Jonathan Collin, MD

Genetic Modification of Mosquitoes to Eradicate Malaria?

Ordinarily we do not worry about malaria in the US except for the occasional traveler who acquired the disease overseas. However, there were more than a few cases in 2023 of mosquito-transmitted malaria in the southeast US in people who had not travelled. Most Americans visiting Africa are prescribed medication to avoid developing the infection and sleep under insecticide-laden nets.

Programs to eradicate malaria in Africa have been in place for decades; most recently the Bill and Melinda Gates Foundation have provided them with substantial funding. Nevertheless, insecticide spraying of the environment and inside homes remains expensive and mosquitoes have developed resistance to the chemicals. Sleeping under nets is effective; however, nets are also costly and most individuals cannot afford to buy them for their families. Worse still, mosquitoes are now biting more during the daytime, especially one species, Aedes stephensi, which has been particularly troublesome in the Horn of Africa; Anopheles gambiae is more commonly recognized as the malaria transmitter.

Improvement in housing could be a very effective means to limit malarial transmission especially in thatched houses with unscreened windows and pervious walls and doors. Remodeling houses with wall plastering and adding window netting would be very inexpensive for us but $250-$500 is beyond a family’s budget in Africa; governments and NGO’s also do not have the funding to patch up everyone’s home. Yet for many children who relapse with malarial symptoms six to eight times yearly, the home renovation work would seem to be a bargain compared to the hospitalization required.

Genetic modification of mosquitoes has been the most recent “weapon” employed in battling malaria as well as other viral diseases such as dengue fever. Modifying the mosquito’s gene to ensure that only male mosquitoes are produced could theoretically wipe out the mosquito population over several generations. However, the infrastructure, expense, and time necessary to eradicate mosquitoes by creating only males would be colossal. Nevertheless, such programs are now underway in the Florida Keys and elsewhere. Still no matter how successful such a program would be, female mosquitoes would eventually return to populate the treated area. Females do all the biting involved in transmitting malaria; males do not bite.

Scientists want to find a genetic solution that does not require eradication of mosquitoes. Gregory Lanzaro, a molecular geneticist at the University of California, Davis is leading an experiment to genetically modify the mosquito’s capability of carrying the parasite causing malaria, Plasmodium falciparum. Of course, the genetic modification does pose some important questions as to whether there would be any unexpected changes to the mosquito beyond its hindrance of the parasite. Malaria kills more than 600,000 people yearly and causes illness in more than 240 million. Given those numbers would genetic engineering of the mosquito be justified despite the risk?

The “ordinary” genetics of modifying the mosquito as shown in the diagram below only modifies a single chromosome.¹ The problem with single chromosome modification is that at best only 50% of the offspring have the gene change. Unfortunately, this would not provide sufficient gene change in the mosquito population to make any difference. Lanzaro’s team at UC Davis has engineered a “gene-driven” method of modifying the gene in one chromosome followed by modification of the gene in its paired chromosome. When both chromosomes are modified the likelihood that all mosquitoes will be modified impairing the malarial parasites’ survival is nearly 100%. Of course, in time, resistance to the gene modification in the mosquito as well as in Plasmodium would mean that malaria transmission would return. Still, it is possible that malaria could effectively be stopped.

As NY Times reporter Stephanie Nolen quips this is the Jurassic Park experiment.¹ Can you genetically modify an organism and know what you will be dealing with when all are modified? Lanzaro is doing preliminary experimentation on the tiny island of Principe 200 miles off the west coast of African country, Gabon. No genetic modification is underway yet. Instead he is “tagging” mosquitoes with green dust and then having volunteers expose their arms and legs to attract the mosquitoes before capturing them for study. Of 253 mosquitoes that were captured, 12 had the phosphorescent green dust offering insight into the mosquito population’s dynamics. The question for Lanzaro is whether genetically modified mosquitoes will successfully mate with wild-type mosquitoes. However, the major stumbling block is that the folks in Principe are not satisfied with the explanation of what genetic modification of the mosquito really means. Local government in Sao Tome do not have the scientific wherewithal to sort out the science and don’t want to authorize the release of modified mosquitoes without a complete evaluation.

For now, there will be no genetically modified mosquitoes on Principe, but Lanzaro and other malaria-eradicating foundations remain determined to proceed.

