An interview with Professor Michael Aviram from Rambam Hospital and the Technion Israel Institute of Technology in Israel.
Sitting at his desk with a panoramic view across the Haifa bay, Professor Michael Aviram greets me with a warm smile. Professor Aviram is a distinguished scientist who has been revolutionizing cardiovascular medicine in his 32 years at Rambam hospital and on the Technion Faculty.
He is both senior vice dean of the Technion-Rappaport Faculty of Medicine (which includes the prestigious Technion American Medical School,TeAMS) and also the Director of the Clinical Research Institute at Rambam. Professor Aviram has written and published over 450 original scientific papers and is widely cited in international journals.
Each year, Rambam hospital launches around 500 new research projects and has achieved medical breakthroughs directly benefitting many of the tens of thousands of patients that they treat each year. Close to 300 of the clinicians at Rambam are also on the teaching faculty at the Technion-Rappaport Faculty of Medicine. These two heavyweights in medical research frequently combine forces to develop groundbreaking medical advances and to train the budding doctors who will implement this medicine of the future both in Israel and the USA.
Preventing Heart Attack and Stroke
Professor Aviram’s chief area of research is the investigation of LDL (“bad cholesterol”) and its formation to cause atherosclerosis (thickening and hardening of the arteries), which leads to heart attacks and strokes.
Aviram’s first research finding was that the type of cholesterol was very significant. No longer was the level of blood cholesterol the only factor in determining the risk of atherosclerosis. What was more important was determining whether it was good blood cholesterol (HDL) or bad blood cholesterol (LDL) and also, whether it was oxidized or not.
“Blood cholesterol, either in HDL or in LDL, can be in its native form or it can also be oxidized cholesterol,” explained Professor Aviram. “Oxidation occurs through everyday exposure to chemicals such as smoke and pollution, radiation, viruses and bacteria. These oxidized cholesterol molecules are extremely harmful to the arteries.”
Discovering cholesterol oxidization led Professor Aviram to look for antioxidants, molecules that block the oxidation of cholesterol and other fats. He studied over 100 different fruits, vegetables, beverages and wines to find the health benefits of these magical molecules. “Most of the antioxidants that I found were present in the skin of the fruit” said Professor Aviram, “with the most cardio-protective foods being pomegranate, red wine and olive oil”.
Finding the health benefits of red wine has been a satisfying discovery for wine drinkers worldwide. The deep red coloring of the wine results from the grape skin which also contains powerful antioxidant qualities. A glass of red wine at meal times has been demonstrated to reduce the levels of oxidized bad cholesterol in the bloodstream and thus the potential for developing atherosclerosis.
Next on the research agenda was pomegranate juice. When Professor Aviram’s team gave patients with atherosclerosis a glass of pomegranate juice to drink each day, the dangerous buildup in the artery walls was decreased by a massive 30% after just one year. In patients who didn’t drink the pomegranate juice, average buildup increased by 10%.
“Once we had discovered the major effect of cholesterol oxidation, it was clear that there must be an additional mechanism in the body which naturally protects against this oxidative stress, as not everyone goes on to develop dangerous levels of oxidized bad cholesterol and not everyone drinks pomegranate juice each day,” explained Professor Aviram.
His third area of research looks at how oxidized cholesterol can be broken down and atherosclerosis development can be reversed, and the results so far have been very promising. He and his team discovered a protective enzyme, paraoxonase (PON) which is attached to blood HDL and is responsible for breaking down oxidized bad cholesterol. Furthermore, they also discovered that pomegranate juice activates PON production. Thus, pomegranate juice not only blocks cholesterol oxidation, but at the same time also stimulates PON activity, reversing the atherosclerosis-causing effects of oxidized bad cholesterol.
Working on the PON research with Professor Aviram has been American medical student John Ward from Michigan. John is part of the Technion American Medical School which matches their students with top scientists to collaborate on their MD research projects. “I’ve worked in many labs prior to commencing my medical studies but none have even come close to working with Professor Aviram,” enthused Ward. “Simply amazing! During my research I studied the cells which ‘eat’ cholesterol and eventually was able to publish my research in a leading medical journal.” Performing research at such a high level enables the doctors of the future to fully understand the anatomy of the diseases they are learning to treat. Professor Aviram embraces this task, supporting his students and tailoring projects for them to maximize the benefit for their medical studies.