Health Technology Research Synopsis
8th Issue Date 2 OCT 2007
Compiled By Ralph Turchiano
Public release date: 12-Sep-2007
Americans spend most on Lipitor, drug survey finds
(updated 2004 figure’s)
Lipitor – 9 Billion
Zocor – 4.7 Billion
Nexium – 4.2 Billion
Prevacid – 2.4 Billion
Zoloft – 1.9 Billion
Plavix – 1.7 Billion
Norvasc – 1.5 Billion
The survey also excluded drugs that are administered in a doctor’s office or hospital, such as cancer drugs.
The full survey is available at http://www.meps.ahrq.gov/mepsweb/data_files/publications/st180/s tat180.pdf.
Public release date: 18-Sep-2007
Less than one-third of women aware of landmark hormone therapy study, Stanford researcher finds
STANFORD, Calif. – Despite the huge publicity generated by a 2002 study on the potential dangers of hormone therapy for postmenopausal women, new research from the Stanford University School of Medicine found that only 29 percent of women surveyed knew about the study two years later.
Additionally, the women were able to correctly identify the possible benefits and risks linked to hormone therapy just 40 percent of the time.
Senior author Randall Stafford, MD, PhD, associate professor of medicine at the Stanford Prevention Research Center, said the new study points out that the medical profession hasn’t yet figured out an effective way of communicating crucial health information to patients.
The survey then asked what the women knew about specific risks and benefits associated with hormone therapy. Only 40 percent of the women answered more questions correctly than incorrectly. For example, 64 percent knew that hormones increased the risk of breast cancer, but just 9 percent knew the medication increased the risk for memory loss and 34 percent knew that it increased the risk for heart disease. The study did not penalize women for responses that reflected scientific uncertainty about the risks and benefits of hormone therapy.
Stafford said his study is indicative of a larger problem – namely, ensuring that people can make informed decisions about their medical care. “It’s a particularly relevant issue because of the increasing burden of chronic disease. Right now, we’re not successful in educating the population about health issues that will become increasingly common and increasingly complex in the future,” he said.
Public release date: 17-Sep-2007
Vaccine tied to ‘superbug’ ear infection
CHICAGO –A vaccine that has dramatically curbed pneumonia and other serious illnesses in children is also having an unfortunate effect: promoting new superbugs that cause ear infections
On Monday, doctors reported discovering the first such germ that is resistant to all drugs approved to treat childhood ear infections. Nine toddlers in Rochester, N.Y., have had the bug and researchers say it may be turning up elsewhere, too.
Wyeth anticipated this and is testing a second-generation vaccine. But it is at least two years from reaching the market, and the new strains could become a public health problem in the meantime if they spread hard-to-treat infections through day care centers and schools.
It is a strain of strep bacteria not included in the pneumococcal vaccine, Wyeth’s Prevnar, which came on the market in 2000. It is recommended for children under age 2.
Prevnar, however, is losing its punch because strains not covered by the vaccine are filling the biological niche that the vaccine strains used to occupy, and they are causing disease.
One strain in particular, called 19A, is big trouble. A new subtype of it caused ear infections in the nine Rochester children, ages 6 months to 18 months, that were resistant to all pediatric medications, said Dr. Michael Pichichero, a microbiologist at the University of Rochester Medical Center.
The children had been unsuccessfully treated with two or more antibiotics, including high-dose amoxicillin and multiple shots of another drug. Many needed surgery to place ear tubes to drain the infection, and some recovered only after treatment with a newer, powerful antibiotic whose safety in children has not been established.
–Scientists from a drug company and two labs analyzed more than 21,000 bacterial samples from around the nation and found 19A increasing. Among children 2 and under, the portion of samples that were this strain rose to 15 percent in 2005-2006, from 4 percent in the previous three years.
–A British lab tracking respiratory infections in U.S. kids found that the 19A strain accounted for 40 percent of drug-resistant cases.
–University of Iowa researchers found 19A accounted for 35 percent of penicillin-resistant infections in 2004-05, compared with less than 2 percent the year before the new vaccine came out.
Public release date: 24-Sep-2007
Pomegranate juice: Tart, trendy, and targeted on prostate cancer cells
Journal of Agricultural and Food Chemistry Researchers in California are reporting new evidence explaining pomegranate juice’s mysterious beneficial effects in fighting prostate cancer. In a study scheduled for the Sept. 19 issue of ACS’ Journal of Agricultural and Food Chemistry, a bi-weekly publication, Navindra Seeram and colleagues have found that the tart, trendy beverage also uses a search-and-destroy strategy to target prostate cancer cells.
In the new study, they researchers discovered evidence in laboratory experiments that pomegranate works in a “seek and destroy” fashion. On consumption, ellagitannins (ET), antioxidants abundant in pomegranate juice, break down to metabolites known as urolithins. The researchers showed that the urolithins concentrate at high levels in prostate tissue after being given orally and by injection to mice with prostate cancer. They also showed that urolithins inhibited the growth of human prostate cancer cells in cell culture.
