duminică, 5 august 2012
First Indication Of People Naturally Protected Against Rabies Found In Remote Amazonian Communities
Main Category: Tropical Diseases
Also Included In: Infectious Diseases / Bacteria / Viruses
Article Date: 03 Aug 2012 - 0:00 PDT Current ratings for:
First Indication Of People Naturally Protected Against Rabies Found In Remote Amazonian Communities
Challenging conventional wisdom that rabies infections are 100 percent fatal unless immediately treated, scientists studying remote populations in the Peruvian Amazon at risk of rabies from vampire bats found 11 percent of those tested showed protection against the disease, with only one person reporting a prior rabies vaccination. Ten percent appear to have survived exposure to the virus without any medical intervention. The findings from investigators at the U.S. Centers for Disease Control and Prevention (CDC) were published in the August 2012 issue of the American Journal of Tropical Medicine and Hygiene.
"The overwhelming majority of rabies exposures that proceed to infections are fatal. However, our results open the door to the idea that there may be some type of natural resistance or enhanced immune response in certain communities regularly exposed to the disease," said Amy Gilbert with the CDC's National Center for Emerging and Zoonotic Infectious Diseases, who is the paper's lead author. "This means there may be ways to develop effective treatments that can save lives in areas where rabies remains a persistent cause of death."
Rabies experts estimate the disease kills 55,000 people each year in Africa and Asia alone, and appears to be on the rise in China, the former Soviet Republics, southern Africa, and Central and South America. According to the CDC, in the United States, human deaths from rabies have declined over the past century from 100 annually to an average of two per year thanks to an aggressive campaign to vaccinate domestic animals against the disease.
In general, people who believe they may have been exposed to rabies are advised to immediately seek treatment which involves post-exposure prophylaxis (PEP) - a series of injections - to prevent the exposure from causing an active infection. These preventive treatments, when administered promptly, are 100 percent successful at preventing disease. Scientists have documented only a small number of individual cases, including one last year in California, in which an exposure to rabies proceeded to infection and the victim survived. Most of those survivors still required intensive medical attention, including one case in Wisconsin in which doctors induced a coma, though this approach has not been successful in most subsequent cases.
This CDC study was conducted in collaboration with the Peruvian Ministry of Health as part of a larger project to understand better bat-human interactions and its relation to rabies and emerging diseases that may be transmitted by bats. For their research, scientists traveled to two communities (Truenococha and Santa Marta) in a remote section of the Peruvian Amazon where outbreaks of fatal infections with rabies caused by bites from vampire bats - the most common "natural reservoir" for the disease in Latin America - have occurred regularly over the last two decades. They interviewed 92 people, 50 of whom reported previous bat bites. Blood samples were taken from 63 individuals and seven (11 percent) were found to have "rabies virus neutralizing antibodies."
One out of the seven individuals reported receiving a rabies vaccination - which generates antibodies to the rabies virus?"but there was no evidence that the other six had received anti-rabies vaccine prior to the blood sampling or had sought out any medical attention for a bat bite, evidence that they had harbored the virus itself.The researchers acknowledged that they could not conclusively determine whether the antibodies were caused by an exposure to the virus that was somehow insufficient to produce disease. But they believe their evidence "suggests that (rabies virus) exposure is not invariably fatal to humans."
Gilbert said non-fatal exposures may happen more often than some think because "unless people have clinical symptoms of the disease they may not go to the hospital or clinic, particularly where access is limited."
"We all still agree that nearly everyone who is found to be experiencing clinical symptoms of rabies dies," Gilbert said. "But we may be missing cases from isolated high-risk areas where people are exposed to rabies virus and, for whatever reason, they don't develop disease."
In the Amazon region where the study was conducted - the Province Datem del Maranon in the Loreto Department of northern Peru - vampire bats, which live off of mammalian blood, regularly come out at night and prefer to feed on livestock. But in the absence of those food sources, they are known to seek out a meal from humans. They can use their extremely sharp teeth and the anticoagulant that naturally occurs in their saliva (appropriately referred to as "draculin") to feed on a sleeping person without awakening them. The rabies virus circulates extensively among vampire bat colonies in the region, and when an infected bat feeds, it passes along the virus to its host.
