Month: July 2024

Categories : Cardiovascular DiseaseTags :

Daily Physical Activity not Sufficient to Protect Against Stroke

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Photo by Emmanuel Ikwuegbe on Unsplash

Research conducted at the University of Gothenburg shows that daily physical activities, at work or in the home, are not sufficient to protect against stroke. Fortunately, the findings, published in JAMA Network Open, suggest that exercising in free time and using active modes of transport are associated with a decreased risk of stroke.

“Physical activity during leisure time and as transportation is becoming increasingly important now that many jobs and domestic activities are becoming more sedentary,” says lead author of the study Adam Viktorisson, researcher at Sahlgrenska Academy at the University of Gothenburg, Sweden.

Twenty year follow-up

The research study covers 3614 people from the region of Västra Götaland, 269 of whom suffered a stroke in the twenty years spanned by the study. Three months after the stroke, 120 of these had died or were dependent on help to carry out activities of daily living.

Physical activity data was gathered from surveys. Some participants were also given a pedometer to wear. Physical activity during leisure time or for transportation showed a link to the objective measurements from the pedometers, while physical activity at work did not.

Occupational physical activity not protective

The health benefits of physical activity are well known, but earlier studies tend to mainly focus on physical activity during leisure time. Research in recent years has shown that physical activity at work can instead have negative health impacts, increasing the risk of cardiovascular disease.

“How and when we carry out physical activity seems to play a crucial role in determining its health benefits. In our study leisure time and transport related physical activities were associated with a lower risk of stroke, whereas activities during work time or in the household were not” Adam Viktorisson points out.

“Physically demanding jobs are often linked to stress, little opportunity for recovery, air pollution and generally poorer socioeconomic conditions, which can counteract the positive effects of physical activity.”

Promote public health

The study used data from the INTERGENE cohort at the University of Gothenburg. Study participants were surveyed and data was collected from 2001 to 2004, consisting of both clinical and questionnaire data. The researchers hope that these results will bring greater awareness and lead to changes in public health policy to encourage physical activity in society.

“Encouraging people to be physically active in their daily lives, for example by walking, cycling and doing other types of exercise, can be an important strategy in reducing the number of strokes and improving the prognosis of people who suffer a stroke,” says Adam Viktorisson.

Source: University of Gothenburg

Categories : Skeletal SystemTags :

Patients with Osteoarthritis are Often Prescribed NSAIDs Despite Contraindications

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Photo by Towfiqu barbhuiya

A new study published in the journal Osteoarthritis and Cartilage has found that people with newly diagnosed osteoarthritis (OA) of the knee or hip with contraindications to or precautions for NSAIDs still continue to be prescribed these drugs. Additionally they had higher use of opioids and slightly lower physical therapy (PT) use within the first year of OA diagnosis, both of which are not consistent with treatment guidelines for OA.

“We found individuals with contraindications to NSAIDs were still commonly prescribed them, placing them at risk for NSAID-related adverse events,” explains corresponding author Tuhina Neogi, MD, PhD, the Alan S. Cohen Professor of Rheumatology and professor of medicine at the school. “Additionally, they were not more likely to receive safer alternatives like PT despite its widespread recommendation as first-line intervention.”

The researchers used population-based register data to identify adults residing in Sweden (between 2004-13) without a previous knee or hip OA diagnosis. Among this group, between 2014-18, they identified people with knee or hip OA diagnosis and presence of contraindications to or precautions for oral NSAIDs at the time of OA diagnosis. They then estimated the risk of: 1) regular oral NSAID use; 2) regular opioid use; 3) PT during the first year after diagnosis among those with versus without contraindications or precautions.

Despite having contraindications to NSAIDs, 21% of those in the study were regular users of NSAIDs within the first year of their OA diagnosis. Similarly, 21% of those with precautions for using NSAIDs were also regular users. They also found a higher proportion of persons with contraindications were regular users of opioids than those without a contraindication or precaution, while a slightly lower proportion received PT.

