Atopic dermatitis in children tied to increased risks of learning and memory difficulties: JAMA

USA: A cross-sectional study suggests prioritizing evaluation for cognitive impairment in children with atopic dermatitis (AD) among those with comorbid neurodevelopmental disorders. The findings were published online in JAMA Dermatology on March 6, 2024.

Using 2021 US National Health Interview Survey data, the researchers found that a weighted sample of 69 732 807 children with atopic dermatitis were more likely to experience memory and learning difficulties than those without AD. However, these associations were primarily limited to children with neurodevelopmental comorbidities, such as learning disabilities or attention-deficit/hyperactivity disorder (ADHD), and not observed among children without comorbid neurodevelopmental disorders.

Previous studies indicate that atopic dermatitis is associated with cognitive impairment in children, but these studies have primarily relied on neurodevelopmental diagnoses (rather than symptoms) as proxy measures of cognitive function. Whether certain subpopulations of children with AD are at greater risk of cognitive impairment remains unknown.

To fill this knowledge gap, Emily Z. Ma, University of Maryland School of Medicine, Baltimore, and colleagues aimed to investigate the association of AD with symptoms of cognitive impairment (difficulty in memory or learning) among US children. They also determined whether this association varies according to the absence or presence of neurodevelopmental comorbidities (developmental delay, ADHD, or learning disability).

The researchers utilized 2021 data from the US National Health Interview Survey collected on children aged 17 years or younger without intellectual disability or autism. AD presence was based on an adult or parent caregiver’s report indicating either a current diagnosis of AD or a previous medical confirmation of AD by a healthcare professional.

The study’s main outcome was difficulty with learning or memory based on the child’s caregiver.

The study led to the following findings:

  • Among the weighted total of 69,732 807 participants, 13.2% had atopic dermatitis.
  • Compared with children without AD, children with AD were more likely to experience difficulties with learning (10.8% versus 5.9%) and difficulties with memory (11.1% versus 5.8%).
  • In multivariable logistic regression models adjusted for sociodemographic factors, food allergies, asthma, and seasonal allergies or hay fever, AD was associated with increased odds of difficulties in learning (adjusted odds ratio [AOR], 1.77) and memory (AOR, 1.69).
  • In analyses stratified by neurodevelopmental comorbidities, AD was associated with 2- to 3-fold greater odds of memory difficulties among children with any neurodevelopmental disorder (AOR, 2.26), including learning disabilities (AOR, 2.04) or ADHD (AOR, 2.90).
  • AD was not associated with learning or memory difficulties among children without neurodevelopmental conditions.

“These findings may improve the risk stratification of children with atopic dermatitis for cognitive impairments and suggest prioritizing evaluation for cognitive difficulties among children with AD and neurodevelopmental disorders,” the researchers concluded.

Reference:

Ma EZ, Chang HR, Radtke S, Wan J. Symptoms of Cognitive Impairment Among Children With Atopic Dermatitis. JAMA Dermatol. Published online March 06, 2024. doi:10.1001/jamadermatol.2024.0015

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High-dose inhaled nitric oxide reduces death risk among critically ill Black COVID-19 patients: Study

USA: A recent study has revealed that high-dose inhaled nitric oxide therapy may improve oxygenation and reduce the risk of mortality among critically ill Black patients with COVID-19. The first-of-its-kind study was published in the American Journal of Respiratory and Critical Care Medicine. 

Acute respiratory distress syndrome, or ARDS, is a condition that most commonly occurs in the setting of a lung infection such as COVID-19.

“In ARDS, the barrier between the blood vessels and air sacs in the lungs is disrupted leading to the accumulation of fluid from the blood vessels in the air sacs, restricting air exchange in the lungs,” said Naman S. Shetty, M.D., a research fellow in the UAB Division of Cardiovascular Disease and the first author of this manuscript. “Poor air exchange in ARDS leads to organ damage and increases the risk of death. Therefore, increasing oxygenation in ARDS may improve survival and decrease organ damage. However, it may not be possible to maintain oxygenation in patients with ARDS when providing external support for breathing using a mechanical ventilator.”

