Aconitine in Traditional Chinese Medicine May Lead to Severe Poisoning

A Chinese woman was diagnosed with aconitine-induced cardiovascular symptoms and doctors warn that this natural ingredient may lead to severe poisoning. The report has been published in the Canadian Journal of Cardiology.

A 45-year-old Chinese woman was diagnosed with a severe heart-rhythm disorder, bidirectional ventricular tachycardia (BVT), associated with aconitine poisoning. BVT is a rare form of tachycardia (characterized by a resting heart rate over 100 beats per minute) and a distinct pattern of ECG waves on presentation. 

The patient's husband reported that she had drunk about 50 milliliters of a medicinal liquid about 30 minutes before she developed a sudden drop in blood pressure and then lost consciousness. The woman had no history of previous heart-rhythm problems and there was no family history of unexpected sudden death or fatal accidents. On examination she had a heart rate of 150 beats per minute and her blood pressure was 50/30. Her skin was cool, moist, and cyanotic. Treatment with the antiarrhythmic agents amiodarone, metoprolol, lidocaine, and potassium chloride was ineffective. An abdominal ultrasound showed marked gastric retention. A gastric tube was used to suction out the contents of her stomach. After two hours, the patient's BVT ceased and her circulation improved. 
Investigation revealed that the patient's blood was positive for aconitine, a substance produced by the Aconitum plant, also known as devil's helmet or monkshood. Although well-known for its highly toxic properties, aconitine is the primary ingredient of the traditional Chinese medicine known as Fuzi, a remedy made from the processed lateral roots of Aconitum carmichaeli Debx. It is widely distributed in the southwest provinces of China and is used in small doses for its anti-inflammatory and pain-relieving effects. 
"Management of potentially lethal ventricular tachyarrhythmia associated with aconitine poisoning presents a therapeutic challenge. In a previously published case, amiodarone was effective in suppressing the BVT. However, in our patient, both lidocaine and amiodarone were ineffective," explained lead author Zhong Yi, MD, PhD, of the Aerospace Center Hospital, Beijing, People's Republic of China. 
"The public should be warned of the risk of severe poisoning that can accompany traditional Chinese medicinal usage of Fuzi," Dr. Yi concluded. 
Commenting on the report, Dr. P. Timothy Pollak, of the Department of Medicine at the University of Calgary, Alberta, cautioned that "not all products of Mother Nature are free of harm. This case report reminds us that aconitine is not the only naturally derived substance that can cause potentially lethal ventricular tachyarrhythmias, including BVT. The report also demonstrates the human tendency to think that if a little is good, more must be better." 
Dr. Pollak advises clinicians to be aware of what their patients are taking and be prepared to discuss alternative remedies, at least at a basic level. "Dodging the discussion can only lend credibility to any patient suspicions that as a practitioner of Western medicine, you have been denied the secrets of alternative remedies or are hiding them for ulterior motives. This report serves as a timely illustration that alternative remedies do have implications for the practice of cardiology that cannot be ignored." 
Source: Eurekalert

 

Ancient Ayurvedic Prakriti Classification Has Genetic Roots: CCMB Director

A major breakthrough discovery has revealed that 'dosha prakriti' or phenotypic classification of traditional Indian medicine indeed has a genetic basis. Scientists at Center for Cellular and Molecular Biology (CCMB) in Hyderabad were finally able to link India's ancient wisdom with modern sciences.

 Ayurveda dates back to the ancient period, where it was practised as the main type of medical system in India. It has first originated in the 1,500 BC and had been in practice for thousand of years. Ayurvedic physicians believe that there are three doshas - Vata (related to space and air), Pitta (fire and water) and Kapha (water and earth). Each individual would have different levels of these doshas, hence the diversities.

 "Whether such phenotypic classification has any molecular basis has been a matter of debate. A few groups had found some correlation when they looked at one or two specific genes. However, the association with Prakriti classification was lacking," said Ch Mohan Rao, director of the Council of Scientific and Industrial Research (CSIR) and Center for Cellular and Molecular Biology (CCMB).

