Tag: 10/1/25

Categories : Cancer Cardiovascular DiseaseTags : Leave a comment

How Checkpoint Immunotherapy also Increases the Risk of Cardiovascular Disease

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Source: Wikimedia CC0

Cancer immunotherapy is known to also make patients more vulnerable to heart attack and stroke. A new study led by researchers at NYU Langone Health points to a possible explanation for this side effect: the treatment interferes with immune regulation in the heart’s largest blood vessels.

This new work focused on immune checkpoint inhibitors, which work by blocking molecules embedded on the surface of cells – immune checkpoints – which normally serve as “brakes” that prevent excess immune activity, or inflammation. Some tumours are known to hijack these checkpoints to weaken the body’s defences, so by blocking the checkpoints, the treatments enable the immune system to kill tumour cells.

Unfortunately, this treatment type may also trigger damaging levels of inflammation in the heart, brain, stomach, and other organs, the researchers say. For example, past studies have shown that about 10% of those with atherosclerosis have a heart attack or stroke following cancer treatment. Until now, the specific mechanisms behind this issue had remained unclear.

To address this question, the research team explored at a cellular level how immune checkpoint inhibitors interact with immune cells within arterial plaques. A genetic analysis by the study authors showed that the same type of immune checkpoints targeted by cancer therapies also appear in arterial immune cells, establishing a link between checkpoint inhibitors and cardiovascular events.

“Our findings provide new insight into how a drug intended to target tumours can also prompt a heightened immune response in arteries and increase risk of heart disease,” said study co-senior author Chiara Giannarelli, MD, PhD. “Cancer patients and their physicians should be aware that they may need to monitor for new heart concerns following cancer treatment,” added Dr Giannarelli.

For the current study, published in Nature Cardiovascular Research, the researchers analysed the genetic activity of thousands of immune cells collected from the plaques of 50 men and women undergoing a surgical procedure to address atherosclerosis.

The investigators also explored how type 2 diabetes, a known risk factor for both cancer and heart disease, may make those with atherosclerosis even more vulnerable to the ill effects of checkpoint inhibitors, adds Dr Giannarelli, also an associate professor in the Department of Pathology at NYU Grossman School of Medicine. As part of the study, the team assessed immune checkpoint activity in arterial tissue collected from eight patients with diabetes and four healthy volunteers. Notably, none had a history of atherosclerosis. The results showed that the diabetes patients had less measurable communication between checkpoints, which in turn can prompt increased inflammation.

Other experiments further revealed that taking immune checkpoint inhibitors might make it harder to combat atherosclerosis. Under normal circumstances, physicians typically prescribe low-fat diets to reduce plaque buildup and inflammation. Indeed, the researchers’ experiments in rodents confirmed that such diets boost communication between immune checkpoints within arteries. However, cancer patients may be at a disadvantage because their therapy, by blocking these same checkpoints, may counteract the anti-inflammatory benefits of fat reduction.

“Our findings highlight how cancer, diabetes, and heart disease do not exist in a vacuum, and that it is critical to consider how targeting one of these conditions can affect the others,” said study co-senior author Kathryn J. Moore, PhD. “Now that experts have a better understanding of the interplay between these diseases, they can begin to explore new strategies to lower the risk of unintended health concerns caused by their treatment,” added Dr Moore. She cautions that the study did not directly assess immune checkpoint behaviour in cancer patients. The team plans to do so in future investigations, she adds.

Source: NYU Langone Health

Categories : Ageing General InterestTags : Leave a comment

Are Robots the Solution to Nursing Home Employee Turnover?

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Photo by Alex Knight on Unsplash

Facing high employee turnover and an aging population, nursing homes have increasingly turned to robots to complete a variety of care tasks, but few researchers have explored how these technologies impact workers and the quality of care.

A new study from a University of Notre Dame expert on the future of work finds that robot use is associated with increased employment and employee retention, improved productivity and a higher quality of care. The research has important implications for the workplace and the long-term care industry.

