Research in Medicine

Kenyan Scientists to Make Saliva Test Kits for Malaria

Cabinet Secretary of Health Mr. James Macharia (middle) cutting a cake to celebrate the Kenya Medical Research Institute (KEMRI) certification for the ISO 9001:2008 (QMS) at KEMRI Headquarters in Ngumo on December 18, 2013. KEMRI scientists will conduct a research on testing of malaria using saliva. PHOTO | FILE

Scientists at the Kenya Medical Research Institute (Kemri) are developing a kit to test malaria from saliva and are hoping it may be available in a few years, allAfrica.com reported Friday.

“Use of saliva would be popular because the procedure is not invasive. Furthermore the diagnostic tool under development would be capable of quantifying parasite density,” commented lead researcher Eva Aluvaala.

Aluvaala noted that current blood tests “cannot quantify parasite density, which is important when trying to assess the severity of disease and whether or not a patient is responding to therapy.”

A study of the test began in February this year and is being sponsored by the Canadian government and ends August next year.

Source: First world med tech

 

Packaging insulin into a pill-friendly form for diabetes treatment

Since insulin’s crucial discovery nearly a century ago, countless diabetes patients have had to inject themselves with the life-saving medicine. Now scientists from the National Institute of Pharmaceutical Education and Research (NIPER), Mohali, Punjab, India are reporting a new development toward a long-sought insulin pill that could save millions the pain of daily shots.

Published in the American Chemical Society (ACS) journal Biomacromolecules, the advance could someday not only eliminate the “ouch” factor, but also get needle-wary — and weary — patients to take their medicine when they should.

Sanyog Jain, assistant professor, centre for pharmaceutical nanotechnology, department of pharmaceutics, NIPER and colleagues explain that patients with diabetes sometimes skip doses or stop taking their insulin because the injections can be painful. But doing so puts their health in danger.

An estimated 347 million people globally (about 26 million in the US) are living with diabetes. In the US, more than a quarter of these patients are taking some kind of insulin therapy.

For years, researchers have sought a way to transform delivery of this therapy from a shot to a pill, but it has been a challenge. The body’s digestive enzymes that are so good at breaking down food also break down insulin before it can get to work. In addition, insulin doesn’t get easily absorbed through the gut into the bloodstream. To overcome these hurdles, Jain’s team combined two approaches to shield insulin from the digestive enzymes and then get it into the blood.

The researchers packaged insulin in tiny sacs made of lipids, or fats, called liposomes, which are already used in some treatments. Then, they wrapped the liposomes in layers of protective molecules called polyelectrolytes. To help these “layersomes” get absorbed into the bloodstream, they attached folic acid, a kind of vitamin B that has been shown to help transport liposomes across the intestinal wall into the blood. In rats, the delivery system lowered blood glucose levels almost as much as injected insulin, though the effects of the layersomes lasted longer than that of injected insulin.

The authors acknowledge funding from the Department of Science and Technology (India) and the Council of Scientific and Industrial Research, New Delhi.
Source: India medical Times

Twin U.S. studies unlock mystery of how HIV causes AIDS

U.S. scientists have discovered the basic mechanisms that allow HIV to wipe out the body’s immune system and cause AIDS, which could lead to new approaches to treatment and research for a cure for the disease that affects 35 million people around the world.

Instead of actively killing immune system cells known as CD4 T cells, much of the damage done by HIV occurs when the virus tries to invade these cells and fails, triggering an innate immune response that causes the cells to self-destruct in a fiery kind of cell suicide known as pyroptosis.

The findings, published simultaneously in the scientific journals Science and Nature, also suggest that an experimental anti-inflammatory drug owned by Vertex Pharmaceuticals Inc that has already been tested in people with epilepsy could be repurposed as a possible new treatment for AIDS.

“Our papers deal with the fundamental issue that causes AIDS, and that is the loss of CD4 T cells,” said Dr Warner Greene of the Gladstone Institutes, an independent biomedical research nonprofit based in San Francisco, whose lab produced the research in both papers.

Dr Anthony Fauci, director of the National Institute of Allergy and Infectious Disease, said the papers offer an “elegant” solution to a question that has eluded scientists since the virus was first identified in 1983.

