Cholesterol Levels Improve With Alternative Treatment

Researchers found that an experimental treatment has shown promise in lowering bad cholesterol, offering hope for people who cannot tolerate drugs called statins, but are at risk of heart disease, they said on Sunday.

 The therapy developed by Amgen pharmaceuticals is known as evolocumab. It is a monoclonal antibody that is injected every couple of weeks or once a month, instead of being taken in a daily pill. 

Evolocumab is part of a new class of drugs known as PCSK9 inhibitors, which suppress a gene involved with cholesterol regulation in the liver. 

Research from two separate phase III trials released at the American College of Cardiology annual meeting showed it was effective in lowering LDL, or bad cholesterol, with few side effects. 

The research showed evolocumab lowered cholesterol further than the only other statin-alternative on the market, ezitimibe. 

It also lowered LDL in patients who were already taking statins, suggesting the approach could be used as an add-on for patients who need big reductions in their cholesterol but left sickened by intensive doses of statins. 

About nine in 10 patients taking evolocumab achieved an LDL cholesterol level of under 70 mg/dL, the target for people at high risk for heart disease. 

- Long-term study needed - 

Reducing LDL is important because too much of it can lead to clogged arteries, raising the risk of heart attack and stroke. 

However, the Amgen-funded studies only lasted three months, so longer term data is needed to fully probe the treatment's safety and see whether it works to prevent heart disease over time. 

"This is a really important, breakthrough kind of area," said Peter Libby, professor of medicine at Harvard Medical School. 

"Ultimately, the proof of the pudding is in the long term outcome studies that show efficacy and show safety," added Libby, who was not involved in the study. 

There are also questions on whether this class of drugs may have negative effects on the brain. 

The US Food and Drug Administration last month asked pharmaceutical companies Regeneron and Sanofi to assess potential neurocognitive adverse events in their PCSK9 inhibitor, alirocumab, causing jitters among stockholders and raising concerns about the drugs' path to market approval. 

The research presented Sunday showed fewer than 10 percent Regeneron experienced side effects such as headache and muscle pain. 

"It is well-tolerated in a difficult, high-risk patient population with a clinically unmet need, so we hope this will be a very good option for these patients," said study author Erik Stroes, professor at the Department of Vascular Medicine in Amsterdam's Medical Center. 

Statins are currently taken by about 25 million Americans, though recent guidelines have suggested that more than twice that number could benefit from them. 

Researchers say about 15 percent of patients are unable to take statins, mainly due to muscle pain which interferes with their ability to work, climb stairs and exercise. 

People who take statins are also at higher risk of developing diabetes. 

"Statins are active drugs, they are wonderful drugs, unless you experience side effects," said Stroes.

 Source: Department of Vascular Medicine in Amsterdam's Medical Center. 

Novel Chinese Herbal Medicine Proves Effective in Treating Hepatitis C

 SBEL1, a new compound derived from Chinese herbal medicines has the ability to inhibit hepatitis C virus (HCV) activity in cells at several points in the virus' lifecycle, shows study.SBEL1 is a compound isolated from Chinese herbal medicines that was found to inhibit HCV activity by approximately 90%. SBEL1 is extracted from a herb found in certain regions of Taiwan and Southern China. In Chinese medicine, it is used to treat sore throats and inflammations. The function of SBEL1 within the plant is unknown and its role and origins are currently being investigated. 

Scientists pre-treated human liver cells in vitro with SBEL1 prior to HCV infection and found that SBEL1 pre-treated cells contained 23 percent less HCV protein than the control, suggesting that SBEL1 blocks virus entry. The liver cells transfected with an HCV internal ribosome entry site (IRES)-driven luciferase reporter that were treated with SBEL1 reduced reporter activity by 50% compared to control. This suggests that that SBEL1 inhibits IRES-mediated translation, a critical process for viral protein production. 

In addition, the HCV ribonucleic acid (RNA) levels were significantly reduced by 78 percent in HCV infected cells treated with SBEL1 compared to the control group. This demonstrates that SBEL1 may also affect the viral RNA replication process. 

