Functional Cure of HIV/AIDS: International HIV/AIDS Symposium in India

From the time it was variously called "gay cancer" or gay related immunodeficiency (GRID) or community acquired immune dysfunction to its identification and establishment as one of the most feared and controversial diseases in modern history, the HIV/AIDS drama as it gradually unfolded and the current challenges in AIDS management were discussed in the inaugural session of the second International Science Symposium on HIV and Infectious Diseases in Chennai, South India (HIV SCIENCE 2014) organized by YRG CARE India.In her keynote address Prof François Barré-Sinoussi, Nobel Prize winner in Medicine-2008 for HIV discovery, President, International AIDS Society, Geneva, Director Regulation of Retroviral Infections Division, Institut Pasteur, France, elaborated on the journey from HIV discovery to HIV cure. She explained the evolution of technologies of research on retroviruses and how clinicians mobilized the retrovirologists at the Intituit Pasteur to arrive at the first report of LAV (lymphadenopathy-associated virus) in Science in May 20th 1983. 

Then began the crucial phase of convincing the scientific community and public authorities that LAV was the etiological agent of AIDS which had to be done on a war footing to identify the disease quickly and prevent its spread. Between 1984 and '85 collaboration with Sanofi Diagnostics Pasteur for production of viral antigens on site, saw a progression with first generation ELISA test and first generation Western Blot test.  

Prof Barré-Sinoussi outlined the challenging task of cloning and sequencing of HIV-1 genome at that time and how the dawn of a new era started with combined ART therapy. Listing the current updates on HIV research and the promises of a functional cure of HIV, the Nobel laureate summed up the 30 years of HIV/AIDS journey as a great example of translational research. 

What we need today in the search for a realistic "functional cure" for HIV/AIDS that promises life-long remission after stopping therapy or long term health with ART are novel, creative ideas, multi disciplinary collaboration partnerships between private and public sectors, international coordination and funding. Among the 35.5 million people living with HIV (PLWH) only 9.7 million are on ART therapy and there are an increasing number of patients in need of costly 2nd line and 3rd line regimen. 

Dr Jack Whitescarver, Director, Office of AIDS research National Institute of Health USA, gave the audience an insight into the initial challenges that the scientific community faced in the early 1980's when very young men were diagnosed with Pneumocytis Pneumonia Carinii (PCP), generally found only in people with seriously compromised immune systems. While the disease was yet unidentified it was thought to be the result of some infectious organism or something that went seriously wrong with the immune system. What was more frightening was the ghastly appearance of the patients as if they were starved for months and they were dying for unknown reasons and that was scary. 

Encouraging young scientists to think out of the box and continue to ask questions, however weird, Dr. Whitescarver said some of the initial guesses before HIV was discovered, were that it could be from a sort of fungus and one clinician even guessed "it could be from dogs because gay men sleep with their dogs!"  First cases were spotted among gay menHaitians and hemophiliacs, but the scenario changed with heterosexual infections and prompted a state of emergency to quickly diagnose the disease and find a cure. 

Highlighting HIV/AIDS research and treatment in India, Dr. Suniti Solomon Founder-director YRG CARE who documented the first evidence of HIV infection in India in 1986, said the legal system in India that labels homosexuality a criminal offence sends the most vulnerable group into hiding, seriously hampering health intervention for HIV/AIDS. 

Challenges in AIDS management that are India-specific revolve around socio-cultural issues such as marriage, fertility pressure and stigma. Very often parents of a homosexual person hide his sexual orientation, sometimes, even the fact that he is HIV infected and force him into marriage with an unsuspecting girl thus paving the way for heterosexual infection. A woman is often pressurized into having a baby as soon possible after marriage and even if she knows her husband is HIV +, the hapless woman gets pregnant to avoid the "barren woman" stigma and transmits HIV infection to the baby. 

On the brighter side, there is now the ART revolution in India where treatment for HIV is almost immediately available and there is counseling, universal precaution, advocacy, public-private partnerships, slight increase in proper sex education to teenagers and most importantly ethical guidelines in research were firmly established after AIDS was found in India. 

The inaugural session was followed by a community training workshop on HIV cure: the basic facts and future direction. Interactions between participants and experts in the field were encouraged through question and answer sessions and a series of panel discussion and scientific paper presentations are scheduled for the next couple of days. Accepted abstracts will be published in the   PubMed indexed journal, BMC Infectious Diseases. 

The symposium attended by over 500 delegates from around the world is scheduled from 30th January - 1st February, 2014 organized by YRG CARE, India. Though we are now in the era of eradication, a lot of unanswered questions remain, in terms of HIV/AIDS eradication and cure. The symposium invites young researchers to think out of the box and come up with fresh ideas to take HIV/AIDS research to the next level to find a permanent cure and  maybe even an eradication of the dreaded HIV/AIDS. 