Yong Suk Lee, associate professor of technology, economy and global affairs at Notre Dame’s Keough School of Global Affairs, was the lead author for the study, published in Labour Economics. Most studies of robots in the workplace have focused on manufacturing and the industrial sector, but Lee’s research broke new ground by analysing long-term care – and by looking at the different types of robots used in this setting. Researchers drew on surveys of Japanese nursing homes taken in 2020 and 2022.

“Our research focused on Japan because it is a super-aging society that provides a good example of what the future could entail elsewhere – a declining population, a growing share of senior citizens and a declining share of working-age people,” Lee said. “We need to be ready for this new reality.”

In 2022, for instance, more than 57 million U.S. residents were 65 or older, according to the National Council on Aging. The Census Bureau forecasts that by 2050, this number will grow to 88.5 million.

The impact on workers

In a future where there are more senior citizens requiring care, using robots in a targeted fashion could benefit workers and patients alike, Lee said. The study analyzed three types of robots that are increasingly used in assisted living facilities:

  • Transfer robots, which nurses use to lift, move and rotate patients in beds and around rooms.
  • Mobility robots, which patients use to move around and to bathe.
  • Monitoring and communication robots, which include technologies such as computer vision and bed sensors that can monitor patient data such as movement and share it with care providers.

“We found that robot adoption complements care workers by reducing quit rates,” Lee said. “This is important because turnover is a big concern in nursing homes. Workers typically experience a great deal of physical pain, particularly in their knees and back. The work is hard and the pay is low. So robot use was associated with employee retention.”

While robot use was associated with an overall employment increase, Lee said, the trend seems to have helped some workers more than others: It was associated with an increased demand for part-time, less experienced employees and with less demand for more experienced workers.

Improving patient care

Patients benefited in facilities that have used robots, according to the study. The nursing homes that Lee’s team studied reported a decrease in the use of patient restraints and in the pressure ulcers or bedsores that nursing home residents commonly suffer, largely because of a lack of mobility. Both metrics are widely used in the long-term care industry to measure patient outcomes, Lee said.

By removing the physical strain associated with certain tasks, Lee said, robots may have made room for care workers to focus on tasks better suited for human beings.

“Robots can improve productivity by shifting the tasks performed by care workers to those involving human touch, empathy and dexterity,” Lee said. “Ultimately, robots can help workers provide a higher level of patient care.”

Source: University of Notre Dame

Categories : CancerTags : Leave a comment

An Inhalable Chemotherapy for Lung Cancer – Inspired by Mussels

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Photo by Mockup Graphics on Unsplash

Researchers from POSTECH and Kyungpook National University have developed a novel inhalable therapeutic delivery system for lung cancer, making use of mucoadhesive protein nanoparticles inspired the adhesive properties of marine mussels.

Non-small cell lung cancer (NSCLC), which accounts for 85% of all lung cancer cases and treatment is particularly challenging due to difficulties in early detection. Current anticancer treatments are predominantly administered intravenously, impacting both malignant and healthy tissues, often leading to severe adverse effects. As a result, inhalable therapeutics have emerged as a promising alternative, enabling localised drug delivery directly to the lungs. A major obstacle to this approach is the lung’s mucosal barriers and immune cells. Building on this context, collaborative research has culminated in the development of a mucoadhesive protein nanoparticle designed for lung cancer treatment.

This approach leverages the remarkable adhesive properties of marine mussel proteins, renowned for their underwater adhesion. Drawing inspiration from the oxidation-reduction mechanisms of foot protein type 6 (fp-6), the researchers engineered foot protein type 1 (fp-1) by integrating cysteine, creating a biomaterial with enhanced adhesive strength and precise drug delivery capabilities within the lung cancer microenvironment. These nanoparticles exhibit exceptional therapeutic efficacy by enabling selective payload release while effectively inhibiting release in healthy tissues to minimise adverse effects. Moreover, the intrinsic biocompatibility, biodegradability, and immunocompatibility of marine mussel proteins ensure superior biological safety and substantially prolong the retention of anticancer drugs, thereby amplifying their therapeutic impact.