Neogi stresses that more options for effective and safe management of OA symptoms are urgently needed, and greater work is required in narrowing and ultimately closing the evidence-knowledge-practice gap.

Source: Boston University

Categories : IT in HealthcareTags : 4 Comments

Introducing the Future of Personalised Healthcare: Ajuda

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Dr Liza Street and Taryn Uhlmann, Co-founders of Ajuda

As technology continues to shrink the world, migration is becoming easier. According to Statista, nearly a million South Africans emigrated in 2020, and the semigration trend in recent years has seen hundreds of thousands of South Africans relocating between provinces. While belongings can go into a truck or shipping container, something even more important is slipping through the cracks: personal health records.

Two highly-motivated, entrepreneurial women are looking to change that with an innovative, user-friendly solution – a secure digital health vault called Ajuda, where anyone and everyone can store their health information and get quick access to it anytime, anywhere, using a secure login from their digital device.

Designed With You In Mind

Ajuda (which means ‘help’ in Portuguese) was founded and developed by both Dr Liza Street, a paediatrician, and Taryn Uhlmann, a technology and marketing business executive.

The two – both moms of three – met when Street began treating Uhlmann’s children. After COVID-19, with all the disruptions and innovations that arose during that time, they got chatting about how disempowering it was for moms not to have easy access to their children’s medical records and thus having to rely on memory when it came to their children’s developmental milestones, doctor consults and medication names. “We don’t realise how often we need to recall this information – for new schools, at doctors’ visits and even when relocating. This frustration, especially for busy parents, is where it all started,” says Uhlmann.

That conversation, three years ago, was the seed for what has blossomed into Ajuda. Uhlmann and Street recently welcomed a third member, Allan Sweidan, as an investor and advisor. Sweidan, a clinical psychologist, brings his experience from co-founding Akeso, Netcare’s mental healthcare clinics, and more recently the mental health app, October Health (Panda), to Ajuda.

Why a Central Health Information Vault?

While the idea may have been born out of a conversation about time-strapped moms managing their kids’ health, Uhlmann and Street soon realised that not having the means to securely and conveniently store one’s health information and have access to one’s medical history was a challenge faced by everyone.

Accurate medical records are necessary in emergency situations, anytime you’re having new medication prescribed, for insurance applications, school applications, visa applications, and in many other instances.

What’s more, not having access to personal health information makes it difficult for people to take control of their own health. Having accurate information on hand helps people keep track of which medications to take, in what dosages and when. It also helps healthcare providers make informed decisions around treatments and prescriptions, based on their patients’ health histories, and can lower the risk of adverse drug interactions. In an age of the ‘sandwich generation’, where adults today often take care of both their children and their parents, a centralised repository of their family’s health information is game-changing.

“We looked at all the challenges,” says Uhlmann. “Memory is a big challenge; migration and movement is a big challenge; and the fact that medical care is fragmented – you might have a scan at one hospital and a blood test at another, or maybe you take your child to a GP while you’re on holiday, and in the end, because you don’t have access to all those records in one place, it means no doctor has all the information required to ever look at you holistically. There are many separate medical apps for various healthcare organisations, but no centralised, consumer facing solution pulling it all together. ” 

Everything In One Place

Ajuda addresses these concerns with a secure, easy-to use digital storage vault that users can access anywhere, anytime, free of charge.

A second time-saving feature of Ajuda is the ‘One Time Form.’  When signing up, a new user creates a profile for themselves and/or their children, which generates a ‘One Time Form’ and they’re set for life. Creating a profile is simple and interactive, and Ajuda users are guided through the process of completing and uploading their personal and health details, step by step, with user-friendly prompts and explanations.

“This is the same core information that you fill in every time you see a new doctor, have a blood test, or do any medical procedure, which becomes frustrating and time consuming,” says Street. “Now you just need to complete it once, unpressurised, in the comfort of your home, with the correct information at hand, and then take it each time you go to a healthcare provider. It’s a win-win for doctors and patients.”

