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Tuesday, April 23, 2024
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One in seven pregnancies worldwide ends in miscarriage, and eleven percent of women endure a failed pregnancy at least once in their lifetime, experts said Tuesday.

Some 23 million miscarriages occur every year, according to data pieced together from around the globe by an international team of 31 researchers.

But the actual tally is sure to be “substantially higher” due to underreporting, they said in a trio of studies published in The Lancet.

Two percent of women — one in 50 — have experienced two miscarriages, while less that one percent have been through three or more.

Levels of care for women suffering miscarriage is highly uneven across countries, and even within many wealthy nations, the data showed.

“A new system is needed to ensure miscarriages are better recognised and women are given the physical and mental health care they need,” the researchers said in a statement.

Misconceptions about miscarriage are widespread.

Many women believe they occur only rarely, for example, or that they can be caused by lifting heavy objects or previous contraceptive use.

They may also think that there’s no effective treatments to prevent a miscarriage, especially in women at high risk.

Such misconceptions can be damaging, leaving women and their partners feeling at fault and discouraging them from seeking treatment and support, the authors note.

Miscarriage can also lead to isolation, since many women might not tell their family, close friends, or even their partner about the loss of a pregnancy.

“Silence around miscarriage remains not only for women who experience it, but also among health care providers, policymakers and research funders,” said co-lead author Siobhan Quenby, a professor at the University of Warwick and director of Tommy’s National Centre for Miscarriage Research.

A miscarriage is widely defined as the loss of a pregnancy before 20 to 24 weeks of gestation, with the exact time period varying from country to country.

Unrecognised trauma
A review of published academic literature up to mid-May 2020 identified many causes for miscarriages, including a more advanced maternal age, previous miscarriages, and a father older than 40.

Other risk factors correlating with pregnancies that end spontaneously are being extremely under- or over-weight, smoking, alcohol consumption, persistent stress, working night shifts, and constant exposure to air pollution or pesticides.

Health consequences can be severe, especially for women who experience a second or multiple miscarriages.

“Recurrent miscarriage is a devastating experience for most women, but the mental health impact is rarely acknowledged or addressed in medical care,” said co-lead author Arri Coomarasamy, from the University of Birmingham.

“Women can experience trauma and bereavement, which may have no obvious sign and can go unrecognised.”

There is also a link with anxiety, depression and — for about 20 percent of women — post-traumatic stress disorder nine months after a miscarriage.

The authors of the three studies noted that most data comes from wealthier nations, but that the “silence around miscarriage” is found everywhere.

They recommended that national health authorities strengthen miscarriage care services, improve research in prevention, and identify women at high risk.

“For too long miscarriage has been minimised and often dismissed,” The Lancet said in an companion editorial.

“The lack of medical progress should be shocking — instead, there is pervasive acceptance.”

“The era of telling women to ‘just try again’ is over,” The Lancet said.

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According to the World Health Organization (WHO), cancer accounted for 10 million deaths worldwide in 2020. Globally, it is a leading cause of death.

In the United States, an estimated 39.5% of people will receive a cancer diagnosis within their lifetime.

Myths tend to develop around particularly prevalent conditions. It is no surprise, therefore, that people often misunderstand cancer.

“Cancer” is a generic term for a group of diseases that can affect any part of the body. This variety adds fuel to the fire of confusion.

In this article, we hope to dispel some myths and clarify this common and varied group of diseases.

1. Cancer is a death sentence

Cancer is not a death sentence. Despite the sobering statistics quoted above, cancer is not always terminal.

As scientists understand cancer better and develop improved treatments, recovery rates continue to improve.

For instance, in January 2019, an estimated 16.9 million cancer survivors were living in the United States. In the United Kingdom, survival rates have doubled in the last 40 years.

It is also worth noting that survival rates vary significantly depending on the type of cancer. For instance, in the U.K., survival rates for testicular cancer are 98%, whereas survival rates for pancreatic cancer are just 1%.

According to the National Cancer Institute:

“In the United States, the likelihood of dying from cancer has dropped steadily since the 1990s. Now, 5-year survival rates for some cancers, such as breast, prostate, and thyroid cancers, are 90% or better. The 5-year survival rate for all cancers combined is currently about 67%.”

Overall, cancer death rates are slowly declining, although the survival rates of some cancers are increasing more than others. An annual report on the status of cancer in the U.S., which appears in Cancer in 2020, concludes:

“[C]ancer death rates decreased 1.5% on average per year during 2001 through 2017.”

2. Cancer is contagious

This is a myth. Cancer is not contagious. Someone with cancer cannot spread it to others.

However, some sexually transmitted diseases, including human papillomavirus (HPV) and hepatitis B and C, can cause cancers in the cervix and the liver. In these cases, an infectious agent causes the cancer, but the cancer itself is not contagious.

As an interesting aside, scientists have documented that cancers in some animals, including Tasmanian devils and dogs, can cause fatal transmissible cancers: devil facial tumor disease and canine transmissible venereal tumor, respectively.

3. Cell phones cause cancer

To date, there is no evidence that cell phones cause cancer. One of the reasons this myth developed is that these devices emit radiofrequency radiation (radio waves), a form of non-ionizing radiation. The body absorbs this radiation.

Scientists know that exposure to ionizing radiation, for instance, X-rays, increases the risk of cancer. However, radiofrequency radiation is non-ionizing radiation, which does not increase cancer risk. The National Cancer Institute writes:

“[A]lthough many studies have examined the potential health effects of non-ionizing radiation from radar, microwave ovens, cell phones, and other sources, there is currently no consistent evidence that non-ionizing radiation increases cancer risk in humans.”

