Diabetes drug found no better than placebo at treating nonalcoholic fatty liver disease: But randomized, double-blind clinical trial suggests better way to conduct future trials

A diabetes medication described in some studies as an effective treatment for nonalcoholic fatty liver disease (NAFLD) works no better than a placebo, report researchers at University of California San Diego School of Medicine, after conducting the first randomized, double-blind, controlled clinical trial of sitagliptin, an oral antihyperglycemic marketed by Merck & Co. under the name Januvia.

 

Januvia (sitagliptin)

Writing in the Journal of Hepatology, a multidisciplinary team headed by study senior author Rohit Loomba, MD, professor of medicine in the Division of Gastroenterology and director of the NAFLD Translational Research Unit at UC San Diego School of Medicine, found that sitagliptin was not significantly better than a placebo in reducing liver fat, as measured by magnetic resonance imaging-proton density fat fraction (MRI-PDFF) and other technologies.

The team included Claude Sirlin, MD, professor and vice chair (translational research) of radiology at UC San Diego School of Medicine, and Richard Ehman, MD, professor of radiology at Mayo Clinic. The labs, led by Sirlin and Ehman, invented and validated the advanced noninvasive imaging techniques applied in this study.

NAFLD is the accumulation of fat in the livers of people who drink little or no alcohol. It is the leading cause of chronic liver disease in the United States. Roughly one-quarter of Americans -- an estimated 100 million adults and children -- have NAFLD, which can progress to a more serious form called nonalcoholic steatohepatitis, which in turn can develop into cirrhosis, liver cancer and liver failure.

Currently, there are no approved, specific therapies for NAFLD. However, it is commonly associated with diabetes, which has prompted researchers to test diabetes medications, such as metformin, rosiglitazone and liraglutide, as potential treatments.

Sitagliptin is another possibility. In clinical trials conducted in patients with type 2 diabetes, sitagliptin has been shown to be effective in improving glycemic (blood sugar) control, cholesterol, lipoproteins and other health measures compared to placebo.

"But human trials of sitagliptin have been limited to date because they have lacked important tools like a placebo arm and allocation concealment (in which researchers do not know what the next treatment allocation will be, further preventing selection bias in testing)," said Loomba.

In the new study, 50 NAFLD patients with pre-diabetes or early diabetes were randomized into two groups: one received a 100 milligram oral dose of sitagliptin daily for 24 weeks, the other received a placebo. Primary outcome was assessed by changes to liver fat measured by MRI-PDFF, conducted by the Liver Imaging Group in the Department of Radiology at UC San Diego Health.

At end-of-treatment, Loomba and colleagues found no significant differences between sitagliptin and placebo across a range of measures. Neither study group experienced any adverse effects.

While the study did not support earlier findings that sitagliptin was an effective treatment for NAFLD, Loomba said it provided new evidence that clinical trials with patients at higher risk of diabetes do not necessarily need a liver biopsy to be efficiently screened for potential therapeutic agents.

"Biopsies present their own complications, such as possible pain and infection," said Loomba. "MRI-PDFF, and magnetic resonance elastography (a non-invasive imaging technique that measures the stiffness of soft tissues) proved to be accurate, quantitative, and useful over the study duration in measuring the state and progression of disease. These technologies should be further investigated in clinical trials, especially those of longer duration."

Mitoxantrone for MS linked to colorectal cancer risk

In continuation of my update on mitoxantrone 

Treatment with mitoxantrone for multiple sclerosis (MS) carries only a mildly increased risk of malignancy overall, but the risk of colorectal cancer and leukaemia is heightened, researchers have found.

They report a threefold increased incidence of colorectal cancer and a 10-fold increased incidence of acute myeloid leukaemia (AML) among 37 of 676 MS patients who were diagnosed with a malignancy over a median 8.7 years after starting mitoxantrone treatment.

The team, led by Mathias Buttmann (University of Würzburg, Germany), notes that colorectal cancer appeared to be the more life-threatening adverse effect, with three of seven affected patients dying from the tumour, whereas all four patients with AML experienced full remission after treatment.

"[P]osttreatment colonoscopy might improve the risk-benefit ratio of this highly active immunosuppressive drug", they recommend in Neurology

Among the 5.5% of patients diagnosed with a malignancy, nine developed breast cancer, seven colorectal cancer and four AML, and there were also two cases each of glioblastoma multiforme, lung, pancreatic and prostate cancer, and one case each of nine other types of cancer.

The overall standardised incidence ratio for any type of malignancy was 1.5 compared with the general population, and other than colorectal cancer and AML no other specific cancer type was associated with a significantly increased risk.

For the majority of patients, mitoxantrone was administered at a dose of 12 mg/m2every 3 months, while 152 patients received induction therapy with three monthly cycles of 12 mg/m2 followed by maintenance infusions of 5 mg/m2 every 3 months once clinical stabilisation had occurred.

Neither cumulative mitoxantrone dose (>75 vs ≤75 mg/m2) nor treatment with other immunosuppressive drugs increased the risk of malignancy. There was also no association with gender. But the risk did increase 1.55-fold with every 5-year increase in age at treatment initiation.

