A computer screen image of the tracheal transplant

 

 

Reviewed by Dr Roger Henderson

WebMD.com, March 23, 2010, by Tim Locke  -  A boy’s own stem cells used in a world first trachea transplant operation at London’s Great Ormond Street Hospital

A 10-year-old British boy has become the first child to have a pioneering windpipe transplant operation in a procedure carried out in London by British and Italian doctors.

A donated trachea had the donor’s cells removed, leaving inert collagen. The child‘s bone marrow stem cells were collected, and added to the trachea to start the process of rebuilding it.

Similar operations have been performed on adults, but Great Ormond Street says this is the first time a child has had this procedure. It’s also the first time the whole length of the trachea has been transplanted.

Doctors hope the technique will greatly reduce the risk of rejection of the windpipe because it is coated with the boy’s own cells.

Why did he need the operation?

The child – who has not been named – suffered from a condition called long segment tracheal stenosis, in which the windpipe is small and will not grow.

The life threatening condition has been likened to having to breathe through a straw.

Medical history

The hospital says the boy had an initial operation on his trachea shortly after birth. Several years ago he had what was a more conventional trachea transplant. Last November his condition deteriorated and a metal stent, which had been placed in his trachea, began to erode, causing life threatening bleeding.

The medical team

Professor Paolo Macchiarini from the Careggi University Hospital Florence, is an honorary consultant at Great Ormond Street. He and colleagues in a pan-European team came up with the plan to use the child’s own body as a ‘bioreactor’, in which the stem cells would regenerate the donor trachea.

He worked with the Italian National Transplant Centre to deliver the donated trachea with the donor’s cells removed.

The operation in London was led by Professor Martin Elliott; he developed Europe’s first specialist tracheal surgery service for children. He also carried out the previous transplant on the boy.

Cardiac surgery was necessary to repair the child’s aorta, which had been damaged by the faulty stent.

Dr Mark Lowdell and colleagues at The Royal Free Hospital, UCL Medical School, received the donor organ from Italy and some bone marrow from the patient at the start of the surgery.
They prepared two different types of stem cells from the patient’s own bone marrow, together with growth signaling chemicals, and returned them to Great Ormond Street with the donor trachea.

Macchiarini applied the cells and the growth factors to the trachea in the operating theatre.

He calls it a “bionic” process, in which cytokine medication is used to make the stem cells rebuild the trachea.

The team believes this new technique, whilst pioneering, is actually simpler than current procedures, and could be adopted in centers around the world.

 

Read more about stem cell organ replacement…………….

18 October 2009

By Adam Fletcher

Appeared in BioNews

Tissue-engineers at Columbia University, New York, US, have grown a jawbone from bone stem cells in the laboratory for the first time. The team, led by Dr Gordana Vunjak-Novakovic, published their work in the journal Proceedings of the National Academy of Sciences. The result marks a milestone in the move towards bone reconstructions – from patients’ own stem cells – for those affected by congenital defects, arthritis or cancer resections.

The team chose the jawbone, or temporomandibular joint (TMJ), to carry out a ‘proof of concept’ study, as it is one of the most complex joints in the body and represents a substantial challenge to model from scratch. ‘We thought the jawbone would be the most rigorous test of our technique; if you can make this, you can make any shape’, commented Dr Vunjak-Novakovic.

First, a scaffold was made form ‘trabecular bone’ – the porous, spongy structure found in the centre of bones – and infused with human mesenchymal stem cells (hMSCs) and all the nutrients needed for a bone to form. The scaffold, based on digital images of patient jawbones, was placed within a custom made ‘bioreactor’, designed to precisely resemble a human jawbone.

After five weeks, layers of bone-like tissue became visible. The tissue was physiologically realistic, the paper says. Yet the structure contained only bone cells – no cartilage, tendons or blood vessels were grown. The team is currently working on ways to make a hybrid structure, connectable to blood vessels in the head.

Professor Anthony Hollander, a tissue engineering expert from the University of Bristol who contributed to the production of an artificial windpipe last year, said: ‘One of the major problems facing scientists in this field is how to engineer a piece of bone with the right dimensions – that is critical for some of these bone defects’.

Other recent achievements in the field of tissue regeneration include the use of pluripotent stem cells to create an artificial bladder and a beating heart in the laboratory, and scientists at Tokyo University earlier this year demonstrated the growth of teeth in mice.

