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Medical Forum / General / Vision / August 2005

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Cataract eye drops

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Robert Kopp - 15 Jun 2005 02:19 GMT
A product called Nu-Eyes, whose active ingredient is acetylcarnosine, is
claimed to cure most eye diseases, including cataracts.

I am very skeptical of such claims. Does anyone have information about
clinical trials of this product?

Signature

Robert T. Kopp
http://analytic.tripod.com/

doctor_my_eye@msn.com - 15 Jun 2005 03:01 GMT
I believe this product works best when pigs fly out of my a.s to
instill the drops.
On a serious note, the field of botanicals and holistic medicines is
virtually unregulated by the FDA.  The "snake oil salesmen" love to use
the patient's natural fear of eye surgery to sell them on the dream of
"dissolving" their cataracts.  This product is at best a work of
fiction and at its worst it might bring non-sterile solutions to an
innocent, virgin eye.  Be very careful.  I have seen some very nasty
eye infections in patients who were infected by their non-sterile
homeopathic "medicine".
Dr Judy - 15 Jun 2005 03:24 GMT
>A product called Nu-Eyes, whose active ingredient is acetylcarnosine, is
> claimed to cure most eye diseases, including cataracts.
>
> I am very skeptical of such claims. Does anyone have information about
> clinical trials of this product?

If it works, it would be equivalent to changing a hard boiled egg back to
its raw state.  The newspaper article contains factual errors about what
cataract is and where in the eye it is located.

PubMed has only one clinical trial, with a very small group of subjects and
it was conducted by researchers employed by the manufacturer.

Dr Judy

N-Acetylcarnosine, a natural histidine-containing dipeptide, as a potent
ophthalmic drug in treatment of human cataracts.

Babizhayev MA, Deyev AI, Yermakova VN, Semiletov YA, Davydova NG, Kurysheva
NI, Zhukotskii AV, Goldman IM.

Innovative Vision Products, Inc., County of New Castle, DE 19810, USA.
markbabizhayev@mail.ru

A study was designed to document and quantify the changes in lens clarity
over 6 and 24 months in 2 groups of 49 volunteers (76 eyes) with an average
age of 65.3 +/- 7.0 enrolled at the time of diagnosis of senile cataracts of
minimal to advanced opacification.The patients received N-acetylcarnosine,
1% sol (NAC) (26 patients, 41 eyes = Group II), placebo composition (13
patients, 21 eyes) topically (two drops, twice daily) to the conjunctival
sac, or were untreated (10 patients, 14 eyes); the placebo and untreated
groups were combined into the control (reference) Group I. Patients were
evaluated upon entry, at 2-month (Trial 1) and 6-month (Trial 2)-intervals
for best corrected visual acuity (b/c VA), by ophthalmoscopy and the
original techniques of glare test (for Trial 1), stereocinematographic
slit-image and retro-illumination photography with subsequent scanning of
the lens. The computerized interactive digital analysis of obtained images
displayed the light scattering/absorbing centers of the lens into 2-D and
3-D scales.The intra-reader reproducibility of measuring techniques for
cataractous changes was good, with the overall average of correlation
coefficients for the image analytical data 0.830 and the glare test readings
0.998. Compared with the baseline examination, over 6 months 41.5% of the
eyes treated with NAC presented a significant improvement of the gross
transmissivity degree of lenses computed from the images, 90.0% of the eyes
showed a gradual improvement in b/c VA to 7-100% and 88.9% of the eyes
ranged a 27-100% improvement in glare sensitivity. Topographic studies
demonstrated less density and corresponding areas of opacification in
posterior subcapsular and cortical morphological regions of the lens
consistent with VA up to 0.3. The total study period over 24 months revealed
that the beneficial effect of NAC is sustainable. No cases resulted in a
worsening of VA and image analytical readings of lenses in the NAC-treated
group of patients. In most of the patients drug tolerance was good. Group I
of patients demonstrated the variability in the densitometric readings of
the lens cloudings, negative advance in glare sensitivity over 6 months and
gradual deterioration of VA and gross transmissivity of lenses over 24
months compared with the baseline and 6-month follow-up examinations.
Statistical analysis revealed the significant differences over 6 and 24
months in cumulative positive changes of overall characteristics of
cataracts in the NAC-treated Group II from the control Group I.The
N-acetylated form of natural dipeptide L-carnosine appears to be suitable
and physiologically acceptable for nonsurgical treatment for senile
cataracts.

