Avraham Cooper
@avrahamcoopermd.bsky.social
Pulm/Crit physician, medical educator, The Curious Clinicians podcast
FORTHCOMING BOOK: WHY DOESN’T YOUR STOMACH DIGEST ITSELF? (W.W. Norton)
FORTHCOMING BOOK: WHY DOESN’T YOUR STOMACH DIGEST ITSELF? (W.W. Norton)
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...
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...
June 19, 2025 at 7:56 PM
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...
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...
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....
www.nejm.org/doi/full/10....
May 18, 2025 at 12:07 PM
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....
www.nejm.org/doi/full/10....
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!
May 9, 2025 at 9:05 PM
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!
Yeesh - if Pseudomonas wasn’t a bad enough actor already, it also apparently secretes an enzyme that degrades plastic
www.cell.com/cell-reports...
www.cell.com/cell-reports...
May 9, 2025 at 11:54 AM
Yeesh - if Pseudomonas wasn’t a bad enough actor already, it also apparently secretes an enzyme that degrades plastic
www.cell.com/cell-reports...
www.cell.com/cell-reports...
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/
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/
April 18, 2025 at 3:52 PM
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/
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/
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/
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/
April 18, 2025 at 3:52 PM
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/
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/
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/
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/
April 18, 2025 at 3:52 PM
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/
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/
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/
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/
April 18, 2025 at 3:52 PM
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/
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/
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/
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/
April 18, 2025 at 3:52 PM
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/
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/
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/
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/
April 18, 2025 at 3:52 PM
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/
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/
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?...
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?...
April 18, 2025 at 3:52 PM
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?...
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?...
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...
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...
April 18, 2025 at 3:52 PM
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...
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...
5/
This granted great value to salt throughout the ancient world.
Ex: in ancient China, wars were fought thousands of years ago over control of salt flats at Lake Yuncheng, and salt later became a form of traded currency.
historycooperative.org/the-history-...
This granted great value to salt throughout the ancient world.
Ex: in ancient China, wars were fought thousands of years ago over control of salt flats at Lake Yuncheng, and salt later became a form of traded currency.
historycooperative.org/the-history-...
April 18, 2025 at 3:52 PM
5/
This granted great value to salt throughout the ancient world.
Ex: in ancient China, wars were fought thousands of years ago over control of salt flats at Lake Yuncheng, and salt later became a form of traded currency.
historycooperative.org/the-history-...
This granted great value to salt throughout the ancient world.
Ex: in ancient China, wars were fought thousands of years ago over control of salt flats at Lake Yuncheng, and salt later became a form of traded currency.
historycooperative.org/the-history-...
4/
Likewise, because of its antiseptic and desiccating properties, salt has been used to preserve fresh food going back at least 5,000 years ago in places including China, Egypt, Mesopotamia, and southern Europe.
pubmed.ncbi.nlm.nih.gov/31721796
Likewise, because of its antiseptic and desiccating properties, salt has been used to preserve fresh food going back at least 5,000 years ago in places including China, Egypt, Mesopotamia, and southern Europe.
pubmed.ncbi.nlm.nih.gov/31721796
April 18, 2025 at 3:52 PM
4/
Likewise, because of its antiseptic and desiccating properties, salt has been used to preserve fresh food going back at least 5,000 years ago in places including China, Egypt, Mesopotamia, and southern Europe.
pubmed.ncbi.nlm.nih.gov/31721796
Likewise, because of its antiseptic and desiccating properties, salt has been used to preserve fresh food going back at least 5,000 years ago in places including China, Egypt, Mesopotamia, and southern Europe.
pubmed.ncbi.nlm.nih.gov/31721796
3/
Going back millenia, salt has been used as an antiseptic to prevent decay of organic material.
For example, the ancient Egyptians used salt in their mummification solutions.
pubmed.ncbi.nlm.nih.gov/11677605/
Going back millenia, salt has been used as an antiseptic to prevent decay of organic material.
For example, the ancient Egyptians used salt in their mummification solutions.
pubmed.ncbi.nlm.nih.gov/11677605/
April 18, 2025 at 3:52 PM
3/
Going back millenia, salt has been used as an antiseptic to prevent decay of organic material.