If users don’t have all their information on hand, no problem – they can fill in the gaps later. Once they’ve completed their profile, they can then enjoy the peace of mind that their personal health information is safely, conveniently and accurately stored.

“For healthcare providers, it provides a comprehensive record of a patient’s health history, not only at their own practice but anywhere the patient has received treatment,” says Street.

Free and Independent

Ajuda is free to use, and you don’t need to be a member of a particular medical scheme or use a particular healthcare provider to access it. By making it free to use, Uhlmann and Street hope to empower everyone with the means to take control of their own health information.

For more information on Ajuda or to sign up, visit Ajuda.co.za 

Categories : Implants and ProsthesesTags :

Common Skin Bacteria in Increasing Cases of Implant-associated Osteomyelitis

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Osteomyelitis from Staphylococcus Aureus infection. Credit: Scientific Animations CC0

In patients who have undergone knee or hip replacement surgery, clinicians are noticing increasing numbers of chronic bone infections linked to a bacterial strain commonly found on the skin. A new study published in the Journal of Orthopaedic Research provides insights into the mechanisms involved, and how the bacteria lingers in bone reservoirs.

Utilising mouse models of bone infection and systematic electron microscopy studies, scientists found that the common skin bacteria Cutibacterium acnes can persist as layers of biofilms for weeks on contaminated titanium or stainless-steel implants. In mice, C. acnes could persist for 28 days in the tibia, and the researchers also observed C. acnes spreading to internal organs. compared to Staphylococcus aureus infections, C. acnes chronic osteomyelitis revealed markedly reduced bone osteolysis and abscess formation.

C. acnes can also invade deep pockets of the bone called osteocyte lacuno-canalicular networks and persist there.

“Our study highlights that osteocyte lacuno-canalicular networks can be a major reservoir for this bacterium and potentially provides a novel mechanism of why Cutibacterium acnes chronic bone infections are difficult to treat in the clinic,” said corresponding author Gowrishankar Muthukrishnan, PhD, of the University of Rochester Medical Center.

Source: Wiley

Categories : Diet and Nutrition GastrointestinalTags :

Specific Type of Dietary Fibre Could Stimulate GLP-1 Release

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Gut Microbiome. Credit Darryl Leja National Human Genome Research Institute National Institutes Of Health

New research led by Frank Duca, associate professor at the University of Arizona, suggests that consuming foods rich in beta-glucan, a type of fibre found in oats and barley, can reduce body weight and obesity by stimulating the release of glucagon-like peptide-1 (GLP-1). The study, published in The Journal of Nutrition, analysed the impact of different fibres on gut microbiota.

“We know that fibre is important and beneficial; the problem is that there are so many different types of fibre,” Duca said. “We wanted to know what kind of fibre would be most beneficial for weight loss and improvements in glucose homeostasis so that we can inform the community, the consumer and then also inform the agricultural industry.”

Not all fibre is created equal

The researchers looked at the effect of five different plant-based fibres in rodent diets: pectin, beta-glucan, wheat dextrin, starch and cellulose. Only beta-glucan resulted in reduction of body weight and fat, as well as improvements in glucose homeostasis. Beta-glucan is a unique fibre that is found in many foods, including oats, barley, mushrooms and yeasts, and future studies will examine how different sources of beta-glucan could differ in their effectiveness.

Changes in metabolites – the molecules produced when gut bacteria interact with fibre – seemed to be responsible for the weight-loss effects,  particularly a specific metabolite called butyrate. Butyrate is a key fuel source for colon cells, promoting a healthy gut barrier to reduce systemic inflammation. Butyrate also induces the release of gut peptides, or messengers that regulate the functions of the gut, such GLP-1.

