Since the introduction of the first antiretroviral therapy (ART) drug for HIV/AIDS treatment 35 years ago, life expectancy in Sub-Saharan Africa has steadily increased. ART medications are specifically designed to help an individual’s immune system fight HIV and in turn suppress HIV replication. However, there is a limited understanding of the combined effects of HIV and ART on disability and healthy longevity for individuals with the disease.
In a study published in The Lancet HIV, investigators from the Brigham and Women’s Hospital collaborated alongside international partners in South Africa to compare people with both virally suppressed and unsuppressed HIV, with people who were uninfected with HIV. The team used data they collected in an observational, longitudinal, population-based cohort study that included baseline interviews and blood collection, as well as subsequent follow-up interviews and blood collection about four years later. Their modelling analysis found that those receiving ART medication were predicted to live considerably longer and with less disability than those with unsuppressed HIV.
This research demonstrates the role of ART in healthy aging, as well as the continued importance for international global health organisations to provide HIV treatment to those all over the world, including in Africa.
“It was exciting for us to find that – at the population level – achieving high rates of viral suppression among people with HIV will not only lead to increases in life expectancy but also to healthier aging,” said senior author Jennifer Manne-Goehler, MD of the Division of Infectious Diseases. “This confirms the critical importance of maintaining support for antiretroviral programs as a way to ensure the best long-term health outcomes for people growing older with HIV.”
Coffee lovers have another thing to rejoice about: drinking two to three cups of coffee a day is linked with a longer lifespan and lower risk of cardiovascular disease (CVD) compared with avoiding coffee, according to a study in the European Journal of Preventive Cardiology. The association was strongest with drinking ground coffee, though instant and decaffeinated preparations also showed this benefit.
“In this large, observational study, ground, instant and decaffeinated coffee were associated with equivalent reductions in the incidence of cardiovascular disease and death from cardiovascular disease or any cause,” said study author Professor Peter Kistler of the Baker Heart and Diabetes Research Institute, Melbourne. “The results suggest that mild to moderate intake of ground, instant and decaffeinated coffee should be considered part of a healthy lifestyle.”
There is little information on the impact of different coffee preparations on heart health and survival. This study examined the associations between types of coffee and incident arrhythmias, CVD and death using data from the UK Biobank, with participants aged 40–69. CVD was comprised of coronary heart disease, congestive heart failure and ischaemic stroke.
The study included 449 563 participants free of arrhythmias or other CVD at baseline. The median age was 58 years and 55.3% were women. Participants completed a questionnaire asking how many cups of coffee they drank each day and whether they usually drank instant, ground (such as cappuccino or filtered coffee), or decaffeinated coffee. They were then grouped into six daily intake categories, consisting of none, less than one, one, two to three, four to five, and more than five cups per day. The usual coffee type was instant in 198 062 (44.1%) participants, ground in 82 575 (18.4%), and decaffeinated in 68 416 (15.2%). A comparator group of 100 510 (22.4%) non-coffee drinkers was included.
Coffee drinkers were compared to non-drinkers for the incidence of arrhythmias, cardiovascular disease and death, after adjusting for age, sex, ethnicity, obesity, hypertension, diabetes, obstructive sleep apnoea, smoking status, and tea and alcohol consumption. Outcome information was obtained from medical records and death records. The median follow up was 12.5 years.
A total of 27 809 (6.2%) participants died during follow up. All types of coffee were linked with a reduction in death from any cause. The greatest risk reduction seen with two to three cups per day, which compared to no coffee drinking was associated with a 14%, 27% and 11% lower likelihood of death for decaffeinated, ground, and instant preparations, respectively.
CVD was diagnosed in 43 173 (9.6%) participants during follow up. All coffee subtypes were associated with a reduction in incident cardiovascular disease. Again, the lowest risk was observed with two to three cups a day, which compared to abstinence from coffee was associated with a 6%, 20%, and 9% reduced likelihood of cardiovascular disease for decaffeinated, ground, instant coffee, respectively.
During follow up, an arrhythmia was diagnosed in 30 100 (6.7%) participants. Ground and instant coffee, but not decaffeinated, was associated with a reduction in arrhythmias including atrial fibrillation. Compared with non-drinkers, the lowest risks were observed with four to five cups a day for ground coffee and two to three cups a day for instant coffee, with 17% and 12% reduced risks, respectively.
Professor Kistler said: “Caffeine is the most well-known constituent in coffee, but the beverage contains more than 100 biologically active components. It is likely that the non-caffeinated compounds were responsible for the positive relationships observed between coffee drinking, cardiovascular disease and survival. Our findings indicate that drinking modest amounts of coffee of all types should not be discouraged but can be enjoyed as a heart healthy behaviour.”
Although SARS-CoV-2 infections mainly attack the lungs, in many cases they can also damage other organs, such as the colon: around 60% of patients experienced digestive tract impacts. A study published in the International Journal of Molecular Sciences analysed the manifestations of COVID in the lungs and colon, identifying the differences at a molecular level.
Their findings serve as the basis for the identification of novel biomarkers and the development of new treatment strategies.
The University of Vienna scientific team, led by Diana Mechtcheriakova, studied the singularities and commonalities in the impact of COVID on the lungs and other organs. Using complex dataset analyses, the researchers recognised that a different molecular mechanism is at work in pulmonary and gastrointestinal manifestations. While SARS-CoV-2 infections of the lungs evoke classic immune system responses, in the gastrointestinal tract they evoke responses related to liver and lipid metabolism.
