Day: January 22, 2021

Aspirin Protects against Colorectal Cancer

Aspirin is known to reduce the risk of colorectal cancer in middle-aged adults and up until age 70, but has some risky side effects, such as colorectal bleeding. 

It was not known at what stage it was still worth it to start taking aspirin. Indeed, the recent Aspirin in Reducing Events in the Elderly (ASPREE) trial reported that participants taking a daily dose of aspirin (100mg) after the age of 70 for five years had a 30% increased risk of cancer mortality.
It is also currently recommended by the US Preventive Services Task Force that people aged 50-59 years with specific cardiovascular risk profiles take aspirin for its protective effect against heart disease.

To answer the question of whether aspirin was beneficial or harmful after age 70, Andrew T Chan MD, MPH, a gastroenterologist and chief of the Clinical and Translational Epidemiology Unit at Massachusetts General Hospital (MGH), led a team of researchers that analysed a pair of large cohort studies.These were The Nurses’ Health Study (January 1980 – June 2014) and the Health Professionals Follow-up Study (January 1986 – January 2014), giving them a total of 94 500 participants over 35 years.

Their findings showed that aspirin could indeed protect adults over 70 from colorectal cancer – with the caveat that the protection only applied if they started taking aspirin before the age of 70.”There is considerable evidence that aspirin can prevent colorectal cancer in adults between 50 and 70 years old,” commented Chan. “But it has not been clear whether the effect is similar in older adults.”

The researchers concluded that their results “strongly suggest that there is a potential biological difference in the effect of aspirin at older ages which requires further research.”

Source: News-Medical.Net

Fatal Netcare Helicopter Crash to Be Investigated

The Civil Aviation Authority has dispatched investigators to the crash site  of a Netcare helicopter on Thursday, in which five people including four health care professionals lost their lives.

The ECMO-equipped air ambulance, Netcare 1, was en route to Hillcrest in KZN to pick up a critically ill patient for transfer back to Milpark Hospital in Johannesburg. The helicopter went down near Bergville..

Netcare on Thursday released the names of those aboard:
Dr Kgopotso Rudolf Mononyane, an anaesthetist. Dr Mononyane had delayed the flight in order to try help to save the life of Jackson Mthembu, who unfortunately passed away from a COVID-related illness.
Curnick Siyabonga Mahlangu, a cardiothoracic surgeon.Mpho Xaba, a specialist theatre nurse for cardiothoracic and transplant.
The above three were all from Netcare Milpark Hospital.
Sinjin Joshua Farrance, an advanced life support paramedic at Netcare 911, Mark Stroxreiter, a helicopter pilot who worked for the National Airways Corporation.

Health Minister Zwile Mkhize said: “We’d like to convey our very sincere condolences to the families of all those doctors and pilot who lost their lives. We know their dedication, their hard work and their effort to try to save lives all the time.”

Dr Richard Friedland, chief executive officer of Netcare said: “We are shocked beyond words at the tragic loss of these healthcare heroes. The whole of Netcare falls silent as we bow our heads in tribute, respect, love and memory of our fallen colleagues and frontline heroes who have died in the line of duty.”

No cause for the accident has yet been identified, although videos from the scene show that wreckage was spread in a wide area. Unconfirmed reports from witnesses recounted a mid-air explosion, whilst a voice note circulating on social media claimed that the helicopter fell to the ground and exploded.

Source: IOL News

Severe COVID May Lead to Stronger Immunity

Researchers from La Jolla Institute for Immunology (LJI), The University of Liverpool and the University of Southampton have discovered that the degree of COVID severity appears to be linked to how long-lasting and strong the subsequent immunity is. 

“The data from this study suggest people with severe COVID-19 cases may have stronger long-term immunity,” said study co-leader LJI Professor Pandurangan Vijayanand, MD, PhD.

The research examines T-cells from COVID infections in unprecedently high detail.

“This study highlights the enormous variability in how human beings react to a viral challenge,” added co-leader Christian Ottensmeier, MD, PhD, FRCP, a professor at the University of Liverpool and adjunct professor at LJI.

Vijayanand and Ottensmeier have been studying how antibodies and the different subsets of T-cells control COVID disease severity. In this study, they examined CD8+ T-cells, which are the T-cells responsible for destroying virus-infected cells, and “memory” CD8+ T-cells are also important for guarding the body against reinfections of the same virus. These memory T-cells are poised to rapidly proliferate and engage their cell-destroying functions on subsequent antigen encounters. They can reside in peripheral organs and their memory can also be shaped by infection history.

Utilising a new technique called single-cell transcriptomics analysis, they were able to study expressions of individual genes of 80 000 CD8+ T-cells drawn from 39 COVID patients and from 10 non-exposed donors, whose blood samples had been taken before the pandemic. Of the COVID patients, 17 cases were mild and non-hospitalised, 13 were hospitalised and 9 had required ICU care.

Surprisingly, the researchers found that the strongest CD8+ T-cell responses were from those with the more severe form of the disease, and not the milder cases.”There is an inverse link between how poorly T cells work and how bad the infection is,” observed Ottensmeier. “I think that was quite unexpected.” A stronger response would be expected from CD8+ T-cells in mild cases due to having the resources of a better functioning immune system. However, the mild group of CD8+ T-cells showed signs of “exhaustion”, which happens when the immune system overloads the T-cells, causing them to lose effectiveness.

