4th Sep 2015, 01:33 AM #2091
Re: Health Bulletin
Killer T-cell therapy shows promise against leukemia
A cancer-killing therapy that engineers a patient's own immune cells to wipe out chronic lymphocytic leukemia (CLL) has shown long-term success in a handful of people, a US study said on Wednesday.
Experts said the approach is on the cutting edge of a growing field known as immunotherapy, which coaxes the body to kill off cancer and may someday revolutionize oncology by ending the use of toxic chemotherapy.
The method, known as CTL019, was developed by the University of Pennsylvania's Abramson Cancer Center and Perelman School of Medicine, which is now reporting the first long-term results on a group of 14 initial patients.
Eight of the adults enrolled in the study (57 percent) responded to the treatment, with four going into long-term remission and the other four experiencing a partial response, said the findings in the journal Science Translational Medicine.
The first person to be treated recently marked five years cancer-free. Two others have made it to four and half years with no sign of cancer's return. The fourth was in remission for 21 months, then died of an infection following a surgery that was unrelated to the leukemia.
"Our tests of patients who experienced complete remissions showed that the modified cells remain in patients' bodies for years after their infusions, with no sign of cancerous or normal B cells," said senior author Carl June, professor of immunotherapy in Penn's department of pathology and laboratory medicine.
"This suggests that at least some of the CTL019 cells retain their ability to hunt for cancerous cells for long periods of time."
Four of the patients (29 percent) responded to the therapy, for a median of seven months, but their cancer eventually returned.
Researchers first reported initial results on three adult patients in 2011, showing that two of the three had gone into remission in the first year of treatment.
Normally, the immune system tries to attack cancer but fails because cancer can evade the body's defenses.
The experimental therapy is made from patients' own immune cells, sometimes known as T-cells, which are collected by researchers and reprogrammed to better search for and kill cancer.
They are modified to contain a protein known as a chimeric antigen receptor (CAR), which targets the CD19 protein found on the surface of cancerous B cells.
After the immune cells are collected and re-engineered, the patient undergoes chemotherapy to wipe out their current immune system before they are re-infused with their newly empowered immune cells.
Jacqueline Barrientos, a medical oncologist at the North Shore-LIJ Cancer Institute who was not involved in the study, described the approach as "revolutionary," because of its ability to wipe out CLL for years.
"This is an exciting time," she told AFP, adding that many experts think June is likely to win the Nobel Prize someday for shepherding in a new era of cancer treatment.
Other experts say the success of immunotherapy — particularly CAR treatments for leukemia and lymphoma — raises new questions about what it could mean to be "cured" of cancer.
"There is certainly a potential for a cure here in some of these patients who have had prolonged remissions," said Joshua Brody, director of the lymphoma immunotherapy program at Mount Sinai Hospital.
"What if they are not cured but they have this ongoing therapy that stays inside of them and keeps fighting back cancer every time cancer rears its head?" added Brody, who was not involved in the study.
"This would be close to a cure from the patient's perspective."
Of course, the treatment did not work for everyone. In addition to the four patients whose cancer returned, six others in the 14-person trial did not respond at all.
Scientists are working hard to figure out why that group's modified T-cells did not expand in their bodies at the same rate as in those who went into long-term remission.
"The patients in this study are pioneers, whose participation has given us a foundation of knowledge and experience on which to build this new approach to help more patients," said lead author David Porter, director of Blood and Marrow Transplantation in Penn's Abramson Cancer Center.
4th Sep 2015, 12:22 PM #2092
Re: Health Bulletin
Lifestyle makes heart grow old before you
You may be in your mid-20's or early 30's, but your heart could be ageing faster than you can imagine. Those prone to cardiac disease may be having a heart 10-15 years older than themselves, research shows.
A recent survey conducted by the Center for Disease Control in US shows that heart age of most men is nearly eight years more than their actual age while an average woman's heart is about five-and-a-half years older than her.
Among Indians, doctors found the difference higher due to genetic predisposition as well as greater prevalence of risk factors such as diabetes, hypertension and smoking. This means they are at higher risk of heart attacks and stroke.