 

Protein Modifies Thyroid Hormone Levels According to Body Temperature: Research

The thyroid hormone thyroxine, which controls our day-to-day activity and was previously believed to remain at a constant level in the blood. 

It actually fluctuates as a result of a protein which modifies the release of the hormone depending on body temperature, new research reveals.The research was published today, 29 January, in the journal Proceedings of the Royal Society B.The hormone thyroxine regulates metabolism in all mammals, including humans. If there is too much, it leads to hyperactivity, and if there is too little, it leads to dormancy. This essential hormone is carried and stored in the blood by the protein thyroxine-binding globulin (TBG). 

It was previously thought that the levels of the hormone remained constant. However, the new research, led by Robin Carrell, Emeritus Professor of Haematology at the University of Cambridge, found that when the body's temperature rises, TBG's affinity for thyroxine decreases, resulting in an increase of the available hormone and a subsequent increase in metabolism. If the body temperature drops, such as when an animal goes into hibernation, TBG's affinity for thyroxine increases, resulting in a decrease in the availability of the hormone and a decrease in metabolism.The findings provide insight into the changes that occur during fevers, when the body accelerates its metabolism to counter infection and inflammation. 

The research shows that TBG has an inbuilt booster which gives a surge in thyroxine release as the body temperature rises above 37ºC. The study found that a body temperature of 39ºC will result in a 23 per cent increase in concentration of thyroxine levels in the blood - temporarily moving into the range seen in patients with hyperthyroidism. Professor Carrell said: "The effect of temperature on thyroxine levels has been largely overlooked because most measurements of the hormone are carried out when the blood is at room temperature. As a result, blood samples taken from hypothermia or heatstroke patients, or from an infant with fever, would not show the change of free thyroxine in the blood. We are excited by our findings as they are directly relevant to better understanding fevers, which, although beneficial, can pose problems, especially to young children."

Evidence of the significance of this surge in thyroxine during fevers is demonstrated in a unique way - an environmental adaptation in the aboriginal Australian. The researchers discovered that a genetic modification in aboriginal Australians recalibrates the TBG protein's effect during fevers and so will cancel the fever-induced boost in metabolism.

The researchers believe that whilst being advantageous as a defence mechanism in temperate climates, such an increase will be a potential disadvantage in the arid climate of central Australia. There the historic survival risk has been not so much the infection itself, but rather the dehydration and heat exhaustion that accompany dysentery and other common illnesses in childhood. The two genetic mutations have become incorporated in the DNA of some 40% of West Australian aboriginals, to give a halving of the surge in metabolic activity that would otherwise take place in fevers.The research also sheds light on infant febrile seizures - convulsive episodes that often accompany the spiking fevers during early childhood. 

Although not typically life threatening, these seizures, which can occur in young babies, can be a terrifying experience for parents. The researchers believe that part of the reason these seizures may occur is because the brain is especially sensitive to thyroxine - rises in thyroxine result in increased brain activity, hyper-excitability and, in the extreme, convulsive seizures. The occurrence of the last in response to increased thyroxine can now be seen to have direct implications for the previously inexplicable febrile seizures which cease as soon as the infant's body is cooled. Additionally, the scientists believe their discovery helps explain the euphoric feeling some people experience after spending time in a sauna or hot-tub. 

Professor Carrell added: "In everyday life, the accelerated release of thyroxine that will take place as the body core temperature rises to 39ºC in a sauna or hot-tub will contribute to an enhancement of the activity of body and mind: to the euphoria and to the occasional Eureka! Old figures of speech - 'hot headedness' and 'fevered imagination' - can now be seen to have a basis in science."
Source: journal Proceedings of the Royal Society B
 

Thyroid Cancer Cells Become Less Aggressive in Outer Space

For people who think that space exploration offers no tangible benefits for those of us on earth, a new research involving thyroid cancer may prove otherwise.In a new report appearing in the February 2014 issue of The FASEB Journal, researchers from Germany and Denmark show that some tumors which are aggressive on earth are considerably less aggressive in microgravity. By understanding the genetic and cellular processes that occur in space, scientists may be able to develop treatments that accomplish the same thing on earth. 
"Research in space or under simulated microgravity using ground-based facilities helps us in many ways to understand the complex processes of life and this study is the first step toward the understanding of the mechanisms of cancer growth inhibition in microgravity," said Daniela Gabriele Grimm, M.D., a researcher involved in the work from the Department of Biomedicine, Pharmacology at Aarhus University in Aarhus, Denmark. "Ultimately, we hope to find new cellular targets, leading to the development of new anti-cancer drugs which might help to treat those tumors that prove to be non-responsive to the currently employed agents." 
To make their discovery, Grimm and colleagues used the Science in Microgravity Box (SIMBOX) experimental facility aboard Shenzhou-8, which was launched on October 31, 2011. Cell feeding was automatically performed in space on day five and automated cell fixation was conducted on day 10. Inflight control was achieved by using a centrifuge in space. On November 17, 2011, Shenzhou-8 landed and the experimental samples were analyzed. Additional cells were analyzed using a random positioning machine which aims to achieve simulated microgravity conditions on the ground by rotating a sample around two axes operated in a random real direction mode. Both cell types were investigated with respect to their gene expression and secretion profiles, employing modern molecular biological techniques, such as whole genome microarrays and multi-analyte profiling. Results suggested that the expression of genes indicating a high malignancy in cancer cells may be down-regulated under altered gravitational stimulation. 
We are just at the beginning of a new field of medicine that studies the effects of microgravity on cell and molecular pathology. Space flight affects our bodies, both for good and bad," said Gerald Weissmann, M.D., Editor-in-Chief of The FASEB Journal. "We've known that microgravity can cause some microorganisms to become more virulent and that prolonged microgravity has negative effects on the human body. Now, we learn that it's not all bad news: what we learn from cells in space should help us understand and treat malignant tumors on the ground."  

