Month: February 2024

Categories : CancerTags :

New Trial Flips the Script for Hormonal Treatment of Breast Cancer

On By ModernMedia
Photo by National Cancer Institute

For decades, hormonal treatment of breast cancer has been going in one direction: blocking oestrogen. Now, a global study has discovered there may be another, less toxic way to defeat the most common form of breast cancer. The results, published in The Lancet Oncology, showed that the androgen receptor (AR) agonist enobosarm, is effective against oestrogen receptor-positive (ER+) breast cancer, which constitutes up to 80% of all breast cancer cases.

“The effectiveness of enobosarm lies in its ability to activate the AR and trigger a natural defence mechanism in breast tissue, thereby slowing the growth of ER+ breast cancer, which relies on the hormone oestrogen to grow and spread,” said senior co-author Professor Wayne Tilley, Director of the Dame Roma Mitchell Cancer Research Laboratories at the University of Adelaide.

“This clinical study is supported by our pre-clinical research, previously published in Nature Medicine, which established that the AR is a tumour suppressor in both normal breast tissue and ER+ breast cancer.”

Along with investigators from the University of Adelaide and Dana-Farber Cancer Institute (DFCI) in Boston, USA, the international study also included researchers from the University of Liverpool in the UK and other experts around the world.

The team assessed enobosarm’s efficacy and safety in 136 postmenopausal women with advanced or metastatic ER-positive, HER2-negative breast cancer.

Enobosarm showed significant anti-tumour activity and was well-tolerated by patients, without adversely affecting their quality of life or causing masculinising symptoms.

This discovery represents the first advancement in hormonal treatment of ER+ breast cancer in decades and offers a promising new oral treatment strategy for the most prevalent form of breast cancer.

The new hormonal strategy differs from the existing standard-of-care hormonal treatments, which have been around for decades and involve suppressing oestrogen activity in the body or inhibiting the ER.

Although successful initially, treatments targeting ER can cause severe side effects and treatment-resistant progression of the disease is common.

“Our findings are very promising. They demonstrate that stimulating the androgen receptor pathway with enobosarm can be beneficial,” said senior co-author and study Principal Investigator Dr Beth Overmoyer from DFCI.

“This is the first time a non-oestrogen receptor hormonal treatment approach has been shown to be clinically advantageous in ER+ breast cancer. The study supports further investigation of enobosarm in earlier stages of breast cancer as well as in combination with targeted therapies, such as ribociclib, a CDK 4/6 inhibitor.”

estrogen to grow and spread,” said senior co-author Professor Wayne Tilley, Director of the Dame Roma Mitchell Cancer Research Laboratories at the University of Adelaide.

“The data strongly encourages more clinical trials for AR-stimulating drugs in treating AR-positive and ER-positive breast cancer. The fact that this drug is well-tolerated also opens possibilities for its use in breast cancer prevention,” said co-author Dr Stephen Birrell, a clinical affiliate of the University of Adelaide.

Source: University of Adelaide

Categories : CancerTags :

How Lung Cancer Transforms from One Type to Another

On By ModernMedia
Lung cancer metastasis. Credit: National Cancer Institute

Adenocarcinomas sometimes respond to initially effective treatments by transforming into a much more aggressive small cell lung cancer (SCLC) that spreads rapidly and has few options for treatment. Researchers at Weill Cornell Medicine have developed a mouse model that illuminates this problematic process, known as histological transformation.

The researchers, whose results were published in Science, discovered that during the transition from lung adenocarcinoma to small cell lung cancer (SCLC), the mutated cells appeared to undergo a change in cell identity through an intermediate, stem cell-like state, which facilitated the transformation.

“It is very difficult to study this process in human patients. So my aim was to uncover the mechanism underlying the transformation of lung adenocarcinoma to small cell lung cancer in a mouse model,” said study lead Dr Eric Gardner, a postdoctoral fellow in the laboratory of Dr Harold Varmus.

The complex mouse model took several years to develop and characterise but has allowed the researchers to crack this difficult problem.

This study was in collaboration with Dr Ashley Laughney, assistant professor of physiology and biophysics and a member of the Meyer Cancer Center at Weill Cornell Medicine and Ethan Earlie, a graduate student in the Laughney lab and part of the Tri-Institutional Computational Biology and Medicine program.

