Month: September 2024

Categories : Injury & Trauma NeurologyTags :

Concussions in Amateur Sport not Linked to Long-term Cognitive Effects

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Photo by Olga Guryanova on Unsplash

The impact of concussion while playing sport is different in those who don’t play professionally, says new research.

Sports-related concussions (SRC) may not be associated with long-term cognitive risks for non-professional athletes, a study led by a UNSW medical researcher suggests. In fact, study participants who had experienced an SRC had better cognitive performance in some areas than those who had never suffered a concussion, pointing to potential protective effects of sports participation.

Published in the Journal of Neurology, Neurosurgery and Psychiatry, the research reveals that individuals who reported experiencing any SRC during their lifetime had a marginally better cognitive performance than those who reported no concussions.

The study, a collaboration between researchers at UNSW Sydney, the University of Oxford, the University of Exeter and Harvard University, analysed data from more than 15 000 participants from the UK-based PROTECT study of 50- to 90-year-olds. This ongoing research aims to understand brain ageing and cognitive decline.

“Our findings suggest that there is something about playing sport, even though a person may experience concussion, that may be beneficial for long-term cognitive outcomes,” says lead author Dr Matt Lennon MD, PhD, at UNSW Medicine & Health.

“While it may be that those who play sports have had access to better education and more resources, we controlled for these factors in the analysis, so that doesn’t explain the result. We hypothesise that there may be physical, social and long-term behavioural effects of sport that may make for healthier adults in late-life,” said Dr Lennon.

Largest study of long-term effects of sports concussions

The study is the largest to date examining the long-term cognitive effects of SRC. Researchers collected lifetime concussion histories from 15 214 participants using the Brain Injury Screening Questionnaire. Among them, 6227 (39.5%) reported at least one concussion and 510 (3.2%) at least one moderate-severe concussion. On average, participants reported suffering their last head injury an average of 29 years prior to the study and their first head injury an average of 39 years earlier.

Researchers then compared cognitive function among individuals with 0, 1, 2 and 3+ SRCs and 0, 1, 2 and 3+ non-sports-related concussions (nSRCs)  (i.e. from falls, car accidents, assaults and other causes). The SRC group showed 4.5 percentile rank better working memory than those who hadn’t experienced an SRC, and 7.9% better reasoning capacity than those without concussions.

Those with one SRC also had better verbal reasoning and attention compared to those with no SRC.

Conversely, participants with 3+ nSRCs – so things like accident and assaults – had worse processing speed and attention, and a declining trajectory of verbal reasoning with age.

“This study suggests that there could be long term benefits from sport which could outweigh any negative effects of concussions, which could have important implications for policy decisions around contact sport participation. It may also be that non-sports related head injuries lead to greater brain damage than sports-related concussions,” said senior author Professor Vanessa Raymont from the University of Oxford and Oxford Health NHS Foundation Trust.

The researchers say the study had some limitations.

“The retrospective design of the study, with elderly participants often recalling details of events over three decades in the past, may have affected the reporting of head injuries, even though we used a well-validated head injury screening tool,” said Prof. Raymont.

Study implications

The study looked at mid-to-late-life people who experienced SRC years earlier, whereas most other studies on SRC focus on younger athletes in the immediate period after their head injuries, where cognitive effects are most salient.

“While these results do not indicate the safety of any sport in particular, they do indicate that overall sports may have greater beneficial effects for long-term cognitive health than the damage it causes, even in those who have experienced concussion,” said Dr Lennon.

“This finding should not be overstated – the beneficial effects were small and in people who had two or more sports-related concussions there was no longer any benefit to concussion. Additionally, this study does not apply to concussions in professional athletes whose head injuries tend to be more frequent, debilitating and severe.”

Anne Corbett, Professor at Exeter University and the lead investigator of the PROTECT study, said: “What we see emerging is a completely different profile of brain health outcomes for people who have concussions as a result of sport compared to those that are not related to sport. Concussions that occur during sport do not lead to brain health concerns whereas other concussion types do, especially when people experience multiple concussions. In fact, people who take part in sport seem to have better brain health regardless of whether they have had a concussion whilst taking part or not.”