Heart age' is the age of a person's cardiovascular system calculated based on his or her risk profile. Risks include high blood pressure, cigarette smoking, diabetes and body mass index as an indicator for obesity.
"CDC uses an online application to calculate heart age. When we put 40 persons (20 controls and 20 diabetics) through the test recently, we found that the average heart age in the control was 10 years more than their chronological age. Among diabetics, the difference was nearly double," said Dr Sujeet Jha, director, Institute of Endocrinology, Diabetes and Metabolism at Max Healthcare.
His findings were corroborated by another exercise at Fortis Escorts Heart Institute. "A normal heart ages by developing deposits in arteries leading to blockages. It is common in old age. But we are seeing young and middle-aged persons suffering from the condition, which clearly reflects a bigger health crisis. The CDC heart age calculator can be an important tool to help people understand the gravity of the situation and take suitable measures," Dr Ashok Seth, chief of cardiac sciences at FEHI, said.
Seth said the median age of persons suffering from heart attack has gone down from 63 years to 55 years in the last 20 years. "Smoking is the biggest risk factor for heart attacks among youngsters. Eight to 10 hours of a sedentary job without any physical exercise, improper diet and alcohol intake increases risk of heart disease," said a doctor.
The CDC survey report states youngsters who don't understand their cardiovascular disease risk are missing out on early opportunities to prevent future heart attacks. "About three in four heart attacks and strokes are due to risk factors that increase heart age, so it's important to increase access to detection and treatment resources," said a CDC official.
4th Sep 2015, 12:25 PM #2093
Re: Health Bulletin
Chemicals in soaps, shampoos linked to miscarriage risk
Exposure to certain substances commonly found in personal care products such as soaps and shampoos and food packaging could be associated with increased risk of miscarriage, a new study has claimed.
The study of more than 300 women suggested that exposure to certain phthalates - substances commonly used in food packaging, personal-care and other everyday products - could be associated with pregnancy loss, mostly between 5 and 13 weeks of pregnancy.
The research is the first epidemiological study on non-work-related exposure to phthalates to provide evidence for the possible link among a general population.
Out of concern over the potential health effects of phthalates, the US has banned six of these substances from use in certain products made for young children, researchers said.
But many are still included as ingredients in paints, medical tubes, vinyl flooring, soaps, shampoos and other items.
Research on phthalates has shown that long-term exposure to low levels of the some of these compounds harms lab animals' health and can increase their risk for pregnancy loss.
Additionally, at least one study found that female factory workers exposed to high levels of phthalates through their work were at a higher risk for miscarriage.
But there is little epidemiological evidence of phthalates' effects on pregnancy among women with non-occupational exposure, researchers said.
Jianying Hu and Huan Shen from Peking University in China and their colleagues wanted to find out if there might be a link.
The researchers tested urine samples from 132 women who had miscarriages and 172 healthy pregnant women in China.
They found pregnancy loss was associated with higher levels of urinary phthalate metabolites from diethyl phthalate (DEP), di-isobutyl phthalate (DiBP) and di-n-butyl phthalate (DnBP).
Although this does not prove that phthalates cause pregnancy loss, the study suggests an association exists that the researchers said should be studied further.
The study was published in the journal Environmental Science and Technology.
5th Sep 2015, 01:52 PM #2094
Re: Health Bulletin
More effective drugs for diabetes in the offing
Scientists have found a new way to lower blood sugar levels by reducing glucose production in the liver, paving the way for more effective drugs for type 2 diabetes.
Some treatments for type 2 diabetes make the body more sensitive to insulin, the hormone that lowers blood sugar.
But new research at Washington University School of Medicine in St Louis suggests a different strategy: slowing the production of glucose in the liver.
Working on mice, the researchers showed they could reduce glucose production in the liver and lower blood sugar levels.
They did so by shutting down a liver protein involved in making glucose, an approach that may work in patients with type 2 diabetes.
"We think this strategy could lead to more effective drugs for type 2 diabetes," said principal investigator Brian N Finck, associate professor of medicine in the Division of Geriatrics and Nutritional Science.
"A drug that shuts down glucose production has the potential to help millions of people affected by the most common form of diabetes," said Finck.
Finck worked with researchers at the University of Texas Southwestern Medical Centre and the biopharmaceutical company Metabolic Solutions Development Co.
