Tag: 22/10/21

Gut Inflammation and Mental Health Link

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Using mouse models, scientists have discovered a link between gut inflammation and mental comorbidities. In response to gut inflammation like that caused by inflammatory bowel disease (IBD), they observed that the vascular barrier in the brain choroid plexus closes, clamping down access to the brain. The findings were published in Science.

Though this gut-brain vascular axis deregulation is likely a protective mechanism for the brain against inflammation, the findings suggest it may also result in the various cognitive and psychiatric symptoms that are occasionally associated with IBD.

Usually associated with intestinal inflammation, IBD can also cause a wide variety of symptoms in other organs. There is a robust link between anxiety and IBD; up to 40% of patients with IBD also present with psychiatric symptoms such as anxiety or depression. While the gut-brain axis is thought to be involved in driving these symptoms, no other related mechanisms are currently known.

Using a mouse model of intestinal inflammation, Sara Carloni and colleagues identified a potential pathogenic link between IBD and its associated mental comorbidities. According to the findings, the gut vascular barrier becomes more permeable due to the inflammatory process, which allows inflammation to spread beyond the intestines.

In response to this spread, the vascular barrier in the choroid plexus of the brain shuts down, which helps to protect the brain from inflammation. However, in doing so, the process also potentially impairs communications between organs and may hinder brain function.

In a mouse model of genetically driven closure of choroid plexus endothelial cells, Carloni and colleagues observed a deficit in short-term memory and anxiety-like behaviour. Thus, the mental deficits observed alongside IBD may result from deregulation of the gut-brain vascular axis, the authors said. This finding could be used for the development of therapeutic targets in treating some behavioural disorders.

Source: News-Medical.Net

Sleep is Also Important in Avoiding Overweight in Babies

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While the importance has long been known, little research has examined the necessity of sufficient sleep during the first months of life. New research suggests that newborns who sleep longer and wake up less throughout the night are less likely to be overweight in infancy. Their results are published in Sleep.

“While an association between insufficient sleep and weight gain is well-established in adults and older children, this link has not been previously recognized in infants,” said study co-author Susan Redline, MD, MPH, senior physician in the Division of Sleep and Circadian Disorders at the Brigham. “In this study, we found that not only shorter nighttime sleep, but more sleep awakenings, were associated with a higher likelihood of infants becoming overweight in the first six months of life.”

To conduct this research, Dr Redline and colleagues observed 298 newborns born at Massachusetts General Hospital between 2016 and 2018. The infants’ sleep patterns were monitored using ankle actigraphy watches – devices that measure patterns of activity and rest over multiple days. Researchers obtained three nights’ worth of data at the one- and six-month marks while parents kept sleep diaries, recording their children’s sleep and wake episodes.

Scientists measured infant height and weight and determined their body mass index, classifying infants as overweight if they fell into or above the 95th percentile on the World Health Organization’s growth charts.

Notably, researchers found that just one extra hour of sleep was associated with a 26% decrease in overweight risk. Additionally, infants that woke up less during the night faced a lower risk of excess weight gain. Scientists speculate that having more sleep promotes routine feeding practices and self-regulation, factors that mitigate overeating.

Investigators noted an underrepresentation of African-American individuals and lower-income families in their dataset. Additionally, confounding variables, such as breastfeeding duration, could have impacted infant growth. In the future, the researchers aim to extend this study to evaluate how sleep patterns impact growth within the first two years of life and identify key factors that mediate the correlation between sleep and weight gain. They also aim to evaluate interventions for promoting healthy sleep habits.

“This study underscores the importance of healthy sleep at all ages,” said Dr Redline. “Parents should consult their pediatricians on the best practices to promote healthy sleep, like keeping consistent sleep schedules, providing a dark and quiet space for sleeping, and avoiding having bottles in bed.”

Source: EurekAlert!

Distinct Lower Airways Bacterial Profile inChildren with Cystic Fibrosis

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In children with cystic fibrosis (CF), their lower airways have a higher burden of infection, more inflammation and lower diversity of microorganisms, compared to children with other illnesses who also have lung issues, researchers have found. They noted a clear divergence in these bacterial communities in toddlers, before progressive lung disease manifests in CF patients. 