Source: University of New South Wales

Categories : Cancer DermatologyTags :

Common Skin Fungus Malassezia may Invade Tissue, Causing Breast Cancer

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Photo by National Cancer Institute on Unsplash

A common skin fungus, Malassezia globosa may invade deep tissues through the skin or by other means, then cause tumour growth, according to a new study. The study results appear in mBio, an open access journal of the American Society for Microbiology.

“It is important to take care of skin not only for beauty, but also for health,” said corresponding study author Qi-Ming Wang, PhD, a professor in the School of Life Sciences, Institute of Life Sciences and Green Development, Hebei University, Hebei, China. “As a factor promoting tumour growth, intertumoural microorganisms need to be paid more attention.” 

Recently, an increasing number of studies have shown a relationship between fungus and cancer. In the new study, Wang and colleagues subjected mouse breast cancer cells to tumour transplantation and then injected the M. globosa into the mammary gland fat pad. At the end of the experiment, they collected the tumour tissue to measure the tumour size and observe the content of intertumoral M. globosa. The researchers discovered that M. globosa colonises in breast fat pads leading to tumour growth. As a lipophilic yeast, the breast fat pad may provide an external source of lipids for the development of M. globosa, said the researchers. They also found that the pro-inflammatory cytokine interleukin (IL)-17a/macrophage axis plays a key role in mechanisms involved in M. globosa-induced breast cancer acceleration from the tumour immune microenvironment perspective.

“Although still controversial, the relationship between microbes and cancer is gaining attention. The imbalance of the microflora in the tumour may lead to disorder in the tumour microenvironment,” Wang said. “For example, Helicobacter pylori emerged as a potential cause of gastric cancer. In addition, Fusobacterium nucleatum has been identified as a potential colorectal cancer biomarker in stool and is predominantly found in the tumour microenvironment. Bacteria or fungi may play a direct (eg, toxins) or indirect (eg, inhibition of anti-tumoural immune responses) role in the tumorigenesis pathways of many of these risk factors. The imbalance of microbial homeostasis in tumours has a certain significance for cancer diagnosis, treatment and prognosis.” 

According to Wang, although the researchers found that M. globosa can promote the growth of tumours, the related transmission route is still unclear. 

Source: American Society for Microbiology

Categories : Cancer NeurologyTags :

Scars of Destroyed Brain Tumours are Fertile Grounds for Recurrence

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Types of tumour cells. Credit: Scientific Animations CC4.0

A Ludwig Cancer Research study has discovered that recurrent tumours of the aggressive brain cancer glioblastoma multiforme (GBM) grow out of the fibrous scars of malignant predecessors destroyed by interventions such as radiotherapy, surgery and immunotherapy.

Led by Ludwig Lausanne’s Johanna Joyce, Spencer Watson and alumnus Anoek Zomer and published in the current issue of Cancer Cell, the study describes how these scars enable the regrowth of tumours and identifies drug targets to sabotage their malignant support. It also demonstrates the efficacy of such combination therapies in preclinical trials using mouse models of GBM.

“We’ve identified fibrotic scarring as a key source of GBM resurgence following therapy, showing how it creates a protective niche for the regrowth of the tumor,” said Joyce. “Our findings suggest that blocking the process of scarring in the brain by adding anti-fibrosis agents to current treatment strategies could help prevent glioblastoma from recurring and improve the outcomes of therapy.”

There is a great need for such interventions. GBM is the most common and aggressive form of brain cancer in adults. Despite considerable effort to develop effective therapies for the cancer, the average life expectancy of patients remains around 14 months following diagnosis.

The origins of the current study date back to 2016, when the Joyce lab reported in the journal Science its examination in mouse models of strategies to overcome resistance to a promising immunotherapy for the treatment of GBM. That experimental therapy, which inhibits signalling by the colony stimulating factor-1 receptor (CSF-1R) and currently in clinical trials, targets immune cells known as macrophages and their brain-resident versions, microglia, both of which are manipulated by GBM cells to support tumour growth and survival.

