Researchers develop probiotic to ameliorate ulcerative colitis

Researchers from the Institute of Process Engineering (IPE) of the Chinese Academy of Sciences have developed a probiotic-based therapeutic that synergistically restores intestinal redox and microbiota homeostasis. This therapeutic effectively relieved inflammation and reduced colonic damage in mouse and non-human primate (NHP) models of colitis. The study was published in Cell Host & Microbe.

Probiotics are potential treatments for ulcerative colitis (UC), but their efficacy is frequently compromised by gastrointestinal conditions that limit adhesion and activity. Moreover, the complicated pathological environment of inflamed tissue also implies the presence of other pathogenic factors.

To address these issues, researchers, employing machine learning and bioinformatics analyses, identified the Lactobacillus genus as a suitable candidate for modulating the gut microbiota, and pinpointed oxidative stress as a pivotal pathogenic factor for targeted intervention.

For verification, researchers collected and analyzed fecal samples from a cohort of healthy donors and UC patients. The results showed a decreased prevalence of Lactobacillus and increased oxidative stress in UC patients.

“Further considering inflammation severity, we discovered correlations between any two aspects of Lactobacillus abundance, 8-hydroxy-2-deoxyguanosine levels, and C-reactive protein values in UC patients, which revealed the close association of these two aspects in UC exacerbation,” said Prof. CUI Yimin from Peking University First Hospital, one of the corresponding authors.

These findings indicated that, beyond delivering adequate viable Lactobacillus, endowing Lactobacillus with the function of scavenging reactive oxygen species (ROS) could further improve UC treatment. Considering that selenium is a nutritional trace element conferring antioxidant effects, researchers proposed that the codelivery of selenium and Lactobacillus could fulfill the synergistic restoration of intestinal redox-microbiota homeostasis.

“We developed a new method to in situ grow selenium dots which are embedded in the pericellular film surrounding the Lactobacillus casei (Lac) cell wall. The resulting Se-fLac not only endowed Lac cells with ultrahigh ROS scavenging activity, but also enhanced gastric acid resistance and intestinal mucoadhesion of Lac cells after oral administration,” said Prof. MA Guanghui from IPE.

At the lesion site, Se-fLac prominently scavenged ROS and had the tendency to modulate gut microbiota, and these two aspects were further observed with a potentially mutual benefit.

“To validate the therapeutic efficacy of Se-fLac, we compared it with 5-aminosalicylic acid treatment, VSL#3 supplements, and their combination. Se-fLac significantly outperformed these three counterparts in all therapeutic indices,” said Prof. WEI Wei from IPE.

Although the UC mouse models have been widely utilized to examine therapeutic efficacies, these mouse models might fail to accurately simulate the anatomic structures and physiological functions of the gastrointestinal tract, as well as pathological features of UC in humans.

“This motivated us to establish an NHP model to bridge mouse- and human-based investigations of Se-fLac, and the potent therapeutic efficacies highlighted the strong translational potential of Se-fLac to develop clinically relevant UC treatments,” said Prof. WEI.

Reference:

Peilin Guo, Wenjing Wang, Qian Xiang, Chao Pan, Yefeng Qiu, Tingting Li, Dongfang Wang, Jian Ouyang, Rongrong Jia, Min Shi, Yugang Wang, Junxia Li, Jiale Zou, Yuan Zhong, Jiawei Zhao, Diwei Zheng, Yimin Cui, Guanghui Ma, Wei Wei, Engineered probiotic ameliorates ulcerative colitis by restoring gut microbiota and redox homeostasis, Cell Host & Microbe, 2024,  https://doi.org/10.1016/j.chom.2024.07.028.

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Long-Term Biologic Treatment tied to Clinical Remission in Nearly Half of Severe Asthma Patients: 7Study Reveals

USA: Recent findings published in The Journal of Allergy and Clinical Immunology highlight the potential for long-term biologic therapy to lead to significant improvements in patients with severe asthma (SA). In a real-world study involving a cohort of individuals with this challenging condition, researchers found that nearly half of the participants achieved clinical remission while on biologic treatment for one year or more. These findings indicate that prolonged biologic therapy can make achieving clinical remission a viable goal for individuals with severe asthma.

“In a landmark study involving patients with severe asthma, biologic therapy resulted in clinical remission for 46% of participants. Notably, remission rates rose from 22.3% after 12 to 13 months to 34.3% after 47 to 48 months of treatment. Additionally, 79.9% of patients reported experiencing no exacerbations or requiring systemic corticosteroids for at least one year during the treatment period,” the researchers reported.