Drugs like semaglutide are synthetic versions of GLP-1, which stimulate insulin and can also help people feel full. One key difference of naturally occurring GLP-1 is its rapid degradation near the intestine, whereas semaglutide is made to last longer and target the brain.

“Part of the benefits of consuming dietary fibre is through the release of GLP-1 and other gut peptides that regulate appetite and body weight,” Duca said. “However, we don’t think that’s all of the effect. We think that there are other beneficial things that butyrate could be doing that are not gut peptide related, such as improving gut barrier health and targeting peripheral organs like the liver.”

Duca is researching other types of fibre that can be beneficial for weight reduction. In a previous study, the Duca Lab discovered that barley flour was the most effective in promoting weight loss compared to several other commercially available flours. Other studies involving oligofructose have also demonstrated beneficial effects. In the future, Duca hopes to collaborate with other researchers to develop enhanced fibres that can optimise the release of butyrate.

Source: University of Arizona

Categories : Pain ManagementTags :

Researchers Delve into the Roots of Chronic Pain

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Source: Pixabay CC0

A team of researcher have identified a new function for the PIEZO2 protein – in mediating chronic pain hypersensitivity. The research suggests a new target for analgesics and potentially explains why pain medications that target voltage gated sodium channels have been disappointing as clinical targets. The study, led by Oscar Sánchez-Carranza in Professor Gary Lewin’s lab at the Max Delbrück Center, was published in the journal Brain.

“There’s a good correlation between chronic pain and the sensitisation of pain receptors, called nociceptors, in humans,” says Lewin. “This study implicates the PIEZO2 channel as a critical mediator of sensory signals that maintain chronic pain.”

PIEZO2 protein forms an ion channel in human sensory receptors. Previous studies have shown that the ion channel is involved in communicating the sense of touch to the brain. People with “loss-of-function” mutations in the PIEZO2 gene are hypo-sensitive to gentle touch or vibration. By contrast, patients with “gain-of-function mutations” in PIEZO are often diagnosed with complex developmental disorders. But whether gain-of-function mutations are responsible for mechanical hypersensitivity had never been proven.

Mutation dramatically sensitises nociceptors

To study the connection, Sánchez-Carranza created two strains of so called “gain-of-function” mice, each carrying a different version of a mutated PIEZO2 gene. He expected to find the touch receptors of these mice to be highly sensitive. In cell biology experiments his team has found that PIEZO2 mutations have a powerful effect on the activity of the ion channel. One mutation, for example, causes the channel to open with 10 times less force compared to normal non-mutated channels.

Using electrophysiological methods developed in the Lewin lab, Sánchez-Carranza and his colleagues measured electrical activity in sensory neurons isolated from the transgenic mice. They found that in addition to sensitising touch receptors as expected, the mutations made nociceptive receptors – neurons that detect painful mechanical stimuli – dramatically more sensitive to mechanical stimuli.

Moreover, the researchers found that the nociceptors were activated by mechanical stimuli that would normally be experienced as light touch.

“You pretty much need to crush the skin to activate nociceptors,” Sánchez-Carranza explains. But the nociceptors from the transgenic mice were triggered by levels of mechanical force that would normally be perceived as a touch. They were incredibly sensitive.”

That a single mutation in PIEZO2 was enough to change the physiology of the nociceptors from one type of neuron to another, was especially surprising, says Lewin. More significantly, when the stimulus was removed, the neurons kept firing. The study is the first time that anyone has linked gain-of-function mutations in the PIEZO2 gene to pain receptors.

PIEZO2 might be involved in pain syndromes like fibromyalgia

Clinical studies have shown that in patients with chronic pain syndromes such as fibromyalgia and small fibre neuropathies, C-fibre nociceptors, which are the sensory receptors that initiate pain, are hyperactive. When researchers have recorded the activity of nociceptors in such people, they found that the they were active in the absence of any mechanical stimulus. But the mechanism was not clear.