4. Power lines cause cancer

This is also a myth. The extremely low frequency (ELF) magnetic fields produced by power lines are non-ionizing and, therefore, do not cause cancer.

The American Cancer Society writes:

“Several large studies have looked at the possible effects of ELF magnetic fields on cancer in rats and mice. These studies expose the animals to magnetic fields much stronger than what people are normally exposed to at home […]. Most of these studies have found no increase in the risk of any type of cancer. In fact, the risk of some types of cancer was actually lower in the animals exposed to the ELF radiation.”

However, the American Cancer Society also explains that some studies have found a slight increase in leukemia risk for children who live close to power lines. However, the reasons for this remain unclear.

Medical News Today spoke with Dr. Joel Newman, a consultant hematologist and specialty lead for pathology at East Sussex Healthcare Trust in the U.K. He puts the risk into perspective:

“We don’t have any real evidence that cell phones or power lines cause cancer, and there are many other things that we do daily that put us at a much greater risk than these ever could, including smoking and alcohol consumption.”

5. Artificial sweeteners cause cancer

To date, there is no good evidence that artificial sweeteners increase the risk of developing cancer.

The National Cancer Institute explains why this myth may have arisen:

“Questions about artificial sweeteners and cancer arose when early studies showed that cyclamate in combination with saccharin caused bladder cancer in laboratory animals.”

However, they explain that further studies “have not provided clear evidence of an association with cancer in humans. Similarly, studies of other [Food and Drug Administration (FDA)]-approved sweeteners have not demonstrated clear evidence of an association with cancer in humans.”

Similarly, a study investigating aspartame and cancer, which included data from more than half a million participants, found no links between “aspartame consumption and lymphoma, leukemia, or brain cancer.”

6. Cancer surgery causes cancer to spread

This is only a partial myth. It is true that cancer surgery can cause the cancer to spread, but this is rare. As the American Cancer Society explains:

“Advances in equipment used during surgery and more detailed imaging tests have helped make this risk very low.”

A related myth indicates that a tumor will grow faster or spread to other parts of the body when exposed to the air. This is untrue.

7. Herbal medicines can cure cancer

There is no evidence that any herbal medicines can cure or treat cancer.

However, some people find certain alternative therapies, such as acupuncture, meditation, and yoga, help with the psychological stress associated with cancer and some of the side effects of cancer treatment.

As the National Cancer points out, just because something is “natural” does not mean it is safe. In some circumstances, herbal supplements can harm a person’s health; they provide a couple of examples:

“[S]ome studies have shown that kava kava, a herb that some people use to help with stress and anxiety, may cause liver damage. And St. John’s wort, which some people use for depression, may cause certain cancer drugs not to work as well as they should.”

It is important that people with cancer speak with a doctor about supplements and vitamins before taking them.

8. Cancer runs in families

Although some cancers are passed on genetically through families, they are the minority of cases: an estimated 3–10% of cancers result from mutations inherited from parents.

Because people are more likely to develop cancer as they age, and people today live longer lives, it is not uncommon for people to have some relatives who develop cancer. This might help explain why this myth persists.

Most cases of cancer are due to a buildup of mutations in genes that accumulate over time. As the American Cancer Society explains:

“Some types of cancer run in certain families, but most cancers are not clearly linked to the genes we inherit from our parents. Gene changes that start in a single cell over the course of a person’s life cause most cancers.”

9. Cancer always comes back

To address this question, MNT spoke with Dr. Collin Vu, a medical oncologist and hematologist at MemorialCare Cancer Institute at Orange Coast Medical Center in Fountain Valley, CA. He said:

“Fortunately for all of us, this statement is a myth and entirely not true. The current therapies for cancers are improving to the point where the cure of cancer — that is, treatments that will kill cancer completely — are improving continuously.”

However, he explains that the subject is complicated because “different cancer types have a markedly different ability to be cured, and different cancer types also have different time frames for which a cancer may typically recur. [This] makes it very difficult for patients to know when they may be truly ‘cured’ or when they still have a high risk of cancer recurrence.”

Dr. Vu has great hopes for the future of cancer treatment; he told MNT:

“In the future, with current scientific progress in better treatments for cancer, and improved population awareness of cancer risks and diagnosis, the statement that ‘cancer always comes back’ may become even more of a myth.”

10. There is no cure for cancer

Thankfully, this is also a myth. As medical science delves deeper into the mechanisms behind cancer, treatments steadily grow more effective.

According to Dr. Vu, some cancers, such as testicular and thyroid cancer, have a 60% cure rate. Dr. Vu defines the cure rate as “the population of cancer patients that has the same life expectancy as the general population.”

Breast, prostate, and bladder also have cure rates of around 50%. Dr. Vu concludes:

“As can be seen by the above data, some cancers can be eradicated, but, unfortunately, not all cancers can be cured completely. There is ongoing optimism that cure rates are increasing given the ongoing focus on screening and better treatments for cancer.”

MNT also spoke with Dr. Anton Bilchik, Ph.D., a surgical oncologist, professor of surgery, chief of gastrointestinal research, and chief of medicine at Saint John’s Cancer Institute at Providence Saint John’s Health Center in Santa Monica, CA. He also leads with a message of hope:

“It is imperative that patients who are diagnosed with cancer, even at an advanced stage, do not lose hope: there are many effective, novel therapies, as well as more effective surgical techniques. A good example is with the use of modern immunotherapy, up to 40% of patients with stage 4 melanoma are curable, and 50% of patients with stage 4 colon cancer metastatic to the liver can be cured with a combination of chemotherapy and surgery.”