Source:The FASEB Journal

Study Finds Hempseed Oil Packed With Health-Promoting Compounds

Cannabis is making a comeback, not just as a source of fiber for textiles, but also as a crop packed with oils that have potential health benefits.
Cannabis is long stigmatized because of its "high"-inducing cousins, hemp derived from low-hallucinogenic varieties. A new study, which appears in ACS' Journal of Agricultural and Food Chemistry, details just how many healthful compounds hempseed oil contains. 

Maria Angeles Fernández-Arche and colleagues note that for millennia, people around the world cultivated cannabis for textiles, medicine and food. Hemp has high levels of vitamins A, C and E and beta carotene, and it is rich in protein, carbohydrates, minerals and fiber. In the early 20th century, many countries banned cannabis because some varieties contain large amounts of the high-inducing compound THC. And although Colorado recently legalized recreational marijuana use — and some states have passed medical marijuana laws — the drug remains illegal according to U.S. federal law. But the European Union has legalized growing low-THC versions of hemp, and it's making its way back into fabrics and paper. With increasing interest in plant oils as a source of healthful compounds, Fernández-Arche's team wanted to investigate hempseed oil's potential. 

They did a detailed analysis of a portion of hempseed oil. They found it has a variety of interesting substances, such as sterols, aliphatic alcohols and linolenic acids, that research suggests promote good health. For example, it contains α-linolenic acid, which is an omega-3 fatty acid that some studies suggest helps prevent coronary heart disease. The findings could have implications in the pharmaceutical, cosmetic, food and non-food industries, they state. 

  Source: ACS' Journal of Agricultural and Food Chemistry,

After Menopause, One Third of Women Have Hot Flashes for 10 Years

Researchers have found that moderate to severe hot flashes continue, on average, for nearly 5 years after menopause, and more than a third of women experience moderate/severe hot flashes for 10 years or more after menopause.The research took place at the Perelman School of Medicine at the University of Pennsylvania. Current guidelines recommend that hormone therapy, the primary medical treatment for hot flashes, not continue for more than 5 years. 

However, the authors write that "empirical evidence supporting the recommended 3- to 5-year hormone therapy for management of hot flashes is lacking." 

Hot flashes are episodes of intense radiating heat experienced by many women around the time of menopause. They can result in discomfort, embarrassment, and disruption of sleep. 

Changing hormone levels are believed to cause hot flashes and other menopausal symptoms such as insomnia, fatigue, memory and concentration problems, anxiety, irritability, and joint and muscle pain. 

In hormone therapy, medications containing female hormones replace the ones the body stops making during menopause. 

While hormone replacement therapy (HRT) is considered the most effective treatment for hot flashes, it is not appropriate for all women. 

In addition, concerns about health hazards linked to HRT have made some doctors less likely to prescribe it, or to adhere strictly to recommended duration guidelines. 

"Our findings point to the importance of individualized treatments that take into account each woman's risks and benefits when selecting hormone or non-hormone therapy for menopausal symptoms," study's lead author, Ellen W. Freeman, PhD, research professor in the department of Obstetrics and Gynecology at Penn Medicine, said. 

"While leading non-hormone therapies such as Paxil or Escitalopram may provide some relief of menopausal symptoms for some women, for others, they may not be as effective as hormone-based therapy," she said. 

Source:The study is published online in the journal Menopause.


