, is it ethical to expose participants to these risks? Why or why not?

3. Is it ethical to deny the possible prevention benefits of high-fiber supplements to persons in the placebo group? Why or why not?

I think since the

4. Do the potential benefits outweigh the potential risks to the participants and to society? Why or why not?

BLG 699 Lecture Notes - Lecture 10: Rheumatoid Arthritis, Esomeprazole, Adalimumab

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