In short: although the battle with cancer is ongoing, science is making significant headway.

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Schizophrenia is a psychiatric condition that is characterized by “positive” symptoms, such as hallucinations and delusions, and “negative” symptoms, such as social withdrawal and apathy.

For almost a century, scientists have speculated about a possible link between the immune system and schizophrenia.

Several lines of evidence suggest that the inflammation provoked by a viral infection, either before birth or during childhood, could trigger the condition in adulthood.

Some studies have also found changes in the blood-brain barriers of people with schizophrenia.

The blood-brain barrier comprises the tightly packed layer of cells that line the blood vessels in the brain and spinal cord. It prevents blood-borne immune cells from gaining entry to the central nervous system.

This is sometimes known as conferring “immune privilege” on the brain — in other words, protecting it from harmful inflammation.

Researchers at the University of Pennsylvania’s School of Veterinary Medicine in Philadelphia wondered whether a compromised blood-brain barrier in people with a rare genetic disorder known as DiGeorge syndrome or 22qDS, a genetic deletion syndrome, could be responsible for their increased risk of schizophrenia.

People born with the condition have a 1 in 4 risk of developing schizophrenia later in life. This is compared with an overall risk of schizophrenia of around 1 in 100 in the wider adult population.

People with 22qDS have a small section of DNA missing from chromosome 22 of their genome.

Leaky barrier

To test their hypothesis, the researchers isolated cells from people with DiGeorge syndrome and schizophrenia and from healthy matched controls. They then turned these cells into pluripotent stem cells, which can develop into any type of cell in the body.

In the laboratory, they transformed the stem cells into the type of cells that line the blood vessels in the brain. These are the cells that together function as the blood-brain barrier.

The researchers found that the cells derived from people with DiGeorge syndrome and schizophenia created a less effective, more “leaky” barrier than those derived from the healthy controls.

In addition, the cells produced more of a type of molecule that promotes inflammation. This allowed more immune cells to penetrate the barrier.

The researchers obtained similar results when they investigated the integrity of the blood-brain barrier in a mouse model of DiGeorge syndrome.

Finally, they performed the same tests in postmortem brain tissue from three people who had DiGeorge syndrome and from three age-matched healthy controls.

They found evidence that the effectiveness of the actual blood-brain barrier of these people had indeed been compromised.

The research, which doctoral student Alexis Crockett led, now appears in the journal Brain.

Other brain disorders

The study authors speculate that a compromised blood-brain barrier may interact with environmental or other genetic risk factors to increase the likelihood not only of psychosis but also of other brain disorders in the case of people with DiGeorge syndrome.

“[W]e think these findings could also be used to understand how the blood-brain barrier and neurological processes impact not only schizophrenia but mental disorders at large,” says senior study author Prof. Jorge Iván Alvarez, from the School of Veterinary Medicine.

In 2019, Medical News Today reported on a study that suggested that a faulty blood-brain barrier in aging mice triggered brain inflammation and cognitive impairment in the animals.

Prof. Alvarez speculates that further research into the link between inflammation and neuropsychiatric disease could lead to new therapies for these conditions.

Anti-inflammatory and immunotherapy drugs have already shown some promise as treatments for schizophrenia, alongside standard treatments.

Schizophrenia is multifactorial

It is worth noting that schizophrenia is a “multifactorial” condition. This means that there is no single, clear cause. Rather, a wealth of different genetic and environmental influences interact to increase or decrease an individual’s risk of developing it.

Prof. Alvarez told MNT that people with the DiGeorge syndrome “phenotype” — that is, the characteristics arising from interactions between genetics and environment — will respond negatively to particular environmental challenges.

“These might include prenatal infection in the mother, or an infection in childhood.”

This “second hit” would worsen their condition in distinctive ways. “In terms of a ‘second hit,’” he said, “we believe that such environmental challenges will exacerbate the phenotype described under [steady] conditions.”

In their paper, Prof. Alvarez and colleagues also report some limitations of their study.

For example, their experiments did not prove that everyone with DiGeorge syndrome has a compromised blood-brain barrier. There remains a possibility that the changes are only present in those who develop schizophrenia.

To test this possibility, Prof. Alvarez said that he and his team would repeat the experiments using pluripotent stem cells from people who have this particular genetic deletion syndrome but have not developed schizophrenia.

“[W]e are planning to run these experiments using deleted non-schizophrenia [stem cells],” he said.

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The Johnson & Johnson COVID-19 vaccine, also called Ad26.COV2.S, was developed by Janssen Pharmaceuticals of Johnson & Johnson.

It is a single-dose vaccine, which differentiates it from two-dose COVID-19 vaccines, such as the ones from Pfizer and Moderna.

In early 2021, the Food and Drug Administration (FDA) and, after a recommendation from the European Medicines Agency (EMA), the European Commission issued emergency and conditional authorization for the Johnson & Johnson vaccine for individuals aged 18 years and older. The vaccine has been approved for emergency use in 40 countries.

However, the FDA recommended a pause in the vaccine’s use, as a precautionary measure following a small number of rare blood clot incidents. At the same time, Johnson & Johnson delayed the distribution of the vaccine in Europe while the EMA conducted its own review.

On April 20, the company announced it would resume distribution of its vaccine in the European Union but with a safety warning, after the EMA concluded that the vaccine’s benefits continue to outweigh its risks.