23 November 2008

By Adam Fletcher

Appeared in BioNews

By Adam Fletcher:
A Colombian woman has become the world’s first recipient of a windpipe grown in part from her own cells. Published in the Lancet journal last week, the team of surgeons from Spain, the UK and Italy, orchestrated the world’s first tissue-engineered whole organ transplant. Professor Paolo Macchiarini, of the Hospital Clinic of Barcelona, carried out the operation in June this year. The success has led some to herald the technique as the beginning of ‘a new age in surgical care’.
   Mother-of-two Claudio Castillo, 30, was left barely able to breathe after a tuberculosis infection left a bronchus irreversibly damaged. Surgeons rarely recommend a trachea transplant, as it condemns a patient to a life dependent on immunosuppressive drugs, leaving them open to other infections. The most common resort for people in similar positions is to remove a lung, which improves health but invariably shortens lifespan. However, given the option of undertaking an experimental ’tissue engineering’ surgery, so far only tried on pigs, Ms Castillo consented.
   To start, the Spanish team removed seven centimeters of trachea from a deceased organ donor. Maria Teresa Conconi and colleagues at the University of Padua then stripped the windpipe of all trace of the donor’s cells, using a potent mixture of detergent and enzymes. After six weeks, just a collagen ‘scaffold’ remained. In the meantime, bone marrow stem cells from Ms Castillo’s hip had been sent to Bristol, where they were induced into becoming cartilage cells. Upon their return to Barcelona – a return voyage nearly ruined by one airline company’s bureaucracy – the collagen scaffold was suffused with the cells in a special bioreactor developed at the Polytechnic of Milan. Another Bristol group seeded epithelial cells, taken from Ms Castillo’s airways, inside the donor trachea. After four days of repopulating the scaffold with cells, the new trachea was sculpted to shape and inserted in place of the damaged bronchus.
   Professor Martin Birchall, professor of surgery at Bristol, who helped differentiate the stem cells, was delighted with the success. ‘Surgeons can now start to see and understand the very real potential for adult stem cells and tissue engineering to radically improve their ability to treat patients with serious diseases’, he said.
   The major benefit of the necessarily laborious procedure is clear – after five months, there is still no sign of transplant rejection, since Ms Castillo’s immune system has no difficulty in recognizing her own cells. The hope is that the operation might become a reality for other transplant operations.

Of all human psychology, self-defeating behavior is among the most puzzling and hard to change   Who repeatedly pursues a path that leads to pain and disappointment?  Many people fall far short of their potential not because they secretly desire to fail but because they are anxious about what it means to succeed.

 

 

By RICHARD A. FRIEDMAN, M.D., The New York Times, March 23, 2010

 

“You could say I’ve been unlucky in love,” a young man told me during a recent consultation.

He went on to describe a series of failed romantic relationships, all united by a single theme: he had been mistreated by unsympathetic women who cheated on him.

This was not his only area of disappointment, though. At work, he had just been passed over for a promotion; it went to a colleague whom he viewed as inferior.

I asked him about his work as a computer scientist and discovered that he worked long hours and relished challenging problems. But he also did some curious things to undermine himself. Once, for example, he “forgot” about an important presentation and arrived 30 minutes late, apologizing profusely.

What was striking about this intelligent and articulate young man was his view that he was a hapless victim of bad luck, in the guise of unfaithful women and a capricious boss; there was no sense that he might have had a hand in his own misfortune.

I decided to push him. “Do you ever wonder why so many disappointing things happen to you?” I asked. “Is it just chance, or might you have something to do with it?”

His reply was a resentful question: “You think it’s all my fault, don’t you?”

Now I got it. He was about to turn our first meeting into yet another encounter in which he was mistreated. It seemed he rarely missed an opportunity to feel wronged.

Of all human psychology, self-defeating behavior is among the most puzzling and hard to change. After all, everyone assumes that people hanker after happiness and pleasure. Have you ever heard of a self-help book on being miserable?

So what explains those men and women who repeatedly pursue a path that leads to pain and disappointment? Perhaps there is a hidden psychological reward.

I got a glimpse of it once from another patient, a woman in her early 60s who complained about her ungrateful children and neglectful friends. As she spoke, it was clear she felt that all the major figures in her life had done her wrong. In fact, her status as an injured party afforded her a psychological advantage: she felt morally superior to everyone she felt had mistreated her. This was a role she had no intention of giving up.