“We show that just by changing one amino acid in PIEZO2, we can actually mimic a lot of what happens in chronic pain in the C-fibres,” says Lewin. In humans, “PIEZO2 might be involved in many of these pathologies.” Nociceptive neurons are the largest population of sensory neurons that innervate the skin – humans have four times more pain receptors in the skin than touch receptors.

Up to 20% of the adult population suffers from chronic pain, according to a 2023 study by the U.S. National Institutes of Health, which is poorly treated with existing medications. The same NIH study found that two thirds of people who reported chronic pain in 2019 were still suffering one year later.

The findings suggest that a particular aspect of the PIEZO2 channels mechanism of opening could be targeted by new pain medications. Much effort on developing new analgesics has focused on voltage gated sodium channels with limited success, says Lewin. “By addressing the root cause of nociceptor sensitisation, new drugs could provide better relief for chronic pain sufferers.”

Source: Max Delbrück Center

Categories : Ethics and LawTags :

iTOO Enters Strategic Partnership with Medical Professional Indemnity Specialist EthiQal

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Photo by Sora Shimazaki

iTOO Special Risks, a specialty risk underwriter and EthiQal, a medical professional indemnity provider for specialist doctors, have announced an exciting strategic partnership. This collaboration, backed by Hollard, one of South Africa’s largest non-life insurers, aims to bolster EthiQal’s mission to protect healthcare professionals with robust, reliable coverage and medico-legal support.

Together, the partnership reinforces the comprehensive suite of medical malpractice insurance cover available across the spectrum; iTOO’s focus on allied professionals, General Practitioners, institutions and clinical trials continues and EthiQal remains focussed on specialist practitioners.

Together this partnership unlocks valuable opportunities to achieve the shared vision of strengthening the protection of the medical profession, without which the delivery of high quality healthcare is not achievable.

EthiQal Reinforced

EthiQal’s dedication to safeguarding specialist practitioners aligns perfectly with iTOO’s extensive network and expertise in specialty insurance. This partnership,  ‘EthiQal Reinforced,’ aims to leverage the strengths of both entities to enhance their offerings and deliver world-class products and services to their clients.

“We are saying  this partnership is ‘EthiQal Reinforced’ because while EthiQal is already a strong entity, together with iTOO, it becomes even bigger and stronger,” says Justin Naylor, CEO at iTOO. “iTOO’s extensive network and resources bring additional and complementary skills and capabilities to support EthiQal and its customers.”

Naylor further elaborates, “We have a 20-year track record and well-established risk underwriting capability with a market-leading diverse product range, backed by a complete cradle-to-grave infrastructure. This partnership combines the expertise and track records of both iTOO and EthiQal, reinforcing their excellent offerings.”

EthiQal’s Vision and Strengths

Alex Brownlee, CEO of EthiQal, highlights the alignment of principles and vision that initially brought the two parties together. “iTOO brings a legacy of deep insurance expertise, an extensive network, and additional skills that complement our own. This partnership provides enhanced financial backing, stability, and reliability,” says Brownlee.

Brownlee emphasises the focused and niche market that EthiQal serves, which requires leading risk management support. “Medical malpractice, particularly in fields like obstetrics, spinal surgery, neonates and neurosurgery, involves high risks and long-duration claims. This has driven us to develop deep expertise and understanding of the medico-legal landscape,” he notes.

EthiQal’s team includes a dedicated clinical team, an in-house legal team available for urgent advice and legal support, and personalised quality service. Brownlee assures that the partnership will not change the way EthiQal does business, nor change its products or services, but will reinforce and support the dedicated and steadfast EthiQal team in their commitment to support doctors.

Financial Resilience and Support

EthiQal has strong financial capacity, with a Solvency Capital Requirement above 120%, well beyond the regulatory 1-in-200-year event solvency requirement. The firm enjoys continued financial backing from Dr. Christo Wiese’s Titan Group and reinsurance cover from Lloyd’s of London. Along with iTOO and Hollard, this combination offers improved financial support, stability, and reliability “for our clients’ benefit”, Brownlee stresses.