After halting vaccination in the United States a few weeks ago, the FDA and the CDC recently recommended that vaccinations resume. They noted, however, that women under the age of 50 should be aware of the risk of rare blood clots.

Moreover, both agencies want women to know that alternative COVID-19 vaccines are available, for which there are currently no reports of rare blood clots.

The World Health Organization (WHO) has stated that, while it continues to monitor the safety responses from regulatory agencies, the vaccine is safe and effective against the severe risks of COVID-19.

How does the vaccine work?

The vaccine is categorized as a viral vector vaccine.

This vaccine form utilizes a different, harmless virus to deliver the genetic instructions for making the SARS-CoV-2 virus’ surface spike protein, which triggers the body’s immune response to produce antibodies. The vaccine does not contain the SARS-CoV-2 virus and cannot cause COVID-19.

The Johnson & Johnson vaccine has a 66% efficacy rate. While this is lower than the efficacy rates of the Pfizer or Moderna vaccines, it should be noted that the clinical trials of the Johnson & Johnson vaccine took place in different contexts — globally in regions where variants were more prevalent, and in the U.S. during a period of significant increase in COVID-19 cases.

The vaccine is around 85% effective at preventing severe disease from COVID-19, including hospitalization and death.

Common side effects

According to the FDA’s vaccine fact sheetTrusted Source, possible side effects include:

Allergies and anaphylaxis

As with other COVID-19 vaccines, the Johnson & Johnson vaccine has a low but potential risk of causing an allergic reaction.

A non-severe allergic reaction may include symptoms such as hives, swelling, rash, and respiratory problems.

A more severe, anaphylaxis response is much rarer. According to the FDA, a severe reaction can be characterized by:

An ingredient that has raised particular concerns about allergic response is polysorbate 80, a chemical that is structurally related to polyethylene glycol (PEG), found in Pfizer’s and Moderna’s mRNA vaccines, both of which have prompted similar worries.

While knowledge about the mechanisms of this allergy is limited, PEG and polysorbate allergies are extremely rare. For the Pfizer vaccine, an analysis of one patient who experienced PEG-related anaphylaxis showed that they had a history of allergic reactions to PEG-containing products.

An evaluation of vaccine allergies with PEG and polysorbate skin testing concluded that the usefulness of skin testing in predicting potential allergic responses remains unclear.

The CDC advises that anyone with a known allergy to any of the vaccine’s ingredients, including polysorbate 80, seek advice from a healthcare professional before receiving the COVID-19 vaccine.

People who have had a severe allergic reaction to any of the vaccine’s ingredients should not receiveTrusted Source this particular shot.

Controversy regarding blood clots

Similar to the AstraZeneca COVID-19 vaccine — Vaxzevria — the Johnson & Johnson vaccine was put on hold after eight cases of a rare blood clotting disorder, in combination with low blood platelet counts, were found in the vaccine recipients.

Most of these cases of thrombosis with thrombocytopenia were extremely rare types, including cerebral venous sinus thrombosis (CVST), which occurs in the brain.

All eight cases occurred within 21 days of vaccination in people under the age of 60. Also, the majority of the eight vaccine recipients who experienced these side effects were women.

The EMA’s safety assessment committee concluded on April 20 that the vaccine’s label should include blood clots as a potential rare side effect and state that the benefits of the vaccine outweigh these risks.

Authorities are uncertain what causes these cases of blood clotting. They suggest that it may be a triggered immune response similar to a rare condition of thrombocytopenia induced by heparin, which is a blood thinner.

CVST is rare in the general population, occurring at a rate of around 5 in 1 million people annually. Reports indicate that there have been eight cases among more than 7 million people who have received the Johnson & Johnson vaccine.

The benefits of receiving the vaccine outweigh the risk of blood clots and the risk of the complications that can come with COVID-19.

However, the pause is likely to have caused some hesitancy toward the vaccine and has slowed rollout.

“There is no doubt in my mind that there are groups for whom this vaccine is of benefit,” Dr. Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia, told The New York Times, “meaning that they’re more likely to get this vaccine than the other vaccines, whether it’s because of where they live, or because they’re homebound, or it’s hard to get a second dose.”

Dr. Offit warns that any vaccine hesitancy caused by this controversy would have “elevated a rare risk above a much more common risk,” that of developing COVID-19, which could place many people’s health in danger.

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Researchers know that HDL, or good, cholesterol reduces inflammation. At healthy levels, HDL can also reduce the risk of stroke and heart attack.

So far, intervention trials using medications to improve or increase HDL levels have been unsuccessful. Also, some genetic research indicates that lifelong high or low levels of HDL do not seem to relate to cardiovascular outcomes, as expected.

That is why some cardiovascular risk prevention researchers are shifting their focus from circulating HDL levels to the actual functional ability of HDL.

Indeed, a research team from the Netherlands has studied the relationship between HDL’s ability to reduce inflammation and the risk of experiencing a first cardiovascular event.

“HDL are very complex particles with anti-atherosclerotic functions that are not reflected by measuring just the cholesterol quantity,” says senior study author Dr. Uwe J. F. Tietge, Ph.D., a professor and head of the Division of Clinical Chemistry at the Karolinska Institute in Stockholm, Sweden.

“Atherosclerosis [plaque buildup in the arteries] underlying cardiovascular disease is increasingly recognized as a disease with a strong inflammatory component, and a central biological function of HDL is to decrease inflammation.”

By analyzing data from 680 adults, the team found evidence to suggest that HDL’s ability to reduce inflammation is associated with a reduced risk of a cardiovascular event.

