What Would Galileo Say?

If we could be sure of anything in the early 17th century, when Shakespeare climbed onto the world stage, it was that the Earth stood still, and that the Sun and all the rest of the universe revolved around Us: We were at the center of everything – We were the Lords of the Universe. We knew this because Aristotle said so as far back as the 4th century BC. Scientists thereafter agreed and, if that wasn’t enough, it was also set down in Holy Scripture as interpreted by the Catholic Church, notably Pope Urban Vlll.

And then along came Galileo Galilei, later recognized as the father of experimental physics, who proposed something radical: that it was the Sun, not the Earth, that was the center of the universe – that we Earthlings and everything else in the universe revolved around It. The trick to Galileo’s discovery was technology – he had just invented the telescope, and with it the ability to track planetary movement.

Technology is indeed powerful.  It brought us the industrial revolution, it took us to the moon, and in the past 10 years it has allowed us to sequence our genomes. And there is yet one more thing it seems willing to do for us: treat one of the most common medical conditions in the United States that affects an estimated 37 million Americans – chronic sinusitis (CRS).

It’s considered chronic because it will last half a year or more, your head will be swollen & painful especially around you sinuses, you will miss a lot of work, and you will probably have to keep going back to the doctor for repeated treatment. People who have it report worse quality-of-life scores than those suffering from chronic obstructive pulmonary disease, congestive heart failure, back pain, or angina. It is stubbornly resistant to cure despite rigorous treatment regimens including surgery, allergy therapy, and prolonged antibiotic therapy.

In a significant sub-population of patients the reason for this treatment failure is thought to be related to the destruction of the sinus area defenses by the chronic sinus infection, resulting in the development of secondary antibiotic resistant microbial colonization of the sinuses – an infection upon an infection.

However, there is hope. Physician-scientist Merill Biel, MD, PhD, who received funding from the National Institutes of Health and published his investigations in the International Forum of Allergy and Rhinology, led a research team in 2011 and again this year to see if they could eliminate microbial pathogens responsible for chronic CRS. The trick, again, was in the technology – they used a procedure called photodynamic therapy (PDT).

The use of PDT is extensively reported in the literature to be safe and effective for the photodestruction of various microorganisms. It is a 2-step process. You apply a chemical compound to the affected area, and then target a beam of light on that compound. The result is that you destroy those microorganisms – bacteria, virus, or fungi – that have absorbed the compound. Recently, PDT has been more comprehensively studied as a potential alternative to conventional antibiotic therapy as antibiotic resistant strains of bacteria become more prevalent, notably methicillin-resistant staphylococcus aureus (MRSA).

The objective of the Biel study was to demonstrate the effectiveness of a non-invasive PDT treatment method of eradicating antibiotic resistant microorganisms known to cause CRS. What they found was extremely encouraging: that PDT reduced the polymicrobial organisms by >99.9% after just one treatment.

The scientists are careful to point out that their work was done in the lab where they duplicated the structure of the sinus cavities and populated them with the relevant microorganisms. However, because of the promise shown by their work these past few years, human clinical studies are currently planned to assess the safety and efficacy of this treatment for CRS.

It would seem that the sooner the better. Researchers at The University of Pennsylvania in 2007 surveyed physicians who treat CRS and found 86% of them were unhappy with current treatments and said there was a need for something proven to be effective and safe: the >99.9% pathogen reduction rate reported by Biel would seem to fit that need.

Galileo’s theory of the universe was largely rejected in his day. He wrote to a colleague expressing his disappointment that he failed to make believers out of all “educated persons” in the scientific community. “My dear Kepler, what would you say of the learned here, who, replete with the pertinacity [stubbornness] of the asp [venomous snake], have steadfastly refused to cast a glance through the telescope?  What shall we make of this?  Shall we laugh, or shall we cry?”  (Emphasis supplied.)

We can imagine, perhaps, that Galileo, if he were able to observe things today, would hope that the scientific community would at least “glance through the telescope” of Biel’s work. Based on his success so far, we can also imagine 37 million Americans and their families who might hope for the same thing.

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