#107
Health Technology Research Synopsis 107th Issue Date 26JUN2011 Compiled By Ralph Turchiano http://www.vit.bz
http://www.youtube.com/vhfilm
Editors Top Five:
1. Potential treatment for deadly E. coli disease
2. Many patients with advanced cancers get treatments that won’t help 3. ‘My dishwasher is trying to kill me’
4. Drug side effect linked with increased health risks for over 65s
5. Roche to fight for Avastin as breast cancer drug In This Issue:
1. Smoking, Even for a Short Time, Significantly Increases a Woman’s Risk for Peripheral Artery Disease
2. Early Release: For Localized Prostate Cancer, Insufficient Evidence to Compare Effectiveness of Radiation Treatments to No Treatment
3. Exposure to BPA has been underestimated, new MU research says
4. Supplement found to improve quality of life for female cancer survivors
5. Study finds high levels of vitamin D needed for bone density drugs to work
6. WHAT, ME WORRY? YOUNG ADULTS GET SELF-ESTEEM BOOST FROM DEBT
7. Many patients with advanced cancers get treatments that won’t help
8. Potential treatment for deadly E. coli disease
9. Apple ingredient keeps muscles strong
10. Older age does not cause testosterone levels to decline in healthy men
11. Coffee drinking improves hepatitis C treatment response
12. Overweight more harmful to the liver than alcohol in middle-aged men
13. Moderate to intense exercise may protect the brain
14. Poplar tree leaf bud extract could fight skin aging
15. Sport doctors say non-alcoholic wheat beer boosts athletes’ health
16. B Vitamins in Mother’s Diet Reduce Colorectal Cancer Risk in Offspring
17. Study confirms safety, cancer-targeting ability of nutrient in broccoli
18. Adulterated cocaine causing serious skin reactions
19. ‘My dishwasher is trying to kill me’
20. Mystery ingredient in coffee boosts protection against Alzheimer’s disease
21. Blueberries Help Lab Rats Build Strong Bones
22. UF review of resveratrol studies confirms potential health boost
23. A wise man’s treatment for arthritis – frankincense?
24. Study shows pine bark naturally improves heart function
25. Dietary leucine may fight prediabetes, metabolic syndrome
26. ‘Good’ cholesterol function as important as its levels
27. Understanding the antiepileptic benefits of an Atkins-like diet
28. NEPHROLOGY: Long live dopamine production by the kidneys
29. Drug side effect linked with increased health risks for over 65s
30. Study of phytoremediation benefits of 86 indoor plants published
31. Lithium profoundly prevents brain damage associated with Parkinson’s disease
32. Roche to fight for Avastin as breast cancer drug
Public release date: 6-Jun-2011
Smoking, Even for a Short Time, Significantly Increases a Woman’s Risk for Peripheral Artery Disease
A prospective study of initially healthy women aged 45 and over found that smoking is a potent risk factor for symptomatic peripheral artery disease, or PAD. PAD is a serious, often debilitating disorder, caused by narrowing of the arteries in the lower extremities. Symptoms of PAD include pain in the legs with normal activity and a feeling of tiredness in the leg muscles.
Researchers followed 38,825 women for an average of 12.7 years to determine if smoking increased a woman’s risk for PAD and if smoking cessation reduced that risk. The women were questioned about their smoking history and if they currently smoked cigarettes. If so, they were asked to disclose how many they smoked per day. During the course of the study, patients periodically filled out questionnaires about their health and smoking habits. Surveys were given twice during the first year and then once per year for the remainder of the study and follow-up period. Participants were asked to report any symptoms of PAD.
The researchers found that smoking increased a woman’s risk for PAD 10-fold. Smoking cessation reduced the risk, but even after abstaining from cigarettes for 20 years, the risk did not lower to that of a woman who had never smoked.
“This study showed that—as has been previously shown for heart attacks and for lung cancer—that smoking is actually very harmful for the development PAD,” said Eruna Pradhan, Assistant Professor of Medicine at Harvard Medical School and an author of the study. “This is significant because PAD is a disease that not only causes a lot of pain and discomfort with usual, daily activities but it also increases the risk of heart attack.”
Ralph’s Note: It has been my Hypothesis for years now, that is the low level of radioactive materials in tobacco ( Lead-210 and Polonium-210 ) that are due to commercial growing practices are the cause. Since these accumulate over time, it may explain the very poor recovery from smoking cessation.
Public release date: 6-Jun-2011
Early Release: For Localized Prostate Cancer, Insufficient Evidence to Compare Effectiveness of Radiation Treatments to No Treatment
Radiation therapy is one of many treatment options for patients with prostate cancer. To
update findings about the clinical and biochemical outcomes of radiation therapies for localized prostate cancer, researchers reviewed 75 studies (10 randomized controlled trials and 65 nonrandomized comparative studies). Their review found insufficient evidence on patient survival to draw definitive conclusions about the effectiveness of radiation treatments for localized prostate cancer compared to no treatment or no initial treatment. Similarly, there was insufficient evidence to determine whether certain forms of radiation treatment were more effective than others. The studies analyzed inconsistently defined and reported outcomes.
Public release date: 6-Jun-2011
Exposure to BPA has been underestimated, new MU research says
Results indicate BPA accumulates more rapidly within the body than previously thought
COLUMBIA, Mo. – A new University of Missouri study shows that the exposure to the controversial chemical Bisphenol A (BPA) through diet has been underestimated by previous lab tests. In the study, researchers compared BPA concentrations in mice that were given a steady diet supplemented with BPA throughout the day, compared to the more common lab method of single exposure, and found an increased absorption and accumulation of BPA in the blood of mice.
This is the first study to examine concentrations of BPA in any animal models after exposure through a regular, daily diet, which is a better method to mirror the chronic and continuous exposure to BPA that occurs in animals and humans. Cheryl Rosenfeld, associate professor in biomedical sciences and Bond Life Sciences investigator, is the corresponding lead author of the study published in Environmental Health Perspectives on June 6.
The authors continuously exposed the mice to BPA through their feed, which is considered the primary route of exposure to this chemical in animals and humans. In previous studies examining the effects of BPA, mice were exposed to BPA only through a one-time administration. Following the exposure through the diet, a significantly greater increase in the active form of BPA, which is the greatest threat as it is the form that can bind to sex steroid receptors and exert adverse effects, was absorbed and accumulated in the animals.
“People are primarily and unknowingly exposed to BPA through the diet because of the various plastic and paper containers used to store our food are formulated with BPA,” Rosenfeld said. “We know that the active form of BPA binds to our steroid receptors, meaning it can affect estrogen, thyroid and testosterone function. It might also cause genetic mutations. Thus, this chemical can hinder our ability to reproduce and possibly cause behavioral abnormalities that we are just beginning to understand.”
The study notes that more than 8 billion pounds of BPA are produced every year, and more than 90 percent of people in the United States have measurable amounts of BPA in their bodies.
“We believe that these mouse model studies where the BPA exposure is through the diet is a more accurate representation of what happens to BPA as the human body attempts to processes this toxic substance,” said Rosenfeld. “When BPA is taken through the food, the active form may remain in the body for a longer period of time than when it is provided through a single treatment, which does not reflect the continuous exposure that occurs in animal and human populations. We need to study this further to determine where the ingested BPA becomes concentrated and subsequently released back into the bloodstream to be distributed throughout the body.”
Public release date: 6-Jun-2011
Supplement found to improve quality of life for female cancer survivors
WINSTON-SALEM, N.C. – June 6, 2011 – A natural nutritional supplement, marketed for the last decade as a sexual aid, has been shown to significantly improve overall quality of life for female cancer survivors, according to researchers at Wake Forest Baptist Medical Center.
The findings will be presented today at the 2011 American Society of Clinical Oncology (ASCO) annual meeting in Chicago.
Interested in quality of life issues for female cancer survivors, Kathryn M. Greven, M.D., a radiation oncologist at Wake Forest Baptist, first learned of the supplement, called ArginMax for WomenTM, from a small study conducted at Stanford University that found that it improved sexual function. Sexual dysfunction is prevalent in female cancer survivors, so Greven set out to see if the supplement could produce the same benefit in this population. She found that, while taking the supplement did not result in any improvement in sexual function for female cancer survivors, the supplement did improve their overall quality of life.
With funding from the National Cancer Institute, researchers at the Comprehensive Cancer Center at Wake Forest Baptist, the Derrick L. Davis Forsyth Regional Cancer Center, and multiple other cancer centers across the country recruited 186 female cancer survivors to participate in the study.
To be considered, adult female volunteers had to be at least six months beyond their last active treatment for any kind of cancer, with no current evidence of cancer. Adhering to standard double-blind, placebo- controlled protocol, neither the participants nor the investigators knew who was receiving the supplement and who was receiving a placebo.
The Daily Wellness Company, based in Honolulu, Hawaii, provided materials for the study, including ArginMaxTM and placebo pills. Participants received three capsules of either ArginMaxTM or placebo twice a day for 12 weeks and were asked to complete two standardized questionnaires that accurately measure sexual function and quality of life. The questionnaires were completed at the start of the study, at four weeks, eight weeks and 12 weeks.
The Female Sexual Function Index is a questionnaire that measures different aspects of sexual function, such as desire, arousal, lubrication, orgasm, satisfaction and pain.
The FACT-G questionnaire measures overall quality of life and has been used in research of all cancer types. It evaluates physical, emotional, social and functional well-being.
ArginMaxTM was originally designed as a sexual enhancement aid, so researchers were primarily looking for improvements in sexual function in this new population. They found no benefit in this area.
However, the study findings did reveal an across-the-board boost in measures of overall quality of life for the patients who were randomized to take ArginMaxTM. The FACT-G questionnaires showed improvements in both physical and functional well being among the participants taking the supplement.
“The group taking the supplements experienced significant improvement in overall quality of life, particularly physical well-being,” said Greven, the lead investigator on the study. “Bothersome symptoms such as lack of energy, pain, nausea, and sleeplessness were all improved, as were measures of functional well-being, for example the ability to perform normal activities at home or work. Simply, they reported a greater enjoyment of life, without any additional side effects from the supplement.”
Edward G. Shaw, M.D., M.A., an oncologist as well as counselor, is principal investigator for Wake Forest Baptist’s Community Clinical Oncology Program Research Base and a co-researcher on the study. He explained that cancer survivors can suffer from persistent inflammation, also known as chronic oxidative stress, that can continue for years following treatment of cancer causing fatigue that affects quality of life. He hypothesized that the ingredients in ArginMax for WomenTM may be helping to counteract this process.
ArginMaxTM is made from a patented formula containing a proprietary blend of L-arginine, ginseng, ginkgo, and 14 vitamins and minerals noted for boosting energy and circulation and optimizing hormonal balance. A separate Men’s formula also is available.
“Beyond managing individual symptoms as they appear, the medical community has not been able to offer cancer patients more global symptom relief,” he said. “This research is empowering for the community of cancer survivors. There’s been some thought that dietary supplements could offer a potential benefit, but previous studies on other drugs and supplements have had disappointing outcomes. We’d like to see the results replicated in other studies, as they give us renewed hope in this area.”
Greven said the findings have sparked interest among researchers about whether the supplement could improve quality of life and energy levels for other populations, as well. Future studies are being planned.