In the study, people who did not experience a cardiovascular event demonstrated higher anti-inflammatory HDL levels than participants who did experience a cardiovascular event.

“By using a novel research tool, our results provide strong support for the concept that plaque buildup in the arteries has an inflammatory component and that the biological properties of HDL particles have clinical relevance to cardiovascular disease risk prediction.” – Dr. Uwe J. F. Tietge, Ph.D.

The study appears in the journal Circulation, which is the American Heart Association’s (AHA) flagship journal. It received funding from the Netherlands Organization for Scientific Research and the Swedish Heart-Lung Foundation.

HDL: A natural anti-inflammatory

HDL is called good cholesterol because it picks up excess cholesterol in the blood and takes it back to the liver, which breaks it down and helps remove it from the body.

HDL can also reduce inflammation in the cells lining blood vessels. This occurs because HDL removes cholesterol stored in macrophage foam cells in atherosclerotic plaques and carries it to the liver.

Atherosclerosis occurs when plaque accumulates on the inner walls of arteries. Plaque is a substance made of cholesterol, calcium, fat, and other molecules.

As plaque deposits grow, they can gradually narrow the blood vessel, reducing blood flow and oxygen delivery to parts of the body or organs.

If atherosclerosis is severe enough, it can lead to major health concerns, including stroke, heart attack, and death.

When HDL removes cholesterol from foam cells in plaques, it helps reduce the size of the plaque. By reducing its size, it also reduces the amount of inflammation associated with the plaque.

Because of these factors, healthcare professionals typically include circulating HDL levels in many cardiovascular risk assessment tools.

HDL’s anti-inflammatory capacity

In the new study, the researchers included participants from a larger study: the PREVEND (Prevention of Renal and Vascular End Stage Disease) Study.

The PREVEND Study began in 1998 and is investigating the relationship between cardiovascular disease and kidney damage. The study has about 40,856 participants, all of whom are adults living in the city of Groningen in Northern Netherlands.

From this massive participant pool, the researchers behind the new study selected 680 participants. They excluded people who had experienced a cardiovascular event before the program tracking period.

The researchers used these 680 participants to create 340 case-control pairs of individuals. This meant that there were two groups: an experimental group of 340 people who experienced an initial cardiovascular event during the PREVEND tracking period and 340 people who did not.

The term “case-control pairs” refers to the fact that individuals from the experimental group were matched with someone from the control group who had the same sex, the same smoking status, and similar HDL levels. Each person in a pair had an age within 5 years of the other.

In the study, the researchers defined a cardiovascular event as experiencing a non-fatal or fatal heart attack, receiving a diagnosis of ischemic heart disease, or having surgery to open clogged coronary arteries.

The researchers extracted HDL from participant blood samples and assessed how much it was able to reduce inflammatory responses in endothelial cells, which line blood vessels.

They also measured levels of the participants’ C-reactive protein, which is a substance that increases in response to body-wide inflammation.

The researchers also assessed the participants’ cholesterol efflux capacity. This refers to how effectively their HDL removes cholesterol from cells similar to those in plaque.

After their analysis, the researchers found that HDL anti-inflammatory capacity was higher in people who did not experience cardiovascular events (31.6%) than in people who did (27%) during the follow-up period (1997–2009). For every 22% increase in HDL anti-inflammatory capacity, the risk of experiencing a heart event during the next 10 years reduced by 23%.

The participants’ HDL anti-inflammatory capacities were not related to circulating HDL cholesterol levels, cholesterol efflux efficiency, or C-reactive protein levels. The protective effect of increased HDL anti-inflammatory capacity was more powerful in women than men.

Improving cardiovascular risk prediction

Importantly, the team was also able to improve cardiovascular risk prediction by factoring HDL anti-inflammatory capacity into the Framingham Risk Score or replacing HDL levels with HDL anti-inflammatory capacity in the formula.

The Framingham Risk Score is a common tool that healthcare professionals use to assess the risk of developing coronary artery disease (CAD) during the next 10 years. It accounts for six CAD risk factors:

  • age
  • sex
  • total cholesterol levels
  • HDL levels
  • systolic blood pressure
  • smoking habits

The researchers write that their findings could have major clinical implications by providing healthcare professionals with more information to assess CAD risk.

If HDL inflammation capacity impacts CAD risk more than HDL levels, they could also help make currently used risk assessment tools more accurate.

Their findings could also encourage researchers to find medications to target or improve HDL inflammation capacity. This could offer healthcare professionals, and people at risk of CAD, a whole new avenue of preventive treatments.

Study limitations

Limitations in the study mean that scientists must now reproduce these findings in a much larger and far more diverse group of individuals.

The study included almost exclusively white participants. Just under 240 of the 340 case-control pairs in the study were male. The researchers also did not include information about stroke incidence in the study.

Furthermore, the study participants were genetically similar, coming from the same relatively small region of the world.

There are also no standardized methods of how to isolate HDL from plasma or how to test HDL functional abilities.

Still, despite these study drawbacks, the researchers are optimistic about their findings and what they could mean for millions of people going forward.

“The HDL cholesterol level is a good, established, simple, and cost efficient [cardiovascular disease] risk biomarker,” says Dr. Tietge.

“Our results, however, demonstrate that the anti-inflammatory capacity or assays looking at HDL function in general have the potential to provide clinically relevant information beyond the static HDL cholesterol measurements that are currently used.”

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In a mouse study, scientists have shown that motor and non-motor symptoms of Parkinson’s disease are associated with two specific neural pathways.

The study paper, published in the journal Nature Neuroscience, opens the door to future research that may help develop interventions to treat the disease and its symptoms.

