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Thursday, 6 June 2013

The Singing Statin, the BCL-2 Gene and Epigenetics

This post has something for both the casual reader and the scientists among you.  Today I will start with the science.

Epigenetics

Epigenetics are chemical markers that can appear on your DNA as the result of some environmental exposure, like diet or stress.  Methylation is a type of epigenetic change in which methyl groups are added to DNA and switch on or off the underlying gene.  This can have severe consequences depending on which gene is affected.

Identical Twins

It seems that if one identical twin has autism, there is a 70% chance that the other twin will be autistic.  In 30% of the cases the twin is neurotypical.  Researchers have very cleverly started to analyse pairs of twins from this 30% group and look for epigenetic marks.  This would highlight genetic causes of autism.

Apoptosis

Apoptosis is a tricky word to spell, for somebody like me, but is actually something quite simple; it is programmed cell death.  Apoptosis happens in all of us, all day long.  If it gets out of control, it becomes bad and something called atrophy will occur.  Too little apoptosis can result in irregular cell growth and cancer.

 
Candidate Genes

Using the epigenetics approach, in 2010 a study was published that identified two “candidate” genes linked to autism.  They were BCL-2 and RORA.

According to that study, BCL-2 is an anti-apoptotic protein located in the outer mitochondrial membrane that is important for cell survival under a variety of stressful conditions.  In other words BCL-2 inhibits cell death.

According to another source, BCL-2 is “one of the foremost anti-apoptotic molecules”.

A very recent study has identified more such genes, using the same approach.
 
If you are really interested in the genetics of autism, there is actually a database of all the indicated genes, maintained by the Simons Foundation.

  
BCL-2 and autism

Going back to 2001, researchers had already noted that the autistic brain was deficient in BCL-2 and they suggested that:-

“These results indicate for the first time that autistic cerebellum may be vulnerable to pro-apoptotic stimuli and to neuronal atrophy as a consequence of decreased BCL-2 levels.”


As we have already learned, in the autistic brain the important Purkinje Cells are reduced in number by half due to atrophy.  If BCL-2 can indeed reduce this excessive apoptosis, it should be a friend indeed.

 
Stimulating production of Bcl-2

Fortunately the clever people working with Professor Wood, at the University of Minnesota, have been studying cholesterol regulation in the brain for some time.  Here is what they have been up to:-

“The lab has recently made the novel discovery that statins both in vivo and in vitro stimulate gene expression and protein levels of one of the foremost anti-apoptotic molecules, Bcl-2. Currently, studies are focused on mechanisms of statin-induction of Bcl-2”

Or in plainer English, statin drugs increase your level of BCL-2 and so reduce cell death.
 

 
The Singing Statin

Now we have finished with the pure science and we move back to the practical world of applied science.

Monty, aged 9, has been taking atorvastatin for a few weeks.  After day one, he developed the urge to play the piano outside of lesson time.  Every day since, he has played more and more.  Now his piano teacher says she thinks he has absolute pitch.  It turns out that this is far more common in the autistic population and there is a great deal of research that has been done on this and music/autism in general.  Here is a short article on the subject.

Now in an earlier post we established the importance of the stress hormone cortisol and also the interesting finding that you can reduce it by singing.  Then I got people asking about, “what about just listening to music” or “what about playing an instrument”.  I did not do the research, but I think nothing works like a good sing.

So yesterday I was delighted to hear that Monty has started to sing spontaneously in his room.  He put on his Mozart CD and started to sing, with his own lyrics and not just in English, but also in his second language.

I have to thank Mr Pfizer and in fact Mr Bruce Roth for bringing us Atorvastatin (called Lipitor or Sortis, depending on where you live).  Mr Roth invented it in 1985.

Perhaps BCL-2 could be better named the Singing Gene?
 
 
 

7 comments:

  1. Hi Peter, if I'm right green tea also has an positive impact on BCL-2 gene. How much matcha green tea powder one has to consume to get the same impact as statin?

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    Replies
    1. Green tea has numerous good properties. Statins have multiple modes of action including on two autism genes BCL-2 and PTEN.

      So you cannot really compare green tea powder and statins. Both might help, but you will never know 100% why, unless you have some genetic testing.

      By the way, Bumetanide has very different diuretic effects in different people. The French researchers seem to have increased their dose to 1mg twice a day. I found 1mg once a day much better than 0.5mg twice a day. They recommended to try it for two months. For us it took two weeks to take effect.

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    2. Thank you Peter, Are statins safe for kids under 8? (Say 20mg of atrovastatin)

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    3. The Food and Drug Administration (FDA) currently approves some statins for use in pediatric age range patients. Some statins are approved for children over 8 years of age, others only from 10 years of age.

      These are being used in children with high cholesterol.

      Statins have been used experimentally for other conditions in even younger children.


      Use of Statins for Dyslipidemia in the Pediatric Population
      http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3018249/

      Best to talk to your doctor.

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  2. Hi Peter
    Are all statins equal with regards to treating autism? My son has high cholesterol due to a mutation in the LDL gene. A couple of years ago the doctors in my country switched from prescribing simvastatin and Atorvastatin ro rosuvastatin (the patent was "expired" and the latter is seen as more effective in treating cholesterol/less likely to produce muscular side effects.) I think I can argue/get the doctor to prescribe any of them, if I prepare, but would really appreciate your knowledge about if one is more effective than the other with regards to autism, if there is anything about blood brain barrier or anything like that.
    Thank you for everything you are doing, literally saving lives in this community!

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    Replies
    1. No, statins are not all equivalent when it comes to treating the brain.

      The first point is that only fat soluble (lipophilic) statins can cross the blood brain barrier. Rosuvastatin is water soluble, so it will not enter the brain.

      The common lipophilic statins are Lovastatin, simvastatin and Atorvastatin. They are all off patent and cheap. Their secondary effects are NOT the same.

      Trying all 3 is not a bad idea. For Fragile X Lovastatin is supposed to be the best one. In our case Atorvastatin works well.

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