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Immune System May ‘Remember’ Infections From Previous Coronaviruses

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FRIDAY, Jan. 22, 2021 — Previous coronavirus infections might prime the immune system to fight the new coronavirus that causes COVID-19, a new study suggests.

There are numerous types of coronaviruses, including many harmless ones that cause mild upper respiratory infections similar to the common cold.

Besides SARS-CoV-2 — the virus that causes COVID-19 — other deadly coronaviruses include MERS-CoV, which caused a 2012 outbreak in Saudi Arabia of Middle East respiratory syndrome, and SARS-CoV-1, the first pandemic coronavirus that caused the 2003 severe acute respiratory syndrome (SARS) outbreak.

The authors of the new study investigated how coronaviruses affect the human immune system and also took a closer look at the workings of the antibody response.

“Our results suggest that the COVID-19 virus may awaken an antibody response that existed in humans prior to our current pandemic, meaning that we might already have some degree of pre-existing immunity to this virus,” said study senior author John Altin. He’s an assistant professor in the infectious disease branch at the Translational Genomics Research Institute, in Flagstaff, Ariz.

The findings could help scientists develop new diagnostic techniques and treatments, assess the effectiveness of convalescent plasma, and design new vaccines or monoclonal antibody therapies that can protect against mutations that may occur in the COVID-19 virus, according to the researchers.

The study was published Jan. 19 in the journal Cell Reports Medicine.

“Our findings highlight sites at which the SARS-CoV-2 response appears to be shaped by previous coronavirus exposures, and which have potential to raise broadly neutralizing antibodies,” Altin said in an institute news release. He explained that these neutralizing antibodies then may “bind” to elements of the new coronavirus, suggesting that the immune system’s response to SARS-CoV-2 could get some help from prior exposure to other coronavirus strains.

The study may help explain why the new coronavirus causes mild or no symptoms in some people, but severe infections that require hospitalization, and often result in death, in others.

According to study author Jason Ladner, an assistant professor at Northern Arizona University’s Pathogen and Microbiome Institute, the new findings “raise the possibility that the nature of an individual’s antibody response to prior endemic coronavirus infection may impact the course of COVID-19 disease.”

© 2021 HealthDay. All rights reserved.

Posted: January 2021

Further Support and Information on COVID-19

Even When Cancer Is in Remission, Patients’ Risks of Severe COVID Rise

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FRIDAY, Jan. 22, 2021 — Your cancer has gone into remission, so you breathe a sigh of relief as you try to navigate the coronavirus pandemic safely.

Not so fast, says new research that finds even cancer patients in remission still have a high risk of severe illness and death from COVID-19.

Previous studies have shown that cancer patients who have active disease or are hospitalized are at increased risk of severe COVID-19. Now, this latest report shows that protective measures such as mask-wearing and social distancing are just as important for cancer patients in remission, Penn Medicine researchers said.

“Patients who have cancer need to be careful not to become exposed during this time,” said senior study author Dr. Kara Maxwell, an assistant professor of hematology-oncology and genetics at the University of Pennsylvania’s Perelman School of Medicine.

“That message has been out there, but these latest findings show us it’s not only for patients hospitalized or on treatment for their cancer,” Maxwell said in a Penn news release. “All oncology patients need to take significant precautions during the pandemic to protect themselves.”

Maxwell’s team studied 323 people who tested positive for COVID-19 through June 2020, and found that nearly 21% had a cancer diagnosis in their medical history. Of those, 73% had inactive cancer.

COVID-19 patients with active cancer (18) and inactive cancer (49) had higher rates of hospitalization than those without cancer (55.2% vs. 29%), intensive care unit admissions (25.4% vs. 11.7%), and death over 30 days (13.4% vs. 1.6%).

Worse outcomes were more strongly associated with patients with active cancer, but patients in cancer remission also had an increased risk of more severe disease, according to the study published online Jan. 21 in the journal JNCI Cancer Spectrum.