As she left my office, she smiled and said, “I don’t expect that you’ll be able to help me.” She was already setting up her next failure: her treatment.

Masochism is not solely the province of psychotherapists; even sociobiologists have had a crack at it. Some see its origins in the self-sacrificial behavior of ants and bees, which, at their own expense, go in search of food for others in the colony, instead of competing with them. Is human self-defeating behavior, similarly, a remnant of altruism that might once have benefited one’s kin? Perhaps, but it has long since lost any adaptive value. Believe me, your family is a lot better off if you succeed in life.

Yet telling people they are the architects of their own misery doesn’t go over very well. The usual response is some variation on “Is it my fault that life is unfair?”

The American Psychiatric Association found itself in this position when it included a category for self-defeating patients in an earlier version of its Diagnostic and Statistical Manual of Mental Disorders.

Partly in response to social and political pressure, the notion of masochistic character has disappeared from the manual altogether, even though the behavior is a source of considerable suffering and a legitimate target for treatment.

Of course, terrible things happen randomly to people all the time, and no one is suggesting that isolated misfortunes are anything more than that.

Moreover, a history of repeated failures, especially in one sphere of life, doesn’t mean someone is a masochist. Many people fall far short of their potential not because they secretly desire to fail but because they are anxious about what it means to succeed.

But if someone has a pattern of disappointment in many areas of life, a therapist should consider that it could be self-engineered. Treatment can help, including psychodynamic and cognitive therapy, but there is still no effective medication for masochism.

It can be an uphill battle, as patients often try to defeat their therapists’ best efforts. But at least there’s a chance these patients can experience in therapy what they so expertly undermine everywhere else: success.

Dr. Richard A. Friedman is a professor of psychiatry at Weill Cornell Medical College.

GoogleNews.com, PalmBeachPost.com, March 24, 2010  -  A new generation of flexible, miniaturized devices that stick onto organs promises better diagnosis and control of medical conditions ranging from heart problems to epilepsy, researchers report.

For example, “in the heart, we could do cardiac mapping and get rid of areas of arrhythmia much faster than is now done,” explained study author Dr. Brian Litt, an associate professor of neurology and bioengineering at the University of Pennsylvania. “In the brain, we could treat movement orders and epilepsy with finer control than ever before.”

The technology might also be useful in monitoring a variety of other organs, the team said.

The new technology uses electrodes flexible enough to stick and hold to wet human tissue — “like putting a thin film of cellophane on the heart,” Litt said, and small enough so that there can be 300 contacts per square centimeter of tissue.

Electronic medical devices such as pacemakers that are currently in use keep all their electronic circuits inside a container that is typically distant from the area being controlled or monitored.

In contrast, the systems now being tested in animals have wires running to hundreds or thousands of tiny electrodes that are magnitudes smaller than those seen in devices today.

One possible goal is a new kind of pacemaker that will allow for better control of abnormal heart rhythms. “We think we can find [arrhythmias] quicker, with a thin, larger flexible patch over the heart,” Litt said. “We could measure rhythm all over the heart at one time.”

The devices are being developed in a collaboration between physicians and engineers at the University of Pennsylvania, the University of Illinois and Northwestern University. They reported their findings in the March 24 issue of Science Translational Medicine.

“By integrating silicon transistors, we can combine signals and use fewer wires to connect these electrodes to external instruments,” said Jonathan Viventi, a graduate student at the University of Pennsylvania, who is due to gain his doctorate next month and who leads a group developing the systems. Their report describes a device capable of measuring electrical activity in the hearts of pigs, animals often used in such research.

The device has more than 2,000 closely spaced electrodes that are flexible enough to fit around the curving surface of the heart, with electronics engineered to operate in the salty environment of body fluids.

“These are flexible electrodes for medical applications, where it is necessary to work with body tissues of irregular shape,” Viventi said. “There are other devices with flexible displays. One prototype device can have a reader with a fold-up screen. We are trying to approach the microscopic dimensions that the body works in.”

The devices are approaching the level where they might be commercially produced, Litt said. “We have done proof-of-principle testing in pig hearts and also are testing in the brains of other large animals,” he said. “We may be able to create a new generation of devices that can map the brain so that we can see where disordered networks of brain cells are. We have other papers in process.”