Remembering Suzanne Somers

I was given the opportunity to interview Suzanne Somers some 15 years ago. I was attending a medical conference put on by the American College for the Advancement of Medicine (ACAM) in Palm Springs, and Suzanne was the featured speaker during the luncheon. With all of her acting ability and TV hosting experience, she was very comfortable expressing her advocacy for use of bio-identical hormone therapies, diet modification, anti-aging approaches, and support of unconventional cancer therapies. Of course, Somers was preaching to the choir given that most ACAM physicians do just that—prescribe bio-identical hormones, recommend supplements for longevity, and advise natural supports in conjunction with oncology care. Still Somers who authored more than 25 books, including Ageless, Knockout, and ToxSick, was heavily criticized by the medical establishment for using her celebrity platform to promote unproven medical treatments. Like most doctors who specialize in integrative and naturopathic medicine, she was always wary of the naysayers who dismissed her writing as without merit. Somers, who is well known for her acting career in Three’s Company, made a mark for those who question the validity of using only pharmaceuticals in treating all conditions and diseases. Additionally, Suzanne greatly elevated the status of “alternative” doctors, like Jonathan Wright, MD, who consider natural approaches first when managing the patient.

Beyond her acting and writing career, Somers and her husband, Alan Hamel, were successful entrepreneurs. Starting in the 1980s she was the spokesman for the exercise equipment, Thigh Master, which was wildly popular, and eventually owned much of the company. Starting in the late 1990s she authored numerous books on diet and weight loss, before publishing her first book on bio-identical hormone treatment, The Sexy Years.

In her writing about bio-identical hormones, Somers noted that the widely used pharmaceuticals, Premarin® and PremPro®, use horse urine to derive a synthetic estrogen that in no way matches the hormones of a woman’s body. Bio-identical hormones are compounded by specialty pharmacies and are individualized unlike the pharmaceutical hormones available from chain pharmacies. As expected, the drug companies have been highly critical of the compounding of bio-identical hormones claiming that their quality control is poor and that many pharmaceuticals, themselves, are bio-identical. Indeed, the FDA is currently reviewing the status of bio-identical hormone compounding and is considering limiting or prohibiting them. (For those wishing additional information on the FDA’s threat to bio-identical hormones visit www.A4PC.org).

Suzanne Somers was diagnosed with breast cancer in 2000 for which she underwent a lumpectomy and radiation treatment but no chemotherapy. Somers was of the mind that chemotherapy did not promise a cure for her cancer and that natural treatment supports would be far superior. Unlike most women who have breast cancer Somers continued her use of estrogen hormone replacement despite the standard of care to use hormone blockers.

Somers always advocated for the need to individualize hormone therapies based on laboratory testing; each hormone’s dosing needed to be adjusted higher or lower depending on the lab value. When she started hormone therapy she found that it took nearly a year before the hormones prescribed were ideal based on labs and symptoms. She was a strong advocate for use of nutraceutical support as an anti-aging strategy using 60+ supplements daily. A decade after she was diagnosed with cancer she became ill and was advised that she had a recurrence; however, she was able to restore her health and the recurrence was thought to be wrongly diagnosed. In July of this year her cancer did recur. She died at home in October one day before her birthday, having spent the day earlier with family and friends.

Somers’ advocacy for bio-identical hormones has introduced millions of women and men worldwide to an alternative to pharmaceutical treatment. While critics disdained her theories, she undoubtedly caused innumerable physicians to change their medical practices prescribing compounded hormones. As a strong voice for alternative approaches to cancer care and longevity medicine, her work will remain a legacy.

Suzanne’s writing in the Townsend Letter print magazine from May 2020, appears in this issue.

Remembering Stephen Harrod Buhner

In my 10/21 Letter from the Publisher, I reviewed Stephen H. Buhner’s book Healing Lyme Disease Coinfections: Complementary and Holistic Treatments for Bartonella and Mycoplasma. I neglected to mention that Buhner died in December 2022 from pulmonary fibrosis. An obituary from his foundation’s website eloquently praised his life and work and is reprinted here:

“Master herbalist, prolific author and Earth poet, Stephen Harrod Buhner has died. Buhner (1952-2022) was the award-winning author of 25 books on nature, indigenous cultures, the environment, and herbal medicine including numerous articles, memoirs, short stories, and poetry on nature, human plant, and human Earth relationships. Through his works he helped millions of people. Stephen was an interdisciplinary, independent scholar, polymath, autodidact, Fellow of Schumacher College UK, and has been head researcher for the Foundation for Gaian Studies for the past thirty years (www.gaianstudies.org). In recognition of his life’s work as a natural philosopher, Stephen was awarded the first McKenna Academy Distinguished Natural Philosopher Award for 2022.

