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January 11, 2023

New mechanism uncovered behind osteoarthritis could inform new treatments

Scientists in the United States and Japan have discovered a new mechanism that backlinks age-similar cartilage tissue stiffening with the repression of a vital protein related with longevity. These conclusions enrich the knowledge of mechanisms that lead to the deterioration of joints that leads to osteoarthritis, according to the authors of a new examine, revealed January 10th in Mother nature Communications.

In the analyze, scientists showed that improved stiffening of the extracellular matrix—a network of proteins and other molecules that encompass and help tissues in the body—led to a minimize in a so-named “longevity protein” called Klotho (α-Klotho) in knee cartilage introduced about by epigenetic modifications. This Klotho reduce then destroyed the cells in wholesome cartilage known as chondrocytes. Conversely, exposing aged chondrocytes to a softer extracellular matrix restored the knee cartilage to a extra youthful point out.

As stiffening of extracellular matrix is a defining feature of cartilage aging, these results demonstrate the job Klotho plays in the formation of osteoarthritis and presents new prospective procedure targets to restore cartilage wellness. The researchers also be aware that their success may perhaps be applicable to the toll that epigenetic components brought about by getting older takes on other tissues all over the system.

“This investigation improves our mechanistic knowledge of why osteoarthritis transpires in the to start with position, and it paves the way for the improvement of therapeutics to prevent these changes. These therapeutics are important since there are presently no sickness-modifying treatment plans for osteoarthritis the finest we can do for now is reduce suffering and disability,” reported Fabrisia Ambrosio, Ph.D., MPT, inaugural director of the Atlantic Constitution Discovery Middle for Musculoskeletal Restoration of the Schoen Adams Analysis Institute at Spaulding Rehabilitation Network, and Member of the Faculty of Bodily Drugs and Rehabilitation at Harvard Professional medical School. “Because matrix stiffening is a function of aged tissues all over the physique, we anticipate that these findings could also have implications over and above cartilage mend for the field of growing old analysis.”

Inspecting the root result in of irreversible cartilage injury

Osteoarthritis happens when cartilage in a joint stiffens and commences to split down which then damages the underlying bone, resulting in soreness, swelling and feelings of stiffness. Osteoarthritis is the most typical variety of arthritis, influencing close to 32.5 million individuals in the United States alone—rates anticipated to rise with the growing older population and developments in weight problems. Osteoarthritis can appreciably interfere with a person’s potential to conduct plan day-to-day jobs about 50 percent of grown ups with the condition are of working age, which impacts their potential to make a residing.

There are at present no remedies to reverse this cartilage stiffening and ensuing damage. Therapies these as workout, bodyweight reduction, physical therapy, medicines, injections and joint substitute operation are aimed at lowering pain and increasing mobility. A great deal has remained unidentified about the molecular brings about of this destruction and how to address it. These unknowns are in particular germane to knee osteoarthritis, the place no single event triggers the cartilage destruction, and the finest predictive possibility component is getting older.

More and more, researchers have sought to far better have an understanding of the purpose epigenetics, or how alterations in behaviors and atmosphere as individuals age change how genes get the job done, can effect tissues and disorder processes during the system.

Applying superior mass spectrometry know-how, the scientists mapped out the trajectory of structural and protein alterations in mice with knee osteoarthritis more than the training course of their lifetimes and according to sexual intercourse. They then compared their results to the present-day being familiar with of knee osteoarthritis in individuals.

The researchers discovered that Klotho was greatly involved in the molecular process that led to osteoarthritis. This do the job was an extension of earlier reports showing that Klotho safeguards mitochondria within skeletal muscle and performs a vital job in skeletal muscle mass regeneration subsequent personal injury. As men and women age, their klotho degrees go down, consequently why it is referred to as a longevity protein.

The new investigation disclosed that when knee cartilage tissue became stiffer, the gene that codes for Klotho was repressed. They verified this in products of young and old chondrocyte cells liable for cartilage formation, which have been seeded in environments designed to mimic younger and previous tissue stiffness. Young chondrocyte cells appeared previous when place on a rigid area because of to the reduction of Klotho, but when the researchers safeguarded the cells from the stiffness in their natural environment, they observed chondrocyte health and fitness.

“These effects provide a powerful new paradigm that will be important for the field in terms of comprehension the link amongst age-related tissue stiffening and danger for osteoarthritis with aging,” explained Hirotaka Iijima, Ph.D., PT, assistant professor at Institute for Advanced Investigate and Graduate College of Drugs in Nagoya University.

Apparently, their examination also unveiled that incidence of osteoarthritis enhanced in male mice with age, whilst feminine mice confirmed no onset of the ailment and their cartilage tissue was frequently preserved. This sudden obtaining differs from the reaction noticed in people today, exactly where put up-menopausal women of all ages are considerably extra likely to develop serious knee osteoarthritis than men. These results warrant even further examine, in accordance to the authors, and a task is underway in Dr. Ambrosio’s lab to take a look at the consequences menopause has on knee osteoarthritis at the molecular degree.

Future analysis aims to handle therapeutic gaps in age-related circumstances

With the most current results, the researchers prepare to examine regardless of whether there are approaches to intervene with the illness process that sales opportunities to osteoarthritis, such as by blocking the pathway that represses Klotho, even in the confront of a rigid extracellular matrix environment. They hope their results can be made use of to create treatment options for osteoarthritis and other conditions prompted by growing older.

“We’re interested in assessing no matter whether epigenetic regulation of Klotho and other longevity variables by the extracellular matrix may possibly support explain useful drop of tissues all over the program,” stated Dr. Ambrosio.

In addition to Drs. Ambrosio and Iijima, co-authors of the review consist of Gabrielle Gilmer, BCE, Kai Wang, Ph.D., Allison C., Bean, MD, Ph.D., Yuchen He, Hold Lin, Ph.D., Wan-Yee Tang, Ph.D., Daniel Lamont, Ph.D., Chia Tai, MS, Akira Ito, Ph.D., PT, Jeffrey J Jones, Ph.D. and Christopher Evans, Ph.D.

