Misfolded Proteins In The Urine May Provide Key To Pre-Eclampsia
Clues to the cause of preeclampsia, a common, but serious hypertension complication of pregnancy that has puzzled doctors and researchers for decades, point to proteins that misfold and aggregate, according to Yale School of Medicine researchers.
These misshapen proteins can be easily detected in the urine, affording a new approach to early diagnosis of the disease, the Yale researchers report in new findings presented at the Society for Maternal Fetal Medicine scientific meetings in San Diego, Calif.
Preeclampsia is one of the most common causes of death in pregnant women in the United States and is responsible for about 76,000 maternal deaths worldwide each year. It is also a leading cause of preterm delivery. Delivery is the only reliable treatment for preeclampsia, and establishing a correct diagnosis can be difficult, especially in women with preexisting hypertension, lupus or kidney disease.
“These results support the hypothesis that preeclampsia is a pregnancy-specific protein misfolding disease,” said lead author on the abstract, Irina Buhimschi, M.D., associate professor in the Department of Obstetrics, Gynecology & Reproductive Sciences. “Our urine dye test is a rapid and non-invasive test that can be used to definitively diagnose preeclampsia.”
In a study of 111 pregnant women, Buhimschi and her team used proteomics to identify key abnormal proteins in the urine weeks before preeclampsia becomes clinically apparent. In order to carry out their individual functions properly, proteins must fold themselves correctly into three-dimensional structures. Misfolding, or failure to fold into the intended shape, produces proteins with different properties that are mainly guided by their shape rather than their amino acid sequence. Proteins of different amino acid sequences may share common shapes when misfolded.
Buhimschi and her team designed a test based on a dye that sticks to misfolded proteins. They analyzed the urine of women in the study starting in the first trimester of pregnancy. Buhimschi was able to use this simple test to identify a study participant who went on to develop severe preeclampsia and required early delivery.
Further work in Buhimschi’s lab, using conformation-specific antibodies developed in Charles Glabe’s laboratory at University of California-Irvine, showed that misfolded shapes similar to those found in Alzheimer’s disease are also present in the urine of preeclamptic women. In contrast to the misfolded proteins identified in Alzheimer’s disease, however, the misfolded aggregates identified in preeclampsia are composed of a group of different proteins, including SERPIN-A1 (also known as alpha-1-antitrypsin).
“Our findings are compelling for several reasons,” said Buhimschi. “This novel identification of preeclampsia as a disorder of protein misfolding opens a door for researchers that may lead to testing of new drugs or developing new therapies. Our future work will seek to determine whether the different shapes employed by the misfolded proteins in preeclampsia are linked to specific clinical symptoms and the different ways this intriguing disease manifests.”
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Article adapted by Medical News Today from original press release.
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Other authors on the abstracts are Catalin Buhimschi, Margaret Baumbusch and Guomao Zhao from Yale School of Medicine; Charles Glabe from University of California-Irvine and Sabina Janciauskiene from the Wallenberg Laboratory in Malmö, Sweden.
Source: Karen N. Peart
Yale University
Obama Set To Lift Restrictions On Stem Cell Research
Researchers in Texas and throughout America are eagerly waiting to hear that President Barack Obama has lifted restrictions on using human
embryonic stem cells in research, an event the US media is expecting to happen later this week.
According to a report in the Houston Chronicle, Baylor College of Medicine and the University of Texas Health Science Center at Houston are both
centres of excellence in stem cell research, and while most of their work has been focusing on adult stem cells, they anticipate a huge expansion of
activity when Obama overturns the policy of former President George W Bush.
Unlike adult stem cell research that uses cells harvested from tissue taken from people without harming them, embryonic stem cells are taken from 5-
day old embryos that have to be destroyed in the process, putting the issue at the centre of a heated ethical and political debate.
Baylor Professor Bill Brinkley, a molecular and cellular biologist, told the Houston Chronicle that lifting the restriction will make embryonic stem
cell research mainstream:
“Most every lab will take advantage of it,” said Baylor.
Embryonic stem cells can become any of the 220 types of cell in the body. Scientists predict they will one day be used to make new tissue to replace
old and diseased nerves, bones, muscles, heart tissue, and blood vessels. For example, animal studies have already shown it may be possible to create
new brain cells, muscle tissue, and pancreatic cells, with potential for treating Parkinson’s, muscular dsytrophy and diabetes, respectively.
In 2001, Bush put the brakes on embryonic stem cell research by restricting it to existing cell lines only (ie no more harvesting from embryos). There
were only about 20 or so of these in existence at the time and their condition was said to be poor and not very useful for clinical work. Many
scientists felt this severely hampered their ability to do serious research in the field.
During his election campaign, Obama promised to lift Bush’s restriction to allow scientists to use stem cells harvested from embryos that would
otherwise be discarded in fertility clinics. He is planning to do this after he has finished working on the plans to revive the economy, said the
Chronicle. A legal bill would still be needed to ratify the policy.
Some say Bush wanted to slow down embryonic stem cell research to make scientists focus on adult stem cells.