Prof. Markus Peck-Radosavljevic, Secretary-General of the European Association for the Study of the Liver and Associate Professor of Medicine, University of Vienna, Austria, commented: "People infected with hepatitis C are at risk of developing severe liver damage including liver cancer and cirrhosis. In the past, less than 20 percent of all HCV patients were treated because the available treatments were unsuitable due to poor efficacy and high toxicity. Recent advances means that we can now virtually cure HCV without unpleasant side effects. However, the different virus genotypes coupled with the complexity of the disease means there is still a major unmet need to improve options for all populations." 

Professor Peck-Radosavljevic continued: "SBEL1 has demonstrated significant inhibition of HCV at multiple stages of the viral lifecycle, which is an exciting discovery because it allows us to gain a deeper understanding of the virus and its interactions with other compounds. Ultimately this adds to our library of knowledge that may bring us closer to improving future treatment outcomes." 

HCV invades cells in the body by binding to specific receptors on the cell, enabling the virus to enter it. 2 Once inside, HCV hijacks functions of the cell known as transcription, translation and replication, which enables HCV to make copies of its viral genome and proteins, allowing the virus to spread to other sites of the body. 2 When HCV enters the host cell, it releases viral (+)RNA that is transcribed by viral RNA replicase into viral (-)RNA, which can be used as a template for viral genome replication to produce more (+) RNA or for viral protein synthesis. Once the viral RNA is transcribed, HCV initiates a process known as IRES-mediated translation, which allows the viral RNA to be translated into proteins by bypassing certain protein translation checkpoints that would normally be required by the host cell to start protein translation. [ii], [iii] Viral RNA is the genetic material that gives HCV its particular characteristics. This process enables the virus to take advantage of the host cell's protein translation machinery for its own purposes. 

There are an estimated 150 million to 200 million people living with chronic HCV and more than 350,000 people die annually from HCV-related diseases. [iv] HCV is transmitted through blood contact between an infected individual and someone who is not infected. This can occur through needlestick injuries or sharing of equipment used to inject drugs. [v] 

 Source:European Association for the Study of the Liver 

 

Chinese Herbal Remedy Equivalent to Methotrexate for Treating Rheumatoid Arthritis?

Research published online in the Annals of the Rheumatic Diseases reveals that a traditional Chinese herbal remedy used to relieve joint pain and inflammation works as well as methotrexate. The latter is a standard drug treatment that is frequently prescribed to control the symptoms of active rheumatoid arthritis.
 

Furthermore, combining the herbal remedy with methotrexate—the disease modifying drug (DMARD) most commonly used to treat rheumatoid arthritis—was more effective than treatment with methotrexate alone, the findings showed. Triptergium wilfordii Hook F, or TwHF for short, is used in traditional Chinese medicine to treat joint pain, swelling, and inflammation, and is already approved for the treatment of rheumatoid arthritis in China. 

The research team randomly assigned 207 patients with active rheumatoid arthritis to one of three treatment groups: methotrexate 12.5 mg once a week; or TwHF 20 mg three times a day; or a combination of the two over a period of 24 weeks. The researchers wanted to find out which of these approaches would sufficiently alleviate symptoms to reach an ACR 50 response. This indicates a 50% improvement in the number of tender or swollen joints and other criteria including pain, disability, and the doctor's assessment of disease severity. It's a measure defined by the American College of Rheumatology. Most (174; 84%) of the participants completed the full 24 weeks of the trial. The proportion of patients achieving ACR 50 was almost 46.5% in those treated with methotrexate alone; 55% in those treated with TwHF alone; and just under 77% in those treated with both. Similar clinically significant patterns of improvement in disease activity and remission rates also occurred among the three treatment groups. There was little difference between the frequency or type of side effects experienced in the different treatment groups, although the number of women who developed irregular periods was slightly higher in those treated with TwHF. More than 300 compounds have been identified in TwHF, including diterpenoids, which experimental research suggests can suppress genes controlling inflammation and dampen down the immune response, the authors point out. 

And an extract of the root has recently been investigated for its potential to treat automimmune diseases and some cancers, say the researchers. They caution that 24 weeks is too short a time to evaluate disease progression, and that the dose of methotrexate used in the trial is lower than that typically given to patients in the West. But they suggest that TwHF could be a promising approach to the treatment of active rheumatoid arthritis, particularly as not all patients respond to DMARDs, and because these drugs are expensive. 

