When we think of a detective the first thing that comes to mind is an investigator, either a member of a police agency or a private entity.  However there are unique detectives within the multifaceted arena of medicine.  All though we might already think of most doctors as detectives there are special doctors, units, working at the National Institute of Health’s (NIH) undiagnosed disease program.  Doctors such as William A. Gahl at the NIH are disease detectives that try to elucidate the causes and genetic basis involved in the hundreds of unsolved and mysterious diseases that arise each year.  Dr. Gahl who was interviewed for an article in scientific American explained that his group has accepted 400 out of 1700 special cases of unsolved disease.  The selection process of these cases is tough, determining which cases are new diseases and if there is a possibility of determining the genetic and biochemical basis of the disease.   As each case is worked mutations are identified that are associated with each disease.  But Dr. Gahl States that this is only the beginning of the puzzle.  The challenge becomes to identify the genetics with the pathology.

Dr. Gahls’ group has been working on a case in which a patient has endured pain for approximately twenty years and muscles of their legs have turned as hard as bricks limiting mobility.  It was determined that the patient had a rare condition in which their blood vessels bore a thick coat of calcium that restricted blood flow.  One of the first steps taken in the study was to examine the parents of the patient.  The parents after examination were healthy, which lead the group to believe that the patients’ disposition might be due to a recessive mutation.  Meaning that each parent had only one copy of a unique mutation but upon having children probability lead to the patient receiving two copies of the mutation.  After an in depth study Dr. Gahls’ group identified the location of the mutation and the error prone gene associated.  The gene that was identified is NT5E.  NT5E is involved in the production of the nucleoside adenosine (which is involved in a number of biochemical processes).  To examine this gene closely doctors cultured the patients skin cells and inserted the normal gene of NT5E and even introduced adenosine alone into the cells and miraculously they observed a reduction in calcification.  Through this analysis a better understanding of adenosine in the regulation of calcium has been brought to light.  However Dr. Gahl explains that there are a number of reasons why patients cannot just receive adenosine, but there is a class of osteoporosis drugs that pose as good candidates for treatment and they are waiting to see how these drugs perform.

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Cyrus Raji et.al. from the University of Pittsburgh have shown that loss in brain volume (a symptom of old age)  is decreased in those who are more physically active. A cohort of 299 adults (mean age of 78 years) were analyzed over the course of 13 years. After correcting for various factors, the Pittsburgh group concluded that walking around 72 blocks on average over 2 weeks, about 5 miles per week was enough to spare loss of brain volume.

Waking at a medium pace on a treadmill (2-3 miles per hour) can let you cover this distance in a half-hour. Even better, the study concluded that walking more than this distance did not help spare any more brain volume.

The study’s authors hope that this brain saving exercise regimen could help slow the progress of Alzheimer’s which is characterized by loss in brain volume, amongst other symptoms.  With the limited number of treatments now available for Alzheimer’s, any treatment, especially one as simple as a walk in the park is a valuable addition to preventing this disabling condition.

These findings were presented at the 2010 meeting of the Radiological Society of North America.

Any individual has a unique genetic profile different from that of another person. Contained within these differences are unique genetic variations that may make a person more susceptible to diseases such as cancer and diabetes. There are genetic profiling centers that can assist you in identifying your genetic variations. With this information you and your physician can watch your health where it is at risk to becoming a problem and mold a life style toward prolonged health. In order to decrease the impact of a possible problem, it is important that you’re analysis be broad-spectrum and precise. It will be of great interest to identify the premier centers for analysis of genetic variants. Be curious and talk with your physician about the resources that will give you the edge in enhancing your quality of life.