Year: 2021

Iron is a ‘Double-edged Sword’ For Cancer Cells

A grant by the American Cancer society will be used to investigate the treatment of certain neuroblastoma by forcing them to overloading on iron.

Neuroblastoma is a cancer that forms in nerve tissue, and most commonly in the glands around the kidneys. It is the most frequently occurring childhood cancer that occurs outside the cranium. MYCN is overexpressed in 20-25% of neuroblastoma, and these cancers contribute to a considerable portion of paediatric cancer-related deaths. Recent research has shown that the MYCN gene introduces a weakness to ferroptosis-inducing drugs because MYCN draws on a lot of iron to help the cancer grow.  

“Iron is a double-edged sword in a cancer cell. It can help the cancer grow and survive, but it also creates these toxic molecules within the cell called reactive oxygen species,” explained Anthony Faber, PhD.

Reactive oxygen species (ROS) are unstable molecules that react with other molecules, causing DNA damage and cell death. This recently discovered form of cell death, largely influenced by iron accumulation, is called ferroptosis. Little is known about ferroptosis, and even less about cancers which may be vulnerable to ferroptosis-inducing drugs. By boosting cellular toxin removal systems, MYCN produces so much iron that it also creates a vulnerability to drugs which prevent cells from eliminating ROS. Blocking these toxin removal systems causes death among MYCN-amplified cells. 

“As MYCN continues to be one of the most important targets in cancer therapeutics, this study highlights a new and clinically important strategy for treating MYCN-associated cancers,” Dr Faber said.

“Fortunately, the Cancer Mouse Models Core run by Jennifer Koblinski, PhD, and Bin Hu, PhD, at Massey is spectacular and will allow us to robustly test these FDA-approved drugs in both patient-derived models and orthotopic models, where the tumors grow atop the adrenal glands similar to the way they grow in patients,” Dr Faber said.

If these models show positive results for the testing of these drugs, they can move on to clinical trials. He added that this study may have far reaching implications, as in certain small cell lung cancers and triple negative breast cancer, whose growth is driven c-MYC, a similar protein .

Source: Medical Xpress

Journal information: Konstantinos V. Floros et al, MYCN-amplified neuroblastoma is addicted to iron and vulnerable to inhibition of the system Xc-/glutathione axis, Cancer Research (2021). DOI: 10.1158/0008-5472.CAN-20-1641

Recent Mother With COVID to Have Life Support Withdrawn

In the UK, a comatose woman with COVID who had recently delivered her son via caesarean section should be allowed to die, a judge has ruled.

Mr Justice Hayden said that doctors should cease the woman’s life support treatment as it was no longer preserving her life but rather dragging out her death.

He said that the situation was “a tragedy of an almost unimaginable dimension” and was told there was “zero” chance of the woman making any meaningful recovery.

The woman (whose identity is withheld) was rushed to hospital a month ago while 32 weeks pregnant, after falling ill with COVID at home.

The judge was told that she had Addison’s disease, an acquired primary adrenal insufficiency from bilateral autoimmune damage to the adrenal cortex. The woman’s pancreas had ceased to function and one of her lungs had “died”, with a specialist saying that she had “essentially no normal lung function”.

The woman, who is of the Muslim faith, has a husband and a three year old son. Her husband and sister opposed the decision to withdraw life support as it was against their beliefs.

“To unplug the machine, this is for us like asking someone to kill us,” the woman’s sister said. “When God has written our death, that is when we will die.”

In an urgent court application, the judge took the case in a virtual hearing held late on Tuesday. The judge concluded that ending the woman’s life was in her best interests, adding that doctors had prepared a palliative care plan.

“This family is seeking a miracle,” he said. “This is a very young mother in circumstances of almost unspeakable sadness.”

Source: The Guardian

Ghana Receives First Vaccines from Covax

Wednesday was a day to celebrate in Ghana as the country took delivery of the first 600 000 vaccines from the Covax inoculation scheme for poorer countries. According to the AFP, some 217 million people have been inoculated so far. 

The Covax scheme, which is led by Gavi the Vaccine Alliance, the World Health Organization and the Coalition for Epidemic Preparedness Innovations , is seeking to ensure low and middle-income countries equitably receive vaccines. head Tedros Adhanom Ghebreyesus cheered on the first delivery of the Covax vaccines with an enthusiastic tweet.

“At last!” he wrote. “A day to celebrate, but it’s just the first step.”