“It is very exciting that we’ve found something that has the potential to affect and improve quality of life for female cancer survivors,” Greven said. “We still need to do further work to find an approach that will improve female sexual dysfunction.”
Public release date: 6-Jun-2011
Study finds high levels of vitamin D needed for bone density drugs to work
To fully optimize a drug therapy for osteoporosis and low bone mineral density (BMD), patients should maintain vitamin D levels above the limits recently recommended by the Institute of Medicine (IOM), according to a new study by researchers from Hospital for Special Surgery in New York. The study will be presented at the Endocrine Society’s Annual Meeting in Boston, June 4-7.
The study demonstrated that maintaining a circulating vitamin D level above 33 ng/ml is associated with a seven-fold greater likelihood of having a more favorable outcome with bisphosphonate therapy. Last November, the IOM issued recommendations that 25-Hydroxy vitamin D levels of 20-30 ng/ml were adequate for normal, healthy people.
“You are seven times more likely to respond to bisphosphonates if your 25-Hydroxy vitamin D level is 33 ng/ml and above. If you want to see a particular outcome from this treatment, then maybe 20 to 30 is not appropriate,” said Richard Bockman, M.D., Ph.D., chief of the Endocrine Service at Hospital for Special Surgery, who directed the study. “When you see a seven times greater effect, that is pretty impressive.”
More than 20 million people take bisphosphonates to preserve and improve skeletal health, and reduce the risk of fractures that can be caused by low BMD and osteoporosis. These drugs, however, do not work well in some patients. Because vitamin D is important to bone health, the researchers investigated whether they could identify levels of vitamin D that are associated with improved outcomes in patients taking bisphosphonates.
They conducted a retrospective chart review of patients seen in an osteoporosis practice of Hospital for
Special Surgery. They identified subjects who were female, postmenopausal, had been taking one of four FDA-approved bisphosphonate drugs for at least 18 months, and had undergone at least two BMD scans separated by 18 to 60 months. The four drugs are alendronate, residronate, ibandronate and zolendronate. Patients were not included if they were nonadherent to bisphosphonate therapy, were chronic steroid users, or had metabolic bone disease or chronic kidney disease.
The researchers collected data on age, body mass index, type of bisphosphonate taken, treatment duration, concurrent calcium supplementation, fracture prior to and during bisphosphonate therapy, BMD and T- score at four sites—lumbar spine, femoral neck, trochanter, and total hip—from the two most recent bone scans. “The way the data are expressed for a bone density is how many standard deviations are you away from the normal,” explained Dr. Bockman. “One standard deviation from the normal is a T score of one. Two standard deviations is a T score of two. Below the normal, it is a minus two and above the normal is a plus two. If your bone density is more than 2.5 standard deviations below the normal, that defines a low bone mass that is considered to be osteoporosis.” The researchers also collected data on circulating levels of vitamin D, obtained with and between the two most recent bone scans.
Patients were deemed nonresponders if they had more than a 3 percent decrease in BMD between the initial and follow-up bone scans, a low-trauma fracture or a T-score less than -3.0 despite at least 24 months of bisphosphonate therapy.
The study included 160 patients, of whom 89 were responders, and 71 were nonresponders, with 42 having decreased BMD, 17 sustaining a fracture, and 12 having a persistent low T-score. The investigators found that only 16.8 percent of responders whereas 54.9 percent of nonresponders had vitamin D levels less than 33 ng/ml. Patients with an average circulating vitamin D level of 33 ng/ml and above had a seven-fold greater likelihood of having a favorable response to bisphosphonates. “We selected 33 as the cutoff and subsequently showed that it was the right choice, with more being better,” Dr.
Bockman said. Nonresponse rates were higher in patients who had low levels of vitamin D: < 20 ng/ml (83.3%), 20-30 ng/ml (77.8%), 30-40 ng/ml (42.3%), and >40 ng/ml (24.6%).
“If you look at the medical literature, researchers talk perhaps about a 20 percent increase in response rate, occasionally a doubling, but when you see a sevenfold improvement in outcome, you have to be impressed that it is probably important,” said Dr. Bockman, who is also professor of Medicine in the Endocrine Division of Weill Cornell Medical College.
Before this study, researchers had not formally studied the relationship between vitamin D levels and the effectiveness of bisphosphonates. “There has been a lot of controversy over the correct vitamin D level for people to have,” Dr. Bockman said. “Vitamin D status should be optimized to improve outcomes in patients taking bisphosphonates.”
Dr. Bockman pointed out that three associations—the American Geriatric Society, Endocrine Society, and the American College of Rheumatology—are coming out with or have guidelines that recommend vitamin D levels higher than the IOM recommended levels for healthy people.
Public release date: 6-Jun-2011
WHAT, ME WORRY? YOUNG ADULTS GET SELF-ESTEEM BOOST FROM DEBT
COLUMBUS, Ohio – Instead of feeling stressed by the money they owe, many young adults actually feel empowered by their credit card and education debts, according to a new nationwide study.
Researchers found that the more credit card and college loan debt held by young adults aged 18 to
27, the higher their self-esteem and the more they felt like they were in control of their lives. The effect was strongest among those in the lowest economic class.
Only the oldest of those studied – those aged 28 to 34 – began showing signs of stress about the money they owed.
“Debt can be a good thing for young people – it can help them achieve goals that they couldn’t otherwise, like a college education,” said Rachel Dwyer, lead author of the study and assistant professor of sociology at Ohio State University.
But the results offer some worrying signs about how many young people view debt, she added.
“Debt can be a positive resource for young adults, but it comes with some significant dangers,” Dwyer said.
“Young people seem to view debt mostly in just positive terms rather than as a potential burden.”
Dwyer conducted the study with Randy Hodson, professor of sociology at Ohio State, and Laura McCloud, an Ohio State graduate now at Pacific Lutheran University.
The findings appear in a recent issue of the journal Social Science Research.
The study involved 3,079 young adults who participated in the National Longitudinal Survey of Youth 1979 – Young Adults sample. The NLSY interviews the same nationally representative group of Americans every two years. It is conducted by Ohio State’s Center for Human Resource Research on behalf of the U.S. Bureau of Labor Statistics.
For this study, the researchers examined data on two types of debt: loans taken out to pay for college, and total credit-card debt. They looked at how both forms of debt were related to people’s self-esteem and sense of mastery – their belief that they were in control of their life, and that they had the ability to achieve their goals.
Researchers have had two competing views of how debt might affect people’s self-concept, Dwyer said. Some have said debt should have positive effects because it helps people invest in their future. Others have said credit should have negative effects because it allows people to spend more money than they make, thereby risking their future.
“We thought educational debt might be seen as a positive because it is an investment in their future, while credit card debt could be viewed more negatively,” Dwyer said.
“Surprisingly, though, we found that both kinds of debt had positive effects for young people. It didn’t matter the type of debt, it increased their self-esteem and sense of mastery.”
Some young people may be using credit card debt to help finance their college education – for items like textbooks — which is why they may see it as a positive, she said. But there is no way to know that from the data.
“Obviously, they are probably using credit cards for multiple purposes. Along with education spending, they could be using credit cards to pay for non-essential items. They may feel good about their debt only because it allows them to buy the things they want without having to delay gratification.”
But how debt affected young people depended on what other financial resources they had available, the study found.
Results showed that those in the bottom 25 percent in total family income got the largest boost from holding debt – the more debt they held, both education and credit card, the bigger the positive impact on their self-esteem and mastery.
Those in the middle class didn’t see any impact on their self-esteem and mastery by holding educational debt, perhaps because it is so common among their peers that it is seen as normal. But they did see boosts from holding credit-card debt – the more debt, the more positive effects.
On the other hand, the study found that young adults who came from the most affluent families received no boost at all from holding debt.
“The wealthiest young people have the most resources and options available to them, so debt is not an issue for them,” Dwyer said.
“The groups that most need the debt – the middle and lower classes – get the most benefits to their self- concept, but may also face the greatest difficulties in paying off what they owe.”
The oldest people in the study, those over age 28, were just starting to feel the stress of their debt, according to Dwyer.
For these young adults, having education debt is still associated with higher self-esteem and mastery, compared to those who don’t have any such debt. That suggests they still see some benefits to investing in a college degree.
But the amount of education debt mattered – having higher levels of debt actually reduced their sense of self-esteem and mastery.
“By age 28, they may be realizing that they overestimated how much money they were going to earn in their jobs. When they took out the loans, they may have thought they would pay off their debts easily, and it is turning out that it is not as easy as they had hoped,” she said.
Overall, Dwyer said the results suggest that debt can be an important resource for young adults that allow them to make investments that improve their self-concept. But the results may also have troubling implications for the future of young people.
“Debt may make young people feel better about themselves in the short-term, but that doesn’t mean it won’t have negative consequences in the long term,” she said.
“We found that the positive effects may wear off over time, but they still have to pay the bills. The question is whether they will be able to. There needs to be additional research to answer this question.”
The study was supported by a grant from the National Science Foundation. Ralphs Note – Debt bondage (or bonded labor) – Live it, learn it. Public release date: 6-Jun-2011
Many patients with advanced cancers get treatments that won’t help
A study of more than 1,000 patients with colon cancer that had spread to distant sites found that one in eight was treated with at least one drug regimen that was not recommended. Those patients were
exposed to significant risk without proven benefits, at an estimated cost—just for the drugs— of more than $2 million.
The study, presented June 7, 2011, by University of Chicago researchers at the American Society for Clinical Oncology’s annual meeting in Chicago, focused on three chemotherapy regimens that were not supported by evidence from prior clinical studies or clinical practice guidelines. One treatment was rated “insufficient data to support,” one had been “shown to be ineffective,” and one was supported by “no data, nor is there a compelling rationale.”
“Patients with advanced cancers that do not respond to standard therapies should either be looking for clinical trials, where there is a chance for a benefit, or should have been thinking about shifting toward palliative care,” said study author Jonas De Souza, M.D., a hematology/oncology fellow at the University of Chicago. “Patients should not face the risks, discomforts and costs of aggressive and often quite toxic chemotherapy with treatment regimens that did not provide a benefit in previous studies.”
Under an agreement with UnitedHealthcare, a health benefits business, the researchers used de-identified medical and pharmaceutical claims data in the collaborative project. They examined claims from 7,642 colon cancer cases treated between January 2007 and June 2010, including 1,041 who developed metastatic disease. Of those 1,041 patients, 140 (13%) received treatments that were not supported by the evidence from clinical studies. Many of them received multiple cycles of non-beneficial chemotherapy.
The researchers focused on three chemotherapy regimens with specific recommendations against their use in the National Comprehensive Cancer Network (NCCN) guidelines. The regimen with insufficient data involved bevacizumab (trade name Avastin) used after the patient had progressed on a combination of that drug and chemotherapy. The treatment shown to be “ineffective” was capecitabine (trade name Xeloda) after progression on the same class of drugs. The regimen with no compelling rationale was panitumumab or cetuximab (trade name Erbitux) after progression on similar drugs.
The 140 patients received 869 cycles of chemotherapy. Some received two or more unproven treatments.