Among the 55 patients who died over the 6220 person-years of follow-up, 12 did so from a malignancy and 43 from other causes.

Buttmann and colleagues note that "[m]itoxantrone is currently the only approved treatment for patients with secondary progressive MS without superimposed relapses and should be considered in patients with rapidly evolving disabling disease."

The overall incidence of all malignancies "appears acceptably low to justify mitoxantrone treatment in severely affected patients with MS if no better therapeutic alternative is available", they conclude.

Revolutionary drug explained by scientists: Scientists figured out how the world's first drug that protects the cell mitochondria from damage by aggressive oxygen can work

Recently, Russian researchers, led by Prof. Vladimir P. Skulachev, managed to create an antioxidant drug that selectively accumulates within mitochondria and protects them from oxidative damage. Under the trade name "Visomitin" the drug was approved for treatment of such eye diseases as cataracts and dry eye. Prof. Armen Mulkidjanian of the Faculty of Bioengineering and Bioinformatics of the Lomonosov Moscow State University and the University of Osnabrück, Germany, and his colleagues have explained why very small doses of synthetic antioxidants such as "Visomitin" could give a pronounced therapeutic effect, despite the presence of large quantities of natural mitochondrial antioxidants.

 Visomitin

Mitochondria are intracellular structures that conduct respiration. Respiration, however, is accompanied by formation of reactive oxygen species (ROS) as by-products. The ROS are capable of damaging the mitochondria. Damaged mitochondria produce even more ROS, which can destroy cells and tissues, so that nature has special mechanisms, such as mitophagy and apoptosis, for elimination of damaged mitochondria and cells. These mechanisms are triggered after a signal of a disorder passes through the double membrane surrounding the mitochondria. Several laboratories have shown that it is possible to avoid the decay of cells and tissues by preventing the oxidation of a particular component of the mitochondrial membrane -- cardiolipin, because the oxidized molecules of cardiolipin are exactly the triggers of the signal chain.

The group of Prof. Vladimir Skulachev, the Dean of the Faculty of Bioengineering and Bioinformatics and the Director of the Belozersky Institute of Physical and Chemical Biology, (the Lomonosov Moscow State University), has developed a line of mitochondria-targeted antioxidants, the so-called SkQ-ions, specifically protecting the molecules of mitochondrial cardiolipin from oxidation. In animal trials, the SkQ-ions cured inflammatory eye diseases, helped to overcome the ischemia-simulating conditions, and even reduced the manifestation of senescence. Although similarly acting drugs have been developed and studied in the US and UK laboratories, the Russian group was the first to get an approval for their drug -- as eye drops. The researchers hope that SkQ-based drugs, in the form of pills and injections, after their certification, would help to attenuate the pathological symptoms that accompany strokes, heart attacks and serious traumas.

Armen Mulkidjanian and his collaborators have managed to suggest answers to some intriguing questions. Specifically, it was not clear why cardiolipin, of all the components of the membrane, it specifically oxidized. Molecules of cardiolipin, while making only 10-20% of total membrane lipids, are specifically targeted by ROS and, after getting oxidized, trigger the self-destruction of cells. Secondly, it was not clear why the natural antioxidants, namely coenzyme Q (ubiquinol) and vitamin E (alpha-tocopherol), which are present in mitochondrial membranes in large quantities, fail in the case of cardiolipin. It remained a mystery why these substances could not protect cardiolipin from oxidation, whereas artificial, mitochondria-targeted antioxidants, designed either by the Skulachev's group in Moscow, or by their counterparts in the US and the UK, perfectly coped with this task, in spite of very small doses of the administered drugs.

Armen Mulkidjanian says that the goal of the study was set by Prof. Skulachev.

'Prof. Skulachev asked our group in Germany to tackle these puzzles,' says Armen Mulkidjanian. 'Most of the work was carried out by the post-graduate students and the employees of the Moscow University, who worked in Russia and in Germany, so that their contribution was decisive. As to the research, we have developed an experimental system to investigate quantitatively the oxidation of the cardiolipin membranes and the ability of various antioxidants to prevent it. It turned out that the SkQ-ions and the molecules of coenzyme Q protected the cardiolipin membranes from oxidation equally well, whereas vitamin E performed much worse'.

To understand why cardiolipin molecules are the main target of the ROS, the researchers compared the experimental data with their previous results and the structures of respiratory enzymes. A fraction of cardiolipin molecules is occluded within respiratory protein complexes, just those that generate ROS. 'These molecules should be the first to be oxidized,' Mulkidjanian says.

The bulky, water-insoluble molecule of coenzyme Q cannot get to these "hidden" cardiolipin molecules, as opposed to small, agile molecules of artificial antioxidants, which, as shown in the study, are capable of protecting cardiolipin molecules from oxidation by accessing them both from the membrane and from the aqueous phase.

"The essence of our work is that we have proposed a mechanism that explains how very low doses of mitochondria-targeted antioxidants could provide a distinct therapeutic effect, even being applied over large amounts of natural antioxidants, which were ineffective in this case. The mechanism should be valid for the whole class of similar drugs. We hope that our findings would help to develop new drugs,' says Armen Mulkidjanian.