A team of researchers recruited 3,416 healthy males in the age group of 20-40 years. They were screened by a software called AyuSoft, developed by C-DAC. Their blood samples were collected, isolation of DNA and genomic studies were carried out.

"In all, 262 individuals were selected for analysis using one million genetic markers," said Dr K.Thangaraj, lead scientist of the study. The findings were published as a paper titled 'Genome-wide analysis correlates Ayurveda Prakriti' in the Journal Nature. 

"Interestingly, although we had individuals from different ancestries and communities, they all got classified into these three classifications. This was a sign that there was real science behind this Ayurvedic classification. This discovery will be beneficial to both Ayurveda and Allopathy practitioners. This work will eventually lead to establishing Ayurveda on a sound footing along with modern medicine," explained Rao. 

 Source:Desk News

Girl With Epilepsy Inspires People to Support Legalization of Medical Marijuana in Mexico

A Mexico girl suffering with epileptic seizures since childhood has shown remarkable improvement after using medicinal cannabis or marijuana for a month.

 Grace can finally sleep through the night without being awakened by one of her epileptic crises since the eight-year-old Mexican girl started taking cannabis-based medicine a month ago.
 Her parents have seen a marked improvement in their daughter's conditions since she became the first person authorized to take medicinal marijuana in October.

"Her reaction has been very good. Since she took the medicine, we noticed that she could sleep all night," her father, Raul Elizalde, said from the family's home in an upper-class neighborhood of the northern industrial hub of Monterrey.

"Her nocturnal epileptic crises have practically disappeared and she's sleeping very well. This was the main change that we saw," he said, as his wife fed Grace, who sat in a baby high chair, and her younger sister, Valentina in their living room.

Grace has become a symbol for those battling to break Mexico's prohibitionist laws against marijuana in a country that has endured a decade of drug cartel violence.

The girl's parents secured an exception to Mexico's laws after they won a court battle in August, forcing health authorities to grant them the right to obtain cannabidiol (CBD), a therapeutic oil. It was a first victory for those advocating for legalization.

The Supreme Court issued a historic ruling on November 4 that opened the door to the legalization of marijuana by authorizing four people to grow and consume cannabis for their personal, recreational use.

Days later, Senator Cristina Diaz, a member of the ruling Institutional Revolutionary Party (PRI), introduced a measure that would allow imports and consumption of medical marijuana, saying it would benefit 5,000 Mexicans.

While President Enrique Pena Nieto has reiterated his opposition to legalization, he suggested that his government could change its mind depending on the outcome of a debate of experts in the coming months.

Other countries in the region are moving faster. More than 20 US states authorize medical marijuana while Colombia said last week that it would do the same. Chile's Congress is debating whether to legalize the drug while Uruguay has done so already.

Opinion polls show that a majority of Mexicans oppose legalization, though a survey by El Universal newspaper this month showed that 79 percent back the drug's use for medicinal purposes.

The national discussion has raised hopes among people like Grace's parents, who believe that medical marijuana can improve the quality of life of patients after other traditional medicine has failed.

Tastes like chocolate
Grace has Lennox-Gastaut syndrome, which caused her to have as many as 400 epileptic fits per day. She moves in a wheelchair and her parents feed her.

On a recent day, her mother, Mayela Benavides, squeezed the chocolate and mint flavored oil into Grace's mouth as her daughter sat in her baby chair.

"We tried other medicine which tasted terrible. The good thing about CBD is that it tastes good," said Benavides, an engineer.

The medicine is not a cure, but the goal is to reduce the number and intensity of seizures that Grace endures. The drug costs $250 for 100 milliliters, a small fortune for Mexico but which her parents can afford. 

She still experiences seizures. As she sat in her high chair, Grace suddenly started shaking, closed her big brown eyes and tightly squeezed her mother's hand for a couple of minutes. Her body finally relaxed and Mayela wiped her mouth.

"She just had one of her crises. But the crises that she's had in the mornings all her life are changing. They're less intense and less frequent. We're on the right path," Mayela said, writing the hour and duration of the latest seizure.