•Ninety-one of those patients went through 632 intravenous cycles of bevacizumab, at an estimated cost of
$1.3 million. Potential side effects include hypertension, heightened risk of bleeding and bowel perforation.
•Fifty-nine patients received 218 non-evidence-based cycles of capecitabine, at a cost of more than
$600,000. This drug, taken orally, can cause diarrhea, nausea, vomiting, fatigue, rash and swelling of the hands or feet.
•Six patients underwent 19 cycles of panitumumab, at a cost of almost $70,000. This drug can trigger itching, dermatitis and rash.
“We did not study why these physicians and patients turned to unproven therapies,” said co-author Caleb Alexander, M.D., associate professor of medicine at the University of Chicago. “I suspect that both patients and care providers, when facing life-threatening disease with limited options, are more willing to step outside guidelines.”
“There could also be financial implications,” he added. “A physician who has run out of options may be hesitant to send a patient to a center that has access to greater resources but may be far away.”
The researchers emphasized, however, that as the costs of cancer care continue to rise, the impetus to base treatment decisions on solid evidence can only increase. “It’s important to get the right medicines to the
right patients,” said Alexander.
“DeSouza’s research highlights the importance of evidence-based treatment for cancer patients,” said Lee Newcomer, M.D., UnitedHealthcare’s senior vice president, oncology. “Expert oncology opinions tell us that the extra therapies that these patients received potentially exposed these patients to unnecessary side effects. We should be relieving symptoms and not causing new ones, even as we try to address the underlying disease.”
Public release date: 6-Jun-2011
Potential treatment for deadly E. coli disease
A potential life-saving treatment for severe E. coli food poisoning outbreaks – developed more than a decade ago – hasn’t gone forward into clinical trials because of lack of commercial interest.
University of Adelaide researchers produced a “designer” probiotic bacterium which binds and neutralises the toxin produced by E. coli, which causes life-threatening attack on the kidneys and blood vessels.
The team of scientists – Dr Adrienne Paton, Associate Professor Renato Morona and Professor James Paton – showed that mice infected with a highly virulent strain of E. coli were completely protected by the probiotic bacterium.
The research was published in the prestigious journal Nature Medicine in 2000 and generated ongoing interest from the scientific and medical community – but the commercial sector hasn’t taken up its development for progress into clinical trials in humans.
“Severe E. coli food poisoning outbreaks such as that currently occurring in Europe are becoming increasingly common,” said Professor Paton, Director, Research Centre for Infectious Diseases at the University of Adelaide.
“They have the potential to cause widespread disease and many patients develop life-threatening complications including kidney failure.
“The probiotic bacterium could be produced cheaply on a large scale. However, in spite of on-going attention from the scientific and medical community, there has been a lack of interest from the commercial sector in taking this product forward into clinical trials.
“If this had been done, and the probiotic had been proven to be safe and efficacious in humans, it could have been deployed during the current European outbreak. This would undoubtedly have saved lives, as well as millions of dollars in current and future health care costs.”
The researchers engineered a harmless bacterium to mimic binding receptors for the potentially fatal Shiga toxin on its surface.
Professor Paton said after diagnosis of E. coli infection there was a window of opportunity for therapeutic intervention before kidneys started to fail. Antibiotics are not used because they can increase the amount of toxin released in the gut.
Public release date: 7-Jun-2011
Apple ingredient keeps muscles strong
Ursolic acid — a waxy substance found in apple peel — reduces muscle wasting and promotes muscle growth in mice; it also reduces fat, blood sugar levels, cholesterol and triglycerides in the animals
In search of a way to prevent the muscle wasting that comes with illness and aging, researchers have landed a natural compound that might just do the trick. The findings reported in the June issue of Cell Metabolism, a Cell Press publication, identify a component of apple peels as a promising new drug candidate for the widespread and debilitating condition that affects nearly everyone at one time or another.
“Muscle wasting is a frequent companion of illness and aging,” said Christopher Adams of The University of Iowa, Iowa City. “It prolongs hospitalization, delays recoveries and in some cases prevents people from going back home. It isn’t well understood and there is no medicine for it.”
Motivated by the desire to change that, Adams’ team first looked at what happens to gene activity in muscles under conditions that promote weakening. Those studies turned up 63 genes that change in response to fasting in both people and mice and another 29 that shift their expression in the muscles of both people who are fasting and those with spinal cord injury. Comparison of those gene expression signatures to the signatures of cells treated with more than 1300 bioactive small molecules led them to ursolic acid as a compound with effects that might counteract those of atrophy.
“Ursolic acid is an interesting natural compound,” Adams said. “It’s part of a normal diet as a component of apple peels. They always say that an apple a day keeps the doctor away…”
The researchers next gave ursolic acid to fasted mice. Those experiments showed that ursolic acid could protect against muscle weakening as predicted. When ursolic acid was added to the food of normal mice for a period of weeks, their muscles grew. Those effects were traced back to enhanced insulin signaling in muscle and to corrections in the gene signatures linked to atrophy.
Animals given ursolic acid also became leaner and had lower blood levels of glucose, cholesterol and triglycerides. The findings therefore suggest that ursolic acid may be responsible for some of the overall benefits of healthy eating.
“We know if you eat a balanced diet like mom told us to eat you get this material,” Adams said. “People who eat junk food don’t get this.”
It is not yet clear whether the findings in mice will translate to human patients, Adams says, but his goal now is to “figure out if this can help people.” If so, they don’t yet know whether ursolic acid at levels that might be consumed as part of a normal diet might or might not be enough.
Public release date: 7-Jun-2011
Older age does not cause testosterone levels to decline in healthy men
A decline in testosterone levels as men grow older is likely the result—not the cause—of deteriorating general health, say Australian scientists, whose new study finds that age, in itself, has no
effect on testosterone level in healthy older men.
The results, to be presented Tuesday at The Endocrine Society’s 93rd Annual Meeting in Boston, are the first findings released from the Healthy Man Study, according to principal investigator David Handelsman, MD, PhD, professor and director of the ANZAC Research Institute at the University of Sydney.
“Some researchers believe that an age-related testosterone deficiency contributes to the deteriorating health of older men and causes nonspecific symptoms, such as tiredness and loss of libido,” he said.
Handelsman and his team, however, found that serum (blood) testosterone levels did not decline with increasing age in older men who reported being in excellent health with no symptoms to complain of.
“We had originally expected age to have an effect on serum testosterone, so the findings were a bit of a surprise,” Handelsman said.
Two study centers in Australia recruited 325 men over the age of 40 (median age, 60) who had self- reported excellent health and no symptom complaints. To test blood testosterone levels, the researchers took blood samples from the men nine times over three months. They excluded men from the study who took medications that affect testosterone.
Obesity caused a mild and clinically unimportant lowering of blood testosterone levels, the investigators reported. Age had no effect on testosterone level.
“The modest decline in blood testosterone among older men, usually coupled with nonspecific symptoms, such as easy fatigue and low sexual desire, may be due to symptomatic disorders that accumulate during aging, including obesity and heart disease,” he said. “It does not appear to be a hormone deficiency state.”
The message for patients and their doctors, Handelsman said, is “older men with low testosterone levels do not need testosterone therapy unless they have diseases of their pituitary or testes.”
Public release date: 7-Jun-2011
Coffee drinking improves hepatitis C treatment response
Advanced hepatitis C patients with chronic liver disease may benefit from drinking coffee during treatment, according to a new study in Gastroenterology, the official journal of the American Gastroenterological Association (AGA) Institute. Patients who received peginterferon plus ribavirin treatment and who drank three or more cups of coffee per day were two times more likely to respond to treatment than non-drinkers.
“Coffee intake has been associated with a lower level of liver enzymes, reduced progression of chronic liver disease and reduced incidence of liver cancer,” said Neal Freedman, PhD, MPH, of the National Cancer Institute and lead author of this study. “Although we observed an independent association between coffee intake and virologic response to treatment, this association needs replication in other studies.”
Among non-drinkers, 46 percent had an early virologic response; 26 percent had no detectable serum hepatitis C virus (HCV) ribonucleic acid at week 20; 22 percent had no detectable serum at week 48; and 11 percent had a sustained virologic response. In contrast, the corresponding proportions for those who drank three or more cups of coffee per day were 73 percent, 52 percent, 49 percent and 26 percent, respectively.
Approximately 70 to 80 percent of individuals exposed to HCV become chronically infected. Worldwide,
these individuals are estimated to number between 130 and 170 million. Higher coffee consumption has been associated with slower progression of pre-existing liver disease and lower risk of liver cancer.
However, the relationship with response to anti-HCV treatment had not been previously evaluated. Treatment with peginterferon and ribavirin resolves chronic hepatitis C in about half of patients. It is unknown whether coffee will improve response with the addition of new drugs that were recently approved for use in the U.S.
Because patients in the Hepatitis C Antiviral Long-term Treatment against Cirrhosis Trial also had previously failed interferon therapy, it is not clear whether the results can be generalized to other patient populations. Future studies among patients with less advanced disease, those who are treatment-naïve to prior therapy, or who are being treated with newer antiviral agents are needed.
Public release date: 7-Jun-2011
Overweight more harmful to the liver than alcohol in middle-aged men
Overweight carries a greatly increased risk of cirrhosis of the liver in men, reveals a new study from the Sahlgrenska Academy. “Given the increasing problem of overweight in Sweden, there is reason to fear that more people will develop cirrhosis of the liver,” says Jerzy Kaczynski, docent at the Sahlgrenska Academy and doctor at Sahlgrenska University Hospital.
A group of researchers at the Sahlgrenska Academy has studied the link between overweight and the risk of developing cirrhosis of the liver in middle-aged men. Published in the Scandinavian Journal of Gastroenterology, the study took 855 men aged 50 and followed them for up to 40 years.
None of the men had liver problems at the beginning of the study but during the long follow-up period almost 2% were diagnosed with cirrhosis of the liver. All of the men with this diagnosis were overweight at the beginning of the study, with an average BMI of 28 (a BMI of above 25 is classified as overweight). The average BMI for the men who were not diagnosed with cirrhosis of the liver during the study was below 25. Statistical analysis has demonstrated that both BMI and raised levels of triglycerides – a type of blood fat – constituted risk factors for the development of cirrhosis of the liver. However, the same link could not be statistically proven for alcohol. One explanation for this could be that some men with alcohol problems may have declined to take part in the study.
The results of the study show that both overweight and raised levels of blood fats, which are common in overweight people, significantly increase the risk of men developing cirrhosis of the liver. Given the increasingly discussed and growing problem of overweight in Sweden, there are good grounds for concern that more people will be diagnosed with cirrhosis of the liver.
“A liver that has been ill and weakened as a result of overweight can take less of a load,” says Kaczynski. “We can therefore speculate that cirrhosis of the liver will develop more quickly in people who drink too much alcohol if they are overweight. Our study does not offer any evidence for this, but this kind of speculation is well founded.”
Public release date: 8-Jun-2011
Moderate to intense exercise may protect the brain
ST. PAUL, Minn. – Older people who regularly exercise at a moderate to intense level may be less likely to develop the small brain lesions, sometimes referred to as “silent strokes,” that are the first sign of cerebrovascular disease, according to a new study published in the June 8, 2011, online issue of Neurology®, the medical journal of the American Academy of Neurology (AAN).
