RadioScope: Icons Of Irish Science, Thursday, 24th August, 8pm, RTÉ Radio 1
Around 400 BC, Hippocrates is said to have prescribed tea made from willow leaves and bark to help ease the pain of childbirth. The magic ingredient in willow is chemically similar to aspirin. Thankfully, women today can avail of more powerful pain blockers when giving birth, but aspirin remains a wonder drug. Not only can it provide cheap relief from pain and inflammation, but a low daily dose can also reduce the risk of heart attack and stroke in susceptible people.
In last week's Icons of Irish Science, series presenter Pauric Dempsey asked Irish clinical pharmacologist Prof Garret FitzGerald about his breakthrough in understanding how aspirin protects the cardiovascular system, and how the scientist faced the might of multinational pharmaceutical companies when he discovered heart-attack risks associated with other anti-inflammatory drugs.
Dempsey's refreshingly hands-off interview style allowed FitzGerald to talk fluently about how his group at the University of Pennsylvania teased out aspirin's role in blocking a key clotting enzyme called Cox-1 in blood platelets. Their breakthrough paved the way for large clinical trials that showed daily low-dose aspirin substantially reduced the risk of a repeat heart attack or stroke.
More ominously, we heard about how FitzGerald's team spotted a problem early on with a newer range of drugs that specifically block the Cox-2 enzyme involved in inflammation. These included the money-spinning brands Vioxx and Celebrex.
FitzGerald's work showed that Cox-2-inhibitors could dampen down natural defence mechanisms in stressed blood platelets, meaning the drugs carried a "small but absolute" risk of heart attack. The pharmaceutical companies ignored his suggestions for addressing the risks in clinical trials and went on to aggressively market their blockbuster Cox-2-inhibitor drugs directly at consumers, a tactic that saw sales rocket to €7 billion per year in the US alone.
But the commercially driven rush eventually upended Merck, which in 2004 pulled Vioxx off the market because of the cardiovascular threat. Now other Cox-2-inhibitors are also being trialled for their potential to increase the risk of heart attack or stroke.
FitzGerald has also been looking at the molecular "clocks" in the body, discovering why we are more likely to succumb to a heart attack at certain times of the day and how hormones regulate the clock machinery. And he is addressing the age-old question of whether it is healthier to gorge our food at occasional sittings or to nibble our fare throughout the day. So far it seems that fortune favours the gorgers - grazing upsets the orchestration of our internal metabolic clocks, possibly leaving us more vulnerable to conditions like metabolic syndrome and diabetes.
You can listen to all aired programmes in the current and previous series at www.rte.ie/radio1/iconsofirishscience