Researchers have reported finding a link between allergic diseases and mental health conditions, but one which was likely not causal.
The analysis of data from the UK Biobank was published in Clinical and Experimental Allergy. The researchers used a genetic instrument derived from associated variants for a broad allergic disease phenotype to test for causal relationships with various mental health outcomes. They also investigated whether these relationships were specific to atopic dermatitis (AD), asthma or hayfever.
The researchers found that people with asthma, atopic dermatitis, and hay fever also had a higher likelihood of having depression, anxiety, bipolar disorder, or neuroticism. However neither category appeared to play a role in causing the other. Nevertheless, future studies should investigate whether interventions that aim to improve allergic diseases might also have an effect on mental health (and vice versa).
“Our research does not rule out a potential causal effect upon the progression of disease, which is yet to be investigated and could help uncover novel treatment strategies for allergic disease or mental health traits,” said lead author Ashley Budu-Aggrey, PhD, of the University of Bristol.
Senior author Hannah Sallis, MSc, PhD, added that the research used a combination of approaches and data from several studies. “This helps to strengthen our confidence in the findings,” she said. “Establishing whether allergic disease causes mental health problems, or vice versa, is important to ensure that resources and treatment strategies are targeted appropriately.”
For 4 out of every 5 COVID survivors, those who have lost sense of smell or taste have these return within six months, with those under 40 more likely to recover, according to a new study.
Among 798 respondents to an ongoing survey of people who had COVID and reported a loss of smell or taste, participants who were younger than 40 recovered their sense of smell at a higher rate than those older than 40, according to study results published in the American Journal of Otolaryngology last month.
Evan Reiter, MD, medical director of the Smell and Taste Disorders Center at Virginia Commonwealth University Health and a co-investigator on the study, said the latest data show 4 in 5 participants, regardless of age, regained their smell and taste within six months.
Insights into COVID survivors’ recovery came from symptoms experienced and pre-existing conditions they had. Those with a history of head injury were less likely to recover their sense of smell, as well as those who had shortness of breath during COVID. However, those with nasal congestion had a higher likelihood of smell recovery.
There have been more than 230 million cases of COVID worldwide, according to the World Health Organization. If estimates from the survey reflect populations worldwide, more than 20 million people could have lingering loss of smell or taste more than six months after COVID.
Previous survey results published in April showed 43% of participants reported feeling depressed and 56% reported decreased enjoyment of life in general while experiencing loss of smell or taste. The most common quality-of-life concern was reduced enjoyment of food, with 87% of respondents indicating it was an issue. An inability to smell smoke was the most common safety risk, reported by 45% of those surveyed. Loss of appetite (55%) and unintentional weight loss (37%) continue to pose challenges for patients, Prof said Professor Daniel Coelho, lead author of the study.
Smell training using essential oils could help people trying to recover their sense of smell.
“I continue to recommend that to my patients. It’s low cost and low risk,” Dr Reiter said.
The Clinical Olfactory Working Group, an international group of physicians with a strong research interest in the sense of smell, recommended the method as an option early this year. The group found that smell (olfactory) training could help foster recovery of nerve damage.
“I’d also say potentially it may get people a little bit more tuned into whatever level of function they have left so it might make them more sensitive and better able to use the remaining sensors and neurons that are working,” Dr Reiter said.
Meanwhile, researchers are in the early stages of developing an implant device to restore sense of smell, which began years before the pandemic. The device would behave much like a cochlear implant, which restores hearing for those with hearing loss.
Using a multi-question assessment, researchers found that 1 in 3 children with food allergies reported food allergy-related bullying, indicating the problem is more widespread than commonly believed.
For the study, reported in the Journal of Pediatric Psychology, children were asked a simple ‘yes’ or ‘no’ question about food allergy-related bullying, to which 17% of kids indicated they’d been bullied, teased or harassed about their food allergy. But when asked to reply to a multi-item list of victimisation behaviours, that number jumped to 31%. Furthermore, Children’s National Hospital researchers found that only 12% of parents reported being aware of it.
The reported bullying ranged from verbal teasing or criticism to more overt acts such as an allergen being waved in their face or intentionally put in their food. Researchers say identifying accurate assessment methods for this problem are critical so children can get the help they need.
“Food allergy-related bullying can have a negative impact on a child’s quality of life. By using a more comprehensive assessment, we found that children with food allergies were bullied more than originally reported and parents may be in the dark about it,” says Linda Herbert, Ph.D., director of the Psychosocial Clinical and Research Program in the Division of Allergy and Immunology at Children’s National and one of the study’s researcher.