“These ‘silent strokes’ are more significant than the name implies, because they have been associated with an increased risk of falls and impaired mobility, memory problems and even dementia, as well as stroke,” said study author Joshua Z. Willey, MD, MS, of Columbia University in New York and a member of the American Academy of Neurology. “Encouraging older people to take part in moderate to intense exercise may be an important strategy for keeping their brains healthy.”
The study involved 1,238 people who had never had a stroke. Participants completed a questionnaire about how often and how intensely they exercised at the beginning of the study and then had MRI scans of their brains an average of six years later, when they were an average of 70 years old.
A total of 43 percent of the participants reported that they had no regular exercise; 36 percent engaged in regular light exercise, such as golf, walking, bowling or dancing; and 21 percent engaged in regular moderate to intense exercise, such as hiking, tennis, swimming, biking, jogging or racquetball.
The brain scans showed that 197 of the participants, or 16 percent, had small brain lesions, or infarcts, called silent strokes. People who engaged in moderate to intense exercise were 40 percent less likely to have the silent strokes than people who did no regular exercise. The results remained the same after the researchers took into account other vascular risk factors such as high blood pressure, high cholesterol and smoking. There was no difference between those who engaged in light exercise and those who did not exercise.
“Of course, light exercise has many other beneficial effects, and these results should not discourage people from doing light exercise,” Willey said.
The study also showed that the benefit of moderate to intense exercise on brain health was not apparent for people with Medicaid or no health insurance. People who exercised regularly at a moderate to intense level who had Medicaid or no health insurance were no less likely to have silent infarcts than people who did no regular exercise. “It may be that the overall life difficulties for people with no insurance or on Medicaid lessens the protective effect of regular exercise,” Willey said.
Public release date: 8-Jun-2011
Poplar tree leaf bud extract could fight skin aging
Antioxidants are popular anti-aging ingredients in skin creams, and now scientists are reporting a new source of these healthful substances — leaf buds of poplar trees. Their study appears in the ACS’ Journal of Agricultural and Food Chemistry.
Xavier Vitrac and colleagues note that there’s a long history of using poplar buds to treat various health problems, such as colds, sinusitis, sunburn and arthritis. A substance found in beehives that is made from poplar buds (called propolis) also appears to have similar disease-fighting benefits. Propolis’ effects seem to be due to poplar bud compounds, but very little is known about these substances. To see whether poplar buds are a good source of antioxidants for skin creams, the researchers decided to test an extract from the buds.
The group found that poplar bud extract had moderate antioxidant activity, and it demonstrated anti-aging effects on cells in the laboratory. “The collective antioxidant properties and transcriptional effect of this extract suggest potential anti-aging properties which could be utilized in cosmetic and nutraceutical formulations,” the scientists say.
Public release date: 9-Jun-2011
Sport doctors say non-alcoholic wheat beer boosts athletes’ health
‘Be-MaGIC,’ largest study of marathons world-wide, reveals positive effects on the immune system and against infection
Many amateur athletes have long suspected what research scientists for the Department of Preventative and Rehabilitative Sports Medicine of the Technische Universitaet Muenchen at Klinikum rechts der Isar have now made official: Documented proof, gathered during the world’s largest study of marathons, “Be- MaGIC” (beer, marathons, genetics, inflammation and the cardiovascular system), that the consumption of non-alcoholic weissbier, or wheat beer, has a positive effect on athletes’ health. Under the direction of Dr. Johannes Scherr, physicians examined 277 test subjects three weeks before and two weeks after the 2009 Munich Marathon.
The study focuses on the health risks for marathon runners and the potential positive effects of polyphenols. These aromatic compounds occur naturally in plants as pigment, flavor, or tannins, many of which have been credited with health-promoting and cancer-preventative properties. Unique to this study was the combination of different polyphenols that were tested on the large pool of participants. The research team met the scientific requirements of the study by conducting a randomized, double-blind, placebo-controlled trial.
Non-alcoholic Erdinger wheat beer was selected as the test beverage, chosen for its rich and varied polyphenol content and its popularity with marathoners and tri-athletes. The “active” group drank up to
1.5 liters of the test beverage per day, while a second group consumed an equal amount of an otherwise indistinguishable placebo beverage that contained no polyphenols and was especially produced for the study.
One result from the study was the discovery that, after running a marathon race, athletes experience intensified inflammatory reactions. The immune system is thrown off balance and runners are much more likely to suffer from upper respiratory infections. This heightened susceptibility to illness following strenuous sport activity has been identified as an “open window.” Furthermore it was shown that non- alcoholic wheat beer containing polyphenols has a positive, health promoting effect on the human body: inflammation parameters in the blood were significantly reduced, and there was a lower frequency of infection with milder symptoms.
Reduced Inflammatory Reaction: Dr. Scherr, who also serves as physician to the German National Ski Team, explains: The analysis of the leukocytes, or white blood cells, which constitute one of the most important parameters for inflammation, revealed values in the active group that were 20% lower than in the placebo group.”
Support for the Immune System: Compounds in the test drink had a compensatory or balancing effect on the immune system. Dr Scherr: “We were able to prove that it strengthens an immune system that has been weakened by physical stress. It also prevents the system from over-performing.”
Prevents Colds: Runners who drank the non-alcoholic wheat beer were up to three times less susceptible to infection than those in the placebo group. Dr. Scherr: “Drinking the non-alcoholic test beverage reduces your risk of developing a cold by one third.”
Improvement with Upper Respiratory Infections: People in the active group who did succumb to a cold experienced a milder or briefer infection than those in the placebo group. Dr. Scherr: “Results showed a Number Needed to Treat (NNT) of eight. That means that for every eight people who had the test drink, one of them was prevented from succumbing to a cold.”
In summary, Dr. Scherr explains: “The potential for foods containing polyphenols to have a positive effect on athletes’ health has already been suggested in several articles. Nevertheless we were ourselves sometimes surprised at how clearly evident this was in the results. We now have scientific confirmation of those assumptions for this test beverage, with its particular combination of polyphenols, vitamins and minerals.”
Dr. Scherr presented this study to the approximately 5,000 scientists, physicians, and trainers attending the world’s largest congress for sports medicine in Denver (USA) hosted by the American College of Sports (ACSM) at the beginning of June 2011. The study will be published in the January printed edition of the professional journal Medicine & Science in Sports & Exercise (MSSE).
Peter Liebert, Managing Director for Technology, Purchasing, Human Resources and Logistics for Erdinger Weissbräu, is pleased about the study results: “In brief, the Be-MaGIC study confirms the benefits for sport athletes and proves new health-promoting effects. Thus, Erdinger alcohol-free is proven to be more than just an isotonic thirst-quencher.”
Public release date: 9-Jun-2011
B Vitamins in Mother’s Diet Reduce Colorectal Cancer Risk in Offspring
BOSTON − Mice born to mothers who are fed a diet supplemented with B vitamins are less likely to develop intestinal tumors, report scientists at the Jean Mayer USDA Human Nutrition Research Center on Aging (USDA HNRCA) at Tufts University.
Previous research in humans and mice suggests that B vitamins, particularly folate, play a role in the prevention of colorectal cancer. Using a mouse model of naturally occurring colorectal cancer, the USDA HNRCA scientists examined whether a mothers’ B vitamin intake impacts her offspring’s cancer risk.
Mothers were fed diets containing supplemental, adequate or mildly deficient quantities of vitamins B2, B6, B12 and folate prior to conception through weaning after which all of the offspring received the same adequate diet.
“We saw, by far, the fewest intestinal tumors in the offspring of mothers consuming the supplemented diet,” says Jimmy Crott, PhD, senior author and a scientist in the Vitamins and Carcinogenesis Laboratory at the USDA HNRCA. “Although the tumor incidence was similar between offspring of deficient and adequate mothers, 54% of tumors in the deficient offspring were advanced and had invaded surrounding tissue while only 18% of tumors in the offspring of adequate mothers displayed these aggressive properties.”
The results were published online June 9 in the journal Gut.
Crott and colleagues associated the tumor suppression seen in the offspring of supplemented mothers with a protection against disruptions to the Wnt signaling pathway, a network of genes commonly altered in colorectal cancer.
“The strongest expression of tumor-suppressing genes in the Wnt pathway was in the offspring of supplemented mothers and the weakest was in the offspring of the mildly deficient mothers,” says first author Eric Ciappio, a PhD candidate at the Friedman School of Nutrition Science and Policy at Tufts.
“We attribute these differences in gene expression to epigenetics, modifications of DNA which are sensitive to environmental factors such as diet,” Ciappio continues. “In this case, changing maternal B
vitamin intake had lasting epigenetic effects in offspring and may explain the differences in tumor incidence and aggressiveness we observed”.
It remains unclear whether maternal consumption of the four B vitamins could impact tumor development in humans. ““While evidence is beginning to accumulate to suggest that maternal consumption of supplements containing folate may afford some protection against childhood cancers in offspring, we don’t yet have the ability to determine whether the same holds true for cancers that normally present in the mid to late decades of life,” explains Crott, who is also an assistant professor at the Friedman School.
Crott adds, “Aside from the known protective effect of maternal folate against neural tube defects such as spina bifida, our results suggest that mothers consuming supplemental quantities of these B vitamins may also be protecting her children against colorectal cancer.”
This study was funded by a cooperative agreement with the Agricultural Research Service (ARS) of the United States Department of Agriculture (USDA).
Public release date: 9-Jun-2011
Study confirms safety, cancer-targeting ability of nutrient in broccoli
CORVALLIS, Ore. – Sulforaphane, one of the primary phytochemicals in broccoli and other cruciferous vegetables that helps them prevent cancer, has been shown for the first time to selectively target and kill cancer cells while leaving normal prostate cells healthy and unaffected.
The findings, made by scientists in the Linus Pauling Institute at Oregon State University, are another important step forward for the potential use of sulforaphone in cancer prevention and treatment. Clinical prevention trials are already under way for its use in these areas, particularly prostate and breast cancer.
It appears that sulforaphane, which is found at fairly high levels in broccoli, cauliflower and other cruciferous vegetables, is an inhibitor of histone deacetylase, or HDAC enzymes. HDAC inhibition is one of the more promising fields of cancer treatment and is being targeted from both a pharmaceutical and dietary approach, scientists say.
“It’s important to demonstrate that sulforaphane is safe if we propose to use it in cancer prevention or therapies,” said Emily Ho, a principal investigator in the Linus Pauling Institute, lead author on the study and associate professor in the OSU Department of Nutrition and Exercise Sciences.
“Just because a phytochemical or nutrient is found in food doesn’t always mean its safe, and a lot can also depend on the form or levels consumed,” Ho said. “But this does appear to be a phytochemical that can selectively kill cancer cells, and that’s always what you look for in cancer therapies.”
The findings were published in Molecular Nutrition and Food Research, a professional journal. Research was supported by the National Cancer Institute, National Institute of Environmental Health Sciences and the OSU Agricultural Experiment Station.
The Linus Pauling Institute has conducted some of the leading studies on sulforaphane’s role as an HDAC inhibitor – one, but not all, of the mechanisms by which it may help prevent cancer. HDACs are a family of enzymes that, among other things, affect access to DNA and play a role in whether certain genes are expressed or not, such as tumor suppressor genes.