Healthcare experts had long been warning that global access to vaccines was necessary to put an end to the pandemic. Thus far, some 112 million people (and likely more, especially in Africa) have been infected with COVID and 2.4 million people have died from the disease. The recession has caused millions of job losses, and set back development in many areas.

The delivery of the Oxford/AstraZeneca vaccines was broadcast live on Ghanian TV, and will be administered in Ghanaian cities from Tuesday. About two billion doses are expected to be distributed this year under the Covax scheme, although it is unclear if this goal will be met, given the difficulty many advanced nations have experienced in getting vaccines. The European Union, for example, has suffered setbacks in deliveries from AstraZeneca and Pfizer. EU member nation Hungary has meanwhile decided to forge ahead with its own vaccine acquisition, ordering five million doses from Chinese firm Sinopharm, and this week began its first vaccinations.

The Ivory Coast is set to receive the next batch from Covax later this week. 

Source: Eyewitness News

Researchers Describe Extremist ‘Psychological Signature’

Researchers at Cambridge University have laid out a ‘psychological signature’ for extremist behaviour.
These extremist behaviours  support violence in the name of ideology, and encompass social, political or religious attitudes. The researchers say that particular behavioural traits and unconscious cognition in the brain make certain individuals more susceptible to extremist behaviour.

These mental factors include poorer working memory and slower “perceptual strategies” (the unconscious processing of changing stimuli, eg shape and colour), and also tendencies towards impulsivity and sensation seeking.

The researchers found that social conservatism is linked to slower but more accurate unconscious decision-making, whereas liberal thinking is linked to faster but less accurate ‘perceptual strategies’.
More dogmatic people are prone to impulsivity but are slower in processing perceptual evidence.
Previous approaches to identifying radicalisation and extremism involved screening individuals by age and gender. 
“I’m interested in the role that hidden cognitive functions play in sculpting ideological thinking,” said lead author Dr Leor Zmigrod, from Cambridge’s Department of Psychology.

“Many people will know those in their communities who have become radicalised or adopted increasingly extreme political views, whether on the left or right. We want to know why particular individuals are more susceptible.”
“By examining ‘hot’ emotional cognition alongside the ‘cold’ unconscious cognition of basic information processing we can see a psychological signature for those at risk of engaging with an ideology in an extreme way,” Zmigrod said.

“Subtle difficulties with complex mental processing may subconsciously push people towards extreme doctrines that provide clearer, more defined explanations of the world, making them susceptible to toxic forms of dogmatic and authoritarian ideologies.”

 Added Zmigrod: “There appear to be hidden similarities in the minds of those most willing to take extreme measures to support their ideological doctrines. Understanding this could help us to support those individuals vulnerable to extremism, and foster social understanding across ideological divides.”
This research revisited 334 participants from a previous study where participants performed 37 cognitive tasks and were assessed on 22 personality traits. They added a further 16 tests
Demographics only weakly predicted extremist behaviour. For example, dogmatism was associated with slower perceptual ‘evidence accumulation’, and lower social risk-taking and agreeableness but greater impulsivity and ethical risk-taking. Adding the psychological signatures to demographics increased the predictive power for dogmatism from 1.53% to 23.6%. 
Political conservatism and nationalism was linked to ‘caution’ in unconscious decision-making, as well as when rewards are less valuable later, and slightly reduced strategic information processing. Personality traits for conservatism and nationalism included greater goal-directedness, impulsivity and reward sensitivity, and lower social risk-taking. For these ideologies, demographics only had a predictive power of less than 8%, but including the psychological signature boosted it to 32.5%.

In all of the ideologies examined, ‘extreme pro-group action’, including violence against others, had a similar psychological signature.

Source: Medical Xpress

Journal information:Philosophical Transactions of the Royal Society B (2021). DOI: 10.1098/rstb.2020.0424

Regular Sleep Patterns in Toddlers Important for BMI

Although getting regular sleep patterns in toddlers has long been a priority for parents, researchers have shown it is important for toddlers’ BMI.

The researchers, led by Lauren Covington, an assistant professor in the University of Delaware School of Nursing, investigated the link between poverty, regular sleep patterns and BMI in toddlers. According to The National Sleep Foundation, toddlers 1- to 3-years-old should have 12 to 14 hours of sleep in a 24-hour period.

“We’ve known for a while that physical activity and diet quality are very strong predictors of weight and BMI,” said Prof Covington, the lead author of the article. “I think it’s really highlighting that sleep may be playing a bigger role here than it’s been given credit for.”