Their findings, published in the journal PLOS ONE, could help providers target specific pathogens earlier, treat them and potentially prevent more severe lung disease.

As lead author Jack O’Connor, at Ann & Robert H. Lurie Children’s Hospital of Chicago explained, “We compared lower airway samples from bronchoscopy in children with CF and disease controls across the age spectrum, and used genetic sequencing to identify microorganisms, finding that a few common cystic fibrosis pathogens begin to dominate at very early ages. Such a clear split from disease controls in this young age group has not been shown before. Our findings deepen our understanding of the disease trajectory in cystic fibrosis and could help improve outcomes through earlier intervention.”

Chronic airway infection and inflammation which leads to progressive, obstructive lung disease is the main cause of illness and death in people with cystic fibrosis.

Researchers tested lower airway samples from 191 patients (63 with cystic fibrosis) aged 0-21 years. The disease controls included patients with diverse conditions, such as cancer, immune deficiency and pneumonia. Using genetic sequencing, researchers were able to identify distinct pathogens that are more dominant at different ages in patients with cystic fibrosis.

“Establishing key age-related differences in lower airway bacterial communities and inflammation in patients with CF, especially during early childhood, may give us a window of opportunity for earlier and more precise treatment,” said senior author Theresa Laguna, MD, MSCS, Division Head of Pulmonary and Sleep Medicine at Lurie Children’s and Associate Professor of Pediatrics at Northwestern University Feinberg School of Medicine. “If we can prevent worse infections, we could improve the quality of life and potentially expand the life expectancy of patients with CF.”

Source: News-Medical.Net

Up to 180 000 Health Workers may Have Died from COVID

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Between 80 000 and 180 000 health and care workers (HCWs) are estimated to have died from COVID between January 2020 and May 2021, the World Health Organization (WHO) said on Thursday.

That grim estimate features in a new WHO working paper based on the 3.45 million coronavirus-related deaths reported globally to the UN health agency up to May. The WHO warns it may well be an underestimate of 60%. To highlight the need for better protection, WHO was joined by global partners working to end the pandemic, to issue an urgent call for concrete action on behalf of workers in the sector.  

WHO Director-General, Dr Tedros Adhanom Ghebreyesus, said that “the backbone of every health system is its workforce.”

“COVID-19 is a powerful demonstration of just how much we rely on these men and women, and how vulnerable we all are when the people who protect our health are themselves unprotected”, he added.  

WHO and partners said that besides the deaths, more and more HCWs are suffering from burnout, stress, anxiety and fatigue. They are urging  equitable access to vaccines so that HCWs are prioritised.  

By the end of last month, on average, two in five HCWs were fully vaccinated, but with considerable differences across regions.

“In Africa, less than one in ten health workers have been fully vaccinated. Meanwhile, in most high-income countries, more than 80% of health workers are fully vaccinated”, Dr Ghebreyesus pointed out.  

For him, over 10 months since the approval of the first vaccines, “the fact that millions of health workers still haven’t been vaccinated is an indictment on the countries and companies that control the global supply of vaccines”.

Currently, 82 nations risk missing the target of vaccinating 40% of their population by year end, and 75% of those countries are faced with insufficient supply. The remainder have some limitations that WHO is helping solve.

Speaking to journalists via videolink, Gordon Brown, former UK Prime Minister and currently WHO’s Ambassador for Global Health Financing, said it would be a “moral catastrophe of historic proportions” if G20 countries cannot act quickly.

These nations have pledged to donate more than 1.2 billion vaccine doses to COVAX. According to WHO, so far, only 150 million have been delivered.  

With wealthy countries stockpiling millions of unused doses, close to expiration, Brown said they should start an “immediate, massive, concerted” airlift of vaccines to low income countries.  

If they do not, he argued, they will be guilty of an “economic dereliction of duty that will shame us all.”  

Brown also warned that “the longer vaccine inequity exists, the longer the virus will be present.”