Greene said for years, scientists had thought that HIV killed immune system cells by infecting them directly, hijacking their DNA machinery and turning them into virus-producing factories.

But this only happens to a small portion of CD4 T cells. In a series of experiments in human spleen, tonsil and lymph node tissues from HIV-infected patients, the Gladstone scientists discovered that the real damage of HIV infection occurs in so-called “bystander cells,” the most common type of CD4 T cell.

These cells are in a resting state, so when the virus attacks, it is unable to hijack them, and aborts the attempt.

But the damage is done. These so-called abortively infected immune cells release a protein that activates an enzyme called caspase-1, which causes the highly inflammatory form of cell suicide, pyroptosis.

“The cell is committing suicide in a vain attempt to protect the host,” Greene said. “The abortive process releases a call for help from new CD4 cells, who then fall victim to this fiery death.”

In the paper published in Science, the Gladstone team identified a mechanism that detects the damaged cells and triggers this cell death pathway.

“This idea that CD4 depletion is more of a cellular suicide than it is a murder by the virus is a new and important concept,” Greene said.

In the paper published in Nature, the team explored the implications of blocking this cellular suicide with experiments using anti-inflammatory drugs that block the caspase-1 enzyme, including the Vertex drug VX-765.

Greene said the company tested the treatment in patients with a chronic seizure disorder who would not respond to normal anti-epileptics, but the effect was not strong enough to continue development.

What they did find in a six-week clinical trial in people is that the drug was safe and well-tolerated.

“We would like to see if that drug could be repurposed to prevent inflammation in CD4 T cell loss in HIV infection,” Greene said.

Gladstone is in talks with Vertex to gain access to the drug for clinical trials as a potential new treatment for HIV infection. Such a drug could have three potential applications.

It could be used globally as a stop-gap treatment for the 16 million individuals who are infected with HIV but do not have access to antiretroviral therapy or ART, the highly effective medicines that keep HIV from replicating in the body.

Because the drug fights the inflammatory response linked with HIV infection, it might also be useful in addition to ART as a way of preventing the long-term consequences of HIV infection, such as early dementia, heart attacks and cancer.

Greene thinks the drug might even be useful in the research for an HIV cure, helping to flush out parts of the virus that go into hiding and cause the infection to start up again once people stop taking antiretroviral therapy.

At this point, all of these potential uses are theoretical, Fauci said. “It still remains to be seen what the ultimate practical usage of this is, but nonetheless, it’s still a significant paper.”

Greene said his team is in negotiations with Vertex for access to its drug, and hopes to come to an agreement soon as to how to proceed. “For the benefit of HIV-infected individuals, this merits testing.”

Source: IBN Money

Diabetes Drug Won’t Help Obese Kids Keep Off Weight

Few children who become obese are able to lose and keep off weight with diet and exercise alone, leading some doctors to prescribe drugs, such as the diabetes drug metformin, to treat childhood obesity. However, a new study suggests that metformin may not help kids and teens without diabetes lose weight over the long term.

The study, which reviewed information from previous research, found no evidence that children and teens who took the drug lost more weight after one year than those who did not take the drug.

While some adolescents who took the drug did experience short-term weight loss (six months or less), the effect was modest, and it’s not clear whether such limited weight loss would actually improve their health, the researchers said. [Lose Weight Smartly: 7 Little-Known Tricks That Shave Pounds]

Given the current evidence, metformin has not been shown to be superior to other weight-loss treatments for kids, such as diet and exercise, the researchers said.

“Unfortunately, this drug is not going to be the answer,” said study researcher Marian McDonagh, of Oregon Health & Science University. Overall, the drug does not appear to provide enough weight reduction for children to experience meaningful health benefits in the long term, McDonagh said.

Still, it’s possible that certain groups of children, such as those who are very obese, may benefit from taking the drug. A large study is needed to identify these groups, the researchers said.

The study analyzed information from 14 previous studies (eight in the United States and others in Canada, Australia, Mexico, Europe, Iran and Turkey), which included a total of 946 children ages 10 to 16 who did not have diabetes. The children’s body mass indices (BMIs) ranged from 26 to 41. In most studies, children who took metformin also engaged in lifestyle changes aimed at helping them lose weight.