Severe asthma is a debilitating condition that often requires intensive management and can lead to frequent exacerbations, diminished quality of life, and increased healthcare costs. Traditionally, managing severe asthma has posed challenges, particularly in finding effective treatments that provide lasting relief. However, the advent of biologic therapies—medications that target specific pathways in the immune system—has transformed the landscape of asthma treatment.

There is a lack of comprehensive real-world data on the percentage of patients with severe asthma who attain clinical remission while undergoing long-term biologic treatment. To address this gap, Christopher S. Ambrose, BioPharmaceuticals Medical, AstraZeneca, Gaithersburg, MD, United States, and colleagues set out to investigate both the proportion of adults with SA who achieve clinical remission and the characteristics of these patients receiving biologic therapy.

For this purpose, the researchers conducted the CHRONICLE observational study involving US adults with SA treated by subspecialists. Participating sites reported instances of exacerbations and biologic usage starting from 12 months before enrollment. Monthly Asthma Control Test (ACT) scores, along with specialist evaluations of asthma control every six months, were collected. Patients who initiated biologic therapy during the study period, from February 2018 to February 2023, and continued for at least 12 months were assessed.

On-treatment clinical remission was defined within a 12-month as having no exacerbations or use of systemic corticosteroids (SCS), achieving at least 50% of ACT scores of 20 or higher in the most recent six months, and a specialist’s assessment confirming asthma control.

The following were the key findings of the study:

  • Among the 611 evaluable patients, the median duration of biologic therapy was 39.6 months.
  • At least once during the study, 79.9% of patients experienced no exacerbations or required systemic corticosteroids.
  • 46.0% of patients achieved clinical remission at some point during the study.
  • The point prevalence of clinical remission increased from 22.3% at 12–13 months of biologic use to 34.3% at 47–48 months of biologic use.

“In a real-world cohort of patients with severe asthma undergoing long-term biologic treatment, nearly half attained on-treatment clinical remission. This suggests that with a year or more of biologic therapy, achieving clinical remission is a realistic treatment objective for individuals with severe asthma,” the researchers concluded.

Reference:

Chipps, B. E., Lugogo, N., Carr, W., Zhou, W., Patel, A., Carstens, D., Trudo, F., & Ambrose, C. S. (2024). On-Treatment Clinical Remission of Severe Asthma With Real-World Longer-Term Biologic Use. Journal of Allergy and Clinical Immunology: Global, 100365. https://doi.org/10.1016/j.jacig.2024.100365

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Women with Premature Menopause may have Lower All-Cause Mortality compared to Men: Study

A recent study published in the Menopause journal highlighted the intriguing differences in all-cause mortality and life span between women who undergo premature menopause and men, using a robust propensity score matching analysis. The research analyzed data from the National Health and Nutrition Examination Survey (NHANES) covering the periods 1999 to 2018 and NHANES III (1988-1994) which provided new inputs into the long-term health outcomes associated with premature menopause.

The study included a substantial a group of 3,214 women who experienced premature menopause and 23,067 men, all of whom were older than 40 years. The research were able to create matched cohorts of women and men by employing a 1:1 ratio in the propensity score matching analysis which ensures a fair comparison between the two groups.

The primary goal of the study was to examine the association between sex and all-cause mortality, as well as survival up to the 75th percentile of life span. Also, a subgroup analysis was conducted to explore the impact of hormone therapy on mortality and life span in women who experienced premature menopause.

The results revealed that women with premature menopause had a significantly lower risk of all-cause mortality when compared to men. The women who faced menopause before the age of 35 had an adjusted HR of 0.65 (95% CI: 0.54-0.78), indicating a 35% lower risk of mortality when compared to men. Also, women who underwent menopause between the ages of 35 to 39 had an adjusted HR of 0.72 (95% CI: 0.59-0.87), and the individuals with menopause before the age of 40 had an adjusted HR of 0.67 (95% CI: 0.60-0.76), both showing a significant reduction in mortality risk compared to their male counterparts.

Despite these findings, the study observed that the advantage women had in terms of life span was statistically insignificant. The adjusted HR values for surviving up to the 75th percentile of life span showed no significant difference between women and men in the matched cohorts. There was no notable difference in the mean life span between deceased women and men.

The subgroup analysis highlighted that the mean life span of deceased women who had never used hormone therapy was significantly longer than that of men (78.3 ± 11.6 vs. 76.6 ± 11.9 years, P = 0.0154). However, no significant difference was observed in the mean life span between women who took hormone therapy and men. Overall, while women who underwent premature menopause had a lower risk of all-cause mortality when compared to men, the overall life span advantage was negligible. 

