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Stem cell transplants show promise for multiple sclerosis

The Kashmir Monitor

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US researchers have reversed multiple sclerosis (MS) symptoms in early stage patients by using bone marrow stem cell transplants to reset the immune system,they said on Thursday.
Some 81 per cent of patients in the early phase study showed signs of improvement with the treatment,which used chemotherapy to destroy the immune system,and injections of the patient’s bone marrow cells taken beforehand to rebuild it.
“We just start over with new cells from the stem cells,” said Dr Richard Burt of Northwestern University in Chicago,whose study appears in the journal Lancet Neurology.
Multiple sclerosis occurs when the immune system mistakenly attacks the myelin sheath protecting nerve cells. It affects 2.5 million people globally and can cause mild illness in some people and permanent disability in others.
Symptoms may include numbness or weakness in the limbs,loss of vision and an unsteady gait.
“MS usually occurs in adults,” Burt said in a telephone interview. Before they get the disease,their immune systems work well,he said,but something happens to make the immune system attack itself.
His approach is aimed at turning back the clock to a time before the immune system began attacking itself.
Burt said the approach ? called autologous non-myeloablative hematopoietic stem-cell transplantation ? is a bit gentler than the therapy used in cancer patients because rather than destroying the entire bone marrow,it attacks just the immune system component of the marrow,making it less toxic.
Burt and colleagues tried the treatment on 21 patients aged 20 to 53 with relapsing-remitting multiple sclerosis,an earlier stage in the disease in which symptoms come and go.
Patients in the study were not helped by at least six months of standard treatment with interferon beta.
After an average follow-up of about three years,17 patients improved by at least one measure on a disability scale,and the disease stabilized in all patients.
Patients continued to improve for up to 24 months after the transplant procedure,and then stabilized. Many had improvements in walking,vision,incontinence and limb strength.
“To date,all therapies for MS have been designed and approved because they slowed the rate of neurological decline. None of them has ever reversed neurological dysfunction,which is what this has done,” Burt said.
Other teams have seen improvements in patients using a more aggressive approach. In one study led by Dr Mark Freedman of the University of Ottawa last year,17 MS patients treated with the more aggressive approach were showing signs of remission two years after treatment.
Burt stressed that the treatment approach needed to be tested in a more scientifically rigorous randomized clinical trial,in which half of the patients get the transplant treatment and the other half get standard treatment.
That trial is under way.


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Health

‘Inactive’ ingredients in most pills may cause allergic reactions: Study

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A vast majority of the most frequently prescribed medications contain at least one ingredient capable of causing an adverse allergic reaction, a US study has found. Known as inactive ingredients, these components are added to improve the taste, shelf-life, absorption and other characteristics of a pill, but the researchers found that more than 90 per cent of all oral medications tested contained at least one ingredient that can cause allergic or gastrointestinal symptoms in sensitive individuals.
Such ingredients include lactose, peanut oil, gluten and chemical dyes, scientists said. “When you’re a clinician, the last thing you want to do is prescribe a medication that could cause an adverse reaction or allergic reaction in a patient,” said C Giovanni Traverso, from Massachusetts Institute of Technology (MIT).
“This project was inspired by a real-life incident where a patient with Celiac disease was prescribed a medication and the formulation of the pill they picked up from the pharmacy had gluten in it,” Traverso said. “We wanted to understand the problem and drill down to characterise the entire universe of inactive ingredients across thousands of drugs,” he said.
Researchers analysed data on the inactive ingredients found in 42,052 oral medications that contained more than 354,597 inactive ingredients. Inactive ingredients are defined as substances that are added to a pill’s formulation but are not intended or expected to have a direct biological or therapeutic effect. Although such ingredients have been tested for safety at the population level, scattered case reports have suggested that inactive ingredients may cause adverse reactions in individuals who have allergies or intolerances.
“There are hundreds of different versions of pills or capsules that deliver the same medication using a different combination of inactive ingredients,” said Daniel Reker, a postdoctoral fellow at MIT. “This highlights how convoluted the possible choices of inactive ingredients are, but also suggests that there is a largely untapped opportunity today to specifically select the most appropriate version of a medication for a patient with unusual sensitivities,” Reker said.
The team found a total of 38 inactive ingredients that have been described in the literature to cause allergic symptoms after oral exposure. Researchers reported that 92.8 per cent of the medications they analysed contained at least one of these inactive ingredients. The team found that inactive ingredients can cause an adverse reaction through an allergy or an intolerance. It is unclear what amount of an ingredient is necessary to trigger a reaction in sensitive individuals — the content of lactose in a medication, for instance, may be too low to cause a reaction in many patients, except for those with severe lactose intolerance or those taking many medications containing lactose.
“While we call these ingredients ‘inactive,’ in many cases, they are not. While the doses may be low, we don’t know what the threshold is for individuals to react in the majority of instances,” said Traverso. “This pushes us to think about precision care and about the role for regulation and legislation when it comes to labelling medications that contain an ingredient that may cause an adverse reaction,” he said.

