Low hanging fruit

John DiTraglia M.D.


The July 20 issue of The New England Journal of medicine has five articles that represent low hanging fruit in the fight against obesity and blood fat problems that could be treated with gene manipulations of the CRISPR revolution that we talked about last week. 1,2,3,4,5

There’s this thing called ANGPTL3. It is made in the liver and blocks lipoprotein lipase. So it is not completely understood by my how ANGPTL3 lowers blood triglycerides and LDL (bad) cholesterol. It also lowers HDL (good) cholesterol, but people and rats who are born without the gene that makes ANGPTL3 or who are given antibodies to antagonize ANGPTL3 have less atherosclerosis and fewer heart attacks.

Statins and other powerful approaches to lowering LDL cholesterol act on LDL receptors in cells. This is a new mechanism and a new avenue of treatment. Also people who have familial hypercholesterolemia have a defect of the LDL receptor and terrible heart disease at an early age. This angle represents a new treatment for them as well.

There’s another thing called follicle stimulating hormone (FSH). It is named for it’s action to stimulate the growth of the follicles that make eggs in women’s ovaries. It is made in the brain. FSH also regulates the development, growth, puberty maturation and reproductive processes of both men and women. It has recently been found that FSH also regulates fat in the body and the use of calories to make heat – called thermogenesis. In mice it was shown that blocking the actions of FSH made them lose fat and increase lean body mass and increase calorie burning metabolism. It is also found that these actions are at least in part independent of the action of estrogens. FSH stimulates estrogens that also can do stuff like that but blocking FSH also prevents fat gain in the absence of estrogen for example after the menopause when FSH levels are elevated and women are observed to get excess fat gain, particularly in the abdominal region, and to have decreased energy expenditure.

There you have it. Multiple new avenues of attack against these crimes against humanity seem to be coming at an ever faster rate. Stay tuned.


John DiTraglia M.D.

John DiTraglia M.D. is a Pediatrician in Portsmouth. He can be reached by e-mail- jditrag@zoomnet.net or phone-354-6605.

John DiTraglia M.D. is a Pediatrician in Portsmouth. He can be reached by e-mail- jditrag@zoomnet.net or phone-354-6605.


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