Adult stem cells are not as versatile as embryonic stem cells: their potential tends to be restricted to the type of tissue they originated from, although
some recent experiments have shown they may be more plastic than first thought and it might be possible to make them behave more like embryonic
stem cells.
However, scientists are nervous about using the adult stem cell approach because it involves using genetically engineered viruses which can cause
tumors.
Paul Simmons, an adult stem cell researcher and director of University of Texas Houston’s Center for Stem Cell Research, told the Chronilce
that the technique was far from perfect and doubts whether it will eventually be as good as using embryonic stem cells. Perhaps in the end, scientists
will find that adult stem cells are good for some things and embryonic stem cells are better for others, he said.
Scientists at the University of California at Irvine have already developed a therapy using embryonic stem cells that made paralyzed rats walk again.
Earlier this month they were given federal approval to go ahead and test their
approach in humans, the first embryonic stem cell treatment to be tested in humans.
According to the Houston Chronicle, research centres in Texas are queueing up to put in grant applications to pursue research in using embryonic stem
cells to treat Parkinson’s, lung disease, and making cartilage to replace worn out joints. If the state legislature supports Obama’s expected move,
experts predict Texas will become a leader in the field of embryonic stem cell research, said the paper.
Sources: The Houston Chronicle, MNTR archives.
Written by: Catharine Paddock, PhD
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today
Genetics Is The Most Important Factor In Explaining The Link Between Sleep Problems Early In Life And The Later Development Of Depression
A study in the Feb. 1 issue of the journal SLEEP was the first to use twin data to examine the longitudinal link between sleep problems and depression. Results of this study demonstrate that sleep problems predict later depression; the converse association was not found. These findings are consistent with the theory that early treatment of sleep problems may protect children from the development of depression.
Results of the study indicate that the stability of sleep problems across time is mainly caused by genetic factors (46 percent of the genetic influences on sleep at age 10 were the same as those that influenced a child at age 8). The stability of depression is mainly caused by non-shared environmental influences (19 percent of the non-shared environmental influence on depression at age 10 remained the same from the age of eight).
According to lead author Alice M. Gregory, senior lecturer in the department of psychology at Goldsmiths College in London, the most surprising result of the study concerned the reasons why there may be links between sleep problems and depression at different points in a young person’s life.
“We reported in a study previously, that genes were the most important factor in explaining the association between sleep problems and depression in eight year olds,” said Gregory. “However, when we examined this issue at age 10, we found that genes were less important in explaining the association and that environmental influences had become more important. This could be because environmental experiences are becoming more relevant as children grow older and could therefore play a role in both sleep problems and depression.”
The process thought to underlie the associations between sleep and depression reflects abnormalities that are known to be influenced by genetic variations. A longitudinal twin study was used in order to distinguish shared and non-shared environmental influences. Shared environmental influences create similarities among individual family members, and can therefore be estimated by calculating the similarity between identical twins that is not due to genetic influences. Non-shared environmental influences individualize family members, and can therefore be estimated by examining the associations between monozygotic (MZ) twin pairs; if there is not a perfect correlation between MZ twins, it can be assumed that non-shared environmental influence are playing a role.
Data were collected from 300 twin pairs born in England and Wales between 1994 and 1996. Anxiety was examined at age 7 using the parent-report Anxiety Related Behaviors Questionnaire (ARBQ), a 21-item scale reflecting commonly assessed anxiety-related behaviors in young children (including general distress, separation anxiety, shyness, inhibition and fears). Two hundred forty-seven twin pairs scored highly on parent-reported anxiety at age seven; fifty-three control twin pairs also were selected to ensure full coverage of the full range of scores on test measures.
Parents reported on their 8-year-old children’s sleep problems using the abbreviated version of the Child Sleep Habits Questionnaire (CSHQ). Eight aspects of commonly reported childhood sleep problems were analyzed, including bedtime resistance, sleep-onset delay, sleep duration, sleep anxiety, night waking, parasomnias, sleep-disordered breathing and daytime sleepiness.
Depressive symptoms were examined in the 8-year-old twins through the Children’s Depression Inventory (CDI), a 27-item self-report questionnaire that examines affective, cognitive and behavioral signs of depression. Approximately two years later when the twins were 10 years old, data on sleep problems and depression were collected again from 250 of the twin pairs.
The authors argue that although childhood sleep problems have only a small influence on later depression, these issues should be given serious consideration as they can negatively affect a child’s mood, attention-span, and social and academic function. They also state that, in comparison with other risk indicators of later problems, sleep difficulties are more easily broached and readily discussed with families without the negative stigma that may be associated with the discussion of mental health problems in children.
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Article adapted by Medical News Today from original press release.
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SLEEP is the official journal of the Associated Professional Sleep Societies, LLC (APSS), a joint venture of the American Academy of Sleep Medicine and the Sleep Research Society. The APSS publishes original findings in areas pertaining to sleep and circadian rhythms. >Sleep, a peer-reviewed scientific and medical journal, publishes 12 regular issues and 1 issue comprised of the abstracts presented at the SLEEP Meeting of the APSS.