Vote this year?
Doctors told the parents that it would take two months for changes to be really noticeable and that her dose could be increased.

Senator Diaz, who is also from Monterrey, said she hoped that her bill will be approved before the end of the year. Colleagues from other parties are backing it, she said.

"We are only talking about imports of medicine, not eliminating the ban on making them in the national territory. But it's a first step. For children like Grace and many other people, improving their quality of life is urgent" said Diaz. 

Source: AFP

 

Traditional Chinese Medicine Improves Quality of Life for Cancer Patients

Traditional chinese medicine has evolved over thousands of years. A meta-analysis of dozens of studies of traditional Chinese medicine such as acupuncture and therapeutic massage, were observed to reduce gastrointestinal disruptions after surgery, and acupuncture was also found to lessen fatigue in cancer patients. The study was reported in Oncotarget.

 Dr. Qiang (Quentin) Liu said, "We think this is the most comprehensive study of traditional Chinese medicine psycho-behavioral interventions and the quality of life of cancer patients published to date. Our findings will promote more investigations into how the body and mind are connected during disease development, and will facilitate better cancer treatments." 

 Other interventions not associated with traditional Chinese medicine, including stress management, cognitive behavioral therapy and physical training, also were found to improve quality of life in Chinese cancer patients, the researchers report. 

The team started with 6,500 studies published in journals in China and 23,000 studies from Western journals. All of the research focused on nonpharmacological interventions involving adult Chinese cancer patients in China. After eliminating duplicate studies, those with nonstandard measures and those that failed to include control subjects or large enough sample sizes, the team ended up with a total of 67 studies, with 16 of them focused on traditional Chinese medicine. 

Keith Kelly said, "The latter 16 studies did not include enough studies of tai chi and qigong to allow the researchers to come to meaningful conclusions about the specific effects of those interventions. The total number of cancer patients included in the analysis was 6,806." 

The researchers said, "We were surprised by the limited number of papers on the use of traditional Chinese medicine psycho-behavioral interventions for Chinese cancer patients that qualified for entry into this meta-analysis, particularly since the TCMs originated and are mostly practiced in China." 

Kelly said, "Traditional Chinese medicine has been practiced for 2,500 years in China. But what is the scientific evidence that it improves quality of life in cancer patients? This paper establishes that it does. Unfortunately, we were not able to determine what specific components of traditional Chinese medicine are the most effective. I hope the evidence that traditional Chinese medicine and other nonpharmacological interventions benefit cancer patients will prompt new interest in research aimed at understanding the physiological mechanisms at play." 

Source: Eurekalert

 

Chronic Lymphocytic Leukemia Mutations Uncovered New Uses of Existing Cancer Drugs

Mining the DNA of chronic lymphocytic leukemia (CLL) patients uncovered 12 mutations that may be targetable using therapies already available for other cancers, revealed Penn Medicine researchers.

 The team, led by Anthony Mato, an assistant professor of Hematology/Oncology in the Perelman School of Medicine at the University of Pennsylvania and Penn's Abramson Cancer Center (ACC), and director of the Center for CLL, used next generation sequencing - tests developed by and run at Penn's Center for Personalized Diagnostics - to take a deeper dive into 87 CLL patients' genetic makeup. They captured a slew of mutations known to be associated with other cancers: ATM, TP53, BRAF and KRAS, to name a few. 

 Today, there are several already available drugs - PARP and BRAF inhibitors, for example - that target many of these mutations, but they are US Food and Drug Administration-approved to treat ovarian, prostate and skin cancers, not CLL. 

Mato said, "About 80% of the patients in the study had at least one mutation, and many of them are clinically actionable in other cancers. It's very likely that these same mutations may be targetable in CLL - which would open up a door for much-needed treatments for patients who fail therapies. These results set the stage for future CLL clinical trials to investigate this precision medicine approach, one that selects therapies already available in practice based on a patient's genetic profile." 

