Day: January 18, 2021

Parkinson’s Disease Spotted in Advance with Health Checkup

A study by the University of Nagoya has shown that general health checkups may be effective at spotting early signs of Parkinson’s disease (PD) in advance.

Specifically, the prodromal stage shows sex differences, with the markers for males being decreased cholesterol and haematocrit (the percentage of red blood cells in blood) levels, while in females it is increased blood pressure. PD is the second most common disease affecting the nervous system after Alzheimer’s disease, is caused by a deficiency in the neurotransmitter dopamine. By the stage where sufferers experience motor symptoms such as tremors, stiffness, bradykinesia (slowness of movement), more than half of all dopaminergic neurons have been lost. Postural instability occurs in the late stage. Several processes have been implicated in PD, such as mitochondrial dysfunction, defective protein clearance mechanisms, and neuroinflammation, but it is not clear how these factors interact.

Prior studies have shown that non-motor symptoms including constipation, rapid eye movement sleep behaviour disorder, impairment of sense of smell, and depression, emerge in patients with PD 10 to 20 years before the onset of motor symptoms – meaning that PD may be detectable in advance with other measures.

“If we can detect biological changes in the patients’ bodies well before the onset of the motor symptoms, we can start medical treatments in an early stage,” said Prof Masahisa Katsuno of the Graduate School of Medicine at Nagoya University.

The team used health checkup data from 22 male and 23 female patients with PD, dating to before they were diagnosed with the disease. They supplemented this with data from 60 male and 60 female healthy individuals who had checkup data for at least four years.The checkup data was compared between healthy individuals and PD patients to establish a baseline, and then were examined for longitudinal changes prior to the onset of PD. They found that in the premotor stage, blood pressure increased in females, while in males total and low-density cholesterol levels and haematocrit decreased.

“In this study, we found that blood pressure, haematocrit, and serum cholesterol levels are potential biomarkers of Parkinson’s disease before the onset of its motor symptoms,” said Prof Katsuno. “This finding indicates that general health checkups can help detect early signs of developing Parkinson’s disease.”  Based on the findings, the team is now working to identify individuals at risk of developing PD in an attempt to forestall the development of their disease.

Source: Medical Xpress

Journal information: Katsunori Yokoi et al. Longitudinal analysis of premotor anthropometric and serological markers of Parkinson’s disease, Scientific Reports (2020). DOI: 10.1038/s41598-020-77415-1

Religiosity-based Stress Linked to Cardiovascular Risk in South Asians

In a new study, the Study on Stress, Spirituality and Health (SSSH) linked proteomics from religiosity-based stress to cardiovascular disease (CVD) risk markers. This study marks the first investigation of protein levels associated with religion and spirituality in any group.

South Asians have an elevated CVD risk compared to other racial/ethnic groups, with the biological risk factors attributable to type 2 diabetes risk factors, and the rest stemming from traditional risk factors which show no enhancements as compared to other racial/ethnic groups.

“Before we can develop the best interventions to reduce CVD disparities, we need to understand the biological pathways through which health disparities are produced,” said principal investigator and co-senior author Alexandra Shields, PhD, associate professor of Medicine at Harvard Medical School (HMS). “As this study shows, psychosocial factors—and religious or spiritual struggles in particular—can affect biological processes that lead to CVD in this high-risk population. Spirituality can also serve as a resource for resilience and have a protective effect. Given that many of the minority communities that experience higher levels of CVD also report higher levels of religiosity and spirituality, studies such as the SSSH may help identify new leverage points, such as spiritually focused psychotherapy for those in spiritual distress, that could reduce risk of CVD for such individuals.”

The study had 100 South Asian participants, 50 diagnosed with CVD and 50 without. The participants were drawn from the Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study, which is following 1164 South Asian participants to investigate the factors that lead to heart disease among this racial/ethnic group. Three proteins were found to be involved in CVD risk after adjustment for diabetes (Contactin-5 [CNTN5], Low affinity immunoglobulin gamma Fc region receptor II-a [FCGR2A], and Complement factor B [CFB]), and of these, the expression of two (Contactin-5 and Complement factor B) were slightly modified by religious struggles interacting with adverse life events.

The results indicate that there may be unique protein expressions associated with CVD among individuals of South Asian descent, and these associations may be affected by religious struggles, such as feeling abandoned by God. “Understanding the pathways of this mechanism at the molecular level using proteomics technology is crucial to developing potential interventions that can help reduce CVD incidence in this population,” says Long H. Ngo, PhD., lead author and co-director of Biostatistics in the Division of General Medicine at BIDMC and associate professor of Medicine at HMS.

Co-senior author Towia Libermann, PhD, at Beth Israel Deaconess Medical Center, added: “The kinds of blood-based protein biomarkers used in this study are particularly effective in assessing CVD risk because they carry clinical information about risk of disease and are the most commonly used molecules for diagnostic applications.

Source: Medical Xpress

Journal information: Long H. Ngo et al, Plasma protein expression profiles, cardiovascular disease, and religious struggles among South Asians in the MASALA study, Scientific Reports (2021). DOI: 10.1038/s41598-020-79429-1

SA Government Aims for a Corruption-free Vaccine Programme

In the past week, President Cyril Ramaphosa and health minister Zweli Mkhize have undertaken a publicity drive to demonstrate how the government is working to ensure a tightly controlled vaccine drive that is not plagued by corruption. This is to avoid a repeat of the corruption in PPE acquisition last year, with some R10.5 billion being investigated for looting, with an Auditor-General report finding some items being purchased at five times the going price.