Revolutionary drug explained by scientists: Scientists figured out how the world's first drug that protects the cell mitochondria from damage by aggressive oxygen can work: An international team now clarifies the molecular mechanism of a drug created in Russia and designed to prevent the damaging of cell mitochondria by reactive oxygen species.

Drug combination could help reduce risk of death in type 2 diabetes

In continuation of my update on metformin

People with type 2 diabetes treated with insulin plus metformin had a reduced risk of death and major cardiac events compared with people treated with insulin alone, a new study by Cardiff University shows.

Led by Professor Craig Currie of the University's School of Medicine, the retrospective research looked at people with type 2 diabetes who were treated with insulin with or without metformin from the year 2000 onwards.

12,020 people were identified from a general practice data source, and the research team tracked them for three and a half years on average, from the time they were first prescribed insulin.

The researchers found than when used in conjunction with insulin, metformin had the potential to reduce mortality and heart attacks. They also found that there was no difference in the risk of cancer between people treated with insulin as a single therapy or in combination with metformin.

Professor Currie said: "Since 1991, the rate of insulin use in type 2 diabetes increased more than six-fold in the UK. In more recent years, metformin has also been used alongside insulin as a treatment.

"Previously, our work showed that increased insulin dose is linked with mortality, cancer and heart attacks. Existing studies have also shown that metformin can attenuate the risks associated with insulin.

"In this research we examined insulin dose along with the impact of combining insulin with metformin. We found that there was a considerable reduction in deaths and heart problems when this cheap and common drug was used in conjunction with insulin.

Around 3.9m people live with diabetes in the UK, with more than 90% of those affected having type 2 diabetes.

"While this research indicates the potential of using these treatments together, further studies are needed to determine the risks and benefits of insulin in type 2 diabetes and the possible benefits associated with the administration of metformin alongside insulin," added Professor Currie.

Drug-like peptides show promise in treating 2 blood diseases: Experts improve blood cell levels, control iron absorption in animal models of thalassemia, polycythemia vera

New research suggests that synthetic peptides called minihepcidins may potentially treat two serious genetic blood diseases in children and adults. Although those diseases, beta-thalassemia and polycythemia vera, have opposite effects on red blood cell production, treating animals with minihepcidin helps to restore normal levels of red blood cells and reduces spleen enlargement. It also controls the accumulation of excess levels of iron in beta-thalassemia that often causes severe toxic effects.

"It seems counterintuitive that one compound could treat two diseases that are quite different, but by restricting iron absorption, it also helps to normalize red blood cell levels in animals," said study leader Stefano Rivella, Ph.D., a hematology researcher and holder of the Kwame Ohene-Frempong Chair in Sickle Cell Anemia at The Children's Hospital of Philadelphia (CHOP). "If these preclinical results translate to humans, this could represent a new treatment for both disorders."

Rivella and colleagues published their study online in the journal Blood.

The researchers used minihepcidins, modified versions of the naturally occurring hormone hepcidin that regulates iron. Minihepcidins are smaller than the full-length hormone but have long-term stability and long-lasting biological activity when administered to animals. Previous researchers showed that minihepcidin treatment can prevent iron overload in mouse models of hemochromatosis, a disease of excess iron absorption associated with low hepcidin production.

First author Carla Casu, Ph.D. from CHOP, along with Rivella and colleagues, investigated in the current study how minihepcidins affected beta-thalassemia and polycythemia vera (PV) in mice separately engineered to model each human disease.

In beta-thalassemia, a long-studied genetic disorder, a mutation impairs hemoglobin production, resulting in defective red blood cells (RBCs). Those cells have a reduced ability to carry oxygen, resulting in anemia. However, the body continues to accumulate iron, because of low levels of hepcidin, generating a vicious cycle that destroys more RBCs and also may cause severe damage in the liver and heart.

In PV, rare mutations drive the overproduction of RBCs, gradually thickening the blood into a ketchup-like consistency. This raises the risk of high blood pressure and thrombosis (clotting), which may cause a stroke. PV also causes a painfully enlarged spleen. The standard treatment for PV is phlebotomy--puncturing a vein to remove blood. However, removing blood does not stop the body from keeping RBC production in overdrive.

Rivella and colleagues bred mouse models of both diseases, first at Weill Cornell Medical College in New York, where their study began, and subsequently at CHOP.

The study team found that, in young mice that modelled beta-thalassemia, minihepcidins normalized RBC levels and relieved both anemia and iron overload. In older mice, the compound improved RBC production and did not interfere with a chelating drug used to remove excess iron deposits.

In mice expressing the gene mutation that causes PV, minihepcidins also normalized RBC production. Because increased iron absorption in PV keeps RBC production in overdrive, when minihepcidins curtailed iron absorption, they lowered the abnormally high numbers of RBCs--which also reduced spleen enlargement.

