The newest Israeli Scientists joke goes like this:
What happened? Israeli scientists, famous for inventing breakthroughs and miracle cures to solve every health issue, be it diabetes or cancer or these days COVID-19, have finally solved old age. From now on, everyone who with spare cash can afford the Hyperbaric Oxygen Therapy (HBOT) treatment by Dr Shai Efrati has the chance to live longer, or maybe forever, free from senescent cells while sporting huge telomeres young ladies will love. Telomeres are the bits of repetitive DNA sequences at the end of your chromosomes, not what you thought, dear reader.
A press release from November 2020, published by AAAS Eureka Alert, proudly proclaimed a breakthrough:
“A new study from Tel Aviv University (TAU) and the Shamir Medical Center in Israel indicates that hyperbaric oxygen treatments (HBOT) in healthy aging adults can stop the aging of blood cells and reverse the aging process. In the biological sense, the adults’ blood cells actually grow younger as the treatments progress.
The researchers found that a unique protocol of treatments with high-pressure oxygen in a pressure chamber can reverse two major processes associated with aging and its illnesses: the shortening of telomeres (protective regions located at both ends of every chromosome) and the accumulation of old and malfunctioning cells in the body. Focusing on immune cells containing DNA obtained from the participants’ blood, the study discovered a lengthening of up to 38% of the telomeres, as well as a decrease of up to 37% in the presence of senescent cells.
The study was led by Professor Shai Efrati of the Sackler School of Medicine and the Sagol School of Neuroscience at TAU and Founder and Director of the Sagol Center of Hyperbaric Medicine at the Shamir Medical Center; and Dr. Amir Hadanny, Chief Medical Research Officer of the Sagol Center for Hyperbaric Medicine and Research at the Shamir Medical Center. The clinical trial was conducted as part of a comprehensive Israeli research program that targets aging as a reversible condition.”
Also the Tel-Aviv-University issued a press release. Their professor was quoted:
“”For many years our team has been engaged in hyperbaric research and therapy – treatments based on protocols of exposure to high-pressure oxygen at various concentrations inside a pressure chamber,” Professor Efrati explains. “Our achievements over the years included the improvement of brain functions damaged by age, stroke or brain injury.” […]
Prof. Efrati: “Today telomere shortening is considered the ‘Holy Grail’ of the biology of aging. Researchers around the world are trying to develop pharmacological and environmental interventions that enable telomere elongation. Our HBOT protocol was able to achieve this, proving that the aging process can in fact be reversed at the basic cellular-molecular level.“
The paper, done together with Efrati’s business partner Amir Hadanny, was this:
Hachmo Y, Hadanny A, Abu-Hamed R, Daniel-Kotovsky M, Catalogna M, Fishlev G, Lang E, Polak N, Doenyas K, Friedman M, Zemel Y, Bechor Y, Efrati S, “Hyperbaric oxygen therapy increases telomere length and decreases immunosenescence in isolated blood cells : a prospective trial“. Aging (2020). doi: 10.18632/aging.202188.
Before we talk telomeres: the Conflict of Interests declaration says: “AH, BY, ZY work for AVIV Scientific LTD. ES [Efrati, Shai- LS] is a shareholder at AVIV Scientific LTD.”
This AVIV Scientific is actually a company co-owned by Efrati as its co-founder and Chair of the Medical Advisory Board (thus, not just a mere shareholder), and its business model is to offer HBOT to rich old Americans and Arabs, in Florida and Dubai:
“The Aviv Medical Program was developed by the Aviv team and Dr. Shai Efrati, Director of the Sagol Center for Hyperbaric Medicine and Research at the Shamir Medical Center, one of the leading teaching hospitals in Israel. Over 200,000 hyperbaric sessions have been conducted there to date. The Aviv Medical Program is based on Dr. Efrati’s extensive clinical experience with over 7,500 people having received treatment utilizing Dr. Efrati’s Protocols. The vast majority of participants reported improved cognitive and physical performance“
So, how did Dr Efrati measure those telomeres? For some reason, he decided not to share with us any actual figures of his comparative flow cytometry analysis of participant samples, not even as supplementary material, maybe he is afraid of nosy PubPeer commenters. The editors of the journal Aging did not ask, but what can you expect from its chief editors Mikhail Blagosklonny (read here), David Sinclair (read here) and the telomere researcher Judith Campisi. Apparently, telomere research progressed into the new, data free stage.