Patients in the study were treated with ibrutinib, a kinase inhibitor approved by the FDA in early 2014 for CLL patients who had received at least one prior therapy, or in combination with chemo-immunotherapy (CIT). Ibrutinib has shown promising response rates; however, approximately 30% of patients do not respond to the treatment and the therapy invariably leads to drug resistance. 

Researchers, including Abramson Cancer physicians Edward Stadtmauer, chief of Hematologic Malignancies and a professor of Hematology/Oncology, Stephen Schuster, the Robert and Margarita Louis-Dreyfus Associate Professor in Chronic Lymphocytic Leukemia and Lymphoma Clinical Care and Research, sequenced the tumors of 87 patients and analyzed clinical characteristics, genetic mutations and progression free survival. Jie Wang, a fellow in the division of Hematology/Oncology, will present the abstract on Sunday. 

The median age was 65.7 years old, 69% were men, and 23% received CIT alone, 20% received ibrutinib, and 27% received both CIT and Ibrutinib. The most frequently mutated genes among the study participants were ATM (15%), SF3B1 (12%), NOTCH1 (9%), DNMT3A (5%), and TP53 (9%). 

The presence of a pathogenic mutation - 19 in total - also predicted worse progression free survival in the patients receiving CIT compared to those without a pathogenic mutation. This was true even when controlling for certain cytogenetic mutations that are known to portend a poorer prognosis, the researchers found. 

CLL is a clinically and biologically heterogeneous disease that is commonly evaluated with fluorescence in situ hybridization (FISH), which screens for specific chromosomal and genetic abnormalities, like del17p in CLL patients, which is known to be associated with decreased survival. 

Wang said, "Next generation sequencing is an important additional tool that could further define genetic alterations that may be working in concert to drive malignancy and identify pathways that could be targeted with novel approaches." 

The CPD is a joint initiative between Penn Medicine's Department of Pathology and Laboratory Medicine and the ACC to support precision medicine at Penn. Since the launch of operations in February 2013, it has performed more than 4,000 advanced diagnostics on patients with a wide range of new and relapsed cancers. 

Source: Eurekalert

 

World’s First Dengue Vaccine Approved by Mexico

The dengue vaccine Dengvaxia, manufactured by Sanofi, has been approved by Mexico for prevention of the deadly mosquito-borne disease. This approval makes it the first vaccine in the world to prevent dengue, thereby bringing fruit to the 20-year effort of the drug company to produce the vaccine. It marks a major advance in medicine, with dengue joining the list of vaccine-preventable diseases.

Dengue has assumed endemic proportions in several parts of the world, claiming a huge number of lives every year. It is no longer limited to the tropics, but has spread far and wide to other regions as well. The virus that causes dengue spreads through the bite of the Aedes aegypti mosquito. The fever results in symptoms of severe joint and muscle pains. Several patients succumb to complications like shock or dengue hemorrhagic fever. With no definite antiviral treatment available against the virus as yet, a vaccine currently seems to offer the best option to deal with the infection. 

 The Dengvaxia vaccine has been approved by Mexico's Federal Commission for the Protection against Sanitary Risk for the prevention of dengue for people ranging from 9 to 45 years. 

Since a vaccine is administered to people who are healthy, it is important that besides being effective, it should not cause any side effects. The vaccine has been found to be safe in large clinical trials prior to its approval. It provides protection against all 4 variants of the dengue virus. Though it has not found to be 100% effective, it will hopefully reduce the number of affected people and thereby the transmission of the infection. 

The approval for the dengue vaccine in Mexico will hopefully be a major boost to the global efforts involved in the prevention of dengue. 
 News Desk

Researchers Identify 30 Key Genes for Longer, Healthier Life

Researchers have zeroed in on 30 genes which, if tweaked a bit, can get you eternal youth - without having to search for and drink that elusive elixir of life. The team revealed that one of these genes proved to be particularly influential - the bcat-1 gene.

 Michael Ristow, professor of energy metabolism at the Swiss Federal Institute of Technology in Zurich (ETH Zurich), said, "When we blocked the effect of this gene, it significantly extended the mean lifespan of the nematode by up to 25%." 