 

Health 2.0 India to organise 3rd annual conference at Bengaluru on Feb 7 & 8, 2014

Health 2.0 is organising its 3rd annual conference in India at Bengaluru on February 7 & 8, 2014.  The event is being held at the CMR Institute of Technology at AECS Layout, Bengaluru.  The theme for Health 2.0 India 2014 is ‘Simply Lead’ which speaks to a belief that we must reboot and reframe leadership for healthcare in the 21st century.
The event will showcase the advanced technology across global markets. The conference will see a participation of over 40 companies with over 20 technology demonstrations which are innovative.  There will be deliberations from a panel of experts from India and global markets. The occasion will also see the presentation of Digital Health Awards 2014.
Health 2.0 has introduced over 500 technology companies to the world stage, hosted more than 15,000 attendees at their conferences and code-a-thons, awarded over $5,277,000 in prizes through their developer challenge programme and inspired the formation of 70 new chapters in cities worldwide.
The conference also serves as a platform that helps companies get noticed and attract funding, revenue generating contracts, distribution partnerships, etc.
This is an exclusive event for leaders, physicians, patients, start-ups, health industry experts, investors, health care corporations, government officials who are working to taken on the challenge of shaping what’s possible in healthcare, according to the organisers.
“The objective is to help patients, physicians and other health stakeholders to realize that the digital revolution, they are seeing around them, can in fact also transform health”, stated James Mathews, chairman, Health 2.0 India.
“We also need to create an awareness among the Indian engineers, entrepreneurs and students that one need not be a medical professional or a pharmacist or nurse to take advantage of market opportunities in health to be a part of transforming the industry,” he added.
Source:Pharmabiz

India accounts for 21% of world’s disease burden, say Accenture report

Despite its growing economic prowess, India ranks among the bottom five countries with the lowest public health spending globally and accounts for 21 per cent of the world’s burden of disease, according to a report done by Accenture.
While the system has evolved in India over the past 50-60 years, the coverage and service levels of the entire public health ecosystem remains inadequate. Indian healthcare system continues to suffer from underfunding and poor governance which have created significant inequities in providing basic health care, says the report titled “‘Delivering e-Health in India – Analysis and Recommendations.’
While India’s healthcare expenditure has increased in the past and the government plans to increase the same further to nearly 2.5 per cent of the GDP in the 12th five year plan, India has invested less public money in health than most comparable countries. India’s overall health spending does reach 6 per cent of the GDP but most of that is private money, it said.
Hospital bed density in India has stagnated at 0.9 per 1000 population since 2005 and falls significantly short of WHO laid guidelines of 3.511 per 1000 patients' population. Moreover, there is a huge inequity in utilization of facilities at the village, district and state levels with state level facilities remaining the most strained.  Low healthcare insurance service coverage leads to high levels of out of pocket spending: Nearly 80 per cent of spend in India is out-of pocket, primarily due to with extremely limited insurance coverage, both personal and government funded. Research has shown that the proportion of medical and healthcare expenditure in overall personal consumption has risen considerably over the years, as per the report.
Source:Pharmabiz

India is currently known to have approximately 600,000 doctors and 1.6 mn nurses. This translates into one doctor for every 1,800 people. The recommended WHO guidelines suggest that there should be 1 doctor for every 600 people. This translates into a resource gap of approximately 1.4 mn doctors and 2.8 mn nurses. There is also a clear disparity in the man power present in the rural and urban areas, it says.

“Our report identifies the importance of shifting from ‘infrastructure focus’ to ‘productivity focus’ to generate corresponding improvements in India’s healthcare access. This can only be achieved if larger fund allocation for healthcare is accompanied by effective and innovative interventions to improve the existing healthcare ecosystem in order to achieve global standards,” said Krishna Giri, managing director, Health & Public Services, Accenture in India.

The report has suggested implementing hospital information systems and records digitization as one of the key measures to be adopted.  Supply chain management system for drugs, vaccines and other consumables, along with equipment and other hard assets, is the cornerstone of all successful healthcare systems. The most critical components of the same are cold chain and logistics systems.

Empowering citizens through information dissemination, handheld based data collection and analytics-enabled real time disease surveillance are the other measures recommended by the report.

Dormant Prostate Cancer Cells may Now be Reawakened!

A new research revealed how prostate cancer cells in bone tissue could be reawakened, and may lead to metastasis to other parts of the body. Understanding this mechanism of action may allow researchers to intervene prior to disease progression. Understanding how and why dormant cells in bone tissue metastasize will aid us in preventing the spread of disease, prolonging survival and improving overall quality of life," said Chia-Yi "Gina" Chu, PhD, a researcher and postdoctoral fellow in the Uro-Oncology Research Program and lead author of the study published in the journal Endocrine-Related Cancer. 
In the study, investigators found that cancerous cells in the bone were reawakened after exposure to RANKL, a signaling molecule commonly produced by inflammatory cells. Researchers then genetically engineered cells to overproduce RANKL and found that these cells could significantly alter the gene expression of surrounding dormant cells in lab studies and in laboratory mice, causing them to transform into aggressive cancer cells.
Researchers then injected these engineered RANKL cells directly into the blood circulation of laboratory mice, which caused dormant cells within the skeleton to reawaken, creating tumors within the bone. When the RANKL receptor or its downstream targets were blocked, tumors did not form. 
"After examination, these engineered tumors were found to contain both RANKL-producing prostate cancer cells and dormant cells, which had been transformed to become cancerous," said Chu. "However, the transformed cells displayed aggressive traits that would metastasize to bone and become resistant to standard hormone therapies used to treat the disease."  
Though findings are preliminary, researchers plan to identify other cells known to produce RANKL that may also recruit and reprogram dormant cells to colonize bone tissue. Investigators plan to embark into clinical research with human patients in collaboration with leading Cedars-Sinai researchers, including Edwin Posadas, MD, medical director of the Urologic Oncology Program.  
"Though more work must be done to understand how RANKL reprograms dormant cells to become cancerous, we look forward to examining its influence on promoting metastasis and secondary tumors, as well as the possibility of 'deprogramming' metastatic cancer cells," said Leland Chung, PhD, director of the Uro-Oncology Research Program.
Source:journal Endocrine-Related Cancer. 



