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Avraham Cooper @avrahamcoopermd.bsky.social · Jul 7

Reposted by Avraham Cooper

The Curious Clinicians Podcast @curiousclinpod.bsky.social · Jul 4

On our latest episode "Null Neutrophils," @tonybreu.bsky.social asks a fascinating physiologic question:

Why is Duffy Null status associated with lower neutrophil counts?

podcasts.apple.com/us/podcast/1...

open.spotify.com/episode/3SdI...

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Avraham Cooper @avrahamcoopermd.bsky.social · Jun 27

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Avraham Cooper @avrahamcoopermd.bsky.social · Jun 19

If you think you’re tough, consider the tardigrade…

In 2007, 3,000 of these tiny animals orbited the Earth OUTSIDE a space rocket for 12 days.

>2/3 of them survived the vacuum of space and being blasted with solar radiation.

www.esa.int/Science_Expl...

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Avraham Cooper @avrahamcoopermd.bsky.social · Jun 19

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Avraham Cooper @avrahamcoopermd.bsky.social · May 21

First bladder transplant in history!

So cool 😎

t.co/Mvyf1Qw7bK

https://www.nytimes.com/2025/05/18/health/bladder-transplant-human.html?smid=nytcore-ios-share&referringSource=articleShare

t.co

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Avraham Cooper @avrahamcoopermd.bsky.social · May 18

This really feels like science fiction- a bespoke CRISPR gene editing treatment for a baby with a urea cycle disorder

www.nejm.org/doi/full/10....

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Avraham Cooper @avrahamcoopermd.bsky.social · May 9

Thank you so much to @corewellhealth.bsky.social and Dr Steve Doyle for the invitation to speak on the art of medicine at their annual education and research day!

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Avraham Cooper @avrahamcoopermd.bsky.social · May 9

Yeesh - if Pseudomonas wasn’t a bad enough actor already, it also apparently secretes an enzyme that degrades plastic

www.cell.com/cell-reports...

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Reposted by Avraham Cooper

The Curious Clinicians Podcast @curiousclinpod.bsky.social · May 2

Each episode, producer @gbuonomomed puts together a paired show notes blog post. For our latest episode, 'Alpha-gal again', we tackle the question: how could alpha-gal be used to treat cancer?

curiousclinicians.com/2025/04/24/e...

open.substack.com/pub/thecurio...

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Reposted by Avraham Cooper

The Curious Clinicians Podcast @curiousclinpod.bsky.social · May 1

On our latest episode, Alpha-gal Again, we
share new insights on how alpha-gal could potentially be used to treat cancer!

podcasts.apple.com/us/podcast/t...

open.spotify.com/episode/1GpK...

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Avraham Cooper @avrahamcoopermd.bsky.social · Apr 28

This story really blew my mind - that alpha-gal could be an entirely new way to treat cancer using immunotherapy

The Curious Clinicians Podcast @curiousclinpod.bsky.social · Apr 27

This week, @avrahamcoopermd.bsky.social shares new insights on the topic of a previous episode: alpha-gal!

We tackle the question: How could alpha-gal be used to treat cancer?

podcasts.apple.com/us/podcast/t...

open.spotify.com/episode/1GpK...

3

Reposted by Avraham Cooper

The Curious Clinicians Podcast @curiousclinpod.bsky.social · Apr 27

This week, @avrahamcoopermd.bsky.social shares new insights on the topic of a previous episode: alpha-gal!

We tackle the question: How could alpha-gal be used to treat cancer?

podcasts.apple.com/us/podcast/t...

open.spotify.com/episode/1GpK...

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Avraham Cooper @avrahamcoopermd.bsky.social · Apr 18

This is such a good album and a monumental achievement!!!

Lakshman Swamy (he/him) @laxswamy.bsky.social · Apr 18

Check it out, new album just dropped 🤩 open.spotify.com/album/5orTSx...

I Thought I Was Better

Enemy in the Sky · Album · 2025 · 10 songs

open.spotify.com

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Reposted by Avraham Cooper

Lakshman Swamy (he/him) @laxswamy.bsky.social · Apr 18

Check it out, new album just dropped 🤩 open.spotify.com/album/5orTSx...

