[Greg H]

Hey Catherine!

Sorry for the slow response. I was out of town for a few days.

Yes indeed, the thought is that the Danazol, an androgen, will improve the telomerase cycle -- the chemical process that repairs and lengthens telomeres. The TERT mutation that I have -- and the TERC mutation that some of our other friends have -- messes up this process.

The folks at NIH have used androgens in the test tube to improve the telomerase cycle in both bone marrow stem cells and white blood cells. They know that doctors in the field have had some success over the past 40 years treating aplastic anemia patients with androgens.

So this trial puts those two facts together in a trial to see if Danazol therapy can lengthen telomeres -- and if that lengthening will result in improved blood counts.

Danazol and other androgens can improve red blood cell counts another way: by increasing the release of EPO from the kidneys -- which has kind of the same effect as Aranesp. I would guess this would be of limited value to folks who are already churning out a lot of EPO, and I fall into that category.

A final interesting point: the test tube studies at NIH showed that the effect of androgens on blood cell telomeres was actually mediated through the aromatization process, which converts testosterone to estrogen. They theorized that it might be possible to use estrogen directly to stimulate the telomerase cycle, but, I suppose, went with a testosterone analog first because of the history of using those substances to treat AA.

Take care!

Greg