Far more facts:
Age-linked matrix stiffening epigenetically regulates α-Klotho expression and compromises chondrocyte integrity, Mother nature Communications (2023). DOI: 10.1038/s41467-022-35359-2

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January 8, 2023

Murderous Medicine: Six Strange and Horrifying Ancient Medical Treatments

The health-related subject has superior significantly in comparison to the place it was fifty many years ago, permit alone over 1,000 several years back. Even though modern-day technologies has allowed us to recognize more about the human body than ever before, medical professionals in historical moments had to make do with the machines and info they had. As a end result, individuals practiced some weird clinical remedies around time. Below are six of the strangest (and often deadliest) professional medical therapies recommended by doctors in historical instances.

1.Bloodletting for Inside Harmony

A person historical healthcare therapy you may possibly have presently heard of is bloodletting. Historical medical professionals these kinds of as Hippocrates considered that people consisted of four “ humors,” or bodily substances. These substances had been black bile, yellow bile, phlegm, and blood. They thought that if any of these humors turned unbalanced, illness would occur. To get rid of the ailment, the humors had to turn out to be rebalanced.

Health problems such as fevers had been often attributed to acquiring “too substantially blood,” so bloodletting was required to restore the humors again to their normal equilibrium. Physicians would typically decide on an very easily-available vein and make it possible for some blood to drain out of the sick person into a container for disposal. Some doctors later on turned to leeches to do the dirty work for them, leaving the leeches on the pores and skin of the patient to have their blood sucked out gradually by way of their pores and skin.

While bloodletting has been about for above 3,000 decades, doctors have only stopped training it in the last few generations. Even George Washington was dealt with with bloodletting, which historians say probable contributed to his loss of life.

A nun bleeding a affected individual beneath the eye of a doctor. Bloodletting as a health care therapy ongoing for hundreds of years, but has been widely discredited. ( Community Area )

2.Raw Veal and Badger Dung for Rabies

Historical Rome was recognized for its innovation, and medication was no exception to that. Roman physicians believed that they experienced identified a cure for rabies employing uncooked veal and badger dung. If a human being was bitten by a rabid animal, the medical professional would treat the wound by wrapping it in raw veal and feeding the affected individual a mixture of hog excess fat and lime. As if that wasn’t plenty of, they would also make the patient clean it down with a particular medicine created of boiled badger dung and wine to cleanse their method. Yuck!

Putting raw meat and excrement on a wound seems like an crazy medical treatment today, but in ancient Rome is was deemed a rabies remedy! (Javier Lastras / CC BY 2. )

3.Liquid Mercury for STDs (and Eternal Everyday living!)

Presently, we know how perilous liquid mercury is for our wellbeing. However, our ancestors weren’t so educated. Historic physicians throughout Greece, Persia, and China considered that liquid mercury was the remedy for a selection of diseases. In actuality, the historical Chinese have been so self-assured in their liquid mercury, that they thought more than enough of it could make you stroll on h2o and stay eternally . Quite a few men and women who thought in its powers at some point died just after consuming a massive selection of mercury pills.

Liquid mercury’s most popular use, however, was in the remedy of STDs this kind of as syphilis. Simply because mercury was prosperous in managing these infections owing to its large metallic qualities, handful of observed the deadly side outcomes of the treatment method till the 20th century. A lot of persons who utilized this treatment method died of kidney and liver injury due to mercury poisoning, while other individuals developed most cancers later in everyday living.

Contemporary drugs treats mercury as a harmful substance, but it was utilised as a typical clinical cure for millennia (Tavo Romann / CC BY 4. )

4.Poop Poultices for Pores and skin Disorders

Most of us would be reluctant to contact poop at all, enable by itself rub it on our open up wounds. But that is particularly what the ancient Egyptians did! Ancient Egyptian physicians used human and animal feces to make balms and ointments to get rid of topical ailments and accidents. Some specialists would also use the feces of puppies, gazelles, and even flies to create ointment for precise conditions, which includes warding off bad spirits.

Lots of cultures use feces in standard medication, while it’s nowhere in close proximity to as well known as it applied to be (DowntownGal / CC BY SA 3. )

5.Corpse Smoothie for Soreness Relief

You are going to be more grateful for Tylenol after this one particular. Some historical medical professionals thought that the continues to be of other people had healing attributes. All those coming in with a headache or stomachache in ancient occasions might have been recommended a liquid combination of human blood, bone, and even flesh to drink. Ultimately, distinct areas of the entire body had been attributed to healing particular conditions, such as the blood of fallen gladiators to address epilepsy.

In the 12th century, “ mummy powder ” was designed of crushed mummified stays stolen from Egypt and utilised to develop a assortment of medicines. Corpse medication grew to become so common that some forms ended up even utilized for recreational needs or preventative medicine. The most frequent illustration of this was “ King’s Drops ,” which was an alcoholic beverage that contains crushed items of a human cranium.

Macabre as it appears to be, numerous health-related therapies included a kind of cannibalism. Mummy powders and crushed skulls ended up bought to deal with different conditions. Quite a few apothecaries had cannisters of mummy powder like the 1 above. (Zinnmann / CC BY 4. )

6.Sulfur Fumigation to Heal Infertility

You’ve most likely under no circumstances nervous about your uterus operating away from you, but historic Greeks definitely believed in ‘ wandering wombs ’. In historic Greece, medical professionals considered that the uterus was its have sentient remaining that could move all over the body. If ladies did not appease the uterus by providing it youngsters early on, it may expand resentful and go away its rightful place in the lessen abdomen. This would then result in infertility and maybe a lot more serious ailments, this sort of as seizures or suffocation.

To handle this infertility, medical practitioners believed they experienced to nudge the uterus into its proper spot in the reduced abdomen. At 1st, they would use mild treatment plans to shift the uterus back to the correct location, such as warm baths and abdominal massages.

If that was ineffective, they would flip to far more drastic treatment plans, this sort of as fumigating the patient’s head with sulfur though rubbing their thighs with sweet-smelling fragrances. They believed that the uterus would go back again down to the accurate position by fleeing the foul sulfur odor at the top of the physique in preference for the sweet smell at the patient’s thighs.

Men’s misguided beliefs in women’s ‘wandering wombs’ led to odd clinical treatment plans like sulfur fumigation. (Wellcome Collection / CC BY 4. )

https://www.youtube.com/enjoy?v=4PD5X8GIFAM

No Much more Mummy Powder

Obviously, medicine has appear a lengthy way considering the fact that historical situations. From bloodletting to sulfur fumigation, people have often taken weird avenues to find answers to our most sophisticated problems. The upcoming time you go to your health practitioner for a cold, try to remember it could be even worse: at least they won’t prescribe you poop ointment or a corpse smoothie!