Some of the mechanisms that help prevent inappropriate cell growth – the hallmark of cancer – are circumvented in cancer cells. HDAC inhibitors can help “turn on” these silenced genes and restore normal
cellular function.
Previous OSU studies done with mouse models showed that prostate tumor growth was slowed by a diet containing sulforaphane.
“It is well documented that sulforaphane can target cancer cells through multiple chemopreventive mechanisms,” the researchers wrote in their study. “Here we show for the first time that sulforaphane selectively targets benign hyperplasia cells and cancerous prostate cells while leaving the normal prostate cells unaffected.”
“These findings regarding the relative safety of sulforaphane to normal tissues have significant clinical relevance as the use of sulforaphane moves towards use in human clinical trials,” they said.
The results also suggest that consumption of sulforaphane-rich foods should be non-toxic, safe, simple and affordable.
Public Release: 20-Jun-2011
Adulterated cocaine causing serious skin reactions
With up to 70 percent contaminated, doctors warn of potential public health epidemic
LOS ANGELES—(June 20, 2011)—Doctors warned of a potential public health epidemic in a recent report on patients in Los Angeles and New York who developed serious skin reactions after smoking or snorting cocaine believed to be contaminated with a veterinary medication drug dealers are using to dilute, or “cut,” up to 70% of the cocaine in the U.S.
The report, published online in the Journal of the American Academy of Dermatology, said six patients developed purple-colored patches of necrotic skin on their ears, nose, cheeks and other parts of their body and, in some instances, suffered permanent scarring after they had used cocaine.
Doctors in San Francisco had previously reported two similar cases there. Others have also reported on users of contaminated cocaine who developed a related life-threatening immune-system disorder called agranulocytosis, which kills 7% to 10% of patients.
The U.S. Department of Justice has reported that up to 70% of cocaine in the U.S. is contaminated with the drug, levamisole, which is cheap, widely available and commonly used for deworming livestock.
Levamisole had been prescribed for humans in the past but was discontinued after developing side effects similar to those found in the cocaine users.
“We believe these cases of skin reactions and illnesses linked to contaminated cocaine are just the tip of the iceberg in a looming public health problem posed by levamisole,” said Noah Craft, MD, PhD, a Los Biomedical Research Institute at Harbor-UCLA Medical Center (LA BioMed) principal researcher and author of the report in the Journal. “We published this report to educate the public to the additional risks associated with cocaine use and to increase awareness among physicians who may see patients with these skin reactions that are a clue to the underlying cause of the disease. Because this reaction can commonly be mistaken as an autoimmune disease called vasculitis, it is important for physicians to know about this new disease entity.”
Dr. Craft said he and other physicians were initially baffled by the severity of the skin damage. He is a member of a team of doctors who advise Logical Images, a company that developed a software program, called VisualDx, for diagnosing skin diseases and other conditions.
During one of their conference calls in May 2010, Dr. Craft said they began discussing the skin damage seen in emergency rooms in New York and Los Angeles and realized they were all seeing similar patterns and that the one common thread was the use of cocaine prior to the development of the skin damage. The cases were pooled and added into the professional database immediately so that other physicians across the US were then able to see this new diagnosis.
“We have had several more cases since we wrote this report,” he said. “In one of the more interesting ones, the patient used cocaine again and developed the same skin reaction again. He then switched drug dealers and the problem cleared up.”
Public release date: 20-Jun-2011
‘My dishwasher is trying to kill me’
New research finds harmful fungal pathogens living in dishwasher seals
Oxford, June 20, 2011 – A potentially pathogenic fungus has found a home living in extreme conditions in some of the most common household appliances, researchers have found. A new paper published in the British Mycological Society journal, Fungal Biology, published by Elsevier, shows that these sites make perfect habitats for extremotolerant fungi (which includes black yeasts). Some of these are potentially dangerous to human health.
Modern living comes with an increasing need for electrical household equipment such as dishwashers, washing machines and coffee machines. A characteristic of these appliances is a moist and hot environment. In the case of dishwashers, high temperatures between 60º to 80ºC are intermittently produced and aggressive detergents and high concentrations of salt are used in each washing cycle.
The article focuses on the occurrence of potentially pathogenic fungal flora located in dishwashers, over a sample of private homes from 101 cities on 6 continents. 62% of the dishwashers contained fungi on the rubber band in door, 56% of which accommodated the polyextremotolerant black yeasts Exophiala dermatitidis and E. phaeomuriformis. Both Exophiala species showed remarkable tolerance to heat, high salt concentrations, aggressive detergents, and to both acid and alkaline water. This is a combination of extreme properties not previously observed in fungi.
Exophiala dermatitidis is rarely isolated from nature, but is frequently encountered as an agent of human disease, both in compromised and healthy people. It is also known to be involved in pulmonary colonization of patients with cystic fibrosis, and also occasionally causes fatal infections in healthy humans. The invasion of black yeasts into our homes represents a potential health risk.
The discovery of this widespread presence of extremophilic fungi in some of our common household appliances suggests that these organisms have embarked on an extraordinary evolutionary process that could pose a significant risk to human health in the future
Public release date: 21-Jun-2011
Mystery ingredient in coffee boosts protection against Alzheimer’s disease
Tampa, FL (June 21, 2011) – A yet unidentified component of coffee interacts with the beverage’s
caffeine, which could be a surprising reason why daily coffee intake protects against Alzheimer’s disease. A new Alzheimer’s mouse study by researchers at the University of South Florida found that this interaction boosts blood levels of a critical growth factor that seems to fight off the Alzheimer’s disease process.
The findings appear in the early online version of an article to be published June 28 in the Journal of Alzheimer’s Disease. Using mice bred to develop symptoms mimicking Alzheimer’s disease, the USF team presents the first evidence that caffeinated coffee offers protection against the memory-robbing disease that is not possible with other caffeine-containing drinks or decaffeinated coffee.
Previous observational studies in humans reported that daily coffee/caffeine intake during mid-life and in older age decreases the risk of Alzheimer’s disease. The USF researchers’ earlier studies in Alzheimer’s mice indicated that caffeine was likely the ingredient in coffee that provides this protection because it decreases brain production of the abnormal protein beta-amyloid, which is thought to cause the disease.
The new study does not diminish the importance of caffeine to protect against Alzheimer’s. Rather it shows that caffeinated coffee induces an increase in blood levels of a growth factor called GCSF (granulocyte colony stimulating factor). GCSF is a substance greatly decreased in patients with Alzheimer’s disease and demonstrated to improve memory in Alzheimer’s mice. A just-completed clinical trial at the USF Health Byrd Alzheimer’s Institute is investigating GCSF treatment to prevent full- blown Alzheimer’s in patients with mild cognitive impairment, a condition preceding the disease. The results of that trial are currently being evaluated and should be known soon.
“Caffeinated coffee provides a natural increase in blood GCSF levels,” said USF neuroscientist Dr. Chuanhai Cao, lead author of the study. “The exact way that this occurs is not understood. There is a synergistic interaction between caffeine and some mystery component of coffee that provides this beneficial increase in blood GCSF levels.”
The researchers would like to identify this yet unknown component so that coffee and other beverages could be enriched with it to provide long-term protection against Alzheimer’s.
In their study, the researchers compared the effects of caffeinated and decaffeinated coffee to those of caffeine alone. In both Alzheimer’s mice and normal mice, treatment with caffeinated coffee greatly increased blood levels of GCSF; neither caffeine alone or decaffeinated coffee provided this effect. The researchers caution that, since they used only “drip” coffee in their studies, they do not know whether “instant” caffeinated coffee would provide the same GCSF response.
The boost in GCSF levels is important, because the researchers also reported that long-term treatment with coffee (but not decaffeinated coffee) enhances memory in Alzheimer’s mice. Higher blood GCSF levels due to coffee intake were associated with better memory. The researchers identified three ways that GCSF seems to improve memory performance in the Alzheimer’s mice. First, GCSF recruits stem cells from bone marrow to enter the brain and remove the harmful beta-amyloid protein that initiates the disease. GCSF also creates new connections between brain cells and increases the birth of new neurons in the brain.
“All three mechanisms could complement caffeine’s ability to suppress beta amyloid production in the brain” Dr. Cao said, “Together these actions appear to give coffee an amazing potential to protect against Alzheimer’s — but only if you drink moderate amounts of caffeinated coffee.”
Although the present study was performed in Alzheimer’s mice, the researchers indicated that they’ve gathered clinical evidence of caffeine/coffee’s ability to protect humans against Alzheimer’s and will soon publish those findings.
Coffee is safe for most Americans to consume in the moderate amounts (4 to 5 cups a day) that appear necessary to protect against Alzheimer’s disease. The USF researchers previously reported this level of coffee/caffeine intake was needed to counteract the brain pathology and memory impairment in Alzheimer’s mice. The average American drinks 1½ to 2 cups of coffee a day, considerably less than the amount the researchers believe protects against Alzheimer’s.
“No synthetic drugs have yet been developed to treat the underlying Alzheimer’s disease process” said Dr. Gary Arendash, the study’s other lead author. “We see no reason why an inherently natural product such as coffee cannot be more beneficial and safer than medications, especially to protect against a disease that takes decades to become apparent after it starts in the brain.”
The researchers believe that moderate daily coffee intake starting at least by middle age (30s – 50s) is optimal for providing protection against Alzheimer’s disease, although starting even in older age appears protective from their studies. “We are not saying that daily moderate coffee consumption will completely protect people from getting Alzheimer’s disease,” Dr. Cao said. “However, we do believe that moderate coffee consumption can appreciably reduce your risk of this dreaded disease or delay its onset.”
The researchers conclude that coffee is the best source of caffeine to counteract the cognitive decline of Alzheimer’s because its yet unidentified component synergizes with caffeine to increase blood GCSF levels. Other sources of caffeine, such as carbonated drinks, energy drinks, and tea, would not provide the same level of protection against Alzheimer’s as coffee, they said.
Coffee also contains many ingredients other than caffeine that potentially offer cognitive benefits against Alzheimer’s disease. “The average American gets most of their daily antioxidants intake through coffee,” Dr. Cao said. “Coffee is high in anti-inflammatory compounds that also may provide protective benefits against Alzheimer’s disease.”
An increasing body of scientific literature indicates that moderate consumption of coffee decreases the risk of several diseases of aging, including Parkinson’s disease, Type II diabetes and stroke. Just within the last few months, new studies have reported that drinking coffee in moderation may also significantly reduce the risk of breast and prostate cancers.
“Now is the time to aggressively pursue the protective benefits of coffee against Alzheimer’s disease,” Dr. Arendash said. “Hopefully, the coffee industry will soon become an active partner with Alzheimer’s researchers to find the protective ingredient in coffee and concentrate it in dietary sources.”
New Alzheimer’s diagnostic guidelines, now encompassing the full continuum of the disease from no overt symptoms to mild impairment to clear cognitive decline, could double the number of Americans with some form of the disease to more than 10 million. With the baby-boomer generation entering older age, these numbers will climb even more unless an effective preventive measure is identified.