"This type of thorough and persistent scientific rabies investigation lends continued support to the belief that even the most dangerous of infectious diseases may be amenable to treatment," said James W. Kazura, MD noted infectious disease expert and president of the American Society of Tropical Medicine and Hygiene (ASTMH). "Continued investment of resources is essential for us to protect the health and well-being of innocent people whose lives and livelihoods are needlessly threatened by infectious diseases like rabies."
Gilbert and her colleagues hope their findings will prompt further studies in remote, at-risk communities to see if the results are replicated. In an editorial accompanying the study, Rodney E. Willoughby, a pediatric disease specialist at Children's Hospital of Wisconsin, said if it turns out there are distinct populations of people with "complete or relative resistance to rabies," there could be the potential to use whole genome sequencing to help develop new, life-saving treatments for rabies infections.
"Careful, respectful genetic study of these genetically unique populations may provide information on which pathways in human biochemistry and physiology promote resistance to human rabies," he wrote. "Equally important, knowing that there is a continuum of disease, even for infectious diseases like rabies, should push us harder to try for cures when confronted by so-called untreatable infectious diseases...."
Gilbert noted that the study was done as part of a larger public health effort to address a series of rabies outbreaks in the Amazon, where some health officials are now considering conducting pre-emptive vaccination campaigns in areas where risk of rabies is high and availability of medical care low. She said that while her study highlights people who appear to have survived an exposure to the virus, the fact remains that rabies outbreaks in small communities in the region have left tragic results.
"These are very small villages and, when they witness ten people dying from what is a horrible disease, it is incredibly traumatic," Gilbert said. "We want to help raise awareness of the problem and try to develop a more proactive response."
Article adapted by Medical News Today from original press release. Source: Burness CommunicationsVisit our tropical diseases section for the latest news on this subject. Please use one of the following formats to cite this article in your essay, paper or report:
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'First Indication Of People Naturally Protected Against Rabies Found In Remote Amazonian Communities'
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Researchers Develop First Potential Medicine For Patients With Most Severe Form Of Congenital Hyperinsulinism
Main Category: Diabetes
Also Included In: Pediatrics / Children's Health; Genetics
Article Date: 04 Aug 2012 - 0:00 PDT Current ratings for:
Researchers Develop First Potential Medicine For Patients With Most Severe Form Of Congenital Hyperinsulinism
A pilot study in adolescents and adults has found that an investigational drug shows promise as the first potential medical treatment for children with the severest type of congenital hyperinsulinism, a rare but potentially devastating disease in which gene mutations cause insulin levels to become dangerously high.
"There is currently no effective medicine for children with the most common and most severe form of hyperinsulinism," said study leader Diva D. De Leon, M.D., a pediatric endocrinologist at The Children's Hospital of Philadelphia. "Our new research shows that this investigational drug, a peptide called exendin-(9-39), controls blood sugar levels in people, a very promising result."
The study appears online ahead of print in the journal Diabetes.
In congenital hyperinsulinism (HI), mutations disrupt the insulin-secreting beta cells in the pancreas. Uncontrolled, excessive insulin levels thus sharply reduce blood glucose levels, a condition called hypoglycemia. If untreated, hypoglycemia may cause irreversible brain damage or death in children. Congenital HI occurs in an estimated one in 50,000 U.S. children, with a higher incidence among Ashkenazic Jews and certain other groups.
The standard treatment for some forms of congenital HI is diazoxide, a drug that controls insulin secretion by opening potassium channels in beta cells. However, this drug does not work in the most common types of HI, in which mutations prevent these potassium channels from forming.
When abnormal beta cells occur only in a discrete portion of the pancreas, precise surgery on the tiny organ can remove the lesion and cure HI. The Congenital Hyperinsulinism Center at The Children's Hospital of Philadelphia is a world leader in diagnosing such lesions and performing the curative surgery on newborns.