Please forgive me for making fun of telomere research, I previously spent over four and a half years in a telomere lab and have a suspicion that that entire research field is pulling our leg. Thing is, the main dogma that youth and longevity are associated with long telomeres and once those get too short after many cell divisions, you grow old, get cancer and die, kind of contradicts what every telomere researcher knows too well: lab mice have gigantic telomeres, much longer than humans. And yet these mice grow old and die way before their second birthday, taking their enviably prolonged telomeres to their graves.
But then again, one of the biggest stars in telomere research field, the German professor Karl Lenhard Rudolph, was found guilty of research misconduct over data manipulation, a practice which might explain how at least some of the groundbreaking discoveries in the field came to be. In this regard, Efrati’s telomere study begins with the dogma that short telomeres make you old, and it does so by referencing the 2013 Cell review by Carlos Lopez-Otin and Guido Kroemer. My regular readers will get the irony, the others are invited to click here.
Nevertheless, telomere research was awarded the Nobel Prize for Physiology or Medicine in 2009. Among the winners was the UCSF professor Elizabeth Blackburn, who went on to collaborate with none other but the biggest guru of all, Deepak Chopra, to prove that yoga and meditation extend telomeres. They are really pulling our leg, no? Blackburn is also on editorial board of Aging, where she shares company with Rudolph, Kroemer and a number of other questionable scientists.
These telomere experts sure were impressed by such a groundbreaking achievement:
“Researchers around the world are trying to develop pharmacological and environmental interventions that enable telomere elongation,” said Efrati. “Our hyperbaric oxygen therapy protocol was able to achieve this, proving that the aging process can in fact be reversed at the basic cellular-molecular level.”
But what did Dr Efrati actually show in his clinical research paper to prove that HBOT extends telomeres and removes senescent cells? Several bar plots and tables, and not much else, which are described as showing the analysis of flow cytometry of blood cells. For telomere length assay, these were stained with a fluorescent telomere probe (PNA), but no FACS plots were offered to allow an actual patient intergroup comparison. Cellular senescence was determined as CD28 negativity of participants’ blood T-cells, a reason for that choice of a “biomarker” was not provided or documented with a reference, nowhere in the paper. Again, how those stainings looked in reality, is none of your business, just be informed that senescent cells were all removed under high oxygen as if by a senolytics magic (surely this impressed Aging editorial board members like Campisi). Dr Efrati also talked several times in that paper about his trial’s exciting HBOT results with HIF1-alpha expression analysis (oxygen-sensing protein, awarded the Nobel Prize last year), which he however refused to show even as a crummy diagram, just one measly sentence, no pictures. Efrati’s word sufficed to pass peer review at that journal.
This was the trial setup:
There were in total 30 participants who received HBOT and donated blood, which was then stained for either telomere probe or CD28. Strangely, 4 patient samples were excluded for “low quality” in the telomere analysis group and 10 in the senescent analysis group. How can that be if the blood was the same? Both methods used same preparations of peripheral blood mononuclear cells (PBMCs), so, again, how can 6 blood samples have been good enough for telomere analysis but not good enough for CD28 staining? I have a suspicion how “low quality” might have been defined there.
Since those numbers are all Dr Efrati is willing to share, I asked an expert, Nick Brown (of Brian Wansink fame), to have a look at the numbers. Who was not impressed and said the statistics made little sense in several cases.
Ever the pooh-pooher of groundbreaking science, Dr Brown commented:
“These p values appear to be meaningless because the groups being compared are not independent.”
But for the sake of argument, Brown decided to pretend otherwise and “concentrate just on the p values from the contingency tables, as if the samples were in fact independent.” He then re-calculated the different p-values as listed in the Table 1 and noticed some are off. Also, he remarked that the telomere analysis contained 25 patients, not 26 as promised in the paper. Their average age calculation was not consistent with the GRIM test, a software to analyse statistical irregularities which Brown designed together with James Heather. Brown’s verdict:
“Table 1 is absurd because they are comparing different subsets of the same sample. Once you have that basic level of incompetence there’s not really any point in reading the paper. If I’d seen that as a reviewer I’d have written a three-line recommendation to reject .”
