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Chillies: out of the frying pan and into the clinic?
Editorial
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Time for new ideas and fresh faces
For more on Grand Challenges in Global Health see www.gcgh.org
Global health is too important to be left to global health experts. That is why a new initiative announced by the Bill & Melinda Gates Foundation in Cape Town on Oct 9 is welcome. The initiative, a 5-year US$100 million grant programme called Grand Challenges Explorations, will provide hundreds of small start-up grants to researchers who come forward with promising new ideas to tackle key problems in global health. The initiative is modelled on the investment strategies favoured by venture capitalists. Initial grants will be about $100 000 but more funds will become available if projects show progress. Successful projects could ultimately receive millions. The Foundation promises that the application process will be simple and the grantreview process swift. The goal is to encourage scientists who might never have worked in the field of global health or even medicine to start to think about global health problems and hopefully come up with new, even unorthodox solutions, and to make it easier for researchers in the developing world to secure grants.
The new initiative will build on the Grand Challenges in Global Health initiative that the Foundation launched in 2003. In that initiative the Foundation, in partnership with the US National Institutes of Health, assembled an international expert panel to identify the major scientific and technological roadblocks obstructing progress in global health. The panel ultimately drew up a list of 14 challenges, ranging from creating new childhood vaccines to enhancing the nutritional value of staple crops. To date, $450 million of Foundation funds as well as funds from the Wellcome Trust and the Canadian Institutes of Health Research have gone to support more than 40 projects in more than 30 countries. But these investments have been conservative, with grants, by and large, going to well-established researchers. The investments of this new programme will, no doubt, prove to be far more risky. Indeed, most are likely to fail. But even if the programme fails to lead to major breakthroughs, it could still enrich the field of global health with new ideas, new people, and new ways of thinking. ■ The Lancet
Lillis Werder
Chillies: out of the frying pan and into the clinic?
For the Nature paper see Nature 2007; 449: 607–10 DOI:10.1038/nature06191
1284
The humble chilli pepper has been a hot topic for the media lately. Last week, a restaurant’s pot of burning chillies accidentally sparked fears of a chemical attack on a busy shopping street in London. BBC Radio 4 listeners recently heard how chilli peppers are preventing elephants from raiding food crops in the droughtaffected Zambezi Basin. And, in the Oct 4 issue of Nature, researchers opened new doors for the use of capsaicin—the component of chilli peppers that makes them spicy—in therapeutics. Alexander Binshtok and colleagues found that capsaicin along with a derivative of the anaesthetic lidocaine (QX314) could, unlike existing local anaesthetics, block pain neurons in rats without disrupting other functions such as movement and touch. The duo work together because capsaicin opens TRPV1 channels, which are only found in nociceptors, allowing QX-314, which cannot permeate cell membranes alone, to selectively block the neurons. Capsaicin is not new to medicine. Although the compound causes irritation to human beings
by activating nociceptors, repeated or lengthy application desensitises this class of neurons. As a result, topical creams with capsaicin are used to treat pain in postherpetic neuralgia, diabetic neuropathy, osteoarthritis, and rheumatoid arthritis. Efficacy in the treatment of musculoskeletal or neuropathic pain, however, is moderate to poor for most patients, and many discontinue treatment because of a common sideeffect—an intolerable burning sensation. This fiery problem also makes capsaicin not such a cool choice for selectively blocking nociceptors. The authors of the Nature paper are testing other compounds that can activate the TRPV1 channel without the burn. Interestingly, the venom of the Trinidad chevron tarantula also activates the receptor. But chilli (or tarantula) farms for medicinal purposes seem an unlikely scenario. And, more importantly, since we do not yet know if the TRPV1 trick works in human beings, the future for Capsicum spp is more in the frying pan and out of the clinic for now. ■ The Lancet www.thelancet.com Vol 370 October 13, 2007
Getty Images
Time for new ideas and fresh faces
For more on Grand Challenges in Global Health see www.gcgh.org
Global health is too important to be left to global health experts. That is why a new initiative announced by the Bill & Melinda Gates Foundation in Cape Town on Oct 9 is welcome. The initiative, a 5-year US$100 million grant programme called Grand Challenges Explorations, will provide hundreds of small start-up grants to researchers who come forward with promising new ideas to tackle key problems in global health. The initiative is modelled on the investment strategies favoured by venture capitalists. Initial grants will be about $100 000 but more funds will become available if projects show progress. Successful projects could ultimately receive millions. The Foundation promises that the application process will be simple and the grantreview process swift. The goal is to encourage scientists who might never have worked in the field of global health or even medicine to start to think about global health problems and hopefully come up with new, even unorthodox solutions, and to make it easier for researchers in the developing world to secure grants.
The new initiative will build on the Grand Challenges in Global Health initiative that the Foundation launched in 2003. In that initiative the Foundation, in partnership with the US National Institutes of Health, assembled an international expert panel to identify the major scientific and technological roadblocks obstructing progress in global health. The panel ultimately drew up a list of 14 challenges, ranging from creating new childhood vaccines to enhancing the nutritional value of staple crops. To date, $450 million of Foundation funds as well as funds from the Wellcome Trust and the Canadian Institutes of Health Research have gone to support more than 40 projects in more than 30 countries. But these investments have been conservative, with grants, by and large, going to well-established researchers. The investments of this new programme will, no doubt, prove to be far more risky. Indeed, most are likely to fail. But even if the programme fails to lead to major breakthroughs, it could still enrich the field of global health with new ideas, new people, and new ways of thinking. ■ The Lancet
Lillis Werder
Chillies: out of the frying pan and into the clinic?
For the Nature paper see Nature 2007; 449: 607–10 DOI:10.1038/nature06191
1284
The humble chilli pepper has been a hot topic for the media lately. Last week, a restaurant’s pot of burning chillies accidentally sparked fears of a chemical attack on a busy shopping street in London. BBC Radio 4 listeners recently heard how chilli peppers are preventing elephants from raiding food crops in the droughtaffected Zambezi Basin. And, in the Oct 4 issue of Nature, researchers opened new doors for the use of capsaicin—the component of chilli peppers that makes them spicy—in therapeutics. Alexander Binshtok and colleagues found that capsaicin along with a derivative of the anaesthetic lidocaine (QX314) could, unlike existing local anaesthetics, block pain neurons in rats without disrupting other functions such as movement and touch. The duo work together because capsaicin opens TRPV1 channels, which are only found in nociceptors, allowing QX-314, which cannot permeate cell membranes alone, to selectively block the neurons. Capsaicin is not new to medicine. Although the compound causes irritation to human beings
by activating nociceptors, repeated or lengthy application desensitises this class of neurons. As a result, topical creams with capsaicin are used to treat pain in postherpetic neuralgia, diabetic neuropathy, osteoarthritis, and rheumatoid arthritis. Efficacy in the treatment of musculoskeletal or neuropathic pain, however, is moderate to poor for most patients, and many discontinue treatment because of a common sideeffect—an intolerable burning sensation. This fiery problem also makes capsaicin not such a cool choice for selectively blocking nociceptors. The authors of the Nature paper are testing other compounds that can activate the TRPV1 channel without the burn. Interestingly, the venom of the Trinidad chevron tarantula also activates the receptor. But chilli (or tarantula) farms for medicinal purposes seem an unlikely scenario. And, more importantly, since we do not yet know if the TRPV1 trick works in human beings, the future for Capsicum spp is more in the frying pan and out of the clinic for now. ■ The Lancet www.thelancet.com Vol 370 October 13, 2007