A Blood Transfusion in a Pill


Well, not quite, but close.

Got a tip from a reader about a potentially revolutionary new drug that could prolong the life of a human who's bleeding out from a severe wound.

According to an article in the New Scientist, medical professionals are experimenting on a pill that can trick the body into thinking it's not in shock when it really is. In other words, the drug can prevent certain mechanisms within the proteins and DNA from permanently breaking down and causing long-term damage when the victim is resuscitated.

When the body loses a lot of blood, it tries to compensate by going into shock. This is a set of emergency measures to raise blood pressure and conserve energy, such as increasing heart rate and shutting down expression of some proteins. However, if the body stays in shock for more than a short time, it can lead to organ failure, and death soon follows.

Recent studies have suggested that around 6 or 7 per cent of genes change their expression in response to shock, via the removal of "epigenetic", chemical additions to the genome called acetylations. As histone deacetylase (HDAC) inhibitors can prevent the removal of such acetylations, Alam wondered if these drugs might improve survival after blood loss.

His team previously showed that valproic acid, an HDAC inhibitor already used to treat epilepsy, increased survival rates in rats that had lost a lot of blood. It seemed to be doing this by preventing acetylation, causing certain "survival pathways" to remain switched on.

The combat medical applications for a drug like this are obvious. The US military has already done an amazing job at lowering the death rate of troopers wounded in hideous explosions and ambushes, including the near ubiquitous fielding and training on the use of tourniquets and lots of combat first aid training. The military medical establishment has also done a lot to speed the process of getting an IED-struck Joe, for example, from route Michigan in Ramadi to Ramstein in literally hours.

But a breakthrough like this could mean the difference between life and death for wounded troopers in more remote locals with fewer medivac options, like Afghanistan. If this proves to work, it could be as revolutionary at Quik Clot and pocket tourniquets.

-- Christian

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