The company is involved in clinical trials that are evaluating the drug compound MSDC-0602 as a treatment for diabetes.
The new study demonstrates that the compound works, at least in part, by inhibiting a protein that's key to glucose production in the liver.
The research team, led by first author Kyle S McCommis, a postdoctoral research scholar, cut sugar production in liver cells by inhibiting a key protein involved in transporting pyruvate, a building block of glucose, from the bloodstream into the energy factories of liver cells, called mitochondria.
Previous research had suggested interfering with pyruvate may limit glucose production in the liver, but this study is the first to demonstrate the critical role played by the pyruvate transport protein.
In addition to diabetes, the researchers also think that interfering with pyruvate transport may help patients with nonalcoholic fatty liver disease, a condition common in people with obesity.
5th Sep 2015, 01:53 PM #2095
Re: Health Bulletin
Stem cell results disheartening: Study
Stem cell therapy that held promise for treating heart attack and heart failure fails to live up to its expectations. Though initial trials conducted on animals and select patients did show some positive results, a study led by AIIMS and Army (Research and Referral) Hospital on over 250 patients has concluded there is no significant benefit of injecting stem cells to improve the heart function.
"The results are disheartening but not the end of stem cell research for heart repair. On the positive side, it has given us lead that there might be some benefit on administering higher dosage of stem cells. We plan to use next generation stem cells—ones that are cultured in lab before transplantation—for future research," said Dr Sandeep Seth, professor of cardiology at AIIMS. He said heart, brain and kidney are the only three organs that cannot heal on its own.
"Transplant is the only option at present for patients with extensive damage to these organs due to various reasons. Even little success in stem cell research can mean a lot to those who suffer from the condition," Seth added.
AIIMS started research on stem cell therapy for heart repair in year 2003 under the leadership of the then director P Venugopal. After initial success, the research was expanded to multiple centres, including the Army Hospital, Military Hospital, CMC Vellore, SGPGI Lucknow and PGIMER Chandigarh. Total 250 patients aged between 20 and 65 years were enrolled for a study.
"All underwent angioplasty or bypass as required. After that, 125 patients were put on standard therapy and the rest were given additional therapy. The dosage of stem cells was lesser than the standard dosage in 53 out of the 125 patients due to inadequate yield of stem cells in bone marrow due to age, co-morbid conditions and smoking," said a senior doctor. The results of the study, which has been published in Indian Journal of Medical Research states there was no significant difference in the primary outcome between patients who received stem cell therapy and those who didn't.
5th Sep 2015, 01:54 PM #2096
Re: Health Bulletin
Farm dust can help protect kids against allergies, asthma
Researchers have found that farm dust can protect kids against asthmas and allergies, a breakthrough that may ultimately lead to the development of an asthma vaccine.
Researchers have successfully established a causal relationship between exposure to farm dust and protection against asthma and allergies.
It is commonly known that drinking raw cow's milk can provide protection against allergies. A research team, led by professors Bart Lambrecht and Hamida Hammad, both associated with Ghent University and Vlaams Instituut voor Biotechnologie, in Belgium, has now established a scientific basis for this claim.
Many years ago, it was found that children growing up on farms are far better protected against asthma and allergies. However, until recently, scientists were unable to pinpoint why this is the case.
"At this point, we have revealed an actual link between farm dust and protection against asthma and allergies," Lambrecht said.
"We did this by exposing mice to farm dust extract from Germany and Switzerland. These tests revealed that the mice were fully protected against house dust mite allergy, the most common cause for allergies in humans," Lambrecht said.
In addition to the causal relationship, the scientists discovered the mechanism behind this - farm dust makes the mucous membrane inside the respiratory tracts react less severely to allergens such as house dust mite.
"This effect is created by the A20 protein, which the body produces upon contact with farm dust. When we inactivate the A20 protein in the mucous membrane of the lungs, farm dust is no longer able to reduce an allergic or asthmatic reaction," Hammad said.
The findings were then tested in patients. The results showed that people suffering from allergies and asthma have a deficiency in the protective protein A20. It explains why they react to allergens so severely.
