Interviewed By Daniel Redwood, D.C. From One of the great medical researchers of our time, Candace Pert combines razor-sharp logic, highly developed intuition, and a refreshing emotional openness that together enable her to embody the holistic, cross-disciplinary vision she advocates.

Pert was a graduate student in her mid-twenties when she discovered the opiate receptor, the cellular bonding site for endorphins, the body's natural painkillers, which she calls our "underlying mechanism for bliss and bonding." This breakthrough presaged a sea-change in scientific understanding of human internal communication systems, pointing the way toward the information-based model that is now supplanting the long-dominant structuralist viewpoint. Ironically, she achieved her eureka moment after having been ordered by her supervisor to stop her research, which he had concluded was a dead-end street. But in this and many other instances, once inspired, Pert is not easily dissuaded.

In the years since, Candace Pert has focused her research on developing non-toxic pharmaceuticals that selectively block receptor sites for the AIDS virus. She has also pursued the "threateningly interdisciplinary" relationship between the nervous and immune systems, developing documentation of a bodywide communication system mediated by peptide molecules and their receptors, which she perceives to be the biochemical basis of emotion and the potential key to many of the most challenging diseases of our time.

>In this interview with Dr. Daniel Redwood, Dr. Pert discusses the two areas of research about which she is now most passionate: the possible role of vaccines in causing autism, and her work on Peptide T, which she believes may herald a major breakthrough in AIDS treatment. She also articulates her vision for the Institute for New Medicine, which she founded in affiliation with the Georgetown University School of Medicine to fund further research on alternative paradigm medicine.

Dr. Pert was awarded her Ph.D. in pharmacology, with distinction, in 1974, from The Johns Hopkins University School of Medicine. Previously, she had completed her undergraduate studies, in biology, cum laude, in 1970, at Bryn Mawr College. Dr. Pert conducted a National Institutes of Health (NIH) Postdoctoral Fellowship with the Department of Pharmacology at Johns Hopkins from 1974-1975. After 1975, she held a variety of research positions with the National Institutes of Health, and until 1987, served as Chief of the Section on Brain Biochemistry of the Clinical Neuroscience Branch of the National Institute of Mental Health (NIMH). She then founded and directed a private biotech laboratory. Dr. Pert currently holds a Research Professorship in the Department of Physiology and Biophysics at Georgetown University School of Medicine in Washington, DC.

Dr. Pert is an internationally recognized pharmacologist who has published over 250 scientific articles on peptides and their receptors and the role of these neuropeptides in the immune system. She has an international reputation in the field of neuropeptide and receptor pharmacology, and chemical neuroanatomy. She has lectured worldwide on these and other subjects, including her theories on emotions and mind-body communication. Dr. Pert holds a number of patents for modified peptides in the treatment of psoriasis, Alzheimer's disease, chronic fatigue syndrome, stroke and head trauma. One of these, Peptide T, is currently in a Phase II trial, in San Francisco, for the treatment of AIDS and neuroAIDS. The Institute for New Medicine website can be accessed at www.tinm.org For further information:

DANIEL REDWOOD: What current research interests you most?

CANDACE PERT: The cause and cure for autism. I'm most interested in that because I'm very interested in the human brain, and in this disease what's impaired are the two things that make us human: language and bonding patterns. That's what's deranged in the autistic kids.

REDWOOD: What studies on autism are most needed?

PERT: I feel that it's critical to evaluate the vaccine hypothesis as to the possible cause of the disease. It has to be a national priority to see why this disease is an epidemic right now. When we had an AIDS epidemic there was a lot of money thrown at it, appropriately, and a lot of progress was made. There's an autism epidemic right now and I'd love to get to the bottom of that.

REDWOOD: What would you say to those who argue that rather than there being an epidemic, the statistics are the result of changed definitions of autism and increased reporting of cases?

PERT: I would say that they're wrong, in a self-serving, ostrich-like, head-in-the-sand way. It's very sad. It's overwhelming both by statistics and experience. Better diagnosis might account for a 30 percent or 50 percent increase. But we're talking about 500 to 600 percent increases, and this is being catalogued not by the Centers for Disease Control but by the education departments across the country. That's compared to a baseline of ten years ago. If you compare it to a baseline of 20 years ago, the increase would be more like 1000 percent.
Also, the disease is appearing in certain forms that it never had before, such as the regressive form. It used to be that most autistics, by far, were born and not made. Now it's called regressive disorder, where they seem totally fine and then they regress when they're about a year and a half old. This is just around the time they get the vaccines. Many mothers believe that it's the vaccine. REDWOOD: Do you believe that vaccination should be mandatory?

PERT: I'm not enough of a socio-legal expert, but I think it's very strange that we have this one form of medical treatment that hasn't really been tested carefully, and yet it's mandatory. It seems unbelievable. There's no long term testing of safety. As I understand it, the vaccine trials are just a few weeks long and do not include long-term follow-up.