Rivella noted that if minihepcidins prove successful in clinical trials, they may provide an important tool in treating these blood disorders. "In animal affected by beta-thalassemia, the compound blocks iron from getting into organs, but doesn't remove excess iron already in organs and tissues. If minihepcidins are used in older patients, they would need to be combined with existing chelating drugs that remove the already-accumulated iron." However, he added that in beta-thalassemia, providing minihepcidins in childhood might halt iron accumulation and prevent more severe adult disease. In PV, minihepcidins may help normalize a patient's RBC production, but, as in beta-thalassemia, would not treat the underlying disease-causing mutations.

Ref : http://www.bloodjournal.org/content/120/18/3829

Photosynthetic bacteria give biologists a cool new tool: Synthetic biologists turn protein pathway into reversible photoreceptor -- ScienceDaily

Photosynthetic bacteria that have lived on Earth for 2.7 billion years are the source of a new and valuable biological regulatory tool being developed by Rice University bioengineers.

Synechocystis bacteria produce a protein pathway that senses the presence of UV-violet light and activates a motor protein that moves the single-cell organism into safer surroundings.

The pathway responds quickly to UV-violet light, a narrow band in the spectrum that includes long ultraviolet and short violet wavelengths, and is blind to all others. That makes it a perfect addition to the growing optogenetic suite of reversible photoreceptors being developed by researchers in the lab of Rice synthetic biologist Jeffrey Tabor. Tabor and graduate student Prabha Ramakrishnan co-authored a new paper about this research in the American Chemical Society journal ACS Synthetic Biology.

"The human eye can see colors that go all the way from violet to red," Ramakrishnan said. "It turns out that marine algae -- especially the bacteria these sensors come from -- have evolved to see these and other colors as well."

Optogenetics is a fairly new discipline in which light-activated, genetically encoded photoreceptors are used to sense or control molecular biological processes like the expression of desired proteins. Because light is easy to direct and control, photoreceptors are simpler to use than tools that respond to chemical prompts.

The Rice researchers turned the photosynthetic bacterial proteins into photoreversible, transcriptional regulators and installed them in Escherichia coli bacterial for lab testing. They reported exploiting them to program gene-expression signals "with high predictability."

The protein pathway known as UirS-UirR is the only optogenetic tool that responds exclusively to UV-violet light and gives biologists the ability to program circuits with light-activated proteins that won't interfere with each other, Tabor said. "Biological systems are regulated by numerous interacting genes, and multiple optogenetic tools that don't optically cross-react are needed to study these networks," he said.

The photoreversible pathway can be turned on by exposure to ultraviolet light and turned off by exposure to green light, or vice versa, depending on how the circuit is designed. Tabor expects they will be useful tools for scientists who design metabolic pathways for drug manufacture and biological sensors.

The new sensors offer speed and versatility in circuit design. "We found that light sensors developed by others take more than two hours to switch on or off, and respond to a broad range of wavelengths," Tabor said. "These aspects are not ideal for studying and controlling bacterial processes."

By contrast, the UV-violet sensor can be switched on or off in 10 minutes, Ramakrishnan said. "That's good because producing proteins or controlling a biological process can be expensive for cells. Producing something that's neither necessary for the cell nor to the product you're trying to synthesize is wasteful."

"Our photoreversible tools allow gene expression to be tuned to different levels more precisely, like a good dimmer switch," Tabor added. "They allow gene expression to be changed to a new level more quickly than a nonphotoreversible tool. All of these features are beneficial for using the tool to study native bacterial gene networks or for industrial applications."

Because the UV-violet sensor responds to such a narrow wavelength of light -- from 380 to 420 nanometers -- there's no crosstalk with the red and green photoreversible tools already developed by the lab. "When these are put together in a single system, the fact that they don't interact with each other at all and turn on and off rapidly is going to be very useful," Ramakrishnan said.

Long-term Warfarin use may increase dementia rates in AF patients

In continuation of  Warfarin

A new study of more than 10,000 patients treated long term with the blood thinner, Warfarin, reveals higher rates of dementia for patients with atrial fibrillation versus non-AF patients.

The study by researchers at the Intermountain Medical Center Heart Institute in Salt Lake City found that atrial fibrillation patients treated long term with Warfarin had higher rates of dementia, Alzheimer's disease and vascular dementia compared to anticoagulated non-atrial fibrillation patients.

Results of the research were presented today at Heart Rhythm 2016, the Heart Rhythm Society's 37th Annual Scientific Sessions in San Francisco.

Atrial fibrillation is is the most common type of arrhythmia, which is a problem with the rate or rhythm of the heartbeat. During an arrhythmia, the heart can beat too fast, too slow, or with an irregular rhythm. Incidence rates of atrial fibrillation are growing dramatically as the population ages.

Dementia is a neurological disorder that impairs memory and other cognitive abilities, and it is now listed among the leading causes of morbidity and mortality in developed countries.

Atrial fibrillation can increase the risk of dementia because it exposes patients to both large and small clots that can affect brain function. Blood thinners used to prevent all forms of clots and strokes can increase the risk of both large and small brain bleeds that can also negatively impact brain function over time.

The study was conducted through the Intermountain Healthcare Clinical Pharmacist Anticoagulation Service, which is part of the Intermountain Healthcare system based in Salt Lake City.