The researchers aimed to investigate the relationship between poverty and BMI in toddlers, and wanted to see whether sleep behaviour, activity or food intake could provide the explanation.

Using data from families in an obesity prevention trial, 70% of whom were below the poverty line, and all eligible for nutritional supplementation grants, Toddlers were given accelerometers to wear to measure physical activity and parents filled out food diaries.

The researchers found that children from households with greater poverty were more likely to have greater inconsistent bedtimes, and those with more inconsistent bedtimes had higher BMI percentages.

Prof Covington said this is likely to be a bidirectional relationship. “There’s a lot of teasing out the relationships of the mechanisms that are at play here, which is really difficult to do because I think they’re all influencing each other,” she said.

Having consistent bedtimes where children go to bed within one hour of the normal time is a recommended guideline, but for families in poverty this may be impossible for a variety of reasons. Single parent households and juggling multiple jobs are part of the challenges they face.

“Implementing a consistent bedtime could be one behavioural change that a family could potentially do,” said Prof Covington. “It’s more attainable than maybe getting healthy food at the grocery store or playing outside on the playground, especially now with the cold weather. Just having a consistent bedtime can help provide some sense of structure, but then maybe have better implications for health and BMI as well.”

Source: Medical Xpress

Journal information: Lauren Covington et al. Longitudinal Associations Among Diet Quality, Physical Activity and Sleep Onset Consistency With Body Mass Index z-Score Among Toddlers in Low-income Families, Annals of Behavioral Medicine (2020). DOI: 10.1093/abm/kaaa100

COVID Tracking in Space Company Employees Yields Antibody Clues

SpaceX, an aerospace manufacturing company currently providing satellite launch services as well as transport of crew  to the International Space Station, collaborated with researchers from MIT to monitor the spread of COVID amongst its employees. 

Unusually, the paper included SpaceX CEO Elon Musk as a byline author. The technology entrepreneur is known to be quite hands-on in his company’s projects. However, he has also courted controversy by openly questioning COVID tests and saying he and his family would not take COVID vaccines, saying that achieving herd immunity naturally was a better strategy.

SpaceX was seeking data-driven methods to safeguard its essential workforce. The collaboration allowed the researchers to track the emergence of mild and asymptomatic cases in a cohort of adults as early as April, when data for such cases were rare.

“Essentially, this study indicates that it’s not simply the presence or absence of antibodies that matter; rather, the amount and type of antibodies may play a defining role in the development of a protective immune response,” said Professor Galit Alter, Harvard Medical School and Immunologist, Division of Infectious Diseases, Massachusetts General Hospital. 

The study was originally aimed at measuring antibody levels over time, but when reinfections began to be reported, the team realised their samples had some valuable information.

“In early spring, we weren’t sure if asymptomatic infection could drive long-lived antibodies,” said Prof Alter, “nor whether they possessed the capability to neutralise or kill the virus.”

The researchers knew that 120 participants had mild or asymptomatic COVID infections, resulting in their bodies producing antibodies. Using sophisticated techniques to analyse those antibodies, they found that individuals with stronger symptoms in mild COVID, had a larger number of antibodies and developed immune functions associated with natural immune protection. 

The study found that although the presence of antibodies was sufficient to determine whether an individual had experienced a COVID infection, they did not automatically mean that individual is protected against the virus in the long term.

Antibody effector functions (on the ‘long arm’ of the antibody) linked to long-term protection, such as T cell activation and virus neutralisation were only seen in certain immune responses. These involved high levels of antibodies targetting a part of the virus known as the receptor binding domain.

“Once you hit a certain threshold of these antibodies, it’s like a switch turns on and we can observe antibody effector functions,” said first author Yannic Bartsch, PhD. “These functions were not observed in individuals with lower antibody binding titers, and the level of protection from reinfections is uncertain in these individuals.”

Source: News-Medical.Net

Journal information: Bartsch, Y. C., et al. (2021) Discrete SARS-CoV-2 antibody titers track with functional humoral stability. Nature Communications. doi.org/10.1038/s41467-021-21336-8.

Russia Reports Bird Flu Transmission to Humans

On Saturday, Russia announced that it had detected the first case of the H5N8 strain of bird flu in humans.