High-Tech Tools Show How Acupuncture Works in Treating Arthritis, Back Pain, Other Ills

Wsj.com, March 23, 2010, by Melinda Beck – Acupuncture has long baffled medical experts and no wonder: It holds that an invisible life force called qi (pronounced chee) travels up and down the body in 14 meridians. Illness and pain are due to blockages and imbalances in qi. Inserting thin needles into the body at precise points can unblock the meridians, practitioners believe, and treat everything from arthritis and asthma to anxiety, acne and infertility.

As fanciful as that seems, acupuncture does have real effects on the human body, which scientists are documenting using high-tech tools. Neuroimaging studies show that it seems to calm areas of the brain that register pain and activate those involved in rest and recuperation. Doppler ultrasound shows that acupuncture increases blood flow in treated areas. Thermal imaging shows that it can make inflammation subside.

Scientists are also finding parallels between the ancient concepts and modern anatomy. Many of the 365 acupuncture points correspond to nerve bundles or muscle trigger points. Several meridians track major arteries and nerves. “If people have a heart attack, the pain will radiate up across the chest and down the left arm. That’s where the heart meridian goes,” says Peter Dorsher, a specialist in pain management and rehabilitation at the Mayo Clinic in Jacksonville, Fla. “Gallbladder pain will radiate to the right upper shoulder, just where the gallbladder meridian goes.”

Many medical experts remain deeply skeptical about acupuncture, of course, and studies of its effectiveness have been mixed. “Something measurable is happening when you stick a needle into a patient—that doesn’t impress me at all,” says Edzard Ernst, a professor of complementary medicine at the University of Exeter in England and co-author of the book, “Trick or Treatment.” Acupuncture “clearly has a very strong placebo effect. Whether it does anything else, the jury is still out.”

Even so, the use of acupuncture continues to spread—often alongside conventional medicine. U.S. Navy, Air Force and Army doctors are using acupuncture to treat musculoskeletal problems, pain and stress in stateside hospitals and combat zones in Iraq and Afghanistan. Delegations from Acupuncturists Without Borders are holding communal ear-needling sessions to reduce stress among earthquake victims in Haiti. Major medical centers—from M.D. Anderson in Houston to Memorial Sloan-Kettering in New York—use acupuncture to counteract the side effects of chemotherapy.

In a 2007 survey, 3.2 million Americans had undergone acupuncture in the past year—up from 2.1 million in 2001, according to the government’s National Center for Complementary and Alternative Medicine.

The most common uses are for chronic pain conditions like arthritis, lower back pain and headaches, as well as fatigue, anxiety and digestive problems, often when conventional medicine fails. At about $50 per session, it’s relatively inexpensive and covered by some insurers.

It is also generally safe. About 10% of patients experience some bleeding at the needle sites, although in very rare cases, fatalities have occurred due to infections or injury to vital organs, mostly due to inexperienced practitioners.

Most states require that acupuncturists be licensed, and the Food and Drug Administration requires that needles be new and sterile.

Diagnoses are complicated. An acupuncturist will examine a patient’s tongue and take three different pulses on each wrist, as well as asking questions about digestion, sleep and other habits, before determining which meridians may be blocked and where to place the needles. The 14 meridians are thought to be based on the rivers of China, and the 365 points may represent the days of the year. “Invaders” such as wind, cold, heat, dampness, dryness factor into illness, so can five phases known as fire, earth, metal, water and wood.

Using Acupuncture to Treat Stress

“It’s not like there’s a Merck Manual for acupuncture,” says Joseph M. Helms, who has trained some 4,000 physicians in acupuncture at his institute in Berkeley, Calif. “Every case is evaluated on an individual basis, based on the presentation of the patient and the knowledge of the acupuncturist.”

Dr. Helms notes that Western doctors also examine a patient’s tongue for signs of illness. As for qi, he says, while the word doesn’t exist in Western medicine, there are similar concepts. “We’ll say, ‘A 27-year-old female appears moribund; she doesn’t respond to stimuli. Or an 85-year old woman is exhibiting a vacant stare.’ We’re talking about the same energy and vitality, we’re just not making it a unique category that we quantify.”

Studies in the early 1980s found that acupuncture works in part by stimulating the release of endorphins, the body’s natural feel-good chemicals, much like vigorous exercise does. Now, a growing body of research suggests that it may have several mechanisms of action. Those include stimulating blood flow and tissue repair at the needle sites and sending nerve signals to the brain that regulate the perception of pain and reboot the autonomic nervous system, which governs unconscious functions such as heart beat, respiration and digestion, according to Alejandro Elorriaga, director of the medical acupuncture program at McMaster University in Ontario, which teaches a contemporary version to physicians.