“The chemopreventive potential of pomegranate ellagitannins and localization of their bioactive metabolites in mouse prostate tissue suggest that pomegranate may play a role in prostate cancer treatment and chemoprevention,” the researchers state, recommending further clinical studies with pomegranate and prostate cancer patients.
Public release date: 24-Sep-2007
How much of the medical literature is shaped behind the scenes by drug companies?
Drug companies control or shape multiple steps in the research, analysis, writing, and publication of a large proportion of the medical literature, and they do so behind the scenes, according to a policy paper in this week’s PLoS Medicine. The paper’s author, Sergio Sismondo (Queen’s University, Kingston, Canada), who is an expert in the philosophy of science, calls this phenomenon “ghost management.”
Such articles are “ghostly” says Dr Sismondo, “because signs of their actual production are largely invisible–academic authors whose names appear at the tops of ghost-managed articles give corporate research a veneer of independence and credibility.” Drug companies hire medical education and communication companies (MECCs) to help produce and place company-funded articles in medical journals, says Dr Sismondo.
These articles are “managed,” he says, because those MECCs “shape the eventual message conveyed by the article or by a suite of articles.” Dr Sismondo looks at one specific example—the published medical literature on the antidepressant drug sertraline.
His analysis suggests that between 18% and 40% of the literature on this drug published between 1998 and 2000 was ghost managed by a single MECC acting on behalf of the drug’s manufacturer. Ghost managed studies, says the author, “affect medical opinion, practice and ultimately, patients,” says Dr. Sismondo. “I suspect that most researchers – even those participating in the system – don’t have a good sense of the extent to which this happens.”
Citation: Sismondo S (2007) Ghost management: How much of the medical literature is shaped behind the scenes by the pharmaceutical industry” PLoS Med 4(9): e286
Public Release: 24-Sep-2007
Researchers say lack of sleep doubles risk of death… but so can too much sleep
Researchers from the University of Warwick, and University College London, have found that lack of sleep can more than double the risk of death from cardiovascular disease. However they have also found that point comes when too much sleep can also more than double the risk of death.
In research to be presented on Monday 24th September 2007, to the British Sleep Society, Professor Francesco Cappuccio from the University of Warwick’s Warwick Medical School will show the results of a study of how sleep patterns affected the mortality of 10,308 civil servants in the “Whitehall II study”. Amongst other things the data they used provided information on the mortality rates and sleep patterns on the same group of civil servants at two points in their life (1985-8 and those still alive in 1992-3).
Those who had cut their sleeping from 7hours to 5 hours or less faced a 1.7 fold increased risk in mortality from all causes, and twice the increased risk of death from a cardiovascular problem in particular.
Curiously the researchers also found that too much sleep also increased mortality. They found that those individuals who showed an increase in sleep duration to 8 hours or more a night were more than twice as likely to die as those who had not changed their habit, however, predominantly from non-cardiovascular diseases.
Public release date: 25-Sep-2007
Consumption of omega-3 fatty acids associated with decreased risk of type 1 diabetes
Preliminary research suggests that in children at increased risk for type 1 diabetes, dietary intake of omega-3 fatty acids was associated with a reduced risk of pancreatic islet autoimmunity, which is linked to the development of diabetes, according to an article in the Sept. 26 issue of JAMA.
Jill M. Norris, M.P.H., Ph.D., of the University of Colorado at Denver and Health Sciences Center, Denver, and colleagues examined whether consumption of omega-3 and omega-6 fatty acids are associated with the development of pancreatic islet autoimmunity (IA; development of antibodies against the cells in pancreas that produce insulin) in children. The study, conducted between 1994 and 2006, included 1,770 children at increased risk for type 1 diabetes, defined as either possession of a high diabetes risk HLA (human leukocyte antigen) genotype or having a sibling or parent with type 1 diabetes. The average age at follow-up was 6.2 years. Islet autoimmunity was assessed in association with reported dietary intake of polyunsaturated fatty acids starting at age 1 year. Fish is the primary source of marine polyunsaturated fatty acids. Childhood diet was measured using a food frequency questionnaire (FFQ).
A case-cohort study (n = 244) was also conducted in which risk of IA by polyunsaturated fatty acid content of erythrocyte membranes (outer portion of the red blood cell) was examined
Fifty-eight children became positive for IA during follow-up. Adjusting for HLA genotype, family history of type 1 diabetes, caloric intake, and total omega-6 fatty acid intake, total omega-3 fatty acid intake was inversely associated with IA risk (a 55 percent reduced risk). The association was strengthened when the definition of the outcome was limited to those positive for two or more autoantibodies. In the case-cohort study, omega-3 fatty acid content of erythrocyte membranes was associated with a 37 percent decreased risk of IA.