 

AIDS/HIV - Lab Tests and FAQs

HIV test is a simple blood test to detect the presence of HIV antibodies for making a diagnosis of HIV infections. For accurate test results, you have to test your blood 3-4 months for the presence of antibodies.
It is important to begin treatment of HIV infection as early as possible as it can improve health outcomes by retarding the progress of the disease. Further, proper screening and diagnosis of HIV can help victims change risky behaviors and adopt healthy ones.The ELISA method of screening is employed to detect antibodies to the HIV virus. If the results are positive, The ELISA test is again repeated.
Subsequently, a Western Blot test is performed to confirm the results.  The Western Blot test which can be performed on urine, blood or an oral sample, are a series of tests done rapidly with results produced in 20 minutes.
If the test results for HIV antibodies are positive on both ELISA and the Western Blot test, then the person is confirmed to be infected with HIV.
It is important to begin treatment of HIV infection as early as possible as it can improve health outcomes by retarding the progress of the disease. Further, proper screening and diagnosis of HIV can help victims change risky behaviors and adopt healthy ones.
Source:



  

How HIV Infects Gut for First Time Ever Decoded

High-resolution electron microscopy has been utilized by researchers to look at HIV infection within the actual tissue of an infected organism, providing perhaps the most detailed characterization yet of HIV infection in the gut. Lead author Mark Ladinsky, an electron microscope scientist at Caltech worked with Pamela Bjorkman, Max Delbruck Professor of Biology at Caltech, used a technique called electron tomography, in which a tissue sample is embedded in plastic and placed under a high-powered microscope. Then the sample is tilted incrementally through a course of 120 degrees, and pictures are taken of it at one-degree intervals. 
All of the images are then very carefully aligned with one another and, through a process called back projection, turned into a 3-D reconstruction that allows different places within the volume to be viewed one pixel at a time.
By procuring such detailed images, researchers were able to confirm several observations of HIV made in prior, in vitro studies, including the structure and behavior of the virus as it buds off of infected cells and moves into the surrounding tissue and structural details of HIV budding from cells within an infected tissue. 
The team also described several novel observations, including the existence of "pools" of HIV in between cells, proof that HIV can infect new cells both by direct contact or by free viruses in the same tissue, and that pools of HIV can be found deep in the gut.

The findings have been published in the journal PLOS Pathogens.

 Source:journal PLOS Pathogens.


 

Father too Responsible for Offspring’s Diabetes and Obesity: Research

The seminal fluid from father helps in determining whether the child, especially son, will have diabetes and obesity in future, claims a new research at University of Adelaide's Robinson Institute.
 "We know from several studies that obesity in males can be tracked back to the father's contribution at the moment of conception. But now we're starting to understand the very complex signals and information being transmitted by the seminal fluid, and it turns out that seminal fluid and female tissues interact in surprising ways," says Professor Sarah Robertson, research leader and Director of the Robinson Institute at the University of Adelaide.
A mother's health and diet have been known to affect a child's health, but the composition of the seminal fluid, and not only sperms, also plays a vital role. Semen comprises sperms and seminal fluid from prostrate and seminal vesicles. Most of the times, a mother's health conditions are given more priority during conception. But the research revealed that indications from seminal fluid to the reproductive tract of the females affected not only conception but also how a child's health would be later.
To assure a healthy future of a baby, now even father's need to be careful and healthy at the time of conception. "If the seminal fluid is of poor quality, it affects the female's capacity to support an embryo. If the embryo manages to survive despite the poor quality seminal fluid, the metabolism of the resulting foetus will be permanently altered, making it more likely to develop a syndrome of metabolic disorders including obesity, high blood pressure and glucose intolerance after birth," says Professor Robertson.

The research will also chart a new path to work on options for infertile couples and IVF methods.

Source:The results of the research were published in Proceedings of the National Academy of Sciences.
 