The study: “The Direction of Longitudinal Associations between Sleep Problems and Depression Symptoms: A study of Twins Aged 8 and 10 Years,”
AASM is a professional membership organization dedicated to the advancement of sleep medicine and sleep-related research. As the national accrediting body for sleep disorders centers and laboratories for sleep related breathing disorders, the AASM promotes the highest standards of patient care. The organization serves its members and advances the field of sleep health care by setting the clinical standards for the field of sleep medicine, advocating for recognition, diagnosis and treatment of sleep disorders, educating professionals dedicated to providing optimal sleep health care and fostering the development and application of scientific knowledge.
Source: Kelly Wagner
American Academy of Sleep Medicine
Post-Operative Crohn’s Disease Recurrence May Be Prevented By Infliximab
The administration of infliximab after intestinal resective surgery was found to be effective at preventing endoscopic and histological recurrence of Crohn’s disease, according to a new study in Gastroenterology, the official journal of the American Gastroenterological Association (AGA) Institute. To date, there have been no randomized controlled trials evaluating infliximab for postoperative Crohn’s disease prevention.
“Our study provides strong evidence that infliximab is effective at preventing endoscopic, clinical and histological postoperative recurrence of Crohn’s disease, and provides a rationale for aggressive postoperative chemoprevention with biologic therapy,” said Miguel Regueiro, MD, of the University of Pittsburgh Medical Center. “We are encouraged by our findings, which warrant future study of the duration of post-operative infliximab maintenance and appropriate endoscopic follow up.”
Crohn’s disease is an inflammation and ulceration process that occurs in the deep layers of the intestinal wall and commonly recurs after intestinal resection. Despite the advent of immunomodulator therapy, approximately 75 percent of Crohn’s disease patients require an intestinal resection for complications.
Researchers randomly assigned 24 Crohn’s disease patients who had undergone ileocolonic resection to receive intravenous infliximab (5 mg/kg), administered within four weeks of surgery and continued for one year, or placebo. The study’s research team elected to use endoscopic recurrence at one year as the primary study endpoint. Secondary endpoints were clinical recurrence and remission and histological recurrence.
At one year, the rate of endoscopic recurrence was significantly lower in the infliximab group (9.1 percent) compared to the placebo group (84.6 percent). There was a non-significant higher proportion of patients in clinical remission in the infliximab group (80 percent) compared to the placebo group (53.8 percent). The histological recurrence rate at one year was significantly lower in the infliximab group (27.3 percent) compared to the placebo group (84.6 percent).
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Article adapted by Medical News Today from original press release.
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Visit http://www.gastro.org/patient for more patient information about Crohn’s disease.
About the AGA Institute
The American Gastroenterological Association (AGA) is dedicated to the mission of advancing the science and practice of gastroenterology. Founded in 1897, the AGA is one of the oldest medical-specialty societies in the U.S. Comprised of two non-profit organizations – the AGA and the AGA Institute – our more than 16,000 members include physicians and scientists who research, diagnose and treat disorders of the gastrointestinal tract and liver. The AGA, a 501(c6) organization, administers all membership and public policy activities, while the AGA Institute, a 501(c3) organization, runs the organization’s practice, research and educational programs. On a monthly basis, the AGA Institute publishes two highly respected journals, Gastroenterology and Clinical Gastroenterology and Hepatology. The organization’s annual meeting is Digestive Disease Week®, which is held each May and is the largest international gathering of physicians, researchers and academics in the fields of gastroenterology, hepatology, endoscopy and gastrointestinal surgery. For more information, please visit http://www.gastro.org.
About Gastroenterology
Gastroenterology, the official journal of the AGA Institute, is the most prominent scientific journal in the specialty and is in the top 1 percent of indexed medical journals internationally. The journal publishes clinical and basic science studies of all aspects of the digestive system, including the liver and pancreas, as well as nutrition. The journal is abstracted and indexed in Biological Abstracts, CABS, Chemical Abstracts, Current Contents, Excerpta Medica, Index Medicus, Nutrition Abstracts and Science Citation Index. For more information, visit http://www.gastrojournal.org.
Source: Alissa Cruz
American Gastroenterological Association
Diagnosis Of Swallowing Disorder In Children
A simple test to swallow three ounces of water can help determine whether a child has the swallowing disorder oropharyngeal dysphagia, establishing for the first time a way to screen for the ailment in children, according to new research published in the February 2009 issue of Otolaryngology – Head and Neck Surgery.
Oropharyngeal dysphagia is a swallowing disorder caused by abnormalities of muscles, nerves, or structures of the oral cavity, pharynx, and upper esophageal sphincter.
The study issued a three-part challenge to 56 children with suspected oropharyngeal dysphagia. In the first two stages, subjects were asked to swallow food and liquid boluses (large capsules), with aspiration measured using a fiberoptic endoscopic evaluation of swallowing (FEES). Following the first two phases, the patients were then asked to drink and swallow three ounces of water out of a cup or straw.