“The results of this study demonstrate a need for greater food allergy education and awareness of food allergy-related bullying among communities and schools where food allergy-related bullying is most likely to occur,” Dr Herbert added.
The study examined food allergy-related bullying and evaluated parent-child disagreement and bullying assessment methods. It included 121 children and 121 primary caregivers who completed questionnaires. The children ranged in age from 9 to 15 years of age and had an allergy diagnosis of one or more of the top eight IgE-mediated food allergies: peanut, tree nut, cow’s milk, egg, wheat, soy, shellfish and fish.
Of the 41 youth who reported food allergy-related bullying:
51% reported experiencing overt physical acts such as an allergen being waved in their face, thrown at them or intentionally put in their food.
66% reported bullying experiences including non-physical overt victimisation acts including verbal teasing, remarks or criticisms about their allergy and verbal threats or intimidation.
Eight reported relational bullying, such as rumour spreading, people speaking behind their back and being intentionally ignored or excluded due to their food allergy.
The researchers also note that food allergy bullying perpetrators included, but were not limited to, classmates and other students, and bullying most commonly occurred at school.
The authors found that only 12% of parents reported that their child had been bullied because of their food allergy and of those, 93% said their child had reported the bullying to them. Some parents even reported being made fun of or teased themselves because of concerns about their child’s food allergy.
“It’s important to find ways for children to open up about food allergy-related bullying,” Dr Herbert said. “Asking additional specific questions about peer experiences during clinic appointments will hopefully get children and caregivers the help and support they need.
New research from the University of Connecticut has brought the drug-free technology of electrical anaesthesia for all chronic pain sufferers a step closer.
Pain stimuli, or ‘nociceptive stimuli’ is picked up by nociceptors which send signals to the spinal cord, which passes it on to the brain where the perception of pain is manifested.
Bin Feng, associate professor in the Biomedical Engineering Department, led research which discovered how electrical stimulation of the dorsal root ganglia (DRG), sensory neural cell body clusters, can block nociceptive signal transmission to the spinal cord and prevent the brain from perceiving chronic pain signals. The findings are reported in PAIN.
Electrical devices to treat pain typically deliver electrical signals to the peripheral nervous system and spinal cord to block nociceptive signals from reaching the brain.
A major obstacle with these devices is that while some patients find them beneficial in relieving their chronic pain, others have little or no pain reduction. Despite incremental developments of neurostimulator technologies, there has not been much improvement in getting the devices to work for these patients.
“The trouble with this technology is that it can benefit a portion of patients very well, but for a larger portion of patients it has little benefit,” Prof Feng said.
One of the reasons is that such devices lag behind research into neural stimulation.
“We’re sitting on a huge pile of clinical data,” Prof Feng says. “But the science of neuromodulation remains understudied.”
Neurostimulators relieve pain according to a ‘gate control’ theory. Our bodies can detect both innocuous stimuli, like something brushing against the skin, and painful stimuli, through low- and high-threshold sensory neurons, respectively.
The spinal cord ‘gate’ can be shut by activating low-threshold sensory neurons, preventing painful nociceptive signals from high-threshold sensory neurons from crossing the spinal cord to the brain.
Neurostimulators reduce pain in patients by activating low-threshold sensory neurons with electrical pulses. This usually causes a non-painful tingling sensation in certain areas of the skin, or paresthaesia, masking the perception of pain.
Many patients receiving DRG stimulation treatment reported pain relief without the expected paraesthesia.
Seeking to understand this, Prof Feng’s lab discovered that electrical stimulation to the DRG can block transmission to the spinal cord at frequencies as low as 20 hertz. This is in contrast to previous research indicating that blocking requires kilohertz electrical stimulation.
“The cell bodies of sensory neurons form a T-junction with the peripheral and central axons in the DRG,” Feng says. “This T-junction appears to be the region that causes transmission block when DRG is stimulated.”
More remarkably, sensory nerve fibres with different characteristics are blocked by different electrical stimulation frequency ranges at the DRG, allowing the development of new neural stimulation protocols to enhance selective transmission blocking with different sensory fibre types.
“A-fibre nociceptors with large axon diameters are generally responsible for causing acute and sharp pain,” Prof Feng explained. “It is the long-lasting and dull-type pain that bothers the chronic pain patients mostIn a chronic pain condition, C-fibre nociceptors with small axon diameter and no myelin sheath play central role in the persistence of pain. Selectively blocking C-fibres while leaving A-fibres intact can be a promising strategy to target the cause of chronic pain.”