“Our study suggests that higher consumption of total omega-3 fatty acids, which was reported on the FFQ, is associated with a lower risk of IA in children at increased genetic risk of type 1 diabetes,” the researchers write.
Public release date: 25-Sep-2007
Tufts University biologists link Huntington’s disease to health benefits in young
MEDFORD/SOMERVILLE, Mass. — For years researchers in neurology have believed that people with Huntington’s disease have more children than the general population because of behavioral changes associated with the disease that lead to sexual promiscuity. In a new Tufts University study, three biologists have challenged that notion by suggesting that people with Huntington’s have more children because they are healthier – not more promiscuous – during their peak reproductive years. “A Darwinian Approach to Huntington’s Disease: Subtle Health Benefits of a Neurological Disorder” is published in the August 8, 2007 online issue of the journal Medical Hypothesis and will soon appear in print.
The Tufts team analyzed the often-noted fertility gap between people who have Huntington’s and those who do not. Studies comparing family members indicated that individuals with the disease had between 1.14 and 1.34 children for every child born to an unaffected sibling. In explaining this difference, previous researchers have theorized that psychological deterioration and difficulty in discriminating between right and wrong – both symptoms associated with Huntington’s – are reasons for promiscuous behavior in people who had the disease. But Eskenazi, Wilson-Rich and Starks observed that such behavior takes place later in life – not during peak reproductive age. They noted that the onset of Huntington’s disease occurs, on average, at 41.5 years of age.
Starks and his team suggested that one key factor behind these health benefits may be p53, and pointed to a 1999 study by doctors at the Danish Huntington Disease Registry at the University of Copenhagen that found lower age-adjusted cancer rates for individuals affected by Huntington’s. “Research has shown that individuals with Huntington’s produce higher levels of cancer-suppressing p53, and we hypothesize that they may also reap the health benefits associated with a generally more vigilant immune system,” said Starks. “These individuals also suffer from the negative impacts of heightened immune function, as they are more likely than those without Huntington’s to suffer from autoimmune diseases.”
Starks, whose research areas include behavior and evolution in a wide range of organisms, noted that Huntington’s disease may be an example of antagonistic pleiotropy, in which one gene creates multiple and conflicting effects. Another example of this phenomenon includes a gene that appears to decrease the incidence of Alzheimer’s disease while increasing the chance of elevated lipids in the blood. The convergence of evolutionary biology and medicine can reap many benefits, he believes. “This marriage has already shed light on phenomena such as fever and morning sickness,” he noted. Huntington’s disease may be one more beneficiary of this synergy.
Public release date: 25-Sep-2007
Sense of taste different in women with anorexia nervosa
Although anorexia nervosa is categorized as an eating disorder, it is not known whether there are alterations of the portions of the brain that regulate appetite. Now, a new study finds that women with anorexia have distinct differences in the insulta – the specific part of the brain that is important for recognizing taste – according to a new study by University of Pittsburgh and University of California, San Diego researchers currently on line in advance of publication in the journal Neuropsychopharmacology.
In response to both the sucrose and water, imaging results showed that women who had recovered from anorexia had significantly reduced response in the insula and related brain regions when compared to the control group. These areas of the brain recognize taste and judge how rewarding that taste is to the person. In addition, while the controls showed a strong relationship between how they judged the pleasantness of the taste and the activity of the insula, this relationship was not seen in those who had recovered from anorexia.
According to Kaye, it is possible that individuals with anorexia have difficulty recognizing taste, or responding to the pleasure associated with food. Because this region of the brain also contributes to emotional regulation, it may be that food is aversive, rather than rewarding. This could shed light on why individuals with anorexia avoid normally “pleasurable” foods, fail to appropriately respond to hunger and are able to lose so much weight.
“We know that the insula and the connected regions are thought to play an important role in interoceptive information, which determines how the individual senses the physiological condition of the entire body,” said Kaye. “Interoception has long been thought to be critical for self-awareness because it provides the link between thinking and mood, and the current body state.”
Public release date: 26-Sep-2007
Discovery supports theory of Alzheimer’s disease as form of diabetes
EVANSTON, Ill. — Insulin, it turns out, may be as important for the mind as it is for the body. Research in the last few years has raised the possibility that Alzheimer’s memory loss could be due to a novel third form of diabetes.
With other research showing that levels of brain insulin and its related receptors are lower in individuals with Alzheimer’s disease, the Northwestern study sheds light on the emerging idea of Alzheimer’s being a “type 3” diabetes.