Publication Types:
 a.. Clinical Trial
 b.. Randomized Controlled Trial
William Stacy - 15 Jun 2005 07:17 GMT
 Patients were
> evaluated upon entry, at 2-month (Trial 1) and 6-month (Trial 2)-intervals
> for best corrected visual acuity (b/c VA), by ophthalmoscopy and the
> original techniques of glare test (for Trial 1)

What the heck is "the original techniques of glare test"?

, stereocinematographic
> slit-image and retro-illumination photography with subsequent scanning of
> the lens.

Scanning of the lens with what?

The computerized interactive digital analysis of obtained images
> displayed the light scattering/absorbing centers of the lens into 2-D and
> 3-D scales.

What the heck is the "light scattering/absorbing center" of a lens????

The intra-reader reproducibility of measuring techniques for
> cataractous changes was good,

Intra-reader?  What the hell is that?

with the overall average of correlation
> coefficients for the image analytical data 0.830 and the glare test readings
> 0.998.

COEFFICIENTS GREATER THAN 0.998! This is pure b.s.

Compared with the baseline examination, over 6 months 41.5% of the
> eyes treated with NAC presented a significant improvement of the gross
> transmissivity degree of lenses computed from the images, 90.0% of the eyes
> showed a gradual improvement in b/c VA to 7-100% and 88.9% of the eyes
> ranged a 27-100% improvement in glare sensitivity.

Bogus numbers.  Meaningless.

 Topographic studies
> demonstrated less density and corresponding areas of opacification in
> posterior subcapsular and cortical morphological regions of the lens
> consistent with VA up to 0.3.

What? Topography of the lens?  VA up to 0.3?  What???

That is the biggest piece of garbage I've read in a while.  Is it a joke
that I don't find funny, or a parody that I've missed?  The whole idea
is kind of stupid anyway when you consider that an 11 minute operation
cures the damned things permanently and fixes existing refractive error
at the same time, no extra charge.

w.stacy, o.d.
Eddie - 29 Jun 2005 19:30 GMT
FWIW, I tried NAC drops when I first developed cataracts (age 34), and
they did nothing but lighten my wallet.

I knew better, but was willing to try anything, which is what
manufacturers of these products are counting on.
Dr Tomato - 25 Aug 2005 04:36 GMT
>>A product called Nu-Eyes, whose active ingredient is acetylcarnosine, is
>> claimed to cure most eye diseases, including cataracts.
[quoted text clipped - 5 lines]
> its raw state.  The newspaper article contains factual errors about what
> cataract is and where in the eye it is located.

In 1940 Max Perutz published "Unboiling an Egg" (I read it in republished form in about 1981).

The essence was to denature the egg (white) at about 60 C.

I think the denaturant was dilute acetic acid. Ie, there was a lot of water used as well. Precipitate out the denatured proteins.

Then slowly cool the precipitate while buffering out the denaturant. Perutz reported achieving renatured ovalbumin after a few hours.

Since then Robert Karplus produced a film on "unfrying an egg" (but I never managed to see that one).

The cooking was probably structural cross-linkages between proteins, and the heat provided enough energy to let the denaturant break those (structural) bonds, AS WELL AS general denaturing the proteins to a gentle extent (at 60 C, it's hot enough for partial cooking). The outcome would have been protein molecules (of ovalbumin) in partly denatured form, in solutions. As the temperature lowered, they would have preferentially renatured (structured) into the native form. The native form is the structured prefered (by minimum free energy, at about the temperature range of life).

So, it has been done to an egg. I'm sure the dilution in water at 60 C helped with the untangling, but I haven't carried out the experiment myself.

[There is also mention on the web of a student, Logan Leslie, reversing stress induced aggregation of alpha-crystillin here:
http://www.westga.edu/~wgpr/news_archive/11_04/conference.html, but details are scanty. It's referred to as like unfrying an egg].

Warning: Do NOT heat your eye to 60 C and add vinegar to remove cataracts. It would be absolutely mad.

The issue is whether something like N-Acetyl-Carnosine would facilitate the same kind of "uncooking, back to raw state".

It seems that Babizhayev et al's paper justifies further research, with significant improvements detected over controls for 76 eyes. Dr Judy refers to this study as "very small", but "very small" generally makes it harder to detect significance. Whether NAC can modify damage (due to glycation, or disulfide bonding, or discarded insoluble short polypeptides, or whatever else is involved in cataract formation), deserves investigation.