During the peak of the COVID-19 pandemic, witnessing the ever-increasing mortality of COVID-19 patients led Pankaj Arora, M.D., the senior author of the manuscript and an associate professor in the UAB Division of Cardiovascular Disease, to collaborate with Lorenzo Berra, M.D., to initiate the NOSARSCOVID trial, an international multicenter trial to examine the effects of high-dose inhaled nitric oxide on improving oxygenation in COVID-19 patients who required support from a mechanical ventilator.

Trials are rare in critically ill patients due to enrollment difficulties; therefore, this effort provided a much-needed boost in critical care research during the pandemic. The primary trial revealed that high-dose inhaled nitric oxide therapy improved oxygenation.

As an extension of the NOSARSCOVID trial, Shetty and his team assessed whether racial differences in the response to inhaled nitric oxide were present. The trial recruited a diverse patient population, allowing them to effectively examine this research question.

“In the study, we evaluated whether the improvement in oxygenation and risk reduction in mortality differed among white and Black patients recruited in the trial,” Shetty said. “Inhaled nitric oxide therapy was associated with a larger improvement in oxygenation among Black patients compared with white patients. Most notably, inhaled nitric oxide therapy reduced the risk of death at 28 and 90 days in Black patients. This benefit was not observed among white patients.”

Arora says these findings may be due to differences in biological systems among different races and ethnicities.

“To ascertain that self-reported race could indicate biological differences, we used data from the All of Us Research Program and restricted the data to include populations where patients were recruited from in our trial,” Arora said. “This was done to determine whether the self-reported race is a good surrogate for genetic ancestry in these individuals. We found that the self-reported race in these geographical areas was a good proxy for genetic ancestry.”

Arora says the differences observed in this study may be attributed to differences in the nitric oxide system.

“Black individuals have been shown to have a suppressed nitric oxide system at baseline compared with white individuals,” Arora said. “The suppressed nitric oxide system in Black individuals increases their susceptibility to developing severe ARDS with a high risk of death. Treatment with inhaled nitric oxide overcomes this intrinsic deficit in the nitric oxide system in Black individuals.”

Arora says this study calls for a larger phase three trial to test the hypothesis in Black patients. Arora explains that, due to the complexity of conducting trials in critical care, the inclusion of a diverse population was traditionally placed lower on the list of priorities.

“Our study highlights that the treatment effect of an intervention may vary by race,” Arora said. “Therefore, there is a need for adequate representation of minority populations in large clinical trials. Furthermore, our study draws attention to the individualization of treatment based on the patient. Precision phenotyping techniques incorporating clinical, physiological, imaging and molecular markers may help guide physicians to individualize therapy in ARDS.”

Reference:

Naman S Shetty , Valentina Giammatteo , Mokshad Gaonkar , Peng Li , Oluwaseun Akeju , Garima Arora , Lorenzo Berra ; Pankaj Arora, Differences in the Response to High-Dose Inhaled Nitric Oxide in Self-identified Black and White Individuals: A Post-Hoc Analysis of the NOSARSCOVID Trial, American Journal of Respiratory and Critical Care Medicine, https://doi.org/10.1164/rccm.202310-1852LE.

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Use of benzodiazepines for seizure control in kids tied to future risk of polytherapy, reveals study

Managing antiseizure treatment in epileptic patients relies on the benefit–risk ratio. More data on using antiseizure medication (ASM) in children must be available.