Parkinson’s disease

According to the National Institute on Aging (NIA), Parkinson’s disease is a progressive neurological condition that typically occurs in people aged 60 and older.

Parkinson’s primarily affects a person’s motor functions, that is, their ability to move their body in a coordinated manner. However, it can also have an impact on a person’s cognition and behavior, leading to mental health issues and problems with memory and attention.

According to the NIA, Parkinson’s occurs when neurons, or brain cells, die or become damaged. Cognitive and motor functions are affected by specific brain cells, and it is damage to these cells in particular that results in the symptoms of Parkinson’s.

Scientists do not know exactly why some people develop Parkinson’s. Research suggests it is likely to be due to a combination of hereditary and environmental factors, as well as the process of aging.

There is no known cure for Parkinson’s disease. As a consequence, treatments usually focus on relieving the symptoms caused by the condition.

To manage these symptoms, it is important to understand the structure of the parts of the brain that may be involved in the key symptoms of the disease.

However, the relationship between different neural circuits and the effects of Parkinson’s disease is still being explored.

Parkinson’s in the brain

In the present study, a team led by researchers from the University of California San Diego (UC San Diego) in La Jolla wanted to contribute to this knowledge.

They conducted a study in mice to understand the relationship between neural circuits in the brain and some of the functions that are typically affected by Parkinson’s disease, such as cognitive and motor abilities.

They looked in particular at the external globus pallidus (GPe) in the brains of mice, which previous research has linked to the motor symptoms of Parkinson’s.

The researchers used multiple methods to give a more detailed overview of this region of the mice’s brains, including electrophysiology, viral tracing, and behavioral experiments.

Importance for Parkinson’s therapy

The researchers identified two areas of the GPe and were able to relate these areas to motor skills and cognitive skills in the mice.

By manipulating neurons in these two parts of the brain, the scientists improved the mice’s locomotion and their reversal learning.

Dr. Byungkook Lim is an associate professor in the Neurobiology Section of the Division of Biological Sciences at UC San Diego and corresponding author of the study.

He explains, “our work demonstrates that the distinct neural circuitries in the basal ganglia are differentially involved in the motor and non-motor symptoms of Parkinsonian-like behaviors that occur at different stages of the disease.”

“This suggests that evaluation of the detailed circuit mechanisms is needed to fully understand the changes in [the] brain during the progression of [Parkinson’s disease] and could provide better therapeutic strategies for the treatment of [Parkinson’s disease].” – Dr. Byungkook Lim

The fact that specific neurons could be linked to particular changes in the brain regions of the mice means that it may be possible to develop new treatments for the symptoms of Parkinson’s.

In Dr. Lim’s words, “[s]elective manipulation of specific changes can rescue one type of symptom — without affecting other symptoms — of Parkinson’s disease.”

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In the past month, more than 1,000 scientific, public health, and legal experts have joined a call to global leaders to ensure access to COVID-19 vaccines for low- and middle-income countries.

“The COVID-19 pandemic will not be over for us until it is over for everyone,” the authors wrote in an open letter.

Now, a health expert in Argentina argues in the BMJ that, on top of supply problems, Latin American countries face an additional challenge due to a lack of publicly available data about vaccines from Russia and China.

Dr. Juan Víctor Ariel Franco, the editor-in-chief of BMJ Evidence-Based Medicine and a lecturer in research methodology, family medicine, and public health at the Instituto Universitario of the Hospital Italiano de Buenos Aires, in Argentina, points out that high-income countries have not had to face this difficulty.

“The lack of publicly available data on these vaccines adds another layer of inequality: We are administering vaccines to millions of individuals in Latin American countries for which we have little to no information beyond press releases,” he writes.

If the virus is allowed to spread unchecked in low- and middle-income countries, Dr. Franco warns, it will mutate into variants that evade the immune protection from vaccines.

Rollout of COVID-19 vaccines

Despite extreme political, economic, and social difficulties in Latin America, the rollout of COVID-19 vaccines started at the end of 2020 due to direct agreements between national governments and vaccine manufacturers.

Dr. Franco notes that the Pfizer-BioNTech and Oxford-AstraZeneca vaccines have been generally well-received because regulators such as the Food and Drugs Administration (FDA) and European Medicines Agency provided free access to the evidence on which they based their approvals.

However, he highlights an initial lack of information about the phase 3 trial of the Russian Sputnik V vaccine, which was distributed in Argentina between December 2020 and January 2021.

At the time, the only publicly available data was in a press release from the Gamaleya Research Institute of Epidemiology and Microbiology, in Moscow, which had developed the vaccine, and a two-page report from the Argentinian medicines regulatory agency.

Dr. Franco says that the publication of an interim analysis of the results in The Lancet in early February 2021 allayed some concerns, but the full protocol for the trial has still not been released.

In addition, he reports that the regulators in Argentina have not issued an independent evaluation of the results.

Vaccines from China

With the second wave of COVID-19 sweeping across the region and variants spreading unchecked, Dr. Franco notes that regulators in Latin America have now approved two more vaccines, made by Sinopharm and Sinovac, in China.

But they did this in the absence of publicly available technical reports on phase 3 clinical trials or published data, he writes.

Dr. Franco points out that there is “little or no information” about the effects of these vaccines in particular subgroups of people or whether these vaccines are as effective against variants.

This is particularly important, he says, given that their efficacy against the original strain could be as low as 50%.

“This would not be acceptable for high-income countries who sign deals with the main manufacturers and align their regulators’ power to guarantee quality control and transparency in the approval process,” Dr. Franco writes.