However, in roughly half of congenital HI cases, abnormal cells are diffused through the pancreas, and surgeons must remove nearly the entire pancreas. This leaves the majority of patients at high risk of developing diabetes.
The current study, which builds on previous research by De Leon and colleagues in animals, uses exendin-(9-39), which blocks the action of a hormone receptor, glucagon-like peptide-1 (GLP-1), in beta cells. The GLP-1 receptor is currently the target of drugs that treat diabetes, using the opposite effect from that investigated in this HI study.
The current pilot study included nine subjects, aged 15 to 47 years old, who had hyperinsulinism caused by mutations in potassium channels. None were being treated for HI at the time of the study, but all were at risk of hypoglycemia during periods of fasting.
In all nine subjects, the drug controlled blood glucose levels during fasting. Exendin also controlled insulin secretion in cell studies of beta cells taken from newborns with HI. The current research did not focus on the biological mechanisms that occurred, but De Leon said the results are encouraging enough to progress to a clinical study in children with HI over the next year.
Article adapted by Medical News Today from original press release. Click 'references' tab above for source.Visit our diabetes section for the latest news on this subject. Financial support for this study came from the National Institutes of Health (grant 1R03DK07835), the Lester and Liesel Baker Foundation, and the Clifford and Katherine Goldsmith Foundation. De Leon's co-authors, all from Children's Hospital, were Charles A. Stanley, M.D., Andrew C. Calabria, M.D., Changhong Li, M.D., and Paul R. Gallagher In addition to their positions at Children's Hospital, De Leon, Stanley and Li also are in the Perelman School of Medicine at the University of Pennsylvania.
"The GLP-1 Receptor Antagonist Exendin-(9-39) Elevates Blood Fasting Glucose Levels in Congenital Hyperinsulinism due to Inactivating Mutations in the ATP-sensitive Potassium Channel," Diabetes, published online Aug.1, 2012, to appear in print, October 2012. doi: 10.2337/db12-0166.
Children's Hospital of Philadelphia Please use one of the following formats to cite this article in your essay, paper or report:
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5 Aug. 2012.
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'Researchers Develop First Potential Medicine For Patients With Most Severe Form Of Congenital Hyperinsulinism'
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luni, 12 decembrie 2011
First Ever All-Ireland Cancer Atlas Shows Cancer Risk In Northern Ireland Lower Than The Republic Of Ireland
Also Included In: Melanoma / Skin Cancer; Lymphoma / Leukemia / Myeloma
Article Date: 12 Dec 2011 - 1:00 PST
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People in Northern Ireland have a lower risk of developing some cancers than those living in the Republic of Ireland, according to the All-Ireland Cancer Atlas - a collaborative publication by the Northern Ireland Cancer Registry at Queen's University Belfast and the National Cancer Registry in Cork.
The first ever All-Ireland Cancer Atlas analysed 18 types of cancer by electoral division over a 12-year period. Those cancers which were significantly higher for both sexes in the Republic of Ireland were:
For men, the risk of prostate cancer was higher in the Republic of Ireland and, for women, cancer of the oesophagus and cervix were higher.Lung cancer, however, was higher in Northern Ireland compared with the Republic.
The following cancers were higher for women in Northern Ireland: Uterus Non-Hodgkin's lymphoma Head and neck cancers The Atlas also found that the following cancers were more common in areas of higher unemployment and/or lower levels of degree attainment across the island: Lung Stomach Head and neck Cervical cancers The following cancers were lower in areas of higher unemployment and/or lower levels of degree attainment: Non melanoma skin cancer Female breast cancer Prostate cancer Melanoma Other findings include: Stomach cancer rates were higher in a band running from Dublin to Donegal, excluding the north-east, but including Belfast. There was no statistically significant difference in female breast cancer risk between the Republic of Ireland and Northern Ireland. The risk of diagnosis of prostate cancer was 29 per cent lower in Northern Ireland. Men in areas with the highest educational attainment had the highest risk. The risk of head and neck cancer was greater, by 21 per cent, for women in Northern Ireland compared to the Republic of Ireland but there was no statistically significant difference for men. Commenting on the findings in the Atlas, Dr Anna Gavin, Director of the Northern Ireland Cancer Registry, said: "Mapping the incidence of cancer geographically in Ireland is hugely important in our quest to understand factors that increase cancer rates and also to provide appropriate treatment and cancer services.