“Our finding that cancer patients with COVID-19 were more likely than non-cancer patients to experience hospitalization and death, even after adjusting for patient-level factors supports the hypothesis that cancer is an independent risk factor for poor COVID-19 outcomes,” Maxwell and her colleagues wrote.

In a separate related study, Penn Medicine researchers found that cancer patients receiving in-person care at a facility with aggressive COVID-19 prevention measures have an extremely low risk of infection. Of 124 cancer patients receiving treatment at Penn Medicine, none tested positive for the virus after their clinical visits (an average of 13 per patient).

The findings suggest that a combination of strict prevention controls in cancer care facilities and social distancing outside the facilities may help protect cancer patients from COVID-19 exposure and infection, the authors said. This study was published on the preprint server medRxiv and has not yet been peer-reviewed.

© 2021 HealthDay. All rights reserved.

Posted: January 2021

Further Support and Information on COVID-19

For Rising Number of People, Obesity Is a Literal Headache

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THURSDAY, Jan. 21, 2021 — As worldwide obesity rates continue to soar, new research shows that growing numbers of people are developing a potentially blinding type of weight-linked headache that was once considered rare.

Though the study was conducted in Wales, one U.S. expert said the same surge in these headaches is likely happening in this country and elsewhere, but he cautioned that just because someone is obese and has headaches doesn’t mean he or she have this rare headache, known as idiopathic intracranial hypertension (IIH).

“Obese individuals are at greater risk for more frequent migraine, too,” noted Dr. Brian Grosberg, director of the Hartford HealthCare Headache Center in Connecticut.

In the study, IIH rates increased sixfold in Wales between 2003 and 2017 — from 12 per 100,000 people to 76 per 100,000 people. During the same 15-year span, obesity rates in Wales rose from 29% of the population to 40%.

“The considerable increase in IIH incidence” has several causes, but is likely “predominately due to rising obesity rates,” said study author William Owen Pickrell, a consultant neurologist at Swansea University. “The worldwide prevalence of obesity nearly tripled between 1975 and 2016, and therefore, these results also have global relevance.”

His findings were published in the Jan. 20 issue of Neurology.

IIH is a type of headache that occurs when the fluid around your brain and spinal cord builds up in your skull. This places extra pressure on your brain and the optic nerve in the back of your eye, causing symptoms that can mimic a brain tumor such as debilitating head pain, blind spots and possibly vision loss, according to the National Eye Institute.

The cause is not fully understood, but weight loss is the main treatment. Some people may need medication and/or surgery to drain the fluid and relieve the pressure. “There is some evidence that weight loss can improve headache symptoms,” Pickrell said.

During the review, researchers found 1,765 cases of IIH, 85% in women. They looked at patients’ body mass index (BMI), a measure of body fat based on height and weight, as well as their economic status based on their address. They compared this information to that of individuals without IIH.

Overall, the risk of developing IIH was higher in those who were obese.

Economic status only affected women’s risk, and this finding was independent of their weight, according to the study. Obese women of child-bearing age were at highest risk of IIH.

People with IIH were also more likely to require emergency hospital admissions than their counterparts without these headaches, with 9% requiring brain surgery to prevent blindness, the study found.

Pickrell did say there could be explanations other than obesity for the surge in IIH.

“The increase may also be attributable to increased IIH diagnosis rates due to raised awareness of the condition and greater use of [digital] technology at routine optometry appointments,” he said. Eye doctors often diagnose IIH during routine exams that look at the back of the eye.

The biggest concern with these headaches is the potential for vision loss, which likely explains the increased rates of emergency hospital admissions seen in the new study among people with IIH.

© 2021 HealthDay. All rights reserved.

Posted: January 2021

You’re More Likely to Maintain Social Distance If Your Friends Do: Study

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FRIDAY, Jan. 22, 2021 — Family and friends can influence whether people follow social distancing recommendations during the coronavirus pandemic, a new study finds.