Now scientists at Northwestern University have discovered why brain insulin signaling — crucial for memory formation — would stop working in Alzheimer’s disease. They have shown that a toxic protein found in the brains of individuals with Alzheimer’s removes insulin receptors from nerve cells, rendering those neurons insulin resistant. (The protein, known to attack memory-forming synapses, is called an ADDL for “amyloid ß-derived diffusible ligand.”)
In the brain, insulin and insulin receptors are vital to learning and memory. When insulin binds to a receptor at a synapse, it turns on a mechanism necessary for nerve cells to survive and memories to form. That Alzheimer’s disease may in part be caused by insulin resistance in the brain has scientists asking how that process gets initiated.
Public release date: 26-Sep-2007
C-diff infection 4 times more likely to kill patients with inflammatory bowel disease
Clostridium difficile infection is four times more likely to kill patients with inflammatory bowel disease, suggests research published ahead of print in the journal Gut.
The findings are based on a representative sample of community hospital admissions in the US for 2003.
The sample covered 994 hospitals in 37 States and included a total of 124,570 patients.
Public release date: 27-Sep-2007
Why don’t painkillers work for people with fibromyalgia?
Research may explain why common drugs don’t help
ANN ARBOR, Mich. — People who have the common chronic pain condition fibromyalgia often report that they don’t respond to the types of medication that relieve other people’s pain. New research from the University of Michigan Health System helps to explain why that might be: Patients with fibromyalgia were found to have reduced binding ability of a type of receptor in the brain that is the target of opioid painkiller drugs such as morphine.
“The reduced availability of the receptor was associated with greater pain among people with fibromyalgia,” says lead author Richard E. Harris, Ph.D., research investigator in the Division of Rheumatology at the U-M Medical School’s Department of Internal Medicine and a researcher at the U-M Chronic Pain and Fatigue Research Center
“These findings could explain why opioids are anecdotally thought to be ineffective in people with fibromyalgia,” he notes. The findings appear in The Journal of Neuroscience. “The finding is significant because it has been difficult to determine the causes of pain in patients with fibromyalgia, to the point that acceptance of the condition by medical practitioners has been slow.”
Opioid pain killers work by binding to opioid receptors in the brain and spinal cord. In addition to morphine, they include codeine, propoxyphene-containing medications such as Darvocet, hydrocodone-containing medications such as Vicodin, and oxycodone-containing medications such as Oxycontin.
The research team also found a possible link with depression. The PET scans showed that the fibromyalgia patients with more depressive symptoms had reductions of MOR binding potential in the amygdala, a region of the brain thought to modulate mood and the emotional dimension of pain.
Public release date: 27-Sep-2007
Clinical trials for diabetes drugs should measure outcomes important to patients
ROCHESTER, Minn. — Most clinical trials for new diabetes drugs do not consider the impact medication will have on a patient’s quality of life or other outcomes that are important to patients, such as the risk of developing complications associated with diabetes, according to a Mayo Clinic commentary in the current issue of The Lancet. Rather, drug trials focus on the effect of a particular medication on blood sugar levels. The result is smaller, shorter and cheaper trials that lead to more drug choices more quickly, but are not necessarily better or safer for patients.
“The apparent benefits of these trials are a mirage and the apparent savings represent false economy,” writes Victor Montori, M.D., an endocrinologist at Mayo Clinic, along with Gunjan Gandhi, M.D., of Mayo Clinic, and Gordon Guyatt, M.D., of McMaster University in Canada. “Any savings are quickly overwhelmed by expenses associated with potentially ineffective, or even harmful, expensive therapies and the incremental costs of treating the harms these interventions might cause. Patients and society may end up paying dearly for medications that cause more harm than good.”
“The medical community should insist that we invest the resources needed to do trials that ascertain the effect of interventions on patient-important outcomes,” the authors state. “This policy will prevent the premature dissemination of therapies that ultimately prove harmful, facilitate patients’ participation in decision making, and speed the day when we can confidently offer safe treatments that can provide important benefit to patients with diabetes.”
In summary, the authors say:
- Diabetes medications have been approved without requiring proof of reducing the risk of complications associated with diabetes, such as heart attack, stroke, amputation, blindness and kidney dialysis.
- The majority of diabetes trials focus on the ability of medications to reduce blood sugar, not on outcomes that matter to patients.
- Diabetes medications may reduce the risk of complications, but we do not know this with confidence.
- The focus should shift from getting new drugs to market to testing the effect of diabetes medications against outcomes important to patients.
Public release date: 28-Sep-2007
Occupational exposures may be linked to death from autoimmune disease
A new study examined the possible associations between occupation and the risk of dying from systemic autoimmune diseases and found that occupational exposures in farming and industry may be linked to higher death rates from these diseases
Led by L.S. Gold and A.J. De Roos, of the Fred Hutchinson Cancer Research Center in Seattle, WA, researchers examined death certificate data from 26 states from 1984 to 1998. Any cases that listed a systemic autoimmune disease (for example, rheumatoid arthritis) as a cause of death, were included, as were disease types with a suspected systemic autoimmune disease origin (such as unspecified connective tissue disorder). Five control subjects matched by age, sex, race, year of death and geographic region were also selected. The researchers established each person’s longest-held occupation from the “usual occupation” listed on the death certificate. In addition, they examined specific exposures based on occupation and industry. These included asbestos, solvents, benzene, pesticides and other substances. Occupations involving significant exposure to the public (such as teachers, and waiters/waitresses) or animals were also tracked.
