Tag: 7/6/24

Researchers Develop Nanoparticle Therapeutic for Fibrosis

Credit: Scientific Animations CC4.0

Researchers at The University of Texas at El Paso are developing a new therapeutic approach that uses nanoparticles for the treatment of skin and lung fibrosis, conditions that can result in severe damage to the body’s tissues.

Md Nurunnabi, PhD, is an associate professor in UTEP’s School of Pharmacy and the lead researcher on two studies published this June in the Journal of Controlled Release; one study focuses on skin fibrosis and the other on lung fibrosis.

“We are closer than ever to developing a safe, effective and reliable approach to treating fibrosis,” Nurunnabi said.

Fibrosis is a condition in which the tissues in an organ become thicker and stiffer, Nurunnabi says. This can have multiple damaging effects, such as the lungs not being able to hold enough oxygen or blood vessels becoming narrower, leading to high blood pressure.

“I studied fibrosis during my postdoctoral training but became interested in focusing on it in my lab during the COVID-19 pandemic,” Nurunnabi said. “I observed that many people were passing away not because of COVID itself, but because of the inflammation and fibrosis caused by the viral infection in the lungs. Our lab focuses on developing nanotechnology that can target specific cells.”

Fibrosis can occur as a side effect of chemotherapy or the result of a viral infection or autoimmune disease, a condition in which the body’s immune system attacks its own cells. For example, with an autoimmune condition, the body kills fibroblasts, the cells that help form connective tissue. The body then produces more collagen than it needs, which leads to fibrosis.

Nurunnabi’s team focused on designing a nanoparticle that could target the cells that are responsible for fibrosis development and progression without disturbing the “good” cells necessary for the body’s healthy functioning. Rather than killing the ”bad” cells, the team was successful in modifying them so that they no longer produced excess collagen, in effect rehabilitating the cells. The studies were conducted in the test tube and in mice.  

“Dr Nurunnabi’s research into skin and lung fibrosis sheds light on the devastating impact of these conditions, whether acute or chronic,” said José Rivera, PharmD, founding dean of the School of Pharmacy. “His findings offer hope for improved treatments that could significantly increase life expectancy and enhance the quality of life for affected individuals.” 

Source: University of Texas at El Paso

For Healthy Adults, New Guideline Recommends only Daily Allowance of Vitamin D

Guideline recommends vitamin D higher than the recommended daily allowance for children, pregnant people, adults over 75 and adults with prediabetes

Photo by Michele Blackwell on Unsplash

Healthy adults under the age of 75 are unlikely to benefit from taking more than the daily intake of vitamin D recommended by the Institutes of Medicine (IOM) and do not require testing for vitamin D levels, according to a new Clinical Practice Guideline issued today by the Endocrine Society. For children, pregnant people, adults older than 75 years and adults with high-risk prediabetes, the guideline recommends vitamin D higher than the IOM recommended daily allowance.

Vitamin D use and blood vitamin D levels have been associated with many common diseases. However, whether vitamin D supplementation lowers the risk of these diseases and what vitamin D blood levels are needed for better health have been debated for years.

In this new guideline, the panel of experts established guidelines for vitamin D use and testing for vitamin D levels in healthy persons without established indications for vitamin D treatment or testing. The guideline relied on clinical trials to develop the recommendations.

The guideline, titled “Vitamin D for the Prevention of Disease: An Endocrine Society Clinical Practice Guideline,” was published online and will appear in the August 2024 print issue of The Journal of Clinical Endocrinology & Metabolism (JCEM), a publication of the Endocrine Society.

“The goal of this guideline was to address the vitamin D requirements for disease prevention in a generally healthy population with no underlying conditions that would put them at risk of impaired vitamin D absorption or action,” said Marie Demay, M.D., of Harvard Medical School and Massachusetts General Hospital in Boston, Mass. Demay is the chair of the panel that developed the guideline. “Healthy populations who may benefit from higher dose vitamin D supplements are those 75 and older, pregnant people, adults with prediabetes, and children and adolescents 18 and younger, but we do not recommend routine testing for vitamin D levels in any of these groups.”