Top rated graphic: Some of these ancient professional medical treatments will make you comprehend how the ‘mad doctor’ trope bought began. Source: vchalup / Adobe Stock

By Lex Leigh

January 3, 2023

Paxlovid ‘last drug in the cupboard’ for Covid as variants in Australia evade other treatments | Australia news

The antiviral Paxlovid is the “last drug still left in the cupboard” to address individuals susceptible to intense condition and loss of life from Covid-19, a major virologist suggests.

The information from Associate Prof Stuart Turville is notably regarding provided the variants circulating now are adept at evading antibodies.

Turville, from the Kirby Institute’s immunovirology and pathogenesis software, says monoclonal antibody treatment options are not helpful versus XBF – presently the dominant variant throughout Australia – and BQ.1.1, which is also circulating.

Monoclonal antibody treatment plans are laboratory-designed proteins made to mimic the organic antibodies created by the immune procedure, halting the virus from replicating. The medications, which consist of Sotrovimab and Evusheld, are shipped intravenously.

A new review that Turville co-authored examined the ability of authorised monoclonal antibody therapies to neutralise at present circulating variants – and the treatments fared poorly.

“The absence of neutralisation activity of Evusheld across a lot of rising variants will have to have to be thought of diligently going forward,” the paper uncovered.

“Whilst Sotrovimab managed action across many variants, it missing neutralisation exercise from BQ.1.1 and XBF.”

The paper concluded that “treatment in the period of a variant combine will deliver a lot of troubles and will involve continued monitoring”.

XBF is the variant most evasive to antibodies derived from immunisation antibody remedy and pure infection, Turville stated.

“The drops in antibody binding and potency vary from 12 fold to 50 fold,” he said. “These are incredibly substantial and the largest drops we have found throughout a lot of variants.”

Paxlovid – an oral antiviral treatment that works by hampering a critical enzyme the virus desires to replicate – stays productive towards the variants, the paper identified.

“The very last drug remaining in the cupboard is Paxlovid,” Turville stated. That signifies procedure options are limited.

Turville’s remarks echo those produced by Prof Sharon Lewin, the head of the Doherty Institute, in December. She claimed development on treatment options to protect the most vulnerable would be vital as Australia tackled the virus into 2023.

“We’ve now bought variants that have knocked out a few of the therapies we had for Covid,” Lewin said.

Turville’s paper identified that even though circulating variants appear really productive at evading antibodies in the human body, they do not appear to be improved able to enter cells and infect persons in the to start with location.

It has been identified considering the fact that the emergence of Omicron variants BA.1 and BA.2 that two-dose vaccination is not adequate for fantastic protection and Turville mentioned this was clearer however with the current BR.2.1 and XBF variants.

“For XBF, we also see numerous persons that have 3 vaccine doses but not a fourth dose following 6 months do not have a fantastic [immune] response,” he reported.

These infected in the present-day wave and who have no vaccination or two doses only want to be reviewed to see why they have “fallen through the cracks,” Turville claimed. But, in very good information, the immune reaction in individuals with three or additional doses is solid towards emerging variants, the virologist explained.

General Covid scenario figures diminished in the course of December but there are a about range of fatalities taking place even with obtain to booster doses and Paxlovid. In the 7 days to 30 December, Victoria recorded 69 fatalities, NSW 32 and South Australia 18.

In Victoria, there was a 47.5{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc} increase in Covid-relevant fatalities in the month to December 3o when as opposed to the preceding month. Of the 667 Covid-relevant fatalities in Victoria in the earlier 3 months, 44{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc} ended up unvaccinated and 50{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc} had not gained their 3rd vaccine dose.

According to Victoria’s wellbeing division, about 60{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc} of sufferers aged above 70 presenting to emergency departments with Covid ended up undiagnosed till they were being examined in clinic – when it was by now as well late for Paxlovid. The drug desires to be administered inside five days of symptom onset to be effective.

“It is critically essential that individuals with indications keep on to check for Covid-19 and that people who check good, and are qualified for antiviral remedies, get those treatments as shortly as attainable,” the section explained.

Turville mentioned hunting abroad to understand what may well take place in Australia upcoming is critical – but it is also becoming considerably less handy.

“Many are on the lookout abroad to see what is going on, but the problem is the US and Europe, for occasion, do not have our variant combine,” he mentioned.

“In the US they are finding anxious about XBB.1.5. It is spreading rapidly and very evasive to antibodies. But in stressing about XXB.1.5, we fail to see that XBF is incredibly, extremely equivalent to XBB.1.5 and XBF is presently the dominant variant across Australia.”

December 25, 2022

As the search for treatments continues, many Maine patients still struggle with long COVID

Celia Koski of Westbrook has experienced long COVID considering that 2020. She has several indications and is participating in the Maine Professional medical Center’s research on the topic. Ben McCanna/Personnel Photographer

Celia Koski is never ever sure until she wakes up in the morning if she can make it to perform at her pores and skin treatment organization. Diagnosed with extensive COVID-19 in 2020, Koski has good and negative times.

“I never know working day to day whether I’m going to be in a position to perform or not,” claimed Koski, who suffers from symptoms including fatigue, “brain fog,” headaches, tremors, extreme joint agony and double eyesight. “It’s this kind of a strange disorder and it is so new. It is aggravating not owning the responses. But on the other hand, I recognize why they do not.”

The 65-yr-old Westbrook resident mentioned she tells her consumers up front that she may perhaps have to cancel appointments on small recognize. She’s also experienced to scale back again the full quantity of people she sees. Irrespective of the frustrations, Koski explained, she’s even now “very hopeful.”

Koski is Patient No. 22 in the Maine Well being Institute for Research’s examine of long COVID-19 individuals, which is part of the Nationwide Institutes of Well being Get better examine (Investigating COVID to Increase Restoration). The aim is to assistance scientists learn about extended COVID-19 and why some sufferers expertise symptoms months or even years immediately after becoming infected with the coronavirus. A better comprehension could guide to efficient treatment plans for long COVID, and some remedies previously are becoming tested in clinical trials.

It’s unclear how lots of folks have signs of extensive COVID – and to what extent. Estimates range from a minimal of 10{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc} to as lots of as 50{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc} of folks who have been infected with COVID-19 have had indications that persist for months or a long time. Several estimates settle somewhere in the middle at 20{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc} to 25{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc}.