“EthiQal offers incredible value for medical specialists, and Titan will continue to invest significant resources to build EthiQal’s capacity to measure, mitigate and absorb medical malpractice risk. Alex Brownlee and the team’s drive and capability is what attracted us to the business and what will ensure EthiQal continues to offer value to its policyholders and broker partners”, says Titan’s investment executive Zac Pitsillis.

Engagement and Education

Brownlee also confirmed that EthiQal will remain actively involved in the medical community through conferences, presentations, and educational grants. “Over the last 2 years in particular we have been extremely active in sharing our knowledge and insights, aiming to support doctors and their medical societies.”

Commitment to Quality and Service

“This partnership with iTOO, backed by Hollard, reinforces the quality and value of EthiQal’s products and people, demonstrating confidence in EthiQal’s future and the team that makes it happen,” Brownlee concludes. “The alignment in our values, vision and approach to clients is a critical reason why this partnership is ideal.”

Categories : Diseases, Syndromes and Conditions HospitalsTags :

Klebsiella Thrives in Nutrient-deprived Hospital Environments

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Photo by Hush Naidoo Jade Photography on Unsplash

Scientists at ADA Forsyth Institute (AFI) have identified a critical factor that may contribute to the spread of hospital-acquired infections (HAIs), shedding light on why these infections are so difficult to combat. Their study reveals that the dangerous multidrug resistant (MDR) pathogen, Klebsiella, thrives under nutrient-deprived polymicrobial community conditions found in hospital environments.

According to the World Health Organization, HAIs pose significant risks to patients, often resulting in prolonged hospital stays, severe health complications, and a 10% mortality rate. One of the well-known challenging aspects of treating HAIs is the pathogens’ MDR. In a recent study published in Microbiome, AFI scientists discovered that Klebsiella colonising a healthy person not only have natural MDR capability, but also dominate the bacterial community when starved of nutrients.

“Our research demonstrated that Klebsiella can outcompete other microorganisms in its community when deprived of nutrients,” said Batbileg Bor, PhD, associate professor at AFI and principal investigator of the study. “We analysed samples of saliva and nasal fluids to observe Klebsiella‘s response to starvation conditions. Remarkably, in such conditions, Klebsiella rapidly proliferates, dominating the entire microbial community as all other bacteria die off.”

Starvation environments

Klebsiella is one of the top three pathogens responsible for HAIs, including pneumonia and irritable bowel disease. As colonising opportunistic pathogens, they naturally inhabit the oral and nasal cavities of healthy individuals but can become pathogenic under certain conditions. “Hospital environments provide ideal conditions for Klebsiella to spread,” explained Dr Bor. “Nasal or saliva droplets on hospital surfaces, sink drains, and the mouths and throats of patients on ventilators, are all starvation environments.”

Dr Bor further elaborated, “When a patient is placed on a ventilator, they stop receiving food by mouth, causing the bacteria in their mouth to be deprived of nutrients and Klebsiella possibly outcompete other oral bacteria. The oral and nasal cavities may serve as reservoirs for multiple opportunistic pathogens this way.”

Additionally, Klebsiella can derive nutrients from dead bacteria, allowing it to survive for extended periods under starvation conditions. The researchers found that whenever Klebsiella was present in the oral or nasal samples, they persisted for over 120 days after being deprived of nutrition.

Other notable findings from the study include the observation that Klebsiella from the oral cavity, which harbours a diverse microbial community, was less prevalent and abundant than those from the nasal cavity, a less diverse environment. These findings suggest that microbial diversity and specific commensal (non-pathogenic) saliva bacteria may play a crucial role in limiting the overgrowth of Klebsiella species. 

The groundbreaking research conducted by AFI scientists offers new insights into the transmission and spread of hospital-acquired infections, paving the way for more effective prevention and treatment strategies.