The present study published in Epilepsia investigated the prevalence of prescription patterns for antiseizure medication for pediatric epilepsy patients in France. The most common antiseizure medicine prescribed was valproate, followed by lamotrigine and levetiracetam. From 2013-2016, there was reduced prevalence of benzodiazepine usage, whereas the prevalence of levetiracetam use increased. Using benzodiazepines increased the likelihood of switching from bitherapy to polytherapy. The usage of benzodiazepines may pose a future risk for polytherapy prescriptions; they highlight
This study described antiseizure medication use in children with epilepsy (CwE) in France, focusing on chronic use of benzodiazepines and related implications.
Researchers conducted a 5-year cohort study from January 2012. They used data from the French national health care data system Children with Epilepsy were identified through the International Classification of Diseases, 10th Revision codes and medications( January 2012 to December 2015; followed them until December 2016) . They described ASMs and assessed whether the risk of initiating a polytherapy after a bitherapy depends on whether benzodiazepine was included in the bitherapy.
Key findings from this study are:
Researchers identified 62 885 Children with Epilepsy.
Valproate was the most reimbursed ASM (40%).
This was followed by lamotrigine, levetiracetam, clobazam, and carbamazepine, which constituted 17.6%, 9.3%, 6.1 %, and 5.8 %, respectively.
Prescriptions were initiated in 74.5% of Children with epilepsy at the hospital.
The number of CwE with at least one benzodiazepine reimbursement decreased from 15.3% to 10.1 % in 2013 and 2016, respectively.
CwE prevalencewith levetiracetam reimbursements increased. On the other hand, the prevalence with valproate decreased.
A switch from a bitherapy to a polytherapy was more likely when the bitherapy included a benzodiazepine with a subdistribution hazard ratio or sHR of 1.20
They concluded that during the study period, CwE prevalence with at least one benzodiazepine reimbursement decreased. Benzodiazepines were also associated with increased use of subsequent ASM polytherapy.
Reference:
Auvin, S., Guillo, S., De Rycke, Y., Tran, D., & Tubach, F. (2024). Benzodiazepines for pediatric epilepsies and their risks in a cohort within the French health care data. Epilepsia. https://doi.org/10.1111/epi.17906

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Which is better – intravenous or nebulized dexmedetomidine as premedication?

Recently published research paper investigates the comparative effectiveness of nebulized dexmedetomidine versus traditional intravenous administration in attenuating hemodynamic responses associated with laryngoscopy and tracheal intubation. The study involved 60 patients undergoing surgery under general anesthesia, who were randomly allocated into two groups receiving either intravenous or nebulized dexmedetomidine as premedication. The study found that nebulized dexmedetomidine resulted in better obtundation of hemodynamic responses following laryngoscopy and maintained hemodynamics intraoperatively, compared to intravenous administration. Nebulized dexmedetomidine was associated with a lower sedation score and fewer adverse effects, such as bradycardia and hypotension, compared to intravenous administration. The study highlights the potential benefits of alternative administration methods for dexmedetomidine in improving perioperative outcomes and enhancing patient safety. The findings suggest that nebulized dexmedetomidine may offer a promising alternative to intravenous administration for attenuating hemodynamic responses during airway manipulation. The study also discusses the importance of assessing the mode of dexmedetomidine delivery on hemodynamic responses and emphasizes the need for further exploration and research in diverse clinical settings and patient populations.

Comparison of Administration Groups

The comparison of basic parameters between the two administration groups showed no significant differences in age, weight, or comorbidities, indicating that the randomization process was effective in creating homogeneous groups. The study also found no significant difference in the ASA grades between the groups. The comparison of baseline vitals showed no significant differences in heart rate, systolic and diastolic blood pressure, MAP, respiratory rate, and temperature between the groups. The study observed a statistically significant decrease in heart rate, blood pressure, and MAP in the intravenous group compared to the nebulized group at various time intervals after induction, highlighting the importance of vigilant monitoring during the post-induction period. Additionally, the study found that nebulized dexmedetomidine achieved a deeper level of sedation compared to intravenous administration.

Study Limitations and Conclusion

The research paper also discusses limitations, such as the evaluation of a single dose of dexmedetomidine and the exclusion of other routes of administration, suggesting the need for further research. Overall, the study presents valuable insights into the potential benefits of nebulized dexmedetomidine in achieving optimal sedation, minimizing hemodynamic fluctuations, and improving patient safety during perioperative care.

Reference –

Singla A, Saraswat R K, Bharadwaj A, et al. (February 23, 2024) Nebulized Versus Intravenously Administered Dexmedetomidine for Obtunding

Hemodynamic Responses to Laryngoscopy and Tracheal Intubation: A Randomized Double-Blind Comparative Study. Cureus 16(2): e54768. DOI

10.7759/cureus.54768

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Water-Free Cyclosporine Solution may Improve Dry Eye Disease symptoms: JAMA

A recent study published in the recent edition of Journal of American Medical Association revealed promising results in the treatment of Dry Eye Disease (DED). This study focused was set out to evaluate the efficacy and safety of a water-free cyclosporine ophthalmic solution in Chinese participants with moderate to severe DED.