"While it is generally accepted that geographic variations in cancer risk are predominantly the result of factors such as tobacco smoking, alcohol drinking, obesity, diet and sexual behaviour there are also a number of findings which we cannot explain yet including the band of increased stomach cancer incidence from Donegal to Dublin. The launch of the first All-Ireland Cancer Atlas will enable us to further identify different contributing factors to cancer in Ireland."
Dr Harry Comber, Director of the National Cancer Registry, said: "The Atlas shows major variations, sometimes more than two-fold, in the risk of several cancers, across the island. Understanding the reasons for this geographical variation, and taking appropriate action, would reduce the cancer burden significantly in Ireland. Areas with unexplained higher than average risk should now be studied in detail and a comprehensive programme of research into already known determinants of cancer risk in Ireland is needed to inform cancer control."
Article adapted by Medical News Today from original press release. Click 'references' tab above for source.Visit our cancer / oncology section for the latest news on this subject. Please use one of the following formats to cite this article in your essay, paper or report:
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duminică, 11 decembrie 2011
First Genome Sequencing Clinical Trial For Triple Negative Cancer Points To New Treatments
Also Included In: Genetics
Article Date: 11 Dec 2011 - 0:00 PST
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Initial results from an ongoing clinical trial, the first designed to examine the utility of whole-genome sequencing for triple negative breast cancer, were reported during the CRTC-AACR San Antonio Breast Cancer Symposium.
The results indicate activation of targets not previously associated with triple negative disease and could point toward new treatment strategies. Based on mutations uncovered by sequencing, physicians recommended the women enter treatment protocols for either existing drugs or new agents being evaluated in pharma-sponsored clinical trials.
Triple negative breast tumors, which make up nearly 20 percent of breast cancers, do not respond to treatment with targeted therapies such as Herceptin® (trastuzumab).
Of eleven tumors sequenced to date, each was genomically unique, but commonalities were observed. Some patients displayed amplified genes in the RAS pathway; one patient had amplification of the BRAF oncogene, as well as activation of a growth pathway known as the MEK/AKT pathway. This patient displayed an impressive response to a MEK/AKT inhibitor currently in a phase I clinical study.
"Those results are quite striking considering that these are women with advanced disease," said Joyce O'Shaughnessy, M.D., who presented the data. "If MEK/AKT activation is found to be present in a substantial fraction of triple negative patients, inhibitors of this pathway could prove a significant tool in fighting this disease."
Dr. O'Shaughnessy is medical director and co-chair of the Breast Cancer Research Committee, US Oncology Research; a practicing oncologist with Texas Oncology; and the Celebrating Women Chair of Breast Cancer Research at Baylor Charles A. Sammons Cancer Center.
"This is among the largest studies of a single tumor type in which whole genome sequencing is being used to identify potential options for targeted treatment," said John Carpten, Ph.D., director of the Integrated Cancer Genomics Division at the Translational Genomics Research Institute (TGen). "As the field of genomic medicine matures, this study is sure to provide key early insights into how sequencing can best be utilized in the clinic."
Article adapted by Medical News Today from original press release. Click 'references' tab above for source.Visit our breast cancer section for the latest news on this subject. The study, titled "Next Generation Sequencing Reveals Co-Activating Events in the MAPK and PI3K/AKT Pathways in Metastatic Triple Negative Breast Cancers," is sponsored by the Translational Genomics Research Institute (TGen) and US Oncology Research with support from Life Technologies Corporation. Whole-genome sequencing of tumors and normal tissue was performed on Life Technologies' Applied Biosystems SOLiD™ platform, and results were validated in a CLIA-certified laboratory.
The Translational Genomics Research Institute
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