“Because Alzheimer’s starts in the brain several decades before it is diagnosed, any protective therapy would obviously need to be taken for decades,” Dr. Cao said. “We believe moderate daily consumption of caffeinated coffee is the best current option for long-term protection against Alzheimer’s memory loss.
Coffee is inexpensive, readily available, easily gets into the brain, appears to directly attack the disease process, and has few side-effects for most of us.”
According to the researchers, no other Alzheimer’s therapy being developed comes close to meeting all these criteria.
“Aside from coffee, two other lifestyle choices — physical and cognitive activity — appear to reduce the risk of dementia. Combining regular physical and mental exercise with moderate coffee consumption would seem to be an excellent multi-faceted approach to reducing risk or delaying Alzheimer’s,” Dr.
Arendash said. “With pharmaceutical companies spending millions of dollars trying to develop drugs against Alzheimer’s disease, there may very well be an effective preventive right under our noses every morning – caffeinated coffee.”
Public Release: 21-Jun-2011
Blueberries Help Lab Rats Build Strong Bones
By Marcia Wood
Compounds in blueberries might turn out to have a powerful effect on formation of strong, healthy bones, if results from studies with laboratory rats turn out to hold true for humans.
Jin-Ran Chen and his colleagues are exploring this idea in research funded by the U.S. Department of Agriculture (USDA) at the Arkansas Children’s Nutrition Center (ACNC) in Little Rock. Chen is a principal investigator and lead scientist at the center’s Skeletal Development Laboratory, and an assistant professor in the department of pediatrics at the University of Arkansas for Medical Sciences, also in Little Rock.
Chen specializes in research on how what we eat during infancy, childhood and early adulthood affects growth and development of bones and the risk of developing osteoporosis or other degenerative bone diseases in later years.
Chen’s studies with young, rapidly growing laboratory rats suggest that polyphenols, the compounds that give blueberries their blue, purple, and red coloration, might aid in building strong bones. The work has paved the way for new research that might reveal whether blueberries could be used in the future in treatments to boost development of bone mass and to help prevent osteoporosis.
Published in the Journal of Bone and Mineral Research in 2010, the investigation showed that animals fed rations that contained 10 percent freeze-dried blueberry powder had significantly more bone mass than their counterparts whose rations were blueberry-free.
When the researchers exposed laboratory cultures of bone-forming cells (osteoblasts) to blood (serum) from the animals, the scientists found that serum from the blueberry-fed rats was associated with an increase in development of osteoblasts into mature, functional bone cells.
Serum in the blueberry-fed rats was high in phenolic acids, derived from the color-impacting polyphenols. The research suggests that the phenolic acids may have had bone-building effects in the rats. Studies are needed to determine whether these benefits occur in humans, Chen noted.
Chen’s research also suggests that the phenolic acids stimulated bone building via a pathway that may involve, for example, two genes, TCF and LEF, and a protein, beta-catenin. Beta-catenin is responsible for prompting osteoblasts to become mature and functional, while TCF and LEF are responsible for promoting synthesis of beta-catenin.
The ACNC is a partnership between the University of Arkansas for Medical Sciences, Arkansas Children’s Hospital in Little Rock, and the Agricultural Research Service, which is USDA’s principal intramural scientific research agency. The research may help improve children’s health and nutrition, a USDA top priority.
Public Release: 21-Jun-2011
UF review of resveratrol studies confirms potential health boost
GAINESVILLE, Fla. — A University of Florida review of research finds the polyphenol compound known as resveratrol found in red wine, grapes and other fruits may not prevent old age, but it might make it more tolerable.
News stories have long touted resveratrol as a cure for various diseases and a preventative against aging.
”We’re all looking for an anti-aging cure in a pill, but it doesn’t exist. But what does exist shows promise of lessening many of the scourges and infirmities of old age,” said UF exercise psychologist Heather Hausenblas, one of the researchers involved in the study.
A comprehensive review of human clinical research on resveratrol has found it has “anti-aging, anti- carcinogenic, anti-inflammatory and antioxidant properties,” but more research of its benefits is needed, she said.
The study, which appeared online this week in Molecular Nutrition and Food Research, examined results gleaned from thousands of laboratory studies with enzymes, cultured cells and laboratory animals. It was conducted by Hausenblas and fellow researchers James Smoliga of Marywood University and Joseph Baur of the University of Pennsylvania School of Medicine. Their review aimed to examine the current state of knowledge of the effects of resveratrol on humans and to use this information to guide much needed future human clinical trials.
Despite numerous clinical studies on resveratrol’s tonic effects on animals, there is little evidence that it benefits human health. That’s because “there haven’t been many studies on humans,” Hausenblas said.
However, she points out, for years many scientists have thought that a link between resveratrol and human health exists. The French people, for example, enjoy low levels of cardiovascular disease, even though their diets are rich in saturated fats and oils. Some researchers think the reason for this paradox lies in France’s national drink — red wine, which is the most important dietary source of resveratrol. The UF review, said Hausenblas, shows that the resveratrol has considerable potential to improve health and prevent chronic disease in humans. However, further research examining the long-term health effects of resveratrol is much needed.
Exactly how resveratrol works isn’t yet fully understood. Correlating factors such as metabolism, the chemical interplay of molecules, genetics, exercise, age, dosage, and many others all play a role.
Among resveratrol’s most intriguing aspects is how it functions as an antioxidant. Oxidation is a natural chemical process in living tissues that results in a transfer of electrons. When this happens, groups of atoms are formed called “free radicals” that can cause cell damage which in turn provides a pathway for diseases. Antioxidants, however, suppress free radicals. “It’s not so easy to say resveratrol is the main factor,” Hausenblas said. “It’s one piece of the overall puzzle that reduces the free radicals.”
The UF study also reveals that resveratrol’s contribution to good health promises to be widespread. Various clinical trials, for example, indicate that this polyphenol — an antibiotic substance produced by plants as a defense against microorganisms — prevents the growth of some cancers in mice, inhibits enzymes that cause inflammation, shrinks tumors and increases blood flow, thus reducing cardiovascular diseases. In many cases, it also extends the life of obese animals. Some evidence also shows that resveratrol could one day be used to help regulate insulin sensitivity in diabetic patients.
Hausenblas and her colleagues think research that explores resveratrol’s potential to alleviate human infirmities will become increasingly more important as the nation’s 76 million baby boomers undergo the
aging process. One trial under way at UF’s College of Medicine in the Institute on Aging examines the effect resveratrol may have on the physical and cognitive skills on older people.
Public Release: 21-Jun-2011
A wise man’s treatment for arthritis – frankincense?
The answer to treating painful arthritis could lie in an age old herbal remedy – frankincense, according to Cardiff University scientists.
Cardiff scientists have been examining the potential benefits of frankincense to help relieve and alleviate the symptoms of the condition.
“The search for new ways of relieving the symptoms of inflammatory arthritis and osteoarthritis is a long and difficult one,” according to Dr Emma Blain, who leads the research with her co-investigators Professor Vic Duance from Cardiff University’s School of Biosciences and Dr Ahmed Ali of the Compton Group.
“The South West of England and Wales has a long standing connection with the Somali community who have used extracts of frankincense as a traditional herbal remedy for arthritic conditions.
“What our research has focused on is whether and how these extracts can help relieve the inflammation that causes the pain,” she added.
The Cardiff scientists believe they have been able to demonstrate that treatment with an extract of Boswellia frereana – a rare frankincense species – inhibits the production of key inflammatory molecules which helps prevent the breakdown of the cartilage tissue which causes the condition.
Dr Ali adds: “The search for new drugs to alleviate the symptoms of conditions like inflammatory arthritis and osteoarthritis is a priority area for scientists. What our research has managed to achieve is to use innovative chemical extraction techniques to determine the active ingredient in frankincense.
“Having done this we are now able to further characterise the chemical entity and compare its success against other anti-inflammatory drugs used for treating the condition.”
The research comes as a result of a seedcorn project, funded by the Severnside Alliance for Translational Research (SARTRE), through the MRC Developmental Pathway Funding Scheme devolved portfolio.
SARTRE is a joint project between Cardiff University and the University of Bristol to combine and accelerate translational research.
Public release date: 22-Jun-2011
Study shows pine bark naturally improves heart function
Research reveals Pycnogenol and CoQ10 taken as an adjunct to medication improves heart health: Blood volume output, physical fitness, blood pressure, as well as heart and respiratory rate
(June 22, 2011) – HOBOKEN, NJ – A recent study published in Panminerva Medica reveals that a Pycnogenol® and Coenzyme Q10 (CoQ10) combination (PycnoQ10®) taken by stable heart failure patients as an adjunct to medical treatment naturally strengthens the heart, increasing the blood volume ejected with each beat. As a consequence, the oxygen-rich blood supply to the organs improves, and
patients become more physically energetic. Furthermore, blood pressure, heart rate and respiratory rates were improved among patients. Pycnogenol® (pic-noj-en-all) is an antioxidant plant extract from the bark of the French maritime pine tree and has been clinically proven to improve endothelial function and blood flow. As evidenced by this study, Pycnogenol®, in combination with CoQ10, offers a potent contribution to heart health management.
Each year there are an estimated 400,000 newly diagnosed cases of heart failure in the U.S., according to the National Heart, Lung and Blood Institute. Heart failure is a common, chronic, long-term condition that develops as a result of hypertension, when with heart chamber walls wear out and heart muscle weaken. The disease can be costly, disabling and potentially deadly and is characterized by the heart’s inability to pump or eject sufficient amounts of blood to the organs.
“Many conditions that lead to heart failure cannot be reversed, but heart failure can often be medically managed with good results,” said Dr. Gianni Belcaro, a lead researcher of the study. “This study shows that a combination of Pycnogenol® and CoQ10 offers an effective, natural solution as adjunct for heart health management.”
The 12-week single-blinded, placebo-controlled observational study was conducted at Chieti-Pescara University in Italy and investigated the effectiveness of Pycnogenol® and Kaneka CoQ10 (PycnoQ10®) supplementation in 53 patients. Patients were between the ages of 54 and 68 and had mild to moderate hypertension, with stable congestive heart failure. Patients recruited had been diagnosed with heart failure with an ejection fraction lower than 40 percent of their original capacity. The ejection fraction, the pumped blood volume to total left heart ventricle volume, was measured by high-resolution ultrasound.
Additional inclusion criteria were a stable level of heart failure within the past three months and stable New York Heart Association (NYHA) class II (mild symptoms) or III (moderate symptoms) heart failure classification. NYHA functional classification system relates symptoms to everyday activities and the patient’s quality of life. All patients were taking prescribed heart medication and most patients used three or more drugs for heart failure treatment.
Patients were divided into two groups: One group received capsules with a combination of 15 mg Pycnogenol® and 50 mg CoQ10 from Kaneka. The second group received placebo capsules in addition to their individual prescription medications. The treatment and control groups were equivalent at baseline. Patients were instructed to take seven capsules, in the morning after breakfast, each day. Patients’ exercise capacity, as judged by walking on a treadmill, ejection fraction and distal edema (swelling in the leg) were evaluated.