Researchers enrolled a total of 10,537 patients with no history of dementia prior to the study. They were treated with a blood thinner for atrial fibrillation and non-AF conditions like valvular heart disease and thromboembolism on a long-term basis.

Other variables in the patients studied included age, hypertension, diabetes, hyperlipidemia, renal failure, smoking history, prior myocardial infarction or cerebral vascular accident, and heart failure. Participants were aged 18 years and older.

Studies show mango consumption may contribute to protective health effects

Four new studies surrounding the effects of mango consumption suggest this superfruit has the potential to help combat adverse effects associated with high fat diets and obesity (animal study), as well inhibit growth of fat cells (anti-lipogenic properties in an in-vivo study), slow advancement of breast cancer tumors (animal study), as well as improve regularity and decrease inflammation associated with constipation (human subject study). The research was presented at the 2016 Experimental Biology conference in San Diego.

"While more research is needed, especially in humans, there is a growing body of studies that suggest mango consumption may contribute to some protective effects in relation to obesity, certain cancers, gut health, and inflammation," said Leonardo Ortega, Director of Research at the National Mango Board.

OBESITY

* Nutrition science researcher, Babajide Ojo at Oklahoma State University, was selected by the American Society for Nutrition (ASN) as one of five finalists to present his research at the 2016 ASN Young Minority Investigator Oral Competition. Ojo's study investigated the effects of supplementing mangos (in the form of freeze-dried mango pulp) in mice fed a high fat diet on body composition, glucose homeostasis and gut inflammatory markers.

* Ojo, B., et. al., Mango Supplementation Prevents Gut Microbial Dysbiosis and Modulates Short Chain Fatty Acid Production Independent of Body Weight Reduction in C57BL/6 Mice Fed a High Fat Diet. The FASEB Journal, April 2016, vol. 30 no. 1 Supplement 1166.6 http://tinyurl.com/zyz6dpc

* Chuo Fang, PhD, of the department of Nutrition and Food Science at Texas A&M University investigated the potential role of mango and its microbial metabolites in regulating lipid metabolism and adipogenesis via the activation of AMPK in differentiated 3T3-L1 adipocytes.

* Fang, C., et. al, Mango polyphenols (Mangifera Indica L.) and their microbial metabolites suppress adipogenesis and fat accumulation by mediating AMPK signaling pathways in 3T3L-1 adipocytes. The FASEB Journalvol. 30 no. 1 Supplement 691.10 http://tinyurl.com/zwe78kq

BREAST CANCER

* Researcher Matt Nemec, of the Interdisciplinary Program of Toxicology at Texas A&M University, studied the anti-proliferative activities of pyrogallol, an intestinal microbial metabolite of gallotannin, a mango polyphenol, on mice with ductal carcinoma in situ breast cancer (DCIS).

* Nemec, M., et. al., Pyrogallol, a microbial metabolites from mango tannins (Mangifera Indica L.) suppresses breast cancer ductal carcinoma in situ proliferation in both in vitro and in vivo. The FASEB Journal, April 2016, vol. 30 no. 1 Supplement 688.7 http://tinyurl.com/ze3y5kx

CONSTIPATION

* Vinicius Paula Venancio, of the Department of Nutrition and Food Science at Texas A&M University, studied the consumption of 300 grams of mango compared to an equivalent amount of fiber (1 teaspoon of a fiber supplement) and its effect on abdominal distention and constipation in otherwise healthy human volunteers.

* Venancio, V.P., et. al., Mango (Mangifera Indica L.) in the promotion of intestinal regularity and decreases inflammation in human subjects with constipation. The FASEB Journal, April 2016, vol. 30 no. 1 Supplement 420.7 http://tinyurl.com/h6pvwnn

Studies show mango consumption may contribute to protective health effects: Four new studies surrounding the effects of mango consumption suggest this superfruit has the potential to help combat adverse effects associated with high fat diets and obesity (animal study), as well inhibit growth of fat cells (anti-lipogenic properties in an in-vivo study), slow advancement of breast cancer tumors (animal study), as well as improve regularity and decrease inflammation associated with constipation (human subject study).

Experimental drug ozanimod moderately effective in treatment of ulcerative colitis

Researchers at University of California San Diego School of Medicine have shown that ozanimod (RPC1063), a novel drug molecule, is moderately effective in the treatment of ulcerative colitis. Results of the Phase II clinical trial will appear in the May 5 issue of theNew England Journal of Medicine.

"This new class of immunotherapy drug traps white blood cells in the lymph nodes to prevent their escape into the gut where they cause inflammation," said William J. Sandborn, MD, professor of medicine at UC San Diego School of Medicine and director of the Inflammatory Bowel Disease Center at UC San Diego Health. "In addition to inducing remission in patients, the experimental drug reduced rectal bleeding and healed the mucosal lining of the intestine."

Ulcerative colits is a debilitating autoimmune disease that causes chronic diarrhea. One of the disease's defining characteristics is an abnormal accumulation of lymphocytes or T-cells in the lining of the gut. This activation of immune cells causes inflammation resulting in chronic, painful bowel movements. To counter this activity, ozanimod, a sphingosime 1-phospahte receptor modulator, halts the body's ability to recruit cells for an immune response.