These efforts include centralised transactions which involve the auditor-general looking out for any discrepancies. Vaccine acquisition and roll-out planning will be handled by the government, with the private sector being tapped for storage and distribution. “What we have done is to get the Treasury and the Department of Health’s office of the chief procurement officer to oversee any form of transaction that is going to happen.

“Right now the procurement of the vaccines is within government. It makes it easier because it’s a tight-knit set of people, the prices are known, the manufacturers are known, the deviation is specific and it’s not the same as what we had in PPE where there were so many vendors, suppliers and so many different prices,” he said.

Furthermore, there will be consultation with the Attorney General. “We are going to say [to the AG]… these are the risks we have identified and ask them to analyse our plans and see if there are further risks we must be aware of and how we can work together to prevent any risk of looting,” Mkhize said.

Medical aid schemes have voiced concerns over the process, having sourced vaccines for their members as well as contributing to the vaccination costs of those not covered by any medical aid scheme.

President Ramaphosa said that South Africa would have pre-paid like other countries to secure vaccines, even given the risks of them failing, if it had the funds to do so.

However, he affirmed that there are funds available to buy the vaccination scheme, saying: “we are going to have the money, it will come from Treasury. There is just no way we can say, when it comes to saving the lives of South Africans, that we don’t have the money. The money will be there. It has to be there to save the lives of South Africans. That one will be my bottom line.”

The Covax programme will provide a vaccine for 10% of the population in the second quarter of 2021, for which a deposit of R283 million has been paid. A further 1.5-million vaccine doses have been secured from AstraZeneca and 9-million from Johnson & Johnson (J&J). The J&J vaccine only requires a single dose to confer immunity, so should be able to cover 9 million people.

“J&J will be producing through Aspen here at home, and we are hoping to get the bulk of our supply from there, once the production starts,” said Ramaphosa.

Source: Times Live

Poor Diet is an Important Factor of Childhood Obesity

A Baylor University study has shown that market-bought food in addition to the traditional diet reliably predicted obesity in Amazonian children, a result that has important insights into the global childhood obesity epidemic.

Globally, 6% of girls and 8% of boys in 2016 were obese, compared to 1% in 1975. In South Africa, 13% of children under the age of five are obese.

“The importance of a poor diet versus low energy expenditure on the development of childhood obesity remains unclear,” said lead author Samuel Urlacher, PhD, of Baylor University. “Using gold-standard measures of energy expenditure, we show that relatively lean, rural forager-horticulturalist children in the Amazon spend approximately the same total number of calories each day as their much fatter peri-urban counterparts and, notably, even the same number of calories each day as children living in the industrialised United States.”

Factors such as income and access to running water were used to establish market integration. Children’s physical activity was measured with wearable devices and immune activity by measuring biomarkers obtained from minimally invasive finger-prick blood samples. Most importantly, children’s daily energy expenditure was measured with the “doubly labeled water” stable isotope-tracking method and children’s resting energy expenditure using respirometry. These are both participant-friendly, gold-standard techniques.

A third of peri-urban children were overweight, while zero rural children were, and peri-urban children on average had 65% more body fat than rural children. Peri-urban and rural children had similar levels of physical activity, and market integration, immune activity and physical activity had no effect on expenditure between rural and peri-urban children’s energy expenditure, in common with previous studies. Compared to rural children, peri-urban children spent 108 less calories while at rest, which is thought to be due to lower immune activity. Most importantly, variation in market foods was related to children’s level of body fat.

“Our findings are in line with a growing body of research pointing toward poor diet being the most important factor underlying the development of childhood obesity,” Urlacher said. “Exercise is absolutely still a critical part of this equation and is essential for living a healthy life, but diet increasingly appears to be most directly related to children’s adiposity and long-term energy balance.”

The researchers plan to follow the children longitudinally to record any development obesity and cardiovascular problems.

Source: News-Medical.Net

EU Angered by Pfizer Delay

Pfizer has said in a statement on Friday that the drop in production is the result of the company upgrading its manufacturing processes, and that there will be an overall increase in supply as a result.

“Although this will temporarily impact shipments in late January to early February, it will provide a significant increase in doses available for patients in late February and March,” Pfizer said.

The German health ministry has said the delays are surprising and regrettable, pointing out that it had secured binding mid-February delivery dates from the company. EU Commission President Ursula von der Leyen said that she had been given assurances by Pfizer’s chief executive that all orders for the first quarter would arrive. She had previously said that Pfizer had promised to double its delivery of doses to the EU to 600 million this year.

However, the EU also has agreements in place with Moderna to supply vaccines, and this is not wholly dependent on Pfizer. However, Johnson & Johnson is also falling behind in its vaccine delivery targets, amidst reports that the US has failed to meet vaccination goals for the end of 2020, and may struggle to meet this year’s goals. Meanwhile, the UK is expected to be slightly impacted by the drop in supply but remains on track to meets its February immunisation goals.

However, the EU has lagged behind the UK in its vaccination programme, for a number of reasons including the fact that the UK ordered and approved its vaccines sooner, while Brussels’ negotiations were slower. Much of the delay is due to the added bureaucracy of the 27 nation political confederation and its decision to acquire vaccines as a single entity instead of individual countries further exacerbated this.

According to Reuters, citing a participant at a meeting last week, a third of the EU’s 27 countries reported difficulties in securing enough vaccines for their vaccination programmes.

Source: BBC News