The fact that SARS-CoV-2 infections not only manifest in the lungs but frequently also manifest in other organs, such as the heart, kidneys, skin or gut, can be attributed to the particular structure of the virus. During the course of COVID, up to 60% of patients experience gastrointestinal symptoms, which may be associated with a longer duration of disease and/or a worse outcome. The results of this study will add to our understanding of the organ- and tissue-specific molecular processes triggered by SARS-CoV-2.
“Our findings can advance the identification of new biomarkers and treatment strategies for COVID, taking account of the specific responses in manifestations outside the lung,” said Diana Mechtcheriakova, Head of the Molecular Systems Biology and Pathophysiology Research Group at MedUni Vienna, holding out the prospect of promising follow-up studies.
Scanning Electron Micrograph of Pseudomonas aeruginosa. Credit: CDC/Janice Carr
Nanoengineers have developed microscopic robots, called microrobots, that can swim around in the lungs, deliver medication and be used to clear up life-threatening cases of bacterial pneumonia.
In mice, the microrobots safely eliminated Pseudomonas aeruginosa in the lungs of infected mice, resulting in a 100% survival rate. By contrast, untreated mice all died within three days after infection. The scientists describe the technology in Nature Materials.
The microrobots are not actually made of metal and plastic: instead they are algae cells armed with antibiotic-filled nanoparticles on their surfaces. The algae provide movement, which allows the microrobots to swim around and deliver antibiotics directly to more bacteria in the lungs. The nanoparticles are also coated with the neutrophil cell membranes, which absorb and neutralise inflammatory molecules produced by bacteria and the body’s immune system. This gives the microrobots a powerful anti-inflammatory tool, and the algae are biodegradable in the body, leaving no toxic traces.
The work is a joint effort between the labs of nanoengineering professors Joseph Wang and Liangfang Zhang, both at the UC San Diego Jacobs School of Engineering, both world leaders in nanoengineering.
“Our goal is to do targeted drug delivery into more challenging parts of the body, like the lungs. And we want to do it in a way that is safe, easy, biocompatible and long lasting,” said Prof Zhang. “That is what we’ve demonstrated in this work.”
The team used the microrobots to treat mice with an acute and potentially fatal form of pneumonia caused by P. aeruginosa. This is commonly seen in mechanically ventilated ICU patients. The researchers administered the microrobots to the lungs of the mice through a tube inserted in the windpipe. The infections fully cleared up after one week. All mice treated with the microrobots survived past 30 days, while untreated mice died within three days.
The microrobots enabled targeted drug delivery of only 500 nanograms of antibiotics per mouse, while an IV injection provided 1.644 milligrams of antibiotics per mouse.
“These results show how targeted drug delivery combined with active movement from the microalgae improves therapeutic efficacy,” said Wang.
“With an IV injection, sometimes only a very small fraction of antibiotics will get into the lungs. That’s why many current antibiotic treatments for pneumonia don’t work as well as needed, leading to very high mortality rates in the sickest patients,” said Professor Victor Nizet, co-author on the study and a physician-scientist collaborator of Profs Wang and Zhang. “Based on these mouse data, we see that the microrobots could potentially improve antibiotic penetration to kill bacterial pathogens and save more patients’ lives.”
The work is still at the proof-of-concept stage. The team plans to do more basic research to understand exactly how the microrobots interact with the immune system. Next steps also include studies to validate the microrobot treatment and scaling it up before testing it in larger animals and eventually, in humans.
“We’re pushing the boundary further in the field of targeted drug delivery,” said Zhang.
In a research letter published in JAMA Internal Medicine, researchers compared the prices of 120 medications commonly used in humans and pets. The authors found human medication prices were typically higher than the price of pet medications – with the same ingredients at common human-equivalent doses.
While some medications are common to both pets and humans, but price differences can be extreme. In 1991, levamisole (introduced in the 1960s as a veterinary antiparasitic) demonstrated efficacy in treating human colon cancer. The introductory human price of Janssen’s Ergamisol (brand-name levamisole; $5 per 50mg tablet) was 100 times the then veterinary price (approximately $0.05 for an equivalent amount). With the COVID pandemic, a misinformation-driven demand for ivermectin as a COVID treatment led to people seeking veterinary formulations of the drug, increasing the price 15-fold over a month ($6 to $92 for 3 tubes). In this cross-sectional study, the researchers sought to compare prices of commonly prescribed medications used to treat both humans and pets.
The researchers from the University of Minnesota found that retail price for human medications was on average 5.5 times higher than pet medications. For more than 60% of medications, even discounted prices for humans were higher than pet prices. On average, discounted prices were 1.5 times higher for human medications than for pet medications.
‘’A 10-day supply of the same medication costs $2 for a pet dog, $10 for a person with a discount coupon, and $100 for a person without a coupon,” said Arjun Gupta, MBBS, assistant professor at the U of M Medical School and oncologist with M Health Fairview. He is also a member of the Masonic Cancer Center. “With many humans and pets uninsured or underinsured, it is important that cash prices for medications are affordable and that pricing is not exploitative.”
Human prices were also higher than pet prices for drugs such as antibiotics. Researchers warn this may promote humans sourcing antibiotics for their own use from pet sources, especially since human antibiotic use is more regulated.
Exactly why there is such a significant price difference is unclear. One possibility may be drug manufacturers engaging in price discrimination by charging consumers different prices in different markets for the same product, the researchers suggest. Additionally, price differences could reflect variations in medication effectiveness, willingness to pay, and manufacturing, storage, and regulatory standards.
Further research is suggested to explore the causes of price differences.