"A one milligram pill of the drug induced clinical remission at week eight," said Sandborn. "Unlike other currently available drugs for inflammatory bowel disease, ozanimod can be orally administered and does not suppress the immune system to the point of increasing likelihood of infection or cancer."

Patients in the study were randomized to ozanimod 0.5 mg, 1.0 mg, or placebo. The most common side effects were anemia and headache.

Other symptoms of ulcerative colitis include intestinal bleeding and weight loss. Bowel obstruction, colon cancer, and malnutrition can also occur, resulting in hospitalization and the possible need for surgical removal of portions of the bowel and colon.

Ref : https://health.ucsd.edu/news/releases/Pages/2016-05-04-ozanimod-effective-for-treating-ulcerative-colitis.aspx

Drinking tart Montmorency cherry juice can reduce early signs of hypertension

 

The Montmorency cherry is a variety of sour cherry (Prunus cerasus) grown in the United States, Canadaand France, particularly in Michigan and in Door County, Wisconsin. Montmorency cherries are part of the lighter-red Amarelle cultivar of sour cherries, rather than the darker-red Morello cultivar. Michigan produces over 90,000 tons of Montmorency cherries each year.

Drinking tart Montmorency cherry juice significantly reduces high blood pressure at a level comparable to that achieved by medication, according to new research from Northumbria University, Newcastle.

The findings, which are published in The American Journal of Clinical Nutrition today (Wednesday 4 May), found that men with early signs of hypertension - more commonly known as high blood pressure - saw a 7% reduction in blood pressure after drinking Montmorency cherry concentrate when compared to drinking a fruit-flavoured cordial.

This reduction is comparable to the level achieved by anti-hypertensive medication.

High blood pressure affects over five million people in England and, if left untreated, increases risk of heart attack, heart failure, kidney disease, stroke or dementia. Normal blood pressure is around 120/80 mmHg.

Researchers from Northumbria University's Department of Sport, Exercise and Rehabilitation worked with fifteen participants who were displaying early hypertension with blood pressure readings of at least 130/90 mmHg, meaning they were at higher risk of experiencing cardiovascular related problems.

They were told that the study was to investigate the effect of a fruit juice on vascular function and were given either 60ml of a Montmorency cherry concentrate or the same amount of a commercially available fruit-flavoured cordial.

Blood pressure and blood samples were taken before the cherry concentrate was consumed and blood pressure was measured on an hourly basis thereafter. Blood samples and a series of other cardiovascular screening tests were taken again on a regular basis over the following eight hours.

The researchers found that the participants who were given the cherry concentrate saw a peak reduction in their blood pressure of 7 mmHg in the three hours after consuming the drink.

Past studies have shown that a reduction of between 5-6 mmHg over a sustained period has been associated with a 38% reduced risk of stroke and 23% reduced risk of coronary heart disease.

Interestingly, those participants with blood pressure levels at the higher end of the scale saw the most benefit.

The greatest improvement in systolic blood pressure occurred when the phenolic acids, protocatechuic and vanillic, within the cherry concentrate reached their peak levels in the plasma. The researchers believe that these particular compounds are, at least in part, responsible for the reduction.

Lead author and Lecturer in Sport and Exercise Nutrition, Karen Keane, explained: "The majority of cardiovascular disease is caused by risk factors that can be controlled, treated or modified, such as high blood pressure, cholesterol, obesity, tobacco use, lack of physical activity and diabetes. Raised blood pressure is the leading cause of deaths from cardiovascular disease, yet relatively small reductions in blood pressure can have a large impact on mortality rates.

"The magnitude of the blood pressure lowering effects we observed was comparable to those achieved by a single anti-hypertensive drug and highlights the potential importance that Montmorency cherries could have in the effective management of high blood pressure."

Drinking tart Montmorency cherry juice can reduce early signs of hypertension: Drinking tart Montmorency cherry juice significantly reduces high blood pressure at a level comparable to that achieved by medication, according to new research from Northumbria University, Newcastle.

The 2016 Nobel Prize in Chemistry.......

A tiny lift, artificial muscles and miniscule motors. The Nobel Prize in Chemistry 2016 is awarded to Jean-Pierre Sauvage, Sir J. Fraser Stoddart and Bernard L. Feringa for their design and production of molecular machines. They have developed molecules with controllable movements, which can perform a task when energy is added.

The development of computing demonstrates how the miniaturisation of technology can lead to a revolution. The 2016 Nobel Laureates in Chemistry have miniaturised machines and taken chemistry to a new dimension.

The first step towards a molecular machine was taken by Jean-Pierre Sauvage in 1983, when he succeeded in linking two ring-shaped molecules together to form a chain, called a catenane. Normally, molecules are joined by strong covalent bonds in which the atoms share electrons, but in the chain they were instead linked by a freer mechanical bond. For a machine to be able to perform a task it must consist of parts that can move relative to each other. The two interlocked rings fulfilled exactly this requirement.