“It is well known that cancer cells continue to evolve, especially to escape the pressure of effective treatments,” said Dr Varmus.

“This study shows how new technologies – including the detection of molecular features of single cancer cells, combined with computer-based analysis of the data – can portray dramatic, complex events in the evolution of lethal cancers, exposing new targets for therapeutic attack.”

Catching Transformation in the Act

SCLC most commonly occurs in heavy smokers, but this type of tumour also develops in a significant number of patients with lung adenocarcinomas, particularly after treatment with therapies that target a protein called Epidermal Growth Factor Receptor (EGFR), which promotes tumour growth.

The new SCLC-type tumours are resistant to anti-EGFR therapy because their growth is fuelled by a new cancer driver, high levels of Myc protein.

To unravel the interplay of these cancer pathways, the researchers engineered mice to develop a common form of lung adenocarcinoma, in which lung epithelial cells are driven by a mutated version of the EGFR gene.

They then turned the adenocarcinoma tumours into SCLC-type tumours, which generally arise from neuroendocrine cells.

They did this by shutting off EGFR in the presence of several other changes including losses of the tumour suppressor genes Rb1 and Trp53 as well as turning up the production of Myc,a known driver of SCLC.

Oncogenes, such as EGFR and Myc, are mutated forms of genes that normally control cell growth. They are known for their roles in driving the growth and spread of cancer. Tumor suppressor genes, on the other hand, normally inhibit cell proliferation and tumor development.

Context-dependent change

Surprisingly, this study showed that oncogenes act in a context-dependent manner.

While most lung cells are resistant to becoming cancerous by Myc, neuroendocrine cells, are very sensitive to the oncogenic effects of Myc. Conversely, epithelial cells, which line the air sacs of the lungs and are the precursors to lung adenocarcinomas, grow excessively in response to mutated EGFR.

“This shows that an ‘oncogene’ in the wrong cell type doesn’t act like an oncogene anymore,” Dr Laughney said.

“So, it fundamentally changes how we think about oncogenes.”

The researchers also discovered a stem cell-like intermediate that was neither adenocarcinoma nor SCLC.

Cells in this transitional state became neuroendocrine in nature only when mutations in the tumour suppressor genes RB1 and TP53 were present.

They observed that loss of another tumour suppressor called Pten accelerated this process.

At that stage, oncogenic Myc could drive these intermediate stem-like cells to form SCLC-type tumours.

This study further supports efforts seeking therapeutics that target Myc proteins, which are implicated in many types of cancers. The researchers now plan to use their new mouse model to further explore the adenocarcinoma-SCLC transition, detailing, for example, how the immune system normally responds to this transition.

Source: Weill Cornell Medicine

Categories : Immune SystemTags :

‘Junk Cells’ Actually Have a Powerful Role against Malaria

On By ModernMedia
Red blood cell Infected with malaria parasites. Colourised scanning electron micrograph of red blood cell infected with malaria parasites (teal). The small bumps on the infected cell show how the parasite remodels its host cell by forming protrusions called ‘knobs’ on the surface, enabling it to avoid destruction and cause inflammation. Uninfected cells (red) have smoother surfaces. Credit: NIAID

Researchers from The Australian National University (ANU) have discovered a previously unknown ability of a group of immune system cells, known as Atypical B cells (ABCs), to fight infectious diseases such as malaria.

The discovery, published in Science Immunology, provides new insight into how the immune system fights infections and brings scientists a step closer to harnessing the body’s natural defences to combat malaria.

The scientists say ABCs could also be key to developing new treatments for chronic autoimmune conditions such as lupus. According to the researchers, ABCs have long been associated with malaria, as malaria patients have more of these cells in their system compared to the general population.

“In this study, we wanted to understand the mechanisms that drive the creation of ABCs in the immune system, but also find out whether these cells are good or bad for us when it comes to fighting infection,” lead author Dr Xin Gao, from ANU, said.

“Although ABCs are known to contribute to chronic inflammatory diseases and autoimmunity, we’ve discovered a previously unknown ability of these cells to fight disease. In this sense, ABCs are like a double-edged sword.

“Contrary to past belief, ABCs are not junk cells; they are more important than we thought.

“Our research found that ABCs are also instrumental in developing T follicular helper cells. These helper cells generate powerful antibodies that help the body fight malaria parasites.