At the conclusion of the 12-week study, there was significant decrease of systolic and diastolic pressure as well as a decrease in heart rate in the PycnoQ10® group, compared to marginal improvements in the control group. Systolic and diastolic pressure was notably lowered with PycnoQ10® from 139.2 to
133.2 mmHg and 82.3 to 77.3 mmHg, versus 140.3 to 139.5 mmHg and 83.4 to 81.2 mmHg in the control group. Heart rate was also significantly lowered from 78.4 to 74.2 beats per minute as compared to 79.1 to 78.4 in the control group. There was also considerable decrease in respiratory rate in PycnoQ10® patients from 23.1 to 21.2 breaths per minute versus 23.3 to 22.3 in the control group. The treatment with PycnoQ10® was found to significantly increase heart ejection fraction by 22.4 percent after treatment, whereas it only slightly decreased in the control group.
The physical abilities of patients improved substantially as evidenced by 3.3 times longer walking distance on a treadmill in PycnoQ10® treated patients, versus marginal improvement in the control group. As the heart is strengthened, a larger blood volume is pumped with every beat. This allows the heart to lower the beat rate and still sufficiently supply body organs with oxygen. The quality of life of patients also improved with PycnoQ10®, as validated with the Karnofsky Index, a performance scale that rates patients according to their functional impairment. At baseline patients had Karnofsky values of 43 percent, which is categorized as “handicapped and dependent on qualified medical help.” After treatment
with PycnoQ10® the values were up to 54.7 percent, described as “help and medical assistance are often required.” No significant improvement of Karnofsky Index was observed in the control group. The distal edema, expressed as the percentage of the initial volumetric value, decreased significantly to 72 percent in PycnoQ10® treated patients but was increased by four percent in the control group. Nine PycnoQ10® treated patients (out of 32) and three (out of 21) taking placebo improved NYHA class.
“Coenzyme Q10 has been extensively researched for its ability to strengthen the heart muscle, specifically in patients with heart failure. Preclinical trials have suggested that Pycnogenol® strengthens heart chamber walls and dilates arteries,” said Dr. Belcaro. “These preliminary observations suggest that the respective contributions of Coenzyme Q10 and Pycnogenol® in PycnoQ10® may significantly improve heart health.”
The study showed decreased blood pressure and heart rate, confirming results from prior studies using Pycnogenol® and CoQ10. Previous studies have found that Pycnogenol® significantly improves endothelial function and consequently improves hypertension as well as long-term consequences such as renal function problems. To date, Pycnogenol® has been investigated in more than 30 clinical trials related to cardiovascular health.
Public release date: 22-Jun-2011
Dietary leucine may fight prediabetes, metabolic syndrome
Joslin study shows improvements in animals with amino acid in diet
BOSTON — June 22, 2011 — A study led by researchers at the Joslin Diabetes Center suggests that adding the amino acid leucine to their diets may help those with pre-diabetes or metabolic syndrome.
In an animal study, published in the journal PloS One, mice who had been on a high-fat diet and who also received twice the usual intake of leucine, an amino acid found in protein, showed reductions in their prediabetic conditions with lower blood sugars and less fat in their livers, two of the collection of medical problems associated with insulin resistance that make up what is known as metabolic syndrome.
“The impact on the animals on the high-fat diet, even though it didn’t change how fat they got, was that their bodies were able to handle glucose better,” said C. Ronald Kahn, M.D., Head of the Joslin Section on Integrative Physiology and Metabolism and the Mary K. Iacocca Professor of Medicine at Harvard Medical School. Kahn led the team of researchers from Joslin and Metabolon Inc. of Durham, N.C.
“Their glucose tolerance tests improved,” he said. “Their bodies responded to insulin better than they would have before they got the leucine. It improved their ability to metabolize sugar and fats. It markedly improved their pre-diabetic condition. Their metabolic syndrome also improved.”
Mice who were fed a normal diet and given leucine showed no significant effects from taking the dietary supplement.
Kahn said the study sought to see what effect just a small change in their environment — in this case in just one small component of the diet — might have on animals with prediabetes or metabolic syndrome.
“We found that adding just this one amino acid to the diet changed the metabolism in a lot of different pathways,” he said. “It had effects that improved insulin sensitivity, improved their ability to metabolize sugar and fats and their overall metabolism improved.”
Kahn said the study, funded by the National Institutes of Health, shows that even small changes in how
we interact with our environment can make a big difference. Such changes can be positive or negative. In this case, they were positive.
He said it is too soon to recommend that those with prediabetes or metabolic syndrome add leucine to their diets, but said the next step should be a study in humans.
Leucine is one of 22 amino acids that serve as building blocks of proteins. It was chosen to be tested because in vitro studies had previously shown that it has effects on insulin signaling, Kahn said. Leucine is found in all protein food sources. It is often taken in supplements by those involved in body building in order to increase muscle mass.
Public release date: 23-Jun-2011
‘Good’ cholesterol function as important as its levels
High levels of “good” cholesterol (HDL cholesterol) are associated with a decreased risk of coronary artery disease (CAD) — a disease of the major arterial blood vessels that is one of the major causes of heart attack and stroke. This suggests that therapeutics that increase HDL levels could be clinically useful. However, such therapies have not yielded clear-cut decreases in disease, indicating that the beneficial effects of HDL are likely not related simply to its abundance. More evidence to support this notion has now been provided by a team of researchers, led by Ulf Landmesser, at the University of Zurich, Switzerland, who found that HDL from patients with (CAD) had different effects on cells lining blood vessels than did HDL from healthy individuals. In particular, the HDL from patients with CAD was found to lack anti-inflammatory effects on blood vessel–lining cells and could not stimulate repair of the blood vessel lining. As noted by the team and, in an accompanying commentary, Philip Shaul and Chieko Mineo, at The University of Texas Southwestern Medical Center, Dallas, these data indicate that if the protective potential of HDL is to be harnessed, its biological functions as well as its abundance must be considered.
Public release date: 23-Jun-2011
Understanding the antiepileptic benefits of an Atkins-like diet
Some individuals with epilepsy fail to respond to treatment with conventional drugs but benefit from consuming a ketogenic diet — a high-fat, low-carbohydrate diet similar to the more commonly known Atkins diet. A team of researchers, led by Detlev Boison, at the Legacy Research Institute, Portland, has now identified in mice the molecular mechanism responsible for the antiepileptic effects of the ketogenic diet.
The team found that a ketogenic diet reduces seizures in mice by decreasing expression of the protein Adk, which is responsible for clearing the natural antiepileptic agent adenosine from the brain. The clinical relevance of these data are highlighted by the team’s finding that brain tissue from patients with epilepsy that fails to respond to treatment with conventional drugs shows increased levels of Adk. The team suggests that their data could lead to the development of less-restrictive antiepileptic diets and alternate pharmaceutical approaches to treatment, notions with which Robert Greene, at The University of Texas Southwestern Medical Center, Dallas, concurs in an accompanying commentary.
Public release date: 23-Jun-2011
NEPHROLOGY: Long live dopamine production by the kidneys
Dopamine is a natural chemical in the body well known for its role in nerve cell communication; loss of dopamine-producing nerves in a specific region of the brain causes Parkinson disease. However, dopamine also exerts effects on other organs of the body, including the kidneys, where it modulates water transport. The dopamine that acts on the kidneys comes both from the circulation and from the kidneys themselves, which have the capacity to make the chemical, but the roles of these distinct sources of dopamine have not been determined. Raymond Harris, Ming-Zhi Zhang, and colleagues, at Vanderbilt University, Nashville, have now investigated this issue in mice and found that dopamine made within the kidneys is critical for maintaining normal blood pressure. As mice unable to make dopamine within their kidneys developed high blood pressure and lived for a much shorter length of time than normal mice, Harris and colleagues suggest that a functional dopaminergic system in the kidney is important for long-term health and survival.
Public release date: 23-Jun-2011
Drug side effect linked with increased health risks for over 65s
A side effect of many commonly used drugs appears to increase the risks of both cognitive impairment and death in older people, according to new research led by the University of East Anglia (UEA).
As part of the Medical Research Council’s Cognitive Function and Ageing Studies (CFAS) project, the study is the first systematic investigation into the long term health impacts of ‘anticholinergic activity’ – a known potential side effect of many prescription and over the counter drugs which affects the brain by blocking a key neurotransmitter called acetylcholine. The findings are published today by the Journal of the American Geriatrics Society.
Medicines with some degree of anticholinergic effect are wide-ranging and many are frequently taken by older people. The groups with the greatest impact include: anti-depressants such as Amitriptyline, Imipramine and Clomipramine; tranquilisers such as Chlorpromazine and Trifluoperazine; bladder medication such as Oxybutynin; and antihistamines such as Chlorphenamine. Other drugs with an anticholinergic effect include: Atenolol, Furosemide and Nifedipine for heart problems; painkillers such as Codeine and Dextropropoxyphene; the asthma treatment Beclometasone; the epilepsy treatment Carbamazepine; and Timolol eyedrops which are used for glaucoma.
The large cohort study was launched as part of the drive to find ways of reducing risk factors for dementia which affects 820,000 people in the UK. The UEA researchers worked in collaboration with colleagues at University of Cambridge, Indiana University and National Health Service clinicians. The project was funded by the Medical Research Council (MRC) and the US National Institute on Aging.
More than 13,000 men and women aged 65 and over from across the UK were included in the two-year study. Around half were found to use a medication with potential anticholinergic properties.
In the study, each drug taken by the participants was given a ranking based on the strength of its anticholinergic activity, or AntiCholinergic Burden (ACB) – 0 for no effect, 1 for mild effect, 2 for moderate effect and 3 for severe effect.
The key findings were:
•Twenty per cent of participants taking drugs with a total ACB of four or more had died by the end of the two-year study, compared with only seven per cent of those taking no anticholinergic drugs – the first time a link between anticholinergics and mortality has been shown.
•For every additional ACB point scored, the odds of dying increased by 26 per cent.
•Participants taking drugs with a combined ACB of five or more scored more than four per cent lower in a cognitive function test than those taking no anticholinergic medications – confirming evidence from previous smaller studies of a link between anticholinergics and cognitive impairment.
•The increased risks from anticholinergic drugs were shown to be cumulative, based on the number of anticholinergic drugs taken and the strength of each drug’s anticholinergic effect.
•Those who were older, of lower social class, and with a greater number of health conditions tended to take the most anticholinergic drugs.
Lead author Dr Chris Fox, clinical senior lecturer at Norwich Medical School, University of East Anglia, said: “This is the first large scale study into the long-term impact of medicines which block acetylcholine – a common brain neurotransmitter – on humans, and our results show a potentially serious effect on mortality. Clinicians should conduct regular reviews of the medication taken by their older patients, both prescribed and over the counter, and wherever possible avoid prescribing multiple drugs with anticholinergic effects.
“Further research must now be undertaken to understand possible reasons for this link and, in particular, whether and how the anticholinergic drugs might cause the increased mortality. In the meantime, I strongly advise patients with any concerns to continue taking their medicines until they have consulted their family doctor or their pharmacist.”
Co-author Prof Carol Brayne, principal investigator of the MRC CFAS project at the University of Cambridge, said: “It is important to scrutinise medications given to older people very carefully to try to minimise harm as well as gain the desired benefit. The admirable wish to give the best possible treatment with good evidence for individual conditions has to be balanced against the fact that in many older people with multiple conditions this will lead to accumulated risk such as that shown by this scale.”