The head of Russia’s health watchdog Rospotrebnadzor, Anna Popova, made the announcement in televised remarks. Scientists at the Vektor laboratory had identified the strain in seven workers at a Southern Russia poultry farm which had experienced an outbreak among the birds in December. No serious health consequences among the workers had been reported, and they are believed to have contracted the virus from the birds on the farm. The World Health Organization had already been alerted to the situation soon before the announcement.

Humans can contract bird flu A(H5N1) and A(H7N9) and swine flu subtypes such as A(H1N1). The bird flu subtype H5N1 is particularly dangerous as it has a 60% mortality rate in humans. According to the WHO, direct transmission between humans of such diseases is limited, and that most transmission comes when humans are in close contact with animals.

Influenza viruses are known to evolve “quite quickly” said Gwenael Vourc’h, head of research at France’s National Institute for Agriculture, Food, and Environment.

She added that there were likely cases outside Russia, saying to the FTP that this “is probably the tip of the iceberg.”

However, Francois Renaud, a researcher at the French National Centre for Scientific Research (CNRS), said that he was “not particularly worried” at this stage as the COVID pandemic had taught countries to react quickly, and that “draconian measures” will be taken to curb the outbreak.

He added that the coronavirus pandemic had taught countries to react quickly to potential health threats. “Draconian measures will be taken to immediately stop the outbreak,” he said.

Avian flu has raged in several European countries including France, where hundreds of thousands of birds have been culled to stop the infection.

The Vektor State Virology and Biotechnology Centre, which picked up the transmission to the poultry farm workers, also developed one of Russia’s coronavirus vaccines. The lab once conducted secret bioweapons research in the Soviet era, and still maintains stockpiles of viruses ranging from Ebola to smallpox.

Vektor chief Rinat Maksyutov said the lab was ready to begin the development of test kits to detect H5N8 in humans, and also to commence working on a vaccine.

Source: Medical Xpress

Novel Transplant Technique Yields More Donor Hearts for Children

Two hospitals in the UK have reported great success in a new heart transplant technique, resulting in a record number of children receiving heart transplants in 2020.

Royal Papworth Hospital in Cambridge and Great Ormond Street Hospital (GOSH) have collaborated on a new procedure which has enabled a much larger supply of donor hearts for children, who have had to wait two and a half times as long as adults for a donation.

Royal Papworth Hospital was the first in Europe to harvest non-beating hearts from adult patients whose life support had been withdrawn, and then been restarted for transplantation, instead of waiting for brain death with a still-beating heart.

By using a special device called the organ care system, surgeons can effectively restart the heart and keep it healthy until transplantation. The first non-beating heart transplant was performed in Australia in 2014. Since February last year, the two hospitals have been offering the service to children.

The use of non-beating hearts had previously been ruled out for transplantation until recently, due to tissue damage from lack of oxygen. The new organ care system, which supplies the heart with oxygenated blood and nutrients, can be used to keep the heart alive and pumping outside the body for up to 12 hours. This is long enough for checks to be performed prior to the transplant procedure, or even transferred to another hospital.

GOSH and Freeman Hospital are the only two centres in the UK with paediatric heart transplant units. In the past five years, 39 children died while waiting for donors.

“Some patients will just not survive the wait,” said Jacob Simmonds, a transplant surgeon at GOSH. “There is also a risk that while waiting they could damage other organs, particularly the lungs.” 

Last year, six paediatric heart transplants were carried out in the UK using the new procedure, and only four elsewhere in the world. The organs came from adult donors, as the organ care system is designed to accommodate hearts from people weighing over 50kg. Development is being carried out on a system which could allow harvesting organs from children. This would increase the available transplants for infants and babies, who have a critical lack of donors.

Source: BBC News

Failure of Joint Corporate Medical Insurance Betrays a Greater Problem

The failure of a joint corporate medical insurance venture to cover the employees of three corporate giants nevertheless holds lessons for the future, its former CEO revealed.

Headed by author, innovator, and surgeon Atul Gawande, MD, Haven was created by Berkshire Hathaway, Amazon, and JP Morgan Chase to provide revolutionary healthcare insurance for their 150 000 employees, delivering high quality at an affordable price. More than just a healthcare system, it was aimed to provide an example for the rest of the United States to follow. Its team of experts created a system of coverage with no co-insurance, no deductibles, 60 critical drugs at no cost, and low-cost mental health services and primary care.

Yet, less than three years after its inception, it is soon to shut down. Dr Gawande had already stepped down as chairman in May 2020, and in a ‘grand rounds’ discussion with Robert Wachter, MD, chair of the University of California San Francisco’s department of medicine he explained the problems behind it. He said that, simply put, the system is fatally flawed — a weakness that was laid bare by the enormous job losses of the COVID pandemic.