Photo: Vitaly Napadow – A specialized MRI scan shows the effects of acupuncture. The top two images show the brain of a healthy subject. In the middle two images, a patient with carpal tunnel syndrome registers pain (indicated by red and yellow). The bottom images show the calming effect (indicated by blue) in the brain after acupuncture.

A specialized MRI scan shows the effects of acupuncture. The top two images show the brain of a healthy subject. In the middle two images, a patient with carpal tunnel syndrome registers pain (indicated by red and yellow). The bottom images show the calming effect (indicated by blue) in the brain after acupuncture.

“You can think Western, you can think Eastern. As long as your needle goes to the nerve, you will get some effect,” Dr. Elorriaga says.

What’s more, an odd phenomenon occurs when acupuncture needles are inserted into the body and rotated: Connective tissue wraps around them like spaghetti around a fork, according to ultrasound studies at the University of Vermont. Helene Langevin, research associate professor of neurology, says this action stretches cells in the connective tissue much like massage and yoga do, and may act like acupuncture meridians to send signals throughout the body. “That’s what we’re hoping to study next,” she says.

Meanwhile, neuroimaging studies at the Martinos Center for Biomedical Imaging at Massachusetts General Hospital in Boston have shown that acupuncture affects a network of systems in the brain, including decreasing activity in the limbic system, the emotional part of the brain, and activating it in the parts of the brain that typically light up when the brain is at rest.

Other studies at the Martinos Center have shown that patients with carpal tunnel syndrome, a painful compression of nerves in the wrist, have heightened activity in parts of the brain that regulate sensation and fear, but after acupuncture, their brain patterns more closely resemble those of healthy subjects. Brain scans of patients with fibromyalgia show that both acupuncture and sham acupuncture (using real needles on random points in the body) cause the release of endorphins. But real acupuncture also increased the number of receptors for pain-reducing neurotransmitters, bringing patients even more relief.

The fact that many patients get some relief and register some brain changes from fake acupuncture has caused controversy in designing clinical trials. Some critics say that proves that what patients think of as benefit from acupuncture is mainly the placebo effect. Acupuncture proponents counter that placebos that too closely mimic the treatment experience may have a real benefit.

“I don’t see any disconnect between how acupuncture works and how a placebo works,” says radiologist Vitaly Napadow at the Martinos center. “The body knows how to heal itself. That’s what a placebo does, too.”

Does It Work?

While scientists say further research is essential, some studies have provided evidence of acupuncture’s effects.

Arthritis of the Knee: Acupuncture significantly reduced pain and restored function, according to a 2004 government study.

Headaches: Two 2009 reviews found that acupuncture cut both tension and migraine headaches.

Lower Back Pain: Acupuncture eased it in a big study last year, but so did a sham treatment where needles didn’t penetrate the skin.

Cancer: Has proven effective in reducing nausea and fatigue caused by chemotherapy.

Infertility: Improves the odds of pregnancy for women undergoing in-vitro fertilization, according to a 2008 review of seven clinical trials.

Addiction: Often used to help quit smoking, drinking, drug use and overeating, but there is no conclusive evidence that it works.

MALVERN, Pa., March 23 /PRNewswire/ — Garnet BioTherapeutics, Inc. (“Garnet”), a regenerative medicine company focused on developing cell based therapies, today announced that the first patient has been treated in a Phase 2 multicenter, double-blind, placebo-controlled study of its lead product candidate GBT009 at Unity Hospital in Rochester, New York.  GBT009 gives off a variety of pro-regenerative growth factors and cytokines which help repair damaged tissue and reduce inflammation, ultimately augmenting the body’s ability to heal itself.  The trial will assess the safety and efficacy of GBT009 for the treatment of incisional wounds following breast reconstruction surgery.

“Recent advances in reconstructive surgery mean that women who have breast cancer today have greater choices that were not widely available 10 years ago,” according to Joseph M. Serletti, MD, Chief of the Division of Plastic Surgery at the University of Pennsylvania School of Medicine, who specializes in breast reconstruction in cancer patients.  “There are definite advantages to this surgery which uses the patient’s own tissue to create a natural breast reconstruction.  However, the limitation of this surgery is scarring in the area of the body where the tissue was taken.  We are excited about the potential of this novel cell therapy which meets an unmet need for patients and surgeons looking for more options to improve scar formation and repair damaged tissue,” he added.  Dr. Serletti is a Principal Investigator for the study and serves as a consultant to Garnet BioTherapeutics, Inc.