On average, children who took metformin for six months achieved a 3.6 percent greater reduction in their BMI compared with those who practiced lifestyle changes alone.

However, studies in adults suggest that, in order for a weight-loss treatment to lead to meaningful improvements in health down the road, it needs to reduce BMI by 5 to 10 percent, McDonagh said.

Children in the studies who took metformin for a year saw about the same decrease in BMI as those who practiced lifestyle changes alone. And after one year, both groups started to slip back to their original weight.

The researchers would like to see more studies on weight-loss treatments that involve a child’s entire family. It’s possible that family-based interventions may help children lose more weight — whether they are taking a drug or not — than interventions that don’t consider the child’s family, McDonagh said.

Metformin is approved by the Food and Drug Administration to treat children and adults with Type 2 diabetes.

Source: Fresh news

Lundbeck hopes to launch new Alzheimer’s drug in 2017

Danish pharmaceutical group Lundbeck said on Monday that it hopes to launch a new Alzheimer’s medicine in 2017 in what would be the first new drug for the condition in more than a decade.

Dementia – of which Alzheimer’s disease is the most common form – already affects 44 million people worldwide and is set to reach 135 million by 2050, according to non-profit campaign group Alzheimer’s Disease International.

There is currently no treatment that can cure the disease or slow its progression, but Lundbeck’s new drug – known as Lu AE58054 – is designed to alleviate some of the symptoms and improve cognitive function.

As such, it would build on treatments currently on the market rather than competing with more ambitious projects under way at large drug companies, which aim to modify the biology of the disease.

“If the studies that we are currently running end well, then we wi

ll probably be the first company to launch a new Alzheimer’s drug in 10 to 15 years,” Lundbeck Chief Scientific Officer Anders Gersel Pedersen told Reuters.

The Danish company, together with its Japanese partner Otsuka, is currently testing its experimental Alzheimer’s drug in 3,000 patients in four final-stage Phase III clinical studies.

Pedersen said he expected the drug to have annual worldwide sales of considerably more than $1 billion, if it is approved.

“There is a huge market for this kind of medicine, until the day you cure the disease,” Pedersen said.

It is more than a decade since the last drug, Ebixa, also from Lundbeck, was approved to treat Alzheimer’s.

Although there is still no treatment that can effectively modify the disease or slow its progression, a number of companies – including Eli Lilly, Merck & Co, Roche and Johnson & Johnson – are pursuing a variety of approaches to get to the root of the memory-robbing disorder.

Health ministers from the Group of Eight countries last week set a goal of finding a cure or a disease-modifying therapy by 2025 – a target that is seen as ambitious given that scientists are still struggling to understand the fundamental biology of Alzheimer’s. (Editing by Simon Johnson and David Goodman)

Source: US web daily

FDA Approves New Magnet Device to Treat Migraines

The U.S. Food and Drug Administration has approved the first device aimed at easing the pain of migraines preceded by aura — sensory disturbances that occur just before an attack.

The Cerena Transcranial Magnetic Stimulator would be obtained through prescription, the FDA said in a statement released Friday. Patients use both hands to hold the device against the back of their head and press a button so that the device can release a pulse of magnetic energy. This pulse stimulates the brain’s occipital cortex, which may stop or ease migraine pain.

“Millions of people suffer from migraines, and this new device represents a new treatment option for some patients,” Christy Foreman, director of the Office of Device Evaluation in the FDA’s Center for Devices and Radiological Health, said in the statement.

The agency’s approval is based on a trial involving 201 patients who had suffered moderate-to-strong migraine with aura. One hundred and thirteen of the patients tried treating their migraines while an attack was in progress, and it was the testimony of this group that led to the approval of the new device, the FDA said.

More than a third (38 percent) of people using the stimulator said they were pain-free two hours later, compared to 17 percent of patients who did not use the device. A full day after the onset of migraine, nearly 34 percent of device users said they were pain-free, compared to 10 percent of people who hadn’t used the device.

Two experts welcomed the news of the approval.

