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A mechanism which can lead to hay fever and other allergic reactions, by preventing the immune system from regulating itself properly, has been discovered by scientists. Researchers hope their finding, published in the journal PLoS Biology, will allow therapies to be developed that treat allergies by stopping this mechanism. The new research shows that a gene known as GATA-3 can block the development of regulatory T-cells in the immune system by locking another gene. This gene, FOXP3, is key to regulatory T cells and when it is blocked new regulatory T cells stop being produced. The scientists, from Imperial College London, the Swiss Institute of Allergy and Asthma Research in Davos, Switzerland, and other international institutions, hope that if they can develop therapies to stop FOXP3 being blocked, they can ensure that regulatory T cells are free to work normally. Regulatory T cells are believed to be vital for averting allergic reactions in healthy individuals because they keep the other cells in check.

 

Treatment with the class of chemotherapy drugs called anthracyclines improves survival in women with HER2-positive breast cancer who have previously had surgery for the disease, according to a study published online in the Journal of the National Cancer Institute. HER2 breast cancer is an aggressive form that strikes one in four women with the disease. The study, however, found that the drug class may not offer any benefit for women with HER2-negative tumors. Randomized clinical trials have demonstrated that treating early breast cancer with anthracycline-based chemotherapy improves disease-free rates and overall survival rates more than non-anthracycline-based regimens. However, the studies have demonstrated that anthracyclines may slightly increase the risk of heart damage and leukemia. Given these side effects, the greatest benefit of these regimens may be in women with breast tumors that overexpress HER2—a gene that is often amplified in tumors that respond to anthracyclines. Researchers at the National Cancer Research Institute in Genoa, Italy, and colleagues compiled data from eight randomized controlled trials that compared anthracyclines and non-anthracyclines, and also reported HER2 status. Overall and among patients with HER2-positive tumors, anthracycline-based chemotherapy produced a greater reduction in the risk of relapse or death than non-anthracycline-based regimens. However, among patients with HER2-negative tumors, there was no difference in survival between the chemotherapy regimens. The researchers said the absence of any effect of anthracyclines in patients with HER2-negative disease suggests that this group of patients could be spared unnecessary toxic effects related to the use of this class of agents.

 

Large numbers of the poorest Americans are suffering from some of the same parasitic infections that affect the poor in Africa, Asia, and Latin America, according to the Editor-in-Chief of PLoS Neglected Tropical Diseases. In an article entitled “Poverty and Neglected Diseases in the ‘Other’ America,” Peter Hotez said there is evidence that the parasitic diseases toxocariasis, cysticercosis, and toxoplasmosis, as well as other neglected infections, are very common in the United States, especially among poor and underrepresented minority populations living in inner cities and poor rural areas. Such infections are known as neglected tropical diseases because they afflict mostly poor people and are often ignored by public health officials and political leaders despite their enormous medical importance. Because these parasitic infections only occur among impoverished people and mostly underrepresented minorities in the United State, Hotez, who is also a professor at George Washington University and the Sabin Vaccine Institute, said he believes there has been a lack of political will to study them. But he said there is an urgent need to support studies that assess the disease burden resulting from these diseases in the United States, identify the minority populations at greatest risk, and identify simple and cost-effective public health solutions.

 

A new scoring system for a form of leukemia known as myelodysplastic syndrome or MDS identifies patients who appear to have low-risk disease, but actually have poor prospects of survival, researchers at The University of Texas M. D. Anderson Cancer Center report online in the journal Leukemia. Myelodysplastic Syndromes are a group of conditions that cause insufficient production of blood cells, which is often lethal. About 10 percent of patients have their MDS transform into acute myelogenous leukemia. The researchers said it is known that an undefined group of MDS patients who are classified as low-risk by present prognostic models will at some point have a sudden worsening of their disease. Though it is not known who these people are, the researchers said if they can be identified, doctors could start those with a poor prognosis on early treatment. Physicians tend to adopt a watch-and-wait approach to low-risk MDS patients, but that misses low-risk/poor prognosis patients. The researchers examined a number of potential molecular and demographic markers to develop a prognostic scoring system for this group by applying them to 856 patients treated at M. D. Anderson between 1976 and 2005. The scoring system is being applied in prospective clinical trials that are under way or planned at M. D. Anderson.