The Joyce lab has demonstrated that CSF-1R inhibition reprograms these immune cells into an anti-tumour state and so induces significant tumour regression. Yet, as the Science study showed, about half the mice show relapse following an initial response to the therapy. “What was most remarkable about that observation was that every single time a brain tumour recurred following immunotherapy, it regrew right next to a scar that had formed at the original site of a tumour,” said Joyce.

In the current study, Joyce, Watson, Zomer and their colleagues examined tumour samples obtained from patients undergoing GBM therapy and showed that fibrotic scarring occurs following therapy in humans as well – and that it is similarly associated with tumour recurrence. They also showed that the fibrotic scarring occurs in response to not only immunotherapy but also following the surgical and radiological removal of tumours.

To explore how fibrosis contributes to relapse, the researchers applied an integrated suite of advanced technologies to analyze the cellular and molecular geography of the scars and the microenvironment of resurgent tumors.

These technologies include the analysis of global gene expression in individual cells, the comprehensive analysis of proteins in the tissues as well a workflow and AI-powered suite of analytical methods for the spatial analysis of tissues named hyperplexed immunofluorescence imaging (HIFI). Recently developed by Watson and colleagues in the Joyce lab, HIFI permits the simultaneous visualisation of multiple molecular markers in and around cells across broad cross-sections of tissues, enabling the generation of granular maps of the tumour microenvironment.

“Applied together, these advanced methods allowed us to see exactly how fibrotic scars form,” said Watson. “They revealed that the fibrosis serves as a kind of protective cocoon for residual cancer cells and pushes them into a dormant state in which they are largely resistant to therapy. We found that it also shields them from surveillance and elimination by the immune system.”

Integrated analyses of the tissue microenvironment following therapy revealed that the descendants of cells associated with tumor-feeding blood vessels become functionally altered to resemble fibroblasts—fiber-producing cells commonly involved in wound-healing. These perivascular-derived fibroblast-like (PDFL) cells fan out across the region previously occupied by the regressing tumor, where they mediate the generation of fibrotic scars. These cells, the researchers found, are especially activated by neuroinflammation and immune factors known as cytokines, most notably one called transforming growth factor-β (TGF-β).

“To see if targeting fibrotic scarring could improve therapeutic outcomes for GBM, we devised a treatment regimen using existing drugs to block TGF-β signaling and suppress neuroinflammation in combination with CSF-1R inhibition and evaluated it in preclinical trials using mouse models of GBM,” said Joyce. “We also timed these additional treatments to coincide with the period of maximal PDFL activation identified by our studies. Our results show that the drug combination inhibited fibrotic scarring, diminished the numbers of surviving tumor cells and extended the survival of treated mice compared to controls.”

The researchers suggest that approaches to limit fibrotic scarring could significantly improve outcomes for GBM patients receiving surgical, radiation or macrophage-targeting therapies. Additional research, they note, will likely yield even better drug targets for such combination therapies.

Source: Ludwig Institute for Cancer Research

Categories : Cancer Mental HealthTags :

Does Cognitive Behavioural Therapy Benefit Cancer Survivors?

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Photo by Tima Miroshnichenko on Pexels

A recent analysis of all relevant published studies reveals clear benefits of Cognitive Behavioural Therapy (CBT) for improving mental health and quality of life in cancer survivors. The findings, which are published in Cancer Medicine, extend CBT’s effects beyond what has long been known in the general population.

For the analysis, investigators uncovered 132 clinical trials comparing CBT with controls, including standard therapy, waitlist control, or active/alternative therapy.

Across the trials, CBT moderately improved mental health and quality of life in people with past or current cancer, regardless of cancer type. It seemed to have stronger effects in younger individuals. In-person CBT also appeared more effective than delivering CBT through technology such as web-based videoconference platforms.

“In addition to confirming the general benefit of CBT for individuals with cancer, this study unveiled important nuances of how CBT can be most effective and for which populations. This has major clinical implications for supportive oncology providers,” said corresponding author Anao Zhang, PhD, of the University of Michigan.