“We have an employer-based system. A job-based system is a broken system in a world where people are moving every couple of years to different roles and many, many, kinds of jobs,” Dr Gawande said.

“The pandemic has really brought this out in spades,” he said. The lockdowns cost many workers their jobs and the benefits that came with them. At the end of 2020, there were 9.4 million fewer jobs in the US.

“The vulnerability we have of tying your healthcare to your job, that remains still a big hill to climb, and the government has to solve it. That is a public core issue that we still have not faced up to,” Dr Gawande said.

He explained that a job-based healthcare system cares only about costs this year, not over the worker’s lifetime. “That’s why we have fights over whether we’ll pay for a hepatitis C treatment that costs $50 000 and up but avert $1 million in costs over the course of a life. We need that life-course commitment and view, and we have not aligned around that,” he said.

But that wasn’t the only reason behind Haven’s dissolution; it proved extremely difficult to make an insurance plan that worked across three different companies with different organisational cultures and employees in different cities, with different populations.

“Once that became clear, then Haven threatens to become a very expensive think tank,” Dr Gawande said. Originally, Haven was supposed to assume benefits management responsibility at the three companies, he explained. But it eventually became clear that “didn’t have the potential to say we’ll take over all of the benefits and running of the insurance for all you three organisations and then add more and more and more and more.”

However, Dr Gawande doesn’t think Haven was a failure. “It definitely did not become what we thought it would be,” he confessed. But the experience enabled him to start called CIC Health, a new venture which launched COVID testing efforts in the Boston area last fall and now has major COVID vaccination efforts underway with more coming.

Source: MedPage Today

Gut Microbiome Changes are Linked to Ageing and Longevity

Ageing in humans is marked by compositional changes in the gut microbiome that become more unique later in life.

Researchers from the Institute for Systems Biology (ISB) analysed gut microbiome, phenotypic and clinical data from over 9000 people across three independent cohorts. Health and survival outcomes were tracked from longitudinal data from a cohort of over 900 community-dwelling older individuals (78-98 years old).

The researchers found that, starting in mid-to-late adulthood, gut microbiomes became increasingly unique as individuals aged, corresponding with a steady decline in the abundance of core bacterial genera common across humans.

Strikingly, while microbiomes became increasingly unique to each individual in healthy aging, the metabolic functions the microbiomes were carrying out shared common traits. Gut microbiome uniqueness was highly correlated with several microbially-derived metabolites in blood plasma. One of them, tryptophan-derived indole, has been shown to extend lifespan in mice. Another metabolite, phenylacetylglutamine, showed the strongest association with uniqueness, and is known to be highly elevated in the blood of people over 100.

“This uniqueness signature can predict patient survival in the latest decades of life,” said study leader Dr Tomasz Wilmanski, who led the study. Healthy individuals aged around 80 showed continued microbial drift toward a uniqueness, but this drift was not seen in less healthy individuals of the same age.

“Interestingly, this uniqueness pattern appears to start in mid-life—40-50 years old—and is associated with a clear blood metabolomic signature, suggesting that these microbiome changes may not simply be diagnostic of healthy aging, but that they may also contribute directly to health as we age,” Wilmanski said. Indoles are known to reduce inflammation in the gut, for example, and chronic inflammation is believed to drive age-related morbidities.

“Prior results in microbiome-aging research appear inconsistent, with some reports showing a decline in core gut genera in centenarian populations, while others show relative stability of the microbiome up until the onset of aging-related declines in health,” said co-corresponding author, microbiome specialist Dr Sean Gibbons. “Our work, which is the first to incorporate a detailed analysis of health and survival, may resolve these inconsistencies. Specifically, we show two distinct aging trajectories: (1) a decline in core microbes and an accompanying rise in uniqueness in healthier individuals, consistent with prior results in community-dwelling centenarians, and (2) the maintenance of core microbes in less healthy individuals.”

This analysis highlights the fact that the adult gut microbiome continues to develop with advanced age in healthy individuals, but not in unhealthy ones, and that microbiome compositions associated with health in early-to-mid adulthood may not be compatible with health in late adulthood.

Source: Medical Xpress

Journal information: Gut microbiome pattern reflects healthy ageing and predicts survival in humans, Nature Metabolism (2021). DOI: 10.1038/s42255-021-00348-0