The results showed that some occupations involving exposure to the public (such as nurses and teachers) were associated with an increased risk of dying from a systemic autoimmune disease but this was not the case with all jobs involving public exposure (for example food service jobs). Farmers showed increased risk of death from systemic autoimmune disease, particularly for those who worked with crops versus livestock. In addition, several industrial occupations such as mining and textile machine operators, as well as timber cutting and logging had an increased risk of death from this group of diseases.
The authors note that autoimmune diseases tend to be underreported on death certificates, and that the increased risk seen with certain occupations, such as teachers, may be due to the fact that these individuals have extensive health benefits even after retirement, and therefore better access to care. This would also help explain why other occupations that involve public contact but lower health insurance coverage, such as waiter/waitress, seemed to have a lower risk of death from autoimmune disease. However, not all the occupational associations they found are expected to be affected by insurance status.
“The size of our study allowed us to estimate associations between specific occupations and death from autoimmune diseases and to generate hypotheses that will be useful as starting points for future studies in this area,” the authors conclude. They note that future studies should focus on obtaining more detailed occupational histories from the groups found to be at increased risk.
Public release date: 28-Sep-2007
The impact of physical activity on weight-bearing knee joint
Exercise for cardiovascular health keeps knee cartilage healthy, too, suggests long-term, community-based study
The world’s most common joint disease, osteoarthritis (OA) is a major cause of disability among adults over the age of 50. Whether physical activity is beneficial or detrimental to weight-bearing joints, knees in particular, has been open to debate. Some studies implicate physical activity in provoking knee OA, while others suggest that physical activity may actually protect the knee joint from the disease. Confounding the matter is the fact that knee injury is a known risk factor for knee OA. Then, there’s the unclear role of osteophytes in knee OA progression, compounded by the limitations of radiographs for monitoring small yet significant changes in joint structure
Among the notable findings, both baseline and current vigorous physical activity— exercise that gets the heart pumping and the body sweating—were associated with an increase in tibial cartilage volume, free from cartilage defects. What’s more, tibial cartilage volume increased with frequency and duration of vigorous activity. Recent weight-bearing exercise was also linked to increased tibial cartilage volume and reduced cartilage defects. Finally, moderate physical activity, including regular walking, was associated with a lower incidence of bone marrow lesions.
“This is the first study to demonstrate a potentially beneficial effect of walking on the reduction in the risk of bone marrow lesions in the knee,” notes the study’s leading author, Dr. Flavia M. Cicuttini. “Bone marrow lesions have been associated with pain and radiograph-defined progression of osteoarthritis, type II collagen degradation, and loss of cartilage volume.”
Demonstrating a protective effect of past and current vigorous physical activity on knee cartilage in healthy adults, this study strongly supports the benefits of exercise for older individuals at risk for OA. Though both the intensity and duration of physical activity had a significant positive impact on cartilage, the ideal amount of physical activity for joint health remains unclear. “Our data suggest that at least 20 minutes once per week of activity sufficient to result in sweating or some shortness of breath might be adequate. This is similar to, if not somewhat less than, the recommendations for cardiovascular health,” Dr. Cicuttini observes.
Article: “Effect of Physical Activity on Articular Knee Joint Structures in Community-Based Adults,” Tina L. Racunica, Andrew J. Teichtahl, Yuanyuan Wang, Anita E. Wluka, Dallas R. English, Graham G. Giles, Richard O’Sullivan, and Flavia M. Cicuttini, Arthritis Care & Research, October 2007; (DOI: 10.1002/art.22990).
Public Release: 28-Sep-2007
U of M study finds that U.S. high school dropout rate higher than thought and hasn’t improved in years
MINNEAPOLIS / ST. PAUL ( 9/27/2007 ) — University of Minnesota sociologists have found that the U.S. high school dropout rate is considerably higher than most people think — with one in four students not graduating — and has not improved appreciably in recent decades. Their findings point to discrepancies in the two major data sources on which most governmental and non-governmental agencies base their findings
Public release date: 1-Oct-2007
Standard treatment for prostate cancer may encourage spread of disease
A popular prostate cancer treatment called androgen deprivation therapy may encourage prostate cancer cells to produce a protein that makes them more likely to spread throughout the body, a new study by Johns Hopkins researchers suggests.