Source: Wiley

Categories : AgeingTags :

Can Being More Flexible Help People to Live Longer?

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Photo by Mikhail Nilov: https://www.pexels.com/photo/a-couple-doing-yoga-at-home-7500701/

Flexibility exercises are often included in the exercise regimens of athletes and exercisers. New research in the Scandinavian Journal of Medicine & Science in Sports suggests that levels of flexibility may affect survival in middle-aged individuals.

After analysing data on 3,139 people (66% men) aged 46–65 years, investigators obtained a body flexibility score, termed Flexindex. This score was derived from a combination of the passive range of motion in 20 movements (each scored 0–4) involving 7 different joints, resulting in a score range of 0–80.

Flexindex was 35% higher in women compared with men. During an average follow-up of 12.9 years, 302 individuals (9.6%) comprising 224 men and 78 women died. Flexindex exhibited an inverse relationship with mortality risk and was nearly 10% higher for survivors compared with non-survivors in both men and women.

After taking age, body mass index, and health status into account, men and women with a low Flexindex had a 1.87- and 4.78-times higher risk of dying, respectively, than those with a high Flexindex.

“Being aerobically fit and strong and having good balance have been previously associated with low mortality. We were able to show that reduced body flexibility is also related to poor survival in middle-aged men and women,” said corresponding author Claudio Gil S. Araújo, MD, PhD, of the Exercise Medicine Clinic – CLINIMEX, in Rio de Janeiro, Brazil.

He added that as flexibility tends to decrease with aging, it may be worth paying more attention to flexibility exercises and routinely including assessments of body flexibility as part of all health-related physical fitness evaluations.

Source: Wiley

Categories : HospitalsTags :

Health Department Misses Another Deadline to Provide Nurses with Uniforms

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The department has committed to paying nurses a once-off allowance by the end of November

By Marecia Damons

Photo by Cottonbro on Pexels

The Department of Health has missed another deadline to provide nurses at public hospitals and clinics with uniforms by 1 September. Instead, a once-off allowance of R3 307 will be paid to nurses by 30 November to buy their own uniforms.

The Democratic Nursing Organisation of South Africa (DENOSA) says its 84 000 members “can hardly afford to get one set of uniforms” with that allowance.

Since 2005, nurses have received an annual allowance to buy their uniforms. In terms of a new agreement signed in March 2023, the department committed to providing uniforms directly to nurses, instead of the allowance of R2,600.

According to the bargaining council agreement, nurses were to receive seven sets of uniforms over two years. The uniform set includes a dress, or a skirt and a top (blouse or shirt), or a pair of trousers and a top (blouse or shirt). Accessories include a brown belt, brown shoes, a maroon jacket and a maroon jersey.

The agreement required the department to supply nurses with four sets of uniforms, one pair of shoes and one jersey in the first year, and three sets of uniforms, one belt, and one jacket in the second year.

However, as the 1 October 2023 deadline approached, the department said it was facing difficulties with the procurement process. In a last-minute bargaining council meeting in September 2023, the department informed nurses’ unions that it would not meet the 1 October 2023 deadline. Instead, it said, the supply of uniforms would be postponed until 1 September 2024 and a temporary allowance would again be paid meanwhile. Uniforms were to be procured through tenders in each province.

But in response to concerns expressed by DENOSA at a meeting in June 2024, the department acknowledged that it was battling with suppliers and would not meet the new deadline either.

Department spokesperson Foster Mohale said there were delays in procurement in some provinces and this was “receiving the urgent attention it deserves”.

He said the department had proposed a new plan and a new deadline of 1 September 2025.

Meanwhile, he said, nurses would be paid a once-off uniform allowance of R3307.60 by 30 November 2024. But DENOSA says this is “too little to buy uniforms”.

“With that amount, a nurse can hardly afford to get one set of uniforms. For a nurse to buy a proper uniform for the whole week, they need between R8500 and R14 000,” the union said in a statement.

Mohale said the uniforms will be supplied in line with the Preferential Procurement Policy Framework Act which stipulates that goods ordered by state institutions must contain a minimum of local content. The policy was first introduced in 2011 in a bid to protect South African industry and jobs.