‘One of the 30 genes that have been identified - namely the bcat-1 gene - proved to be particularly influential in extending the mean lifespan of a nematode by up to 25%. The findings could influence how age-related diseases such as diabetes or high blood pressure could be prevented.’

Ristow has no doubt that the same mechanism occurs in humans. He said, "We looked only for the genes that are conserved in evolution and, therefore, exist in all organisms, including humans." 

The bcat-1 gene carries the code for the enzyme of the same name which degrades so-called branched-chain amino acids that naturally occurs in food protein building blocks. 

When the researchers inhibited the gene activity of bcat-1, the branched-chain amino acids accumulated in the tissue, triggering a molecular signalling cascade that increased longevity in the nematodes. Moreover, the time span during which the worms remained healthy was extended. 

The study that involved researchers from JenAge consortium from Jena in Zurich said, "As a measure of vitality, the researchers measured the accumulation of aging pigments, the speed at which the creatures moved, and how often the nematodes successfully reproduced. All of these parameters improved when the scientists inhibited the activity of the bcat-1 gene." 

In order to detect these genes, the researchers combed through 40,000 genes in the nematode C. elegans, zebra fish and mice. The multiple branched-chain amino acids are already being used to treat liver damage and are also added to sport nutrition products. 

The authors said, "However, the point is not for people to grow even older, but rather to stay healthy for longer." 

The study, published in the Nature Communication, will deliver important indicators on how the aging process could be influenced and how age-related diseases such as diabetes or high blood pressure could be prevented.

Source: IANS
 

Losing One Gram Fat from Pancreas can Reverse Type 2 Diabetes

Previous research has suggested that Type-2 diabetes is caused by fat accumulating in the pancreas. A new study has now revealed that losing less than one gram of that fat through weight loss could reverse the condition.

 Lead researcher Roy Taylor from Newcastle University in England said, "For people with Type-2 diabetes, losing weight allows them to drain excess fat out of the pancreas and allows function to return to normal. So if you ask how much weight you need to lose to make your diabetes go away, the answer is one gram! But that gram needs to be fat from the pancreas. At present the only way we have to achieve this is by calorie restriction by any means - whether by diet or an operation." 

‘Excess fat in diabetic pancreas is specific to Type-2 diabetes and prevents insulin being made as normal. When that excess fat is removed, insulin secretion increases to normal levels, and people become diabetes free.’

For the study, 18 people with Type-2 diabetes and nine people who did not have diabetes were measured for weight, fat levels in the pancreas and insulin response before and after bariatric surgery. The patients with Type-2 diabetes had been diagnosed for an average of 6.9 years. The people with Type-2 diabetes were found to have increased levels of fat in the pancreas. 

The participants in the study had all been selected to have gastric bypass surgery for obesity and were measured before the operation then again eight weeks later. After the operation, those with Type-2 diabetes were immediately taken off their medication. 

Both groups lost the same amount of weight, around 13% of their initial body weight. Critically, the pool of fat in the pancreas did not change in the non-diabetics but decreased to a normal level in those with Type-2 diabetes. The researchers said, "This shows that the excess fat in the diabetic pancreas is specific to Type-2 diabetes and important in preventing insulin being made as normal. When that excess fat is removed, insulin secretion increases to normal levels. In other words, they were diabetes free." 

The study appears online in Diabetes Care.

Source: IANS
 

Why Some People are Unable to Use Facial Features to Recognize a Person

People with congenital prosopagnosia, or face blindness, are unable to use facial features to identify the person in front of them. Until now, the cause of facial blindness was assumed to be associated with the later stages of the perceptual process. However, a new study has now revealed that the causes of congenital face blindness can be traced back to an early stage in the perceptual process.

 Lead researcher Andreas Luschow from Charite hospital in Berlin said, "We were able to show that even the earliest face-selective responses, those recorded approximately 170 milliseconds after seeing a face, are altered in people with congenital prosopagnosia. We were also able to show that these changes are closely linked to their deficit in recognizing faces."