Key recommendations from the guideline include:

  • We suggest against vitamin D supplements at doses beyond the reference dietary intakes recommended by the IOM in healthy adults under 75 years old.
  • We identified the following populations that may benefit from supplementation above the intakes recommended by the IOM because of the potential to reduce specific health risks:
    • Children and adolescents 18 and younger—potential to prevent nutritional rickets and to reduce the chance of respiratory infections.
    • Individuals 75 and older—potential to lower mortality risk.
    • Pregnant people—potential to reduce risk of pre-eclampsia, intra-uterine mortality, preterm birth, small-for-gestational age birth and neonatal mortality.
    • People with prediabetes—potential to reduce progression to diabetes.
  • In adults ages 50 years and older who have indications for vitamin D supplementation or treatment, we suggest daily, lower-dose vitamin D instead of non-daily, higher-dose vitamin D.
  •  We suggest against routine testing for 25-hydroxyvitamin D levels in any of the populations studied, since outcome-specific benefits based on these levels have not been identified. This includes 25-hydroxyvitamin D screening in people with dark complexion or obesity.

Even though the evidence on the role of vitamin D in health and disease has increased over the last decade, the panel noted many limitations in the available evidence. For example, many of the large clinical trials were not designed for several of the outcomes that they reported, and the studied populations had vitamin D blood levels that most would consider adequate to begin with. Based on insufficient evidence, the panel could not determine specific blood-level thresholds for 25-hydroxyvitamin D for adequacy or for target levels for disease prevention.

Source: The Endocrine Society

Researchers Offer New Understanding of Antidepressant Mechanism

Evidence suggests serotonin-boosting actions relieve depression by restoring normal communication and connections in the brain

Photo by Sydney Sims on Unsplash

Researchers at the University of Colorado Anschutz Medical Campus have established a new framework for understanding how classic antidepressants work in treating major depressive disorder (MDD), reemphasising their importance and aiming to reframe clinical conversation around their role in treatment.

The nature of the dysfunction at the root of MDD has been under investigation for decades. Classic antidepressants, such as SSRIs (selective serotonin reuptake inhibitors, such as fluoxetine) cause an elevation in serotonin levels, a key neurotransmitter. This observation led to the idea that antidepressants work because they restore a chemical imbalance, such as a lack of serotonin.

But subsequent years of research showed no significant decrease in serotonin in people with depression. While experts have moved away from this hypothesis due to lack of concrete evidence, this has led to a shift in public opinion on the effectiveness of these medications.

Antidepressants, such as SSRIs and serotonin and norepinephrine reuptake inhibitors (SNRIs), are still effective in alleviating depressive episodes in many patients, however. In a paper published in Molecular Psychiatry, researchers outline a new framework for understanding how antidepressants are efficacious in treating MDD. This framework helps clarify how antidepressants like SSRIs can still be helpful, even if MDD isn’t caused by a lack of serotonin.

Evidence points to a communication problem

“The best evidence of changes in the brain in people suffering from MDD is that some brain regions are not communicating with each other normally,” said Scott Thompson, PhD, professor in the Department of Psychiatry and senior author. “When the parts of the brain responsible for reward, happiness, mood, self-esteem, even problem-solving in some cases, are not communicating with each other properly, then they can’t do their jobs properly,” Thompson said.

“There is good evidence that antidepressants that increase serotonin, like SSRIs, all work by restoring the strength of the connections between these regions of the brain. So do novel therapeutics such as esketamine and psychedelics. This form of neuroplasticity helps release brain circuits from being ‘stuck’ in a pathological state, ultimately leading to a restoration of healthy brain function,” Thompson said.  

Thompson and colleagues liken this theory to a car running off the road and getting stuck in a ditch, requiring the help of a tow truck to pull the car out of its stuck state, allowing it to move freely down the road again. Researchers are hoping healthcare providers will use their examples to bolster conversations with apprehensive patients about these treatments, helping them better understand their condition and how to treat it.

Study aims to reshape the conversation

“We are hoping this framework provides clinicians new ways to communicate the way these treatments work in combating MDD,” said C. Neill Epperson, MD, co-author of the paper and professor of the Department of Psychiatry at the CU School of Medicine.

“Much of the public conversation around the effectiveness of antidepressants, and the role serotonin plays in diagnosis and treatment, has been negative and largely dangerous,” Epperson said. “While MDD is a heterogenous disorder with no one-fits-all solution, it is important to emphasise that if treatments or medications are working for you, then they are lifesaving. Understanding how these medications promote neuroplasticity can help strengthen that message.”

Source: CU Anschutz Medical Campus

Metabolic Parameters Similar in Children Born via Frozen and Fresh Embryo Transfer

No differences in blood glucose, insulin, or cholesterol levels seen in children born via frozen versus fresh embryo transfer regardless of age, gender, or method of assisted conception

Children born via frozen embryo transfer have similar metabolic profiles to those born via fresh embryo transfer, according to a study published June 6th in the open-access journal PLOS Medicine by Linlin Cui and Zi-Jiang Chen from Shandong University, China, and colleagues.

