In the brains of patients with Alzheimer’s disease, A-beta proteins stick together to form plaques that are at least associated with, and may actually precipitate the clinical syndrome.

A-beta proteins are formed when enzymes known as secretases digest a larger protein known as amyloid precursor protein.

Knowing this, drug designers have tried to find something that inhibits the secretases, but so far the search has been fruitless.

Malcolm Leissring and a team at Mayo Clinic, Florida have taken a different approach. They searched for compounds that hasten the destruction A-beta proteins, and they may have hit paydirt.

In a report published in PLoS ONE, the scientists used in vitro procedures to isolate 2 chemicals that stimulate insulin-degrading enzyme or IDE, which chews up A-beta proteins faster than Owen and Jen’s white Lab Marley could dismantle a sofa.

Almost immediately after the chemicals were added to IDE, more than 99 percent of the A-beta was destroyed.
 
“This study describes the first examples of synthetic small-molecule activators of IDE, showing that activation of this enzyme is achievable,” Leissring told BurrillReport.

“If it is possible to generate drugs for human use that stimulate the activity of IDE, these agents might offer therapeutic benefit for treating and preventing Alzheimer’s disease.”
 
IDE is shaped like a clamshell that opens and shuts, like Pac-Man.

When IDE is open, A-beta fits snugly inside. The protease then closes like a Venus-fly trap and digests the A-beta.

IDE’s primary role is to digest excess insulin in the body, so small molecule activators like the ones uncovered by Leissring’s group might prove to be useful in managing diabetes one day as well.

The compounds are years away from human testing.

Data are filtering in on Massachusetts’ grand plan to extend health insurance coverage to virtually all Bay Staters. The good news is just about everyone’s covered. The bad news is just about everything else.

When it comes to controlling health care costs, the state’s performance has been abysmal. Experts recently predicted that the state will spend $600 million more in 2009 on health care than in 2006, a 42% bump.

Now comes troubling data on a measure of access to care, emergency room visit volume.

In theory, the state’s new law should cut the costly visits because more people have access to PCPs that can either treat health situations before they reach crisis proportions or prevent them altogether.

In fact, ER visits went up 7% and the cost per ER visit jumped 17% in Massachusetts between 2005 and 2007, according to data shared with the Boston Globe.

The fraction of ER visits for non-urgent matters that could have been handled by a PCP remained unchanged at an astonishingly high 47%.

Massachusetts officials said several more years were required before accurate assessments could be made regarding the impact of their law on access to care.

The law actually went into effect half-way through the data collection period used to make the conclusions above, so they may have a point there.

Still, many worry that simply extending health insurance coverage isn’t going to control costs or improve access. They say the state needs to beef up its PCP corps before the program can work.

“Just because you have insurance doesn’t mean there’s a [PCP] who can see you,” said Sandra Schneider, VP of the American College of Emergency Physicians. “I am not surprised that visits went up.”