The multicenter, double-blind, vehicle-controlled, phase 3 randomized clinical trial was conducted from March 4, 2021 to July 22, 2022 and enrolled a total of 206 adult participants from 12 hospitals in China. The participants were randomly assigned to receive either the water-free cyclosporine solution or a vehicle control. After a 29-day treatment period, the results were analyzed.

The primary endpoints of the study were changes in total corneal fluorescein staining (tCFS) and dryness score on a visual analog scale (VAS) at day 29. The findings revealed a marked improvement in tCFS in the cyclosporine group when compared to the vehicle group by demonstrating the superiority of the treatment. However, the dryness score on the VAS did not show notable improvement between the two groups at day 29.

The study also evaluated the safety profile of the treatment. During the 29-day treatment period, treatment-related adverse events were reported in a small percentage of participants in both the cyclosporine and vehicle groups that indicates an acceptable safety profile for the water-free cyclosporine solution. Overall, the development of a water-free cyclosporine ophthalmic solution presents a potential solution to the challenges posed by the hydrophobic nature of traditional cyclosporine formulations in delivering effective treatment to the ocular surface.

Reference:

Peng, R., Jie, Y., Long, Q., Gong, L., Zhu, L., Zhong, X., Zhao, S., Yan, X., Gu, H., Wu, H., Li, G., Zhang, K., Krösser, S., Xu, R., & Hong, J. (2024). Water-Free Cyclosporine Ophthalmic Solution vs Vehicle for Dry Eye Disease. In JAMA Ophthalmology. American Medical Association (AMA). https://doi.org/10.1001/jamaophthalmol.2024.0101

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Exercise Caution: Meta-analysis reports significant prevalence of bleeding after PCI

Iran: A systematic review and meta-analysis has shown that the incidence of bleeding after PCI is 4.4 %, which is a significant result. The findings, published in the Indian Heart Journal, highlight the need for healthcare policymakers to pay more attention to the complications associated with PCI.

The researchers suggest that interventional cardiologists should consider the effective factors in these bleeding and how to control and treat them due to the importance of this complication.

Percutaneous coronary intervention (PCI) is one of the most widely used methods for treating coronary artery disease. Previous studies have shown that complications such as hematoma, bleeding, and embolism may occur due to the trauma inflicted on the vessels during the procedure. Among these complications, the most common one of PCI is bleeding, which is tied to an increased risk of adverse events, including myocardial infarction (MI), death, and stroke, and an increased length of hospital costs and stay.

Reza Heidary Moghadam, Kermanshah University of Medical Sciences, Kermanshah, Iran, and colleagues aimed to determine the prevalence of bleeding after PCI through a systematic review and meta-analysis covering the period from 1989 to 2023.

Multiple databases were searched using validated keywords. The I2 index was used to check for heterogeneity among studies. The meta-analysis included observational studies (case-control studies, cohort studies, cross-sectional studies), access to the full text of the article, randomized clinical trials, and studies that reported the frequency or percentage of bleeding after PCI.

Based on the analysis, the researchers reported the following findings:

  • The review of 8 studies, with a sample size of 397,298 participants, showed high heterogeneity (I2: 97.8 %). Therefore, the random effects method was used to analyze the results.
  • The prevalence of bleeding after intervention in percutaneous coronary arteries was reported to be 4.4 %.

In conclusion, the incidence of bleeding after PCI was reported to be 4.4 %, which is a significant result. Therefore, the results can serve as an important criterion for developing suitable treatment and prevention strategies.

“Health policymakers can also utilize the findings of the meta-analysis to prioritize research on the complication of bleeding after PCI and its outcomes and implement effective measures to prevent and manage this complication.,” the researchers wrote.

One limitation of the meta-analysis is that it only included studies published in English, potentially excluding relevant studies published in other languages. Furthermore, various studies were excluded due to inadequate quality, such as those that did not report prevalence and those with small sample sizes.

Reference:

Heidary Moghadam R, Mohammadi A, Salari N, Ahmed A, Shohaimi S, Mohammadi M. The prevalence of bleeding after percutaneous coronary interventions: A systematic review and meta-analysis. Indian Heart J. 2024 Jan-Feb;76(1):16-21. doi: 10.1016/j.ihj.2024.01.009. Epub 2024 Jan 10. PMID: 38216122.