He observes that this openness by the regulators in high-income countries is maintained “even in the most sensitive cases,” as with concerns about a possible link between the AstraZeneca vaccine and adverse events.

Call for greater transparency

On their own, low- and middle-income countries do not have the power to negotiate access to the vaccines with more transparent data, Dr. Franco writes, “amid a brutal fight over vaccine doses” among high-income countries.

In his article, Dr. Franco calls for international collaborations — with the support of bodies such as the Pan American Health Organization and World Health Organization (WHO) — to ensure that all vaccine data are made available as soon as possible.

Given the global shortage, he concedes that low- and middle-income countries may have to deploy vaccines with lower efficacy:

“But this must be done with publicly available data and wide consultation to relevant stakeholders. We cannot afford to fuel anti-vaxxers, conspiracy theorists, and COVID-deniers in countries that are struggling to ramp up vaccination during a global crisis.”

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People may have been producing and drinking kefir, a fermented milk drink that originated in Tibet and the North Caucasus, for thousands of years.

People can make the sour, slightly effervescent brew by infusing milk with kefir grains, which are a starchy matrix containing a symbiotic community of lactic acid bacteria, acetic bacteria, and yeasts.

The drink has many reputed health benefits, which include lowering cholesterol, reducing inflammation, and exerting an antioxidant effect.

In common with other probiotics, kefir also has antimicrobial properties. However, scientists were unsure exactly how it inhibits the growth of disease-causing bacteria.

Researchers at Ben-Gurion University of the Negev (BGU) in Be’er Sheva, Israel, have now discovered that a type of yeast in kefir called Kluyveromyces marxianus secretes a molecule that disrupts bacterial communication.

Scientists already knew that plants and algae produce this substance, called tryptophol acetate, but this is the first time that they have found a yeast that makes it.

They discovered that tryptophol acetate interferes with “quorum sensing” — a form of microbial communication — in several disease-causing bacteria.

In quorum sensing, bacteria release signaling molecules into their surroundings. When the molecules reach a particular concentration, they trigger changes in the expression of genes in bacteria of the same species.

These changes allow disease-causing bacteria to coordinate their activity according to their numbers. This coordination is necessary for some bacteria to defend themselves or attack their hosts.

In some cases, when they reach a certain density, the microbes may come together to form a slimy, protective coating, or “biofilm,” on a surface.

Disease-causing bacteria

In lab cultures, the researchers found that tryptophol acetate had an inhibitory effect over quorum sensing in several disease-causing bacteria, including some Gram-negative bacteria.

Some of the tested species were:

  • Pseudomonas aeruginosa, which causes pneumonia when it infects the lungs.
  • S. enterica, which is responsible for food poisoning.
  • Staphylococcus aureus, which can trigger sepsis, among other life threatening infections.
  • V. cholerae, which causes cholera.

The research, which Ph.D. student Orit Malka led, appears in the journal BMC Microbiome.

“These results are notable, since this is the first demonstration that virulence of human pathogenic bacteria can be mitigated by molecules secreted in probiotic milk products, such as yogurt or kefir,” says senior author Prof. Raz Jelinek.

The scientists focused in particular on the effect of tryptophol acetate on V. cholerae.

They found that the substance blocked quorum sensing in this bacteria and reduced its virulence.

It did this by changing the expression of bacterial genes that control quorum sensing.

The researchers write that this kind of interference in bacterial communication may be commonplace in complex environments where many different microorganisms live together, such as in probiotic food or the human gut.

Antibiotic resistance

The development of antibiotic resistance in bacteria poses a major threat to public health.

In recent years, scientists have begun to explore alternatives to conventional antibiotics, including drugs that interfere with quorum sensing.

The researchers behind the latest discovery have set up a company to develop and market tryptophol acetate and other small molecules through BGN Technologies, which is BGU’s technology transfer organization.

“In a world where antibiotic resistant bacteria are becoming an imminent threat, the novel molecules discovered by BGU scientists pave a completely new path for fighting bacterial infections by disrupting cell-cell communications in pathogenic bacteria.”– Josh Peleg, CEO of BGN Technologies.

In a follow-up study, which they have not yet published, the researchers discovered that the same molecules might have anti-inflammatory properties.

According to the scientists, their work in animal models of disease hints that the molecules could calm the excessive immune response known as the cytokine storm that has occurred in some people with severe COVID-19.

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Scientists have offered a detailed view of the biochemical pathway surrounding Parkin — a protein that plays a key role in maintaining cellular energy.

The research, which appears in the journal Science Advances, may help scientists develop new treatments for Parkinson’s disease, type 2 diabetes, and cancer, which can all occur when Parkin is not functioning properly.

Mitophagy

Parkin’s central role is to remove damaged mitochondria, which are the power stations of the cell that are responsible for generating energy. Cellular stress can damage mitochondria.

Damaged or dysfunctional mitochondria tend to accumulate in the cell, and the body needs to clear them away using a process known as mitophagy. This process is essential for cell health and energy production.

Researchers have implicated mitochondrial dysfunction in neurodegenerative diseases such as Parkinson’s.

A key question for scientists has been how Parkin is able to respond to cellular stress so quickly. The signal for Parkin to do its work appeared to occur after it had already started.

Biochemical pathways

In the present study, the scientists gained a better perspective on the biochemical pathway that signals Parkin to clear away damaged mitochondria.

According to Prof. Reuben Shaw, director of the Salk Cancer Center in La Jolla, CA, and senior author of the study, “our findings represent the earliest step in Parkin’s alarm response that anyone has ever found by a long shot.”