Widespread Health Problem That Needs More Attention: Caffeine Addiction

"I'm a zombie without my morning coffee." "My blood type is Diet Coke." "Caffeine isn't a drug, it's a vitamin." Serious caffeine addiction is dismissed as unimportant by most people who make jokes like these about needing a daily boost from their favorite caffeinated beverage—whether first thing in the morning or to prevent the after-lunch slump. But a recent study coauthored by American University psychology professor Laura Juliano indicates that more people are dependent on caffeine to the point that they suffer withdrawal symptoms and are unable to reduce caffeine consumption even if they have another condition that may be impacted by caffeine—such as a pregnancy, a heart condition, or a bleeding disorder.
These symptoms combined are a condition called "Caffeine Use Disorder." And according to the study Juliano coauthored, even though caffeine is the most commonly used drug in the world—and is found in everything from coffee, tea, and soda, to OTC pain relievers, chocolate, and now a whole host of food and beverage products branded with some form of the word "energy"—health professionals have been slow to characterize problematic caffeine use and acknowledge that some cases may call for treatment.
"The negative effects of caffeine are often not recognized as such because it is a socially acceptable and widely consumed drug that is well integrated into our customs and routines," Juliano said. "And while many people can consume caffeine without harm, for some it produces negative effects, physical dependence, interferes with daily functioning, and can be difficult to give up, which are signs of problematic use."
"Caffeine Use Disorder: A Comprehensive Review and Research Agenda," which Juliano coauthored with Steven Meredith and Roland Griffiths of the Johns Hopkins University School of Medicine and John Hughes from the University of Vermont, published last fall in the Journal of Caffeine Research.   Grounds for More Research The study summarizes the results of previously published caffeine research to present the biological evidence for caffeine dependence, data that shows how widespread dependence is, and the significant physical and psychological symptoms experienced by habitual caffeine users. Juliano and her coauthors also address the diagnostic criteria for Caffeine Use Disorder and outline an agenda to help direct future caffeine dependence research.
In so far as heeding the call for more research, the scientific community is beginning to wake up and smell the coffee. Last spring, the American Psychiatric Association officially recognized Caffeine Use Disorder as a health concern in need of additional research in the Diagnostic and Statistical Manual of Mental Health Disorders—the standard classification of mental disorders, now in its fifth edition (DSM-5), used by mental health professionals in the United States.
"There is misconception among professionals and lay people alike that caffeine is not difficult to give up. However, in population-based studies, more than 50 percent of regular caffeine consumers report that they have had difficulty quitting or reducing caffeine use," said Juliano, who served as an appointed advisor to the DSM-5 Substance Use Disorders work group and helped outline the symptoms for the Caffeine Use Disorder inclusion.
"Furthermore, genetics research may help us to better understand the effects of caffeine on health and pregnancy as well as individual differences in caffeine consumption and sensitivity," she added.

A Lack of Labelling Based on current research, Juliano advises that healthy adults should limit caffeine consumption to no more than 400 mg per day—the equivalent of about two to three 8-oz cups of coffee. Pregnant women should consume less than 200 mg per day and people who regularly experience anxiety or insomnia—as well as those with high blood pressure, heart problems, or urinary incontinence—should also limit caffeine.
But limiting one's caffeine intake is often easier said than done as most people don't know how much caffeine they consume daily.
"At this time, manufacturers are not required to label caffeine amounts and some products such as energy drinks do not have regulated limits on caffeine," Juliano said, adding that if this changed, people could perhaps better limit their consumption and ideally, avoid caffeine's possible negative effects.  
But in a nation where a stop at Starbucks is a daily ritual for many people, is there really a market for caffeine cessation? Juliano says yes.
"Through our research, we have observed that people who have been unable to quit or cut back on caffeine on their own would be interested in receiving formal treatment—similar to the outside assistance people can turn to if they want to quit smoking or tobacco use."
Source:Journal of Caffeine Research.









 

Lab-Grown Blood and Lymph Capillaries Make an Entrance

Around 11 million people around the world suffer from burns every year; and the resulting deep wounds don't just heal slowly, but also result in lifelong scars. What is needed to reduce this kind of scarring is the grafting of functional full-thickness skin. Only a very limited area of skin can be removed from the individual patient as the surgery, in turn, creates new wounds. Besides conventional skin grafting, another option is to engineer a skin graft in the lab which firstly is composed of the patient's cells and secondly is very similar to natural human skin.

Up to now these complex skin grafts didn't contain any blood or lymphatic capillaries, pigmentation, sebaceous glands, hair follicles or nerves. The researchers at the Tissue Biology Research Unit, the research department of the Surgical Clinic and at the Research Centre for Children at the University Children's Hospital Zurich have been engineering dermo-epidermal skin grafts for some time but now they have succeeded in constructing a more complex organ. "We were able to isolate all the necessary skin cells from a human skin sample and to engineer a skin graft similar to full-thickness skin that contains for the first time blood and lymphatic capillaries too", says Martin Meuli, Head of the Surgical Clinic at the University Children's Hospital Zurich.

