Day: July 4, 2024

How Metastatic Cancer Cells Gain a Foothold

Colourised scanning electron micrograph of a breast cancer cell. Credit: NIH

Metastatic cancer cells, which cause 90% of cancer-related deaths, must overcome numerous hurdles to spread from a primary tumour through the bloodstream. Now, a new study led by investigators from the Mass General Cancer Center has identified a gene whose expression confers a growth advantage to these cells.

Mechanistically, the gene’s expression allows metastatic cancer cells to cause changes to their surrounding environment so that they can grow in new locations in the body. The findings are published in Nature Cell Biology.

“Our results point to potentially novel therapeutic avenues to specifically target metastatic cancer,” said senior author Raul Mostoslavsky, MD, PhD, who is the scientific director of the Krantz Family Center for Cancer Research at the Mass General Cancer Center.

Mostoslavsky and colleagues first compared gene expression patterns in primary versus metastatic tumours in mice with pancreatic cancer or breast cancer. After identifying various genes whose expression increased in metastatic tumour cells, the researchers silenced each gene individually.

In these experiments, silencing the Gstt1 gene had no effect on primary tumour cells from mice, but it stripped metastatic cancer cells of their ability to grow and spread. It also blocked cell growth in two metastatic-derived human pancreatic cancer cell lines.

Gstt1 encodes an enzyme that is a member of a superfamily of proteins involved with protecting cells from toxins, among other functions. Mechanistic studies indicated that the Gstt1 enzyme causes metastatic cancer cells to modify and secrete a protein called fibronectin, which is important for helping cells to attach themselves to the extracellular matrix, a large network of proteins and other molecules that surround, support, and give structure to cells and tissues in the body.

“Gstt1 alters the matrix surrounding the metastatic cells so they can grow in these foreign niches,” said Mostoslavsky. “Our results could lead to new strategies for the treatment of metastatic disease. This would be especially impactful for pancreatic cancer, in which most patients present with metastases when initially diagnosed.”

Source: Massachusetts General Hospital

New Brain Surgery Approach Targets Difficult Tumours at Skull Base

Source: CC0

Tumours arising in the base of the skull are among the most difficult to remove in neurosurgery. The current treatment method is to perform surgical removal by what is known as the microscopic anterior transpetrosal approach (ATPA). Seeking to lessen the risk of damage and postoperative complications, as the skull base is densely packed with nerves, blood vessels, and other tissues, not to mention the brain stem, an Osaka Metropolitan University medical research team is taking a new approach.

Led by Dr Hiroki Morisako, a lecturer in the Graduate School of Medicine’s Department of Neurosurgery, and its department head Professor Takeo Goto, the team has developed a minimally invasive surgical technique called a purely endoscopic subtemporal keyhole ATPA. The team members write in The Journal of Neurosurgery that this is, to their knowledge, the first time this procedure to remove lesions in the skull base region known as the petrous apex has been described in an article.

Diagram of skin incision and extent of craniotomy. New endoscopic neurosurgery approach does not require a large craniotomy, so the result is a smaller scar. Credit: Osaka Metropolitan University

The endoscopic technique means a smaller area of the skull needs to be surgically opened compared to the microscopic approach, an average of only 11.2 cm² versus 33.9 cm². The risk of damage to the brain is also reduced.

The team performed 10 neurosurgeries using their method from 2022 to 2023 at Osaka Metropolitan University Hospital and compared the results to 13 surgeries using the microscopic ATPA from 2014 to 2021. In terms of operative time, the endoscopic approach reduced it noticeably, from an average of 410.9 minutes to 252.9 minutes. Similarly, blood loss lessened from a mean of 193 ml to 90 ml. The degree of tumour resection (surgical removal) was just as high as the microscopic method, while neurological functions were preserved at a rate equal to or higher than with the conventional approach.

“Comparison of the new endoscopic method and the conventional microscopic method showed no significant difference in tumour resection rate or in the ability to perform daily activities before and after surgery, with the new endoscopic approach resulting in shorter operative times and less blood loss,” Professor Goto stated. “The widespread use of this surgical procedure is expected to improve the treatment results of brain tumours in the base of the skull, not only in Japan but also worldwide.”