But DENOSA said a centralised procurement system, similar to those used for police and army uniforms would be more effective than provincial procurement.

“The issue of quality is extremely concerning to us…This is going to open up the whole process to corruption which we have warned against, but it looks like the department has closed its ears on that matter,” DENOSA spokesperson Sibongiseni Delihlazo said.

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

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Categories : Injury & Trauma NeurologyTags :

Engineered T Cells aid the Recovery of Spinal Cord Injury

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View of the spinal cord. Credit: Scientific Animations CC4.0

In a recent study published in Nature, researchers prevented T cells from causing the normal autoimmune damage that comes with spinal cord injury, sparing neurons and successfully aiding recovery in mouse models.

In spinal cord injury, the wound site attracts a whole host of peripheral immune cells, including T cells, which result in both beneficial and deleterious effects. Notably, antigen-presenting cells activate CD4+ T cells to release cytokines, ultimately leading to neuroinflammation and tissue destruction. This neuroinflammation is notably most pronounced during the acute phase of spinal cord injury. The problem is that these same T cells have a neuroprotective effect initially, only later developing autoimmunity and attacking the injury site.

Using single cell RNA sequencing, the researchers found that CD4+ T cell clones in mice showed antigen specificity towards self-peptides of myelin and neuronal proteins. Self-peptides have been implicated in a wide range of autoimmune conditions.

Using mRNA techniques, the researchers edited the T cell receptor, so that they shut off after a few days. In mouse models of spinal cord injury, they showed notable neuroprotective efficacy, partly as a result of modulating myeloid cells via interferon-γ.

Their findings provided insights into the mechanisms behind the neuroprotective function of injury-responsive T cells. This will help pave the way for the future development of T cell therapies for central nervous system injuries, and perhaps treatments for neurodegenerative diseases such as Alzheimer’s.

Categories : HospitalsTags :

No Silver Bullet for Bridging SA’s Healthcare Divide, say Delegates at Hospital Conference

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Photo by Hush Naidoo Jade Photography on Unsplash

By Ufrieda Ho

With South Africa’s healthcare system facing a myriad challenges, experts at a health conference have put forward a range of practical solutions to address some of the country’s pressing issues. Ufrieda Ho rounds up some of the proposed solutions to improve patient care, including the use of public-private partnerships.

Closing the inequality gap and making trusted healthcare services accessible to the majority will require a whole systems overhaul. This was the underlying message of speakers at the recent Hospital Association of South Africa Conference who tackled the question of pragmatic steps to address the divides and failings of the country’s healthcare system. They put forward a range of solutions, models and case studies while highlighting the looming crises as more people fall through the cracks.

Around 15% of people in South Africa are members of private medical aid schemes, leaving 85% of people in the country largely reliant on a severely strained public healthcare system (though some do pay out-of-pocket to visit private sector doctors). As reported in Business Day, an argument was made at the conference for making medical scheme membership compulsory for everyone in formal employment, a move it is estimated could triple the number of people with medical scheme coverage and result in a 25% reduction in medical scheme premiums.

Delegates at the conference also heard that an integrated and coordinated whole systems approach is necessary. Speakers stressed that implementable interventions and innovations must kick in with urgency. Some argued that more political will is required, along with greater corporate commitment if effective public-private partnerships are to be established. Such partnerships was a key theme of the conference.

A kidney care example

Dr Chevon Clark, chief executive of National Renal Care, a private renal therapy provider, outlined the stark reality of an enlarging public health crisis as more people face kidney dysfunction.

“Globally, 850 million people have chronic kidney disease, acute kidney injury or are on renal replacement therapy. This signals a significant public health issue. This is twice the number of individuals estimated to have diabetes, and is 20 times higher than the number of individuals affected by HIV/AIDS.

“There has also been a 29.3% increase in reported chronic kidney disease over the last three decades. Not only is this increase deeply concerning, but so is the ability of our healthcare system to manage and treat individuals impacted by chronic kidney disease,” said Clark.

