Michael McIntosh, MD, Professor at the University of Utah, and Psychiatrist at the Salt Lake City VA Medical Center talks about using compounds in venom extracted from cone snails to possibly help treat and even prevent chronic pain.
Interview conducted by Ivanhoe Broadcast News in November 2017.
Tell me a little bit about the study because it’s pretty cool that the answer for chronic pain might be in the ocean.
Dr. McIntosh: It is. We’ve found it quite interesting because these snails who live out in the sea and make their living by hunting prey seem to be providing us not only with very powerful tools for studying the nervous system but also with compounds to be able to treat diseases of the nervous system including neuropathic pain.
Tell me a little bit about what’s been done with the research so far.
Dr. McIntosh: What we’ve done is isolate compounds from the venom of these carnivorous cone snails. The snails themselves use the venom to capture prey but what we’ve found is that the compounds are highly specific for receptors and ion channels that are in the nervous system or in immune cells. What we’ve discovered is a compound that if you administer it at the time of injury of a nerve not only helps to treat the pain but also accelerates the functional recovery of that nerve.
So you wouldn’t need to continue treating the pain, it would actually go away?
Dr. McIntosh: That’s the hope. That we’re not just masking the pain but that we’re actually favorably altering the disease process.
Is this just theoretical so far or have you actually been able to try this in humans?
Dr. McIntosh: Theoretical as far as humans. We’ve done it in animal studies and it’s quite encouraging there but not yet in humans.
How do you test for pain in an animal? For pain going away?
Dr. McIntosh: Yes, what we do is we have different types of models that mimic human pain. So for example, we can give a chemotherapy agent that is used to treat human cancers but one of the side effects from that agent is it can produce pain and we give that same chemotherapy agent to an animal. In this case they’re extra sensitive to cold and so we put them on a metal plate that’s cold and we measure how long it takes for them to react to that and that gives us an idea of what they’re experiencing.
The response so far how encouraging is it?
Dr. McIntosh: It’s quite encouraging because what happens is after several days of treatment the mouse or rat is no longer experiencing the pain. But then we’ve been able to stop giving the medication and even several weeks after we’ve stopped the medication the animal is not experiencing pain. So we feel like there’s been some healing that’s gone on.
This could be revolutionary for people who have been dealing with pain for years and decades.
Dr. McIntosh: We hope so.
Without those and we’re talking about right in the middle of this huge opioid epidemic, we hear news about it every day. What would the treatment affect that?
Dr. McIntosh: The hope would be that first, patients could get something to prevent transition from acute pain to chronic pain so that perhaps opioids wouldn’t be needed or wouldn’t be needed long term. Second, if opioids were needed that the dose could be much lower and therefore the propensity for side effects reduced.
How far away are you from testing this in humans?
Dr. McIntosh: We think within the next couple of years we’ll reach human clinical trials. It has to go through various phases then to become a marketed drug.
What’s the name of the poison or the venom?
Dr. McIntosh: The compound comes from a snail called Conus regius or crown cone. It’s interesting because the venom itself contains a complex mixture of different peptides, so there may be two hundred different compounds in this venom all of which are used by a cone snail to either capture the prey or defend itself against predators. What we’ve done is isolate one particular compound that’s useful for chronic pain. The potential gold mine here though is that there are hundreds of species of snails each of which contain hundreds of different compounds so there are literally thousands of compounds that might be utilized in various ways to treat diseases.
What is it called and how did you think to go to the ocean to get the snails to get the compounds?
Dr. McIntosh: We’ve been interested in the cone snails for quite some time. One of my colleagues, Toto Olivera, collected seashells as boy. When he became a professor he went back to try to find out what was in these snails thinking that it could just be something simple like what’s in snakes. What’s particularly interesting about these cone snails is that they have hundreds of different compounds within a single venom and there are hundreds of different species of cone snails so there are literally thousands of components that have been selected by evolution to act with high potency and specificity on the nervous system. So individually they make wonderful tools for studying physiology and a certain subset of them also make very promising lead compounds for medications.
How would you even think to isolate that one compound that it might help in this particular situation?
Dr. McIntosh: That’s a great question. Actually some colleagues of ours in Australia noticed a compound in a snail that had these types of properties. There were some problems with it so we went into our library of cone snails and used molecular biology techniques to fish out a similar compound. The process takes a lot of creative thinking. We have a lot of students at the university who are bright and creative thinkers and sometimes they come up with unique ideas that we think probably wouldn’t work but then they do.
What haven’t I asked you about this that you think is important to add to the story?
Dr. McIntosh: I think it’s important to know that nature can come up with solutions that medicinal chemists may not be able to. And it’s just so critical to have access to these natural resources and funding to be able to discover what nature has already done for us.
END OF INTERVIEW
This information is intended for additional research purposes only. It is not to be used as a prescription or advice from Ivanhoe Broadcast News, Inc. or any medical professional interviewed. Ivanhoe Broadcast News, Inc. assumes no responsibility for the depth or accuracy of physician statements. Procedures or medicines apply to different people and medical factors; always consult your physician on medical matters.
If you would like more information, please contact:
Michael McIntosh, MD
Stacy Kish
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