 Source:Annals of the Rheumatic Diseases 

Increase in Cultivation of Medicinal Trees Due to Rising Demand for Herbal Medicine

Potential to increase the demand for on-farm grown raw material and raise the level of cultivation of medicinal tree species in smallholder farms, is seen due to formalizing trade in herbal medicinal products.

A study carried out by the World Agroforestry Centre (ICRAF) in Kenya shows that trade in herbal medicinal products is rising in the urban areas and formalization in terms of better hygienic packaging and labeling of the products is likely to increase cultivation of these tree species. Traditional medicine is practiced in in many rural areas in the developing world. The World Health Organization estimates that about 80% of Africans rely on traditional medicine, a great proportion of which is herbal, to meet their health needs and this could increase because of the rising acceptability of natural therapies. 

The study published in the scientific journal, Forests Trees and Livelihoods, says that In Kenya, the majority of traditional medicines are sold as wild plant parts, but in urban areas, demand for traditional medicines is rising and this is leading to increased formalization of the market, with traditional medicines now found in powders, liquids and creams. 

Jonathan Muriuki, lead author of the study and research scientist at ICRAF, believes that as lifestyles improve, consumers demand better quality. "This opens up greater opportunities for trade in medicinal tree products among actors in the value chain, such as collectors, producers, healers, processors, manufacturers and even exporters," outlines Muriuki.Muriuki and co-authors set out to learn where medicinal plant traders in Kenya sourced their raw materials and to determine if formalization of the market could provide more opportunities for cultivation. 

"Cultivation would not only provide a sustainable supply of medicinal products but also increase the incomes of poor smallholder farmers while addressing current problems of over-harvesting and resource degradation which have reduced the abundance of wild materials." 

Their research revealed that 49 per cent of traders in herbal medicine sourced materials from farms and the demand was rising. However, 69 per cent of traders expressed a preference for materials sourced from the wild mainly because they perceived these plants would have higher potency than farm-grown material. Such perception is based on the expectation that wild plants will have grown to full maturity and in rich soils with less interference from human activities such as chemical application. 

Those who preferred farm-sourced material said this was because of expected higher quality from good crop husbandry, increasing scarcity in the wild, and for some, a deliberate choice to conserve wild resources."While these types of formal enterprise are fairly recent in Kenya, we found that they are all experiencing annual growth and demanding more uniform raw materials which cultivation can provide," says Muriuki. 

The study reveals that most farmers sell timber and fruits from their trees but are not selling medicinal tree products because they do not have access to markets "Farmers stated they would sell medicinal products if they had access to market opportunities," says Muriuki. "Access to markets for other tree products has led to increased cultivation of tree species providing these, so it would be fair to assume the same could be applied for medicinal trees". 

To improve the market in traditional medicines, the study recommends linking traders to farmers in the form of grower groups, especially women, which could initially focus on the most traded species as alternative crops are recommended. 
Source:Forests Trees and Livelihoods, 
 

Reduction in Cardiovascular Diseases and Cancer Risks With Edible Chinese Flowers

Common edible flowers in China are rich in phenolics, having excellent antioxidant capacity and can reduce risk of cardiovascular disease and certain cancers, finds a new study.

The researchers have found that common edible flowers common edible flowers have the potential to be used as an additive in food to prevent chronic disease, help health promotion and prevent food oxidization. 

However, the researchers said that the antioxidant mechanisms, the anti-tumor, anti-inflammation and anti-aging activity of the edible flower extracts should be further studied to develop more applications as natural antioxidants. 

The study was published in the 
 Source:Journal of Food Science.

 

Research Sheds Light on Watching HIV Bud from Cells

A way to watch newly forming AIDS virus particles emerging or "budding" from infected human cells without interfering with the process has been devised by University of Utah researchers.

The method shows a protein named ALIX gets involved during the final stages of virus replication, not earlier, as was believed previously. 

"We watch one cell at a time" and use a digital camera and special microscope to make movies and photos of the budding process, says virologist Saveez Saffarian, an assistant professor of physics and astronomy and senior author of a new study of HIV budding published online today in the Public Library of Science journal PLOS ONE. 