Incompetence? I beg your pardon? That paper made news all over Israel and beyond! There are oodles of wealthy Israeli, American and Arab senior citizens probably queuing outside AVIV Scientific offices right now, clutching wads of money and ready for the HBOT magic to take its course.
And in any case, Dr Efrati has cured many diseases with HBOT already, according to his perfectly objective Wikipedia profile. Hypertension no longer a problem thanks to discoveries in Leitman et al 2020, and stroke was cured already 7 years before, in Efrati et al PLOS One 2013. Brain concussion was solved by the clinical trial Boussi-Gross et al PLOS One 2013 and, for those not yet convinced, in Tal et al Frontiers Human Neurosc 2017. The highly acclaimed learned society of world’s biggest scholars and its world-renowned journal, Undersea & Hyperbaric Medicine : Journal of the Undersea and Hyperbaric Medical Society, published Dr Efrati’s hope-giving editorial announcing a cure for nothing less but cerebral palsy: Efrati & Ben-Jacob 2014. And more recently, Dr Efrati found a genius way to make the entire Israeli nation smarter, both young (Vadas et al Frontiers Integr Neurosc 2017) and old (Hadanny et al Aging 2020), if only the government would mandate his HBOT method of brain
enlargement enhancement. Read this, in Times of Israel:
“One of the volunteers from his experiment, Avi Rabinovitch, 69, said that he “entered this study healthy, and left it a tiger,”
In 2015, Dr Efrati cured women of fibromyalgia, a chronic pain and fatigue syndrome, using HBOT:
Efrati S, Golan H, Bechor Y, Faran Y, Daphna-Tekoah S, Sekler G, Fishlev G, Ablin JN, Bergan J, Volkov O, Friedman M, Ben-Jacob E, Buskila D “Hyperbaric oxygen therapy can diminish fibromyalgia syndrome–prospective clinical trial“. PLOS One. (2015). doi: 10.1371/journal.pone.0127012.
But each genius has detractors. The same number-crunching Dr Brown had a look at the tables in that 2015 paper. He noticed that its results section speaks of 48 female patients being included, 24 in the control and 24 in the Crossover group (meaning, those received HBOT later). The Table 1 however claims there were 50 patients in total, 26 of whom in the Crossover group:
Brown commented with yellow notes:
“The text says there were 24 in this group, but the percentages suggest that N=26 (e.g., “Life style: Secular: 17”, 17/26=0.6538, which would give 65.4% if correctly rounded instead of the reported 65.3% [sigh], whereas 17/24=70.8%). Regardless, there are GRIM inconsistencies, and sometimes SPRITE issues (no solution found), whether we use N=26 or N=24.“
In the Table 2, it got weirder. Aside of various GRIM inconsistencies Brown highlighted, he noticed something else: the life quality of patients changed from abysmally bleak to very slightly, but not really less abysmally bleak. The SCL-90 score is a symptom questionnaire which uses “a 5-point Likert scale from 0 to 4 with a higher score corresponding to higher distress.” The SF-36 questionnaire “generates a score from 0 to 100, with a high score indicating better health and less body pain“, as the paper explains. But look at the values:
Brown criticised very low SCL-90 baseline score for fibromyalgia patients. I personally am also puzzled how come the crossover group baseline score was 1.5 times higher than that of control group (and then fell significantly even without an HBOT intervention). And as for SF-36, Brown writes:
“These scores are all more or less impossible for a scale that runs from 0-100. An improvement from 3.15 to 3.48 would still indicate basically zero quality of life.”
But for his next medical achievement, there surely must be some kind of national award to Dr Efrati: he helped women to overcome fibromyalgia due to history of sexual abuse in childhood:
Hadanny A, Bechor Y, Catalogna M, Daphna-Tekoah S, Sigal T, Cohenpour M, Lev-Wiesel R, and Efrati S “Hyperbaric Oxygen Therapy Can Induce Neuroplasticity and Significant Clinical Improvement in Patients Suffering from Fibromyalgia with a History of Childhood Sexual Abuse-Randomized Controlled Trial“. Frontiers in Psychology (2018). doi: 10.3389/fpsyg.2018.02495.
Also here, the numbers are weird. About “Physical Limitation” values in the treated group post-HBOT, I personally also note that the baseline of “physical limitations” of the treated group was 21.7 ± 35.2, while the control group had baseline of 13.3 ± 28.1, almost half of that. But Brown found out:
“The highlighted SDs of ~40 in this part of the table cover almost half the range of values (0-100). They imply that around a quarter of people who previously scored 15-30 scored 95-100 after treatment, while another quarter scored 0-5 — which would represent a catastrophic side-effect of the treatment.