“The Cerena TMS is another tool in the battle to relieve migraines,” said Dr. Mark Green, director of Headache and Pain Management at the Mount Sinai Medical Center in New York City. “Experience with TMS over the past few years have shown that these agents have the potential to reduce the pain of an attack without the use of medications, or in addition to medical treatment.”

Dr. Noah Rosen is director of the Headache Center at North Shore-LIJ’s Cushing Neuroscience Institute, in Manhasset NY. He said that, “although only 20 percent of migraneurs suffer from an aura associated with their headaches, they suffer significantly. Although this device is unwieldy, it may be a preferred choice by those who don’t want [drug] treatment.”

Side effects from the device were rare, the FDA said, but included “single reports of sinusitis, aphasia (inability to speak or understand language) and vertigo.”

The new device is approved only for use by those aged 18 or older, and should not be used by people with suspected or diagnosed epilepsy or a family history of seizures. It should also not be used by anyone with any metal device implanted in the head, neck or upper body, or by people with “an active implanted medical device such as a pacemaker or deep brain stimulator,” the FDA said.

The stimulator, manufactured by eNeura Therapeutics of Sunnyvale, Calif., is not meant to be used more than once every 24 hours, the FDA added. It has also not been tested to see if it is effective against other symptoms of migraine such as nausea or sensitivities to light or sound.

Green called that last point “disappointing,” and added that “the other concern is whether insurance carriers will make the product available [to patients].”

Source: Web md

Severed Hand Saved By Being Sewn To Ankle

Man has severed hand attached to leg to keep it alive, Changsha, Hunan Province, China - 10 Dec 2013

Graphic images show a man’s severed hand attached to his ankle – surgery that saved his limb.

A man who lost his right hand in an accident at work has had it successfully reattached after doctors
grafted it to his ankle for a month.

Xiao Wei underwent reattachment surgery in Changsha, Hunan province, after badly injuring himself in
November.

Initially, doctors said they would be unable to save his limb.

Mr Wei said: “I was just shocked and frozen to the spot, until colleagues unplugged the machine and
retrieved my hand and took me to the hospital.

“I am still young, and I couldn’t imagine life without a right hand.”

However, doctors at a larger hospital offered a solution and opted to sew the hand to the ankle to stop
it dying while they treated his other injuries.

Wei’s doctor told Rex Features: “His injury was severe. Besides ripping injuries, his arm was also
flattened. We had to clear and treat his injuries before taking on the hand reattachment surgery.”

Nearly a month after his hand was severed, Wei had recovered sufficiently to undergo reattachment
surgery.

According to doctors he will need to undergo several other procedures, but they are hopeful that he will
regain full function of his hand.

Source: sky news

Can parasitic worms or hot baths treat autism?

Some participants in the trial showed improvement in certain symptoms, including a decrease in repetitive behaviors.

Although the remedies may sound unconventional, doctors are currently testing whether infecting people with worms or giving them hot baths could reduce some symptoms of autism.

In small, early clinical trials, the unusual treatments — which involve using parasitic worm eggs to trigger anti-inflammatory signals in the gut, or raising the body temperature to mimic the effects of an infection — lessened the repetitive behaviors and other symptoms of the disorders; even so, scientists say the effects must be replicated before the treatments can be considered safe and effective.

“All three studies are interesting and merit further investigation,” said Dr. Andrew Adesman, chief of developmental and behavioral pediatrics at Steven & Alexandra Cohen Children’s Medical Center of New York in New Hyde Park, who was not involved in the studies. “To what extent they can lead to clinical treatment is unclear,” Adesman said. [5 Wacky Things That Are Good for Your Health]

In addition, parents should note that trying such treatments at home, without the guidance of a medical specialist, could be dangerous.

Inflammation and autism
Autism spectrum disorder, or ASD, is a group of developmental brain disorders associated with impairments in social skills, communication problems and repetitive behaviors. The causes of the disorder are not fully understood, but are thought to be complex and varied, and current treatments address only the symptoms.

One theory of what causes autism holds that during pregnancy, activation of the mother’s immune system results in inflammation in the baby, which leads to developmental and behavioral abnormalities. Modern human society, some say, has become hyper-sanitized, ridding humans of exposure to common microbes, and so when exposed to even benign “bugs” their immune systems go on the offense. One of the results is inflammation. Some scientists believe germ-free living may explain the higher incidence of inflammatory disorders, such as asthma and allergies, in developed countries.