In animal models of lung cancer, the nanoparticles developed by the research team and their contained anti-cancer drugs showed effectiveness in inhibiting cancer cell metastasis and invasion after being delivered to the lungs through a nebuliser and adhering to the mucosa for extended periods. This advancement holds the potential to enhance patient access to lung cancer treatment, as the simplified inhalation-based drug administration could be self-managed at home. Furthermore, this approach may significantly improve patients’ quality of life by reducing the need for hospital visits.

Professor Hyung Joon Cha, who spearheaded the collaborative research at POSTECH, stated, “The findings from our study have the potential to substantially enhance both the precision and efficacy of lung cancer treatments, while significantly improving patients’ quality of life.”

Source: Pohang University of Science & Technology (POSTECH)

Categories : Injury & TraumaTags : Leave a comment

Diagnosing and Managing Blast Injuries

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Photo by Jeff Kingma on Unsplash

The prevalence of armed conflicts, terrorist attacks and industrial accidents necessitates clinician understanding of blast injuries in both civilian and military settings. Blast injuries are a complex form of trauma, resulting from the explosive release of energy. The severity and types of injury depend on the proximity to the blast, blast pressure and the presence of other elements like fragments and heat.

In a new video published in the New England Journal of Medicine‘s “Video in Clinical Medicine” section, authors from Boston University Chobanian & Avedisian School of Medicine and Boston Medical Center (BMC), in collaboration with the department of anaesthesiology at Walter Reed National Military Medical Center, focus on the mechanisms and classifications of blast injuries and present essential knowledge for initial diagnosis and management.

“Blast injuries present a unique challenge in trauma medicine due to their complex mechanisms and varied presentations. A comprehensive understanding and approach to managing these injuries is essential to improve patient outcomes,” explains corresponding author Rafael Ortega, MD, FASA, chair & professor of anaesthesiology at the school.

The video provides a review on blast injury types including: primary injuries to the lungs, ears and bowels due to the blast wave; secondary injuries caused by trauma from propelled debris; tertiary injuries due to blast wind impacts on the body; quaternary injuries like burns, asphyxiation and exposure to toxic substances; and quinary injuries, clinical repercussions of chemical, radiologic or biologic contaminants occurring post-detonation. Also considered are the types of explosives, such as dynamite and Molotov cocktails.

The authors point out that explosions can inflict injuries on many organ systems and that the diagnosis of blast injuries requires a high index of suspicion to identify silent blunt injuries. They suggest initial assessment should follow advanced trauma life support (ATLS) protocols including imaging methods, such as radiographs, CT scans, and ultrasonography, which are critical for detecting internal injuries. Injuries to the pulmonary, gastrointestinal system, along with neurological, cardiovascular, facial and auditory, musculoskeletal systems are also reviewed.

In terms of diagnosis, the authors indicate that ATLS guidelines offer a structured approach to trauma care after explosions. “However, their application should be tailored to the specific situation and patient needs, with the order of interventions potentially varying based on clinical judgment and immediate life threats,” says Ortega who also is chief of anaesthesiology at BMC.

According to the authors, blast injuries should be managed using a multidisciplinary approach tailored to the individual patient’s injuries. “When possible, involve different specialties such as emergency medicine, trauma surgery, neurosurgery, orthopaedic surgery, maxillofacial surgery, otolaryngology and anaesthesiology to ensure the best possible patient outcomes,” he adds.

In terms of preventive strategies, the authors recommend public education, improved safety regulations for handling explosives, and the use of personal protective equipment which can help reduce the impact of blast injuries and designing public spaces to minimise the impact of blasts.