The second step was taken by Fraser Stoddart in 1991, when he developed arotaxane. He threaded a molecular ring onto a thin molecular axle and demonstrated that the ring was able to move along the axle. Among his developments based on rotaxanes are a molecular lift, a molecular muscle and a molecule-based computer chip.

Bernard Feringa was the first person to develop a molecular motor; in 1999 he got a molecular rotor blade to spin continually in the same direction. Using molecular motors, he has rotated a glass cylinder that is 10,000 times bigger than the motor and also designed a nanocar.

2016's Nobel Laureates in Chemistry have taken molecular systems out of equilibrium's stalemate and into energy-filled states in which their movements can be controlled. In terms of development, the molecular motor is at the same stage as the electric motor was in the 1830s, when scientists displayed various spinning cranks and wheels, unaware that they would lead to electric trains, washing machines, fans and food processors. Molecular machines will most likely be used in the development of things such as new materials, sensors and energy storage systems.

Details : https://www.nobelprize.org/nobel_prizes/chemistry/laureates/2016/advanced-chemistryprize2016.pdf

  

Blueberry component PS may protect against dry eye disease

  

Pterostilbene (PS), a component of blueberries, have been found to protect against dry eye disease according to a new study. The research is being presented at the 2016 Annual Meeting of the Association for Research in Vision and Ophthalmology (ARVO) this week in Seattle, Wash.

When introduced to human corneal epithelial cells, PS significantly reduced the levels of oxidative damage, which in turn reduced inflammation. Inflammation can contribute to dry eye disease, a condition that becomes increasing common with age. PS is a molecule chemically related to resveratrol.

Omega-3 Fish Oil Supplements Might Boost Antidepressants' Effects

Omega-3 fish oil supplements may improve the effectiveness of antidepressants, new research suggests.

Researchers reviewed the findings of eight clinical trials worldwide, as well as other evidence, and concluded that the supplements appear to help battle depression in people already on medication.

"Omega-3 fish oil -- in combination with antidepressants -- had a statistically significant effect over a placebo," said study leader Jerome Sarris. He is head of the ARCADIA Mental Health Research Group at the University of Melbourne in Australia.

The study looked at the result of trials where patients battling depression took either a standard antidepressant plus a form of omega-3 fish oil, versus the antidepressant plus an inactive placebo.

"The difference for patients taking both antidepressants and omega-3, compared to a placebo, was highly significant," Sarris said in a university news release. "This is an exciting finding because here we have a safe, evidence-based approach that could be considered a mainstream treatment," he explained.

"Many studies have shown omega-3s are very good for general brain health and improving mood, but this is the first analysis of studies that looks at using them in combination with antidepressant medication," Sarris said.

Doctors may be reluctant to prescribe dietary supplements in combination with antidepressants due to a lack of scientific evidence and concerns about safety. But, Sarris noted, the researchers found no major safety concerns in combining the two therapies.

However, the study authors stressed that patients should always talk with their health care provider before taking dietary supplements. In addition, people need to be aware that these supplements can differ in quality.

"We're not telling people to rush out and buy buckets of supplements. Always speak to your medical professional before changing or initiating a treatment," Sarris said.

One expert in the United States believes the findings might be of use to patients.

"The general population is often looking for natural remedies to treat health problems," said Dr. Victor Fornari.

"A large number of individuals with depression do not reach remission with one or two trials of medication," added Fornari. He directs child and adolescent psychiatry at Cohen Children's Medical Center in New Hyde Park, N.Y.

"This may enhance the recovery of individuals who do not respond to antidepressants alone," he said. However, Fornari agreed with the authors that "individuals are cautioned to consult with their medical professional before proceeding."

Omega-3 Fish Oil Supplements Might Boost Antidepressants' Effects  

Coffee, Wine Good for Healthy Gut, Sodas May Be Bad

The food you eat and the medicines you take can alter your gut bacteria in ways that either help or harm your health, two new studies suggest.

Foods like fruits, vegetables, coffee, tea, wine, yogurt and buttermilk can increase the diversity of bacteria in a person's intestines. And that diversity can help ward off illness, said Dr. Jingyuan Fu, senior author of one of the studies.

"It is believed that higher diversity and richness [in gut bacteria] is beneficial," explained Fu. She is an associate professor of genetics at the University of Groningen in the Netherlands.

On the other hand, foods containing loads of simple carbohydrates appear to reduce bacterial diversity in the gut, Fu and colleagues found. These include high-fat whole milk and sugar-sweetened soda.

In addition, medications can also play a part in the makeup of your gut bacteria. Antibiotics, the diabetes drug metformin and antacids can cut down on gut bacterial diversity, the researchers found. Smoking and heart attacks also can have a negative effect, the team said.

Each person's intestines contain trillions of microorganisms, which doctors refer to as the "gut microbiome," said Dr. David Johnson. He is chief of gastroenterology at Eastern Virginia Medical School in Norfolk, Va., and a past president of the American College of Gastroenterology.

The gut microbiome plays an essential but little-understood role in human health, said Johnson, who was not involved with the new studies.

"It's the largest immune system in the body," Johnson explained. "These bacteria have a very dramatic and prominent role in determining health and disease."