British researchers analyzed information from more than 6,600 people in 114 countries. Those who thought their close social circle adhered to distancing guidelines were more likely to do the same, the analysis found.

This influence outweighed whether people personally felt distancing was the right thing to do, according to findings published Jan. 21 in the British Journal of Psychology.

The findings suggest that emphasizing shared values and using the influence of family and friends could get more people to follow COVID-19 safety measures, according to the researchers.

“We saw that people didn’t simply follow the rules if they felt vulnerable or were personally convinced. Instead, this uncertain and threatening environment highlighted the crucial role of social influence,” said lead author Bahar Tunçgenç, a research fellow in the School of Psychology at the University of Nottingham.

She noted that the most diligent followers of the guidelines were those whose loved ones also followed the rules.

“We also saw that people who were particularly bonded to their country were more likely to stick to lockdown rules — the country was like family in this way, someone you were willing to stick your neck out for,” Tunçgenç said in a journal news release.

Using social media to let family and friends know that you’re following COVID-19 safety guidelines could encourage them to do the same, Tunçgenç suggested.

Also, public health messages by trusted people could emphasize collective values, such as doing things for the benefit of loved ones and the community.

Tunçgenç also said that social apps — similar to social-based exercise apps — could tell people whether their family or close friends are enrolled for vaccination, which could encourage them to follow suit.

© 2021 HealthDay. All rights reserved.

Posted: January 2021

Further Support and Information on COVID-19

Meth Overdose Deaths Are Surging in America, With Minorities Most at Risk

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FRIDAY, Jan. 22, 2021 — Deaths from overdoses of methamphetamine are rising across the United States, especially among Blacks and American Indians/Alaska Natives, a new study warns.

“While much attention is focused on the opioid crisis, a methamphetamine crisis has been quietly, but actively, gaining steam — particularly among American Indians and Alaska Natives, who are disproportionately affected by a number of health conditions,” said researcher Dr. Nora Volkow, director of the U.S. National Institute on Drug Abuse (NIDA).

The researchers found that fatal meth overdoses more than quadrupled among American Indians and Alaska Natives from 2011 to 2018 (from 5 to 21 per 100,000 people). In this group, deaths for men rose from nearly 6 to 26 per 100,000 and from nearly 4 to 16 per 100,000 among women.

Black Americans, too, are experiencing a big upsurge in meth overdoses, according to the NIDA report. That’s a worrying trend in a group that previously had very low rates of methamphetamine overdose deaths.

However, meth-linked deaths are rising among all Americans, NIDA says. Overall, fatal OD rates rose from less than 2 to 10 per 100,000 men, and from 0.8 to 4.5 per 100,000 women — a more than fivefold increase from 2011 to 2018, the report found.

These findings, published Jan. 20 in JAMA Psychiatry, highlight the need to develop prevention and treatment strategies that target specific cultures, the researchers said.

Decreased access to education, high rates of poverty and discrimination are among factors that contribute to health disparities for American Indians and Alaska Natives, the study authors noted.

“American Indian and Alaska Native populations experience structural disadvantages, but have cultural strengths that can be leveraged to prevent methamphetamine use and improve health outcomes for those living with addiction,” Volkow added in an NIDA news release.

A holistic approach to wellness is a deeply rooted tradition among some American Indian and Alaska Native groups, such as talking circles and ceremonies. Using these traditions and other community-based approaches may be a way to help prevent drug use among young people, the study team suggested.

According to researcher Dr. Beth Han, also from NIDA, “Identifying populations that have a higher rate of methamphetamine overdose is a crucial step toward curbing the underlying methamphetamine crisis. By focusing on the unique needs of individuals and developing culturally tailored interventions, we can begin to move away from one-size-fits-all approaches and toward more effective, tailored interventions.”

There was a bit of recent good news when it comes to methamphetamine addiction: A pair of prescription drugs, taken together, appears to help patients significantly reduce their meth use, or quit altogether. A trial into the treatment was published Jan. 14 in the New England Journal of Medicine.