Source: Osaka Metropolitan University

Hacked Healthcare: New KnowBe4 Report Shines a Spotlight on Cybersecurity Crisis in Sector

Report shows the alarming global rise of cyberattacks on the healthcare sector and the urgent need to prioritise cybersecurity

Photo by Nahel Abdul on Unsplash

KnowBe4 (www.KnowBe4.com), the provider of the world’s largest security awareness training and simulated phishing platform, released its International Healthcare Report. The report takes a closer look at the cybersecurity crisis currently experienced by the healthcare sector, in particular hospital groups, across the world.

Africa was the global region with the highest average number of weekly cyberattacks per organisation in 2023. One in every 19 organisations on the continent experienced an attempted attack every week. Although South Africa’s healthcare sector has managed to avoid a major attack since 2020, the alarming escalation of attacks in other sectors within the country suggests that it’s only a matter of time before the next attack strikes, making it a question of “when” rather than “if”.

Hospitals have become increasingly attractive targets for ransomware attacks due to their comprehensive patient databases, sensitive information, and their interconnectedness between systems and equipment. Moreover, poor security measures have made hospitals vulnerable to cyber threats. When attacked, cybercriminals can potentially take control of entire hospital systems, and gain access not only to patients’ health information but also their financial and insurance data.

Hospitals are severely impacted by cyberattacks (https://apo-opa.co/4csCXH4), which can lead to a reduction in patient care, loss of access to electronic systems, and a reliance on incomplete paper records. This can also result in the cancellation of surgeries, tests, appointments, and, in some cases, even loss of life.

Some shocking facts discussed in the report include:

  • In the first three quarters of 2023, the global healthcare sector experienced a staggering 1,613 cyberattacks per week, nearly four times the global average, and a significant increase from the same period the previous year.
  • The healthcare sector has seen a dramatic surge in cyberattack costs over the past three years, with the average cost of a breach reaching nearly $11 million, more than three times the global average. This makes healthcare the costliest sector for cyberattacks.
  • Ransomware attacks have been the most prevalent type of cyberattack on healthcare organisations, accounting for over 70% of successful attacks in the past two years.
  • The majority of cyberattacks (between 79% and 91%), across sectors, begin with phishing or social engineering tactics, which allow cybercriminals to gain access to accounts or servers.
  • According to KnowBe4’s 2024 Phishing by Industry Benchmarking Report (https://apo-opa.co/4csuiEB), healthcare and pharmaceutical organisations are among the most vulnerable to phishing attacks, with employees in large organisations in the sector having a 51.4% likelihood of falling victim to a phishing email. This means that cybercriminals have a better than 50/50 chance of successfully phishing an employee in the sector.

“The healthcare sector remains a prime target for cybercriminals looking to capitalise on the life-or-death situations hospitals face,” says Stu Sjouwerman, CEO of KnowBe4. “With patient data and critical systems held hostage, many hospitals feel like they are left with no choice but to pay exorbitant ransoms. This vicious cycle can be broken by prioritising comprehensive security awareness training to empower employees and cultivate a positive security culture as a strong defence against phishing and social engineering attacks.”

The report examines the state of cybersecurity in the healthcare sector in North America, Europe, the United Kingdom, Asia-Pacific, Africa, and Latin America. In addition it also highlights some of the most prolific global ransomware attacks that occurred between December 2023 and May 2024, the aftermath thereof and what healthcare organisations can do to protect themselves from cyberattacks.

To download a copy of KnowBe4’s International Healthcare Report, click here (https://apo-opa.co/3xIjjaY).

Dengue Linked to Heightened Short- and Long-term Risk of Depression in Taiwan

New study also uncovers short-term links with sleep disorders

Photo by Ekamelev on Unsplash

Analysis of the medical records of nearly 50 000 people who experienced dengue fever in Taiwan suggests that this disease is associated with elevated short- and long-term risk of depression. Hsin-I Shih and colleagues of National Cheng Kung University and National Health Research Institutes, Taiwan present these findings in the open-access journal PLOS Neglected Tropical Diseases.