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Depression in 20s linked to memory loss in 50s: Study

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As part of a recent study, a team of psychologists has found that depression in the 20s can be linked to memory loss in 50s. The psychologists analyzed data from the National Child Development Study, which was established in 1958 with a cohort of over 18,000 babies and followed participants from birth into childhood and through to adulthood.
The psychologists found that an accumulation of symptoms experienced by participants over the three decades provided a strong indicator of a linear decrease in memory function by the time the adults were fifty.
They found that one episode of depression or anxiety had little effect on the memory function of adults in midlife, regardless of which decade it was experienced, but that once the episodes increased to two or three over the course of the three decades, that this predicted a steady decrease in the participant’s memory function by the time they reached fifty.
“We found that the more episodes of depression people experience in their adulthood, the higher risk of cognitive impairment they have later in life.This finding highlights the importance of effective management of depression to prevent the development of recurrent mental health problems with long-term negative outcomes,” said Darya Gaysina, senior author of the study.
“We’d, therefore, like to see the government investing more in the mental health provision for young adults, not only for the immediate benefit of the patients but also to help protect their future brain health,” Gaysina explained. As well as memory, the psychologists also assessed verbal fluency, information processing speed and accuracy scores of the participants once they turned fifty.
Encouragingly, episodes of depression and anxiety had little impact on the latter four areas of cognitive function but the associated loss of memory suggests that depressive symptoms experienced in early adulthood could predict dementia in older adulthood.
Previous research had found a relationship between depressive symptoms experienced in older adulthood and a faster rate of cognitive decline, but this is the first time that such a large and UK nationally representative sample has been able to make this link in the first three decades of adulthood.
“We knew from previous research that depressive symptoms experienced in mid-adulthood to late adulthood can predict a decline in brain function in later life but we were surprised to see just how clearly persistent depressive symptoms across three decades of adulthood are an important predictor of poorer memory function in mid-life,” said Amber John, one of the lead researchers.

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Brain function gets better while inhaling

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Israeli research has found that inhalation improves brain performance, the Weizmann Institute of Science (WIS) in Israel reported.
The research, published in the journal Nature Human Behavior, found that the success rate of subjects who solved questions during inhalation was higher than their success during exhalation, Xinhua news agency reported.
The research results may lead to better learning methods and even help people who suffer from ADHD (Attention Deficit Hyperactivity Disorder) by influencing the nature and pace of their breathing.
The sense of smell is the earliest sense of mammals and is therefore believed to be an initial pattern for all brain development.
The WIS researchers hypothesized that the whole brain is coming to attention of processing information while inhaling, even when it comes to functions that have nothing to do with smell (“sniffing brain”).
First, the researchers measured the flow of air in the noses of subjects while solving math exercises, performing visual-spatial tasks and dealing with language tasks.
The subjects were asked to press a button as soon as they were ready for the next exercise. It turned out that they tended to put air into their bodies in time for their readiness to deal with the next task.
Then, in a visual-spatial task, half of the questions appeared during the subjects’ inhalation and the other half with exhalation. It was found that the success rates were significantly improved when solving questions while inhaling.
The researchers also measured the electrical activity in the subjects’ brains at rest and during taking tasks, and found in both cases that the connectivity between the brain areas was significantly different between inhalation and exhalation. The researchers noted that the results have nothing to do with oxygen entering the body, as the effect on the brain in the experiments was immediate (about 0.2 seconds).

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