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Comment by Flatcircle | Hacker News Reader

Can anyone simplify this?

All-trans retinoic acid (ATRA) is a form of Vitamin A which is used to treat one particular type of leukemia. This group tested it against some gastric cancer cells. Not sure why it's on the front page of HN.

They are trying to turn a natural metabolite of vitamin A into a drug that they can sell to cancer patients because the natural metabolize vitamin A inhibit cancer growth.

It would be better to eat more organ meats.

It's more complicated than this. The conversion of vitamin A (carotenoids) to ATRA is highly regulated by various enzymes, and giving ATRA directly will bypass the enzymes and result in much higher doses than would normally be achieved.

ATRA he found an organ meats like the liver.

But when not eat healthier in the meantime?

Listen, it’s better to prevent cancer than to have to take some special metabolite drug of vitamin A for a gazillion dollars to cure it, isn’t it?

Hmm... I'm not sure that follows. The ACE-inhibitor drugs like lisinopril (and several others ending in -pril) are front-line drugs for treating high blood pressure. I take lisinopril myself, as do other friends and family members.

The ACE-inhibitors are modifications of a substance found in the venom of Bothrops jararaca, a South American pit viper. Scientists observed that when a prey animal is bitten by one of these snakes it experiences a sudden and profound drop in blood pressure (ideally to zero, from the snake's point of view).

You could argue that allowing yourself to be bitten by one of these snakes would somehow be more "natural" than taking a pill, but myself, I'm going to stick with the pill. :-)

While perhaps not as dramatic, vitamin A is also quite toxic in large amounts. Some of the early polar explorers came to grief from eating sled dog livers or other animal livers.

You’re making a false equivalent.

There are many other ways to control high blood pressure as well, and one of those includes diet.

> You’re making a false equivalent.

Not at all.

You: taking Vitamin A in a pill is unnatural. You should get it naturally, by eating organ meat (at the potential cost of getting sick from Vitamin A overdose, which is something that actually happens).

Me: taking an ACE inhibitor in a pill is unnatural. You should get it naturally, by allowing a snake to bite you (at the potential cost of dying from the snake bite).

There's no "false equivalent" here. The statements are exactly analogous.

I think this is a very cynical take. Patients with gastric cancer are often in a dire situation: many of them have had their stomach removed and have generally significant difficulties with digestion, which makes consuming specific foods very difficult. The therapeutically effective doses of ATRA are also high compared to what you'd get from foods, meaning that injections are nearly the only solution for these patients. Finally, naturally derived compounds generally have the weakest patents, so if anything, we should thank these researchers for looking into the therapeutic potential of these drugs. I can assure you that few pharmaceutical companies would research this, as the commercial incentives are really weak to do so.

I’m talking about prevention not cures.

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