Although the finding could eventually lead to changes in this standard treatment for a sometimes deadly disease, the Johns Hopkins researchers caution that their discovery is far too preliminary for prostate cancer patients or physicians to stop using it. The therapy is effective at slowing tumor growth, they emphasized.
David Berman, an assistant professor of pathology, urology and oncology at The Johns Hopkins University School of Medicine, and his colleagues identified the unsuspected potential problem with treatments that suppress testosterone after discovering that the gene that codes for the protein, called nestin, was active in lab-grown human prostate cancer cells.
Curious about whether prostate cancer cells in people also produce nestin, the researchers looked for it in cells taken from men who had surgery to remove locally confined cancers of their prostates and found none. But when they looked for nestin in prostate cancer cells isolated from patients who had died of metastatic prostate cancer – in which cancer cells spread out from the prostate tumor – they found substantial evidence that the nestin gene was active.
What was different, Berman speculated, is that androgen deprivation therapy, a treatment that reduces testosterone in the body, is generally given only when prostate cancers become aggressive and likely to metastasize.
Because prostate cancer growth is typically stimulated by testosterone, the treatment is thought to slow tumor growth and weaken the disease. Patients who eventually die because their disease metastasizes are almost certain to have received this type of therapy, he says.
Speculating that depriving cells of androgens might also, however, affect nestin expression, the researchers experimented on a prostate cancer cell line that depends on androgens to grow. When they removed androgens from the chemical mixture that the cells live in, their production of nestin increased.
Aware that the nestin gene has long been suggested to play some role in cell growth and development, Berman and his colleagues used a bit of laboratory sabotage called RNA interference to decrease the genetic expression of nestin and found that these cells weren’t able to move around and through other cells nearly as well as cells with normal nestin levels.
Prostate cancer cells with hampered nestin expression were also less likely than normal prostate cancer cells to migrate to other parts of the body when transplanted into mice. However, while nestin expression seemed pivotal for metastasis in these experiments, it didn’t seem to make a difference in tumor growth.
“What all this suggests is that nestin levels increased when prostate cancer cells are deprived of androgens and may encourage the cells to metastasize,” says Berman.
Public release date: 1-Oct-2007
Low maternal cholesterol tied to premature birth
Pregnant women who have very low cholesterol may face a greater risk of delivering their babies prematurely than women with more moderate cholesterol levels, a team led by the National Human Genome Research Institute (NHGRI), part of the National Institutes of Health (NIH), reported today.
“Based on our initial findings, it appears that too little cholesterol may be as bad as too much cholesterol during pregnancy, but it is too early to extrapolate these results to the general population. More research is needed to replicate this outcome and to extend it to other groups,” said Dr. Muenke, the study’s senior author and chief of the Medical Genetics Branch in NHGRI’s Division of Intramural Research. “For now, the best advice for pregnant women is to follow the guidance of their health care providers when it comes to diet and exercise.”
In their study of 1,058 South Carolina women and their newborns, researchers found about 5 percent of the women with cholesterol levels in the moderate range of 159-261 milligrams per deciliter (mg/dl) gave birth prematurely. In contrast, white women with the lowest cholesterol levels — less than 159 mg/dl — had a 21 percent incidence of premature births. Interestingly, no increase in premature births was observed among African American women in the low-cholesterol category. However, full-term babies born to both white and African Americans with low cholesterol weighed 5 ounces less on average than full-term babies born to women with moderate cholesterol.
Public release date: 1-Oct-2007
Chemical compound found in tree bark stimulates growth, survival of brain cells
Researchers have identified a compound in tree bark that mimics the chemical reactions of a naturally occurring molecule in the brain responsible for stimulating neuronal cell signaling. Neuronal cell signaling plays a crucial role in the growth, plasticity and survival of brain cells.
Results of the study are published online in the Proceedings of the National Academy of Sciences and will be published in a future print edition.
The tree bark compound, known as gambogic amide, behaves much like Nerve Growth Factor (NGF), a molecule found in the brain. NGF binds to TrkA, a neuronal receptor, and activates neuronal signaling. It is known that the loss of TrkA density correlates with neuronal atrophy and severe cognitive impairment such as that associated with Alzheimer’ disease.
Because gambogic amide also binds to TrKA and activates neuronal signaling, the researchers believe it may have potential as a therapeutic treatment in people affected by neurodegenerative disease, such as stroke, AlzheimerÕs disease and peripheral diabetic neuropathies.
Gambogic amide is derived from gambogic acid, a major ingredient of gamboges, a brownish-orange resin exuded from the Southeast Asian Garcinia hanburryi tree. The resin has been used in that area of the world for thousands of years to treat cancers without any reported toxicity to noncancerous cells.
The researchers are now conducting further pre-clinical research to investigate how the body processes gambogic amide and to confirm that it is in fact non-toxic.
