The Nobel Nose

The Nobel Prize in Physiology and Medicine this year has gone to two American scientists who worked to improve our understanding of how the human brain understands the sense of smell. Richard Axel and Linda Buck of New York’s Columbia University discovered that in the nose, each olfactory cell carries an odorant receptor which is specific for a particular odor. When an odor molecule meets a receptor, the receptor changes shape. A cascade of biochemical changes follows, which triggers a signal which is carried to the olfactory bulb. Since each smell is a complex mixture of subtle smells, the pattern of receptors triggered is typical for an odor. The pattern activated in the olfactory bulb is further interpreted, linked to memories and stored in micro regions of the olfactory cortex. This discovery has no apparent immediate clinical relevance. But, then when electricity was discovered it was considered to have no immediate practical importance too (BMJ 9 October 2004; 329: 815).

Fats, fads and films

What happens when you eat nothing but food from McDonald’s for 1 month? You gain weight, you become sick and if you make a film on it like Morgan Spurlock did in the UK, the sales of the giant company McDonald’s fall by 75%. The documentary "Super Size Me" currently running in the UK about the ill effects of fast food has made a definite hit on the consumption of junk food in the UK. Public pressure has been so strong that content of salt in sauce has been reduced; availability of giant food helpings curtailed and health foods like salads, organic milk and juices are being served in fast food joints considered the bastion of high salt and high calorie containing snacks. The movie was made when two obese school girls in New York filed a suit against the company McDonalds claiming their food had made them ill. Their claim was dismissed on the grounds of lack of proof. Finally, what is important is the growing public awareness about the ill effects of childhood obesity (BMJ 2004; 329: 820).

Rofecoxib withdrawn

The highly successful COX 2 inhibitor rofecoxib effective in osteoarthritis and rheumatoid arthritis has been removed from the market by Merck, after clinical data proved that it’s use for more than 18 months will double the risk for myocardial infarction. In year 2000 when Merck submitted a study called VIGOR (Vioxx gastrointestinal out-comes research) to the FDA, side effect analysis by a cardiologist from Cleveland Clinic, Ohio cast doubts on its cardiovascular safety. A recent multicentric randomized trial of its use in prevention of neoplastic gut poylps has clearly documented a doubling of risks of serious thromboembolic events. New drugs bring new problems and constant clinical surveillance is the only solution (BMJ 2004; 329: 816).

Gouri Rao Passi,
Consultant,
Department of Pediatrics,
Choithram Hospital & Research Center,
Indore, India.
E-mail: [email protected]