People may develop dengue fever after being bitten by a mosquito carrying the dengue virus. Dengue fever can be mild, but it can also progress to life-threatening severity, and some people may have long-term health effects. Prior research has uncovered links between active dengue fever and psychiatric disorders, such as depression and anxiety. However, few studies have examined the long-term risk of such disorders after a dengue infection.

To address this knowledge gap, Shih and colleagues analysed the medical records of 45 334 dengue patients in Taiwan and, for comparison, 226 670 patients who did not experience dengue. Covering the years 2002 to 2015, the researchers examined whether dengue patients were more likely to develop anxiety, depressive disorders, and sleep disorders at various time points after infection. To help account for other factors that could influence mental health, the dengue patients were grouped with demographically similar non-dengue patients for statistical analysis.

The researchers found that the dengue patients had a greater likelihood of developing a depressive order across all timeframes, including less than three months, three to 12 months, and more than 12 months after their infection. Sleep disorders were only elevated within three to 12 months post-infection, and there was no observable elevated risk of anxiety.

Taking a closer look at patients whose dengue was severe enough for them to be hospitalized, the researchers found an elevated risk of anxiety disorders within the first three months of infection, as well as elevated risk of sleep disorders in the first 12 months. This subgroup also had elevated risk of depression across timeframes.

These findings suggest a potential link between dengue fever and subsequent depressive disorder. However, further research is needed to determine whether dengue contributes directly to development of depression, or if the association is due to some indirect mechanism.

The authors add: “This study highlights a significant association between dengue fever and an elevated risk of depression in both the short and long term, underscoring the need for further research into the mental health impacts of dengue infection.”

Provided by PLOS

Smoking Behaviour is Linked to Personality Traits

Smokers are on average more extraverted, but less conscientious and agreeable

Cigarette smokers, cigar smokers, and non-smokers each have distinct personality profiles, according to a study published July 3, 2024 in the open-access journal PLOS ONE by Dritjon Gruda from Universidade Catolica Portuguesa, Portugal, and Jim McCleskey from Western Governors University, USA.

Tobacco use remains a formidable global public health challenge, responsible for more than 8 million deaths annually, including those attributed to second-hand smoke exposure. Emerging research underscores the critical role of psychological factors, including personality traits, in shaping tobacco consumption patterns. To further explore this issue, Gruda and McCleskey examined the association between Big Five personality traits (openness, conscientiousness, extraversion, agreeableness, and neuroticism) and cigar or cigarette smoking in a sample of 9918 older adults across 11 European countries.

Photo by Sara Kurfess on Unsplash

The results showed that smoking is associated with lower scores in conscientiousness and agreeableness and higher extraversion scores than not smoking. The authors speculate that relatively low conscientiousness among smokers may reflect a lack of self-discipline and disregard for long-term health risks, characteristic of more impulsive behaviours, while reduced agreeableness could help explain why smokers often persist despite societal disapproval. They also suggest that the higher extraversion observed may suggest that these individuals enjoy the social nature of smoking.

The analysis also determined personality differences between types of smokers, finding that cigar smokers tend to exhibit lower neuroticism and higher openness compared to both cigarette smokers and non-smokers, underlining that the motivations and contexts of tobacco use are varied.

These findings suggest that personality traits are antecedents of smoking behaviour, with implications for targeted public health interventions and social policies aimed at combating the global tobacco epidemic. According to the authors, future research should explore these relationships in younger cohorts, potentially informing early intervention strategies that preempt the onset of smoking based on predisposition to certain personality types. Further studies could also expand the scope to include other forms of tobacco products such as chewing tobacco or more recent smoking trends such as e-cigarettes and vaping.

The authors add: “Basically what we found is: ‘tell me what you smoke, and I’ll tell you who you are.’”

Provided by PLOS