Volkow said the “synergistic” power of using this combo of drugs — bupropion and naltrexone — is good news, amounting to the largest effect seen from a large, randomized clinical trial in the treatment of methamphetamine use disorder.

© 2021 HealthDay. All rights reserved.

Posted: January 2021

Maybe Money Can Help Buy Happiness, After All

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THURSDAY, Jan. 21, 2021 — Millionaires, rejoice! It turns out that money can, in fact, buy happiness. And a new study suggests more is better, with well-being rising as earnings grow.

“Having more money gives people a greater sense of control over life,” said study author Matthew Killingsworth.

The finding stems from more than 1.7 million real-time reports of well-being from more than 33,000 U.S. adults. They were prompted by their cellphones to answer the question “How do you feel right now?” at random times during their waking hours.

Previous research had suggested that an annual income of more than $75,000 might not improve people’s day-to-day lives, and that notion has been widely circulated.

But this study appears to disagree.

Seen from a moment-by-moment angle, Killingsworth said, the data show “evidence that happiness rises continuously, far above $75,000,” which means there’s reason to believe that more money really does improve people’s lives.

“If you have more money, you can choose how to spend your time and how to direct your life,” said Killingsworth, a senior fellow at the University of Pennsylvania’s Wharton School of Business, in Philadelphia.

Stress reduction

This study found that a sense of control accounted for as much as 74% of the apparent link between greater income and greater well-being.

People who earn more spend less time stressing out about bills, Killingsworth noted.

The study found that 44% of low-earners had money problems, compared with 7% among those earning over $500,000, he said.

“To put it another way: People with low incomes were seven times as likely to report trouble coping with bills,” Killingsworth explained.

The report was published in the Jan. 26 issue of the Proceedings of the National Academy of Sciences.

On average, participants were 33 years old and made about $85,000 per year. About 1% earned $500,000 or more. Just over one-third were married (37%), and about two-thirds were women.

Real-time well-being reports were solicited randomly throughout the day. Participants were also asked how important money was to them; whether they equated money with success; whether they felt in control of their life; and how optimistic, financially insecure, and/or time-pressed they were.

After stacking responses up against income, Killingsworth broadly found that the more money you make, the better you feel day-to-day and the more satisfied you are with life overall.

He found no evidence of a ceiling in the relationship between money and happiness. Above $80,000 a year, larger incomes were associated with significantly higher levels of all positive feelings (confident, good, interested and proud) and significantly lower levels of negative feelings (bored, bad, sad, upset).

So are people on the short end of the economic stick doomed to a less happy existence?

Not necessarily. While wealth matters, it’s “far from the most important thing,” Killingsworth said.

For one thing, while money can afford a sense of control, there’s always an opportunity to find other ways to achieve the same end, he said. And some people say money just isn’t that important to them.

“For those people, happiness is virtually unaffected by how much they earn,” Killingsworth said. “So it’s possible that people who don’t earn high salaries, but nevertheless craft lives that they enjoy, may find they don’t actually miss having more money.”

A complex relationship

The goal, he said, should be to keep money in perspective, because “people are happiest when they don’t equate money and success in life.”

The findings came as little surprise to James Maddux, senior scholar with the Center for the Advancement of Well-Being at George Mason University, in Fairfax, Va.

“Research on the relationship between wealth and happiness, for individuals and nations, has been evolving for decades and has shown that the relationship is complex, as this study again demonstrates,” Maddux noted.

So Killingsworth’s finding of a link between higher incomes and life satisfaction “is not a radical take or an alternative ‘school of thought,'” Maddux said. “It’s simply new information about a very complex research question.”

And given the finding of a strong connection between a sense of control and well-being, Maddux offered some advice.

“Stop trying to become happier by buying more and more expensive stuff,” he said, because that’s the road to debt. “And debt is detrimental to life satisfaction, partly because it leads to feelings of insecurity and loss of control.”

© 2021 HealthDay. All rights reserved.