Source: UN News

No Finding of Early Miscarriage Risk from COVID Vaccinations

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A new study has found no association between COVID vaccinations and risk of first-trimester miscarriages, providing further evidence of the safety of COVID vaccination during pregnancy. The findings were published in the New England Journal of Medicine.

Study co-author Dr Deshayne Fell said, “The study analysed several national health registries in Norway to compare the proportion of vaccinated women who experienced a miscarriage during the first trimester and women who were still pregnant at the end of the first trimester.”  Dr Fell, is Associate Professor in the School of Epidemiology and Public Health in the University of Ottawa’s Faculty of Medicine and a Scientist at the Children’s Hospital of Eastern Ontario (CHEO) Research Institute.

“Our study found no evidence of an increased risk for early pregnancy loss after COVID vaccination and adds to the findings from other reports supporting COVID vaccination during pregnancy,” the study authors wrote. 

“The findings are reassuring for women who were vaccinated early in pregnancy and support the growing evidence that COVID vaccination during pregnancy is safe.”

Dr Fell and colleagues found no relationship between the type of vaccine received and miscarriage. In Norway, the vaccines used included Pfizer, Moderna and AstraZeneca.

“It is important that pregnant women are vaccinated since they have a higher risk of hospitalisations and COVID-complications, and their infants are at higher risk of being born too early. Also, vaccination during pregnancy is likely to provide protection to the newborn infant against COVID infection in the first months after birth,” the study authors stressed.

Source: University of Ottawa

Can Prozac be Used to Treat Macular Degeneration?

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The antidepressant fluoxetine, best known as Prozac, could offer the first treatment for the leading cause of blindness among people over 50, new research from the University of Virginia School of Medicine suggests.

Researchers have found early evidence that the drug fluoxetine may be effective against atrophic (or ‘dry’) age-related macular degeneration, a condition that affects nearly 200 million people worldwide. An analysis based on bench research, mouse models and huge insurance databases concluded that patients taking fluoxetine were less likely to develop atrophic macular degeneration (AMD).

On the strength of their findings, which were published in PNAS, the researchers are urging the investigation of fluoxetine to treat AMD, possibly as an oral pill or slow-release implant in the eye.

“These findings are an exciting example of the promise of drug repurposing, using existing medicines in new and unexpected ways,” said Bradley D. Gelfand, PhD, of UVA’s Center for Advanced Vision Science. “Ultimately, the best way to test whether fluoxetine benefits macular degeneration is to run a prospective clinical trial.”

The researchers believe fluoxetine works by binding with an inflammasome, NLRP3-ASC, which triggers the breakdown of the pigmented layer of the eye’s retina.

After conducting extensive bench research, Dr Gelfand and his team tested fluoxetine and eight other depression drugs in lab mice. Fluoxetine slowed the progression of the disease, but the others did not, the scientists found.

Encouraged by their findings, the researchers looked at fluoxetine use among patients aged over 50 in two enormous insurance databases with over 100 million records. They found that people taking the drug had a “significantly” slower rate of developing dry AMD.

Their approach, which combines bench research with big-data analysis, could lead to faster repurposing of existing drugs.

“Traditional approaches to drug development can be expensive and time-consuming: On average, a new FDA-approved drug takes 10–12 years and costs $2.8 billion (present-day dollars) to develop,” the researchers wrote. “Our identification of the unrecognised therapeutic activity of an existing FDA-approved drug using big data mining, coupled with demonstrating its efficacy in a disease-relevant model, could greatly accelerate and reduce the cost of drug development.”

Dr Gelfand was involved earlier this year in using a similar approach to determine that HIV drugs known as nucleoside reverse transcriptase inhibitors, or NRTIs, may be useful against dry macular degeneration as well.

“While we have had a great deal of success with the approach of using real-world patient data, we may have only begun to scratch the surface of finding new uses for old drugs,” said Dr Gelfand, of UVA’s departments of ophthalmology and biomedical engineering. “It is tempting to think about all the untapped therapeutic potential of medicines sitting on pharmacy shelves.”

Source: University of Virginia