“Antibodies can block parasites in the blood as they travel from the site of the infectious mosquito bite to the liver, where the infection is first established.”

In 2022, malaria killed more than 600 000 people worldwide. Although the disease is preventable and curable, scientists face an uphill battle to find long-lasting treatments as malaria parasites continue to find new ways to build resistance to current therapies.

Using gene-editing technology on mice, the ANU researchers discovered a gene called Zeb2 is crucial to the production of ABCs.

“We found that manipulating the Zeb2 gene disrupted the creation of ABCs in the immune system,” study co-author Professor Ian Cockburn, from The ANU John Curtin School of Medical Research, said.

“Importantly, we found that mice without the Zeb2 gene were unable to control malaria infection.

“Therefore, the findings show that ABCs play a crucial role in fighting malaria infections.”

The researchers say targeting ABCs could also pave the way for new treatments for certain autoimmune diseases such as lupus.

“ABCs also appear in large numbers in many autoimmune diseases, including lupus, which can be life-threating in severe cases,” Professor Cockburn said.

“By developing a better understanding of the role of ABCs in the immune system and the cells’ role in fighting disease, it could bring us a step closer to one day developing new and more effective therapies.”

Source: Australian National University

Categories : Healthcare Politics and RegulationsTags :

Unemployed Doctors March to Department of Health

On By ModernMedia

They demand permanent jobs and no budget cuts to healthcare

Doctors marched to the Department of Health offices in Pietermaritzburg on Monday to demand jobs. Photo: Joseph Bracken.

Over 80 unemployed doctors marched from UNISA campus on Longmarket Road to the KwaZulu-Natal Department of Health’s offices in Langalibele Street, Pietermaritzburg, on Monday.

They went to hand over their CVs and a memorandum demanding that the healthcare budget be increased to accommodate over 700 qualifying medical practitioners. The department was given 14 days to respond.

Eighty-four unemployed doctors also signed a register handed to the department.

The doctors were met by Deputy Health Minister Sibongiseni Dhlomo who said health minister Joe Phaahla had another engagement. Dhlomo said the department was working to address the issue of unemployed doctors, and that the minister would raise it this week in Parliament and ask that healthcare be exempt from budget cuts.

Dr Siya Shozi, part of a “small committee” of unemployed doctors with no political affiliation mandated to liaise with the department, said the march was coordinated through a WhatsApp group. Shozi was happy with the turnout but said it did not represent the large number of unemployed doctors in KZN and its rural areas.

Busiziwe Mancotywa, a grade one medical officer who has been unemployed since completing her training at the end of last year, said, “You apply for some positions where you meet the minimum requirements but for whatever reason you are never contacted”.

Mancotywa was joined by her brother, Nqaba, who is finishing his internship at Greys Hospital. He said if action is not taken now, he won’t find a job in the future.

Nomfundo Mbanjwa, also a grade one medical officer, complained about the cost of applying for jobs, including printing applications and transport to interviews. Mbanjwa says she had to sell her car to cover these costs.

Representatives from the South African Medical Association Trade Union (SAMATU) and the Public Servants Association of South Africa (PSA) joined the march and pledged support for the doctors.

Republished from GroundUp under a Creative Commons Attribution-NoDerivatives 4.0 International License.

Source: GroundUp

Categories : Environmental EffectsTags :

Even Today, DDT Impacts Men’s Reproductive Health in South Africa and Elsewhere

On By ModernMedia
Photo by Arjun Mj on Unsplash

In a study that signals potential reproductive and health complications in humans, now and for future generations, researchers from McGill University, the University of Pretoria, Université Laval, Aarhus University, and the University of Copenhagen, have concluded that fathers exposed to environmental toxins, notably DDT, may produce sperm with health consequences for their children.

The decade-long research project examined the impact of DDT on the sperm epigenome of South African Vhavenda and Greenlandic Inuit men, some of whom live in Canada’s North.

The study, published in the journal Environmental Health Perspectives, demonstrates a link between long-term exposure to DDT and changes in the sperm epigenome. These changes, particularly in genes vital for fertility, embryo development, neurodevelopment, and hormone regulation, correspond to increased rates of birth defects and diseases, including neurodevelopmental and metabolic disorders.