There were over 79,000 breast reconstruction procedures performed by plastic surgeons in the U.S. in 2008.(i)  The transverse rectus abdominis myocutaneous (TRAM) flap is a common type of breast reconstruction that uses skin, muscle tissue and fat tissue from the lower abdomen to create a very natural looking breast.  Breast reconstruction with TRAM flap surgery is a major, invasive procedure and carries with it the possibility of significant complications, including poor wound healing.(ii)

The GBT009 clinical trial targets female patients scheduled for a mastectomy with breast reconstruction surgery using an abdominal flap technique.  The goal of this study is to assess whether intradermal injections of GBT009 along full thickness abdominal incisions following surgery leads to an improvement in scar appearance.  Efficacy measures include assessments of scar appearance that will be periodically evaluated by the Investigator and patient using the Patient Observer Scar Assessment Scale (POSAS), the Manchester Scar Scale (MSS) and a Visual Analog Scale (VAS).  In addition, photographs will be taken throughout the study and an independent scar assessment panel will evaluate and rate the standardized, calibrated digital photographs.

“We are very pleased to report the first patient being enrolled in this study of GBT009.  The event marks a key milestone for women, notably breast cancer survivors, because this therapy addresses one of the least-desired attributes of our patients – the visible scars which linger as a reminder of their ordeal,” explained Dr. Stephen Vega, study investigator and plastic surgeon working in Rochester, New York.

More information about the trial can be found at www.clinicaltrials.gov and the identifier is NCT01053897.

Garnet is initially developing its cell-based therapy for cosmetic and dermatologic applications where accelerated healing and reduced scarring are desirable.  The company believes that the cell-based therapy may also be applicable for treatment of burns, auto-immune disorders such as psoriasis, and in other conditions where inflammation or scar formation plays an important role in disease pathology.  In addition, Garnet has developed proprietary scalable cell manufacturing technology that has largely solved the challenge of commercial manufacturing scale-up of patient doses from a single donor source.

About Garnet BioTherapeutics

Garnet BioTherapeutics is a clinical stage regenerative medicine company based in Malvern, PA.  Garnet’s cell-product GBT009 releases anti-inflammatory and pro-healing factors that accelerate healing and reduce scarring.  The company is currently targeting dermatology applications, with plans to expand into other reconstructive and cosmetic procedures as well as looking at ways to advance the technology for use in orthopedic and cardiovascular surgical procedures, burn treatment, chronic wound healing and auto-immune disorders.  For more information, please visit www.garnetbio.com.

(i)                 American Society of Plastic Surgeons.  2008 Reconstructive Surgery Procedures.  Statistics.

(ii)               http://search.plasticsurgery.org/search?q=2008+Reconstructive+Surgery+Procedures

(iii)             American Cancer Society.  Breast Reconstruction After Mastectomy.  http://www.cancer.org/docroot/cri/content/cri_2_6x_breast_reconstruction_after_mastectomy_5.asp  

SOURCE Garnet BioTherapeutics, Inc.

RELATED LINKS
http://www.garnetbio.com

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WashingtonPost.com, March 23, 2010  -  I’d like to start this week’s column with a toast to the researchers who have proved that a drink or two a day may actually help women stay slimmer: Thank you for making my nightly glass-of-red ritual that much more enjoyable — nay, almost smugly satisfying.

This news certainly runs counter to prevailing wisdom. I mean, what weight-conscious person among us hasn’t struggled to balance the desire to unwind with a glass of merlot or a martini against the diet mantra that calorie-laden cocktails pack on the pounds? Alcohol contains a relatively hefty seven calories per gram, for one thing, compared with four calories per gram for carbohydrates and proteins and nine for fat. That translates into approximately 100 calories for a five-ounce glass of wine or a shot of liquor, and 150 calories for a regular beer — calories that continue to add up when you factor in today’s giant-size pours or the fruit juice and sugar in many of the most delicious bar concoctions.

But according to a study published this month in the Archives of Internal Medicine, light to moderate drinkers actually gain less weight than teetotalers over time, and they have a lower chance of ending up obese or overweight.