REDWOOD: As to where we go from here on this issue of autism, is your own focus, and should society's focus, be primarily set on determining the degree to which vaccines are responsible and thereby preventing it by changing vaccination policies? Or is your interest also in new methods of treatment?

PERT: You can't separate them. I always say that in order to cure a disease, you have to understand exactly what causes it. The cure part is easier; it's the cause part that's the hard one. So what's interesting about the vaccine hypothesis is that there is a plausible mechanism, whereby if you can document it and understand it, you will really understand the disease at the cellular and the molecular level. And that could lead to treatment.

REDWOOD: With autism, is this an issue that relates to vaccines across the board or are there certain vaccines that seem most problematic?

PERT: The one that many of the parents are talking about, and which the new data from England has implicated, is the MMR vaccine-mumps, measles, and rubella. At this point a kid needs 34 separate shots before he's five years old. The number of vaccinations has been increasing exponentially each decade.

REDWOOD: Why? What's the rationale for that?

PERT: The tragedy is that it's well-meaning. There's this feeling that diseases are caused by microbes and that they can be eliminated. There are now vaccinations (the Hepatitis-B vaccine) that are given to newborns before they leave the hospital. These problems may be from a particular vaccine, but in some cases I'm sure it can be a general inflammatory reaction, if someone is genetically predisposed. Our lab last year showed that chemokines, a class of peptides, play a role in inflammation, and they actually can regulate which neurons [nerve cells] survive and which neurons die. The key is that the brain is still developing at 18 months, and the parts that are developing are language and eye contact, the very things that become deranged in autism.

REDWOOD: What specific findings would be necessary to prove the link between vaccines and autism?

PERT: The gold standard would be a study that's actually been proposed by Dr. Marie Bristol-Powers, who is the head of autism at the National Institutes of Health. It would be a prospective study where you would have to follow many women, perhaps 100,000 women, through their pregnancies. You would keep complete vaccine records, look at reactions to the vaccines, see which children develop autism, and follow the ones that do. By some estimates, there's one in 200 births now that are turning into autistic children. So maybe statistically she wouldn't need to do quite so many.

That's the gold standard, but what Michael Ruff and I are working on (he's an immunologist, I'm a neuroscientist), using well-controlled samples of blood from autistic children and matched controls, is to determine whether there are certain antibodies against certain viruses or viral products. It might be possible to find something in the blood of children with autism and get a really good indication of what's going on. I like that because the other study would take at least three years.

REDWOOD: Is the other study actually going to happen?

PERT: That's an interesting question. I know that Dr. Bristol-Powers very much wants it to happen. I saw her in action at a meeting with the parents. She is open-minded and thinks it's necessary to look at the vaccine. The study is going to cost $70 million. But it seems like most of the health professionals have the wagons circled on this one. It's just too horrible, and they don't even want to look at it.

REDWOOD: Do other nations, in Europe and elsewhere, require a course of vaccines similar to that in the United States? Or is this unique?

PERT: I'm not an expert on this, but as far as I know nobody's got as extensive a program as we've got. In fact, one of the most controversial, but to me most interesting aspects of the evidence is that when the MMR was introduced in the United States, in the next two years there was a five-fold increase in autism. But England, for example, required more proof and kept it out for ten more years. And when it was introduced there, they had the same increase. So they had a parallel curve. Unfortunately, the whole debate about whether vaccines play a role in autism has now been framed in terms of this question about whether the English data (put together by Wakefield) is true, or whether it's a statistical fluke. Everybody's focusing on the data in the UK and whether autism actually increased before or after the vaccine. There have been many exchanges in The Lancet and in various medical journals. It's silly that the debate is focused on the UK when all you really have to do is look at the education statistics in the United States.

After the release of my book, Molecules of Emotion, I've given many lectures to education groups. Principals, superintendents, teachers. They have come to me; they're the ones who alerted me to it. People would say, "I've been teaching 30 years in the school system, and what's going on? There used to be so few Special Ed students, and now there are so many."

REDWOOD: The other area of research in which you're deeply involved relates to HIV and AIDS. Please tell us about your work.

PERT: You happen to be calling at a critical moment. Starting next week at the St. Francis Memorial Hospital in San Francisco, there will, for the first time, be a small, careful trial to see if Peptide T makes the virus levels go down. Even though the drug Peptide T was invented in 1986, it's taken until now to reach this point.

REDWOOD: If there is a significant decrease in the viral levels, where does that lead?

PERT: It will lead immediately to a large scale trial. If it continues to work, that would lead to registration of the drug within months.

REDWOOD: In what ways would it be an improvement over current AIDS medications in terms of safety and efficacy?