Dr. Clifford Rosen, principal investigator for the Maine Wellbeing Institute for Investigation, claimed that the societal impacts of lengthy COVID are staggering, with several people owning to fall out of the workforce or significantly scale again how a lot they function.

Rosen and fellow researchers at MaineHealth, by means of the review, could be aspect of the remedy.

So considerably, 109 Maine patients are participating in the Recover review of 12,500 individuals nationwide, enrolled through the institute. Maine joined the Recuperate study in December 2021 – receiving a $1.5 million federal grant – and the to start with Maine people ended up enrolled this yr.

Scientists nonetheless never know the cause or will cause of prolonged COVID, but Rosen explained they are generating progress.

Dr. Clifford Rosen, of Maine Well being Institute for Investigation, is top the Very long COVID investigation work at Maine Wellbeing. Carl D. Walsh/Staff members Photographer

“One theory is that the virus is still there in the tissues, hiding out in the excess fat cells,” he claimed. “So people’s immune units are not really up to snuff for the reason that the virus has in no way been cleared.”

An additional risk is that the immune method is tricked into considering the virus is still current even when it is gone, producing immune reactions that make people today sense sick.

“One of the inquiries we are hunting to answer is regardless of whether the immune process (in extended COVID sufferers) is not performing its task effectively adequate or (is) performing its work also effectively,” Rosen reported.

He stated researchers also are hunting at irrespective of whether a spike protein on the coronavirus that has been detected in the blood of long COVID people up to a calendar year just after they are infected plays a role in how prolonged they go through from signs and symptoms. A further concept is that small blood clots identified as microclots could be producing the troubles.

As a individual in the Recover review, Koski has been through a collection of assessments and evaluations, which include genetic checks, blood exams, CAT scans, glucose measurements, bodily therapy assessments and neurological examinations. They are intended to establish a baseline of what sorts of signs persons are experiencing and aid attempts to find out why.

Celia Koski of Westbrook is even now hopeful scientists will uncover a way to ease her lengthy COVID indications. Ben McCanna/Team Photographer

“I consider to stay individual, and I’m hopeful that a little something is heading to operate,” Koski claimed.

Rosen mentioned there still is a good deal of disinformation out there about the COVID-19 vaccines and prolonged COVID. He stated 1 issue is sure: The vaccines do not add to lengthy COVID. Side outcomes from the vaccines, he stated, are scarce, pretty much always benign and solve promptly.

Remedy Analysis

On the therapy front, the Maine institute is taking part in two countrywide medicine research, of immulina and paxlovid.

Paxlovid is an antiviral that is now given within just five times of an infection, but Rosen stated it has possible for men and women suffering from very long COVID. Immulina is a normal complement – derived from an extract of blue-environmentally friendly algae – that aims to lower irritation and could probably simplicity indicators, Rosen explained.

“For people today who have extended COVID, there are these new research trials currently being began all the time,” he said. “There is hope.”

Dr. Cliff Rosen, of the Maine Well being Institute for Analysis, discusses Extensive COVID exploration with MIHR Supervisor of Physiology Care, Victoria DeMambro in the Scarborough lab. Carl D. Walsh/Personnel Photographer

A different medicine, naltrexone, confirmed promise this yr in a modest National Institutes of Wellness research of 52 sufferers who took a small dose, and will be investigated even more. Naltrexone is at present utilised to address opioid and alcohol use problems.

Koski stated she has been cleared to just take a very low dose of naltrexone starting up in January, and she hopes it increases her signs. Naltrexone is not aspect of the MaineHealth study.

A person myth that is continue to out there, Rosen said, is that ivermectin can simplicity extensive COVID symptoms. He said ivermectin, which is utilised to handle intestinal parasites – does not do the job and can be destructive.

Ready FOR Reduction

Whilst sufferers wait for productive treatments, their lives continue to be upended.

Dawn Summers-McDonald, 52, who is from Westbrook but has moved to Florida, claimed the long COVID signs and symptoms she has experienced since 2020 have “destroyed my programs for my long term.”

“I love to prepare dinner and I was contemplating of opening up a catering business enterprise,” she explained. Not only did she fall that system but she’s isolated. She does not socialize considerably, fearful of catching COVID-19 a 2nd time.

Gretchen Drown of Portland holds a self portrait she painted when she was extremely ill with COVID-19. Drown has been battling with lengthy COVID for two many years and has enhanced but continue to suffers with many symptoms. Gregory Rec/Team Photographer

Summers-McDonald does immunoglobulin therapy at the Mayo Clinic, and that has helped, but she continue to suffers from several indicators, which include blurred vision, numbness, a burning sensation on the skin and gastrointestinal problems.

“I quite substantially have had a sore throat each individual day for two many years,” said Gretchen Drown, a 57-calendar year-outdated Portland resident who is portion of the Recover study. “It will flare up and lower, but it practically never ever goes away.”

Drown, who has experienced from prolonged COVID due to the fact 2020, claimed her signs and symptoms have enhanced in excess of the past many months, but it is continue to exceptional that she goes a full working day without the need of having any. They consist of thoughts of euphoria and melancholy, nerve ache, insomnia and cognitive problems.

Drown believes the Get better analyze will be crucial to restoring her health. But she expects individualized treatment plans, not one particular that will work for absolutely everyone, will produce the greatest outcomes due to the fact persons with long COVID have this kind of a extensive selection of complications.

Gretchen Drown of Portland has been battling with long COVID for two yrs and has improved but however suffers with a lot of signs. Gregory Rec/Team Photographer

“There’s not nonetheless an knowledge of what is driving these indicators. This is heading to be so important,” Drown claimed. “This is going to be the facts set that all of our providers conclusion up relying on for decades to appear.”

For individuals with long COVID who live in Maine and want to share their activities, there is a support group on Facebook referred to as “C19 Long Haulers Maine.”

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Comparative Oncology: Trial cancer treatments for dogs could also lead to breakthroughs for humans – 60 Minutes

If you’ve ever lost a dog to disease. It may well have been cancer. Some 4 million dogs in the U.S. are diagnosed with it every year, often the same kinds of cancers humans get.

We share many of the same genes with our canine companions. And for cancer research, that’s an opportunity scientists are trying to make the most of. It’s called comparative oncology. Now funded in part by the White House’s Cancer Moonshot Initiative, doctors and scientists are studying naturally developing cancers, mostly in dogs, and using what they learn to speed potential treatments to them and us.