Previous research has investigated treatment using parasitic worm eggs, known as Trichura suis ova (TSO), to treat autoimmune diseases, such as Crohn’s disease, finding the treatment to be effective in small studies. Anecdotal reports suggest that TSO infection may reduce certain symptoms of autism by reducing underlying inflammation. TSO is a common pig parasite, but is generally considered harmless in humans.

Dr. Eric Hollander, a clinical psychiatrist at Albert Einstein College of Medicine and Montefiore Medical Center, decided to test the treatment in people with autism. In the trial, five high-functioning young adults with the condition were randomly assigned to drink a dose of worm eggs mixed in saltwater, while another five high-functioning participants with autism were given a placebo for three months. Then, after a one-month period of no treatment, each group received the opposite drink for three months.

While receiving the worm treatment, the participants showed a decrease in the repetitive behaviors that are common among people with autism, according to preliminary results from five of the patients that Hollander presented on Dec. 12 at a meeting of the American College of Neuropsychopharmacology (the other five patients are still doing the trial). However, during the worm treatment, the patients did not show improvement in social or communication skills.

More evidence needed
The Food and Drug Administration has not approved the worm treatment for autism. Scientists will need to demonstrate it’s effective in larger trials first, Hollander said. “Clearly more work needs to be done, but this offers a new avenue for treatments,” he told LiveScience.

Worms aren’t the only type of therapy for autism Hollander is exploring. Another theory suggests high levels of stress on the mother during pregnancy can cause autism by leading to a spike in the stress hormone cortisol, which interferes with the development of a specific signaling pathway in the baby’s brain. [7 Ways Pregnant Women Affect Their Babies]

Changes in this signaling pathway might explain why about a third of children with autism experience improvement in their symptoms when they have a fever, according to reports from parents.

In another study Hollander presented today, 15 children with autism, some of whom had a history of improvement due to fever and some of whom didn’t, soaked in a hot tub at 102 degrees Fahrenheit (38.9 Celsius) or 98 F (37 C) for 30 minutes.

The children who had a history of improvement in their autism symptoms after fever showed some improvement in social skills after spending time in the 102-degree hot tub. Exactly why the heat may help remains unclear, but the temperature might affect certain enzymes that control whether genes are turned on or off in the brain, Hollander said.

Adesman called the study “clever” and “intriguing,” but noted that it was unclear whether children who don’t see their autism symptoms improve from fever also benefit from the hot tub therapy.

Elaine Hsiao, a researcher at Caltech who studies autism and immunity said the research “lends support for immune-based therapies for ASD.”

Growing research shows that microbes with the human body modulate brain function and behavior, Hsiao said. It will be important for researchers to figure out how the worm treatment leads to beneficial effects on behavior, whether it’s through changing the immune system, the digestive tract, or other indirect effects, she told LiveScience.

Hollander also presented a third study today, which involved giving 34 high-functioning adults with autism a drug that blocks reuptake of the brain chemical norepinephrine, which may be activating the same brain circuits as fever does. These adults showed improvements in attention and executive function, Hollander reported, though he called for these findings to be replicated as well.

Source: Mother Nature Network

Recycled plastic turned into ‘nanofibers’ to attack fungal infection

Scientists say they have made a “nanomedicine breakthrough” by creating “antifungal nanofibers” from recycled plastic materials that are able to target and attack specific fungal infections. This is according to a study published in the journal Nature Communications.

Researchers from the International Business Machines Corporation (IBM), based in the US, and the Institute of Bioengineering and Nanotechnology (IBN) in Singapore, say they created the technology by converting plastic materials such as polyethylene terephthalate (PET) – commonly used in plastic bottles – into non-toxic biocompatible materials that act as “antifungal agents.”

Fungal infections are extremely common all over the world and cover a broad number of conditions. Mild fungal infections include athlete’s foot, a rash or a mild respiratory illness. But other fungal infections, such as fungal pneumonia or bloodstream infection, can be severe.

According to the researchers, a person is more likely to develop a fungal infection if they possess an altered immune system as a result of antibiotic treatment, or have conditions such as HIV/AIDS or cancer.