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High CRP in Metabolic Syndrome patients Linked to high Cancer Risk, finds study

Metabolic syndrome (MetS) has long been associated with an increased risk of cancer development. However, the dynamics of MetS over time and its correlation with cancer risk remain understudied. This study delves into the trajectories of MetS scores and their relationship with the onset of various cancers, shedding light on the importance of sustained monitoring for early intervention. This study was published in the journal Cancer by Deng L. and colleagues,

Metabolic syndrome, characterised by a cluster of metabolic abnormalities including obesity, hypertension, dyslipidemia, and insulin resistance, has been linked to heightened cancer susceptibility. Chronic inflammation, often coexisting with MetS, further exacerbates this risk, potentially accelerating cancer initiation and progression.

In this prospective cohort study, researchers analysed data from 44,115 participants to investigate the association between MetS score trajectories and new-onset cancer. Latent mixture modelling was employed to identify distinct MetS score trajectory patterns, and Cox proportional hazards regression models were used to assess cancer risk based on these patterns.

Key Findings:

Four MetS score trajectory patterns were identified:

  • Low-stable (n = 4657)

  • Moderate-low (n = 18,018)

  • Moderate-high (n = 18,288)

  • Elevated-increasing (n = 3152)

Compared to those with a low-stable trajectory, individuals with an elevated-increasing pattern had a significantly higher risk of overall cancer incidence and specific cancer types:

  • Overall cancer risk (HR: 1.27; 95% CI: 1.04–1.55)

  • Breast cancer (HR: 2.11; 95% CI: 1.04–4.34)

  • Endometrial cancer (HR: 3.33; 95% CI: 1.16–6.77)

  • Kidney cancer (HR: 4.52; 95% CI: 1.17–10.48)

  • Colorectal cancer (HR: 2.54; 95% CI: 1.27–5.09)

  • Liver cancer (HR: 1.61; 95% CI: 1.09–4.57)

  • Moreover, among participants exhibiting chronic inflammation (C-reactive protein levels ≥3 mg/L), the elevated-increasing trajectory was significantly associated with subsequent breast, endometrial, colorectal, and liver cancers.

The research  indicates that individuals with MetS, particularly when coupled with chronic inflammation, are at an increased risk of cancer.

Furthermore the. study underscores the significance of long-term monitoring and evaluation of MetS trajectories in assessing cancer risk. Identification of elevated-increasing MetS trajectories may serve as an early indicator for heightened cancer susceptibility, particularly for breast, endometrial, kidney, colorectal, and liver cancers. This emphasises the necessity for proactive management strategies targeting MetS to mitigate cancer risk effectively.

Reference:

Deng, L., Liu, T., Liu, C.-A., Zhang, Q., Song, M.-M., Lin, S.-Q., Wang, Y.-M., Zhang, Q.-S., & Shi, H.-P. The association of metabolic syndrome scores trajectory patterns with risk of all cancer types. Cancer,2024. https://doi.org/10.1002/cncr.35235

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Elevated CSF glial fibrillary acid protein linked to nonrelapsing progressive multiple sclerosis: JAMA

USA: A recent cohort study published in JAMA Neurology has shed light on the emerging cerebrospinal fluid (CSF) biomarkers of disease activity and progression in multiple sclerosis.

In the study, activated glial markers (glial fibrillary acid protein [GFAP] in particular) and neurofilament heavy chains were associated specifically with nonrelapsing progressive disease outcomes. Elevated CSF GFAP was associated with long-term multiple sclerosis disease progression.

“We found that elevated GFAP and neurofilament heavy chain were associated with nonrelapsing progression and lymphocyte measures were associated with relapsing biology in patients with both relapsing and primary progressive clinical phenotypes,” the researchers wrote. “Elevated neurofilament light chain reflected both processes.”

There is a lack of biomarkers distinguishing nonrelapsing progressive disease biology from relapsing biology in multiple sclerosis. Cerebrospinal fluid is an accessible fluid that most closely reflects central nervous system biology. Considering this, Anne H. Cross, Washington University School of Medicine, St Louis, Missouri, and colleagues aimed to identify CSF biological measures associated with progressive MS pathobiology.