Public release date: 1-Oct-2007
Almost one-third of US children regularly take dietary supplements
More than 30 percent of American children age 18 and younger take some form of dietary supplement, most often multivitamins and multiminerals, according to a report in the October issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.
Most U.S. adults—including 57 percent of women and 47 percent of men—take dietary supplements, according to background information in the article. Professional organizations emphasize diet as the best source of nutrients for children; however, physicians may recommend supplements for certain children at risk of deficiency.
Mary Frances Picciano, Ph.D., of the Office of Dietary Supplements, National Institutes of Health, Bethesda, Md., and colleagues analyzed data from the 1999 to 2002 National Health and Nutrition Examination Survey. This nationally representative survey included 10,136 children age 18 or younger. Participants were given medical examinations and families were interviewed, usually at home.
The researchers found that:
- 31.8 percent of children had used dietary supplements in the previous 30 days, including 11.9 percent of infants younger than 1 year, 38.4 percent of children age 1 to 3 years, 40.6 percent of 4- to 8-year-old children, 28.9 percent of 9- to 13-year-olds and 25.7 percent of teenagers 14 to 18 years
- more non-Hispanic white (38.3 percent) and Mexican American (22.4 percent) children used supplements than non-Hispanic black participants (18.8 percent)
- multivitamins and multiminerals (18.3 percent) were the most commonly used supplements, followed by single vitamins (4.2 percent), single minerals (2.4 percent) and botanical supplements (0.8 percent)
- children who took supplements at all during the previous 30 days took them regularly, with more than 50 percent having taken a supplement 30 times in the past month and more than 60 percent having taken supplements for at least 12 months
- supplement use was associated with higher family income, a smoke-free environment, lower body mass index in children and less daily television, video game or computer time
- children who were underweight or at risk for being underweight were the most likely to take supplements
- 83.9 percent of those who took any supplements took only one, 11.8 percent took two and 4.3 percent took three or more
“In conclusion, dietary supplements provide a consistent daily source of nutrients for nearly one-third of U.S. children, yet individual and national-level estimates of nutrient intake rarely account for them,” the authors write. “Dietary Reference Intakes and Dietary Guidelines for Americans provide recommended nutrient intakes and advice on food choices that promote health and reduce the risk of disease. To truly assess the nutrient status and estimate the potential health risks of U.S. children, we must include nutrient intakes from dietary supplements as well as from food.”
Public release date: 1-Oct-2007
Mental disorders cause 1.3 billion annual days of lost role performance
New findings published by Drs. Kathleen Merikangas from the National Institute of Mental Health (NIMH) and Ronald Kessler from Harvard Medical School and colleagues in the October 2007 issue of the Archives of General Psychiatry show that more than half of U.S. adults have a mental or physical condition that influences their role functioning. In addition, more than 1.3 billion days out of role performance are lost each year in the U.S. due to mental disorders, and major depression is the mental disorder associated with the largest number of days out of role. The study also found that the number of days out of role due to mental disorders is roughly half as large as the number of days associated with all chronic physical conditions combined.
The findings showed that more than half of U.S. adults have a mental or physical condition that is associated with excess days out of role, leading to an estimated 3.7 billion days per year out of role associated with the conditions studied. Nationwide, about 2.4 billion disability days resulted from the chronic physical conditions studied and about 1.3 billion disability days resulted from the mental conditions studied. The effects of individual mental conditions were as large as those of most chronic physical conditions. Chronic back-neck pain was the condition associated with the largest number of days out of role (1.2 billion), followed by major depression resulting in the second largest number of days out of role (387 million).
Public release date: 2-Oct-2007
Low doses of a red wine ingredient fight diabetes in mice
Even relatively low doses of resveratrol—a chemical found in the skins of red grapes and in red wine—can improve the sensitivity of mice to the hormone insulin, according to a report in the October issue of Cell Metabolism, a Cell Press publication. As insulin resistance is often characterized as the most critical factor contributing to the development of type 2 diabetes, the findings “provide a potential new therapeutic approach for preventing or treating” both conditions, the researchers said.
The research group also confirmed that increased levels of an enzyme called SIRT1, which earlier studies had linked to longevity, DNA repair, and insulin secretion, improve insulin sensitivity in mice. Resveratrol is known to activate the SIRT1 enzyme.
The findings suggest that those who drink red wine for the health-promoting benefits of resveratrol might “think about drinking less,” Zhai said. Previously, he noted, the effects of resveratrol seen in mice had implied that humans might need to drink about 120 liters of red wine each day to get enough resveratrol to enjoy the same benefit. “According to our findings, people might need to drink about three liters of red wine each day to get sufficient resveratrol—about 15 mg—for its biological effects.”
Ralphs Note- (one cap of resveratol contains approx 15mg.)