Although there are antifungal drugs available to treat these infections, there is the issue of drug resistance.

The investigators explain that traditional antifungal drugs work by attempting to get into cells to attack the infection. However, the drugs find it difficult to target and break through the membrane wall of the fungi.

They also note that fungi are similar to mammalian cells in terms of metabolism. This means the antifungal drugs that are currently used have difficulty determining the difference between infected and healthy cells.

With these factors in mind, the investigators looked to develop a new antifungal agent that could combat the issue of drug resistance.

How does the technology work?
The scientists transformed PET into completely new antifungal molecules using a hydrogen-bonding process that causes them to self-assemble.

The researchers explain that the way these molecules stick together is “like molecular velcro in a polymer-like fashion to form nanofibers.” They note that this process is important because the antifungal agents only work in their “fiber or polymer-like form.”

Explaining how the agents, or “nanofibers” work, the researchers say they possess a positive charge that is able to specifically target a fungal membrane that is negatively charged, and attach to these alone through “electrostatic interaction.”

Dr. Yi Yan Yang, of IBN and leader of the study, says:

“The ability of these molecules to self-assemble into nanofibers is important because unlike discrete molecules, fibers increase the local concentration of cationic charges and compound mass.

This facilitates the targeting of the fungal membrane and its subsequent lysis, enabling the fungi to be destroyed at low concentrations.”

Nanofibers ‘proved successful in fungi eradication’
The assembly of the antifungal nanofibers was simulated in order to predict which different structures could destroy fungi.

From this, the researchers found that the lowest concentration that stops the visible growth of fungi – known as the minimum inhibitory concentration (MIC) – proved the most effective against a variety of fungal infections.

Further research revealed that the nanofibers erased 99.9% of Candida Albicans (C. albicans) – a fungus that is a cause of oral and genital infections in humans, as well as the third most common bloodstream infection in the US.

The fungi was eradicated after 1 hour of incubation and demonstrated no sign of resistance after 11 treatments.

Comparing these results to traditional antifungal drugs, the researchers note that traditional therapeutics developed resistance after 6 hours and were only able to suppress additional fungal growth.

Further studies also looked at the activity of the nanofibers in mouse models. This was done using a C. albicans biofilm infection linked to use of contact lenses.

The researchers found that the nanofibers were able to significantly reduce the number of fungi, prevented new structural growth of fungi in the cornea, and decreased inflammation in the eye.

Commenting on the findings, Prof. Jackie Y. Ying, executive director of IBN, says:

“A key focus of IBN’s nanomedicine research efforts is the development of novel polymers and materials for more effective treatment and prevention of various diseases.

Our latest breakthrough with IBM allows us to specifically target and eradicate drug-resistant and drug-sensitive fungi strains and fungal biofilms, without harming surrounding healthy cells.”

Source: Medical news today

Gene test can help recommend best psychiatric medications for patients

Psychiatrists can use a simple genetic test to determine which psychoactive medications will be most easily metabolized by their patients. And a third clinical study has confirmed that this test has a positive effect on treatment outcome.

The Pine Rest study, published in Discovery Medicine, showed that when psychiatrists have their patients use GeneSite, those in the group whose treatment is guided by the technology showed a greater than two-fold response and remission rate.

GeneSite only requires swabbing the inside of the cheeks and sending the swab into a central lab. Basically, the test segments medications into “green” (use as directed), “yellow” (use with caution) or “red” (use with increased caution) categories, depending on the way a patient’s unique genomic makeup will interact with psychiatric medicines.

Psychiatrists who used GeneSite in the study were twice as likely to switch medications or adjust dosages of medications. In fact, 100 percent of clinicians using GeneSite made such changes, whereas only 50 percent of clinicians without the guidance did so.

The results of the Pine Rest study are similar to those of the La Crosse Study, published in July 2013 in Pharmacogenetics and Genomics. In that study of 227 participants, the GeneSite-guided group experienced a more than two-fold improvement in symptoms and likelihood to achieve remission.

Given the repeated success of GeneSite in these trials, I now use it frequently to help tailor medication treatment for patients. I suggest that you speak with your psychiatrist about it, as well.

Source: top news today