"We saw ALIX recruited into HIV budding for the first time," he says. "Everybody knew ALIX is involved in HIV budding, but nobody could visualize the recruitment of ALIX into the process." 

The finding is "fundamental basic science" and has no immediate clinical significance for AIDS patients because ALIX is involved in too many critical functions like cell division to be a likely target for new medications, Saffarian says. 

"We know a lot about the proteins that help HIV get out of the cell, but we do not know how they come together to help the virus get out, and it will be in the next 10 to 20 years that we will know a lot more of about this mechanism," he adds. "Would this be a drug target? Would this be a part of biochemistry used in a therapeutic or biotech industry later on? I can't tell you now. But if it was not because of our curiosity as a species, we would not have the technology we have today." 

The new study "is nice work," says HIV budding expert Wes Sundquist, who advised Saffarian and is professor and co-chair of biochemistry at the University of Utah School of Medicine. "It's of genuine interest for those of us who study the mechanism of HIV assembly." 

The study was funded by the National Science Foundation. Saffarian conducted the study with first author, Pei-I Ku, a University of Utah doctoral student in physics; Mourad Bendjennat, a postdoctoral fellow in physics and astronomy; technician Jeff Ballew; and Michael Landesman, another postdoctoral fellow in physics and astronomy who previously worked in Sundquist's biochemistry lab. 
 Source:journal PLOS ONE.  

Yoga Program Could Help Women With Urinary Incontinence

Yoga training program could help women who suffer from urinary incontinence, finds new study.

 

In a study scheduled to be published on April 25, 2014 in Female Pelvic Medicine & Reconstructive Surgery, the official journal of the American Urogynecologic Society, UCSF researchers discovered that a yoga training program, designed to improve pelvic health, can help women gain more control over their urination and avoid accidental urine leakage. 

"Yoga is often directed at mindful awareness, increasing relaxation, and relieving anxiety and stress," said first author Alison Huang, MD, assistant professor in the UCSF School of Medicine. "For these reasons, yoga has been directed at a variety of other conditions - metabolic syndrome or pain syndromes - but there's also a reason to think that it could help for incontinence as well." 

Huang and her colleagues recruited 20 women from the Bay Area who were 40 years and older and who suffered from urinary incontinence on a daily basis. Half were randomly assigned to take part in a six-week yoga therapy program and the other half were not. The women who took part in the yoga program experienced an overall 70 percent improvement - or reduction - in the frequency of their urine leakage compared to the baseline. The control group - or the group that did not start yoga therapy - only had 13 percent improvement. Most of the observed improvement in incontinence was in stress incontinence, or urine leakage brought on by activities that increase abdominal pressure such as coughing, sneezing, and bending over. 

Huang and her colleagues believe that yoga can improve urinary incontinence through more than one mechanism. Because incontinence is associated with anxiety and depression, women suffering from incontinence may benefit from yoga's emphasis on mindful meditation and relaxation. But regular practice of yoga may also help women strengthen the muscles of the pelvic floor that support the bladder and protect against incontinence. 

"We thought this would be a good opportunity for women to use yoga to become more aware of and have more control over their pelvic floor muscles," Huang said. 

Approximately 25 million adults in America suffer from some form of urinary incontinence, according to the National Association for Continence. Up to 80 percent of them are women. Urinary incontinence becomes more common as women age, although many younger women also suffer from it. 

"We specifically developed a yoga therapy program that would be safe for older women, including women with minor mobility limitations," Huang said. "So we were partially assessing safety of this program for older women who are at highest risk for having incontinence in the first place." 

Not all types of yoga may help with urinary incontinence. The yoga program used in the study was specially designed with input from yoga consultants Leslie Howard and Judith Hanson Lasater, who have experience teaching women to practice yoga in ways that will improve their pelvic health. Still Huang and her colleagues believe that many women in the community can be taught to preserve pelvic muscle strength and prevent incontinence. 

"It would be a way for women to gain more control over their pelvic floor muscles without having to go through traditional costly and time-intensive rehabilitation therapy," Huang said. 

Men were not included in this study because urinary incontinence in men is often related to problems related to the prostate, which may be less likely to improve with yoga. Huang and her colleagues hope to eventually build on this study and double the length of the study to 12 weeks.

 Source:Female Pelvic Medicine & Reconstructive Surgery,