Source:

Xing, Z., & Kirby, R. S. (2024). Sex differences in all-cause mortality and life span between women with premature menopause and men: propensity score matching analysis. In Menopause. Ovid Technologies (Wolters Kluwer Health). https://doi.org/10.1097/gme.0000000000002412

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Beer-only drinkers’ diets worse than wine drinkers, suggests study

Beer drinkers have lower-quality diets, are less active, and are more likely to smoke cigarettes than people who drink wine, liquor, or a combination, according to a study scheduled for presentation at The Liver Meeting, held by the American Association for the Study of Liver Diseases.

“Alcohol overuse is the leading cause of cirrhosis in the U.S., and metabolic dysfunction-associated steatotic liver disease (MASLD) is rapidly increasing,” said Madeline Novack, chief resident at Tulane School of Medicine’s internal medicine residency program and lead author of the study. “Both types of liver disease often coexist, and lifestyle changes are key to managing and preventing these conditions, starting with understanding the link between alcohol use and poor nutrition.”

Using a survey of a nationally representative sample of more than 1,900 U.S. adults who reported current alcohol use, researchers compared the diet quality among people who consume beer only (38.9%), wine only (21.8%), liquor only (18.2%), or a combination of alcohol types (21%), measuring self-reported eating habits against the Healthy Eating Index, a validated standardized tool based on dietary guidelines.

None of the alcohol-using groups came close to achieving the 80-point score that is considered an adequate diet on the 100-point Healthy Eating Index, Novack said, but the beer drinkers scored lowest at 49. Wine drinkers scored 55, and both liquor-only drinkers and combination drinkers scored nearly 53.

Beer-only drinkers, who were more likely to be male, younger, smokers, and low income, also reported the highest total daily caloric intake, adjusting for body weight, and the lowest level of physical activity. Previous studies have found that dietary quality declines with increasing alcohol consumption of any type, but little has been reported on the influence of specific alcoholic beverage type.

Novack said the differences in diet quality among drinkers could be attributed to the context in which food and alcohol consumed together. In the U.S., beer is often chosen in settings where the available foods tend to be low in fiber and high in carbohydrates and processed meats. On the other hand, wine — particularly red wine — is often paired with meals complete with meat, vegetables and dairy.

Another possibility is the inverse, where dietary choices influence the choice of alcohol consumed, Novack said. For example, fried or salty foods create thirst that may also lead to beer-only consumption.

For prevention of liver disease and other health issues, physicians should ask about the type of alcohol consumed to guide discussion of healthy behaviors, Novack said. For example, findings of this study can be applied to patients who identify as beer-only drinkers and physicians could suggest increasing fruit and vegetable intake, as well as physical activity.

Madeline Novack, MD, will present the study, “Beer Consumption is Associated with Low Dietary Quality Among Alcohol Users,” abstract 3019, on Sunday, Nov. 17, at 1 p.m. PST. The study is simultaneously being published in the journal Nutrients.

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Nitrofurantoin and cranberry products could decrease risk of UTI episodes in pediatric patients: Study

The prevention of recurrent urinary tract infections (UTIs) in children has long been a complex challenge for the medical community. A recent research published in the Pediatrics Journal found that specific prophylactic measures, including the use of nitrofurantoin and cranberry products, may offer significant benefits in reducing symptomatic UTI episodes in pediatric patients.

The systematic review analyzed data from major electronic databases including PubMed/Medline, Scopus, and the Cochrane Library up to November 26, 2023. This review and meta-analysis of 23 randomized controlled trials encompassed a total of 3,335 participants to identify the most effective options for preventing recurrent UTIs and minimizing future complications such as kidney scarring. The primary metric was the incidence of symptomatic UTI in children during prophylactic treatment. Mean differences and standard deviations were used to evaluate continuous outcomes, while odds ratios were calculated for dichotomous outcomes.

The analysis revealed that both cranberry products and nitrofurantoin significantly reduced the odds of symptomatic UTI episodes when compared to control groups and alternative prophylactic treatments.

  • Cranberry Products: These natural supplements were found to effectively lower the recurrence rate of symptomatic UTIs during the study period when compared to placebo or no treatment.
  • Nitrofurantoin: This antibiotic emerged as the most effective intervention by outperforming other options such as trimethoprim-sulfamethoxazole and trimethoprim alone in reducing the incidence of UTIs.

The findings of this meta-analysis suggest that nitrofurantoin could be considered the preferred option for reducing symptomatic UTI recurrences in children. However, the absence of kidney scarring prevention points to a significant gap in current treatment approaches. Future randomized controlled trials should focus on exploring nonantibiotic prophylaxis methods and their potential benefits for pediatric patients at risk of both recurrent UTIs and kidney damage.