PERT: The problem of the virus becoming resistant has never gone away. And by using the [currently recommended] triple drug combination, you're assaulting several different mechanisms of action of the virus. It helps, it's great. You're able to keep resistance from developing for a while. But resistance eventually develops, and what's happening now is that many of the people who have been on the triple drug cocktail for three years are starting to fail, because the virus has mutated and the virus levels have come back up. In response, doctors are switching the drugs around. Plus, the toxicity profiles of the drugs are pretty serious.

REDWOOD: What is known about the toxicity profile of Peptide T?

PERT: We know that it is virtually completely nontoxic in hundreds of man/woman years of testing. The other thing is that people in the mainstream AIDS establishment have been crying out for a drug that would work by a new mechanism. The new mechanism they want is called a "viral entry inhibitor," something that blocks the receptors that the virus uses to get into the cell. And, of course, we were the first ones to talk about that mechanism years ago.
In the last three years we've realized that Peptide T actually works through the chemokine-5 receptor, which is the main receptor that's used by the virus to infect in the earlier stages of the disease. We published this last year in the journal Clinical Immunology. This is classical pharmacology. If a drug works by a new mechanism, then it can be highly effective because it's synergistic with the other mechanisms.

REDWOOD: Is it possible that in response to Peptide T treatment the AIDS virus would mutate in such a way that it would learn to dock at a different location?

PERT: Theoretically, anything's possible. But experimentally, people haven't seen that. What people have seen is that there's a change where the HIV virus goes in the early stages from the C-5 (chemokine-5) receptor to the late stages of the disease where it goes to the C-4 receptor. So there is some shifting of which subreceptors in the family it uses, but it doesn't have the ability to manufacture a brand new receptor, as far as we can see.

REDWOOD: The scale of the AIDS epidemic in Africa dwarfs anything we've seen in North America or Europe. One of the big problems has been that the expense of industrially manufactured medications is far too high for people in Africa to pay. If the new Peptide T treatment is shown to be valid in the upcoming studies, is there the possibility that it would get to those large numbers of people in need?

PERT: Yes there is, because we're behind it.

REDWOOD: How would it be done?

PERT: It will be made available somehow. If it can really help the situation, then we will do our best to introduce the drug and use our technology to find ways to manufacture it as inexpensively as possible to get in there and do the job. As to making it available to people in Africa, perhaps there will be an act of Congress or perhaps the World Health Organization. I don't know. You're asking me hard questions, because I'm just a scientist, not a political scientist.

I want to add that Peptide T has already been shown in a $10 million government trial to be effective in neuroAIDS [where AIDS affects the nervous system]. That was a trial that started in 1989 and went on for seven or eight years.

REDWOOD: So the hope now is that Peptide T will have a more global effect on AIDS in its many forms.

PERT: It was originally designed to block the virus. I'm an expert on peptides and receptors (endorphins are a peptide), and the idea was to find the exact chemical structure, the exact sequence of amino acids, on the part of the virus that bound to the receptor. We did that by a computer-assisted database search, and then we showed that in the test tube it did block the virus from entering and infecting the cells, and decreased the amount of infection in the test tube. So Peptide T was designed to block the virus from entering the cells. It's also kind of an antidote to the envelope protein of the virus. So there's an interesting twist that could explain the Peter Duesberg debate.

REDWOOD: This is the controversial hypothesis where Duesberg asserts that AIDS is not actually caused by the HIV virus?

PERT: Yes. Of course it is really the virus, but just a part of the virus. That's why the presence of AIDS doesn't correlate exactly with the virus levels. The viral envelope, the part that goes around the outside, is the part of the virus that actually binds to the receptors. It turns out that for each perfect little virus that gets spit out of a cell, there are millions of copies of the loose envelope protein that circulate, and almost act like an ectopic hormone, acting at a distance and binding to the natural receptors, the chemokine receptors and VIP [vasoactive intestinal peptide] receptors. It causes disease in that way. We've published many papers over the years showing how it's possible to actually block the binding of the envelope protein. So it's a whole other mechanism of action. It is more global and it's been shown to alleviate many of the symptoms of AIDS. People feel better when they're on the drug.

REDWOOD: What are your views about the potential good and potential harm from biotechnology and genetic engineering?

PERT: I am getting more and more concerned about it. I have been dragged kicking and screaming from a very old paradigm point of view, which says that everything's cool, everything's great, and technology is wonderful. I can remember arguing 30 years ago with a friend who was telling me why an egg from a free range chicken that was allowed to be having sex is much better. And I thought she was, like, totally crazy. [Laughter]. It's been a process of slow education, but I actually joined a board yesterday of people who are concerned about issues like this.