The researchers concluded that patients who pass the test can begin new diets consisting of not just thin liquids, but also other food consistencies, including pureed, chopped, soft-solid, or regular diet, depending on how much the patient aspirated during the challenge’s first two phases.
According the research, 39.3 percent of the patients passed the water swallow challenge, and were cleared for an oral diet, with 86.4 percent of those passing resuming a solid food diet. Furthermore, 61.4 percent of those who failed the test were able to tolerate thin liquids based on FEES results.
Previously, there had been no reliable screening test for children suspected of having oropharyngeal dysphagia. While the prevalence of the ailment in children is unknown, the impact is substantial, and can result in poor weight gain and stunted growth, along with dehydration, oral aversion, and pneumonia. Finding a screening test for children means physicians can avoid diagnosis using a videofluoroscopy (which exposes a child to radiation) or a transnasal endoscopy (which can be uncomfortable).
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Article adapted by Medical News Today from original press release.
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The research coincides with the February 2009 observance of Kids ENT Health Month, an annual opportunity to educate parents and their children on the various otolaryngic health issues that kids face. More information on Kids ENT Health Month can be found at http://www.entnet.org/kidsENT.
Otolaryngology – Head and Neck Surgery is the official scientific journal of the American Academy of Otolaryngology – Head and Neck Surgery Foundation (AAO-HNSF) and the American Academy of Otolaryngic Allergy (AAOA). The study’s authors are Debra M. Suiter, PhD; Steven B. Leder, PhD; and David E. Karas, MD.
About the AAO-HNS
The American Academy of Otolaryngology – Head and Neck Surgery (www.entnet.org), one of the oldest medical associations in the nation, represents nearly 12,000 physicians and allied health professionals who specialize in the diagnosis and treatment of disorders of the ears, nose, throat, and related structures of the head and neck. The Academy serves its members by facilitating the advancement of the science and art of medicine related to otolaryngology and by representing the specialty in governmental and socioeconomic issues. The organization’s vision: “Empowering otolaryngologist-head and neck surgeons to deliver the best patient care.”
Source: Matt Daigle
American Academy of Otolaryngology — Head and Neck Surgery
Study Findings And Policy Implications For Improving The Nutrition And Health Of US Children And Adolescents
A special Supplement to the February 2009 issue of the Journal of the American Dietetic Association presents findings from the recently released Third School Nutrition Dietary Assessment Study (SNDA-III), conducted by Mathematica Policy Research, Inc., as well as research from other studies using SNDA-III data. Sponsored by the Food and Nutrition Service of the US Department of Agriculture (USDA), SNDA-III assesses the quality and contributions of the National School Lunch Program (NSLP) and the School Breakfast Program (SBP), longstanding government efforts to bring good food to the children of America.
The National School Lunch Program (NSLP), created in 1946, currently operates in nearly all public and many private schools in the United States, providing subsidized meals to more than 30 million children each school day. More than 10 million children also take advantage of the School Breakfast Program (SBP), which became a permanent federal program in 1975.
SNDA-III examines the school food environment, children’s dietary behaviors at school and outside of school and child overweight/obesity. SNDA-III was based on a nationally representative sample of 130 public School Food Authorities (districts that offer federally subsidized school meals), 398 schools within those districts and 2,314 public school students in grades 1-12 in 287 of these schools. Data were collected in the second half of school year 2004-2005 from district foodservice directors and their staff, school foodservice managers, principals, students and their parents. In addition, field interviewers who were collecting data from students and parents observed and recorded the types of competitive foods available in visited schools.
Supplement Guest Editor Mary Story, PhD, RD, School of Public Health, University of Minnesota, emphasizes the importance of the SNDA-III study. She writes, “Results of SNDA-III show that many schools have improved the nutritional quality of the NSLP and SBP school meals and foods sold outside of the reimbursable meal programs (competitive foods). However, there is much more room for improvement. Schools need to do even more to reduce the availability of high-calorie, low-nutrient foods and make school meals more nutritious. Although the majority of US schools offer breakfasts and lunches that meet the standards for key nutrients (such as protein, vitamins A and C, calcium and iron), reimbursable school meals remain too high in saturated fat and sodium, and children are not consuming enough fruits, vegetables and whole grains. Many public schools are constrained in providing better meals because of limited funds. It is time to reexamine the formulas used to set national reimbursement rates with reference to the costs of producing and serving school meals that meet the Dietary Guidelines for Americans 2005.”
“As an Institute of Medicine expert panel considers revisions to the meal patterns and nutrition standards for USDA’s school meal programs and Congress takes up reauthorization of the school nutrition programs again in 2009, the SNDA-III findings are particularly important,” commented Anne Gordon, PhD, a senior researcher at Mathematica in Princeton, NJ, who led the SNDA-III analysis. “Future studies will look back to SNDA-III to examine how school meals and school food environments have changed after implementation of subsequent federal policy initiatives. SNDA-III data could also be used to estimate the potential effects of proposed changes in policy on schoolchildren’s diets.”
