Ciggie smoking, fructose consumption worsens liver disease

April 28, 2010 By Leave a Comment

Washington, Apr 28 (ANI): Modifiable risk factors such as cigarette smoking and fructose consumption can worsen nonalcoholic fatty liver disease (NAFLD), scientists have claimed.

With NAFLD, fat accumulates in the liver of overweight individuals despite drinking little alcohol, causing in some cases liver scarring that can lead to liver failure. Identifying modifiable factors that contribute to disease severity and progression is essential in improving patient outcomes, according to recent studies.

Details of these studies are published in the May issue of Hepatology, a journal of the American Association for the Study of Liver Diseases (AASLD).

NAFLD is the most common cause of liver disease worldwide and research suggests the number of cases will climb given an increasing trend toward higher fat diets, obesity, decreased physical activity, and a rise in diabetes.

In the first study, Ramón Bataller, M.D., and colleagues from the Hospital Clínic in Barcelona, Spain investigated the effects of cigarette smoking (CS) in obese rats. Rats were divided into 4 groups: obese smokers, obese non-smokers, control smokers and control non-smokers. Smoker rats were exposed to 2 cigarettes/day, 5 days/week for 4 weeks. Researchers found that obese rats exposed to CS showed a significant increase in ALT serum levels (indicating liver disease), while this effect was not observed in control rats.

“Our results show that CS causes oxidative stress and worsens the severity of NAFLD in obese rats,” said Dr. Bataller. “Further studies should investigate longer exposures to CS, and assess whether this finding also occurs in patients with obesity and NAFLD.”

Additionally, prior studies suggest an over consumption of high fructose corn syrup (HFCS), primarily in the form of soft-drinks, have contributed to weight gain and the rise in obesity, particularly in children and adolescents. Table sugar (sucrose) and HFCS are the two major dietary sources of fructose. Over the past 40 years, consumption of dietary fructose has increased 1,000 percent according to Bray et al, and doctors believe it to be a major cause of NAFLD.

Researchers from Duke University studied 341 adults enrolled in the NASH Clinical Research Network who responded to a Block food questionnaire within 3 months of a liver biopsy. Fructose consumption was estimated conservatively by including that found in beverages, which accounts for 50 percent of dietary fructose intake. Results showed that 27.9 percent of participants consumed at least 1 fructose-containing beverage per day, 52.5 percent had 1 to 6 beverages with fructose per week, and 19.7 percent drank no beverages with fructose.

“In patients with NAFLD, daily fructose ingestion was associated with reduced fatty liver (steatosis), but we found increased fibrosis,” noted Manal Abdelmalek, M.D., M.P.H, and lead author of the study. “Further dietary intervention studies are needed to evaluate whether a low-fructose diet improves metabolic disturbances associated with NAFLD and improves patient outcomes for those at risk of disease progression,” concluded Dr. Abdelmalek.

A second fructose study led by Ling-Dong Kong, M.D., from Nanjing University in China investigated the effects of curcumin on fructose-induced hypertriglyceridemia and fatty liver in rats. Curcumin, a compound derived from turmeric (curcuma root), is sold as an herbal supplement and is believed to have anti-inflammatory, anti-tumor, and anti-viral properties. Researchers observed a hyperactivity of hepatic protein tyrosine phosphatase 1B (PTP1B), which is associated with defective insulin and leptin signaling, in fructose-fed rats. (ANI)

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First biomarker for multiple sclerosis found

March 29, 2010 By Leave a Comment

London, March 29 (ANI): Scientists have discovered the first biomarker for multiple sclerosis (MS) that might predict which patients will respond to a standard therapy and which will not.

Researchers at the University of Alabama at Birmingham (UAB), along with researchers at Stanford University, found that patients with a particular type of T helper immune cells responded well to interferon-ß, the usual first-line therapy for the disease, while those with a different T helper immune-cell type either did not respond or experienced worsening symptoms.

“Interferon-ß is typically the first therapeutic choice for most MS patients, but there is a subset of about 30 percent of patients for whom it does not work and may make the patient worse,” said Chander Raman, associate professor in the Division of Clinical Immunology and Rheumatology and lead investigator of the study.

“Our findings, in both animal and human models, indicate that the type of T helper cell present is the determining factor in predicting whether interferon-ß will be effective,” Raman added.

Raman suggests this might be another rung on the ladder leading to personalized medicine, in which therapies are based on an individual’s physiology and genetic makeup and the nature of disease.

“When our findings are verified in an expanded human trial, a simple blood test could be used to determine which type of T helper cell is predominantly responsible for the disease in an MS patient, enabling clinicians to provide the proper therapy from the beginning of treatment and eliminate the guesswork,” Raman said.

The researchers examined T helper Type 1 cells and T helper Type 17 cells in an animal model for multiple sclerosis. Both Th1 and Th17 cells are major initiators of MS and important in disease severity. The researchers found that interferon-ß was effective in mice with disease initiated by Th1 cells, but worsened disease initiated by Th17 cells.

The findings were replicated with striking consistency in analysis of human-patient serum with relapsing-remitting multiple sclerosis, the most common form of the disease.

“This research reinforces the concept that diseases have certain signatures that help define their origin and give us glimpses of how they manifest in our bodies. The more we understand these signatures, the more likely we will be able to intervene at a critical junction and design and provide therapies that lessen or cure disease,” said Raman.