“We identified regions of the sperm epigenome that are associated with the serum levels of DDE (chemicals that form when DDT breaks down) and this association follows a dose-response trend. I think that’s quite striking, in that the more DDE you’re exposed to, the higher the chromatin, or DNA methylation defects are in the sperm,” said Ariane Lismer, PhD, the study’s lead author, who completed the work while pursuing her PhD at McGill’s Department of Pharmacology and Therapeutics.

“We demonstrate the sperm epigenome’s response to toxin exposures may be linked with disease in the next generation,” said Sarah Kimmins, PhD, who led the research as Professor of Pharmacology and Therapeutics at McGill and is also now a professor in the Department of Pathology and Cell Biology at Université de Montréal. “This is a critical new step for the field because while there are many studies of animals demonstrating toxin effects on the sperm epigenome, studies in humans have not comprehensively demonstrated this.”

Malaria, climate change, and the ‘grasshopper effect’

Despite a global ban on DDT to protect humans and the environment from its effects, the South African government has special permission to use it as an insecticide to control malaria. In some areas, home interiors are coated with the toxin. The study’s findings underscore the urgency to find alternative ways to control malaria and other vector-borne diseases.

“The reality is that people, especially young children and pregnant women, are still dying from malaria. We cannot afford for people in malaria-endemic regions to refuse spraying of their houses, as it will increase their risk of getting malaria,” says Tiaan de Jager, PhD, Dean of the Faculty of Health Sciences and Professor in Environmental Health at the School of Health Systems and Public Health at the University of Pretoria.

What’s more, the number of people and animals exposed to DDT is reportedly increasing due to climate change. DDT can travel vast distances through what is known as the ‘grasshopper effect,’ evaporating with warm air and returning to Earth with rain and snow in colder regions, where it persists in the Arctic food chain.

Rethinking fathers’ role in child development

The findings also highlight the importance of considering fathers in discussions about child health and development. While it’s commonly understood that women should avoid exposure to environmental contaminants during pregnancy, less attention has been given to how toxins affect fathers.

“We tend to think all fathers have to do is fertilise. But in fact, we forget that half of that genome and epigenome comes from the fathers, and half of it comes from the mothers. What that epigenome does in embryo development is critical for normal development,” says study co-author, Janice Bailey, PhD, formerly Professor of Animal Sciences at Université Laval and now the Scientific Director at Fonds de Recherche du Québec en Nature et Technologies (FRQNT).

Although the study focuses on DDT exposures, the researchers say it is not a leap to suggest that exposures to more common household endocrine disruptors such as those found in cosmetics and personal care items may act similarly.

Source: McGill University

Categories : Pain ManagementTags :

For Neuropathic Pain, the More Capsaicin Patch Applications the Better

On By ModernMedia
Photo by Sasun Bughdaryan on Unsplash

Capsaicin, derived from hot chili pepper plants, has been used to treat various types of pain, and a high concentration capsaicin patch (HCCP) is approved for the treatment of neuropathic pain. In a real-world study published in Pain Practice that included 97 outpatients in Germany diagnosed primarily with neuropathic back pain, postoperative/posttraumatic neuropathic pain, or postherpetic neuralgia (shingles pain), patients appeared to benefit from multiple HCCP applications.

Among the study participants, 38 received 2 HCCP treatments, and 59 received at least 3. Following HCCP treatments, most patients required significantly lower doses of opioids to manage their pain. Also, two-thirds of patients experienced a reduction in pain intensity after multiple HCCP treatments, and the proportion of patients experiencing a reduction in pain intensity was substantially higher among those who received at least 3 applications compared with those who received 2 applications.

“Consistent with the progressive response seen in prospective clinical trials involving repeated use of topical capsaicin, our research indicates that patients appear to benefit from multiple applications in terms of pain intensity and concomitant opioid use in real-world clinical practice,” said corresponding author Kai-Uwe Kern, MD, PhD, of the Institute for Pain Medicine/Pain Practice, in Wiesbaden, Germany.

Source: Wiley

Categories : Healthcare Politics and RegulationsTags :

Patient-centred Health Care: The NHI Revolution You Deserve

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A patient-centred health system will remain an illusion under the NHI unless the public health system is ramped up to better serve users and a clear path is outlined for public-private partnerships, argue Bernard Mutsago and Haseena Majid.