“Stephen Harrod Buhner died on Dec. 8, 2022. He was present, aware, conscious, humorous, open hearted, holding the space for his death and those few friends and family in attendance and in ceremony. And so very brave. Yet his death was not unexpected. Stephen prepared himself, his family, and his public through his posts and articles about his dying and preparations for death. He hated secrets and much of his work was about exposing them. ‘And death is one of them,’ he said. He wrote about his own dying in part to break the injunctions about saying truths about dying out loud and in large part because he was in service to what is real which he did in his articles and books that hold timeless truths and guidance of how to be a human being, one species among many in the community of Earth.

“As he did with everything he rubbed his life up against, he researched, contemplated, talked about and wrote about the process he was going through. Some of this can be found on his Facebook thread as well as under the listing of articles on his website. Those who attended his workshops were moved often to tears, always by his humor and most memorable was his full-hearted laughs that filled the room and the hearts of his attendees. Stephen was a rare teacher devoted to making his teaching an art form of the highest degree paying keen attention to the most subtle detail and nearly imperceptible movement in the room. He loved teaching and giving people the ends of golden threads to grab hold of. The world will miss him as his loss reverberates around the world. He was a pioneer, a bard, a maverick, an outlaw.

“Stephen comes from a long line of healers including Leroy Burney, Surgeon General of the U.S. under Eisenhower and Kennedy, and Elizabeth Lusterheide, a midwife and herbalist who worked in rural Indiana in the early nineteenth century. The greatest influence on his work, however, was his great-grandfather, C.G. Harrod who primarily used botanical medicines, also in rural Indiana, when he began his work as a physician in 1911.”

Here, in Buhner’s work, is his moving Facebook posting on Dec. 4, 2022:

“Hi All: Regrettably, my body has taken a severe turn for the worst; it doesn’t look like will be able to be corrected. I spend most of the day sleeping. I am having seizures and mini-strokes now. Julie brings me back from them but it is getting harder and harder for her to do so. It’s only a few more days now. Sorry for this last long journey into night. I had hoped to find a different outcome.

“Pulmonary fibrosis is not a kind disease, and in many ways, cancer is far more benevolent oddly enough. I have spent most of my time on the couch in front of the computer or about 20 feet away lying in bed, that is about all I can do and I have to have help to make it that far. I can no longer move on my own. Your very kind donations have allowed us to clear all our credit cards and buy a few expensive care items that we had hoped to have and which have helped immensely. You have helped us so much in the end; this has made more of a difference that you know and I can’t thank you deeply enough.

“I am lucky enough to be buried deep in the Gila Forest in a place few people are aware of. Luckily, New Mexico is still supportive of home and green burial. So, it is just me and my beloved forest, right adjacent to the Aldo Leopold wilderness area, which makes a lot of sense to me given my life’s work. The truth is that as I have grown older and more tired, I feel my connection to the land more deeply. I have been lucky enough to be buried in a handmade wooden shroud. One made with care and love, the deer buttons are quite lovely.”

His last book was published posthumously, Becoming Vegetalista. I have only read Buhner’s Bartonella and Mycoplasm book but I was very impressed with how he envisioned how these organisms interact with our bodies in innately intelligent ways deserving of respect.

TACT Trial Important Milestone for Chelation Therapy

I remember the day when chelation therapy was scoffed at as being without any scientific merit for use in treating cardiovascular disease. Wait—that was this morning when I looked up “chelation therapy” on Wikipedia. Alternative medicine skeptics, “quackbusters,” summarily dismiss any evidence that chelation therapy is efficacious for prevention and treatment of atherosclerotic heart disease. The Wikipedia discussion of chelation is replete with editorial opinions that chelation does not work for heart disease but cites minimal confirming studies. A few poorly designed and limited studies of chelation had negative outcomes; these studies largely ignored the smaller studies with positive outcomes that were done outside of medical institutions. It was not unusual in 2012, and earlier, for cardiologists to quip that chelation therapy was without merit and undertaking treatment was not without risk.

The TACT study, the first double-blinded, multiple-arm, randomized, multi-institution, controlled trial of chelation published in 2013 revealed quite the opposite – that chelation therapy offered a definite reduction in total mortality, myocardial infarction and stroke events, interventional revascularization, and time hospitalized. In this issue, Terry Chappell, MD, reviews TACT and its impact on conventional cardiovascular care. At this time TACT-2 is underway; if it also has a positive outcome, chelation will move that much closer to standard of care.

Reference

1. Nolen, S. The gamble: Can genetically modified mosquitoes end disease?. NY Times.Sept. 29, 2023. https://www.nytimes.com/2023/09/29/health/mosquitoes-genetic-engineering.html?smid=nytcore-ios-share&referringSource=articleShare

Published November 18, 2023