"We also assessed a test group of 2,000 children growing up on farms, and found that most of them are protected. Those who are not protected and still develop allergies have a genetic variant of the A20 gene which causes the A20 protein to malfunction," Lambrecht said.
The researchers are now trying to identify the active substance in farm dust that is responsible for providing protection. Once this has been identified, the development of a preventive medicine against asthma may be the next step.
"We already suspect that to some extent, the answer lies in the endotoxines, which form part of the cell wall of specific bacteria," Hammad said.
"Discovering how farm dust provides this type of protection has certainly put us on the right track towards developing an asthma vaccine and new allergy therapies However, several years of research are required still before they will be available to patients," Hammad said.
6th Sep 2015, 03:41 PM #2097
Re: Health Bulletin
When crinkling papers make you tingle
What could possibly be entertaining or engaging in watching hearing online soft whispers, the snip of a pair of scissors, a barista making an espresso shot or someone folding a wrapping paper?
But there's a thriving audience for such online content, which supposedly provides a unique pleasurable tingling satisfying feeling to viewers through what's scientifically known as ASMR or Autonomous Sensory Meridian Response. YouTube channels such as Heather Feather ASMR, ASMRequests enjoy subscription numbers in lakhs.Gentle Whispering ASMR is one of the most popular channels with 4.7 lakh subscriptions. Among the Indian channels are India Love (over 4,100 subscribers), IndianASMR (over 1600 subscribers) and thezenwoman (over a thousand subscribers). Some provide long minutes of "triggers" for tingles such as soft talking, bristle sounds, crinkling papers, slow hand movements, and even role play involving a nurturing personal attention from the artist (referred to as the ASMRtist) such as a hairdresser, optometrist, teacher and the like. There are even ASMR "music" albums such as Inaudible Whispers by ASMR HQ and Softer Somewhere by Springbrook ASMR. There are also ASMR podcasts such as ASMR Sleep Station to listen to.
What exactly is ASMR? It is difficult to describe, there's no conclusive scientific ex planation for it and everyone doesn't experience it. Anecdotal evidence suggests that it is a "good feeling" that you typically experience on your head, scalp, neck and other peripheral regions. Crinkling papers, manicured nails softly tapping on plastic, and even folding towels can apparently throw many people into throes of ASMR.
Called "braingasm" or "headgasm" initially because the sensation resembles a sexual orgasm, the sensory phenomenon has now come to be known as ASMR. US researchers Dr Craig Richard, Jennifer Allen and Karissa Burnett are currently running a project studying ASMR. They have surveyed nearly 13,000 persons online on their website asmruniversity.com. So far less than one percent of those surveyed are from India. Richard believes that noisiness, rampant in Indian cities, "may inhibit the ability to experience ASMR". Although good headphones might help.
Delhi-based clinical psychologist Pulkit Sharma says that the phenomenon could be considered under the broad rubric of music therapy. "In music therapy, one note or chord is played repeatedly to induce relaxation. This could be similar. Different people react differently to stimuli. In case of whispering, some might find it ticklish, others might find it pleasurable," says Sharma.
ASMR seekers are not just seeking tingles but customizations too. The community's discussion threads on Reddit have people making specific requests, such as an ASMR video in an Indian accent, or ones with role play, with the ASMRtist pretending to cut your hair or give you an eye exam! Currently, besides Richard's research team, there have been more scientific investigations into the phenomenon from the University of Swansea, UK, and University of Virginia, Charlottesville. Once there is more research on the subject, psychiatrists feel the knowledge from the results can have a clinical use. The whispers, meanwhile, are only getting louder.
6th Sep 2015, 03:41 PM #2098
Re: Health Bulletin
Smart pill with benefits for the brain
In 1998, the Food and Drug Administration (FDA) approved the drug modafinil as a treatment for narcolepsy, a condition in which the brain has trouble regulating its sleep-wake cycle and results in sudden "sleep attacks" where a person falls asleep at unwanted or inappropriate times.
In the years since, modafinil has become popular for another, off-label use: to boost a person's cognitive abilities -an effect that hadn't been thoroughly studied by scientists.
Now a team of researchers has reviewed the literature to find that modafinil does, in fact, increase a number of important activities in the brain, according to a study published in the journal European Neuropsychopharmacology.