By Bernard Mutsago and Haseena Majid

National Health Insurance (NHI) is South Africa’s chosen financing vehicle for Universal Health Coverage (UHC). The plan is a step closer to being a reality after the NHI bill was passed by Parliament’s National Council of Provinces on 6 December 2023. The legislation aims for a single NHI fund that will buy services from public and private providers, it will be free at the point of delivery, and will prevent medical schemes from covering services that the NHI provides. The bill is likely to soon be signed into law by President Cyril Ramaphosa, although it may take years before all sections of the bill will come into force.

However, achieving a universal, affordable, high-quality, comprehensive, and patient-focused health system under the NHI will remain an illusion unless shortcomings of the public health system is fixed to meet the needs of the public. This can be achieved through a structured system that enables efficient and equitable pooling and distribution of resources across the public, private, and civil society sectors to improve service delivery.

As it stands, the absence of a clear framework for public-private partnerships in health service delivery is a barrier to progressive planning.

South Africa, over the last decade, has seen a significant decline in the state of its health sector. Despite initiatives such as the primary healthcare (PHC) re-engineering programme, and outreach services to improve service access, the health system faces a myriad of challenges. Budget constraints have crippled our human resource capacity. Corruption, maladministration, and neglect have resulted in the decay of facilities and their inability to withstand the increasing demands for basic and complex health services.

Most importantly, the data management system, public administration processes, and the referral pathways require significant intervention to align with the digital age and the potential role of artificial intelligence to improve health service delivery. The result is a poorly representative and possibly outdated set of data indicators to inform health service delivery needs that are contextual to geographic and institutional needs.

Applying a blanket approach to health interventions, in the absence of a significantly strengthened data collection and assessment pathway has led to questionable methods to achieving universal healthcare via NHI. The implementation of NHI pilot sites in the build-up to delivering the NHI has failed to show how the health system will move from the current curative approach to a more patient-centred approach. Failing to establish the patient-centred pathway at the onset from the public administration and health service delivery system, will result in the ongoing reality of some people being unable to access the health services closest to them at the lowest cost. It also has an extended impact on preventive strategies for better health outcomes.

South Africa has a fragmented, two-tiered and inequitable health system in which about only 17% of the population in 2018 had medical aid coverage, while more than 80% of the population are largely dependent on the public health sector. This is according to the Competition Commission’s final Health Market Inquiry report, released in November 2019.

The pathway to universal healthcare should entail crucial actions like maintaining and strengthening healthcare infrastructure and implementing strategic initiatives to bolster the workforce through robust recruitment, retention drives, and public-private collaborations.

But attention to these vital steps have been diverted by the government’s emphasis on a specific funding model -the NHI – The plan has faced considerable pushback with criticism, , largely rooted in the government’s inability to deliver essential services, theft due to corruption and cadre deployment, to the detriment of health users. These concerns  have been ignored. Instead, the determination to move ahead with the NHI amid outcries from the health sector, academics, and civil society is likely driven by politics.

Lessons from Ghana

Ghana’s failed NHI experiment is a luminous example for many countries attempting different financing models for delivering UHC. Ghana’s attempted NHI approach was taken off the national policy agenda due to public political opposition, weak civil society mobilisation, and low trust in the political leadership. This begs the question of whether due diligence was taken by the crafters of the NHI to establish the viability and sustainability of this model within the South African context.

Government needs fertile collaboration to materialise any policy goals. Whereas the NHI Bill has already been passed by the legislature, the successful implementation of the policy is dependent on people beyond the political realm. Engagements to structure and implement the operational plan for the NHI requires that government take on an approach that shows its willingness and commitment to take input from across all sectors, embrace the criticism, and find an approach that unifies all actors within the health sector and financing space.

Public-private partnership 

A well-designed public-private partnership model, with strong monitoring and evaluation processes could offer an opportunity to create the foundation for a medium-term solution. This could improve resource capacity in the public health sector to address the current health service backlogs, improve health infrastructure and technology, and create a functional system between the public and private health sectors to harvest  accurate health data. A strengthened data collection system that is inclusive and reflective of all users of the health system is after all essential to craft a responsive health system rather than a reactive one, thus placing the patient central to the health system.

Additionally, structures for community participation to inform healthcare service delivery, such as clinic committees and hospital boards, need to be bolstered as they are currently poorly functioning or non-existent. Including all voices, especially those of the public and clinicians, is critical for establishing  a capable health system that offers equitable health access for all people. This is only achievable through amplified voices and a united call for government to urgently re-evaluate its current approach toward NHI implementation.