For this purpose, the researchers assessed data from two prospective MS cohorts: a test cohort provided serial CSF, clinical, and imaging assessments in a multicenter study of patients with relapsing MS (RMS) or primary progressive MS (PPMS) who were initiating anti-CD20 treatment. A single-site confirmation cohort assessed CSF at baseline and long-term (>10 years) clinical follow-up (analysis: 2022-2023).

Test-cohort participants were initiated standard-of-care ocrelizumab treatment. Confirmation-cohort participants received standard-of-care disease-modifying MS therapies or were untreated.

The study’s outcomes were twenty-five CSF markers, including neurofilament heavy chain, neurofilament light chain, and GFAP; 24-week confirmed disability progression (CDP24); and brain magnetic resonance imaging measures reflecting tissue loss, focal injury, and progressive biology (slowly expanding lesions [SELs]).

The following were the key findings of the study:

  • The test cohort (n = 131) included 100 patients with RMS (mean age, 36.6 years; Expanded Disability Status Scale [EDSS] score, 0-5.5), and 31 patients with PPMS (mean age, 44.9 years; EDSS score, 3.0-6.5).
  • The confirmation cohort (n = 68) included 41 patients with RMS and 27 with PPMS enrolled at diagnosis (age 40 years).
  • In the test cohort, GFAP was correlated with SEL count (r = 0.33), a greater proportion of T2 lesion volume from SELs (r = 0.24), and lower T1-weighted intensity within SELs (r = –0.33) but not with acute inflammatory measures.
  • Neurofilament heavy chain was correlated with SEL count (r = 0.25) and lower T1-weighted intensity within SELs (r = –0.28).
  • Immune markers correlated with measures of acute inflammation and, unlike GFAP, were impacted by anti-CD20.
  • In the confirmation cohort, higher baseline CSF GFAP levels were associated with long-term CDP24 (hazard ratio, 2.1).

“The findings underscore a role for chronic inflammation and glial activity in nonrelapsing progressive pathobiology and identify GFAP and NfH as more specific candidate biomarkers for progressive biology, potentially improving on NfL, which indicates both injury from acute disease activity and insidious injury,” the research team wrote.

“Future clinical trials should incorporate combined measurement of these markers, which could be useful for assessing the effect of emerging therapies on subclinical relapsing and progressive disease mechanisms,” they concluded.

Reference:

Cross AH, Gelfand JM, Thebault S, et al. Emerging Cerebrospinal Fluid Biomarkers of Disease Activity and Progression in Multiple Sclerosis. JAMA Neurol. Published online March 11, 2024. doi:10.1001/jamaneurol.2024.0017

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Magnolia berry, fruit used in Chinese medicine, promising as treatment in colon cancer: Study

UK: A new study published in ACS Pharmacology & Translational Science found that a fruit used in Chinese medicine contains a very effective compound that could help treat colon cancer.

The compound called Schisandrin B (Sch B), a lignan extracted from the fruit of Schisandra chinensis (known as five-flavor berry or magnolia berry), induced apoptosis and inhibited cell proliferation and tumor growth in vitro and in vivo. The findings provide an essential background for clinical trials investigating the effects of Sch B in patients with colon cancer.

The anti-tumor compound, when introduced to late-stage colon cancer cells, performed especially well.

The tiny magnolia berry, a staple in traditional Chinese medicine, may hold the key to fighting one of the most common and lethal forms of cancer. The plant is already widely available online, though it should be taken only under medical supervision due to various known adverse drug interactions.

Colon cancer, or colorectal cancer, is among the most prevalent and lethal malignant tumors in the world. The lack of effective therapies highlights the need for novel therapeutic approaches. Schisandrin B is a lignan extracted from the fruit of Schisandra chinensis and has been reported for its anticancer properties. However, to date, no studies have been performed to characterize the exact molecular mechanisms underlying the antitumorigenic effects of Sch B in colon cancer.

To address the knowledge gap, Murphy Lam Yim Wan, School of Pharmacy and Biomedical Sciences, Faculty of Science and Health, University of Portsmouth, Portsmouth, United Kingdom, and colleagues aimed to explore the antitumorigenic effects of Sch B in colon cancer and to understand the underlying therapeutic mechanism.