Source: Forsyth Institute

Categories : Exercise Mental HealthTags :

Researchers Find New Clues as to Why Exercise Relieves Depression

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Photo by Robert Ruggiero on Unsplash

While physical activity, especially aerobic exercise, is known to reduce depressive symptoms, the processes behind this have been poorly understood – until now. In a new review article published in Translational Psychiatry, researchers propose a novel hypothesis to understand the antidepressant effects of exercise. They believe that the process may hinge on motivation, which is very important for alleviating a number of symptoms of depression, such as anhedonia (a lack of interest or joy in life’s experiences), low energy and ‘brain fog’.

The team summarised research papers that explored the mechanisms of depression in both humans and animals and concluded that depression, especially anhedonia, is associated with elevated inflammation (caused by the body’s immune response). Importantly, inflammation is also linked to disrupted dopamine transmission. These biological changes may represent key processes leading to changes in motivation, and in particular a lower willingness to exert physical or mental effort.

Meanwhile, exercise reduces inflammation, boosts dopamine function, and enhances motivation. The researchers believe that this could be an important reason as to why exercise exerts an antidepressant effect.

Lead author, Dr Emily Hird (UCL Institute of Cognitive Neuroscience) said: “The antidepressant effect of aerobic exercise has been convincingly demonstrated through randomised controlled trials, but its mechanism is not well understood. This is, in part, because it likely involves a variety of biological and psychological processes.

“For example, alongside its positive effect on inflammation, dopamine and reward processing, exercise also reduces oxidative stress and improves self-esteem and self-efficacy.

“However, we are proposing that exercise – particularly aerobic activities that make you sweaty and out of breath – decreases inflammation and boosts dopamine transmission, which in turn increases the desire to exert effort, and therefore boosts motivation generally.”

The team hope that this understanding of how exercise reduces symptoms of depression will help to inform the development of new treatment strategies – such as personalised exercise programmes.

Dr Hird said: “Understanding the mechanisms that underly the antidepressant effects of physical activity in depression could also inform our understanding of the mechanisms causing depression and the development of novel intervention strategies, in particular personalised intervention, and social prescribing.”

To further test their hypothesis, the researchers advise that large randomised controlled trials need to be conducted that assess the antidepressant effects of exercise, whilst also measuring the effect on variables including inflammation, dopamine transmission and motivation.

It would also be important to investigate any potential barriers to exercise.

Dr Hird said: “Addressing barriers to exercise – particularly in people with depression – is crucial, as regular physical activity may be able to alleviate symptoms, enhance mood and empower individuals on their path to recovery. As part of this, finding strategies to encourage exercise is key.”

The team are now running a trial based on the hypothesis proposed in the review, which will involve 250 participants aged 18 to 60 and is funded by a Wellcome Mental Health Award.

Source: University College London

Categories : HIVTags :

New Research Shows Great Strides have been Made in Controlling HIV in South Africa

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Image: supplied.

Although South Africa has the largest number of people living with HIV worldwide, strides have been made in controlling the epidemic, especially in the reduction of HIV incidence, testing, and treatment.  Researchers from the South African Medical Research Council (SAMRC) and University of KwaZulu-Natal (UKZN) are inching closer to finding the answer to the natural control of HIV infection, leading to improved health outcomes and quality of life amongst South Africans.

 According to the latest survey by the Human Sciences Research Council, in 2022, there were approximately 7.8 million people afflicted with HIV in South Africa, the highest absolute number of people living with HIV globally. Yet despite having the largest genetic diversity in the world, African human genome sequences represent the lowest of all the human genomes that have been sequenced worldwide. There is a dire need to leverage genomics to back up and scale targeted intervention programs to put more people living with HIV on effective treatment.