‘The causes of congenital face blindness can be traced back to an early stage in the perceptual process. And even life-long contact with other people does not enable affected persons to compensate for this face recognition deficit.’

 Results showed that even life-long contact with other people does not enable affected persons to compensate for this face recognition deficit. This would suggest that the underlying neural mechanisms are divided into distinct, closed units, making it impossible for other areas of the brain to take over their function. 

A better understanding of cognitive processes is not only important in the field of medicine, but also in other areas of research, such as robotics, where such knowledge may be able to provide 'biological inspiration' for the development and improvement of technological systems. 

The findings were published in PLOS ONE.

Source: IANS
 

New Technique to Ramp Up the Conversion of Skin Cells into Dopamine Neurons

Parkinson's disease occurs when neurons in an area of the brain that controls movement become impaired or die. Normally, these nerve cells produce an important brain chemical known as dopamine. But when they die or become impaired, they produce less dopamine. For decades, researchers have been finding a way to repair faulty dopamine neurons and put them back into Parkinson's patients, where they will start producing dopamine again. Now, Parkinson's disease researchers have developed a way to ramp up the conversion of skin cells into dopamine neurons.

 Previously, researchers have used fetal material, which is difficult to obtain and of variable quality. Embryonic stem cells represented a tremendous innovation, but making dopamine neurons from stem cells is a long process with a low yield. These issues have driven researchers to try to develop ways to turn cells that are easy to obtain, such as skin cells, into dopamine neurons, which are normally hidden in the brain. But here, too, it has been difficult to obtain sufficient quantities of neurons. 

 

‘Parkinson's disease researchers have developed a way to ramp up the conversion of skin cells into dopamine neurons. This discovery enables researchers to generate patient-specific neurons in a dish that could then be transplanted into the brain to repair the faulty neurons.’

 he researchers at the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo have identified - and found a way to overcome - a key obstacle to such cellular conversions. At the same time, the researchers say the finding has profound implications for changing the way scientists work with all cells. 

The new research is published in Nature Communications. It revolves around their discovery that p53, a transcription factor protein, acts as a gatekeeper protein. 

Jian Feng, senior author and professor in the Department of Physiology and Biophysics in the Jacobs School of Medicine and Biomedical Sciences at UB, said, "We found that p53 tries to maintain the status quo in a cell, it guards against changes from one cell type to another. We found that p53 acts as a kind of gatekeeper protein to prevent conversion into another type of cell. Once we lowered the expression of p53, then things got interesting: We were able to reprogram the fibroblasts into neurons much more easily. The advance has importance to basic cell biology." 

Feng further added, "This is a generic way for us to change cells from one type to another. It proves that we can treat the cell as a software system, when we remove the barriers to change. If we can identify transcription factor combinations that control which genes are turned on and off, we can change how the genome is being read. We might be able to play with the system more quickly and we might be able to generate tissues similar to those in the body, even brain tissue. People like to think that things proceed in a hierarchical way, that we start from a single cell and develop into an adult with about 40 trillion cells, but our results prove that there is no hierarchy. All our cells have the same source code as our first cell; this code is read differently to generate all types of cells that make up the body." 

Feng said, "We found that the point in the cell cycle just before the cell tries to sense its environment to ensure that all is ready for duplicating the genome, is the prime time when the cell is receptive to change. By lowering the genomic gatekeeper p53 at the right time of cell cycle, they could easily turn the skin cells into dopamine neurons, with transcription factor combinations discovered in previous studies. These manipulations turn on the expression of Tet1, a DNA modification enzyme that changes how the genome is read. Our method is faster and much more efficient than previously developed ones. The best previous method could take two weeks to produce 5% dopamine neurons. With ours, we got 60% dopamine neurons in ten days." 

The researchers have done multiple experiments to prove that these neurons are functional mid-brain dopaminergic neurons, the type lost in Parkinson's disease. The finding enables researchers to generate patient-specific neurons in a dish that could then be transplanted into the brain to repair the faulty neurons. It can also be used to efficiently screen new treatments for Parkinson's disease.

Source: Eurekalert