Last week marked Kidney Awareness week in South Africa. Against this backdrop, Clark said South Africa falls behind other middle income countries in having enough nephrologists and nephrology nurses for their populations. There is a combined 147 facilities for treatment and care in the public and private sectors – a shortfall, she said.

Clark said smarter public-private partnership initiatives are needed. She added these need to be focused on stronger stakeholder engagement, innovative funding mechanisms, advocacy and refining weak policy frameworks.

She presented a case study of National Renal Care (a private company) partnering with the Western Cape Department of Health and Wellness to set up a dialysis clinic at the Vredenburg Provincial Hospital. The hospital services a rural community. Before the unit was opened, patients had to travel long distances to access care in Cape Town. The inflow of patients from outside Cape Town also added to congestion at its facilities.

A benefit of the partnership, she said, is that they have been able to introduce newer technologies. Clark said they have a system that enables online and remote monitoring of patients. Patients’ records can be updated continuously and are maintained digitally. Clark said that patients have also been enrolled on a mobile app making patients “active partners in their healthcare and to drive compliance for better outcomes”.

Tele-health to track diabetes patients

Dr Atiya Mosam, a public health consultant and founder of Mayibuye Health, highlighted the importance of getting the basics right. She presented a case study of a public-private partnership in which a ‘tele-health doctor’ called diabetes patients from the Hanover Park Clinic daily for two weeks to monitor their glucose levels, adjust their medication when needed, and offer health advice.

Mosam said 74% of the patients contacted had to have their medication adjusted, indicating the need for this kind of immediate monitoring and treatment management. Mosam added that the intervention saw improvements in patients’ conditions and improvements in patients staying in targeted ranges for their glucose readings.

She added: “One man articulated that he had a new lease on life, attested to by his family. They said before the intervention, he was really very grumpy. Very interesting for us too was that many patients articulated that by having this contact with the ‘tele-health doctor’, they felt that the government cared for them.”

Cancer care

One area where efforts at a public-private partnership appears to have failed is cancer care in Gauteng. As widely reported, the Gauteng Department of Health set aside R784m early in 2023 for radiation oncology services, which would have included the outsourcing of some services to the private sector. That outsourcing hasn’t yet happened and the Cancer Alliance has since taken the department to court over the ongoing cancer treatment backlogs.

Health activist Mark Heywood, speaking at the conference on behalf of The Cancer Alliance, mentioned the ongoing litigation and  said a hearing has been scheduled for 21 November.

Heywood drew parallels between HIV and cancer to illustrate how the fight for cancer treatment looks set to evolve, but also where wins could be achieved.

He said: “Cancer treatment and cancer medicines, like HIV medicines two decades ago, is inordinately expensive. It means that whilst cancer can be cured for the vast majority of people it is unaffordable and inaccessible. For the vast majority of people in our country, a cancer diagnosis is often a diagnosis that indicates a vastly shortened lifespan and the beginning of a journey to severe illness, very often indignity and death, and that is not how it should be.”

Heywood said government had an obligation to follow the constitutional framework to ensure access to cancer treatment as a basic health right. He also said private healthcare providers had to do better.

“There have been complaints of discrimination by medical schemes of only partial coverage of the costs and needs of care. This leaves people unable to complete treatment. There are allegations of overcharging by hospitals and specialists. There’s also a lack of collaboration between the private and the public sector, a lack of monitoring and a lack of a determination of healthcare outcomes when it comes to cancer,” he said.

But Heywood said the long – but ultimately successful – fight for access to treatment for HIV positive people in the country held important lessons that could be applied to cancer.

“What we learned with HIV was that with political will and with resource mobilisation, it is possible to dramatically alter the landscape of care and to tip the balance towards greater equality and social justice in healthcare,” he said.

“The question remains for the Hospital Association of South Africa and private health providers – what can you do to make cancer care more affordable, more accessible, and to build on public private partnerships to take them to scale to reach a greater number of people in a shorter period of time?,” Heywood said.

Republished from Spotlight under a Creative Commons licence.