This provides evidence to place more electrodes for devices that target the DRG and surrounding neuronal tissues, letting doctors provide more precise neuromodulation.
“The next-generation neurostimulators will be more selective with fewer off-target effects,” Prof Feng said. “They should also be more intelligent by incorporating chemical and electrical sensory capabilities and ability to communicate bidirectionally to a cloud-based server.”
Prof Feng hopes that more people will be eventually able to achieve chronic pain relief with this technology. He is now working toward conducting clinical studies with his collaborators at UConn Health to test the efficacy of this method in humans.
One in seven cancer patients around the world have missed out on potentially life-saving operations during COVID lockdowns, according to a new study led by the University of Birmingham.
Planned cancer surgery was impacted by lockdowns regardless of the local COVID rates at that time, especially in lower income countries. Though lockdowns have protected the public from COVID, they have had collateral impact on care for other patients and health conditions. Researchers in this study showed that lockdowns resulted in significant delays for cancer surgery and potentially more cancer deaths.
Researchers are calling for major global reorganisation during the pandemic recovery to provide protected elective surgical pathways and critical care beds that will allow surgery to continue safely, as well as investment in ‘surge’ capacity for future public health emergencies.
‘Ring-fenced’ intensive care beds would support patients with other health conditions and those with advanced disease (who are most at risk from delays) to undergo timely surgery. Investment in staffing and infrastructure for emergency care would mitigate against disruption of elective services.
The COVIDSurg Collaborative involved 5000 surgeons and anaesthetists around the world working together as part of the to analyse data from the 15 most common solid cancer types in 20 000 patients in 61 countries. The findings were reported in The Lancet Oncology.
The researchers compared cancellations and delays before cancer surgery during lockdowns to those during times with light restrictions. During full lockdowns, one in seven patients (15%) did not receive their planned operation after a median of 5.3 months from diagnosis – all with a COVID related reason for non-operation. However, during light restriction periods, the non-operation rate was very low (0.6%).
Patients awaiting surgery for longer than six weeks during full lockdown were less likely to have their planned cancer surgery. Frail patients, those with advanced cancer, and those waiting surgery in lower-middle income countries were all less likely to have the cancer operation they urgently needed.
Researchers analysed data from adult patients suffering from cancer types including colorectal, oesophageal, gastric, head and neck, thoracic, liver, pancreatic, prostate, bladder, renal, gynaecological, breast, soft-tissue sarcoma, bony sarcoma, and intracranial malignancies.
Lockdowns directly impact hospital procedures and planning, as health systems change to reflect stringent government policies restricting movement. The researchers found that full and moderate lockdowns independently raised the likelihood of non-operation after adjustment for local COVID case notification rates. They hope that this information will help guide future lockdowns and restrictions by governments.
SARS-CoV-2 viruses (yellow) infecting a human cell. Credit: NIH
In a study of patients with COVID being treated in intensive care units, people mounting only a low antibody response against the SARS-CoV-2 virus had a greater risk of dying.
Previous studies by the researchers had indicated that levels of SARS-CoV2 viral RNA and antigens in the blood was related to COVID severity.
The study, which is published in the Journal of Internal Medicine, recruited 92 patients severely ill with COVID who were admitted to the ICU. The researchers found that patients with strong antibody responses against the virus had low levels of viral RNA in their blood, especially anti-S (Spike protein) antibodies. Those with poor antibody responses had high viral RNA levels and disseminated viral proteins in the blood, 2.5 times higher than those with strong antibody responses.
Previous studies have shown that critical COVID patients develop higher titers of SARS-CoV-2 antibodies than those with milder disease, suggesting that antibody response alone is insufficient to avoid severe disease. The findings nonetheless support that critical COVID patients would need to mount a robust anti-S antibody response to survive.
The results could help establish the optimal antibody levels needed for an individual to overcome COVID when critically ill. The study also provided evidence of the importance of antibodies against the Spike protein of SARS-CoV-2 to block the virus’ replication, which are the antibodies induced by vaccination.
“Our findings support that treatment with exogenous antibodies in COVID should be personalised, reserving this therapy for those patients with absent or low endogenous antibodies levels,” said co–senior author Jesús F. Bermejo-Martin, MD, PhD, of the Instituto de Investigación Biomédica de Salamanca (IBSAL) & CIBERES, in Spain.