Public release date: 2-Oct-2007
Avoiding sweets may spell a longer life, study in worms suggests
A new study in the October issue of Cell Metabolism, a publication of Cell Press, reveals that worms live to an older age when they are unable to process the simple sugar glucose. Glucose is a primary source of energy for the body and can be found in all major dietary carbohydrates as a component of starches and other forms of sugar, including sucrose (table sugar) and lactose
“In the US and Europe, added sugar accounts for 15 to 20 percent of daily calories, and the breakdown of that sugar always generates glucose,” said Michael Ristow of the University of Jena in Germany and the German Institute of Human Nutrition Potsdam-Rehbrücke. If the findings in worms hold for humans, it “suggests that, in healthy people, glucose may have negative effects on life span.” The findings may also cast some doubt on the prevailing treatments for type 2 diabetes, all of which are aimed at lowering blood levels of glucose by increasing the amount of sugar taken up by body tissues, Ristow said
To begin to address the issue in the current study, the researchers exposed the nematode Caenorhabditis elegans to a chemical that blocked the worms’ ability to process glucose, producing a metabolic state the researchers said resembles that of dietary glucose restriction. That treatment extended the worms’ life span up to 20 percent, Ristow reported, noting that the observed gain extrapolated to humans would mean an additional 15 years of life
Public release date: 2-Oct-2007
Daisies lead scientists down path to new leukemia drug
A new, easily ingested form of a compound that has already shown it can attack the roots of leukemia in laboratory studies is moving into human clinical trials, according to a new article by University of Rochester investigators in the journal, Blood.
The Rochester team has been leading the investigation of this promising therapy on the deadly blood cancer for nearly five years. And to bring it from a laboratory concept to patient studies in that time is very fast progress in the drug development world, said Craig T. Jordan, Ph.D., senior author of the Blood article and director of Translational Research for Hematologic Malignancies at the James P. Wilmot Cancer Center, at the University of Rochester Medical Center.
Under development is dimethylamino-parthenolide (DMAPT), a form of parthenolide (PTL) that is derived from a daisy-like plant known as feverfew or bachelor’s button. DMAPT is a water-soluble agent that scientists believe will selectively target leukemia at the stem-cell level, where the malignancy is born. This is significant because standard chemotherapy does not strike deep enough to kill cancer at the roots, thus resulting in relapses. Even the most progressive new therapies, such as Gleevec, are effective only to a degree because they do not reach the root of the cancer.
DMAPT appears to be unique. It’s mechanism of action is to boost the cancer cell’s reactive oxygen species – which is like pushing the stress level of the cell over the edge – to the point where the cell can no long protect itself and dies, said Monica L. Guzman, Ph.D., the lead researcher on the DMAPT project and a senior instructor at the University of Rochester Medical Center.
Leukemia is different from most cancers and particularly hard to eradicate because leukemia stem cells lie dormant. Standard cancer treatments are designed to seek out actively dividing cells. But in studies so far, DMAPT can kill both dormant cells and cells that are busy dividing, Guzman said
Rochester investigators looked at whether DMAPT could eliminate leukemia in donated human cells, and in mice and dogs. In all cases, DMAPT induced rapid death of AML stem and progenitor cells, without harming healthy blood cells.
DMAPT also has shown potential as a treatment for breast and prostate cancer, melanoma, and multiple myeloma, Guzman said, although those studies have only been conducted in cell cultures to date.
“Once we begin seeing evidence from the clinical trials, it will give us more insight into the pharmacological properties of DMAPT and it will be easier to figure out its potential for other cancers,” Guzman said.
Public release date: 2-Oct-2007
New study shows Concord grape juice has a heart-healthy effect not yet reported with red wine
Take heart: laboratory research, just presented at the WINEHEALTH 2007 conference in Bordeaux, France, showed that Concord grape juice stimulated an arterial relaxation effect in a similar fashion to red wine. The French researchers also reported that the Concord grape juice induced a prolonged relaxation effect that has not yet been reported with red wine.
Dr. Valérie Schini-Kerth and a team of researchers of the Université Louis Pasteur de Strasbourg, France, found that Concord grape juice stimulated the production of nitric oxide in endothelial cells, providing a vasorelaxation effect. It is known that nitric oxide is important in the body’s natural system for maintaining healthy, flexible blood vessels and helps support healthy blood pressure
Researchers further discovered that Concord grape juice produced this relaxation effect by stimulating the same chemical reactions in the arteries that are activated by red wine. The beneficial effect provided by Concord grape juice lasted up to six hours, whereas this extended effect has not been reported with red wine. This research suggests that the benefits of drinking Concord purple grape juice may last long after finishing the juice.
This study supports other preliminary research in which Concord grape juice had a blood pressure-lowering effect. So, for those looking for an alternative to red wine, grape juice made from Concord grapes provides a delicious, family-friendly, heart-healthy alternative.