The researchers believe that it will be beneficial to study whether this phenomenon may hinder the ability to build long-term immunity.

“People who have severe disease are likely to end up with a good number of memory cells,” said Vijayanand. “People with milder disease have memory cells, but they seem exhausted and dysfunctional—so they might not be effective for long enough.

“What the researchers would like to look at next is to look at T-cells from lung tissue as opposed to blood samples, because that is where the infection hits hardest.

“This study is very much a first step in understanding the spectrum of immune responses against infectious agents,” said Ottensmeier. The researchers will also look at T-cells in cancer patients who are also infected with COVID.

Source: Medical Xpress

Journal information: Anthony Kusnadi et al, Severely ill COVID-19 patients display impaired exhaustion features in SARS-CoV-2-reactive CD8+ T cells, Science Immunology  21 Jan 2021: Vol. 6, Issue 55, eabe4782 DOI: 10.1126/sciimmunol.abe4782

Paralysed Mice Walk Again with ‘Designer’ Cytokines

Scientists have sought a means to regenerate spinal cord injuries which leaves patients paraplegic or quadriplegic – and now a breakthrough by researchers at Ruhr-University Bochum, Germany, may see that dream realised.

By the time humans reach adulthood, after an injury they can no longer regenerate the axons which transfer nerve impulses from brain to muscles. In 2013, the researchers discovered that a cytokine called interleukin-6 (IL-6) promoted the regeneration of optic axon fibres in vitro. IL-6 was known to be involved in nerve regeneration as well as in neuropathic pain from peripheral nerve injuries. As promising as this experiment was, delivery of the cytokine to the injury location deep in the body was an obstacles, as was the fact that it had a fairly weak effect on stimulating nerve tissue regrowth.

The team subsequently developed hyper-IL-6, an artificial variant of IL-6 that was far more potent than its natural counterpart. However, the “designer” cytokine still could not be delivered to the injured tissue where it was needed. To get around this, the researchers turned to a somewhat novel delivery method: gene therapy. A few motor neurons in the brain’s sensorimotor cortex are altered via engineered viruses to produce hyper-IL-6, which is then distributed along the axon’s length to the injury site.

“Thus, gene therapy treatment of only a few nerve cells stimulated the axonal regeneration of various nerve cells in the brain and several motor tracts in the spinal cord simultaneously,” explained senior author Dr Dietmar Fischer.

After a single injection of the engineered virus and its hyper-IL-6 payload, mice with severed spinal cords were able to walk again after two to three weeks.

“This came as a great surprise to us at the beginning, as it had never been shown to be possible before after full paraplegia,” said Dr. Fischer.
Following the success of these experiments, Dr. Fischer’s team is looking at combining the engineered cytokine treatment to other promising applications, such as tissue grafts. Additionally, they are investigating whether the hyper-IL-6 treatment can regenerate spinal cord damage that occurred weeks beforehand.

“This aspect would be particularly relevant for application in humans. We are now breaking new scientific ground. These further experiments will show, among other things, whether it will be possible to transfer these new approaches to humans in the future.”

However, adapting this designer cytokine treatment to be one that is safe for humans will take several years.

Source: Medical News Today

Biden’s Promise to “Manage the Hell” out of COVID

Almost immediately upon assuming office, the newly sworn-in President Joe Biden started to deliver on his promise to tackle the COVID pandemic raging in the United States.

On Wednesday, shortly after being sworn in, he wrote to both the United Nations Secretary General and the WHO Director General to notify them of the United States’ return to the WHO – a move no doubt welcomed around the world. He also began to sign a raft of orders related to the COVID pandemic.

Following up on his promise to “manage the hell” out of the COVID pandemic, President Biden signed a directive which “seeks to support the international health and humanitarian response to the COVID-19 pandemic and its secondary impacts, global health security and diplomacy, and better biopreparedness and resilience for emerging and future biological threats.”

His actions and executive orders include:– Increased equipment procurement. Using the Defense Production Act (DPA) to accelerate manufacturing and meet shortfalls in COVID-related equipment and supplies.
– Increased COVID testing. Another order establishes a testing board to help expand the supply of tests and testing equipment, as well as supporting the public healthcare force.
– Increasing studies on COVID-19 treatments. More studies requested on COVID, as well as on COVID in diverse populations. Also requests more healthcare workers.
– Speeding up vaccinations. Federal Emergency Management Agency (FEMA) is directed to begin deploying vaccination centres, aiming toward a goal of 100 in the next month.
– Reopening schools and businesses. The Departments of Education and Health and Human Services (HHS) are directed to provide guidance on safe reopening and operating for education institutions and child care providers.
– Improving protections for workers. Clear guidance for employers to keep employees safe from COVID exposure.
– Increasing travel safety. Masks are to be worn in federal buildings, and mask requirements are extended to interstate travel, including on planes, trains, and buses. People flying into the US from another country will need to test negative for COVID prior to departure and quarantine upon arrival.

President Biden’s plan and the full texts of the executive orders were detailed in a 200 page document which was made available on Thursday.

At a White House signing ceremony, he affirmed his commitment to “following the science” on COVID, saying: “We will make sure that scientists and public health experts will speak directly to you — not the president, but real, genuine experts and scientists.” He added that they will work free of political interference.

He also warned Americans of a “dark winter” ahead, and the nation was in a national emergency and that “we should treat it like one.”

Source: MedPage Today