For example, the ancient Egyptians used salt in their mummification solutions.
pubmed.ncbi.nlm.nih.gov/11677605/
Going back millenia, salt has been used as an antiseptic to prevent decay of organic material.
For example, the ancient Egyptians used salt in their mummification solutions.
pubmed.ncbi.nlm.nih.gov/11677605/
1/THREAD
As the old idiom goes, one deliberately causes additional pain by "pouring/rubbing salt in an open wound".
But this is also literally true. Physiologically, why would it hurt so much to have salt poured into a wound?
As the old idiom goes, one deliberately causes additional pain by "pouring/rubbing salt in an open wound".
But this is also literally true. Physiologically, why would it hurt so much to have salt poured into a wound?
April 18, 2025 at 3:52 PM
1/THREAD
As the old idiom goes, one deliberately causes additional pain by "pouring/rubbing salt in an open wound".
But this is also literally true. Physiologically, why would it hurt so much to have salt poured into a wound?
As the old idiom goes, one deliberately causes additional pain by "pouring/rubbing salt in an open wound".
But this is also literally true. Physiologically, why would it hurt so much to have salt poured into a wound?
I’m always amazed by our similarities and homologies with bacteria.
Our version of a foreign nucleic acid sensor called STING, which activates interferon, is almost identical to the version that bacteria use to sense and defend against viruses.
www.nature.com/articles/s41...
Our version of a foreign nucleic acid sensor called STING, which activates interferon, is almost identical to the version that bacteria use to sense and defend against viruses.
www.nature.com/articles/s41...
April 10, 2025 at 4:50 PM
I’m always amazed by our similarities and homologies with bacteria.
Our version of a foreign nucleic acid sensor called STING, which activates interferon, is almost identical to the version that bacteria use to sense and defend against viruses.
www.nature.com/articles/s41...
Our version of a foreign nucleic acid sensor called STING, which activates interferon, is almost identical to the version that bacteria use to sense and defend against viruses.
www.nature.com/articles/s41...
Was truly an honor to give this talk for OSU Internal Medicine Grand Rounds.
In times of uncertainty, curiosity and humanism can help us find joy as clinicians.
In times of uncertainty, curiosity and humanism can help us find joy as clinicians.
March 27, 2025 at 8:53 PM
Was truly an honor to give this talk for OSU Internal Medicine Grand Rounds.
In times of uncertainty, curiosity and humanism can help us find joy as clinicians.
In times of uncertainty, curiosity and humanism can help us find joy as clinicians.
My writing website is live! Huge thank you to the endlessly talented Miriam Hiersteiner for designing it
www.avrahamcooper.com
www.avrahamcooper.com
March 16, 2025 at 8:33 PM
My writing website is live! Huge thank you to the endlessly talented Miriam Hiersteiner for designing it
www.avrahamcooper.com
www.avrahamcooper.com
Excited to share a little piano piece I wrote and presented at the 2025 OSU College of Medicine Arts Festival!!
medartsgallery.squarespace.com/work/cooper
medartsgallery.squarespace.com/work/cooper
March 6, 2025 at 9:49 PM
Excited to share a little piano piece I wrote and presented at the 2025 OSU College of Medicine Arts Festival!!
medartsgallery.squarespace.com/work/cooper
medartsgallery.squarespace.com/work/cooper
Classic but very cool study. Does aspirin reduce the risk of cancer metastases?
www.thelancet.com/journals/lan...
www.thelancet.com/journals/lan...
March 5, 2025 at 11:13 PM
Classic but very cool study. Does aspirin reduce the risk of cancer metastases?
www.thelancet.com/journals/lan...
www.thelancet.com/journals/lan...
Crazy cool study investigating alpha-gal gene therapy for refractory solid cancers (leading the immune system to ‘reject’ the cancer like an organ transplant)
www.cell.com/cell/fulltex...
www.cell.com/cell/fulltex...
January 22, 2025 at 1:48 AM
Crazy cool study investigating alpha-gal gene therapy for refractory solid cancers (leading the immune system to ‘reject’ the cancer like an organ transplant)
www.cell.com/cell/fulltex...
www.cell.com/cell/fulltex...