“All the other known biochemical events happen at 1 hour; we have now found something that happens within 5 minutes.”

“Decoding this major step in the way cells dispose of defective mitochondria has implications for a number of diseases.”

Building on their prior research, the scientists searched for proteins that activate in response to the enzyme ULK1, which the enzyme AMPK triggers. They found that Parkin was a prime candidate.

The results were surprising as biochemical pathways are normally very complicated, involving up to 50 different proteins.

The scientists confirmed the findings using mass spectrometry. This process revealed how ULK1 was interacting with Parkin, offering a detailed view of how the various proteins work together.

It is this chain, from AMPK to ULK1 to Parkin, that accounts for the speed with which Parkin can react to cellular stress.

Future treatments?

By drawing a link between Parkin and AMPK, the research may aid in the development of new treatments for various diseases.

For Prof. Shaw, “the big takeaway […] is that metabolism and changes in the health of your mitochondria are critical in cancer, they are critical in diabetes, and they are critical in neurodegenerative diseases.”

“Our finding says that a diabetes drug that activates AMPK, which we previously showed can suppress cancer, may also help restore function in patients with neurodegenerative disease.”

“That is because the general mechanisms that underpin the health of the cells in our bodies are way more integrated than anyone could have ever imagined.”

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According to the Centers for Disease Control and Prevention (CDC), the prevalence of obesity among adults in the United States increased from 30.5% in 1999–2000 to 42.4% in 2017–2018.

The prevalence of severe obesity almost doubled over the same period, from 4.7% to 9.2%.

One of the factors behind the steep rise in obesity rates may be the intensive marketing of high calorie, nutrient-poor food in restaurants, on screens, and on billboards.

Past research suggested that children with excess weight or obesity are more susceptible to food advertising, which may cause a cycle of weight gain and overeating.

Whether adults with obesity are also more prone to food marketing was unclear, however.

Researchers in Canada and France have found that women with obesity also appear to be more vulnerable to marketing — but that weight loss due to bariatric surgery can free them from the cycle.

If the scientists had found that marketing still holds sway over people after weight loss, this would imply an inbuilt vulnerability to overeating.

“That would mean people are endowed with unchangeable psychological characteristics that would always make them more responsive to marketing — which would make it very difficult to sustain a medically recommended weight,” says the study’s lead researcher Yann Cornil, Ph.D., from the University of British Columbia (UBC) in Vancouver, Canada.

“But one of the positive things is that after significant weight loss, people become less responsive to marketing, such that it is more sustainable to remain at a lower body mass index,” he adds.

The research, which was a collaboration between UBC and the Pitié-Salpêtrière University Hospital in Paris, France, appears in the Journal of Consumer Psychology.

Tests of susceptibility

The scientists compared the susceptibility to food marketing of three groups of women:

  • Group one: Comprising 73 women with severe obesity who were due to receive bariatric surgery (gastric bypass or band), which involves surgically altering the digestive system to promote weight loss.
  • Group two: Consisting of 41 women with moderate weight, who the scientists referred to as “lean controls.” The team matched these individuals to the first group in terms of their age, gender, income, employment, and marital status.
  • Group three: Comprising 29 women with obesity who were not in line to receive bariatric surgery or any other weight loss procedure.

The researchers tested the patients with obesity who were due for surgery before the procedure, then 3 and 12 months afterward.

They tested the second group twice, 6 months apart, and the third group only once.

The tests measured participants’ susceptibility to three common marketing strategies that portray food and portion sizes as more healthy than they actually are.

The first strategy, called the “health halo” effect, involves framing a product as natural or healthy.

The researchers asked participants to estimate the calorie content of 4 “healthy” snacks, including apple juice and granola bars, and 4 “indulgent” snacks, including a can of cola and chocolate bars.

In reality, the “healthy” snacks all contained more calories than the “indulgent snacks.”

The second marketing strategy involves downplaying portion sizes by renaming them, which tends to make people overeat.

The researchers asked participants to imagine choosing a portion of fries or a drink from a range of three options.

There were labels providing the actual size of each portion in grams or centiliters (cl), but these names either understated the sizes (as “mini,” “small,” and “medium”) or overstated them (as “medium,” “large,” and “extra-large.”)

The third marketing strategy involves omitting the smallest option in a size range, which can also lead to people choosing larger portions.

In this test, participants chose from a menu with 47, 65, and 95 cl size options, or from a menu with 24, 47, and 65 cl size variants.

The tests revealed that women with obesity were significantly more responsive than those with a moderate weight to the health halo and size labeling effects.

Crucially, however, women with obesity who underwent bariatric surgery were no more susceptible to these marketing ploys 12 months after the procedure than the control group with moderate weight.

Reward and motivation

In their paper, the scientists note neuroscientific research suggesting that brain regions involved in reward and motivation are more active in those with obesity.

They add that bariatric surgery may “rewire” the brain’s reward system in favor of more healthy food choices.

Alternatively, they write, the psychological impact of undergoing radical surgery to reduce their weight may motivate patients to eat more healthily.

At any rate, it remains unclear whether people who lose weight through other means, for example, through exercise or dieting, also become less responsive to food marketing.

The authors acknowledge that their study had some other limitations.

For example, they tested women with obesity only up to 12 months after surgery, so the durability of the effects beyond this point is unknown.

In addition, all the participants were adult French women. “Future research should therefore examine a larger and more diverse sample of people with obesity, including men and adolescents,” they write.

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