For mean change, an SD of ~40 is just about possible, but […] SD of 66.6 requires multiple patients to have gone from ~0 to ~100 and at least one to have gone from ~100 to ~0.“
I will translate: apparently, Dr Efrati performed the old Israeli miracle of making lame (the tetraplegic, 100% immobile lame) walk and dance, with some forward, and with some sinners, tragically in reverse. And yet these same patients, who went from 100 mobility to crippled in a wheelchair and unable to move, are described as “improved in all domains (physical limitations,..”? What is going on? Maybe Dr Efrati is bullshitting us with some imaginary stats again? Is this the reason why he publishes his medical breakthroughs in such elite outlets like Frontiers and Aging?
But who needs fancy journals if journalists eat from your hands. A problem for Efrati’s business might be that, unless you convince hospitals and health insurances, you can’t really offer your costly HBOT therapy to patients. Most brain trauma and myalgia patients are stingy buggers who won’t travel to wherever Dr Efrati’s Aviv Scientific is offering its HBOT services. Most can’t be
tricked educated to pay the perfectly reasonable and justified costs of a life-changing oxygen therapy. On the other hand, rich old men are the perfect customers. Money can buy everything as they say, surely it can buy health and youth, and maybe even eternal life? And this is what Dr Efrati’s genius new paper in Aging is offering. Take a deep breath of pressurised oxygen, and emerge rejuvenated, with your telomeres, once shrivelled, short and hanging loose, now stretching proud, unwavering like those of a 20 year old man, and you didn’t even have to inject his actual blood for it like some do.
Another problem is, HBOT cannot be patented. Which is unfair to Dr Efrati for sure. Look, other doctors like Daniel Rossignol are curing autism with HBOT behind Dr Efrai’s back, as Smut Clyde noticed:
Daniel A Rossignol, James J Bradstreet, Kyle Van Dyke, Cindy Schneider, Stuart H Freedenfeld, Nancy O’Hara, Stephanie Cave, Julie A Buckley, Elizabeth A Mumper, Richard E Frye “Hyperbaric oxygen treatment in autism spectrum disorders” Medical Gas Research (2012) DOI: 10.1186/2045-9912-2-16
As aside, one of these HBOT-grifting autism quacks is the infamous antivaxxer James “Jeff” Bradstreet, who shot himself when FBI raided his home over GcMAF quack cures. But don’t get me wrong, I never would want to imply that Efrati is just another grifting quack, that would be just pathetic diaspora Jew whinging from me. No, I am a big fan of “Israeli Scientists” humour! Look, Efrati’s Sackler Medcial School and Tel Aviv University pushed their
antivaxxer vaccine-sceptic professor Yehuda Shoenfeld into Israel Academy!
Dr Efrati never replied to my emails. Also his Sackler Medical School and Tel Aviv University superiors were not interested. Maybe they only communicate with paying customers? Should I have booked an HBOT session to extend my telomeres, instead of sending them Brown’s criticisms?
Several HBOT clinical trials are happening, including at Karolinska Institutet in Sweden! The Undersea and Hyperbaric Medical Society collated the information here, and of course also Efrati and Hadanny are running a clinical trial! The trial NCT04358926 with 30 participants was registered in April 2020, with recruitment completed since 3 November 2020. It was supposed to be a “Randomized controoled, [sic!] double blinded study“, with control group receiving normobaric oxygen, but Shai is stingy, so now it’s one HBOT group with 21 participants and one standard care arm with 8 patients. The trial was therefore changed to single blinded for outcomes assessor (i.e., Hadanny). I guess the trial’s randomization depended on who paid for HBOT and who didn’t? And instead of day 1 and 7 time points there will be only one blood assessment at day 5. Viral load tests and chest X-Rays are cancelled.
Oh, and for some reason in October 2020 Efrati was removed as principal investigator, now it’s only Hadanny.
If you are interested to support my work, you can leave here a small tip of $5. Or several of small tips, just increase the amount as you like (2x=€10; 5x=€25). I am saving for a hyperbaric oxygen therapy, to stretch my telomeres.