A dog show might seem like an odd place to conduct cancer research, but this summer in Norwalk, Connecticut, that’s where we met scientists from the National Institutes of Health, swabbing and collecting DNA samples from all sorts of breeds.

They’ve been doing this for nearly 30 years and have collected about 40,000 samples so far.

Leading the team is Elaine Ostrander, a senior geneticist at the NIH.

Anderson Cooper: I always thought that the National Institutes of Health studied human diseases. Why is there a scientist at the NIH studying dogs?

Elaine Ostrander: We are studying human disease, and we’re doing it through dogs. And so dogs live in our world. They get all the same diseases we do. They eat our food. They’re exposed to the same environmental pollutants. But they also have all the same genes that we do. And they have mutations in those genes that make them susceptible to everything you and I get – whether it’s diabetes or cancer or neuromuscular diseases. Everything humans get, dogs get.

Ostrander says it’s easier to study genes in dogs than humans because for the last 200 years, they’ve been bred to emphasize specific traits. That’s why they have all these distinct noses and tails and sizes, from great danes to chihuahuas.

Anderson Cooper: So before Victorian times, dogs were pretty much the same?

Elaine Ostrander: So there was some variation. We know that from fossil and archaeologic records, but almost all the variation you see running around in– in the rings today, that’s all happened in the last 200 years.

Anderson Cooper: That’s really incredible that there’s so much variety in that short of time.

Elaine Ostrander: Right. So that means it’s probably gonna be a really small number of genes responsible for most of the major differences.

It turns out just one gene determines if a dog has cream colored hair, or black. Other genes determine long hair or short. And Ostrander’s team at the NIH has discovered some physical traits in dogs, like ear position, hold surprising clues about human health.

Elaine Ostrander: This was a study looking at prick ears versus floppy ears. And that’s due to a mutation in– in one gene called MSRB3.

Anderson Cooper: So just a mutation in one gene–

Elaine Ostrander: One gene. Isn’t that amazing?

Anderson Cooper: –Makes the difference between pointy ears and–

Elaine Ostrander: Yep.

Anderson Cooper: –floppy ears.

Elaine Ostrander: Isn’t that amazing? But what’s really interesting about this story is that when this gene is perturbed or more dramatically mutated in humans, we get a form of deafness.

Anderson Cooper: Really?

Elaine Ostrander: Yeah.

Ostrander told us some of the most promising genetic research in dogs involves cancer.

Some breeds get certain types of cancers more often — making it easier for researchers to locate some of the genes responsible. Scottish terriers, for instance, are about 20 times more likely to get bladder cancer than the average mixed breed dog.

Elaine Ostrander: Now, if I were to look at a group of humans with bladder cancer, the story would be so much more complex. There would be different genes in different populations. There’d be different mutations. Different contributions of environmental effects. So when I look in one breed, I get much simpler stories.

Dogs are diagnosed with many of the same cancers found in humans – lymphoma, melanoma, brain and breast cancer, and the deadly bone cancer osteosarcoma.

University of Pennsylvania professor and veterinarian Nicola Mason oversees a national network of comparative oncology trials funded by the White House’s Cancer Moonshot Initiative. She showed us just how similar osteosarcoma looks in dogs and people.

Nicola Mason: So, what you can see, there’s lots of purple dots here. These are the nuclei of the cancerous cells. They look identical.

Anderson Cooper: Yeah. Even a professional looking under a microscope would not be able to tell the difference between a dog with osteosarcoma and a human?

Nicola Mason: Correct. Incredibly similar.

Osteosarcoma is aggressive and malignant. More than 10,000 dogs in the United States are estimated to get it each year. But only about ,1000 people are, mostly children and young adults. Krystie Gomes was diagnosed in 2020, when she was 11.

Anderson Cooper: Which was the leg that was hurting?

Krystie Gomes: It’s the left.

Anderson Cooper: So it was hurting up in your thigh.

Krystie Gomes: It was up in, like– yeah, here.

Krystie was used to getting bruised on the soccer field, so she and her mom, Kathy Feder, chalked it up to a sports injury. But after months of physical therapy, her doctor discovered osteosarcoma had eroded most of Krystie’s thigh bone.

Kathy Feder: She comes in and she goes, “Krystie has a cancerous tumor in her femur.” And I was like, “What?”

Krystie Gomes: And I was– I’m not, like, a crier. So I, like– I think I was processing it. And as I was processing it, I saw her cry. So then I started crying.

Kathy Feder: And then she was like, “Wait. I have cancer?”

Doctors removed the remaining bone and replaced it with a 9-inch metal rod. Months of grueling chemotherapy withered Krystie to 72 pounds. But her pediatric oncologist, Dr. Elyssa Rubin, told us, the cancer came back – this time in Krystie’s lungs.

Dr. Elyssa Rubin: Patients, once their tumor comes back, are at a really high risk, probably 80{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc} of the time will get new tumors.

Anderson Cooper: Have there been a lot of new treatments for osteosarcoma?

Dr. Elyssa Rubin: Unfortunately, no. We’ve been using the same chemotherapy for about the last 60 years or so.

Anderson Cooper: Really?

Anderson Cooper: Is that because it’s a rare form of cancer?

Dr. Elyssa Rubin: Yeah. It’s harder to study ’cause there’s smaller number of patients to, you know, study in large trials. And also since it’s rare, not a lot of funding of– goes to a lot of trials for it.

But there were trials in pet dogs of an experimental immunotherapy treatment for osteosarcoma that began in 2012, led by Dr. Nicola Mason, using the bacteria listeria.

Dr. Nicola Mason: This is listeria, causes food poisoning. This particular listeria has been genetically modified so that it is far less virulent.

The listeria has also been modified to contain a specific protein — called HER2 — that’s found on some osteosarcoma cells. Once injected into the dogs’ bloodstream, the listeria awakens their immune systems, making them feel sick. It also triggers killer immune cells to patrol the body and destroy the cancerous cells.

Sandy, a 9-year-old golden retriever, joined a nationwide trial in 2018. She’s had her front leg amputated because of osteosarcoma. We met her this past August with her owner, Matt Olson. During the trial, Dr. Mason told us, Sandy’s immune system reacted to the listeria just as she’d hoped.

Nicola Mason: Her body temperature started to increase, peaked around about four hours, and then started to drop down again. We sort of want to see that because it tells us that the immunotherapy is in fact stimulating her immune response, which is what we want to happen.