Researchers at Boston’s Brigham and Women’s Hospital followed 19,220 healthy, normal-weight women ages 39 and older for nearly 13 years and found that those who didn’t drink at all put on an average of eight pounds during that period; the weight gain was smaller for women who consumed one to two drinks a day, some 5 1/2 pounds, while those who drank two or more glasses a day added just 3.4 pounds. Some 41 percent of all the women became overweight or obese during the study, but those who had one to two drinks a day were the least likely to do so and, by comparison, were 30 percent less likely than teetotalers to become so, according to the study.

And pinot grigio or Amstel Light lovers, take note: While red wine is the current media darling for its antioxidants and ostensible role in reducing the risk of cardiovascular disease and did, indeed, have the strongest association with a reduced risk of obesity, the weight link was also noted for white wine, beer and hard liquor.

So those of us who enjoy a cocktail every now and again — or even every night — can probably keep right on boozing without worrying too much about our waistlines. “In the absence of a family history of alcoholism . . . light to moderate alcohol consumption, which is typically about a drink a day [for women], seems to be a reasonable approach to your diet without jeopardizing long-term weight gain,” says co-author Howard Sesso, an assistant professor of medicine at Brigham and Women’s Hospital. “But it’s important to remember that everyone [in the study] still gained weight over time, so it’s not as if drinking is a good diet technique. You definitely shouldn’t drink to lose weight.”

As for how, exactly, alcohol influences weight gain, the researchers said that remains to be seen. Interestingly, the moderate drinkers in this study tended to be a healthier bunch overall: thinner at the start as well as more active. But the association between alcohol consumption and putting on fewer pounds held true even after controlling for diet, lifestyle and other factors.

“It seems likely that there is something else going on,” says Sesso, who notes that the data showed that the drinkers tended to substitute liquor for other food (particularly carbs), rather than consume it in addition to their meals. It may be that women metabolize alcohol differently than they do carbs or fat, he said, expending more energy and burning more calories than they take in and producing a “net energy loss” that translates into better weight maintenance over time. But that is just a theory.

Still, before you head out to the nearest happy hour or “boozy playgroup,” as my friends like to call it, critics raise some concerns about applying these results. For example, preventive medicine specialist Scott Kahan, co-director of the George Washington University Weight Management Program, says the study has several limitations, such as its being observational research, with its data on diet, weight and drinking habits having been self-reported. “The other major issue is that [it] only looked at normal-weight, middle-aged, mostly educated and white professional women,” he says, “so whether it applies to less-educated women, women with nonprofessional jobs, minorities or women who are overweight or obese right now — that’s all still up in the air.”

Of course, your waistline isn’t everything, and the question of whether or not to drink becomes even more complicated when you factor in the mixed bag of what we know about alcohol and other health considerations.

“There’s not a simple answer,” says family physician Ranit Mishori, a faculty member at the Georgetown University School of Medicine. She lists the proven benefits of light to moderate drinking — a reduced risk of heart attack, stroke and peripheral vascular disease — and the potential downside, which includes significant research showing that alcohol increases your chances of developing breast and other cancers.

For example, a study of more than a million women in the United Kingdom, published last year in the Journal of the National Cancer Institute, found that middle-aged, moderate drinkers had a higher chance of developing breast, liver and rectal cancers than did those who had fewer than two drinks a week; those risks rose with each additional drink per day.

Given the pros and cons, Mishori recommends that patients make their drinking decisions on an individualized basis, taking medical, psychological and family history of conditions such as cardiovascular disease and breast cancer into account. No matter what, she says, “there’s a very fine line with alcohol consumption, and we really want to keep it to having a drink with a meal every day, maybe, as opposed to binge drinking or heavier drinking,” which is associated with additional adverse effects such as pancreatitis, high blood pressure and liver dysfunction.

“This study shouldn’t give anyone permission to start drinking if it’s not already part of their diet or routine, just like those studies showing an association with cancer shouldn’t make everyone stop drinking, because there are so many other factors that are related to weight gain, heart disease and cancer,” adds Mishori. “If you’re worried about gaining weight as you grow older, you should think about diet and exercising and leading a generally healthy lifestyle. But on the other hand, we are creatures that seek pleasure. . . . [And] I think that if you have a drink a day and you enjoy it and it fits within your life, then that’s perfectly fine.”

Not exactly a license to lush, but a glass of wine a day is more than enough for this pleasure-seeking, scale-conscious creature.