Of particular interest in the global investigations into HIV is “elite controllers” (ECs), a rare group of HIV‐1‐positive individuals whose immune systems can seemingly suppress the infection from developing without taking antiretrovirals (ARVs). For every 200 people living with HIV, around one may be an elite controller (0.5%). In South Africa, with its high rate of HIV infection, the prevalence of ECs also appears to be higher. By “unmasking” the secrets of ECs through research, clues can be revealed, and new therapies potentially developed to benefit broader groups of people living with the disease.

In order to identify the polymorphism and mutations within individuals of African descent, and understand how they are associated with HIV disease progression, Dr Veron Ramsuran, Associate Professor at UKZN, and Prof Thumbi Ndung’u, Director for Basic & Translational Science at the Africa Health Research Institute, joined hands with SAMRC, MGI and local South African clinics in 2019 to take their 20+ years of work in EC research to the next level using whole genome sequencing (WGS).

“The HIV Host Genome project was started at the same time as we launched SAMRC’s African Genomics Centre in Cape Town with the support from MGI,” said project co-investigator Rizwana Mia, also co-founder of the SAMRC Genomics Centre and Senior Program Manager in Precision Medicine at SAMRC. “The partnership saw MGI putting down a high-throughput sequencing workflow and assisted us with the specialised scaled infrastructure design in our lab. This was at a time when there was no real infrastructure for large-scale next generation sequencing in Africa.”

“More importantly, by moving our laboratory workflow to scale, we are hoping to develop genomic research to address this quadruple burden of disease that South Africa faces,” explained Mia. “Our project looks at a unique cohort of patients that have the ability to control the HIV virus to ascertain how disease progresses and the host-directed mechanisms for innate immune control. In addition, we included family sets to help us better understand the relationship between pediatric non-progressors and their parents who are also HIV positive, to uncover and genetic differences that may contribute to host immune control of HIV.”

“We’ve identified new genes and polymorphism that are playing a role with HIV disease through new data generated from Whole Genome Sequencing,” said Dr Veron Ramsuran, principal investigator of the HIV Host Genome project. “Traditionally, there is a list of mutations or genes that are known to associate with HIV, yet they are largely based on studies on Caucasian populations. Our HIV research is adding to the general pool of knowledge pertaining to individuals of African descendent, which will thereby inform new treatment and new vaccine opportunities.”

“What’s important is also understanding how drugs interact with the individual,” added Ramsuran. “We’ve found in the past that certain polymorphism is associated with drug metabolism in genes. Building on this understanding of drugs in combination with the genetics of the individual, we can develop prediction tools to inform clinicians on drug type or dosage depending on the presence of the polymorphism to facilitate a more rapid metabolism of the drug.”

Encouragingly, investigations into Africa’s diseases will continue beyond this point. The HIV Host Genome project has laid the groundwork for the ambitious National 110K Human Genome Project. This large-scale population study will involve 110 000 participants from the South African population, aiming to understand more about of their genomic diversity, address various health challenges, and pave the way for personalized medicine in the country. Furthermore, the data collected will be incorporated into a national population database, enhancing research outcomes and deepening disease understanding for Africa.

Given South Africa’s diverse population, limited human genomics data and significant healthcare burden from diseases such as HIV, understanding pathogenesis and inherent mutations is important for implementing targeted treatments and public health programs. With its lower sequencing cost, high quality data, and efficient all-in-one workflows, MGI’s equipment play an instrumental role , will continue to drive progress in studying rare HIV phenotypes, which holds great promise in advancing the development of targeted interventions and cures– not only for HIV – but many other diseases.

“Looking at the genetic variation and its impact on HIV is a gamechanger, because it will shed light on some of the best immune responses that can be generated against the HIV virus,” stated Prof Thumbi Ndung’u, principal investigator of several of the project’s cohort studies. “And actually, this knowledge will be widely applicable and could have an impact on other diseases – infectious and non-infectious – as well as their drug interventions. It will make sure that Africans, just like everybody else, are at the centre of drug and vaccine development.”