Posted: January 2021

Will Vaccines Work Against the New Coronavirus Variants?

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FRIDAY, Jan. 22, 2021 — Everyone has heard the scary reports about the new, more infectious coronavirus variants that are circulating in countries around the world, but scientists aren’t pushing the panic button at this point.

Why? Because the new COVID-19 vaccines should still work on these viral interlopers.

Luckily, the new variants still rely on the coronavirus’ “spike protein” to infect cells, and the two COVID vaccines now on the U.S. market specifically target the spike protein to prevent transmission, explained Dr. Kathryn Edwards, scientific director of the Vanderbilt University Vaccine Research Program in Nashville.

“The spike is really critical. It’s really what is needed to interact with the cell,” Edwards said. “So, I think it would be hard to circumvent the spike in terms of function.”

New COVID variants out of Britain, South Africa and Brazil appear to be more infectious, possibly because the spike protein has mutated to make transmission between people easier, said Dr. Mirella Salvatore, an infectious disease expert and assistant professor at Weill Cornell Medicine in New York City.

“The spike protein is needed to bind to the cell, to allow the virus to enter,” Salvatore explained. “If there are a lot of these mutations, maybe this binding is stronger and the virus can enter more easily. This is a possibility why this virus seems to transmit more easily.”

But the Pfizer and Moderna vaccines are designed to not only target the spike protein, but to promote the creation of antibodies that will attack it in several different ways, Salvatore said.

Therefore, it’s not likely that a mutation would be able to evade the complex immune response created by a vaccine, even if the mutation makes the spike protein more effective at infecting unvaccinated people, the experts said.

“It’s not one single antibody, so if there is a mutation that changed a little bit of the structure of the spike protein, then there would be a lot of other substantial antibodies that would be able to stop the virus from attacking the cell and entering the cell,” Salvatore noted.

Edwards and Salvatore spoke Thursday during a briefing hosted by the Infectious Diseases Society of America, of which they are both fellows.

There was a bit of bad news delivered during the briefing: The new Brazilian and South African variants do appear to be capable of reinfecting people who’ve had COVID before, the experts said.

For example, a Brazilian health care worker fell ill from both the original COVID-19 virus and, months later, again from what turned out to be a new mutation of the virus, Edwards said.

However, the man did not suffer severe illness either time, so it’s possible that his body didn’t mount a strong enough immune response during the first infection to protect him against the second, Edwards said.

“The height of the antibody response may be somewhat proportional to how sick you are in the beginning. Maybe if the patient had been vaccinated or maybe had a more severe disease, he would have had a higher antibody count that would have protected him,” Edwards said.

The heightened transmissibility of the new strains and their potential to evade the natural immunity caused by infection has raised concerns about a new wave of coronavirus in the United States, said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota.

“I am extremely worried about the U.K. variant,” Osterholm said during a HD Live! interview this week. “I think over the course of the next six to 12 weeks we could see the darkest days of this pandemic in this country, with that variant being responsible for greatly increased transmission.”

The new variants haven’t proven more lethal than the original COVID strain, Salvatore said, but increased infection could increase the number of people who die from the coronavirus.

Public health and infectious disease experts will need to continue to track new variants of COVID and decipher their genetics, just in case a new mutation causes a severe decline in vaccine effectiveness, the experts said.

But if that happens, it likely will be easy to change up the lab-created messenger RNA vaccines to maintain their effectiveness against new mutations, Edwards said.

“That is an advantage of the mRNA vaccines,” Edwards said, noting that public health officials already change the flu vaccine every year to maintain its effectiveness against the much more mutation-prone influenza virus.

“That process is done so efficiently by the [U.S. Food and Drug Administration] and other regulators that the ability to change is something we do every year,” Edwards said. “I think as we are going forward, we are using influenza as the model.”

© 2021 HealthDay. All rights reserved.