*Mutsago is a health policy analyst, health equity activist, and primary healthcare enthusiast and Majid is a Global Atlantic Fellow for Health Equity in South Africa and director of public health programmes at civil society organisation Usawa.

Republished from Spotlight under a Creative Commons licence.

Source: Spotlight

Categories : Cancer Cardiovascular DiseaseTags :

Clues to Ponatinib’s Deadly Side Effects could Make it a Safer Cancer Drug

On By ModernMedia
Pexels Photo by Freestocksorg

For some leukaemia patients, the only potential chemotherapy option is ponatinib, a drug that also carries a high risk of heart failure. This means that some patients who recover from their cancer will end up dying of heart disease brought on by the cure.

In a new study, researchers from the University of Illinois Chicago and other universities have identified mechanisms that cause ponatinib to harm the heart. They also identified a promising treatment that could reverse this process.

The paper, with senior author Sang Ging Ong, assistant professor of pharmacology and medicine at UIC, is published in Circulation Research. The study is part of a growing field called cardio-oncology that investigates drugs that shrink tumours but can also cause heart problems.

While there are three options of drugs for treating chronic myeloid leukaemia, many patients are resistant to the other two, leaving ponatinib as their only choice.

“These patients have no other options for treatment,” Ong said, despite the concerns about the drug’s side effects.

In fact, ponatinib was pulled from the market for a few months after its introduction in 2012 because of concerns about heart problems.

The researchers were interested in understanding the interaction between ponatinib and the heart cells responsible for contraction.

They discovered that ponatinib damages these cells by activating a process known as the integrated stress response.

The mechanism for this is related to the functioning of a kinase (an enzyme involved in energy transfer) called GCN2.

The researchers found that ponatinib, despite being a kinase inhibitor, actually activates GCN2, which in turn switches on the integrated stress response.

While this response isn’t always a bad thing, normally protecting cells, it can also lead to their death under prolonged stress.

To see if this response was harming the cells, the researchers studied what would happen if they used a small molecule to block the integrated stress response in both cells and in mice during ponatinib treatment.

They found that the treatment helped protect heart cells from the damaging side effects of the drug yet did not diminish ponatinib’s tumour-fighting efficacy.

“It protects the heart but at the same time, it still allows us to kill cancer cells,” Ong said.

More research is needed to know if this protective measure would work well in humans, Ong said.

The mechanisms they identified are important in other cardiac diseases, as well, which could lead to future research on how to protect cells against different conditions.

Source: University of Illinois Chicago

Categories : Cancer Pain ManagementTags :

Among Cancer Survivors, Physical Activity is Linked to Reduced Pain

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Study shows that higher levels of physical activity are linked with less pain, and to a similar extent in adults with and without a history of cancer.

Photo by Barbara Olsen on Pexels

People who have had cancer often experience ongoing pain, but a new study reveals that being physically active may help lessen its intensity. The study is published by Wiley online in CANCER, a peer-reviewed journal of the American Cancer Society.

Although physical activity has been shown to lessen various types of pain, its effects on cancer-related pain are unclear. To investigate, a team led by senior author Erika Rees-Punia, PhD, MPH, of the American Cancer Society, and first author Christopher T.V. Swain, PhD, of the University of Melbourne, in Australia, analysed information pertaining to 51 439 adults without a history of cancer and 10,651 adults with a past cancer diagnosis. Participants were asked, “How would you rate your pain on average,” with responses ranging from 0 (no pain) to 10 (worst pain imaginable). Participants were also asked about their usual physical activity.

US guidelines recommend 150 minutes (2 hours 30 minutes) to 300 minutes (5 hours) a week of moderate-intensity, or 75 minutes (1 hour 15 minutes) to 150 minutes (2 hours 30 minutes) a week of vigorous-intensity aerobic physical activity.

Based on participants’ responses, the investigators found that, for individuals who had cancer in the past as well as for those without a history of cancer, more physical activity was linked with lower pain intensity. The extent of the association was similar for both groups of individuals, indicating that exercise may reduce cancer-related pain just as it does for other types of pain that have been studied in the past.