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Categories : Cancer NeurologyTags :

Glioma Cells can Also Fire off Electrical Signals in the Brain

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Source: Pixabay

Researchers at Baylor College of Medicine and the Jan and Dan Duncan Neurological Research Institute at Texas Children’s Hospital have uncovered a new cell type in human brain cancers. Their study, published in Cancer Cell, reveals that a third of the cells in glioma, fire electrical impulses. Interestingly, the impulses, also called action potentials, originate from tumour cells that are part neuron and part glia, supporting the groundbreaking idea that neurons are not the only cells that can generate electric signals in the brain.

The scientists also discovered that cells with hybrid neuron-glia characteristics are present in the non-tumour human brain. The findings highlight the importance of further studying the role of these newly identified cells in both glioma and normal brain function.

“Previous studies have shown that patient survival outcomes are associated with tumour proliferation and invasiveness, which are influenced by tumour intrinsic and extrinsic factors, including communication between tumour cells and neurons that reside in the brain,” said Dr Benjamin Deneen, professor in the Department of Neurosurgery at Baylor.

Researchers have previously described that glioma and surrounding healthy neurons connect with each other and that neurons communicate with tumours in ways that drive tumour growth and invasiveness. 

“We have known for some time now that tumour cells and neurons interact directly,” said first author Dr Rachel N. Curry, postdoctoral fellow in paediatrics – neuro oncology at Baylor, who was responsible for conceptualising the project. “But one question that always lingered in my mind was, ‘Are cancer cells electrically active?’ To answer this question correctly, we required human samples directly from the operating room. This ensured the biology of the cells as they would exist in the brain was preserved as much as possible.”

To study the ability of glioma cells to spike electrical signals and identify the cells that produce the signals, the team used Patch-sequencing, a combination of techniques that integrates whole-cell electrophysiological recordings to measure spiking signals with single-cell RNA-sequencing and analysis of the cellular structure to identify the type of cells.

The electrophysiology experiments were conducted by research associate and co-first author Dr Qianqian Ma in the lab of co-corresponding author associate professor of neuroscience Dr Xiaolong Jiang. This innovative approach has not been used before to study human brain tumour cells. “We were truly surprised to find these tumour cells had a unique combination of morphological and electrophysiological properties,” Ma said. “We had never seen anything like this in the mammalian brain before.”

“We conducted all these analyses on single cells. We analysed their individual electrophysiological activity. We extracted each cell’s content and sequenced the RNA to identify the genes that were active in the cell, which tells us what type of cell it is,” Deneen said. “We also stained each cell with dyes that would visualise its structural features.”

Integrating this vast amount of individual data required the researchers to develop a novel way to analyse it.

“To define the spiking cells and determine their identity, we developed a computational tool – Single Cell Rule Association Mining (SCRAM) – to annotate each cell individually,” said co-corresponding author, Dr Akdes Serin Harmanci, assistant professor of neurosurgery at Baylor.

“Finding that so many glioma cells are electrically active was a surprise because it goes against a strongly held concept in neuroscience that states that, of all the different types of cells in the brain, neurons are the only ones that fire electric impulses,” Curry said. “Others have proposed that some glia cells known as oligodendrocyte precursor cells (OPCs) may fire electrical impulses in the rodent brain, but confirming this in humans had proven a difficult task. Our findings show that human cells other than neurons can fire electrical impulses. Since there is an estimated 100 million of these OPCs in the adult brain, the electrical contributions of these cells should be further studied.”

“Moreover, the comprehensive data analyses revealed that the spiking hybrid cells in glioma tumours had properties of both neurons and OPC cells,” Harmanci said. “Interestingly, we found non-tumour cells that are neuron-glia hybrids, suggesting that this hybrid population not only plays a role in glioma growth but also contributes to healthy brain function.”

“The findings also suggest that the proportion of spiking hybrid cells in glioma may have a prognostic value,” said co-corresponding author Dr Ganesh Rao, professor and chair of neurosurgery at Baylor. “The data shows that the more of these spiking hybrid glioma cells a patient has, the better the survival outcome. This information is of great value to patients and their doctors.”