This finding, however, doesn't ensure that your doctor will prescribe it to you to help you cram for an exam.
Scientists still aren't sure exactly how modafinil works, though past studies have found that the drug increases the levels of the neurotransmitters histamine and orexin, both of which regulate sleep and wake cycles. It also elevates levels of serotonin (which affects mood) and glutamate (which helps to excite brain cells). These chemical changes make modafinil effective at treating narcolepsy, but it also has some unintended effects on other brain functions.
It makes the patient more attentive, a better learner, and more adept at "higher level" tasks that involve executive function and require inputs from several simpler brain functions, according to a press release. This is similar to how some ADHD medications, like Adderall, work, though they increase the activity of other neurotransmitters, norepinephrine and dopamine.
The researchers reviewed 24 studies about modafinil's effects on cognition that were published between 1990 and 2014 and found that modafinil did, indeed, provide a boost in tasks that require, "planning and decision making, flexibility, learning and memory, and creativity," the press release states. It didn't have a significant effect on working memory (how the brain temporarily stores information).
Plus, the drug had very few serious side effects, making it a strong candidate to be a bona fide "smart pill."
The researchers were quick to point out that these findings don't mean that modafinil is now approved as a cognitive enhancement - that decision is up to government regulatory bodies like the FDA.
But their conclusions may encourage modafinil's manufacturer to apply for the drug to be prescribed for this use. They also note that any cognitive enhancement comes with "ethical considerations" that would be important to explore in future studies.
7th Sep 2015, 01:11 PM #2099
Re: Health Bulletin
Govt to curb prescription and sale of antibiotics to combat drug resistance
The government may soon issue restrictions on prescription and sale of commonly used antibiotics in an attempt to avoid development of drug resistance to infectious diseases like tuberculosis, malaria, urinary tract infection and even HIV.
This means doctors and chemists will have to follow certain mandatory protocols and guidelines while prescribing antibiotics. For instance, chemists will have to maintain records of all kinds of antibiotics that they procure and sell along with the doctor's prescription.
The move is part of the new global strategy, adopted by all member countries of the World Health Organization, to fight drug-resistant diseases.
While WHO will assess implementation of the strategy at its ongoing South East Asia Regional Committee meeting in Timor Leste, India is so far ahead of the May 2017 deadline set up at the World Health Assembly meeting of WHO in Geneva in May, officials said. The resolution passed at the Assembly, which is the highest decision making body of the UN agency, asked countries to frame plans by May 2017 and align them with WHO's global strategy.
Standard drug treatment protocol ready
"India is ready with the standard treatment protocol," said Rajesh Bhatia, chief scientific advisor to the regional director, WHO SEARO.
The health ministry, along with central drug regulator Drugs Controller General of India, has already framed standard treatment guidelines, which will be notified very soon, he said.
Doctors alarmed as antibiotics lose sting.
The guidelines, part of a national action plan on anti-microbial resistance, will present a blueprint with specific norms for doctors, chemists and patients.
While all countries are struggling with the problem of rising drug resistance, India is primarily coping with antibiotics resistance which is posing an increasing threat to treating infectious diseases, as well as undermining many other advances in medicine.
Currently, over 700,000 deaths each year are attributed to drug resistance. In India, an additional two million lives can be lost by 2050 due to drug resistance.
READ ALSO: BMC ready with policy on best use of antibiotics
For instance, while India accounts for the highest number of tuberculosis cases, it is also the hub of multi-drug resistant (MDR) tuberculosis. Out of the estimated global annual incidence of 9 million tuberculosis cases, India accounts for 2.3 million.
Antibiotic overuse turns germs drug-resistant.
India tops global chart of TB cases
Apart from the standard protocol, WHO's global plan sets out five key objectives — improve awareness and understanding of anti-microbial resistance, strengthen surveillance and research, reduce incidence of infection, optimize use of anti-microbial medicines, and ensure sustainable investment in countering antimicrobial resistance.
The plan also covers use of anti-microbial medicines in animal health and agriculture, apart from human health.
7th Sep 2015, 01:12 PM #2100
Re: Health Bulletin