Fully functional lymphatic capillaries generated for the first timeTissue fluid is excreted from a wound which accumulates in a cavity on the skin's surface and can impede wound healing. Lymphatic vessels drain off this fluid. The researchers isolated lymphatic capillary cells from the human dermis. Together with the blood capillaries that were also engineered, this guarantees rapid, efficient vesicular supply of the skin graft. Up to now, this had been a major unsolved problem in molecular tissue biology and regenerative medicine.
The scientists in the team of Ernst Reichmann, Head of the Tissue Biology Research Unit, were surprised by three findings. The individual lymphatic cells spontaneously arranged themselves into lymphatic capillaries with all the characteristics of lymphatic vessels. In preclinical trials both the human lymphatic capillaries and the blood capillaries engineered in the laboratory connected with those of the laboratory animals. "What's novel is that the lymphatic capillaries collected and transported tissue fluid; hence they were functional", explains Ernst Reichmann and goes on to add, "We assume that skin grafts with lymphatic and blood capillaries will, in future, both prevent the accumulation of tissue fluid and ensure rapid blood supply of the graft". This could markedly improve the healing process and the typical organ structure of this type of skin graft.

The first clinical application of these complex skin grafts is scheduled for 2014. They will not, however, contain any blood or lymphatic capillaries as approval has still to be obtained.

 Source: University Children's Hospital Zurich
 

Choline Recommendation During Pregnancy Need to be High, Study

Large amounts of choline may be needed during the third trimester of the pregnancy to support fetal development, a new study found. Conclusions of the research revealed that current recommendations may be too low.¹ Choline deficiency in pregnant women may result in elevated levels of homocysteine, potentially resulting in birth defects. January is National Birth Defects Prevention Month, and according to the National Birth Defects Prevention Network (NBDPN), every 4½ minutes a baby is born with a birth defect such as spina bifida.² This study adds to the growing body of evidence demonstrating that adequate maternal choline intake is vital to a healthy pregnancy.

Choline Needed for Healthy Fetal Growth
Choline is an essential nutrient that is required to make phosphatidylcholine, a component of all cell membranes. Researchers evaluated pregnant and non-pregnant women who were all given a controlled diet that provided 380 milligrams/day (mg/d) of choline, primarily from eggs. The women were then randomly assigned to receive choline supplements of 100 or 550 mg/d. The study found that there is an increased fetal demand for phosphatidylcholine during pregnancy, much of it being transferred to the developing fetus.

"The methodology we employed in this study helped us clearly see changes in choline metabolism during pregnancy," says Dr. Marie Caudill, professor in the Division of Nutritional Sciences at Cornell University and lead investigator of this study. "The results are very meaningful because they demonstrate the substantial demand for choline during pregnancy and may call for an increase in the amount of choline recommended in the diets of expecting mothers."

Additional Benefits of Choline
There is a significant body of research demonstrating the vital role choline plays in the diets of pregnant and breastfeeding women.

• Choline has been shown to play an important role in fetal and infant brain development, affecting the areas of the brain responsible for memory and life-long learning ability.³
• Moreover, research shows that choline may help prevent neural tube defects. Compared with women who get sufficient choline in their diets, women with diets low in choline have four times greater risk of having babies with neural tube defects such as spina bifida.⁴

Eggs Are a Simple Way to Add Choline to the Diet
Research shows that nine out of 10 Americans don't get enough choline.⁵ With numerous implications for health, increasing choline intake can be as easy as incorporating eggs into a healthy diet. Egg yolks are an excellent source of choline, providing about 125 mg, or roughly one-quarter of the recommended daily amount. "As one of the most convenient and low-cost food sources of choline, eggs are a food that I commonly encourage pregnant and breastfeeding women to consume," says pediatric physician assistant Chris Barry, PA-C, MMSc. "Eggs are all-natural, packed with a number of nutrients and a delicious addition to a healthy diet."

 Source:Cornell University

Association Between Diabetes, Depression and Eating Disorders Explained

There is an independent association between diabetes diagnosis and depression and eating disorders after adjustment for presence of other mental disorders, a new study found. The research, published in Diabetologia (the journal of The European Association for the Study of Diabetes), supports the focus on depression as an independent risk factor for diabetes, but also suggests this focus should be extended to impulse control disorders. The study is the first to report on the association between impulse control disorders and diabetes diagnosis. The research is by Dr Peter de Jonge, Interdisciplinary Center for Psychopathology and Emotion Regulation, University Medical Center Groningen, University of Groningen, Netherlands, and colleagues worldwide.