The findings have been published online March 28 in Nature Medicine. (ANI)

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Home-based UVB therapy for psoriasis as safe as hospital treatment

May 8, 2009 By Leave a Comment

London, May 08 (ANI): Treating psoriasis patients with ultraviolet B (UVB) at home is as effective and as safe as conventional hospital based phototherapy, a new study has found.

The findings also showed that patients find home UVB therapy less of a burden and are more satisfied with treatment.

Psoriasis is a common, chronic inflammatory skin condition that causes significant disability to sufferers and their families.

Most dermatologists believe that home phototherapy is inferior to hospital treatment and that it carries more risks, despite there being no evidence to support this.

So, a team of researchers in the Netherlands compared the safety and effectiveness of home phototherapy with standard hospital based phototherapy.

They identified 196 patients with psoriasis from 14 hospital dermatology departments. Patients were randomised to receive either home UVB phototherapy or hospital based phototherapy.

The home group used a phototherapy unit in their homes, while the hospital group received the treatment at their local hospital.

Both treatment at home and at the hospital were applied according to standard routine practice. Disease severity after treatment was measured using recognised scoring scales. Side effects and total cumulative dose of UVB were also recorded.

Both groups completed questionnaires to assess the burden of treatment, quality of life and patient satisfaction for the two treatment settings.

The results showed that home phototherapy is equally safe and equally effective as outpatient phototherapy, both clinically and in terms of quality of life.

Researchers also found that patients treated at home reported a significantly lower burden of treatment and greater satisfaction with treatment. And the majority of patients said they would prefer home UVB therapy to hospital-based therapy in the future.

The study appears on bmj.com. (ANI)

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New biomarker that may help predict leukemia aggressiveness identified

April 20, 2009 By Leave a Comment

Washington, Apr 20 (ANI): Scientists from University of California, San Diego and the Moores UCSD Cancer Centre have identified a biomaker that may help predict aggressiveness of difficult-to-treat form of leukaemia.

The research team, led by Dr Paul A. Insel, professor of pharmacology and medicine at the UC San Diego School of Medicine, has found that high levels of a enzyme, called PDE7B, in the blood are an indicator that chronic lymphocytic leukemia (CLL) – the most common form of adult leukaemia.

In the previous study, Insel’s group had discovered that among a group of enzymes, cyclic nucleotide phosphodiesterases, one of the phosphodiesterases, PDE7B, was 10 times higher in CLL patients than in healthy individuals. PDE7B controls the levels of cyclic AMP (cAMP), a molecule that can promote programmed cell death, a process that is defective in CLL.

“The question was, could the level of PDE7B expression provide evidence for the clinical stage and diagnosis for individual patients?” Insel said.

During the study, Insel along with postodoctoral fellow Linghzi Zhang, compared the amount of PDE7B in white blood cells in 85 untreated patients with CLL to those of 30 healthy adults, and watched for changes over time.

“We found that individuals with high levels really had worse disease and showed that PDE7B expression had predictive value relative to other currently available markers for disease severity and progression,” Insel said.

“In some cases, the level of PDE7B expression provided prognostic information that was additive to existing markers,” he added.

Zhang said that PDE7B can be used alone as a biomarker for CLL if the levels are high enough, but may be used with other markers if the level is lower and ambiguous.

“PDE7B may not be good enough by itself if it’s not high enough. If it is low, other markers could be helpful,” she said.

Insel said that their research to date implies that PDE7B has a role in prognosis and could also be a good drug target because it reflects part of the biology of the disease.

“This implies that if we can develop drugs to block this enzyme, which would raise cAMP and promote apoptosis – which is really at the heart of the underlying pathology,” he added.

The study was presented at the AACR 100th Annual Meeting 2009 in Denver. (ANI)

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Psoriasis patients ‘at increased heart disease, diabetes risk’

March 8, 2009 By 1 Comment

Washington, Mar 8 (ANI): People with severe psoriasis are at an increased risk of developing serious medical conditions, including cardiovascular disease and diabetes, says a dermatologist from University of Pennsylvania.

He has also found that patients with severe psoriasis may have shorter life expectancies than those without the condition.

Those with severe psoriasis may die three to five years earlier than patients who do not have the disease.

“Patient education is critical in the early detection and management of these related conditions, many of which can be controlled with proper medical care,” said Dr Joel M. Gelfand, MSCE, FAAD, assistant professor of dermatology at the University of Pennsylvania School of Medicine in Philadelphia.

To minimize the risk of developing associated medical conditions, Dr. Gelfand recommended that psoriasis patients lead a healthy lifestyle, avoid smoking, maintain an ideal body weight and get routine screenings for cardiovascular risk factors – such as blood pressure and cholesterol checks.

Previous studies have also shown that excessive inflammation is a critical feature of psoriasis.

This discovery has led to innovative approaches to treating psoriasis, with therapies targeting selected areas of the immune system that are over-active in psoriasis patients.

Excess inflammation also is present in other common conditions, such as hardening of the arteries, heart attacks, stroke, obesity and diabetes – which may explain why some psoriasis patients may be at an increased risk for developing these other serious conditions.

“We need to educate psoriasis patients about the increased risk of cardiovascular disease so the prevention efforts can be instituted,” said Gelfand.

He also said that further research is needed to better determine how skin disease severity and activity affect the risk of developing these associated conditions and whether successful treatment of psoriasis alters the risks.

The study was presented at 67th Annual Meeting of the American Academy of Dermatology. (ANI)

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