Clare Miller, MS, RD, a nutrition consultant and member of the American Dietetic Association School Nutrition Dietetic Practice Group, offers a commentary on the key findings of SNDA-III, and identifies many areas of concern for food and nutrition professionals, as well as for policymakers and parents. She notes, for example, that few schools provided lunches that met the recommendations in the 2005 Dietary Guidelines for fiber and none of the schools met the recommended sodium limitations. Also, she discusses the availability of competitive foods in public schools and how, regardless of whether children ate a school lunch, the competitive foods purchased were generally low-nutrient, energy-dense foods, including candy, desserts, salty snacks, french fries, muffins, donuts, sweet rolls, toaster pastries and caloric beverages other than milk or 100% fruit juice.
In a second commentary, Nancy Montanez Johner, Undersecretary, Food, Nutrition and Consumer Services at the US Department of Agriculture, emphasizes the need for studies such as SNDA-III to address critical challenges that remain to make the programs as effective as they can be in meeting the needs of participating children. Although more than 70% of schools serve meals that meet standards for many nutrients that contribute to healthful diets, few schools (6% to 7%) met all nutrition standards in school year 2004-2005, primarily because most meals served contain too much fat, too much saturated fat or too few calories. Although most schools offer the opportunity to select a balanced meal, few students make the more healthful choice.
The Special Supplement continues with nine research contributions coauthored by staff from Mathematica that expand on the findings of SNDA-III. The first describes the background and study design including complete details of the sampling methods and study limitations. “Because the SNDA-III study is comprehensive, recent and nationally representative, it provides not only a clear picture of the meals currently eaten by many of our nation’s children, but also a strong foundation for future policy development and research,” said Mary Kay Crepinsek, a senior researcher at Mathematica who oversaw the compilation of the special supplement.
Four articles present the central SNDA-III results regarding the nutrient content of school meals as offered and served, students’ nutrient intakes on school days, foods offered in school meals and in breakfasts and lunches consumed by students and the availability and consumption of competitive foods in school.
Two further articles examine students’ consumption of low-nutrient, energy-dense foods at home, school or other locations and the relationship of the school food environment to their dietary behaviors. Two final articles tie the SNDA-III results to the data on children’s body mass index to assess the effects of the school meal programs, the school environment and dietary behaviors on children’s weight status and child obesity. The Supplement closes with a summary of the findings and policy implications.
The Supplement is published with support from the Robert Wood Johnson Foundation. “Improving the nutritional quality of the foods that schools serve their students – and holding officials accountable for that quality – is critically important if the country hopes to reverse the childhood obesity epidemic,” said C. Tracy Orleans, senior scientist and distinguished fellow at the Foundation. “Results from the latest national dietary assessment illustrate the progress that has been made as well as the problems we still confront. They definitely should help guide local, state and national policy-makers.”
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Article adapted by Medical News Today from original press release.
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These articles appear in a Special Supplement to the Journal of the American Dietetic Association entitled “The School Food Environment, Children’s Diets, and Obesity: Findings from the Third School Nutrition Dietary Assessment Study,” published in February 2009 by Elsevier. Access to the Supplement is available at http://www.adajournal.org. Support for the special Supplement was provided by the Robert Wood Johnson Foundation. The SNDA-III study was conducted by Mathematica Policy Research, Inc., under a contract with the USDA Food and Nutrition Service.
Source: Lynelle Korte
Elsevier Health Sciences
The Activation Of Pro-Inflammatory Cytokines May Be A Mechanism By Which Short And Long Sleep Durations Affect Health
A study in the Feb. 1 issue of the journal SLEEP shows that sleep duration is associated with changes in the levels of specific cytokines that are important in regulating inflammation. The results suggest that inflammation may be the pathway linking extreme sleep durations to an increased risk for disease.
Each additional hour of self-reported sleep duration was associated with an eight-percent increase in C-reactive protein (CRP) levels and a seven-percent increase in interleukin-6 (IL-6), which are two inflammatory mediators. In contrast, each hour of reduction in sleep measured objectively by polysomnography was associated with an eight-percent increase in tumor necrosis factor alpha, another pro-inflammatory cytokine.
“The most surprising finding was that we found different relationships based on how sleep was measured,” said lead author Dr. Sanjay R. Patel, assistant professor of medicine at Case Western Reserve University in Cleveland, Ohio.
According to the authors, research has linked both short and long sleep durations with an increased risk for mortality, coronary heart disease, diabetes and obesity. Chronic elevations in cytokines such as CRP and IL-6 also are associated with an increased risk of problems such as diabetes and heart disease.
The study involved 614 individuals from the Cleveland Family Study, a longitudinal family-based epidemiological cohort designed to study the genetics of obstructive sleep apnea (OSA). Participants completed questionnaires about sleep habits and underwent one night of polysomnography. In the morning a fasting blood sample was collected, and it was analyzed for five inflammatory cytokines.