Posted: January 2021

Further Support and Information on COVID-19

AHA News: Keeping Your Brain Sharp Isn’t About Working More Puzzles

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THURSDAY, Jan. 21, 2021 (American Heart Association News) — Mental decline is one of the most feared aspects of growing older. People will do just about anything to prevent it, from swallowing supplements touted as memory boosters to spending hours solving Sudoku and crossword puzzles.

But do these things really keep the aging brain sharp? The short answer is, not really.

“It can certainly help you concentrate if you spend an hour or two doing puzzles,” said Dr. Vladimir Hachinski, a Canadian neurologist and global expert in the field of brain health. “It’s good because you’re exercising your brain. But don’t expect too much from it.”

One in 8 Americans age 60 or older report having at least some memory loss and roughly 35% of them report problems with brain function, according to the Centers for Disease Control and Prevention. While this doesn’t always lead to full-blown dementia, the number of older people in the United States struggling with cognitive issues is growing: The CDC predicts the number of people in the U.S. with dementia – including its most common form, Alzheimer’s disease – will nearly triple to roughly 14 million people by 2060.

Research suggests there are indeed ways to prevent or delay many types of cognitive loss, but they don’t involve fish oil supplements or brain teasers. Instead, Hachinski and others in the field agree, people who want to preserve good brain function should take the same steps they would to protect their hearts.

“If you have a good heart, you have a good brain,” said Dr. Rong Zhang, professor of neurology at UT Southwestern Medical Center in Dallas. “Whatever risk factors that are bad for your heart, such as high blood pressure, smoking, obesity or a lack of physical activity, these things are also bad for your brain.”

The link between heart health and brain health is well established.

The American Heart Association and an expert-led Lancet Commission advise people to focus on their risk factors for heart disease and stroke. These include lowering blood pressure, blood sugar and cholesterol levels; getting enough sleep; not smoking; limiting alcohol intake; eating a healthy diet; exercising at least 150 minutes per week; maintaining a healthy weight; and staying socially active. The Lancet Commission recently expanded its list of dementia risk factors to also include head injuries in mid-life and exposure to air pollution.

Researchers believe at least 40% of dementias can be prevented or delayed by modifying these risk factors. Hachinski said the percentage could well be higher if more strokes were prevented. He was the lead author of a 2019 paper published by the World Stroke Organization calling for the joint prevention of stroke and dementia.

Stroke doubles the chance of developing dementia and high blood pressure is a powerful predictor of stroke, Hachinski said, adding that an estimated 90% of strokes are preventable.

“All major dementias have a vascular (blood vessel) component,” he said, because the brain needs good blood flow to provide it with sufficient nutrients and oxygen to work properly. “If you control the vascular component, you can diminish or prevent dementia.”

While major strokes cause an obvious and sudden decline in cognitive function, it’s more common for people to have smaller, silent strokes they don’t even realize are happening, Hachinski said. These “mini-strokes” have been shown to accelerate mental decline, as does uncontrolled blood pressure at any age.

Type 2 diabetes, which often can be prevented or delayed by losing weight and increasing physical activity, also increases the risk of dementia by 60%.

“By and large, the onset of dementia is gradual,” Hachinski said, likening the process to “descending into an abyss. It can happen in different ways, at different rates and to different depths.”

The best way to slow that decline, he said, is to identify your personal risk factors and then tackle the biggest ones. Do you need to lose weight? Exercise more? Eat a healthier diet? Lower your blood sugar?

“Know your family history. Have some idea of what you’re facing,” he said. “Get your blood pressure taken. Risk factors love company. If you have high blood pressure, you undoubtedly have other things going on.”

During the day, the brain uses a lot of energy, in the process discarding excess proteins that build up like junk in a teenager’s room. “The brain needs a way to get rid of these bad proteins,” Zhang said, “to clear away the waste. When there is a lot of garbage in the environment, it hurts the brain.”

Exercise helps with this clearance, and so does sleep, he said.

Building good brain health habits should start long before cognition starts to decline, experts advise.

“In middle age, the risk begins to climb rather rapidly,” Hachinski said. “It’s never too late, but the earlier, the better. I think the most important thing is to begin.”