To study the effect of lifestyle on the gut microbiome, Fu and her colleagues collected stool samples from more than 1,100 people living in the northern Netherlands.

The samples were used to analyze the DNA of the bacteria and other organisms that live in the gut. In addition to stools, the study collected information on the participants' diets, medicine use and health.

In the second study, researchers with the Flemish Gut Flora Project performed a similar analysis on stool samples taken from 5,000 volunteers in Belgium.

Both studies concluded that diet has a profound effect on the diversity of gut bacteria, although, Fu said, the "underlying theories of these dietary factors remain largely unknown."

Johnson added that medicines can have the same effect, and antibiotics actually can kill off some important strains of gut bacteria. "One dose of an antibiotic may disrupt your gut bacteria for a year," he said.

Both sets of researchers emphasized that their studies only help explain a fraction of gut bacteria variation -- roughly 18 percent for the Netherlands study, and about 7 percent for the Flemish study.

However, the findings from the two groups overlapped about 80 percent of the time, indicating that they are on the right track, the researchers said.

The Belgian researchers estimated that over 40,000 human samples will be needed to capture a complete picture of gut bacteria diversity.

Johnson noted that other research has shown that poor sleep, obesity, diabetes and the use of artificial sweeteners also can interfere with gut bacteria.

"The general rule is a balanced diet with high fiber and low carbs tends to drive a better gut health overall," he said.

According to Fu, once researchers have a clearer understanding of the gut microbiome and its effects on health, doctors could be able to help prevent or heal illness by reading or influencing the bacteria within people's bodies.

"The personalized microbiome may assist in personalized nutrition, personalized medicine, disease risk stratification and treatment decision-making," she said.

Both studies were published in the April 29 issue of the journal Science.

Coffee, Wine Good for Healthy Gut, Sodas May Be Bad  

Additional Treatments Offer Little Benefit for Pancreatic Cancer: Study

In continuation of my updates on Erlotinib, gemcitabine and capecitabine

Additional treatments for locally advanced pancreatic cancer don't appear to boost survival, a new French study reports.

Researchers looked at the effects of adding a second drug -- erlotinib (Tarceva) -- to the initial round of chemotherapy. They also tested whether adding radiation to a second round of chemotherapy (chemoradiotherapy) would offer any survival benefit.

 erlotinib (Tarceva)

Unfortunately, the addition of the second drug didn't help people live longer, and those on chemoradiotherapy didn't fare any better.

"Chemoradiotherapy was not superior to chemotherapy," said the study's senior author, Dr. Pascal Hammel. Hammel is from the department of gastroenterology-pancreatology at Beaujon Hospital, in Clichy, France.

The study was funded by the pharmaceutical company Roche, the maker of Tarceva, and the French National Institute of Cancer.

More than 53,000 Americans are diagnosed with pancreatic cancer annually, the U.S. National Cancer Institute (NCI) says. About 42,000 Americans die each year from the disease, the NCI reports.

The new study focused on 449 people with pancreatic cancer. Their average age was just over 63.

All received standard four-month chemotherapy with the drug gemcitabine (Gemzar). Gemzar is currently used to treat a range of cancers, including pancreatic, ovarian, breast, and non-small cell lung cancers, the drug's labeling information says. For the study, about half the patients (219) also took Tarceva along with Gemzar.

 gemcitabine (Gemzar).

After completing initial treatment, imaging tests revealed that 269 patients appeared to have tumors that were under control. That meant their cancer was stable and didn't appear to have spread, or metastasized.

But the tumors couldn't be surgically removed because they had developed around the arteries surrounding the pancreas, study authors said.

About half this group of stable patients (136) received two additional months of the same chemotherapy regimen. The other half (133) was treated with a combination of radiation and the chemotherapy drug capecitabine (Xeloda).

 capecitabine (Xeloda)

After three years of follow-up, the researchers found that patients given Gemzar chemotherapy alone survived an average of 13.6 months. Those given the combination of Gemzar and Tarceva had an average survival of 11.9 months, the study found.

Patients treated with chemoradiotherapy lived an average of 15.2 months. Those who got chemotherapy alone lived an average of 16.5 months, the study found.

Hammel said there's still work to be done to improve the results of both chemotherapy and radiotherapy treatments.

But for now, Dr. Deborah Schrag agreed that "the French trial demonstrates that routine addition of chemo-radiation following initial chemotherapy for patients with locally advanced pancreatic cancer does not improve survival compared to continued chemotherapy." Schrag, chief of the Division of Population Sciences, Medical Oncology, at the Dana-Farber Cancer Institute in Boston, wrote an accompanying editorial in the same issue of the journal.

"[And] given the burdens of daily radiation therapy, there is no routine role for the application of this treatment strategy," added Schrag.

Schrag said it's possible there might be a certain group of pancreatic cancer patients who could get some measurable benefit from radiation. "Further evaluation of the tumor samples from the study participants might help to more precisely determine who might benefit from radiation, and such data are eagerly awaited," she said.

Additional Treatments Offer Little Benefit for Pancreatic Cancer: Study