Mean self-reported habitual sleep duration was 7.6 hours; mean sleep duration measured by polysomnography on the night prior to blood sampling was 6.2 hours. Those with long sleep durations, assessed by either measure, were significantly younger. Short sleep duration measured by polysomnography was associated with an increased prevalence of diabetes, hypertension and obstructive sleep apnea.
According to the authors the differing patterns of association with cytokine levels suggest that self-reported habitual sleep duration may measure chronic sleep exposure, while polysomnography may measure an acute exposure. They also note that the two methods of measuring sleep duration may be influenced differently by an underlying predictor of sleep habits such as stress or mood, which may have a direct effect on cytokine levels.
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Article adapted by Medical News Today from original press release.
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SLEEP is the official journal of the Associated Professional Sleep Societies, LLC (APSS), a joint venture of the American Academy of Sleep Medicine and the Sleep Research Society. The APSS publishes original findings in areas pertaining to sleep and circadian rhythms. SLEEP, a peer-reviewed scientific and medical journal, publishes 12 regular issues and 1 issue comprised of the abstracts presented at the SLEEP Meeting of the APSS.
The study: “Sleep Duration and Biomarkers of Inflammation”
AASM is a professional membership organization dedicated to the advancement of sleep medicine and sleep-related research. As the national accrediting body for sleep disorders centers and laboratories for sleep related breathing disorders, the AASM promotes the highest standards of patient care. The organization serves its members and advances the field of sleep health care by setting the clinical standards for the field of sleep medicine, advocating for recognition, diagnosis and treatment of sleep disorders, educating professionals dedicated to providing optimal sleep health care and fostering the development and application of scientific knowledge.
Source: Kelly Wagner
American Academy of Sleep Medicine
Obstructive Sleep Apnea Severity And Daytime Functional Impairments Confounded By Short Sleep Duration
A study in the Feb. 1 issue of the journal SLEEP shows that daytime functional impairments in older men with obstructive sleep apnea (OSA) are largely explained by total sleep time rather than OSA severity.
A modest link between OSA severity and daytime sleepiness, measured by the Epworth Sleepiness Scale, was no longer statistically significant after controlling for total sleep time. Neither sleep disturbances, measured by the Pittsburgh Sleep Quality Index, nor sleep-related quality of life, measure by the Functional Outcome of Sleep Questionnaire, were associated with OSA severity; all three measures were modestly associated with total sleep time.
According to lead author Dr. Eric J. Kezirian, director of the division of sleep surgery in the department of otolaryngology at the University of California in San Francisco, the study shows that the functional consequences of OSA in older men may differ from those in younger populations and may need to be measured with instruments designed specifically for the demographic.
“While the disorder is associated with behavioral and health-related effects that improve with treatment in young and middle-aged adults, there is little evidence concerning its adverse consequences or treatment benefits in older adults,” said Kezirian. “This study showed that in a community-dwelling group of older men, the severity of OSA was not associated with daytime sleepiness, sleep symptoms, or sleep-related quality of life, after controlling for sleep duration.”
Data were collected from 2,849 men with a mean age of 76.4 years. Thirteen percent (365/2849) of participants had an ESS of at least 10, a level commonly considered to be excessive sleepiness. The presence and severity of OSA were measured by in-home polysomnography. Overall the study group demonstrated mild to moderate OSA with an average apnea-hypopnea index (AHI) of 17.0. Forty-three percent had an AHI of 15 or more.
Average total sleep time was measured by actigraphy over multiple nights. Thirty-one percent (889/2849) had a short sleep time of less than 360 minutes per night, and the prevalence of short sleep time increased with AHI. Individuals with higher AHI levels also were slightly older than men with lower AHI levels, and they had a higher body mass index, poorer self-reported health status and a higher Geriatric Depression Scale score.
Keizirian said that having a better understanding of OSA in older adults will help medical professionals treat the condition more effectively.
According to the American Academy of Sleep Medicine, OSA is a sleep-related breathing disorder that involves a decrease or complete halt in airflow despite an ongoing effort to breathe. It occurs when the muscles relax during sleep, causing soft tissue in the back of the throat to collapse and block the upper airway. This leads to partial reductions (hypopneas) and complete pauses (apneas) in breathing that can produce abrupt reductions in blood oxygen saturation. Brief arousals from sleep restore normal breathing but can cause a fragmented quality of sleep. Most people with sleep apnea snore loudly and frequently, and they often experience excessive daytime sleepiness.
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Article adapted by Medical News Today from original press release.
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More information about OSA is available from the AASM at http://www.sleepeducation.com/Disorder.aspx?id=7.
SLEEP is the official journal of the Associated Professional Sleep Societies, LLC (APSS), a joint venture of the American Academy of Sleep Medicine and the Sleep Research Society. The APSS publishes original findings in areas pertaining to sleep and circadian rhythms. SLEEP, a peer-reviewed scientific and medical journal, publishes 12 regular issues and 1 issue comprised of the abstracts presented at the SLEEP Meeting of the APSS.
