R. Rox Anderson, M.D.: ‘Mother Nature does great clinical research, but she only publishes in a journal called

In a world in which researchers see drugs as a key in health, R. Rox Anderson, M.D., has seen the light.

During the Sunday Plenary, Dr. Anderson delivered the Eugene J. Van Scott Award for Innovative Therapy of the Skin and Phillip Frost Leadership Lecture, "Chase Those Magic Bullets, But, How?" in which he discussed how to make physical agents strategically selective.

Dr. Anderson, professor of dermatology at Harvard Medical School and director of the Wellman Center For Photomedicine — the world's largest laboratory dedicated to the use of light in medicine for treatment and diagnosis — said most "magic bullets" are drugs. However, common physical agents, such as light, heat, cold, sound waves, electricity and particles can be just as "magic" on the microscopic scale — and easier to develop.

Dr. Anderson began by discussing laser treatments, which he uses when treating children.

"My passion, what still drives me today, is taking care of kids," said Dr. Anderson, who announced that his prize would be used to help improve the lives of children. "Over half of my practice still hasn't gone to kindergarten yet."

It's possible, he said, to use flashes of light at different wavelengths that are absorbed by various skin malformations — such as vascular malformations, birthmarks and pigmented lesions — to selectively heat and destroy them.

While dermatologists have used lasers for some time now, Dr. Anderson believes we're entering a time in which devices and physical agents can be used with the same kind of selectivity at the cellular and molecular level that we're used to thinking about for drugs.

Dr. Anderson also spoke about the possibilities of image-guided skin treatments, which are not yet established, but all the pieces are available. These include the non-invasive detection of "target" structures, fast, non-invasive imaging, real-time image analysis and high-speed, accurate laser scanning.

"In essence, a smart shooter is equivalent to a magic bullet," he said. "The imaging of skin — we're going to see this come our way."

Dr. Anderson spent the last portion of his lecture discussing another strategy to discover better skin treatments — paying attention to Mother Nature.

"Mother Nature does great clinical research, but she only publishes in a journal called ‘Reality,'" he said. "I think it's probably a foreign language journal to which clinicians have a lifetime subscription. The idea here is just pay attention and when she hands you lemons make some lemonade."

An example of this, he said, involves the two main reasons for plastic surgery — having too little and too much fat.

"If you look at Mother Nature's experiments, we have known for decades that cold exposure in infants can produce the selective loss of subcutaneous fat tissue, so we ask the question … is it possible to do that in adults and maybe come up with a magic bullet for subcutaneous fat?" Dr. Anderson asked.

Together with his colleagues, Dr. Anderson studied the process by looking at mice, pigs and, finally, people. They discovered that lipid molecules will freeze well above the temperate at which water freezes. One can crystallize lipids at temperatures that do not harm cells that are not filled with lipid.

Dr. Anderson said this is a fascinating example of a magic bullet from the point of view that cells with a lot of lipid or fats in their cytoplasm suffer a particular type of injury related to the crystallization of those lipids. That mechanism, he said, can be useful — not just for fat, but for other lipid-rich cells associated with problems dermatologists face.

We are not in an age where devices and drugs are melding together, he said.

"This caused me to think about our own barriers," Dr. Anderson said. "I think the separation is completely bogus. We have different people, we have different training and different FDA regulations. Drug and device industries sometimes don't even understand each other, but in Mother Nature's journal of reality we always use them together, and I think these self-erected barriers kind of inhibit our thinking and our progress."

In conclusion, he encouraged attendees to continue listening to the lecture that's always unfolding.

"Remember," Dr. Anderson said, "Mother Nature gives a better talk."

To hear Dr. Anderson talking more about "Chasing the Magic Bullet," click here.