While previous studies have explored the associations between diabetes and depression, they have limitations. First, most have been conducted in Europe and the USA, and diabetes and depression vary in prevalence worldwide, thus more global studies are needed. Secondly, and the authors say more importantly, depression often co-occurs with several other mental health disorders—not only with anxiety disorders but also with many of the other Diagnostic Statistical Manual, 4th edition (DSM-IV) mental disorders such as eating disorders and alcohol abuse. Thus the authors did this new study, within the framework of the World Mental Health Surveys* to examine the associations between a wide range of DSM-IV mental disorders and diabetes diagnosis. This approach enabled them to investigate the association between first onset of mood, anxiety, impulse control (including eating disorders) and substance use disorders with diabetes diagnosis in a large international sample, with data coming from 19 countries: Colombia, Mexico, Peru, USA, Shenzhen (China), Japan, New Zealand, Belgium, France, Germany, Italy, the Netherlands, Romania, Spain, Portugal, Israel, Iraq, the UK (Northern Ireland) and Poland. More than 50,000 participants were included in the analysis. 
The authors identified 2,580 cases of adult-onset diabetes (diagnosed in those aged 21 years and over). Although all 16 DSM-IV disorders were associated with diabetes diagnosis, the same was not true after adjustment for the presence of other mental health conditions. After this adjustment, only depression (30% increased risk), intermittent explosive disorder (60% increased risk), binge eating disorder (2.6 times increased risk) and bulimia nervosa (2.1 times increased risk) independently increased the risk of diabetes diagnosis. While the association between depression and diabetes is within the range reported in other meta-analyses, the authors say the association between impulse control disorders (including eating disorders) and diabetes has not been reported before. While the population-level estimates** of prevalence for these mental health disorders vary (0.9% for binge eating disorder, 0.5% for bulimia nervosa and 1.8% for intermittent explosive disorder and 11.3% for depression), at a population level effective interventions to prevent these conditions might ultimately, suggest the authors, prevent substantial numbers of diabetes diagnoses.
The authors conclude: "Our findings thus suggest that the focus on depression in the context of diabetes prediction is warranted, but this focus may be extended to impulse control disorders."

Source:University Medical Center Groningen, University of Groningen, Netherlands,

 

Screening for transformed human mesenchymal stromal cells with tumorigenic potential

Researchers at Erasmus University Medical Center Rotterdam, The Netherlands, led by Dr. Qiuwei Pan and Dr. Luc van der Laan, have discovered that spontaneous tumorigenic transformation of human mesenchymal stem/stromal cells (MSCs) can occur during cell culture expansion, although the frequency is relatively low and often only observed after extensive passage in culture. This report appears in the January 2014 issue of Experimental Biology and Medicine.
Currently, MSCs are being widely investigated as a potential treatment for various diseases. According to ClinicalTrials.gov, over 350 clinical trials using MSCs have been registered by the end of 2013 (with a search of: mesenchymal stem cells). For cell transplantation, MSCs are often isolated from either the patient or from a third party donor, and then expanded in cell culture before therapeutic application. In fact, spontaneous transformation of primary cells in cell culture has been well-investigated over decades. Malignant transformation of murine and monkey MSCs has also recently been reported.
The current study confirmed that spontaneous tumorigenic transformation of human MSCs can occur during cell culture expansion. This potentially has large implications for the clinical application of ex vivo expanded MSCs. "Although this transformation is rare, we do need to carefully examine the presence of these aberrant cells in MSC cultures, before transplanting into patients", stresses the first author Dr. Pan. "We now have identified RNA molecule signatures that can be applied as a potential biomarker for the detection of these dangerous cells in long-term cultures", said senior author Dr. van der Laan. "However, further research is required to validate this biomarker in clinical grade cultures of MSCs that are used in clinical trials".

Dr. Steven R. Goodman, Editor-in-Chief of Experimental Biology and Medicinesaid "This study provides a possible method for testing the safety of expanded adult stem cells. We look forward to the validation of these RNA biomarkers".

Source:Experimental Biology and Medicine.

Slow reaction time linked with early death

Having a slow reaction time in midlife increases risk of having died 15 years later, according to new research published in the journal PLOS ONE.
Researchers from UCL and the University of Edinburgh looked at data from more than 5,000 participants (age 20 to 59) collected from the Third National Health and Nutrition Examination Survey (NHANES-III) in the US. At the start of the study in 1990s, participants visited an examination centre and had their reaction times measured. The task was very simple – they had to press a button when they saw an image appear on a computer screen. Over the next 15 years, they were followed to record who had died and who survived.
A total of 378 (7.4%) people in the sample died, but those with slower reaction times were 25% more likely to have died (from any cause) compared to those with average reaction times. This remained the case after the researchers had accounted for the participants' age, sex, ethnic group, socio-economic background and lifestyle factors into account. There was no relationship between reaction time and death from cancer or respiratory problems.
Lead researcher Dr Gareth Hagger-Johnson, from the UCL Department of Epidemiology and Public Health, said: "Reaction time is thought to reflect a basic aspect of the central nervous system and speed of information processing is considered a basic cognitive ability (mental skill). Our research shows that a simple test of reaction time in adulthood can predict survival, independently of age, sex, ethnic group and socio-economic background. Reaction time may indicate how well our central nervous and other systems in the body are working. People who are consistently slow to respond to new information may go on to experience problems that increase their risk of early death. In the future, we may be able to use reaction times to monitor health and survival. For now, a healthy lifestyle is the best thing people can do in order to live longer".
Source:PLOS ONE.