With these results, clinicians may have more clarity in selecting effective treatment plans for children prone to UTIs. Meanwhile, the parents and caregivers are advised to discuss these findings with medical professionals to understand the best approach for needs of their child. Overall, the findings of this comprehensive review opens up to a better understanding of how to manage recurrent UTIs in children and emphasizes the importance of continued research into holistic and targeted prevention strategies.

Reference:

Gkiourtzis, N., Stoimeni, A., Glava, A., Chantavaridou, S., Michou, P., Cheirakis, K., Lalayiannis, A. D., Hulton, S. A., & Tramma, D. (2024). Prophylaxis Options in Children With a History of Recurrent Urinary Tract Infections: A Systematic Review. In Pediatrics. American Academy of Pediatrics (AAP). https://doi.org/10.1542/peds.2024-066758

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Age-Associated Hearing Loss and Peripheral Neuropathy Linked to Higher Mortality in Elderly: Study

A recent study published in the Journal of the American Geriatrics Society revealed that age-associated hearing loss (AAHL) and peripheral neuropathy (PN) significantly contribute to balance impairment, increased risk of falls, and ultimately, earlier mortality in older adults. This research was a part of the Oklahoma Longitudinal Assessment of the Health Outcomes of Mature Adults (OKLAHOMA) Studies and highlighted the importance of recognizing and addressing these conditions in primary care settings to improve the health and longevity of the elderly population.

The study analyzed data from a total 793 primary care patients by focusing on the prevalence and severity of AAHL, and its association with PN, balance, gait, and mortality. The results found that 63% of participants had some form of AAHL, with a marked 20% expressing low-frequency hearing loss and 4% having unilateral deficits. Additionally, 32% of the participants were diagnosed with PN.

One of the significant outcomes of this study was the clear connection between AAHL, PN, and impaired balance. The participants with moderate to severe AAHL and the individuals with PN showed markedly reduced balance and increased gait time that leads to a higher risk of falls. These factors collectively contributed to a decrease in survival time.

In terms of mortality, the outcomes suggest that both AAHL and PN independently increased the risk of premature death. The participants with moderate or severe AAHL had a 36% higher risk of earlier mortality, while the participants with PN had a 32% higher risk when compared to the participants without these conditions. When both conditions were present, the risk of earlier mortality increased even further by indicating an additive effect.

The structural equation modeling (SEM) suggested that the impact of AAHL and PN on mortality is mediated partly through impaired balance. The mechanisms underlying these associations are likely complex and multifaceted by involving factors such as sensory deficits, reduced mobility, and an increased likelihood of falls.

These findings bring out the critical need for healthcare providers to screen for and address hearing loss and peripheral neuropathy in older adults. Early identification and intervention could reduce the risk of falls and other complications by potentially improving balance, mobility, and overall survival. Overall, the study highlights the significant role that AAHL and PN play in the health outcomes of older adults. As these conditions are common in the aging population, their early detection and management are crucial for enhancing quality of life and extending longevity. 

Source:

Mold, J. W., Lawler, F. H., Liao, X., & Bard, D. E. (2024). Associations between hearing loss, peripheral neuropathy, balance, and survival in older primary care patients. In Journal of the American Geriatrics Society. Wiley. https://doi.org/10.1111/jgs.19142

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Over 800 million adults living with diabetes with more than half not receiving treatment, global study suggests

The total number of adults living with either type 1 or type 2 diabetes in the world has surpassed 800 million—over four times the total number in 1990, according to findings from a global analysis published ahead of World Diabetes Day in The Lancet. Additionally, 445 million adults aged 30 years and older with diabetes (59%) did not receive treatment in 2022, three and a half times the number in 1990.

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Protein linked to airway obstruction in asthma provides a potential treatment target

Researchers at National Jewish Health and colleagues have identified a mechanism involved in the formation of mucus plugs in asthma. Mucus plugs are thick, sticky accumulations of mucus that can form in asthma patients resulting in the blockage of airways. The researchers identified a protein involved in the generation of pathologic mucus present in plugs, which is a prominent feature of the disease in patients with type 2 inflammatory asthma.

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Neuropathic pain drugs linked to higher hip fracture risk in seniors

A new study by Monash University medicine safety experts found the use of gabapentinoids—medicines widely used to treat neuropathic pain—increased the risk of hip fractures, especially in older patients who were frail or had kidney disease.

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Self-reported screening can reduce distressing symptoms for pediatric patients with cancer

Regular, self-reported symptom screening was associated with reduced symptom burden when compared with usual care for pediatric patients with cancer, according to new research led by scientists at the University of Toronto and The Hospital for Sick Children (SickKids).

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