For this purpose, the researchers performed a comprehensive analysis of the molecular mechanism underlying the antitumorigenic effects of Sch B on human colon cancer cells using a combination of RNA-seq, Raman spectroscopy, molecular biological experiments, and computational docking.

The in vivo efficacy was evaluated by a mouse xenograft model. Sch B reduced cell proliferation and triggered apoptosis in human colon cancer cell lines.

The key findings of the study were as follows:

  • Raman spectroscopy, computational, RNA-seq, and molecular and cellular studies revealed that Sch B activated unfolded protein responses by interacting with CHOP and upregulating CHOP, which thereby induced apoptosis.
  • CHOP knockdown alleviated the Sch B-induced reduction in cell viability and apoptosis.
  • Sch B reduced colon tumor growth in vivo.

The latest study gives cause for hope as it opens up new avenues toward more targeted, less toxic therapies where natural compounds play a larger role in cancer treatment.

Despite the promising potential of Sch B and magnolia berry extract in cancer treatment, the high costs of clinical trials and the inability to patent natural products pose significant barriers to their approval as medical treatments.

“These results provided an essential background for clinical trials examining the effects of Sch B in colon cancer patients,” the researchers concluded.

Reference:

ACS Pharmacol. Transl. Sci. 2024, 7, 3, 863–877. Publication Date: February 22, 2024. https://doi.org/10.1021/acsptsci.4c00009

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Proinflammatory diet, higher habitual salt intake tied to increased risk of type 2 diabetes: Study

China: Adopting an anti-inflammatory diet and reducing salt intake can significantly reduce the risk of type 2 diabetes (T2D), a recent study has shown.

The findings published in Diabetes, Obesity and Metabolism journal emphasize the importance of promoting healthy eating habits and reducing high-salt foods intake to prevent T2D and improve public health.

“Participants who followed a proinflammatory diet had an 18% higher risk of type 2 diabetes than those who adhered to an anti-inflammatory diet, after accounting for all confounding factors,” the researchers reported.

In the fully adjusted model, participants who reported always adding salt to foods had a higher T2D (HR, 1.30) risk than those who never or rarely added salt.

The study was conducted by Ningjian Wang, Shanghai Jiao Tong University School of Medicine, Shanghai, China, and colleagues to explore the relationship between proinflammatory diet, habitual salt intake and the onset of type 2 diabetes.

For this purpose, the researchers conducted a prospective study among 171 094 UK Biobank participants who completed at least one 24-hour dietary questionnaire and were free of diabetes at baseline. The participants were followed up until March 1, 2023, for T2D incidence, with diagnosis information obtained from linked medical records.

Based on 28 food parameters, an Energy-adjusted Diet Inflammatory Index (E-DII) was calculated. Habitual salt intake was determined through the self-reported frequency of salt addition to foods. The Cox proportional hazard regression model was used to test the associations between E-DII, habitual salt intake, and type 2 diabetes incidence.

The study led to the following findings:

  • Over a median follow-up period of 13.5 years, 6216 cases of type 2 diabetes were documented.
  • Compared with participants with a low E-DII (indicative of an anti-inflammatory diet), participants with a high E-DII (indicative of a pro-inflammatory diet) had an 18% heightened risk of developing type 2 diabetes.
  • The association between E-DII and type 2 diabetes tends to be linear after adjustment for major confounders.
  • Participants with a proinflammatory diet and always adding salt to foods had the highest risk of type 2 diabetes incidence (hazard ratio 1.60).

In conclusion, the findings indicate that a higher habitual salt intake and proinflammatory diet were associated with an increased risk of type 2 diabetes.

“These results support the public health promotion of an anti-inflammatory diet and reducing salt intake to prevent the onset of type 2 diabetes,” the researchers concluded.

Reference:

Shen W, Cai L, Wang B, Li J, Sun Y, Chen Y, Xia F, Wang N, Lu Y. Associations of a proinflammatory diet, habitual salt intake, and the onset of type 2 diabetes: A prospective cohort study from the UK Biobank. Diabetes Obes Metab. 2024 Feb 26. doi: 10.1111/dom.15517. Epub ahead of print. PMID: 38409502.

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