 

STROKE: HIGH TRIGLYCERIDES, OTHER CHOLESTEROL RAISES RISK OF CLOT

People with high triglycerides and another type of cholesterol tested but not usually evaluated as part of a person’s risk assessment have an increased risk of a certain type of stroke, according to research published in the online issue of Neurology. LDL or “bad” cholesterol has been the primary target for reducing the risk of stroke, but researchers from the UCLA Medical Center in Los Angeles said these results show that other types of cholesterol may be more strongly linked with a risk of stroke. The researchers analyzed the records of 1,049 people admitted to a university hospital with a stroke or mini-stroke over four years. Of those, 247 people had a large artery atherosclerotic stroke, a type of ischemic stroke caused by a blockage of blood flow to the brain. People with this type of stroke have blockage in the large arteries leading to the brain. Those with high triglycerides and elevated non-high density lipoprotein cholesterol were more likely to have a large artery atherosclerotic stroke than those with low levels of these fats in the blood. Those with the highest triglycerides were 2.7 times more likely to have this type of stroke than those with the lowest level. Triglycerides are fatty acids and are the most common type of fat in the blood. Those with the greatest non-high density lipoprotein cholesterol, which is neither the “good” nor the “bad” cholesterol, were 2.4 times more likely to have a large artery stroke.

 

Asking emergency department patients about their alcohol use and talking with them about how to reduce harmful drinking patterns is an effective way to lower rates of risky drinking in these patients, according to a nationwide study supported by the National Institute on Alcohol Abuse and Alcoholism and the Substance Abuse and Mental Health Services Administration. Emergency department patients who underwent a regimen of alcohol screening and brief intervention reported lower rates of risky drinking at three-month follow-up than did those who received only written information about reducing their drinking. A report of the study by the Academic Emergency Department Screening, Brief Intervention and Referral to Treatment Research Collaborative appears in the Annals of Emergency Medicine. Investigators at 14 university-based emergency centers throughout the United States used a brief questionnaire to assess the alcohol use patterns of 7,751 emergency patients, regardless of whether they had signs of alcohol use on admission. They found that more than one-fourth of the patients exceeded the limits for low-risk drinking—defined as no more than: four drinks per day for men and three drinks per day for women; and not more than 14 drinks per week for men, and seven drinks per week for women. The researchers conclude that widespread use of these techniques by emergency personnel could significantly reduce unhealthy alcohol use. They said the study results should provide the impetus for broader implementation of screening, brief intervention, and referral for treatment in the emergency department setting.

 

Researchers from the National Institute of Environmental Health Sciences have shown that farm women who have contact with some commonly used pesticides in farm work may increase their risk of allergic asthma. The study, published in the American Journal of Respiratory and Critical Care Medicine, assessed pesticide and other occupational exposures as risk factors for adult-onset asthma in more than 25,000 farm women in North Carolina and Iowa. They found an average increase of 50 percent in the prevalence of allergic asthma in all farm women who applied or mixed pesticides. Remarkably, although the association with pesticides was higher among women who grew up on farms, these women still had a lower overall risk of having allergic asthma compared to than those who did not grow up on farms. But this protective effect remains poorly understood. Some legal but rarely used compounds, such as parathion, were associated with almost a three-fold increase in allergic asthma. But even some commonly used pesticides, such as Malathion, were associated with a marked increase in allergic asthma prevalence.  

Therapy that stimulates the hand muscles may help treat the condition called musician’s dystonia, a movement disorder that causes muscles spasms in musicians, according to a study from researchers at UCL Institute of Neurology in London, United Kingdom published in the journal Neurology. Musician’s dystonia occurs in musicians who have practiced particular complicated movements for years. The muscle spasms are usually painless and generally occur only when playing the instrument. Using transcranial magnetic stimulation, the researchers evaluated the reaction in the sensorimotor area of the brain back to the muscle during vibration of a single hand muscle. In healthy people, the vibration of a muscle increases the amount of brain messages back to the muscle and at the same time reduces the amount of messages to muscles that did not receive vibration. In people with musician’s dystonia, vibration in any one hand muscle increases the amount of messages to all hand muscles. The researchers hope that stimulation can retrain how the brain responds. The study found that the vibration intervention in which subjects had to attend to their thumb muscle tended to restore a more normal pattern in the sensorimotor area of the brain in people with musician’s dystonia.  

 

Previously uninsured adults who received Medicare coverage reported improvements in health, especially those with cardiovascular disease or diabetes, according to a study in the JAMA. Uninsured near-elderly adults, particularly those with cardiovascular disease or diabetes, experience worse health outcomes and use more health services as Medicare beneficiaries after age 65 years than insured near-elderly adults. Because chronic diseases are prevalent and insurance coverage is often unaffordable for older uninsured adults, the impact of near-universal Medicare coverage at age 65 years on the health of previously uninsured adults may be substantial, according to researchers at Brigham and Women’s Hospital and Harvard Medical School in Boston. The researchers conclude that providing earlier health insurance coverage for uninsured adults, particularly those with cardiovascular disease or diabetes, may have considerable social and economic value for the United States by improving health outcomes.