The study: “Behavioral Correlates of Sleep-Disordered Breathing in Older Men,”
AASM is a professional membership organization dedicated to the advancement of sleep medicine and sleep-related research. As the national accrediting body for sleep disorders centers and laboratories for sleep related breathing disorders, the AASM promotes the highest standards of patient care. The organization serves its members and advances the field of sleep health care by setting the clinical standards for the field of sleep medicine, advocating for recognition, diagnosis and treatment of sleep disorders, educating professionals dedicated to providing optimal sleep health care and fostering the development and application of scientific knowledge.
Source: Kelly Wagner
American Academy of Sleep Medicine
Striking Association Between Pregnancy-Related Restless Legs Syndrome And Increased Levels Of The Steroid Hormone Estradiol
A study in the Feb. 1 issue of the journal Sleep shows that the elevation in estradiol levels that occurs during pregnancy is more pronounced in pregnant women with restless legs syndrome (RLS) than in controls.
During the last trimester of pregnancy, levels of the estrogenic steroid hormone estradiol were 34,211 pg/mL in women with RLS and 25,475 pg/mL in healthy controls. At three months postpartum, estradiol levels had dropped to 30.73 pg/mL in the RLS group and 94.92 pg/mL in controls. Other hormone levels did not differ significantly between the study groups.
According to the authors the data strongly suggest that estrogens play an important role in RLS during pregnancy. The study also supports previous reports of high RLS incidence in the last trimester of pregnancy when estradiol is maximally elevated.
“Our findings strongly support the concept that neuroactive hormones play a relevant pathophysiological role in RLS,” said principal investigator Thomas Pollmacher, MD, director of the Center for Medical Health at Klinikum Ingolstadt and professor of psychiatry at Ludwig Maximilians University in Munich, Germany. “This information will increase the understanding of RLS in pregnancy and will assist in the development of specific therapeutic approaches.”
The American Academy of Sleep Medicine describes RLS as a sleep-related movement disorder that involves an almost irresistible urge to move the legs at night. This urge tends to be accompanied by unusual feelings or sensations, called “paresthesias,” that occur deep in the legs. These uncomfortable sensations often are described as a burning, tingling, prickling or jittery feeling. RLS can profoundly disturb a person’s ability to go to sleep or return to sleep after an awakening.
The AASM reports that RLS occurs 1.5 to two times more often in women than in men. Eighty percent to 90 percent of people with RLS also experience periodic limb movements (PLMs) during sleep, which are involuntary jerking or twitching movements of the feet or legs.
According to the authors RLS symptoms often occur for the first time during pregnancy. Symptoms typically worsen during pregnancy and improve or even disappear after delivery. The risk of developing RLS increases gradually with the number of pregnancies.
The study also found that women with RLS had more PLMs than controls before and after delivery. PLMs decreased significantly after delivery in women with RLS and stayed low in women without RLS.
Only minor differences appeared between the two study groups in subjective sleep quality and objective sleep measures. One explanation suggested by the authors is that only RLS patients who did not need pharmacological treatment were selected for the study; RLS symptoms of participants were in the mild to moderate range.
The study involved nine healthy pregnant women (mean age 32.9 years) who were placed in a control group and 10 pregnant women (mean age 31.6 years) who fulfilled diagnostic criteria for RLS. Eight women from the RLS group reported symptoms previous to the present pregnancy, and all members of the RLS group described worsening of symptoms during pregnancy. The mean age of onset for RLS symptoms was 22.6 years.
Sleep data and leg movements were recorded during overnight polysomnography around the 36th week of gestation and again at 12 weeks postpartum. Blood samples were taken each morning after the polysomnography and before breakfast. Accompanying questionnaires on sleep and RLS symptoms also were collected.
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Article adapted by Medical News Today from original press release.
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More information about RLS is available from the AASM at http://www.sleepeducation.com/Disorder.aspx?id=11.
SLEEP is the official journal of the Associated Professional Sleep Societies, LLC (APSS), a joint venture of the American Academy of Sleep Medicine and the Sleep Research Society. The APSS publishes original findings in areas pertaining to sleep and circadian rhythms. SLEEP, a peer-reviewed scientific and medical journal, publishes 12 regular issues and 1 issue comprised of the abstracts presented at the SLEEP Meeting of the APSS.
The study: “Elevated Estradoil Plasma Levels in Women with Restless Legs during Pregnancy,”
AASM is a professional membership organization dedicated to the advancement of sleep medicine and sleep-related research. As the national accrediting body for sleep disorders centers and laboratories for sleep related breathing disorders, the AASM promotes the highest standards of patient care. The organization serves its members and advances the field of sleep health care by setting the clinical standards for the field of sleep medicine, advocating for recognition, diagnosis and treatment of sleep disorders, educating professionals dedicated to providing optimal sleep health care and fostering the development and application of scientific knowledge.
Source: Kelly Wagner
American Academy of Sleep Medicine
Tiny Gold Spheres Seek And Destroy Melanoma Cells
US researchers armed tiny hollow gold spheres with a highly targeted peptide so they could hunt down and get deep inside melanoma cells and
then destroy them using heat converted from infra red light.