I Thought I Was Better

Enemy in the Sky · Album · 2025 · 10 songs

open.spotify.com

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Avraham Cooper @avrahamcoopermd.bsky.social · Apr 18

15/SUMMARY
Salt in wounds causes pain by multiple probable mechanisms.

These include:

🧂Increasing local osmolarity, which stimulates osmo-sensitive TRPV nociceptive neurons (the same neurons through which capsaicin signals)
🧂Osmotic stress leading to cellular injury/death

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Avraham Cooper @avrahamcoopermd.bsky.social · Apr 18

14/
Another mechanism seems to be that the local hyperosmolar state induced by salt in wounds also creates osmotic stress on cells, leading to cellular injury and death.

This independently activates nociceptive neurons in the skin.

pubmed.ncbi.nlm.nih.gov/29675710/

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Avraham Cooper @avrahamcoopermd.bsky.social · Apr 18

13/
TRPV/capsaicin signaling likely isn't the whole story, though, because in the same study as #11, TRPV4 knockout mice had equivalent (and intense) pain responses to a 10% saline solution.

pubmed.ncbi.nlm.nih.gov/16213085/

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Avraham Cooper @avrahamcoopermd.bsky.social · Apr 18

12/
Glutamate may be a key mediator of salt-induced pain, as it is known to be released after TRPV 1 and 4 activation (pubmed.ncbi.nlm.nih.gov/39626870/), and injection of 5.8% hypertonic saline into the biceps muscle leads to spikes in glutamate production.

pubmed.ncbi.nlm.nih.gov/26485281/

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Avraham Cooper @avrahamcoopermd.bsky.social · Apr 18

11/
In a mouse model, mild increases in osmolarity (eg w/ 2% saline) in paw wounds also activated a different nociceptive capsaicin-sensitive receptor from the same family called TRPV4.

pubmed.ncbi.nlm.nih.gov/16213085/

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Avraham Cooper @avrahamcoopermd.bsky.social · Apr 18

10/
This dramatic ⬆️ in local osmolarity stimulates osmosensitive' cation pain receptor channels called TRPV (transient receptor potential vanilloid), similar to how these receptors respond to capsaicin.

Example of activation of TRPV1 is shown below.

pubmed.ncbi.nlm.nih.gov/21779403/

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Avraham Cooper @avrahamcoopermd.bsky.social · Apr 18

9/
So why does salt in a wound hurt so much?

One key clue is that salt in tissue causes significant increases in local osmolarity. For example, a 10% NaCl solution has an osmolarity of 3250 mOSM (>10x physiologic osmolarity).

pubmed.ncbi.nlm.nih.gov/16213085/

TRPV4 mediates pain-related behavior induced by mild hypertonic stimuli in the presence of inflammatory mediator - PubMed

The ligand-gated ion channel, TRPV4, functions as a transducer of hypotonic stimuli in primary afferent nociceptive neurons and contributes to inflammatory and neuropathic pain. Hypertonic saline also...

pubmed.ncbi.nlm.nih.gov

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Avraham Cooper @avrahamcoopermd.bsky.social · Apr 18

8/
The degree to which NaCl can induce painful responses in the body has been studied in physiology experiments dating back to the 1930s.

In this 1997 study, infusing hypertonic saline into a muscle induced significantly more pain than normal saline.

pubmed.ncbi.nlm.nih.gov/9060024/

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Avraham Cooper @avrahamcoopermd.bsky.social · Apr 18

7/
One of the earliest references I came across for salt causing pain in wounds was from Pliny the Elder in the 1st century CE.

He recommended adding salt to beef fat to cure boils, but to avoid using salt if the combination caused pain.

www.perseus.tufts.edu/hopper/text?...

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Avraham Cooper @avrahamcoopermd.bsky.social · Apr 18

6/
The Hippocratic authors in ancient Greece endorsed sea water as a wound healing treatment, observing that it helped heal wounds on the hands of fishermen.

A few centuries later, Galen similarly recommended salt to aid in wound healing.

pmc.ncbi.nlm.nih.gov/articles/PMC...

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