Kevin Geddings:
0:22
Dr. Michael Koren he normally joins us on Monday, but we asked him if he could join us on Thursday this week and we'll get to one of the main reasons why, which is a big event taking place tomorrow. But before we get to that, one thing you notice when you watch football or any sort of regular commercial television, especially local newscasts or cable news, you see a lot of pharmaceutical ads and it seems like the pharmaceutical companies Dr. Koren are very focused on taking care of our ongoing chronic illnesses, but maybe not so focused on actually curing those illnesses. What do you say?
Dr. Michael Koren:
0:56
Interesting. Good morning, Kevin. Happy Thursday.
Kevin Geddings:
0:57
Happy Thursday.
Dr. Michael Koren:
0:59
Yeah, so interesting point. I went to a WJCT lecture by Ira Flatow on Tuesday and this concept came up to whether or not the pharmaceutical industry was really rubbing their hands together and not curing things that they can cure, because it's more profitable to just keep people with a disease and manage the disease, and I can understand why people say that. So, for example, they're talking about the obesity epidemic and we have all these great drugs now that help people lose weight that we're studying and then we continue to study, but that requires an ongoing commitment to these drugs and the cost of that. On the other hand, what is the actual cause of obesity? Well, obviously people overweigh for a lot of reasons, but at the end of the day, it's too much. There are some biological signals that cause people to do that and there are some nutritional reasons in terms of having a lot of available calories that are so easy to consume. But at the end of the day, it's an issue about how the human mind is programmed and how we eat for comfort and how we eat to sustain ourselves and how we live in a society where we're burning too few calories and eating too many. But to the notion that the "pharmaceutical industry is trying to overly profit" from that and not quote cure it, I think is a little bit extreme. Maybe we'll have the technology at some point to truly understand all the mechanisms of appetite and "cure it. But at this point we're doing the best we can in terms of managing that with some really, really interesting innovations that actually are understanding the chemistry between your gut and your brain. And I just remind everybody, these GLP1 drugs, like Ozympic and , work by actually increasing the normal signaling between the gut and the brain, which is what turns off your appetite. So, so interesting. But getting back to the original point about cure versus management, there have been diseases that have been cured. A famous recent example of that is hepatitis C. Gilead Pharmaceuticals came out with a drug a number of years ago. Sovaldi, you probably remember that there's some controversy about the cost of it, but the argument was okay. Now we have a drug that can actually cure a problem, a chronic problem, that costs tremendous morbidity and mortality around the world, and you take this drug for several weeks and you're done. And so what is the cost of that? What should society be willing to pay for that? And these drugs are now readily on the market that truly cure something. The flip side of that is that there are other diseases that we don't have a drug for. But we've been able to quote cure for public health measures and vaccines, and that's the most prominent example, that smallpox. We've talked about that before. That smallpox is a scourge of mankind for hundreds and hundreds of years and that's been eradicated because of a vaccine strategy. So in fact, industry has been able to quote cure diseases and in fact, eradicate them. But there are some diseases that we don't necessarily understand well enough, or we understand them really well, but the way to cure them is pretty extreme. So an example that would be the CRISPR technology for, say, sickle cell anemia, where literally we can change the genes for somebody. That requires basically bone marrow transplant, which is your multimillion dollar type of intervention, and who's gonna pay for that, and and how do we deal with resource allocation, those sort of circumstances, even though we now theoretically have the technology to do it? So a lot, a lot of really, really interesting questions.
Kevin Geddings:
4:57
Yeah, and indeed you know, however, your views on it, the actual COVID vaccine itself or the shingles vaccine those are. You know, those are things designed to eliminate disease, right?
Dr. Michael Koren:
5:09
Yeah, so those are good examples. So that the COVID vaccine it prepares your immune system for exposure to the virus. So it basically it. It takes the approach from a disease standpoint that these viruses are out there, you're going to be exposed to them, so at least when you are exposed to them your body is ready. Yeah, these very simple RNA viruses like COVID or influenza are constantly changing, so you can't really cure them because it's gonna be a different virus each year. But you can certainly prepare the immune system for that type of interaction with the virus. So again, depending on the exact nature of the problem, there's gonna be a different medical solution.
Kevin Geddings:
5:52
Hey, if you're just tuning in, that's the voice of Dr. Michael Koren. Of course he's with ENCORE Research Group and they are recruiting for leading edge you know, medical advances right here in St. John's County, in St. Augustine. They have offices really close to UF Flagler Hospital and indeed some of the things we're just talking about you are recruiting for, you know, average citizens to participate in correct yeah, yeah so, and, by the way, it's not always drugs and the technologies that we're working on or information technology products.
Dr. Michael Koren:
6:22
so one that I'm actually really, really excited about is it's an application on your phone that helps people with congestive heart failure. So, we know, congestive heart failure is again one of those diseases that you can't really cure because we typically don't diagnose it until people already have some very severe damage to their heart scarring or enlargement or other problems with the muscle function of the heart that leads to shortness of breath and often hospitalizations and death if you don't actually treat it effectively. So it's a, you know, very severe problem, but the good news is that we have a lot of drugs that make a huge difference and if you get an early warning on what's happening with this problem, you can intervene quickly and simply. So the work that we're doing now involves an app basically talking to your phone, and the phone then uses artificial intelligence to determine whether or not your speech patterns are changing or your breathing patterns are changing, and that will give you an alert and give your doctor an alert that maybe the congestive heart failure is becoming worse and it can be intervened on in the very early stages with a simple intervention like a diuretic. So this is a great example of a study that we're recruiting for right now in St. Augustine, by the way, and so if you have congestive heart failure and you're hearing my voice, you might be interested in learning more about this.
Kevin Geddings:
7:40
Yeah, well, you can do that by going to ENCOREdocs. com. That's ENCOREdocs. com. If you know someone in your circle of friends, a family member too, get them to call this number to ask any questions. You know they're very friendly and you're gonna get a real-life human being when you call 904-730-0166. That number again, 904-730-0166, and Dr. Koren, before we let you go, tell us about an event that's coming up tomorrow at the WJCT Public Radio Studios in Jacksonville.
Dr. Michael Koren:
8:11
Yeah, I'm very, very excited Dr. Stephen Toenjes and I will be speaking about Alzheimer's dementia, and Dr. Toenjes is a great neurologist, really, really knowledgeable guy, and he and I are gonna kind of break it down for everybody and help people understand the latest research. And there's a lot of really, really interesting stuff related to tau protein and amyloid plaques that you probably hear in the media but probably don't understand it exactly. So we're gonna break that down and also talk about some of the really breaking research that's trying to manage this condition.
Kevin Geddings:
8:44
And that event takes place when tomorrow.
Dr. Michael Koren:
8:46
It's noon at the WJCT studio in Jacksonville, right across from our famous football stadium.
Kevin Geddings:
8:52
That's right, that's right well, Dr. Koren, thank you very much for your time today. We appreciate it. Good luck with the event tomorrow. Okay.
Dr. Michael Koren:
9:00
Much appreciated, Kevin. Have a great rest of the week.