Prior studies have shown inconsistent results on the long-term metabolic health impacts of assisted reproductive technology. Some have shown that children born via frozen embryo transfer have a higher risk of metabolic disorders, such as obesity, and unfavorable lipid profiles. Other studies have failed to find any significant metabolic differences between those born via frozen or fresh embryo transfer.

In this study, researchers compared the glucose and lipid profiles of more than 4000 children between 2 and 5 years of age – approximately half had been born via fresh embryo transfer and half had been born via frozen embryo transfer.

Researchers followed the children for an average of 3.6 years and assessed metabolic factors often associated with heart disease and diabetes, such as fasting blood glucose, insulin, cholesterol, and triglycerides.

They found no difference in any of the metabolic factors among children born via fresh embryo transfer and those born via frozen embryo transfer.

Given the relatively large number of participants in this study, the researchers were able to conduct subgroup analyses. After dividing the children into groups based on gender, age, embryo transfer state, and method of conception, there were still no differences in metabolic factors among the frozen and fresh embryo transfer groups.

The study provides more information to women and couples weighing the pros and cons of different techniques offered for assisted reproduction, but the researchers noted the need for additional data on the effect of assisted reproductive technology on long-term metabolic health.

The authors add, “Frozen embryo transfer shows no significant adverse effects on metabolic profiles in early childhood, providing crucial evidence for counseling couples undergoing assisted reproductive technology treatment on its safety.”

Provided by PLOS

A Little Humour Goes a Long Way in the Wards

Study finds that a light joke can lift everybody’s mood – but sarcasm can sour things

Photo by Carmel Nsenga

A humorous remark at just the right time can go a long way. Benevolent humour helps medical assistants (MAs) cope positively with their stressful working day, according to a new study published in the journal BMC Primary Care. Researchers surveyed more than 600 MAs to find out how they experience their work and what style of humour they use in their daily working lives. They found that if the respondents preferred light, well-intended humour, they were more satisfied with their work and received more positive feedback. Dark humour, such as sarcasm, was more likely to have disadvantages.

Medical assistants mostly work in primary health care, especially medical practices. In Germany, working as an MA requires a three-year vocational training. The daily work routine of MAs can be very demanding. They are responsible for administrative work and, for example, taking blood samples and applying wound dressings. This new study by Martin Luther University Halle-Wittenberg (MLU) and the Federal Institute for Vocational Education and Training (BIBB) aimed to investigate how humour helps them get through their day.

“Medical assistants are in very close contact with patients for most of the day. They have a lot of responsibility and experience a lot of stress,” says Julia Raecke from BIBB, who is doing her doctorate at MLU. It has long been known that humour can help healthcare workers cope with stress. “However, little is known about the consequences of different humour styles. We set out to investigate those, as it should make a big difference, whether MAs use puns or sarcasm when dealing with patients. Talking to people that are potentially sick requires a lot of empathy and verbal dexterity,” explains Professor René Proyer, a psychologist at MLU.

The two researchers conducted an online survey of more than 600 MAs. The aim was to understand better the relationship between job satisfaction and different humour styles. In addition to the kind of humour they prefer, respondents also provided information about their well-being in the workplace and how competent they feel at work.

If the respondents preferred positive and benevolent humour, they were in general also more satisfied with their work. But not only that: “MAs with a preference for light humour stated that they received more positive feedback and were more likely to feel that they were making a difference at work,” says Julia Raecke. Surprisingly, presumably negative or dark humour did not score worse across the board. “Even though satire and irony are considered dark humour, we found no negative correlation with the respondents’ well-being,” adds Raecke. In contrast, cynicism and especially sarcasm had negative effects. Yet, this does not mean that sarcasm should be condemned completely. “A short sarcastic remark among colleagues might help to release frustration,” says René Proyer.

According to the researchers, humour is one of several factors that influence well-being at work. “Knowing about the effects of humour and different styles can help to make conversations with patients more pleasant. That said, waiting rooms are not supposed to become comedy clubs. It’s more about using humour consciously and appropriately,” concludes Proyer.

The results of the study could help to develop new training programmes. For example, Raecke is investigating whether the social and emotional skills of MAs can be improved with the help of online training.

Source: Martin-Luther-Universität Halle-Wittenberg