When Sandy was first diagnosed, her life expectancy with the standard care of amputation and chemotherapy, was around a year. But that was four years ago.

Anderson Cooper: There’s no sign of cancer?

Nicola Mason: No.

Anderson Cooper: And you’ve had four great years with her?

Matt Olson: Yeah.

Anderson Cooper: Did she get, like, extra treats once she got through it all?

Matt Olson: She got everything. She still does man.

Anderson Cooper: She does? I bet she does.

Mason, Matt Olsen, Sandy and correspondent Anderson Cooper

Dr. Mason believes studying and treating naturally occurring cancers in pet dogs is more promising compared to using lab mice, which have to be artificially given cancer.

Nicola Mason: What we’re trying to do is find a better way to determine which are the best treatments to take forward into the humans.

Anderson Cooper: This is not giving dogs rare forms of cancer and then studying them and testing them in a lab?

Nicola Mason: Exactly. So these are naturally occurring cancers. These are clinical trials, just as you or I would go onto a clinical trial if we had a cancer. And we do exactly the same in the veterinary field.

Results from the first listeria trial in pet dogs were encouraging — showing the dogs “tolerated” the immunotherapy and that it “significantly increased duration of survival time.” Those results were submitted to the Food and Drug Administration.

Last year the FDA approved a phase II clinical trial using modified listeria to treat young adults and children like Krystie Gomes who have recurrent osteosarcoma that’s spread to their lungs.

We were with Krystie in August at Children’s Hospital of Orange County when she received her third listeria infusion.

First, she was given medications that made her sleepy.

Anderson Cooper: When the infusion’s actually happening, do you remember it afterward? Or, do you basically sleep through it?

Krystie Gomes: Just sleep. And then when I wake up, it hits like a truck.

Anderson Cooper: Is that right?

Krystie Gomes: Yeah.

Anderson Cooper: You get a headache?

Krystie Gomes: Uh-huh (AFFIRM). Bad headache and nauseous. And I hate nau– nauseous and headache, two things I don’t like. And it’s two things guaranteed.

Once she was dozing, the listeria started dripping into Krystie’s IV.

Anderson Cooper: It’s kind of amazing to think that you’re both on the cutting edge of medicine.

Kathy Feder: I know. And I don’t think she, I don’t think she realizes how important this is.

An hour later, that truck Krystie told us about hit her. Hard.

But similar to what happened to Sandy — the golden retriever — the listeria appeared to awaken Krystie’s immune system. And after ten minutes her headache got better. A few hours later, she was able to leave the hospital.

Anderson Cooper: It’s so amazing to me how similar humans’ and dogs’ immune response is.

Nicola Mason: We’re very similar. You know, I think perhaps more so than we might like to admit.

The National Cancer Institute is spending more than $20 million to analyze cancer samples from pet dogs all over the country and oversee comparative oncology trials to improve treatments in humans and dogs.

One of their targets is brain cancer. This is Otto, a 7-year-old boxer who belongs to Dan Heffron. Otto was diagnosed with a deadly brain tumor in 2021.

And this is Julie Hinseth, who is 59, she was diagnosed in 2020 with a similar nearly incurable brain cancer – glioblastoma. She’s had surgery, radiation, and chemotherapy, but the cancer came back. Julie and Otto enrolled in clinical trials at the University of Minnesota that used virtually the same experimental treatment.

A neurosurgeon and veterinary surgeon teamed up to treat and operate on Otto and other dogs with brain cancer and then shared their data about safety and dosing with a neuro-oncologist treating Julie and others.

Julie, along with her husband, Doug, and daughter, Kelly, met Otto for the first time last spring. Two patients, similar cancers, different species.

Anderson Cooper: What’s it like to meet Otto?

Julie Hinseth: Ah. I’m crying now.

Inflammation in Julie’s brain makes it difficult for her to speak.

Anderson Cooper: I never thought I would be having a conversation with a person and and a dog who were having the same treatment.

Anderson Cooper: It’s incredible.

Julie Hinseth: I didn’t realize that until now.

Dan Heffron: Yeah, and I didn’t until after his first surgery. You know, what sort of an impact that he was gonna have. You know, not only for him but other dogs and humans.

But two months after that meeting, Otto’s symptoms worsened, it appeared his cancer returned. Dan took him for a final swim in his favorite river and then said goodbye to the dog he called his best friend and a medical pioneer.

Julie Hinseth’s symptoms have now worsened as well, she’s stopped taking part in the trial and is spending time with her family. She told us she is grateful to have been a part of an innovative, inter-species battle to find new treatments.

Julie Hinseth: I helped fight cancer.

Anderson Cooper: It gives you satisfaction to know that you helped fight cancer.

Julie Hinseth: Yeah.

Anderson Cooper: I’ve had two dogs who have had cancer. And the idea that cancer can be studied and treated, and it can have an impact on humans, is incredible.

Julie Hinseth: Might be the key, right?

Anderson Cooper: Yeah, dogs may hold the key.

Krystie Gomes, who’s now well into her freshman year in high school, says she agrees.

Krystie Gomes: We have to have more common things than we think.

Anderson Cooper: It’s not just that they need us for food and that–

Krystie Gomes: It’s not just that we’re besties.

Anderson Cooper: there’s really a connection.

Krystie Gomes: It’s that we have to have, like, more connection than that.

Krystie’s last scan showed no signs of cancer. She continues to get immunotherapy every three weeks. Between treatments and homework, you’ll find her with her yorkie, Benny — a gift from her mom. One more dog that’s helping her in her recovery.

Produced by Denise Schrier Cetta. Associate producer, Katie Brennan. Broadcast associate, Annabelle Hanflig. Edited by Matthew Lev.

Anderson Cooper

Anderson Cooper, anchor of CNN’s “Anderson Cooper 360,” has contributed to 60 Minutes since 2006. His exceptional reporting on big news events has earned Cooper a reputation as one of television’s pre-eminent newsmen.

November 26, 2022

Covid long-haulers turn to unproven treatments in desperation

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For the burgeoning population of covid long-haulers, there is an abundance of new treatment options: Specially formulated nutraceuticals imported from India that promise to “get you life back from covid.” Pure oxygen delivered in a pressurized chamber. And, if time and money are no obstacle, a process known as “blood washing” that’s available in Cyprus, or $25,000 stem cell treatments in the Cayman Islands.