You know, it's the same old hubris. It's very similar to what we were saying about vaccines, or giving psychiatric drugs to children. It's based on an assumption that Mother Nature can be just arbitrarily changed and that everything will be cool and nothing's going to happen. Without testing! Without long term safety testing. It's the hubris factor. So while I'm not an expert on the genetically engineered food issue, I'm really concerned. I heard that something like 70 percent of our food has now got some genetic engineering in it. We don't even know what it is because it's not even labeled.

REDWOOD: In Molecules of Emotion, you mention your strong interest in alternative and complementary medicine. What areas of this field interest you most? Which do you use personally?

PERT: I guess the answer is that I'm interested in all of it. There's this debate about how if you call it "alternative," then it's too political and antagonizes people, so instead we'll call it "integrative" or "complementary." Actually, I like to call it alternative paradigm medicine. This new paradigm says that consciousness, mind, and spirit really matter. That they're real and that they're scientific if people bother to look at the scientific literature.
Over the years I've used acupuncture and chiropractic. Just last night I had a much-needed chiropractic treatment which cleared up some very bothersome back pain from a fall earlier in the week. I also meditate daily with TM [Transcendental Meditation] and Ayurveda works very well for me.

REDWOOD: So alternative paradigm medicine has had both theoretical and practical meaning for you.

PERT: Absolutely practical. It's been a gradual transition. My first foray into "alternative medicine" was when I started to critically look at my childbirth experiences. I started to research this when I was pregnant with my second child, who'll be 25 on Saturday. I was just astounded in reading the literature about the negative effects of drugs that are taken shortly before birth, and whether you should break the amniotic sac, and alternative methods for pain relief. To study that, see that, and experience that myself, and to see again the hubris where they say, "Oh, it can't hurt to do this or do that." The whole interference with the natural process which has been there for millions of years and has evolved and serves it purpose. That always concerns me.

REDWOOD: What is your vision for the Institute for New Medicine which you founded in affiliation with Georgetown University Medical School?

PERT: My vision for the Institute for New Medicine is that it will become the Howard Hughes of the new medicine.

REDWOOD: Howard Hughes had many aspects to his life. [Laughter]. I am assuming you're not talking about manufacturing airplanes or becoming a strange recluse. What is it about Hughes that you wish to emulate?

PERT: I'm talking about having incredibly large amounts of revenue. That way we can give serious attention to researching the ancient wisdom-modern science link and to really research alternative paradigm medicine, not just at Georgetown but all over the world. We'd like to fund labs so that alternative paradigm medicine can be brought up to the level of respect and attention that it deserves in the culture, to set things right with it. And then, of course, we want to have a Ph.D. program at Georgetown.

REDWOOD: In integrative medicine research?

PERT: Yes, exactly. That's what we're planning to do. I think the whole thing can withstand scrutiny. I don't believe you need to do a different kind of science for this. I think the normal rules of science apply and I'm excited about researching it. The only thing that's lacking is the money.

REDWOOD: Best wishes on finding it. Or earning it.

PERT: The plan is for the money to come from Peptide T. I think that's why Peptide T took so long, because the universe had to be at the place where the institute was on line. I also had to reach a certain stage of my development to be able to realize the importance of Peptide T in the master plan, to fund and catalyze the transformation to what I call vthe new medicine." But, of course, it's really old in some ways and new in others.

REDWOOD: Do you own the rights to Peptide T?

PERT: Yes, the rights were licensed by the NIH, where Michael Ruff and I worked when it was invented. It's had a long and unusual history in both the licensing and business aspects of it.

REDWOOD: Where is it now?

PERT: It's now in a company called Advanced Immunity, a small company in which Michael and I are partners.

REDWOOD: There was recently a well-publicized scandal at The New England Journal of Medicine, because dozens of articles evaluating new pharmaceuticals had been published in the journal by authors who failed to disclose their financial ties to the manufacturers of the drugs they were evaluating. What steps have you taken to ensure the integrity of current and future studies on Peptide T?

PERT: We have taken great care to follow all the appropriate guidelines. The San Francisco study follows all standard FDA protocols and is being administered under the auspices of Georgetown Medical School. Probably the key point is that neither Michael Ruff nor I will have any role in gathering or handling the raw data. And, of course, there will be full disclosure at the time of publication.

REDWOOD: If Peptide T does what you believe it can do in treating AIDS, the potential for funding the Institute for New Medicine is substantial.

PERT: It is very substantial. And I should mention that Peptide T has the potential to work for more than AIDS. By the terms of the license, as well as by any moral terms and our own intentions, we have to spend the funds on AIDS and have the breakthrough before spending the funds for the other uses. But the other uses include Alzheimer's disease, multiple sclerosis, psoriasis, and a number of neuro-inflammatory diseases.

REDWOOD: These are also mediated by the cellular docking mechanism?

PERT: Exactly. That's why it's really big and why it goes well beyond AIDS.

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