The research was the work of scientists from the University of Texas MD Anderson Cancer Center and is published in the 1 February
issue of Clinical Cancer Research.
Senior author Dr Chun Li, a professor in MD Anderson’s Department of Experimental Diagnostic Imaging said:
“Active targeting of nanoparticles to tumors is the holy grail of therapeutic nanotechnology for cancer.”
Li said he and his team were getting closer to that goal.
Co-author, Dr Jim Zhang professor in the University of California-Santa Cruz Department of Chemistry developed the tiny gold spheres, 40 to 50
nanometres in diameter. Their hollowness allows them to penetrate cells, and they have a strong but narrow and tunable ability to absorb light at the
visible and near-infrared end of the spectrum, something other metal nanoparticles don’t have.
Li, Zhang and colleagues used the minimally invasive treatment on live lab mice. The method is called photothermal ablation, where target tissue is
destroyed by irradatiating the target area in which the thermal material, in this case nanoparticles, but sometimes optical fibres are used, is irradiated
with light which is turned into heat to destroy the surrounding tissue.
However, melanomas are not easy to treat in this way because it is hard to get the targetting metal particles to differentiate between healthy and
cancerous tissue. Li and colleagues were able to do this by embedding a peptide, a small molecule made up of amino acids, in the gold nanospheres.
The peptide was highly targeted, it would only bind to the melanocortin type 1 receptor, which is overly abundant in melanoma cells.
First in Cultured Cells
Li and colleagues first treated the melonoma cells in culture. When they switched on the infra-red light, the nanospheres absorbed the light and converted it to heat, which burned off the tumors (they
literally got “cooked”). Infra-red light penetrates deeper into tissue than visible or ultraviolet light.
They found that the actively targeted gold nanospheres did more than eight times more damage to the melanoma tumors than the same
nanospheres that were not actively targeted.
It is possible to treat cancer just using the targeted light on its own (via embedded optical fibres), but as already mentioned, melanomas are much
harder because they are surrounded by healthy tissue. With the highly targeted gold nanospheres as a way to focus the light, Li and colleagues were
able to use 12 per cent of the dose required, which is more likely to spare surrounding healthy tissue.
The injected nanospheres are small enough to get right inside the melanoma tumor and attach themselves to the cancer cells’ blood supply. Using
fluorescent tagging on the nanospheres that they tested on the cultured melanoma cells, Li and Zhang and colleagues were able to show that the
targeted nanospheres were drawn right into the cells through the cell membrane while the untargeted ones were not.
When they irradiated the treated cultures, the researchers found that most cells containing the targeted nanospheres died, and nearly all those left where
damaged beyond repair. But this did not happen with the untargeted nanospheres, only a very small fraction of cells treated with them died.
Also, irradiation with near-infrared light alone, or treatment with nanospheres alone without light, had no effect on the cells.
It was therefore the combination of highly targeted nanospheres and the irradiation that had the maximum effect of killing targeted cancer
cells.
Then in Live Mice
In the live mice, fluorescent tagging showed that the untargeted nanospheres gathered near the tumor’s blood vessels whereas the targeted ones
penetrated into the tumor and were found spread around inside it.
A common problem with using nanoparticles is that the body sends foreign matter to the liver and spleen for destruction. Most of the targeted
nanospheres stayed in the tumor, with some found in the liver and spleen. But most of the untargeted nanospheres gathered in the spleen, then the liver
and then the tumor. The researchers said this showed the importance of targeting the nanospheres more selectively.
Li said:
“There are many biological barriers to effective use of nanoparticles, with the liver and spleen being the most important.”
When they irradiated the mice with the near infrared light, those that had been injected with targeted nanospheres, had nearly 66 per cent of their
tumors destroyed. This compared with only 7.9 per cent tumor destruction in the mice that had only been injected with untargeted
nanospheres.
The researchers were able to measure the tumors by using tagged glucose (F-18-labelled). This shows up on a PET scan. Tumors treated with
targeted nanospheres did not light up very much, showing there was little metabolized tagged glucose in them.
Clinical Implications
While the findings of this study show implications for the treatment of melanomas, Li said they were proof of principle for other cancers too.
“Receptors common to other cancers can also be targeted by a peptide-guided hollow gold nanosphere,” said Li.
“We’ve also shown that non-invasive PET can monitor early response to treatment,” he added, explaining that the hollow nanospheres are also made
with pure gold, which has a long history of safe use in medicine with few side effects.
The National Cancer Institute Alliance for Nanotechnology in Cancer, the John S. Dunn Foundation, and the U.S. Department of Defense paid for the
study.
Co-authors with Zhang, and Li were: Wei Lu (first author), Chiyi Xiong, Guodong Zhang, Qian Huang and Rui Zhang, all from MD Anderson’s
Department of Experimental Diagnostic Imaging.
Click here for Clinical Cancer
Research
Sources: University of Texas MD Anderson Cancer Center.
Written by: Catharine Paddock, PhD
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today
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