Source: Boston University School of Medicine

Categories : Ethics and Law Respiratory DiseasesTags : Leave a comment

Activists Furious after Competition Commission Drops Probe into Pharma Company

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Life-saving drugs still not available to many cystic fibrosis patients

Photo by Robina Weermeijer on Unsplash

By Tania Broughton

Health campaigners have slammed a decision by the Competition Commission to end its investigation into Vertex Pharmaceuticals’ monopoly on life-saving medicines for people living with cystic fibrosis.

“We are concerned that the Commission has fallen victim to Vertex’s well-known and aggressive PR and legal strategy, designed to safeguard its global patent monopoly at all costs,” said a statement by nine organisations: the South African Cystic Fibrosis Association, Right to Breathe Campaign, Health Justice Initiative, Vertex Save Us, Just Treatment, SECTION27, Treatment Action Campaign, People’s Health Movement and Cancer Alliance.

The Commission, in a statement released on 11 December, said it had initiated the probe against Vertex based on allegations that it was engaging in exclusionary practices and excessive pricing in the provision of Kalydeco, Orkambi, Symdeko and Trikafta – medicines used to treat cystic fibrosis.

“Following the Commission’s investigation and various engagements with Vertex, Vertex gave formal undertakings to the Commission to continue to make Trikafta available in South Africa through Section 21 of the Medicines and Related Substances Act, which enables the sale of unregistered drugs within South Africa,” it said.

This undertaking, it said, had resulted in a “non referral” of all allegations against the company.

It said that Trikafta had broadly replaced the use of the other medicines. Previously patients with cystic fibrosis had to import it. To reduce the financial burden, Vertex had from April this year begun supplying it through a local distributor.

“This makes Trikafta available locally at prices that enable cystic fibrosis patients to access treatment. Separately, financial assistance is available through a patient assistance programme managed by a non-government organisation, and eligible cystic fibrosis patients who belong to certain medical schemes get Trikafta at no cost as they also receive some financial assistance from their medical aid schemes.”

Unavailable

But health campaigners are not happy They say for the vast majority of cystic fibrosis patients (about 63%), nothing has changed.

“The real victims of this decision by the Commission are the most vulnerable South African children and young people who rely on the public health sector, who are not rich, and who have little or no medical scheme cover,” they said.

“These patients do not currently, and will not get access to this medication because of Vertex’s patents and secretive, limited access and excessive pricing strategies.”

Alarmingly, they said, the medicine remains unregistered in South Africa, forcing patients to either import it or rely on the “administratively burdensome” section 21 approval process.

“This is not a sustainable way to address a chronic treatment need,” they said.

The so-called patient assistance programme did not promote equity, was far from transparent, nor sustainable and the price was undisclosed.

They said they were seeking an urgent meeting with the Commission

“We cannot allow the manipulation of South Africa’s laws, regulations and health system to go unchecked in the name of one drug company’s self-interested monopoly greed.”

Vertex replies

Approached for comment, Vetex said more than 180 cystic fibrosis patients were accessing the medicine through the Section 21 pathway “which represents about 50% of the eligible population”.

“We took this pathway because we strongly believe that this is the fastest and most efficient route to sustainable access in South Africa, given that it does not require a regulatory filing, which can take many years.”

The company said even with regulatory approval, most novel, high value medicines were not included on the Prescribed Minimum Benefits list.

“There is therefore no obligation for funders [private and public health insurances] to reimburse the costs of these medicines, which effectively make them inaccessible to most patients. In our opinion, a license application would not speed up the process for broad access to our cystic fibrosis medicines.”

It said its triple combination therapy was currently funded by eleven healthcare providers, who cover most cystic fibrosis patients in the private sector in the country.

“We are continuing discussions with other health insurers and are in parallel exploring potential sustainable access opportunities in the public sector, which has been historically challenging for rare disease medicines in South Africa.”

It said “exact pricing” and details of its partnerships remained confidential.

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

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