“This work is the result of extensive equal collaboration across multiple disciplines – neurosurgery, bioinformatics, neuroscience and cancer modelling – disciplines strongly supported by state-of-the-art groups at Baylor,” Deneen said. “The results offer an enhanced understanding of glioma tumours and normal brain function, a sophisticated bioinformatics pipeline to analyse complex cellular populations and potential prognostic implications for patients with this devastating disease.”

Source: Baylor College of Medicine

Categories : Paediatrics Respiratory DiseasesTags :

Saline Nasal Drops Shorten the Common Cold in Children by Two Days

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Photo by Andrea Piacquadio on Unsplash

Using hypertonic saline nasal drops can reduce the length of the common cold in children by two days, according to a study presented at the European Respiratory Society (ERS) Congress in Vienna, Austria [1]. They can also reduce the onward transmission of colds to family members.

The results of the ELVIS-Kids randomised controlled trial were presented by Professor Steve Cunningham from Child Life and Health, University of Edinburgh, UK.

He said: “Children have up to 10 to 12 upper respiratory tract infections, what we refer to as colds, per year, which have a big impact on them and their families. There are medicines to improve symptoms, such as paracetamol and ibuprofen, but no treatments that can make a cold get better quicker.”

ELVIS-Kids Chief Investigator Dr Sandeep Ramalingam, consultant virologist, NHS Lothian, Edinburgh, UK, had noted that salt-water solutions are often used by people in South Asia, as nasal irrigation and gargling, to treat a cold and wanted to explore if this clinical benefit could be replicated in a large study.

The research team recruited 407 children aged up to six years to a study where they were given either hypertonic saline ~2.6% (salt-water) nasal drops or usual care when they developed a cold. Overall, 301 children developed a cold; for 150 of these, their parents were given sea salt and taught to make and apply salt-water nose drops to the children’s noses (three drops per nostril, a minimum of four times per day, until well) and 151 children had usual cold care.

Professor Cunningham explains: “We found that children using salt-water nose drops had cold symptoms for an average of six days where those with usual care had symptoms for eight days. The children receiving salt water nose drops also needed fewer medicines during their illness.

“Salt is made up of sodium and chloride. Chloride is used by the cells lining the nose and windpipes to produce hypochlorous acid within cells, which they use to defend against virus infection. By giving extra chloride to the lining cells this helps the cells produce more hypochlorous acid, which helps suppress viral replication, reducing the length of the virus infection, and therefore the duration of symptoms.”

When children got salt-water nose drops, fewer households reported family members catching a cold (46% vs 61% for usual care). Eighty-two per cent of parents said the nose drops helped the child get better quickly and 81% said they would use nose drops in the future.

Professor Cunningham added: “Reducing the duration of colds in children means that fewer people in their house also get a cold, with clear implications for how quickly a household feels better and can return to their usual activities like school and work etc.

“Our study also showed that parents can safely make and administer nose drops to their children and therefore have some control over the common cold affecting their children.”

Professor Alexander Möeller is Head of the ERS Paediatric Assembly and Head of the Department for Respiratory Medicine at the University Children’s Hospital Zurich, Switzerland, and was not involved in the research. He said: “This is an important study that is the first of its kind to investigate the impact of salty nose drops in children with colds. Although most colds usually don’t turn into anything serious, we all know how miserable they can be, especially for young children and their families.

“This extremely cheap and simple intervention has the potential to be applied globally; providing parents with a safe and effective way to limit the impact of colds in their children and family would represent a significant reduction in health and economic burden of this most common condition.”

The team hope to further investigate the effect of saltwater nose drops on wheeze during colds, after initial results from this study showed that children who received the drops had significantly fewer episodes of wheeze (5% vs 19%).

Reference

[1] Abstract no: OA1985 “A randomised controlled trial of hypertonic saline nose drops as a treatment in children with the common cold (ELVIS-Kids trial)”, by Dr Sandeep Ramalingam et al; Presented in session “Advancements in paediatric infectious respiratory health” at 15:45–17:00 CEST on Sunday 8 September 2024.

https://live.ersnet.org/programme/session/92864

Source: European Respiratory Society