Ian Maidment, a mental health pharmacist working within the NHS, added: “One of the issues is that as we age, we tend to be prescribed more medicines which have an anticholinergic effect, increasing the overall burden.”
Dr Susanne Sorensen, head of research at the Alzheimer’s Society, said: “It is very important that we have a clear picture of the side effects of drugs commonly taken by older people with cognitive impairment and other conditions. This robust study provides valuable findings, and must be taken seriously. However it is vital that people do not panic or stop taking their medication without consulting their GP.
“We would urge people to have regular appointments with their doctor to review all drug treatments they are taking. This will help ensure they are on the best medications for their conditions, and that any side effects have been taken into consideration.”
Prof Chris Kennard, chairman of the MRC’s Neuroscience and Mental Health Board, which funded the research, said: “The Medical Research Council invests in cohort studies like CFAS because they provide vital clinical information through observation. Such projects require long-term commitment to fulfil their potential but having supported cohort studies for well over half a century, MRC funding and collaborations have made the UK an international leader in this field.”
Anticholinergics affect the brain by blocking acetylcholine, a nervous system neurotransmitter. Over-the-counter products containing diphenhydramine, sold under various brand names such as Benadryl®, Dramamine®, Excedrin PM®, Nytol®, Sominex®, Tylenol PM®, and Unisom®, have anticolinergic activity. Other anticholinergic drugs, such as Paxil®, Detrol®, Demerol® and Elavil® are available by prescription.
Public release date: 23-Jun-2011
Study of phytoremediation benefits of 86 indoor plants published
Japanese royal fern tops list for formaldehyde removal effectiveness
SUWON, KOREA—Formaldehyde is a major contaminant of indoor air, originating from particle board, carpet, window coverings, paper products, tobacco smoke, and other sources. Indoor volatile organic compounds (VOCs) such as formaldehyde can contribute to allergies, asthma, headaches, and a condition known as ”sick building syndrome”. The concern is widespread; a 2002 report from the World Health Organization estimated that undesirable indoor volatiles represent a serious health problem that is responsible for more than 1.6 million deaths per year and 2.7% of the global burden of disease.
Scientists have long known the benefits of using plants to absorb and metabolize gaseous formaldehyde. Phytoremediation—the use of green plants to remove pollutants or render them harmless—is seen as a potentially viable and environmentally significant means of improving the indoor air quality in homes and offices. A team of scientists from Korean’s Rural Development Administration and the Department of Horticulture at the University of Georgia tested the efficiency of volatile formaldehyde removal in 86 species of plants representing five general classes (ferns, woody foliage plants, herbaceous foliage plants, Korean native plants, and herbs). The results of the extensive research were published in HortScience.
Phytoremediation potential was assessed by exposing the plants to gaseous formaldehyde in airtight chambers constructed of inert materials and measuring the rate of removal. Osmunda japonica (Japanese royal fern), Selaginella tamariscina (Spikemoss), Davallia mariesii (Hare’s-foot fern), Polypodium formosanum, Psidium guajava (Guava), Lavandula (Sweet Lavender), Pteris dispar, Pteris multifida (Spider fern), and Pelargonium (Geranium) were the most effective species tested. Ferns had the highest formaldehyde removal efficiency of the five classes of plants tested, with Osmunda japonica determined to be most effective of all 86 species, coming in at 50 times more effective than the least (D. deremensis) efficient species.
“Based on the wide range of formaldehyde removal efficiency among the plants tested, we separated the species into three general groups: excellent, intermediate, and poor”, said corresponding author Kwang Jin Kim. “The species classified as excellent are considered desirable for use in homes and offices where the formaldehyde concentration in the air is a concern. It is evident from our results that certain species have the potential to improve interior environments and, in so doing, the health and well-being of the inhabitants”.
Public release date: 24-Jun-2011
Lithium profoundly prevents brain damage associated with Parkinson’s disease
Buck Institute research in mice moves into preclinical stage; working toward human trials
Lithium profoundly prevents the aggregation of toxic proteins and cell loss associated with Parkinson’s disease (PD) in a mouse model of the condition.
Preclinical research is now underway at the Buck Institute for Research on Aging to determine correct dosages for a drug that continues to be the gold standard for the treatment of bipolar disorder. The Buck is currently working toward initiating a Phase IIa clinical studies of lithium in humans in conjunction with
standard PD drug therapy. The research appears in the June 24 online edition of the Journal of Neuroscience Research.
“This is the first time lithium has been tested in an animal model of PD,” said lead author and Buck Professor Julie Andersen, PhD. “The fact that lithium’s safety profile in humans is well understood greatly reduces trial risk and lowers a significant hurdle to getting it into the clinic.”
According to Andersen, lithium has recently been suggested to be neuroprotective in relation to several neurodegenerative conditions including Alzheimer’s disease, Huntington’s disease and amyotrophic lateral sclerosis and has been touted for its anti-aging properties in simple animals. “We fed our mice levels of lithium that were at the low end of the therapeutic range,” said Andersen. “The possibility that lithium could be effective in PD patients at subclinical levels is exciting, because it would avoid many side effects associated at the higher dose range.” Overuse of lithium has been linked to hyperthyroidism and kidney toxicity.
PD is a progressive, incurable neurodegenerative disorder that affects 1 million Americans and results in tremor, slowness of movement and rigidity. It is the second most common neurodegenerative disease after Alzheimer’s. Between 50,000 and 60,000 new cases are diagnosed each year. Age is the largest risk factor for the PD. Onset usually begins between the ages of 45 and 70 years.
Andersen’s research focuses on lithium as a potential treatment for PD as well as its efficacy in combination with drugs currently used to control the symptoms of the disease. An internet search reveals stories from PD patients who are using lithium “off label” as part of their treatment regime; others report benefits from low dose lithium salts which are available as a supplement in some health food stores. “This finding gives us an opportunity to explore lithium as a recognized therapeutic for PD, in doses that are safe and effective” said Andersen.
Public release date: 26-Jun-2011
Roche to fight for Avastin as breast cancer drug
By Anna Yukhananov Anna Yukhananov Sun Jun 26, 12:18 pm ET
WASHINGTON (Reuters) — Drugmaker Roche Holding AG will try to convince U.S. regulators to reverse course on Avastin, the world’s best-selling cancer medicine, and approve its use for breast cancer in a hearing this week.
But analysts say the Food and Drug Administration, which proposed removing the breast cancer indication in December, is unlikely to change its opinion without new evidence about Avastin’s ability to help breast cancer patients live longer.
“There seems to be only a very slim chance that Avastin will stay on the market for breast cancer,” said Tim Race, analyst at Deutsche Bank in London. “It would be a major U-turn for the FDA … and there would be quite a lot of fallout from such a change of stance.”
For Swiss-based Roche, a FDA decision could shave off almost a billion dollars in annual Avastin sales, according to analysts.
And for patients, an FDA rejection of the appeal could mean insurance companies would stop covering the expensive drug, potentially jeopardizing treatment for an estimated 17,000 women currently using the medicine, advocates say.
After skin cancer, breast cancer is the second-leading type of cancer among women, according to the Centers for Disease Control.
SURVIVAL VERSUS QUALITY OF LIFE
Avastin won U.S. clearance for breast cancer in 2008 based on a study showing the drug stalled cancer growth by 5.5 months. As part of an accelerated approval, the FDA required Roche to run follow- up studies to confirm the drug worked.
Later studies found only a one- to three-month delay in breast cancer growth. And no studies showed Avastin extended the lives of patients with advanced breast cancer.
The drug also had side effects, including holes in the stomach and intestines, severe bleeding and blood clots.
In December, the FDA proposed revoking Avastin’s clearance for breast cancer while keeping the drug on the market for colon, lung, brain and kidney cancers.
Genentech, a Roche unit, has been fighting the decision, saying the extension of time without cancer growing was meaningful for patients with advanced breast cancer. At that stage, the disease cannot be cured and the goal is to stabilize patients as much as possible.
“We looked at metastatic cancer, where almost everyone will have a recurrence of their disease,” said Dr. Philippe Bishop, head of global clinical development for Avastin. “We look for how long a patient can live without their disease getting worse.”
Roche also claimed the rate of side effects was low, less than 4 percent in breast cancer trials. Stripping the breast cancer indication for Avastin would not prevent doctors from using it. But without
FDA approval, insurers may refuse to pay Avastin’s $8,000-a-month price tag. And Genentech would
not be able to promote Avastin for that use.
Many breast cancer groups and U.S. lawmakers were outraged by the FDA’s December decision on Avastin, charging it was based on cost, something the FDA is forbidden from doing. They also accused the agency of trying to limit patient options and dictate medical care.
In a rare move, the FDA granted Genentech an appeal, allowing the company to make its case at a public hearing on Tuesday and Wednesday. It is the first time the agency has had an appeal hearing over its decision to withdraw the breast cancer indication under accelerated approval, the FDA said.
Dr. Stanley Waintraub, a chief of breast oncology at the John Theurer Cancer Center at Hackensack University Medical Center in New Jersey, plans to testify in favor of Avastin.
He said 17,000 women in the United States are currently using the medicine, including some of his patients.
“I have been a doctor since 1977, and I have been in oncology since 1982,” he said. “I have watched too many patients die. This drug works. It doesn’t work all the time. But nothing works all the time, not even an aspirin.
“If the FDA opposes this drug, it would be a horrible day in history for patients in this country.” FOCUS ON GENETIC MARKERS
Most analysts believe the panel will not change its mind, especially as five of the six panelists voted against Avastin’s use in breast cancer at a hearing last July.
This time around, panelists will also have an option to keep Avastin’s indication for breast cancer, pending further Roche studies that show a more significant clinical benefit.
“They do have an opportunity to say that there’s not a lot of harm that can be done while we wait (to see) what happens with that additional trial,” said Ira Loss, an analyst with Washington Analysis. He thinks it’s possible the breast cancer use will not be removed completely.
Roche has also said it plans to run studies that could pinpoint genetic markers to identify who would best respond to Avastin. The FDA has said it is open to any new research that can identify specific types of women likely to benefit.
“Roche has been searching for years for the right biomarker. At this point, it would be an unexpected outcome if the FDA decided to preserve the label while they’re waiting for that data,” said Morningstar analyst Karen Andersen.
IMPACT ON SALES
Analysts estimate about $1 billion of Avastin’s more than $6 billion in yearly sales come from breast cancer uses. The product used to be Roche’s top-selling drug, and some expected it to become the world’s biggest-selling drug by 2014.
But its prospects have dimmed after doubts about its benefits in breast cancer and after it failed in clinical trials for prostate and stomach cancer.
Morningstar’s Andersen said her projections for Roche’s overall earnings would not be greatly affected by the FDA’s decision. Avastin is still used for breast cancer in other countries, and European authorities relaxed curbs on the drug in April after initially restricting use.
An FDA revocation would likely see Medicare, the U.S. federal health insurer, cut coverage for the drug, shrinking U.S. sales by half in 2011 to $400 million, Andersen said.
She sees a 60 percent chance that private health insurers would still maintain coverage for Avastin on an off-label basis.
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