American Heart Association News covers heart and brain health. Not all views expressed in this story reflect the official position of the American Heart Association. Copyright is owned or held by the American Heart Association, Inc., and all rights are reserved. If you have questions or comments about this story, please email editor@heart.org.

By Laura Williamson

© 2021 HealthDay. All rights reserved.

Posted: January 2021

Could Stem Cell Therapy Be a Breakthrough Against MS?

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THURSDAY, Jan. 21, 2021 — Stem cell transplants may have long-lasting benefits for some people with aggressive cases of multiple sclerosis, a new study suggests.

Italian researchers found that among 210 multiple sclerosis (MS) patients who received a stem cell transplant — with cells from their own blood — two-thirds saw no worsening in their disability 10 years out.

That included 71% of patients with relapsing-remitting MS, the most common form of the disease.

The sustained level of effectiveness is “pretty dramatic,” said Bruce Bebo, executive vice-president of research programs for the National Multiple Sclerosis Society.

At the same time, there are important caveats, said Bebo, who was not involved in the study.

For one, the patients were not part of a clinical trial that directly tested stem cell transplants against standard MS medications. They all underwent transplants at various Italian medical centers between 1997 and 2019.

So it’s unclear exactly how such transplants measure up against the most effective MS drugs now available.

Beyond that, Bebo said there are ongoing questions about which MS patients are the best candidates for a transplant, and the optimal timing for it.

Those are no small matters, since a stem cell transplant is a major undertaking, he pointed out.

“And it’s not reversible, like a medication you can change when it’s not working,” Bebo said.

MS is a neurological disorder caused by a misguided immune system attack on the body’s own myelin — the protective sheath around nerve fibers in the spine and brain. That leads to symptoms such as vision problems, muscle weakness, numbness, and difficulty with balance and coordination.

About 85% of people with MS initially have the relapsing-remitting form, according to the MS society. That means symptoms flare for a time and then ease. Most people, though, eventually transition to a progressive form of the disease, and their disability worsens over time.

Why treat MS with a stem cell transplant? Stem cells from the bone marrow are the building blocks of the immune system, and the goal of the transplant is to “reboot” the faulty immune system, Bebo explained.

The procedure involves removing stem cells from a patient’s own blood, then using powerful chemotherapy drugs to knock down the existing immune system.

After that, the stored stem cells are infused back into the patient, and the immune system rebuilds itself over time.

It requires a long hospital stay, plus a period of months when patients are severely immunocompromised, Bebo said.

In the current study, three patients died after their transplant, though none occurred after 2007.

“This is important evidence,” said Dr. Alexander Rae-Grant, a neurologist and fellow of the American Academy of Neurology. “But it doesn’t prove [stem cell transplant] is better than the standard treatments we currently have.”

Still, Rae-Grant said, the longer-term data do offer some reassurance on the safety of the procedure for MS patients, and additional evidence that it is “a reasonable approach.”

Like Bebo, he pointed to the bigger-picture issue: When is it best to try a stem cell transplant?

Right now, Rae-Grant said, the general thinking is that the approach may be best for patients with relapsing-remitting MS who are relatively young and have “very active” disease despite medication.

The trick, according to Rae-Grant, is to strike a balance: Doctors would not want to be overly aggressive in using stem cell transplants, but would also want to intervene early enough to forestall disability as much as possible.

Clinical trials, including one in the United States called BEAT-MS, are underway to directly test stem cell transplant against the most effective MS medications.

Ideally, eligible patients would get into a clinical trial, said Dr. Matilde Inglese, one of the researchers on the current study.

Otherwise, they should consult one of the small number of medical centers with extensive experience in using the procedure for MS, said Inglese, head of the Multiple Sclerosis Center at the University of Genoa, in Italy.

Bebo stressed that point. This is not, he said, an undertaking that can be done at self-described “stem cell clinics” that advertise their services for various conditions.