Months-long waits at long-covid clinics combined with the sluggish pace of research have left vulnerable patients clamoring for immediate care as manufacturers bring novel remedies to market, often with little data behind them.

“I have tried, I would say, as many different things as anyone could do in my situation,” said Donna Davis-Doneghy, a 62-year-old accountant with Hearthside Food Solutions in London, Ky., who has been tormented by headaches since coming down with covid in November 2020.

“People will say to me, ‘Here’s a phone number,’ and off I go chasing something different,” said Davis-Doneghy, whose treatment regimen has ranged from acupuncture and Botox to nerve-block injections and vitamin infusions.

Long covid has taken to new heights a medical conflict that shows up with cancer and other dire diagnoses: the tension between the desire for evidence and the pressing needs of patients who are suffering. In their rush for relief, patients are turning to unproven treatments, putting them at risk of potentially harmful health effects as well as having their hopes dashed and their wallets emptied. Doctors often follow the practice of prescribing drugs off-label, not for the purpose the Food and Drug Administration originally approved them for.

What you need to know about the latest on long covid

“You want to protect people from charlatans,” said Harlan Krumholz, a professor of medicine at the Yale School of Medicine. “We need to resist the temptation to adopt tests and treatments without sufficient evidence to justify their use.”

But until researchers discover the mechanism — or, more likely, mechanisms — that cause long covid, clinicians are having to rely on their experience treating other illnesses.

“We’re kind of stuck,” said Michelle Haddad, a neuropsychologist who runs a long-covid clinic at Emory Rehabilitation Hospital in Atlanta. “I can define areas where you have impairments and how impaired you are. I can tell you what works in other, similar conditions. But I don’t have a magic pill.”

The scale of the problem — and opportunities for profiteering — are increasing as the number of Americans reporting long-lasting symptoms ramps up to as many as 15 million adults. Data released this summer by the Centers for Disease Control and Prevention suggests that almost 15 percent of the population has had long covid, or symptoms that lasted three months or longer after the acute infection.

Many long-haulers describe being devastated by disabilities that range from fatigue to brain fog and body-wracking tremors. Facing disbelief from their families and physicians, and frustrated by the slow pace of science, they are turning to social media to share ideas for relief.

While some patients report getting insurance coverage for the treatment of some symptoms, such as migraines, many end up spending thousands of dollars, out of pocket. Robert Harris, a 48-year-old veteran in Texas, estimates he has paid $25,000 for treatments, from over-the-counter supplements to the horse dewormer ivermectin and hyperbaric oxygen. “I can’t figure out what research is being done, what treatments have been approved,” he said.

The $1.15 billion Recover program, awarded nearly two years ago to the National Institutes of Health, is aimed at understanding the biological basis of long covid. Establishing the safety and efficacy of potential treatments involves a further step — setting up randomized controlled trials. Although NIH recently announced its intent to investigate the potential impact of the antiviral Paxlovid, results are not expected until 2024, reinforcing some scientists’ argument for a more agile research model to match the urgency of the moment.

“Government-sponsored and government-funded mechanisms are designed for incremental innovation — for steady and safe discoveries,” said David Putrino, director of rehabilitation innovation for Mount Sinai Health System in New York.

Under the swiftly changing circumstances of the pandemic, smaller research teams, advocacy groups and private companies with a variety of standards have stepped in — often without robust scientific evidence that the products actually work.

“We are the ETSY of long covid — DIY but giving you something the establishment can’t,” tweeted Ram Yogendra, an anesthesiologist with the California company IncellDx, referring to the company’s do-it-yourself approach, modeled on the online craftsmanship marketplace. IncellDx purports to have developed a diagnostic blood test for long covid.

Using machine learning to identify what is unusual in long-haulers’ blood, IncellDx claims to have found an immune signature or “cytokine profile” for the condition. The company, which has received a patent for using the HIV drug maraviroc to treat coronaviruses, has published three studies, enrolling more than 700 patients.

‘We are in trouble’: Study raises alarm about impacts of long covid

Krumholz said immune signatures are likely to become important for diagnosis and treatment. But after reviewing the data on the IncellDx website, he warned about the dangers of researchers rushing to adopt tests before the evidence is sufficient. “The evidentiary standards need to be much higher and the transparency about the science much greater than we have today to justify widespread use,” he said.

The $415 diagnostic test has been used by about 10,000 people, creating a “tremendous database,” according to Bruce Patterson, the former Stanford virologist who leads the company. The results, Patterson said, can be used to inform personalized treatment protocols typically administered by the patients’ primary care providers. A company spokeswoman said many long-haulers pay an additional $250 for a follow-up consultation and buy additional tests to check how the therapy is working. She said the company recognizes that the data need to “evolve” and said that IncellDX is helping people in the meantime.

Patterson, who said he is working on contracts for clinical trials of a “drug combination that we think works,” said it is up to patients and their doctors to decide how to proceed with treatment. “We do what clinical pathologists should do: ‘Here is a test report, you treat accordingly,’” he said. Company doctors are available to offer guidance, Patterson said.

But Alba Azola, a physical medicine and rehabilitation specialist at Johns Hopkins Medicine, said she has treated patients who report having spent hundreds of dollars for the tests and then don’t know what to make of the results.

“They bring it to me, like, ‘Look at this,’” Azola said. “And I’m, ‘I don’t know what to do with that.’”

Other long-haulers, including Harris, have paid for treatments promoted by groups linked to vaccine hesitancy and anti-science messaging.

Among them is the Front Line Covid-19 Critical Care Alliance, a nonprofit that promotes the anti-parasitic ivermectin not only for the prevention and treatment of acute covid but also as part of its long-covid protocol. The alliance publishes a list of pharmacies that will supply ivermectin, approved by the FDA to treat some parasitic worms, head lice and skin conditions like rosacea in humans. But the drug has not been shown to be effective in the treatment of acute covid illness. The American Medical Association and other professional groups oppose using the drug for covid outside of clinical trials because of its potential toxicity.

How long covid is accelerating a revolution in medical research

The alliance was co-founded by Pierre Kory, a critical-care physician who touted ivermectin as a “miracle drug” in Senate testimony and also runs a private telemedicine practice where he treats long-haulers. Kory, who charges $1,650 for an initial video consultation, follow-ups and check-in calls according to patients’ needs, said the drugs he prescribes, including ivermectin, steroids and anti-inflammatories, are safe.