It would be better than having the gullible try "anything" and the profession try "nothing that works"

T.
Sven Golly - 25 Aug 2005 21:48 GMT
> It seems that Babizhayev et al's paper justifies further research,
> with significant improvements detected over controls for 76 eyes. Dr
[quoted text clipped - 3 lines]
> polypeptides, or whatever else is involved in cataract formation),
> deserves investigation.

Since I have floaters & high probability of cataracts due to an RD, I
asked my retinologist about this. His comment was that he knew of no
evidence to say it would help and had never heard of the (possibly
bogus) Babizhayev study. He also said he didn't think the drops would
hurt. So, I'm using them -- or at least this version....

http://www.betterlife.com/prod_home_page.asp?prod_id=20676

Two people on one of the RD discussion froups I belong claim some
reduction in floaters using NAC drops. Study population of 2. :-)

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Sven Golly
Trolling as usual
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Dr Tomato - 26 Aug 2005 02:17 GMT
>> It seems that Babizhayev et al's paper justifies further research,
>> with significant improvements detected over controls for 76 eyes. Dr
[quoted text clipped - 14 lines]
> Two people on one of the RD discussion froups I belong claim some
> reduction in floaters using NAC drops. Study population of 2. :-)

I don't have any evidence myself that NAC drops make a difference for
cataracts. The Babizhayev study definitely looks like a proper _scientific_ study
to me. I say scientific to distinguish it from something like a formal drug trial
for FDA (or pick your country's NHMRC) approval - which are large scale
and test for both efficacy and side-effects (safety). Babizhayev says "significant"
and their numbers back up their statements. Is he "bogus"? I don't know, but
he has several patents under his name and papers published apart from the
NAC paper. I can't find a CV on the net.

My own interest in Carnosine is not with NAC and cataracts, but I think
the cataracts question should be answered (either to use it properly if it
works, or to stop thousands of sufferers wasting money if it doesn't).

My interest is L_carnosine (not NAC, just C) for CAPD (problems separating
sound  from background noise, and other listening/hearing confusions). I can verify
benefits and improvement. Similarly (probably relatedly), it has been used with
success for Asperger's syndrome and Autism.

T.
Dr Judy - 26 Aug 2005 19:42 GMT
>>A product called Nu-Eyes, whose active ingredient is acetylcarnosine, is
>> claimed to cure most eye diseases, including cataracts.
[quoted text clipped - 5 lines]
> its raw state.  The newspaper article contains factual errors about what
> cataract is and where in the eye it is located.

In 1940 Max Perutz published "Unboiling an Egg" (I read it in republished
form in about 1981).

The essence was to denature the egg (white) at about 60 C.

snip

Warning: Do NOT heat your eye to 60 C and add vinegar to remove cataracts.
It would be absolutely mad.

The issue is whether something like N-Acetyl-Carnosine would facilitate the
same kind of "uncooking, back to raw state".

It seems that Babizhayev et al's paper justifies further research, with
significant improvements detected over controls for 76 eyes. Dr Judy refers
to this study as "very small", but "very small" generally makes it harder to
detect significance. Whether NAC can modify damage (due to glycation, or
disulfide bonding, or discarded insoluble short polypeptides, or whatever
else is involved in cataract formation), deserves investigation.

It would be better than having the gullible try "anything" and the
profession try "nothing that works"

The onus is on those making therapeutic claims to prove that their remedies
are safe and effective BEFORE they market them to the public.

Unfortunately, only the one study has been done, it was done by someone with
a financial interest in the drops, it has not be replicated by independant
researchers and the drops have not been tested for effectiveness or side
effects by any regulatory agencies.   Given all that I cannot ethically
recommend those drops to any patient as a treatment for cataract.

Further study should be done and funded by those selling the drops, and it
should be done before anyone markets and makes a profit from the drops.

Dr Judy

T.
Dr Tomato - 29 Aug 2005 02:42 GMT
> ...
> The onus is on those making therapeutic claims to prove that their remedies
[quoted text clipped - 6 lines]
>
> Dr Judy

All valid concerns, but the pragmatic issues are:

(1) If it's not medicine, it's not regulated strictly (coming under consumer law instead), and

(2) Lots of hopefuls are willing to spend the cash and try something with a hint of a promise of efficacy and safety.

Efficacy is much easier to test than safety, and conventional Rx is usually a trade-off between benefits and side-effects+risks.

There is also a hard economics problem of approval trials for naturally occurring substances. A patent on an effective drug is a cashflow for a Pharma, but it not so for many naturally occurring treatments, eg, Artemisinin. How do you get something like that up?

T.

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