Among participants with a past cancer diagnosis, those exceeding physical activity guidelines were 16% less likely to report moderate-to-severe pain compared to those who failed to meet physical activity guidelines. Also, compared with people who remained inactive, those who were consistently active or became active in older adulthood reported less pain.

“It may feel counterintuitive to some, but physical activity is an effective, non-pharmacologic option for reducing many types of pain. As our study suggests, this may include pain associated with cancer and its treatments,” said Dr Rees-Punia. 

Source: Wiley

Categories : Lab Tests and Imaging NeurologyTags :

Visualising Multiple Sclerosis with a New MRI Procedure

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This is a pseudo-colored image of high-resolution gradient-echo MRI scan of a fixed cerebral hemisphere from a person with multiple sclerosis. Credit: Govind Bhagavatheeshwaran, Daniel Reich, National Institute of Neurological Disorders and Stroke, National Institutes of Health

A key feature of multiple sclerosis (MS) is that it causes the patient’s own immune system to attack and destroy the myelin sheaths in the central nervous system. To date, it hasn’t been possible to visualise the myelin sheaths well enough to use this information for the diagnosis and monitoring of MS.  Now researchers have developed a new magnetic resonance imaging (MRI) procedure that maps the condition of the myelin sheaths more accurately than was previously possible.

The researchers successfully tested the procedure on healthy people for the first time, and published their results in Magnetic Resonance in Medicine.

In the future, the MRI system with its special head scanner could help doctors to recognise MS at an early stage and better monitor the progression of the disease.

This technology, developed by the researchers at ETH Zurich and University of Zurich, led by Markus Weiger and Emily Baadsvik from the Institute for Biomedical Engineering, could also facilitate the development of new drugs for MS. But it doesn’t end there: the new MRI method could also be used by researchers to better visualise other solid tissue types such as connective tissue, tendons and ligaments.

Quantitative myelin maps

Conventional MRI devices capture only inaccurate, indirect images of the myelin sheaths because these devices typically work by reacting to water molecules in the body that have been stimulated by radio waves in a strong magnetic field.

But the myelin sheaths, which wrap around the nerve fibres in several layers, consist mainly of fatty tissue and proteins. That said, there is some water – known as myelin water – trapped between these layers.

Standard MRIs build their images primarily using the signals of the hydrogen atoms in this myelin water, rather than imaging the myelin sheaths directly.

The ETH researchers’ new MRI method solves this problem and measures the myelin content directly.

It puts numerical values on MRI images of the brain to show how much myelin is present in a particular area compared to other areas of the image.

A number 8, for instance, means that the myelin content at this point is only 8 percent of a maximum value of 100, which indicates a significant thinning of the myelin sheaths.

Essentially, the darker the area and the smaller the number in the image, the more the myelin sheaths have been reduced.

This information ought to enable doctors to better assess the severity and progression of MS.

Measuring signals within millionths of a second

It is difficult however to image the myelin sheaths directly, since the signals that the MRI triggers in the tissue are very short-lived; the signals that emanate from the myelin water last much longer.

“Put simply, the hydrogen atoms in myelin tissue move less freely than those in myelin water. That means they generate much briefer signals, which disappear again after a few microseconds,” Weiger says, adding: “And bearing in mind a microsecond is a millionth of a second, that’s a very short time indeed.” A conventional MRI scanner can’t capture these fleeting signals because it doesn’t take the measurements fast enough.

To solve this problem, the researchers used a specially customised MRI head scanner that they have developed over the past ten years together with the companies Philips and Futura.

This scanner is characterised by a particularly strong gradient in the magnetic field.

“The greater the change in magnetic field strength generated by the three scanner coils, the faster information about the position of hydrogen atoms can be recorded,” Baadsvik says.

Generating such a strong gradient calls for a strong current and a sophisticated design.

As the researchers scan only the head, the magnetic field is more contained and concentrated than with conventional devices.

In addition, the system can quickly switch from transmitting radio waves to receiving signals; the researchers and their industry partners have developed a special circuit for this purpose.

The researchers have already successfully tested their MRI procedure on tissue samples from MS patients and on two healthy individuals. Next, they want to test it on MS patients themselves. Whether the new MRI head scanner will make its way into hospitals in the future now depends on the medical industry. “We’ve shown that our process works,” Weiger says. “Now it’s up to industry partners to implement it and bring it to market.”

Source: ETH Zurich