In an interview, Kory said he does not follow the AMA’s position on ivermectin because the association provides general guidance but does not treat people. Other researchers say that the risks of the drug are known and that its benefits have not been shown.

“Based on the lack of effectiveness in acute covid, combined with what we know about long covid, it is extremely unlikely that ivermectin would be beneficial for someone suffering from long covid,” said Francesca Beaudoin, head of the Brown University School of Public Health’s Long Covid Initiative.

Kory also criticized the research community for being too slow to keep up with patient needs.

“We’re stuck right now trying to help patients with trial and error until the science evolves,” he said. “All of my patients get better to some extent.”

How long covid could change the way we think about disability

Among the most common online offerings are dietary supplements, which do not have to meet the same regulatory standards as pharmaceuticals. While drugs must be shown to be safe and effective before they reach the consumer, there are no such provisions for the FDA to regulate vitamins, herbs and amino acids.

One of the most widely touted supplements among long-haulers is Vedicinals-9, a new herbal suspension that purports to support “the human organism in the recovery phase from viral infections.”

The nutraceutical is made in India, where it is regulated as a food for special medical purpose, or FSMP, and then shipped around the world. A 42-day supply costs $95, according to the product website.

Harris said he bought several boxes but that the solution didn’t reduce the muscle spasms and pain he has suffered since testing positive 10 months ago. Other patients have reported benefits.

The company’s founder, retired German businessman Joachim Gerlach, said he had long been interested in finding natural remedies for chronic illness, which he has witnessed among family members. He turned his attention to acute covid in early 2020, Gerlach said, hoping, as long covid emerged, to find a common approach that would help large numbers of people. He believes that many symptoms stem from an imbalance of the gut bacteria that can help combat disease.

Gerlach, who has reached out to prominent long-covid researchers around the world to plan research next year, said his progress on long covid was “lacking a little bit on the side of publishing.” But by financing Vedicinals out of his own pocket, he said, he can “act fully in the patient’s interest” without pressure from shareholders.

Paxlovid may reduce long covid risk for some patients, VA study finds

New tests and products keep cropping up.

Earlier this month, QMC Health, a diagnostic testing technology company, announced its intention to produce a long-covid rapid test, based on blood biomarkers.

MDHyperbaric, a company in New York, offers oxygen therapy for a variety of conditions, from healing bones to slowing aging and improving long-covid symptoms, saying it plans to measure long-hauler outcomes.

And in October, Norman B. Gaylis, a Miami-based rheumatologist, collaborated with Tel Aviv researchers to release an “all-natural, patented formula RESTORE,” described on the company’s website as “proven by clinical study” to improve symptoms of covid long-haulers.

That study, published in Frontiers in Nutrition, involved 51 patients with positive coronavirus tests who reported lingering symptoms three to 11 months after infection. On average, the participants reported that their symptoms were milder after two weeks and better still after four, according to the study.

The study is small and lacked a control group to assess whether the patients’ symptoms would have improved anyway over time or whether their self-reported improvements resulted from a placebo effect.

“Obviously, a double-blind control is more valuable,” Gaylis said in a telephone interview. “Between time and cost and urgency, these things take so long, we felt it was sufficient.” The biggest endorsement of the product, he said, was that so many people who took part in the study asked to buy it.

Without solid data about treatments, some primary care physicians have fallen into a “kitchen-sink approach,” according to Haddad, the rehabilitation specialist at Emory.

Haddad saw one patient who had been prescribed Benadryl and several other sedating drugs in addition to an antidepressant that she was already taking. When the patient complained of brain fog, her doctor added Adderal, a stimulant — a little like chasing shots of hard liquor with double espressos.

“They kept throwing things at the post-covid,” Haddad said. “They didn’t step back and ask, ‘Could medications be part of the culprit?’”

Meanwhile, clinicians who are running long-covid clinics at major medical centers are drawing on their experience treating conditions with similar symptoms, such as ME/CFS, or chronic fatigue syndrome; POTS, a blood circulation disorder that causes a rapid heartbeat; and what’s known as post-ICU syndrome.

“We’re using a lot of experience, anecdotal evidence and related evidence with other conditions,” said Benjamin Abramoff, director of the Post-COVID Assessment and Recovery Clinic at Penn Medicine. “A lot of the things we do have not gone through trials.”

Mexico City gave ivermectin to thousands of covid patients. Officials face an ethics backlash.

Many rehab experts have been meeting at CDC-funded monthly webinars to pool the expertise they are gaining and come up with guidance published by the American Academy of Rehabilitation and Physical Medicine.

There are likely to be therapeutic benefits to some of the treatments long-haulers are trying. A few small studies have suggested hyperbaric oxygen may provide relief. The spice turmeric, or curcumin — an ingredient found in Vedicinals and the Front Line Covid-19 Critical Care Alliance’s protocols — has anti-inflammatory properties. The key, clinicians say, is to evaluate the risk/benefit ratio for every therapy, including potentially detrimental interactions with other medications.

“For things patients are interested in trying, I won’t dissuade them if the risk of harm is low,” said Jeffrey Fine, director of rehabilitation medicine at NYU Langone Hospital, who said he tries “to meet patients where they are.”

In the meantime, patients continue their own research, through online resources such as Twitter.

“It’s my social life, my family, my research library,” said Molly Gordon, a 69-year-old executive coach in Washington state who gradually pieced together a self-diagnosis of mast cell activation syndrome — a condition akin to allergic reactions — that she believes came from long covid. Gordon said she is putting about $500 a month of her retirement savings toward supplements and cannabis.

Those networks have turned long-covid care into an international free-for-all, as patients search for therapies overseas, often with little idea of the regulatory oversight — or lack thereof.

Laura Wright, 45, a reflexologist in England, joined Twitter to glean information from fellow sufferers around the world about how to combat the fatigue that has plagued her since she came down with covid a year ago. She tried hyperbaric oxygen and began taking “every supplement under the sun and adding new ones every month,” Wright said, including garlic, hawthorn, B-12 and magnesium, until she began wondering whether they were doing her more harm than good.

She went cold turkey. With one exception: Boluoke.

Wright has pinned her hopes on the earthworm extract that is thought to promote circulatory health. A bottle of 30 capsules, which she imports from Canada, costs about $55.

“If I can get back to working again, then it will be worth it,” Wright said.