Even when done at a reputable medical center, other issues loom, including cost.

Bebo said he’s seen figures in the $150,000 to $250,000 range, and people may or may not be able to get their insurance to cover it.

The findings were published online Jan. 20 in Neurology.

© 2021 HealthDay. All rights reserved.

Posted: January 2021

Diabetes Boosts Odds for Heart Trouble 10-fold in Younger Women

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THURSDAY, Jan. 21, 2021 – – With rising obesity rates, more young women American women are developing type 2 diabetes, putting them at hugely increased risk for heart disease, new research shows.

In fact, the study found that women under 55 with type 2 diabetes had a tenfold greater risk of having heart disease over the next two decades compared to their non-diabetic peers.

Even just having high blood sugar appeared to increase the risk for premature heart disease by 600%, according to researchers at Boston’s Brigham and Women’s Hospital.

All of this means that “we’re going to see, unfortunately, younger and younger people having heart attacks,” said researcher Dr. Samia Mora, of Brigham’s Center for Lipid Metabolomics.

“When a younger individual has a cardiovascular event, it will affect their quality of life going forward, their productivity, and their contribution to society,” Mora said in a hospital news release.

None of that is inevitable, since so many risk factors for heart disease — including obesity, diabetes and smoking — can be brought under control, according to one diabetes specialist.

“Risk factor management at a younger age is important and can significantly reduce cardiovascular events in the future years,” said Dr. Shuchie Jaggi, attending physician in endocrinology, diabetes and metabolism at Northwell Health in Great Neck, N.Y. She wasn’t involved in the new report.

In their research, Mora’s group analyzed more than 50 heart risk factors among more than 28,000 American women who took part in the ongoing Women’s Health Study.

For example, they tracked 50 “biomarkers” tied to cardiovascular health, including low-density lipoprotein (LDL) cholesterol (“bad” cholesterol) and hemoglobin A1C (a measure of blood sugar levels).

Both of those factors had weaker associations with heart disease onset in women younger than 55 than lipoprotein insulin resistance (LPIR,) a newer metric for insulin resistance.

Insulin resistance occurs when cells in muscles, fat and the liver don’t respond well to insulin and can’t use glucose. It’s typically a precursor to diabetes.

Whereas LDL cholesterol was only associated with a 40% increase in the risk of heart disease onset in women under 55, an unhealthy LPIR measurement was tied to a 600% increase. And overall, the study found that women under 55 with type 2 diabetes had a tenfold greater risk of having heart disease over the next two decades.

So, “in otherwise healthy women, insulin resistance, type 2 diabetes, and its sister diagnosis, metabolic syndrome, were major contributors to premature coronary events,” Mora explained. “Women under 55 who have obesity had about a fourfold increased risk for coronary events, as did women in that age group who smoked or had hypertension. Physical inactivity and family history are all part of the picture as well.”

One other expert said such research is long overdue.

“For many years, cardiovascular research was done only in men and the older patient population,” noted Dr. Roshini Malaney, a cardiologist at Staten Island University Hospital in New York City.

But waiting until later in life to address health issues is suboptimal, she said, so a focus on younger women is welcome.

By the time a woman reaches her senior years, “there is no time to intervene prior to having a cardiac event,” Malaney said.

The new data “helps primary care doctors and cardiologists hone in on other identifying factors in order to prevent heart disease,” she believes. “While we can’t control our genes, this study gives us more data to promote lifestyle changes early on and have numbers to back us up.”

Mora agreed.

“Diabetes is mostly preventable, but it’s a systemwide problem, and we urgently need further research into new strategies to address it,” she said. “These could be innovative lifestyle-based strategies, like community efforts, greater public health efforts, ways to medically target metabolic pathways, or new surgical approaches.”

“We need new strategies to improve outcomes in these younger individuals and address the risk of diabetes because we’re only seeing the beginning of this epidemic now.”

The report was published online Jan. 20 in the journal JAMA Cardiology.

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Posted: January 2021